Risk factors for local failure requiring salvage neurosurgery after radiosurgery for brain metastases

International Nuclear Information System (INIS)

Weltman, Eduardo; Hanriot, Rodrigo de Morais; Prisco, Flavio Eduardo; Nadalin, Wladimir; Brandt, Reynaldo Andre; Moreira, Frederico Rafael

2004-01-01

Objective: the aim of this study is to select the risk factors for local failure requiring salvage neurosurgery in patients with brain metastases treated with stereotactic radiosurgery in a single institution. Methods: the follow-up of 123 patients, with 255 brain metastases treated with radiosurgery at the Radiation Oncology Department of the Hospital Israelita Albert Einstein from July 1993 to August 2001, was retrospectively analyzed. The criteria for salvage neurosurgery were tumor volume enlargement, or tumor persistence leading to severe neurological symptoms, life threatening situation or critical steroid dependence. We considered the case as local failure when the histopathologic evaluation showed morphologically preserved cancer cells (tumor recurrence, persistence or progression). We applied the Fisher's exact test to evaluate the statistical correlation between local failure and primary tumor histology, volume of the brain metastases, prescribed radiosurgery dose, and whole brain radiotherapy. Results: fourteen of 123 patients (11%) underwent salvage neurosurgery. Histology showed preserved cancer cells with necrosis and/or bleeding in 11 cases (9% of the total accrual), and only necrosis with or without bleeding (without preserved cancer cells) in three cases. The primary tumor histology among the 11 patients considered with active neoplasia was malignant melanoma in five cases (21% of the patients with melanoma), breast adenocarcinoma in three (16% of the patients with breast cancer), and other histology in the remaining three. Breast cancer diagnosis, non-elective whole brain irradiation, volume of the brain metastases, and the prescribed radiosurgery dose did not correlate with the risk of local failure. Patients treated with elective whole brain radiotherapy showed fewer local failures, when compared to all patients receiving whole brain radiotherapy, and to the patients not receiving this treatment, with incidence of failure in 4%,7% and 14

Chemical cleaning's role in tube failure prevention and correction

International Nuclear Information System (INIS)

Shields, K.J.; Dooley, R.B.

2002-01-01

Properly applied, chemical cleaning is a valuable tool used to prevent tube failures involving overheating and corrosion due to waterside deposits. In many cases, however, cleaning becomes yet an additional cost associated with correction of tube failure incidents. Discussion is focused on approaches taken to appraise tube waterside cleanliness and determine the need to clean, as typically practiced in conventional fossil plants. Also presented is an assessment of the suitability and limitations of these approaches to plants with heat recovery steam generator (HRSG) units. (orig.)

Patterns of failure after involved field radiotherapy for locally advanced esophageal squamous cell carcinoma.

Science.gov (United States)

Li, Duo-Jie; Li, Hong-Wei; He, Bin; Wang, Geng-Ming; Cai, Han-Fei; Duan, Shi-Miao; Liu, Jing-Jing; Zhang, Ya-Jun; Cui, Zhen; Jiang, Hao

2016-01-01

To retrospectively analyze the patterns of failure and the treatment effects of involved-field irradiation (IFI) on patients treated with locally advanced esophageal squamous cell carcinoma (ESCC) and to determine whether IFI is practicable in these patients. A total of 79 patients with locally advanced ESCC underwent three dimensional conformal (3D)CRT) or intensity modulated radiotherapy (IMRT) using IFI or elective nodal irradiation (ENI) according to the target volume. The patterns of failure were defined as local/regional, in-field, out)of)field regional lymph node (LN) and distant failure. With a median follow)up of 32.0 months, failures were observed in 66 (83.6%) patients. The cumulative incidence of local/regional failure (55.8 vs 52.8%) and in)field regional lymph node failure (25.6 vs 19.4%) showed no statistically significant difference between the IFI and the ENI group (p=0.526 and 0.215, respectively). Out)of)field nodal relapse rate of only 7.0% was seen in the IFI group. Three)year survival rates for the ENI and IFI group were 22.2 and 18.6%, respectively (p=0.240), and 3)year distant metastasis rates were 27.8 and 32.6%, respectively (p=0.180). The lung V10, V20, V30 and mean lung dose of the ENI group were greater than those of the IFI group, while the mean lung dose and V10 had statistically significant difference. The patterns of failure and survival rates in the IFI group were similar as in the ENI group; the regional recurrence and distant metastasis are the main cause of treatment failure. IFI is feasible for locally advanced ESCC. Further investigation is needed to increase local control and decrease distant metastasis in these patients.

Cladding failure by local plastic instability

International Nuclear Information System (INIS)

Kramer, J.M.; Deitrich, L.W.

1977-01-01

Cladding failure is one of the major considerations in analysis of fast-reactor fuel pin behavior during hypothetical accident transients since time, location and nature of failure govern the early post-failure material motion and reactivity feedback. Out-of-Pile transient burst tests of both irradiated and unirradiated fast-reactor cladding show that local plastic instability, or bulging, often precedes rupture. To investigate the details of cladding bulging, a perturbation analysis of the equations governing the large deformation of a cylindrical shell has been developed. The overall deformation history is assumed to consist of a small perturbation epsilon of the radial displacement superimposed on large axisymmetric displacements. Computations have been carried out using high temperature properties of stainless steel in conjunction with various constitutive theories, including a generalization of the Endochronic Theory of Plasticity in which both time-independent and time-dependent plastic strains are modeled. Although the results of the calculations are all qualitatively similar, it appears that modeling of both time-independent and time-dependent plastic strains is necessary to interpret the transient burst test results. Sources for bulge formation that have been considered include initial geometric imperfections and thermal perturbations due to either eccentric fuel pellets or non-symmetric cooling. (Auth.)

Periodic imperfect preventive maintenance with two categories of competing failure modes

Energy Technology Data Exchange (ETDEWEB)

Zequeira, R.I. [ISTIT FRE CNRS 2732-Equipe LM2S, Universite de Technologie de Troyes, 12 rue Marie Curie, BP 2060, 10010 Troyes (France)]. E-mail: romulo.zequeira@utt.fr; Berenguer, C. [ISTIT FRE CNRS 2732-Equipe LM2S, Universite de Technologie de Troyes, 12 rue Marie Curie, BP 2060, 10010 Troyes (France)]. E-mail: christophe.berenguer@utt.fr

2006-04-15

A maintenance policy is studied for a system with two types of failure modes: maintainable and non-maintainable. The quality of maintenance actions is modelled by its effect on the system failure rate. Preventive maintenance actions restore the system to a condition between as good as new and as bad as immediately before the maintenance action. The model presented permits to study the equipment condition improvement (improvement factor) as a function of the time of the preventive maintenance action. The determination of the maintenance policy, which minimizes the cost rate for an infinite time span, is examined. Conditions are given under which a unique optimal policy exists.

Periodic imperfect preventive maintenance with two categories of competing failure modes

International Nuclear Information System (INIS)

Zequeira, R.I.; Berenguer, C.

2006-01-01

A maintenance policy is studied for a system with two types of failure modes: maintainable and non-maintainable. The quality of maintenance actions is modelled by its effect on the system failure rate. Preventive maintenance actions restore the system to a condition between as good as new and as bad as immediately before the maintenance action. The model presented permits to study the equipment condition improvement (improvement factor) as a function of the time of the preventive maintenance action. The determination of the maintenance policy, which minimizes the cost rate for an infinite time span, is examined. Conditions are given under which a unique optimal policy exists

Salvage Stereotactic Body Radiation Therapy (SBRT) for Local Failure After Primary Lung SBRT

Energy Technology Data Exchange (ETDEWEB)

Hearn, Jason W.D., E-mail: hearnj@ccf.org; Videtic, Gregory M.M.; Djemil, Toufik; Stephans, Kevin L.

2014-10-01

Purpose: Local failure after definitive stereotactic body radiation therapy (SBRT) for early-stage non-small cell lung cancer (NSCLC) is uncommon. We report the safety and efficacy of SBRT for salvage of local failure after previous SBRT with a biologically effective dose (BED) of ≥100 Gy{sub 10}. Methods and Materials: Using an institutional review board–approved lung SBRT registry, we identified all patients initially treated for early-stage NSCLC between August 2004 and January 2012 who received salvage SBRT for isolated local failure. Failure was defined radiographically and confirmed histologically unless contraindicated. All patients were treated on a Novalis/BrainLAB system using ExacTrac for image guidance, and received a BED of ≥100 Gy{sub 10} for each SBRT course. Tumor motion control involved a Bodyfix vacuum system for immobilization along with abdominal compression. Results: Of 436 patients treated from August 2004 through January 2012, we identified 22 patients with isolated local failure, 10 of whom received SBRT for salvage. The median length of follow-up was 13.8 months from salvage SBRT (range 5.3-43.5 months). Median tumor size was 3.4 cm (range 1.7-4.8 cm). Two of the 10 lesions were “central” by proximity to the mediastinum, but were outside the zone of the proximal bronchial tree. Since completing salvage, 3 patients are alive and without evidence of disease. A fourth patient died of medical comorbidities without recurrence 13.0 months after salvage SBRT. Two patients developed distant disease only. Four patients had local failure. Toxicity included grade 1-2 fatigue (3 patients) and grade 1-2 chest wall pain (5 patients). There was no grade 3-5 toxicity. Conclusions: Repeat SBRT with a BED of ≥100 Gy{sub 10} after local failure in patients with early-stage medically inoperable NSCLC was well tolerated in this series and may represent a viable salvage strategy in select patients with peripheral tumors ≤5 cm.

Safety of the pressure vessels of water reactors. Prevention of sudden failure

International Nuclear Information System (INIS)

Petrequin, P.; Barrachin, B.

1975-01-01

From the safety view point the primary circuit is considered as the essential barrier against the diffusion of radioactive products in the event of fuel element failure. The safety of the vessel itself, the failure of which is not accounted for in accident analyses, is based chiefly on a series of preventive measures such as the suitable choice of materials and manufacturing process, compliances with detailed specifications concerning tests and defect tolerances, supervision in service. All these points are examined in detail when the safety analysis is performed. In this context the Service de Recherches Metallurgiques Appliquees assists the Department de Surete Nucleaire in the study of special problems such as the prevention of sudden failure and the characterisation of steels as a function of working conditions, particularly neutron irradiation. The report is thus devoted mainly to the presentation of methods to prevent sudden failure, with special emphasis on the limits of application. Some results obtained at the Service de Recherches Metallurgiques Appliquees on steels typical of those used for water reactor vessels (A533 and A508Cl.3) are given by way of example. Part two concentrates on the role of various factors influencing embrittlement by irradiation [fr

Engaging local businesses in HIV prevention efforts: the consumer perspective.

Science.gov (United States)

Phillips-Guzman, Christina M; Martinez-Donate, Ana P; Hovell, Melbourne F; Blumberg, Elaine J; Sipan, Carol L; Rovniak, Liza S; Kelley, Norma J

2011-07-01

Participation of different community sectors, including the private business sector, is necessary to fight the HIV/AIDS epidemic. Local businesses may be reluctant to participate in HIV prevention because of fear of negative customer reactions and loss of revenue. This study examines the extent to which residents of two communities in San Diego, California, would support HIV prevention initiatives in local businesses. A population-based household survey (N = 200) is conducted in two communities with higher versus lower risk for HIV. The survey includes questions regarding the acceptability of HIV prevention activities, such as condom and brochure distribution in businesses, and history of exposure to HIV prevention activities in local businesses. Most residents agree that (a) business involvement in prevention activities would reduce HIV (92%), (b) free or low-cost condoms available in businesses could prevent the spread of HIV (90.9%) and increase condom accessibility (87%), and (c) they would prefer to shop at businesses that supported HIV prevention versus those that did not (87.4%). These findings suggest that HIV prevention in local businesses would be supported by residents and would be unlikely to adversely affect business profits. This information could be used to design interventions to engage local businesses in HIV-prevention efforts.

Prevention of bolting degradation or failure in pressure boundary and support applications

International Nuclear Information System (INIS)

Merrick, E.A.; Rivers, A.; Bickford, J.; Marston, T.U.

1986-01-01

A discussion is presented of bolting degradation or failure experience in pressure boundary and component support applications in US commercial nuclear plants and the industry program to prevent failures in the future. The focus turns to steps which plant owners can take today to guard against pressure boundary bolt failure or degradation for existing plants or units being constructed. 'Tools' or products which the plant owner can expect from current industry programs which will be available in the near future to aid in understanding and improving bolting practices are described. (author)

Ductile failure analysis of API X65 pipes with notch-type defects using a local fracture criterion

International Nuclear Information System (INIS)

Oh, Chang-Kyun; Kim, Yun-Jae; Baek, Jong-Hyun; Kim, Young-Pyo; Kim, Woo-Sik

2007-01-01

A local failure criterion for API X65 steel is applied to predict ductile failure of full-scale API X65 pipes with simulated corrosion and gouge defects under internal pressure. The local failure criterion is the stress-modified fracture strain as a function of the stress triaxiality (defined by the ratio of the hydrostatic stress to the effective stress). Based on detailed finite element (FE) analyses with the proposed local failure criterion, burst pressures of defective pipes are estimated and compared with experimental data. For pipes with simulated corrosion defects, FE analysis with the proposed local fracture criterion indicates that predicted failure takes place after the defective pipes attain maximum loads for all cases, possibly due to the fact that the material has sufficient ductility. For pipes with simulated gouge defects, on the other hand, it is found that predicted failure takes place before global instability, and the predicted burst pressures are in good agreement with experimental data, providing confidence in the present approach

Supersonic Localized Excitations Mediate Microscopic Dynamic Failure

Science.gov (United States)

Ghaffari, H. O.; Griffith, W. A.; Pec, M.

2017-12-01

A moving rupture front activates a fault patch by increasing stress above a threshold strength level. Subsequent failure yields fast slip which releases stored energy in the rock. A fraction of the released energy is radiated as seismic waves carrying information about the earthquake source. While this simplified model is widely accepted, the detailed evolution from the onset of dynamic failure to eventual re-equilibration is still poorly understood. To study dynamic failure of brittle solids we indented thin sheets of single mineral crystals and recorded the emitted ultrasound signals (high frequency analogues to seismic waves) using an array of 8 to 16 ultrasound probes. The simple geometry of the experiments allows us to unravel details of dynamic stress history of the laboratory earthquake sources. A universal pattern of failure is observed. First, stress increases over a short time period (1 - 2 µs), followed by rapid weakening (≈ 15 µs). Rapid weakening is followed by two distinct relaxation phases: a temporary quasi-steady state phase (10 µs) followed by a long-term relaxation phase (> 50 µs). We demonstrate that the dynamic stress history during failure is governed by formation and interaction of local non-dispersive excitations, or solitons. The formation and annihilation of solitons mediates the microscopic fast weakening phase, during which extreme acceleration and collision of solitons lead to non-Newtonian behavior and Lorentz contraction, i.e. shortening of solitons' characteristic length. Interestingly, a soliton can propagate as fast as 37 km/s, much faster than the p-wave velocity, implying that a fraction of the energy transmits through soliton excitations. The quasi-steady state phase delays the long-term ageing of the damaged crystal, implying a potentially weaker material. Our results open new horizons for understanding the complexity of earthquake sources, and, more generally, non-equilibrium relaxation of many body systems.

Development of an Advanced Digital Reactor Protection System Using Diverse Dual Processors to Prevent Common-Mode Failure

International Nuclear Information System (INIS)

Shin, Hyun Kook; Nam, Sang Ku; Sohn, Se Do; Chang, Hoon Seon

2003-01-01

The advanced digital reactor protection system (ADRPS) with diverse dual processors has been developed to prevent common-mode failure (CMF). The principle of diversity is applied to both hardware design and software design. For hardware diversity, two different types of CPUs are used for the bistable processor and local coincidence logic (LCL) processor. The Versa Module Eurocard-based single board computers are used for the CPU hardware platforms. The QNX operating system and the VxWorks operating system were selected for software diversity. Functional diversity is also applied to the input and output modules, and to the algorithm in the bistable processors and LCL processors. The characteristics of the newly developed digital protection system are described together with the preventive capability against CMF. Also, system reliability analysis is discussed. The evaluation results show that the ADRPS has a good preventive capability against the CMF and is a highly reliable reactor protection system

Antimetabolites in cataract surgery to prevent failure of a previous trabeculectomy.

Science.gov (United States)

Thomas, Roger E; Crichton, Andrew; Thomas, Bennett C

2014-07-28

Patients having cataract surgery have often earlier undergone a trabeculectomy for glaucoma. However, cataract surgery may be associated with failure of the previous glaucoma surgery and antimetabolites may be used with cataract surgery to prevent such failure. There is no systematic review on whether antimetabolites with cataract surgery prevent failure of a previous trabeculectomy. To assess the effects of antimetabolites with cataract surgery on functioning of a previous trabeculectomy. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 5), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to June 2014), EMBASE (January 1980 to June 2014), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to June 2014), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 10 June 2014. We also searched the Science Citation Index database (July 2013) and reference lists of potentially relevant studies. Randomised controlled trials (RCTs) of antimetabolites with cataract surgery in people with a functioning trabeculectomy. Two review authors independently reviewed the titles and abstracts from the electronic searches. Two review authors independently assessed relevant full-text articles and entered data. We identified no RCTs to test the effectiveness of antimetabolites with cataract surgery in individuals with the intention of preventing failure of a previous trabeculectomy. There are no RCTs of antimetabolites with cataract surgery in people with a functioning trabeculectomy. Appropriately powered RCTs

On possibilities of using global monitoring in effective prevention of tailings storage facilities failures.

Science.gov (United States)

Stefaniak, Katarzyna; Wróżyńska, Magdalena

2018-02-01

Protection of common natural goods is one of the greatest challenges man faces every day. Extracting and processing natural resources such as mineral deposits contributes to the transformation of the natural environment. The number of activities designed to keep balance are undertaken in accordance with the concept of integrated order. One of them is the use of comprehensive systems of tailings storage facility monitoring. Despite the monitoring, system failures still occur. The quantitative aspect of the failures illustrates both the scale of the problem and the quantitative aspect of the consequences of tailings storage facility failures. The paper presents vast possibilities provided by the global monitoring in the effective prevention of these failures. Particular attention is drawn to the potential of using multidirectional monitoring, including technical and environmental monitoring by the example of one of the world's biggest hydrotechnical constructions-Żelazny Most Tailings Storage Facility (TSF), Poland. Analysis of monitoring data allows to take preventive action against construction failures of facility dams, which can have devastating effects on human life and the natural environment.

'NTA', a locally named unclear condition that causes failure to thrive ...

African Journals Online (AJOL)

'NTA', a locally named unclear condition that causes failure to thrive amongst under five children in southeastern Nigeria: An assessment of mothers' and caregivers' perception of its causes and management.

Genre-Specific Cultivation Effects: Lagged Associations between Overall TV Viewing, Local TV News Viewing, and Fatalistic Beliefs about Cancer Prevention.

Science.gov (United States)

Lee, Chul-Joo; Niederdeppe, Jeff

2011-12-01

Cultivation theory and research has been criticized for its failure to consider variation in effects by genre, employ appropriate third-variable controls, and determine causal direction. Recent studies, controlling for a variety of demographic characteristics and media use variables, have found that exposure to local television (TV) newscasts is associated with a variety of problematic "real-world" beliefs. However, many of these studies have not adequately assessed causal direction. Redressing this limitation, we analyzed data from a two-wave national representative survey which permitted tests of lagged association between overall TV viewing, local TV news viewing, and fatalistic beliefs about cancer prevention. We first replicated the original cultivation effect and found a positive association between overall TV viewing at time 1 and increased fatalistic beliefs about cancer prevention at time 2. Analyses also provided evidence that local TV news viewing at time 1 predicts increased fatalistic beliefs about cancer prevention at time 2. There was little evidence for reverse causation in predicting changes in overall TV viewing or local TV news viewing. The paper concludes with a discussion of theoretical and practical implications of these findings.

Evaluation of a cavity flooding strategy for the prevention of reactor vessel failure in a severe accident

Energy Technology Data Exchange (ETDEWEB)

Park, Rae Joon; Je, Moo Sung; Park, Chang Kyoo [Korea Atomic Energy Research Institute, TaeJon (Korea, Republic of)

1994-10-01

As a part of the evaluation of accident management strategies for severe accident prevention or mitigation in a station blackout scenario for YGN 3 and 4, an external vessel cooling strategy for the prevention of reactor vessel failure has been estimated using the MAAP4 computer code. The sensitivity studies have been performed such as actuating timings and the number of spray pumps used. To explore external vessel cooling strategies, containment spray pumps were actuated by varying time spanning core uncovery, core melting and relocation of molten core material. It was shown that flooding of the reactor cavity using the containment spray system may prevent reactor vessel failure but may not prevent the failure of the relocation of molten core material during the station blackout sequence of YGN 3 and 4. Reactor vessel failure can be prevented by external vessel cooling using condensed water from the operation of two containment spray pumps at the time of core melting and using water from the operation of one containment spray pumps at the time of core melting and using water from the operation of one containment spray pump at the time of core uncovery. (Author) 46 refs., 26 figs., 5 tabs.

Preventing blood transfusion failures: FMEA, an effective assessment method.

Science.gov (United States)

Najafpour, Zhila; Hasoumi, Mojtaba; Behzadi, Faranak; Mohamadi, Efat; Jafary, Mohamadreza; Saeedi, Morteza

2017-06-30

Failure Mode and Effect Analysis (FMEA) is a method used to assess the risk of failures and harms to patients during the medical process and to identify the associated clinical issues. The aim of this study was to conduct an assessment of blood transfusion process in a teaching general hospital, using FMEA as the method. A structured FMEA was recruited in our study performed in 2014, and corrective actions were implemented and re-evaluated after 6 months. Sixteen 2-h sessions were held to perform FMEA in the blood transfusion process, including five steps: establishing the context, selecting team members, analysis of the processes, hazard analysis, and developing a risk reduction protocol for blood transfusion. Failure modes with the highest risk priority numbers (RPNs) were identified. The overall RPN scores ranged from 5 to 100 among which, four failure modes were associated with RPNs over 75. The data analysis indicated that failures with the highest RPNs were: labelling (RPN: 100), transfusion of blood or the component (RPN: 100), patient identification (RPN: 80) and sampling (RPN: 75). The results demonstrated that mis-transfusion of blood or blood component is the most important error, which can lead to serious morbidity or mortality. Provision of training to the personnel on blood transfusion, knowledge raising on hazards and appropriate preventative measures, as well as developing standard safety guidelines are essential, and must be implemented during all steps of blood and blood component transfusion.

Intensity-Modulated Radiotherapy for Oral Cavity Squamous Cell Carcinoma: Patterns of Failure and Predictors of Local Control

International Nuclear Information System (INIS)

Daly, Megan E.; Le, Quynh-Thu; Kozak, Margaret M.; Maxim, Peter G.; Murphy, James D.; Hsu, Annie; Loo, Billy W.; Kaplan, Michael J.; Fischbein, Nancy J.; Chang, Daniel T.

2011-01-01

Purpose: Few studies have evaluated the use of intensity-modulated radiotherapy (IMRT) for squamous cell carcinoma (SCC) of the oral cavity (OC). We report clinical outcomes and failure patterns for these patients. Methods and Materials: Between October 2002 and June 2009, 37 patients with newly diagnosed SCC of the OC underwent postoperative (30) or definitive (7) IMRT. Twenty-five patients (66%) received systemic therapy. The median follow-up was 38 months (range, 10-87 months). The median interval from surgery to RT was 5.9 weeks (range, 2.1-10.7 weeks). Results: Thirteen patients experienced local-regional failure at a median of 8.1 months (range, 2.4-31.9 months), and 2 additional patients experienced local recurrence between surgery and RT. Seven local failures occurred in-field (one with simultaneous nodal and distant disease) and two at the margin. Four regional failures occurred, two in-field and two out-of-field, one with synchronous metastases. Six patients experienced distant failure. The 3-year actuarial estimates of local control, local-regional control, freedom from distant metastasis, and overall survival were 67%, 53%, 81%, and 60% among postoperative patients, respectively, and 60%, 60%, 71%, and 57% among definitive patients. Four patients developed Grade ≥2 chronic toxicity. Increased surgery to RT interval predicted for decreased LRC (p = 0.04). Conclusions: Local-regional control for SCC of the OC treated with IMRT with or without surgery remains unsatisfactory. Definitive and postoperative IMRT have favorable toxicity profiles. A surgery-to-RT interval of <6 weeks improves local-regional control. The predominant failure pattern was local, suggesting that both improvements in target delineation and radiosensitization and/or dose escalation are needed.

SU-F-R-20: Image Texture Features Correlate with Time to Local Failure in Lung SBRT Patients

Energy Technology Data Exchange (ETDEWEB)

Andrews, M; Abazeed, M; Woody, N; Stephans, K; Videtic, G; Xia, P; Zhuang, T [The Cleveland Clinic Foundation, Cleveland, OH (United States)

2016-06-15

Purpose: To explore possible correlation between CT image-based texture and histogram features and time-to-local-failure in early stage non-small cell lung cancer (NSCLC) patients treated with stereotactic body radiotherapy (SBRT).Methods and Materials: From an IRB-approved lung SBRT registry for patients treated between 2009–2013 we selected 48 (20 male, 28 female) patients with local failure. Median patient age was 72.3±10.3 years. Mean time to local failure was 15 ± 7.1 months. Physician-contoured gross tumor volumes (GTV) on the planning CT images were processed and 3D gray-level co-occurrence matrix (GLCM) based texture and histogram features were calculated in Matlab. Data were exported to R and a multiple linear regression model was used to examine the relationship between texture features and time-to-local-failure. Results: Multiple linear regression revealed that entropy (p=0.0233, multiple R2=0.60) from GLCM-based texture analysis and the standard deviation (p=0.0194, multiple R2=0.60) from the histogram-based features were statistically significantly correlated with the time-to-local-failure. Conclusion: Image-based texture analysis can be used to predict certain aspects of treatment outcomes of NSCLC patients treated with SBRT. We found entropy and standard deviation calculated for the GTV on the CT images displayed a statistically significant correlation with and time-to-local-failure in lung SBRT patients.

