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Sample records for lveda parameters fails

  1. Age of failed restorations: A deceptive longevity parameter

    NARCIS (Netherlands)

    Opdam, N.J.M.; Bronkhorst, E.M.; Cenci, M.S.; Huysmans, M.C.D.N.J.M.; Wilson, N.H.F.

    2011-01-01

    There is pressing need to enhance evidence base in respect of longevity of restorations. Currently, there is lack of appreciation of differences between survival data based on the age of failed restorations as compared to gold standard Kaplan-Meier statistics. OBJECTIVES: This study was undertaken t

  2. Failing Failed States

    DEFF Research Database (Denmark)

    Holm, Hans-Henrik

    2002-01-01

    When states are failing, when basic state functions are no longer carried out, and when people have no security, humanitarian crises erupt. In confronting this problem, the stronger states have followed an ad hoc policy of intervention and aid. In some cases, humanitarian disasters have resulted ...

  3. Failing Failed States

    DEFF Research Database (Denmark)

    Holm, Hans-Henrik

    2002-01-01

    When states are failing, when basic state functions are no longer carried out, and when people have no security, humanitarian crises erupt. In confronting this problem, the stronger states have followed an ad hoc policy of intervention and aid. In some cases, humanitarian disasters have resulted...

  4. Failing Decision

    DEFF Research Database (Denmark)

    Knudsen, Morten

    2014-01-01

    as a controlled cost for achieving organizational goals. Decisions must fail so the organization can succeed. This chapter uses two cases to elaborate on these ideas. By way of introduction, I will reflect on the notion of ‘failing decisions’ within organization and decision theory. This chapter is also propelled...... deals not with traffic delays, but with failing decisions in organizations. The assumption of this chapter is that failing decisions today are as normal as delayed trains. Instead of being the exception, failure is part of the everyday reproduction of organizations – as an uncontrolled effect but also...... by an interest in failure as one way of improving understanding of present-day decision making in organizations....

  5. Reaching the limits of prognostication in non-small cell lung cancer: an optimized biomarker panel fails to outperform clinical parameters.

    Science.gov (United States)

    Grinberg, Marianna; Djureinovic, Dijana; Brunnström, Hans Rr; Mattsson, Johanna Sm; Edlund, Karolina; Hengstler, Jan G; La Fleur, Linnea; Ekman, Simon; Koyi, Hirsh; Branden, Eva; Ståhle, Elisabeth; Jirström, Karin; Tracy, Derek K; Pontén, Fredrik; Botling, Johan; Rahnenführer, Jörg; Micke, Patrick

    2017-07-01

    Numerous protein biomarkers have been analyzed to improve prognostication in non-small cell lung cancer, but have not yet demonstrated sufficient value to be introduced into clinical practice. Here, we aimed to develop and validate a prognostic model for surgically resected non-small cell lung cancer. A biomarker panel was selected based on (1) prognostic association in published literature, (2) prognostic association in gene expression data sets, (3) availability of reliable antibodies, and (4) representation of diverse biological processes. The five selected proteins (MKI67, EZH2, SLC2A1, CADM1, and NKX2-1 alias TTF1) were analyzed by immunohistochemistry on tissue microarrays including tissue from 326 non-small cell lung cancer patients. One score was obtained for each tumor and each protein. The scores were combined, with or without the inclusion of clinical parameters, and the best prognostic model was defined according to the corresponding concordance index (C-index). The best-performing model was subsequently validated in an independent cohort consisting of tissue from 345 non-small cell lung cancer patients. The model based only on protein expression did not perform better compared to clinicopathological parameters, whereas combining protein expression with clinicopathological data resulted in a slightly better prognostic performance (C-index: all non-small cell lung cancer 0.63 vs 0.64; adenocarcinoma: 0.66 vs 0.70, squamous cell carcinoma: 0.57 vs 0.56). However, this modest effect did not translate into a significantly improved accuracy of survival prediction. The combination of a prognostic biomarker panel with clinicopathological parameters did not improve survival prediction in non-small cell lung cancer, questioning the potential of immunohistochemistry-based assessment of protein biomarkers for prognostication in clinical practice.

  6. Failing the market, failing deliberative democracy

    DEFF Research Database (Denmark)

    Lippert, Ingmar

    2016-01-01

    Corporate carbon footprint data has become ubiquitous. This data is also highly promissory. But as this paper argues, such data fails both consumers and citizens. The governance of climate change seemingly requires a strong foundation of data on emission sources. Economists approach climate chang...

  7. Failed endotracheal intubation

    Directory of Open Access Journals (Sweden)

    Sheykhol Islami V

    1995-07-01

    Full Text Available The incidence of failed intubation is higher in obstetric than other surgical patients. Failed intubation was the 2nd commonest cause of mortality during anesthesia. Bearing in mind that failre to intubate may be unavoidable in certain circumstances, it is worth reviewing. The factors, which may contribute to a disastrous out come. Priorities of subsequent management must include maintaining oxygenation and preventing aspiration of gastric contents. Fiber optic intubation is now the technique of choice with a high success rate and with least trauma to the patient.

  8. When physical intuition fails

    OpenAIRE

    Singh, Chandralekha

    2016-01-01

    We analyze the problem solving strategies of physics professors in a case where their physical intuition fails. A non-intuitive introductory-level problem was identified and posed to twenty physics professors. The problem placed the professors in a situation often encountered by students, and their response highlights the importance of intuition and experience in problem solving. While professors had difficulty in solving the problem under the time constraint, they initially employed a system...

  9. Who fails lantern tests?

    Science.gov (United States)

    Cole, B L; Vingrys, A J

    1983-05-01

    A battery of clinical colour vision tests was given to a group of 100 observers with abnormal colour vision who were also tested on the Farnsworth lantern and the Holmes-Wright lanterns types A and B. It was found that clinical colour vision tests are imperfect predictors of lantern test performance. However, observers classified as having a 'severe' colour vision defect were found to fail the lantern tests but only one half to two-thirds of those who fail the lantern tests can be identified in this way. It is not possible to identify with certainty any of the people likely to pass the lantern tests: about one-third to two-thirds of observers classified as being mildly affected fail the lantern tests. The Farnsworth D-15 and City University tests were found to be the best predictors of lantern test performance but other tests such as the Nagel anomaloscope, the H-16, L'Anthony's desaturated test can also be used. The lack of a strong correlation between clinical tests and the recognition of the small coloured stimuli presented by the lantern tests suggests that clinical tests do not test the same aspect of colour vision that is important to the recognition of signal lights. For this reason lantern tests should be retained for occupational testing of colour vision.

  10. Failed theories of superconductivity

    CERN Document Server

    Schmalian, Joerg

    2010-01-01

    Almost half a century passed between the discovery of superconductivity by Kammerlingh Onnes and the theoretical explanation of the phenomenon by Bardeen, Cooper and Schrieffer. During the intervening years the brightest minds in theoretical physics tried and failed to develop a microscopic understanding of the effect. A summary of some of those unsuccessful attempts to understand superconductivity not only demonstrates the extraordinary achievement made by formulating the BCS theory, but also illustrates that mistakes are a natural and healthy part of the scientific discourse, and that inapplicable, even incorrect theories can turn out to be interesting and inspiring.

  11. Abortion: Strong's counterexamples fail

    DEFF Research Database (Denmark)

    Di Nucci, Ezio

    2009-01-01

    This paper shows that the counterexamples proposed by Strong in 2008 in the Journal of Medical Ethics to Marquis's argument against abortion fail. Strong's basic idea is that there are cases--for example, terminally ill patients--where killing an adult human being is prima facie seriously morally......'s scenarios have some valuable future or admitted that killing them is not seriously morally wrong. Finally, if "valuable future" is interpreted as referring to objective standards, one ends up with implausible and unpalatable moral claims....

  12. When physical intuition fails

    CERN Document Server

    Singh, Chandralekha

    2016-01-01

    We analyze the problem solving strategies of physics professors in a case where their physical intuition fails. A non-intuitive introductory-level problem was identified and posed to twenty physics professors. The problem placed the professors in a situation often encountered by students, and their response highlights the importance of intuition and experience in problem solving. While professors had difficulty in solving the problem under the time constraint, they initially employed a systematic approach, e.g., visualizing the problem, considering various conservation laws, and examining limiting cases. After finding that familiar techniques were not fruitful, they made incorrect predictions based on one of two equally important factors. By contrast, other more familiar problems that require the consideration of two important principles (e.g., conservation of both energy and momentum for a ballistic pendulum) are quickly solved by the same professors. The responses of students who were given the same problem...

  13. When physical intuition fails

    Science.gov (United States)

    Singh, Chandralekha

    2002-11-01

    We analyze the problem-solving strategies of physics professors in a case where their physical intuition fails. A nonintuitive introductory-level problem was identified and posed to twenty physics professors. The problem placed the professors in a situation often encountered by students, and their response highlights the importance of intuition and experience in problem solving. Although professors had difficulty in solving the problem under the time constraint, they initially employed a systematic approach, for example, visualizing the problem, considering various conservation laws, and examining limiting cases. After finding that familiar techniques were not fruitful, they made incorrect predictions based on one of two equally important factors. In contrast, other more familiar problems that require the consideration of two important principles (for example, conservation of both energy and momentum for a ballistic pendulum) were quickly solved by the same professors. The responses of students who were given the same problem reflected no overarching strategies or systematic approaches, and a much wider variety of incorrect responses were given. This investigation highlights the importance of teaching effective problem-solving heuristics, and suggests that instructors assess the difficulty of a problem from the perspective of beginning students.

  14. To fail or not to fail : clinical trials in depression

    NARCIS (Netherlands)

    Santen, Gijs Willem Eduard

    2008-01-01

    To fail or not to fail – Clinical trials in depression investigates the causes of the high failure rate of clinical trials in depression research. Apart from the difficulties in the search for new antidepressants during drug discovery, faulty clinical trial designs hinder their evaluation during dru

  15. Echocardiographic Assessment of Preload Responsiveness in Critically Ill Patients

    Directory of Open Access Journals (Sweden)

    Alexander Levitov

    2012-01-01

    Full Text Available Fluid challenges are considered the cornerstone of resuscitation in critically ill patients. However, clinical studies have demonstrated that only about 50% of hemodynamically unstable patients are volume responsive. Furthermore, increasing evidence suggests that excess fluid resuscitation is associated with increased mortality. It therefore becomes vital to assess a patient's fluid responsiveness prior to embarking on fluid loading. Static pressure (CVP, PAOP and echocardiographic (IVC diameter, LVEDA parameters fails to predict volume responsiveness. However, a number of dynamic echocardiographic parameters which are based on changes in vena-caval dimensions or cardiac function induce by positive pressure ventilation or passive leg raising appear to be highly predictive of volume responsiveness.

  16. DECOFF Probabilities of Failed Operations

    DEFF Research Database (Denmark)

    Gintautas, Tomas

    A statistical procedure of estimation of Probabilities of Failed Operations is described and exemplified using ECMWF weather forecasts and SIMO output from Rotor Lift test case models. Also safety factor influence is investigated. DECOFF statistical method is benchmarked against standard Alpha...

  17. Why good projects fail anyway.

    Science.gov (United States)

    Matta, Nadim F; Ashkenas, Ronald N

    2003-09-01

    Big projects fail at an astonishing rate--more than half the time, by some estimates. It's not hard to understand why. Complicated long-term projects are customarily developed by a series of teams working along parallel tracks. If managers fail to anticipate everything that might fall through the cracks, those tracks will not converge successfully at the end to reach the goal. Take a companywide CRM project. Traditionally, one team might analyze customers, another select the software, a third develop training programs, and so forth. When the project's finally complete, though, it may turn out that the salespeople won't enter in the requisite data because they don't understand why they need to. This very problem has, in fact, derailed many CRM programs at major organizations. There is a way to uncover unanticipated problems while the project is still in development. The key is to inject into the overall plan a series of miniprojects, or "rapid-results initiatives," which each have as their goal a miniature version of the overall goal. In the CRM project, a single team might be charged with increasing the revenues of one sales group in one region by 25% within four months. To reach that goal, team members would have to draw on the work of all the parallel teams. But in just four months, they would discover the salespeople's resistance and probably other unforeseen issues, such as, perhaps, the need to divvy up commissions for joint-selling efforts. The World Bank has used rapid-results initiatives to great effect to keep a sweeping 16-year project on track and deliver visible results years ahead of schedule. In taking an in-depth look at this project, and others, the authors show why this approach is so effective and how the initiatives are managed in conjunction with more traditional project activities.

  18. Gender differences in electrophysiological gene expression in failing and non-failing human hearts.

    Directory of Open Access Journals (Sweden)

    Christina M Ambrosi

    Full Text Available The increasing availability of human cardiac tissues for study are critically important in increasing our understanding of the impact of gender, age, and other parameters, such as medications and cardiac disease, on arrhythmia susceptibility. In this study, we aimed to compare the mRNA expression of 89 ion channel subunits, calcium handling proteins, and transcription factors important in cardiac conduction and arrhythmogenesis in the left atria (LA and ventricles (LV of failing and nonfailing human hearts of both genders. Total RNA samples, prepared from failing male (n = 9 and female (n = 7, and from nonfailing male (n = 9 and female (n = 9 hearts, were probed using custom-designed Taqman gene arrays. Analyses were performed to explore the relationships between gender, failure state, and chamber expression. Hierarchical cluster analysis revealed chamber specific expression patterns, but failed to identify disease- or gender-dependent clustering. Gender-specific analysis showed lower expression levels in transcripts encoding for K(v4.3, KChIP2, K(v1.5, and K(ir3.1 in the failing female as compared with the male LA. Analysis of LV transcripts, however, did not reveal significant differences based on gender. Overall, our data highlight the differential expression and transcriptional remodeling of ion channel subunits in the human heart as a function of gender and cardiac disease. Furthermore, the availability of such data sets will allow for the development of disease-, gender-, and, most importantly, patient-specific cardiac models, with the ability to utilize such information as mRNA expression to predict cardiac phenotype.

  19. When Organization Fails: Why Authority Matters

    DEFF Research Database (Denmark)

    Blaschke, Steffen

    2015-01-01

    Review of: James R. Taylor and Elizabeth J. Van Every / When Organization Fails: Why Authority Matters. (New York: Routledge, 2014. 220 pp. ISBN: 978 0415741668)......Review of: James R. Taylor and Elizabeth J. Van Every / When Organization Fails: Why Authority Matters. (New York: Routledge, 2014. 220 pp. ISBN: 978 0415741668)...

  20. Is journalism failing on climate?

    Science.gov (United States)

    Rahmstorf, Stefan

    2012-12-01

    How can we build a reliable and affordable energy supply based on renewables? How rapidly do we need to cut greenhouse gas emissions to keep climate change within manageable bounds? What does it take to maintain a stable common currency of different nations? These are just a few examples of questions that are critical for our future and that require an understanding of complex systems—the energy system, the climate system, the financial system. Finding sound answers to these questions requires sophisticated scientific analysis and expert knowledge; a lay person's intuition will clearly not suffice. Yet, decisions in a democracy are (and should be!) taken by politicians and the voting public who are not usually scientific experts. Hence the well-being of our societies—and even more so the living conditions of future generations, which are defined by the decisions we take today—depends on the wider public being well informed about the state of scientific knowledge and discourse. The media are the most important means by which lay people obtain their information about science. Good science journalism is therefore a decisive factor for the long-term success of modern society. Good science journalism clearly must be critical journalism, and it requires journalists who know what is what, who can put things into a perspective, and who are able to make well-informed judgements. After all, the role of science journalism is not simply to act as a 'translator' who conveys the findings of scientists in a language understandable to lay people. Rather, good science journalism will provide the public with a realistic impression of what is well established in science and what are current 'hot topics', uncertainties and controversies. It will also discuss the methods and social context of the scientific endeavour. There is ample evidence that in the area of climate science, journalism too often is failing to deliver this realistic picture to its audience, despite many good

  1. Probiotic Supplements Failed to Prevent Babies' Infections

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_167008.html Probiotic Supplements Failed to Prevent Babies' Infections Benefits of ... 3, 2017 MONDAY, July 3, 2017 (HealthDay News) -- Probiotic supplements may not protect babies from catching colds ...

  2. Commitment escalation to a failing family business

    OpenAIRE

    Chirico, Francesco; Salvato, Carlo; Byrne, Barbara; Akhter, Naveed; Arriaga Múzquiz, Juan

    2017-01-01

    The overarching intent of this manuscript is to heighten awareness to the concept of commitment escalation as it bears on a failing family business. Specifically, drawing on the concept of emotional ownership, together with self-justification arguments, we a) identify factors considered to be most forceful in contributing to the presence of commitment escalation and thus, resistance to change in a failing family business (i.e., emotional ownership, feeling of responsibility, investment of cap...

  3. Merger incentives and the failing firm defense

    NARCIS (Netherlands)

    Bouckaert, J.M.C.; Kort, P.M.

    2014-01-01

    The merger incentives between profitable firms differ fundamentally from the incentives of a profitable firm to merge with a failing firm. We investigate these incentives under different modes of price competition and Cournot behavior. Our main finding is that firms strictly prefer exit of the faili

  4. Merger incentives and the failing firm defense

    NARCIS (Netherlands)

    Bouckaert, J.M.C.; Kort, P.M.

    2014-01-01

    The merger incentives between profitable firms differ fundamentally from the incentives of a profitable firm to merge with a failing firm. We investigate these incentives under different modes of price competition and Cournot behavior. Our main finding is that firms strictly prefer exit of the

  5. Examination of a failed fifth wheel coupling

    CSIR Research Space (South Africa)

    Fernandes, PJL

    1998-03-01

    Full Text Available Examination of a fifth wheel coupling which had failed in service showed that it had been modified and that the operating handle had been moved from its original design position. This modification completely eliminated the safety device designed...

  6. Transcatheter Replacement of Failed Bioprosthetic Valves

    DEFF Research Database (Denmark)

    Simonato, Matheus; Webb, John; Kornowski, Ran

    2016-01-01

    Background-Transcatheter valve implantation inside failed bioprosthetic surgical valves (valve-in-valve [ViV]) may offer an advantage over reoperation. Supra-annular transcatheter valve position may be advantageous in achieving better hemodynamics after ViV. Our objective was to define targets fo...

  7. Contested Spaces of a "Failing" Elementary School

    Science.gov (United States)

    Kawai, Roi; Serriere, Stephanie; Mitra, Dana

    2014-01-01

    Amid the recent proliferation of teacher-led movements resisting high-stakes testing across the United States, the authors identify how a "failing" elementary school reclaimed local discourse by taking political action against top-down measures. Framed as competing modes of school reform, the authors offer the sociocultural framework of…

  8. Examination of a Failed Professional Learning Community

    Science.gov (United States)

    Sims, Rachel L.; Penny, G. Richard

    2015-01-01

    Schools are using various forms of professional learning communities (PLCs) in order to increase student achievement and improve educational practices through enhanced communication and collaboration among teachers. This study examined a PLC that had too narrow a focus and failed therefore to affect student achievement. A critical shortcoming of…

  9. Underachievement, Failing Youth and Moral Panics

    Science.gov (United States)

    Smith, Emma

    2010-01-01

    This paper considers contemporary "moral panics" around the underachievement of boys in school examinations in the UK and America. In the UK, in particular, the underachievement of boys is central to current "crisis accounts" about falling standards and failing pupils. "Underachievement" is a familiar word to those…

  10. Understanding Failing Schools: Perspectives from the Inside

    Science.gov (United States)

    Nicolaidou, Maria; Ainscow, Mel

    2005-01-01

    This paper analyses the experience of so-called "failing schools" in order to develop understandings that can inform improvement efforts. It reports on a study of the experiences of a small number of English primary schools placed in "special measures" as a result of being inspected. The study is unusual in that, in the past, researchers have…

  11. Gravitational wave triggered searches for failed supernovae

    Science.gov (United States)

    Annis, James; Dark Energy Survey Collaboration

    2016-03-01

    Stellar core collapses occur to all stars of sufficiently high mass and often result in supernovae. A small fraction of supergiant stars, however, are thought to collapse directly into black holes without producing supernovae. A survey of such ``failed'' supernovae would require monitoring millions of supergiants for several years. That is very challenging even for current surveys. With the start of the Advanced LIGO science run, we investigate the possibility of detecting failed supernovae by looking for missing supergiants associated with gravitational wave triggers. We use the Dark Energy Camera (DECam). Our project is a joint effort between the community and the Dark Energy Survey (DES) collaboration. In this talk we report on our ongoing efforts and discuss prospects for future searches.

  12. Transfemoral amputation after failed knee arthroplasty

    DEFF Research Database (Denmark)

    Gottfriedsen, Tinne B; Morville Schrøder, Henrik; Odgaard, Anders

    2016-01-01

    BACKGROUND: Transfemoral amputation is considered the last treatment option for failed knee arthroplasty. The extent to which this procedure is performed is not well known. The purpose of this study was to identify the incidence and causes of amputation following failure of knee arthroplasty...... in a nationwide population. METHODS: Data were extracted from the Danish Civil Registration System, the Danish National Patient Register, and the Danish Knee Arthroplasty Register. With use of individual data linkage, 92,785 primary knee arthroplasties performed from 1997 to 2013 were identified. Of these, 258...... for causes related to failed knee arthroplasty. The 15-year cumulative incidence of amputation was 0.32% (95% confidence interval [CI], 0.23% to 0.48%). The annual incidence of amputation following arthroplasties performed from 1997 to 2002 was 0.025% compared with 0.018% following arthroplasties performed...

  13. Systems with randomly failing repairable components

    DEFF Research Database (Denmark)

    Der Kiureghian, Armen; Ditlevsen, Ove Dalager; Song, Junho

    2005-01-01

    Closed-form expressions are derived for the steady-state availability, mean rate of failure, mean duration of downtime and reliability of a general system with randomly and independently failing repairable components. Component failures are assumed to be homogeneous Poisson events in time and rep......, or reducing the mean duration of system downtime. Example applications to an electrical substation system demonstrate the use of the formulas developed in the paper....

  14. The Failed Image and the Possessed

    DEFF Research Database (Denmark)

    Suhr, Christian

    2015-01-01

    This article asks if the recurrent queries regarding the value of images in visual anthropology could find new answers by exploring responses to visual media in neo-orthodox Islam. It proposes that the visual display of the photographic image shares a curious resemblance to the bodies of people...... possessed by invisible spirits called jinn. The image as a failed example or model of reality works like the possessed body as an amplifier of invisibility pointing towards that which cannot be seen, depicted visually, or represented in writing. This suggests a negative epistemology in which images obtain...

  15. Multivariate predictors of failed prehospital endotracheal intubation.

    Science.gov (United States)

    Wang, Henry E; Kupas, Douglas F; Paris, Paul M; Bates, Robyn R; Costantino, Joseph P; Yealy, Donald M

    2003-07-01

    Conventionally trained out-of-hospital rescuers (such as paramedics) often fail to accomplish endotracheal intubation (ETI) in patients requiring invasive airway management. Previous studies have identified univariate variables associated with failed out-of-hospital ETI but have not examined the interaction between the numerous factors impacting ETI success. This study sought to use multivariate logistic regression to identify a set of factors associated with failed adult out-of-hospital ETI. The authors obtained clinical and demographic data from the Prehospital Airway Collaborative Evaluation, a prospective, multicentered observational study involving advanced life support (ALS) emergency medical services (EMS) systems in the Commonwealth of Pennsylvania. Providers used standard forms to report details of attempted ETI, including system and patient demographics, methods used, difficulties encountered, and initial outcomes. The authors excluded data from sedation-facilitated and neuromuscular blockade-assisted intubations. The main outcome measure was ETI failure, defined as failure to successfully place an endotracheal tube on the last out-of-hospital laryngoscopy attempt. Logistic regression was performed to develop a multivariate model identifying factors associated with failed ETI. Data were used from 45 ALS systems on 663 adult ETIs attempted during the period June 1, 2001, to November 30, 2001. There were 89 cases of failed ETI (failure rate 13.4%). Of 61 factors potentially related to ETI failure, multivariate logistic regression revealed the following significant covariates associated with ETI failure (odds ratio; 95% confidence interval; likelihood ratio p-value): presence of clenched jaw/trismus (9.718; 95% CI = 4.594 to 20.558; p endotracheal tube through the vocal cords (7.653; 95% CI = 3.561 to 16.447; p < 0.0001); inability to visualize the vocal cords (7.638; 95% CI = 3.966 to 14.707; p < 0.0001); intact gag reflex (7.060; 95% CI = 3.552 to 14

  16. We still fail to account for Mendel's observations

    Directory of Open Access Journals (Sweden)

    Porteous John W

    2004-08-01

    Full Text Available Abstract Background The present article corrects common textbook accounts of Mendel's experiments by re-establishing what he wrote and how he accounted for his observations. It notes the long-established tests for the validity of any explanations that purport to explain observations obtained by experiment. Application of these tests to Mendel's paper shows that the arguments he used to explain his observations were internally consistent but were, on one crucial issue, implausible. The same tests are applied to the currently accepted explanation for Mendel's observations. Conclusions The currently favoured explanation for Mendel's observations is untenable. It misrepresents Mendel, fails to distinguish between the parameters and the variables of any system of interacting components, its arguments are inconsistent, it repeats the implausibility in Mendel's paper, fails to give a rational explanation for his observed 3:1 trait ratio and cannot explain why this ratio is not always observed in experimental practice. A rational explanation for Mendel's observations is initiated. Readers are challenged to complete the process before a further article appears.

  17. A Solution to ``Too Big to Fail''

    Science.gov (United States)

    Kohler, Susanna

    2016-10-01

    Its a tricky business to reconcile simulations of our galaxys formation with our current observations of the Milky Way and its satellites. In a recent study, scientists have addressed one discrepancy between simulations and observations: the so-called to big to fail problem.From Missing Satellites to Too Big to FailThe favored model of the universe is the lambda-cold-dark-matter (CDM) cosmological model. This model does a great job of correctly predicting the large-scale structure of the universe, but there are still a few problems with it on smaller scales.Hubble image of UGC 5497, a dwarf galaxy associated with Messier 81. In the missing satellite problem, simulations of galaxy formation predict that there should be more such satellite galaxies than we observe. [ESA/NASA]The first is the missing satellites problem: CDM cosmology predicts that galaxies like the Milky Way should have significantly more satellite galaxies than we observe. A proposed solution to this problem is the argument that there may exist many more satellites than weve observed, but these dwarf galaxies have had their stars stripped from them during tidal interactions which prevents us from being able to see them.This solution creates a new problem, though: the too big to fail problem. This problem states that many of the satellites predicted by CDM cosmology are simply so massive that theres no way they couldnt have visible stars. Another way of looking at it: the observed satellites of the Milky Way are not massive enough to be consistent with predictions from CDM.Artists illustration of a supernova, a type of stellar feedback that can modify the dark-matter distribution of a satellite galaxy. [NASA/CXC/M. Weiss]Density Profiles and Tidal StirringLed by Mihai Tomozeiu (University of Zurich), a team of scientists has published a study in which they propose a solution to the too big to fail problem. By running detailed cosmological zoom simulations of our galaxys formation, Tomozeiu and

  18. Etiologic analysis of 100 anatomically failed dacryocystorhinostomies

    Directory of Open Access Journals (Sweden)

    Dave TV

    2016-07-01

    Full Text Available Tarjani Vivek Dave, Faraz Ali Mohammed, Mohammad Javed Ali, Milind N Naik The Institute of Dacryology, L V Prasad Eye Institute, Hyderabad, India Background: The aim of this study was to assess the etiological factors contributing to the failure of a dacryocystorhinostomy (DCR. Patients and methods: Retrospective review was performed in 100 consecutive patients who were diagnosed with anatomically failed DCR at presentation to a tertiary care hospital over a 5-year period from 2010 to 2015. Patient records were reviewed for demographic data, type of past surgery, preoperative endoscopic findings, previous use of adjuvants such as intubation and mitomycin C, and intraoperative notes during the re-revision. The potential etiological factors for failure were noted. Results: Of the 100 patients with failed DCRs, the primary surgery was an external DCR in 73 and endoscopic DCR in 27 patients. Six patients in each group had multiple revisions. The mean ages at presentation in the external and endoscopic groups were 39.41 years and 37.19 years, respectively. All patients presented with epiphora. The most common causes of failure were inadequate osteotomy (69.8% in the external group and 85.1% in the endoscopic group, P=0.19 followed by inadequate or inappropriate sac marsupialization (60.2% in the external group and 77.7% in the endoscopic group, P=0.16 and cicatricial closure of the ostium (50.6% in the external group and 55.5% in the endoscopic group, P=0.83. The least common causes such as ostium granulomas and paradoxical middle turbinate (1.37%, n=1 were noted in the external group only. Conclusion: Inadequate osteotomy, incomplete sac marsupialization, and cicatricial closure of the ostium were the most common causes of failure and did not significantly differ in the external and endoscopic groups. Meticulous evaluation to identify causative factors for failure and addressing them are crucial for subsequent successful outcomes. Keywords: failed

  19. Fail-over file transfer process

    Science.gov (United States)

    Semancik, Susan K. (Inventor); Conger, Annette M. (Inventor)

    2005-01-01

    The present invention provides a fail-over file transfer process to handle data file transfer when the transfer is unsuccessful in order to avoid unnecessary network congestion and enhance reliability in an automated data file transfer system. If a file cannot be delivered after attempting to send the file to a receiver up to a preset number of times, and the receiver has indicated the availability of other backup receiving locations, then the file delivery is automatically attempted to one of the backup receiving locations up to the preset number of times. Failure of the file transfer to one of the backup receiving locations results in a failure notification being sent to the receiver, and the receiver may retrieve the file from the location indicated in the failure notification when ready.

  20. Salvage arthrodesis for failed total ankle arthroplasty

    Science.gov (United States)

    Zürcher, Arthur W

    2010-01-01

    Background and purpose Total ankle arthroplasty (TAA) has gained popularity in recent years. If it fails, however, salvage arthrodesis must be reliable as a rescue procedure. We therefore investigated the clinical, radiographic, and subjective outcome after salvage arthrodesis in a consecutive group of patients, and concentrated on the influence of the method of fixation on union rate and on salvage in inflammatory joint disease. Patients and methods Between 1994 and 2005, salvage arthrodesis was performed on 18 ankles (18 patients). Diagnosis was inflammatory joint disease (IJD) in 15 cases and osteoarthritis (OA) in 3. Tibio-talar fusion was performed in 7 ankles, and tibio-talocalcaneal fusion in 11. Serial radiographs were studied for time to union. Clinical outcome at latest follow-up was measured by the AOFAS score, the foot function index (FFI) and by VAS scores for pain, function, and satisfaction. Results Blade plates were used in 7 ankles (4 IJD, 3 OA); all united. Nonunion developed in 7 of the 11 rheumatic ankles stabilized by other methods. 11 patients (8 fused ankles, 3 nonunions) were available for clinical evaluation. Their mean AOFAS score was 62 and mean overall FFI was 70. VAS score for pain was 20, for function 64, and for satisfaction 74. The scores were similar in united and non-united ankles. Interpretation Blade plate fixation is successful in salvage arthrodesis for failed TAA. A high nonunion rate was found after salvage ankle arthrodesis in IJD with other methods of fixation. Clinical results were fair to good. PMID:20175648

  1. Revision of Failed Artroscopic Bankart Repairs

    Science.gov (United States)

    Muiño, José María Silberberg; Gimenez, Martín Alejandro; Salvucci, Mauro Gabriel Maroa; Ferro, Diego; Rullan, Ramón Muiña

    2017-01-01

    Objectives: To present our functional outcomes from patients treated arthroscopically for a failed Bankart repair, using suture anchors and capsulolabral tissue only. Methods: Series of 22 patients presented with a recurrence of instability after a previous stabilization surgery (3 Latarjet, Bankart 19). We treated them by a an all-arthroscopic procedure, avoiding bone grafts, when glenoid track was found to be enough to proceed. The failure was associated with trauma in 11 patients, a non-anatomic repair in 6 patients, capsular laxity in 4 patients and a non-union of the coracoid graft in 1 patient. Revision surgery included: Bankart repair with anchors in 17 cases, a posterior-inferior capsulo-labral plication in one case, and 5 remplissages. In 4 cases subscapularis augmentation was used because of poor capsular quality. Screw removal was necessary when treating the non-union case. Patients were followed-up by a minimum of 23 months (range 23-26), and evaluated by the UCLA Test, SS test and Rowe score. Results: Thirteen patients had an excellent result, 6 good, 2 satisfactory and one bad result, according to UCLA score. The mean Rowe score was 90.4, at final follow up. The Simple Shoulder Test went from an 8 preoperative to an 11 postoperative, mean scores. 19 of 22 patients returned to the same level of activity prior to the injury. Complications: recurrence in 2 cases, subluxation in 2 and one shoulder stiffness that required an arthrolysis. Conclusion: An arthroscopic revision surgery, after a failed Bankart repair, presents satisfactory results in selected patients. Arthroscopic vision allows a correct diagnosis of injuries as possible causes of failure and subsequent treatment.

  2. Proteomic analysis of membrane microdomains derived from both failing and non-failing human hearts.

    Science.gov (United States)

    Banfi, Cristina; Brioschi, Maura; Wait, Robin; Begum, Shajna; Gianazza, Elisabetta; Fratto, Pasquale; Polvani, Gianluca; Vitali, Ettore; Parolari, Alessandro; Mussoni, Luciana; Tremoli, Elena

    2006-03-01

    Eukaryotic cells plasma membranes are organized into microdomains of specialized function such as lipid rafts and caveolae, with a specific lipid composition highly enriched in cholesterol and glycosphingolipids. In addition to their role in regulating signal transduction, multiple functions have been proposed, such as anchorage of receptors, trafficking of cholesterol, and regulation of permeability. However, an extensive understanding of their protein composition in human heart, both in failing and non-failing conditions, is not yet available. Membrane microdomains were isolated from left ventricular tissue of both failing (n = 15) and non-failing (n = 15) human hearts. Protein composition and differential protein expression was explored by comparing series of 2-D maps and subsequent identification by LC-MS/MS analysis. Data indicated that heart membrane microdomains are enriched in chaperones, cytoskeletal-associated proteins, enzymes and protein involved in signal transduction pathway. In addition, differential protein expression profile revealed that 30 proteins were specifically up- or down-regulated in human heart failure membrane microdomains. This study resulted in the identification of human heart membrane microdomain protein composition, which was not previously available. Moreover, it allowed the identification of multiple proteins whose expression is altered in heart failure, thus opening new perspectives to determine which role they may play in this disease.

  3. 7 CFR 983.52 - Failed lots/rework procedure.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Failed lots/rework procedure. 983.52 Section 983.52..., ARIZONA, AND NEW MEXICO Regulations § 983.52 Failed lots/rework procedure. (a) Substandard pistachios... committee may establish, with the Secretary's approval, appropriate rework procedures. (b) Failed...

  4. 30 CFR 77.312 - Fail safe monitoring systems.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Fail safe monitoring systems. 77.312 Section 77... Thermal Dryers § 77.312 Fail safe monitoring systems. Thermal dryer systems and controls shall be protected by a fail safe monitoring system which will safely shut down the system and any related...

  5. Fail forward: Mitigating failure in energy research and innovation

    DEFF Research Database (Denmark)

    Brix, Jacob

    2015-01-01

    on participant observation and empirical field research in three case companies, the OFEI model is developed to identify inappropriate behaviors that cause energy research and innovation to fail. The OFEI model can be used to give failed (or failing) projects a second chance and the article concludes...

  6. Cognitive emotion regulation fails the stress test.

    Science.gov (United States)

    Raio, Candace M; Orederu, Temidayo A; Palazzolo, Laura; Shurick, Ashley A; Phelps, Elizabeth A

    2013-09-10

    Cognitive emotion regulation has been widely shown in the laboratory to be an effective way to alter the nature of emotional responses. Despite its success in experimental contexts, however, we often fail to use these strategies in everyday life where stress is pervasive. The successful execution of cognitive regulation relies on intact executive functioning and engagement of the prefrontal cortex, both of which are rapidly impaired by the deleterious effects of stress. Because it is specifically under stressful conditions that we may benefit most from such deliberate forms of emotion regulation, we tested the efficacy of cognitive regulation after stress exposure. Participants first underwent fear-conditioning, where they learned that one stimulus (CS+) predicted an aversive outcome but another predicted a neutral outcome (CS-). Cognitive regulation training directly followed where participants were taught to regulate fear responses to the aversive stimulus. The next day, participants underwent an acute stress induction or a control task before repeating the fear-conditioning task using these newly acquired regulation skills. Skin conductance served as an index of fear arousal, and salivary α-amylase and cortisol concentrations were assayed as neuroendocrine markers of stress response. Although groups showed no differences in fear arousal during initial fear learning, nonstressed participants demonstrated robust fear reduction following regulation training, whereas stressed participants showed no such reduction. Our results suggest that stress markedly impairs the cognitive regulation of emotion and highlights critical limitations of this technique to control affective responses under stress.

  7. Why Lumbar Artificial Disk Replacements (LADRs) Fail.

    Science.gov (United States)

    Pettine, Kenneth; Ryu, Robert; Techy, Fernando

    2017-07-01

    A retrospective review of prospectively collected data. To determine why artificial disk replacements (ADRs) fail by examining results of 91 patients in FDA studies performed at a single investigational device exemption (IDE) site with minimum 2-year follow-up. Patients following lumbar ADR generally achieve their 24-month follow-up results at 3 months postoperatively. Every patient undergoing ADR at 1 IDE site by 2 surgeons was evaluated for clinical success. Failure was defined as Maverick, 25 patients; Charité, 31 patients; and Kineflex, 35 patients. All procedures were 1-level operations performed at L4-L5 or L5-S1. Demographics and inclusion/exclusion criteria were similar and will be discussed. Overall clinical failure occurred in 26% (24 of 91 patients) at 2-year follow-up. Clinical failure occurred in: 28% (Maverick) (7 of 25 patients), 39% (Charité) (12 of 31 patients), and 14% (Kineflex) (5 of 35 patients). Causes of failure included facet pathology, 50% of failure patients (12 of 24). Implant complications occurred in 5% of total patients and 21% of failure patients (5 of 24). Only 5 patients went from a success to failure after 3 months. Only 1 patient went from a failure to success after a facet rhizotomy 1 year after ADR. Seventy-four percent of patients after ADR met strict clinical success after 2-year follow-up. The clinical success versus failure rate did not change from their 3-month follow-up in 85 of the 91 patients (93%). Overall clinical success may be improved most by patient selection and implant type.

  8. Interior's Climate Science Centers: Focus or Fail

    Science.gov (United States)

    Udall, B.

    2012-12-01

    After a whirlwind two years of impressive and critical infrastructure building, the Department of Interior's Climate Science Centers are now in a position to either succeed or fail. The CSCs have a number of difficult structural problems including too many constituencies relative to the available resources, an uneasy relationship among many of the constituencies including the DOI agencies themselves, a need to do science in a new, difficult and non-traditional way, and a short timeframe to produce useful products. The CSCs have built a broad and impressive network of scientists and stakeholders. These entities include science providers of the universities and the USGS, and decision makers from the states, tribes, DOI land managers and other federal agencies and NGOs. Rather than try to support all of these constituencies the CSCs would be better served by refocusing on a core mission of supporting DOI climate related decision making. The CSCs were designed to service the climate science needs of DOI agencies, many of which lost their scientific capabilities in the 1990s due to a well-intentioned but ultimately harmful re-organization at DOI involving the now defunct National Biological Survey. Many of these agencies would like to have their own scientists, have an uneasy relationship with the nominal DOI science provider, the USGS, and don't communicate effectively among themselves. The CSCs must not succumb to pursuing science in either the traditional mode of the USGS or in the traditional mode of the universities, or worse, both of them. These scientific partners will need to be flexible, learn how to collaborate and should expect to see fewer resources. Useful CSC processes and outputs should start with the recommendations of the 2009 NRC Report Informing Decisions in a Changing Climate: (1) begin with users' needs; (2) give priority to process over products; (3) link information producers and users; (4) build connections across disciplines and organizations

  9. Rescue of failed filtering blebs with ab interno trephination.

    Science.gov (United States)

    Shihadeh, Wisam A; Ritch, Robert; Liebmann, Jeffrey M

    2006-06-01

    We evaluated the effectiveness of ab interno automated trephination as a technique for rescuing failed mature filtering blebs. A retrospective chart review of 40 failed blebs of 38 patients who had a posttrephination follow-up period of at least 3 months was done. With success defined as intraocular pressure (IOP) control with other modalities of management. Complications were few. We believe that ab interno trephination is an excellent option for rescuing selected failed filtering blebs.

  10. Sparse approximation problem: how rapid simulated annealing succeeds and fails

    Science.gov (United States)

    Obuchi, Tomoyuki; Kabashima, Yoshiyuki

    2016-03-01

    Information processing techniques based on sparseness have been actively studied in several disciplines. Among them, a mathematical framework to approximately express a given dataset by a combination of a small number of basis vectors of an overcomplete basis is termed the sparse approximation. In this paper, we apply simulated annealing, a metaheuristic algorithm for general optimization problems, to sparse approximation in the situation where the given data have a planted sparse representation and noise is present. The result in the noiseless case shows that our simulated annealing works well in a reasonable parameter region: the planted solution is found fairly rapidly. This is true even in the case where a common relaxation of the sparse approximation problem, the G-relaxation, is ineffective. On the other hand, when the dimensionality of the data is close to the number of non-zero components, another metastable state emerges, and our algorithm fails to find the planted solution. This phenomenon is associated with a first-order phase transition. In the case of very strong noise, it is no longer meaningful to search for the planted solution. In this situation, our algorithm determines a solution with close-to-minimum distortion fairly quickly.

  11. SPERM CHROMATIN STRUCTURE ASSAY PARAMETERS AS PREDICTORS OF FAILED PREGNANCY FOLLOWING ASSISTED REPRODUCTIVE TECHNIQUES. (R827019)

    Science.gov (United States)

    The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

  12. ADULT EXPOSURE TO PHYTOESTROGEN APIGENIN RESULTS IN CHANGES IN ENDOCRINE PARAMETERS BUT FAILS TO ALTER FECUNDITY

    Science.gov (United States)

    Plant-derived estrogens offer the opportunity to investigate the potential for weakly estrogenic compounds to influence endocrine function and reproduction. The presence of these phytoestrogens in foods, and agricultural and industrial runoff has the potential to increase the tot...

  13. 7 CFR 983.152 - Failed lots/rework procedure.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Failed lots/rework procedure. 983.152 Section 983.152..., ARIZONA, AND NEW MEXICO Rules and Regulations § 983.152 Failed lots/rework procedure. (a) Inshell rework procedure for aflatoxin. If inshell rework is selected as a remedy to meet the aflatoxin regulations of...

  14. Venus and Mars as Failed Biospheres

    Science.gov (United States)

    Grinspoon, D.

    2014-04-01

    What kinds of planets can support life? A widely held belief is that to support life, a planet should have stable bodies of liquid surface water. This assumption has in turn led to the conventional notion of a habitable zone (HZ) as a range of distances from a star where water can exist on the surface of a solid planet for biologically relevant timescales. As our understanding of terrestrial planet evolution has increased, the importance of water abundance as a substance controlling many evolutionary factors has become increasingly clear. This is true of biological evolution, as the presence of liquid water is widely regarded as the key to the possibility of finding "life as we know it" on other worlds. It is also true of geological and climatic evolution. Water is among the most important climatically active atmospheric gasses on the terrestrial planets. It is also a controlling variable for tectonic style and geologic processes, as well as a mediator of surface-atmosphere chemical reactions. Of the three local terrestrial planets, two have lost their oceans either to a subsurface cryosphere or to space, and one has had liquid oceans for most of its history. It is likely that planetary desiccation in one form or another is common among extrasolar terrestrial planets near the edges of their habitable zones. Thus, understanding the sources and sinks for surface water and characterizing the longevity of oceans and the magnitude of loss mechanisms on terrestrial planets of differing size, composition and proximity to stars of various stellar types, as well as the range of physical parameters which facilitates plate tectonics, is key to defining stellar habitable zones. The global biosphere of Earth has greatly altered many physical properties of the planet, and it is unclear to what extent the long-term habitability of Earth is the result of its inhabitation. Only comparative planetology, eventually including comparison with other inhabited planets, will answer this

  15. Parameter Estimation

    DEFF Research Database (Denmark)

    2011-01-01

    of optimisation techniques coupled with dynamic solution of the underlying model. Linear and nonlinear approaches to parameter estimation are investigated. There is also the application of maximum likelihood principles in the estimation of parameters, as well as the use of orthogonal collocation to generate a set......In this chapter the importance of parameter estimation in model development is illustrated through various applications related to reaction systems. In particular, rate constants in a reaction system are obtained through parameter estimation methods. These approaches often require the application...... of algebraic equations as the basis for parameter estimation.These approaches are illustrated using estimations of kinetic constants from reaction system models....

  16. The Experience of Failed Humor: Implications for Interpersonal Affect Regulation.

    Science.gov (United States)

    Williams, Michele; Emich, Kyle J

    2014-01-01

    The purpose of this study was to investigate failed interpersonal affect regulation through the lens of humor. We investigated individual differences that influenced people's affective and cognitive responses to failed humor and their willingness to persist in the interpersonal regulation of positive affect after a failed attempt. Using well-established autobiographical narrative methods and surveys, we collected data at two time points. All participants (n = 127) received identical surveys at time 1. At time 2, they were randomly assigned to complete a narrative about either successful or failed humor as well as a second survey. Using moderated regression analyses and SEM, we found significant differences between our failed and successful humor conditions. Specifically, individual differences, including gender, affective perspective taking, and humor self-efficacy, were associated with negative reactions to failed humor and the willingness of individuals to persist in the interpersonal regulation of positive affect. Moreover, affective perspective taking moderated the effect of gender in both the failed and successful humor conditions. Our results suggest that failed humor is no laughing matter. Understanding individuals' willingness to continue in attempts to regulate the affect of others contributes to the comprehension of an understudied phenomenon that has implications for interpersonal behavior in organizations such as helping, group decision making, and intragroup conflict. Studies of interpersonal affect regulation often focus on people's ability to successfully regulate others' emotions. In contrast, this is the first quantitative study to explore factors that influence individual's willingness to persist in interpersonal affect regulation after failure, and to investigate how individual differences influence the personal outcomes associated with failed attempts.

  17. Childhood obesity: parents fail to recognise, general practitioners fail to act.

    LENUS (Irish Health Repository)

    White, A

    2012-01-01

    General Practitioners (GPs) have an important role to play in recognition of and intervention against childhood obesity in Ireland. Data were collected prospectively on a cohort of children aged 4-14 and their parents (n = 101 pairs) who attended consecutively to a semi-rural group general practice. Parents estimated their child\\'s weight status. Actual weight status was determined for both parent and child using the United States Centres\\' for Disease Control\\'s BMI-for-age references. 15 (14.9%) of the children and 49 (51.6%) of the parents were overweight or obese. While 71 (95.5%) of normal weight status children were correctly identified, parents showed poor concordance in identifying their children as overweight 2 (18.2%) or obese 0 (0%). BMI was only evidently recorded in the clinical records of 1 out of 15 cases of overweight children identified. With parents failing to recognise childhood obesity, GPs have a responsibility in tackling this problem at a family level.

  18. Childhood obesity: parents fail to recognise, general practitioners fail to act.

    Science.gov (United States)

    White, A; O'Brien, B; Houlihan, T; Darker, C; O'Shea, B

    2012-01-01

    General Practitioners (GPs) have an important role to play in recognition of and intervention against childhood obesity in Ireland. Data were collected prospectively on a cohort of children aged 4-14 and their parents (n = 101 pairs) who attended consecutively to a semi-rural group general practice. Parents estimated their child's weight status. Actual weight status was determined for both parent and child using the United States Centres' for Disease Control's BMI-for-age references. 15 (14.9%) of the children and 49 (51.6%) of the parents were overweight or obese. While 71 (95.5%) of normal weight status children were correctly identified, parents showed poor concordance in identifying their children as overweight 2 (18.2%) or obese 0 (0%). BMI was only evidently recorded in the clinical records of 1 out of 15 cases of overweight children identified. With parents failing to recognise childhood obesity, GPs have a responsibility in tackling this problem at a family level.

  19. Fail-Safe Magnetic Bearing Controller Demonstrated Successfully

    Science.gov (United States)

    Choi, Benjamin B.; Provenza, Andrew J.

    2001-01-01

    The Structural Mechanics and Dynamics Branch has successfully demonstrated a fail-safe controller for the Fault-Tolerant Magnetic Bearing rig at the NASA Glenn Research Center. The rotor is supported by two 8-pole redundant radial bearings, and coil failing situations are simulated by manually shutting down their control current commands from the controller cockpit. The effectiveness of the controller was demonstrated when only two active coils from each radial bearing could be used (that is, 14 coils failed). These remaining two coils still levitated the rotor and spun it without losing stability or desired position up to the maximum allowable speed of 20,000 rpm.

  20. Pictorial essay: Role of ultrasound in failed carpal tunnel decompression

    Directory of Open Access Journals (Sweden)

    Rajesh Botchu

    2012-01-01

    Full Text Available USG has been used for the diagnosis of carpal tunnel syndrome. Scarring and incomplete decompression are the main causes for persistence or recurrence of symptoms. We performed a retrospective study to assess the role of ultrasound in failed carpal tunnel decompression. Of 422 USG studies of the wrist performed at our center over the last 5 years, 14 were for failed carpal tunnel decompression. Scarring was noted in three patients, incomplete decompression in two patients, synovitis in one patient, and an anomalous muscle belly in one patient. No abnormality was detected in seven patients. We present a pictorial review of USG findings in failed carpal tunnel decompression.

  1. Histological, histomorphometric and microtomographic analyses of retrieval hip resurfacing arthroplasty failed at different times

    Directory of Open Access Journals (Sweden)

    Salamanna Francesca

    2013-01-01

    Full Text Available Abstract Background Metal-on-metal hip resurfacing arthroplasty (HR has been gaining popularity especially for young and active patients. Although different series report good mid-term results, the long-term outcome and failure mechanisms are still concerning. In this consecutive revision case series, 9 retrieved specimens of a failed Birmingham Hip Resurfacing (BHR were divided according to the time to fracture: 3 specimens failed at less than 6 months (Group 1, 3 failed between 6 months and 3 years (Group 2 and 3 failed later than 3 years (Group 3. The objective of the study was to examine by a specific quantitative histomorphometry and microtomography (micro-CT method the characteristics of bone quality and its microarchitecture in retrieved metal-on-metal HR. Methods A series of 948 BHR were performed between 2001 and 2009. Among these implants 10 failures occurred and nine of these underwent revision surgery and were examined by histomorphometry and micro-CT. Results Histomorphometry showed a significant increase in trabecular separation (Tb.Sp in Group 3 in comparison with Group 1 (113%, p  Conclusions This study showed that the morphometric parameters considered are crucial for a good understanding of mechanical properties of HR and may be of significant importance in the pathogenesis of HR failure particularly in the development of late fractures.

  2. High rate of virological re-suppression among patients failing ...

    African Journals Online (AJOL)

    [9] In Khayelitsha, where routine viral load (VL) testing is available, targeted genotyping .... plans made were noted in the patient's folder .... n=1. Fig. 2. Flow diagram of outcomes of patients failing second-line antiretroviral therapy enrolled in a.

  3. Heterotopic Pregnancy in a Natural Conception Following Failed ...

    African Journals Online (AJOL)

    2011-02-23

    Feb 23, 2011 ... Heterotopic Pregnancy in a Natural Conception Following Failed. Contraceptive Practice ... her husband vehemently rejected surgical treatment of the ectopic pregnancy ... He also posited that her doctor only referred her for.

  4. Failing The Final Exam In Equal Employment And Opportunity

    Directory of Open Access Journals (Sweden)

    Greg Tower

    2011-07-01

    Full Text Available Anglo-American educational global leaders are failing the final exam for overall transparency of EEO activities with over 90% non-disclosure.  Australian entities should be modeled as important communication exemplars.

  5. Articulatory Parameters.

    Science.gov (United States)

    Ladefoged, Peter

    1980-01-01

    Summarizes the 16 parameters hypothesized to be necessary and sufficient for linguistic phonetic specifications. Suggests seven parameters affecting tongue shapes, three determining the positions of the lips, one controlling the position of the velum, four varying laryngeal actions, and one controlling respiratory activity. (RL)

  6. Parameter Estimation

    DEFF Research Database (Denmark)

    Sales-Cruz, Mauricio; Heitzig, Martina; Cameron, Ian;

    2011-01-01

    of optimisation techniques coupled with dynamic solution of the underlying model. Linear and nonlinear approaches to parameter estimation are investigated. There is also the application of maximum likelihood principles in the estimation of parameters, as well as the use of orthogonal collocation to generate a set...

  7. Failing the market, failing deliberative democracy: How scaling up corporate carbon reporting proliferates information asymmetries

    Directory of Open Access Journals (Sweden)

    Ingmar Lippert

    2016-10-01

    Full Text Available Corporate carbon footprint data has become ubiquitous. This data is also highly promissory. But as this paper argues, such data fails both consumers and citizens. The governance of climate change seemingly requires a strong foundation of data on emission sources. Economists approach climate change as a market failure, where the optimisation of the atmosphere is to be evidence based and data driven. Citizens or consumers, state or private agents of control, all require deep access to information to judge emission realities. Whether we are interested in state-led or in neoliberal ‘solutions’ for either democratic participatory decision-making or for preventing market failure, companies’ emissions need to be known. This paper draws on 20 months of ethnographic fieldwork in a Fortune 50 company’s environmental accounting unit to show how carbon reporting interferes with information symmetry requirements, which further troubles possibilities for contesting data. A material-semiotic analysis of the data practices and infrastructures employed in the context of corporate emissions disclosure details the situated political economies of data labour along the data processing chain. The explicit consideration of how information asymmetries are socially and computationally shaped, how contexts are shifted and how data is systematically straightened out informs a reflexive engagement with Big Data. The paper argues that attempts to automatise environmental accounting’s veracity management by means of computing metadata or to ensure that data quality meets requirements through third-party control are not satisfactory. The crossover of Big Data with corporate environmental governance does not promise to trouble the political economy that hitherto sustained unsustainability.

  8. Failing the market, failing deliberative democracy: How scaling up corporate carbon reporting proliferates information asymmetries

    Directory of Open Access Journals (Sweden)

    Ingmar Lippert

    2016-10-01

    Full Text Available Corporate carbon footprint data has become ubiquitous. This data is also highly promissory. But as this paper argues, such data fails both consumers and citizens. The governance of climate change seemingly requires a strong foundation of data on emission sources. Economists approach climate change as a market failure, where the optimisation of the atmosphere is to be evidence based and data driven. Citizens or consumers, state or private agents of control, all require deep access to information to judge emission realities. Whether we are interested in state-led or in neoliberal ‘solutions’ for either democratic participatory decision-making or for preventing market failure, companies’ emissions need to be known. This paper draws on 20 months of ethnographic fieldwork in a Fortune 50 company’s environmental accounting unit to show how carbon reporting interferes with information symmetry requirements, which further troubles possibilities for contesting data. A material-semiotic analysis of the data practices and infrastructures employed in the context of corporate emissions disclosure details the situated political economies of data labour along the data processing chain. The explicit consideration of how information asymmetries are socially and computationally shaped, how contexts are shifted and how data is systematically straightened out informs a reflexive engagement with Big Data. The paper argues that attempts to automatise environmental accounting’s veracity management by means of computing metadata or to ensure that data quality meets requirements through third-party control are not satisfactory. The crossover of Big Data with corporate environmental governance does not promise to trouble the political economy that hitherto sustained unsustainability.

  9. US Intervention in Failed States: Bad Assumptions=Poor Outcomes

    Science.gov (United States)

    2002-01-01

    NATIONAL DEFENSE UNIVERSITY NATIONAL WAR COLLEGE STRATEGIC LOGIC ESSAY US INTERVENTION IN FAILED STATES: BAD ASSUMPTIONS = POOR ...2002 2. REPORT TYPE 3. DATES COVERED 00-00-2002 to 00-00-2002 4. TITLE AND SUBTITLE US Intervention in Failed States: Bad Assumptions= Poor ...country remains in the grip of poverty , natural disasters, and stagnation. Rwanda Rwanda, another small African country, is populated principally

  10. The Failed State and the State of Failure

    Directory of Open Access Journals (Sweden)

    Peter Hitchcock

    2008-01-01

    Full Text Available What does Marx have to say about the “failed state”? Less than one might think. Peter Hitchcock seizes on the problem of the organic composition of capital to bring theories of state sovereignty and its dissolution into chiastic relation with Marxist political economy. This flexibly-bound double of Marxism and failed-state theory then offers a new perspective on our current moment and its possible futures.

  11. [Predictors of failed trial of labor in obese nulliparous].

    Science.gov (United States)

    Carassou-Maillan, A; Mulliez, A; Curinier, S; Houlle, C; Canis, M; Lemery, D; Gallot, D

    2014-11-01

    To identify predictors of failed trial of labour (TOL) in obese nulliparous at term. Retrospective study about 213 nulliparous with a body mass index (BMI) greater than 30kg/m(2) who delivered a vertex singleton after 37 weeks of gestation (WG). Planned caesarean sections were excluded. Maternal, sonographic, per-partum and neonatal characteristics were analyzed according to the mode of entry into labor and delivery route. Univariate and multivariate logistic regression analysis were performed. The cesarean delivery rate was 28%. Induction of labor (aOR=4.3 [1.8-10.7]), prolonged pregnancy (aOR=10.8 [1.7-67.6]), macrosomia (aOR=5.6 [1.1-27.3]), meconium-stained amniotic fluid (aOR: 2.57 [1.03-6.42]), use of trinitrine (aOR=5.5 [1.39-21.6]) and neonatal head circumference greater than 35cm (aOR=3.1 [1.2-8.0]) were predictors of failed TOL. There was no significant correlation between failed TOL and preconceptional BMI. Univariate analysis revealed an association between excessive weight gain and failed TOL. Predictors of failed TOL are the same in obese and non-obese women. Preconceptional BMI does not predict failed TOL in this nulliparous obese population. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  12. Inventory parameters

    CERN Document Server

    Sharma, Sanjay

    2017-01-01

    This book provides a detailed overview of various parameters/factors involved in inventory analysis. It especially focuses on the assessment and modeling of basic inventory parameters, namely demand, procurement cost, cycle time, ordering cost, inventory carrying cost, inventory stock, stock out level, and stock out cost. In the context of economic lot size, it provides equations related to the optimum values. It also discusses why the optimum lot size and optimum total relevant cost are considered to be key decision variables, and uses numerous examples to explain each of these inventory parameters separately. Lastly, it provides detailed information on parameter estimation for different sectors/products. Written in a simple and lucid style, it offers a valuable resource for a broad readership, especially Master of Business Administration (MBA) students.

  13. Lotka-Volterra pairwise modeling fails to capture diverse pairwise microbial interactions.

    Science.gov (United States)

    Momeni, Babak; Xie, Li; Shou, Wenying

    2017-03-28

    Pairwise models are commonly used to describe many-species communities. In these models, an individual receives additive fitness effects from pairwise interactions with each species in the community ('additivity assumption'). All pairwise interactions are typically represented by a single equation where parameters reflect signs and strengths of fitness effects ('universality assumption'). Here, we show that a single equation fails to qualitatively capture diverse pairwise microbial interactions. We build mechanistic reference models for two microbial species engaging in commonly-found chemical-mediated interactions, and attempt to derive pairwise models. Different equations are appropriate depending on whether a mediator is consumable or reusable, whether an interaction is mediated by one or more mediators, and sometimes even on quantitative details of the community (e.g. relative fitness of the two species, initial conditions). Our results, combined with potential violation of the additivity assumption in many-species communities, suggest that pairwise modeling will often fail to predict microbial dynamics.

  14. Failed MTR Fuel Element Detect in a Sipping Tests

    Energy Technology Data Exchange (ETDEWEB)

    Zeituni, C.A.; Terremoto, L.A.A.; da Silva, J.E.R.

    2004-10-06

    This work describes sipping tests performed on Material Testing Reactor (MTR) fuel elements of the IEA-R1 research reactor, in order to find out which one failed in the core during a routine operation. Radioactive iodine isotopes {sup 131}I and {sup 133}I, employed as failure monitors, were detected in samples corresponding to the failed fuel element. The specific activity of each sample, as well as the average leaking rate, were measured for {sup 137}Cs. The nuclear fuels U{sub 3}O{sub 8} - Al dispersion and U - Al alloy were compared concerning their measured average leaking rates of {sup 137}Cs.

  15. Ballooning osteolysis in 71 failed total ankle arthroplasties.

    Science.gov (United States)

    Singh, Gurpal; Reichard, Theresa; Hameister, Rita; Awiszus, Friedemann; Schenk, Katja; Feuerstein, Bernd; Roessner, Albert; Lohmann, Christoph

    2016-08-01

    Background and purpose - Aseptic loosening is a major cause of failure in total ankle arthroplasty (TAA). In contrast to other total joint replacements, large periarticular cysts (ballooning osteolysis) have frequently been observed in this context. We investigated periprosthetic tissue responses in failed TAA, and performed an element analysis of retrieved tissues in failed TAA. Patients and methods - The study cohort consisted of 71 patients undergoing revision surgery for failed TAA, all with hydroxyapatite-coated implants. In addition, 5 patients undergoing primary TAA served as a control group. Radiologically, patients were classified into those with ballooning osteolysis and those without, according to defined criteria. Histomorphometric, immunohistochemical, and elemental analysis of tissues was performed. Von Kossa staining and digital microscopy was performed on all tissue samples. Results - Patients without ballooning osteolysis showed a generally higher expression of lymphocytes, and CD3+, CD11c+, CD20+, and CD68+ cells in a perivascular distribution, compared to diffuse expression. The odds of having ballooning osteolysis was 300 times higher in patients with calcium content >0.5 mg/g in periprosthetic tissue than in patients with calcium content ≤0.5 mg/g (p < 0.001). Interpretation - There have been very few studies investigating the pathomechanisms of failed TAA and the cause-effect nature of ballooning osteolysis in this context. Our data suggest that the hydroxyapatite coating of the implant may be a contributory factor.

  16. Failing Boys! Beyond Crisis, Moral Panic and Limiting Stereotypes

    Science.gov (United States)

    Martino, Wayne

    2011-01-01

    For some time now, school boards, Ministries of Education, and the popular media have been expressing concerns about failing boys and how best to meet their needs, framing these concerns in terms of a crisis in which boys are the "new disadvantaged". This perspective does not provide an accurate representation of the problem and, in fact, detracts…

  17. The Failing Heart Relies on Ketone Bodies as a Fuel.

    Science.gov (United States)

    Aubert, Gregory; Martin, Ola J; Horton, Julie L; Lai, Ling; Vega, Rick B; Leone, Teresa C; Koves, Timothy; Gardell, Stephen J; Krüger, Marcus; Hoppel, Charles L; Lewandowski, E Douglas; Crawford, Peter A; Muoio, Deborah M; Kelly, Daniel P

    2016-02-23

    Significant evidence indicates that the failing heart is energy starved. During the development of heart failure, the capacity of the heart to utilize fatty acids, the chief fuel, is diminished. Identification of alternate pathways for myocardial fuel oxidation could unveil novel strategies to treat heart failure. Quantitative mitochondrial proteomics was used to identify energy metabolic derangements that occur during the development of cardiac hypertrophy and heart failure in well-defined mouse models. As expected, the amounts of proteins involved in fatty acid utilization were downregulated in myocardial samples from the failing heart. Conversely, expression of β-hydroxybutyrate dehydrogenase 1, a key enzyme in the ketone oxidation pathway, was increased in the heart failure samples. Studies of relative oxidation in an isolated heart preparation using ex vivo nuclear magnetic resonance combined with targeted quantitative myocardial metabolomic profiling using mass spectrometry revealed that the hypertrophied and failing heart shifts to oxidizing ketone bodies as a fuel source in the context of reduced capacity to oxidize fatty acids. Distinct myocardial metabolomic signatures of ketone oxidation were identified. These results indicate that the hypertrophied and failing heart shifts to ketone bodies as a significant fuel source for oxidative ATP production. Specific metabolite biosignatures of in vivo cardiac ketone utilization were identified. Future studies aimed at determining whether this fuel shift is adaptive or maladaptive could unveil new therapeutic strategies for heart failure. © 2016 American Heart Association, Inc.