SU-F-R-20: Image Texture Features Correlate with Time to Local Failure in Lung SBRT Patients

International Nuclear Information System (INIS)

Andrews, M; Abazeed, M; Woody, N; Stephans, K; Videtic, G; Xia, P; Zhuang, T

2016-01-01

Purpose: To explore possible correlation between CT image-based texture and histogram features and time-to-local-failure in early stage non-small cell lung cancer (NSCLC) patients treated with stereotactic body radiotherapy (SBRT).Methods and Materials: From an IRB-approved lung SBRT registry for patients treated between 2009–2013 we selected 48 (20 male, 28 female) patients with local failure. Median patient age was 72.3±10.3 years. Mean time to local failure was 15 ± 7.1 months. Physician-contoured gross tumor volumes (GTV) on the planning CT images were processed and 3D gray-level co-occurrence matrix (GLCM) based texture and histogram features were calculated in Matlab. Data were exported to R and a multiple linear regression model was used to examine the relationship between texture features and time-to-local-failure. Results: Multiple linear regression revealed that entropy (p=0.0233, multiple R2=0.60) from GLCM-based texture analysis and the standard deviation (p=0.0194, multiple R2=0.60) from the histogram-based features were statistically significantly correlated with the time-to-local-failure. Conclusion: Image-based texture analysis can be used to predict certain aspects of treatment outcomes of NSCLC patients treated with SBRT. We found entropy and standard deviation calculated for the GTV on the CT images displayed a statistically significant correlation with and time-to-local-failure in lung SBRT patients.

Bridging the gap in heart failure prevention: rationale and design of the Nurse-led Intervention for Less Chronic Heart Failure (NIL-CHF) Study

DEFF Research Database (Denmark)

Carrington, Melinda J; Stewart, Simon; de Courten, Barbora

2010-01-01

AIMS: The primary objective of the Nurse-led Intervention for Less Chronic Heart Failure (NIL-CHF) Study is to develop a programme of care that cost-effectively prevents the development of chronic heart failure (CHF). Methods NIL-CHF is a randomized controlled trial of a hybrid, home- and clinic-...

Radiotherapy in desmoid tumors. Treatment response, local control, and analysis of local failures

Energy Technology Data Exchange (ETDEWEB)

Santti, Kirsi; Beule, Annette; Tuomikoski, Laura; Jaeaeskelaeinen, Anna-Stina; Saarilahti, Kauko; Tarkkanen, Maija; Blomqvist, Carl [Helsinki University Hospital and University of Helsinki, Comprehensive Cancer Center, Helsinki (Finland); Roenty, Mikko [HUSLAB and University of Helsinki, Department of Pathology, Helsinki (Finland); Ihalainen, Hanna [Helsinki University Hospital and University of Helsinki, Department of Plastic Surgery, Helsinki (Finland)

2017-04-15

Desmoid tumors (aggressive fibromatosis) are rare soft tissue tumors which frequently recur after surgery. Desmoid tumors arise from musculoaponeurotic tissue in the extremities, head and neck, abdominal wall, or intra-abdominally. Our aim was to examine the outcome of radiotherapy of desmoid tumors in a single institution series. We evaluated 41 patients with desmoid tumors treated with 49 radiotherapies between 1987 and 2012. Radiologic images for response evaluation were reassessed and responses to treatment registered according to RECIST criteria 1.1. For patients with local failures radiation dose distribution was determined in each local failure volume using image co-registration. Recurrences were classified as in-target, marginal, or out-of-target. Prognostic factors for radiotherapy treatment failure were evaluated. Radiotherapy doses varied from 20-63 Gy (median 50 Gy) with a median fraction size of 2 Gy. The objective response rate to definitive radiotherapy was 55% (12/22 patients). Median time to response was 14 months. A statistically significant dose-response relation for definitive and postoperative radiotherapy was observed both in univariate (p-value 0.002) and in multivariate analysis (p-value 0.02) adjusted for potential confounding factors. Surgery before radiotherapy or surgical margin had no significant effect on time to progression. Nine of 11 (82%) local failures were classified as marginal and two of 11 (18%) in-target. None of the recurrences occurred totally out-of-target. Radiotherapy is a valuable option for treating desmoid tumors. Radiotherapy dose appears to be significantly associated to local control. (orig.) [German] Desmoide (aggressive Fibromatosen) sind seltene Weichteiltumore der muskulaeren Membranen von Kopf, Hals, Extremitaeten und Bauchwand. Ziel war es, die Wirksamkeit der Strahlentherapie bei aggressiver Fibromatose an einer einzelnen Klinik zu untersuchen. Ausgewertet wurden 41 Patienten mit aggressiver Fibromatose, die

Single-stage Kanban system with deterioration failures and condition-based preventive maintenance

International Nuclear Information System (INIS)

Xanthopoulos, A.S.; Koulouriotis, D.E.; Botsaris, P.N.

2015-01-01

Despite the fact that the fields of pull type production control policies and condition-based preventive maintenance have much in common contextually, they have evolved independently up to now. In this investigation, an attempt is made to bridge the gap between these two branches of knowledge by introducing the single-stage Kanban system with deterioration failures and condition-based preventive maintenance. The formalism of continuous time Markov chains is used to model the system and expressions for eight performance metrics are derived. Two important, from a managerial perspective, constrained optimization problems for the proposed model are defined where the objective is the simultaneous optimization of the Kanban policy, the preventive maintenance policy and the inspection schedule under conflicting performance criteria. Multiple instances of each optimization problem are solved by means of the augmented Lagrangian genetic algorithm. The results from the optimization trials coupled by the results from extensive numerical examples facilitate the thorough investigation of the system’s behaviour. - Highlights: • Kanban system with deterioration failures and preventive maintenance is introduced. • The system is modeled as a continuous time Markov chain. • Expressions for eight performance metrics are derived. • The behavior of the system is studied through numerical examples. • Optimization results for selected performance metrics are presented

The Effect of Fiber Strength Stochastics and Local Fiber Volume Fraction on Multiscale Progressive Failure of Composites

Science.gov (United States)

Ricks, Trenton M.; Lacy, Jr., Thomas E.; Bednarcyk, Brett A.; Arnold, Steven M.

2013-01-01

Continuous fiber unidirectional polymer matrix composites (PMCs) can exhibit significant local variations in fiber volume fraction as a result of processing conditions that can lead to further local differences in material properties and failure behavior. In this work, the coupled effects of both local variations in fiber volume fraction and the empirically-based statistical distribution of fiber strengths on the predicted longitudinal modulus and local tensile strength of a unidirectional AS4 carbon fiber/ Hercules 3502 epoxy composite were investigated using the special purpose NASA Micromechanics Analysis Code with Generalized Method of Cells (MAC/GMC); local effective composite properties were obtained by homogenizing the material behavior over repeating units cells (RUCs). The predicted effective longitudinal modulus was relatively insensitive to small (8%) variations in local fiber volume fraction. The composite tensile strength, however, was highly dependent on the local distribution in fiber strengths. The RUC-averaged constitutive response can be used to characterize lower length scale material behavior within a multiscale analysis framework that couples the NASA code FEAMAC and the ABAQUS finite element solver. Such an approach can be effectively used to analyze the progressive failure of PMC structures whose failure initiates at the RUC level. Consideration of the effect of local variations in constituent properties and morphologies on progressive failure of PMCs is a central aspect of the application of Integrated Computational Materials Engineering (ICME) principles for composite materials.

Understanding the role of waste prevention in local waste management: A literature review.

Science.gov (United States)

Zacho, Kristina O; Mosgaard, Mette A

2016-10-01

Local waste management has so far been characterised by end-of-pipe solutions, landfilling, incineration, and recycling. End-of-pipe solutions build on a different mind-set than life cycle-based approaches, and for this reason, local waste managers are reluctant to consider strategies for waste prevention. To accelerate the transition of waste and resource management towards a more integrated management, waste prevention needs to play a larger role in the local waste management. In this review article, we collect knowledge from the scientific community on waste prevention of relevance to local waste management. We analyse the trends in the waste prevention literature by organising the literature into four categories. The results indicate an increasing interest in waste prevention, but not much literature specifically concerns the integration of prevention into the local waste management. However, evidence from the literature can inform local waste management on the prevention potential; the environmental and social effects of prevention; how individuals in households can be motivated to reduce waste; and how the effects of prevention measures can be monitored. Nevertheless, knowledge is still lacking on local waste prevention, especially regarding the methods for monitoring and how local waste management systems can be designed to encourage waste reduction in the households. We end the article with recommendations for future research. The literature review can be useful for both practitioners in the waste sector and for academics seeking an overview of previous research on waste prevention. © The Author(s) 2016.

Crack phantoms: localized damage correlations and failure in network models of disordered materials

International Nuclear Information System (INIS)

Zaiser, M; Moretti, P; Lennartz-Sassinek, S

2015-01-01

We study the initiation of failure in network models of disordered materials such as random fuse and spring models, which serve as idealized representations of fracture processes in quasi-two-dimensional, disordered material systems. We consider two different geometries, namely rupture of thin sheets and delamination of thin films, and demonstrate that irrespective of geometry and implementation of the disorder (random failure thresholds versus dilution disorder) failure initiation is associated with the emergence of typical localized correlation structures in the damage patterns. These structures (‘crack phantoms’) exhibit well-defined characteristic lengths, which relate to the failure stress by scaling relations that are typical for critical crack nuclei in disorder-free materials. We discuss our findings in view of the fundamental nature of failure processes in materials with random microstructural heterogeneity. (paper)

Monitoring burst (M-burst) — A novel framework of failure localization in all-optical mesh networks

KAUST Repository

Ali, Mohammed L.; Ho, Pin-Han; Wu, Bin; Tapolcai, Janos; Shihada, Basem

2011-01-01

Achieving instantaneous and precise failure localization in all-optical wavelength division multiplexing (WDM) networks has been an attractive feature of network fault management systems, and is particularly important when failure

M-Burst: A Framework of SRLG Failure Localization in All-Optical Networks

KAUST Repository

Ali, Mohammed L.; Ho, Pin-Han; Tapolcai, Já nos; Shihada, Basem

2012-01-01

Fast and unambiguous failure localization for shared risk link groups (SRLGs) with multiple links is essential for building a fully survivable and functional transparent all-optical mesh network. Monitoring trails (m-trails) have been proposed

Local authorities facing flood related networks failures in France

Directory of Open Access Journals (Sweden)

Gallet Violette

2016-01-01

Full Text Available Network critical infrastructures have become vital to keep our societies running in every-day situations, but also during crisis and recovery. Involving many stakeholders at different scales, they form a complex system that can be easily disturbed by internal or external events, because then all the dependencies that allow to optimizing their working become flaws that help failures to spread beyond the flooded area and from one network to another. Thus every flood reminds us how vulnerable infrastructures are and how much it costs when they fail. But whereas it isn’t so difficult to adapt new urban development, what about all the existing and exposed infrastructures? CEPRI carried out research on encountered difficulties and good practices to understand the situation and consider improvement opportunities. We worked out three steps to a better territory resilience to flood. First, get a better knowledge of networks. Then, as far as possible, reduce networks vulnerability. Finally, as risks of network failures always remain, get prepared to cope with disruptions! CEPRI gathered many experiences to illustrate and strengthen its work, which aims at helping local authorities to reduce their vulnerability to flood and related networks failures.

Electrical failure during cardiopulmonary bypass: an evaluation of incidence, causes, management and guidelines for preventative measures.

LENUS (Irish Health Repository)

Hargrove, M

2012-02-03

The incidence of electrical failure during cardiopulmonary bypass (CPB) has been reported to occur in approximately 1 per 1000 cases. While the resultant morbidity and mortality is low, electrical failure is a life-threatening scenario. We report three major electrical failures during CPB in a patient population of 3500 over a 15-year period. These cases involved mains failure and generator shut down, mains failure and generator power surge, and failure of the uninterruptable power supply (UPS), which caused protected sockets to shut down. Protocols for preventative maintenance, necessary equipment, battery backup and guidelines for the successful management of such accidents during CPB are discussed.

Effect on localized waste-container failure on radionuclide transport from an underground nuclear waste vault

International Nuclear Information System (INIS)

Cheung, S.C.H.; Chan, T.

1983-07-01

In the geological disposal of nuclear fuel waste, one option is to emplace the waste container in a borehole drilled into the floor of the underground vault. In the borehole, the waste container is surrounded by a compacted soil material known as the buffer. A finite-element simulation has been performed to study the effect of localized partial failure of the waste container on the steady-state radionuclide transport by diffusion from the container through the buffer to the surrounding rock and/or backfill. In this study, the radionuclide concentration at the buffer-backfill interface is assumed to be zero. Two cases are considered at the interface between the buffer and the rock. In case 1, a no-flux boundary condition is used to simulate intact rock. In case 2, a constant radionuclide concentration condition is used to simulate fractured rock with groundwater flow. The results show that the effect of localized partial failure of the waste container on the total flux is dependent on the boundary condition at the buffer-rock interface. For the intact rock condition, the total flux is mainly dependent on the location of the failure. The total flux increases as the location changes from the bottom to the top of the emplaced waste container. For a given localized failure of the waste container, the total flux remains unaffected by the area of failed surface below the top of the failure. For fractured rock, the total flux is directly proportional to the failed surface area of the waste container regardless of the failure location

A Tool for Preventing Teamwork Failure: the TFP Questionnaire

DEFF Research Database (Denmark)

Qvist, Palle; Rebollar, Rubeén; Lidón, Iván

2010-01-01

This paper presents the process used to devise the Teamwork Failure Prevention Questionnaire (TFP Questionnaire), a tool that allows teams with problems in functioning to be detected early. The TFP Questionnaire was formulated in a project management course at the University of Zaragoza (Spain......). In this course, teams of five or six students have to manage a project for a real client. The questionnaire was then tested on students on this course and on a similar one at Aalborg University (Denmark). This article analyses the psychometric characteristics of the TFP Questionnaire and then presents...

How change management can prevent the failure of information systems implementation among Malaysian government hospitals?

Science.gov (United States)

ChePa, Noraziah; Jasin, Noorhayati Md; Bakar, Nur Azzah Abu

2017-10-01

Fail to prevent or control challenges of Information System (IS) implementation have led to the failure of its implementation. Successful implementation of IS has been a challenging task to any organization including government hospitals. Government has invested a big amount of money on information system (IS) projects to improve service delivery in healthcare. However, several of them failed to be implemented successfully due to several factors. This article proposes a prevention model which incorporated Change Management (CM) concepts to avoid the failure of IS implementation, hence ensuring the success of it. Challenges of IS implementation in government hospitals have been discovered. Extensive literature review and deep interview approaches were employed to discover these challenges. A prevention model has been designed to cater the challenges. The model caters three main phases of implementation; pre-implementation, during implementation, and post-implementation by adopting CM practices of Lewin's, Kotter's and Prosci's CM model. Six elements of CM comprising thirteen sub-elements adopted from the three CM models have been used to handle CFFs of Human and Support issues; guiding team, resistance avoidance, IS adoption, enforcement, monitoring, and IS sustainability. Successful practice of the proposed mapping is expected to prevent CFFs to occur, hence ensuring a successful implementation of IS in the hospitals. The proposed model has been presented and successfully evaluated by the domain experts from the selected hospitals. The proposed model is believed to be beneficial for top management, IT practitioners and medical practitioners in preventing IS implementation failure among government hospitals towards ensuring the success implementation.

Local strategies to prevent and treat osteoporosis.

Science.gov (United States)

Torstrick, F Brennan; Guldberg, Robert E

2014-03-01

Despite advances in systemic osteoporosis therapeutic outcomes, management of fragility fractures and implant fixation in osteoporotic bone remain difficult clinical challenges. Low initial bone density and a prolonged healing response can lead to fracture nonunion and aseptic implant loosening. Local treatment strategies could be used to prevent fracture, accelerate healing, and increase implant fixation by locally stimulating anabolic pathways or inhibiting catabolic pathways. Local strategies under investigation include direct drug release from injectable materials or implant surface coatings. Common locally delivered drugs include bisphosphonates, parathyroid hormone, and bone morphogenetic proteins, yet additional compounds targeting novel pathways in bone biology are also being actively explored. Mechanical stimulation via low intensity pulsed ultrasound, alone or in combination with drug therapy, may also prove effective to promote local bone healing and implant fixation within osteoporotic bone.

Crack arrest concepts for failure prevention and life extension. Proceedings

International Nuclear Information System (INIS)

Wiesner, C.S.

1996-01-01

These proceedings contain the thirteen papers presented at a seminar on crack arrest concepts for failure prevention and life extension. They provide a picture of the current position of crack arrest testing, models and applications, discussion of the relevance of recent research to industrial problems, and an assessment of whether the application of crack arrest models provides additional safety. Separate abstracts have been prepared for seven papers of relevance to the nuclear industry and, in particular, reactor pressure vessels. (UK)

Obesity Prevention: The Impact of Local Health Departments

Science.gov (United States)

Chen, Zhuo (Adam); Roy, Kakoli; Gotway Crawford, Carol A

2013-01-01

Objective To examine the association between bodyweight status and provision of population-based prevention services. Data Sources The National Association of City and County Health Officials 2005 Profile survey data, linked with two cross-sections of the Behavioral Risk Factor Surveillance System (BRFSS) survey in 2004 and 2005. Study Design Multilevel logistic regressions were used to examine the association between provision of obesity-prevention services and the change in risk of being obese or morbidly obese among BRFSS respondents. The estimation sample was stratified by sex. Low-income samples were also examined. Falsification tests were used to determine whether there is counterevidence. Principal Findings Provision of population-based obesity-prevention services within the jurisdiction of local health departments and specifically those provided by the local health departments are associated with reduced risks of obesity and morbid obesity from 2004 to 2005. The magnitude of the association appears to be stronger among low-income populations and among women. Results of the falsification tests provide additional support of the main findings. Conclusions Population-based obesity-prevention services may be useful in containing the obesity epidemic. PMID:22816510

Accident management to prevent containment failure and reduce fission product release

International Nuclear Information System (INIS)

Lehner, J.R.; Lin, C.C.; Luckas, W.J.; Pratt, W.T.

1991-01-01

Brookhaven National Laboratory, under the auspices of the US Nuclear Regulatory Commission, is investigating accident management strategies which could help preserve containment integrity or minimize releases during a severe accident. The strategies considered make use of existing plant systems and equipment in innovative ways to reduce the likelihood of containment failure or to mitigate the release of fission products to the environment if failure cannot be prevented. Many of these strategies would be implemented during the later stages of a severe accident, i.e. after vessel breach, and sizable uncertainties exist regarding some of the phenomena involved. The identification and assessment process for containment and release strategies is described, and some insights derived from its application to specific containment types are presented. 2 refs., 5 figs., 2 tabs

Effects of Educating Local Government Officers and Healthcare and Welfare Professionals in Suicide Prevention

Directory of Open Access Journals (Sweden)

Yoshio Hirayasu

2012-02-01

Full Text Available Suicide is a major public health issue. In Japan, local governments are responsible for suicide prevention, and local government officers are therefore expected to act as gatekeepers for suicide prevention. In this study, through a questionnaire survey, the authors examined the current knowledge and attitudes concerning suicide prevention among local government officers and healthcare and welfare professionals, and the effects of providing suicide prevention education on their knowledge of and attitudes toward suicide and its prevention. One hundred eighty-three local government officers and 432 healthcare/welfare professionals completed the survey before and after a single education session. Before the session, the local government officers and healthcare/welfare professionals showed mainly positive attitudes toward suicide prevention efforts, with little difference between the two groups. After the training, knowledge and attitudes were further improved for most questionnaire items. Respondents with one or more experiences of suicide prevention training showed significantly more knowledge and positive attitudes before the training than those with no such experience. Moreover, knowledge of depression and having a sympathetic attitude were found to be especially associated with the overall attitude that “suicide can be prevented”. Training in suicide prevention was shown to be effective in promoting appropriate knowledge and attitudes among local government officers and healthcare/welfare professionals who are gatekeepers for preventing suicide. Our findings confirm the importance of suicide prevention education, and will contribute to creating a standard educational program on suicide prevention in Japan.

Software verification and validation methodology for advanced digital reactor protection system using diverse dual processors to prevent common mode failure

International Nuclear Information System (INIS)

Son, Ki Chang; Shin, Hyun Kook; Lee, Nam Hoon; Baek, Seung Min; Kim, Hang Bae

2001-01-01

The Advanced Digital Reactor Protection System (ADRPS) with diverse dual processors is being developed by the National Research Lab of KOPEC for ADRPS development. One of the ADRPS goals is to develop digital Plant Protection System (PPS) free of Common Mode Failure (CMF). To prevent CMF, the principle of diversity is applied to both hardware design and software design. For the hardware diversity, two different types of CPUs are used for Bistable Processor and Local Coincidence Logic Processor. The VME based Single Board Computers (SBC) are used for the CPU hardware platforms. The QNX Operating System (OS) and the VxWorks OS are used for software diversity. Rigorous Software Verification and Validation (V and V) is also required to prevent CMF. In this paper, software V and V methodology for the ADRPS is described to enhance the ADRPS software reliability and to assure high quality of the ADRPS software

Local government`s pollution prevention program

Energy Technology Data Exchange (ETDEWEB)

Swanson, D. [Boulder Country Pollution Prevention Program, Boulder, CO (United States)

1996-12-31

The pollution prevention program operated by the Health Department of Boulder County is called Business Partners for a Clean Environment (Business Partners). It is a cooperative effort among local businesses, the City of Boulder, Boulder County, and the Boulder Chamber of Commerce. This nonregulatory, incentive-based program provides industry with pollution prevention information and technical assistance necessary to reduce and/or eliminate environmental waste. This paper provides an overview of the program development, creation of partnerships and trust, and some of the results from implementation of the program. Following the first 18 months of the program, 35 businesses were recognized as Business Partners. The Business Partners program has also received an achievement award from the National Association of Counties for promoting {open_quotes}responsible, responsive, and effective government{close_quotes} and two governor`s awards from the State of Colorado. Participating businesses have demonstrated that a pollution prevention program can reduce environmental waste, increase employee safety, and decrease costs. 4 refs., 4 figs., 5 tabs.

An Experimental Investigation into Failure and Localization Phenomena in the Extension to Shear Fracture Transition in Rock

Science.gov (United States)

Choens, R. C., II; Chester, F. M.; Bauer, S. J.; Flint, G. M.

2014-12-01

Fluid-pressure assisted fracturing can produce mesh and other large, interconnected and complex networks consisting of both extension and shear fractures in various metamorphic, magmatic and tectonic systems. Presently, rock failure criteria for tensile and low-mean compressive stress conditions is poorly defined, although there is accumulating evidence that the transition from extension to shear fracture with increasing mean stress is continuous. We report on the results of experiments designed to document failure criteria, fracture mode, and localization phenomena for several rock types (sandstone, limestone, chalk and marble). Experiments were conducted in triaxial extension using a necked (dogbone) geometry to achieve mixed tension and compression stress states with local component-strain measurements in the failure region. The failure envelope for all rock types is similar, but are poorly described using Griffith or modified Griffith (Coulomb or other) failure criteria. Notably, the mode of fracture changes systematically from pure extension to shear with increase in compressive mean stress and display a continuous change in fracture orientation with respect to principal stress axes. Differential stress and inelastic strain show a systematic increase with increasing mean stress, whereas the axial stress decreases before increasing with increasing mean stress. The stress and strain data are used to analyze elastic and plastic strains leading to failure and compare the experimental results to predictions for localization using constitutive models incorporating on bifurcation theory. Although models are able to describe the stability behavior and onset of localization qualitatively, the models are unable to predict fracture type or orientation. Constitutive models using single or multiple yield surfaces are unable to predict the experimental results, reflecting the difficulty in capturing the changing micromechanisms from extension to shear failure. Sandia

Participatory mapping for crime prevention in South Africa - local solutions to local problems

CSIR Research Space (South Africa)

Liebermann, S

2004-10-01

Full Text Available . suburban parts or the central business districts in urban areas is property- related.(3) Links between land use and crime types became apparent when crime statistics were broken down by location at the local scale. Adirect link between undeveloped... step involves setting the scene and discussing crime, place and crime prevention. Many of the resident community participants have never heard of crime prevention, therefore this introductory step outlines the three factors necessary for a crime...

Monitoring burst (M-burst) — A novel framework of failure localization in all-optical mesh networks

KAUST Repository

Ali, Mohammed L.; Ho, Pin-Han; Wu, Bin; Tapolcai, Janos; Shihada, Basem

2011-01-01

Achieving instantaneous and precise failure localization in all-optical wavelength division multiplexing (WDM) networks has been an attractive feature of network fault management systems, and is particularly important when failure-dependent protection is employed. The paper introduces a novel framework of real-time failure localization in all-optical WDM mesh networks, called monitoring-burst (m-burst), which aims to initiate a graceful compromise between consumed monitoring resources and monitoring delay. Different from any previously reported solution, the proposed m-burst framework has a single monitoring node (MN) which launches optical bursts along a set of pre-defined close-loop routes, called monitoring cycles (m-cycles), to probe the links along the m-cycles. Bursts along different m-cycles are kept non-overlapping through any link of the network. By identifying the lost bursts due to single link failure events only, the MN can unambiguously localize the failed link in at least 3-connected networks. We will justify the feasibility and applicability of the proposed m-burst framework in the scenario of interest. To avoid possible collision among optical bursts launched by the MN, we define the problem of collision-free scheduling and formulate it into an integer linear program (ILP) in order to minimize the monitoring delay. Numerical results demonstrate the effectiveness of the proposed framework and the proposed solution.

Monitoring burst (M-burst) — A novel framework of failure localization in all-optical mesh networks

KAUST Repository

Ali, Mohammed L.

2011-10-10

Achieving instantaneous and precise failure localization in all-optical wavelength division multiplexing (WDM) networks has been an attractive feature of network fault management systems, and is particularly important when failure-dependent protection is employed. The paper introduces a novel framework of real-time failure localization in all-optical WDM mesh networks, called monitoring-burst (m-burst), which aims to initiate a graceful compromise between consumed monitoring resources and monitoring delay. Different from any previously reported solution, the proposed m-burst framework has a single monitoring node (MN) which launches optical bursts along a set of pre-defined close-loop routes, called monitoring cycles (m-cycles), to probe the links along the m-cycles. Bursts along different m-cycles are kept non-overlapping through any link of the network. By identifying the lost bursts due to single link failure events only, the MN can unambiguously localize the failed link in at least 3-connected networks. We will justify the feasibility and applicability of the proposed m-burst framework in the scenario of interest. To avoid possible collision among optical bursts launched by the MN, we define the problem of collision-free scheduling and formulate it into an integer linear program (ILP) in order to minimize the monitoring delay. Numerical results demonstrate the effectiveness of the proposed framework and the proposed solution.

Systematic analysis and prevention of human originated common cause failures in relation to maintenance activities at Finnish nuclear power plants

Energy Technology Data Exchange (ETDEWEB)

Laakso, K. [VTT Industrial Systems, Espoo (Finland)

2006-12-15

inspections and functional testing. Such a planning case shall include a need evaluation of both the component and system level testing at the end of work. In addition, the use of condition monitoring information helps in reducing the uncertainty about equipment operability after intrusive maintenance or modifications. An increased use of condition information for a situation specific steering of preventive maintenance actions could also help to avoid unnecessary predetermined preventive maintenance actions which have the potential to cause unnecessary failures. A more agile adjustment of work orders to correspond the new conditions identified by maintenance personnel locally during work was also found necessary to reduce human CCFs caused by e.g. missing testing or inspections. The results emphasize the responsibility and requirements of versatility and specialisation of the planning and performance of maintenance and operability verification which brings this work to a knowledge work. For instance, flexibility is needed for the adaptation to specific conditions of the equipment and work as well as adhering to the rules and procedures is required. And mostly both a specialist knowledge of the equipment and a functional overview of the system are required. The event and error analyses of the multiple and single errors would help in training the maintenance, operation and technical personnel to identify better error mechanisms and prevent undetected human CCFs and errors, too. An earlier and better defined examination of the CCF risks as a part of the failure reporting and repair and modification processes would also help to identify, investigate and prevent CCFs. Generally, operability verification of the work objects in plant equipment should be planned and implemented better as an integral part of the plant maintenance process requiring knowledge of both the maintenance and operation branches. Methods for analysis of maintenance history information, examples of presentation

Systematic analysis and prevention of human originated common cause failures in relation to maintenance activities at Finnish nuclear power plants

International Nuclear Information System (INIS)

Laakso, K.

2006-12-01

inspections and functional testing. Such a planning case shall include a need evaluation of both the component and system level testing at the end of work. In addition, the use of condition monitoring information helps in reducing the uncertainty about equipment operability after intrusive maintenance or modifications. An increased use of condition information for a situation specific steering of preventive maintenance actions could also help to avoid unnecessary predetermined preventive maintenance actions which have the potential to cause unnecessary failures. A more agile adjustment of work orders to correspond the new conditions identified by maintenance personnel locally during work was also found necessary to reduce human CCFs caused by e.g. missing testing or inspections. The results emphasize the responsibility and requirements of versatility and specialisation of the planning and performance of maintenance and operability verification which brings this work to a knowledge work. For instance, flexibility is needed for the adaptation to specific conditions of the equipment and work as well as adhering to the rules and procedures is required. And mostly both a specialist knowledge of the equipment and a functional overview of the system are required. The event and error analyses of the multiple and single errors would help in training the maintenance, operation and technical personnel to identify better error mechanisms and prevent undetected human CCFs and errors, too. An earlier and better defined examination of the CCF risks as a part of the failure reporting and repair and modification processes would also help to identify, investigate and prevent CCFs. Generally, operability verification of the work objects in plant equipment should be planned and implemented better as an integral part of the plant maintenance process requiring knowledge of both the maintenance and operation branches. Methods for analysis of maintenance history information, examples of presentation

On the applicability of local approaches for the determination of the failure behavior of ductile steels

International Nuclear Information System (INIS)

Kussmaul, K.; Eisele, U.; Seidenfuss, M.

1992-01-01

The strength and deformation behavior of specimens and components is, on one hand, influenced by the local state of stress and strain and, on the other hand by the chemical composition and the microstructure of the material used. Using two different steels it was investigated in how far it is possible to predict the failure behavior of specimens and components qualitatively and quantitatively by means of local approaches. For this purpose two methods differing considerably from the basic idea were chosen. For the description of the failure behavior so-called damage models were used. These damage models try to describe numerically the process developing microscopically and finally leading to fracture by means of continuum mechanical approaches in order to calculate the macroscopical failure behavior. The results show that for ductile materials the damage models allow a very accurate calculation of smooth and notched specimens and components. The efforts presently required for the calculation are however still very high. Analyses using fracture mechanics approaches (J-Integral) in combination with the local stress states (multiaxiality) were performed to describe the failure behavior. With this approach it was tried to calculate crack initiation and maximum load of precracked specimens and components. The fracture mechanics methods are to be preferred for cracked components if an engineering estimation of crack initiation and maximum load is required only, since the calculational efforts of the fracture mechanics methods are much lower than those of the damage models

Melatonin and Fertoprotective Adjuvants: Prevention against Premature Ovarian Failure during Chemotherapy.

Science.gov (United States)

Jang, Hoon; Hong, Kwonho; Choi, Youngsok

2017-06-07

Premature ovarian failure is one of the side effects of chemotherapy in pre-menopausal cancer patients. Preservation of fertility has become increasingly important in improving the quality of life of completely recovered cancer patients. Among the possible strategies for preserving fertility such as ovarian tissue cryopreservation, co-treatment with a pharmacological adjuvant is highly effective and poses less of a burden on the human body. Melatonin is generally produced in various tissues and acts as a universally acting antioxidant in cells. Melatonin is now more widely used in various biological processes including treating insomnia and an adjuvant during chemotherapy. In this review, we summarize the information indicating that melatonin may be useful for reducing and preventing premature ovarian failure in chemotherapy-treated female patients. We also mention that many adjuvants other than melatonin are developed and used to inhibit chemotherapy-induced infertility. This information will give us novel insights on the clinical use of melatonin and other agents as fertoprotective adjuvants for female cancer patients.

Secondary prevention- an essential component of the comprehensive rehabilitation of patients with heart failure

Directory of Open Access Journals (Sweden)

Pop Dana

2017-12-01

Full Text Available Heart failure is currently a real public health problem due to the extremely high morbidity and mortality of this disease. In this context, cardiovascular prevention measures should be implemented as early as possible. In addition to classic prevention measures, a number of extremely important specific recommendations should be considered: informing patients about their underlying disease, identifying the cardiovascular and non-cardiovascular factors that have led to cardiac decompensation, reducing daily salt consumption, monitoring body weight, forbidding smoking and recreational substances, conducting a regular exercise program under supervision, and increasing adherence to treatment.

Towards a unified solution of localization failure with mixed finite elements

Science.gov (United States)

Benedetti, Lorenzo; Cervera, Miguel; Chiumenti, Michele; Zeidler, Antonia; Fischer, Jan-Thomas

2015-04-01

Notwithstanding computational scientists made significant steps in the numerical simulation of failure in last three decades, the strain localization problem is still an open question. Especially in a geotechnical setting, when dealing with stability analysis of slopes, it is necessary to provide correct distribution of displacements, to evaluate the stresses in the ground and, therefore, to be able to identify the slip lines that brings to progressive collapse of the slope. Finite elements are an attractive method of solution thanks to profound mathematical foundations and the possibility of describing generic geometries. In order to account for the onset of localization band, the smeared crack approach [1] is introduced, that is the strain localization is assumed to occur in a band of finite width where the displacements are continuous and the strains are discontinuous but bounded. It is well known that this kind of approach poses some challenges. The standard irreducible formulation of FEM is known to be heavily affected by spurious mesh dependence when softening behavior occurs and, consequently, slip lines evolution is biased by the orientation of the mesh. Moreover, in the case of isochoric behavior, unbounded pressure oscillations arise and the consequent locking of the stresses pollutes the numerical solution. Both problems can be shown not to be related to the mathematical statement of the continuous problem but instead to its discrete (FEM) counterpart. Mixed finite element formulations represent a suitable alternative to mitigate these drawbacks. As it has been shown in previous works by Cervera [2], a mixed formulation in terms of displacements and pressure not only provides a propitious solution to the problem of incompressibility, but also it was found to possess the needed robustness in case of strain concentration. This presentation introduces a (stabilized) mixed finite element formulation with continuous linear strain and displacement

Pretreatment Apparent Diffusion Coefficient of the Primary Lesion Correlates With Local Failure in Head-and-Neck Cancer Treated With Chemoradiotherapy or Radiotherapy

International Nuclear Information System (INIS)

Hatakenaka, Masamitsu; Nakamura, Katsumasa; Yabuuchi, Hidetake; Shioyama, Yoshiyuki; Matsuo, Yoshio; Ohnishi, Kayoko; Sunami, Shunya; Kamitani, Takeshi; Setoguchi, Taro; Yoshiura, Takashi; Nakashima, Torahiko; Nishikawa, Kei; Honda, Hiroshi

2011-01-01

Purpose: This study was performed to evaluate whether the apparent diffusion coefficient (ADC) of a primary lesion correlates with local failure in primary head-and-neck squamous cell carcinoma (HNSCC) treated with chemoradiotherapy or radiotherapy. Methods and Materials: We retrospectively studied 38 patients with primary HNSCC (12 oropharynx, 20 hypopharynx, 4 larynx, 2 oral cavity) treated with chemoradiotherapy or radiotherapy with radiation dose to gross tumor volume equal to or over 60 Gy and who underwent pretreatment magnetic resonance imaging, including diffusion-weighted imaging. Ten patients developed local failure during follow-up periods of 2.0 to 9.3 months, and the remaining 28 showed local control during follow-up periods of 10.5 to 31.7 months. The variables that could affect local failure (age, tumor volume, ADC, T stage, N stage, dose, treatment method, tumor location, and overall treatment time) were analyzed using logistic regression analyses for all 38 patients and for 17 patients with Stage T3 or T4 disease. Results: In univariate logistic analysis for all 38 cases, tumor volume, ADC, T stage, and treatment method showed significant (p < 0.05) associations with local failure. In multivariate analysis, ADC and T stage revealed significance (p < 0.01). In univariate logistic analysis for the 17 patients with Stage T3 or T4 disease, ADC and dose showed significant (p < 0.01) associations with local failure. In multivariate analysis, ADC alone showed significance (p < 0.05). Conclusions: The results suggest that pretreatment ADC, along with T stage, is a potential indicator of local failure in HNSCC treated with chemoradiotherapy or radiotherapy.

Low-waste technology of prevention, decontamination and localization of radioactive contamination

International Nuclear Information System (INIS)

Kizhnerov, L. V.; Konstantinov, Ye. A.; Prokopenko, V. A.; Sorokin, N. M.

1997-01-01

The report presents the results of research in developing a low-waste technology of prevention, decontamination and localization of radioactive contamination founded on the of easily removed protective polymeric coating based on water and alcohol latexes and dispersion of polymers with special activating additives. The developed technology provides for the reduction of weakly fixed radioactive contamination of non-painted and painted surfaces to admissible levels (as a rule), it securely prevents and localizes contamination and does not generate secondary liquid radioactive wastes

State practitioner insights into local public health challenges and opportunities in obesity prevention: a qualitative study.

Science.gov (United States)

Stamatakis, Katherine A; Lewis, Moira; Khoong, Elaine C; Lasee, Claire

2014-03-13

The extent of obesity prevention activities conducted by local health departments (LHDs) varies widely. The purpose of this qualitative study was to characterize how state obesity prevention program directors perceived the role of LHDs in obesity prevention and factors that impact LHDs' success in obesity prevention. From June 2011 through August 2011, we conducted 28 semistructured interviews with directors of federally funded obesity prevention programs at 22 state and regional health departments. Interviews were transcribed verbatim, coded, and analyzed to identify recurring themes and key quotations. Main themes focused on the roles of LHDs in local policy and environmental change and on the barriers and facilitators to LHD success. The role LHDs play in obesity prevention varied across states but generally reflected governance structure (decentralized vs centralized). Barriers to local prevention efforts included competing priorities, lack of local capacity, siloed public health structures, and a lack of local engagement in policy and environmental change. Structures and processes that facilitated prevention were having state support (eg, resources, technical assistance), dedicated staff, strong communication networks, and a robust community health assessment and planning process. These findings provide insight into successful strategies state and local practitioners are using to implement innovative (and evidence-informed) community-based interventions. The change in the nature of obesity prevention requires a rethinking of the state-local relationship, especially in centralized states.

Phantom Tumor of the Lung: Localized Interlobar Effusion in Congestive Heart Failure

Directory of Open Access Journals (Sweden)

Mislav Lozo

2014-01-01

Full Text Available Localized interlobar effusions in congestive heart failure (phantom or vanishing lung tumor/s is/are uncommon but well known entities. An 83-year-old man presented with shortness of breath, swollen legs, and dry cough enduring five days. Chest-X-ray (CXR revealed massive sharply demarked round/oval homogeneous dense shadow 10 × 7 cm in size in the right inferior lobe. The treatment with the loop diuretics and fluid intake reduction resulted in complete resolution of the observed round/oval tumor-like image on the control CXR three days later. Radiologic appearance of such a mass-like configuration in patients with congestive heart failure demands correction of the underlying heart condition before further diagnostic investigation is performed to avoid unnecessary, expensive, and possibly harmful diagnostic and treatment errors.

Expression and subcellular localization of p70S6 kinase under heart failure

Directory of Open Access Journals (Sweden)

Usenko V. S.

2010-11-01

Full Text Available The PI3K/PDK/Akt/mTOR/p70S6K signaling pathway is primary associated with the activation of insulin receptors and is important for cardiomyocytes survival. p70S6K is a key regulator of the speed and efficiency of protein biosynthesis within the cell. Recently the pro-apoptotic protein BAD has been identified as a new target for р70S6K1. BAD is inactivated in normal cardiomyocytes by р70S6K1 phosphorylation which prevents the cardiomyocytes apoptosis. Aim. To study possible changes in р70S6K1 expression and/or cellular localization at heart failure progression – in DCM- affected human myocardia and murine hearts with experimental DCM-like pathology. Methods. Western-blot analysis and immunohystochemistry. Results. The substantial decrease in р70S6K1 level was observed at the final stage of pathology progression and in the dynamics of DCM pathogenesis as well. For the first time relocalization of the protein to the connective tissue was shown according to the Western-blot results. Conclusions. The data obtained allow us to understand a possible role of р70S6K1 in the regulation of stress-induced apoptotic signaling in cardiomyocytes.

The Effect of Local Irradiation in Prevention and Reversal of Acute Rejection of Transplanted Kidney with High-dose Steroid Pulse

International Nuclear Information System (INIS)

Kim, I. H.; Ha, S. W.; Park, C. I.; Kim, S. T.

1986-01-01

From 1979 to 1984, 39 local allograft irradiations were given to 29 patients: 10 irradiations were administered for prevention and 29 for reversal of acute rejection of transplanted kidney. Three doses of 150 cGy every other day were combined with high-dose of methylprednisolone pulse (1 gm/day) for 3 days. For prevention of acute rejection, local irradiation was delivered on the days 1, 3, and 5 after the transplantation, and for reversal, irradiation started after the diagnosis of acute rejection. Eight out of 10 patients irradiated for prevention had acute allograft rejection, and, what is more, there was no surviving graft at 15 months after transplantation. Reversal of acute rejection was achieved in 71%. When the pre-irradiation level of serum creatinine was below 5.5 mg%, the reversal rate was 93%, but above 5.5 mg% the reversal rate was only 17% (p<0.01). Reirradiation after failure was not successful. Among 15 reversed patients, 7 (47%) had subsequent rejection (s). The functional graft survivals at 6 month, 1, 2, and 3 year were 70%, 65%, 54%, and 65%, respectively. Therapeutic irradiation resulted in better graft survival when serum creatinine was below 5.5 mg% (p<0.001) or when irradiation started within 15 days after the diagnosis of acute rejection (p<0.001)

Cascading failures with local load redistribution in interdependent Watts-Strogatz networks

Science.gov (United States)

Hong, Chen; Zhang, Jun; Du, Wen-Bo; Sallan, Jose Maria; Lordan, Oriol

2016-05-01

Cascading failures of loads in isolated networks have been studied extensively over the last decade. Since 2010, such research has extended to interdependent networks. In this paper, we study cascading failures with local load redistribution in interdependent Watts-Strogatz (WS) networks. The effects of rewiring probability and coupling strength on the resilience of interdependent WS networks have been extensively investigated. It has been found that, for small values of the tolerance parameter, interdependent networks are more vulnerable as rewiring probability increases. For larger values of the tolerance parameter, the robustness of interdependent networks firstly decreases and then increases as rewiring probability increases. Coupling strength has a different impact on robustness. For low values of coupling strength, the resilience of interdependent networks decreases with the increment of the coupling strength until it reaches a certain threshold value. For values of coupling strength above this threshold, the opposite effect is observed. Our results are helpful to understand and design resilient interdependent networks.

National strategy for suicide prevention in Japan: impact of a national fund on progress of developing systems for suicide prevention and implementing initiatives among local authorities.

Science.gov (United States)

Nakanishi, Miharu; Yamauchi, Takashi; Takeshima, Tadashi

2015-01-01

In Japan, the Cabinet Office released the 'General Principles of Suicide Prevention Policy' in 2007 and suggested nine initiatives. In 2009, a national fund was launched to help prefectures (the administrative divisions of Japan) and local authorities implement five categories of suicide-prevention programs. This paper examines the impact of the national fund on the establishment of the systems for suicide prevention and the implementation of these initiatives among local authorities. The present study included 1385 local authorities (79.5%) from all 47 prefectures that responded to the cross-sectional questionnaire survey. Improved suicide-prevention systems and the implementation of nine initiatives in April 2013 were observed among 265 local authorities (19.1%) that implemented 'Training of community service providers' and 'Public awareness campaigns'; 178 local authorities (12.9%) that implemented 'Face-to-face counseling', 'Training of community service providers' and 'Public awareness campaigns'; and 324 local authorities (23.4%) that implemented 'Trauma-informed policies and practices'. There was no significant difference in suicide-prevention systems and the implementation of nine initiatives between 203 local authorities (14.7%) that implemented only 'Public awareness campaigns' and 231 local authorities (16.7%) that did not implement any suicide-prevention programs. The results of our study suggest that the national fund promoted the establishment of community systems for suicide prevention and helped implement initiatives among local authorities. The national suicide-prevention strategy in Japan should explore a standard package of programs to guide community suicide-prevention efforts with a sustained workforce among local authorities. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

Patterns of failure following bone marrow transplantation for metastatic breast cancer: the role of consolidative local therapy

International Nuclear Information System (INIS)

Shah, Amit B.; Hartsell, William F.; Ghalie, Richard; Kaizer, Herbert

1995-01-01

Purpose: The purpose of this analysis is to evaluate the patterns of failure and the role of local therapy in conjunction with bone marrow transplantation (BMT) for metastatic or recurrent breast cancer. Methods and Materials: Between June 1986 and November 1991, 46 patients with hormone unresponsive metastatic or recurrent breast cancer underwent high dose chemotherapy (HDC) with hematopoietic stem cell support. The most commonly used preparative regimen consisted of thiotepa (750 mg/m 2 ), cisplatin (150 mg/m 2 ), and cyclophosphamide (120 mg/kg) followed by autologous BMT. Consolidative surgery or irradiation was considered in patients whose cancer responded to BMT and had localized sites of disease. Results: Six patients (13%) died of BMT-related complications. Of the remaining 40 patients, 22 were candidates for consolidative therapy, and 18 of those patients received consolidative irradiation (17 patients) or surgery (1 patient) to one or more sites. At median follow-up of 27 months (range, 20-78), 12 of 18 (67%) patients have continuous local control at the 22 consolidated sites (1 of 4 controlled at chest wall sites, 7 of 8 at regional nodal sites, 7 of 7 at localized bone sites, and 1 of 3 at lung/mediastinal sites). Toxicity of consolidative irradiation was mainly limited to myelosuppression in 6 of 17 patients. Two patients did not complete the consolidative local therapy, one because of hematologic toxicity and one because of rapid systemic tumor progression during treatment. Conclusion: In patients with localized areas of extravisceral metastases, consolidative irradiation is feasible with acceptable hematologic toxicity. Consolidative irradiation can result in continuous local control, especially in isolated bone metastases and in regional nodal sites; however, the advantage is less clear in patients undergoing consolidative irradiation for chest wall failures. Because distant visceral metastases still remain a major site of failure after this HDC

Predictors and Patterns of Local, Regional, and Distant Failure in Squamous Cell Carcinoma of the Vulva.

Science.gov (United States)

Bogani, Giorgio; Cromi, Antonella; Serati, Maurizio; Uccella, Stefano; Donato, Violante Di; Casarin, Jvan; Naro, Edoardo Di; Ghezzi, Fabio

2017-06-01

To identify factors predicting for recurrence in vulvar cancer patients undergoing surgical treatment. We retrospectively evaluated data of consecutive patients with squamous cell vulvar cancer treated between January 1, 1990 and December 31, 2013. Basic descriptive statistics and multivariable analysis were used to design predicting models influencing outcomes. Five-year disease-free survival (DFS) and overall survival (OS) were analyzed using the Cox model. The study included 101 patients affected by vulvar cancer: 64 (63%) stage I, 12 (12%) stage II, 20 (20%) stage III, and 5 (5%) stage IV. After a mean (SD) follow-up of 37.6 (22.1) months, 21 (21%) recurrences occurred. Local, regional, and distant failures were recorded in 14 (14%), 6 (6%), and 3 (3%) patients, respectively. Five-year DFS and OS were 77% and 82%, respectively. At multivariate analysis only stromal invasion >2 mm (hazard ratio: 4.9 [95% confidence interval, 1.17-21.1]; P=0.04) and extracapsular lymph node involvement (hazard ratio: 9.0 (95% confidence interval, 1.17-69.5); P=0.03) correlated with worse DFS, although no factor independently correlated with OS. Looking at factors influencing local and regional failure, we observed that stromal invasion >2 mm was the only factor predicting for local recurrence, whereas lymph node extracapsular involvement predicted for regional recurrence. Stromal invasion >2 mm and lymph node extracapsular spread are the most important factors predicting for local and regional failure, respectively. Studies evaluating the effectiveness of adjuvant treatment in high-risk patients are warranted.

Analysis of Mancos shale failure in light of localization theory for transversely isotropic materials.

Science.gov (United States)

Ingraham, M. D.; Dewers, T. A.; Heath, J. E.

2016-12-01

Utilizing the localization conditions laid out in Rudnicki 2002, the failure of a series of tests performed on Mancos shale has been analyzed. Shale specimens were tested under constant mean stress conditions in an axisymmetric stress state, with specimens cored both parallel and perpendicular to bedding. Failure data indicates that for the range of pressures tested the failure surface is well represented by a Mohr- Coulomb failure surface with a friction angle of 34.4 for specimens cored parallel to bedding, and 26.5 for specimens cored perpendicular to bedding. There is no evidence of a yield cap up to 200 MPa mean stress. Comparison with the theory shows that the best agreement in terms of band angles comes from assuming normality of the plastic strain increment. Sandia National Laboratories is a multi-program laboratory managed and operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-AC04-94AL85000.

An Enhanced Preventive Maintenance Optimization Model Based on a Three-Stage Failure Process

Directory of Open Access Journals (Sweden)

Ruifeng Yang

2015-01-01

Full Text Available Nuclear power plants are highly complex systems and the issues related to their safety are of primary importance. Probabilistic safety assessment is regarded as the most widespread methodology for studying the safety of nuclear power plants. As maintenance is one of the most important factors for affecting the reliability and safety, an enhanced preventive maintenance optimization model based on a three-stage failure process is proposed. Preventive maintenance is still a dominant maintenance policy due to its easy implementation. In order to correspond to the three-color scheme commonly used in practice, the lifetime of system before failure is divided into three stages, namely, normal, minor defective, and severe defective stages. When the minor defective stage is identified, two measures are considered for comparison: one is that halving the inspection interval only when the minor defective stage is identified at the first time; the other one is that if only identifying the minor defective stage, the subsequent inspection interval is halved. Maintenance is implemented immediately once the severe defective stage is identified. Minimizing the expected cost per unit time is our objective function to optimize the inspection interval. Finally, a numerical example is presented to illustrate the effectiveness of the proposed models.

Locoregional failures following thoracic irradiation in patients with limited-stage small cell lung carcinoma

International Nuclear Information System (INIS)

Giuliani, Meredith E.; Lindsay, Patricia E.; Sun, Alexander; Bezjak, Andrea; Le, Lisa W.; Brade, Anthony; Cho, John; Leighl, Natasha B.; Shepherd, Frances A.; Hope, Andrew J.

2012-01-01

Purpose: To determine the patterns of loco-regional (LR) and distant failure in patients with limited-stage small cell lung carcinoma (LS-SCLC) treated with curative intent. Methods: From 1997 to 2008, 253 LS-SCLC patients were treated with curative intent chemo-radiation at our institution. A retrospective review identified sites of failure. The cumulative LR failure (LRF) rate was calculated. Distant failure-free survival (FFS) and overall survival (OS) were calculated using the Kaplan–Meier method. Volumetric images of LR failures were delineated and registered with the original radiation treatment plans if available. Dosimetric parameters for the delineated failure volumes were calculated from the original treatment information. Results: The median follow-up was 19 months. The site of first failure was LR in 34, distant in 80 and simultaneous LR and distant in 31 patients. The cumulative LRF rate was 29% and 38% at 2 and 5 years. OS was 44% at 2 years. Seventy patients had electronically archived treatment plans of which there were 16 LR failures (7 local and 39 regional failure volumes). Of the local and regional failure volumes 29% and 31% were in-field, respectively. Conclusions: The predominant pattern of LR failure was marginal or out-of-field. LR failures may be preventable with improved radiotherapy target definition.

Self-Regulation, Cooperative Learning, and Academic Self-Efficacy: Interactions to Prevent School Failure

OpenAIRE

Fernández Río, Francisco Javier; Cecchini Estrada, José Antonio; Méndez Giménez, Antonio; Prieto Saborit, José Antonio

2017-01-01

Learning to learn and learning to cooperate are two important goals for individuals. Moreover, self regulation has been identified as fundamental to prevent school failure. The goal of the present study was to assess the interactions between self-regulated learning, cooperative learning and academic self-efficacy in secondary education students experiencing cooperative learning as the main pedagogical approach for at least one school year. 2.513 secondary education students (1.308 males, 1.20...