  18. The ugly twins: Failed global sourcing projects and their substitutes

    NARCIS (Netherlands)

    Schiele, Holger; Horn, Philipp; Horn, Philipp; Werner, Welf

    2010-01-01

    Purpose of the paper and literature addressed: Analyzing the impact of failed global sourcing projects on the entire commodity group and exploring isomorphism as potential antecedent to the observed phenomenon. The paper is embedded in the global sourcing literature, as well as isomorphism and total

  19. Civil Liability for Failing to Report Child Abuse.

    Science.gov (United States)

    Lehto, Neil J.

    1977-01-01

    The article examines the Landeros decision (which ruled that a doctor who fails to report a child abuse victim can be held liable for subsequent injuries inflicted on the child) and discusses three theories of proving civil liability for the failure to report child abuse victims. Addressed are the following topics: the problem of child abuse and…

  20. Why Young People Fail To Get and Hold Jobs.

    Science.gov (United States)

    New York State Dept. of Labor, Albany.

    This booklet provides advice to young people seeking their first jobs on how to avoid the pitfalls that have caused others to lose jobs or fail to be hired. Topics discussed in short, one-page sections include appearance, attitude and behavior, ignorance of labor market facts, misrepresentation, sensitivity about a physical defect, unrealistic…

  1. Preventing Suicide: A Mission Too Big to Fail

    Science.gov (United States)

    2013-03-01

    Preventing Suicide: A Mission Too Big to Fail by Ms. Gloria Duck Lieutenant Colonel Timothy Holman Ms. Jennifer Jessup...Lieutenant Colonel Timothy Holman United States Army Ms. Jennifer Jessup Department of Veterans Affairs Civilian Colonel Keith...Gloria Duck Department of the Army Civilian Lieutenant Colonel Timothy Holman United States Army Ms. Jennifer Jessup Department of Veterans Affairs

  2. Super-Earths as Failed Cores in Orbital Migration Traps

    Science.gov (United States)

    Hasegawa, Yasuhiro

    2016-11-01

    I explore whether close-in super-Earths were formed as rocky bodies that failed to grow fast enough to become the cores of gas giants before the natal protostellar disk dispersed. I model the failed cores’ inward orbital migration in the low-mass or type I regime to stopping points at distances where the tidal interaction with the protostellar disk applies zero net torque. The three kinds of migration traps considered are those due to the dead zone's outer edge, the ice line, and the transition from accretion to starlight as the disk's main heat source. As the disk disperses, the traps move toward final positions near or just outside 1 au. Planets at this location exceeding about 3 M ⊕ open a gap, decouple from their host traps, and migrate inward in the high-mass or type II regime to reach the vicinity of the star. I synthesize the population of planets that formed in this scenario, finding that a fraction of the observed super-Earths could have been failed cores. Most super-Earths that formed this way have more than 4 M ⊕, so their orbits when the disks dispersed were governed by type II migration. These planets have solid cores surrounded by gaseous envelopes. Their subsequent photoevaporative mass loss is most effective for masses originally below about 6 M ⊕. The failed core scenario suggests a division of the observed super-Earth mass-radius diagram into five zones according to the inferred formation history.

  3. Establishing Pass/Fail Criteria for Bronchoscopy Performance

    DEFF Research Database (Denmark)

    Konge, Lars; Clementsen, Paul; Larsen, Klaus Richter;

    2012-01-01

    Background: Several tools have been created to assess competence in bronchoscopy. However, educational guidelines still use an arbitrary number of performed procedures to decide when basic competency is acquired. Objectives: The purpose of this study was to define pass/fail scores for two...

  4. Finite element analysis of bone loss around failing implants

    NARCIS (Netherlands)

    Wolff, J.; Narra, N.; Antalainen, A.K.; Valášek, J.; Kaiser, J.; Sandór, G.K.; Marcián, P.

    2014-01-01

    Dental implants induce diverse forces on their surrounding bone. However, when excessive unphysiological forces are applied, resorption of the neighbouring bone may occur. The aim of this study was to assess possible causes of bone loss around failing dental implants using finite element analysis. A

  5. Evidence of a "Failing Newspaper" under the Newspaper Preservation Act.

    Science.gov (United States)

    Picard, Robert G.

    The Newspaper Preservation Act of 1970 makes it possible for competing newspapers to combine advertising, production, circulation and management functions into a single newspaper corporation. For the attorney general and the courts to authorize a joint operating agreement (JOA) for a "failing newspaper," certain conditions must be met and certain…

  6. "Badminton Player-Coach" Interactions between Failing Students

    Science.gov (United States)

    Mascret, Nicolas

    2011-01-01

    Background: Physical education teachers often use the player-coach dyad in individual opposition sports so that students can obtain information on their actions and then better regulate them. This type of work also develops methodological and social skills. However, the task of observing a partner often poses problems for failing students, who…

  7. 78 FR 54373 - Records of Failed Insured Depository Institutions

    Science.gov (United States)

    2013-09-04

    .../individual/failed/pls/ ; www.fdic.gov/regulations/compliance/manual/pdf/II-8.1.pdf . The ``reasonably... instances where the FDIC issues a final rule as defined by the APA (5 U.S.C. 551 et seq.). Because the FDIC is issuing a final rule as defined by the APA, the FDIC will file the reports required by the SBREFA...

  8. Government failings on energy efficiency and fuel poverty

    Energy Technology Data Exchange (ETDEWEB)

    Warren, A. [Association for the Conservation of Energy (United Kingdom)

    2008-09-15

    The author delivered this year's Melchett Lecture as part of the EI's Energy in transition event in July, having been awarded the 72nd Melchett Award about the organizing for energy efficiency and the Government's current failing on fuel poverty strategy. 3 figs.

  9. "It's All Human Error!": When a School Science Experiment Fails

    Science.gov (United States)

    Viechnicki, Gail Brendel; Kuipers, Joel

    2006-01-01

    This paper traces the sophisticated negotiations to re-inscribe the authority of Nature when a school science experiment fails during the enactment of a highly rated science curriculum unit. Drawing on transcriptions from classroom videotapes, we identify and describe four primary patterns of interaction that characterize this process, arguing…

  10. Organization Theory: Bright Prospects for a Permanently Failing Field

    NARCIS (Netherlands)

    P.P.M.A.R. Heugens (Pursey)

    2008-01-01

    textabstractOrganization theory is a paradoxical field of scientific inquiry. It has struggled for more than fifty years to develop a unified theory of organizational effectiveness under girded by a coherent set of assumptions, and it has thus far failed to produce one. Yet, by other standards it is

  11. "It's All Human Error!": When a School Science Experiment Fails

    Science.gov (United States)

    Viechnicki, Gail Brendel; Kuipers, Joel

    2006-01-01

    This paper traces the sophisticated negotiations to re-inscribe the authority of Nature when a school science experiment fails during the enactment of a highly rated science curriculum unit. Drawing on transcriptions from classroom videotapes, we identify and describe four primary patterns of interaction that characterize this process, arguing…

  12. Why Insurgents Fail: Examining Post-World War II Failed Insurgencies Utilizing the Prerequisites of Successful Insurgencies as a Framework

    Science.gov (United States)

    2007-03-01

    Baylis and Son, 1970. Geyer, Georgie A. “Why Guevara Failed: An Interview with Regis Debray.” Saturday Review. August 24, 1968. 156 Gonzalez...1949): 8-11, 34-35. Howard , Harry N. Greece and the United Nations, 1946-1949; A Summary Record. Report of the U.N. Special Committee on the

  13. Looked-but-failed-to-see-errors in traffic

    DEFF Research Database (Denmark)

    Herslund, Mai-Britt; Jørgensen, N O

    2003-01-01

    until immediately before the collision even though the bicycle must have been clearly visible.Similar types of accidents have been the subject of studies elsewhere. In literature they are labelled "looked-but-failed-to-see", because it seems clear that in many cases the car drivers have actually been......Danish studies of traffic accidents at priority intersections have shown a particular type of accidents. In these accidents a car driver supposed to give way has collided with a bicycle rider on the priority road. Often the involved car drivers have maintained that they did not see the bicycle...... looking in the direction where the other parties were but have not seen (i.e. perceived the presence of) the other road user. This paper describes two studies approaching this problem.One study is based on 10 self-reported near accidents. It does show that "looked-but-failed-to-see" events do occur...

  14. A survey of failed post-retained restorations

    DEFF Research Database (Denmark)

    Peutzfeldt, A; Sahafi, A; Asmussen, E

    2008-01-01

    Survival of endodontically treated, post-restored teeth depends on a multitude of factors, all of which are practically impossible to include in a randomized, controlled clinical study. The purpose of this survey was to characterize and analyze reported failures of post-retained restorations...... to identify factors critical to failure and to type of failure. A questionnaire was mailed to private practitioners in Denmark with a request to complete the questionnaire whenever a patient presented with a failed post-retained restoration. Information was gathered on factors related to the patient...... increased with the functioning time until failure. Fracture of the post was more common among male than female patients. On the basis of this survey of failed post-retained restorations, it was concluded that tapered posts were associated with a higher risk of tooth fracture than were parallel-sided posts....

  15. Failed total carpometacarpal joint prosthesis of the thumb

    DEFF Research Database (Denmark)

    Hansen, Torben Bæk; Homilius, Morten

    2010-01-01

    . The male:female ratio was 1:4 and the mean duration of observation 32 months (range 6-52). In three patients the revised implant was a MOJE uncemented carpometacarpal joint prosthesis and in seven patients an Elektra uncemented one. At follow-up grip strength was reduced to less than 90% of the other hand...... in eight of 10 patients, but the mean Disabilities of the arm, shoulder, and hand (DASH) scores, self-reported pinch-grip-related function, and pain were comparable with our earlier published results with the Elektra carpometacarpal total joint prosthesis.......Total joint prosthesis in carpometacarpal joint arthritis of the thumb often fails. Loosening of the implant is often treated by resection arthroplasty, and we reviewed 10 patients, mean age 54 years (range 47-63) who were treated by resection arthroplasty after a failed total joint prosthesis...

  16. Etiology, Diagnosis, and Management of Failed SLAP Repair.

    Science.gov (United States)

    Werner, Brian C; Brockmeier, Stephen F; Miller, Mark D

    2014-09-01

    In general, favorable outcomes have been achieved with arthroscopic repair of superior labral anterior-posterior (SLAP) tears. However, some patients remain dissatisfied or suffer further injury after SLAP repair and may seek additional treatment to alleviate their symptoms. The cause of persistent pain or recurrent symptoms after repair is likely multifactorial; therefore, careful preoperative workup is required to elucidate the cause of pain. Review of the details of previous surgical procedures is crucial because certain fixation methods are prone to failure or can cause additional injury. Failed SLAP repair can be managed with nonsurgical or surgical options. Nonsurgical modalities include physical therapy and strengthening programs, anti-inflammatory agents, and activity modification. Surgical options include revision SLAP repair and biceps tenotomy or tenodesis with or without revision SLAP repair. Outcomes after surgical management of failed SLAP repair are inferior to those of primary repair. Select patients may be better served by primary biceps tenodesis rather than SLAP repair.

  17. Counterterrorism in African Failed States: Challenges and Potential Solutions

    Science.gov (United States)

    2006-04-01

    observed in these three failed states were able to operate without attracting the attention or effective sanction of the United States or its allies...anecdotal rather than quantitative in methology .14 Sageman’s two-celled terrorist model discriminates between “hubs” and “nodes” in describing the... observing “its lack of a functioning central government” and “the absence of functioning police, immigration, customs, and intelligence agencies

  18. Why Do Insurance-Linked Exchange-Traded Derivatives Fail?

    OpenAIRE

    Sylvie Bouriaux; Michael J. Tomas III

    2014-01-01

    This paper analyzes the reasons why exchange-traded insurance-linked derivatives like catastrophe insurance futures and options have failed to attract interest from financial market participants. There are various risk components embedded in exchange-traded catastrophe insurance derivatives—namely, basis risk, liquidity risk, and development risk—which may limit their appeal to the hedging and investing communities. Our analysis suggests that the choice of an industry loss index as a trigger ...

  19. Medical Support to Failed States: Start with the Prisons

    Science.gov (United States)

    2011-03-11

    population can be significant. In Russia overcrowded prisons have bred new drug-resistant strains of tuberculosis that have proliferated virulently...among the general public.26 Similarly in the early 1990‟s the Los Angeles Jail experienced an outbreak of cerebral meningitis that spread to the local...community.27 In the Failed States of Africa, the spread of drug resistant Tuberculosis and HIV in the prisons now pose a grave threat to the region

  20. Late sodium current in failing heart: friend or foe?

    Science.gov (United States)

    Maltsev, Victor A; Undrovinas, Albertas

    2008-01-01

    Most cardiac Na+ channels open transiently upon membrane depolarization and then are quickly inactivated. However, some channels remain active, carrying the so-called persistent or late Na+ current (INaL) throughout the action potential (AP) plateau. Experimental data and the results of numerical modeling accumulated over the past decade show the emerging importance of this late current component for the function of both normal and failing myocardium. INaL is produced by special gating modes of the cardiac-specific Na+ channel isoform. Heart failure (HF) slows channel gating and increases INaL, but HF-specific Na+ channel isoform underlying these changes has not been found. Na+ channels represent a multi-protein complex and its activity is determined not only by the pore-forming alpha subunit but also by its auxiliary beta subunits, cytoskeleton, calmodulin, regulatory kinases and phosphatases, and trafficking proteins. Disruption of the integrity of this protein complex may lead to alterations of INaL in pathological conditions. Increased INaL and the corresponding Na+ flux in failing myocardium contribute to abnormal repolarization and an increased cell Ca2+ load. Interventions designed to correct INaL rescue normal repolarization and improve Ca2+ handling and contractility of the failing cardiomyocytes. This review considers (1) quantitative integration of INaL into the established electrophysiological and Ca2+ regulatory mechanisms in normal and failing cardiomyocytes and (2) a new therapeutic strategy utilizing a selective inhibition of INaL to target both arrhythmias and impaired contractility in HF.

  1. Paying for innovation. Failed strategies add to hospitals' reimbursement losses.

    Science.gov (United States)

    Pallarito, K

    Hospitals across the country are struggling to balance revenue shortfalls and cost increases as the lid on government and private-payer payments closes tighter. They're also grappling with losses on failed physician and HMO investments, the expense of new medical technologies and larger-than-planned costs related to "millennium bug" cures. This is the second part of a two-part series on financial turmoil in healthcare.

  2. Reorganized PKA-AKAP associations in the failing human heart.

    Science.gov (United States)

    Aye, Thin-Thin; Soni, Siddarth; van Veen, Toon A B; van der Heyden, Marcel A G; Cappadona, Salvatore; Varro, Andras; de Weger, Roel A; de Jonge, Nicolaas; Vos, Marc A; Heck, Albert J R; Scholten, Arjen

    2012-02-01

    Here we reveal that the characterization of large-scale re-arrangements of signaling scaffolds induced by heart failure can serve as a novel concept to identify more specific therapeutic targets. In the mammalian heart, the cAMP pathway, with the cAMP-dependent protein kinase (PKA) in a central role, acts directly downstream of adrenergic receptors to mediate cardiac contractility and rhythm. Heart failure, characterized by severe alterations in adrenergic stimulation is, amongst other interventions, often treated with β-blockers. Contrasting results, however, have shown both beneficial and detrimental effects of decreased cAMP levels in failing hearts. We hypothesize that the origin of this behavior lies in the complex spatiotemporal organization of the regulatory subunit of PKA (PKA-R), which associates tightly with various A-kinase anchoring proteins (AKAPs) to specifically localize PKA's activity. Using chemical proteomics directly applied to human patient and control heart tissue we demonstrate that the association profile of PKA-R with several AKAPs is severely altered in the failing heart, for instance effecting the interaction between PKA and the novel AKAP SPHKAP was 6-fold upregulated upon failing heart conditions. Also a significant increase in captured cGMP-dependent protein kinase (PKG) and phosphodiesterase 2 (PDE2) was observed. The observed altered profiles can already explain many aspects of the aberrant cAMP-response in the failing human heart, validating that this dataset may provide a resource for several novel, more specific, treatment options. This article is part of a Special Issue entitled "Local Signaling in Myocytes".

  3. Fail-safe designs for large capacity battery systems

    Science.gov (United States)

    Kim, Gi-Heon; Smith, Kandler; Ireland, John; Pesaran, Ahmad A.; Neubauer, Jeremy

    2016-05-17

    Fail-safe systems and design methodologies for large capacity battery systems are disclosed. The disclosed systems and methodologies serve to locate a faulty cell in a large capacity battery, such as a cell having an internal short circuit, determine whether the fault is evolving, and electrically isolate the faulty cell from the rest of the battery, preventing further electrical energy from feeding into the fault.

  4. Organizational crisis management - crisis communication when IT fails

    OpenAIRE

    Glad, Jutta

    2009-01-01

    HELSINKI SCHOOL OF ECONOMICS ABSTRACT International Business, Master’s Thesis Jutta Glad 08.05.2009 ORGANIZATIONAL CRISIS MANAGEMENT – CRISIS COMMUNICATION WHEN INFORMATION TECHNOLOGY FAILS Objectives of the thesis The objective of this study is to find out what different factors an organization should consider when responding to an organizational crisis that has been caused by an information technology failure. The study also tries to find out whether crisis communicat...

  5. Why Not Let IT Fail? The IT Project Success Paradox

    OpenAIRE

    Ambrose, Paul,; Munro, David

    2013-01-01

    Part 7: Shorter Papers; International audience; Is a focus on information systems or information technology success a myopic view of evaluating IT success and failure? Are success and failure the opposite ends of a continuum for evaluating IT projects? Conventional measures of success such as meeting cost, time, budgets, and user needs do not address positives that can emerge from failures. We contend that a focus on success and failing to factor the possibility of failure actually hamper IT ...

  6. Study on characteristics of base isolation system with fail-safe devices. ; Fundamental dynamic characteristic of fail-safe devices. Menshin sochi no fail-safe kiko ni kansuru kenkyu. ; Fail-safe sochi no kihon dotokusei

    Energy Technology Data Exchange (ETDEWEB)

    Teramura, A.; Nakamura, T.; Suzuki, T.; Nohata, A.; Tsunoda, T.; Okada, H.; Yasui, Y. (Obayashi, Corp., Tokyo (Japan))

    1990-08-10

    This study describes fail-safe mechanisms to be built in the laminated rubber base isolation devices for the purpose of developing a base isolation system necessary for the application to nuclear fuel facilities. There are two types of fail-safe devices developed in the fundamental study; a landing type on which the bottom of the building is supported and a stopper type for restricting excessive development. The basic characteristics of these devices were investigated through static and dynamic fundamental tests and input of earthquake force on a shaking table. As a result of these tests and analyses, it was proved that the whole restoring force characteristics of the two types of fail-safe devices were almost the same as expected, and their earthquake response characteristics met the initially designed performance. Moreover, it was shown that they prevent buckling of rubber bearings under input of excessive earthquake forces and consequently enhance safety of superstructures of the buildings. 4 refs., 19 figs., 1 tab.

  7. Failed magnetic resonance imaging examinations due to claustrophobia

    Energy Technology Data Exchange (ETDEWEB)

    Sarji, S.A.; Abdullah, B.J.J.; Kumar, G.; Tan, A.H.; Narayanan, P. [University of malaya Centre, Kuala Lumpar (Malaysia). Department of Radiology

    1998-11-01

    A recognised cause of incomplete or cancelled MRI examinations is anxiety and claustrophobic symptoms in patients undergoing MR scanning. This appears to be a problem in many MRI centres in Western Europe and North America, where it is said to be costly in terms of loss of valuable scan time, and has led to researchers suggesting several anxiety reducing approaches for MRI. To determine the incidence of failed MRI examination among our patients and if there are any associations with a patient`s sex, age and education level, we studied claustrophobia that led to premature termination of the MRI examination in the University Malaya Medical Centre (UMMC) in 3324 patients over 28 months. The incidence of failed MRI examinations due to claustrophobia in the UMMC was found to be only 0.54%. There are associations between claustrophobia in MRI with the patients` sex, age and level of education. The majority of those affected were male patients and young patients in the 25-45-year age group. The patients` education level appears to be the strongest association with failed MRI examinations due to claustrophobia, where the majority of the affected were highly educated individuals. Claustrophobia in MRI is more of a problem among the educated individuals or patients from a higher socio-economic group, which may explain the higher incidence in Western European and North American patients. Copyright (1998) Blackwell Science Pty Ltd 9 refs.

  8. Palmitoylethanolamide in the Treatment of Failed Back Surgery Syndrome

    Directory of Open Access Journals (Sweden)

    Antonella Paladini

    2017-01-01

    Full Text Available Introduction. This observational study was designed to evaluate the efficacy of ultramicronized palmitoylethanolamide (um-PEA (Normast® administration, as add-on therapy for chronic pain, in the management of pain-resistant patients affected by failed back surgery syndrome. Methods. A total of 35 patients were treated with tapentadol (TPD and pregabalin (PGB. One month after the start of standard treatment, um-PEA was added for the next two months. Pain was evaluated by the Visual Analogue Scale (VAS at the time of enrollment (T0 and after one (T1, two (T2, and three (T3 months. Results. After the first month with TDP + PGB treatment only, VAS score decreased significantly from 5.7±0.12 at the time of enrollment (T0 to 4.3 ± 0.11 (T1 (p<0.0001; however, it failed to provide significant subjective improvement in pain symptoms. Addition of um-PEA led to a further and significant decrease in pain intensity, reaching VAS scores of 2.7 ± 0.09 (T2 and 1.7 ± 0.11 (T3, end of treatment (p<0.0001 without showing any side effects. Conclusions. This observational study provides evidence, albeit preliminary, for the efficacy and safety of um-PEA (Normast as part of a multimodal therapeutic regimen in the treatment of pain-resistant patients suffering from failed back surgery syndrome.

  9. Super-Earths as Failed Cores in Orbital Migration Traps

    CERN Document Server

    Hasegawa, Yasuhiro

    2016-01-01

    We explore whether close-in super-Earths were formed as rocky bodies that failed to grow fast enough to become the cores of gas giants before the natal protostellar disk dispersed. We model the failed cores' inward orbital migration in the low-mass or type I regime, to stopping points at distances where the tidal interaction with the protostellar disk applies zero net torque. The three kinds of migration traps considered are those due to the dead zone's outer edge, the ice line, and the transition from accretion to starlight as the disk's main heat source. As the disk disperses, the traps move toward final positions near or just outside 1~au. Planets at this location exceeding about 3~M$_\\oplus$ open a gap, decouple from their host trap, and migrate inward in the high-mass or type II regime to reach the vicinity of the star. We synthesize the population of planets formed in this scenario, finding that some fraction of the observed super-Earths can be failed cores. Most super-Earths formed this way have more t...

  10. Evidence of structural remodeling in the dyssynchronous failing heart.

    Science.gov (United States)

    Helm, Patrick A; Younes, Laurent; Beg, Mirza F; Ennis, Daniel B; Leclercq, Christophe; Faris, Owen P; McVeigh, Elliot; Kass, David; Miller, Michael I; Winslow, Raimond L

    2006-01-01

    Ventricular remodeling of both geometry and fiber structure is a prominent feature of several cardiac pathologies. Advances in MRI and analytical methods now make it possible to measure changes of cardiac geometry, fiber, and sheet orientation at high spatial resolution. In this report, we use diffusion tensor imaging to measure the geometry, fiber, and sheet architecture of eight normal and five dyssynchronous failing canine hearts, which were explanted and fixed in an unloaded state. We apply novel computational methods to identify statistically significant changes of cardiac anatomic structure in the failing and control heart populations. The results demonstrate significant regional differences in geometric remodeling in the dyssynchronous failing heart versus control. Ventricular chamber dilatation and reduction in wall thickness in septal and some posterior and anterior regions are observed. Primary fiber orientation showed no significant change. However, this result coupled with the local wall thinning in the septum implies an altered transmural fiber gradient. Further, we observe that orientation of laminar sheets become more vertical in the early-activated septum, with no significant change of sheet orientation in the late-activated lateral wall. Measured changes in both fiber gradient and sheet structure will affect both the heterogeneity of passive myocardial properties as well as electrical activation of the ventricles.

  11. Supergranular Parameters

    Science.gov (United States)

    Udayashankar, Paniveni

    2016-07-01

    I study the complexity of supergranular cells using intensity patterns from Kodaikanal solar observatory. The chaotic and turbulent aspect of the solar supergranulation can be studied by examining the interrelationships amongst the parameters characterizing supergranular cells namely size, horizontal flow field, lifetime and physical dimensions of the cells and the fractal dimension deduced from the size data. The findings are supportive of Kolmogorov's theory of turbulence. The Data consists of visually identified supergranular cells, from which a fractal dimension 'D' for supergranulation is obtained according to the relation P α AD/2 where 'A' is the area and 'P' is the perimeter of the supergranular cells. I find a fractal dimension close to about 1.3 which is consistent with that for isobars and suggests a possible turbulent origin. The cell circularity shows a dependence on the perimeter with a peak around (1.1-1.2) x 105 m. The findings are supportive of Kolmogorov's theory of turbulence.

  12. Efficacy of repeated 5-fluorouracil needling for failing and failed filtering surgeries based on simple gonioscopic examination

    Directory of Open Access Journals (Sweden)

    Rashad MA

    2012-12-01

    Full Text Available Mohammad A RashadOphthalmology Department, Faculty of Medicine, Ain Shams University, Cairo, EgyptPurpose: To evaluate the success rate of a modified bleb needling technique in eyes with previous glaucoma surgery that had elevated intraocular pressure.Methods: A retrospective study of 24 eyes of 24 patients that underwent repeated bleb needling performed for failing and failed blebs on slit lamp with 5-fluorouracil (5-FU injections on demand. This was performed after gonioscopic examination to define levels of filtration block.Results: There was significant reduction of mean IOP from 36.91 mmHg to 14.73 mmHg at the final follow-up (P < 0.001. The overall success rate was 92%.Conclusion: Repeated needling with adjunctive 5-FU proved a highly effective, safe alternative to revive filtration surgery rather than another medication or surgery.Keywords: bleb, failure, 5-FU, needling, gonioscopy

  13. Innovative drugs to treat depression: did animal models fail to be predictive or did clinical trials fail to detect effects?

    Science.gov (United States)

    Belzung, Catherine

    2014-04-01

    Over recent decades, encouraging preclinical evidence using rodent models pointed to innovative pharmacological targets to treat major depressive disorder. However, subsequent clinical trials have failed to show convincing results. Two explanations for these rather disappointing results can be put forward, either animal models of psychiatric disorders have failed to predict the clinical effectiveness of treatments or clinical trials have failed to detect the effects of these new drugs. A careful analysis of the literature reveals that both statements are true. Indeed, in some cases, clinical efficacy has been predicted on the basis of inappropriate animal models, although the contrary is also true, as some clinical trials have not targeted the appropriate dose or clinical population. On the one hand, refinement of animal models requires using species that have better homological validity, designing models that rely on experimental manipulations inducing pathological features, and trying to model subtypes of depression. On the other hand, clinical research should consider carefully the results from preclinical studies, in order to study these compounds at the correct dose, in the appropriate psychiatric nosological entity or symptomatology, in relevant subpopulations of patients characterized by specific biomarkers. To achieve these goals, translational research has to strengthen the dialogue between basic and clinical science.

  14. Total hip arthroplasty following failed fixation of proximal hip fractures

    Directory of Open Access Journals (Sweden)

    Srivastav Shekhar

    2008-01-01

    Full Text Available Background: Most proximal femoral fractures are successfully treated with internal fixation but a failed surgery can be very distressing for the patient due to pain and disability. For the treating surgeon it can be a challenge to perform salvage operations. The purpose of this study was to evaluate the short-term functional outcome and complications of total hip arthroplasty (THA following failed fixation of proximal hip fracture. Materials and Methods: In a retrospective study, 21 hips in 20 patients (13 females and seven males with complications of operated hip fractures as indicated by either established nonunion or fracture collapse with hardware failure were analysed. Mean age of the patients was 62 years (range 38 years to 85 years. Nine patients were treated for femoral neck fracture, 10 for intertrochanteric (I/T fracture and two for subtrochanteric (S/T fracture of the hip. Uncemented THA was done in 11 cases, cemented THA in eight hip joints and hybrid THA in two patients. Results: The average duration of follow-up was four years (2-13 years. The mean duration of surgery was 125 min and blood loss was 1300 ml. There were three dislocations postoperatively. Two were managed conservatively and one was operated. There was one superficial infection and one deep infection. Only one patient required a walker while four required walking stick for ambulation. The mean Harris Hip score increased from 32 preoperatively to 79 postoperatively at one year interval. Conclusion: Total hip arthroplasty is an effective salvage procedure after failed osteosynthesis of hip fractures. Most patients have good pain relief and functional improvements inspite of technical difficulties and high complication rates than primary arthroplasty.

  15. Fail-safe neutron shutter used for thermal neutron radiography

    Energy Technology Data Exchange (ETDEWEB)

    Sachs, R.D.; Morris, R.A.

    1976-11-01

    A fail-safe, reliable, easy-to-use neutron shutter was designed, built, and put into operation at the Omega West Reactor, Los Alamos Scientific Laboratory. The neutron shutter will be used primarily to perform thermal neutron radiography, but is also available for a highly collimated source of thermal neutrons (neutron flux = 3.876 x 10/sup 6/ (neutrons)/(cm/sup 2/.s)). Neutron collimator sizes of either 10.16 by 10.16 cm or 10.16 by 30.48 cm are available.

  16. Google+ is Google's Facebook killer doomed to fail?

    CERN Document Server

    Dino, G

    2012-01-01

    Do you have a Facebook profile? How about a Google+ page? Which do you prefer: Facebook or Google+? You may have both, but not use one as often as the other. You may have just one while waiting for the right time to join the other. The question is: When is the right time? Are you waiting to see which one is the better product? This issue has been the talk of the cybersphere since Google+ was released - will it be the Facebook killer that a number of other social media sites in the past have failed to become?

  17. A Novel Endoscopic Technique for Failed Nasogastric Tube Placement.

    Science.gov (United States)

    Boston, Andrew G

    2015-10-01

    Direct visualization of the nasopharynx gives the otolaryngologist a unique advantage for addressing difficult nasopharyngeal anatomy. One common situation is being consulted to assist when the blind placement of a nasogastric tube has failed. A novel technique for managing a patient with a nasogastric tube embedded in the adenoid remnant is described with illustrations. The atraumatic method is easily employed by a resident armed with a portable nasolaryngoscope and plain suture. By using a repeated pull-through technique, the nasogastric tube can be guided past difficult nasopharyngeal anatomy and into a position from where it can be advanced into the patient's esophagus.

  18. Surgical management of vestibular schwannomas after failed radiation treatment.

    Science.gov (United States)

    Nonaka, Yoichi; Fukushima, Takanori; Watanabe, Kentaro; Friedman, Allan H; Cunningham, Calhoun D; Zomorodi, Ali R

    2016-04-01

    Increasing numbers of patients with vestibular schwannoma (VS) have been treated with focused-beam stereotactic radiation treatment (SRT) including Gamma knife, CyberKnife, X-knife, Novalis, or proton beam therapy. The purpose of this study was to document the incidence of tumor regrowth or symptoms that worsened or first developed following SRT and to discuss surgical strategies for patients who have failed SRT for VS. A consecutive series of 39 patients with SRT failed VS were surgically treated. Clinical symptoms, tumor regrowth at follow-up, intraoperative findings, and surgical outcome were evaluated. There were 15 males and 24 females with a mean age of 51.8 years. Thirty-six patients (92.3%) demonstrated steady tumor growth after SRT. Two (5.1%) patients with slight increase of the mass underwent surgical resection because of development of unbearable facial pain. Symptoms that worsened or newly developed following SRT in this series were deafness (41%), dizziness (35.9%), facial numbness (25.6%), tinnitus (20.5%), facial nerve palsy (7.7%), and facial pain (7.7%). Intraoperative findings demonstrated fibrous changes of the tumor mass, cyst formation, and brownish-yellow or purple discoloration of the tumor capsule. Severe adhesions between the tumor capsule and cranial nerves, vessels, and the brainstem were observed in 69.2%. Additionally, the facial nerve was more fragile and irritable in all cases. Gross total resection (GTR) was achieved in 33.3% of patients, near-total resection (NTR) in 35.9%, and subtotal resection (STR) in 30.8% of patients. New facial nerve palsy was seen in seven patients (19.4%) postoperatively. Our findings suggest that patients with VS who fail SRT with either tumor progression or worsening of clinical symptoms will have an increased rate of adhesions to the neurovascular structures and may have radiation-influenced neuromalacia. Salvage surgery of radiation-failed tumors is more difficult and will have a higher risk of

  19. Has Multiculturalism Really Failed? A Canadian Muslim Perspective

    Directory of Open Access Journals (Sweden)

    Baljit Nagra

    2013-12-01

    Full Text Available In recent years, claims that multiculturalism has created segregated communities, encouraged terrorism, and failed to foster shared national identities in western nations have gained popularity. In this paper, we use young Canadian Muslims’ lived experience of multiculturalism to reflect on this debate. Contrary to popular rhetoric, our interviews of 50 young Muslim adults show that many maintain a dual Canadian-Muslim identity by utilizing the ideology of multiculturalism, even though they are increasingly stigmatized for their religion. These findings lead us to problematize the discourse surrounding the ‘failure’ of multiculturalism and to highlight the contradictions within it.

  20. A Perplexed Economist Confronts 'too Big to Fail'

    Directory of Open Access Journals (Sweden)

    Scherer, F. M.

    2010-12-01

    Full Text Available This paper examines premises and data underlying the assertion that some financial institutions in the U.S. economy were "too big to fail" and hence warranted government bailout. It traces the merger histories enhancing the dominance of six leading firms in the U. S. banking industry and he sharp increases in the concentration of financial institution assets accompanying that merger wave. Financial institution profits are found to have soared in tandem with rising concentration. The paper advances hypotheses why these phenomena might be related and surveys relevant empirical literature on the relationships between market concentration, interest rates received and charged by banks, and economies of scale in banking.

  1. Predictors of failed enema reduction in childhood intussusception.

    Science.gov (United States)

    Fike, Frankie B; Mortellaro, Vincent E; Holcomb, George W; St Peter, Shawn D

    2012-05-01

    Initial management of intussusception is enema reduction. Data are scarce on predicting which patients are unlikely to have a successful reduction. Therefore, we reviewed our experience to identify factors predictive of enema failure. A retrospective review of all episodes of intussusception over the past 10 years was conducted. Demographics, presentation variables, colonic extent of intussusceptions, and hospital course were collected. Extent of intussusception was classified as right, transverse, descending, and rectosigmoid. Episodes were grouped as success or failure of enema reduction and compared using the Student t test for continuous variables and χ(2) test for dichotomous variables. Significance was P less than .05. We identified 405 episodes of intussusception and 371 attempts at enema reduction. There were 285 successful enema reductions. There was no difference between groups in age; sex; or the presence of emesis, fever, or abdominal mass. The failed enema group was more likely to have had symptoms over 24 hours before presentation (P = .006), bloody diarrhea (P Predictors of failed enema reduction of intussusception include presence of symptoms over 24 hours, diarrhea, lethargy, and distal extent of intussusception. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Adult cancer clinical trials that fail to complete: an epidemic?

    Science.gov (United States)

    Stensland, Kristian D; McBride, Russell B; Latif, Asma; Wisnivesky, Juan; Hendricks, Ryan; Roper, Nitin; Boffetta, Paolo; Hall, Simon J; Oh, William K; Galsky, Matthew D

    2014-09-01

    The number and diversity of cancer therapeutics in the pipeline has increased over the past decade due to an enhanced understanding of cancer biology and the identification of novel therapeutic targets. At the same time, the cost of bringing new drugs to market and the regulatory burdens associated with clinical drug development have progressively increased. The finite number of eligible patients and limited financial resources available to evaluate promising new therapeutics represent rate-limiting factors in the effort to translate preclinical discoveries into the next generation of standard therapeutic approaches. Optimal use of resources requires understanding and ultimately addressing inefficiencies in the cancer clinical trials system. Prior analyses have demonstrated that a large proportion of trials initiated by the National Cancer Institute (NCI) Cooperative Group system are never completed. While NCI Cooperative Group trials are important, they represent only a small proportion of all cancer clinical trials performed. Herein, we explore the problem of cancer clinical trials that fail to complete within the broader cancer clinical trials enterprise. Among 7776 phase II-III adult cancer clinical trials initiated between 2005-2011, we found a seven-year cumulative incidence of failure to complete of approximately 20% (95% confidence interval = 18% to 22%). Nearly 48000 patients were enrolled in trials that failed to complete. These trials likely contribute little to the scientific knowledge base, divert resources and patients from answering other critical questions, and represent a barrier to progress.

  3. Recapitulating maladaptive, multiscale remodeling of failing myocardium on a chip.

    Science.gov (United States)

    McCain, Megan L; Sheehy, Sean P; Grosberg, Anna; Goss, Josue A; Parker, Kevin Kit

    2013-06-11

    The lack of a robust pipeline of medical therapeutic agents for the treatment of heart disease may be partially attributed to the lack of in vitro models that recapitulate the essential structure-function relationships of healthy and diseased myocardium. We designed and built a system to mimic mechanical overload in vitro by applying cyclic stretch to engineered laminar ventricular tissue on a stretchable chip. To test our model, we quantified changes in gene expression, myocyte architecture, calcium handling, and contractile function and compared our results vs. several decades of animal studies and clinical observations. Cyclic stretch activated gene expression profiles characteristic of pathological remodeling, including decreased α- to β-myosin heavy chain ratios, and induced maladaptive changes to myocyte shape and sarcomere alignment. In stretched tissues, calcium transients resembled those reported in failing myocytes and peak systolic stress was significantly reduced. Our results suggest that failing myocardium, as defined genetically, structurally, and functionally, can be replicated in an in vitro microsystem by faithfully recapitulating the structural and mechanical microenvironment of the diseased heart.

  4. Possible involvement of phosphorylated heat-shock factor-1 in changes in heat shock protein 72 induction in the failing rat heart following myocardial infarction.

    Science.gov (United States)

    Marunouchi, Tetsuro; Murata, Mao; Takagi, Norio; Tanonaka, Kouichi

    2013-01-01

    It is supposed that an increase in the level of heat shock protein 72 (HSP72) in the failing heart would be beneficial for reducing the myocardial damage. However, the induction of HSP72 after an exposure to heat shock is blunted in the failing rat heart following myocardial infarction. In this study, to clarify the possible mechanisms underlying this reduction in the ability for HSP72 induction in the failing heart, the possible involvement of heat-shock factor-1 (HSF1), an HSP transcription factor, in this reduction was examined. When hemodynamic parameters of rats with myocardial infarction 8 weeks after coronary artery ligation were measured, the animals showed the signs of chronic heart failure. The HSF1 content was increased in the viable myocardium in the failing heart. The ability to induce cardiac HSP72 was reduced after an exposure to hyperthermia. The level of HSF1 in the cytosolic fraction from the failing heart with or without exposure to hyperthermia was increased, whereas that of HSF1 in the nuclear fraction was reduced. In the failing heart, the level of HSF1 on its serine 303 (Ser303) residue, which phosphorylation represses HSF1, was increased. These findings suggest that HSF1 translocation from the cytosol into the nucleus was attenuated after an exposure to hyperthermia and that an increase in the phosphorylation of HSF1 Ser303 was involved in the impairment of heat shock-induced HSP72 induction in the failing heart following myocardial infarction.

  5. Lotka-Volterra pairwise modeling fails to capture diverse pairwise microbial interactions

    Science.gov (United States)

    Momeni, Babak; Xie, Li; Shou, Wenying

    2017-01-01

    Pairwise models are commonly used to describe many-species communities. In these models, an individual receives additive fitness effects from pairwise interactions with each species in the community ('additivity assumption'). All pairwise interactions are typically represented by a single equation where parameters reflect signs and strengths of fitness effects ('universality assumption'). Here, we show that a single equation fails to qualitatively capture diverse pairwise microbial interactions. We build mechanistic reference models for two microbial species engaging in commonly-found chemical-mediated interactions, and attempt to derive pairwise models. Different equations are appropriate depending on whether a mediator is consumable or reusable, whether an interaction is mediated by one or more mediators, and sometimes even on quantitative details of the community (e.g. relative fitness of the two species, initial conditions). Our results, combined with potential violation of the additivity assumption in many-species communities, suggest that pairwise modeling will often fail to predict microbial dynamics. DOI: http://dx.doi.org/10.7554/eLife.25051.001 PMID:28350295

  6. Microbial water quality before and after the repair of a failing onsite wastewater treatment system adjacent to coastal waters

    Science.gov (United States)

    Conn, K.E.; Habteselassie, M.Y.; Denene, Blackwood A.; Noble, R.T.

    2012-01-01

    Aims: The objective was to assess the impacts of repairing a failing onsite wastewater treatment system (OWTS, i.e., septic system) as related to coastal microbial water quality. Methods and Results: Wastewater, groundwater and surface water were monitored for environmental parameters, faecal indicator bacteria (total coliforms, Escherichia coli, enterococci) and the viral tracer MS2 before and after repairing a failing OWTS. MS2 results using plaque enumeration and quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) often agreed, but inhibition limited the qRT-PCR assay sensitivity. Prerepair, MS2 persisted in groundwater and was detected in the nearby creek; postrepair, it was not detected. In groundwater, total coliform concentrations were lower and E.??coli was not detected, while enterococci concentrations were similar to prerepair levels. E.??coli and enterococci surface water concentrations were elevated both before and after the repair. Conclusions: Repairing the failing OWTS improved groundwater microbial water quality, although persistence of bacteria in surface water suggests that the OWTS was not the singular faecal contributor to adjacent coastal waters. A suite of tracers is needed to fully assess OWTS performance in treating microbial contaminants and related impacts on receiving waters. Molecular methods like qRT-PCR have potential but require optimization. Significance and Impact of Study: This is the first before and after study of a failing OWTS and provides guidance on selection of microbial tracers and methods. ?? 2011 The Authors. Journal of Applied Microbiology ?? 2011 The Society for Applied Microbiology.

  7. The growth hormone receptor gene-disrupted mouse fails to respond to an intermittent fasting diet.

    Science.gov (United States)

    Arum, Oge; Bonkowski, Michael S; Rocha, Juliana S; Bartke, Andrzej

    2009-12-01

    The interaction of longevity-conferring genes with longevity-conferring diets is poorly understood. The growth hormone receptor gene-disrupted (GHR-KO) mouse is long lived; and this longevity is not responsive to 30% caloric restriction, in contrast to wild-type animals from the same strain. To determine whether this may have been limited to a particular level of dietary restriction, we subjected GHR-KO mice to a different dietary restriction regimen, an intermittent fasting diet. The intermittent fasting diet increased the survivorship and improved insulin sensitivity of normal males, but failed to affect either parameter in GHR-KO mice. From the results of two paradigms of dietary restriction, we postulate that GHR-KO mice would be resistant to any manner of dietary restriction; potentially due to their inability to further enhance insulin sensitivity. Insulin sensitivity may be a mechanism and/or a marker of the lifespan extending potential of an intervention.

  8. [Multimodal therapy concepts for failed back surgery syndrome].

    Science.gov (United States)

    Casser, Hans-Raimund

    2016-09-01

    Failed back surgery syndrome (FBSS) is a frequent complication (15-40 %) of lumbar disc surgery and is rarely successfully treated by surgery with the exception of a re-prolapse associated with radicular pain. Multimodal pain treatment, however, is indicated by a lack of pathoanatomical correlates, unclear cause and psychosocial risk factors.This review describes a standardized non-operative treatment starting with broad interdisciplinary clarification by medical, psychological and physiotherapeutic means (assessment).If the conditions for multimodal pain therapy are met, the OPS 8‑918-procedure can be applied to avoid chronic developing pain. In doing so, the already issued quality standards and guidelines for documentation should be respected.

  9. Optimised to Fail: Card Readers for Online Banking

    Science.gov (United States)

    Drimer, Saar; Murdoch, Steven J.; Anderson, Ross

    The Chip Authentication Programme (CAP) has been introduced by banks in Europe to deal with the soaring losses due to online banking fraud. A handheld reader is used together with the customer’s debit card to generate one-time codes for both login and transaction authentication. The CAP protocol is not public, and was rolled out without any public scrutiny. We reverse engineered the UK variant of card readers and smart cards and here provide the first public description of the protocol. We found numerous weaknesses that are due to design errors such as reusing authentication tokens, overloading data semantics, and failing to ensure freshness of responses. The overall strategic error was excessive optimisation. There are also policy implications. The move from signature to PIN for authorising point-of-sale transactions shifted liability from banks to customers; CAP introduces the same problem for online banking. It may also expose customers to physical harm.

  10. Unaware person recognition from the body when face identification fails.

    Science.gov (United States)

    Rice, Allyson; Phillips, P Jonathon; Natu, Vaidehi; An, Xiaobo; O'Toole, Alice J

    2013-11-01

    How does one recognize a person when face identification fails? Here, we show that people rely on the body but are unaware of doing so. State-of-the-art face-recognition algorithms were used to select images of people with almost no useful identity information in the face. Recognition of the face alone in these cases was near chance level, but recognition of the person was accurate. Accuracy in identifying the person without the face was identical to that in identifying the whole person. Paradoxically, people reported relying heavily on facial features over noninternal face and body features in making their identity decisions. Eye movements indicated otherwise, with gaze duration and fixations shifting adaptively toward the body and away from the face when the body was a better indicator of identity than the face. This shift occurred with no cost to accuracy or response time. Human identity processing may be partially inaccessible to conscious awareness.

  11. Intended to Fail? Jatropha Development Project in Indonesia

    Directory of Open Access Journals (Sweden)

    Tristam P. Moeliono

    2016-07-01

    Full Text Available Article offers an analytical description of the legal framework of the Indonesian biofuel energy policy : commercialization of Jatropha. Its purpose is to explain why the legal framework failed. Methodology used to collect data is library research, including shifting through related legal documents. Additional information was collected through interviews with key informants. The purpose is to be able to place the relevant legal framework within a broader economic-political context. The main findings were that government intervention in the economic sector (commercialization of Jatropha, were made more in the spirit of poverty eradication programs and lessening government financial burden in providing cheap fossil fuel. Cautious approach based on economic calculations and other considerations (Jatropha not being sufficiently tested and developed as biofuel crop as advised by researchers (2006 working under the auspices of the Ministry of Agriculture were simply ignored. 

  12. Signaling pathways in failing human heart muscle cells.

    Science.gov (United States)

    Drexler, H; Hasenfuss, G; Holubarsch, C

    1997-07-01

    Experimental studies have delineated important signaling pathways in cardiomyocytes and their alterations in heart failure; however, there is now evidence that these observations are not necessarily applicable to human cardiac muscle cells. For example, angiotensin II (A II) does not exert positive inotropic effects in human ventricular muscle cells, in contrast to observation in rats. Thus, it is important to elucidate cardiac signaling pathways in humans in order to appreciate the functional role of neurohumoral or mechanical stimulation in human myocardium in health and disease. In the present article, we review signal pathways in the failing human heart based on studies in human cardiac tissues and in vivo physiological studies related to A II, nitric oxide, and β-adrenergic stimulation. (Trends Cardiovasc Med 1997; 7:151-160). © 1997, Elsevier Science Inc.

  13. The Nixon years: failed national health reform from both parties.

    Science.gov (United States)

    Goldfield, N

    1992-01-01

    In the November 1991 elections, popular support for national health reform (NHR) enabled Harry Wofford to become a U.S. Senator from Pennsylvania. Since then a bevy of congressional proposals to reform America's health care system have emerged, with even national health insurance, or a single payer system, becoming a prominent contender for the first time in 20 years. National health reform is now a regular feature on the evening news. However, this is not the first time that NHR has attracted national attention. As pointed out in the first article in this series (Physician Executive, March-April 1992, page 23), there have been numerous efforts to enact NHR in the U.S. Each has failed because of strident opposition by interest groups, lack of active presidential interest in the specific legislation, and the absence of strong popular interest.

  14. Behavior of Puerto Rican parrots during failed nesting attempts

    Science.gov (United States)

    Wilson, K.A.; Wilson, M.H.; Field, R.

    1997-01-01

    We compared patterns of nesting behavior of four pairs of Puerto Rican Parrots (Amazona vittata) that experienced failed nesting attempts to behavior of four pairs of parrots that experienced no substantial nest problems and successfully fledged young without management intervention. Only changes in female parrots' behavior were clearly associated with nest failure. During incubation, decreases in nest attendance, increases in duration of recesses, and increases in frequency of nest entries by female parrots were associated with imminent abandonment of nests. During early chick rearing, similar behavior was associated with the loss of broods. Low nest attendance and long recesses by female parrots during incubation were also associated with successful hatching of eggs followed by death of young several days later. The behavior patterns and changes in Puerto Rican Parrot nesting behavior described in this paper may alert biologists to nest problems that might be mitigated by management intervention.

  15. Why did ISO 9001:2008 system fail to deliver?

    Science.gov (United States)

    Langford, Melvyn

    2014-02-01

    This article is based on an actual investigation undertaken, and summarises the subsequent report's findings and observations. It has been anonymised for obvious reasons. In May 2013 an analysis was undertaken by a multidisciplinary team that compared an NHS Trust estates department's managerial systems against the NHS national recommendations. The conclusions stated that: 'There was a systemic failure across a large number of topics generating intolerable/substantial risks to the organisation, its staff, and patients; this despite the department's managerial systems being accredited to the International Standard ISO 9001:2008'. The natural question raised when presented with this demonstrable and auditable evidence was: 'Why did the ISO 9001:2008 system fail?'

  16. Unrecognized failed airway management using a supraglottic airway device.

    Science.gov (United States)

    Vithalani, Veer D; Vlk, Sabrina; Davis, Steven Q; Richmond, Neal J

    2017-10-01

    911 Emergency Medical Services (EMS) systems utilize supraglottic devices for either primary advanced airway management, or for airway rescue following failed attempts at direct laryngoscopy endotracheal intubation. There is, however, limited data on objective confirmation of supraglottic airway placement in the prehospital environment. Furthermore, the ability of EMS field providers to recognize a misplaced airway is unknown. Retrospective review of patients who underwent airway management using the King LTS-D supraglottic airway in a large urban EMS system, between 3/1/15-9/30/2015. Subjective success was defined as documentation of successful airway placement by the EMS provider. Objective success was confirmed by review of waveform capnography, with the presence of a 4-phase waveform greater than 5mmHg. Sensitivity and specificity of the field provider's assessment of success were then calculated. A total of 344 supraglottic airway attempts were reviewed. No patients met obvious death criteria. 269 attempts (85.1%) met criteria for both subjective and objective success. 19 attempts (5.6%) were recognized failures by the EMS provider. 47 (13.8%) airways were misplaced but unrecognized by the EMS provider. 4 attempts (1.2%) were correctly placed but misidentified as failures, leading to the unnecessary removal and replacement of the airway. Sensitivity of the provider's assessment was 98.5%; specificity was 28.7%. The use of supraglottic airway devices results in unrecognized failed placement. Appropriate utilization and review of waveform capnography may remedy a potential blind-spot in patient safety, and systemic monitoring/feedback processes may therefore be used to prevent unrecognized misplaced airways. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Open Latarjet procedure for failed arthroscopic Bankart repair.

    Science.gov (United States)

    Flinkkilä, T; Sirniö, K

    2015-02-01

    This retrospective study assessed the functional results of open Latarjet operation for recurrence of instability after arthroscopic Bankart repair in a consecutive series of patients. Fifty two patients (mean age 28.4 [range 17-62] years, 45 men) were operated on using open Latarjet operation after one (n=46) or two (n=6) failed arthroscopic Bankart repairs. The indication for revision surgery was recurrent dislocation or subluxation. Fifty patients had a Hill-Sachs lesion and 32 patients had glenoid bone lesions on plain radiographs. No attempt was made to grade the severity of bony pathology. Functional outcome and stability of 49 shoulders were assessed after an average follow-up of 38 (range 24-85) months using Western Ontario Shoulder Instability (WOSI) score, Oxford shoulder instability score, and subjective shoulder value (SSV). Forty-two patients had a stable shoulder at follow-up. Seven of 49 (14%) had symptoms of instability; one patient had recurrent dislocation, and six patients had subluxations. Mean WOSI, Oxford, and SSV scores were 83.9, 19.9, and 84.9, respectively. All scores were significantly better in patients who had a stable shoulder compared with those who had an unstable shoulder (WOSI 86.8 vs. 64.3; Oxford 18.2 vs. 30.8; and SSV 88.3 vs. 61.7; PLatarjet operation is a good option for failed arthroscopic Bankart repair. The instability recurrence rate is acceptable and the reoperation rate was low. Level IV, retrospective case series. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  18. Evaluation and Management of Failed Shoulder Instability Surgery

    Science.gov (United States)

    Cartucho, António; Moura, Nuno; Sarmento, Marco

    2017-01-01

    Background: Failed shoulder instability surgery is mostly considered to be the recurrence of shoulder dislocation but subluxation, painful or non-reliable shoulder are also reasons for patient dissatisfaction and should be considered in the notion. Methods: The authors performed a revision of the literature and online contents on evaluation and management of failed shoulder instability surgery. Results: When we look at the reasons for failure of shoulder instability surgery we point the finger at poor patient selection, technical error and an additional traumatic event. More than 80% of surgical failures, for shoulder instability, are associated with bone loss. Quantification of glenoid bone loss and investigation of an engaging Hill-Sachs lesion are determining facts. Adequate imaging studies are determinant to assess labrum and capsular lesions and to rule out associated pathology as rotator cuff tears. CT-scan is the method of choice to diagnose and quantify bone loss. Arthroscopic soft tissue procedures are indicated in patients with minimal bone loss and no contact sports. Open soft tissue procedures should be performed in patients with small bone defects, with hiperlaxity and practicing contact sports. Soft tissue techniques, as postero-inferior capsular plication and remplissage, may be used in patients with less than 25% of glenoid bone loss and Hill-Sachs lesions. Bone block procedures should be used for glenoid larger bone defects in the presence of an engaging Hill-Sachs lesion or in the presence of poor soft tissue quality. A tricortical iliac crest graft may be used as a primary procedure or as a salvage procedure after failure of a Bristow or a Latarjet procedure. Less frequently, the surgeon has to address the Hill-Sachs lesion. When a 30% loss of humeral head circumference is present a filling graft should be used. Conclusion: Reasons for failure are multifactorial. In order to address this entity, surgeons must correctly identify the causes and

  19. Microbial diversity in failed endodontic root-filled teeth

    Institute of Scientific and Technical Information of China (English)

    ZHANG Chen; HOU Ben-xiang; ZHAO Huan-ying; SUN Zheng

    2012-01-01

    Background Persistent/secondary infections of human root canals play an important role in the failure of endodontic treatment.This study used 16S rRNA sequencing to assess microbial diversity in root-filled teeth associated with failed endodontic treatment.Methods DNA was extracted from 15 teeth with persistent intraradicular infections,and the 16S rRNA of all present bacteria were amplified by PCR,followed by cloning and sequencing of the 16S rRNA amplicons.Results All sample extracts were positive for PCR amplification using the universal 16S rRNA gene primers.Negative control reactions yielded no amplicons.Sixty-five phylotypes belonging to seven phyla were identified from 760 clones; a mean of 9.4 phylotypes were detected in each sample (range 3-15).Twenty-eight phylotypes were detected in more than one sample,revealing a high inter-sample variability.Parvimonas micra (60%,9/15),Solobacterium moore (47%,7/15),Dialister invisus (33%,5/15),Enterococcus faecalis (33%,5/15),Filifactor alocis (27%,4/15),and Fusobacterium nucleatum (27%,4/15) were the prevalent species.Nineteen as-yet-uncultivated phylotypes were identified,comprising a substantial proportion of the bacteria in many cases.Conclusions Persistent intraradicular infections were present in all root-filled teeth associated with failed endodontic treatment.The current observations reveal new candidate endodontic pathogens,including as-yet-uncultivated bacteria and phylotypes that may participate in the mixed infections associated with post-treatment apical periodontitis.

  20. Outcomes of Autologous Chondrocyte Implantation in the Knee following Failed Microfracture

    Science.gov (United States)

    Riff, Andrew Joseph; Yanke, Adam Blair; Tilton, Annemarie K.; Cole, Brian J.

    2016-01-01

    patellar anteromedialization, 9 patients underwent meniscal allograft, and 6 underwent realignment ostetomies (5 HTO, 1 DFO). Follow-up was available on 84 of 92 patients (91%) at an average length of follow-up of 47 months (range, 24-102 months). The control group of patients was well matched with regard to age, gender, BMI, workers compensation status, and preoperative subjective scores. Failure, defined by need for further cartilage restoration or knee arthroplasty, occurred in 8 patients (3 osteochondral allograft, 3 TKA, 1 revision ACI, 1 Denovo NT). Seventeen additional patients underwent reoperation for intra-articular debridement. There was no difference between the failure rate (8.7% v. 2.9%, p=0.21) or reoperation rate (27.2% v. 27.2%, p=0.98) in the study and control groups. For the study group, significant improvements were witnessed postoperatively for all measured questionairre parameters. No significant differences were witnessed between the study and control groups (p>0.05) with regard to any of the postoperative subjective parameters (Figure). Conclusion: In patients with discrete articular cartilage lesions of the knee and history of failed microfracture, ACI may render favorable clinical outcomes comparable to primary ACI. While other series have demonstrated inferior results following previous microfracture, our series suggests that in appropriately selected patients ACI may be used successfully as a second line treatment following failed microfracture.

  1. Associations of Pass-Fail Outcomes with Psychological Health of First-Year Medical Students in a Malaysian Medical School

    Directory of Open Access Journals (Sweden)

    Muhamad S. B. Yusoff

    2013-02-01

    Full Text Available Objectives: The demanding and intense environment of medical training can create excessive pressures on medical students that eventually lead to unfavorable consequences, either at a personal or professional level. These consequences can include poor academic performance and impaired cognitive ability. This study was designed to explore associations between pass-fail outcome and psychological health parameters (i.e. stress, anxiety, and depression symptoms. Methods: A cross-sectional study was conducted on a cohort of first-year medical students in a Malaysian medical school. The depression anxiety stress scale 21-item assessment (DASS-21 was administered to them right after the final paper of the first-year final examination. Their final examination outcomes (i.e. pass or fail were traced by using their student identity code (ID through the Universiti Sains Malaysia academic office. Results: A total of 194 (98.0% of medical students responded to the DASS-21. An independent t-test showed that students who passed had significantly lower stress, anxiety, and depression symptoms than those who failed the first-year final examination (P <0.05. Those who experienced moderate to high stress were at 2.43 times higher risk for failing the examination than those who experienced normal to mild stress. Conclusion: Medical students whofailed in the final examination had higher psychological distress than those who passed the examination. Those who experienced high stress levels were more likely to fail than those who did not. Reducing the psychological distress of medical students prior to examination may help them to perform better in the examination.

  2. Proteomic analysis of mitochondria reveals a metabolic switch from fatty acid oxidation to glycolysis in the failing heart

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    This work characterizes the mitochondrial proteomic profile in the failing heart and elucidates the molecular basis of mitochondria in heart failure. Heart failure was induced in rats by myocardial infarction, and mitochondria were isolated from hearts by differential centrifugation. Using two-dimensional gel electrophoresis and matrix-assisted laser desorption/ionization-time of flight mass spectrometry, a system biology approach was employed to investigate differences in mitochondrial proteins between normal and failing hearts. Mass spectrometry identified 27 proteins differentially expressed that involved in energy metabolism. Among those, the up-regulated proteins included tricarboxylic acid cycle enzymes and pyruvate dehydrogenase complex subunits while the down-regulated proteins were involved in fatty acid oxidation and the OXPHOS complex. These results suggest a substantial metabolic switch from free fatty acid oxidation to glycolysis in heart failure and provide molecular evidence for alterations in the structural and functional parameters of mitochondria that may contribute to cardiac dysfunction during ischemic injury.

  3. 49 CFR 199.103 - Use of persons who fail or refuse a drug test.

    Science.gov (United States)

    2010-10-01

    ... SAFETY DRUG AND ALCOHOL TESTING Drug Testing § 199.103 Use of persons who fail or refuse a drug test. (a) An operator may not knowingly use as an employee any person who— (1) Fails a drug test required by... 49 Transportation 3 2010-10-01 2010-10-01 false Use of persons who fail or refuse a drug test. 199...

  4. 40 CFR 205.171-8 - Passing or failing under SEA.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Passing or failing under SEA. 205.171... Passing or failing under SEA. (a) A failing exhaust system is one which, when installed on any motorcycle... equal to the number in Column A, the sample passes. (c) Pass or failure of a SEA takes place when...

  5. 40 CFR 205.160-6 - Passing or failing under SEA.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Passing or failing under SEA. 205.160... failing under SEA. (a) A failing vehicle is one whose measured noise level is in excess of the applicable... vehicles is less than or equal to the number in Column A, the sample passes. (c) Pass or failure of an...

  6. FGF23 fails to inhibit uremic parathyroid glands.

    Science.gov (United States)

    Canalejo, Rocío; Canalejo, Antonio; Martinez-Moreno, Julio Manuel; Rodriguez-Ortiz, M Encarnacion; Estepa, Jose C; Mendoza, Francisco Javier; Munoz-Castaneda, Juan Rafael; Shalhoub, Victoria; Almaden, Yolanda; Rodriguez, Mariano

    2010-07-01

    Fibroblast growth factor 23 (FGF23) modulates mineral metabolism by promoting phosphaturia and decreasing the production of 1,25-dihydroxyvitamin D(3). FGF23 decreases parathyroid hormone (PTH) mRNA and secretion, but despite a marked elevation in FGF23 in uremia, PTH production increases. Here, we investigated the effect of FGF23 on parathyroid function in normal and uremic hyperplastic parathyroid glands in rats. In normal parathyroid glands, FGF23 decreased PTH production, increased expression of both the parathyroid calcium-sensing receptor and the vitamin D receptor, and reduced cell proliferation. Furthermore, FGF23 induced phosphorylation of extracellular signal-regulated kinase 1/2, which mediates the action of FGF23. In contrast, in hyperplastic parathyroid glands, FGF23 did not reduce PTH production, did not affect expression of the calcium-sensing receptor or vitamin D receptor, and did not affect cell proliferation. In addition, FGF23 failed to activate the extracellular signal-regulated kinase 1/2-mitogen-activated protein kinase pathway in hyperplastic parathyroid glands. We observed very low expression of the FGF23 receptor 1 and the co-receptor Klotho in uremic hyperplastic parathyroid glands, which may explain the lack of response to FGF23 in this tissue. In conclusion, in hyperparathyroidism secondary to renal failure, the parathyroid cells resist the inhibitory effects of FGF23, perhaps as a result of the low expression of FGF23 receptor 1 and Klotho in this condition.