Pre- and post-radiotherapy computed tomography in laryngeal cancer: imaging-based prediction of local failure

International Nuclear Information System (INIS)

Pameijer, Frank A.; Hermans, Robert; Mancuso, Anthony A.; Mendenhall, William M.; Parsons, James T.; Stringer, Scott P.; Kubilis, Paul S.; Tinteren, Harm van

1999-01-01

Purpose: To determine if pre-radiotherapy (RT) and/or post-radiotherapy computed tomography (CT) can predict local failure in patients with laryngeal carcinoma treated with definitive RT. Methods and Materials: The pre- and post-RT CT examinations of 59 patients (T3 glottic carcinoma [n = 30] and T1-T4 supraglottic carcinoma [n = 29]) were reviewed. For each patient, the first post-RT CT study between 1 and 6 months after irradiation was used. All patients were treated with definitive hyperfractionated twice-daily continuous-course irradiation to a total dose of 6,720-7,920 cGy, and followed-up clinically for at least 2 years after completion of RT. Local control was defined as absence of primary tumor recurrence and a functioning larynx. On the pre-treatment CT study, each tumor was assigned a high-or low-risk profile for local failure after RT. The post-RT CT examinations were evaluated for post-treatment changes using a three-point post-RT CT-score: 1 = expected post-RT changes; 2 = focal mass with a maximal diameter of 1 cm, or < 50% estimated tumor volume reduction. Results: The local control rates at 2 years post-RT based on pre-treatment CT evaluation were 88% for low pre-treatment risk profile patients (95% CI: 66-96%) and 34% (95% CI: 19-50%) for high pre-treatment risk profile patients (risk ratio 6.583; 95% CI: 2.265-9.129; p = 0.0001). Based on post-treatment CT, the local control rates at 2 years post-RT were 94% for score 1, 67% for score 2, and 10% for score 3 (risk ratio 4.760; 95% CI: 2.278-9.950 p 0.0001). Post-RT CT scores added significant information to the pre-treatment risk profiles on prognosis. Conclusions: Pre-treatment CT risk profiles, as well as post-RT CT evaluation can identify patients, irradiated for laryngeal carcinomas, at high risk for developing local failure. When the post-RT CT score is available, it proves to be an even better prognosticator than the pre-treatment CT-risk profile

Actions to reduce radioactive emissions: prevention of containment failure by flooding Containment and Reactor Cavity

International Nuclear Information System (INIS)

Fornos Herrando, J.

2013-01-01

The reactor cavity of Asco and Vandellos II is dry type, thus a severe accident leading to vessel failure might potentially end up resulting in the loss of containment integrity, depending on the viability to cool the molten core. Therefore, significant radioactive emissions could be released to outside. In the framework of Fukushima Stress Tests, ANAV has analyzed the convenience of carrying out different actions to prevent failure of the containment integrity in order to reduce radioactive emissions. The aim of this paper is to present and describe the main phenomenological aspects associated with two of these actions: containment flooding and reactor cavity flooding.

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

Science.gov (United States)

Zhang, Xiaowei; Sahraei, Elham; Wang, Kai

2016-09-01

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

Heart Failure

Science.gov (United States)

... Other diseases. Chronic diseases — such as diabetes, HIV, hyperthyroidism, hypothyroidism, or a buildup of iron (hemochromatosis) or ... transplantation or support with a ventricular assist device. Prevention The key to preventing heart failure is to ...

Implementation of SNS Model for Intrusion Prevention in Wireless Local Area Network

DEFF Research Database (Denmark)

Isah, Abdullahi

The thesis has proposed and implemented a so-called SNS (Social network security) model for intrusion prevention in the Wireless Local Area Network of an organization. An experimental design was used to implement and test the model at a university in Nigeria.......The thesis has proposed and implemented a so-called SNS (Social network security) model for intrusion prevention in the Wireless Local Area Network of an organization. An experimental design was used to implement and test the model at a university in Nigeria....

Design of Detection and Prevention System of Unauthorized Data Sending from the Local Network

Directory of Open Access Journals (Sweden)

D. A. Moskvin

2010-03-01

Full Text Available Malware often aims at breaking confidentiality. A malicious program gets inside the local network, finds out necessary data and then illegally transfers this data to the intruder. Prevention of unauthorized data transfer requires development of a special software product, which will detect and prevent leak of information from the local network.

Preoperative Prevention of Heart Failure in Noncardiac Surgery

Directory of Open Access Journals (Sweden)

V. V. Likhvantsev

2016-01-01

Full Text Available Congestive heart failure is consistently associated with adverse outcomes, and is characterized by a twofold increase in mortality in noncardiac surgery. In this regard, developing the methods aimed to prevent and treatacute heart failure (AHF in the intraoperative period remain a challenging problem.Objective. To evaluate the efficacy of preoperative levosimendan infusion in reduction both mortality and duration of treatment of elderly patients with reduced left ventricular ejection fraction in noncardiac surgery.Material and Methods. Design: Multicenter blind randomized placebocontrolled study. Patients: 81 patients operated on abdominal organs. The main endpoint of the study: The length of stay in the Intensive Care Unit (ICU and at the hospital were chosen as the primary endpoints. The secondary endpoints of the study were 30 day and annual mortality, the rate of acute myocardial infarction and stroke.Results. Levosimendan infusion at a rate of 0,05 μg/kg/min — 0,1 μg/kg/min to patients with low left ven tricular ejection fraction just before the surgery reduced the length of stay in ICU for 2 days and required hospital stay for 3 days. NTproBNP showed the best ratio of sensitivity/specificity in predicting 30day mortality in cumulative group: AUC=0,86 (90,77 to 0,93, P<0,0001. From other indicators the most informative were the Inotropes scoring, no change or decrease of a left ventricular ejection fraction, and cardiac index.Conclusion. To reduce perioperative mortality, the intravenous infusion of levosimendan at a rate of 0,05—0,1 μg/kg/min in elderly patients with low left ventricular ejection fraction is recommened as a preoperative preparation the day before the alleged noncardiac surgery.

Nonparametric method for failures detection and localization in the actuating subsystem of aircraft control system

Science.gov (United States)

Karpenko, S. S.; Zybin, E. Yu; Kosyanchuk, V. V.

2018-02-01

In this paper we design a nonparametric method for failures detection and localization in the aircraft control system that uses the measurements of the control signals and the aircraft states only. It doesn’t require a priori information of the aircraft model parameters, training or statistical calculations, and is based on algebraic solvability conditions for the aircraft model identification problem. This makes it possible to significantly increase the efficiency of detection and localization problem solution by completely eliminating errors, associated with aircraft model uncertainties.

Report for the ASC CSSE L2 Milestone (4873) - Demonstration of Local Failure Local Recovery Resilient Programming Model.

Energy Technology Data Exchange (ETDEWEB)

Heroux, Michael Allen; Teranishi, Keita

2014-06-01

Recovery from process loss during the execution of a distributed memory parallel application is presently achieved by restarting the program, typically from a checkpoint file. Future computer system trends indicate that the size of data to checkpoint, the lack of improvement in parallel file system performance and the increase in process failure rates will lead to situations where checkpoint restart becomes infeasible. In this report we describe and prototype the use of a new application level resilient computing model that manages persistent storage of local state for each process such that, if a process fails, recovery can be performed locally without requiring access to a global checkpoint file. LFLR provides application developers with an ability to recover locally and continue application execution when a process is lost. This report discusses what features are required from the hardware, OS and runtime layers, and what approaches application developers might use in the design of future codes, including a demonstration of LFLR-enabled MiniFE code from the Matenvo mini-application suite.

Boiler tube failure prevention in fossil fired boilers

International Nuclear Information System (INIS)

Townsend, R.D.

1993-01-01

It is the common experience of power generating companies worldwide that the main causes of forced outages on power plant are those due to boiler tube failures on fossil units. The main reason for the large number of failures are the severe environmental conditions in fossil boilers as the effects of stress, temperature, temperature gradients, corrosion, erosion and vibration combine to produce degradation of the tube steel. Corrosion by oxidation, by combustion products and by impure boiler water can significantly reduce the tube wall thickness and result in failure of a tube many years before its designed service life. Errors can also occur in the design manufacturer, storage, operation, and maintenance of boiler tubing and the wrong material installed in a critical location can lead to premature failure. Altogether, experts in the US and UK, from many different disciplines, have identified seven broad categories of boiler tube failure mechanisms. 1 tab., 2 figs

Assessing the impact of heart failure specialist services on patient populations

Directory of Open Access Journals (Sweden)

Lyratzopoulos Georgios

2004-05-01

Full Text Available Abstract Background The assessment of the impact of healthcare interventions may help commissioners of healthcare services to make optimal decisions. This can be particularly the case if the impact assessment relates to specific patient populations and uses timely local data. We examined the potential impact on readmissions and mortality of specialist heart failure services capable of delivering treatments such as b-blockers and Nurse-Led Educational Intervention (N-LEI. Methods Statistical modelling of prevented or postponed events among previously hospitalised patients, using estimates of: treatment uptake and contraindications (based on local audit data; treatment effectiveness and intolerance (based on literature; and annual number of hospitalization per patient and annual risk of death (based on routine data. Results Optimal treatment uptake among eligible but untreated patients would over one year prevent or postpone 11% of all expected readmissions and 18% of all expected deaths for spironolactone, 13% of all expected readmisisons and 22% of all expected deaths for b-blockers (carvedilol and 20% of all expected readmissions and an uncertain number of deaths for N-LEI. Optimal combined treatment uptake for all three interventions during one year among all eligible but untreated patients would prevent or postpone 37% of all expected readmissions and a minimum of 36% of all expected deaths. Conclusion In a population of previously hospitalised patients with low previous uptake of b-blockers and no uptake of N-LEI, optimal combined uptake of interventions through specialist heart failure services can potentially help prevent or postpone approximately four times as many readmissions and a minimum of twice as many deaths compared with simply optimising uptake of spironolactone (not necessarily requiring specialist services. Examination of the impact of different heart failure interventions can inform rational planning of relevant healthcare

Assessing the impact of heart failure specialist services on patient populations.

Science.gov (United States)

Lyratzopoulos, Georgios; Cook, Gary A; McElduff, Patrick; Havely, Daniel; Edwards, Richard; Heller, Richard F

2004-05-24

The assessment of the impact of healthcare interventions may help commissioners of healthcare services to make optimal decisions. This can be particularly the case if the impact assessment relates to specific patient populations and uses timely local data. We examined the potential impact on readmissions and mortality of specialist heart failure services capable of delivering treatments such as b-blockers and Nurse-Led Educational Intervention (N-LEI). Statistical modelling of prevented or postponed events among previously hospitalised patients, using estimates of: treatment uptake and contraindications (based on local audit data); treatment effectiveness and intolerance (based on literature); and annual number of hospitalization per patient and annual risk of death (based on routine data). Optimal treatment uptake among eligible but untreated patients would over one year prevent or postpone 11% of all expected readmissions and 18% of all expected deaths for spironolactone, 13% of all expected readmisisons and 22% of all expected deaths for b-blockers (carvedilol) and 20% of all expected readmissions and an uncertain number of deaths for N-LEI. Optimal combined treatment uptake for all three interventions during one year among all eligible but untreated patients would prevent or postpone 37% of all expected readmissions and a minimum of 36% of all expected deaths. In a population of previously hospitalised patients with low previous uptake of b-blockers and no uptake of N-LEI, optimal combined uptake of interventions through specialist heart failure services can potentially help prevent or postpone approximately four times as many readmissions and a minimum of twice as many deaths compared with simply optimising uptake of spironolactone (not necessarily requiring specialist services). Examination of the impact of different heart failure interventions can inform rational planning of relevant healthcare services.

Snow fracture: From micro-cracking to global failure

Science.gov (United States)

Capelli, Achille; Reiweger, Ingrid; Schweizer, Jürg

2017-04-01

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

Failure mode and fracture behavior evaluation of pipes with local wall thinning subjected to bending load

International Nuclear Information System (INIS)

Ahn, Seok Hwan; Nam, Ki Woo; Kim, Seon Jin; Kim, Jin Hwan; Kim, Hyun Soo; Do, Jae Yoon

2003-01-01

Fracture behaviors of pipes with local wall thinning are very important for the integrity of nuclear power plant. In pipes of energy plants, sometimes, the local wall thinning may result from severe Erosion-Corrosion (E/C) damage. However, the effects of local wall thinning on strength and fracture behaviors of piping system were not well studied. In this paper, the monotonic bending tests were performed of full-scale carbon steel pipes with local wall thinning. A monotonic bending load was applied to straight pipe specimens by four-point loading at ambient temperature without internal pressure. From the tests, fracture behaviors and fracture strength of locally thinned pipe were manifested systematically. The observed failure modes were divided into four types; ovalization, crack initiation/growth after ovalization, local buckling and crack initiating/growth after local buckling. Also, the strength and the allowable limit of piping system with local wall thinning were evaluated

Local relative density modulates failure and strength in vertically aligned carbon nanotubes.

Science.gov (United States)

Pathak, Siddhartha; Mohan, Nisha; Decolvenaere, Elizabeth; Needleman, Alan; Bedewy, Mostafa; Hart, A John; Greer, Julia R

2013-10-22

Micromechanical experiments, image analysis, and theoretical modeling revealed that local failure events and compressive stresses of vertically aligned carbon nanotubes (VACNTs) were uniquely linked to relative density gradients. Edge detection analysis of systematically obtained scanning electron micrographs was used to quantify a microstructural figure-of-merit related to relative local density along VACNT heights. Sequential bottom-to-top buckling and hardening in stress-strain response were observed in samples with smaller relative density at the bottom. When density gradient was insubstantial or reversed, bottom regions always buckled last, and a flat stress plateau was obtained. These findings were consistent with predictions of a 2D material model based on a viscoplastic solid with plastic non-normality and a hardening-softening-hardening plastic flow relation. The hardening slope in compression generated by the model was directly related to the stiffness gradient along the sample height, and hence to the local relative density. These results demonstrate that a microstructural figure-of-merit, the effective relative density, can be used to quantify and predict the mechanical response.

Stormwater Volume Control to Prevent Increases in Lake Flooding and Dam Failure Risk

Science.gov (United States)

Potter, K. W.

2017-12-01

Urban expansion is not often considered a major factor contributing to dam failure. But if urbanization occurs without mitigation of the hydrologic impacts, the risk of dam failure will increase. Of particular concern are increases in the volume of storm runoff resulting from increases in the extent of impervious surfaces. Storm runoff volumes are not regulated for much the U.S, and where they are, the required control is commonly less than 100%. Unmitigated increases in runoff volume due to urbanization can pose a risk to dams. A recent technical advisory committee of Dane County has recommended that the county require 100% control of stormwater volumes for new developments. The primary motivation was to prevent increases in the water levels in the Yahara Lakes, slowly draining lakes that are highly sensitive to runoff volume. The recommendations included the use of "volume trading" to achieve efficient compliance. Such recommendations should be considered for other slowly draining lakes, including those created by artificial structures.

Improvement of the safety of a clinical process using failure mode and effects analysis: Prevention of venous thromboembolic disease in critical patients.

Science.gov (United States)

Viejo Moreno, R; Sánchez-Izquierdo Riera, J Á; Molano Álvarez, E; Barea Mendoza, J A; Temprano Vázquez, S; Díaz Castellano, L; Montejo González, J C

2016-11-01

To improve critical patient safety in the prevention of venous thromboembolic disease, using failure mode and effects analysis as safety tool. A contemporaneous cohort study covering the period January 2014-March 2015 was made in 4 phases: phase 1) prior to failure mode and effects analysis; phase 2) conduction of mode analysis and implementation of the detected improvements; phase 3) evaluation of outcomes, and phase 4) (post-checklist introduction impact. Patients admitted to the adult polyvalent ICU of a third-level hospital center. A total of 196 patients, older than 18 years, without thromboembolic disease upon admission to the ICU and with no prior anticoagulant treatment. A series of interventions were implemented following mode analysis: training, and introduction of a protocol and checklist to increase preventive measures in relation to thromboembolic disease. Indication and prescription of venous thrombosis prevention measures before and after introduction of the measures derived from the failure mode and effects analysis. A total of 59, 97 and 40 patients were included in phase 1, 3 and 4, respectively, with an analysis of the percentage of subjects who received thromboprophylaxis. The failure mode and effects analysis was used to detect potential errors associated to a lack of training and protocols referred to thromboembolic disease. An awareness-enhancing campaign was developed, with staff training and the adoption of a protocol for the prevention of venous thromboembolic disease. The prescription of preventive measures increased in the phase 3 group (91.7 vs. 71.2%, P=.001). In the post-checklist group, prophylaxis was prescribed in 97.5% of the patients, with an increase in the indication of dual prophylactic measures (4.7, 6.7 and 41%; P<.05). There were no differences in complications rate associated to the increase in prophylactic measures. The failure mode and effects analysis allowed us to identify improvements in the prevention of

Failure Behavior of Elbows with Local Wall Thinning

Science.gov (United States)

Lee, Sung-Ho; Lee, Jeong-Keun; Park, Jai-Hak

Wall thinning defect due to corrosion is one of major aging phenomena in carbon steel pipes in most plant industries, and it results in reducing load carrying capacity of the piping components. A failure test system was set up for real scale elbows containing various simulated wall thinning defects, and monotonic in-plane bending tests were performed under internal pressure to find out the failure behavior of them. The failure behavior of wall-thinned elbows was characterized by the circumferential angle of thinned region and the loading conditions to the piping system.

Where Is Obesity Prevention on the Map? Distribution and Predictors of Local Health Department Prevention Activities in Relation to County-Level Obesity Prevalence in the US

Science.gov (United States)

Stamatakis, Katherine A.; Leatherdale, Scott T.; Marx, Christine; Yan, Yan; Colditz, Graham A.; Brownson, Ross C.

2013-01-01

Context The system of local health departments (LHD) in the US has potential to advance a locally-oriented public health response in obesity control and reduce geographic disparities. However, the extent to which obesity prevention programs correspond to local obesity levels is unknown. Objective This study examines the extent to which LHDs across the US have responded to local levels of obesity by examining the association between jurisdiction level obesity prevalence and the existence of obesity prevention programs. Design Data on LHD organizational characteristics from the Profile Study of Local Health Departments and county-level estimates of obesity from the Behavioral Risk Factor Surveillance System were analyzed (n=2,300). Since local public health systems are nested within state infrastructure, multilevel models were used to examine the relationship between county-level obesity prevalence and LHD obesity prevention programming and to assess the impact of state-level clustering. Setting 2,300 local health department jurisdictions defined with respect to county boundaries Participants Practitioners in local health departments who responded to the 2005 Profile Study of Local Health Departments. Main Outcome Measures Likelihood of having obesity prevention activities and association with area-level obesity prevalence Results The existence of obesity prevention activities was not associated with prevalence of obesity in the jurisdiction. A substantial portion of the variance in LHD activities was explained by state-level clustering. Conclusions This paper identified a gap in the local public health response to the obesity epidemic and underscores the importance of multilevel modeling in examining predictors of LHD performance. PMID:22836530

No significant fuel failures (NSFF)

International Nuclear Information System (INIS)

Domaratzki, Z.

1979-01-01

It has long been recognized that no emergency core cooling system (ECCS) could be absolutely guaranteed to prevent fuel failures. In 1976 the Atomic Energy Control Board decided that the objective for an ECCS should be to prevent fuel failures, but if the objective could not be met it should be shown that the consequences are acceptable for dual failures comprising any LOCA combined with an assumed impairment of containment. Out of the review of the Bruce A plant came the definition of 'no significant fuel failures': for any postulated LOCA combined with any one mode of containment impairment the resultant dose to a person at the edge of the exclusion zone is less than the reference dose limits for dual failures

Are the effects of drugs to prevent and to treat heart failure always concordant? The statin paradox and its implications for understanding the actions of antidiabetic medications.

Science.gov (United States)

Packer, Milton

2018-03-22

Most treatments for chronic heart failure are effective both in preventing its onset and reducing its progression. However, statins prevent the development of heart failure, but they do not decrease morbidity and mortality in those with established heart failure. This apparent discordance cannot be explained by an effect to prevent interval myocardial infarctions. Instead, it seems that the disease that statins were preventing in trials of patients with a metabolic disorder was different from the disease that they were treating in trials of chronic heart failure. The most common phenotype of heart failure in patients with obesity and diabetes is heart failure with a preserved ejection fraction (HFpEF). In this disorder, the anti-inflammatory effects of statins might ameliorate myocardial fibrosis and cardiac filling abnormalities, but these actions may have little relevance to patients with heart failure and a reduced ejection fraction (HFrEF), whose primary derangement is cardiomyocyte loss and stretch. These distinctions may explain why statins were ineffective in trials that focused on HFrEF, but have been reported to produce with favourable effects in observational studies of HFpEF. Similarly, selective cytokine antagonists were ineffective in HFrEF, but have been associated with benefits in HFpEF. These observations may have important implications for our understanding of the effects of antihyperglycaemic medications. Glucagon-like peptide-1 receptor agonists have had neutral effects on heart failure events in people at risk for HFpEF, but have exerted deleterious actions in HFrEF. Similarly, sodium-glucose co-transporter 2 inhibitors, which exert anti-inflammatory effects and reduce heart failure events in patients who are prone to HFpEF, may not be effective in HFrEF. The distinctions between HFrEF and HFpEF may explain why the effects of drugs on heart failure events in diabetes trials may not be relevant to their use in patients with systolic dysfunction

Evolving Use of Natriuretic Peptides as Part of Strategies for Heart Failure Prevention.

Science.gov (United States)

McDonald, Ken; Wilkinson, Mark

2017-01-01

Heart failure (HF) remains one of the major cardiovascular challenges to the Western world. Once established, HF is characterized by compromised life expectancy and quality of life with considerable dependence on hospital care for episodic clinical deterioration. Much is understood about the risk factors that predispose to the development of HF. With such a broad range of factors, it is clear that there is a large population at risk, potentially in excess of 25% of the adult population. Therein lies the major challenge at the outset of our efforts to prevent HF. With such a large population at risk, how do we develop an effective prevention strategy? HF prevention requires a multimodal approach. In this review, we focus primarily on the role of natriuretic peptide (NP) as a tool in a prevention strategy. Prevention of HF is a major public health challenge, underlined by the concerning epidemiological trends, the associated costs, and the continued difficulty to find effective therapies for the growing number of patients with preserved systolic function HF. Population-based approaches focusing on lifestyle and risk factor control have made some impact but not to a satisfactory level and also tend to result in a uniform approach across a population with different risk profiles. Individualizing risk is therefore required, with emerging data indicating that NP-guided risk stratification and intervention can reduce downstream incident HF and other cardiovascular events. © 2016 American Association for Clinical Chemistry.

Resected Pancreatic Neuroendocrine Tumors: Patterns of Failure and Disease-Related Outcomes With or Without Radiotherapy

International Nuclear Information System (INIS)

Zagar, Timothy M.; White, Rebekah R.; Willett, Christopher G.; Tyler, Douglas S.; Papavassiliou, Paulie; Papalezova, Katia T.; Guy, Cynthia D.; Broadwater, Gloria; Clough, Robert W.; Czito, Brian G.

2012-01-01

Purpose: Pancreatic neuroendocrine tumors (NET) are rare and have better disease-related outcomes compared with pancreatic adenocarcinoma. Surgical resection remains the standard of care, although many patients present with locally advanced or metastatic disease. Little is known regarding the use of radiotherapy in the prevention of local recurrence after resection. To better define the role of radiotherapy, we performed an analysis of resected patients at our institution. Methods: Between 1994 and 2009, 33 patients with NET of the pancreatic head and neck underwent treatment with curative intent at Duke University Medical Center. Sixteen patients were treated with surgical resection alone while an additional 17 underwent resection with adjuvant or neoadjuvant radiation therapy, usually with concurrent fluoropyrimidine-based chemotherapy (CMT). Median radiation dose was 50.4 Gy and median follow-up 28 months. Results: Thirteen patients (39%) experienced treatment failure. Eleven of the initial failures were distant, one was local only and one was local and distant. Two-year overall survival was 77% for all patients. Two-year local control for all patients was 87%: 85% for the CMT group and 90% for the surgery alone group (p = 0.38). Two-year distant metastasis-free survival was 56% for all patients: 46% and 69% for the CMT and surgery patients, respectively (p = 0.10). Conclusions: The primary mode of failure is distant which often results in mortality, with local failure occurring much less commonly. The role of radiotherapy in the adjuvant management of NET remains unclear.

The failure of suicide prevention in primary care: family and GP perspectives - a qualitative study.

Science.gov (United States)

Leavey, Gerard; Mallon, Sharon; Rondon-Sulbaran, Janeet; Galway, Karen; Rosato, Michael; Hughes, Lynette

2017-11-21

Although Primary care is crucial for suicide prevention, clinicians tend to report completed suicides in their care as non-preventable. We aimed to examine systemic inadequacies in suicide prevention from the perspectives of bereaved family members and GPs. Qualitative study of 72 relatives or close friends bereaved by suicide and 19 General Practitioners who have experienced the suicide of patients. Relatives highlight failures in detecting symptoms and behavioral changes and the inability of GPs to understand the needs of patients and their social contexts. A perceived overreliance on anti-depressant treatment is a major source of criticism by family members. GPs tend to lack confidence in the recognition and management of suicidal patients, and report structural inadequacies in service provision. Mental health and primary care services must find innovative and ethical ways to involve families in the decision-making process for patients at risk of suicide.

Vitamin D and Heart Failure.

Science.gov (United States)

Marshall Brinkley, D; Ali, Omair M; Zalawadiya, Sandip K; Wang, Thomas J

2017-10-01

Vitamin D is principally known for its role in calcium homeostasis, but preclinical studies implicate multiple pathways through which vitamin D may affect cardiovascular function and influence risk for heart failure. Many adults with cardiovascular disease have low vitamin D status, making it a potential therapeutic target. We review the rationale and potential role of vitamin D supplementation in the prevention and treatment of chronic heart failure. Substantial observational evidence has associated low vitamin D status with the risk of heart failure, ventricular remodeling, and clinical outcomes in heart failure, including mortality. However, trials assessing the influence of vitamin D supplementation on surrogate markers and clinical outcomes in heart failure have generally been small and inconclusive. There are insufficient data to recommend routine assessment or supplementation of vitamin D for the prevention or treatment of chronic heart failure. Prospective trials powered for clinical outcomes are warranted.