  7. Experimenting `learn by doing' and `learn by failing'

    Science.gov (United States)

    Pozzi, Rossella; Noè, Carlo; Rossi, Tommaso

    2015-01-01

    According to the literature, in recent years, developing experiential learning has fulfilled the requirement of a deep understanding of lean philosophy by engineering students, demonstrating the advantages and disadvantages of some of the key principles of lean manufacturing. On the other hand, the literature evidences how some kinds of game-based experiential learning overlook daily difficulties, which play a central role in manufacturing systems. To fill the need of a game overcoming such lack of vision, an innovative game direct in-field, named Kart Factory, has been developed. Actual production shifts are simulated, while keeping all the elements peculiar to a real production set (i.e. complexity, effort, safety). The working environment is a real pedal car assembly department, the products to be assembled have relevant size and weight (i.e. up to 35 kg approximately), and the provided tools are real production equipment (e.g. keys, screwdrivers, trans-pallets, etc.). Due to the need to maximise the impact on students, a labour-intensive process characterises the production department. The whole training process is based on three educational principles: Experience Value Principle, Error Value Principle, and Team Value Principle. As the 'learn by doing' and 'learn by failing' are favoured, the theory follows the practice, while crating the willingness to 'do' instead of just designing or planning. The gathered data prove the Kart Factory's effectiveness in reaching a good knowledge of lean concepts, notwithstanding the students' initial knowledge level.

  8. Dam and spillway construction to remediate a failed reservoir rim

    Energy Technology Data Exchange (ETDEWEB)

    Kostaschuk, R.; Grover, P.; Wanner, C. [AMEC Earth and Environmental Ltd., Calgary, AB (Canada); Lockhart, S. [Priddis Greens Golf and Country Club, Priddis, AB (Canada)

    2009-07-01

    Priddis Greens Golf and Country Club (PGGCC) is located in southern Alberta, about 25 kilometres southwest of Calgary. Lake Loon reservoir supplies water for irrigation of the 36-hole golf course and also supplies water to the water treatment plant that provides potable water to the golf course and the housing development. An earthen spillway channel on the reservoir rim failed by erosion at the PGGCC during an extreme flood event in June 2005. The failure resulted in loss of the reservoir for the water supply system servicing the golf course and its housing cooperative. Design and reconstruction of the reservoir rim were undertaken and a new concrete spillway structure was built. This paper provided background information on the June 2005 failure and provided an overview of the design concept for reservoir restoration. The Alberta Environment permitting process was also outlined. Hydrology, flood management and spillway design were explained in detail. A geotechnical design of earthworks was also provided. The paper concluded with a discussion of an emergency preparedness and response plan and operation, maintenance and surveillance manual that were developed for the project. 2 refs., 20 figs.

  9. Requirements: Towards an understanding on why software projects fail

    Science.gov (United States)

    Hussain, Azham; Mkpojiogu, Emmanuel O. C.

    2016-08-01

    Requirement engineering is at the foundation of every successful software project. There are many reasons for software project failures; however, poorly engineered requirements process contributes immensely to the reason why software projects fail. Software project failure is usually costly and risky and could also be life threatening. Projects that undermine requirements engineering suffer or are likely to suffer from failures, challenges and other attending risks. The cost of project failures and overruns when estimated is very huge. Furthermore, software project failures or overruns pose a challenge in today's competitive market environment. It affects the company's image, goodwill, and revenue drive and decreases the perceived satisfaction of customers and clients. In this paper, requirements engineering was discussed. Its role in software projects success was elaborated. The place of software requirements process in relation to software project failure was explored and examined. Also, project success and failure factors were also discussed with emphasis placed on requirements factors as they play a major role in software projects' challenges, successes and failures. The paper relied on secondary data and empirical statistics to explore and examine factors responsible for the successes, challenges and failures of software projects in large, medium and small scaled software companies.

  10. Why does informed consent fail? A discourse analytic approach.

    Science.gov (United States)

    Ness, David E; Kiesling, Scott F; Lidz, Charles W

    2009-01-01

    Informed consent often fails to meet the intended goals that a prospective subject should understand fully and choose autonomously to participate in research. The current study is an attempt to understand such failures by applying linguistic methods of discourse analysis to the transcripts of informed consent interviews. Elements of conversation and of the frame of discourse were analyzed to understand how the participants shaped their spoken interaction during the interview. We looked at the degree to which the subject appeared to be fully informed, at the problem of therapeutic misconception, and at the degree to which the subject was helped to explore concerns relevant to the choice at hand. We found that lapses or miscommunications could be understood specifically in terms of conversational elements and framing. This kind of detailed, language-based analysis is an alternative to approaches that are more abstract and inferential, such as those that are based upon the attitudes or the cognitive performance of speakers. We discuss possible educational and research implications of this approach.

  11. Cluster Development Test 2: An Assessment of a Failed Test

    Science.gov (United States)

    Machin, Ricardo A.; Evans, Carol T.

    2009-01-01

    On 31 July 2008 the National Aeronautics and Space Administration Crew Exploration Vehicle Parachute Assembly System team conducted the final planned cluster test of the first generation parachute recovery system design. The two primary test objectives were to demonstrate the operation of the complete parachute system deployed from a full scale capsule simulator and to demonstrate the test technique of separating the capsule simulator from the Low Velocity Air Drop pallet used to extract the test article from a United States Air Force C-17 aircraft. The capsule simulator was the Parachute Test Vehicle with an accurate heat shield outer mold line and forward bay compartment of the Crew Exploration Vehicle Command Module. The Parachute Test Vehicle separated cleanly from the pallet following extraction, but failed to reach test conditions resulting in the failure of the test and the loss of the test assets. No personnel were injured. This paper will discuss the design of the test and the findings of the team that investigated the test, including a discussion of what were determined to be the root causes of the failure.

  12. CLINICAL EVALUATION OF FAILED ENDONASAL DCR OPERATIONS AND THEIR MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Mohammed Naveed

    2014-09-01

    Full Text Available INTRODUCTION: Endoscopic Intra nasal approach to by-pass the obstruction of lacrimal apparatus is a simple and commonly practiced surgery among the ENT Surgeons. Various modifications in the form of usage of micro drill, application of Mitomycin C and preserving the nasal flap to line the opening in the sac to name a few are being used. Recurrence of epiphora and closure of the neo opening is described and observed are labeled as failed endonasal DCR. This study makes an attempt to review retrospectively and prospectively to evaluate the degree of recurrence and causes of failure. OBJECTIVE OF THE STUDY: This study also attempts to determine the causes of failure of endonasal DCR and its subsequent management. Thus this study precludes the role of revision DCR. Materials and Methods: 50 patients who underwent endonasal DCR surgery at GGH Kurnool and reported with symptoms of returning of epiphora, purulent discharge from the eye were included. A detailed history taking and endoscopic examination done to find the cause of failure. An attempt is made to classify the causes and find suitable remedy.RESULTS:36% of the patients showed tendency to form synaechiae, 18.6% of patients presented with thick lacrimal crest, 9% of them showed formation of a thin veil like membrane over the neo-ostium. All the patients were subjected to revision surgery and subjective improvement in 92% of the patients reported at the time of reporting of the study.

  13. Fracture surface analysis of clinically failed fixed partial dentures.

    Science.gov (United States)

    Taskonak, B; Mecholsky, J J; Anusavice, K J

    2006-03-01

    Ceramic systems have limited long-term fracture resistance, especially when they are used in posterior areas or for fixed partial dentures. The objective of this study was to determine the site of crack initiation and the causes of fracture of clinically failed ceramic fixed partial dentures. Six Empress 2 lithia-disilicate (Li(2)O x 2SiO(2))-based veneered bridges and 7 experimental lithia-disilicate-based non-veneered ceramic bridges were retrieved and analyzed. Fractography and fracture mechanics methods were used to estimate the stresses at failure in 6 bridges (50%) whose fracture initiated from the occlusal surface of the connectors. Fracture of 1 non-veneered bridge (8%) initiated within the gingival surface of the connector. Three veneered bridges fractured within the veneer layers. Failure stresses of the all-core fixed partial dentures ranged from 107 to 161 MPa. Failure stresses of the veneered fixed partial dentures ranged from 19 to 68 MPa. We conclude that fracture initiation sites are controlled primarily by contact damage.

  14. Management of failed angioplasty with laser balloon angioplasty

    Science.gov (United States)

    Jenkins, Ronald D.; Spears, J. Richard

    1990-07-01

    Laser balloon angioplasty (LBA) is a technique for improving the post angioplasty result by the radial diffusion of continuous wave Neodymium:YAG laser energy to the arterial wall during the final inflation of percutaneous transluminal coronary angioplasty (PTCA). Potential mechanisms of luminal improvement include sealing of dissections, reduction of arterial recoil, desiccation of thrombus, and reduction of thrombogenicity of tissues at the luminal surface. These effects are helpful in the management of failed PTCA as defined by the presence of a greater than 50% stenosis after conventional PTCA. Preliminary data suggest that LBA may be safe and effective for the treatment of abrupt closure, with a majority of patients successfully avoiding emergency coronary artery bypass surgery. Similarly, a cohort in which the residual post-PTCA luminal diameter was less than 50% of reference diameter (n=13) was subsequently treated with LBA and demonstrated uniform success in improving luminal diameter, with a mean increment of 0.9mm. Data on the long-term clinical outcome of this cohort is encouraging.

  15. Failed back surgery syndrome: review and new hypotheses

    Directory of Open Access Journals (Sweden)

    Bordoni B

    2016-01-01

    Full Text Available Bruno Bordoni,1,2 Fabiola Marelli2 1Department of Cardiology, Foundation Don Carlo Gnocchi, IRCCS, Institute of Hospitalization and Care, S Maria Nascente, Milan, 2School CRESO, Osteopathic Centre for Research and Studies, Falconara Marittima, Ancona, Italy Abstract: Failed back surgery syndrome (FBSS is a term used to define an unsatisfactory outcome of a patient who underwent spinal surgery, irrespective of type or intervention area, with persistent pain in the lumbosacral region with or without it radiating to the leg. The possible reasons and risk factors that would lead to FBSS can be found in distinct phases: in problems already present in the patient before a surgical approach, such as spinal instability, during surgery (for example, from a mistake by the surgeon, or in the postintervention phase in relation to infections or biomechanical alterations. This article reviews the current literature on FBSS and tries to give a new hypothesis to understand the reasons for this clinical problem. The dysfunction of the diaphragm muscle is a component that is not taken into account when trying to understand the reasons for this syndrome, as there is no existing literature on the subject. The diaphragm is involved in chronic lower back and sacroiliac pain and plays an important role in the management of pain perception. Keywords: diaphragm, fascia, chronic pain, pain, spine FBSS

  16. Why Buildings Fail: Are We Learning From Our Mistakes?

    Directory of Open Access Journals (Sweden)

    M. Kevin Parfitt

    2012-09-01

    Full Text Available Most building professionals have investigated or performed remedial designs for at least one architectural or engineering system failure during their careers. Other practitioners, especially those who work for forensic consultants or firms specializing in disaster response and repair, are more familiar with the variety and extent of building failures as they assist their clients in restoring damaged or deficient buildings. The advent of social medial and twenty-four-hour news channels along with the general ease of finding more examples of failures in the Internet have made us realize that building failures in the broad sense are much more common than we may have realized.Relatively recent events leading to building failures such as the Christchurch, New Zealand earthquakes, the roof/parking deck of the Algo Centre mall in the northern Ontario, Canada city of Elliot Lake and the Indiana State Fairground stage collapse in the US are just a few reminders that much more work needs to be done on a variety of fronts to prevent building failures from a life safety standpoint. The need is compounded by economic concerns from what would be considered more mundane or common failures. Inspections by the author after Hurricane Katrina revealed a huge number of failures associated rain water alone as roofs, windows, flashing, mechanical penetrations etc. failed leading to interior water penetration often resulting in more damage from damp conditions and mold propagation than outright structural collapses.

  17. Association Between Difficult Airway Predictors and Failed Prehosptial Endotracheal Intubation.

    Science.gov (United States)

    Gaither, Joshua B; Stolz, Uwe; Ennis, Joshua; Moiser, Jarrod; Sakles, John C

    2015-01-01

    Difficult airway predictors (DAPs) are associated with failure of endotracheal intubation (ETI) in the emergency department (ED). The purpose of this study was to determine if DAPs are associated with failure of prehospital ETI. This retrospective study compared the prevalence of DAPs in cases of failed prehospital ETI successfully intubated in the ED (FPH/SED) with cases with no prehospital attempt that were successfully intubated in the ED on the first attempt by a physician using direct laryngoscopy (NPH/SED). All cases were transported by ground or air to an academic, level-1 trauma center. A total of 1377 ED ETIs were performed; 161 FPH/SED and 530 NPH/SED were identified. The odds ratios with 95% confidence intervals (CIs) of finding DAPs in the FPH/SED group compared with the NPH/SED group was blood = 5.80 (95% CI, 3.89-8.63), vomit = 2.01 (95% CI, 1.25-3.21), short neck = 2.67 (95% CI, 1.39-5.03), neck immobility = 2.52 (95% CI, 1.72-3.67), airway edema = 10.52 (95% CI, 4.15-29.92), facial trauma = 4.64 (95% CI, 2.91-7.39), and large tongue = 3.08 (95% CI, 1.75-5.40). When grouped by the number of DAPs per case (0, 1, 2, 3, or ≥ 4), the odds of multiple DAPs in cases of FPH/SED compared with NPH/SED ranged from 2.89 (95% CI, 1.71-4.90) with 1 DAP to 24.55 (95% CI, 10.60-56.90) with ≥ 4 DAPs. Cases of FPH/SED have more DAPs than NPH/SEDs. Copyright © 2015 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

  18. Machine-learning-assisted materials discovery using failed experiments

    Science.gov (United States)

    Raccuglia, Paul; Elbert, Katherine C.; Adler, Philip D. F.; Falk, Casey; Wenny, Malia B.; Mollo, Aurelio; Zeller, Matthias; Friedler, Sorelle A.; Schrier, Joshua; Norquist, Alexander J.

    2016-05-01

    Inorganic-organic hybrid materials such as organically templated metal oxides, metal-organic frameworks (MOFs) and organohalide perovskites have been studied for decades, and hydrothermal and (non-aqueous) solvothermal syntheses have produced thousands of new materials that collectively contain nearly all the metals in the periodic table. Nevertheless, the formation of these compounds is not fully understood, and development of new compounds relies primarily on exploratory syntheses. Simulation- and data-driven approaches (promoted by efforts such as the Materials Genome Initiative) provide an alternative to experimental trial-and-error. Three major strategies are: simulation-based predictions of physical properties (for example, charge mobility, photovoltaic properties, gas adsorption capacity or lithium-ion intercalation) to identify promising target candidates for synthetic efforts; determination of the structure-property relationship from large bodies of experimental data, enabled by integration with high-throughput synthesis and measurement tools; and clustering on the basis of similar crystallographic structure (for example, zeolite structure classification or gas adsorption properties). Here we demonstrate an alternative approach that uses machine-learning algorithms trained on reaction data to predict reaction outcomes for the crystallization of templated vanadium selenites. We used information on ‘dark’ reactions—failed or unsuccessful hydrothermal syntheses—collected from archived laboratory notebooks from our laboratory, and added physicochemical property descriptions to the raw notebook information using cheminformatics techniques. We used the resulting data to train a machine-learning model to predict reaction success. When carrying out hydrothermal synthesis experiments using previously untested, commercially available organic building blocks, our machine-learning model outperformed traditional human strategies, and successfully predicted

  19. Machine-learning-assisted materials discovery using failed experiments.

    Science.gov (United States)

    Raccuglia, Paul; Elbert, Katherine C; Adler, Philip D F; Falk, Casey; Wenny, Malia B; Mollo, Aurelio; Zeller, Matthias; Friedler, Sorelle A; Schrier, Joshua; Norquist, Alexander J

    2016-05-05

    Inorganic-organic hybrid materials such as organically templated metal oxides, metal-organic frameworks (MOFs) and organohalide perovskites have been studied for decades, and hydrothermal and (non-aqueous) solvothermal syntheses have produced thousands of new materials that collectively contain nearly all the metals in the periodic table. Nevertheless, the formation of these compounds is not fully understood, and development of new compounds relies primarily on exploratory syntheses. Simulation- and data-driven approaches (promoted by efforts such as the Materials Genome Initiative) provide an alternative to experimental trial-and-error. Three major strategies are: simulation-based predictions of physical properties (for example, charge mobility, photovoltaic properties, gas adsorption capacity or lithium-ion intercalation) to identify promising target candidates for synthetic efforts; determination of the structure-property relationship from large bodies of experimental data, enabled by integration with high-throughput synthesis and measurement tools; and clustering on the basis of similar crystallographic structure (for example, zeolite structure classification or gas adsorption properties). Here we demonstrate an alternative approach that uses machine-learning algorithms trained on reaction data to predict reaction outcomes for the crystallization of templated vanadium selenites. We used information on 'dark' reactions--failed or unsuccessful hydrothermal syntheses--collected from archived laboratory notebooks from our laboratory, and added physicochemical property descriptions to the raw notebook information using cheminformatics techniques. We used the resulting data to train a machine-learning model to predict reaction success. When carrying out hydrothermal synthesis experiments using previously untested, commercially available organic building blocks, our machine-learning model outperformed traditional human strategies, and successfully predicted conditions

  20. Metabolomic Profiling in Individuals with a Failing Kidney Allograft

    Science.gov (United States)

    Biancone, Luigi; Bussolino, Stefania; Merugumala, Sai; Tezza, Sara; D’Addio, Francesca; Ben Nasr, Moufida; Valderrama-Vasquez, Alessandro; Usuelli, Vera; De Zan, Valentina; El Essawy, Basset; Venturini, Massimo; Secchi, Antonio; De Cobelli, Francesco; Lin, Alexander; Chandraker, Anil; Fiorina, Paolo

    2017-01-01

    Background Alteration of certain metabolites may play a role in the pathophysiology of renal allograft disease. Methods To explore metabolomic abnormalities in individuals with a failing kidney allograft, we analyzed by liquid chromatography-mass spectrometry (LC-MS/MS; for ex vivo profiling of serum and urine) and two dimensional correlated spectroscopy (2D COSY; for in vivo study of the kidney graft) 40 subjects with varying degrees of chronic allograft dysfunction stratified by tertiles of glomerular filtration rate (GFR; T1, T2, T3). Ten healthy non-allograft individuals were chosen as controls. Results LC-MS/MS analysis revealed a dose-response association between GFR and serum concentration of tryptophan, glutamine, dimethylarginine isomers (asymmetric [A]DMA and symmetric [S]DMA) and short-chain acylcarnitines (C4 and C12), (test for trend: T1-T3 = p<0.05; p = 0.01; p<0.001; p = 0.01; p = 0.01; p<0.05, respectively). The same association was found between GFR and urinary levels of histidine, DOPA, dopamine, carnosine, SDMA and ADMA (test for trend: T1-T3 = p<0.05; p<0.01; p = 0.001; p<0.05; p = 0.001; p<0.001; p<0.01, respectively). In vivo 2D COSY of the kidney allograft revealed significant reduction in the parenchymal content of choline, creatine, taurine and threonine (all: p<0.05) in individuals with lower GFR levels. Conclusions We report an association between renal function and altered metabolomic profile in renal transplant individuals with different degrees of kidney graft function. PMID:28052095

  1. Prognostic indicators for failed nonsurgical reduction of intussusception

    Directory of Open Access Journals (Sweden)

    Khorana J

    2016-08-01

    Full Text Available Jiraporn Khorana,1 Jesda Singhavejsakul,1 Nuthapong Ukarapol,2 Mongkol Laohapensang,3 Jakraphan Siriwongmongkol,1 Jayanton Patumanond4 1Division of Pediatric Surgery, Department of Surgery, 2Division of Gastroenterology, Department of Pediatrics, Chiang Mai University Hospital, Chiang Mai, 3Division of Pediatric Surgery, Department of Surgery, Siriraj Hospital, Mahidol University, Bangkok, 4Center of Excellence in Applied Epidemiology, Thammasat University Hospital, Pathumthani, Thailand Purpose: To identify the risk factors for failure of nonsurgical reduction of intussusception. Methods: Data from intussusception patients who were treated with nonsurgical reduction in Chiang Mai University Hospital and Siriraj Hospital between January 2006 and December 2012 were collected. Patients aged 0–15 years and without contraindications (peritonitis, abdominal X-ray signs of perforation, and/or hemodynamic instability were included for nonsurgical reduction. The success and failure groups were divided according to the results of the reduction. Prognostic indicators for failed reduction were identified by using generalized linear model for exponential risk regression. The risk ratio (RR was used to report each factor. Results: One hundred and ninety cases of intussusception were enrolled. Twenty cases were excluded due to contraindications. A total of 170 cases of intussusception were included for the final analysis. The significant risk factors for reduction failure clustered by an age of 3 years were weight <12 kg (RR =1.48, P=0.004, symptom duration >3 days (RR =1.26, P<0.001, vomiting (RR =1.63, P<0.001, rectal bleeding (RR =1.50, P<0.001, abdominal distension (RR =1.60, P=0.003, temperature >37.8°C (RR =1.51, P<0.001, palpable abdominal mass (RR =1.26, P<0.001, location of mass (left over right side (RR =1.48, P<0.001, poor prognostic signs on ultrasound scans (RR =1.35, P<0.001, and method of reduction (hydrostatic over pneumatic (RR =1

  2. Collapsars Gamma-Ray Bursts and Explosions in "Failed Supernovae"

    CERN Document Server

    MacFadyen, A I

    1999-01-01

    Using a two-dimensional hydrodynamics code (PROMETHEUS), we study the continued evolution of rotating massive helium stars whose iron core collapse does not produce a successful outgoing shock, but instead forms a black hole. We study the formation of a disk, the associated flow patterns, and the accretion rate for disk viscosity parameter, alpha ~ 0.001 and 0.1. For the standard 14 solar mass model the average accretion rate for 15 s is 0.07 solar masses per second and the total energy deposited along the rotational axes by neutrino annihilation is (1 - 14) x 10**51 erg, depending upon the evolution of the Kerr parameter and uncertain neutrino efficiencies. Simulated deposition of this energy in the polar regions results in strong relativistic outflow - jets beamed to about 1.5% of the sky. The jets remain highly focused, and are capable of penetrating the star in 5 - 10 s. After the jet breaks through the surface of the star, highly relativistic flow can commence. Because of the sensitivity of the mass ejec...

  3. The Search for Failed Supernovae with the Large Binocular Telescope: Constraints from 7 Years of Data

    CERN Document Server

    Adams, S M; Gerke, J R; Stanek, K Z

    2016-01-01

    We report updated results for the first 7 years of our program to monitor 27 galaxies within 10 Mpc using the Large Binocular Telescope to search for failed supernovae -- core-collapses of massive stars that form black holes without luminous supernovae. In the new data, we identify no new compelling candidates and confirm the existing candidate. Given the 6 successful core-collapse SNe in the sample and one likely failed SN, the implied fraction of core-collapses that result in failed SNe is $f = 0.14^{+0.33}_{-0.10}$ at 90% confidence. If the current candidate is a failed SN, the fraction of failed SN naturally explains the missing high-mass RSG SN progenitors and the black hole mass function. If the current candidate is ultimately rejected, the data implies a 90% confidence upper limit on the failed SN fraction of $f < 0.35$.

  4. Data Compilation for AGR-3/4 Designed-to-Fail (DTF) Fuel Particle Batch LEU04-02DTF

    Energy Technology Data Exchange (ETDEWEB)

    Hunn, John D [ORNL; Miller, James Henry [ORNL

    2008-10-01

    This document is a compilation of coating and characterization data for the AGR-3/4 designed-to-fail (DTF) particles. The DTF coating is a high density, high anisotropy pyrocarbon coating of nominal 20 {micro}m thickness that is deposited directly on the kernel. The purpose of this coating is to fail early in the irradiation, resulting in a controlled release of fission products which can be analyzed to provide data on fission product transport. A small number of DTF particles will be included with standard TRISO driver fuel particles in the AGR-3 and AGR-4 compacts. The ORNL Coated Particle Fuel Development Laboratory 50-mm diameter fluidized bed coater was used to coat the DTF particles. The coatings were produced using procedures and process parameters that were developed in an earlier phase of the project as documented in 'Summary Report on the Development of Procedures for the Fabrication of AGR-3/4 Design-to-Fail Particles', ORNL/TM-2008/161. Two coating runs were conducted using the approved coating parameters. NUCO425-06DTF was a final process qualification batch using natural enrichment uranium carbide/uranium oxide (UCO) kernels. After the qualification run, LEU04-02DTF was produced using low enriched UCO kernels. Both runs were inspected and determined to meet the specifications for DTF particles in section 5 of the AGR-3 & 4 Fuel Product Specification (EDF-6638, Rev.1). Table 1 provides a summary of key properties of the DTF layer. For comparison purposes, an archive sample of DTF particles produced by General Atomics was characterized using identical methods. This data is also summarized in Table 1.

  5. Improvement of chronic back pain or failed back surgery with vitamin D repletion: a case series.

    Science.gov (United States)

    Schwalfenberg, Gerry

    2009-01-01

    This article reviews 6 selected cases of improvement/resolution of chronic back pain or failed back surgery after vitamin D repletion in a Canadian family practice setting. Pub Med was searched for articles on chronic back pain, failed back surgery, and vitamin D deficiency. Chronic low back pain and failed back surgery may improve with repletion of vitamin D from a state of deficiency/insufficiency to sufficiency. Vitamin D insufficiency is common; repletion of vitamin D to normal levels in patients who have chronic low back pain or have had failed back surgery may improve quality of life or, in some cases, result in complete resolution of symptoms.

  6. CT findings in ten patients with failed renal allografts: comparison with findings in functional grafts

    Energy Technology Data Exchange (ETDEWEB)

    Gayer, Gabriela E-mail: gayer_h@netvsion.net.il; Apter, Sara; Katz, Rama; Ben-David, Aharon; Katzir, Ze' ev; Hertz, Marjorie

    2000-12-01

    Our aim is to report the computed tomography (CT) features of the long-term failed renal allograft. Ten patients with failed renal transplants in whom the graft was left in situ underwent CT for various unrelated indications. The majority of the failed grafts showed marked shrinkage and coarse punctate diffuse parenchymal calcifications. Small cysts were seen in four grafts. A long-term failed renal transplant appeared on CT as a small rounded soft tissue mass. The graft was almost always heavily calcified. Lack of awareness of the nature of such a mass may mislead the radiologist in interpreting it as a space-occupying lesion.

  7. Design Parameters in Multimodal Games for Rehabilitation.

    Science.gov (United States)

    Shah, Nauman; Basteris, Angelo; Amirabdollahian, Farshid

    2014-02-01

    Objectives: The repetitive and sometimes mundane nature of conventional rehabilitation therapy provides an ideal opportunity for development of interactive and challenging therapeutic games that have the potential to engage and motivate the players. Certain game design parameters that may encourage patients to actively participate by making the games more enjoyable have been identified. In this article, we describe a formative study in which we designed and evaluated some of these parameters with healthy subjects. Materials and Methods: The "operant conditioning" and "scoring" design parameters were incorporated in a remake of a classic labyrinth game, "Marble Maze." A group of participants (n=37) played the game twice: Once in the control condition without both modalities and then with either one of the parameters or with both. Measures of game duration and number of fails in the game were recorded along with survey questionnaires to measure player perceptions of intrinsic motivation on the game. Results: Longer playtimes, higher levels of interest/enjoyment, and effort to play the game were recorded with the introduction of these parameters. Conclusions: This study provides an understanding on how game design parameters can be used to motivate and encourage people to play longer. With these positive results, future aims are to test the parameters with stroke patients, providing much clearer insight as to what influences these parameters have on patients undergoing therapy. The ultimate goal is to utilize game design in order to maintain longer therapeutic interaction between a patient and his or her therapy medium.

  8. Combining bosentan and sildenafil in pulmonary arterial hypertension patients failing monotherapy: real-world insights.

    Science.gov (United States)

    Dardi, Fabio; Manes, Alessandra; Palazzini, Massimiliano; Bachetti, Cristina; Mazzanti, Gaia; Rinaldi, Andrea; Albini, Alessandra; Gotti, Enrico; Monti, Enrico; Bacchi Reggiani, Maria Letizia; Galiè, Nazzareno

    2015-08-01

    Pulmonary arterial hypertension is a severe disease with a complex pathogenesis, for which combination therapy is an attractive option.This study aimed to assess the impact of sequential combination therapy on both short-term responses and long-term outcomes in a real-world setting.Patients with idiopathic/heritable pulmonary arterial hypertension, or pulmonary arterial hypertension associated with congenital heart disease or connective tissue disease and who were not meeting treatment goals on either first-line bosentan or sildenafil monotherapy, were given additional sildenafil or bosentan and assessed after 3-4 months. Double combination therapy significantly improved clinical and haemodynamic parameters, independent of aetiology or the order of drug administration. Significant improvements in functional class were observed in patients with idiopathic/heritable pulmonary arterial hypertension. The 1-, 3- and 5-year overall survival estimates were 91%, 69% and 59%, respectively. Patients with pulmonary arterial hypertension associated with connective tissue disease had significantly poorer survival rates compared to other aetiologies (p<0.003).The favourable short-term haemodynamic results and good survival rates, observed in patients receiving both bosentan and sildenafil, supports the use of sequential combination therapy in patients failing on monotherapy in a real-world setting.

  9. Experimental research and finite element analysis of bridge piers failed in flexure-shear modes

    Institute of Scientific and Technical Information of China (English)

    Sun Zhiguo; Si Bingjun; Wang Dongsheng; Guo Xun

    2008-01-01

    In recent earthquakes,a large number of reinforced concrete (RC) bridges were severely damaged due to mixed flexure-shear failure modes of the bridge piers.An integrated experimental and finite element (FE) analysis study is described in this paper to study the seismic performance of the bridge piers that failed in flexure-shear modes.In the first part,a nonlinear cyclic loading test on six RC bridge piers with circular cross sections is carried out experimentally.The damage states,ductility and energy dissipation parameters,stiffness degradation and shear strength of the piers are studied and compared with each other.The experimental results suggest that all the piers exhibit stable flexural response at displacement ductilities up to four before exhibiting brittle shear failure.The ultimate performance of the piers is dominated by shear capacity due to significant shear cracking,and in some cases,rupturing of spiral bars.In the second part,modeling approaches describing the hysteretic behavior of the piers are investigated by using ANSYS software.A set of models with different parameters is selected and evaluated through comparison with experimental results.The influences of the shear retention coefficients between concrete cracks,the Bauschinger effect in longitudinal reinforcement,the bond-slip relationship between the longitudinal reinforcement and the concrete and the concrete failure surface on the simulated hysteretie curves are discussed.Then,a modified analysis model is presented and its accuracy is verified by comparing the simulated results with experimental ones.This research uses models available in commercial FE codes and is intended for researchers and engineers interested in using ANSYS software to predict the hysteretic behavior of reinforced concrete structures.

  10. Experimental research and finite element analysis of bridge piers failed in flexure-shear modes

    Science.gov (United States)

    Sun, Zhiguo; Si, Bingjun; Wang, Dongsheng; Guo, Xun

    2008-12-01

    In recent earthquakes, a large number of reinforced concrete (RC) bridges were severely damaged due to mixed flexure-shear failure modes of the bridge piers. An integrated experimental and finite element (FE) analysis study is described in this paper to study the seismic performance of the bridge piers that failed in flexure-shear modes. In the first part, a nonlinear cyclic loading test on six RC bridge piers with circular cross sections is carried out experimentally. The damage states, ductility and energy dissipation parameters, stiffness degradation and shear strength of the piers are studied and compared with each other. The experimental results suggest that all the piers exhibit stable flexural response at displacement ductilities up to four before exhibiting brittle shear failure. The ultimate performance of the piers is dominated by shear capacity due to significant shear cracking, and in some cases, rupturing of spiral bars. In the second part, modeling approaches describing the hysteretic behavior of the piers are investigated by using ANSYS software. A set of models with different parameters is selected and evaluated through comparison with experimental results. The influences of the shear retention coefficients between concrete cracks, the Bauschinger effect in longitudinal reinforcement, the bond-slip relationship between the longitudinal reinforcement and the concrete and the concrete failure surface on the simulated hysteretic curves are discussed. Then, a modified analysis model is presented and its accuracy is verified by comparing the simulated results with experimental ones. This research uses models available in commercial FE codes and is intended for researchers and engineers interested in using ANSYS software to predict the hysteretic behavior of reinforced concrete structures.

  11. Left ventricular assist device effects on metabolic substrates in the failing heart.

    Directory of Open Access Journals (Sweden)

    Lindsay B Weitzel

    Full Text Available BACKGROUND: Heart failure patients have inadequate nutritional intake and alterations in metabolism contributing to an overall energy depleted state. Left ventricular assist device (LVAD support is a common and successful intervention in patients with end-stage heart failure. LVAD support leads to alterations in cardiac output, functional status, neurohormonal activity and transcriptional profiles but the effects of LVADs on myocardial metabolism are unknown. This study set out to measure cardiac metabolites in non-failing hearts, failing hearts, and hearts post-LVAD support. METHODS: The study population consisted of 8 non-ischemic failing (at LVAD implant and 8 post-LVAD hearts, plus 8 non-failing hearts obtained from the tissue bank at the University of Colorado. NMR spectroscopy was utilized to evaluate differences in myocardial energy substrates. Paired and non-paired t-tests were used to determine differences between the appropriate groups. RESULTS: Glucose and lactate values both decreased from non-failing to failing hearts and increased again significantly in the (paired post-LVAD hearts. Glutamine, alanine, and aromatic amino acids decreased from non-failing to failing hearts and did not change significantly post-LVAD. Total creatine and succinate decreased from non-failing to failing hearts and did not change significantly post-LVAD. DISCUSSION: Measured metabolites related to glucose metabolism are diminished in failing hearts, but recovered their values post-LVAD. This differed from the amino acid levels, which decreased in heart failure but did not recover following LVAD. Creatine and the citric acid cycle intermediate succinate followed a similar pattern as the amino acid levels.

  12. Ab Interno Trabeculectomy With the Trabectome as a Valuable Therapeutic Option for Failed Filtering Blebs.

    Science.gov (United States)

    Wecker, Thomas; Neuburger, Matthias; Bryniok, Laura; Bruder, Kathrin; Luebke, Jan; Anton, Alexandra; Jordan, Jens F

    2016-09-01

    Uncontrolled intraocular pressure (IOP) after glaucoma filtration surgery is a challenging problem in the management of glaucoma patients. The Trabectome is a device for selective electroablation of the trabecular meshwork through a clear cornea incision without affecting the conjunctiva. Minimally invasive glaucoma surgery using the Trabectome is safe and effective as primary glaucoma surgery. Here we investigate the results of ab interno trabeculectomy with the Trabectome for IOP control in patients with a failed filtering bleb. A total of 60 eyes of 60 consecutive patients with primary open-angle glaucoma (POAG) or pseudoexfoliative glaucoma (PXG) were enrolled in this single center observational study. Trabectome surgery was performed alone or in combination with phacoemulsification by 2 experienced surgeons. IOP readings and number of IOP lowering medication as primary outcome parameters were taken by an independent examiner. Intraoperative and postoperative medication were recorded systematically. Mean IOP before surgery was 24.5±3.5 mm Hg and decreased to 15.7±3.4 (-36%) after mean follow-up of 415 days. The number of necessary IOP lowering medication dropped from 2.1±1.3 to 1.8±1.2 (14% reduction from baseline). A total of 25% (n=15) of cases reported here needed additional surgery after 517 days (range: 6 to 1563 d). No major complications were observed. After mean follow-up, we found a qualified success rate for PXG of 87% and 50% for POAG as revealed by the Kaplan-Meier analysis according to the definitions for success in advanced glaucoma cases according to the World Glaucoma Association (40% reduction from baseline IOP and maximum IOP of 15 mm Hg). Trabectome surgery for uncontrolled IOP after trabeculectomy is safe and effective especially in PXG patients. Given the demanding subgroup of patients studied here, it is not surprising that success rates are lower compared with previous studies investigating the Trabectome for primary glaucoma surgery

  13. Lumped-parameter models

    Energy Technology Data Exchange (ETDEWEB)

    Ibsen, Lars Bo; Liingaard, M.

    2006-12-15

    A lumped-parameter model represents the frequency dependent soil-structure interaction of a massless foundation placed on or embedded into an unbounded soil domain. In this technical report the steps of establishing a lumped-parameter model are presented. Following sections are included in this report: Static and dynamic formulation, Simple lumped-parameter models and Advanced lumped-parameter models. (au)

  14. Pass/fail patterns of candidates who failed COMLEX-USA level 2-PE because of misrepresentation of clinical findings on postencounter notes.

    Science.gov (United States)

    Langenau, Erik E; Sandella, Jeanne M

    2011-07-01

    In 2007, The National Board of Osteopathic Medical Examiners (NBOME) instituted a policy to address the accuracy and integrity of postencounter written documentation recorded during the Comprehensive Osteopathic Medical Licensing Examination Level 2-Performance Evaluation (COMLEX-USA Level 2-PE). This policy was instituted not only to protect the integrity of the examination, but also to highlight that overdocumentation of clinical findings not obtained during patient encounters may jeopardize patient safety. To investigate overall and domain pass/fail patterns of candidates who misrepresented clinical findings with regard to past and subsequent performance on COMLEX-USA Level 2-PE. Specifically, to investigate what percentage of candidates failed because of misrepresentation on first attempts and how they performed on subsequent administrations, as well as the previous performance patterns of candidates who failed because of misrepresentation on examination retakes. Historical records from NBOME's COMLEX-USA Level 2-PE database (testing cycles 2007-2008, 2008-2009, and 2009-2010) were used to analyze overall and domain pass/fail patterns of candidates who failed at least once because of misrepresentation of clinical findings. Of the 24 candidates who failed because of misrepresentation of postencounter (SOAP) notes, 20 candidates (83%) were first-time examinees. Four candidates (17%) were repeating the examination, 2 of whom were making a third attempt to pass. Among these 20 candidates who failed because of misrepresentation of clinical findings on their first attempt, 19 passed on their next attempt. At the time of study analysis, all but 2 candidates eventually passed the examination in subsequent attempts. Among candidates found to have misrepresented clinical findings on postencounter written documentation on COMLEX-USA Level 2-PE, no pattern existed between their past or subsequent performance with regard to overall or domain pass/fail results. The vast

  15. Parameter Extraction of Solar Photovoltaic Modules Using Gravitational Search Algorithm

    Directory of Open Access Journals (Sweden)

    R. Sarjila

    2016-01-01

    Full Text Available Parameter extraction of a solar photovoltaic system is a nonlinear problem. Many optimization algorithms are implemented for this purpose, which failed in giving better results at low irradiance levels. This article presents a novel method for parameter extraction using gravitational search algorithm. The proposed method evaluates the parameters of different PV panels at various irradiance levels. A critical evaluation and comparison of gravitational search algorithm with other optimization techniques such as genetic algorithm are given. Extensive simulation analyses are carried out on the proposed method and show that GSA is much suitable for parameter extraction problem.

  16. Fail-Safe Entrepreneurship: Six Reasons You Shouldn't Start a Small Business.

    Science.gov (United States)

    Paradiso, James R.

    Given the statistic that 97 percent of all new businesses fail, it is unwise to enter into a new small business venture. Many aspiring entrepreneurs lack the characteristics and background they need to survive and instead display several common characteristics which predispose them to failure, such as being non-aggressive and casual, failing to…

  17. Failure to Fail in a Final Pre-Service Teaching Practicum

    Science.gov (United States)

    Danyluk, Patricia J.; Luhanga, Florence; Gwekwerere, Yovita N.; MacEwan, Leigh; Larocque, Sylvie

    2015-01-01

    This article presents a Canadian perspective on the issue of failure to fail in Bachelor of Education programs. The issue of failure to fail in Bachelor of Education programs is one that had not been explored in any great detail. What literature does exist focuses on the strain that a teacher experiences when s/he mentors a student teacher…

  18. The Value of Failing in Career Development: A Chaos Theory Perspective

    Science.gov (United States)

    Pryor, Robert G. L.; Bright, James E. H.

    2012-01-01

    Failing is a neglected topic in career development theory and counselling practice. Most theories see failing as simply the opposite of success and something to be avoided. It is contended that the Chaos Theory of Careers with its emphasis on complexity, uncertainty and consequent human imitations, provides a conceptually coherent account of…

  19. Neglected City Narratives And Failed Rebranding: Focusing On Riga And Aarhus

    DEFF Research Database (Denmark)

    Mousten, Birthe; Locmele, Gunta

    2017-01-01

    Rīga, Latvia went through a failed rebranding process as the forerunner of its status as a European Capital of Culture (2014). The same thing happened in Aarhus, Denmark. Aarhus will be a European Capital of Culture (2017) and leading to this, it went through a failed rebranding process. Based on...

  20. The Value of Failing in Career Development: A Chaos Theory Perspective

    Science.gov (United States)

    Pryor, Robert G. L.; Bright, James E. H.

    2012-01-01

    Failing is a neglected topic in career development theory and counselling practice. Most theories see failing as simply the opposite of success and something to be avoided. It is contended that the Chaos Theory of Careers with its emphasis on complexity, uncertainty and consequent human imitations, provides a conceptually coherent account of…

  1. 38 CFR 1.986 - Result if employee fails to meet deadlines.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Result if employee fails to meet deadlines. 1.986 Section 1.986 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS GENERAL PROVISIONS Salary Offset Provisions § 1.986 Result if employee fails to meet deadlines. An...

  2. 49 CFR 1017.6 - Result if employee fails to meet deadlines.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Result if employee fails to meet deadlines. 1017.6... OFFSET FROM INDEBTED GOVERNMENT AND FORMER GOVERNMENT EMPLOYEES § 1017.6 Result if employee fails to meet... this part whichever is applicable, will not result in denial of a hearing or in immediate offset, if...

  3. 7 CFR 3.76 - Result if employee fails to meet deadlines.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Result if employee fails to meet deadlines. 3.76 Section 3.76 Agriculture Office of the Secretary of Agriculture DEBT MANAGEMENT Federal Salary Offset § 3.76 Result if employee fails to meet deadlines. An employee will not be granted a hearing and will...

  4. The Role of Tertiary Education in Fixing Failed States: Globalization and Public Goods

    Science.gov (United States)

    Tierney, William G.

    2011-01-01

    The plight of nations labeled as "failed" is well-documented, as are suggested strategies to fix them. One area that receives a great deal of focus in the extant literature is education. How can education contribute to the rebuilding of a failed State? Most often the responses to this question focus on the importance of reestablishing primary and…

  5. The effect of bosentan in patients with a failing Fontan circulation

    NARCIS (Netherlands)

    Ovaert, Caroline; Thijs, Daisy; Dewolf, Daniel; Ottenkamp, Jaap; Dessy, Hugues; Moons, Philip; Gewillig, Marc; Mertens, Luc

    2009-01-01

    Objectives: To investigate the effect of bosentan in patients with a failing Fontan circulation. Design: A multicentric open label, non-controlled study. Setting: 5 tertiary care centres for congenital cardiology. Patients: We included 10 patients with a failing Fontan circulation. Their median age

  6. Ineffective Staff, Ineffective Supervision, or Ineffective Administration? Why Some Nursing Homes Fail to Provide Adequate Care.

    Science.gov (United States)

    Sheridan, John E.; And Others

    1992-01-01

    This study involved 530 nursing staff working in 25 for-profit and nonprofit nursing homes, 2 of which failed to meet residential care standards. Nursing home climate in failed homes was perceived as being significantly lower in human relations and higher in laissez-faire and status orientation dimensions that the climate in the successful homes.…

  7. Understanding "Failed" Markets: Conflicting Logics and Dissonance in Attempts to Price the Priceless Child

    NARCIS (Netherlands)

    Vermeulen, P.A.M.; Ansari, S.; Lounsbury, M.

    2017-01-01

    While scholars have developed increasingly well-developed accounts of institutional change, little attention has been paid to how change is resisted and, in particular, how efforts to marketize fail. We draw on the institutional logics perspective to guide analysis of an empirical case of the failed

  8. 40 CFR 141.561 - What happens if my system's turbidity monitoring equipment fails?

    Science.gov (United States)

    2010-07-01

    ... happens if my system's turbidity monitoring equipment fails? If there is a failure in the continuous... 40 Protection of Environment 22 2010-07-01 2010-07-01 false What happens if my system's turbidity monitoring equipment fails? 141.561 Section 141.561 Protection of Environment ENVIRONMENTAL PROTECTION...

  9. When Success Makes Me Fail: (De)constructing Failure and Success in a Conventional American Classroom

    Science.gov (United States)

    DePalma, Renee

    2008-01-01

    This article examines the case of Laura, a 9-year-old Mexican immigrant who officially "failed to learn English" in an American school. It may be more accurate to say that schooling failed Laura, and in ways that went beyond language learning. This diagnosis of failure is criticized, along with the individualistic and essentialist assumptions…

  10. Turning the Question Around: Do Colleges Fail to Meet Students' Expectations?

    Science.gov (United States)

    Rosenbaum, James E.; Becker, Kelly Iwanaga; Cepa, Kennan A.; Zapata-Gietl, Claudia E.

    2016-01-01

    Research often focuses on how students fail to meet college expectations, but it rarely asks how colleges fail to meet students' expectations. This study examines students' expectations of college and their institutional confidence--their level of certainty that college will meet their expectations. Drawing on 65 pilot interviews and a survey of…

  11. MHD Forces in Quasi-Static Evolution, Catastrophe, and ``Failed'' Eruption of Solar Flux Ropes

    Science.gov (United States)

    Chen, James

    2017-08-01

    This paper presents the first unified theoretical model of flux rope dynamics---a single set of flux-rope equations in ideal MHD---to describe as one dynamical process the quasi-static evolution, catastrophic transition to eruption, cessation (``failure'') of eruption, and the post-eruption quasi-equilibria. The model is defined by the major radial {\\it and} minor radial equations of motion including pressure. The initial equilibrium is a flux rope in a background plasma with pressure $p_c(Z)$ and an overlying magnetic field $B_c(Z)$. The flux rope is initially force-free, but theevolution is not required to be force- free. A single quasi-static control parameter, the rate of increase in poloidal flux, is used for the entire process. As this parameter is slowly increased, the flux rope rises, following a sequence of quasi-static equilibria. As the apex of the flux rope rises past a critical height $Z_{crt}$, it expands on a dynamical (Alfvénic) timescale. The eruption rapidly ceases, as the stored magnetic energy of eruption is exhausted, and a new equilibrium is established at height $Z_1 > Z_{crt}$. The calculated velocity profile resembles the observed velocity profiles in ``failed'' eruptions including a damped oscillation. In the post-eruption equilibria, the outward hoop force is balanced by the tension of the toroidal self magnetic field and pressure gradient force. Thus, the flux rope does not evolve in a force-free manner. The flux rope may also expand without reaching a new equilibrium, provided a sufficient amount of poloidal flux is injected on the timescale of eruption. This scenario results in a full CME eruption. It is shown that the minor radial expansion critically couples the evolution of the toroidal self-field and pressure gradient force. No parameter regime is found in which the commonly used simplifications---near-equilibrium minor radial expansion, force-free expansion, and constant aspect ratio $R/a$ (e.g., the torus instability equation

  12. Redefining solubility parameters: the partial solvation parameters.

    Science.gov (United States)

    Panayiotou, Costas

    2012-03-21

    The present work reconsiders a classical and universally accepted concept of physical chemistry, the solubility parameter. Based on the insight derived from modern quantum chemical calculations, a new definition of solubility parameter is proposed, which overcomes some of the inherent restrictions of the original definition and expands its range of applications. The original single solubility parameter is replaced by four partial solvation parameters reflecting the dispersion, the polar, the acidic and the basic character of the chemical compounds as expressed either in their pure state or in mixtures. Simple rules are adopted for the definition and calculation of these four parameters and their values are tabulated for a variety of common substances. In contrast, however, to the well known Hansen solubility parameters, their design and evaluation does not rely exclusively on the basic rule of "similarity matching" for solubility but it makes also use of the other basic rule of compatibility, namely, the rule of "complementarity matching". This complementarity matching becomes particularly operational with the sound definition of the acidic and basic components of the solvation parameter based on the third σ-moments of the screening charge distributions of the quantum mechanics-based COSMO-RS theory. The new definitions are made in a simple and straightforward manner, thus, preserving the strength and appeal of solubility parameter stemming from its simplicity. The new predictive method has been applied to a variety of solubility data for systems of pharmaceuticals and polymers. The results from quantum mechanics calculations are critically compared with the results from Abraham's acid/base descriptors.

  13. Right ventricular arrhythmogenesis in failing human heart: the role of conduction and repolarization remodeling

    Science.gov (United States)

    Lou, Qing; Janks, Deborah L.; Holzem, Katherine M.; Lang, Di; Onal, Birce; Ambrosi, Christina M.; Fedorov, Vadim V.; Wang, I-Wen

    2012-01-01

    Increased dispersion of repolarization has been suggested to underlie increased arrhythmogenesis in human heart failure (HF). However, no detailed repolarization mapping data were available to support the presence of increased dispersion of repolarization in failing human heart. In the present study, we aimed to determine the existence of enhanced repolarization dispersion in the right ventricular (RV) endocardium from failing human heart and examine its association with arrhythmia inducibility. RV free wall preparations were dissected from five failing and five nonfailing human hearts, cannulated and coronary perfused. RV endocardium was optically mapped from an ∼6.3 × 6.3 cm2 field of view. Action potential duration (APD), dispersion of APD, and conduction velocity (CV) were quantified for basic cycle lengths (BCL) ranging from 2,000 ms to the functional refractory period. We found that RV APD was significantly prolonged within the failing group compared with the nonfailing group (560 ± 44 vs. 448 ± 39 ms, at BCL = 2,000 ms, P < 0.05). Dispersion of APD was increased in three failing hearts (161 ± 5 vs. 86 ± 19 ms, at BCL = 2,000 ms). APD alternans were induced by rapid pacing in these same three failing hearts. CV was significantly reduced in the failing group compared with the nonfailing group (81 ± 11 vs. 98 ± 8 cm/s, at BCL = 2,000 ms). Arrhythmias could be induced in two failing hearts exhibiting an abnormally steep CV restitution and increased dispersion of repolarization due to APD alternans. Dispersion of repolarization is enhanced across the RV endocardium in the failing human heart. This dispersion, together with APD alternans and abnormal CV restitution, could be responsible for the arrhythmia susceptibility in human HF. PMID:23042951

  14. Two field trials for deblending of simultaneous source surveys: Why we failed and why we succeeded?

    Science.gov (United States)

    Zu, Shaohuan; Zhou, Hui; Chen, Haolin; Zheng, Hao; Chen, Yangkang

    2017-08-01

    Currently, deblending is the main strategy for dealing with the intense interference problem of simultaneous source data. Most deblending methods are based on the property that useful signal is coherent while the interference is incoherent in some domains other than common shot domain. In this paper, two simultaneous source field trials were studied in detail. In the first trial, the simultaneous source survey was not optimal, as the dithering code had strong coherency and the minimum distance between the two vessels was also small. The chosen marine shot scheduling and vessel deployment made it difficult to deblend the simultaneous source data, and result was an unexpected failure. Next, we tested different parameters (the dithering code and the minimum distance between vessels) of the simultaneous source survey using the simulated blended data and got some useful insights. Then, we carried out the second field trial with a carefully designed survey that was much different from the first trial. The deblended results in common receiver gather, common shot gather or the final stacked profile were encouraging. We obtained a complete success in the second field trial, which gave us confidence in the further test (such as a full three dimensional acquisition test or a high-resolution acquisition test with denser spatial sampling). Remembering that failures with simultaneous sourcing seldom reported, in this paper, our contribution is the discussion in detail about both our failed and successful field experiments and the lessons we have learned from them with the hope that the experience gained from this study can be very useful to other researchers in the same field.

  15. Revision total knee arthroplasty using a custom tantalum implant in a patient following multiple failed revisions.

    Science.gov (United States)

    McNamara, Colin A; Gösthe, Raúl G; Patel, Preetesh D; Sanders, Kristopher C; Huaman, Gustavo; Suarez, Juan C

    2017-03-01

    The number of revision total knee arthroplasty procedures performed annually is increasing and, subsequently, so is the number of patients presenting following a failed revision. Rerevising a total knee arthroplasty after one or more failed revision procedures presents many challenges, including diminished bone stock for prosthetic fixation. "Off the shelf" implants may not offer the best alternative for reconstruction. We present the case of a 55-year-old patient who required a rerevision total knee arthroplasty following multiple failed revisions with severe femoral and tibia bone loss. We describe a novel technique we employed to improve component fixation within the compromised bone stock.

  16. Proteomic analysis of mitochondria reveals a metabolic switch from fatty acid oxidation to glycolysis in the failing heart

    Institute of Scientific and Technical Information of China (English)

    WANG Jun; WANG TingZhong; LIU Ping; FAN FenLing; GUAN YouFei; MA AiQun; BAI Ling; LI Jing; SUN ChaoFeng; ZHAO Jin; CUI ChangCong; HAN Ke; LIU Yu; ZHUO XiaoZhen

    2009-01-01

    This work characterizes the mitochondrial proteomic profile in the failing heart and elucidates the molecular basis of mitochondria in heart failure.Heart failure was induced in rats by myocardial infarction,and mitochondria were isolated from hearts by differential centrifugation.Using two-dimensional gel electrophoresis and matrix-assisted laser desorption/ionization-time of flight mass spectrometry,a system biology approach was employed to investigate differences in mitochondrial proteins between normal and failing hearts.Mass spectrometry identified 27 proteins differentially expressed that involved in energy metabolism.Among those,the up-regulated proteins included tricarboxylic acid cycle enzymes and pyruvate dehydrogenase complex subunita while the down-regulated proteins were involved in fatty acid oxidation and the OXPHOS complex.These results suggest a substantial metabolic switch from free fatty acid oxidation to glycolysis in heart failure and provide molecular evidence for alterations in the structural and functional parameters of mitochondria that may contribute to cardiac dysfunction during ischemic injury.

  17. High-dose misoprostol as an alternative therapy after failed medical abortion.

    Science.gov (United States)

    Li, Yiu-Tai; Hou, Guang-Qiong; Chen, Tien-Hui; Chu, Yi-Chih; Lin, Ta-Chin; Kuan, Long-Ching; Lin, Mau; Huang, Shu-Feng; Chen, Fu-Min; Kuo, Tsung-Cheng

    2008-12-01

    The aim of this study was to determine the complete abortion rate for the vaginal administration of high-dose misoprostol after a failed medical abortion. When their medical abortions failed after the conventional oral administration of mifepristone and misoprostol, participants then received 1,000 microg of misoprostol vaginally. The efficacy and side effects of this treatment were evaluated. Twenty-seven women who failed to abort after the conventional administration of mifepristone and misoprostol were enrolled in this trial. Fourteen days after the vaginal administration of 1,000 microg misoprostol, the overall complete expulsion rate had reached 88.8% (24/27). Most adverse effects were mild to moderate and did not require treatment. The vaginal administration of 1,000 microg misoprostol as a salvage therapy after a failed medical abortion appears to be a safe and highly effective alternative to surgical intervention.

  18. High-Dose Vitamin D Failed to Curb Heart Disease in Study

    Science.gov (United States)

    ... medlineplus.gov/news/fullstory_164472.html High-Dose Vitamin D Failed to Curb Heart Disease in Study ... 5, 2017 (HealthDay News) -- Taking high doses of vitamin D once a month won't lower your ...

  19. First-Try Antibiotics Now Fail in 1 in 4 Adult Pneumonia Cases

    Science.gov (United States)

    ... medlineplus.gov/news/fullstory_165801.html First-Try Antibiotics Now Fail in 1 in 4 Adult Pneumonia ... 2017 (HealthDay News) -- The first prescription of an antibiotic that the average U.S. adult with pneumonia receives ...

  20. On the fail-safe design of tendon-driven manipulators with redundant tendons

    Energy Technology Data Exchange (ETDEWEB)

    Sheu, Jinn Biau; Liu, Tyng; Lee, Jyh Jone [National Taiwan University, Taipei (China)

    2012-06-15

    A tendon-driven manipulator having redundant tendons may possess more flexibility in operation, such as optimizing the performance of tendons, reducing the burden of each tendon, and providing fail-safe features. The purpose of this paper is to investigate the design of tendon-driven manipulators with a fail-safe feature, that is, to synthesize a system that may still remain controllable as any of the tendons have broken down or malfunctioned. Characteristics of tendon-driven manipulators are briefly discussed. Criteria for tendon-driven manipulators with redundant tendons and fail-safe feature are then established. Subsequently, constraints for such system are derived from the structure of tendon-driven manipulator. Associated with the criteria, manipulators can remain controllable when any of the tendons fails to function. Finally, a geometric method for determining the structure is developed. Examples of two-DOF and three-DOF tendondriven manipulators are demonstrated.

  1. Comment Fail-Stop Blind Signature Scheme Design Based on Pairings

    Institute of Scientific and Technical Information of China (English)

    HU Xiaoming; HUANG Shangteng

    2006-01-01

    Fail-stop signature schemes provide security for a signer against forgeries of an enemy with unlimited computational power by enabling the signer to provide a proof of forgery when a forgery happens. Chang et al proposed a robust fail-stop blind signature scheme based on bilinear pairings. However, in this paper, it will be found that there are several mistakes in Chang et al' fail-stop blind signature scheme. Moreover, it will be pointed out that this scheme doesn' meet the property of a fail-stop signature: unconditionally secure for a signer. In Chang et al' scheme, a forger can forge a valid signature that can' be proved by a signer using the "proof of forgery". The scheme also doesn' possess the unlinkability property of a blind signature.

  2. Too many to fail - How bonus taxation prevents gambling for bailouts

    OpenAIRE

    Hilmer, Michael

    2014-01-01

    Using a simple symmetric principal-agent model of two banks, this paper studies the effects of both bailouts and bonus taxes on risk taking and managerial compensation. In contrast to existing literature, we assume financial institutions to be systemic only on a collective basis, implying support only if they collectively fail. This too-many-to-fail assumption generates incentives for herding and collective moral hazard. If banks can anticipate bailouts, they can coordinate on equilibrium whe...

  3. Anatomical Glenoid Reconstruction Using Fresh Osteochondral Distal Tibia Allograft After Failed Latarjet Procedure

    OpenAIRE

    Sanchez, Anthony; Ferrari, Marcio B.; Akamefula, Ramesses A.; Frank, Rachel M.; Sanchez, George; Provencher, Matthew T.

    2017-01-01

    In the treatment of recurrent anterior glenohumeral instability, the Latarjet procedure has been shown to fail. This results in a need for viable revisional procedures for patients who present with this challenging pathology. We report our preferred technique for anatomical glenoid reconstruction using a fresh osteochondral distal tibia allograft after a failed Latarjet procedure. This bony augmentation technique employs a readily available dense, weight-bearing osseous tissue source that has...

  4. Cardiac protein kinases: the cardiomyocyte kinome and differential kinase expression in human failing hearts

    OpenAIRE

    Fuller, Stephen J.; Osborne, Sally A.; Leonard, Sam J.; Hardyman, Michelle A.; Vaniotis, George; Allen, Bruce G.; Sugden, Peter H.; Clerk, Angela

    2015-01-01

    Aims. Protein kinases are potential therapeutic targets for heart failure, but most studies of cardiac protein kinases derive from other systems, an approach that fails to account for specific kinases expressed in the heart and the contractile cardiomyocytes. We aimed to define the cardiomyocyte kinome (i.e. the protein kinases expressed in cardiomyocytes) and identify kinases with altered expression in human failing hearts. Methods and Results. Expression profiling (Affymetrix microarrays) d...

  5. Very Preterm Infants Failing CPAP Show Signs of Fatigue Immediately after Birth.

    Directory of Open Access Journals (Sweden)

    Melissa L Siew

    Full Text Available To investigate the differences in breathing pattern and effort in infants at birth who failed or succeeded on continuous positive airway pressure (CPAP during the first 48 hours after birth.Respiratory function recordings of 32 preterm infants were reviewed of which 15 infants with a gestational age of 28.6 (0.7 weeks failed CPAP and 17 infants with a GA of 30.1 (0.4 weeks did not fail CPAP. Frequency, duration and tidal volumes (VT of expiratory holds (EHs, peak inspiratory flows, CPAP-level and FiO2-levels were analysed.EH incidence increased 9 ml/kg with higher peak inspiratory flows than CPAP-fail infants (71.8 ± 15.8 vs. 15.5 ± 5.2 ml/kg.s, p <0.05. CPAP-fail infants required higher FiO2 (0.31 ± 0.03 vs. 0.21 ± 0.01, higher CPAP pressures (6.62 ± 0.3 vs. 5.67 ± 0.26 cmH2O and more positive pressure-delivered breaths (45 ± 12 vs. 19 ± 9% (p <0.05.At 9-12 minutes after birth, CPAP-fail infants more commonly used lower VTs and required higher peak inspiratory flow rates while receiving greater respiratory support. VT was less variable and larger VT was infrequently used reflecting early signs of fatigue.

  6. X-Parameter Based Modelling of Polar Modulated Power Amplifiers

    DEFF Research Database (Denmark)

    Wang, Yelin; Nielsen, Troels Studsgaard; Sira, Daniel

    2013-01-01

    X-parameters are developed as an extension of S-parameters capable of modelling non-linear devices driven by large signals. They are suitable for devices having only radio frequency (RF) and DC ports. In a polar power amplifier (PA), phase and envelope of the input modulated signal are applied...... at separate ports and the envelope port is neither an RF nor a DC port. As a result, X-parameters may fail to characterise the effect of the envelope port excitation and consequently the polar PA. This study introduces a solution to the problem for a commercial polar PA. In this solution, the RF-phase path...

  7. FAILED STATE

    African Journals Online (AJOL)

    Dr. Miles R. Cone

    The state as a concept and an everyday reality conjures up vastly different images and ... population tied together by some form of socio-political cohesion and governed by a ... the expectation of the provision of certain political, economic and social goods. In .... In such instances the halt and virtual disappearance of a.

  8. Application of spreadsheet to estimate infiltration parameters

    Directory of Open Access Journals (Sweden)

    Mohammad Zakwan

    2016-09-01

    Full Text Available Infiltration is the process of flow of water into the ground through the soil surface. Soil water although contributes a negligible fraction of total water present on earth surface, but is of utmost importance for plant life. Estimation of infiltration rates is of paramount importance for estimation of effective rainfall, groundwater recharge, and designing of irrigation systems. Numerous infiltration models are in use for estimation of infiltration rates. The conventional graphical approach for estimation of infiltration parameters often fails to estimate the infiltration parameters precisely. The generalised reduced gradient (GRG solver is reported to be a powerful tool for estimating parameters of nonlinear equations and it has, therefore, been implemented to estimate the infiltration parameters in the present paper. Field data of infiltration rate available in literature for sandy loam soils of Umuahia, Nigeria were used to evaluate the performance of GRG solver. A comparative study of graphical method and GRG solver shows that the performance of GRG solver is better than that of conventional graphical method for estimation of infiltration rates. Further, the performance of Kostiakov model has been found to be better than the Horton and Philip's model in most of the cases based on both the approaches of parameter estimation.