Dispersed Trading and the Prevention of Market Failure

DEFF Research Database (Denmark)

Porter, David C.; Tanggaard, Carsten; G. Weaver, Daniel

With augmented demands on power grids resulting in longer and larger blackouts combined with heightened concerns of terrorist attacks, trading institutions and policy makers have widened their search for systems that avoid market failure during these disturbing events. We provide insight into thi......With augmented demands on power grids resulting in longer and larger blackouts combined with heightened concerns of terrorist attacks, trading institutions and policy makers have widened their search for systems that avoid market failure during these disturbing events. We provide insight...... combined with widely dispersed trading locations may be a viable means of protection against market failure during massive power disruptions or terrorist attacks....

Body Mass Index and Prostate-Specific Antigen Failure Following Brachytherapy for Localized Prostate Cancer

International Nuclear Information System (INIS)

Efstathiou, Jason A.; Skowronski, Rafi Y.; Coen, John J.; Grocela, Joseph A.; Hirsch, Ariel E.; Zietman, Anthony L.

2008-01-01

Purpose: Increasing body mass index (BMI) is associated with prostate-specific antigen (PSA) failure after radical prostatectomy and external beam radiation therapy (EBRT). We investigated whether BMI is associated with PSA failure in men treated with brachytherapy for clinically localized prostate cancer. Patients and Methods: Retrospective analyses were conducted on 374 patients undergoing brachytherapy for stage T1c-T2cNXM0 prostate cancer from 1996-2001. Forty-nine patients (13%) received supplemental EBRT and 131 (35%) received androgen deprivation therapy (ADT). Height and weight data were available for 353 (94%). Cox regression analyses were performed to evaluate the relationship between BMI and PSA failure (nadir + 2 ng/ml definition). Covariates included age, race, preimplantation PSA, Gleason score, T category, percent of prescription dose to 90% of the prostate, use of supplemental EBRT, and ADT. Results: Median age, PSA, and BMI were 66 years (range, 42-80 years), 5.7 ng/ml (range, 0.4-22.6 ng/ml), and 27.1 kg/m 2 (range, 18.2-53.6 kg/m 2 ), respectively. After a median follow-up of 6.0 years (range, 3.0-10.2 years), there were 76 PSA recurrences. The BMI was not associated with PSA failure. Six-year PSA failure rates were 30.2% for men with BMI less than 25 kg/m 2 , 19.5% for BMI of 25 or greater to less than 30 kg/m 2 , and 14.4% for BMI of 30 kg/m 2 or greater (p = 0.19). Results were similar when BMI was analyzed as a continuous variable, using alternative definitions of PSA failure, and excluding patients treated with EBRT and/or ADT. In multivariate analyses, only baseline PSA was significantly associated with shorter time to PSA failure (adjusted hazard ratio, 1.12; 95% confidence interval, 1.05-1.20; p 0.0006). Conclusions: Unlike after surgery or EBRT, BMI is not associated with PSA failure in men treated with brachytherapy for prostate cancer. This raises the possibility that brachytherapy may be a preferred treatment strategy in obese

Aircraft Loss-of-Control Accident Prevention: Switching Control of the GTM Aircraft with Elevator Jam Failures

Science.gov (United States)

Chang, Bor-Chin; Kwatny, Harry G.; Belcastro, Christine; Belcastro, Celeste

2008-01-01

Switching control, servomechanism, and H2 control theory are used to provide a practical and easy-to-implement solution for the actuator jam problem. A jammed actuator not only causes a reduction of control authority, but also creates a persistent disturbance with uncertain amplitude. The longitudinal dynamics model of the NASA GTM UAV is employed to demonstrate that a single fixed reconfigured controller design based on the proposed approach is capable of accommodating an elevator jam failure with arbitrary jam position as long as the thrust control has enough control authority. This paper is a first step towards solving a more comprehensive in-flight loss-of-control accident prevention problem that involves multiple actuator failures, structure damages, unanticipated faults, and nonlinear upset regime recovery, etc.

Neoadjuvant versus definitive chemoradiotherapy for locally advanced esophageal cancer. Outcomes and patterns of failure

Energy Technology Data Exchange (ETDEWEB)

Haefner, Matthias Felix; Lang, Kristin; Koerber, Stefan Alexander; Debus, Juergen [University Hospital of Heidelberg, Department of Radiation Oncology, Heidelberg (Germany); National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg (Germany); Verma, Vivek [University of Nebraska Medical Center, Department of Radiation Oncology, Omaha, NE (United States); Uhlmann, Lorenz [University of Heidelberg, Institute of Medical Biometry and Informatics (IMBI), Heidelberg (Germany); Sterzing, Florian [National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg (Germany); Hospital Kempten, Department of Radiation Oncology, Kempten (Germany)

2018-02-15

Randomized trials examining neoadjuvant chemoradiotherapy followed by surgical resection (nCRT-S) and definitive CRT (dCRT) for esophageal cancer (EC) patients are hampered by use of nonstandard treatment paradigms. Outcomes of nCRT-S versus dCRT in a more common patient population are lacking. We investigated local control and survival, evaluated clinical factors associated with endpoints, and assessed patterns of failure between these cohorts. We retrospectively analyzed 130 patients with locally advanced EC receiving either dCRT or nCRT-S at our institution from 2000-2012. Inclusion criteria were curatively treated nonmetastatic EC, Karnofsky performance status ≥70%, and receipt of concomitant CRT. Patients were excluded if receiving <41 Gy neoadjuvantly or <50 Gy definitively. Kaplan-Meier analysis was used to evaluate local recurrence (LR), progression-free survival (PFS), and overall survival (OS). Univariate and multivariate Cox proportional hazards modeling addressed factors associated with outcomes. Patterns of failure were enumerated as local, regional, or distant. Mean follow-up was 34.2 months. The 3-year LR was 10.8% in the nCRT-S group and 21.5% in the dCRT group (p = 0.266). Median PFS were 15.6 and 14.9 months, respectively (p = 0.549). Median OS were 20.6 and 25.9 months, respectively (p = 0.81). On univariate and multivariate analysis, none of the investigated factors was associated with outcomes, although node-positive disease showed a trend for worse OS and PFS. Most common failures in both groups were distant (dCRT 31.2% vs. nCRT-S 21.6%) followed by local in-field recurrences (dCRT 26.9% vs. nCRT-S 10.8%). In this institutional analysis, no significant differences regarding outcomes and patterns of failure were observed between nCRT-S and dCRT. (orig.) [German] Randomisierte Studien, welche die neoadjuvante Radiochemotherapie (CRT) einschliesslich konsekutiver Operation (nCRT-S) mit der definitiven Radiochemotherapie (dCRT) fuer

Reliability based topology optimization for continuum structures with local failure constraints

DEFF Research Database (Denmark)

Luo, Yangjun; Zhou, Mingdong; Wang, Michael Yu

2014-01-01

This paper presents an effective method for stress constrained topology optimization problems under load and material uncertainties. Based on the Performance Measure Approach (PMA), the optimization problem is formulated as to minimize the objective function under a large number of (stress......-related) target performance constraints. In order to overcome the stress singularity phenomenon caused by the combined stress and reliability constraints, a reduction strategy on target reliability index is proposed and utilized together with the ε-relaxation approach. Meanwhile, an enhanced aggregation method...... is employed to aggregate the selected active constraints using a general K–S function, which avoids expensive computational cost from the large-scale nature of local failure constraints. Several numerical examples are given to demonstrate the validity of the present method....

[Localized invasive intracranial aspergillosis with multiple cranial nerve failure -- case report and review of the literature].

Science.gov (United States)

Winkler, F; Seelos, K; Hempel, J M; Pfister, H-W

2002-12-01

Contrary to the more frequent hematogenously spread cerebral aspergillosis, localized invasive intracranial aspergillosis is a fungal infection that can also occur in patients who are not severely immunosuppressed. This illness can be effectively treated in some of these patients by early and rigorous therapy. Localized invasion of the fungus, generally from one of the nasal sinuses, causes intracranial growth mainly along the base of the skull and larger vessels,where fibrous, granulomatous tissue develops. This generally leads to damage of the cranial nerves (primarily I-VI) as well as localized pain syndromes. We report on the clinical course documented by MRI of a patient with localized invasive intracranial aspergillosis who had multiple failure of cranial nerves following surgery for an aspergilloma of the maxillary sinus. Clinical course, imaging findings, and treatment of the illness are discussed with a review of the relevant literature.

The failure trace archive : enabling comparative analysis of failures in diverse distributed systems

NARCIS (Netherlands)

Kondo, D.; Javadi, B.; Iosup, A.; Epema, D.H.J.

2010-01-01

With the increasing functionality and complexity of distributed systems, resource failures are inevitable. While numerous models and algorithms for dealing with failures exist, the lack of public trace data sets and tools has prevented meaningful comparisons. To facilitate the design, validation,

Non-small cell lung cancer: current status of chemoradiation for locally advanced disease and an update on susceptibility and prevention

International Nuclear Information System (INIS)

Byhardt, Roger W.

1996-01-01

Locally advanced, inoperable non-small cell lung cancer (NSCLC) afflicts 40,000 patients yearly. The traditional treatment has been radiation therapy (RT) alone with 5 year survival rates averaging around 5%. Recent reports of randomized clinical trials using combined radiochemotherapy suggest significant improvement in survival compared to RT alone. These trials are difficult to evaluate because of differences in dose, timing and sequencing of both the chemotherapy (CT) and the RT. Dr. Byhardt will give an overview of the significant chemoradiation trials, especially with respect to the factors associated with reduction of local failure and distant metastasis. Dr. Tishler will review the biologic rationale of these regimens and make some prognostications about the potential role of new chemotherapy agents, new developments in RT dose-time-fractionation, and new RT technology in future radiochemotherapy trials. While progress continues to be made using the more traditional cancer treatment modalities, investigations in NSCLC epidemiology and prevention are providing new insights regarding susceptibility, etiology, failure risk stratification, and potential avenues of therapeutic intervention. Dr. Spitz will discuss NSCLC as a paradigm of an environmentally induced disease in which host susceptibility may be determined by genetically determined modulation of environmental exposures. A mutagen sensitivity assay can determine individuals at high risk for developing NSCLC if exposed to carcinogens such as those in cigarette smoke. This susceptibility may have prognostic implications that could influence choice of therapy. Highly susceptible individuals can also be selected for special counseling, smoking cessation, with consideration given to chemoprevention. Dr. Gritz will review major work done in this area

Updating the FORECAST formative evaluation approach and some implications for ameliorating theory failure, implementation failure, and evaluation failure

Science.gov (United States)

Katz, Jason; Wandersman, Abraham; Goodman, Robert M.; Griffin, Sarah; Wilson, Dawn K.; Schillaci, Michael

2013-01-01

Historically, there has been considerable variability in how formative evaluation has been conceptualized and practiced. FORmative Evaluation Consultation And Systems Technique (FORECAST) is a formative evaluation approach that develops a set of models and processes that can be used across settings and times, while allowing for local adaptations and innovations. FORECAST integrates specific models and tools to improve limitations in program theory, implementation, and evaluation. In the period since its initial use in a federally funded community prevention project in the early 1990s, evaluators have incorporated important formative evaluation innovations into FORECAST, including the integration of feedback loops and proximal outcome evaluation. In addition, FORECAST has been applied in a randomized community research trial. In this article, we describe updates to FORECAST and the implications of FORECAST for ameliorating failures in program theory, implementation, and evaluation. PMID:23624204

Patterns of failure after iodine-125 seed implantation for prostate cancer

International Nuclear Information System (INIS)

Lamb, David S.; Greig, Lynne; Russell, Grant L.; Nacey, John N.; Broome, Kim; Studd, Rod; Delahunt, Brett; Iupati, Douglas; Jain, Mohua; Rooney, Colin; Murray, Judy; Lamb, Peter J.; Bethwaite, Peter B.

2014-01-01

Purpose: To determine the site of relapse when biochemical failure (BF) occurs after iodine-125 seed implantation for prostate cancer. Materials and methods: From 2001–2009, 500 men underwent implantation in Wellington, New Zealand. Men who sustained BF were placed on relapse guidelines that delayed restaging and intervention until the prostate-specific antigen (PSA) was ⩾20 ng/mL. Results: Most implants (86%) had a prostate D90 of ⩾90%, and multivariate analysis showed that this parameter was not a variable that affected the risk of BF. Of 21 BFs that occurred, the site of failure was discovered to be local in one case and distant in nine cases. Restaging failed to identify the site of relapse in two cases. In nine cases the trigger for restaging had not been reached. Conclusions: If post-implant dosimetry is generally within the optimal range, distant rather than local failure appears to be the main cause of BF. Hormone treatment is therefore the most commonly indicated secondary treatment intervention (STI). Delaying the start of STI prevents the unnecessary treatment of men who undergo PSA ‘bounce’ and have PSA dynamics initially mimicking those of BF

Local anesthetic failure associated with inflammation: verification of the acidosis mechanism and the hypothetic participation of inflammatory peroxynitrite

Directory of Open Access Journals (Sweden)

Takahiro Ueno

2008-11-01

Full Text Available Takahiro Ueno1, Hironori Tsuchiya2, Maki Mizogami1, Ko Takakura11Department of Anesthesiology, Asahi University School of Dentistry, Mizuho, Gifu, Japan; 2Department of Dental Basic Education, Asahi University School of Dentistry, Mizuho, Gifu, JapanAbstract: The presence of inflammation decreases local anesthetic efficacy, especially in dental anesthesia. Although inflammatory acidosis is most frequently cited as the cause of such clinical phenomena, this has not been experimentally proved. We verified the acidosis mechanism by studying the drug and membrane lipid interaction under acidic conditions together with proposing an alternative hypothesis. Liposomes and nerve cell model membranes consisting of phospholipids and cholesterol were treated at different pH with lidocaine, prilocaine and bupivacaine (0.05%–0.2%, w/v. Their membrane-interactive potencies were compared by the induced-changes in membrane fluidity. Local anesthetics fluidized phosphatidylcholine membranes with the potency being significantly lower at pH 6.4 than at pH 7.4 (p < 0.01, supporting the acidosis theory. However, they greatly fluidized nerve cell model membranes even at pH 6.4 corresponding to inflamed tissues, challenging the conventional mechanism. Local anesthetics acted on phosphatidylserine liposomes, as well as nerve cell model membranes, at pH 6.4 with almost the same potency as that at pH 7.4, but not on phosphatidylcholine, phosphatidylethanolamine and sphingomyelin liposomes. Since the positively charged anesthetic molecules are able to interact with nerve cell membranes by ion-paring with anionic components like phosphatidylserine, tissue acidosis is not essentially responsible for the local anesthetic failure associated with inflammation. The effects of local anesthetics on nerve cell model membranes were inhibited by treating with peroxynitrite (50 μM, suggesting that inflammatory cells producing peroxynitrite may affect local anesthesia

Which antibiotic regimen prevents implant failure or infection after dental implant surgery? A systematic review and meta-analysis.

Science.gov (United States)

Rodríguez Sánchez, Fabio; Rodríguez Andrés, Carlos; Arteagoitia, Iciar

2018-04-01

To assess which antibiotic regimen prevents dental implant failures or postoperative infections following dental implant placement. Systematic review and meta-analysis. Pubmed, Cochrane, Science Direct, and EMBASE via OVID were searched up to August 2017. Only randomized controlled clinical trials (RCT) using antibiotics were included. Outcome measures were set on dental implant failures or postoperative infection incidence after dental implant surgery. Three reviewers independently undertook risk of bias assessment and data extraction. Stratified meta-analyses of binary data using fixed-effects models were performed using Stata 14.0. The risk ratio (RR) and 95% confidence interval (CI) were estimated. Nine articles were included corresponding to 15 RCTs. All RCTs tested only oral amoxicillin. Implant-failure analysis: overall RR = 0.53 (P = .005, 95% CI: 0.34-0.82) and overall NNT = 55 (95% CI, 33-167). Single-dose oral amoxicillin preoperatively (SDOAP) is beneficial (RR = 0.50, CI: 0.29-0.86. P = .012), when compared to postoperative oral amoxicillin (POA): RR = 0.60, CI: 0.28-1.30. P = .197. Postoperative-infection analysis: overall RR = 0.76 (P = 0.250, 95% CI: 0.47-1.22). Neither SDOAP (RR = 0.82, CI = 0.46-1.45, P = .488) nor POA (RR = 0.64, CI = 0.27-1.51, P = .309) are beneficial. I 2  = 0.0%, chi-squared tests P ≈ 1. Only SDOAP is effective and efficacious at preventing implant failures, but it was not significant for postoperative infections following dental implant surgeries. Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Circuit card failures and industry mitigation strategy

Energy Technology Data Exchange (ETDEWEB)

Mondal, U. [Candu Owners Group, Toronto, Ontario (Canada)

2012-07-01

In recent years the nuclear industry has experienced an increase in circuit card failures due to ageing of components, inadequate Preventive Maintenance (PM), lack of effective circuit card health monitoring, etc. Circuit card failures have caused loss of critical equipment, e.g., electro hydraulic governors, Safety Systems, resulting in loss of function and in some cases loss of generation. INPO completed a root cause analysis of 40 Reactor Trips/Scrams in US reactors and has recommended several actions to mitigate Circuit Card failures. Obsolescence of discrete components has posed many challenges in conducting effective preventative maintenance on circuit cards. In many cases, repairs have resulted in installation of components that compromise performance of the circuit cards. Improper termination and worn edge connectors have caused intermittent contacts contributing to circuit card failures. Traditionally, little attention is paid to relay functions and preventative maintenance of relay. Relays contribute significantly to circuit card failures and have dominated loss of generation across the power industry. The INPO study recommended a number of actions to mitigate circuit card failures, such as; identification of critical components and single point vulnerabilities; strategic preventative maintenance; protection of circuit boards against electrostatic discharge; limiting power cycles; performing an effective burn-in prior to commissioning of the circuit cards; monitoring performance of DC power supplies; limiting cabinet temperatures; managing of component aging/degradation mechanism, etc. A subcommittee has been set up under INPO sponsorship to understand the causes of circuit card failure and to develop an effective mitigation strategy. (author)

Risk factors for acute renal failure: inherent and modifiable risks.

Science.gov (United States)

Leblanc, Martine; Kellum, John A; Gibney, R T Noel; Lieberthal, Wilfred; Tumlin, James; Mehta, Ravindra

2005-12-01

Our purpose is to discuss established risk factors in the development of acute renal failure and briefly overview clinical markers and preventive measures. Findings from the literature support the role of older age, diabetes, underlying renal insufficiency, and heart failure as predisposing factors for acute renal failure. Diabetics with baseline renal insufficiency represent the highest risk subgroup. An association between sepsis, hypovolemia, and acute renal failure is clear. Liver failure, rhabdomyolysis, and open-heart surgery (especially valve replacement) are clinical conditions potentially leading to acute renal failure. Increasing evidence shows that intraabdominal hypertension may contribute to the development of acute renal failure. Radiocontrast and antimicrobial agents are the most common causes of nephrotoxic acute renal failure. In terms of prevention, avoiding nephrotoxins when possible is certainly desirable; fluid therapy is an effective prevention measure in certain clinical circumstances. Supporting cardiac output, mean arterial pressure, and renal perfusion pressure are indicated to reduce the risk for acute renal failure. Nonionic, isoosmolar intravenous contrast should be used in high-risk patients. Although urine output and serum creatinine lack sensitivity and specificity in acute renal failure, they remain the most used parameters in clinical practice. There are identified risk factors of acute renal failure. Because acute renal failure is associated with a worsening outcome, particularly if occurring in critical illness and if severe enough to require renal replacement therapy, preventive measures should be part of appropriate management.

Patients Commonly Believe Their Heart Failure Hospitalizations Are Preventable and Identify Worsening Heart Failure, Nonadherence, and a Knowledge Gap as Reasons for Admission.

Science.gov (United States)

Gilotra, Nisha A; Shpigel, Adam; Okwuosa, Ike S; Tamrat, Ruth; Flowers, Deirdre; Russell, Stuart D

2017-03-01

There are few data describing patient-identified precipitants of heart failure (HF) hospitalization. We hypothesized a patient's perception of reason for or preventability of an admission may be related to 30-day readmission rates. Ninety-four patients admitted with decompensated HF from July 2014 to March 2015 completed a brief questionnaire regarding circumstances leading to admission. Thirty-day outcomes were assessed via telephone call and chart review. Mean age was 58 ± 14 years, with 60% blacks (n = 56) and 41% females (n = 39). Median left ventricular ejection fraction was 30%; 27 had preserved ejection fraction. Seventy-two patients identified their hospitalization to be due to HF (± another condition). Most common patient-identified precipitants of admission were worsening HF (n = 37) and dietary nonadherence (n = 11). Readmitted patients tended to have longer time until first follow-up appointment (21 vs 8 days). Seven of the 42 patients who identified their hospitalization as preventable were readmitted compared with 21/49 who believed their hospitalization was unpreventable (P = .012). On multivariate regression analysis, patients who thought their hospitalization was preventable were less likely to be readmitted (odds ratio 0.31; 95% confidence interval 0.10-0.91; P = .04). Almost 50% of patients believe their HF hospitalization is preventable, and these patients appear to be less likely to be readmitted within 30 days. Notably, patients cite nonadherence and lack of knowledge as reasons hospitalizations are preventable. These results lend insight into possible interventions to reduce HF readmissions. Copyright © 2016 Elsevier Inc. All rights reserved.

Perioperative acute renal failure.

LENUS (Irish Health Repository)

Mahon, Padraig

2012-02-03

PURPOSE OF REVIEW: Recent biochemical evidence increasingly implicates inflammatory mechanisms as precipitants of acute renal failure. In this review, we detail some of these pathways together with potential new therapeutic targets. RECENT FINDINGS: Neutrophil gelatinase-associated lipocalin appears to be a sensitive, specific and reliable biomarker of renal injury, which may be predictive of renal outcome in the perioperative setting. For estimation of glomerular filtration rate, cystatin C is superior to creatinine. No drug is definitively effective at preventing postoperative renal failure. Clinical trials of fenoldopam and atrial natriuretic peptide are, at best, equivocal. As with pharmacological preconditioning of the heart, volatile anaesthetic agents appear to offer a protective effect to the subsequently ischaemic kidney. SUMMARY: Although a greatly improved understanding of the pathophysiology of acute renal failure has offered even more therapeutic targets, the maintenance of intravascular euvolaemia and perfusion pressure is most effective at preventing new postoperative acute renal failure. In the future, strategies targeting renal regeneration after injury will use bone marrow-derived stem cells and growth factors such as insulin-like growth factor-1.

Can we reduce preventable heart failure readmissions in patients enrolled in a Disease Management Programme?

LENUS (Irish Health Repository)

Phelan, D

2012-02-01

BACKGROUND: Disease Management Programmes (DMPs) are successful in reducing hospital readmissions in heart failure (HF). However, there remain a number of patients enrolled in a DMP who are readmitted with HF. The primary aim of the study was to determine the proportion of preventable readmissions (PR). The secondary aim was to recognise patient characteristics which would identify certain patients at risk of having a PR. METHODS: A retrospective chart search was performed on patients readmitted over a 1-year period. RESULTS: 38.5% of readmissions were classified as PR. None of these patients made prior contact with the DMP. Admission levels of BNP, potassium, urea and creatinine were significantly lower in the PR group. CONCLUSION: DMP have proven benefits in reducing hospital readmission nonetheless a significant proportion of these readmissions are preventable. Further work is required to prospectively analyse why these patients fail to contact the DMP.

Patterns of failure following curative resection of gastric carcinoma

Energy Technology Data Exchange (ETDEWEB)

Landry, J.; Tepper, J.E.; Wood, W.C.; Moulton, E.O.; Koerner, F.; Sullinger, J. (Massachusetts General Hospital Cancer Center, Boston (USA))

1990-12-01

To identify patterns of failure following curative resection of gastric carcinoma, the records of 130 patients undergoing resection with curative intent at the Massachusetts General Hospital were reviewed. The total local-regional failure rate was 38% (49/130 patients), with 21 patients having local-regional failure alone and 28 patients having local-regional failure and distant metastases. The incidence of local failure rose with the more advanced stages of disease. Tumors staged B2, B3, C2, and C3 had local-regional failure rates in excess of 35%. This group of patients might benefit from adjuvant radiation therapy to the tumor bed and regional lymphatics. Local-regional failure rate was highest in the anastomosis or stump 33/130 (25%), followed by the stomach bed 27/130 (21%). The overall incidence of distant metastases was 52% (67/130 patients) and rose in the more advanced disease stages. Tumors staged B2, B3, C2, and C3 had rates of distant metastases greater than 50%. Sixty-one patients (77%) had failure in the abdomen (liver, peritoneal surface, adrenal, kidney, and spleen, but excluding tumor bed, anastomosis, or regional nodes). Patients with Stage B2, B3, C2, and C3 tumors had total abdominal failure rates greater than 40%. The highest failure rates in the liver were in Stages B3 and C3, in which the subsequent development of liver metastasis was 40% and 47%, respectively. Peritoneal seeding occurred in 30/130 (23%) of patients and was highest in Stages C2 and C3, with rates of 27% and 41%, respectively.

Patterns of failure following curative resection of gastric carcinoma

International Nuclear Information System (INIS)

Landry, J.; Tepper, J.E.; Wood, W.C.; Moulton, E.O.; Koerner, F.; Sullinger, J.

1990-01-01

To identify patterns of failure following curative resection of gastric carcinoma, the records of 130 patients undergoing resection with curative intent at the Massachusetts General Hospital were reviewed. The total local-regional failure rate was 38% (49/130 patients), with 21 patients having local-regional failure alone and 28 patients having local-regional failure and distant metastases. The incidence of local failure rose with the more advanced stages of disease. Tumors staged B2, B3, C2, and C3 had local-regional failure rates in excess of 35%. This group of patients might benefit from adjuvant radiation therapy to the tumor bed and regional lymphatics. Local-regional failure rate was highest in the anastomosis or stump 33/130 (25%), followed by the stomach bed 27/130 (21%). The overall incidence of distant metastases was 52% (67/130 patients) and rose in the more advanced disease stages. Tumors staged B2, B3, C2, and C3 had rates of distant metastases greater than 50%. Sixty-one patients (77%) had failure in the abdomen (liver, peritoneal surface, adrenal, kidney, and spleen, but excluding tumor bed, anastomosis, or regional nodes). Patients with Stage B2, B3, C2, and C3 tumors had total abdominal failure rates greater than 40%. The highest failure rates in the liver were in Stages B3 and C3, in which the subsequent development of liver metastasis was 40% and 47%, respectively. Peritoneal seeding occurred in 30/130 (23%) of patients and was highest in Stages C2 and C3, with rates of 27% and 41%, respectively

[The activity of local health units in agriculture: promotion, prevention, control].

Science.gov (United States)

Angotzi, G; Ariano, E; Quercia, A

2010-01-01

Agriculture shows an high proportion of injuries, mostly by machineries and instruments, and the highest proportion between fatal and total injuries. The Conference of Regions has adopted the National Agriculture and Forestry Prevention Plan, in application of the "Pact for health and safety in workplaces". The plan gives priority to actions improving the safety of agricultural machines, specially if more frequently involved in serious and fatal injuries. Goal is to achieve an homogenous intervention standard all over in the country, composed by a mix of information, support and control, addressed to farms and agricultural machines traders. Public prevention organizations of Local Health Units moreover will record homogenously the happen modality of fatal and serious accidents, will collaborate in joining prevention objectives with Rural Develop Plans and in drawing up good practices. At another level in some regions have been developed prevention activities for other risk factors: definition of exposition profiles of pesticides, development of professionally exposed workers formation, control of buildings and cattle breeding, medical and epidemiological periodic survey of employees.

Nutrition in Heart Failure

OpenAIRE

Reci Meseri

2013-01-01

Heart failure is defined as decreased ability of heart due to various reasons. It%u2019s seen 2-3% but the prevalence increases sharply after the age of seventy. The objectives of nutrition therapy in heart failure are to prevent from water retention and edema, to avoid from hard digestion and to offer a balanced diet. In order to avoid fluid retention and edema, daily sodium and fluid intake must be monitored carefully. Main dilemma of the heart failure patients is the obesity-cachexia dilem...

Increased risk of biochemical and local failure in patients with distended rectum on the planning CT for prostate cancer radiotherapy

International Nuclear Information System (INIS)

Crevoisier, Renaud de; Tucker, Susan L.; Dong Lei; Mohan, Radhe; Cheung, Rex; Cox, James D.; Kuban, Deborah A.

2005-01-01

Purpose: To retrospectively test the hypothesis that rectal distension on the planning computed tomography (CT) scan is associated with an increased risk of biochemical and local failure among patients irradiated for prostate carcinoma when a daily repositioning technique based on direct prostate-organ localization is not used. Methods and Materials: This study included 127 patients who received definitive three-dimensional conformal radiotherapy for prostate cancer to a total dose of 78 Gy at University of Texas M.D. Anderson Cancer Center. Rectal distension was assessed by calculation of the average cross-sectional rectal area (CSA; defined as the rectal volume divided by length) and measuring three rectal diameters on the planning CT. The impact of rectal distension on biochemical control, 2-year prostate biopsy results, and incidence of Grade 2 or greater late rectal bleeding was assessed. Results: The incidence of biochemical failure was significantly higher among patients with distended rectums (CSA >11.2 cm 2 ) on the planning CT scan (p 0.0009, log-rank test). Multivariate analysis indicates that rectal distension and high-risk disease are independent risk factors for biochemical failure, with hazard ratios of 3.89 (95% C.I. 1.58 to 9.56, p = 0.003) and 2.45 (95% C.I. 1.18 to 5.08, p = 0.016), respectively. The probability of residual tumor without evidence of radiation treatment (as scored by the pathologist) increased significantly with rectal distension (p = 0.010, logistic analysis), and a lower incidence of Grade 2 or greater late rectal bleeding within 2 years was simultaneously observed with higher CSA values (p = 0.031, logistic analysis). Conclusions: We found strong evidence that rectal distension on the treatment-planning CT scan decreased the probability of biochemical control, local control, and rectal toxicity in patients who were treated without daily image-guided prostate localization, presumably because of geographic misses. Therefore, an

Dispersed trading and the prevention of market failure

DEFF Research Database (Denmark)

Porter, David C.; Tanggaard, Carsten; Weaver, Daniel G.

2008-01-01

With augmented demands on power grids resulting in longer and larger blackouts combined with heightened concerns of terrorist attacks, trading institutions and policy makers have widened their search for systems that avoid market failure during these disturbing events. We provide insight...... into this issue by examining trading behaviour at the Copenhagen Stock Exchange during a major blackout. We find that although market quality declined, markets remained functional and some price discovery occurred during the blackout period suggesting that the NOREX structure of interlinked trading systems...... combined with widely dispersed trading locations may be a viable means of protection against market failure during massive power disruptions or terrorist attacks....

Self-Regulation, Cooperative Learning, and Academic Self-Efficacy: Interactions to Prevent School Failure.

Science.gov (United States)

Fernandez-Rio, Javier; Cecchini, Jose A; Méndez-Gimenez, Antonio; Mendez-Alonso, David; Prieto, Jose A

2017-01-01

Learning to learn and learning to cooperate are two important goals for individuals. Moreover, self regulation has been identified as fundamental to prevent school failure. The goal of the present study was to assess the interactions between self-regulated learning, cooperative learning and academic self-efficacy in secondary education students experiencing cooperative learning as the main pedagogical approach for at least one school year. 2.513 secondary education students (1.308 males, 1.205 females), 12-17 years old ( M = 13.85, SD = 1.29), enrolled in 17 different schools belonging to the National Network of Schools on Cooperative Learning in Spain agreed to participate. They all had experienced this pedagogical approach a minimum of one school year. Participants were asked to complete the cooperative learning questionnaire, the strategies to control the study questionnaire and the global academic self-efficacy questionnaire. Participants were grouped based on their perceptions on cooperative learning and self-regulated learning in their classes. A combination of hierarchical and κ -means cluster analyses was used. Results revealed a four-cluster solution: cluster one included students with low levels of cooperative learning, self-regulated learning and academic self-efficacy, cluster two included students with high levels of cooperative learning, self-regulated learning and academic self-efficacy, cluster three included students with high levels of cooperative learning, low levels of self-regulated learning and intermediate-low levels of academic self-efficacy, and, finally, cluster four included students with high levels of self-regulated learning, low levels of cooperative learning, and intermediate-high levels of academic self-efficacy. Self-regulated learning was found more influential than cooperative learning on students' academic self-efficacy. In cooperative learning contexts students interact through different types of regulations: self, co, and

Self-Regulation, Cooperative Learning, and Academic Self-Efficacy: Interactions to Prevent School Failure

Science.gov (United States)

Fernandez-Rio, Javier; Cecchini, Jose A.; Méndez-Gimenez, Antonio; Mendez-Alonso, David; Prieto, Jose A.

2017-01-01

Learning to learn and learning to cooperate are two important goals for individuals. Moreover, self regulation has been identified as fundamental to prevent school failure. The goal of the present study was to assess the interactions between self-regulated learning, cooperative learning and academic self-efficacy in secondary education students experiencing cooperative learning as the main pedagogical approach for at least one school year. 2.513 secondary education students (1.308 males, 1.205 females), 12–17 years old (M = 13.85, SD = 1.29), enrolled in 17 different schools belonging to the National Network of Schools on Cooperative Learning in Spain agreed to participate. They all had experienced this pedagogical approach a minimum of one school year. Participants were asked to complete the cooperative learning questionnaire, the strategies to control the study questionnaire and the global academic self-efficacy questionnaire. Participants were grouped based on their perceptions on cooperative learning and self-regulated learning in their classes. A combination of hierarchical and κ-means cluster analyses was used. Results revealed a four-cluster solution: cluster one included students with low levels of cooperative learning, self-regulated learning and academic self-efficacy, cluster two included students with high levels of cooperative learning, self-regulated learning and academic self-efficacy, cluster three included students with high levels of cooperative learning, low levels of self-regulated learning and intermediate-low levels of academic self-efficacy, and, finally, cluster four included students with high levels of self-regulated learning, low levels of cooperative learning, and intermediate-high levels of academic self-efficacy. Self-regulated learning was found more influential than cooperative learning on students’ academic self-efficacy. In cooperative learning contexts students interact through different types of regulations: self, co, and

SU-D-204-07: Retrospective Correlation of Dose Accuracy with Regions of Local Failure for Early Stage Lung Cancer Patients Treated with Stereotactic Body Radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Devpura, S; Li, H; Liu, C; Fraser, C; Ajlouni, M; Movsas, B; Chetty, I [Henry Ford Health System, Detroit, MI (United States)

2016-06-15

Purpose: To correlate dose distributions computed using six algorithms for recurrent early stage non-small cell lung cancer (NSCLC) patients treated with stereotactic body radiotherapy (SBRT), with outcome (local failure). Methods: Of 270 NSCLC patients treated with 12Gyx4, 20 were found to have local recurrence prior to the 2-year time point. These patients were originally planned with 1-D pencil beam (1-D PB) algorithm. 4D imaging was performed to manage tumor motion. Regions of local failures were determined from follow-up PET-CT scans. Follow-up CT images were rigidly fused to the planning CT (pCT), and recurrent tumor volumes (Vrecur) were mapped to the pCT. Dose was recomputed, retrospectively, using five algorithms: 3-D PB, collapsed cone convolution (CCC), anisotropic analytical algorithm (AAA), AcurosXB, and Monte Carlo (MC). Tumor control probability (TCP) was computed using the Marsden model (1,2). Patterns of failure were classified as central, in-field, marginal, and distant for Vrecur ≥95% of prescribed dose, 95–80%, 80–20%, and ≤20%, respectively (3). Results: Average PTV D95 (dose covering 95% of the PTV) for 3-D PB, CCC, AAA, AcurosXB, and MC relative to 1-D PB were 95.3±2.1%, 84.1±7.5%, 84.9±5.7%, 86.3±6.0%, and 85.1±7.0%, respectively. TCP values for 1-D PB, 3-D PB, CCC, AAA, AcurosXB, and MC were 98.5±1.2%, 95.7±3.0, 79.6±16.1%, 79.7±16.5%, 81.1±17.5%, and 78.1±20%, respectively. Patterns of local failures were similar for 1-D and 3D PB plans, which predicted that the majority of failures occur in centraldistal regions, with only ∼15% occurring distantly. However, with convolution/superposition and MC type algorithms, the majority of failures (65%) were predicted to be distant, consistent with the literature. Conclusion: Based on MC and convolution/superposition type algorithms, average PTV D95 and TCP were ∼15% lower than the planned 1-D PB dose calculation. Patterns of failure results suggest that MC and convolution

Optimizing production and imperfect preventive maintenance planning's integration in failure-prone manufacturing systems

International Nuclear Information System (INIS)

Aghezzaf, El-Houssaine; Khatab, Abdelhakim; Tam, Phuoc Le

2016-01-01

This paper investigates the issue of integrating production and maintenance planning in a failure-prone manufacturing system. It is assumed that the system's operating state is stochastically predictable, in terms of its operating age, and that it can accordingly be preventively maintained during preplanned periods. Preventive maintenance is assumed to be imperfect, that is when performed, it brings the manufacturing system to an operating state that lies between ‘as bad as old’ and ‘as good as new’. Only an overhauling of the system brings it to a ‘as good as new’ operating state again. A practical integrated production and preventive maintenance planning model, that takes into account the system's manufacturing capacity and its operational reliability state, is developed. The model is naturally formulated as a mixed-integer non-linear optimization problem, for which an extended mixed-integer linear reformulation is proposed. This reformulation, while it solves the proposed integrated planning problem to optimality, remains quite demanding in terms of computational time. A fix-and-optimize procedure, that takes advantage of some properties of the original model, is then proposed. The reformulation and the fix-and-optimize procedure are tested on some test instances adapted from those available in the literature. The results show that the proposed fix-and-optimize procedure performs quite well and opens new research direction for future improvements. - Highlights: • Integration of production planning and imperfect preventive maintenance is explored. • Imperfect maintenance is modeled using a fitting age reduction hybrid hazard rate. • A practical approximate optimization model for this integration is proposed. • The resulting naturally MINL optimization model is reformulated and solved as a MILP. • An effective fix-and-optimize procedure is proposed for large instances of this MILP.

Robust Floor Determination Algorithm for Indoor Wireless Localization Systems under Reference Node Failure

Directory of Open Access Journals (Sweden)

Kriangkrai Maneerat

2016-01-01

Full Text Available One of the challenging problems for indoor wireless multifloor positioning systems is the presence of reference node (RN failures, which cause the values of received signal strength (RSS to be missed during the online positioning phase of the location fingerprinting technique. This leads to performance degradation in terms of floor accuracy, which in turn affects other localization procedures. This paper presents a robust floor determination algorithm called Robust Mean of Sum-RSS (RMoS, which can accurately determine the floor on which mobile objects are located and can work under either the fault-free scenario or the RN-failure scenarios. The proposed fault tolerance floor algorithm is based on the mean of the summation of the strongest RSSs obtained from the IEEE 802.15.4 Wireless Sensor Networks (WSNs during the online phase. The performance of the proposed algorithm is compared with those of different floor determination algorithms in literature. The experimental results show that the proposed robust floor determination algorithm outperformed the other floor algorithms and can achieve the highest percentage of floor determination accuracy in all scenarios tested. Specifically, the proposed algorithm can achieve greater than 95% correct floor determination under the scenario in which 40% of RNs failed.

Extensive extraosseous localization of bone imaging agent in a patient with renal failure and rhabdomyolysis accompanied by combined hypercalcemia and hyperphosphatemia

International Nuclear Information System (INIS)

Shih, W.J.; Flueck, J.; O'Connor, W.; Domstad, P.A.

1989-01-01

Four sequential Tc-99m pyrophosphate (PYP) imaging studies were performed in a 28-year-old man with high fever and exudate pharyngitis associated with renal failure. Radiotracer localization in the left ventricle (LV), lungs, kidneys, and skeletal muscles were seen in two, initial imaging studies. In the second and third imaging studies, area of increase in activity was seen in the left-sided bowel. In studies done two months later (in the third study), the radioactivity in the skeletal muscles was no longer seen. Studies obtained nine months (in the fourth study) after the first imaging showed less radiotracer localization in the LV, lungs, and kidneys as compared to that seen in the initial study. Myocardial necrosis and microcalcification were proved by LV biopsy. The exact mechanism of extraosseous bone-imaging agent localization is unknown. However, this phenomenon may be related to renal failure, rhabdomyolysis, hypercalcemia, hyperphosphatemia, or elevated parathyroid hormone. The Tc-99m PYP imaging study is useful and sensitive in the detection of extraosseous tissue calcification and monitoring of the disease process

Prediction of local failures with a combination of pretreatment tumor volume and apparent diffusion coefficient in patients treated with definitive radiotherapy for hypopharyngeal or oropharyngeal squamous cell carcinoma

International Nuclear Information System (INIS)

Ohnishi, Kayoko; Shioyama, Yoshiyuki; Hatakenaka, Masamitsu

2011-01-01

The purpose of this study was to investigate the clinical factors for predicting local failure after definitive radiotherapy in oropharyngeal or hypopharyngeal squamous cell carcinoma. Between July 2006 and December 2008, 64 consecutive patients with squamous cell carcinoma of the hypopharynx or the oropharynx treated with definitive radiotherapy were included in this study. Clinical factors, such as pretreatment hemoglobin (Hb) level, T-stage, gross tumor volume of primary tumors (pGTV), and maximum standardized uptake value (SUV max ) on 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET), were evaluated for the correlation with local failure. A subset analysis of 32 patients with MR images including diffusion-weighted images (DWI) as a pretreatment evaluation was also performed. The Kaplan-Meier curves, the log-rank test, and the Cox proportional hazards model were used to evaluate these clinical factors. Eleven of 64 patients experienced local recurrence, with a median follow-up time of 15 months. In the univariate analysis, Hb level (p=0.0261), T-stage (p=0.012), pGTV (p=0.0025), and SUV max (p=0.024) were significantly associated with local failure. In the multivariate analysis, pGTV (p=0.0070) remained an adverse factor for local control. In the subset analysis of 32 patients with DWI, the median apparent diffusion coefficient (ADC) value of primary tumors on DWI was 0.79 x 10 -3 mm 2 /s (range, 0.40-1.60 x 10 -3 mm 2 /s). Patients with a high ADC value (>0.79 x 10 -3 mm 2 /s) had a significantly lower local control rate than patients with a low ADC value (100% vs. 44%, p=0.0019). The rate of local failure among patients with a large pGTV and a high ADC value was 55% (6/11), whereas no local failures occurred (0%, 0/21) among patients with a small pGTV or a low ADC. These results suggest that a combination of a large tumor volume and a high ADC value could be predictive of local recurrence after definitive radiotherapy in hypopharyngeal or

Improving Suicide Prevention in Dutch Regions by Creating Local Suicide Prevention Action Networks (SUPRANET): A Study Protocol.

Science.gov (United States)

Gilissen, Renske; De Beurs, Derek; Mokkenstorm, Jan; Mérelle, Saskia; Donker, Gé; Terpstra, Sanne; Derijck, Carla; Franx, Gerdien

2017-03-28

The European Alliance against Depression (EAAD) program is to be introduced in The Netherlands from 2017 onwards. This program to combat suicide consists of interventions on four levels: (1) increasing the awareness of suicide by local media campaigns; (2) training local gatekeepers, such as teachers or police officers; (3) targeting high-risk persons in the community; and (4) training and support of professionals in primary care settings. The implementation starts in seven Dutch pilot regions. Each region is designated as a Suicide Prevention Action NETwork (SUPRANET). This paper describes the SUPRANET program components and the evaluation of its feasibility and impact. The findings will be used to facilitate the national implementation of EAAD in The Netherlands and to add new findings to the existing literature on EAAD.

Micromechanical local approach to brittle failure in bainite high resolution polycrystals: A short presentation

International Nuclear Information System (INIS)

N'Guyen, C.N.; Osipov, N.; Cailletaud, G.; Barbe, F.; Marini, B.; Petry, C.

2012-01-01

The problem of determining the probability of failure in a brittle material from a micromechanical local approach has recently been addressed in few works, all related to bainite polycrystals at different temperatures and states of irradiation. They have separately paved the ground for a full-field modelling with high realism in terms of constitutive modelling and microstructural morphology. This work first contributes to enhance this realism by assembling the most pertinent/valuable characteristics (dislocation density based model, large deformation framework, fully controlled triaxiality conditions, explicit microstructure representation of grains and sub-grains,... ) and by accounting for a statistically representative Volume Element; this condition indeed must be fulfilled in order to capture rare events like brittle micro-fractures which, in the stress analysis, correspond to the tails of distribution curves. The second original contribution of this work concerns the methodology for determining fracture probabilities: rather than classically - and abruptly - considering a polycrystal as broken as soon as an elementary link (grain or sub-grain) has failed, the possibility of microcrack arrest at microstructural barriers is introduced, which enables to determine the probability of polycrystal failure according to different scenarios of multiple micro-fractures. (authors)

Prevention of Localized Osteitis in Mandibular Third-Molar Sites Using Platelet-Rich Fibrin

Directory of Open Access Journals (Sweden)

Donald R. Hoaglin

2013-01-01

Full Text Available Purpose. To review our experience utilizing platelet rich fibrin (PRF, which is reported to aid in wound healing of extraction sites, for the prevention of localized osteitis following lower third-molar removal. Materials and Methods. PRF was placed in the mandibular third-molar extraction sites, 200 sites total, on 100 consecutive patients treated in our practice, by the authors. The patients were managed with standard surgical techniques, intraoperative IV antibiotic/steroid coverage, and routine postoperative narcotic analgesics/short-term steroid coverage. All patients were reevaluated for localized osteitis within 7–10 days of the surgery. A comparison group consisted of 100 consecutive patients who underwent bilateral removal of indicated mandibular wisdom teeth and did not receive PRF placement within the lower third molar surgical sites. Results. The incidence of localized osteitis (LO following removal of 200 lower third molars with simultaneous PRF placement within the extraction site was 1% (2 sites out of 200. The group of patients whose mandibular 3rd molar sockets were not treated with PRF demonstrated a 9.5% (19 sites out of 200 incidence of localized osteitis. The latter group also required 6.5 hours of additional clinical time to manage LO than the study group who received PRF. Conclusions. This retrospective review demonstrated that preventative treatment of localized osteitis can be accomplished using a low cost, autogenous, soluble, biologic material, PRF, that PRF enhanced third-molar socket healing/clot retention and greatly decreased the clinical time required for postoperative management of LO.

Making Strategic Planning Work in Local Government: An Empirical Study of Success And Failure

Directory of Open Access Journals (Sweden)

Ángel IGLESIAS

2015-10-01

Full Text Available Since the 1990s, local governments all over Europe have launched reforms to improve local democracy, public management and efficiency in the provision of local services. Some of these reforms are inspired by what previously has worked in private management and some of them have also a macro-level approach, whose main aim is to introduce institutional reforms and reorganizations to ensure contextual problem solving by strengthening governance within the local public sector. In this context, Strategic Planning in public organizations has attracted interest among academic researchers and practitioners as an instrument for dealing with a complex environment and for the achievement of higher performance and the attainment of greater democracy. But the decision on how to introduce Strategic Planning might follow a different rationale. The hypothesis maintained in this paper is that those that are based in an endogenous rationale are more likely to succeed. To test our hypothesis this paper draws on a comparative empirical analysis concerning the design and implementation of a Strategic Planning process within two Spanish city governments: one considered to have been a failure and the other a success. Focusing on the way in which the use of Strategic Planning has to face the trade-offs between urban and economic development and democracy, the paper explores how this formal mechanism of citizen´s and business’ participation serves to establish relational processes to reinvigorate local economic development, democracy and administrative modernization only when a strong political and administrative leadership is put into motion. Overall, the study yields evidence consistent with the notion that a successful Strategic Planning at the local level has to take into account not only institutional issues, but also the communal, social and political resources that frame the deliberations propelled by the Strategic Planning process.

New Therapeutic Approaches to Prevent or Delay Beta-Cell Failure in Diabetes

Directory of Open Access Journals (Sweden)

Ionica Floriana Elvira

2015-09-01

Full Text Available Background and aims: The most recent estimates of International Diabetes Federation indicate that 382 million people have diabetes, and the incidence of this disease is increasing. While in type 1 diabetes mellitus (T1DM beta-cell death is autoimmunemediated, type 2 diabetes mellitus (T2DM results from an interaction between genetic and environmental factors that impair beta-cell function and insulin action. Many people with T2DM remain unaware of their illness for a long time because symptoms may take years to appear or be recognized, while the body is affected by excess blood glucose. These patients are often diagnosed only when diabetes complications have already developed. The aim of this article was to perform a review based on literature data on therapeutic modalities to prevent/delay beta cell function decline. Material and Methods: We searched MEDLINE from 2000 to the present to identify the therapeutic approaches to prevent or delay beta-cell failure in patients with T2DM. Results and conclusions: Several common polymorphisms in genes linked to monogenic forms of diabetes appear to influence the response to T2DM pharmacotherapy. Recent studies report the role of the G protein coupled receptor 40 (GPR40, also known as Free Fatty Acids Receptor 1 (FFAR1 in the regulation of beta-cell function- CNX-011-67 (a GPR40 agonist has the potential to provide good and durable glycemic control in T2DM patients.

Nanowire failure: long = brittle and short = ductile.

Science.gov (United States)

Wu, Zhaoxuan; Zhang, Yong-Wei; Jhon, Mark H; Gao, Huajian; Srolovitz, David J

2012-02-08

Experimental studies of the tensile behavior of metallic nanowires show a wide range of failure modes, ranging from ductile necking to brittle/localized shear failure-often in the same diameter wires. We performed large-scale molecular dynamics simulations of copper nanowires with a range of nanowire lengths and provide unequivocal evidence for a transition in nanowire failure mode with change in nanowire length. Short nanowires fail via a ductile mode with serrated stress-strain curves, while long wires exhibit extreme shear localization and abrupt failure. We developed a simple model for predicting the critical nanowire length for this failure mode transition and showed that it is in excellent agreement with both the simulation results and the extant experimental data. The present results provide a new paradigm for the design of nanoscale mechanical systems that demarcates graceful and catastrophic failure. © 2012 American Chemical Society

Combinatorial analysis of systems with competing failures subject to failure isolation and propagation effects

International Nuclear Information System (INIS)

Xing Liudong; Levitin, Gregory

2010-01-01

This paper considers the reliability analysis of binary-state systems, subject to propagated failures with global effect, and failure isolation phenomena. Propagated failures with global effect are common-cause failures originated from a component of a system/subsystem causing the failure of the entire system/subsystem. Failure isolation occurs when the failure of one component (referred to as a trigger component) causes other components (referred to as dependent components) within the same system to become isolated from the system. On the one hand, failure isolation makes the isolated dependent components unusable; on the other hand, it prevents the propagation of failures originated from those dependent components. However, the failure isolation effect does not exist if failures originated in the dependent components already propagate globally before the trigger component fails. In other words, there exists a competition in the time domain between the failure of the trigger component that causes failure isolation and propagated failures originated from the dependent components. This paper presents a combinatorial method for the reliability analysis of systems subject to such competing propagated failures and failure isolation effect. Based on the total probability theorem, the proposed method is analytical, exact, and has no limitation on the type of time-to-failure distributions for the system components. An illustrative example is given to demonstrate the basics and advantages of the proposed method.

Long-Term Outcome and Toxicity of Salvage Brachytherapy for Local Failure After Initial Radiotherapy for Prostate Cancer

International Nuclear Information System (INIS)

Burri, Ryan J.; Stone, Nelson N.; Unger, Pam; Stock, Richard G.