  9. Estimating Cosmological Parameter Covariance

    CERN Document Server

    Taylor, Andy

    2014-01-01

    We investigate the bias and error in estimates of the cosmological parameter covariance matrix, due to sampling or modelling the data covariance matrix, for likelihood width and peak scatter estimators. We show that these estimators do not coincide unless the data covariance is exactly known. For sampled data covariances, with Gaussian distributed data and parameters, the parameter covariance matrix estimated from the width of the likelihood has a Wishart distribution, from which we derive the mean and covariance. This mean is biased and we propose an unbiased estimator of the parameter covariance matrix. Comparing our analytic results to a numerical Wishart sampler of the data covariance matrix we find excellent agreement. An accurate ansatz for the mean parameter covariance for the peak scatter estimator is found, and we fit its covariance to our numerical analysis. The mean is again biased and we propose an unbiased estimator for the peak parameter covariance. For sampled data covariances the width estimat...

  10. Clinical observation of treating 62 patients with severe aplastic anemia failing in immunosuppressive therapy by integrative medicine

    Institute of Scientific and Technical Information of China (English)

    苏尔云

    2013-01-01

    Objective To explore treatment methods for patients with severe aplastic anemia(SAA) failing in immunosuppressive therapy(IST). Methods Totally 62 SAA patients failing in IST were treated by integrative medicine(IM).

  11. Failure to Fail in a Final Pre-service Teaching Practicum

    Directory of Open Access Journals (Sweden)

    Patricia J. Danyluk

    2015-12-01

    Full Text Available This article presents a Canadian perspective on the issue of failure to fail in Bachelor of Education programs. The issue of failure to fail in Bachelor of Education programs is one that had not been explored in any great detail. What literature does exist focuses on the strain that a teacher experiences when s/he mentors a student teacher (Siebert, Clark, Kilbridge, & Peterson, 2006 and the wide variety of situations that can result in failure (Sudzina & Knowles, 1992. This study examines whether the issue of failure to fail in final pre-service practica exist and, if so, why? Twelve interviews were conducted at a mid-sized Canadian university in Ontario with university supervisors and associate teachers on the topic of teacher candidate failure during the final teaching practicum. All participants had experience with teacher candidates struggling during practicum. Faculty commented on their supervision of student teachers in Ontario, other provinces in Canada, and the United States. Results indicate that both university supervisors and associate teachers find the decision to fail a student teacher difficult, taking an emotional toll on both the supervisor and the student. University faculty report the decision to fail results in additional work for the faculty responsible; however, failure to fail an underperforming student teacher could diminish the reputation of professional programs. Associate teachers feel a sense of betrayal when their recommendations to fail an under-performing student are not followed by the university. These findings have implications for improving the quality of field experiences and support for students, associate teachers, and faculty in Bachelor of Education programs.

  12. Functional desensitization to isoproterenol without reducing cAMP production in canine failing cardiocytes.

    Science.gov (United States)

    Laurent, C E; Cardinal, R; Rousseau, G; Vermeulen, M; Bouchard, C; Wilkinson, M; Armour, J A; Bouvier, M

    2001-02-01

    To corroborate alterations in the functional responses to beta-adrenergic receptor (beta-AR) stimulation with changes in beta-AR signaling in failing cardiomyocytes, contractile and L-type Ca(2+) current responses to isoproterenol along with stimulated cAMP generation were compared among cardiomyocytes isolated from canines with tachycardia-induced heart failure or healthy hearts. The magnitude of shortening of failing cardiomyocytes was significantly depressed (by 22 +/- 4.4%) under basal conditions, and the maximal response to isoproterenol was significantly reduced (by 45 +/- 18%). Similar results were obtained when the responses in the rate of contraction and rate of relaxation to isoproterenol were considered. The L-type Ca(2+) current amplitude measured in failing cardiomyocytes under basal conditions was unchanged, but the responses to isoproterenol were significantly reduced compared with healthy cells. Isoproterenol-stimulated cAMP generation was similar in sarcolemmal membranes derived from the homogenates of failing (45 +/- 6.8) and healthy cardiomyocytes (52 +/- 8.5 pmol cAMP. mg protein(-1). min(-1)). However, stimulated cAMP generation was found to be significantly reduced when the membranes were derived from the homogenates of whole tissue (failing: 67 +/- 8.1 vs. healthy: 140 +/- 27.8 pmol cAMP. mg protein(-1). min(-1)). Total beta-AR density was not reduced in membranes derived from either whole tissue or isolated cardiomyocyte homogenates, but the beta(1)/beta(2) ratio was significantly reduced in the former (failing: 45/55 vs. healthy: 72/28) without being altered in the latter (failing: 72/28, healthy: 77/23). We thus conclude that, in tachycardia-induced heart failure, reduction in the functional responses of isolated cardiomyocytes to beta-AR stimulation may be attributed to alterations in the excitation-contraction machinery rather than to limitation of cAMP generation.

  13. Lumped-parameter models

    DEFF Research Database (Denmark)

    Ibsen, Lars Bo; Liingaard, Morten

    A lumped-parameter model represents the frequency dependent soil-structure interaction of a massless foundation placed on or embedded into an unbounded soil domain. The lumped-parameter model development have been reported by (Wolf 1991b; Wolf 1991a; Wolf and Paronesso 1991; Wolf and Paronesso 19...

  14. The failing human heart is unable to use the Frank-Starling mechanism.

    Science.gov (United States)

    Schwinger, R H; Böhm, M; Koch, A; Schmidt, U; Morano, I; Eissner, H J; Uberfuhr, P; Reichart, B; Erdmann, E

    1994-05-01

    There is evidence that the failing human left ventricle in vivo subjected to additional preload is unable to use the Frank-Starling mechanism. The present study compared the force-tension relation in human nonfailing and terminally failing (heart transplants required because of dilated cardiomyopathy) myocardium. Isometric force of contraction of electrically driven left ventricular papillary muscle strips was studied under various preload conditions (2 to 20 mN). To investigate the influence of inotropic stimulation, the force-tension relation was studied in the presence of the cardiac glycoside ouabain. In skinned-fiber preparations of the left ventricle, developed tension was measured after stretching the preparations to 150% of the resting length. To evaluate the length-dependent activation of cardiac myofibrils by Ca2+ in failing and nonfailing myocardium, the tension-Ca2+ relations were also measured. After an increase of preload, the force of contraction gradually increased in nonfailing myocardium but was unchanged in failing myocardium. There were no differences in resting tension, muscle length, or cross-sectional area of the muscles between both groups. Pretreatment with ouabain (0.02 mumol/L) restored the force-tension relation in failing myocardium and preserved the force-tension relation in nonfailing tissue. In skinned-fiber preparations of the same hearts, developed tension increased significantly after stretching only in preparations from nonfailing but not from failing myocardium. The Ca2+ sensitivity of skinned fibers was significantly higher in failing myocardium (EC50, 1.0; 95% confidence limit, 0.88 to 1.21 mumol/L) compared with nonfailing myocardium (EC50, 1.7; 95% confidence limit, 1.55 to 1.86 mumol/L). After increasing the fiber length by stretching, a significant increase in the sensitivity of the myofibrils to Ca2+ was observed in nonfailing but not in failing myocardium. These experiments provide evidence for an impaired force

  15. 40 CFR 1042.320 - What happens if one of my production-line engines fails to meet emission standards?

    Science.gov (United States)

    2010-07-01

    ...-line engines fails to meet emission standards? 1042.320 Section 1042.320 Protection of Environment... if one of my production-line engines fails to meet emission standards? (a) If you have a production... an initial failed test if all of the following are true: (1) The catalyst was in a green...

  16. Characteristics of successful and failed mentoring relationships: a qualitative study across two academic health centers.

    Science.gov (United States)

    Straus, Sharon E; Johnson, Mallory O; Marquez, Christine; Feldman, Mitchell D

    2013-01-01

    To explore the mentor-mentee relationship with a focus on determining the characteristics of effective mentors and mentees and understanding the factors influencing successful and failed mentoring relationships. The authors completed a qualitative study through the Departments of Medicine at the University of Toronto Faculty of Medicine and the University of California, San Francisco, School of Medicine between March 2010 and January 2011. They conducted individual, semistructured interviews with faculty members from different career streams and ranks and analyzed transcripts of the interviews, drawing on grounded theory. The authors completed interviews with 54 faculty members and identified a number of themes, including the characteristics of effective mentors and mentees, actions of effective mentors, characteristics of successful and failed mentoring relationships, and tactics for successful mentoring relationships. Successful mentoring relationships were characterized by reciprocity, mutual respect, clear expectations, personal connection, and shared values. Failed mentoring relationships were characterized by poor communication, lack of commitment, personality differences, perceived (or real) competition, conflicts of interest, and the mentor's lack of experience. Successful mentorship is vital to career success and satisfaction for both mentors and mentees. Yet challenges continue to inhibit faculty members from receiving effective mentorship. Given the importance of mentorship on faculty members' careers, future studies must address the association between a failed mentoring relationship and a faculty member's career success, how to assess different approaches to mediating failed mentoring relationships, and how to evaluate strategies for effective mentorship throughout a faculty member's career.

  17. The Reputational Consequences of Failed Replications and Wrongness Admission among Scientists.

    Directory of Open Access Journals (Sweden)

    Adam K Fetterman

    Full Text Available Scientists are dedicating more attention to replication efforts. While the scientific utility of replications is unquestionable, the impact of failed replication efforts and the discussions surrounding them deserve more attention. Specifically, the debates about failed replications on social media have led to worry, in some scientists, regarding reputation. In order to gain data-informed insights into these issues, we collected data from 281 published scientists. We assessed whether scientists overestimate the negative reputational effects of a failed replication in a scenario-based study. Second, we assessed the reputational consequences of admitting wrongness (versus not as an original scientist of an effect that has failed to replicate. Our data suggests that scientists overestimate the negative reputational impact of a hypothetical failed replication effort. We also show that admitting wrongness about a non-replicated finding is less harmful to one's reputation than not admitting. Finally, we discovered a hint of evidence that feelings about the replication movement can be affected by whether replication efforts are aimed one's own work versus the work of another. Given these findings, we then present potential ways forward in these discussions.

  18. The dilemma of the failed state thesis in post-9/11 world affairs

    Directory of Open Access Journals (Sweden)

    A. Schoeman

    2008-07-01

    Full Text Available The 9/11 terrorist attacks shifted the emphasis of failed states as just a regional humanitarian problem to one that could present a global security threat. In this regard US policymakers, especially, identified failed states as possible terrorist threats. However, this renewed attention to the study of state failure has exposed a number of theoretical weaknesses in this body of literature. The latter could mainly be ascribed to the way in which US policy makers have often used generalised definitions of failed states and then applied it to states that are perceived as threats. Another problem is the fact that government sponsored research institutes and think tanks are operating independently from university academics. This situation has caused theoretical confusion as conditions in failed states are often interpreted differently resulting in the development of a number of opposing theories, definitions and confusing classification models. The body of literature is further accused of endorsing a “Weberian” definition (ideal type of the state against which degrees of “failure” in non-complying states are measured. This article will investigate the extent of these theoretical weaknesses and expose the dangers of following an approach that seem to misinterpret the political realities of developing states (often regarded as failed – this despite having an extensive popular following. It will further focus on possible alternative approaches – or the formulation of ideas that are better suited and relevant to the often unique internal political, social and economic dynamics of unstable states.

  19. Bayesian method for system reliability assessment of overlapping pass/fail data

    Institute of Scientific and Technical Information of China (English)

    Zhipeng Hao; Shengkui Zeng; Jianbin Guo

    2015-01-01

    For high reliability and long life systems, system pass/fail data are often rare. Integrating lower-level data, such as data drawn from the subsystem or component pass/fail testing, the Bayesian analysis can improve the precision of the system reli-ability assessment. If the multi-level pass/fail data are overlapping, one chal enging problem for the Bayesian analysis is to develop a likelihood function. Since the computation burden of the existing methods makes them infeasible for multi-component systems, this paper proposes an improved Bayesian approach for the system reliability assessment in light of overlapping data. This approach includes three steps: fristly searching for feasible paths based on the binary decision diagram, then screening feasible points based on space partition and constraint decomposition, and final y sim-plifying the likelihood function. An example of a satel ite rol ing control system demonstrates the feasibility and the efficiency of the proposed approach.

  20. Rotationplasty after failed limb-sparing tumor surgery: a report of two cases.

    Science.gov (United States)

    Brigman, Brian E; Kumagai, Steven G; McGuire, Michael H

    2003-10-01

    Rotationplasty was used in two cases of failed limb salvage in adults after tumor resection and reconstruction. Each patient had distal femoral osteosarcoma, one treated with osteoarticular allograft reconstruction, the other with a custom endoprosthetic reconstruction. Both patients had failure attributable to infection, and after multiple surgeries, elected to have rotationplasty. Both had complications associated with the rotationplasty but went on to have functional limbs with Musculoskeletal Tumor Society functional scores of 67% and 87%. One patient died of metastatic disease 29 months after rotationplasty, the other had no problems 50 months after rotationplasty. Although rotationplasty offers a functional improvement over transfemoral amputation in the salvage of failed tumor reconstructions, only 10 such cases have been reported in adults. Rotationplasty should be considered in selected patients for whom an amputation is being considered after failed limb salvage surgery.

  1. Is the pass/fail system applicable to a medical school in Korea?

    Science.gov (United States)

    Kim, Mee Young

    2007-01-01

    To determine whether a pass/fail system is more appropriate for medical education instead of a grade-based system, a survey of medical students and faculty members of Hallym University, Korea, was taken. A questionnaire was delivered to 54 junior students and 36 faculty members from a medical school in Korea and analyzed. Of these participants, 37.7% of students and 36.1% of faculty agreed to the pass/fail system, while 28.3% of students and 52.8% of faculty objected to it. The most frequent reason for objection was the potential decrease in learning achievement. A pass/fail system should be considered after persuasion of the students and faculty to think positively of this system.

  2. Bicanalicular versus monocanalicular intubation after failed probing in congenital nasolacrimal duct obstruction

    Science.gov (United States)

    Rajabi, Mohammad Taher; Zavarzadeh, Najmeh; Mahmoudi, Alireza; Johari, Mohammad Karim; Hosseini, Seyedeh Simindokht; Abrishami, Yalda; Rajabi, Mohammad Bagher

    2016-01-01

    AIM To investigate the clinical outcomes of different intubation techniques in the cases of failed primary probing. METHODS This retrospective study was performed on 338 patients with the diagnosis of congenital nasolacrimal duct obstruction with age 1-4y that had failed primary probing. Intubation was performed under light sedation in operating room and the stent was left 3mo in place. Clinical outcome was investigated 3mo after tube removal. RESULTS Bicanalicular intubation method had higher complete and relative success rates compared to monocanalicular intubation (P=0.00). In addition, Monoka intubation had better outcomes compared to Masterka technique (P=0.046). No difference was found between genders but the higher the age, the better the outcomes with bicanalicular technique rather than monocanalicular. CONCLUSION Overall success rate of bicanalicular intubation is superior to monocanalicular technique especially in older ages. Also, based upon our clinical outcomes, Masterka intubation is not recommended in cases of failed probing. PMID:27803865

  3. Acute effects of sildenafil and dobutamine in the hypertrophic and failing right heart in vivo

    DEFF Research Database (Denmark)

    Andersen, Asger; Nielsen, Jan M; Rasalingam, Sivagowry

    2013-01-01

    Abstract The purpose of this study was to investigate whether acute intravenous administration of the phosphodiesterase type 5 (PDE-5) inhibitor sildenafil in a single clinically relevant dose improves the in vivo function of the hypertrophic and failing right ventricle (RV). Wistar rats ([Formula...... significant hypertrophy, cardiac fibrosis, and reduction in RV function evaluated by echocardiography (TAPSE) and invasive pressure measurements. Sildenafil did not improve the function of the hypertrophic failing right heart in vivo, measured by TAPSE, RV systolic pressure (RVsP), and dp/dtmax. Dobutamine...... administration of the PDE-5 inhibitor sildenafil in a single clinically relevant dose did not modulate the in vivo function of the hypertrophic failing right heart of the rat measured by echocardiography and invasive hemodynamics. In the same model, dobutamine acutely improved RV function....

  4. Semi-automated Method for Failed Eruptions Search in SDO Data Base: Methodology and First Results

    Science.gov (United States)

    Mrozek, T.; Gronkiewicz, D.; Kołomański, S.; Chmielewska, E.; Chruślińska, M.

    It is well known that not all solar flares are connected with eruptions followed by coronal mass ejection (CME). Even strongest X-class flares may not be accompanied by eruptions or are accompanied by failed eruptions. There are several mechanisms responsible which were proposed. Present observations of SDO/AIA give a chance for deep statistical analysis of properties of an active region that may confine an eruption. Therefore, we developed automated method which can recognize moving structures and confined eruptions in AIA images. We present the algorithm and its performance for 1 April 2012 - 1 July 2012 period. The algorithm found more than 600 dynamic events. More than 30% of them are failed eruptions. Developed algorithm is very effective and gives a chance for huge increase of failed eruption data base.

  5. Supersymmetry Parameter Analysis

    CERN Document Server

    Kalinowski, Jan

    2002-01-01

    Supersymmetric particles can be produced copiously at future colliders. From the high-precision data taken at e+e- linear colliders, TESLA in particular, and combined with results from LHC, and CLIC later, the low-energy parameters of the supersymmetric model can be determined. Evolving the parameters from the low-energy scale to the high-scale by means of renormalization group techniques the fundamental supersymmetry parameters at the high scale, GUT or Planck, can be reconstructed to reveal the origin of supersymmetry breaking.

  6. Magnetic S-parameter

    DEFF Research Database (Denmark)

    Sannino, Francesco

    2010-01-01

    We propose a direct test of the existence of gauge duals for nonsupersymmetric asymptotically free gauge theories developing an infrared fixed point by computing the S-parameter in the electric and dual magnetic description. In particular we show that at the lower bound of the conformal window...... the magnetic S-parameter, i.e. the one determined via the dual magnetic gauge theory, assumes a simple expression in terms of the elementary magnetic degrees of freedom. The results further support our recent conjecture of the existence of a universal lower bound on the S parameter and indicates...

  7. New Developments in FPGA Devices: SEUs and Fail-Safe Strategies from the NASA Goddard Perspective

    Science.gov (United States)

    Berg, Melanie; LaBel, Kenneth; Pellish, Jonathan

    2016-01-01

    It has been shown that, when exposed to radiation environments, each Field Programmable Gate Array (FPGA) device has unique error signatures. Subsequently, fail-safe and mitigation strategies will differ per FPGA type. In this session several design approaches for safe systems will be presented. It will also explore the benefits and limitations of several mitigation techniques. The intention of the presentation is to provide information regarding FPGA types, their susceptibilities, and proven fail-safe strategies; so that users can select appropriate mitigation and perform the required trade for system insertion. The presentation will describe three types of FPGA devices and their susceptibilities in radiation environments.

  8. New Developments in FPGA: SEUs and Fail-Safe Strategies from the NASA Goddard Perspective

    Science.gov (United States)

    Berg, Melanie D.; Label, Kenneth A.; Pellish, Jonathan

    2016-01-01

    It has been shown that, when exposed to radiation environments, each Field Programmable Gate Array (FPGA) device has unique error signatures. Subsequently, fail-safe and mitigation strategies will differ per FPGA type. In this session several design approaches for safe systems will be presented. It will also explore the benefits and limitations of several mitigation techniques. The intention of the presentation is to provide information regarding FPGA types, their susceptibilities, and proven fail-safe strategies; so that users can select appropriate mitigation and perform the required trade for system insertion. The presentation will describe three types of FPGA devices and their susceptibilities in radiation environments.

  9. Percutaneous N-Butyl cyanoacrylate embolization of a pancreatic pseudoaneurysm after failed attempts of transcatheter embolization

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ri Hyeon; Yoo, Roh Eul; Kim, Hyo Cheol [Seoul National University Medical Research Center, and Clinical Research Institute, Seoul National University Hospital, Seoul (Korea, Republic of)

    2014-10-15

    One common complication after major pancreatic surgery is bleeding. Herein we describe a case of pancreatic pseudoaneurysm which developed after pylorous preserving pancreaticoduodenectomy for common bile duct cancer. Three attempts of transcatheter embolization failed since feeders to the pseudoaneurysm had unfavorable anatomy. Direct percutaneous N-butyl cyanoacrylate injection was performed under fluoroscopy-guidance and the pseudoaneurysm was successfully treated. Percutaneous fluoroscopy-guided direct N-butyl cyanoacrylate injection may be a useful alternative when selective transcatheter embolization fails or is technically challenging.

  10. Anatomical Glenoid Reconstruction Using Fresh Osteochondral Distal Tibia Allograft After Failed Latarjet Procedure.

    Science.gov (United States)

    Sanchez, Anthony; Ferrari, Marcio B; Akamefula, Ramesses A; Frank, Rachel M; Sanchez, George; Provencher, Matthew T

    2017-04-01

    In the treatment of recurrent anterior glenohumeral instability, the Latarjet procedure has been shown to fail. This results in a need for viable revisional procedures for patients who present with this challenging pathology. We report our preferred technique for anatomical glenoid reconstruction using a fresh osteochondral distal tibia allograft after a failed Latarjet procedure. This bony augmentation technique employs a readily available dense, weight-bearing osseous tissue source that has excellent conformity, as well as the added benefit of a cartilaginous surface to correct chondral deficiencies. Given its effectiveness in the Latarjet revision setting and low complication rate, the distal tibia allograft is a reasonable treatment option.

  11. In my Wish List, an Automated Tool for Fail-Secure Design Analysis: an Alloy-Based Feasibility Draft

    Directory of Open Access Journals (Sweden)

    Gurvan Le Guernic

    2014-05-01

    Full Text Available A system is said to be fail-secure, sometimes confused with fail-safe, if it maintains its security requirements even in the event of some faults. Fail-secure analyses are required by some validation schemes, such as some Common Criteria or NATO certifications. However, it is an aspect of security which as been overlooked by the community. This paper attempts to shed some light on the fail-secure field of study by: giving a definition of fail-secure as used in those certification schemes, and emphasizing the differences with fail-safe; and exhibiting a first feasibility draft of a fail-secure design analysis tool based on the Alloy model checker.

  12. Expression of chondro-osteogenic BMPs in ossified failed tendon healing model of tendinopathy.

    Science.gov (United States)

    Yee Lui, Pauline Po; Wong, Yin Mei; Rui, Yun Feng; Lee, Yuk Wa; Chan, Lai Shan; Chan, Kai Ming

    2011-06-01

    Chondrocytes phenotype/markers were expressed in clinical samples of tendinopathy and calcifying tendinopathy. This study examined the spatial-temporal expression of chondro-osteogenic Bone Morphogenetic Proteins (BMPs), which might contribute to ectopic chondro-osteogenesis and failed healing process in tendinopathy. Collagenase was injected into patellar tendon of rats to induce ossified failed tendon healing. At week 2, 4, 8, 12, and 16, the patella tendon was harvested for immunohistochemical staining and analysis of BMP-2/4/7. BMP-4/7 showed similar expression patterns, which was different from BMP-2. The expression of BMP-2 in the tendon matrix increased at week 2 and was reduced to nearly undetectable level afterwards except at the chondro-ossification sites. However, the expression of BMP-4/7 in the healing tendon fibroblast-like cells and matrix increased at week 2, reduced at week 4 and 8 and increased again at week 12 and 16, consistent with transient healing at week 8 in this animal model. There was increasing strong expression of BMP-4/7 in the chondrocyte-like cells in the un-ossified and ossified areas from week 8-16. BMP-4/7, besides BMP-2, might also contribute to ectopic chondro-osteogenesis and failed healing in tendon injuries. BMP-4/7, but not BMP-2, might be involved in regulating late events in ossified failed tendon healing.

  13. Biomechanics of failed deglutitive upper esophageal sphincter relaxation in neurogenic dysphagia.

    Science.gov (United States)

    Williams, Rohan B H; Wallace, Karen L; Ali, Galib N; Cook, Ian J

    2002-07-01

    Our aims were to examine the etiology and biomechanical properties of the nonrelaxing upper esophageal sphincter (UES) and the relationship between UES opening and failed relaxation. We examined the relationships among swallowed bolus volume, intrabolus pressure, sagittal UES diameter, the pharyngeal swallow response, and geniohyoid shortening in 18 patients with failed UES relaxation, 23 healthy aged controls, and 15 with Zenker's diverticulum. Etiology of failed UES relaxation was 56% medullary disease, 33% Parkinson's or extrapyramidal disease; and 11% idiopathic. Extent of UES opening ranged from absent to normal and correlated with preservation of the pharyngeal swallow response (P = 0.012) and geniohyoid shortening (P = 0.046). Intrabolus pressure was significantly greater compared with aged controls (P < 0.001) or Zenker's diverticulum (P < 0.001). The bolus volume-dependent increase in intrabolus pressure evident in controls was not observed in failed UES relaxation. The nonrelaxing UES therefore displays a constant loss of sphincter compliance throughout the full, and potentially normal, range of expansion during opening. Adequacy of UES opening is influenced by the degree of preservation of the pharyngeal swallow response and hyolaryngeal traction. In contrast, the stenotic UES displays a static loss of compliance, only apparent once the limit of sphincter expansion is reached.

  14. Assisting Driver Sovereignty: A Fail-Safe Design Approach to Driver Distraction

    NARCIS (Netherlands)

    Van Gijssel, A.

    2013-01-01

    This thesis investigates the potential of a fail-safe approach to driver distraction through novel interface concepts for integrated Advanced Driver Assistance Systems (ADAS). Traffic accidents are a negative side effect of the universal and economical desire for mobility. The year 2009 saw the alar

  15. Glucose-6-phosphate dehydrogenase-derived NADPH fuels superoxide production in the failing heart

    Science.gov (United States)

    In the failing heart, NADPH oxidase and uncoupled NO synthase utilize cytosolic NADPH to form superoxide. NADPH is supplied principally by the pentose phosphate pathway, whose rate-limiting enzyme is glucose 6-phosphate dehydrogenase (G6PD). Therefore, we hypothesized that cardiac G6PD activation dr...

  16. Timing of dialysis initiation in transplant-naive and failed transplant patients

    Science.gov (United States)

    Molnar, Miklos Z.; Ojo, Akinlolu O.; Bunnapradist, Suphamai; Kovesdy, Csaba P.; Kalantar-Zadeh, Kamyar

    2017-01-01

    Over the past two decades, most guidelines have advocated early dialysis initiation on the basis of studies showing improved survival in patients starting dialysis early. These recommendations led to an increase in the proportion of patients initiating dialysis with an estimated glomerular filtration rate (eGFR) >10 ml/min/1.73 m2, from 20% in 1996 to 52% in 2008. During this period, patients starting dialysis with an eGFR ≥15 ml/min/1.73 m2 increased from 4% to 17%. However, recent studies have failed to substantiate a benefit of early dialysis initiation and some data have suggested worse outcomes in patients starting dialysis with a higher eGFR. Several reasons for this seemingly paradoxical observation have been suggested, including the fact that patients requiring early dialysis are likely to have more severe symptoms and comorbidities, leading to confounding by indication, as well as biological mechanisms that causally relate early dialysis therapy to adverse outcomes. Dialysis reinitiation in patients with a failing renal allograft encounters similar problems. However, unique factors associated with a failed allograft means that the optimal timing of dialysis initiation in failed transplant patients might differ from that in transplant-naive patients. In this Review, we will discuss studies of dialysis initiation and compare risks and benefits of early versus late dialysis therapy. PMID:22371250

  17. On Global Absences: Reflections on the Failings in the Education and Poverty Relationship in Latin America

    Science.gov (United States)

    Bonal, Xavier

    2007-01-01

    This paper explores some of the aspects of the relationship between education and poverty as it has been constructed by international organisations and national governments in Latin America. The analysis is carried out from two separate angles. On the one hand, the paper highlights the main failings that underlie the positive and hoped-for…

  18. Fit to be unethical: How successful/failed regulatory goal attainment motivates unethical behavior

    NARCIS (Netherlands)

    Vriend, Tim; Jordan, Jennifer; Janssen, Onne

    2013-01-01

    On the basis of regulatory fit theory we argue and show that a regulatory fit induced through successful or failed attainment of goals that specify gains vs. losses (Study 1) or nurturance vs. security (Study 2), will lead individuals to engage in unethical behavior in a subsequent task.

  19. Large Steel Tank Fails and Rockets to Height of 30 meters - Rupture Disc Installed Incorrectly

    DEFF Research Database (Denmark)

    Hedlund, Frank Huess; Selig, Robert Simon; Kragh, Eva K.

    2016-01-01

    At a brewery, the base plate-to-shell weld seam of a 90-m3 vertical cylindrical steel tank failed catastrophically. The 4 ton tank “took off” like a rocket leaving its contents behind, and landed on a van, crushing it. The top of the tank reached a height of 30 m. The internal overpressure...

  20. Measuring too-big-to-fail funding advantages from small banks’ CDS spreads

    NARCIS (Netherlands)

    Bijlsma, M.; Lukkezen, J.H.J.; Marinova, K.

    2014-01-01

    Large banks derive a funding advantage from being too-big-to-fail, while small banks do not. To estimate the funding advantage we explain the CDS spreads of small banks in six major European countries during the crisis by market fundamentals and bank-specific characteristics. Next, we extrapolate an

  1. Persistent postpartum haemorrhage after failed arterial ligation: value of pelvic embolisation

    Energy Technology Data Exchange (ETDEWEB)

    Fargeaudou, Yann; Soyer, Philippe; Sirol, Marc; Boudiaf, Mourad; Dahan, Henri; Dref, Olivier le [Hopital Lariboisiere AP-HP et Universite Diderot-Paris 7, Department of Abdominal and Interventional Imaging, Paris (France); Morel, Olivier; Barranger, Emmanuel [Hopital Lariboisiere AP-HP, Department of Obstetrics and Gynecology, Paris (France); Gayat, Etienne; Mebazaa, Alexandre [Hopital Lariboisiere AP-HP, Department of Anesthesiology and Intensive Care Medicine, Paris (France)

    2010-07-15

    To evaluate the role and efficacy of pelvic embolisation in the treatment of persistent postpartum haemorrhage after failed arterial ligation and to identify the complications of this procedure in this specific population. The clinical files and angiographic examinations of 12 consecutive women (mean age 32 years) who were treated with pelvic embolisation because of persistent, severe postpartum haemorrhage after failed arterial ligation were reviewed. Angiography revealed that persistent bleeding was due to incomplete arterial ligation (n = 4) or the presence of newly developed anastomotic routes (n = 8). In 11 women, pelvic embolisation stopped the bleeding. Hysterectomy was needed in one woman with retained placenta. Two complications due to pelvic embolisation, including leg ischaemia and transient sciatic nerve ischaemia, were identified, both after internal iliac artery ligation. In women with persistent postpartum haemorrhage after failed arterial ligation, pelvic embolisation is an effective treatment in most cases. However, embolisation of the anastomotic routes that contribute to persistent bleeding may result in ischaemic complications. These potential complications reaffirm that arterial ligation should not be the favoured option for postpartum haemorrhage and that special care must be given during pelvic embolisation after failed arterial ligation. (orig.)

  2. Clinically failed eggs as a source of normal human embryo stem cells.

    Science.gov (United States)

    De Sousa, Paul A; Gardner, John; Sneddon, Sharon; Pells, Steve; Tye, Britt Jorgensen; Dand, Pawlina; Collins, Daniel M; Stewart, Karen; Shaw, Lisa; Przyborski, Stefan; Cooke, Michael; McLaughlin, K John; Kimber, Susan J; Lieberman, Brian A; Wilmut, Ian; Brison, Daniel R

    2009-05-01

    The promise of human embryo stem cells (hESCs) for regenerative medicine is offset by the ethical and practical challenges involved in sourcing eggs and embryos for this objective. In this study we sought to isolate an hESC line from clinically failed eggs, the usage of which would not conflict with donor interests to conceive. A total of 8 blastocysts were allocated for hESC derivation from a pool of 579 eggs whose fertilization had been clinically assessed to have occurred abnormally (i.e., three pronuclei) or failed (i.e., no pronuclei) following in vitro insemination or intracytoplasmic sperm injection (ICSI). The latter were subjected to a recovery intervention consisting of either reinsemination by ICSI or parthenogenetic stimulation. One hESC line (RCM1) was obtained from a failed-to-fertilize inseminated egg recovered by parthenogenetic activation. Standard in vitro and in vivo characterization revealed this line to possess all of the properties attributed to a normal euploid hESC line. Whole-genome single-nucleotide polymorphism analysis further revealed that the line was biparental, indicating that sperm penetration had occurred, although parthenogenetic stimulation was required for activation. Our results demonstrate the viability of an alternative strategy to generate normal hESC lines from clinically failed eggs, thereby further minimizing the potential to conflict with donor reproductive interest to conceive.

  3. The Consistency and Uncertainty in Examiners' Definitions of Pass/Fail Performance on OSCE Stations.

    Science.gov (United States)

    Rothman, Arthur I.; And Others

    1996-01-01

    Results of the fall 1993 administration of part two of the Medical Council of Canada's Evaluating Examination for 744 candidates provided evidence of the consistency of the pass/fail and cutting score definitions for the objective- structured clinical examination stations used across examiners. These results support the validity of this…

  4. Comparison of Dental Students' Academic Performance Using Honors/Pass/Fail and Letter Grades.

    Science.gov (United States)

    Leske, Gary S.; Ripa, Louis

    1985-01-01

    Performance in a second-year course in pedodontics/orthodontics for three classes at the State University of New York at Stony Brook School of Dental Medicine who received grades under an honors/pass/fail system was compared to that of three academically comparable classes that received letter grades. (Author/MLW)

  5. Reverse translation of failed treatments can help improving the validity of preclinical animal models

    NARCIS (Netherlands)

    't Hart, Bert A.

    2015-01-01

    A major challenge in translational research is to reduce the currently high proportion of new candidate treatment agents for neuroinflammatory disease, which fail to reproduce promising effects observed in animal models when tested in patients. This disturbing situation has raised criticism against

  6. CO2 laser surface treatment of failed dental implants for re-implantation: an animal study.

    Science.gov (United States)

    Kasraei, Shahin; Torkzaban, Parviz; Shams, Bahar; Hosseinipanah, Seyed Mohammad; Farhadian, Maryam

    2016-07-01

    The aim of the present study was to evaluate the success rate of failed implants re-implanted after surface treatment with CO2 laser. Despite the widespread use of dental implants, there are many incidents of failures. It is believed that lasers can be applied to decontaminate the implant surface without damaging the implant. Ten dental implants that had failed for various reasons other than fracture or surface abrasion were subjected to CO2 laser surface treatment and randomly placed in the maxillae of dogs. Three failed implants were also placed as the negative controls after irrigation with saline solution without laser surface treatment. The stability of the implants was evaluated by the use of the Periotest values (PTVs) on the first day after surgery and at 1, 3, and 6 months post-operatively. The mean PTVs of treated implants increased at the first month interval, indicating a decrease in implant stability due to inflammation followed by healing of the tissue. At 3 and 6 months, the mean PTVs decreased compared to the 1-month interval (P implant stability. The mean PTVs increased in the negative control group compared to baseline (P implants were significantly lower than control group at 3 and 6 months after implant placement (P implantation of failed implants in Jack Russell Terrier dogs after CO2 laser surface debridement is associated with a high success rate in terms of implant stability.

  7. 49 CFR 192.1009 - What must an operator report when compression couplings fail?

    Science.gov (United States)

    2010-10-01

    ...) PIPELINE SAFETY TRANSPORTATION OF NATURAL AND OTHER GAS BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Gas... 49 Transportation 3 2010-10-01 2010-10-01 false What must an operator report when compression couplings fail? 192.1009 Section 192.1009 Transportation Other Regulations Relating to Transportation...

  8. Assisting Driver Sovereignty: A Fail-Safe Design Approach to Driver Distraction

    NARCIS (Netherlands)

    Van Gijssel, A.

    2013-01-01

    This thesis investigates the potential of a fail-safe approach to driver distraction through novel interface concepts for integrated Advanced Driver Assistance Systems (ADAS). Traffic accidents are a negative side effect of the universal and economical desire for mobility. The year 2009 saw the alar

  9. Comparison of Dental Students' Academic Performance Using Honors/Pass/Fail and Letter Grades.

    Science.gov (United States)

    Leske, Gary S.; Ripa, Louis

    1985-01-01

    Performance in a second-year course in pedodontics/orthodontics for three classes at the State University of New York at Stony Brook School of Dental Medicine who received grades under an honors/pass/fail system was compared to that of three academically comparable classes that received letter grades. (Author/MLW)

  10. When social security fails to provide emotional security: single parent households and the contractual welfare state

    NARCIS (Netherlands)

    Tonkens, E.; Verplanke, L.

    2013-01-01

    The provision of services in the contractual welfare state is conditional. If one wants to receive a service, one has to comply with the demands of the provider. If one fails to do so, the organisation threatens to terminate its services, and indeed often does so. There are, however, people who brea

  11. Leadership and the Failed State Status of Nigeria (2010 -2012. An Enquiry

    Directory of Open Access Journals (Sweden)

    Jide Ibietan

    2013-08-01

    Full Text Available The main objective of this paper is to evaluate the impact of leadership in redressing the failed state status of Nigeria with a focus on the present administration (between 2010 and 2012. For the past three years, Nigeria has been keeping the ugly company and ranking consistently as the fourteenth on the list of failed states, but the governing elites have been making spirited campaigns and slow haste in explaining away this situation. Through heavy reliance on secondary sources of data, the utilization of elite theory as framework, backed by the analytical approach to the issues raised/discussed, the paper observed that the ranking of Nigeria on the failed state index ignores some historical facts and current situational realities which make the failed criteria suspect and questionable. There is therefore the need to rethink and tinker with some of these criteria to reflect socio-economic and political performance in realistic terms. Purposeful and people –centered approach to governance capable of redressing the dysfunctions of the Nigerian state is also canvassed.

  12. When goal pursuit fails: The functions of counterfactual thought in intention formation

    NARCIS (Netherlands)

    Epstude, K.; Roese, N.J.

    2011-01-01

    Counterfactual thoughts predominantly occur in response to failed goal pursuit. The primary function of self-related counterfactuals seems to be correction of specific behaviors and preparation for future successful goal attainment. In the present article we describe a model that outlines this view

  13. Cognitive Levels and Approaches Taken by Students Failing Written Examinations in Mathematics

    Science.gov (United States)

    Roegner, Katherine

    2013-01-01

    A study was conducted at the Technical University Berlin involving students who twice failed the written examination in the first semester course Linear Algebra for Engineers in order to better understand the reasons behind their failure. The study considered student understanding in terms of Bloom's taxonomy and the ways in which students…

  14. Why Fish Oil Fails: A Comprehensive 21st Century Lipids-Based Physiologic Analysis

    Directory of Open Access Journals (Sweden)

    B. S. Peskin

    2014-01-01

    Full Text Available The medical community suffered three significant fish oil failures/setbacks in 2013. Claims that fish oil’s EPA/DHA would stop the progression of heart disease were crushed when The Risk and Prevention Study Collaborative Group (Italy released a conclusive negative finding regarding fish oil for those patients with high risk factors but no previous myocardial infarction. Fish oil failed in all measures of CVD prevention—both primary and secondary. Another major 2013 setback occurred when fish oil’s DHA was shown to significantly increase prostate cancer in men, in particular, high-grade prostate cancer, in the Selenium and Vitamin E Cancer Prevention Trial (SELECT analysis by Brasky et al. Another monumental failure occurred in 2013 whereby fish oil’s EPA/DHA failed to improve macular degeneration. In 2010, fish oil’s EPA/DHA failed to help Alzheimer’s victims, even those with low DHA levels. These are by no means isolated failures. The promise of fish oil and its so-called active ingredients EPA / DHA fails time and time again in clinical trials. This lipids-based physiologic review will explain precisely why there should have never been expectation for success. This review will focus on underpublicized lipid science with a focus on physiology.

  15. 30 CFR 77.902-1 - Fail safe ground check circuits; maximum voltage.

    Science.gov (United States)

    2010-07-01

    ... voltage. 77.902-1 Section 77.902-1 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF... OF UNDERGROUND COAL MINES Low- and Medium-Voltage Alternating Current Circuits § 77.902-1 Fail safe ground check circuits; maximum voltage. The maximum voltage used for ground check circuits under §...

  16. 30 CFR 77.803-1 - Fail safe ground check circuits; maximum voltage.

    Science.gov (United States)

    2010-07-01

    ... voltage. 77.803-1 Section 77.803-1 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF... OF UNDERGROUND COAL MINES Surface High-Voltage Distribution § 77.803-1 Fail safe ground check circuits; maximum voltage. The maximum voltage used for ground check circuits under § 77.803 shall...

  17. The Impact of a Pass/Fail Option on Negotiation Course Performance.

    Science.gov (United States)

    Craver, Charles B.

    1998-01-01

    A law school professor analyzed data on pass/fail grading and conventional grading in his legal negotiation class over 11 years to determine statistically significant differences in performance of the two groups of students. Grades for both negotiation simulation exercises and written papers were analyzed. Results showed differences between the…

  18. Investigation of Occupational Asthma: Do Clinicians Fail to Identify rRelevant Occupational Exposures?

    Directory of Open Access Journals (Sweden)

    Carlo de Olim

    2015-01-01

    Full Text Available BACKGROUND: Specific inhalation challenges (SIC enable the identification of the agent responsible of occupational asthma (OA. A clinician may fail to identify a specific agent in the workplace, which may potentially lead to a misdiagnosis. The expert assessment method performed by an occupational hygienist has been used to evaluate occupational exposures in epidemiological studies.

  19. Contribution of NHE-1 to cell length cardiac shortening of normal and failing rabbit myocytes

    NARCIS (Netherlands)

    M.M.G.J. van Borren; J.G. Zegers; A. Baartscheer; J.H. Ravesloot

    2006-01-01

    At the same intracellular pH (pH(i)) Na+/H+ exchange (NHE-1) fluxes of ventricular myocytes of hypertrophied failing hearts (HFH) are increased. We assessed how NHE-1 affected cell length shortening. pH(i) was measured fluorimetrically in resting and twitching (1 - 3 Hz)normal and HFH rabbit myocyte

  20. The Revival of a Failed Constructed Wetland Treating of a High Fe Load AMD

    Science.gov (United States)

    A.D. Karathanasis; C.D. Barton

    1999-01-01

    Acid mine drainage (AMD) from abandoned mines has significantly impaired water quality in eastern Kentucky. A small surface flow wetland constructed in 1989 to reduce AMD effects and subsequently failed after six months of operation was renovated by incorporating anoxic limestone drains (ALDs) and anaerobic subsurface drains promoting vertical flow through successive...

  1. Preschoolers' Behavioural Reenactment of ''Failed Attempts'': The Roles of Intention-Reading, Emulation and Mimicry

    Science.gov (United States)

    Huang, Chi-Tai; Heyes, Celilia; Charman, Tony

    2006-01-01

    To clarify the nature of the social cognitive skills involved in preschoolers' reenactment of actions on objects, we studied 31- and 41-month-old children's reenactment of intended acts (''failed attempts'') in Meltzoff's [Meltzoff, A. N. (1995)]. Understanding the intentions of others: Reenactment of intended acts by 18-month-old children.…

  2. Why Communes Fail: A Comparative Analysis of the Viability of Danish and American Communes

    Science.gov (United States)

    Shey, Thomas H.

    1977-01-01

    Danish communes, while exhibiting substantial flexibility, ingenuity and viability, invariably fail for primarily personal reasons or motives. However, unlike their American counterparts, economic and practical considerations play a correspondingly minor role. Presented at the Southern Sociological Society, Miami, Florida, April 9, 1976. (Author)

  3. The Effect of Dexmedetomidine on Lumbar Epidural Injection for Failed Back Surgery Syndrome

    Directory of Open Access Journals (Sweden)

    Ashraf Eskandr

    2016-01-01

    Full Text Available Purpose. Failed back surgery syndrome is a chronic pain condition requiring rapid, effective, and efficient management. This study evaluates the effect of adding dexmedetomidine to lumbar epidural steroids in patients with failed back surgery syndrome. Methods. Fifty patients suffering from failed back surgery syndrome were randomly assigned to one of two groups, receiving an epidural injection of 20 mL of either a mixture of betamethasone (14 mg and bupivacaine 0.5 mg (group C or a mixture of betamethasone (14 mg, bupivacaine 0.5 mg, and dexmedetomidine (0.5 μg/kg (group D adjusted to the volume with normal saline. The effect was evaluated using visual analogue scale (VAS, analgesic requirement, and Oswestry disability index 2 weeks, 4 weeks, 8 weeks, and 12 weeks after injection. Results. VAS and ibuprofen consumption showed a significant reduction in group D. The Oswestry disability index was significantly improved in group D. There were no records of hypotension, bradycardia, sedation, or hypoxemia in both groups. Conclusion. The present study demonstrated potential safe and effective usage of adding dexmedetomidine to epidural steroid to control pain in patients with failed back surgery syndrome.

  4. Updated EAU Guidelines for Clear Cell Renal Cancer Patients Who Fail VEGF Targeted Therapy.

    Science.gov (United States)

    Powles, Thomas; Staehler, Michael; Ljungberg, Börje; Bensalah, Karim; Canfield, Steven E; Dabestani, Saeed; Giles, Rachel; Hofmann, Fabian; Hora, Milan; Kuczyk, Markus A; Lam, Thomas; Marconi, Lorenzo; Merseburger, Axel S; Volpe, Alessandro; Bex, Axel

    2016-01-01

    The European Association of Urology renal cancer guidelines have been updated to recommend nivolumab and cabozantinib over the previous standard of care in patients who have failed one or more lines of VEGF targeted therapy. Copyright © 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  5. 49 CFR 26.47 - Can recipients be penalized for failing to meet overall goals?

    Science.gov (United States)

    2010-10-01

    ... overall goals? 26.47 Section 26.47 Transportation Office of the Secretary of Transportation PARTICIPATION... Goals, Good Faith Efforts, and Counting § 26.47 Can recipients be penalized for failing to meet overall goals? (a) You cannot be penalized, or treated by the Department as being in noncompliance with...

  6. Greek Technical-Vocational Education (1870-1940): Intentions and Failed Aspirations

    Science.gov (United States)

    Kiprianos, Pandelis

    2013-01-01

    From 1870 until the outbreak of the Second World War there were various attempts at educational reform in Greece, one of the most significant being the intention to establish a national technical-vocational education. The aim of this study is to examine why such a reform was deemed necessary and yet failed to be implemented. The first part…

  7. When goal pursuit fails: The functions of counterfactual thought in intention formation

    NARCIS (Netherlands)

    Epstude, K.; Roese, N.J.

    2011-01-01

    Counterfactual thoughts predominantly occur in response to failed goal pursuit. The primary function of self-related counterfactuals seems to be correction of specific behaviors and preparation for future successful goal attainment. In the present article we describe a model that outlines this view

  8. 13 CFR 142.13 - What happens if a defendant fails to file an answer?

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false What happens if a defendant fails to file an answer? 142.13 Section 142.13 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION PROGRAM FRAUD CIVIL REMEDIES ACT REGULATIONS Procedures Following Service of A Complaint § 142.13...

  9. Learning Factor Models of Students at Risk of Failing in the Early Stage of Tertiary Education

    Science.gov (United States)

    Gray, Geraldine; McGuinness, Colm; Owende, Philip; Hofmann, Markus

    2016-01-01

    This paper reports on a study to predict students at risk of failing based on data available prior to commencement of first year. The study was conducted over three years, 2010 to 2012, on a student population from a range of academic disciplines, n=1,207. Data was gathered from both student enrollment data and an online, self-reporting,…

  10. Cognitive Levels and Approaches Taken by Students Failing Written Examinations in Mathematics

    Science.gov (United States)

    Roegner, Katherine

    2013-01-01

    A study was conducted at the Technical University Berlin involving students who twice failed the written examination in the first semester course Linear Algebra for Engineers in order to better understand the reasons behind their failure. The study considered student understanding in terms of Bloom's taxonomy and the ways in which students…

  11. Grizzly West: A Failed Attempt to Reintroduce Grizzly Bears in the Mountain West

    Directory of Open Access Journals (Sweden)

    Douglas M. Richardson

    2016-05-01

    Full Text Available Reviewed: Grizzly West: A Failed Attempt to Reintroduce Grizzly Bears in the Mountain West. By Michael M. Dax. Lincoln, NE: University of Nebraska Press, 2015. x + 289 pp. US$ 37.50. ISBN 978-0-8032-6673-5.

  12. Revisiting Cosmological parameter estimation

    CERN Document Server

    Prasad, Jayanti

    2014-01-01

    Constraining theoretical models with measuring the parameters of those from cosmic microwave background (CMB) anisotropy data is one of the most active areas in cosmology. WMAP, Planck and other recent experiments have shown that the six parameters standard $\\Lambda$CDM cosmological model still best fits the data. Bayesian methods based on Markov-Chain Monte Carlo (MCMC) sampling have been playing leading role in parameter estimation from CMB data. In one of the recent studies \\cite{2012PhRvD..85l3008P} we have shown that particle swarm optimization (PSO) which is a population based search procedure can also be effectively used to find the cosmological parameters which are best fit to the WMAP seven year data. In the present work we show that PSO not only can find the best-fit point, it can also sample the parameter space quite effectively, to the extent that we can use the same analysis pipeline to process PSO sampled points which is used to process the points sampled by Markov Chains, and get consistent res...

  13. Parameter Estimation Through Ignorance

    CERN Document Server

    Du, Hailiang

    2015-01-01

    Dynamical modelling lies at the heart of our understanding of physical systems. Its role in science is deeper than mere operational forecasting, in that it allows us to evaluate the adequacy of the mathematical structure of our models. Despite the importance of model parameters, there is no general method of parameter estimation outside linear systems. A new relatively simple method of parameter estimation for nonlinear systems is presented, based on variations in the accuracy of probability forecasts. It is illustrated on the Logistic Map, the Henon Map and the 12-D Lorenz96 flow, and its ability to outperform linear least squares in these systems is explored at various noise levels and sampling rates. As expected, it is more effective when the forecast error distributions are non-Gaussian. The new method selects parameter values by minimizing a proper, local skill score for continuous probability forecasts as a function of the parameter values. This new approach is easier to implement in practice than alter...

  14. MSSM without free parameters

    Science.gov (United States)

    Kitano, Ryuichiro; Motono, Ryuji; Nagai, Minoru

    2016-12-01

    It is often argued that the minimal supersymmetric standard model has O (100 ) free parameters, and the generic parameter region is already excluded by the null observation of the flavor and C P -violating processes as well as the constraints from the LHC experiments. This situation naturally leads us to consider the case where all the dangerous soft supersymmetry breaking terms, such as the scalar masses and scalar couplings, are absent, while only the unified gaugino mass term and the μ term are nonvanishing at the grand unification scale. We revisit this simple situation taking into account the observed Higgs boson mass, 125 GeV. Since the gaugino mass and the μ term are fixed in order to explain the Higgs boson and the Z boson masses, there is no free parameter left in this scenario. We find that there are three independent parameter sets that exist including ones which have not been discussed in the literature. We also find that the abundance of the dark matter can be explained by relic gravitinos which are nonthermally produced as decay products of the supersymmetry particles while satisfying constraints from big bang nucleosynthesis. We discuss the effects of the gravity mediation which generically gives a contribution to the soft terms of the order of the gravitino mass. It turns out that a newly found parameter set is preferable to explain the Higgs boson mass as well as the gravitino dark matter while satisfying the constraints from the electric dipole moments of the electron and the nucleon.

  15. Targeted gene-silencing reveals the functional significance of myocardin signaling in the failing heart.

    Directory of Open Access Journals (Sweden)

    Mario Torrado

    Full Text Available BACKGROUND: Myocardin (MYOCD, a potent transcriptional coactivator of smooth muscle (SM and cardiac genes, is upregulated in failing myocardium in animal models and human end-stage heart failure (HF. However, the molecular and functional consequences of myocd upregulation in HF are still unclear. METHODOLOGY/PRINCIPAL FINDINGS: The goal of the present study was to investigate if targeted inhibition of upregulated expression of myocd could influence failing heart gene expression and function. To this end, we used the doxorubicin (Dox-induced diastolic HF (DHF model in neonatal piglets, in which, as we show, not only myocd but also myocd-dependent SM-marker genes are highly activated in failing left ventricular (LV myocardium. In this model, intra-myocardial delivery of short-hairpin RNAs, designed to target myocd variants expressed in porcine heart, leads on day 2 post-delivery to: (1 a decrease in the activated expression of myocd and myocd-dependent SM-marker genes in failing myocardium to levels seen in healthy control animals, (2 amelioration of impaired diastolic dysfunction, and (3 higher survival rates of DHF piglets. The posterior restoration of elevated myocd expression (on day 7 post-delivery led to overexpression of myocd-dependent SM-marker genes in failing LV-myocardium that was associated with a return to altered diastolic function. CONCLUSIONS/SIGNIFICANCE: These data provide the first evidence that a moderate inhibition (e.g., normalization of the activated MYOCD signaling in the diseased heart may be promising from a therapeutic point of view.

  16. The benefits of pass-fail grading on stress, mood, and group cohesion in medical students.

    Science.gov (United States)

    Rohe, Daniel E; Barrier, Patricia A; Clark, Matthew M; Cook, David A; Vickers, Kristin S; Decker, Paul A

    2006-11-01

    To objectively measure the effect of a pass-fail grading system on stress, mood, group cohesion, and test anxiety in medical students. Beginning with the class of 2006, the Mayo Medical School, Rochester, Minn, changed the grading system for first-year courses from a 5-interval grading system to a pass-fail grading system. Students in the previous class of 2005, who were graded using a 5-interval system during their first year of medical school, were compared with students in the class of 2006. Using a prospective study design, the 2 groups were compared at the end of both the first year and the second year of medical school on the Perceived Stress Scale, Profile of Mood States, Perceived Cohesion Scale, Test Anxiety Inventory, and (after year 2) the United States Medical Licensing Examination Step 1. Data collection occurred in 2002 and 2003 with the class of 2005 and in 2003 and 2004 with the class of 2006. Students graded with the pass-fail system had less perceived stress (median, 15.0 vs 21.0; P-.01) and greater group cohesion (median, 34.5 vs 30.0; P=.02) at the end of their second year of coursework than their 5-interval graded peers. The pass-fail group had better mood (median, 46.5) than the graded group (median, 64.0), but this difference was not statistically significant (P=.07). No significant differences were found between the 2 groups in test-taking anxiety or in United States Medical Licensing Examination Step 1 board scores. Pass-fail grading may reduce stress and increase group cohesion in medical students compared with traditional 5-interval grading.

  17. Failed landings after laying hen flight in a commercial aviary over two flock cycles.

    Science.gov (United States)

    Campbell, D L M; Goodwin, S L; Makagon, M M; Swanson, J C; Siegford, J M

    2016-01-01

    Many egg producers are adopting alternative housing systems such as aviaries that provide hens a tiered cage and a litter-covered open floor area. This larger, more complex environment permits expression of behaviors not seen in space-limited cages, such as flight. Flight is an exercise important for strengthening bones; but domestic hens might display imperfect flight landings due to poor flight control. To assess the potential implications of open space, we evaluated the landing success of Lohmann white laying hens in a commercial aviary. Video recordings of hens were taken from 4 aviary sections at peak lay, mid lay and end lay across two flock cycles. Observations were made in each focal section of all flights throughout the day noting flight origin and landing location (outer perch or litter) and landing success or failure. In Flock 1, 9.1% of all flights failed and 21% failed in Flock 2. The number of flights decreased across the laying cycle for both flocks. Proportionally more failed landings were observed in the double row sections in Flock 2. Collisions with other hens were more common than slipping on the ground or colliding with aviary structures across sections and flocks. More hens slipped on the ground and collided with physical structures at peak lay for Flock 2 than at other time points. More collisions with other hens were seen at mid and end lay than at peak lay for Flock 2. Landings ending on perches failed more often than landings on litter. These results indicate potential for flight-related hen injuries in aviary systems resulting from failed landings, which may have implications for hen welfare and optimal system design and management.

  18. A Retrospective Analysis of Dental Implants Replacing Failed Implants in Grafted Maxillary Sinus: A Case Series.

    Science.gov (United States)

    Manor, Yifat; Chaushu, Gavriel; Lorean, Adi; Mijiritzky, Eithan

    2015-01-01

    To evaluate the survival rate of dental implants replacing failed implants in grafted maxillary sinuses using the lateral approach vs nongrafted posterior maxillae. A retrospective analysis was conducted to study the survival of secondary dental implants inserted in the posterior maxilla in previously failed implant sites between the years 2000 and 2010. The study group consisted of patients who had also undergone maxillary sinus augmentation, and the control group consisted of patients in whom implants in the posterior maxilla had failed. Clinical and demographic data were analyzed using a structured form. Seventy-five patients with a total of 75 replaced implants were included in the study. The study group comprised 40 patients and the control group, 35 patients. None of the replaced implants in the study group failed, resulting in an overall survival of 100%; three replaced implants in the control group failed (92% survival). The main reason for the primary implant removal was lack of osseointegration (35 [87.5%] of 40 study group implants and 23 [65.7%] of 35 control group implants [P = .027]). The difference between the groups with regard to the timing of primary implant failure was statistically significant. The study group had more early failures of the primary implant than did the control group (77% vs 62%; P = .038). Dental implants replaced in the posterior maxilla had a high survival rate. A higher rate of survival was found in augmented maxillary sinus sites. Within the limits of the present study, it can be concluded that previous implant failures in the grafted maxillary sinus should not discourage practitioners from a second attempt.

  19. One-stage dorsal lingual mucosal graft urethroplasty for the treatment of failed hypospadias repair

    Directory of Open Access Journals (Sweden)

    Hong-Bin Li

    2016-01-01

    Full Text Available The aim of this study was to retrospectively investigate the outcomes of patients who underwent one-stage onlay or inlay urethroplasty using a lingual mucosal graft (LMG after failed hypospadias repairs. Inclusion criteria included a history of failed hypospadias repair, insufficiency of the local skin that made a reoperation with skin flaps difficult, and necessity of an oral mucosal graft urethroplasty. Patients were excluded if they had undergone a failed hypospadias repair using the foreskin or a multistage repair urethroplasty. Between January 2008 and December 2012, 110 patients with failed hypospadias repairs were treated in our center. Of these patients, 56 underwent a one-stage onlay or inlay urethroplasty using LMG. The median age was 21.8 years (range: 4-45 years. Of the 56 patients, one-stage onlay LMG urethroplasty was performed in 42 patients (group 1, and a modified Snodgrass technique using one-stage inlay LMG urethroplasty was performed in 14 (group 2. The median LMG urethroplasty length was 5.6 ± 1.6 cm (range: 4-13 cm. The mean follow-up was 34.7 months (range: 10-58 months, and complications developed in 12 of 56 patients (21.4%, including urethrocutaneous fistulas in 7 (6 in group 1, 1 in group 2 and neourethral strictures in 5 (4 in group 1, 1 in group 2. The total success rate was 78.6%. Our survey suggests that one-stage onlay or inlay urethroplasty with LMG may be an effective option to treat the patients with less available skin after failed hypospadias repairs; LMG harvesting is easy and safe, irrespective of the patient′s age.

  20. Predictors of failed attendances in a multi-specialty outpatient centre using electronic databases

    Directory of Open Access Journals (Sweden)

    Chen Mark I

    2005-08-01

    Full Text Available Abstract Background Failure to keep outpatient medical appointments results in inefficiencies and costs. The objective of this study is to show the factors in an existing electronic database that affect failed appointments and to develop a predictive probability model to increase the effectiveness of interventions. Methods A retrospective study was conducted on outpatient clinic attendances at Tan Tock Seng Hospital, Singapore from 2000 to 2004. 22864 patients were randomly sampled for analysis. The outcome measure was failed outpatient appointments according to each patient's latest appointment. Results Failures comprised of 21% of all appointments and 39% when using the patients' latest appointment. Using odds ratios from the mutliple logistic regression analysis, age group (0.75 to 0.84 for groups above 40 years compared to below 20 years, race (1.48 for Malays, 1.61 for Indians compared to Chinese, days from scheduling to appointment (2.38 for more than 21 days compared to less than 7 days, previous failed appointments (1.79 for more than 60% failures and 4.38 for no previous appointments, compared with less than 20% failures, provision of cell phone number (0.10 for providing numbers compared to otherwise and distance from hospital (1.14 for more than 14 km compared to less than 6 km were significantly associated with failed appointments. The predicted probability model's diagnostic accuracy to predict failures is more than 80%. Conclusion A few key variables have shown to adequately account for and predict failed appointments using existing electronic databases. These can be used to develop integrative technological solutions in the outpatient clinic.

  1. Fundamental stellar parameters

    CERN Document Server

    Wittkowski, M

    2004-01-01

    I present a discussion of fundamental stellar parameters and their observational determination in the context of interferometric measurements with current and future optical/infrared interferometric facilities. Stellar parameters and the importance of their determination for stellar physics are discussed. One of the primary uses of interferometry in the field of stellar physics is the measurement of the intensity profile across the stellar disk, both as a function of position angle and of wavelength. High-precision fundamental stellar parameters are also derived by characterizations of binary and multiple system using interferometric observations. This topic is discussed in detail elsewhere in these proceedings. Comparison of observed spectrally dispersed center-to-limb intensity variations with models of stellar atmospheres and stellar evolution may result in an improved understanding of key phenomena in stellar astrophysics such as the precise evolutionary effects on the main sequence, the evolution of meta...

  2. Variations on tremor parameters

    Science.gov (United States)

    Boose, A.; Jentgens, Ch.; Spieker, S.; Dichgans, J.

    1995-03-01

    This paper describes our analysis procedure for long-term tremor EMG recordings, as well as three examples of applications. The description of the method focuses on how characteristics of the tremor (e.g. frequency, intensity, agonist-antagonist interaction) can be defined and calculated based on surface EMG data. The resulting quantitative characteristics are called ``tremor parameters.'' We discuss sinusoidally modulated, band-limited white noise as a model for pathological tremor-EMG, and show how the basic parameters can be extracted from this class of signals. The method is then applied to (1) estimate tremor severity in clinical studies, (2) quantify agonist-antagonist interaction, and (3) investigate the variations of the tremor parameters using simple methods from time-series analysis.

  3. Optomechanical parameter estimation

    CERN Document Server

    Ang, Shan Zheng; Bowen, Warwick P; Tsang, Mankei

    2013-01-01

    We propose a statistical framework for the problem of parameter estimation from a noisy optomechanical system. The Cram\\'er-Rao lower bound on the estimation errors in the long-time limit is derived and compared with the errors of radiometer and expectation-maximization (EM) algorithms in the estimation of the force noise power. When applied to experimental data, the EM estimator is found to have the lowest error and follow the Cram\\'er-Rao bound most closely. With its ability to estimate most of the system parameters, the EM algorithm is envisioned to be useful for optomechanical sensing, atomic magnetometry, and classical or quantum system identification applications in general.

  4. Band parameters of phosphorene

    DEFF Research Database (Denmark)

    Lew Yan Voon, L. C.; Wang, J.; Zhang, Y.;

    2015-01-01

    Phosphorene is a two-dimensional nanomaterial with a direct band-gap at the Brillouin zone center. In this paper, we present a recently derived effective-mass theory of the band structure in the presence of strain and electric field, based upon group theory. Band parameters for this theory...

  5. Ovarian reserve parameters

    DEFF Research Database (Denmark)

    Bentzen, J G; Forman, Julie Lyng; Pinborg, Anja;

    2012-01-01

    was observed between duration of hormonal-contraception use and ovarian reserve parameters. No dose-response relation was found between the dose of ethinyloestradiol and AMH or AFC. This study indicates that ovarian reserve markers are lower in women using sex steroids for contraception. Thus, AMH...

  6. Response model parameter linking

    NARCIS (Netherlands)

    Barrett, Michelle Derbenwick

    2015-01-01

    With a few exceptions, the problem of linking item response model parameters from different item calibrations has been conceptualized as an instance of the problem of equating observed scores on different test forms. This thesis argues, however, that the use of item response models does not require

  7. Identification of optimal parameter combinations for the emergence of bistability.

    Science.gov (United States)

    Májer, Imre; Hajihosseini, Amirhossein; Becskei, Attila

    2015-11-24

    Bistability underlies cellular memory and maintains alternative differentiation states. Bistability can emerge only if its parameter range is either physically realizable or can be enlarged to become realizable. We derived a general rule and showed that the bistable range of a reaction parameter is maximized by a pair of other parameters in any gene regulatory network provided they satisfy a general condition. The resulting analytical expressions revealed whether or not such reaction pairs are present in prototypical positive feedback loops. They are absent from the feedback loop enclosed by protein dimers but present in both the toggle-switch and the feedback circuit inhibited by sequestration. Sequestration can generate bistability even at narrow feedback expression range at which cooperative binding fails to do so, provided inhibition is set to an optimal value. These results help to design bistable circuits and cellular reprogramming and reveal whether bistability is possible in gene networks in the range of realistic parameter values.

  8. Identification of optimal parameter combinations for the emergence of bistability

    Science.gov (United States)

    Májer, Imre; Hajihosseini, Amirhossein; Becskei, Attila

    2015-12-01

    Bistability underlies cellular memory and maintains alternative differentiation states. Bistability can emerge only if its parameter range is either physically realizable or can be enlarged to become realizable. We derived a general rule and showed that the bistable range of a reaction parameter is maximized by a pair of other parameters in any gene regulatory network provided they satisfy a general condition. The resulting analytical expressions revealed whether or not such reaction pairs are present in prototypical positive feedback loops. They are absent from the feedback loop enclosed by protein dimers but present in both the toggle-switch and the feedback circuit inhibited by sequestration. Sequestration can generate bistability even at narrow feedback expression range at which cooperative binding fails to do so, provided inhibition is set to an optimal value. These results help to design bistable circuits and cellular reprogramming and reveal whether bistability is possible in gene networks in the range of realistic parameter values.

  9. Conventional dacryocystorhinostomy in a failed Trans-canalicular laser-assisted dacryocystorhinostomy

    Directory of Open Access Journals (Sweden)

    Rajesh Subhash Joshi

    2011-01-01

    Full Text Available We report the success rate and problems associated with conventional dacryocystorhinostomy (DCR in failed cases of Trans-canalicular, laser-assisted DCR (TCLADCR. Out of 50 patients operated by the TCLADCR technique during the period 2005 - 2006, 33 patients had failure, which was confirmed on syringing of the nasolacrimal passage. Before considering them for conventional DCR, a thorough ear, nose, throat (ENT examination was done by an ENT surgeon, to rule out a nasal pathology. All the patients were operated by the conventional standard DCR method at a medical college. While performing the surgery, the problems that came across were identified and noted. The success rate was found to be 91% in this study in a follow-up period of one year, with no major intra-operative problems. Conventional DCR is still a gold standard and should be considered as a procedure of choice in failed cases of TCLDCR.

  10. Large Steel Tank Fails and Rockets to Height of 30 meters - Rupture Disc Installed Incorrectly

    DEFF Research Database (Denmark)

    Hedlund, Frank Huess; Selig, Robert Simon; Kragh, Eva K.

    2016-01-01

    responsible for the failure was an estimated 60 kPa. A rupture disc rated at tank from being covered by the European Pressure Equipment Directive. This safeguard failed and it was later discovered that the rupture disc had been installed upside......At a brewery, the base plate-to-shell weld seam of a 90-m3 vertical cylindrical steel tank failed catastrophically. The 4 ton tank “took off” like a rocket leaving its contents behind, and landed on a van, crushing it. The top of the tank reached a height of 30 m. The internal overpressure...... down. The organizational root cause of this incident may be a fundamental lack of appreciation of the hazards of large volumes of low-pressure compressed air or gas. A contributing factor may be that the standard piping and instrumentation diagram (P&ID) symbol for a rupture disc may confuse and lead...

  11. Failing States as Epidemiologic Risk Zones: Implications for Global Health Security.

    Science.gov (United States)

    Hirschfeld, Katherine

    Failed states commonly experience health and mortality crises that include outbreaks of infectious disease, violent conflict, reductions in life expectancy, and increased infant and maternal mortality. This article draws from recent research in political science, security studies, and international relations to explore how the process of state failure generates health declines and outbreaks of infectious disease. The key innovation of this model is a revised definition of "the state" as a geographically dynamic rather than static political space. This makes it easier to understand how phases of territorial contraction, collapse, and regeneration interrupt public health programs, destabilize the natural environment, reduce human security, and increase risks of epidemic infectious disease and other humanitarian crises. Better understanding of these dynamics will help international health agencies predict and prepare for future health and mortality crises created by failing states.

  12. Why conventional detection methods fail in identifying the existence of contamination events.

    Science.gov (United States)

    Liu, Shuming; Li, Ruonan; Smith, Kate; Che, Han

    2016-04-15

    Early warning systems are widely used to safeguard water security, but their effectiveness has raised many questions. To understand why conventional detection methods fail to identify contamination events, this study evaluates the performance of three contamination detection methods using data from a real contamination accident and two artificial datasets constructed using a widely applied contamination data construction approach. Results show that the Pearson correlation Euclidean distance (PE) based detection method performs better for real contamination incidents, while the Euclidean distance method (MED) and linear prediction filter (LPF) method are more suitable for detecting sudden spike-like variation. This analysis revealed why the conventional MED and LPF methods failed to identify existence of contamination events. The analysis also revealed that the widely used contamination data construction approach is misleading.

  13. DebtRank: too central to fail? Financial networks, the FED and systemic risk.

    Science.gov (United States)

    Battiston, Stefano; Puliga, Michelangelo; Kaushik, Rahul; Tasca, Paolo; Caldarelli, Guido

    2012-01-01

    Systemic risk, here meant as the risk of default of a large portion of the financial system, depends on the network of financial exposures among institutions. However, there is no widely accepted methodology to determine the systemically important nodes in a network. To fill this gap, we introduce, DebtRank, a novel measure of systemic impact inspired by feedback-centrality. As an application, we analyse a new and unique dataset on the USD 1.2 trillion FED emergency loans program to global financial institutions during 2008-2010. We find that a group of 22 institutions, which received most of the funds, form a strongly connected graph where each of the nodes becomes systemically important at the peak of the crisis. Moreover, a systemic default could have been triggered even by small dispersed shocks. The results suggest that the debate on too-big-to-fail institutions should include the even more serious issue of too-central-to-fail.

  14. Categorization of failed and damaged spent LWR (light-water reactor) fuel currently in storage

    Energy Technology Data Exchange (ETDEWEB)

    Bailey, W.J.

    1987-11-01

    The results of a study that was jointly sponsored by the US Department of Energy and the Electric Power Research Institute are described in this report. The purpose of the study was to (1) estimate the number of failed fuel assemblies and damaged fuel assemblies (i.e., ones that have sustained mechanical or chemical damage but with fuel rod cladding that is not breached) in storage, (2) categorize those fuel assemblies, and (3) prepare this report as an authoritative, illustrated source of information on such fuel. Among the more than 45,975 spent light-water reactor fuel assemblies currently in storage in the United States, it appears that there are nearly 5000 failed or damaged fuel assemblies. 78 refs., 23 figs., 19 tabs.

  15. When dialogue fails. Music therapy with elderly with neurological degenerative diseases

    DEFF Research Database (Denmark)

    Wigram, Anthony Lewis

    2004-01-01

    traces in the brain. Using the same “hello-song” in the beginning of a session - session after session - gives stability. Stability is constancy and familiarity of cues over time (Roberts & Algase 1988), and even people with severe memory deficits are capable of creating new memory traces and of learning......When dialogue fails. Music therapy with elderly with neurological degenerative diseases. In persons suffering from neurological degenerative diseases we often see the following symptoms: difficulties in remembering, concentrating, perceiving input, and controlling and timing movements. Normal every...... degenerative disease like e.g. dementia are often socially isolated because of their failing abilities to communicate. Even if they live in a facility and are surrounded by care staff and peer residents, they might experience the environment as chaotic and the people as non-comprehensible. A missing meaningful...

  16. Preliminary analysis of potential chemical environments inside failed waste containers at the proposed Yucca Mountain repository

    Energy Technology Data Exchange (ETDEWEB)

    Colten-Bradley, V. [Nuclear Regulatory Commission, Rockville, MD (United States); Walton, J.C. [Univ. of Texas, El Paso, TX (United States)

    1994-12-31

    Prediction of radionuclide release rates for high-level waste requires estimates of the rates of waste form alteration and formation of secondary minerals inside the failed canister. Unsaturated repository sites may promote development of a variety of chemical environments related to two phase (liquid/vapor) transport and temperature gradients caused by radiogenic decay. A mass balance (shell balance) approach is used to estimate the effects of dripping water, evaporation, and condensation on the waste canister and the presence of saline water inside the failed waste canister. The simplified calculations predict large variability of water chemistry over spatial scales of a few centimeters. The effects of the predicted aqueous chemistry on waste form alteration, secondary mineral formation, and radionuclide solubility are examined.

  17. Division Tenorrhaphy: A Novel Technique for Chronic or Failed Nonoperatively Treated Achilles Tendon Rupture.

    Science.gov (United States)

    Doty, Jesse; Katsuura, Yoshihiro; Richardson, Nicholas

    2017-06-01

    Here we describe a modified open technique for the repair of a ruptured Achilles tendon using multiple looped sutures with the creation of interdigitating tendon stumps maximizing surface area for suture application as well as allowing for significant tissue overlay. This technique produces a high strength repair that is useful in cases of extensive degeneration or poor-quality tissue. Degenerative tissue may be encountered with chronic ruptures or failed nonoperative treatment, as well as those ruptures that occur at the proximal myotendinous junction. We present 2 cases in which the technique was utilized: one of a failed nonoperatively treated rupture and another of a chronic rupture. The technique was found to be successful for both patients with improvement in visual analogue scale, Achilles tendon total rupture score, American Orthopaedic Foot and Ankle Score, and Foot and Ankle Disability Index. Level IV.

  18. Failed Radiatively Accelerated Dusty Outflow Model of the Broad Line Region in Active Galactic Nuclei. I. Analytical Solution

    Science.gov (United States)

    Czerny, B.; Li, Yan-Rong; Hryniewicz, K.; Panda, S.; Wildy, C.; Sniegowska, M.; Wang, J.-M.; Sredzinska, J.; Karas, V.

    2017-09-01

    The physical origin of the broad line region in active galactic nuclei is still unclear despite many years of observational studies. The reason is that the region is unresolved, and the reverberation mapping results imply a complex velocity field. We adopt a theory-motivated approach to identify the principal mechanism responsible for this complex phenomenon. We consider the possibility that the role of dust is essential. We assume that the local radiation pressure acting on the dust in the accretion disk atmosphere launches the outflow of material, but higher above the disk the irradiation from the central parts causes dust evaporation and a subsequent fallback. This failed radiatively accelerated dusty outflow is expected to represent the material forming low ionization lines. In this paper we formulate simple analytical equations to describe the cloud motion, including the evaporation phase. The model is fully described just by the basic parameters of black hole mass, accretion rate, black hole spin, and viewing angle. We study how the spectral line generic profiles correspond to this dynamic. We show that the virial factor calculated from our model strongly depends on the black hole mass in the case of enhanced dust opacity, and thus it then correlates with the line width. This could explain why the virial factor measured in galaxies with pseudobulges differs from that obtained from objects with classical bulges, although the trend predicted by the current version of the model is opposite to the observed trend.

  19. Spectral and timing evolution of the bright failed outburst of the transient black hole Swift J174510.8-262411

    CERN Document Server

    Del Santo, M; Tomsick, J A; Sbarufatti, B; Bel, M Cadolle; Casella, P; Castro-Tirado, A; Corbel, S; Grinberg, V; Homan, J; Kalemci, E; Motta, S; Munoz-Darias, T; Pottschmidt, K; Rodriguez, J; Wilms, J

    2015-01-01

    We studied time variability and spectral evolution of the Galactic black hole transient Swift J174510.8-262411 during the first phase of its outburst. INTEGRAL and Swift observations collected from 2012 September 16 until October 30 have been used. The total squared fractional rms values did not drop below 5% and QPOs, when present, were type-C, indicating that the source never made the transition to the soft-intermediate state. Even though the source was very bright (up to 1 Crab in hard X-rays), it showed a so called failed outburst as it never reached the soft state. XRT and IBIS broad band spectra, well represented by a hybrid thermal/non-thermalComptonisationmodel, showed physical parameters characteristic of the hard and intermediate states. In particular, the derived temperature of the geometrically thin disc black body was about 0.6 keV at maximum.We found a clear decline of the optical depth of the corona electrons (close to values of 0.1), as well as of the total compactness ratio lh/ls. The hard-to...

  20. Correlation of Positive and Negative Reciprocity Fails to Confer an Evolutionary Advantage: Phase Transitions to Elementary Strategies

    Directory of Open Access Journals (Sweden)

    Attila Szolnoki

    2013-11-01

    Full Text Available Economic experiments reveal that humans value cooperation and fairness. Punishing unfair behavior is therefore common, and according to the theory of strong reciprocity, it is also directly related to rewarding cooperative behavior. However, empirical data fail to confirm that positive and negative reciprocity are correlated. Inspired by this disagreement, we determine whether the combined application of reward and punishment is evolutionarily advantageous. We study a spatial public goods game, where in addition to the three elementary strategies of defection, rewarding, and punishment, a fourth strategy that combines the latter two competes for space. We find rich dynamical behavior that gives rise to intricate phase diagrams where continuous and discontinuous phase transitions occur in succession. Indirect territorial competition, spontaneous emergence of cyclic dominance, as well as divergent fluctuations of oscillations that terminate in an absorbing phase are observed. Yet, despite the high complexity of solutions, the combined strategy can survive only in very narrow and unrealistic parameter regions. Elementary strategies, either in pure or mixed phases, are much more common and likely to prevail. Our results highlight the importance of patterns and structure in human cooperation, which should be considered in future experiments.

  1. Correlation of Positive and Negative Reciprocity Fails to Confer an Evolutionary Advantage: Phase Transitions to Elementary Strategies

    Science.gov (United States)

    Szolnoki, Attila; Perc, Matjaž

    2013-10-01

    Economic experiments reveal that humans value cooperation and fairness. Punishing unfair behavior is therefore common, and according to the theory of strong reciprocity, it is also directly related to rewarding cooperative behavior. However, empirical data fail to confirm that positive and negative reciprocity are correlated. Inspired by this disagreement, we determine whether the combined application of reward and punishment is evolutionarily advantageous. We study a spatial public goods game, where in addition to the three elementary strategies of defection, rewarding, and punishment, a fourth strategy that combines the latter two competes for space. We find rich dynamical behavior that gives rise to intricate phase diagrams where continuous and discontinuous phase transitions occur in succession. Indirect territorial competition, spontaneous emergence of cyclic dominance, as well as divergent fluctuations of oscillations that terminate in an absorbing phase are observed. Yet, despite the high complexity of solutions, the combined strategy can survive only in very narrow and unrealistic parameter regions. Elementary strategies, either in pure or mixed phases, are much more common and likely to prevail. Our results highlight the importance of patterns and structure in human cooperation, which should be considered in future experiments.

  2. Distributed Parameter Modelling Applications

    DEFF Research Database (Denmark)

    2011-01-01

    Here the issue of distributed parameter models is addressed. Spatial variations as well as time are considered important. Several applications for both steady state and dynamic applications are given. These relate to the processing of oil shale, the granulation of industrial fertilizers and the d......Here the issue of distributed parameter models is addressed. Spatial variations as well as time are considered important. Several applications for both steady state and dynamic applications are given. These relate to the processing of oil shale, the granulation of industrial fertilizers...... sands processing. The fertilizer granulation model considers the dynamics of MAP-DAP (mono and diammonium phosphates) production within an industrial granulator, that involves complex crystallisation, chemical reaction and particle growth, captured through population balances. A final example considers...

  3. Physical Parameter Eclipse Mapping

    CERN Document Server

    Vrielmann, S

    2000-01-01

    The tomographic method "Physical Parameter Eclipse Mapping" is a tool to reconstruct spatial distributions of physical parameters (like temperatures and surface densities) in accretion discs of cataclysmic variables. After summarizing the method, we apply it to multi-colour eclipse light curves of various dwarf novae and nova-likes like VZ Scl, IP Peg in outburst, UU Aqr, V2051 Oph and HT Cas in order to derive the temperatures (and surface densities) in the disc, the white dwarf temperature, the disc size, the effective temperatures and the viscosities. The results allows us to establish or refine a physical model for the accretion disc. Our maps of HT Cas and V2051 Oph, for example, indicate that the (quiescent) disc must be structured into a cool, optically thick inner disc sandwiched by hot, optically thin chromospheres. In addition, the disc of HT Cas must be patchy with a covering factor of about 40% caused by magnetic activity in the disc.

  4. Prevalence of difficult airway predictors in cases of failed prehospital endotracheal intubation.

    Science.gov (United States)

    Gaither, Joshua B; Spaite, Daniel W; Stolz, Uwe; Ennis, Joshua; Mosier, Jarrod; Sakles, John J

    2014-09-01

    Difficult airway predictors (DAPs) are associated with failed endotracheal intubation (ETI) in the emergency department (ED). However, little is known about the relationship between DAPs and failed prehospital ETI. Our aim was to determine the prevalence of common DAPs among failed prehospital intubations. We reviewed a quality-improvement database, including all cases of ETI in a single ED, over 3 years. Failed prehospital (FP) ETI was defined as a case brought to the ED after attempted prehospital ETI, but bag-valve-mask ventilation, need for a rescue airway (supraglottic device, cricothyrotomy, etc.), or esophageal intubation was discovered at the ED. Physicians performing ETI evaluated each case for the presence of DAPs, including blood/emesis, facial/neck trauma, airway edema, spinal immobilization, short neck, and tongue enlargement. There were a total of 1377 ED ETIs and 161 had an FP-ETI (11.8%). Prevalence of DAPs in cases with FP-ETI was obesity 13.0%, large tongue 18.0%, short neck 13%, small mandible 4.3%, cervical immobility 49.7%, blood in airway 57.8%, vomitus in airway 23.0%, airway edema 12.4%, and facial or neck trauma 32.9%. The number of cases with FP-ETI and 0, 1, 2, 3, or 4 or more DAPs per case was 22 (13.6%), 43 (26.7%), 23 (24.3%), 42 (26.1%), and 31 (19.3%), respectively. DAPs are common in cases of FP-ETI. Some of these factors may be associated with FP-ETI. Additional study is needed to determine if DAPs can be used to identify patients that are difficult to intubate in the field. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Salvage of a Failed Agility Total Ankle Replacement System Associated with Acute Traumatic Periprosthetic Midfoot Fractures.

    Science.gov (United States)

    Roukis, Thomas S

    2015-10-01

    This article presents a rare case involving combined revision of a failed Agility Total Ankle Replacement System (DePuy Orthopaedics, Warsaw, Indiana) and open reduction with internal fixation of periprosthetic midfoot fractures secondary to acute traumatic injury. The rationale for these procedures, the operative sequence of events, and recovery course are presented in detail. Causes for concern regarding subsequent revision, should this be required, are raised.

  6. Late Failing Heart Allografts: Pathology of Cardiac Allograft Vasculopathy and Association With Antibody-Mediated Rejection.

    Science.gov (United States)

    Loupy, A; Toquet, C; Rouvier, P; Beuscart, T; Bories, M C; Varnous, S; Guillemain, R; Pattier, S; Suberbielle, C; Leprince, P; Lefaucheur, C; Jouven, X; Bruneval, P; Duong Van Huyen, J P

    2016-01-01

    In heart transplantation, there is a lack of robust evidence of the specific causes of late allograft failure. We hypothesized that a substantial fraction of failing heart allografts may be associated with antibody-mediated injury and immune-mediated coronary arteriosclerosis. We included all patients undergoing a retransplantation for late terminal heart allograft failure in three referral centers. We performed an integrative strategy of heart allograft phenotyping by assessing the heart vascular tree including histopathology and immunohistochemistry together with circulating donor-specific antibodies. The main analysis included 40 explanted heart allografts patients and 402 endomyocardial biopsies performed before allograft loss. Overall, antibody-mediated rejection was observed in 19 (47.5%) failing heart allografts including 16 patients (40%) in whom unrecognized previous episodes of subclinical antibody-mediated rejection occurred 4.5 ± 3.5 years before allograft loss. Explanted allografts with evidence of antibody-mediated rejection demonstrated higher endothelitis and microvascular inflammation scores (0.89 ± 0.26 and 2.25 ± 0.28, respectively) compared with explanted allografts without antibody-mediated rejection (0.42 ± 0.11 and 0.36 ± 0.09, p = 0.046 and p < 0.0001, respectively). Antibody-mediated injury was observed in 62.1% of failing allografts with pure coronary arteriosclerosis and mixed (arteriosclerosis and atherosclerosis) pattern, while it was not observed in patients with pure coronary atherosclerosis (p = 0.0076). We demonstrate that antibody-mediated rejection is operating in a substantial fraction of failing heart allografts and is associated with severe coronary arteriosclerosis. Unrecognized subclinical antibody-mediated rejection episodes may be observed years before allograft failure.

  7. When dialogue fails. Music therapy with elderly with neurological degenerative diseases

    DEFF Research Database (Denmark)

    Wigram, Anthony Lewis

    2004-01-01

    When dialogue fails. Music therapy with elderly with neurological degenerative diseases. In persons suffering from neurological degenerative diseases we often see the following symptoms: difficulties in remembering, concentrating, perceiving input, and controlling and timing movements. Normal every...... interaction with others means that psychosocial needs are not met, and this leads to secondary symptoms of the neurological degeneration. Secondary symptoms might be expressed as repetitive behaviour, catastrophic reactions and situationally inappropriate behaviour. In a music therapeutical setting...

  8. "Failure to assign failing grades": issues with grading the unsafe student.

    Science.gov (United States)

    Luhanga, Florence; Yonge, Olive J; Myrick, Florence

    2008-01-01

    In a grounded theory study examining the process of precepting an unsafe student, it was found that preceptors assigned passing grades to students who in fact should not have passed. Although preceptors perceived their role as gatekeepers for the profession, by not assigning failing grades to students who should not have passed a course, essentially they were abdicating their responsibility. Indeed, the simple act of assuming responsibility for precepting a student implies professional as well as pedagogical accountability.

  9. Popeye domain-containing 1 is down-regulated in failing human hearts.

    Science.gov (United States)

    Gingold-Belfer, Rachel; Bergman, Michael; Alcalay, Yifat; Schlesinger, Hadassa; Aravot, Dan; Berman, Marius; Salman, Hertzel; Brand, Thomas; Kessler-Icekson, Gania

    2011-01-01

    Congestive heart failure, a complex disease of heterogeneous etiology, involves alterations in the expression of multiple genes. The Popeye domain-containing (POPDC) family of three novel muscle-restricted genes (POPDC1-3) is evolutionarily conserved and developmentally regulated. In mice, POPDC1 has been shown to play an important role in skeletal and cardiac muscles subjected to injury or stress. However, it has never been explored in human hearts. In biopsies from non-failing and failing human hearts, we examined the cellular distribution of POPDC1 as well as the expression patterns of POPDC1-3 mRNAs. POPDC1 was visualized by immunohistochemistry and estimated by Western immunoblotting. The mRNA levels of POPDC1-3 and ß myosin heavy chain (MYHC7) were assessed using reverse transcription/quantitative polymerase chain reaction. POPDC1 was predominantly localized in the sarcolemma with an enhanced expression in the intercalated discs. In failing hearts, many cardiomyocytes appeared deformed and POPDC1 labeling was deranged. The three POPDC mRNAs were expressed in the four heart chambers with higher transcript levels in the ventricles compared to the atria. Heart failure concurred with reduced levels of POPDC1 mRNA and protein in the left ventricle. Correlation analyses of mRNA levels among the failing heart specimens indicated the coordinated regulation of POPDC1 with POPDC3 and of POPDC2 with MYHC7. It can be concluded that POPDC gene expression is modified in end-stage heart failure in humans in a manner suggesting regulatory and/or functional differences between the three family members and that POPDC1 is particularly susceptible to this condition.

  10. Functional remodeling of Ca2+-activated Cl- channel in pacing induced canine failing heart

    Institute of Scientific and Technical Information of China (English)

    Ning Li; Kejuan Ma; Siyong Teng; Jonathan C.Makielski; Jielin Pu

    2008-01-01

    Objective To determine whether Ca2+ activated Cl- current(Icl(Ca)) contributes to the functional remodeling of the failing heart.Methods Whole cell patch-clamp recording technique was employed to record the Icl(Ca) in cardiac myocytes enzymatically isolatedfrom rapidly pacing induced canine failing hearts at room temperature and compared that of the normal hearts (Nor).Results Thecurrent density of DIDS(200M)sensitive Icl(Ca) induced by intracellular Ca2+ release trigged by L-type Ca2+ current(Ica,L)wassignificantly decreased in heart failare(HE)cells compared to Nor cells.At membrane voltage of 20mV,the Icl(Ca) density was 3.02±0.54 pA/pF in Nor(n=6)vs.1.31±0.25 pA/pF in HF(n=8)cells,(P<0.01),while the averaged Ica,L density did not show differencebetween two groups.The time constant of current decay of Icl(Ca) was similar in both types of cells.On the other hand,in intra cellularCa2+ clamped mode,where the[Ca2+];was maintained at 100nmol/L,Icl(Ca) density be increased significantly in HF cells when themembrane voltage at+30mV or higher.Conclusions Our results suggest that Icl(Ca) density was decreased in pacing induced failingheart but the channel function be enhanced.Impaired Ca2+ handing in HF cells rather than reduced,Icl(Ca) channel function itself may havecaused this abnormality.The Icl(Ca) density reduction might contribute to the prolongation of action potential in failing heart.The Icl(Ca)channel function up-rugulation is likely to cause cardiac arrhythmia by inducing a delayed after depolarization,when Ca2+ overloadoccurred in diastolic failing heart cells.

  11. Making DidFail Succeed: Enhancing the CERT Static Taint Analyzer for Android App Sets

    Science.gov (United States)

    analyzer for sets of Android apps . In addition to improving the analyzer itself, the enhancements include a new testing framework new test apps , and test...use the most current version of FlowDroid and Soot, increasing its success rate from 18% to 68% on our test set of real-world apps . Analytical...features were added for more types of components and shared static fields and new apps developed to test these features. The improved DidFail analyzer and

  12. Money Talks: Why Nigeria’s Petroleum Industry Bill will Fail to End Gas Flaring

    Science.gov (United States)

    2012-11-02

    Industry Bill ( PIB ) that if enacted would ban gas flaring. However, as currently written the PIB will not end flaring for the same reasons that...previous legislation failed. Loopholes in the PIB combined with corruption, lack of effective enforcement mechanisms and lack of incentives to develop...Bill ( PIB ) that if enacted would ban gas flaring. However, as currently written, the PIB will not end flaring for the same reasons that previous

  13. Weak and Failing States: Evolving Security Threats and U.S. Policy

    Science.gov (United States)

    2008-08-28

    for International Studies, Working Paper No. 2005/20 (2005); Rose E. Brooks, “Failed States, or the State as Failure?” The University of Chicago Law...Threats: Fact of Fiction?” The Washington Quarterly 29 (2006), pp. 27-53; Rumsfeld (2002), op. cit.; and Ray Takeyh and Nikolas Gvosdev, “Do Terrorist...sometimes be less conducive to a terrorist presence than countries that are still weak, but retain some governmental effectiveness.15 International Crime

  14. Changes in the organization of excitation-contraction coupling structures in failing human heart.

    Directory of Open Access Journals (Sweden)

    David J Crossman

    Full Text Available BACKGROUND: The cardiac myocyte t-tubular system ensures rapid, uniform cell activation and several experimental lines of evidence suggest changes in the t-tubular system and associated excitation-contraction coupling proteins may occur in heart failure. METHODS AND RESULTS: The organization of t-tubules, L-type calcium channels (DHPRs, ryanodine receptors (RyRs and contractile machinery were examined in fixed ventricular tissue samples from both normal and failing hearts (idiopathic (non-ischemic dilated cardiomyopathy using high resolution fluorescent imaging. Wheat germ agglutinin (WGA, Na-Ca exchanger, DHPR and caveolin-3 labels revealed a shift from a predominantly transverse orientation to oblique and axial directions in failing myocytes. In failure, dilation of peripheral t-tubules occurred and a change in the extent of protein glycosylation was evident. There was no change in the fractional area occupied by myofilaments (labeled with phalloidin but there was a small reduction in the number of RyR clusters per unit area. The general relationship between DHPRs and RyR was not changed and RyR labeling overlapped with 51±3% of DHPR labeling in normal hearts. In longitudinal (but not transverse sections there was an ∼30% reduction in the degree of colocalization between DHPRs and RyRs as measured by Pearson's correlation coefficient in failing hearts. CONCLUSIONS: The results show that extensive remodelling of the t-tubular network and associated excitation-contraction coupling proteins occurs in failing human heart. These changes may contribute to abnormal calcium handling in heart failure. The general organization of the t-system and changes observed in failure samples have subtle differences to some animal models although the general direction of changes are generally similar.

  15. Failing the future: three unsuccessful attempts to replicate Bem's 'retroactive facilitation of recall' effect.

    Directory of Open Access Journals (Sweden)

    Stuart J Ritchie

    Full Text Available Nine recently reported parapsychological experiments appear to support the existence of precognition. We describe three pre-registered independent attempts to exactly replicate one of these experiments, 'retroactive facilitation of recall', which examines whether performance on a memory test can be influenced by a post-test exercise. All three replication attempts failed to produce significant effects (combined n = 150; combined p = .83, one-tailed and thus do not support the existence of psychic ability.

  16. Dynamic analysis of a high-speed train operating on a curved track with failed fasteners

    Institute of Scientific and Technical Information of China (English)

    Li ZHOU; Zhi-yun SHEN

    2013-01-01

    A high-speed train-track coupling dynamic model is used to investigate the dynamic behavior of a high-speed train operating on a curved track with failed fasteners.The model considers a high-speed train consisting of eight vehicles coupled with a ballasted track.The vehicle is modeled as a multi-body system,and the rail is modeled with a Timoshenko beam resting on the discrete sleepers.The vehicle model considers the effect of the end connections of the neighboring vehicles on the dynamic behavior.The track model takes into account the lateral,vertical,and torsional deformations of the rails and the effect of the discrete sleeper support on the coupling dynamics of the vehicles and the track.The sleepers are assumed to move backward at a constant speed to simulate the vehicle running along the track at the same speed.The train model couples with the track model by using a Hertzian contact model for the wheel/rail normal force calculation,and the nonlinear creep theory by Shen et al.(1984) is used for wheel/rail tangent force calculation.In the analysis,a curved track of 7000-m radius with failed fasteners is selected,and the effects of train operational speed and the number of failed fasteners on the dynamic behaviors of the train and the track are investigated in detail.Furthermore,the wheel/rail forces and derailment coefficient and the wheelset loading reduction are analyzed when the high-speed train passes over the curved track with the different number of continuously failed fasteners at different operational speeds.Through the detailed numerical analysis,it is found that the high-speed train can operate normally on the curved track of 7000-m radius at the speeds of 200 km/h to 350 km/h.

  17. Setting Parameters by Example

    OpenAIRE

    1999-01-01

    We introduce a class of "inverse parametric optimization" problems, in which one is given both a parametric optimization problem and a desired optimal solution; the task is to determine parameter values that lead to the given solution. We describe algorithms for solving such problems for minimum spanning trees, shortest paths, and other "optimal subgraph" problems, and discuss applications in multicast routing, vehicle path planning, resource allocation, and board game programming.

  18. Military display performance parameters

    Science.gov (United States)

    Desjardins, Daniel D.; Meyer, Frederick

    2012-06-01

    The military display market is analyzed in terms of four of its segments: avionics, vetronics, dismounted soldier, and command and control. Requirements are summarized for a number of technology-driving parameters, to include luminance, night vision imaging system compatibility, gray levels, resolution, dimming range, viewing angle, video capability, altitude, temperature, shock and vibration, etc., for direct-view and virtual-view displays in cockpits and crew stations. Technical specifications are discussed for selected programs.

  19. Oksimoron "Failed State" Absennya Negara dan BAngkitnya Gerakan Masyarakat Sipil Menyelamatkan Ruang Publik Pasca Erupsi Merapi

    Directory of Open Access Journals (Sweden)

    AB Widyanta

    2011-05-01

    Full Text Available This study elucidates on strength of social capital in civil society with respect to effort to preserve public space for natural disaster refugees in light of the deterioration of the ability of the state to accomplish civil rights obligation. The analysis began with a study on the characteristics of a failed state. The state can be categorized as failed state if it fulfills three characteristics which are: 1 the negligence in fulfilling civil rights obligations; 2 the disposition of aggressive behaviors; and 3 the intensification of democracy deficit. On the basis of the failed state paradigm, this o the study subsequently moved toward to the focal point, which was that was divided into three parts. The first part examined the paradigm of basic essence in the national constitution and legislation on disasters, relating to public welfare. The second parts discussed the phenomenon of Mt. Merapi's eruption including the chronology of event which in part was responsible for the large number of refugees. The third pat elaborated on the best practice, which where adopted by Posko Mandiri Kadiosoka, as a forum that was established to deal with relief and assistance and service originally intended to fulfill basic rights of refugees. The erosion of social capital capacity in the long term, coupled with and decline in the role of the state as the basic rights handling disasters has seriously limited the independence of civil society in Posko Mandiri Kadiosoko.

  20. Implications of Fail-forward in an Online Environment under Alternative Grading Schemes

    Directory of Open Access Journals (Sweden)

    Hilde Patron

    2011-01-01

    Full Text Available The concept of fail-forward can be used as a teaching technique to motivate students to learn from their mistakes. For example, when students are allowed to re-work incorrect responses on a test for a partial grade they are failing-forward. In this paper we look at the effects of failing-forward on student effort in online learning environments. We consider two alternative grading schemes with different levels of penalties for failure. Under the first grading scheme students are allowed to submit their work up to three times without being penalized. Under the alternative grading scheme students are penalized every time that they answer questions incorrectly. We find that instructors may be able to use the “average of all scores” grading scheme to increase the level of preparation of students even with differences in students’ innate ability. However, the benefits are less pronounced in fully online classes where there is no face-to-face instruction time.

  1. Office-based endoscopic revision using a microdebrider for failed endoscopic dacryocystorhinostomy.

    Science.gov (United States)

    Park, Jongyeop; Kim, Hochang

    2016-12-01

    This article is to introduce office-based endoscopic revision surgery using a microdebrider for failed endoscopic dacryocystorhinostomy (EN-DCR). The authors conducted retrospective, non-comparative, interventional case series analysis of 27 eyes of 24 patients, treated by office-based revision EN-DCR using a microdebrider. After local anesthesia, anatomical failures (cicatrization, granuloma, synechia) after primary EN-DCR were treated with a microdebrider (Osseoduo 120, Bien-Air Surgery, Le Noirmont, Switzerland) in an office setting, and a bicanalicular silicone tube was placed. Anatomical improvement and functional relief of epiphora were evaluated at 6-months after revision. The causes of failed EN-DCR were rhinostomy site cicatrization (17/27, 63.0 %), granulomatous obstruction (7/27, 25.9 %) and synechial formation (3/27, 11.1 %). The anatomical success rate was 100 %, and 85.2 % cases achieved complete relief of epiphora. The surgery did not exceed 10 min in any case and no complications were observed. Office-based revision EN-DCR using a microdebrider provided prompt management of post-DCR epiphora. The portable nature and all-round ability of the microdebrider allowed office-based surgery, which offered advantage to work with the surgeon's own well-trained office staff. Office-based revision EN-DCR can be both time- and money-saving, and might be regarded the treatment of choice for failed EN-DCR.

  2. Fail-safe design and analysis for the guide vane of a hydro turbine

    Directory of Open Access Journals (Sweden)

    Bentang Arief Budiman

    2016-07-01

    Full Text Available A design for the fail-safe mechanism of a guide vane in a Francis-type hydro turbine is proposed and analyzed. The mechanism that is based on a shear pin as a sacrificial component was designed to remain simple. Unlike the requirements of conventional designs, a shear pin must be able to withstand static and dynamic loads but must fail under a certain overload that could damage a guide vane. An accurate load determination and selection of the shear pin material were demonstrated. The static load for various opening angles of the guide vane were calculated using the computational fluid dynamics Fluent and finite element method Ansys programs. Furthermore, simulations for overload and dynamic load due to the waterhammer phenomenon were also conducted. The results of load calculations were used to select an appropriate shear pin material. Quasi-static shear tests were performed for two shear pins of aluminum alloy Al2024 subjected to different aging treatments (i.e. artificial and natural aging. The test results indicated that the Al2024 treated by natural aging is an appropriate material for a shear pin designed to function as a fail-safe mechanism for the guide vanes of a Francis-type hydro turbine.

  3. Neutrinos from failed supernovae at future water and liquid argon detectors

    CERN Document Server

    Keehn, James G

    2010-01-01

    We discuss the diffuse flux of electron neutrinos and antineutrinos from cosmological failed supernovae, stars that collapse directly into a black hole, with no explosion. This flux has a hotter energy spectrum compared to regular, neutron-star forming collapses, and therefore it dominates the total diffuse flux from core collapses above 20-45 MeV of neutrino energy. Reflecting the features of the originally emitted neutrinos, the flux of nu_e and anti-nu_e at Earth is larger for larger survival probability of these species, and for stiffer equations of state of nuclear matter. In the energy window 19-29 MeV, the flux from failed supernovae is susbtantial, ranging from 7% to a dominant fraction of the total flux from all core collapses. It can be as large as phi = 0.38 s^{-1} cm^{-2} for anti-nu_e (phi = 0.28 s^{-1} cm^{-2} for nue), normalized to a local rate of core collapses of R_{cc}(0)=10^{-4} yr^{-1} Mpc^{-3}. In 5 years, a 0.45 Mt water Cherenkov detector should see 5-65 events from failed supernovae, ...

  4. Outside the box: Medications worth considering when traditional antiepileptic drugs have failed.

    Science.gov (United States)

    Turner, Adrian L; Perry, M Scott

    2017-08-01

    Review and discuss medications efficacious for seizure control, despite primary indications for other diseases, as treatment options in patients who have failed therapy with traditional antiepileptic drugs (AEDs). Literature searches were conducted utilizing PubMed and MEDLINE databases employing combinations of search terms including, but not limited to, "epilepsy", "refractory", "seizure", and the following medications: acetazolamide, amantadine, bumetanide, imipramine, lidocaine, verapamil, and various stimulants. Data from relevant case studies, retrospective reviews, and available clinical trials were gathered, analyzed, and reported. Experience with acetazolamide, amantadine, bumetanide, imipramine, lidocaine, verapamil, and various stimulants show promise for cases of refractory epilepsy in both adults and children. Many medications lack large scale, randomized clinical trials, but the available data is informative when choosing treatment for patients that have failed traditional epilepsy therapies. All neurologists have encountered a patient that failed nearly every AED, diet, and surgical option. For these patients, we often seek fortuitous discoveries within small series and case reports, hoping to find a treatment that might help the patient. In the present review, we describe medications for which antiepileptic effect has been ascribed after they were introduced for other indications. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  5. Late sodium current is a new therapeutic target to improve contractility and rhythm in failing heart.

    Science.gov (United States)

    Undrovinas, Albertas; Maltsev, Victor A

    2008-10-01

    Most cardiac Na+ channels open transiently within milliseconds upon membrane depolarization and are responsible for the excitation propagation. However, some channels remain active during hundreds of milliseconds, carrying the so-called persistent or late Na+ current (I(NaL)) throughout the action potential plateau. I(NaL) is produced by special gating modes of the cardiac-specific Na+ channel isoform. Experimental data accumulated over the past decade show the emerging importance of this late current component for the function of both normal and especially failing myocardium, where I(NaL) is reportedly increased. Na+ channels represent a multi-protein complex and its activity is determined not only by the pore-forming alpha subunit but also by its auxiliary beta subunits, cytoskeleton, and by Ca2+ signaling and trafficking proteins. Remodeling of this protein complex and intracellular signaling pathways may lead to alterations of I(NaL) in pathological conditions. Increased I(NaL) and the corresponding Na+ influx in failing myocardium contribute to abnormal repolarization and an increased cell Ca2+ load. Interventions designed to correct I(NaL) rescue normal repolarization and improve Ca2+ handling and contractility of the failing cardiomyocytes. New therapeutic strategies to target both arrhythmias and deficient contractility in HF may not be limited to the selective inhibition of I(NaL) but also include multiple indirect, modulatory (e.g. Ca(2+)- or cytoskeleton- dependent) mechanisms of I(NaL) function.

  6. Reusing of the Failing Free Flap “Nutrient Flap” as Salvage Procedure

    Directory of Open Access Journals (Sweden)

    Koji Takahashi, MD

    2014-01-01

    Full Text Available Summary: A 26-year-old woman sustained a traffic accident injury to her left medial malleolus. A soft-tissue defect 15 × 7 cm with exposure of bone was found and underwent free anterolateral thigh flap to cover it. On the second postoperative day, venous congestion occurred and re-exploration was performed. Re-anastomosis of the vein was done after the thrombectomy; unfortunately, the flap did not recover. We found there was a good granulation bed under the failing flap and thinned the failing flap and used it as a full-thickness skin graft. The graft survived completely; 9 months later, the graft site was softer and of good texture. The patient can wear the same size shoes without a debulking procedure. The free flap provided nutrients to the raw surface and nurtured a good granulation bed while it survived for 50 hours; as a result, it was used as “the nutrient flap.” Reuse of the failing free flap as “the nutrient flap” is useful as an alternative backup procedure.

  7. Functional Outcomes of Revision Total Knee Arthroplasty Following Failed Unicompartmental Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Chris Ironside

    2014-12-01

    Full Text Available Introduction: Unicompartmental knee arthroplasty (UKA can be used to treat medial compartment osteoarthritis of the knee. Some of these knees will eventually fail, and need to be revised. There is controversy about using UKA in younger patients as a definitive procedure or as a means to delay total knee arthroplasty (TKA because the outcomes of subsequent revision surgery may be inferior to a primary TKA. Methods: We retrospectively reviewed a series of 46 revision TKA patients following failed UKA (UKA revisions using functional outcomes questionnaires and compared the results with a cohort of age and gender matched primary TKA patients. Our hypothesis was that UKA revision surgery would be inferior to primary TKA surgery. Results: Data was collected on 33 knees after a mean follow-up period of five years. There was no significant difference in the Oxford Knee Score (33.7 vs 37.1, p = 0.09 or the Western Ontario and MacMasters Universities Arthritis Index (WOMAC (24.8 vs. 19.1, p = 0.22. A subgroup analysis demonstrated that UKAs, which fail early, are more likely to produce an inferior outcome following revision surgery than those that survive more than five years. Discussion: We conclude that UKA can be used effectively in appropriately selected patients, as the functional outcome of their subsequent revision to TKA is not significantly inferior to a primary TKA.

  8. Surgical Reimplantation for the Correction of Vesicoureteral Reflux following Failed Endoscopic Injection

    Directory of Open Access Journals (Sweden)

    Boris Chertin

    2011-01-01

    Full Text Available Purpose. In recent years, endoscopic injection became the procedure of choice for the correction of vesicoureteral reflux in the majority of the centers. Unfortunately, endoscopic treatment is not always successful and sometimes requires more than one trial to achieve similar results to that of an open reimplantation surgery. Our aim of this study is to evaluate the feasibility and success rate of open ureteral reimplantation following failed endoscopic procedure. Patients and Methods. During 2004–2010, we evaluated 16 patients with persistent vesicoureteral reflux (grades II–IV following failed endoscopic treatment. All patients underwent open ureteral reimplantation. All patients were followed with an ultrasound 6 weeks following surgery and every 6 months thereafter for an average of 22 months. Voiding cystography was performed at 3 months after surgery. Results. During unilateral open ureteral reimplantation, the implanted deposit from previous procedures was either excised, drained, or incorporated into the neotunnel with the ureter. Vesicoureteral reflux was resolved in all patients with 100% success rate. No new hydronephrosis or signs of obstruction developed in any of the patients. qDMSA renal scan was available in 8 patients showing improvement of function in 5 and stable function in 3, and no new scars were identified. Conclusions. Open ureteral reimplantation is an excellent choice for the correction of failed endoscopic treatment in children with vesicoureteral reflux.

  9. mRNA expression levels in failing human hearts predict cellular electrophysiological remodeling: a population-based simulation study.

    Directory of Open Access Journals (Sweden)

    John Walmsley

    Full Text Available Differences in mRNA expression levels have been observed in failing versus non-failing human hearts for several membrane channel proteins and accessory subunits. These differences may play a causal role in electrophysiological changes observed in human heart failure and atrial fibrillation, such as action potential (AP prolongation, increased AP triangulation, decreased intracellular calcium transient (CaT magnitude and decreased CaT triangulation. Our goal is to investigate whether the information contained in mRNA measurements can be used to predict cardiac electrophysiological remodeling in heart failure using computational modeling. Using mRNA data recently obtained from failing and non-failing human hearts, we construct failing and non-failing cell populations incorporating natural variability and up/down regulation of channel conductivities. Six biomarkers are calculated for each cell in each population, at cycle lengths between 1500 ms and 300 ms. Regression analysis is performed to determine which ion channels drive biomarker variability in failing versus non-failing cardiomyocytes. Our models suggest that reported mRNA expression changes are consistent with AP prolongation, increased AP triangulation, increased CaT duration, decreased CaT triangulation and amplitude, and increased delay between AP and CaT upstrokes in the failing population. Regression analysis reveals that changes in AP biomarkers are driven primarily by reduction in I[Formula: see text], and changes in CaT biomarkers are driven predominantly by reduction in I(Kr and SERCA. In particular, the role of I(CaL is pacing rate dependent. Additionally, alternans developed at fast pacing rates for both failing and non-failing cardiomyocytes, but the underlying mechanisms are different in control and heart failure.

  10. 'Failed' eruptions revealed by integrated analysis of gas emission and volcanic tremor data at Mt. Etna, Italy

    Science.gov (United States)

    Salerno, G. G.; Falsaperla, S. M.; Behncke, B.; Langer, H. K.; Neri, M.; Giammanco, S.; Pecora, E.; Biale, E.

    2013-12-01

    Mt Etna in Sicily is among the most intensely monitored and studied volcanoes on Earth due to its very frequent activity, and its location in a densely populated area. Through a sophisticated monitoring system run by the Istituto Nazionale di Geofisica e Vulcanologia - Osservatorio Etneo (INGV-OE), scientists are gaining every day and in real time a picture of the state of volcanic activity of Etna. During the spring of 2007, various episodes of paroxysmal activity occurred at the South-East Crater, one of the four summit craters of Mt Etna. These episodes were always associated with a sharp increase in the amplitude of the volcanic tremor as well as changes in the spectral characteristics of this signal. Eruptive activity ranged from strong Strombolian explosions to lava fountains coupled with copious emission of lava flows and tephra. During inter-eruptive periods, recurrent seismic unrest episodes were observed in form of both temporary enhancements of the volcanic tremor amplitude as well as changes of spectral characteristics. These changes often triggered the automatic alert systems in the operation room of the INGV-OE, even though not being followed by manifest eruptive activity at the surface. The influence of man-made or meteorologically induced noise could be ruled out as a cause for the alarms. We therefore performed a multi-parametric analysis of these inter-eruptive periods by integrating seismic volcanic tremor, in-soil radon, plume SO2 flux and thermal data, discussing the potential volcano-dependent source of these episodes. Short-term changes were investigated applying pattern classification, in particular Kohonen Maps and fuzzy clustering, simultaneously on volcanic tremor, radon and ambient parameters (pressure and temperature). The well established SO2 flux and thermal radiation data were used as the 'smoking gun', for certifying that the observed changes in seismic and in radon data can be considered as volcanogenic. Our results unveil ';failed

  11. Infrared Drying Parameter Optimization

    Science.gov (United States)

    Jackson, Matthew R.

    In recent years, much research has been done to explore direct printing methods, such as screen and inkjet printing, as alternatives to the traditional lithographic process. The primary motivation is reduction of the material costs associated with producing common electronic devices. Much of this research has focused on developing inkjet or screen paste formulations that can be printed on a variety of substrates, and which have similar conductivity performance to the materials currently used in the manufacturing of circuit boards and other electronic devices. Very little research has been done to develop a process that would use direct printing methods to manufacture electronic devices in high volumes. This study focuses on developing and optimizing a drying process for conductive copper ink in a high volume manufacturing setting. Using an infrared (IR) dryer, it was determined that conductive copper prints could be dried in seconds or minutes as opposed to tens of minutes or hours that it would take with other drying devices, such as a vacuum oven. In addition, this study also identifies significant parameters that can affect the conductivity of IR dried prints. Using designed experiments and statistical analysis; the dryer parameters were optimized to produce the best conductivity performance for a specific ink formulation and substrate combination. It was determined that for an ethylene glycol, butanol, 1-methoxy 2- propanol ink formulation printed on Kapton, the optimal drying parameters consisted of a dryer height of 4 inches, a temperature setting between 190 - 200°C, and a dry time of 50-65 seconds depending on the printed film thickness as determined by the number of print passes. It is important to note that these parameters are optimized specifically for the ink formulation and substrate used in this study. There is still much research that needs to be done into optimizing the IR dryer for different ink substrate combinations, as well as developing a

  12. Measuring the chargino parameters

    Indian Academy of Sciences (India)

    J Kalinowski

    2000-07-01

    After the supersymmetric particles have been discovered, the priority will be to determine independently the fundamental parameters to reveal the structure of the underlying supersymmetric theory. In my talk I discuss how the chargino sector can be reconstructed completely by measuring the cross-sections with polarized beams at e+e- collider experiments: $\\tilde{X}^{+}_{i}\\tilde{X}^{-}_{j}[i,j=1,2]$. The closure of the two-chargino system can be investigated by analysing sum rules for the production cross-sections.

  13. Observation of functional remodeling of Ca2+-activated Cl- channel in pacing-induced canine failing heart

    Institute of Scientific and Technical Information of China (English)

    浦介麟

    2006-01-01

    Objective To study whether Ca2+-activated Cl-current (Ito2) contributes to the functional remodeling of the failing heart. Methods The cardiac myocytes were isolated enzymatically from rapidly pacing-induced failing canine hearts (HF) at room temperature. Patch-Clamp whole cell recording technique was employed to record the Ito2.The Cl- transport blocker 4,4’-diisothiocyanos-

  14. Beyond Failure: Potentially Mitigating Failed Author Searches in the Online Library Catalog through the Use of Linked Data

    Science.gov (United States)

    Moulaison, Heather Lea; Stanley, Susan Nicole

    2013-01-01

    Linked data stores house vetted content that can supplement the information available through online library catalogs, potentially mitigating failed author searches if information about the author exists in linked data formats. In this case study, a total of 689 failed author index queries from a large Midwestern academic library's online library…

  15. 30 CFR 75.803 - Fail safe ground check circuits on high-voltage resistance grounded systems.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Fail safe ground check circuits on high-voltage resistance grounded systems. 75.803 Section 75.803 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION... High-Voltage Distribution § 75.803 Fail safe ground check circuits on high-voltage resistance...

  16. 30 CFR 77.803 - Fail safe ground check circuits on high-voltage resistance grounded systems.

    Science.gov (United States)

    2010-07-01

    ... circuits on high-voltage resistance grounded systems. On and after September 30, 1971, all high-voltage, resistance grounded systems shall include a fail safe ground check circuit or other no less effective device... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Fail safe ground check circuits on...

  17. 49 CFR 236.567 - Restrictions imposed when device fails and/or is cut out en route.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Restrictions imposed when device fails and/or is cut out en route. 236.567 Section 236.567 Transportation Other Regulations Relating to Transportation...; Locomotives § 236.567 Restrictions imposed when device fails and/or is cut out en route. Where an...

  18. 12 CFR 360.8 - Method for determining deposit and other liability account balances at a failed insured...

    Science.gov (United States)

    2010-01-01

    ..., the depository institution's normal posting procedures. (2) In its role as receiver of a failed... assets under the FDI Act (12 U.S.C. 1821(d)(11)) as of the FDIC Cutoff Point, the FDIC will use its best... may make in its role as receiver of the failed depository institution. (3) In determining Close-of...

  19. The use of low-dose protracted oral clofarabine in a patient with myelodysplastic syndrome after failing 5-azacitidine

    OpenAIRE

    2013-01-01

    Patients with myelodysplastic syndrome who fail hypomethylating agents have a very short median survival and about 25% risk of disease transformation to acute myeloid leukemia. We report our experience with low-dose protracted oral clofarabine in one patient who achieved stable disease for more than two years after failing 5-azacitidine.

  20. The Outcome and Predictors of Failed Extubation in Intensive Care Patients—The  Elderly is an Important Predictor

    Directory of Open Access Journals (Sweden)

    Ai-Chin Cheng

    2011-12-01

    Conclusion: Our study indicated that patients with failed extubation experienced significantly increased admission expenditure, increased tracheostomy rate, and higher hospital mortality. Advanced age should be considered an important risk factor for failed extubation and overall mortality when planning extubation in critically ill ICU patients.

  1. Patient Education in a 14-month Randomised Trial Fails to Improve Adherence in Ulcerative Colitis: Influence of Demographic and Clinical Parameters on Non-adherence.

    Science.gov (United States)

    Nikolaus, S; Schreiber, S; Siegmund, B; Bokemeyer, B; Bästlein, E; Bachmann, O; Görlich, D; Hofmann, U; Schwab, M; Kruis, W

    2017-09-01

    Recent observational studies document that non-adherence to mesalamine therapy during remission is frequent. We aimed to investigate patient impact of patient education using objective assessments of adherence. A 14-month randomised, prospective clinical trial of adherence to mesalamine was conducted in 248 patients with ulcerative colitis [UC], Colitis Activity Index [CAI] ≤ 9, receiving standard care [n = 122] versus a standardised patient education programme [n = 126]. Primary endpoint was adherence at all visits (5-aminosalicylic acid [5-ASA] urine levels). Secondary endpoints included quality of life (inflammatory bowel disease questionnaise [IBDQ]), disease activity, partial adherence, and self-assessment of adherence. Patient allocation was well balanced. Baseline non-adherence was high in quiescent/mildly active UC [52.4%] without difference between the groups (52.4% of patients in the education group versus 52.5% in the standard care group [p = 0.99]). No difference between the intervention group and standard care was seen in IBDQ, partial adherence, self-assessment of adherence, or therapy satisfaction at all visits. We suggest a model in which individual risks for non-adherence are driven by patients with young age, short disease duration, and low education levels. Non-adherence is frequent in a population with quiescent/mildly active UC. Although more than 25% of the population was not in remission at the various time points, no relationship between disease activity and adherence was seen over the 14-month observation period. Physicians should maximise their efforts to motivate high-risk patients for adherence. Future trials should use objective exposure assessments to examine the impact of continuous education and consultations on the background of individual risks to develop non-adherence.

  2. G3DB: A database of successful and failed grasps with RGB-D images, point clouds, mesh models and gripper parameters

    CSIR Research Space (South Africa)

    Kleinhans, A

    2015-05-01

    Full Text Available of unknown objects through a synergistic use of edge and surface information. The international journal of robotics research, 2012. [9] A. Singh, J. Sha, K. S. Narayan, T. Achim, and P. Abbeel. Bigbird: A large-scale 3d database of object instances. In IEEE...

  3. [Spinal cord stimulation and failed back surgery syndrome. Clinical results with laminectomy electrodes].

    Science.gov (United States)

    García March, Guillermo; Bordes, Vicente; Roldán, Pedro; Real, Luis; González Darder, José Manuel

    2015-01-01

    Spinal cord stimulation is a widely-accepted technique in the treatment of back pain resulting from failed back surgery. Classically, stimulation has been carried out with percutaneous electrodes implanted under local anaesthesia and sedation. However, the ease of migration and the difficulty of reproducing electrical paresthesias in large areas with such electrodes has led to increasing use of surgical plate leads, which have the disadvantage of the need for general anaesthesia and a laminectomy for implantation. Our objective was to report the clinical results, technical details, advantages and benefits of laminectomy lead placement under epidural anaesthesia in failed back surgery syndrome cases. Spinal cord stimulation was performed in a total of 119 patients (52 men and 67 women), aged between 31 and 73 years (average, 47.3). Epidural anaesthesia was induced with ropivacaine. In all cases we inserted the octapolar or 16-polar lead in the epidural space through a small laminectomy. The final position of the leads was the vertebral level that provided coverage of the patient's pain. The electrodes were connected at dual-channel or rechargeable pulse generators. After a mean follow-up of 4.7 years, the results in terms of improvement of the previous painful situation was satisfactory, with an analgesia level of 58% of axial pain and 60% of radicular pain in more than 70% of cases. None of the patients said that the surgery stage was painful or unpleasant. No serious complications were included in the group, but in 6 cases the system had to be explanted because of ineffectiveness or intolerance of long-term neurostimulation. This study, with a significant number of patients, used epidural anaesthesia for spinal cord stimulation of lead implants by laminectomy in failed back surgery syndromes. The technique seems to be safe and effective. Copyright © 2014 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  4. Quantification of carbonic anhydrase gene expression in ventricle of hypertrophic and failing human heart

    Directory of Open Access Journals (Sweden)

    Alvarez Bernardo V

    2013-01-01

    Full Text Available Abstract Background Carbonic anhydrase enzymes (CA catalyze the reversible hydration of carbon dioxide to bicarbonate in mammalian cells. Trans-membrane transport of CA-produced bicarbonate contributes significantly to cellular pH regulation. A body of evidence implicates pH-regulatory processes in the hypertrophic growth pathway characteristic of hearts as they fail. In particular, Na+/H+ exchange (NHE activation is pro-hypertrophic and CA activity activates NHE. Recently Cardrase (6-ethoxyzolamide, a CA inhibitor, was found to prevent and revert agonist-stimulated cardiac hypertrophy (CH in cultured cardiomyocytes. Our goal thus was to determine whether hypertrophied human hearts have altered expression of CA isoforms. Methods We measured CA expression in hypertrophied human hearts to begin to examine the role of carbonic anhydrase in progression of human heart failure. Ventricular biopsies were obtained from patients undergoing cardiac surgery (CS, n = 14, or heart transplantation (HT, n = 13. CS patients presented mild/moderate concentric left ventricular hypertrophy and normal right ventricles, with preserved ventricular function; ejection fractions were ~60%. Conversely, HT patients with failing hearts presented CH or ventricular dilation accompanied by ventricular dysfunction and EF values of 20%. Non-hypertrophic, non-dilated ventricular samples served as controls. Results Expression of atrial and brain natriuretic peptide (ANP and BNP were markers of CH. Hypertrophic ventricles presented increased expression of CAII, CAIV, ANP, and BNP, mRNA levels, which increased in failing hearts, measured by quantitative real-time PCR. CAII, CAIV, and ANP protein expression also increased approximately two-fold in hypertrophic/dilated ventricles. Conclusions These results, combined with in vitro data that CA inhibition prevents and reverts CH, suggest that increased carbonic anhydrase expression is a prognostic molecular marker of cardiac

  5. Beneficial effects of acute inhibition of the oxidative pentose phosphate pathway in the failing heart.

    Science.gov (United States)

    Vimercati, Claudio; Qanud, Khaled; Mitacchione, Gianfranco; Sosnowska, Danuta; Ungvari, Zoltan; Sarnari, Roberto; Mania, Daniella; Patel, Neel; Hintze, Thomas H; Gupte, Sachin A; Stanley, William C; Recchia, Fabio A

    2014-03-01

    In vitro studies suggested that glucose metabolism through the oxidative pentose phosphate pathway (oxPPP) can paradoxically feed superoxide-generating enzymes in failing hearts. We therefore tested the hypothesis that acute inhibition of the oxPPP reduces oxidative stress and enhances function and metabolism of the failing heart, in vivo. In 10 chronically instrumented dogs, congestive heart failure (HF) was induced by high-frequency cardiac pacing. Myocardial glucose consumption was enhanced by raising arterial glycemia to levels mimicking postprandial peaks, before and after intravenous administration of the oxPPP inhibitor 6-aminonicotinamide (80 mg/kg). Myocardial energy substrate metabolism was measured with radiolabeled glucose and oleic acid, and cardiac 8-isoprostane output was used as an index of oxidative stress. A group of five chronically instrumented, normal dogs served as control. In HF, raising glycemic levels from ∼ 80 to ∼ 170 mg/dL increased cardiac isoprostane output by approximately twofold, whereas oxPPP inhibition normalized oxidative stress and enhanced cardiac oxygen consumption, glucose oxidation, and stroke work. In normal hearts glucose infusion did not induce significant changes in cardiac oxidative stress. Myocardial tissue concentration of 6P-gluconate, an intermediate metabolite of the oxPPP, was significantly reduced by ∼ 50% in treated versus nontreated failing hearts, supporting the inhibitory effect of 6-aminonicotinamide. Our study indicates an important contribution of the oxPPP activity to cardiac oxidative stress in HF, which is particularly pronounced during common physiological changes such as postprandial glycemic peaks.

  6. Survival of dental implants placed in sites of previously failed implants.

    Science.gov (United States)

    Chrcanovic, Bruno R; Kisch, Jenö; Albrektsson, Tomas; Wennerberg, Ann

    2016-10-14

    To assess the survival of dental implants placed in sites of previously failed implants and to explore the possible factors that might affect the outcome of this reimplantation procedure. Patients that had failed dental implants, which were replaced with the same implant type at the same site, were included. Descriptive statistics were used to describe the patients and implants; survival analysis was also performed. The effect of systemic, environmental, and local factors on the survival of the reoperated implants was evaluated. 175 of 10,096 implants in 98 patients were replaced by another implant at the same location (159, 14, and 2 implants at second, third, and fourth surgeries, respectively). Newly replaced implants were generally of similar diameter but of shorter length compared to the previously placed fixtures. A statistically significant greater percentage of lost implants were placed in sites with low bone quantity. There was a statistically significant difference (P = 0.032) in the survival rates between implants that were inserted for the first time (94%) and implants that replaced the ones lost (73%). There was a statistically higher failure rate of the reoperated implants for patients taking antidepressants and antithrombotic agents. Dental implants replacing failed implants had lower survival rates than the rates reported for the previous attempts of implant placement. It is suggested that a site-specific negative effect may possibly be associated with this phenomenon, as well as the intake of antidepressants and antithrombotic agents. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Bias associated with failing to incorporate dependence on event history in Markov models.