2010-01-01

Purpose: To describe long-term outcomes and toxicity after salvage brachytherapy (BT) for local failure after initial radiotherapy for prostate cancer. Methods and Materials: Between 1994 and 2008, 37 men with local failure after initial prostate radiotherapy (32 external-beam radiation therapy [EBRT] and 5 BT) underwent salvage BT with 103 Pd or 125 I. Estimates of freedom from biochemical failure (FFbF, Phoenix definition) and cause-specific survival (CSS) were calculated using the Kaplan-Meier method. Toxicities were graded using CTCv3.0. Results: Median follow-up was 86 months (range, 2-156). The median dose to 90% of the prostate volume was 122 Gy (range, 67-166). The 10-year FFbF and CSS were 54% and 96%, respectively. On univariate analysis, prostate-specific antigen (PSA) >10 ng/mL at initial diagnosis was significantly associated with FFbF (p = 0.01), and there were trends for both age <70 years (p = 0.08) and PSA <6 ng/mL (p = 0.08) at the time of salvage BT. On multivariate analysis, only presalvage PSA <6 ng/mL (p = 0.046) was significantly associated with improved FFbF. There were three Grade 3 toxicities and one Grade 4 toxicity. Pelvic lymph node dissection before salvage BT was the only variable significantly associated with Grade ≥2 toxicity (p = 0.03). Conclusion: With a median follow-up of 86 months, salvage prostate BT was associated with a 10-year FFbF of 54% and CSS of 96%. Improved FFbF was associated with a presalvage PSA <6 ng/mL. Toxicity was worse in patients who had undergone pelvic lymph node dissection before salvage BT. Careful patient selection for salvage BT may result in improved outcomes and reduced toxicity.

Salvage prostate HDR brachytherapy combined with interstitial hyperthermia for local recurrence after radiation therapy failure

Energy Technology Data Exchange (ETDEWEB)

Kukielka, A.M.; Hetnal, M.; Dabrowski, T.; Walasek, T.; Brandys, P.; Reinfuss, M. [Centre of Oncology, M. Sklodowska - Curie Institute, Krakow Branch, Department of Radiotherapy, Krakow (Poland); Nahajowski, D.; Kudzia, R.; Dybek, D. [Centre of Oncology, M. Sklodowska - Curie Institute, Krakow Branch, Department of Medical Physics, Department of Radiotherapy, Krakow (Poland)

2014-02-15

The aim of the present retrospective study is to evaluate toxicity and early clinical outcomes of interstitial hyperthermia (IHT) combined with high-dose rate (HDR) brachytherapy as a salvage treatment in patients with biopsy-confirmed local recurrence of prostate cancer after previous external beam radiotherapy. Between September 2008 and March 2013, 25 patients with local recurrence of previously irradiated prostate cancer were treated. The main eligibility criteria for salvage prostate HDR brachytherapy combined with interstitial hyperthermia were biopsy confirmed local recurrence and absence of nodal and distant metastases. All patients were treated with a dose of 30 Gy in 3 fractions at 21-day intervals. We performed 62 hyperthermia procedures out of 75 planned (83 %). The aim of the hyperthermia treatment was to heat the prostate to 41-43 C for 60 min. Toxicity for the organs of the genitourinary system and rectum was assessed according to the Common Terminology Criteria for Adverse Events (CTCAE, v. 4.03). Determination of subsequent biochemical failure was based on the Phoenix definition (nadir + 2 ng/ml). The median age was 71 years (range 62-83 years), the median initial PSA level was 16.3 ng/ml (range 6.37-64 ng/ml), and the median salvage PSA level was 2.8 ng/ml (1.044-25.346 ng/ml). The median follow-up was 13 months (range 4-48 months). The combination of HDR brachytherapy and IHT was well tolerated. The most frequent complications were nocturia, weak urine stream, urinary frequency, hematuria, and urgency. Grade 2 rectal hemorrhage was observed in 1 patient. No grade 3 or higher complications were observed. The 2-year Kaplan-Meier estimate of biochemical control after salvage treatment was 74 %. The PSA in 20 patients decreased below the presalvage level, while 11 patients achieved a PSA nadir < 0.5 ng/ml. All patients are still alive. Of the 7 patients who experienced biochemical failure, bone metastases were found in 2 patients. IHT in combination

A Novel Risk Stratification to Predict Local-Regional Failures in Urothelial Carcinoma of the Bladder After Radical Cystectomy

Energy Technology Data Exchange (ETDEWEB)

Baumann, Brian C. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Guzzo, Thomas J. [Department of Urology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); He Jiwei [Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Keefe, Stephen M. [Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Tucker, Kai; Bekelman, Justin E. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Hwang, Wei-Ting [Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Vaughn, David J. [Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Malkowicz, S. Bruce [Department of Urology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Christodouleas, John P., E-mail: christojo@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)

2013-01-01

Purpose: Local-regional failures (LF) following radical cystectomy (RC) plus pelvic lymph node dissection (PLND) with or without chemotherapy for invasive urothelial bladder carcinoma are more common than previously reported. Adjuvant radiation therapy (RT) could reduce LF but currently has no defined role because of previously reported morbidity. Modern techniques with improved normal tissue sparing have rekindled interest in RT. We assessed the risk of LF and determined those factors that predict recurrence to facilitate patient selection for future adjuvant RT trials. Methods and Materials: From 1990-2008, 442 patients with urothelial bladder carcinoma at University of Pennsylvania were prospectively followed after RC plus PLND with or without chemotherapy with routine pelvic computed tomography (CT) or magnetic resonance imaging (MRI). One hundred thirty (29%) patients received chemotherapy. LF was any pelvic failure detected before or within 3 months of distant failure. Competing risk analyses identified factors predicting increased LF risk. Results: On univariate analysis, pathologic stage {>=}pT3, <10 nodes removed, positive margins, positive nodes, hydronephrosis, lymphovascular invasion, and mixed histology significantly predicted LF; node density was marginally predictive, but use of chemotherapy, number of positive nodes, type of surgical diversion, age, gender, race, smoking history, and body mass index were not. On multivariate analysis, only stage {>=}pT3 and <10 nodes removed were significant independent LF predictors with hazard ratios of 3.17 and 2.37, respectively (P<.01). Analysis identified 3 patient subgroups with significantly different LF risks: low-risk ({<=}pT2), intermediate-risk ({>=}pT3 and {>=}10 nodes removed), and high-risk ({>=}pT3 and <10 nodes) with 5-year LF rates of 8%, 23%, and 42%, respectively (P<.01). Conclusions: This series using routine CT and MRI surveillance to detect LF confirms that such failures are relatively common

A Novel Risk Stratification to Predict Local-Regional Failures in Urothelial Carcinoma of the Bladder After Radical Cystectomy

International Nuclear Information System (INIS)

Baumann, Brian C.; Guzzo, Thomas J.; He Jiwei; Keefe, Stephen M.; Tucker, Kai; Bekelman, Justin E.; Hwang, Wei-Ting; Vaughn, David J.; Malkowicz, S. Bruce; Christodouleas, John P.

2013-01-01

Purpose: Local-regional failures (LF) following radical cystectomy (RC) plus pelvic lymph node dissection (PLND) with or without chemotherapy for invasive urothelial bladder carcinoma are more common than previously reported. Adjuvant radiation therapy (RT) could reduce LF but currently has no defined role because of previously reported morbidity. Modern techniques with improved normal tissue sparing have rekindled interest in RT. We assessed the risk of LF and determined those factors that predict recurrence to facilitate patient selection for future adjuvant RT trials. Methods and Materials: From 1990-2008, 442 patients with urothelial bladder carcinoma at University of Pennsylvania were prospectively followed after RC plus PLND with or without chemotherapy with routine pelvic computed tomography (CT) or magnetic resonance imaging (MRI). One hundred thirty (29%) patients received chemotherapy. LF was any pelvic failure detected before or within 3 months of distant failure. Competing risk analyses identified factors predicting increased LF risk. Results: On univariate analysis, pathologic stage ≥pT3, <10 nodes removed, positive margins, positive nodes, hydronephrosis, lymphovascular invasion, and mixed histology significantly predicted LF; node density was marginally predictive, but use of chemotherapy, number of positive nodes, type of surgical diversion, age, gender, race, smoking history, and body mass index were not. On multivariate analysis, only stage ≥pT3 and <10 nodes removed were significant independent LF predictors with hazard ratios of 3.17 and 2.37, respectively (P<.01). Analysis identified 3 patient subgroups with significantly different LF risks: low-risk (≤pT2), intermediate-risk (≥pT3 and ≥10 nodes removed), and high-risk (≥pT3 and <10 nodes) with 5-year LF rates of 8%, 23%, and 42%, respectively (P<.01). Conclusions: This series using routine CT and MRI surveillance to detect LF confirms that such failures are relatively common in

Local Failure in Parameningeal Rhabdomyosarcoma Correlates With Poor Response to Induction Chemotherapy

Energy Technology Data Exchange (ETDEWEB)

Ladra, Matthew M. [Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Mandeville, Henry C. [The Royal Marsden Hospital, London (United Kingdom); Niemierko, Andrzej; Padera, Timothy P.; Friedmann, Alison M.; MacDonald, Shannon M.; Ebb, David; Chen, Yen-Lin; Tarbell, Nancy J. [Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Yock, Torunn I., E-mail: tyock@partners.org [Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States)

2015-06-01

Background: Local control remains a challenge in pediatric parameningeal rhabdomyosarcoma (PM-RMS), and survival after local failure (LF) is poor. Identifying patients with a high risk of LF is of great interest to clinicians. In this study, we examined whether tumor response to induction chemotherapy (CT) could predict LF in embryonal PM-RMS. Methods: We identified 24 patients with embryonal PM-RMS, age 2 to 18 years, with complete magnetic resonance imaging and gross residual disease after surgical resection. All patients received proton radiation therapy (RT), median dose 50.4 Gy{sub RBE} (50.4-55.8 Gy{sub RBE}). Tumor size was measured before initial CT and before RT. Results: With a median follow-up time of 4.1 years for survivors, LF was seen in 9 patients (37.5%). The median time from the initiation of CT to the start of RT was 4.8 weeks. Patients with LF had a similar initial (pre-CT) tumor volume compared with patients with local controlled (LC) (54 cm{sup 3} vs 43 cm{sup 3}, P=.9) but a greater median volume before RT (pre-RT) (40 cm{sup 3} vs 7 cm{sup 3}, P=.009) and a smaller median relative percent volume reduction (RPVR) in tumor size (0.4% vs 78%, P<.001). Older age (P=.05), larger pre-RT tumor volume (P=.03), and smaller RPVR (P=.003) were significantly associated with actuarial LF on univariate Cox analysis. Conclusions: Poor response to induction CT appears to be associated with an increased risk of LF in pediatric embryonal PM-RMS.

Analysis of Service Recovery Failure: From Minority Perspective

OpenAIRE

Yasemin Öcal Atınç

2016-01-01

We investigate the service failures towards diverse customer groups for the purpose to bring insightful proposals to the managers to recover from these failures. Previous literature provided insights regarding the perception of service failures by minorities and the challenge of recovery due to racial implications driven from the failure, however lacked to propose suggestions for the managers so that they can take either corrective steps toward service failure recovery or prevent service fail...

Failure Analysis

International Nuclear Information System (INIS)

Iorio, A.F.; Crespi, J.C.

1987-01-01

After ten years of operation at the Atucha I Nuclear Power Station a gear belonging to a pressurized heavy water reactor refuelling machine, failed. The gear box was used to operate the inlet-outlet heavy-water valve of the machine. Visual examination of the gear device showed an absence of lubricant and that several gear teeth were broken at the root. Motion was transmitted with a speed-reducing device with controlled adjustable times in order to produce a proper fitness of the valve closure. The aim of this paper is to discuss the results of the gear failure analysis in order to recommend the proper solution to prevent further failures. (Author)

Protocol-based image-guided salvage brachytherapy. Early results in patients with local failure of prostate cancer after radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Lahmer, G.; Lotter, M.; Kreppner, S.; Fietkau, R.; Strnad, V. [University Hospital Erlangen (Germany). Dept. of Radiation Oncology

2013-08-15

Purpose: To assess the overall clinical outcome of protocol-based image-guided salvage pulsed-dose-rate brachytherapy for locally recurrent prostate cancer after radiotherapy failure particularly regarding feasibility and side effects. Patients and methods: Eighteen consecutive patients with locally recurrent prostate cancer (median age, 69 years) were treated during 2005-2011 with interstitial PDR brachytherapy (PDR-BT) as salvage brachytherapy after radiotherapy failure. The treatment schedule was PDR-BT two times with 30 Gy (pulse dose 0.6 Gy/h, 24 h per day) corresponding to a total dose of 60 Gy. Dose volume adaptation was performed with the aim of optimal coverage of the whole prostate (V{sub 100} > 95 %) simultaneously respecting the protocol-based dose volume constraints for the urethra (D{sub 0.1} {sub cc} < 130 %) and the rectum (D{sub 2} {sub cc} < 50-60 %) taking into account the previous radiation therapy. Local relapse after radiotherapy (external beam irradiation, brachytherapy with J-125 seeds or combination) was confirmed mostly via choline-PET and increased PSA levels. The primary endpoint was treatment-related late toxicities - particularly proctitis, anal incontinence, cystitis, urinary incontinence, urinary frequency/urgency, and urinary retention according to the Common Toxicity Criteria. The secondary endpoint was PSA-recurrence-free survival. Results: We registered urinary toxicities only. Grade 2 and grade 3 toxicities were observed in up to 11.1 % (2/18) and 16.7 % (3/18) of patients, respectively. The most frequent late-event grade 3 toxicity was urinary retention in 17 % (3/18) of patients. No late gastrointestinal side effects occurred. The biochemical PSA-recurrence-free survival probability at 3 years was 57.1 %. The overall survival at 3 years was 88.9 %; 22 % (4/18) of patients developed metastases. The median follow-up time for all patients after salvage BT was 21 months (range, 8-77 months). Conclusion: Salvage PDR

ACE inhibitors and calcium antagonists in the treatment of congestive heart failure

DEFF Research Database (Denmark)

Hansen, J F

1995-01-01

heart failure in the SOLVD trials. In post-myocardial infarction patients, the calcium antagonist nifedipine did not affect mortality or morbidity; diltiazem improved prognosis in patients without congestive heart failure and in patients with non-Q-wave infarction; and verapamil improved prognosis...... by prevention of reinfarction and sudden death. Combination treatment with both verapamil, which has pronounced antiischemic properties and prevents sudden death and reinfarction, and an ACE inhibitor, which prevents the progression of heart failure, is a possibility for future cardiovascular therapy...

A Biochemical Approach to Understanding the Fanconi Anemia Pathway-Regulated Nucleases in Genome Maintenance for Preventing Bone Marrow Failure and Cancer

Science.gov (United States)

2014-04-01

the Fanconi Anemia Pathway- Regulated Nucleases in Genome Maintenance for Preventing Bone Marrow Failure and Cancer PRINCIPAL INVESTIGATOR...GRANT NUMBER 4. TITLE AND SUBTITLE A Biochemical Approach to Understanding the Fanconi Anemia Pathway-Regulated Nucleases in Genome Maintenance for...Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Fanconi anemia is the most prevalent inherited BMF syndromes, caused by mutations in

Tools for in service monitoring and testing of riser to prevent failure and extend service life

Energy Technology Data Exchange (ETDEWEB)

Ward, Haakon; Bondevik, Jon Olav; Skjerve, Haavard; Tveit, Oeyvind [SeaFlex AS, Asker (Norway)

2005-07-01

Exploration and development of new oil and gas fields is heavily dependant on use of flexible pipes and many field developments would not have been possible without them. The number of flexible risers in service is constantly increasing since relatively few offshore projects have reached the estimated operational life and the operational lifetime of several fields in-service has been extended due to new and improved technology. Many risers have been in service over a large number of years. Some risers have been operated under demanding conditions such as severe dynamic loads, high pressure and temperatures. One may in some cases find that risers actually have shorter service life than estimated in the design phase due to the severe operational conditions. In order to extend the use of the riser, some risers may have to be modified and re-terminated and prepared for a new and less demanding application. In order to operate risers safely, it is important to re-assess the fatigue life in order to prevent potential riser failure. The operator should implement methods and tools for in-service monitoring and testing. This paper addresses efficient and reliable methods and tools for monitoring of critical operational parameters as well as in-service riser testing. A brief description of structural failure modes will also be given in order to understand how to interpret test results in view of potential failure modes. (author)

Electrical failure analysis for root-cause determination

International Nuclear Information System (INIS)

Riddle, J.

1990-01-01

This paper outlines a practical failure analysis sequence. Several technical definitions are required. A failure is defined as a component that was operating in a system where the system malfunctioned and the replacement of the device restored system functionality. The failure mode is the malfunctioning behavior of the device. The failure mechanism is the underlying cause or source of the failure mode. The failure mechanism is the root cause of the failure mode. The failure analysis procedure needs to be adequately refined to result in the determination of the cause of failure to the degree that corrective action or design changes will prevent recurrence of the failure mode or mechanism. An example of a root-cause determination analysis performed for a nuclear power industry customer serves to illustrate the analysis methodology

Canadian Cardiovascular Society Consensus Conference recommendations on heart failure update 2007: Prevention, management during intercurrent illness or acute decompensation, and use of biomarkers.

Science.gov (United States)

Arnold, J Malcom O; Howlett, Jonathan G; Dorian, Paul; Ducharme, Anique; Giannetti, Nadia; Haddad, Haissam; Heckman, George A; Ignaszewski, Andrew; Isaac, Debra; Jong, Philip; Liu, Peter; Mann, Elizabeth; McKelvie, Robert S; Moe, Gordon W; Parker, John D; Svendsen, Anna M; Tsuyuki, Ross T; O'Halloran, Kelly; Ross, Heather J; Rao, Vivek; Sequeira, Errol J; White, Michel

2007-01-01

Heart failure is common, yet it is difficult to treat. It presents in many different guises and circumstances in which therapy needs to be individualized. The Canadian Cardiovascular Society published a comprehensive set of recommendations in January 2006 on the diagnosis and management of heart failure, and the present update builds on those core recommendations. Based on feedback obtained through a national program of heart failure workshops during 2006, several topics were identified as priorities because of the challenges they pose to health care professionals. New evidence-based recommendations were developed using the structured approach for the review and assessment of evidence adopted and previously described by the Society. Specific recommendations and practical tips were written for the prevention of heart failure, the management of heart failure during intercurrent illness, the treatment of acute heart failure, and the current and future roles of biomarkers in heart failure care. Specific clinical questions that are addressed include: which patients should be identified as being at high risk of developing heart failure and which interventions should be used? What complications can occur in heart failure patients during an intercurrent illness, how should these patients be monitored and which medications may require a dose adjustment or discontinuation? What are the best therapeutic, both drug and nondrug, strategies for patients with acute heart failure? How can new biomarkers help in the treatment of heart failure, and when and how should BNP be measured in heart failure patients? The goals of the present update are to translate best evidence into practice, to apply clinical wisdom where evidence for specific strategies is weaker, and to aid physicians and other health care providers to optimally treat heart failure patients to result in a measurable impact on patient health and clinical outcomes in Canada.

Failure Modes of thin supported Membranes

DEFF Research Database (Denmark)

Hendriksen, Peter Vang; Høgsberg, J.R.; Kjeldsen, Ane Mette

2007-01-01

Four different failure modes relevant to tubular supported membranes (thin dense films on a thick porous support) were analyzed. The failure modes were: 1) Structural collapse due to external pressure 2) burst of locally unsupported areas, 3) formation of surface cracks in the membrane due to TEC......-mismatches, and finally 4) delamination between membrane and support due to expansion of the membrane on use. Design criteria to minimize risk of failure by the four different modes are discussed. The theoretical analysis of the two last failure modes is compared to failures observed on actual components....

Submandibular gland-sparing radiation therapy for locally advanced oropharyngeal squamous cell carcinoma: patterns of failure and xerostomia outcomes

International Nuclear Information System (INIS)

Gensheimer, Michael F; Liao, Jay J; Garden, Adam S; Laramore, George E; Parvathaneni, Upendra

2014-01-01

Saliva from submandibular glands (SMG) is necessary to minimize xerostomia. It is unclear whether SMG can be safely spared in patients undergoing bilateral neck radiotherapy for locally advanced oropharyngeal cancer without increasing the risk of marginal recurrence. We evaluated the outcomes of contralateral submandibular gland (cSMG) sparing intensity-modulated radiation therapy (IMRT). All patients with stage III/IV oropharyngeal squamous cell carcinoma treated with bilateral neck IMRT from 2006–2012 at our institution were included. Appropriately selected patients with favorable primary tumor characteristics and no definite contralateral neck disease were treated with cSMG-sparing IMRT. Patterns of failure and xerostomia outcomes were retrospectively analyzed. 114 patients were treated. 89% had stage IV disease and 89% received definitive radiation therapy. 76 patients (67%) received cSMG sparing IMRT. With a median follow-up of 30 months, there were 10 local, 9 regional, and 10 distant recurrences. 2-year overall survival was 86% and 2-year loco-regional control was 87%. In cSMG spared patients, the mean cSMG dose was 30.7 Gy. Late grade 2+ xerostomia was significantly reduced in the cSMG spared group compared to those without SMG sparing (6 months: 23% vs. 72%, 12 months: 6% vs. 41%, 24 months: 3% vs. 36%, all p < 0.0007). There were no peri-SMG marginal recurrences in the cSMG-spared cohort. cSMG sparing IMRT did not increase marginal failures in this series of locally advanced oropharyngeal SCC patients. Xerostomia was significantly reduced in cSMG spared patients

Internet optical infrastructure issues on monitoring and failure restoration

CERN Document Server

Tapolcai, János; Babarczi, Péter; Rónyai, Lajos

2015-01-01

This book covers the issues of monitoring, failure localization, and restoration in the Internet optical backbone, and focuses on the progress of state-of-the-art in both industry standard and academic research. The authors summarize, categorize, and analyze the developed technology in the context of Internet fault management and failure recovery under the Generalized Multi-Protocol Label Switching (GMPLS), via both aspects of network operations and theories. Examines monitoring, failure localization, and failure restoration in the Internet backbone Includes problem formulations based on combinatorial group testing and topology coding Covers state-of-the-art development for the Internet backbone fault management and failure recovery

Evaluation of the adequacy of maintenance tasks using the failure consequences of railroad vehicles

International Nuclear Information System (INIS)

Kim, Jaehoon; Jeong, Hyun- Yong

2013-01-01

The purpose of this study is to improve the efficiency, reliability and safety related to railroad maintenance tasks through an evaluation of the consequences of failures. The brake system was selected based on the failure data obtained from railroad vehicles in operation as one of the safety systems in railroad vehicles. The failure causes, failure effects, and the criticality of the failure mode were drawn for 62 failure modes of the braking system through the use of an FMECA for the 30 sub-devices having primary functions. The various maintenance tasks for the braking system were categorized into the 62 failure modes and failure consequences using the FMECA and the logic of maintenance decisions. Braking systems manufactured by the same manufacturer and operated by two different operators were studied in an effort to analyze preventive maintenance and to evaluate the adequacy of preventive maintenance tasks for the 62 failure modes. Based on results of the evaluation of these preventive maintenance tasks, new maintenance tasks were proposed, and concrete cost-cutting effects were determined from the calculation of the maintenance time and expected costs, using a preventive maintenance template developed specifically for railroad vehicles

Modeling combined tension-shear failure of ductile materials

International Nuclear Information System (INIS)

Partom, Y

2014-01-01

Failure of ductile materials is usually expressed in terms of effective plastic strain. Ductile materials can fail by two different failure modes, shear failure and tensile failure. Under dynamic loading shear failure has to do with shear localization and formation of adiabatic shear bands. In these bands plastic strain rate is very high, dissipative heating is extensive, and shear strength is lost. Shear localization starts at a certain value of effective plastic strain, when thermal softening overcomes strain hardening. Shear failure is therefore represented in terms of effective plastic strain. On the other hand, tensile failure comes about by void growth under tension. For voids in a tension field there is a threshold state of the remote field for which voids grow spontaneously (cavitation), and the material there fails. Cavitation depends on the remote field stress components and on the flow stress. In this way failure in tension is related to shear strength and to failure in shear. Here we first evaluate the cavitation threshold for different remote field situations, using 2D numerical simulations with a hydro code. We then use the results to compute examples of rate dependent tension-shear failure of a ductile material.

Preventing failure in distance learning: the use of Spector tool

Directory of Open Access Journals (Sweden)

Maciej Słomczyński

2012-12-01

Full Text Available In 2011 and 2012, University of Warsaw conducted a two-stage research which goals were: (1 to verify whether students’ access to information showing the characteristics of their learning organization is connected with a sense of efficacy, level of motivation, preferred learning forms and perceived teacher presence; (2 to examine the relations between organizational learning styles and the usage of Spector module. One of the means used in the project was introduction of a mechanism for teaching and learning management in an e-learning setting – Spector. This way, a support for prevention, diagnosis and learning failure therapy was introduced. The mechanism was implemented as a Moodle LMS extension. Its goal was to process activity reports gathered by Moodle and present them in an user-friendly way to both students and teachers. The first-stage research results did not confirm the correlation between mentioned variables, although the majority of students taking part in the research pointed out Spector’s importance to improving their motivation and planning their learning activities. Resolving of all the doubts set in the project required a further, more complex study (including organizational learning styles. The second stage of the research proved that students’ opinion about the usage of Spector is related to their current studies programme (Bachelor’s, Master’s or Doctoral.