    Science.gov (United States)

    Bentley, Tanya G K; Kuntz, Karen M; Ringel, Jeanne S

    2010-01-01

    When using state-transition Markov models to simulate risk of recurrent events over time, incorporating dependence on higher numbers of prior episodes can increase model complexity, yet failing to capture this event history may bias model outcomes. This analysis assessed the tradeoffs between model bias and complexity when evaluating risks of recurrent events in Markov models. The authors developed a generic episode/relapse Markov cohort model, defining bias as the percentage change in events prevented with 2 hypothetical interventions (prevention and treatment) when incorporating 0 to 9 prior episodes in relapse risk versus a model with 10 such episodes. Magnitude and sign of bias were evaluated as a function of event and recovery risks, disease-specific mortality, and risk function. Bias was positive in the base case for a prevention strategy, indicating that failing to fully incorporate dependence on event history overestimated the prevention's predicted impact. For treatment, the bias was negative, indicating an underestimated benefit. Bias approached zero as the number of tracked prior episodes increased, and the average bias over 10 tracked episodes was greater with the exponential compared with linear functions of relapse risk and with treatment compared with prevention strategies. With linear and exponential risk functions, absolute bias reached 33% and 78%, respectively, in prevention and 52% and 85% in treatment. Failing to incorporate dependence on prior event history in subsequent relapse risk in Markov models can greatly affect model outcomes, overestimating the impact of prevention and treatment strategies by up to 85% and underestimating the impact in some treatment models by up to 20%. When at least 4 prior episodes are incorporated, bias does not exceed 26% in prevention or 11% in treatment.

  8. Endovascular Therapy is Effective Treatment for Focal Stenoses in Failing Infrapopliteal Vein Grafts

    Science.gov (United States)

    Westin, Gregory G.; Armstrong, Ehrin J.; Javed, Usman; Balwanz, Christopher R.; Saeed, Haseeb; Pevec, William C.; Laird, John R.; Dawson, David L.

    2014-01-01

    Objective To evaluate the efficacy of endovascular therapy for maintaining patency and preserving limbs among patients with failing infrapopliteal bypass grafts. Methods We gathered data from a registry of catheter-based procedures for peripheral artery disease. Of 1554 arteriograms performed from 2006 to 2012, 30 patients had interventions for failing bypass vein grafts to infrapopliteal target vessels. The first intervention for each patient was used in this analysis. Duplex ultrasonography was used within 30 days after intervention and subsequently at 3-6 month intervals for graft surveillance. Results Interventions were performed for duplex ultrasonography surveillance findings in 21 patients and for symptoms of persistent or recurrent critical limb ischemia in 9 patients. Procedural techniques included cutting balloon angioplasty (83%), conventional balloon angioplasty (7%), and stent placement (10%). Procedural success was achieved in all cases. There were no procedure-related complications, amputations, or deaths within 30 days. By Kaplan-Meier analysis, 37% were free from graft restenosis at 12 months and 31% were at 24 months. Receiver operating characteristic analysis indicated that a lesion length of 1.75 cm best predicted freedom from restenosis (C statistic: 0.74). Residual stenosis (P=0.03), patency without reintervention (P=0.01), and assisted patency with secondary intervention (P=0.02) rates were superior for short lesions compared to long lesions. The cohort had acceptable rates of adverse clinical outcomes, with 96% of patients free from amputation at both 12 and 24 months; clinical outcomes were also better in patients with short lesions. Conclusions In this single-center experience with endovascular therapies to treat failing infrapopliteal bypass grafts, rates of limb preservation were high, but the majority of patients developed graft restenosis within 12 months. Grafts with longer stenoses fared poorly by comparison. These data suggest that

  9. Conditions inside Water Pooled in a Failed Nuclear Waste Container and its Effect on Radionuclide Release

    Science.gov (United States)

    Hamdan, L. K.; Walton, J. C.; Woocay, A.

    2009-12-01

    Nuclear power use is expected to expand in the future, as part of the global clean energy initiative, to meet the world’s surging energy demand, and attenuate greenhouse gas emissions, which are mainly caused by fossil fuels. As a result, it is estimated that hundreds of thousands of metric tons of spent nuclear fuel (SNF) will accumulate. SNF disposal has major environmental (radiation exposure) and security (nuclear proliferation) concerns. Storage in unsaturated zone geological repositories is a reasonable solution for dealing with SNF. One of the key factors that determine the performance of the geological repository is the release of radionuclides from the engineered barrier system. Over time, the nuclear waste containers are expected to fail gradually due to general and localized corrosions and eventually infiltrating water will have access to the nuclear waste. Once radionuclides are released, they will be transported by water, and make their way to the accessible environment. Physical and chemical disturbances in the environment over the container will lead to different corrosion rates, causing different times and locations of penetration. One possible scenario for waste packages failure is the bathtub model, where penetrations occur on the top of the waste package and water pools inside it. In this paper the bathtub-type failed waste container is considered. We shed some light on chemical and physical processes that take place in the pooled water inside a partially failed waste container (bathtub category), and the effects of these processes on radionuclide release. Our study considers two possibilities: temperature stratification of the pooled water versus mixing process. Our calculations show that temperature stratification of the pooled water is expected when the waste package is half (or less) filled with water. On the other hand, when the waste package is fully filled (or above half) there will be mixing in the upper part of water. The effect of

  10. Nasolacrimal recanalization as an alternative to external dacryocystorhinostomy for treating failed nasolacrimal duct intubation.

    Science.gov (United States)

    Hong, Jiaxu; Qian, Tingting; Wei, Anji; Sun, Zhongmou; Wu, Dan; Chen, Yihe; Marmalidou, Anna; Lu, Yi; Sun, Xinghuai; Liu, Zuguo; Amparo, Francisco; Xu, Jianjiang

    2016-07-01

    To compare the surgical duration and clinical outcomes of nasolacrimal recanalization versus external dacryocystorhinostomy (DCR) in the treatment of failed nasolacrimal duct intubation.This is a retrospective, comparative, and interventional study. We evaluated the outcomes of 66 consecutive patients undergoing either nasolacrimal recanalization (n = 32) or DCR (n = 34) in a tertiary lacrimal disease referral center. Length of surgical duration, clinical outcomes, and rate of recurrence at 18 months postoperatively were compared.The mean surgical duration was 18.5 minutes (range, 15-25 minutes) for nasolacrimal recanalization and 48.2 minutes (range, 45-61 minutes) for DCR, respectively (P < 0.001). The rate of success was 84.4% in the recanalization group and 85.3% in the DCR group, respectively (P = 0.91). The time to recurrence was 2.6 ± 1.1 months in the recanalization group and 5.6 ± 2.1 months in the DCR group (P < 0.001). Five failed cases in each group received a secondary DCR surgery with the same resolution rate (40%). The absence of ocular discharge at baseline was a significant predictor for a successful outcome in the recanalization group (P = 0.04) but not in the DCR group (P = 0.63).Nasolacrimal recanalization is an effective, safe, and time-saving alternative to DCR for the treatment of failed nasolacrimal duct intubation. Clinicians should be cautious in patients with discharge.

  11. Improving speech outcomes after failed palate repair: evaluating the safety and efficacy of conversion Furlow palatoplasty.

    Science.gov (United States)

    Nayar, Harry S; Cray, James J; MacIsaac, Zoe M; Argenta, Anne E; Ford, Matthew D; Fenton, Regina A; Losee, Joseph E; Grunwaldt, Lorelei J

    2014-03-01

    Velopharyngeal insufficiency occurs in a nontrivial number of cases following cleft palate repair. We hypothesize that a conversion Furlow palatoplasty allows for long-term correction of VPI resulting from a failed primary palate repair, obviating the need for pharyngoplasty and its attendant comorbidities. A retrospective review of patients undergoing a conversion Furlow palatoplasty between 2003 and 2010 was performed. Patients were grouped according to the type of preceding palatal repair. Velopharyngeal insufficiency was assessed using Pittsburgh Weighted Speech Scale (PWSS). Scores were recorded and compared preoperatively and postoperatively at 3 sequential visits. Sixty-two patients met inclusion criteria and were grouped by preceding repair (straight-line repair (n = 37), straight-line repair with subsequent oronasal fistula (n = 14), or pharyngeal flap (n = 11). Median PWSS scores at individual visits were as follows: preoperative = 11, first postoperative = 3 (mean, 114.0 ± 6.7 days), second postoperative = 1 (mean, 529.0 ± 29.1 days), and most recent postoperative = 3 (mean, 1368.6 ± 76.9 days). There was a significant difference between preoperative and postoperative PWSS scores in the entire cohort (P 0.05). Eight patients failed to improve and showed no differences in PWSS scores over time (P > 0.05). Patients with a PWSS score of 7 or greater (n = 8) at the first postoperative visit (0-6 months) displayed improvement at the most recent visit (Pspeech. Future studies should elucidate which factors predict the success of this technique following failed palate repair.

  12. Timetable Attractiveness Parameters

    DEFF Research Database (Denmark)

    Schittenhelm, Bernd

    2008-01-01

    Timetable attractiveness is influenced by a set of key parameters that are described in this article. Regarding the superior structure of the timetable, the trend in Europe goes towards periodic regular interval timetables. Regular departures and focus on optimal transfer possibilities make...... these timetables attractive. The travel time in the timetable depends on the characteristics of the infrastructure and rolling stock, the heterogeneity of the planned train traffic and the necessary number of transfers on the passenger’s journey. Planned interdependencies between trains, such as transfers...... and heterogeneous traffic, add complexity to the timetable. The risk of spreading initial delays to other trains and parts of the network increases with the level of timetable complexity....

  13. N-acetylcysteine manipulation fails to elicit an increase in glutathione in a teleost model

    DEFF Research Database (Denmark)

    Birnie-Gauvin, Kim; Larsen, Martin Hage; Aarestrup, Kim

    2017-01-01

    and vegetable shortening, at two different concentrations (100 and 400 mg/kg), with the appropriate controls and shams, under controlled laboratory settings. We found that NAC failed to elicit an increase in GSH over three time periods and concluded that NAC is not an effective method to enhance GSH levels...... in teleost fish using the concentrations and vehicles tested here. We emphasize the importance of validation studies across all new species/taxa when possible and suggest that more investigation is required with regard toNAC manipulation in fish if this approach is to be used...

  14. Impact of failed mitral valve repair on hospital outcome of redo mitral valve procedures.

    Science.gov (United States)

    Onorati, Francesco; Gatti, Giuseppe; Perrotti, Andrea; Mariscalco, Giovanni; Reichart, Daniel; Milano, Aldo; Della Ratta, Ester; Rubino, Antonio; Santarpino, Giuseppe; Salsano, Antonio; Biancari, Fausto; Detter, Christian; Chocron, Sidney; Beghi, Cesare; De Feo, Marisa; Mignosa, Carmelo; Fischlein, Theodor; Pappalardo, Aniello; D'Errigo, Paola; Santini, Francesco; Faggian, Giuseppe

    2017-05-01

    The prognostic impact of failed mitral valve repair (FMR) on in-hospital outcome after redo mitral valve surgery has not been thoroughly investigated. Hospital outcomes after redo mitral valve surgery because of an FMR in patients from nine European centres were reported. Logistic regressions identified predictors of mortality in combined or isolated redo mitral valve operations. Hospital outcome was compared between propensity-matched cohorts with FMR and native mitral valves in the context of redo surgery and FMR versus failed prostheses. A total of 246 patients with FMR yielded a 6.5% mortality rate at redo surgery. FMR per se did not impact mortality at multivariable analysis ( P = 0.64). A preoperative Global Initiative for Chronic Obstructive Lung Disease (GOLD) score ≥2 chronic obstructive lung disease (COPD) (OR 15.2, P FMR population. GOLD ≥ 2 COPD (OR 12.3, P = 0.049), age at surgery (OR 1.15 for each incremental year, P = 0.049) and cardiopulmonary bypass duration (OR 1.02, P = 0.022) predicted mortality in isolated redo mitral valve surgery for FMR. The fourth (> 68 years = 13.8% mortality) and the fifth quintiles of age (≥73.4 years = 14.8%) reported the highest mortality (OR 3.8 and 4.2 respectively, P = 0.002) in this subgroup. Propensity-matched cohorts of FMR and native mitral valves in the context of redo surgery showed no differences in terms of mortality ( P = 0.69) and major morbidity (acute myocardial infarction P = 0.31, stroke P = 0.65, acute kidney injury P  = 1.0), whereas more perioperative dialysis ( P = 0.04) and transfusions ( P = 0.02) were noted in propensity-matched failed prostheses compared to FMR. A failed mitral repair does not impact hospital outcome of redo surgery. Given the role of severe left ventricular dysfunction and advanced age on hospital mortality rates, an early indication for redo surgery may improve outcome.

  15. The Airtraq as a rescue airway device following failed direct laryngoscopy: a case series.

    LENUS (Irish Health Repository)

    Maharaj, C H

    2007-06-01

    We report the successful use of the Airtraq as a rescue device following failed direct laryngoscopy, in patients deemed at increased risk for difficult tracheal intubation. In a series of seven patients, repeated attempts at direct laryngoscopy with the Macintosh blade, and the use of manoeuvres to aid intubation, such as the gum elastic bougie placement, were unsuccessful. In contrast, with the Airtraq device, each patient\\'s trachea was successfully intubated on the first attempt. This report underlines the utility of the Airtraq device in these patients.

  16. Failed fibreoptic intubation in a patient with a large mandibular fibreosseous lesion.

    Science.gov (United States)

    Baddoo, Hk; Parkins, Ge

    2008-12-01

    A case is presented of a 25 year old patient with a 15 year history of a lesion in the oral cavity, the histology of which showed it to be fibrous dysplasia. Conventional laryngoscopy and intubation were not possible as the lesion filled the entire oral cavity. Attempted awake fibreoptic intubation failed as the lesion extended into the nasopharynx and oropharynx, making it impossible to pass the fibreoptic scope beyond the nasopharynx. A tracheostomy was performed under local anaesthesia and surgery proceeded uneventfully. Although fibreoptic intubation has proved to be extremely useful in difficult intubations, there are a number of situations where fibreoptic intubation is not possible.

  17. Results of Latarjet Coracoid Transfer to Revise Failed Arthroscopic Instability Repairs

    Science.gov (United States)

    Nicholson, Gregory P.; Rahman, Zain; Verma, Nikhil N.; Romeo, Anthony A.; Cole, Brian J.; Gupta, Anil Kumar; Bruce, Benjamin

    2014-01-01

    Objectives: Arthroscopic instability repair has supplanted open techniques to anatomically reconstruct anteroinferior instability pathology. Arthroscopic technique can fail for a variety of reasons. We have utilized the Latarjet as a revision option in failed arthroscopic instability repairs when there is altered surgical anatomy, capsular deficiency and/or glenoid bone compromise and recurrent glenohumeral instability. Methods: We reviewed 51 shoulders (40 ♀, 11♂) that underwent Latarjet coracoid transfer for the revision of failed previous arthroscopic instability repair. The avg. age was 32.6 yrs (16-58). All patients had recurrent symptomatic anterior instability after previous arthroscopic surgery, and avg. time from arthroscopic repair to Latarjet was 13 months (4-40 mn). All had either CT or MRI that revealed suture anchor material in the glenoid, labral and capsular stripping, and anteroinferior glenoid bone loss or erosion. Advanced bone loss percentage analysis was not performed for this study. We excluded all patients that had a previous open repair, a seizure disorder, or if the Latarjet was a primary procedure. Outcome scores pre-operatively avg: SST: 6.7 (1-12); VAS: 3 (0-8); ASES: 63 (32-89). Coracoid transfer was performed thru a subscapularis split in 38, and with tendon takedown in 13. The coracoid was osteotomized along its long axis parallel to the undersurface of the lateral aspect. This provided at least 2.5 to 3.5 cm of graft with the conjoined tendon attached. The coracoacromial (CA) ligament was incised leaving a 1 cm. stump. The transfer was affixed flush with the articular surface but not lateral to it, with two 3.5 mm cortical screws in lag fashion overdrilling the coracoid with the CA ligament directed laterally. The capsule was then repaired to the CA ligament to make the transfer extra-articular. Results: At avg. 4 yr (2-7 yrs) follow-up stability had been maintained in 51 (100%).without further instability surgery. There were no

  18. Interposed Abdominal Compression CPR for an Out-of-Hospital Cardiac Arrest Victim Failing Traditional CPR

    Directory of Open Access Journals (Sweden)

    Christian D. McClung

    2015-10-01

    Full Text Available Interposed abdominal compression cardiopulmonary resuscitation (IAC-CPR is an alternative technique to traditional cardiopulmonary resuscitation (CPR that can improve perfusion and lead to restoration of circulation in patients with chest wall deformity either acquired through vigorous CPR or co-morbidity such as chronic obstructive pulmonary disease. We report a case of out-of-hospital cardiac arrest where IAC-CPR allowed for restoration of spontaneous circulation and eventual full neurologic recovery when traditional CPR was failing to generate adequate pulses with chest compression alone.

  19. Use of ozone in healing failed pectoralis major myocutaneous advancement flap

    Directory of Open Access Journals (Sweden)

    Titiksha T. Pol

    2016-06-01

    Full Text Available Infection of the sternotomy wound following cardiac surgery is quiet common. The PMMF (pectoralis major myocutaneous advancement flap procedure is commonly used to treat non healing sternotomy wounds following CABG (coronary artery bypass graft procedure. Ozone is used in the treatment of chronic, infected non healing wounds. A 65 year old female with a similar type of situation was treated with ozone in our study and the effects of ozone to significantly control infection and promote healing of the failed PMMF (pectoralis major myocutaneous advancement flap graft can be well appreciated. [Int J Res Med Sci 2016; 4(6.000: 2487-2490

  20. The neurophysiology of failed visual perceptions: some implications for medical teaching.

    Science.gov (United States)

    Welsby, Philip D

    2016-02-01

    Failed perceptions of clinical abnormalities may have a neurophysiological explanation including three major covert eye problems and seven major brain-processing problems. Seven suggestions are made in an attempt to minimise their effect. We see in detail much less than we think and there is no substitute for seeing real-life clinical abnormalities. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  1. [Results of emergency coronary artery bypass surgery after failed coronary angioplasty].

    Science.gov (United States)

    Imazeki, T; Yokoyama, M; Murai, N; Kurimoto, Y; Sakurada, M; Simizu, Y

    1995-06-01

    In the past 7 years, 9 emergent or urgent coronary artery bypass operations after failed percutaneous transluminal angioplasty (PTCA) were performed among 947 (PTCA). Since the introduction of coronary perfusion catheter system for the support of coronary perfusion during PTCA we could reduce the number of emergent cases and these patients could be operated on semi-emergently and securely without endangering co-medical staffs in a hurry. It is also unnecessary to be on standby all the time when the PTCA is being undertaken. Two acute myocardial infarction cases died in the early phase of this study (operative mortality 22%) and none after the introduction of coronary perfusion system during PTCA.

  2. Edna:a Failed Life Mediator Contrasting with Madame Ratignolle and Madame Reisz

    Institute of Scientific and Technical Information of China (English)

    Cairang Wangmu

    2015-01-01

    The Awakening is about the heroine Edna Pontellier awakes and tries to reset her relation with the world in New Orleans, a place the family chose to spend the summer, where there also are influences working their way to awake Edna. Among them, the effects from Madame Ratignolle and Madame Reisz are of great importance in the process of Edna’s awakening and to her final sui⁃cide. This dissertation will see how Edna is affected by and distinguished from them, and get the conclusion that Edna fails being a life mediator by contrasting with the two women.

  3. Frequency and causes of failed MODIS cloud property retrievals for liquid phase clouds over global oceans

    Science.gov (United States)

    Cho, Hyoun‐Myoung; Meyer, Kerry; Lebsock, Matthew; Platnick, Steven; Ackerman, Andrew S.; Di Girolamo, Larry; C.‐Labonnote, Laurent; Cornet, Céline; Riedi, Jerome; Holz, Robert E.

    2015-01-01

    Abstract Moderate Resolution Imaging Spectroradiometer (MODIS) retrieves cloud droplet effective radius (r e) and optical thickness (τ) by projecting observed cloud reflectances onto a precomputed look‐up table (LUT). When observations fall outside of the LUT, the retrieval is considered “failed” because no combination of τ and r e within the LUT can explain the observed cloud reflectances. In this study, the frequency and potential causes of failed MODIS retrievals for marine liquid phase (MLP) clouds are analyzed based on 1 year of Aqua MODIS Collection 6 products and collocated CALIOP and CloudSat observations. The retrieval based on the 0.86 µm and 2.1 µm MODIS channel combination has an overall failure rate of about 16% (10% for the 0.86 µm and 3.7 µm combination). The failure rates are lower over stratocumulus regimes and higher over the broken trade wind cumulus regimes. The leading type of failure is the “r e too large” failure accounting for 60%–85% of all failed retrievals. The rest is mostly due to the “r e too small” or τ retrieval failures. Enhanced retrieval failure rates are found when MLP cloud pixels are partially cloudy or have high subpixel inhomogeneity, are located at special Sun‐satellite viewing geometries such as sunglint, large viewing or solar zenith angles, or cloudbow and glory angles, or are subject to cloud masking, cloud overlapping, and/or cloud phase retrieval issues. The majority (more than 84%) of failed retrievals along the CALIPSO track can be attributed to at least one or more of these potential reasons. The collocated CloudSat radar reflectivity observations reveal that the remaining failed retrievals are often precipitating. It remains an open question whether the extremely large r e values observed in these clouds are the consequence of true cloud microphysics or still due to artifacts not included in this study. PMID:27656330

  4. A Tale of Two Projects: why IT projects fail (and why they sometimes actually succeed

    Directory of Open Access Journals (Sweden)

    David Wilton

    2005-05-01

    Full Text Available This Case describes two similar outsourced IS projects that took place in Wellington, New Zealand (NZ during the period 1992-99, with emphasis on the reasons why one project failed (the prime contractor repudiated the contract and the project was abandoned and why the other succeeded. The same prime contractor was used for both projects and there were a number of other similarities, yet the outcomes were totally different. The Case provides lessons in some of the fundamental aspects of IS/IT project management, including scope, time, risk, human resources, procurement and quality management.

  5. Making DidFail Succeed: Enhancing the CERT Static Taint Analyzer for Android App Sets

    Science.gov (United States)

    2015-03-01

    we tested this app on a physical phone, alongside BroadcastTx. Figure 4.8 shows the log messages (from adb logcat) when running BroadcastTx and...registered BroadcastReceiver to be handled by DidFail, a dummy static declaration of the BroadcastReceiver must be added to the manifest file so that...FlowDroid can appropriately analyze it. This dummy declaration can be added after analysis of the code shows a BroadcastReceiver is dynamically registered

  6. Stem cell therapy for failing hearts: there is something else beyond the cells

    Institute of Scientific and Technical Information of China (English)

    Gianluca Rigatelli; Francesco Zanon

    2006-01-01

    @@ Heart failure (HF) affects a rapidly growing population of patients. Despite improvements in the understanding and therapy of many stages of cardiovascular disease,there has been little progress in treating HF. In late-stage disease, current options are cardiac transplantation and mechanical support-options that are limited to a small patient collective. The ischemically injured failing heart lacks contractile myocardium, functional vasculature, and electrical integrity, which has made treatment of the underlying injury untenable in the past. Restoring all of these components at once seems to be an overwhelming challenge.

  7. Reusing of the Failing Free Flap “Nutrient Flap” as Salvage Procedure

    OpenAIRE

    Koji Takahashi, MD; Ching-Hua Hsieh, MD, PhD; Seng-Feng Jeng, MD

    2014-01-01

    Summary: A 26-year-old woman sustained a traffic accident injury to her left medial malleolus. A soft-tissue defect 15 × 7 cm with exposure of bone was found and underwent free anterolateral thigh flap to cover it. On the second postoperative day, venous congestion occurred and re-exploration was performed. Re-anastomosis of the vein was done after the thrombectomy; unfortunately, the flap did not recover. We found there was a good granulation bed under the failing flap and thinned the failin...

  8. varying elastic parameters distributions

    KAUST Repository

    Moussawi, Ali

    2014-12-01

    The experimental identication of mechanical properties is crucial in mechanics for understanding material behavior and for the development of numerical models. Classical identi cation procedures employ standard shaped specimens, assume that the mechanical elds in the object are homogeneous, and recover global properties. Thus, multiple tests are required for full characterization of a heterogeneous object, leading to a time consuming and costly process. The development of non-contact, full- eld measurement techniques from which complex kinematic elds can be recorded has opened the door to a new way of thinking. From the identi cation point of view, suitable methods can be used to process these complex kinematic elds in order to recover multiple spatially varying parameters through one test or a few tests. The requirement is the development of identi cation techniques that can process these complex experimental data. This thesis introduces a novel identi cation technique called the constitutive compatibility method. The key idea is to de ne stresses as compatible with the observed kinematic eld through the chosen class of constitutive equation, making possible the uncoupling of the identi cation of stress from the identi cation of the material parameters. This uncoupling leads to parametrized solutions in cases where 5 the solution is non-unique (due to unknown traction boundary conditions) as demonstrated on 2D numerical examples. First the theory is outlined and the method is demonstrated in 2D applications. Second, the method is implemented within a domain decomposition framework in order to reduce the cost for processing very large problems. Finally, it is extended to 3D numerical examples. Promising results are shown for 2D and 3D problems.

  9. Evaluation of the Effect of Surgical Crown Lengthening on Periodontal Parameters

    OpenAIRE

    2015-01-01

    Background: Surgical crown lengthening is needed for teeth with subgingival caries, fractured teeth, insufficient crown length, and deep subgingival margin of failed restorations. Since there is no agreement on the effects of crown lengthening surgery on gingival parameters, the purpose of this study was to evaluate periodontal parameters in patients who needed crown lengthening surgery. Methods: Twenty patients who had healthy periodontium and needed surgical crown lengthening were included ...

  10. Effects of KATP channel openers diazoxide and pinacidil in coronary-perfused atria and ventricles from failing and non-failing human hearts

    Science.gov (United States)

    Fedorov, Vadim V.; Glukhov, Alexey V.; Ambrosi, Christina M.; Kostecki, Geran; Chang, Roger; Janks, Deborah; Schuessler, Richard B.; Moazami, Nader; Nichols, Colin G.; Efimov, Igor R.

    2011-01-01

    INTRODUCTION This study compared the effects of ATP-regulated potassium channel (KATP) openers, diazoxide and pinacidil, on diseased and normal human atria and ventricles. METHODS We optically mapped the endocardium of coronary-perfused right (n=11) or left (n=2) posterior atrial-ventricular free wall preparations from human hearts with congestive heart failure (CHF, n=8) and non-failing human hearts without (NF, n=3) or with (INF, n=2) infarction. We also analyzed the mRNA expression of the KATP targets Kir6.1, Kir6.2, SUR1, and SUR2 in the left atria and ventricles of NF (n=8) and CHF (n=4) hearts. RESULTS In both CHF and INF hearts, diazoxide significantly decreased action potential durations (APDs) in atria (by −21±3% and −27±13%, p<0.01) and ventricles (by −28±7% and −28±4%, p<0.01). Diazoxide did not change APD (0±5%) in NF atria. Pinacidil significantly decreased APDs in both atria (−46 to - 80%, p<0.01) and ventricles (−65 to −93%, p<0.01) in all hearts studied. The effect of pinacidil on APD was significantly higher than that of diazoxide in both atria and ventricles of all groups (p<0.05). During pinacidil perfusion, burst pacing induced flutter/fibrillation in all atrial and ventricular preparations with dominant frequencies of 14.4±6.1 Hz and 17.5 ±5.1 Hz, respectively. Glibenclamide (10 μM) terminated these arrhythmias and restored APDs to control values. Relative mRNA expression levels of KATP targets were correlated to functional observations. CONCLUSION Remodeling in response to CHF and/or previous infarct potentiated diazoxide-induced APD shortening. The activation of atrial and ventricular KATP channels enhances arrhythmogenicity, suggesting that such activation may contribute to reentrant arrhythmias in ischemic hearts. PMID:21586291

  11. Mitochondrial structure and function are not different between nonfailing donor and end-stage failing human hearts.

    Science.gov (United States)

    Holzem, Katherine M; Vinnakota, Kalyan C; Ravikumar, Vinod K; Madden, Eli J; Ewald, Gregory A; Dikranian, Krikor; Beard, Daniel A; Efimov, Igor R

    2016-08-01

    During human heart failure, the balance of cardiac energy use switches from predominantly fatty acids (FAs) to glucose. We hypothesized that this substrate shift was the result of mitochondrial degeneration; therefore, we examined mitochondrial oxidation and ultrastructure in the failing human heart by using respirometry, transmission electron microscopy, and gene expression studies of demographically matched donor and failing human heart left ventricular (LV) tissues. Surprisingly, respiratory capacities for failing LV isolated mitochondria (n = 9) were not significantly diminished compared with donor LV isolated mitochondria (n = 7) for glycolysis (pyruvate + malate)- or FA (palmitoylcarnitine)-derived substrates, and mitochondrial densities, assessed via citrate synthase activity, were consistent between groups. Transmission electron microscopy images also showed no ultrastructural remodeling for failing vs. donor mitochondria; however, the fraction of lipid droplets (LDs) in direct contact with a mitochondrion was reduced, and the average distance between an LD and its nearest neighboring mitochondrion was increased. Analysis of FA processing gene expression between donor and failing LVs revealed 0.64-fold reduced transcript levels for the mitochondrial-LD tether, perilipin 5, in the failing myocardium (P = 0.003). Thus, reduced FA use in heart failure may result from improper delivery, potentially via decreased perilipin 5 expression and mitochondrial-LD tethering, and not from intrinsic mitochondrial dysfunction.-Holzem, K. M., Vinnakota, K. C., Ravikumar, V. K., Madden, E. J., Ewald, G. A., Dikranian, K., Beard, D. A., Efimov, I. R. Mitochondrial structure and function are not different between nonfailing donor and end-stage failing human hearts.

  12. Use of a trabecular metal implant in ankle arthrodesis after failed total ankle replacement

    Science.gov (United States)

    2010-01-01

    Background and purpose Arthrodesis after failed total ankle replacement is complicated and delayed union, nonunion, and shortening of the leg often occur—especially with large bone defects. We investigated the use of a trabecular metal implant and a retrograde intramedullary nail to obtain fusion. Patients and methods 13 patients with a migrated or loose total ankle implant underwent arthrodesis with the use of a retrograde intramedullary nail through a trabecular metal Tibial Cone. The mean follow-up time was 1.4 (0.6–3.4) years. Results At the last examination, 7 patients were pain-free, while 5 had some residual pain but were satisfied with the procedure. 1 patient was dissatisfied and experienced pain and swelling when walking. The implant-bone interfaces showed no radiographic zones or gaps in any patient, indicating union. Interpretation The method is a new way of simplifying and overcoming some of the problems of performing arthrodesis after failed total ankle replacement. PMID:21067435

  13. Plasma cytokine profiles in depressed patients who fail to respond to selective serotonin reuptake inhibitor therapy.

    LENUS (Irish Health Repository)

    O'Brien, Sinead M

    2012-02-03

    OBJECTIVE: Approximately 30% of patients with depression fail to respond to a selective serotonin reuptake inhibitor (SSRI). Few studies have attempted to define these patients from a biological perspective. Studies suggest that overall patients with depression show increased production of proinflammatory cytokines. We examined pro- and anti-inflammatory cytokine levels in patients who were SSRI resistant. METHODS: Plasma concentrations of IL-6, IL-8, IL-10, TNF-alpha and sIL-6R were measured with enzyme linked immunosorbent assays (ELISA) in DSM-1V major depressives who were SSRI resistant, in formerly SSRI resistant patients currently euthymic and in healthy controls. RESULTS: Patients with SSRI-resistant depression had significantly higher production of the pro-inflammatory cytokines IL-6 (p=0.01) and TNF-alpha (p=0.004) compared to normal controls. Euthymic patients who were formerly SSRI resistant had proinflammatory cytokine levels which were similar to the healthy subject group. Anti-inflammatory cytokine levels did not differ across the 3 groups. CONCLUSION: Suppression of proinflammatory cytokines does not occur in depressed patients who fail to respond to SSRIs and is necessary for clinical recovery.

  14. Causes and consequences of failed adaptation to biological invasions: the role of ecological constraints.

    Science.gov (United States)

    Lau, Jennifer A; terHorst, Casey P

    2015-05-01

    Biological invasions are a major challenge to native communities and have the potential to exert strong selection on native populations. As a result, native taxa may adapt to the presence of invaders through increased competitive ability, increased antipredator defences or altered morphologies that may limit encounters with toxic prey. Yet, in some cases, species may fail to adapt to biological invasions. Many challenges to adaptation arise because biological invasions occur in complex species-rich communities in spatially and temporally variable environments. Here, we review these 'ecological' constraints on adaptation, focusing on the complications that arise from the need to simultaneously adapt to multiple biotic agents and from temporal and spatial variation in both selection and demography. Throughout, we illustrate cases where these constraints might be especially important in native populations faced with biological invasions. Our goal was to highlight additional complexities empiricists should consider when studying adaptation to biological invasions and to begin to identify conditions when adaptation may fail to be an effective response to invasion. © 2015 John Wiley & Sons Ltd.

  15. Failed biliary cannulation: Clinical and technical outcomes after tertiary referral endoscopic retrograde cholangiopancreatography

    Institute of Scientific and Technical Information of China (English)

    Michael P Swan; Michael J Bourke; Stephen J Williams; Sina Alexander; Alan Moss; Rick Hope; David Ruppin

    2011-01-01

    AIM: Prospective evaluation of repeat endoscopic retrograde cholangiopancreatography (ERCP) for failed Schutz grade 1 biliary cannulation in a high-volume center.METHODS: Prospective intention-to-treat analysis of patients referred for biliary cannulation following recent unsuccessful ERCP.RESULTS: Fifty-one patients (35 female; mean age: 62.5 years; age range: 40-87 years) with previous failed biliary cannulation were referred for repeat ERCP. The indication for ERCP was primarily choledocholithiasis (45%) or pancreatic malignancy (18%). Successful biliary cannulation was 100%. The precut needle knife sphincterotomy (NKS) rate was 27.4%. Complications occurred in 3.9% (post-ERCP pancreatitis). An identifiable reason for initial unsuccessful biliary cannulation was present in 55% of cases. Compared to a cohort of 940 na?ve papilla patients (female 61%; mean age: 59.9 years; age range: 18-94 years) who required sphincterotomy over the same time period, there was no statistical difference in the cannulation success rate (100% vs 98%) or post-ERCP pancreatitis (3.1% vs 3.9%). Precut NKS use was more frequent (27.4% vs 12.7%) (P = 0.017).CONCLUSION: Referral to a high-volume center following unsuccessful ERCP is associated with high technical success, with a favorable complication rate, compared to routine ERCP procedures.

  16. Factors associated with failed retrieval of the Günther Tulip inferior vena cava filter.

    Science.gov (United States)

    Marquess, Joel S; Burke, Charles T; Beecham, Ashley H; Dixon, Robert G; Stavas, Joseph M; Sag, Alan A; Koch, Gary G; Mauro, Matthew A

    2008-09-01

    To identify potential factors associated with failed retrieval of the Günther Tulip inferior vena cava (IVC) filter. A retrospective review was performed of patients who underwent placement of the Günther Tulip filter with at least one attempt at filter retrieval over a 3-year period. Patient demographics, filter dwell time, filter angulation, and filter leg protrusion were analyzed. A total of 188 patients were included in the study. Primary retrieval success was achieved in 166 patients (88.3%), for an overall retrieval success rate of 94.2%. The overall mean dwell time was 63 days, whereas the mean dwell time in cases of retrieval failure was 95.4 days. A total of seven filters were in place for longer than 6 months, four of which were successfully retrieved. The degree of filter tilt was not found to be significantly related to retrieval success (P = .36), even though filter angulation was commonly cited as a reason for retrieval failure. On venography, 90.9% of filters that could not be retrieved showed leg protrusion beyond the lumen of the IVC. Finally, increasing patient age also correlated with retrieval failure (P = .01). Prolonged dwell time and increasing patient age are associated with failed filter retrieval. However, even filters in place for extended periods can be safely removed.

  17. Time-saving and fail-safe dissection method for vestibulocochlear organs in gross anatomy classes.

    Science.gov (United States)

    Suzuki, Ryoji; Konno, Naoaki; Ishizawa, Akimitsu; Kanatsu, Yoshinori; Funakoshi, Kodai; Akashi, Hideo; Zhou, Ming; Abe, Hiroshi

    2017-09-01

    Because the vestibulocochlear organs are tiny and complex, and are covered by the petrous part of the temporal bone, they are very difficult for medical students to dissect and visualize during gross anatomy classes. Here, we report a time-saving and fail-safe procedure we have devised, using a hand-held hobby router. Nine en bloc temporal bone samples from donated human cadavers were used as trial materials for devising an appropriate procedure for dissecting the vestibulocochlear organs. A hand-held hobby router was used to cut through the temporal bone. After trials, the most time-saving and fail-safe method was selected. The performance of the selected method was assessed by a survey of 242 sides of 121 cadavers during gross anatomy classes for vestibulocochlear dissection. The assessment was based on the observation ratio. The best procedure appeared to be removal of the external acoustic meatus roof and tympanic cavity roof together with removal of the internal acoustic meatus roof. The whole procedure was completed within two dissection classes, each lasting 4.5 hr. The ratio of surveillance for the chorda tympani and three semicircular canals by students was significantly improved during 2013 through 2016. In our dissection class, "removal of the external acoustic meatus roof and tympanic cavity roof together with removal of the internal acoustic meatus roof" was the best procedure for students in the limited time available. Clin. Anat. 30:703-710, 2017. © 2017Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  18. An ERP study on L2 syntax processing: When do learners fail?

    Science.gov (United States)

    Meulman, Nienke; Stowe, Laurie A.; Sprenger, Simone A.; Bresser, Moniek; Schmid, Monika S.

    2014-01-01

    Event-related brain potentials (ERPs) can reveal online processing differences between native speakers and second language (L2) learners during language comprehension. Using the P600 as a measure of native-likeness, we investigated processing of grammatical gender agreement in highly proficient immersed Romance L2 learners of Dutch. We demonstrate that these late learners consistently fail to show native-like sensitivity to gender violations. This appears to be due to a combination of differences from the gender marking in their L1 and the relatively opaque Dutch gender system. We find that L2 use predicts the effect magnitude of non-finite verb violations, a relatively regular and transparent construction, but not that of gender agreement violations. There were no effects of age of acquisition, length of residence, proficiency or offline gender knowledge. Additionally, a within-subject comparison of stimulus modalities (written vs. auditory) shows that immersed learners may show some of the effects only in the auditory modality; in non-finite verb violations, an early native-like N400 was only present for auditory stimuli. However, modality failed to influence the response to gender. Taken together, the results confirm the persistent problems of Romance learners of Dutch with online gender processing and show that they cannot be overcome by reducing task demands related to the modality of stimulus presentation. PMID:25309492

  19. Effects of ozone on the pain and disability in patients with failed back surgery syndrome

    Directory of Open Access Journals (Sweden)

    Danilo Costa Barbosa

    Full Text Available Summary Introduction: Low back pain is one of the painful disorders of higher prevalence. It has several etiologies and surgery may be indicated in the presence of neurological deficits or compression syndromes. However, in up to 40% of cases, patients develop worsening of pain and failed back surgery syndrome (FBSS, which is an important cause of chronic pain with high morbidity and disability. In the last two decades, ozone has been shown to be a new therapeutic option for FBSS due to its analgesic and anti-inflammatory properties. Objective: To evaluate the effect of ozone therapy on pain and disability in patients with failed back surgery syndrome. Method: We selected 19 patients undergoing epiduroscopy and injection of ozone. Patients were evaluated preoperatively and 21 days after the procedure, using the following instruments: Visual Analogue Scale (VAS, Brief Pain Inventory, Roland-Morris Questionnaire Disability, Oswestry Disability Index (ODI, Neuropathic Pain Symptom Inventory and Douleur Neuropathique 4. Results: The patients showed significant pain relief, but no improvement was observed in the functional scales. Conclusion: Our results suggest that epidural ozone therapy can be a treatment option in FBSS to reduce the intensity of the pain.

  20. Late Prosthetic Shoulder Hemiarthroplasty after Failed Management of Complex Proximal Humeral Fractures

    Directory of Open Access Journals (Sweden)

    A. Panagopoulos

    2013-01-01

    Full Text Available Background. The purpose of this study was to report our experience with shoulder hemiarthroplasty in the context of old trauma. Methods. 33 patients with failed treatment for a complex proximal humeral fracture underwent prosthetic hemiarthroplasty. There were 15 men and 18 women with a mean age of 58.1 years. The average period from initial treatment was 14.9 months. Sequelae included 11 malunions, 4 nonunions, 15 cases with avascular necrosis (AVN and 3 neglected posterior locked dislocations. Follow up investigation included radiological assessment and clinical evaluation using the Constant score and a visual analogue pain scale. Results. After a mean follow up of 82.5 months the median Constant score was 75.7 points, improved by 60% in comparison to preoperative values. Greater tuberosity displacement, large cuff tears and severe malunion were the factors most affected outcome. No cases of stem loosening or severe migration were noted. 60% of the patients were able to do activities up to shoulder level compared with 24% before reconstruction. Conclusions. Late shoulder hemiarthroplasty is technically difficult and the results are inferior to those reported for acute humeral head replacement, nonetheless remains a satisfactory reconstructive option when primary treatment fails.

  1. Endoscopic ultrasound-guided choledochoduodenostomy in patients with failed endoscopic retrograde cholangiopancreatography

    Institute of Scientific and Technical Information of China (English)

    Takao Itoi; Fumihide Itokawa; Atsushi Sofuni; Toshio Kurihara; Takayoshi Tsuchiya; Kentaro Ishii; Shujiro Tsuji; Nobuhito Ikeuchi; Fuminori Moriyasu

    2008-01-01

    Endoscopic ultrasonography (EUS)-guided biliary drainage was performed for treatment of patients who have obstructive jaundice in cases of failed endoscopic retrograde cholangiopancreatography (ERCP). In the present study, we introduced the feasibility and outcome of EUS-guided choledochoduodenostomy in four patients who failed in ERCP. We performed the procedure in 2 papilla of Vater, including one resectable case, and 2 cases of cancer of the head of pancreas. Using a curved linear array echoendoscope, a 19 G needle or a needle knife was punctured transduodenally into the bile duct under EUS visualization. Using a biliary catheter for dilation, or papillary balloon dilator, a 7-Fr plastic stent was inserted through the choledochoduodenostomy site into the extrahepatic bile duct. In 3 (75%) of 4 cases, an indwelling plastic stent was placed, and in one case in which the stent could not be advanced into the bile duct, a naso-biliary drainage tube was placed instead. In all cases, the obstructive jaundice rapidly improved after the procedure. Focal peritonitis and bleeding not requiring blood transfusion was seen in one case. In this case, pancreatoduodenectomy was performed and the surgical findings revealed severe adhesion around the choledochoduodenostomy site. Although further studies and development of devices are mandatory, EUS-guided choledochoduodenostomy appears to be an effective alternative to ERCP in selected cases.

  2. On failed intersubjectivity: Recollections of loneliness experiences in offspring of Holocaust survivors.

    Science.gov (United States)

    Wiseman, Hadas

    2008-07-01

    Intergenerational consequences of extensive trauma experienced by parents for the loneliness experienced by their children were explored in 52 adults (26 men and 26 women) who grew up in Holocaust survivor families. These adults, children of mothers who had survived Nazi concentration camps, were recruited from a random nonclinical Israeli sample. A narrative analysis of their recollected accounts of loneliness in childhood and adolescence yielded 4 major categories of loneliness experiences in the context of growing up in Holocaust survivor families: (a) echoes of parental intrusive traumatic memories; (b) echoes of parental numbing and detachment; (c) perceived parents' caregiving style; and (d) social comparison with other families, in particular the lack of grandparents. The echoes of the parental trauma in the recollected loneliness accounts are conceptualized as representing a sense of failed intersubjectivity in these interpersonal processes. The experiences of not being understood by others, not understanding others, and the lack of shared understanding involved in failed intersubjectivity are discussed and related to the importance of opening lines of communication between survivors and their descendents.

  3. Distractor suppression when attention fails: behavioral evidence for a flexible selective attention mechanism.

    Science.gov (United States)

    Elliott, James C; Giesbrecht, Barry

    2015-01-01

    Despite consistent evidence showing that attention is a multifaceted mechanism that can operate at multiple levels of processing depending on the structure and demands of the task, investigations of the attentional blink phenomenon have consistently shown that the impairment in reporting the second of two targets typically occurs at a late, or post-perceptual, stage of processing. This suggests that the attentional blink phenomenon may represent the operation of a unique attentional mechanism that is not as flexible as other attentional mechanisms. To test whether the attentional blink is a fixed or flexible phenomenon, we manipulated first target task demands (i.e., difficulty) and measured the influence this had on processing a subsequently presented distractor and the second target. If the attentional blink represents a mechanism that is fixed and consistently fails at a single stage of processing, then manipulations of task difficulty should not affect distractor processing. However, if the attentional blink represents a more multifaceted and flexible mechanism, then task difficulty should modulate distractor processing. The results revealed that distractor processing during the AB was attenuated under high task difficulty. In addition, unlike previous studies, we failed to find a correlation between distractor processing and the severity of the attentional blink. Using a simulation, we demonstrate that the previously reported correlations may have been spurious and due to using variables that were not independent. Overall, the present results support the conclusion that the selectivity of attention during the AB is flexible and depends on the structure and demands of the task.

  4. An ERP study on L2 syntax processing: When do learners fail?

    Directory of Open Access Journals (Sweden)

    Nienke eMeulman

    2014-09-01

    Full Text Available Event-related brain potentials (ERPs can reveal online processing differences between native speakers and second language (L2 learners during language comprehension. Using the P600 as a measure of native-likeness, we investigated processing of grammatical gender agreement in highly proficient immersed Romance L2 learners of Dutch. We demonstrate that these late learners consistently fail to show native-like sensitivity to gender violations. This appears to be due to a combination of differences from the gender marking in their L1 and the relatively opaque Dutch gender system. We find that L2 use predicts the effect magnitude of non-finite verb violations, a relatively regular and transparent construction, but not that of gender agreement violations. There were no effects of age of acquisition, length of residence, proficiency or offline gender knowledge. Additionally, a within-subject comparison of stimulus modalities (written vs. auditory shows that immersed learners may show some of the effects only in the auditory modality; in non-finite verb violations, an early native-like N400 was only present for auditory stimuli. However, modality failed to influence the response to gender. Taken together, the results confirm the persistent problems of Romance learners of Dutch with online gender processing and show that they cannot be overcome by reducing task demands related to the modality of stimulus presentation.

  5. Impact of truncated area under the curve on failed bioequivalence studies: a computer simulation analysis.

    Science.gov (United States)

    Mahmood, Iftekhar

    2004-01-01

    The common measures used in a bioequivalence study are area under the curve (AUC) and the maximum plasma concentration. Estimation of AUC requires frequent blood samples. For long half-life drugs, sampling for long periods of time may become cumbersome. To resolve this issue some investigators have suggested the use of truncated AUC in bioequivalence studies for long half-life drugs. The suggested length of time for the truncated AUC is 72 hours. Many studies have been conducted to show that truncated AUC till 72 hours is a suitable approach. However, the suitability of truncated AUC for failed bioequivalence study has not been demonstrated. This report of simulated plasma concentration versus time data evaluates the suitability of truncated AUC for failed bioequivalence study of two hypothetical drugs. The results of the study indicate that the truncated approach for the estimation of the AUC for long half-life drugs in bioequivalence studies may be useful but it also increases the probability of accepting drugs as being bioequivalent when they are not.

  6. Respiratory mechanics in COPD patients who failed non-invasive ventilation: role of intrinsic PEEP.

    Science.gov (United States)

    Antonaglia, Vittorio; Ferluga, Massimo; Capitanio, Guido; Lucangelo, Umberto; Piller, Fulvia; Roman-Pognuz, Erik; Biancardi, Bruno; Caggegi, Giuseppe Davide; Zin, Walter A

    2012-10-15

    Non-invasive positive pressure ventilation (NPPV) is the first choice to treat exacerbations in COPD patients. NPPV can fail owing to different causes related to gas exchange impairment (RF group) or intolerance (INT group). To assess if the respiratory mechanical properties and the ratio between the dynamic and static intrinsic positive end-expiratory pressure (PEEP(i),dyn/PEEP(i),stat), reflecting lung mechanical inequalities, were different between groups, 29 COPD patients who failed NPPV (15 RF and 14 INT) were studied, early after the application of invasive ventilation. Blood gas analysis, clinical status, and mechanical properties were measured. pH was higher in INT patients before intubation (p<0.001). PEEP(i),dyn/PEEP(i),stat was found higher in INT group with (p=0.021) and without PEEP (ZEEP, p<0.01). PEEP(i),dyn/PEEP(i),stat was exponentially associated with the duration of NPPV in INT group (p=0.011). INT and RF patients had similar impairment of respiratory system resistance and elastance.

  7. Temperature evolution of magnetic flux rope in a failed solar eruption

    CERN Document Server

    Song, Hongqiang; Cheng, Xin; Chen, Yao; Liu, Rui; Wang, Yuming; Li, Bo

    2014-01-01

    In this presentation, we report for the first time the detailed temperature evolution process of the magnetic flux rope in a failed solar eruption. Occurred on January 05, 2013, the flux rope was impulsively accelerated to a speed of ~ 400 km/s in the first minute, then decelerated and came to a complete stop in two minutes. The failed eruption resulted in a large-size high-lying (~ 100 Mm above the surface) high-temperature "fire ball" sitting in the corona for more than two hours. The time evolution of the thermal structure of the flux rope was revealed through the differential emission measure analysis technique, which produced temperature maps using observations of the Atmospheric Imaging Assembly on board Solar Dynamic Observatory. The average temperature of the flux rope steadily increased from ~ 5 MK to ~ 10 MK during the first nine minutes of the evolution, which was much longer than the rise time (about three minutes) of the associated soft X-ray flare. We suggest that the flux rope be heated by the ...

  8. The treatment of nonmelancholic depression: when antidepressants fail, does psychotherapy work?

    Science.gov (United States)

    Parker, Gordon; Graham, Rebecca; Sheppard, Elizabeth

    2014-07-01

    Treatment-resistant depression (TRD) is used as a descriptive or diagnostic term and has generated many management guidelines weighting antidepressant (AD) therapy, but which may be an inappropriate paradigm for the nonmelancholic disorders where psychotherapy may be a more salient modality. This study sought to evaluate the effectiveness of psychological therapy in patients whose nonmelancholic depressive condition had been resistant to at least 2 ADs. Principal analyses compared 32 patients, diagnosed with a nonmelancholic depression who received 12 weeks of psychological therapy, with a small control group. Comparative analyses failed to find a distinct therapeutic effect, leading to an extension study pursuing candidate explanatory factors for this lack of response, including psychosocial factors. While our sample showed a 41% response and 22% remission rate to psychotherapy, their improvement pattern was similar to the control group, thus arguing against any specific therapeutic benefit. Explanatory factors nominated by the treating psychologist weighted personality issues for 35% of the patients, distal stressors for 22%, and comorbid anxiety conditions for 18%. When sample members were compared with an age- and sex-matched sample of patients with nonmelancholic depression who improved distinctly during a similar 12-week period, rates of such putative personality, stress, and anxiety risk factors did not differ, arguing against the likelihood of these factors compromising improvement. Patients with nonmelancholic TRD also failed to demonstrate a clear response to a psychotherapeutic approach, while our pursuit of clinically explanatory variables was not supported empirically.

  9. Role of 5 fluorouracil in the management of failed glaucoma surgery

    Directory of Open Access Journals (Sweden)

    Sood N

    1990-01-01

    Full Text Available Filtering surgery for glaucoma usually controls the intraocular pressure adequately. However, in glaucoma patients with aphakia, neovascularisation of iris, previous failed filtering surgeries and relatively young patients, results of surgery leave much scope for improvement. Most failures of filtering surgery are related to extra-ocular factors. Histopathological studies of eyes after failed filtering operations have suggested that proliferation of fibroblasts and deposition of collagen constitute a barrier to filteration. There is also a positive correlation between success of filtering surgery and inhibition of fibroblast growth by the patients aqueous humour. Thus agents inhibiting fibroblast proliferation should play an important role in increasing the success rate of filtering surgery. 5 Fluorouracil is a pyrimidine analogue which has been utilised for over 15 years as an antimetabolite in cancer therapy. Its efficiency in inhibiting fibroblast proliferation in vitro and in rabbit eyes has been proved beyond doubt. We undertook a pilot project to estimate the efficiency of the subconjunctival 5 FU to increase the changes of success in problematic cases of glaucoma in pigmented eyes.

  10. Thrill of victory or agony of defeat? Perceivers fail to utilize information in facial movements.

    Science.gov (United States)

    Aviezer, Hillel; Messinger, Daniel S; Zangvil, Shiri; Mattson, Whitney I; Gangi, Devon N; Todorov, Alexander

    2015-12-01

    Although the distinction between positive and negative facial expressions is assumed to be clear and robust, recent research with intense real-life faces has shown that viewers are unable to reliably differentiate the valence of such expressions (Aviezer, Trope, & Todorov, 2012). Yet, the fact that viewers fail to distinguish these expressions does not in itself testify that the faces are physically identical. In Experiment 1, the muscular activity of victorious and defeated faces was analyzed. Higher numbers of individually coded facial actions--particularly smiling and mouth opening--were more common among winners than losers, indicating an objective difference in facial activity. In Experiment 2, we asked whether supplying participants with valid or invalid information about objective facial activity and valence would alter their ratings. Notwithstanding these manipulations, valence ratings were virtually identical in all groups, and participants failed to differentiate between positive and negative faces. While objective differences between intense positive and negative faces are detectable, human viewers do not utilize these differences in determining valence. These results suggest a surprising dissociation between information present in expressions and information used by perceivers.

  11. Failed Replication of Oxytocin Effects on Trust: The Envelope Task Case.

    Directory of Open Access Journals (Sweden)

    Anthony Lane

    Full Text Available The neurohormone Oxytocin (OT has been one of the most studied peptides in behavioral sciences over the past two decades. Many studies have suggested that OT could increase trusting behaviors. A previous study, based on the "Envelope Task" paradigm, where trust is assessed by the degree of openness of an envelope containing participant's confidential information, showed that OT increases trusting behavior and reported one of the most powerful effects of OT on a behavioral variable. In this paper we present two failed replications of this effect, despite sufficient power to replicate the original large effect. The non-significant results of these two failed replications clearly exclude a large effect of OT on trust in this paradigm but are compatible with either a null effect of OT on trust, or a small effect, undetectable with small sample size (N = 95 and 61 in Study 1 and 2, respectively. Taken together, our results question the purported size of OT's effect on trust and emphasize the need for replications.

  12. The search for failed supernovae with the Large Binocular Telescope: confirmation of a disappearing star

    CERN Document Server

    Adams, S M; Gerke, J R; Stanek, K Z; Dai, X

    2016-01-01

    We present Hubble Space Telescope imaging confirming the optical disappearance of the failed supernova candidate identified by Gerke et al. (2015). This $\\sim 25~M_{\\odot}$ red supergiant experienced a weak $\\sim 10^{6}~L_{\\odot}$ optical outburst in 2009 and is now at least 5 magnitudes fainter than the progenitor in the optical. The mid-IR flux has slowly decreased to the lowest levels since the first measurements in 2004. There is faint ($2000-3000~L_{\\odot}$) near-IR emission likely associated with the source. We find the late-time evolution of the source to be inconsistent with obscuration from an ejected, dusty shell. Models of the spectral energy distribution indicate that the remaining bolometric luminosity is $>6$ times fainter than that of the progenitor and is decreasing as $\\sim t^{-4/3}$. We conclude that the transient is unlikely to be a SN impostor or stellar merger. The event is consistent with the ejection of the envelope of a red supergiant in a failed supernova and the late-time emission co...

  13. Interleukin-25 fails to activate STAT6 and induce alternatively activated macrophages.

    Science.gov (United States)

    Stolfi, Carmine; Caruso, Roberta; Franzè, Eleonora; Sarra, Massimiliano; De Nitto, Daniela; Rizzo, Angelamaria; Pallone, Francesco; Monteleone, Giovanni

    2011-01-01

    Interleukin-25 (IL-25), a T helper type 2 (Th2) -related factor, inhibits the production of inflammatory cytokines by monocytes/macrophages. Since Th2 cytokines antagonize classically activated monocytes/macrophages by inducing alternatively activated macrophages (AAMs), we here assessed the effect of IL-25 on the alternative activation of human monocytes/macrophages. The interleukins IL-25, IL-4 and IL-13 were effective in reducing the expression of inflammatory chemokines in monocytes. This effect was paralleled by induction of AAMs in cultures added with IL-4 or IL-13 but not with IL-25, regardless of whether cells were stimulated with lipopolysaccharide or interferon-γ. Moreover, pre-incubation of cells with IL-25 did not alter the ability of both IL-4 and IL-13 to induce AAMs. Both IL-4 and IL-13 activated signal transducer and activator of transcription 6 (STAT6), and silencing of this transcription factor markedly reduced the IL-4/IL-13-driven induction of AAMs. In contrast, IL-25 failed to trigger STAT6 activation. Among Th2 cytokines, only IL-25 and IL-10 were able to activate p38 mitogen-activated protein kinase. These results collectively indicate that IL-25 fails to induce AAMs and that Th2-type cytokines suppress inflammatory responses in human monocytes by activating different intracellular signalling pathways.

  14. Tubercular mediastinal lymphadenopathy: An unusual cause of failed decannulation and tracheostomy

    Directory of Open Access Journals (Sweden)

    Deepak Thapa

    2011-01-01

    Full Text Available Literature has described many causes of failed decannulation and weaning. However, failed decannulation and weaning from ventilator due to a hilar lymph node compressing upon a bronchus has not been described. We report a case of a 30-year-old man with Guillain-Barré syndrome who had quadriparesis and respiratory distress. After 1 year of intensive care unit admission, he was ambulatory, haemodynamically stable, devoid of sepsis, had effective cough with tracheostomy in situ. Every attempt of decannulation led to pooling of secretions in left side of chest, hypercarbia and altered sensorium. This was followed by re-institution of ventilator support. Chest x-ray was unremarkable, but computed tomography (CT chest done during this time showed a mass compressing upon left lower lobe bronchus. Flexible fibre-optic bronchoscopy and transbronchial biopsy confirmed the diagnosis to be tubercular lymph node. After 1 month of starting of anti-tubercular treatment, there was resolution of the mass with relief of the bronchial compression and a successful decannulation thereafter. Role of CT in difficult cases of weaning is emphasized, and role of bronchoscopy is highlighted in difficult cases of weaning and decannulation.

  15. Stages of change in adults who have failed an online hearing screening.

    Science.gov (United States)

    Laplante-Lévesque, Ariane; Brännström, K Jonas; Ingo, Elisabeth; Andersson, Gerhard; Lunner, Thomas

    2015-01-01

    Hearing screening has been proposed to promote help-seeking and rehabilitation in adults with hearing impairment. However, some longitudinal studies point to low help-seeking and subsequent rehabilitation after a failed hearing screening (positive screening result). Some barriers to help-seeking and rehabilitation could be intrinsic to the profiles and needs of people who have failed a hearing screening. Theories of health behavior change could help to understand this population. One of these theories is the transtheoretical (stages-of-change) model of health behavior change, which describes profiles and needs of people facing behavior changes such as seeking help and taking up rehabilitation. According to this model, people go through distinct stages toward health behavior change: precontemplation, contemplation, action, and finally, maintenance. The present study describes the psychometric properties (construct validity) of the stages of change in adults who have failed an online hearing screening. Stages of change were measured with the University of Rhode Island Change Assessment (URICA). Principal component analysis is presented, along with cluster analysis. Internal consistency was investigated. Finally, relationships between URICA scores and speech-in-noise recognition threshold, self-reported hearing disability, and self-reported duration of hearing disability are presented. In total, 224 adults who had failed a Swedish online hearing screening test (measure of speech-in-noise recognition) completed further questionnaires online, including the URICA. A principal component analysis identified the stages of precontemplation, contemplation, and action, plus an additional stage, termed preparation (between contemplation and action). According to the URICA, half (50%) of the participants were in the preparation stage of change. The contemplation stage was represented by 38% of participants, while 9% were in the precontemplation stage. Finally, the action stage

  16. ADHD subjects fail to suppress eye blinks and microsaccades while anticipating visual stimuli but recover with medication.

    Science.gov (United States)

    Fried, Moshe; Tsitsiashvili, Eteri; Bonneh, Yoram S; Sterkin, Anna; Wygnanski-Jaffe, Tamara; Epstein, Tamir; Polat, Uri

    2014-08-01

    Oculomotor behavior and parameters are known to be affected by the allocation of attention and could potentially be used to investigate attention disorders. We explored the oculomotor markers of Attention-deficit/hyperactivity disorder (ADHD) that are involuntary and quantitative and that could be used to reveal the core-affected mechanisms, as well as be used for differential diagnosis. We recorded eye movements in a group of 22 ADHD-diagnosed patients with and without medication (methylphenidate) and in 22 control observers while performing the test of variables of attention (t.o.v.a.). We found that the average microsaccade and blink rates were higher in the ADHD group, especially in the time interval around stimulus onset. These rates increased monotonically over session time for both groups, but with significantly faster increments in the unmedicated ADHD group. With medication, the level and time course of the microsaccade rate were fully normalized to the control level, regardless of the time interval within trials. In contrast, the pupil diameter decreased over time within sessions and significantly increased above the control level with medication. We interpreted the suppression of microsaccades and eye blinks around the stimulus onset as reflecting a temporal anticipation mechanism for the transient allocation of attention, and their overall rates as inversely reflecting the level of arousal. We suggest that ADHD subjects fail to maintain sufficient levels of arousal during a simple and prolonged task, which limits their ability to dynamically allocate attention while anticipating visual stimuli. This impairment normalizes with medication and its oculomotor quantification could potentially be used for differential diagnosis. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. [Acoustical parameters of toys].

    Science.gov (United States)

    Harazin, Barbara

    2010-01-01

    Toys play an important role in the development of the sight and hearing concentration in children. They also support the development of manipulation, gently influence a child and excite its emotional activities. A lot of toys emit various sounds. The aim of the study was to assess sound levels produced by sound-emitting toys used by young children. Acoustical parameters of noise were evaluated for 16 sound-emitting plastic toys in laboratory conditions. The noise level was recorded at four different distances, 10, 20, 25 and 30 cm, from the toy. Measurements of A-weighted sound pressure levels and noise levels in octave band in the frequency range from 31.5 Hz to 16 kHz were performed at each distance. Taking into consideration the highest equivalent A-weighted sound levels produced by tested toys, they can be divided into four groups: below 70 dB (6 toys), from 70 to 74 dB (4 toys), from 75 to 84 dB (3 toys) and from 85 to 94 dB (3 toys). The majority of toys (81%) emitted dominant sound levels in octave band at the frequency range from 2 kHz to 4 kHz. Sound-emitting toys produce the highest acoustic energy at the frequency range of the highest susceptibility of the auditory system. Noise levels produced by some toys can be dangerous to children's hearing.

  18. A study of parameter identification

    Science.gov (United States)

    Herget, C. J.; Patterson, R. E., III

    1978-01-01

    A set of definitions for deterministic parameter identification ability were proposed. Deterministic parameter identificability properties are presented based on four system characteristics: direct parameter recoverability, properties of the system transfer function, properties of output distinguishability, and uniqueness properties of a quadratic cost functional. Stochastic parameter identifiability was defined in terms of the existence of an estimation sequence for the unknown parameters which is consistent in probability. Stochastic parameter identifiability properties are presented based on the following characteristics: convergence properties of the maximum likelihood estimate, properties of the joint probability density functions of the observations, and properties of the information matrix.

  19. YOGA IMPROVES CARDIOVASCULAR PARAMETERS

    Directory of Open Access Journals (Sweden)

    Pramod P. Kadu

    2016-06-01

    Full Text Available ABSTRACT Yoga in ancient technique practices by sage for a desirable and healthy life. Yogic exercise and Pranayam may modulate cardiovascular function. To assess the cardiovascular parameter in control and study group. We selected 90 healthy volunteers between age group 35 – 50 years and divided into two groups. i Study group – 45 ii Control group – 45. Control group was not doing any type of exercise or yoga during 1 yr of period whereas yoga group did yogic exercise for 1 yr under supervision of yoga expert. In both the group heart rate SBP and DBP evaluate at 0, 6 and 12 month period. In control group heart rate, SBP, and DBP showed no significant change at 0, 6, and 12 month reading, whereas study group (yoga 81.96±5.65 showed significant decreased heart rate From 81.96 ±5.65 to 75.60 ± 3.44 at 6 month and 73.75 ± 11.36 at 12 month (p<0.001 SBP decreased from 128 ± 7.66 to 120.97 ± 4.21 at 6 month and 120.48± 3.86 at 12 months (p<0.001. DBP showed significant decreased from 88.44 ± 5.25 to 80.53 ± 3.44 at 6 months and 80.53 ± 2.53 at 12months (p<0.001. Yogic exercise and Pranayam done regularly at long term improve cardiovascular efficiency.

  20. Forecasts of non-Gaussian parameter spaces using Box-Cox transformations

    CERN Document Server

    Joachimi, B

    2011-01-01

    Forecasts of statistical constraints on model parameters using the Fisher matrix abound in many fields of astrophysics. The Fisher matrix formalism involves the assumption of Gaussianity in parameter space and hence fails to predict complex features of posterior probability distributions. Combining the standard Fisher matrix with Box-Cox transformations, we propose a novel method that accurately predicts arbitrary posterior shapes. The Box-Cox transformations are applied to parameter space to render it approximately multivariate Gaussian, performing the Fisher matrix calculation on the transformed parameters. We demonstrate that, after the Box-Cox parameters have been determined from an initial likelihood evaluation, the method correctly predicts changes in the posterior when varying various parameters of the experimental setup and the data analysis, with marginally higher computational cost than a standard Fisher matrix calculation. We apply the Box-Cox-Fisher formalism to forecast cosmological parameter con...

  1. Parameters of care for craniosynostosis

    DEFF Research Database (Denmark)

    McCarthy, Joseph G; Warren, Stephen M; Bernstein, Joseph

    2012-01-01

    A multidisciplinary meeting was held from March 4 to 6, 2010, in Atlanta, Georgia, entitled "Craniosynostosis: Developing Parameters for Diagnosis, Treatment, and Management." The goal of this meeting was to create parameters of care for individuals with craniosynostosis....

  2. Fails-to-Deliver Data under 10,000 Shares between September 16, 2008 and July 1, 2009

    Data.gov (United States)

    Securities and Exchange Commission — This file contains the date, CUSIP numbers, ticker symbols, issuer name, price, and total number of fails-to-deliver (i.e., the balance level outstanding) recorded...

  3. S-parameter uncertainty computations

    DEFF Research Database (Denmark)

    Vidkjær, Jens

    1993-01-01

    A method for computing uncertainties of measured s-parameters is presented. Unlike the specification software provided with network analyzers, the new method is capable of calculating the uncertainties of arbitrary s-parameter sets and instrument settings.......A method for computing uncertainties of measured s-parameters is presented. Unlike the specification software provided with network analyzers, the new method is capable of calculating the uncertainties of arbitrary s-parameter sets and instrument settings....

  4. Subsurface Geotechnical Parameters Report

    Energy Technology Data Exchange (ETDEWEB)

    D. Rigby; M. Mrugala; G. Shideler; T. Davidsavor; J. Leem; D. Buesch; Y. Sun; D. Potyondy; M. Christianson

    2003-12-17

    The Yucca Mountain Project is entering a the license application (LA) stage in its mission to develop the nation's first underground nuclear waste repository. After a number of years of gathering data related to site characterization, including activities ranging from laboratory and site investigations, to numerical modeling of processes associated with conditions to be encountered in the future repository, the Project is realigning its activities towards the License Application preparation. At the current stage, the major efforts are directed at translating the results of scientific investigations into sets of data needed to support the design, and to fulfill the licensing requirements and the repository design activities. This document addresses the program need to address specific technical questions so that an assessment can be made about the suitability and adequacy of data to license and construct a repository at the Yucca Mountain Site. In July 2002, the U.S. Nuclear Regulatory Commission (NRC) published an Integrated Issue Resolution Status Report (NRC 2002). Included in this report were the Repository Design and Thermal-Mechanical Effects (RDTME) Key Technical Issues (KTI). Geotechnical agreements were formulated to resolve a number of KTI subissues, in particular, RDTME KTIs 3.04, 3.05, 3.07, and 3.19 relate to the physical, thermal and mechanical properties of the host rock (NRC 2002, pp. 2.1.1-28, 2.1.7-10 to 2.1.7-21, A-17, A-18, and A-20). The purpose of the Subsurface Geotechnical Parameters Report is to present an accounting of current geotechnical information that will help resolve KTI subissues and some other project needs. The report analyzes and summarizes available qualified geotechnical data. It evaluates the sufficiency and quality of existing data to support engineering design and performance assessment. In addition, the corroborative data obtained from tests performed by a number of research organizations is presented to reinforce

  5. Salvage of a failed Sauve-Kapandji procedure using a total distal radio-ulnar joint replacement.

    Science.gov (United States)

    Atwal, N S; Clark, D A; Amirfeyz, R; Bhatia, R

    2010-01-01

    This is the first report in the literature of a patient treated with a DRUJ replacement after Sauvé-Kapandji procedure failed due to pain and instability. The DRUJ replacement is an unconstrained, biomechanically more advantageous implant which can confer stability in cases where soft tissues are inadequate. We describe the treatment and outcome of persistent ulnar instability with a distal radio-ulnar joint replacement following failed salvage procedures for a malunion of a distal radius fracture.

  6. A modified technique for removing a failed abutment screw from an implant with a custom guide tube.

    Science.gov (United States)

    Taira, Yohsuke; Sawase, Takashi

    2012-04-01

    Fracture of abutment screw is a serious prosthodontic complication. When the abutment screw is fractured at the junction of the screw shank and screw thread, removal of the fractured screw fragment from the screw hole can be difficult. This article describes a modified technique for removing the failed abutment screw with a custom guide tube and tungsten carbide bur. The failed screw can be removed speedily without damaging the screw hole of the implant body or the screw threads.

  7. Horses fail to use social learning when solving spatial detour tasks

    DEFF Research Database (Denmark)

    Rørvang, Maria Vilain; Peerstrup Ahrendt, Line; Christensen, Janne Winther

    2015-01-01

    Social animals should have plenty of opportunities to learn from conspecifics, but most studies have failed to document social learning in horses. This study investigates whether young Icelandic horses can learn a spatial detour task through observation of a trained demonstrator horse of either...... the same age (Experiments 1 and 2, n = 22) or older (Experiment 3, n = 24). Observer horses were allowed to observe the demonstrator being led three times through the detour route immediately before being given the opportunity to solve the task themselves. Controls were allowed only to observe...... the demonstrator horse eating at the final position, but not the demonstration of the route. Although we found a tendency towards better performance by observer horses in the second experiment, we were unable to repeat this result in a similar set-up with a new group of horses and older, dominant demonstrator...

  8. Assessment and confirmation of tracheal intubation when capnography fails: a novel use for an USB camera.

    Science.gov (United States)

    Karippacheril, John George; Umesh, Goneppanavar; Nanda, Shetty

    2013-10-01

    A 62 year old male with a right pyriform fossa lesion extending to the right arytenoid and obscuring the glottic inlet was planned for laser assisted excision. Direct laryngoscopic assessment after topicalization of the airway, showed a Cormack Lehane grade 3 view. We report a case where, in the absence of a fiberscope, a novel inexpensive Universal Serial Bus camera was used to obtain an optimal laryngoscopic view. This provided direct visual confirmation of tracheal intubation with a Laser Flex tube, when capnography failed to show any trace. Capnography may not be reliable as a sole indicator of confirmation of correct endotracheal tube placement. Video laryngoscopy may provide additional confirmation of endotracheal intubation.

  9. Treating refractory obsessive-compulsive disorder: what to do when conventional treatment fails?

    Directory of Open Access Journals (Sweden)

    Adelar Pedro Franz

    2013-01-01

    Full Text Available Obsessive-compulsive disorder (OCD is a chronic and impairing condition. A very small percentage of patients become asymptomatic after treatment. The purpose of this paper was to review the alternative therapies available for OCD when conventional treatment fails. Data were extracted from controlled clinical studies (evidence-based medicine published on the MEDLINE and Science Citation Index/Web of Science databases between 1975 and 2012. Findings are discussed and suggest that clinicians dealing with refractory OCD patients should: 1 review intrinsic phenomenological aspects of OCD, which could lead to different interpretations and treatment choices; 2 review extrinsic phenomenological aspects of OCD, especially family accommodation, which may be a risk factor for non-response; 3 consider non-conventional pharmacological approaches; 4 consider non-conventional psychotherapeutic approaches; and 5 consider neurobiological approaches.

  10. Treating refractory obsessive-compulsive disorder: what to do when conventional treatment fails?

    Science.gov (United States)

    Franz, Adelar Pedro; Paim, Mariana; Araújo, Rafael Moreno de; Rosa, Virgínia de Oliveira; Barbosa, Ísis Mendes; Blaya, Carolina; Ferrão, Ygor Arzeno

    2013-01-01

    Obsessive-compulsive disorder (OCD) is a chronic and impairing condition. A very small percentage of patients become asymptomatic after treatment. The purpose of this paper was to review the alternative therapies available for OCD when conventional treatment fails. Data were extracted from controlled clinical studies (evidence-based medicine) published on the MEDLINE and Science Citation Index/Web of Science databases between 1975 and 2012. Findings are discussed and suggest that clinicians dealing with refractory OCD patients should: 1) review intrinsic phenomenological aspects of OCD, which could lead to different interpretations and treatment choices; 2) review extrinsic phenomenological aspects of OCD, especially family accommodation, which may be a risk factor for non-response; 3) consider non-conventional pharmacological approaches; 4) consider non-conventional psychotherapeutic approaches; and 5) consider neurobiological approaches.

  11. Parasites resistant to the antimalarial atovaquone fail to transmit by mosquitoes.

    Science.gov (United States)

    Goodman, Christopher D; Siregar, Josephine E; Mollard, Vanessa; Vega-Rodríguez, Joel; Syafruddin, Din; Matsuoka, Hiroyuki; Matsuzaki, Motomichi; Toyama, Tomoko; Sturm, Angelika; Cozijnsen, Anton; Jacobs-Lorena, Marcelo; Kita, Kiyoshi; Marzuki, Sangkot; McFadden, Geoffrey I

    2016-04-15

    Drug resistance compromises control of malaria. Here, we show that resistance to a commonly used antimalarial medication, atovaquone, is apparently unable to spread. Atovaquone pressure selects parasites with mutations in cytochrome b, a respiratory protein with low but essential activity in the mammalian blood phase of the parasite life cycle. Resistance mutations rescue parasites from the drug but later prove lethal in the mosquito phase, where parasites require full respiration. Unable to respire efficiently, resistant parasites fail to complete mosquito development, arresting their life cycle. Because cytochrome b is encoded by the maternally inherited parasite mitochondrion, even outcrossing with wild-type strains cannot facilitate spread of resistance. Lack of transmission suggests that resistance will be unable to spread in the field, greatly enhancing the utility of atovaquone in malaria control. Copyright © 2016, American Association for the Advancement of Science.

  12. Failed drug discovery in psychiatry: time for human genome-guided solutions.

    Science.gov (United States)

    Papassotiropoulos, Andreas; de Quervain, Dominique J F

    2015-04-01

    Our knowledge about the molecular and neural mechanisms of emotional and cognitive processes has increased exponentially in the past decades. Unfortunately, there has been no translation of this knowledge into the development of novel and improved pharmacological treatments for psychiatric disorders. We comment on some of the reasons for failed drug discovery in psychiatry, particularly on the use of ill-suited disease models and on the use of diagnostic constructs unrelated to the underlying biological mechanisms. Furthermore, we argue that the use of human genetic findings together with biologically informed phenotypes and advanced data-mining methodology will catalyze the identification of promising drug targets and, finally, will lead to improved therapeutic outcomes.

  13. Case report: revision of failed Sauvé-Kapandji procedure with an ulnar head prosthesis.

    Science.gov (United States)

    Rotsaert, P; Cermak, K; Vancabeke, M

    2008-02-01

    The Sauvé-Kapandji procedure has been developed in order to solve distal radioulnar joint (DRUJ) disorders. Postoperative results are variable. Complications such as painful ulnar stump, ulnar instability and loss of grip strength have often been described. We report the case of a painful ulnar stump instability resulting from a Sauvé-Kapandji procedure. After several attempted salvage procedures, a custom-made Herbert distal ulnar head prosthesis was implanted. Long-term results showed complete pain relief, improvement of the range of motion and satisfactory grip strength recovery. Our findings confirm that the Herbert custom-made ulnar head prosthesis appear to be a reliable salvage solution for failed Sauvé-Kapandji procedures.

  14. Ocular rehabilitation following socket reconstruction with amniotic membrane transplantation with failed primary hydroxyapatite implant post enucleation.

    Science.gov (United States)

    Aggarwal, Himanshi; Kumar, Pradeep; Singh, Raghuwar Dayal; Chand, Pooran; Alvi, Habib A

    2015-02-01

    There are several clinical situations that require enucleation in children, with retinoblastoma being the most common. Intra-orbital implants are routinely placed in children at the time of initial surgery to provide motility and cosmesis in addition to adequate orbital volume. Current practice employs intra-orbital implants made of nonporous silicone, hydroxyapatite, or porous polyethylene. Complications are usually minimal with these implants but they do occur. The purpose of this clinical report is to describe the rehabilitation of a pediatric patient with failed primary intra-orbital coralline hydroxyapatite implant post enucleation, who was successfully fitted with custom ocular prosthesis following secondary socket reconstruction with amniotic membrane transplantation after removal of infected implant.

  15. HIV-1 CCR5 gene therapy will fail unless it is combined with a suicide gene.

    Science.gov (United States)

    Pandit, Aridaman; de Boer, Rob J

    2015-12-17

    Highly active antiretroviral therapy (ART) has successfully turned Human immunodeficiency virus type 1 (HIV-1) from a deadly pathogen into a manageable chronic infection. ART is a lifelong therapy which is both expensive and toxic, and HIV can become resistant to it. An alternative to lifelong ART is gene therapy that targets the CCR5 co-receptor and creates a population of genetically modified host cells that are less susceptible to viral infection. With generic mathematical models we show that gene therapy that only targets the CCR5 co-receptor fails to suppress HIV-1 (which is in agreement with current data). We predict that the same gene therapy can be markedly improved if it is combined with a suicide gene that is only expressed upon HIV-1 infection.

  16. Checklists and Monitoring in the Cockpit: Why Crucial Defenses Sometimes Fail

    Science.gov (United States)

    Dismukes, R. Key; Berman, Ben

    2010-01-01

    Checklists and monitoring are two essential defenses against equipment failures and pilot errors. Problems with checklist use and pilots failures to monitor adequately have a long history in aviation accidents. This study was conducted to explore why checklists and monitoring sometimes fail to catch errors and equipment malfunctions as intended. Flight crew procedures were observed from the cockpit jumpseat during normal airline operations in order to: 1) collect data on monitoring and checklist use in cockpit operations in typical flight conditions; 2) provide a plausible cognitive account of why deviations from formal checklist and monitoring procedures sometimes occur; 3) lay a foundation for identifying ways to reduce vulnerability to inadvertent checklist and monitoring errors; 4) compare checklist and monitoring execution in normal flights with performance issues uncovered in accident investigations; and 5) suggest ways to improve the effectiveness of checklists and monitoring. Cognitive explanations for deviations from prescribed procedures are provided, along with suggestions for countermeasures for vulnerability to error.

  17. New therapies for the failing heart: trans-genes versus trans-cells.

    Science.gov (United States)

    Lionetti, Vincenzo; Recchia, Fabio A

    2010-09-01

    During the past 30 years, hundreds of pharmacological agents have been developed for the treatment of heart failure; yet few of them ultimately have been tested in patients. Such a disconcerting debacle has spurred the search for non pharmacological therapies, including those based on cardiac delivery of transgenes and stem cells. Cardiac gene therapy preceded stem cell therapy by approximately 10 years; however, both of them already have known an initial phase of enormous enthusiasm followed by moderate-to-strong skepticism, not necessarily justified. The aim of the present review is to discuss succinctly some key aspects of these 2 biological therapies and to argue that, after a phase of disillusionment, gene therapy for the failing heart likely will have the chance to regain the stage. In fact, discoveries in stem cell biology might revitalize gene therapy and, vice versa, gene therapy might potentiate synergistically the regenerative capacity of stem cells. Copyright 2010. Published by Mosby, Inc.

  18. Lean Transformation Guidance: Why Organizations Fail To Achieve and Sustain Excellence Through Lean Improvement

    Directory of Open Access Journals (Sweden)

    Mohammed Hamed Ahmed

    2013-06-01

    Full Text Available Many companies are complaining that lean didn’t achieve their long-term goals, and the improvement impact was very short-lived. 7 out of each 10 lean projects fail as companies try to use lean like a toolkit, copying and pasting the techniques without trying to adapt the employee’s culture, manage the improvement process, sustain the results, and develop their leaders. When the Toyota production system was created, the main goal was to remove wastes from the shop floor using some lean techniques and tools. What was not clear is that this required from Toyota a long process of leadership development, and a high commitment to training and coaching their employee. A Failure to achieve and sustain the improvement is a problem of both management and leadership as well as the improper understanding of the human behavior, and the required culture to success.

  19. Percutaneous valved stent repair of a failed homograft: implications for the Ross procedure.

    Science.gov (United States)

    Pretorius, Victor; Jones, Alan; Taylor, Dylan; Coe, Yashu; Ross, David B

    2008-08-01

    A case of percutaneous pulmonary valve implantation following a failed homograft in the pulmonary position is reported. A 16-year-old boy developed infective endocarditis of his pulmonary homograft, which was implanted four years earlier during a Ross procedure for congenital aortic stenosis. Following successful medical therapy, the boy was symptomatic due to pulmonary stenosis and regurgitation. A 22 mm Melody valve (Medtronic, USA) was successfully implanted percutaneously. His symptoms resolved and he was discharged home one day after the procedure. Echocardiography at the six-month follow-up demonstrated a normally functioning pulmonary valve. Percutaneous pulmonary valve replacement may make the Ross procedure a more attractive option for patients with aortic stenosis, particularly in the pediatric population.

  20. Idiopathic chylopericardium treated by percutaneous thoracic duct embolization after failed surgical thoracic duct ligation

    Energy Technology Data Exchange (ETDEWEB)

    Courtney, Malachi; Ayyagari, Raj R. [Yale School of Medicine, Yale New Haven Hospital, New Haven, CT (United States); Division of Interventional Radiology, Department of Radiology, 789 Howard Avenue, P.O. Box 208042, New Haven, CT (United States)

    2015-06-15

    Chylopericardium rarely occurs in pediatric patients, but when it does it is most often a result of lymphatic injury during cardiothoracic surgery. Primary idiopathic chylopericardium is especially rare, with few cases in the pediatric literature. We report a 10-year-old boy who presented with primary idiopathic chylopericardium after unsuccessful initial treatment with surgical lymphatic ligation and creation of a pericardial window. Following readmission to the hospital for a right-side chylothorax resulting from the effluent from the pericardial window, he had successful treatment by interventional radiology with percutaneous thoracic duct embolization. This case illustrates the utility of thoracic duct embolization as a less-invasive alternative to surgical thoracic duct ligation, or as a salvage procedure when surgical ligation fails. (orig.)

  1. Expanded haloes, abundance matching and too-big-to-fail in the Local Group

    CERN Document Server

    Brook, Chris B

    2014-01-01

    Observed kinematical data of 40 Local Group members are used to derive the dark matter halo mass of such galaxies. Haloes are selected from the theoretically expected Local Group mass function and two different density profiles are assumed, the standard NFW model and a mass dependent profile which accounts for the effects of baryons in modifying the dark matter distribution within galaxies. The resulting relations between stellar and halo mass are compared with expectations from abundance matching. Using the NFW profile, the ensemble of Local Group galaxies is generally fit in relatively low mass haloes, leaving dark many massive haloes of Mhalo>10^10Msun: this reflects the "too big to fail" problem in the Local Group and results in a Mstar-Mhalo relation that differs from abundance matching predictions. Moreover, the star formation efficiency of isolated Local Group galaxies increases with decreasing halo mass when adopting a NFW model. By contrast, using the mass dependent density profile, relatively high s...

  2. Do helmets worn for hurling fail to protect the ear? Identification of an emerging injury pattern.

    LENUS (Irish Health Repository)

    Martin-Smith, James D

    2012-12-01

    Hurling is an Irish national game of stick and ball known for its ferocity, played by 190 000 players. Facial injuries were common but have been significantly reduced by legislation enforcing compulsory helmet wearing. Current standard helmets worn by hurlers do not offer protection to the external ear. Here we describe an emerging pattern of ear injuries and demonstrate the risk of external ear injuries in hurlers complying with current helmet safety standards. A 6-month retrospective analysis was carried out of patients attending Cork University Hospital (CUH) with ear lacerations sustained while hurling. Patient notes were reviewed and helmet manufacturers were interviewed. Seven patients were identified, all of whom sustained complex through ear lacerations while wearing helmets complying with current safety standards. Current helmet design fails to protect the external ear placing it at an increased risk of injury, a potential solution is to include ear protection in the helmet design.

  3. Reciprocity-based reasons for benefiting research participants: most fail, the most plausible is problematic.

    Science.gov (United States)

    Sofaer, Neema

    2014-11-01

    A common reason for giving research participants post-trial access (PTA) to the trial intervention appeals to reciprocity, the principle, stated most generally, that if one person benefits a second, the second should reciprocate: benefit the first in return. Many authors consider it obvious that reciprocity supports PTA. Yet their reciprocity principles differ, with many authors apparently unaware of alternative versions. This article is the first to gather the range of reciprocity principles. It finds that: (1) most are false. (2) The most plausible principle, which is also problematic, applies only when participants experience significant net risks or burdens. (3) Seldom does reciprocity support PTA for participants or give researchers stronger reason to benefit participants than equally needy non-participants. (4) Reciprocity fails to explain the common view that it is bad when participants in a successful trial have benefited from the trial intervention but lack PTA to it.

  4. Successful isolation of Helicobacter pylori after prolonged incubation from a patient with failed eradication therapy

    Institute of Scientific and Technical Information of China (English)

    Yan Yin; Li-Hua He; Jian-Zhong Zhang

    2009-01-01

    Helicobacter pylori ( H pylori), a gastric pathogen, is a major cause of chronic gastritis and peptic ulcer disease, and is an important risk factor for the development of gastric malignancies. Culture of the bacterium from gastric biopsy is essential for the determination of drug resistance of H pylori. However, the isolation rates of H pylori from infected individuals vary from 23.5% to 97% due to a number of factors such as biopsy preparation, cultural environment, medium and the method adopted. In the present case, we found that a prolonged incubation period of up to 19 d allowed successful isolation of H pylori from a patient who received triple therapy that failed to eradicate the bacterium.

  5. Ultrasonic technology for enhanced oil recovery from failing oil wells and the equipment for its implemention.

    Science.gov (United States)

    Abramov, Vladimir O; Mullakaev, Marat S; Abramova, Anna V; Esipov, Igor B; Mason, Timothy J

    2013-09-01

    A new method for the ultrasonic enhancement of oil recovery from failing wells is described. The technology involves lowering a source of power ultrasound to the bottom of the well either for a short treatment before removal or as a permanent placement for intermittent use. In wells where the permeability is above 20 mD and the porosity is greater than 15% ultrasonic treatment can increase oil production by up to 50% and in some cases even more. For wells of lower permeability and porosity ultrasonic treatment alone is less successful but high production rates can be achieved when ultrasound is applied in conjunction with chemicals. An average productivity increase of nearly 3 fold can be achieved for this type of production well using the combined ultrasound with chemical treatment technology. Copyright © 2013 Elsevier B.V. All rights reserved.

  6. Defining health inequality: why Rawls succeeds where social welfare theory fails.

    Science.gov (United States)

    Bommier, Antoine; Stecklov, Guy

    2002-05-01

    While there has been an important increase in methodological and empirical studies on health inequality, not much has been written on the theoretical foundation of health inequality measurement. We discuss several reasons why the classic welfare approach, which is the foundation of income inequality analysis, fails to provide a satisfactory foundation for health inequality analysis. We propose an alternative approach which is more closely linked to the WHO concept of equity in health and is also consistent with the ethical principles espoused by Rawls [A Theory of Justice. Harvard University Press, Cambridge, MA, 1971]. This approach in its simplest form, is shown to be closely related to the concentration curve when health and income are positively related. Thus, the criteria presented in our paper provide an important theoretical foundation for empirical analysis using the concentration curve. We explore the properties of these approaches by developing policy scenarios and examining how various ethical criteria affect government strategies for targeting health interventions.

  7. A strategy for complex dimer formation when biomimicry fails: total synthesis of ten coccinellid alkaloids.

    Science.gov (United States)

    Sherwood, Trevor C; Trotta, Adam H; Snyder, Scott A

    2014-07-09

    Although dimeric natural products can often be synthesized in the laboratory by directly merging advanced monomers, these approaches sometimes fail, leading instead to non-natural architectures via incorrect unions. Such a situation arose during our studies of the coccinellid alkaloids, when attempts to directly dimerize Nature's presumed monomeric precursors in a putative biomimetic sequence afforded only a non-natural analogue through improper regiocontrol. Herein, we outline a unique strategy for dimer formation that obviates these difficulties, one which rapidly constructs the coccinellid dimers psylloborine A and isopsylloborine A through a terminating sequence of two reaction cascades that generate five bonds, five rings, and four stereocenters. In addition, a common synthetic intermediate is identified which allows for the rapid, asymmetric formal or complete total syntheses of eight monomeric members of the class.

  8. The Fate of Failed Bank Material and Implications for Lateral Retreat: Lake Tahoe Basin

    Science.gov (United States)

    Simon, A.; Thomas, R. E.

    2009-12-01

    The ability to deterministically predict the critical conditions for streambank failure in alluvial materials has improved markedly in recent years. Analytic tools such as the Bank-Stability and Toe-Erosion Model (BSTEM) account for a broad range of controlling processes and factors including hydraulic erosion of the bank toe, positive and negative pore-water pressures, layers of varying geotechnical resistance and root reinforcement. When failure is predicted, the failed mass is assumed to be transported away from the section by the flow, either as a single mass or as dispersed aggregates. Field observations indicate, however, that in cases where cohesive strength is high, either due to the effective cohesion of the soil skeleton or due to dense mats of fine roots, the failed block comes to rest in the vicinity of the bank toe. In this case, the resistance of the bank-toe region to hydraulic scour may be increased markedly and resistance to geotechnical failure may also be increased by buttressing. Conversely, deposition of blocks at bank toes may cause flow acceleration and scour landward of the block, resulting in further undercutting of the bank mass. Failure to account for these processes can lead to errors in predicting of rates of failure frequency, lateral retreat and streambank loadings.Once deposited at the bank toe, failed blocks can be eroded by hydraulic forces either as a mass and/or by erosion of aggregates comprising the block. Field research on the nature of hydraulic resistance and block erosion has been conducted along selected reaches of the Upper Truckee River (UTR) and Trout Creek, Lake Tahoe Basin, California. Block materials are generally characterized by lower apparent cohesive strength than their in situ counterparts due to the lower values of matric suction owing to their proximity to the water surface. Still, submerged jet-test device conducted in root-permeated blocks show critical shear stresses one to two orders of magnitude greater

  9. Why evidence-based medicine failed in patient care and medicine-based evidence will succeed.

    Science.gov (United States)

    Horwitz, Ralph I; Singer, Burton H

    2017-04-01

    Evidence-based medicine (EBM) has succeeded in strengthening the evidence base for population medicine. Where EBM has failed is in answering the practicing doctor's question of what a likely outcome would be when a given treatment is administered to a particular patient with her own distinctive biological and biographical (life experience) profile. We propose Medicine-based evidence (MBE), based on the profiles of individual patients, as the evidence base for individualized or personalized medicine. MBE will build an archive of patient profiles using data from all study types and data sources, and will include both clinical and socio-behavioral information. The clinician seeking guidance for the management of an individual patient will start with the patient's longitudinal profile and find approximate matches in the archive that describes how similar patients responded to a contemplated treatment and alternative treatments. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Scalable and fail-safe deployment of the ATLAS Distributed Data Management system Rucio

    CERN Document Server

    Lassnig, Mario; The ATLAS collaboration; Beermann, Thomas Alfons; Barisits, Martin-Stefan; Garonne, Vincent; Serfon, Cedric

    2015-01-01

    This contribution details the deployment of Rucio, the ATLAS Distributed Data Management system. The main complication is that Rucio interacts with a wide variety of external services, and connects globally distributed data centres under different technological and administrative control, at an unprecedented data volume. It is therefore not possibly to create a duplicate instance of Rucio for testing or integration. Every software upgrade or configuration change is thus potentially disruptive and requires fail-safe software and automatic error recovery. Rucio uses a three-layer scaling and mitigation strategy based on quasi-realtime monitoring. This strategy mainly employs independent stateless services, automatic failover, and service migration. The technologies used for deployment and mitigation include OpenStack, Puppet, Graphite, HAProxy and Apache. In this contribution, the interplay between these component, their deployment, software mitigation, and the monitoring strategy are discussed.

  11. Scalable and fail-safe deployment of the ATLAS Distributed Data Management system Rucio

    CERN Document Server

    Lassnig, Mario; The ATLAS collaboration; Barisits, Martin-Stefan; Beermann, Thomas Alfons; Serfon, Cedric; Garonne, Vincent

    2015-01-01

    This contribution details the deployment of Rucio, the ATLAS Distributed Data Management system. The main complication is that Rucio interacts with a wide variety of external services, and connects globally distributed data centres under different technological and administrative control, at an unprecedented data volume. It is therefore not possibly to create a duplicate instance of Rucio for testing or integration. Every software upgrade or configuration change is thus potentially disruptive and requires fail-safe software and automatic error recovery. Rucio uses a three-layer scaling and mitigation strategy based on quasi-realtime monitoring. This strategy mainly employs independent stateless services, automatic failover, and service migration. The technologies used for deployment and mitigation include OpenStack, Puppet, Graphite, HAProxy, Apache, and nginx. In this contribution, the reasons and design decisions for the deployment, the actual implementation, and an evaluation of all involved services and c...

  12. Scalable and fail-safe deployment of the ATLAS Distributed Data Management system Rucio

    Science.gov (United States)

    Lassnig, M.; Vigne, R.; Beermann, T.; Barisits, M.; Garonne, V.; Serfon, C.

    2015-12-01

    This contribution details the deployment of Rucio, the ATLAS Distributed Data Management system. The main complication is that Rucio interacts with a wide variety of external services, and connects globally distributed data centres under different technological and administrative control, at an unprecedented data volume. It is therefore not possible to create a duplicate instance of Rucio for testing or integration. Every software upgrade or configuration change is thus potentially disruptive and requires fail-safe software and automatic error recovery. Rucio uses a three-layer scaling and mitigation strategy based on quasi-realtime monitoring. This strategy mainly employs independent stateless services, automatic failover, and service migration. The technologies used for deployment and mitigation include OpenStack, Puppet, Graphite, HAProxy and Apache. In this contribution, the interplay between these components, their deployment, software mitigation, and the monitoring strategy are discussed.

  13. Failing to do the right thing: nurse practice and the family experience.

    Science.gov (United States)

    Milton, Constance L

    2010-07-01

    Ethical end of life decisions are increasingly viewed by the global healthcare community as complex and imbued with uncertainty in institutional healthcare settings. Each person experiences health decision-making and the concept of time differently and uniquely. In the context of end of life situations, both the recipients of healthcare and their families may experience complex decision-making in situations where profound questioning and uncertainty surfaces with a struggling of desiring to do the right thing comingling with the possibilities of failing to do the right thing according to the expectations of self and others. This column begins a discussion of possible meanings found in ethical decision-making with families as articulated with the lens of the humanbecoming family model.

  14. Why most Brand Manuals fail when it comes to defining Brand Colors

    DEFF Research Database (Denmark)

    Abildgaard, Michael

    2016-01-01

    From top class Universities and governmental organizations to high-end global brands and well-known local brands, a surprising consistency of inattentiveness has been published in these compa-nies’ prestigious Brand Manuals and Brand Guides. When it comes to providing technical guidance, defining......, comments or warnings of color deviations nor indications of acceptable color tolerances. Only 1.3 % of the Brand Manuals also define their Brand Colors with device independent CIELAB-values. It appears that when designers and Brand Owners select and specifies Brand Colors they tend to choose colors which...... and describing their Brand Colors, they all fail. By examining and analyzing more than 300 different Brand Colors from 156 Brand Manuals by reputable local and global Brands including 28 of the 100 Best Global Brands (see Appendix) and by numerous of visits and interviews with responsible professionals from both...

  15. Rethinking cardiac metabolism: metabolic cycles to refuel and rebuild the failing heart.

    Science.gov (United States)

    Taegtmeyer, Heinrich; Lubrano, Genna

    2014-01-01

    The heart is a self-renewing biological pump that converts chemical energy into mechanical energy. The entire process of energy conversion is subject to complex regulation at the transcriptional, translational and post-translational levels. Within this system, energy transfer occurs with high efficiency, facilitated by a series of compound-conserved cycles. At the same time, the constituent myocardial proteins themselves are continuously made and degraded in order to adjust to changes in energy demand and changes in the extracellular environment. We recently have identified signals arising from intermediary metabolism that regulate the cycle of myocardial protein turnover. Using a new conceptual framework, we discuss the principle of metabolic cycles and their importance for refueling and for rebuilding the failing heart.

  16. Emphysematous pyelonephritis in failed renal allograft: Case report and review of literature.

    Science.gov (United States)

    Bansal, Rahul Kumar; Lambe, Shahid; Kapoor, Anil

    2016-01-01

    Emphysematous pyelonephritis (EPN) in renal allograft is rare but potentially lethal complication and requires aggressive medical and/or surgical therapy to achieve cure. We report a case of 60-year-old diabetic male with poor cardiac function on maintenance hemodialysis, who underwent delayed allograft nephrectomy for EPN in failed renal allograft. Blood culture grew Bacteroides. He was stable in the postoperative period but passed away on day 4 due to myocardial infarction likely secondary to poor baseline cardiac function. Delay in diagnosis and treatment could have contributed to this unfavorable outcome. There is a paucity of published literature regarding EPN in the transplant population, such that management decisions (percutaneous conservative versus urgent surgical) are challenging. Further studies are required to establish treatment guidelines.

  17. Oncological and functional outcomes of salvage renal surgery following failed primary intervention for renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Fernando G. Abarzua-Cabezas

    2015-02-01

    Full Text Available Purpose To assess the oncologic and functional outcomes of salvage renal surgery following failed primary intervention for RCC. Materials and Methods We performed a retrospective review of patients who underwent surgery for suspected RCC during 2004-2012. We identified 839 patients, 13 of whom required salvage renal surgery. Demographic data was collected for all patients. Intraoperative and postoperative data included ischemic duration, blood loss and perioperative complications. Preoperative and postoperative assessments included abdominal CT or magnetic resonance imaging, chest CT and routine laboratory work. Estimated glomerular filtration rate (eGFR was calculated according to the Modification of Diet in Renal Disease equation. Results The majority (85% of the patients were male, with an average age of 64 years. Ten patients underwent salvage partial nephrectomy while 3 underwent salvage radical nephrectomy. Cryotherapy was the predominant primary failed treatment modality, with 31% of patients undergoing primary open surgery. Pre-operatively, three patients were projected to require permanent post-operative dialysis. In the remaining 10 patients, mean pre- and postoperative serum creatinine and eGFR levels were 1.35 mg/dL and 53.8 mL/min/1.73 m2 compared to 1.43 mg/dL and 46.6 mL/min/1.73 m2, respectively. Mean warm ischemia time in 10 patients was 17.4 min and for all patients, the mean blood loss was 647 mL. The predominant pathological stage was pT1a (8/13; 62%. Negative surgical margins were achieved in all cases. The mean follow-up was 32.9 months (3.5-88 months. Conclusion While salvage renal surgery can be challenging, it is feasible and has adequate surgical, functional and oncological outcomes.

  18. Drug resistance mutations in HIV-2 patients failing raltegravir and influence on dolutegravir response.

    Science.gov (United States)

    Requena, Silvia; Treviño, Ana; Cabezas, Teresa; Garcia-Delgado, Rosa; Amengual, María José; Lozano, Ana Belén; Peñaranda, María; Fernández, Juan Manuel; Soriano, Vicente; de Mendoza, Carmen

    2017-07-01

    A broader extent of amino acid substitutions in the integrase of HIV-2 compared with HIV-1 might enable greater cross-resistance between raltegravir and dolutegravir in HIV-2 infection. Few studies have examined the virological response to dolutegravir in HIV-2 patients that failed raltegravir. All patients recorded in the HIV-2 Spanish cohort were examined. The integrase coding region was sequenced in viraemic patients. Changes associated with resistance to raltegravir and dolutegravir in HIV-1 were recorded. From 319 HIV-2-infected patients recorded in the HIV-2 Spanish cohort, 53 integrase sequences from 30 individuals were obtained (20 raltegravir naive and 10 raltegravir experienced). Only one secondary mutation (E138A) was found in one of the 20 raltegravir-naive HIV-2 patients. For raltegravir-experienced individuals, the resistance mutation profile in 9 of 10 viraemic patients was as follows: N155H + A153G/S (four); Y143G + A153S (two); Q148R + G140A/S (two); and Y143C + Q91R (one). Of note, all patients with Y143G and N155H developed a rare non-polymorphic mutation at codon 153. Rescue therapy with dolutegravir was given to 5 of these 10 patients. After >6 months on dolutegravir therapy, three patients with baseline N155H experienced viral rebound. In two of them N155H was replaced by Q148K/R and in another by G118R. A wide repertoire of resistance mutations in the integrase gene occur in HIV-2-infected patients failing on raltegravir. Although dolutegravir may allow successful rescue in most HIV-2 raltegravir failures, we report and characterize three cases of dolutegravir resistance in HIV-2 patients, emerging variants Q148K and Q148R and a novel change G118R.

  19. Naloxone fails to produce conditioned place aversion in mu-opioid receptor knock-out mice.

    Science.gov (United States)

    Skoubis, P D; Matthes, H W; Walwyn, W M; Kieffer, B L; Maidment, N T

    2001-01-01

    There is growing evidence that tonic activity of the opioid system may be important in the modulation of affective state. Naloxone produces a conditioned place aversion in rodents, an effect that is centrally mediated. Previous pharmacological data using antagonists with preferential actions at mu-, delta-, and kappa-opioid receptors indicate the importance of the mu-opioid receptor in mediating this effect. We sought to test the mu-opioid receptor selectivity of naloxone aversion using mu-opioid receptor knock-out mice. mu-Opioid receptor knock-out and wild-type mice were tested for naloxone (10 mg/kg, s.c.) aversion using a place conditioning paradigm. As a positive control for associative learning, knock-out mice were tested for conditioned place aversion to a kappa agonist, U50,488H (2 mg/kg, s.c.). Naloxone produced a significant place aversion in wild-type mice, but failed to have any effect in mu-opioid receptor knock-out mice. On the other hand, both knock-out and wild-type mice treated with U50,488H spent significantly less time in the drug-paired chamber compared to their respective vehicle controls. We conclude that the mu-opioid receptor is crucial for the acquisition of naloxone-induced conditioned place aversion. Furthermore, in a separate experiment using C57BL/6 mice, the delta-selective antagonist naltrindole (10 or 30 mg/kg, s.c.) failed to produce conditioned place aversion.Taken together, these data further support the notion that naloxone produces aversion by antagonizing tonic opioid activity at the mu-opioid receptor.

  20. Distractor suppression when attention fails: behavioral evidence for a flexible selective attention mechanism.

    Directory of Open Access Journals (Sweden)

    James C Elliott

    Full Text Available Despite consistent evidence showing that attention is a multifaceted mechanism that can operate at multiple levels of processing depending on the structure and demands of the task, investigations of the attentional blink phenomenon have consistently shown that the impairment in reporting the second of two targets typically occurs at a late, or post-perceptual, stage of processing. This suggests that the attentional blink phenomenon may represent the operation of a unique attentional mechanism that is not as flexible as other attentional mechanisms. To test whether the attentional blink is a fixed or flexible phenomenon, we manipulated first target task demands (i.e., difficulty and measured the influence this had on processing a subsequently presented distractor and the second target. If the attentional blink represents a mechanism that is fixed and consistently fails at a single stage of processing, then manipulations of task difficulty should not affect distractor processing. However, if the attentional blink represents a more multifaceted and flexible mechanism, then task difficulty should modulate distractor processing. The results revealed that distractor processing during the AB was attenuated under high task difficulty. In addition, unlike previous studies, we failed to find a correlation between distractor processing and the severity of the attentional blink. Using a simulation, we demonstrate that the previously reported correlations may have been spurious and due to using variables that were not independent. Overall, the present results support the conclusion that the selectivity of attention during the AB is flexible and depends on the structure and demands of the task.

  1. Single-Port Onlay Mesh Repair of Recurrent Inguinal Hernias after Failed Anterior and Laparoscopic Repairs

    Science.gov (United States)

    Tran, Kim; Zajkowska, Marta; Lam, Vincent; Hawthorne, Wayne J.

    2015-01-01

    Background and Objectives: Despite the exponential increase in the use of laparoscopic inguinal herniorrhaphy, overall recurrence rates have remained unchanged. Therefore, a growing number of patients are presenting with recurrent hernias after conventional anterior and laparoscopic repairs have failed. This study reports our experience with single-incision laparoscopic (SIL) intraperitoneal onlay mesh (IPOM) repair of these hernias. Methods: Patients referred with two or more recurrences of inguinal hernia underwent SIL-IPOM from November 1, 2009, to June 24, 2014. A 2.5-cm infraumbilical incision was made, and an SIL port was placed intraperitoneally. Modified dissection techniques were used: chopstick and inline dissection, 5.5-mm/52-cm/30° angled laparoscope, and conventional straight dissecting instruments. The peritoneum was incised above the pubic symphysis, and dissection was continued laterally and proximally, raising the inferior flap below the previous extraperitoneal mesh while reducing any direct, indirect, femoral, or cord lipoma before placement of antiadhesive mesh, which was fixed to the pubic ramus, as well as superiorly, with nonabsorbable tacks before the inferior border was fixed with fibrin sealant. The inferior peritoneal flap was then tacked back onto the mesh. Results: Nine male patients underwent SIL-IPOM. Their mean age was 53 years and mean body mass index was 26.8 kg/m2. Mean mesh size was 275 cm2. Mean operation time was 125 minutes, with a hospital stay of 1 day. The umbilical scar length was 23 mm at the 6-week follow-up. There were no intra-/postoperative complications, port-site hernias, chronic groin pain, or recurrence of the hernia during a mean follow-up of 24 months. Conclusion: Inguinal hernias recurring after two or more failed conventional anterior and laparoscopic repairs can be safely and efficiently treated with SIL-IPOM. PMID:25848186

  2. Salvage of Failed Prosthetic Breast Reconstructions by Autologous Conversion With Free Tissue Transfers

    Science.gov (United States)

    Rabey, N. G.; Lie, K. H.; Kumiponjera, D.; Erel, E.; Simcock, J. W.; Malata, C. M.

    2013-01-01

    Objective: Implant-based breast reconstructions are conceptually simple but prone to surgical revisions. Additional procedures often fail to address the problems associated with the reconstructive outcome, especially in patients who have received radiotherapy. However, conversion to free flaps may improve symptoms and aesthetic results. We reviewed our experience in the United Kingdom with autologous replacement of failed prosthetic reconstructions with the aims of documenting the indications for “tertiary” reconstructions and comparing our outcomes with those of other centers. Methods: Patients undergoing salvage surgery for suboptimal prosthetic breast reconstructions between 2000 and 2012 were retrospectively reviewed for their original reconstructive operation, previous radiotherapy, indications for revision, corrective procedures undertaken, and final outcomes. Results: Of 14 patients identified, 7 had delayed and 7 had immediate reconstructions. Twelve had received radiotherapy; 6 before the initial delayed prosthetic reconstructions and 6 after immediate reconstructions. Ten patients presented after undergoing previous revisions of their original reconstructions (average 1.6). Indications for autologous conversion were capsular contracture, persistent pain, and poor cosmetic outcomes (often in combination). Salvage comprised explantation, total capsulectomy, and abdominal free flap reconstruction using deep inferior epigastric artery flaps (9) and transverse rectus abdominis myocutaneous flaps (5). The average interval between initial reconstruction and salvage was 8 years (r = 1-14). All flap transfers were successful with satisfactory aesthetic outcomes (average 21 months follow-up). Conclusions: We recommend early salvage autologous conversion of implant-based reconstructions once initial prosthetic reconstructions become unsatisfactory, particularly in recipients of radiotherapy. Many of these patients may have been better served by initial

  3. Anatomic Localization and Autonomic Modulation of AV Junctional Rhythm in Failing Human Hearts

    Science.gov (United States)

    Fedorov, Vadim V.; Ambrosi, Christina M.; Kostecki, Geran; Hucker, William J.; Glukhov, Alexey V.; Wuskell, Joseph P.; Loew, Leslie M.; Moazami, Nader; Efimov, Igor R.

    2011-01-01

    Background The structure-function relationship in the atrioventricular junction (AVJ) of various animal species has been investigated in detail, however less is known about the human AVJ. In this study, we performed high-resolution optical mapping of the human AVJ (n=6) to define its pacemaker properties and response to autonomic stimulation. Methods and Results Isolated, coronary-perfused AVJ preparations from failing human hearts (n=6, 53±6 years) were optically mapped using the near-infrared, voltage-sensitive dye, di-4-ANBDQBS, with isoproterenol (Iso, 1 μM) and acetylcholine (ACh, 1μM). An algorithm detecting multiple components of optical action potentials was used to reconstruct multi-layered intramural AVJ activation and to identify specialized slow and fast conduction pathways (SP and FP). The anatomical origin and propagation of pacemaker activity was verified via histology. Spontaneous AVJ rhythms of 29±11 bpm (n=6) originated in the nodal-His region (NH, n=3) and/or the proximal His bundle (H, n=4). Iso accelerated the AVJ rhythm to 69±12 bpm (n=5); shifted the leading pacemaker to the transitional cell (TC) regions near the FP and SP (n=4) and/or coronary sinus (n=2); and triggered reentrant arrhythmias (n=2). ACh (n=4) decreased the AVJ rhythm to 18±4 bpm; slowed FP/SP conduction leading to block between the AVJ and atrium; and shifted the pacemaker to either the TC or TC/NH (bifocal activation). Conclusions We have demonstrated that the AVJ pacemaker in failing human hearts is located in the NH or H-regions and can be modified with autonomic stimulation. Moreover, we found that both the FP and SP are involved in anterograde and retrograde conduction. PMID:21646375

  4. Bordetella pertussis naturally occurring isolates with altered lipooligosaccharide structure fail to fully mature human dendritic cells.

    Science.gov (United States)

    Brummelman, Jolanda; Veerman, Rosanne E; Hamstra, Hendrik Jan; Deuss, Anna J M; Schuijt, Tim J; Sloots, Arjen; Kuipers, Betsy; van Els, Cécile A C M; van der Ley, Peter; Mooi, Frits R; Han, Wanda G H; Pinelli, Elena

    2015-01-01

    Bordetella pertussis is a Gram-negative bacterium and the causative agent of whooping cough. Despite high vaccination coverage, outbreaks are being increasingly reported worldwide. Possible explanations include adaptation of this pathogen, which may interfere with recognition by the innate immune system. Here, we describe innate immune recognition and responses to different B. pertussis clinical isolates. By using HEK-Blue cells transfected with different pattern recognition receptors, we found that 3 out of 19 clinical isolates failed to activate Toll-like receptor 4 (TLR4). These findings were confirmed by using the monocytic MM6 cell line. Although incubation with high concentrations of these 3 strains resulted in significant activation of the MM6 cells, it was found to occur mainly through interaction with TLR2 and not through TLR4. When using live bacteria, these 3 strains also failed to activate TLR4 on HEK-Blue cells, and activation of MM6 cells or human monocyte-derived dendritic cells was significantly lower than activation induced by the other 16 strains. Mass spectrum analysis of the lipid A moieties from these 3 strains indicated an altered structure of this molecule. Gene sequence analysis revealed mutations in genes involved in lipid A synthesis. Findings from this study indicate that B. pertussis isolates that do not activate TLR4 occur naturally and that this phenotype may give this bacterium an advantage in tempering the innate immune response and establishing infection. Knowledge on the strategies used by this pathogen in evading the host immune response is essential for the improvement of current vaccines or for the development of new ones.

  5. In vitro fertilization and intracytoplasmic sperm injection for couples with unexplained infertility after failed direct intraperitoneal insemination.

    Science.gov (United States)

    Takeuchi, S; Minoura, H; Shibahara, T; Shen, X; Futamura, N; Toyoda, N

    2000-10-01

    The objective was to determine the optimal insemination technique in patients undergoing in vitro fertilization (IVF) after failed direct intraperitoneal insemination (DIPI) and the outcome of intracytoplasmic sperm injection (ICSI) in such cases. In case-control studies, 53 couples with unexplained infertility who underwent IVF after four failed DIPI cycles were compared with 75 couples with tubal or endometriosis infertility as controls. Thirty couples with unexplained infertility after failing to conceive with DIPI and conventional IVF who underwent ICSI and 58 couples with male-factor infertility as controls also were compared. Fertilization cleavage, embryo quality, implantation, and pregnancy were compared after IVF and after ICSI. There was a significant difference in fertilization rates after IVF between cases of unexplained infertility after failing to conceive with DIPI (40.4%) and patients with tubal or endometriosis infertility (67.9%). There also was a significant difference in total fertilization failure rates between the two groups (30.4% and 3.9%, respectively). There was a slight but significant difference in numbers of fertilized oocytes after ICSI between patients with low fertilization rate undergoing IVF after failing to conceive DIPI (85.8%) and patients with male factor (90.4%). Total fertilization failure was not observed in these cases. Couples with unexplained infertility after failing to conceive with DIPI show a failed fertilization or a low fertilization rate after IVF. However, they demonstrated a good chance of becoming pregnant after subsequent ICSI, even with statistically significant difference in fertilization rate as compared with male-factor cases.

  6. Academic and professional career outcomes of medical school graduates who failed USMLE Step 1 on the first attempt.

    Science.gov (United States)

    McDougle, Leon; Mavis, Brian E; Jeffe, Donna B; Roberts, Nicole K; Ephgrave, Kimberly; Hageman, Heather L; Lypson, Monica L; Thomas, Lauree; Andriole, Dorothy A

    2013-05-01

    This study sought to determine the academic and professional outcomes of medical school graduates who failed the United States Licensing Examination Step 1 on the first attempt. This retrospective cohort study was based on pooled data from 2,003 graduates of six Midwestern medical schools in the classes of 1997-2002. Demographic, academic, and career characteristics of graduates who failed Step 1 on the first attempt were compared to graduates who initially passed. Fifty medical school graduates (2.5 %) initially failed Step 1. Compared to graduates who initially passed Step 1, a higher proportion of graduates who initially failed Step 1 became primary care physicians (26/49 [53 %] vs. 766/1,870 [40.9 %]), were more likely at graduation to report intent to practice in underserved areas (28/50 [56 %] vs. 419/1,939 [ 21.6 %]), and more likely to take 5 or more years to graduate (11/50 [22.0 %] vs. 79/1,953 [4.0 %]). The relative risk of first attempt Step 1 failure for medical school graduates was 13.4 for African Americans, 7.4 for Latinos, 3.6 for matriculants >22 years of age, 3.2 for women, and 2.3 for first generation college graduates. The relative risk of not being specialty board certified for those graduates who initially failed Step 1 was 2.2. Our observations regarding characteristics of graduates in our study cohort who initially failed Step 1 can inform efforts by medical schools to identify and assist students who are at particular risk of failing Step 1.

  7. A preliminary description of the Gan-Hang failed rift, southeastern china

    Science.gov (United States)

    Goodell, P. C.; Gilder, S.; Fang, X.

    1991-10-01

    The Gan-Hang failed rift, as defined by present-day topography, extends at least 450 km in length and 50 km in width. It is a northeast-southwest trending series of features spanning from Hangzhou Bay in Zhejiang province into Jiangxi province through Fuzhou City. Southwest of Fuzhou, the rift splits into two portions: one continuing along the southwestern trend, and the other diverging westward. The total extent of the rift cannot be defined at this time. The rift is superimposed upon a major suture zone of Caledonian or early Mesozoic age. The suture represents the fusing of the South China (Huanan) and Yangtze cratons. Perhaps in Late Triassic, but for sure by Late-Middle Jurassic time, the rifting was initiated and followed this older suture, in part. This time corresponds roughly to the middle stage of the Yanshanian orogeny and to the subduction of the postulated Pacific- Kula ridge southeast of the continental margin. The total thickness of the sediments and volcanics filling the rift valley reaches more than 10,000 m. Peak intensity of extension was between Late-Middle Jurassic and Middle to Late Cretaceous. Sedimentation within the rift was not continuous and is marked with periodic unconformities. Sediments within the rift include red beds, sandstones, siltstones, mudstones, conglomerates, breccias, tuffs, and ignimbrites. Vertebrate fossils and dinosaur eggs are also found. Contemporaneous volcanics within and flanking the rift include basalts, rhyolites, granites, gabbros, dacites, and andesites. Silicic volcanics are mostly attributed to caldera systems. Early basalts are tholeiitic and later change to alkaline-olivine basalt. Bimodal volcanism is recognized. Peak intensity of volcanism ranges between 135 and 75 Ma. In Early Cenozoic time, the area was a topographic low. Paleocene- Eocene sediments and evaporites are the last rocks to be deposited in the rift. Today the rift is delineated by major, high-angle faults (the Pingxiang-Guangfeng deep fault

  8. Evolution of System Architectures: Where Do We Need to Fail Next?

    Science.gov (United States)

    Bermudez, Luis; Alameh, Nadine; Percivall, George

    2013-04-01

    Innovation requires testing and failing. Thomas Edison was right when he said "I have not failed. I've just found 10,000 ways that won't work". For innovation and improvement of standards to happen, service Architectures have to be tested and tested. Within the Open Geospatial Consortium (OGC), testing of service architectures has occurred for the last 15 years. This talk will present an evolution of these service architectures and a possible future path. OGC is a global forum for the collaboration of developers and users of spatial data products and services, and for the advancement and development of international standards for geospatial interoperability. The OGC Interoperability Program is a series of hands-on, fast paced, engineering initiatives to accelerate the development and acceptance of OGC standards. Each initiative is organized in threads that provide focus under a particular theme. The first testbed, OGC Web Services phase 1, completed in 2003 had four threads: Common Architecture, Web Mapping, Sensor Web and Web Imagery Enablement. The Common Architecture was a cross-thread theme, to ensure that the Web Mapping and Sensor Web experiments built on a base common architecture. The architecture was based on the three main SOA components: Broker, Requestor and Provider. It proposed a general service model defining service interactions and dependencies; categorization of service types; registries to allow discovery and access of services; data models and encodings; and common services (WMS, WFS, WCS). For the latter, there was a clear distinction on the different services: Data Services (e.g. WMS), Application services (e.g. Coordinate transformation) and server-side client applications (e.g. image exploitation). The latest testbed, OGC Web Service phase 9, completed in 2012 had 5 threads: Aviation, Cross-Community Interoperability (CCI), Security and Services Interoperability (SSI), OWS Innovations and Compliance & Interoperability Testing & Evaluation

  9. Increasing Rates of Imaging in Failed Back Surgery Syndrome Patients: Implications for Spinal Cord Stimulation.

    Science.gov (United States)

    Farber, S Harrison; Han, Jing L; Petraglia Iii, Frank W; Gramer, Robert; Yang, Siyun; Pagadala, Promila; Parente, Beth; Xie, Jichun; Petrella, Jeffrey R; Lad, Shivanand P

    2017-09-01

    Failed back surgery syndrome (FBSS) has a high incidence following spinal surgery, is notoriously refractory to treatment, and results in high health care utilization. Spinal cord stimulation (SCS) is a well-accepted modality for pain relief in this population; however, until recently magnetic resonance imaging (MRI) was prohibited due to risk of heat conduction through the device. We examined trends in imaging use over the past decade in patients with FBSS to determine its impact on health care utilization and implications for patients receiving SCS. Retrospective. Inpatient and outpatient sample. We identified patients from 2000 to 2012 using the Truven MarketScan database. Annual imaging rates (episodes per 1000 patient months) were determined for MRI, computed tomography (CT) scan, x-ray, and ultrasound. A multivariate Poisson regression model was used to determine imaging trends over time, and to compare imaging in SCS and non-SCS populations. A total of 311,730 patients with FBSS were identified, of which 5.17% underwent SCS implantation (n = 16,118). The median (IQR) age was 58.0 (49.0 - 67.0) years. Significant increases in imaging rate ratios were found in all years for each of the modalities. Increases were seen in the use of CT scans (rate ratio [RR] = 3.03; 95% confidence interval [CI]: 2.79 - 3.29; P imaging procedures overall (P pain symptomatology. Miscoding cannot be precluded, as this sample is taken from a large nationwide database. We found a significant trend for increased use of advanced imaging modalities between the years 2000 and 2012 in FBSS patients. Those patients treated with SCS were 50% less likely to receive an MRI (as expected, given prior incompatibility of neuromodulation devices), yet 32% and 27% more likely to receive CT and x-ray, respectively. Despite the decrease in the use of MRI in those patients treated with SCS, their overall imaging rate increased by 19% compared to patients without SCS. This underscores the utility of MR

  10. Detection and analysis of particles with failed SiC in AGR-1 fuel compacts

    Energy Technology Data Exchange (ETDEWEB)

    Hunn, John D., E-mail: hunnjd@ornl.gov [Oak Ridge National Laboratory (ORNL), P.O. Box 2008, Oak Ridge, TN 37831-6093 (United States); Baldwin, Charles A.; Gerczak, Tyler J.; Montgomery, Fred C.; Morris, Robert N.; Silva, Chinthaka M. [Oak Ridge National Laboratory (ORNL), P.O. Box 2008, Oak Ridge, TN 37831-6093 (United States); Demkowicz, Paul A.; Harp, Jason M.; Ploger, Scott A. [Idaho National Laboratory (INL), P.O. Box 1625, Idaho Falls, ID 83415-6188 (United States)

    2016-09-15

    Highlights: • Cesium release was used to detect SiC failure in HTGR fuel. • Tristructural-isotropic particles with SiC failure were isolated by gamma screening. • SiC failure was studied by X-ray tomography and SEM. • SiC degradation was observed after irradiation and subsequent safety testing. - Abstract: As the primary barrier to release of radioactive isotopes emitted from the fuel kernel, retention performance of the SiC layer in tristructural isotropic (TRISO) coated particles is critical to the overall safety of reactors that utilize this fuel design. Most isotopes are well-retained by intact SiC coatings, so pathways through this layer due to cracking, structural defects, or chemical attack can significantly contribute to radioisotope release. In the US TRISO fuel development effort, release of {sup 134}Cs and {sup 137}Cs are used to detect SiC failure during fuel compact irradiation and safety testing because the amount of cesium released by a compact containing one particle with failed SiC is typically ten or more times higher than that released by compacts without failed SiC. Compacts with particles that released cesium during irradiation testing or post-irradiation safety testing at 1600–1800 °C were identified, and individual particles with abnormally low cesium retention were sorted out with the Oak Ridge National Laboratory (ORNL) Irradiated Microsphere Gamma Analyzer (IMGA). X-ray tomography was used for three-dimensional imaging of the internal coating structure to locate low-density pathways through the SiC layer and guide subsequent materialography by optical and scanning electron microscopy. All three cesium-releasing particles recovered from as-irradiated compacts showed a region where the inner pyrocarbon (IPyC) had cracked due to radiation-induced dimensional changes in the shrinking buffer and the exposed SiC had experienced concentrated attack by palladium; SiC failures observed in particles subjected to safety testing were

  11. Vaginal birth after cesarean delivery: a group practice's approach to minimizing failed trial of labor.

    Science.gov (United States)

    Stedman; Scudder; Joseph

    1998-07-01

    Objective: Among women attempting a trial of labor (TOL) after a prior abdominal delivery, 60-80% accomplish a vaginal birth after cesarean (VBAC). McMahon and coworkers (N Engl J Med, 1996) have indicated that at a 60% success level for TOL, the remaining 40% incurred enough major complications that the scheduled repeat cesarean section group was less morbid overall. The same authors speculated that a success rate of 80% might be necessary for the TOL group's morbidity to be superior. We sought to review our group's patient selection experience during an interval when successful TOL consistently exceeded 80%.Methods: The study interval ranged from January 1995 through June 1997 and was limited to patients with one previous low transverse cesarean section. Rather than using administrative or charge-related diagnoses, we analyzed a departmental database that included each delivering physician's selection of one of four VBAC categories: successful VBAC, unsuccessful VBAC, patient declined trial of labor, or physician advised against trial of labor. All deliveries were at a single institution and were performed by one of seven obstetricians in a group practice.Results: During the study interval, 332 women provided a history of a single previous cesarean delivery. Of these 332, a total of 173 attempted a TOL and 150 of the 173 (87%) were successful. Fifty-eight of the 332 (18%) declined a trial of labor despite being assessed as excellent candidates, and 101 (30%) were advised against a TOL by their physician. Most common reasons for physicians discouraging labor included malpresentation, fetal macrosomia, and clinically small pelvis. Complications for the 23 of 173 (13%) experiencing a failed TOL included 1 asymptomatic partial separation of a uterine scar and 4 cases of puerperal fever; neither transfusion nor hysterectomy was required.Conclusions: This study demonstrates that in a population of women with one prior cesarean delivery, it is possible for a group

  12. Clinical predictors of failing one dose of methotrexate for ectopic pregnancy after in vitro fertilization.

    Science.gov (United States)

    Brady, Paula C; Missmer, Stacey A; Farland, Leslie V; Ginsburg, Elizabeth S

    2017-03-01

    The aim of this study is to investigate the clinical predictors of failure of a single dose of methotrexate (MTX) for management of ectopic pregnancy after in vitro fertilization (IVF). A retrospective cohort study was performed of women who conceived ectopic pregnancies following fresh or frozen IVF cycles at an academic infertility clinic between 2007 and 2014, and received intramuscular MTX (50 mg/m(2)). Successful single-dose MTX treatment was defined as a serum beta-human chorionic gonadotropin (hCG) decline ≥15% between days 4 and 7 post-treatment. Logistic regression models adjusted for oocyte age, number of embryos transferred, and prior ectopic pregnancy were used to estimate the adjusted odds ratio (OR) (95% confidence interval [CI]) of failing one dose of MTX. Sixty-four patients with ectopic pregnancies after IVF were included. Forty required only one dose of MTX (62.5%), while 15 required additional MTX alone (up to four total doses, 23.4%), and 9 required surgery (14.1%). By multivariable logistic regression, the highest tertiles of serum hCG at peak (≥499 IU/L, OR = 9.73, CI 1.88-50.25) and at first MTX administration (≥342 IU/L, OR = 4.74, CI 1.11-20.26), fewer embryos transferred (OR = 0.37 per each additional embryo transferred, CI 0.19-0.74), and adnexal mass by ultrasound (OR = 3.65, CI 1.10-12.11) were each correlated with greater odds of requiring additional MTX and/or surgery. This is the first study to report that in women with ectopic pregnancies after IVF, higher hCG-though well below treatment failure thresholds previously described in spontaneous pregnancies-fewer embryos transferred, and adnexal masses are associated with greater odds of failing one dose of MTX. These findings can be used to counsel IVF patients regarding the likelihood of success with single-dose MTX.

  13. Successful and Failing plumes in a Heterogeneous Mantle: the Icelandic Case

    Science.gov (United States)

    Kumagai, I.; Davaille, A.; Kurita, K.; Stutzmann, E.

    2007-12-01

    Although Iceland is always cited as an exemple of hot spot volcanism produced by a deep mantle plume, an increasing number of observations cannot be explained by the classical plume model of a mushroom-shaped plume out of a sustained localized heat source. Volcanic episodes with moderate temperature predate the major episode of mafic magma emplacement (~60Ma) containing hot picrite magma with strong rare gas anomalies. Present-day Iceland shows moderate temperatures, a strong rare gas anomaly, and an apparent disconnection between slow seismic anomalies in the upper and lower mantle. Noteworthy, the same mixture of geochemical ingredients are found in Icelandic lavas during its 80 Myr of activity. We present a new experimental study of the more realistic case of thermochemical convective instabilities developping out of a heterogeneous bottom hot thermal boundary layer. Depending on the buoyancy ratio B, two end-member regimes are observed. For large B, a thermal plume develops above the denser layer and only a small amount of denser fluid is entrained in the plume. For small B, the dense layer can be sufficently heated to become buoyant and rise: the thermo-chemical plume is therefore mainly constituted of material from the chemically denser layer. The fate of the heterogeneous material in the plume then depends on time since the instability cools as it ascends. As a result, the core of the plume head, which consists of initially hotter but chemically heavier material, can cool enough to become denser than the ambient fluid before reaching the surface of the tank: the heterogeneous material then sinks back and a new thermal plume with a lower temperature anomaly is generated from the top edge of the heavier collapsing blob. In this "failing-plume" mode, the thermo-chemical plume fails to deliver most of the chemical heterogeneity to the surface. Hence, the thermal and compositional structure of a thermo-chemical plume changes with time and is quite irregular. In

  14. Emergency coronary artery bypass surgery for failed percutaneous coronary angioplasty. A 10-year experience.

    Science.gov (United States)

    Craver, J M; Weintraub, W S; Jones, E L; Guyton, R A; Hatcher, C R

    1992-01-01

    Six hundred ninety-nine patients have required emergency coronary artery bypass after failed elective percutaneous coronary angioplasty during the decade September 1980 through December 1990. This represents 4% of 9860 patients having 12,146 elective percutaneous coronary angioplasty procedures during this interval. Emergency coronary artery bypass was required for acute refractory myocardial ischemia in 82%. Hospital mortality rate for all patients was 3.1%; 3.7% in patients with refractory myocardial ischemia but 0.8% in patients without refractory myocardial ischemia, p = 0.08. Postprocedural Q-wave myocardial infarctions were observed in 21% versus 2.4%, p less than 0.0001, and intra-aortic balloon pumping was required in 19% with versus 0.8% without refractory myocardial ischemia, p less than 0.0001. Multivessel disease, p = 0.004, age older than 65 years, p = 0.005, and refractory myocardial ischemia, p = 0.08, interacted to produce the highest risk of in-hospital death. Follow-up shows that there have been 28 additional late deaths, including 23 of cardiac causes for a 91% survival at 5 years. Freedom from both late death and Q-wave myocardial infarction at 5 years was 61%. In the group going to emergency coronary artery bypass with refractory myocardial ischemia, the late cardiac survival was 90%, and in those without ischemia, 92% at 5 years, p = not significant. The MI--free survival in the group with refractory ischemia, however, was 56% versus 83% in the group without ischemia, p less than 0.0001. Multivariate analysis showed the highest late event rates for patients with Q-wave myocardial infarction at the initial emergency coronary artery bypass, age older than 65 years, angina class III or IV, and prior coronary bypass surgery. In spite of a continuing high incidence of early acute myocardial infarction and an increasing operative mortality rate (7%) in the latest 3 years cohort of patients, excellent late survival and low subsequent cardiac event

  15. PARAMETER ESTIMATION OF EXPONENTIAL DISTRIBUTION

    Institute of Scientific and Technical Information of China (English)

    XU Haiyan; FEI Heliang

    2005-01-01

    Because of the importance of grouped data, many scholars have been devoted to the study of this kind of data. But, few documents have been concerned with the threshold parameter. In this paper, we assume that the threshold parameter is smaller than the first observing point. Then, on the basis of the two-parameter exponential distribution, the maximum likelihood estimations of both parameters are given, the sufficient and necessary conditions for their existence and uniqueness are argued, and the asymptotic properties of the estimations are also presented, according to which approximate confidence intervals of the parameters are derived. At the same time, the estimation of the parameters is generalized, and some methods are introduced to get explicit expressions of these generalized estimations. Also, a special case where the first failure time of the units is observed is considered.

  16. MODFLOW-style parameters in underdetermined parameter estimation

    Science.gov (United States)

    D'Oria, Marco D.; Fienen, Michael N.

    2012-01-01

    In this article, we discuss the use of MODFLOW-Style parameters in the numerical codes MODFLOW_2005 and MODFLOW_2005-Adjoint for the definition of variables in the Layer Property Flow package. Parameters are a useful tool to represent aquifer properties in both codes and are the only option available in the adjoint version. Moreover, for overdetermined parameter estimation problems, the parameter approach for model input can make data input easier. We found that if each estimable parameter is defined by one parameter, the codes require a large computational effort and substantial gains in efficiency are achieved by removing logical comparison of character strings that represent the names and types of the parameters. An alternative formulation already available in the current implementation of the code can also alleviate the efficiency degradation due to character comparisons in the special case of distributed parameters defined through multiplication matrices. The authors also hope that lessons learned in analyzing the performance of the MODFLOW family codes will be enlightening to developers of other Fortran implementations of numerical codes.

  17. Parameter estimation in food science.

    Science.gov (United States)

    Dolan, Kirk D; Mishra, Dharmendra K

    2013-01-01

    Modeling includes two distinct parts, the forward problem and the inverse problem. The forward problem-computing y(t) given known parameters-has received much attention, especially with the explosion of commercial simulation software. What is rarely made clear is that the forward results can be no better than the accuracy of the parameters. Therefore, the inverse problem-estimation of parameters given measured y(t)-is at least as important as the forward problem. However, in the food science literature there has been little attention paid to the accuracy of parameters. The purpose of this article is to summarize the state of the art of parameter estimation in food science, to review some of the common food science models used for parameter estimation (for microbial inactivation and growth, thermal properties, and kinetics), and to suggest a generic method to standardize parameter estimation, thereby making research results more useful. Scaled sensitivity coefficients are introduced and shown to be important in parameter identifiability. Sequential estimation and optimal experimental design are also reviewed as powerful parameter estimation methods that are beginning to be used in the food science literature.

  18. Failing to meet the goals of periodontal recall programs. What next?

    Science.gov (United States)

    McCracken, Giles; Asuni, Abisola; Ritchie, Mark; Vernazza, Christopher; Heasman, Peter

    2017-10-01

    Supportive periodontal care is a crucial aspect of the management of chronic periodontitis and peri-implantitis and is inevitably a long-term commitment for both the clinician and the patient. The principal goals of supportive care are to achieve a high standard of plaque control, minimize bleeding and maintain pockets at less than 6 mm. Gain of attachment around natural teeth during supportive periodontal care has been reported, although gain of attachment and of bone during supportive care may be a more pragmatic and aspirational aim in the longer term. Furthermore, we occasionally see patients for whom, despite excellent home and professional care (surgical or nonsurgical), including the management of risk factors, supportive periodontal care appears to be failing and therefore for such patients the clinician needs to consider further management options. This review considers, in particular, the options of using local or systemically delivered antimicrobials to eradicate periodontal and peri-implant disease progression and discusses the extent to which culture and sensitivity testing before the prescription of systemically delivered antimicrobials may be a cost-effective alternative to prescribing 'blind'. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Failed cytokinesis of neural progenitors in citron kinase-deficient rats leads to multiciliated neurons.

    Science.gov (United States)

    Anastas, Sara B; Mueller, Dorit; Semple-Rowland, Susan L; Breunig, Joshua J; Sarkisian, Matthew R

    2011-02-01

    Most, if not all, cortical neurons possess a single primary cilium; however, little is known about the mechanisms that control neuronal ciliogenesis. The Citron kinase-deficient (Citron-K(fh/fh)) rat, a model in which failed cytokinesis during development produces cortical neurons containing multiple cellular organelles, provides a unique system in which to examine the relationship between centriole inheritance and neuronal ciliogenesis. In this study, we analyzed the cerebral cortex of these animals using immunohistochemistry, serial confocal, and electron microscopy to determine if the multinucleated neurons present in the cortex of these animals also possess multiple centrioles and cilia. We found that neurons containing multiple nuclei possessed multiple centrioles and cilia whose lengths varied across cortical regions. Despite the presence of multiple cilia, we found that perinatal expression of adenylyl cyclase III, a cilia-specific marker, and somatostatin receptor 3, a receptor enriched in cilia, were preserved in developing Citron-K(fh/fh) brain. Together, these results show that multinucleated neurons arising from defective cytokinesis can extend multiple cilia.

  20. Grief responses and coping strategies among infertile women after failed in vitro fertilization treatment.

    Science.gov (United States)

    Lee, Shu-Hsin; Wang, Shu-Chuan; Kuo, Ching-Pyng; Kuo, Pi-Chao; Lee, Maw-Sheng; Lee, Meng-Chih

    2010-09-01

    Reproductive technology has increased the childbearing potential for many infertile women, but in vitro fertilization (IVF) failures are common, which often trigger grief responses and coping strategies to manage the stressful life event. The present cross-sectional study investigated 66 women who had experienced at least one failure with IVF treatment. The data were gathered by a self-administered structured questionnaire, and included the participant's personal profile, grief responses and the Jalowiec's coping scale. The most common grief response among the respondents was bargaining, followed by acceptance, depression, anger, denial, and isolation. The order of coping strategies used, from highest-to-lowest, were confrontative, optimistic, self-reliant, fatalistic, supportive, evasive, palliative, and emotive. Use and self-perceived effectiveness among all coping strategies had a high correlation, except emotion. Bargaining, the most common grief response, was associated with a variety of coping strategies. All coping strategies were correlated with grief responses. The results of identifying the grief responses and associated coping strategies of women who have undergone failed IVF treatment may assist nurses and other health care professionals in their efforts to provide appropriate information, care and psychological support.

  1. Vitamin C fails to protect amino acids and lipids from oxidation during acute inflammation.

    Science.gov (United States)

    Gaut, Joseph P; Belaaouaj, Abderrazzaq; Byun, Jaeman; Roberts, L Jackson; Maeda, Nobuyo; Frei, Balz; Heinecke, Jay W

    2006-05-01

    The observation that antioxidant vitamins fail to confer protective benefits in large, well-designed randomized clinical trials has led many to question the role of oxidative stress in the pathogenesis of disease. However, there is little evidence that proposed antioxidants actually scavenge reactive intermediates in vivo. Ascorbate reacts rapidly with oxidants produced by activated neutrophils in vitro, and neutrophils markedly increase their oxidant production when mice are infected intraperitoneally with the gram-negative bacterium Klebsiella pneumoniae. To explore the antioxidant properties of ascorbate in vivo, we therefore used K. pneumoniae infection as a model of oxidative stress. When mice deficient in L-gulono-gamma-lactone oxidase (Gulo(-/-)), the rate-limiting enzyme in ascorbate synthesis, were depleted of ascorbate and infected with K. pneumoniae, they were three times as likely as ascorbate-replete Gulo(-/-)mice to die from infection. Mass spectrometric analysis of peritoneal lavage fluid revealed a marked increase in the levels of oxidized amino acids and of F2-isoprostanes (sensitive and specific markers of lipid oxidation) in infected animals. Surprisingly, there were no significant differences in the levels of the oxidation products in the ascorbate-deficient and -replete Gulo(-/-)mice. Our observations suggest that ascorbate plays a previously unappreciated role in host defense mechanisms against invading pathogens but that the vitamin does not protect amino acids and lipids from oxidative damage during acute inflammation. To examine the oxidation hypothesis of disease, optimal antioxidant regimens that block oxidative reactions in animals and humans need to be identified.

  2. Stealing or Steeling the Image? The Failed Branding of the Guerrillero Heroico image of Che Guevara

    Directory of Open Access Journals (Sweden)

    Maria-Carolina Cambre

    2012-05-01

    Full Text Available This article traces the ongoing tension between those who would characterize Alberto Korda’s famous image of Che Guevara, The Guerrillero Heroico, as a brand, trademark or logo, and those who insist it is a political/cultural icon and non-commercial and that these categories are mutually exclusive. The question of whether the image has been emptied of political content, and the debate around the copyrighting of an image considered by many to be in the public domain and a cultural icon are explored. The long-lasting struggle over the meanings and collective memories associated with this image indicate the possibility that both processes of commodification and radicalization of the image of Che Guevara can coexist. Using the literature on consumer research to engage definitions of branding as a commercially geared venture, this article teases out the problematics of different uses of the photograph and its derivatives, and highlights ambiguities around the notions of creation and authorship. After examining this image’s role within Cuba, Cuban use outside of Cuba, and its commercial and non-commercial uses by non-Cubans, I conclude that attempts at branding products with this particular image fail, and therefore its copyrighting is irrelevant.

  3. Neutralizing antibody fails to impact the course of Ebola virus infection in monkeys.

    Directory of Open Access Journals (Sweden)

    Wendelien B Oswald

    2007-01-01

    Full Text Available Prophylaxis with high doses of neutralizing antibody typically offers protection against challenge with viruses producing acute infections. In this study, we have investigated the ability of the neutralizing human monoclonal antibody, KZ52, to protect against Ebola virus in rhesus macaques. This antibody was previously shown to fully protect guinea pigs from infection. Four rhesus macaques were given 50 mg/kg of neutralizing human monoclonal antibody KZ52 intravenously 1 d before challenge with 1,000 plaque-forming units of Ebola virus, followed by a second dose of 50 mg/kg antibody 4 d after challenge. A control animal was exposed to virus in the absence of antibody treatment. Passive transfer of the neutralizing human monoclonal antibody not only failed to protect macaques against challenge with Ebola virus but also had a minimal effect on the explosive viral replication following infection. We show that the inability of antibody to impact infection was not due to neutralization escape. It appears that Ebola virus has a mechanism of infection propagation in vivo in macaques that is uniquely insensitive even to high concentrations of neutralizing antibody.

  4. Why nafta failed and what's needed to protect workers' health and safety in international trade treaties.

    Science.gov (United States)

    Brown, Garrett

    2005-01-01

    Labor standards, including occupational health and safety regulations and enforcement, are being subjected to intense downward pressures as a result of fundamental shifts in the global economy. The 1994 North American Free Trade Agreement (NAFTA) was the first trade treaty that attempted to promote and protect workplace health and safety through a "labor side agreement." NAFTA failed to protect workers' health and safety due to the weaknesses of the side agreement's text; the political and diplomatic considerations limiting its implementation; and the failure to recognize and address the economic context, and political consequences of this context, in which the agreement was implemented. Subsequent trade treaties, both bilateral and regional, have not overcome the weaknesses of NAFTA. The treaty components needed to protect workers' health in future trade agreements are: 1) a minimum floor of occupational health and safety regulations; 2) an "upward harmonization" of regulatory standards and actual practice; 3) inclusion of employers so that they have formal responsibility and liability for violations of the standards; 4) effective enforcement of national regulations and international standards; 5) transparency and public participation; and 6) recognition of disparate economic conditions among trading partners and provision of financial and technical assistance to overcome economic disincentives and lack of resources. Also required are continued actions by non-governmental actors, including the workers themselves and civil society organizations.

  5. Calibration of the Failed-Fuel-Element Detection Systems in the Aagesta Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Strindehag, O.

    1966-06-15

    Results from a calibration of the systems for detection of fuel element ruptures in the Aagesta reactor are presented. The calibration was carried out by means of foils of zirconium-uranium alloy which were placed in a special fuel assembly. The release of fission products from these foils is due mainly to recoil and can be accurately calculated. Before the foils were used in the reactor their corrosion behaviour in high temperature water was investigated. The results obtained with the precipitator systems for bulk detection and localization are in good agreement with the expected performance. The sensitivity of these systems was found to be high enough for detection and localization of small defects of pin-hole type ({nu} = 10{sup -8}/s ). The general performance of the systems was satisfactory during the calibration tests, although a few adjustments are desirable. A bulk detecting system for monitoring of activities in the moderator, in which the {gamma}-radiation from coolant samples is measured directly after an ion exchanger, showed lower sensitivity than expected from calculations. It seems that the sensitivity of the latter system has to be improved to admit the detection of small defects. In the ion exchanger system, and to some extent in the precipitator systems, the background from A{sup 41} in the coolant limits the sensitivity. The calibration technique utilized seems to be of great advantage when investigating the performance of failed-fuel-element detection systems.

  6. Failed Reverse Total Shoulder Arthroplasty Caused by Recurrent Candida glabrata Infection with Prior Serratia marcescens Coinfection

    Science.gov (United States)

    Skedros, John G.; Keenan, Kendra E.; Updike, Wanda S.; Oliver, Marquam R.

    2014-01-01

    This report describes a 58-year-old insulin-dependent diabetic male patient who initially sustained a proximal humerus fracture from a fall. The fracture fixation failed and then was converted to a humeral hemiarthroplasty, which became infected with Candida glabrata and Serratia marcescens. After these infections were believed to be cured with antibacterial and antifungal treatments and two-stage irrigation and debridement, he underwent conversion to a reverse total shoulder arthroplasty. Unfortunately, the C. glabrata infection recurred and, nearly 1.5 years after implantation of the reverse total shoulder, he had a resection arthroplasty (removal of all implants and cement). His surgical and pharmacologic treatment concluded with (1) placement of a tobramycin-impregnated cement spacer also loaded with amphotericin B, with no plan for revision arthroplasty (i.e., the spacer was chronically retained), and (2) chronic use of daily oral fluconazole. We located only three reported cases of Candida species causing infection in shoulder arthroplasties (two C. albicans, one C. parapsilosis). To our knowledge, a total shoulder arthroplasty infected with C. glabrata has not been reported, nor has a case of a C. glabrata and S. marcescens periprosthetic coinfection in any joint. In addition, it is well known that S. marcescens infections are uncommon in periprosthetic joint infections. PMID:25431708

  7. Failed Reverse Total Shoulder Arthroplasty Caused by Recurrent Candida glabrata Infection with Prior Serratia marcescens Coinfection

    Directory of Open Access Journals (Sweden)

    John G. Skedros

    2014-01-01

    Full Text Available This report describes a 58-year-old insulin-dependent diabetic male patient who initially sustained a proximal humerus fracture from a fall. The fracture fixation failed and then was converted to a humeral hemiarthroplasty, which became infected with Candida glabrata and Serratia marcescens. After these infections were believed to be cured with antibacterial and antifungal treatments and two-stage irrigation and debridement, he underwent conversion to a reverse total shoulder arthroplasty. Unfortunately, the C. glabrata infection recurred and, nearly 1.5 years after implantation of the reverse total shoulder, he had a resection arthroplasty (removal of all implants and cement. His surgical and pharmacologic treatment concluded with (1 placement of a tobramycin-impregnated cement spacer also loaded with amphotericin B, with no plan for revision arthroplasty (i.e., the spacer was chronically retained, and (2 chronic use of daily oral fluconazole. We located only three reported cases of Candida species causing infection in shoulder arthroplasties (two C. albicans, one C. parapsilosis. To our knowledge, a total shoulder arthroplasty infected with C. glabrata has not been reported, nor has a case of a C. glabrata and S. marcescens periprosthetic coinfection in any joint. In addition, it is well known that S. marcescens infections are uncommon in periprosthetic joint infections.

  8. Compounding artefacts with uncertainty, and an amyloid cascade hypothesis that is 'too big to fail'.

    Science.gov (United States)

    Castellani, Rudy J; Smith, Mark A

    2011-06-01

    With each failure of anti-amyloid-β therapy in clinical trials, new trials are initiated with no hint of slowing down. This may be due, in part, to the fact that the amyloid cascade hypothesis has been so modified over time that it is now impossible to confirm or deny. The hypothesis now states, in effect, that invisible molecules target invisible structures. Still relevant, however, are multiple factors that surely cast some doubt but have either been rationalized or overlooked. Among these are the poor correlation between amyloid-β deposits and disease, the substantial differences between familial and sporadic disease, pathological assessment that indicates the secondary nature of lesions/proteins/cascades, the fact that soluble species are poorly reproducible laboratory phenomena, and the irrelevance of synaptic assessment to pathological interpretation. Although not yet dogma, the premature addition of mild cognitive impairment as the implied in vivo homologue to the soluble toxin-synapse interaction is also problematic. In either case, the amyloid cascade hypothesis continues to dominate the Alzheimer's disease literature and grant applications. The more the neuroscience community perseverates along these lines in the face of accumulating outcome data to the contrary, the more one is left to wonder whether the hypothesis is too big to fail.

  9. Synaptically released neurotransmitter fails to desensitize postsynaptic GABA(A) receptors in cerebellar cultures.

    Science.gov (United States)

    Mellor, J R; Randall, A D

    2001-05-01

    GABA concentration jump experiments performed on membrane patches predict that postsynaptic GABA(A) receptors will become desensitized following the release of the contents of a single GABA-containing synaptic vesicle. To examine this we used a single synaptic bouton stimulation technique to directly examine whether postsynaptic GABA(A) receptors in cultured cerebellar granule cells exhibit transmitter-induced desensitization. In a large number of recordings, no evidence was found for desensitization of postsynaptic GABA(A) receptors by vesicularly released transmitter. This was the case even when as many as 40 vesicles were released from a single bouton within 1.5 s. In addition, postsynaptic depolarization and application of the benzodiazepine flunitrazepam, manipulations previously shown to enhance desensitization of GABA(A) receptors, failed to unmask transmitter-induced desensitization. In contrast, a single 2- to 3-s application of a high concentration of exogenous GABA was able to depress synaptic responsiveness for up to 70 s. Furthermore, pharmacological depletion of GABA eliminated inhibitory synaptic communication, suggesting that GABA is the transmitter and the desensitization-resistant inhibitory postsynaptic currents are not mediated by a "nondesensitizing" ligand such as beta-alanine. Overall our data indicate that a specific desensitization-resistant population of GABA(A) receptors are present at postsynaptic sites on cultured cerebellar granule cells.

  10. Failed venture: Gordon Murray and the W. P. Caven Memorial Research Foundation, 1949-74.

    Science.gov (United States)

    McKellar, S

    2001-01-01

    This paper examines the founding and operation of the W. P. Caven Memorial Research Foundation, a private Toronto laboratory, which existed from 1949 to 1974. The Caven Foundation's Research Director was celebrated Toronto surgeon Gordon Murray (1894-1976), who, in 1949, accepted this position amidst personal and public expectations of great medical discoveries and innovations to come. For 25 years Murray carried on his research at the Caven Foundation, generating more controversy and disappointment than medical cures, before the laboratory was closed for financial reasons. What might have been a successful alternative to the University-based medical research structure in Canada resulted in a failed venture. The Foundation did not become a viable research centre largely because of its Research Director and his inability to adapt to the many changes occurring in the conduct and funding of clinical research. The history of the Caven Foundation is explored here within the context of increasingly specialized research techniques and methodology, the rising predominance of the interdisciplinary research team, and the new system of grantsmanship.

  11. FSHD myoblasts fail to downregulate intermediate filament protein vimentin during myogenic differentiation.

    Directory of Open Access Journals (Sweden)

    Lipinski M.

    2011-10-01

    Full Text Available Facioscapulohumeral muscular dystrophy (FSHD is an autosomal dominant hereditary neuromuscular disorder. The clinical features of FSHD include weakness of the facial and shoulder girdle muscles followed by wasting of skeletal muscles of the pelvic girdle and lower extremities. Although FSHD myoblasts grown in vitro can be induced to differentiate into myotubes by serum starvation, the resulting FSHD myotubes have been shown previously to be morphologically abnormal. Aim. In order to find the cause of morphological anomalies of FSHD myotubes we compared in vitro myogenic differentiation of normal and FSHD myoblasts at the protein level. Methods. We induced myogenic differentiation of normal and FSHD myoblasts by serum starvation. We then compared protein extracts from proliferating myoblasts and differentiated myotubes using SDS-PAGE followed by mass spectrometry identification of differentially expressed proteins. Results. We demonstrated that the expression of vimentin was elevated at the protein and mRNA levels in FSHD myotubes as compared to normal myotubes. Conclusions. We demonstrate for the first time that in contrast to normal myoblasts, FSHD myoblasts fail to downregulate vimentin after induction of in vitro myogenic differentiation. We suggest that vimentin could be an easily detectable marker of FSHD myotubes

  12. Tidal stirring of satellites with shallow density profiles prevents them from being too big to fail

    CERN Document Server

    Tomozeiu, Mihai; Quinn, Thomas

    2016-01-01

    The "too big to fail" problem is revisited by studying the tidal evolution of populations of dwarf satellites with different density profiles. The high resolution cosmological $\\rm \\Lambda CDM$ "ErisMod" set of simulations is used. These simulations can model both the stellar and dark matter components of the satellites, and their evolution under the action of the tides of a MW-sized host halo at a force resolution better than 10 pc. The stronger tidal mass loss and re-shaping of the mass distribution induced in satellites with $\\gamma=0.6$ dark matter density distributions, as those resulting from the effect of feedback in hydrodynamical simulations of dwarf galaxy formation, is sufficient to bring the circular velocity profiles in agreement with the kinematics of MW's dSphs. In contrast, in simulations in which the satellites retain cusps at $z=0$ there are several "massive failures" with circular velocities in excess of the observational constraints. Various sources of deviations in the conventionally adop...

  13. Will Jakarta Be The Next Atlantis? Excessive Groundwater Use Resulting From A Failing Piped Water Network

    Directory of Open Access Journals (Sweden)

    Nicola Colbran

    2009-06-01

    Full Text Available This article examines the connection between a failing piped water network and excessive groundwater use in Jakarta. It discusses the political history of the city's piped water network, which was privatised in 1998, and how privatisation was intended to increase access to clean, safe water for its residents. The article asserts that this has not eventuated, and that tap water remains costly, unreliable and does not provide noticeable benefits when compared with groundwater. The result is that households, industry, businesses, luxury apartment complexes and hotels choose alternative water sources and distribution methods, in particular groundwater. This is having an unsustainable impact on groundwater levels and Jakarta 's natural environment, causing significant land subsidence, pollution and salinisation of aquifers, and increased levels of flooding. The effect is so severe that the World Bank has predicted much of Jakarta will be inundated by seawater in 2025, rendering one third of the city uninhabitable and displacing millions. The article concludes by discussing and assessing the steps the government has taken to address excessive and unlicensed groundwater use. These steps include new regulations on groundwater, a public awareness campaign on the importance of groundwater and a commitment to improve the raw water supplied to the piped water network. However, the article observes that the government is yet to develop long term policies for improvement of the network itself. The question therefore remains, has the government done enough, or will groundwater use continue unabated making Jakarta the next lost city of Atlantis?

  14. The influence of shame on posttrauma disorders: have we failed to see the obvious?

    Directory of Open Access Journals (Sweden)

    Terry F. Taylor

    2015-09-01

    Full Text Available Background: While fear is known to be the dominant affect associated with posttraumatic stress disorder (PTSD, the presence and possible influence of other emotions is less well explored. Recent changes to diagnostic criteria have added anger, guilt and shame alongside fear as significant emotional states associated with the disorder. This article suggests that shame is a frequent, often poorly recognised sequel to trauma, occurring as a result of the meaning the individual places on the traumatic experience and on subsequent interpersonal and environmental events. Methods: The article reviews the literature on the socio-interpersonal aspects of the posttraumatic experience with particular emphasis on the emotion of shame as both primary and secondary emotion, in its intrapersonal and interpersonal contexts, and in adaptive and maladaptive forms. Results: The review suggests that posttrauma shame, and maladaptive shame regulation strategies, often manifesting as anger, substance abuse, social withdrawal or depression, may play an important role in the maintenance or exacerbation of the symptoms of PTSD and the development of co-morbidities. Conclusion: The recognition of shame and maladaptive shame regulation strategies in PTSD treatment and management is critical. However, because shame is frequently considered a painful and discomforting emotion, it may fail to be addressed in the therapeutic setting by both client and therapist. Examination of potential shame-related changes in self-concept, close interpersonal relationships and social inclusion are recommended for individuals who have experienced a range of traumas to identify and address any underlying unacknowledged shame.

  15. Fetal Hematopoietic Stem Cell Transplantation Fails to Fully Regenerate the B-Lymphocyte Compartment.

    Science.gov (United States)

    Ghosn, Eliver Eid Bou; Waters, Jeffrey; Phillips, Megan; Yamamoto, Ryo; Long, Brian R; Yang, Yang; Gerstein, Rachel; Stoddart, Cheryl A; Nakauchi, Hiromitsu; Herzenberg, Leonore A

    2016-01-12

    B cells are key components of cellular and humoral immunity and, like all lymphocytes, are thought to originate and renew from hematopoietic stem cells (HSCs). However, our recent single-HSC transfer studies demonstrate that adult bone marrow HSCs do not regenerate B-1a, a subset of tissue B cells required for protection against pneumonia, influenza, and other infections. Since B-1a are regenerated by transfers of fetal liver, the question arises as to whether B-1a derive from fetal, but not adult, HSCs. Here we show that, similar to adult HSCs, fetal HSCs selectively fail to regenerate B-1a. We also show that, in humanized mice, human fetal liver regenerates tissue B cells that are phenotypically similar to murine B-1a, raising the question of whether human HSC transplantation, the mainstay of such models, is sufficient to regenerate human B-1a. Thus, our studies overtly challenge the current paradigm that HSCs give rise to all components of the immune system.

  16. Why hospital improvement efforts fail: a view from the front line.

    Science.gov (United States)

    Longenecker, Clinton O; Longenecker, Paul D

    2014-01-01

    In the 21st century, healthcare executives are facing changes of unprecedented magnitude in virtually every area, affecting their ability to compete. That hindrance brings with it a greater need for rapid and effective organizational change and improvement. Yet changes in the U.S. healthcare delivery system have historically been criticized as slow and less than effective in responding to the changes necessary for rapid performance improvement. To that end, the purpose of this applied research study was to help healthcare executives better understand the barriers to effective organizational change and improvement from the perspective of frontline leaders. Focus groups were conducted with 167 frontline leaders from four community hospitals to explore why hospital change efforts fail. Participants representing 11 different functional areas, including all facets of hospital operations, were asked to identify the primary causes of failure of a recent change initiative at their hospital. A content analysis of the focus group data identified 10 primary barriers to successful hospital change, some of which are ineffective implementation planning and overly aggressive timelines, failure to create project buy-in and ownership, ineffective leadership and lack of trust in upper management, unrealistic improvement plans, and communication breakdowns. Leadership lessons and recommendations based on the research findings are provided.

  17. Horses fail to use social learning when solving spatial detour tasks.

    Science.gov (United States)

    Rørvang, Maria Vilain; Ahrendt, Line Peerstrup; Christensen, Janne Winther

    2015-07-01

    Social animals should have plenty of opportunities to learn from conspecifics, but most studies have failed to document social learning in horses. This study investigates whether young Icelandic horses can learn a spatial detour task through observation of a trained demonstrator horse of either the same age (Experiments 1 and 2, n = 22) or older (Experiment 3, n = 24). Observer horses were allowed to observe the demonstrator being led three times through the detour route immediately before being given the opportunity to solve the task themselves. Controls were allowed only to observe the demonstrator horse eating at the final position, but not the demonstration of the route. Although we found a tendency towards better performance by observer horses in the second experiment, we were unable to repeat this result in a similar set-up with a new group of horses and older, dominant demonstrator horses. We conclude that horses exposed to prior demonstration did not perform better than control horses in solving spatial detour tasks.

  18. Successfully Climbing the "STAIRs": Surmounting Failed Translation of Experimental Ischemic Stroke Treatments.

    Science.gov (United States)

    Kahle, Michael P; Bix, Gregory J

    2012-01-01

    The Stroke Therapy Academic Industry Roundtable (STAIR) provided initial (in 1999) and updated (in 2009) recommendations with the goal of improving preclinical stroke therapy assessment and to increase the translational potential of experimental stroke treatments. It is important for preclinical stroke researchers to frequently consider and revisit these concepts, especially since promising experimental stroke treatments continue to fail in human clinical trials. Therefore, this paper will focus on considerations for several key aspects of preclinical stroke studies including the selection and execution of the animal stroke model, drug/experimental treatment administration, and outcome measures to improve experimental validity and translation potential. Specific points of interest discussed include the incorporation of human comorbid conditions and drugs, the benefits of defining a proposed mechanism of action, replication of results using multiple methods, using clinically relevant routes of administration and treatment time windows, and performing and reporting good experimental methods to reduce bias such as, as suggested by the updated STAIR recommendations, sample size calculations, randomization, allocation concealment, blinding, and appropriate inclusion/exclusion criteria. It is our hope that reviewing and revisiting these considerations will benefit researchers in their investigations of stroke therapies and increase the likelihood of translational success in the battle against stroke.

  19. Successfully Climbing the “STAIRs”: Surmounting Failed Translation of Experimental Ischemic Stroke Treatments

    Directory of Open Access Journals (Sweden)

    Michael P. Kahle

    2012-01-01

    Full Text Available The Stroke Therapy Academic Industry Roundtable (STAIR provided initial (in 1999 and updated (in 2009 recommendations with the goal of improving preclinical stroke therapy assessment and to increase the translational potential of experimental stroke treatments. It is important for preclinical stroke researchers to frequently consider and revisit these concepts, especially since promising experimental stroke treatments continue to fail in human clinical trials. Therefore, this paper will focus on considerations for several key aspects of preclinical stroke studies including the selection and execution of the animal stroke model, drug/experimental treatment administration, and outcome measures to improve experimental validity and translation potential. Specific points of interest discussed include the incorporation of human comorbid conditions and drugs, the benefits of defining a proposed mechanism of action, replication of results using multiple methods, using clinically relevant routes of administration and treatment time windows, and performing and reporting good experimental methods to reduce bias such as, as suggested by the updated STAIR recommendations, sample size calculations, randomization, allocation concealment, blinding, and appropriate inclusion/exclusion criteria. It is our hope that reviewing and revisiting these considerations will benefit researchers in their investigations of stroke therapies and increase the likelihood of translational success in the battle against stroke.

  20. National Courts of Last Instance Failing to Make a Preliminary Reference

    DEFF Research Database (Denmark)

    Broberg, Morten

    2016-01-01

    According to Article 267 of the Treaty on the Functioning of the European Union (TFEU), Member State courts may – and sometimes must – refer questions on the interpretation or validity of EU legal measures to the Court of Justice of the European Union for a binding preliminary ruling. But what ar......’s judgment, and there may also be a requirement on Member State administrative authorities to reopen the case file if, after the ruling by the Member State court, it becomes apparent that this court erred with regards to EU law....... are the consequences if a Member State court fails to make a preliminary reference in a situation where it was legally obliged to do so? The article shows that such failure may constitute an infringement of the right to a fair trial as laid down in Article 6(1) of the European Convention of Human Rights. It may also...... form the basis for a claim for damages under EU law. Moreover, it may instigate the European Commission to institute infringement proceedings against the Member State in question. Finally, in some situations, a failure to make a preliminary reference may affect the validity of the Member State court...

  1. Rifampicin fails to eradicate mature biofilm formed by methicillin-resistant Staphylococcus aureus

    Directory of Open Access Journals (Sweden)

    Keli Cristine Reiter

    2012-08-01

    Full Text Available INTRODUCTION: Antimicrobial activity on biofilms depends on their molecular size, positive charges, permeability coefficient, and bactericidal activity. Vancomycin is the primary choice for methicillin-resistant Staphylococcus aureus (MRSA infection treatment; rifampicin has interesting antibiofilm properties, but its effectivity remains poorly defined. METHODS: Rifampicin activity alone and in combination with vancomycin against biofilm-forming MRSA was investigated, using a twofold serial broth microtiter method, biofilm challenge, and bacterial count recovery. RESULTS: Minimal inhibitory concentration (MIC and minimal bactericidal concentration for vancomycin and rifampicin ranged from 0.5 to 1mg/l and 0.008 to 4mg/l, and from 1 to 4mg/l and 0.06 to 32mg/l, respectively. Mature biofilms were submitted to rifampicin and vancomycin exposure, and minimum biofilm eradication concentration ranged from 64 to 32,000 folds and from 32 to 512 folds higher than those for planktonic cells, respectively. Vancomycin (15mg/l in combination with rifampicin at 6 dilutions higher each isolate MIC did not reach in vitro biofilm eradication but showed biofilm inhibitory capacity (1.43 and 0.56log10 CFU/ml reduction for weak and strong biofilm producers, respectively; p<0.05. CONCLUSIONS: In our setting, rifampicin alone failed to effectively kill biofilm-forming MRSA, demonstrating stronger inability to eradicate mature biofilm compared with vancomycin.

  2. Irradiated Xenon Isotopic Ratio Measurement for Failed Fuel Detection and Location in Fast Reactor

    Science.gov (United States)

    Ito, Chikara; Iguchi, Tetsuo; Harano, Hideki

    2009-08-01

    The accuracy of xenon isotopic ratio burn-up calculations used for failed fuel identification was evaluated by an irradiation test of xenon tag gas samples in the Joyo test reactor. The experiment was carried out using pressurized steel capsules containing unique blend ratios of stable xenon tag gases in an on-line creep rupture experiment in Joyo. The tag gas samples were irradiated to total neutron fluences of 1.6 to 4.8 × 1026 n/m2. Laser resonance ionization mass spectrometry was used to analyze the cover gas containing released tag gas diluted to isotopic ratios of 100 to 102 ppb. The isotopic ratios of xenon tag gases after irradiation were calculated using the ORIGEN2 code. The neutron cross sections of xenon nuclides were based on the JENDL-3.3 library. These cross sections were collapsed into one group using the neutron spectra of Joyo. The comparison of measured and calculated xenon isotopic ratios provided C/E values that ranged from 0.92 to 1.10. The differences between calculation and measurement were considered to be mainly due to the measurement errors and the xenon nuclide cross section uncertainties.

  3. Isopods failed to acclimate their thermal sensitivity of locomotor performance during predictable or stochastic cooling.

    Directory of Open Access Journals (Sweden)

    Matthew S Schuler

    Full Text Available Most organisms experience environments that vary continuously over time, yet researchers generally study phenotypic responses to abrupt and sustained changes in environmental conditions. Gradual environmental changes, whether predictable or stochastic, might affect organisms differently than do abrupt changes. To explore this possibility, we exposed terrestrial isopods (Porcellio scaber collected from a highly seasonal environment to four thermal treatments: (1 a constant 20°C; (2 a constant 10°C; (3 a steady decline from 20° to 10°C; and (4 a stochastic decline from 20° to 10°C that mimicked natural conditions during autumn. After 45 days, we measured thermal sensitivities of running speed and thermal tolerances (critical thermal maximum and chill-coma recovery time. Contrary to our expectation, thermal treatments did not affect the thermal sensitivity of locomotion; isopods from all treatments ran fastest at 33° to 34°C and achieved more than 80% of their maximal speed over a range of 10° to 11°C. Isopods exposed to a stochastic decline in temperature tolerated cold the best, and isopods exposed to a constant temperature of 20°C tolerated cold the worst. No significant variation in heat tolerance was observed among groups. Therefore, thermal sensitivity and heat tolerance failed to acclimate to any type of thermal change, whereas cold tolerance acclimated more during stochastic change than it did during abrupt change.

  4. Failing to Focus on Healthy Aging: A Frailty of Our Discipline?

    Science.gov (United States)

    Friedman, Susan M; Shah, Krupa; Hall, William J

    2015-07-01

    The academic geriatrics community has provided outstanding leadership in addressing frailty and complexity in older adults, but a minority of older adults are frail. Although resources to treat older adults are limited, and it is appropriate to focus clinical efforts on those with frailty and multimorbidity, there is also important expertise that can be brought to bear on the health of ALL older adults. A review of the literature suggests that attention to healthy or successful aging has failed to keep pace with the focus on frailty. By providing leadership to promote successful aging, the quality of life of older adults across the spectrum can be improved and transitions to frailty reduced. The template that leaders have established in understanding frailty-defining and operationalizing it, understanding outcomes, identifying pathophysiology-can be used as an approach to successful aging. Several community-based programs have been successful in promoting successful aging. These are potentially highly scalable and could have a substantial effect on the aging population, but their essential components need to be better understood. The geriatrics community is uniquely positioned to take on this role. This is a critical time to work together to make the lives of all older adults as healthy and fulfilling as possible.

  5. Pulsed Nd:YAG laser treatment for failing dental implants due to peri-implantitis

    Science.gov (United States)

    Nicholson, Dawn; Blodgett, Kris; Braga, Charles; Finkbeiner, Larry; Fourrier, Jeanne; George, John; Gregg, Robert; Honigman, Allen; Houser, Bruce; Lamas, William; Lehrman, Neal; Linden, Eric; McCarthy, Delwin; McCawley, Tom; McCormick, Randy; Marcus, Ed; Noraian, Kirk; Rubelman, Peter; Salama, Maurice; Saunders, Steven; Seamons, Brandon; Thein, David; Toms, Michael; Vassos, George; Harris, David M.

    2014-02-01

    A large percentage of dental implants experience complications, most commonly, infection leading to peri-implantitis and peri-mucositis, inflammatory disease involving pathogen contamination. It presents with radiographic findings of crestal bone loss. At this time there appears to be no compelling evidence for an effective intervention. The LANAP protocol is a FDA cleared surgical protocol that produces new attachment and bone regeneration when applied to periodontally infected natural teeth. The LANAP protocol and laser dosimetry have been modified to treat ailing and failing implants. Twenty-one clinicians who have been trained to perform the LANAP protocol and the LAPIPTM protocol have volunteered 26 LAPIP case reports. The time from implant to intervention ranges from 3 months to 16 years. Post-LAPIP radiographs range from 2-48 months. Ten cases were excluded for technical reasons. All 16 remaining cases provide radiographic evidence of increase in crestal bone mass around the implant and, when reported, probe depth reductions. All treating clinicians report control of the infection, reversal of bone loss and rescue of the incumbent implant. Although the success/failure rate cannot be judged from these data, any successes in this area deserve reporting and further study.

  6. Role of laparohysteroscopy in women with normal pelvic imaging and failed ovulation stimulation with intrauterine insemination

    Directory of Open Access Journals (Sweden)

    K Jayakrishnan

    2010-01-01

    Full Text Available Context: Women with primary infertility and no obvious pelvic pathology on clinical evaluation and imaging are either treated empirically or further investigated by laparoscopy. Aims: The role of diagnostic laparoscopy in women who fail to conceive after empirical treatment with ovulation induction and intrauterine insemination was evaluated. Settings and Design: Retrospective study at a private infertility center. Materials and Methods: A study of patients who underwent diagnostic laparoscopy between 1 st January 2001 and 31 st December 2008 was performed. Those patients who had no detectable pathology based on history, physical examination, and ultrasound and had treatment for three or more cycles in the form of ovulation induction and IUI were included in the study. Moderate and severe male factor infertility and history of any previous surgery were exclusion criteria. Statistical Analysis Used: Data were statistically analyzed using Statistics Package for Social Sciences (ver. 16.0; SPSS Inc., Chicago. Results: Of the 127 women who underwent diagnostic laparoscopy and hysteroscopy, 87.4% ( n= 111 of patients had positive findings. Significant pelvic pathology (moderate endometriosis, pelvic inflammatory disease, and tubal pathology was seen in 26.8% of cases. Conclusion: One in four women had significant pelvic pathology where treatment could possibly improve future fertility. Diagnostic laparoscopy has a role in infertile women with no obvious abnormality before they proceed to more aggressive treatments.

  7. Six Serum miRNAs Fail to Validate as Myotonic Dystrophy Type 1 Biomarkers.

    Directory of Open Access Journals (Sweden)

    Juan M Fernandez-Costa

    Full Text Available Myotonic dystrophy type 1 (DM1 is an autosomal dominant genetic disease caused by expansion of a CTG microsatellite in the 3' untranslated region of the DMPK gene. Despite characteristic muscular, cardiac, and neuropsychological symptoms, CTG trinucleotide repeats are unstable both in the somatic and germinal lines, making the age of onset, clinical presentation, and disease severity very variable. A molecular biomarker to stratify patients and to follow disease progression is, thus, an unmet medical need. Looking for a novel biomarker, and given that specific miRNAs have been found to be misregulated in DM1 heart and muscle tissues, we profiled the expression of 175 known serum miRNAs in DM1 samples. The differences detected between patients and controls were less than 2.6 fold for all of them and a selection of six candidate miRNAs, miR-103, miR-107, miR-21, miR-29a, miR-30c, and miR-652 all failed to show consistent differences in serum expression in subsequent validation experiments.

  8. Six Serum miRNAs Fail to Validate as Myotonic Dystrophy Type 1 Biomarkers.

    Science.gov (United States)

    Fernandez-Costa, Juan M; Llamusi, Beatriz; Bargiela, Ariadna; Zulaica, Miren; Alvarez-Abril, M Carmen; Perez-Alonso, Manuel; Lopez de Munain, Adolfo; Lopez-Castel, Arturo; Artero, Ruben

    2016-01-01

    Myotonic dystrophy type 1 (DM1) is an autosomal dominant genetic disease caused by expansion of a CTG microsatellite in the 3' untranslated region of the DMPK gene. Despite characteristic muscular, cardiac, and neuropsychological symptoms, CTG trinucleotide repeats are unstable both in the somatic and germinal lines, making the age of onset, clinical presentation, and disease severity very variable. A molecular biomarker to stratify patients and to follow disease progression is, thus, an unmet medical need. Looking for a novel biomarker, and given that specific miRNAs have been found to be misregulated in DM1 heart and muscle tissues, we profiled the expression of 175 known serum miRNAs in DM1 samples. The differences detected between patients and controls were less than 2.6 fold for all of them and a selection of six candidate miRNAs, miR-103, miR-107, miR-21, miR-29a, miR-30c, and miR-652 all failed to show consistent differences in serum expression in subsequent validation experiments.

  9. Brugia malayi infective larvae fail to activate Langerhans cells and dermal dendritic cells in human skin.

    Science.gov (United States)

    Cotton, R N; McDonald-Fleming, R; Boyd, A; Spates, K; Nutman, T B; Tolouei Semnani, R

    2015-02-01

    Filarial infection in humans is initiated when a mosquito deposits third-stage parasite larvae (L3) in the skin. Langerhans cells (LCs) and dermal dendritic cells (DDCs) are the first cells that the parasite encounters, and L3s must evade these highly effective antigen-presenting cells to establish infection. To assess LC and DDC responses to L3 in human skin, we employed three models of increasing physiologic relevance: in vitro-generated LCs, epidermal blister explants and full-thickness human skin sections. In vitro-generated LCs expressed TLR1-10 and robustly produced IL-6 and TNF-α in response to PolyI:C, but pre-exposure to L3s did not alter inflammatory cytokine production or TLR expression. L3s did not modulate expression of LC markers CDH1, CD207, or CD1a, or the regulatory products TSLP or IDO in epidermal explants or in vitro-generated LC. LC, CD14+ DDC, CD1c+ DC and CD141+ DC from human skin sections were analysed by flow cytometry. While PolyI:C potently induced CCL22 production in LC, CD1c+ DC, and CD141+ DC, and IL-10 production in LC, L3s did not modulate the numbers of or cytokine production by any skin DC subset. L3s broadly failed to activate or modulate LCs or DDCs, suggesting filarial larvae expertly evade APC detection in human skin.

  10. Cortical neurogenesis in adult rats after ischemic brain injury:most new neurons fail to mature

    Institute of Scientific and Technical Information of China (English)

    Qing-quan Li; Guan-qun Qiao; Jun Ma; Hong-wei Fan; Ying-bin Li

    2015-01-01

    The present study examines the hypothesis that endogenous neural progenitor cells isolated from the neocortex of ischemic brain can differentiate into neurons or glial cells and contribute to neural regeneration. We performed middle cerebral artery occlusion to establish a model of cerebral ischemia/reperfusion injury in adult rats. Immunohistochemical staining of the cortex 1, 3, 7, 14 or 28 days after injury revealed that neural progenitor cells double-positive for nestin and sox-2 appeared in the injured cortex 1 and 3 days post-injury, and were also positive for glial ifbrillary acidic protein. New neurons were labeled using bromodeoxyuridine and different stages of maturity were identiifed using doublecortin, microtubule-associated protein 2 and neuronal nuclei antigen immunohistochemistry. Immature new neurons coexpressing doublecortin and bromodeoxyuridine were observed in the cortex at 3 and 7 days post-injury, and semi-mature and mature new neurons double-positive for microtubule-associated protein 2 and bromode-oxyuridine were found at 14 days post-injury. A few mature new neurons coexpressing neuronal nuclei antigen and bromodeoxyuridine were observed in the injured cortex 28 days post-injury. Glial ifbrillary acidic protein/bromodeoxyuridine double-positive astrocytes were also found in the injured cortex. Our ifndings suggest that neural progenitor cells are present in the damaged cortex of adult rats with cerebral ischemic brain injury, and that they differentiate into astrocytes and immature neurons, but most neurons fail to reach the mature stage.

  11. A fail-safe system for the ribosome under zinc-limiting conditions in Bacillus subtilis.

    Science.gov (United States)

    Natori, Yousuke; Nanamiya, Hideaki; Akanuma, Genki; Kosono, Saori; Kudo, Toshiaki; Ochi, Kozo; Kawamura, Fujio

    2007-01-01

    As zinc is an essential trace metal ion for all living cells, cells elaborate a variety of strategies to cope with zinc starvation. In Bacillus subtilis, genes encoding ribosomal proteins L31 and S14 are duplicated into two types: one type contains a zinc-binding motif (RpmE or RpsN), whereas the other does not (YtiA or YhzA). We have previously shown that displacement of RpmE (L31) by YtiA from already assembled ribosomes is controlled by zinc, and this replacement could contribute to zinc mobilization under zinc-limiting conditions. We propose here that the switch between the two types of S14 has a different significance. rpsN is indispensable for growth and depletion of RpsN results in defective 30S subunits. YhzA can functionally replace RpsN to allow continued ribosome assembly under zinc-limiting conditions. Unlike YtiA, YhzA appeared in the ribosome at a slower rate consistent with incorporation into newly synthesized, rather than pre-existing ribosomes. These results raise the possibility that YhzA is involved in a fail-safe system for the de novo synthesis of ribosomes under zinc-limiting conditions.

  12. Pigeons (Columba livia) fail to connect dots in learning biological motion.

    Science.gov (United States)

    Yamamoto, Eriko; Goto, Kazuhiro; Watanabe, Shigeru

    2015-09-01

    Biological motion point-light displays provide a powerful method for studying motion perception. Nonhuman animals are capable of discriminating point-light displays, but it remains unknown how they perceive biological motion in these displays. We trained two groups of pigeons to discriminate video stimuli using two different classification rules. The motion-congruent group was trained to discriminate full-detail and corresponding point-light displays of pigeons from full-detail and point-light displays of humans. The motion-incongruent group was trained to discriminate full-detail pigeons and point-light humans from the other displays. Both groups acquired the discrimination. When tested with novel displays, pigeons showed good transfer of learning. Transfer was poorest with the point-light displays in the motion-congruent group. The results indicate that the pigeons failed to make the connection between the full-detail displays and their point-light counterparts even when the common motion was available as a cue.

  13. Is there a "too big to fail" problem in the field?

    CERN Document Server

    Papastergis, Emmanouil; Haynes, Martha P; Shankar, Francesco

    2014-01-01

    We use the Arecibo Legacy Fast ALFA (ALFALFA) 21cm survey to measure the number density of galaxies as a function of their rotational velocity, Vrot,HI (as inferred from the width of their 21cm emission line). Based on the measured velocity function we statistically connect galaxies with their host halos, via abundance matching. In a LCDM cosmology, low-velocity galaxies are expected to be hosted by halos that are significantly more massive than indicated by the measured galactic velocity; allowing lower mass halos to host ALFALFA galaxies would result in a vast overestimate of their number counts. We then seek observational verification of this predicted trend, by analyzing the kinematics of a literature sample of field dwarf galaxies. We find that galaxies with Vrot,HI<25 km/s are kinematically incompatible with their predicted LCDM host halos, in the sense that hosts are too massive to be accommodated within the measured galactic rotation curves. This issue is analogous to the "too big to fail" problem ...

  14. Exercise training fails to modify arterial baroreflex sensitivity in ovariectomized female rats.

    Science.gov (United States)

    Minami, Naoyoshi; Mori, Nobuyoshi; Nagasaka, Makoto; Ito, Osamu; Ogawa, Mika; Kurosawa, Hajime; Kanazawa, Masayuki; Kohzuki, Masahiro

    2007-04-01

    In men, exercise training attenuates age-related reduction in baroreflex sensitivity, which is related to cardiovascular health. It is unknown, however, if this holds true for post-menopausal women. We examined the effects of exercise training on baroreceptor-heart rate (HR) reflex sensitivity in ovariectomized (OVX) and sham-operated (SO) Wistar-Kyoto rats. At the age of 8 weeks, OVX and SO rats were assigned to either sedentary or exercise-trained group. Exercise training was performed on a treadmill 5 days per week. At the age of 20 weeks, baroreflex sensitivity in response to increases in blood pressure (BRSinc) and decreases in blood pressure (BRSdec) were evaluated by injections of phenylephrine and sodium nitroprusside, respectively. Both BRSinc and BRSdec were significantly reduced in sedentary OVX rats compared with sedentary SO rats. Exercise training decreased resting HR and BRSdec, but had no effect on BRSinc in SO rats. In OVX rats, exercise training decreased resting HR but modified neither BRSdec nor BRSinc. We conclude that withdrawal of female sex hormones in normotensive female rats is associated with reduced baroreflex sensitivity in response to both increase and decrease in blood pressure and that exercise training fails to modulate the decline of BRSinc associated with withdrawal of female sex hormones. To maintain high level of BRSinc in post-menopausal women, hormone replacement therapy may be needed.

  15. Are we failing to communicate? Internet-based patient education materials and radiation safety

    Energy Technology Data Exchange (ETDEWEB)

    Hansberry, David R., E-mail: hansbedr@njms.rutgers.edu; Ramchand, Tekchand, E-mail: ramchate@njms.rutgers.edu; Patel, Shyam, E-mail: patel288@njms.rutgers.edu; Kraus, Carl, E-mail: krauscf@njms.rutgers.edu; Jung, Jin, E-mail: jungjk@njms.rutgers.edu; Agarwal, Nitin, E-mail: nitin.agarwal@rutgers.edu; Gonzales, Sharon F., E-mail: gonzalsh@njms.rutgers.edu; Baker, Stephen R., E-mail: bakersr@njms.rutgers.edu

    2014-09-15

    Introduction: Patients frequently turn to the Internet when seeking answers to healthcare related inquiries including questions about the effects of radiation when undergoing radiologic studies. We investigate the readability of online patient education materials concerning radiation safety from multiple Internet resources. Methods: Patient education material regarding radiation safety was downloaded from 8 different websites encompassing: (1) the Centers for Disease Control and Prevention, (2) the Environmental Protection Agency, (3) the European Society of Radiology, (4) the Food and Drug Administration, (5) the Mayo Clinic, (6) MedlinePlus, (7) the Nuclear Regulatory Commission, and (8) the Society of Pediatric Radiology. From these 8 resources, a total of 45 articles were analyzed for their level of readability using 10 different readability scales. Results: The 45 articles had a level of readability ranging from 9.4 to the 17.2 grade level. Only 3/45 (6.7%) were written below the 10th grade level. No statistical difference was seen between the readability level of the 8 different websites. Conclusions: All 45 articles from all 8 websites failed to meet the recommendations set forth by the National Institutes of Health and American Medical Association that patient education resources be written between the 3rd and 7th grade level. Rewriting the patient education resources on radiation safety from each of these 8 websites would help many consumers of healthcare information adequately comprehend such material.

  16. Nuss procedure for repair of pectus excavatum after failed Ravitch procedure in adults: indications and caveats

    Science.gov (United States)

    Kocher, Gregor J.; Gstrein, Nathalie; Jaroszewski, Dawn E.; Ewais, Mennatallah M.

    2016-01-01

    Background Recurrence of pectus excavatum (PE) is not an uncommon problem after open repair using the Ravitch technique. The optimal approach for redo surgery is still under debate, especially in adults with less chest wall pliability. Aim of this study was to investigate the usefulness and efficacy of the minimally invasive Nuss technique for repair of recurrent PE after conventional open repair. Methods We performed a retrospective multicentre review of 20 adult patients from University Hospital Bern (n=6) and the US Mayo Clinic (n=14) who underwent minimally invasive repair of recurrent PE after unsuccessful prior Ravitch procedure. Results Mean patient age at primary open correction was 21 years, with recurrence being evident after a mean duration of 10.5 years (range, 0.25–47 years). Mean age at redo surgery using the Nuss technique was 31 years, with a mean Haller index of 4.7 before and 2.5 after final correction. Main reason for redo surgery was recurrent or persistent deformity (100%), followed by chest pain (75%) and exercise intolerance (75%). No major intraoperative or postoperative complications occurred and successful correction was possible in all patients. Conclusions Although the procedure itself is more challenging, the minimally invasive Nuss technique can be safely and successfully used for repair of recurrent PE after failed open surgery. In our series final results were good to excellent in the majority of patients without major complications or recurrence. PMID:27621850

  17. Pulsatile hyperglucagonemia fails to increase hepatic glucose production in normal man

    Energy Technology Data Exchange (ETDEWEB)

    Paolisso, G.; Scheen, A.J.; Luyckx, A.S.; Lefebvre, P.J.

    1987-01-01

    To study the metabolic effects of pulsatile glucagon administration, six male volunteers were submitted to a 260-min glucose-controlled glucose intravenous infusion using the Biostator. The endogenous secretion of the pancreatic hormones was inhibited by somatostatin, basal insulin secretion was replaced by a continuous insulin infusion, and glucagon was infused intravenously in two conditions at random: either continuously or intermittently. Blood glucose levels and glucose infusion rate were monitored continuously by the Biostator, and classical methodology using a D-(3-/sup 3/H)glucose infusion allowed the authors to study glucose turnover. While basal plasma glucagon levels were similar in both conditions, they plateaued at 189 +/- 38 pg ml/sup -1/ during continuous infusion and varied between 95 and 501 pg x ml/sup -1/ during pulsatile infusion. When compared with continuous administration, pulsatile glucagon infusion 1) initially induced a similar increase in endogenous (hepatic) glucose production and blood glucose, 2) did not prevent the so-called evanescent effect of glucagon on blood glucose, and 3) after 3 h tended to reduce rather than increase hepatic glucose production. In conclusion, in vivo pulsatile hyperglucanemia in normal man fails to increase hepatic glucose production.

  18. A triple-helix forming oligonucleotide targeting genomic DNA fails to induce mutation.

    Science.gov (United States)

    Reshat, Reshat; Priestley, Catherine C; Gooderham, Nigel J

    2012-11-01

    Purine tracts in duplex DNA can bind oligonucleotide strands in a sequence specific manner to form triple-helix structures. Triple-helix forming oligonucleotides (TFOs) targeting supFG1 constructs have previously been shown to be mutagenic raising safety concerns for oligonucleotide-based pharmaceuticals. We have engineered a TFO, TFO27, to target the genomic Hypoxanthine-guanine phosphoribosyltransferase (HPRT) locus to define the mutagenic potential of such structures at genomic DNA. We report that TFO27 was resistant to nuclease degradation and readily binds to its target motif in a cell free system. Contrary to previous studies using the supFG1 reporter construct, TFO27 failed to induce mutation within the genomic HPRT locus. We suggest that it is possible that previous reports of triplex-mediated mutation using the supFG1 reporter construct could be confounded by DNA quadruplex formation. Although the present study indicates that a TFO targeting a genomic locus lacks mutagenic activity, it is unclear if this finding can be generalised to all TFOs and their targets. For the present, we suggest that it is prudent to avoid large purine stretches in oligonucleotide pharmaceutical design to minimise concern regarding off-target genotoxicity.

  19. Six Serum miRNAs Fail to Validate as Myotonic Dystrophy Type 1 Biomarkers

    Science.gov (United States)

    Fernandez-Costa, Juan M.; Llamusi, Beatriz; Bargiela, Ariadna; Zulaica, Miren; Alvarez-Abril, M. Carmen; Perez-Alonso, Manuel; Lopez de Munain, Adolfo

    2016-01-01

    Myotonic dystrophy type 1 (DM1) is an autosomal dominant genetic disease caused by expansion of a CTG microsatellite in the 3’ untranslated region of the DMPK gene. Despite characteristic muscular, cardiac, and neuropsychological symptoms, CTG trinucleotide repeats are unstable both in the somatic and germinal lines, making the age of onset, clinical presentation, and disease severity very variable. A molecular biomarker to stratify patients and to follow disease progression is, thus, an unmet medical need. Looking for a novel biomarker, and given that specific miRNAs have been found to be misregulated in DM1 heart and muscle tissues, we profiled the expression of 175 known serum miRNAs in DM1 samples. The differences detected between patients and controls were less than 2.6 fold for all of them and a selection of six candidate miRNAs, miR-103, miR-107, miR-21, miR-29a, miR-30c, and miR-652 all failed to show consistent differences in serum expression in subsequent validation experiments. PMID:26919350

  20. Patients' Expectations on Spinal Cord Stimulation for Failed Back Surgery Syndrome: A Qualitative Exploration.

    Science.gov (United States)

    Henssen, Dylan J H A; Scheepers, Nicole; Kurt, Erkan; Arnts, Inge; Steegers, Monique; Vissers, Kris; van Dongen, Robert; Engels, Yvonne

    2017-07-25

    Spinal cord stimulation (SCS) is an effective therapy to reduce pain in patients that suffer from failed back surgery syndrome (FBSS). In order to inform patients optimally prior to this therapy, knowing their expectations is crucial. Thirteen patients suffering from FBSS and scheduled for SCS were interviewed, using a semi-structured protocol. Patients were interviewed either at home or at their treating hospital. Data from these interviews were analyzed using directed content analysis. In addition to the qualitative interviews, an adjusted Brief Pain Inventory (BPI-) questionnaire was used to quantify expectations. The expectations of patients with regard to SCS could be subdivided into 13 categories, which could be grouped into six general themes: 1) physical well-being, 2) social well-being, 3) material well-being, 4) emotional well-being, 5) development and activity and 6) constraints of the procedure of SCS. These findings confirm patients' expectations about the improvement of their quality of life by SCS for FBSS. This indicates that assessing pain relief is not enough to adequately evaluate the effects of SCS. The small diversity within the studied population and the lack of patient-to-patient education are two possible limitations of this study. To improve education for patients prior to SCS surgery and to evaluate the effects of SCS, a multidimensional approach needs to be implemented. Possible disadvantages of SCS need to be discussed prior to the treatment. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.