Failure Patterns After Hemithoracic Pleural Intensity Modulated Radiation Therapy for Malignant Pleural Mesothelioma

Energy Technology Data Exchange (ETDEWEB)

Rimner, Andreas, E-mail: rimnera@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Spratt, Daniel E. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Zauderer, Marjorie G. [Department of Medicine, Thoracic Oncology Service, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, New York, New York (United States); Rosenzweig, Kenneth E. [Department of Radiation Oncology, Mount Sinai Medical Center, New York, New York (United States); Wu, Abraham J.; Foster, Amanda [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Yorke, Ellen D. [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Adusumilli, Prasad; Rusch, Valerie W. [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Krug, Lee M. [Department of Medicine, Thoracic Oncology Service, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, New York, New York (United States)

2014-10-01

Purpose: We previously reported our technique for delivering intensity modulated radiation therapy (IMRT) to the entire pleura while attempting to spare the lung in patients with malignant pleural mesothelioma (MPM). Herein, we report a detailed pattern-of-failure analysis in patients with MPM who were unresectable or underwent pleurectomy/decortication (P/D), uniformly treated with hemithoracic pleural IMRT. Methods and Materials: Sixty-seven patients with MPM were treated with definitive or adjuvant hemithoracic pleural IMRT between November 2004 and May 2013. Pretreatment imaging, treatment plans, and posttreatment imaging were retrospectively reviewed to determine failure location(s). Failures were categorized as in-field (within the 90% isodose line), marginal (<90% and ≥50% isodose lines), out-of-field (outside the 50% isodose line), or distant. Results: The median follow-up was 24 months from diagnosis and the median time to in-field local failure from the end of RT was 10 months. Forty-three in-field local failures (64%) were found with a 1- and 2-year actuarial failure rate of 56% and 74%, respectively. For patients who underwent P/D versus those who received a partial pleurectomy or were deemed unresectable, the median time to in-field local failure was 14 months versus 6 months, respectively, with 1- and 2-year actuarial in-field local failure rates of 43% and 60% versus 66% and 83%, respectively (P=.03). There were 13 marginal failures (19%). Five of the marginal failures (38%) were located within the costomediastinal recess. Marginal failures decreased with increasing institutional experience (P=.04). Twenty-five patients (37%) had out-of-field failures. Distant failures occurred in 32 patients (48%). Conclusions: After hemithoracic pleural IMRT, local failure remains the dominant form of failure pattern. Patients treated with adjuvant hemithoracic pleural IMRT after P/D experience a significantly longer time to local and distant failure than

Using Social Network Theory to Influence the Development of State and Local Primary Prevention Capacity-Building Teams

Science.gov (United States)

Cook-Craig, Patricia G.

2010-01-01

This article examines the role that social network theory and social network analysis has played in assessing and developing effective primary prevention networks across a southeastern state. In 2004 the state began an effort to develop a strategic plan for the primary prevention of violence working with local communities across the state. The…

3D Printing of Materials with Tunable Failure via Bioinspired Mechanical Gradients.

Science.gov (United States)

Kokkinis, Dimitri; Bouville, Florian; Studart, André R

2018-05-01

Mechanical gradients are useful to reduce strain mismatches in heterogeneous materials and thus prevent premature failure of devices in a wide range of applications. While complex graded designs are a hallmark of biological materials, gradients in manmade materials are often limited to 1D profiles due to the lack of adequate fabrication tools. Here, a multimaterial 3D-printing platform is developed to fabricate elastomer gradients spanning three orders of magnitude in elastic modulus and used to investigate the role of various bioinspired gradient designs on the local and global mechanical behavior of synthetic materials. The digital image correlation data and finite element modeling indicate that gradients can be effectively used to manipulate the stress state and thus circumvent the weakening effect of defect-rich interfaces or program the failure behavior of heterogeneous materials. Implementing this concept in materials with bioinspired designs can potentially lead to defect-tolerant structures and to materials whose tunable failure facilitates repair of biomedical implants, stretchable electronics, or soft robotics. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

An approach to integrating surveillance and maintenance tasks to prevent the dominant failure causes of critical components

International Nuclear Information System (INIS)

Martorell, S.; Munoz, A.; Serradell, V.

1995-01-01

Surveillance requirements and maintenance activities in a nuclear power plant aim to preserve components' inherent reliability. Up to now, predictive and preventive maintenance mainly concerned plant staff, but the US Nuclear Regulatory Commission Maintenance Rule released in July 1991 will have significant impact on how nuclear power plants perform and document this maintenance. Reliability Centered Maintenance (RCM) is a systematic methodology to establish maintenance tasks for critical components in plant with a high degree of compliance with the goals of the Rule. RCM pursues the identification of applicable and efficient tasks to prevent these components from developing their dominant failure causes, and, in turn, towards achieving proper levels of components availability with low cost. In this paper, we present an approach for identifying the most suitable set of tasks to achieve this goal, which involves the integration of maintenance activities and surveillance requirements for each critical component based on the unavailability and cost associated with each individual task which is performed on it

A Zebrafish Heart Failure Model for Assessing Therapeutic Agents.

Science.gov (United States)

Zhu, Xiao-Yu; Wu, Si-Qi; Guo, Sheng-Ya; Yang, Hua; Xia, Bo; Li, Ping; Li, Chun-Qi

2018-03-20

Heart failure is a leading cause of death and the development of effective and safe therapeutic agents for heart failure has been proven challenging. In this study, taking advantage of larval zebrafish, we developed a zebrafish heart failure model for drug screening and efficacy assessment. Zebrafish at 2 dpf (days postfertilization) were treated with verapamil at a concentration of 200 μM for 30 min, which were determined as optimum conditions for model development. Tested drugs were administered into zebrafish either by direct soaking or circulation microinjection. After treatment, zebrafish were randomly selected and subjected to either visual observation and image acquisition or record videos under a Zebralab Blood Flow System. The therapeutic effects of drugs on zebrafish heart failure were quantified by calculating the efficiency of heart dilatation, venous congestion, cardiac output, and blood flow dynamics. All 8 human heart failure therapeutic drugs (LCZ696, digoxin, irbesartan, metoprolol, qiliqiangxin capsule, enalapril, shenmai injection, and hydrochlorothiazide) showed significant preventive and therapeutic effects on zebrafish heart failure (p failure model developed and validated in this study could be used for in vivo heart failure studies and for rapid screening and efficacy assessment of preventive and therapeutic drugs.

Psychosocial risk factors and heart failure hospitalization

DEFF Research Database (Denmark)

Rod, Naja Hulvej; Andersen, Ingelise; Prescott, Eva

2011-01-01

Prospective studies on the role of psychosocial factors in heart failure development are virtually nonexistent. The authors aimed to address the effect of psychosocial factors on the risk of heart failure hospitalization in men and women free of cardiovascular disease. In 1991-1993, the 8......-fourth of the population reported some degree of vital exhaustion. The vital exhaustion score was associated with a higher risk of heart failure in a dose-response manner (P risk of heart failure in both men (hazard ratio = 1.93, 95% confidence...... in the population, even a modestly higher risk of heart failure associated with vital exhaustion may be of importance in the planning of future preventive strategies for heart failure....

Common-Cause Failure Analysis in Event Assessment

International Nuclear Information System (INIS)

Rasmuson, D.M.; Kelly, D.L.

2008-01-01

This paper reviews the basic concepts of modeling common-cause failures (CCFs) in reliability and risk studies and then applies these concepts to the treatment of CCF in event assessment. The cases of a failed component (with and without shared CCF potential) and a component being unavailable due to preventive maintenance or testing are addressed. The treatment of two related failure modes (e.g. failure to start and failure to run) is a new feature of this paper, as is the treatment of asymmetry within a common-cause component group

Factors associated with local public health agency participation in obesity prevention in southern States.

Science.gov (United States)

Hatala, Jeffrey J; Fields, Tina T

2015-05-01

Obesity rates in the southern US states are higher than in other states. Historically, large-scale community-based interventions in the United States have not proven successful. With local public health agencies (LPHAs) tasked with prevention, their role in obesity prevention is important, yet little research exists regarding what predicts the participation of LPHAs. Cross-sectional data from the 2008 National Association of City and County Health Officials profile study and two public health conceptual frameworks were used to assess structural and environmental predictors of LPHA participation in obesity prevention. The predictors were compared between southern and nonsouthern states. Univariate and weighted logistic regressions were performed. Analysis revealed that more LPHAs in southern states were engaged in nearly all of the 10 essential public health functions related to obesity prevention compared with nonsouthern states. Presence of community-based organizations and staffing levels were the only significant variables in two of the six logistic regression models. This study provides insights into the success rates of the obesity prevention efforts of LPHAs in southern and nonsouthern states. Future research is needed to understand why and how certain structural elements and any additional factors influence LPHA participation in obesity prevention.

A practical and applied approach to assessing the cross cutting nature of child injury prevention as a basis for policy making at the local level

Directory of Open Access Journals (Sweden)

Beatrice Scholtes

2015-12-01

Full Text Available Aim: Risk factors for child injury are multi-faceted. Social, environmental and economic factors place responsibility for prevention upon many stakeholders across traditional sectors such as health, justice, environment and education. Multi-sectoral collaboration for injury prevention is thus essential. In addition, co-benefits due to injury prevention initiatives exist. However, multi-sectoral collaboration is often difficult to establish and maintain. We present an applied approach for practitioners and policy makers at the local level to use to explore and address the multi-sectoral nature of child injury. Methods: We combined elements of the Haddon Matrix and the Lens and Telescope model, to develop a new approach for practitioners and policy makers at the local level. Results: The approach offers the opportunity for diverse sectors at the local level to work together to identify their role in child injury prevention. Based on ecological injury prevention and life-course epidemiology it encourages multi-disciplinary team building from the outset. The process has three phases: first, visualising the multi-sectoral responsibilities for child injury prevention in the local area; second,  demonstrating the need for multi-sectoral collaboration and helping plan prevention activities together; and third, visualising potential co-benefits to other sectors and age groups that may arise from child injury prevention initiatives. Conclusion: The approach and process encourages inter-sectoral collaboration for child injury prevention at the local level. It is a useful addition for child injury  prevention at the local level, however testing the practicality of the approach in a real-world setting, and refinement of the process would improve it further.

PPARγ agonist pioglitazone reverses pulmonary hypertension and prevents right heart failure via fatty acid oxidation.

Science.gov (United States)

Legchenko, Ekaterina; Chouvarine, Philippe; Borchert, Paul; Fernandez-Gonzalez, Angeles; Snay, Erin; Meier, Martin; Maegel, Lavinia; Mitsialis, S Alex; Rog-Zielinska, Eva A; Kourembanas, Stella; Jonigk, Danny; Hansmann, Georg

2018-04-25

Right ventricular (RV) heart failure is the leading cause of death in pulmonary arterial hypertension (PAH). Peroxisome proliferator-activated receptor γ (PPARγ) acts as a vasoprotective metabolic regulator in smooth muscle and endothelial cells; however, its role in the heart is unclear. We report that deletion of PPARγ in cardiomyocytes leads to biventricular systolic dysfunction and intramyocellular lipid accumulation in mice. In the SU5416/hypoxia (SuHx) rat model, oral treatment with the PPARγ agonist pioglitazone completely reverses severe PAH and vascular remodeling and prevents RV failure. Failing RV cardiomyocytes exhibited mitochondrial disarray and increased intramyocellular lipids (lipotoxicity) in the SuHx heart, which was prevented by pioglitazone. Unbiased ventricular microRNA (miRNA) arrays, mRNA sequencing, and lipid metabolism studies revealed dysregulation of cardiac hypertrophy, fibrosis, myocardial contractility, fatty acid transport/oxidation (FAO), and transforming growth factor-β signaling in the failing RV. These epigenetic, transcriptional, and metabolic alterations were modulated by pioglitazone through miRNA/mRNA networks previously not associated with PAH/RV dysfunction. Consistently, pre-miR-197 and pre-miR-146b repressed genes that drive FAO ( Cpt1b and Fabp4 ) in primary cardiomyocytes. We recapitulated our major pathogenic findings in human end-stage PAH: (i) in the pressure-overloaded failing RV (miR-197 and miR-146b up-regulated), (ii) in peripheral pulmonary arteries (miR-146b up-regulated, miR-133b down-regulated), and (iii) in plexiform vasculopathy (miR-133b up-regulated, miR-146b down-regulated). Together, PPARγ activation can normalize epigenetic and transcriptional regulation primarily related to disturbed lipid metabolism and mitochondrial morphology/function in the failing RV and the hypertensive pulmonary vasculature, representing a therapeutic approach for PAH and other cardiovascular/pulmonary diseases. Copyright

Failure analysis for WWER-fuel elements

International Nuclear Information System (INIS)

Boehmert, J.; Huettig, W.

1986-10-01

If the fuel defect rate proves significantly high, failure analysis has to be performed in order to trace down the defect causes, to implement corrective actions, and to take measures of failure prevention. Such analyses are work-consuming and very skill-demanding technical tasks, which require examination methods and devices excellently developed and a rich stock of experience in evaluation of features of damage. For that this work specifies the procedure of failure analyses in detail. Moreover prerequisites and experimental equipment for the investigation of WWER-type fuel elements are described. (author)

Regional Lymph Node Uptake of [{sup 18}F]Fluorodeoxyglucose After Definitive Chemoradiation Therapy Predicts Local-Regional Failure of Locally Advanced Non-Small Cell Lung Cancer: Results of ACRIN 6668/RTOG 0235

Energy Technology Data Exchange (ETDEWEB)

Markovina, Stephanie [Mallinckrodt Institute of Radiology and Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri (United States); Duan, Fenghai [Department of Biostatistics and Center for Statistical Sciences, Brown University School of Public Health, Providence, Rhode Island (United States); Snyder, Bradley S. [Center for Statistical Sciences, Brown University School of Public Health, Providence, Rhode Island (United States); Siegel, Barry A. [Mallinckrodt Institute of Radiology and Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri (United States); Machtay, Mitchell [Department of Radiation Oncology, Case Western Reserve University, Cleveland, Ohio (United States); Bradley, Jeffrey D., E-mail: jbradley@radonc.wustl.edu [Mallinckrodt Institute of Radiology and Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri (United States)

2015-11-01

Purpose: The American College of Radiology Imaging Network (ACRIN) 6668/Radiation Therapy Oncology Group (RTOG) 0235 study demonstrated that standardized uptake values (SUV) on post-treatment [{sup 18}F]fluorodeoxyglucose-positron emission tomography (FDG-PET) correlated with survival in locally advanced non-small cell lung cancer (NSCLC). This secondary analysis determined whether SUV of regional lymph nodes (RLNs) on post-treatment FDG-PET correlated with patient outcomes. Methods and Materials: Included for analysis were patients treated with concurrent chemoradiation therapy, using radiation doses ≥60 Gy, with identifiable FDG-avid RLNs (distinct from primary tumor) on pretreatment FDG-PET, and post-treatment FDG-PET data. ACRIN core laboratory SUV measurements were used. Event time was calculated from the date of post-treatment FDG-PET. Local-regional failure was defined as failure within the treated RT volume and reported by the treating institution. Statistical analyses included Wilcoxon signed rank test, Kaplan-Meier curves (log rank test), and Cox proportional hazards regression modeling. Results: Of 234 trial-eligible patients, 139 (59%) had uptake in both primary tumor and RLNs on pretreatment FDG-PET and had SUV data from post-treatment FDG-PET. Maximum SUV was greater for primary tumor than for RLNs before treatment (P<.001) but not different post-treatment (P=.320). Post-treatment SUV of RLNs was not associated with overall survival. However, elevated post-treatment SUV of RLNs, both the absolute value and the percentage of residual activity compared to the pretreatment SUV were associated with inferior local-regional control (P<.001). Conclusions: High residual metabolic activity in RLNs on post-treatment FDG-PET is associated with worse local-regional control. Based on these data, future trials evaluating a radiation therapy boost should consider inclusion of both primary tumor and FDG-avid RLNs in the boost volume to maximize local

Regional Lymph Node Uptake of ["1"8F]Fluorodeoxyglucose After Definitive Chemoradiation Therapy Predicts Local-Regional Failure of Locally Advanced Non-Small Cell Lung Cancer: Results of ACRIN 6668/RTOG 0235

International Nuclear Information System (INIS)

Markovina, Stephanie; Duan, Fenghai; Snyder, Bradley S.; Siegel, Barry A.; Machtay, Mitchell; Bradley, Jeffrey D.

2015-01-01

Purpose: The American College of Radiology Imaging Network (ACRIN) 6668/Radiation Therapy Oncology Group (RTOG) 0235 study demonstrated that standardized uptake values (SUV) on post-treatment ["1"8F]fluorodeoxyglucose-positron emission tomography (FDG-PET) correlated with survival in locally advanced non-small cell lung cancer (NSCLC). This secondary analysis determined whether SUV of regional lymph nodes (RLNs) on post-treatment FDG-PET correlated with patient outcomes. Methods and Materials: Included for analysis were patients treated with concurrent chemoradiation therapy, using radiation doses ≥60 Gy, with identifiable FDG-avid RLNs (distinct from primary tumor) on pretreatment FDG-PET, and post-treatment FDG-PET data. ACRIN core laboratory SUV measurements were used. Event time was calculated from the date of post-treatment FDG-PET. Local-regional failure was defined as failure within the treated RT volume and reported by the treating institution. Statistical analyses included Wilcoxon signed rank test, Kaplan-Meier curves (log rank test), and Cox proportional hazards regression modeling. Results: Of 234 trial-eligible patients, 139 (59%) had uptake in both primary tumor and RLNs on pretreatment FDG-PET and had SUV data from post-treatment FDG-PET. Maximum SUV was greater for primary tumor than for RLNs before treatment (P<.001) but not different post-treatment (P=.320). Post-treatment SUV of RLNs was not associated with overall survival. However, elevated post-treatment SUV of RLNs, both the absolute value and the percentage of residual activity compared to the pretreatment SUV were associated with inferior local-regional control (P<.001). Conclusions: High residual metabolic activity in RLNs on post-treatment FDG-PET is associated with worse local-regional control. Based on these data, future trials evaluating a radiation therapy boost should consider inclusion of both primary tumor and FDG-avid RLNs in the boost volume to maximize local-regional control.

Strategies of learning from failure.

Science.gov (United States)

Edmondson, Amy C

2011-04-01

Many executives believe that all failure is bad (although it usually provides Lessons) and that Learning from it is pretty straightforward. The author, a professor at Harvard Business School, thinks both beliefs are misguided. In organizational life, she says, some failures are inevitable and some are even good. And successful learning from failure is not simple: It requires context-specific strategies. But first leaders must understand how the blame game gets in the way and work to create an organizational culture in which employees feel safe admitting or reporting on failure. Failures fall into three categories: preventable ones in predictable operations, which usually involve deviations from spec; unavoidable ones in complex systems, which may arise from unique combinations of needs, people, and problems; and intelligent ones at the frontier, where "good" failures occur quickly and on a small scale, providing the most valuable information. Strong leadership can build a learning culture-one in which failures large and small are consistently reported and deeply analyzed, and opportunities to experiment are proactively sought. Executives commonly and understandably worry that taking a sympathetic stance toward failure will create an "anything goes" work environment. They should instead recognize that failure is inevitable in today's complex work organizations.

Market failure, policy failure and other distortions in chronic disease markets

Directory of Open Access Journals (Sweden)

Segal Leonie

2009-06-01

Full Text Available Abstract Background The increasing prevalence of chronic disease represents a significant burden on most health systems. This paper explores the market failures and policy failures that exist in the management of chronic diseases. Discussion There are many sources of market failure in health care that undermine the efficiency of chronic disease management. These include incomplete information as well as information asymmetry between providers and consumers, the effect of externalities on consumer behaviour, and the divergence between social and private time preference rates. This has seen government and policy interventions to address both market failures and distributional issues resulting from the inability of private markets to reach an efficient and equitable distribution of resources. However, these have introduced a series of policy failures such as distorted re-imbursement arrangements across modalities and delivery settings. Summary The paper concludes that market failure resulting from a preference of individuals for 'immediate gratification' in the form of health care and disease management, rather than preventative services, where the benefits are delayed, has a major impact on achieving an efficient allocation of resources in markets for the management of chronic diseases. This distortion is compounded by government health policy that tends to favour medical and pharmaceutical interventions further contributing to distortions in the allocation of resources and inefficiencies in the management of chronic disease.

Mechanical behavior and localized failure modes in a porous basalt from the Azores

Science.gov (United States)

Loaiza, S.; Fortin, J.; Schubnel, A.; Guéguen, Y.; Moreira, M.; Vinciguerra, S.

2012-04-01

Basaltic rocks are the main component of the oceanic upper crust. This is of potential interest for water and geothermal resources, or for storage of CO2. The aim of our work is to investigate experimentally the mechanical behavior and the failure modes of porous basalt as well as the permeability evolution during deformation. Cylindrical basalt samples, from the Azores, of 30 mm in diameter and 60 mm in length were deformed the triaxial cell of the Laboratoire de Geologie at the Ecole Normale Supérieure (Paris) at room temperature and at a constant axial strain rate of 10-5 s-1. The initial porosity of the sample was 18%. The Geodesign triaxial cell can reach 300MPa confining pressure; axial load is performed through a piston and can reach 900 MPa (for a 30mm diameter sample); maximum pore pressure is 100MPa (applied using two precision volumetric pumps). In our study, a set of experiments were performed at confining pressure in the range of 25-290 MPa. The samples were deformed under saturated conditions at a constant pore pressure of 5MPa. Two volumetric pumps kept the pore pressure constant, and the pore volume variations were recorded. The evolution of the porosity was calculated from the total volume variation inside the volumetric pumps. Permeability measurements were performed using the steady-state technique. Our result shows that two modes of deformation can be highlighted in this basalt. At low confining pressure (Pc < 50 MPa), the differential stress attains a peak before the sample undergoes strain softening; the failure of sample occurs by shear localization. Yet, the brittle regime is commonly observed in this low Pc range, the experiments performed at confining pressure higher than 50 MPa, show a totally different mode of deformation. In this second mode of deformation, an appreciable inelastic porosity reduction is observed. Comparing to the hydrostatic loading, the rock sample started to compact beyond a critical stress state; and from then

Predictors of Prevention Failure in College Students Participating in Two Indicated Depression Prevention Programs

Science.gov (United States)

Blanco, Vanessa; Rohde, Paul; Vázquez, Fernando L.; Otero, Patricia

2014-01-01

The purpose of this study was to identify subgroups of university students with the highest likelihood of remaining at elevated levels of depressive symptoms six months following the receipt of a depressive prevention intervention on the basis of known risk factors and participation in one of two depression prevention programs. Data from a randomized controlled trial evaluating depression prevention among 133 college students with elevated depressive symptoms were analyzed. Participants were randomized to a cognitive-behavioral or relaxation training group preventive intervention. Classification tree analysis showed that older age was the strongest risk factor for persistently elevated depression. Additional risk factors were: (1) for younger students, fewer daily pleasant activities; (2) for those with higher level of pleasant activities, higher level of stressful events; and (3) for those with higher level of stressful events, lower assertiveness. Results offer directions for prevention foci, identify specific subgroups of college students to target for depression prevention efforts, and suggest that research aim to help older, non-traditional students or graduating students manage the transition from college to the work force. PMID:24714056

Reassessing guidelines for heart failure

Directory of Open Access Journals (Sweden)

Helmut Drexler

2004-03-01

Full Text Available Significant progress has been made in the last few years in the management of heart failure. In particular several trials have given significant results. It has become apparent that heart failure may be prevented in some patients by treatment of risk factors such as coronary artery disease. Experience with angiotensin-converting enzyme (ACE inhibitors has shown that the survival and symptomatic benefits do last in the long term, and confirm that they are the first-line treatment in heart failure. The results of a number of trials using the angiotensin receptor blockers (ARBs candesartan, valsartan and losartan are presented and discussed. There is also some experience now in the use of candesartan for patients with heart failure and preserved left ventricular systolic function. The COMET trial compared the β-blockers carvedilol and metoprolol tartrate, and suggests that there may be differences in clinical effect between β-blockers. The selective aldosterone receptor blocker eplerenone was evaluated in the EPHESUS trial in post-MI patients with signs of heart failure. Based on these clinical trials, heart failure guidelines are now being updated.

Strain limit criteria to predict failure

International Nuclear Information System (INIS)

Flanders, H.E.

1995-01-01

In recent years extensive effort has been expended to qualify existing structures for conditions that are beyond the original design basis. Determination of the component failure load is useful for this type of evaluation. This paper presents criteria based upon strain limits to predict the load at failure. The failure modes addressed are excessive plastic deformations, localized plastic strains, and structural instability. The effects of analytical method sophistication, as built configurations, material properties degradation, and stress state are addressed by the criteria

Preventing abusive head trauma resulting from a failure of normal interaction between infants and their caregivers.

Science.gov (United States)

Barr, Ronald G

2012-10-16

Head trauma from abuse, including shaken baby syndrome, is a devastating and potentially lethal form of infant physical abuse first recognized in the early 1970s. What has been less recognized is the role of the early increase in crying in otherwise normal infants in the first few months of life as a trigger for the abuse. In part, this is because infant crying, especially prolonged unsoothable crying, has been interpreted clinically as something wrong with the infant, the infant's caregiver, or the interactions between them. Here, we review an alternative developmental interpretation, namely, that the early increase in crying is a typical behavioral development in normal infants and usually does not reflect anything wrong or abnormal. We also review evidence indicating that this normal crying pattern is the most common trigger for abusive head trauma (AHT). Together, these findings point to a conceptualization of AHT as the consequence of a failure in an otherwise common, iterative, and developmentally normal infant-caregiver interaction. They also imply that there is a window of opportunity for prevention of AHT, and potentially other forms of infant abuse, through a public health primary universal prevention strategy aimed at changing knowledge and behaviors of caregivers and society in general concerning normal development of infants and the significance of early increased infant crying. If effective, there may be important implications for prevention of infant abuse nationally and internationally.

Failure rate of no-scalpel vasectomy in prevention of pregnancy in Shiraz, Southern Iran

Directory of Open Access Journals (Sweden)

S Shakeri

2006-07-01

Full Text Available BACKGROUND: Bilateral vasectomy is the most effective method of male contraception but there are still some reports on its failure. This study was undertaken to determine the failure rate of the no-scalpel vasectomy in Shiraz Vasectomy Center, Southern Iran. METHODS: From 2001 to 2003, 3900 no-scalpel vasectomies were done in Nader Kazemi Health Center. The records were studied for any failure in the method. Presence of any live sperm 6 months after surgery or any report of pregnancy post-vasectomy were considered as vasectomy failure. RESULTS:Among 3900 cases, 2928 patients had a complete follow up file while failure in the method was visible among 109 (3.72% cases. CONCLUSION: The low failure rate of no-scalpel method indicated its high efficacy to control the fertility in males but there is still need of performance by expert surgeons in well organized centers. KEYWORDS: Iran, no-scalpel vasectomy, failure rate.

Process Equipment Failure Mode Analysis in a Chemical Industry

Directory of Open Access Journals (Sweden)

J. Nasl Seraji

2008-04-01

Full Text Available Background and aims   Prevention of potential accidents and safety promotion in chemical processes requires systematic safety management in them. The main objective of this study was analysis of important process equipment components failure modes and effects in H2S and CO2  isolation from extracted natural gas process.   Methods   This study was done in sweetening unit of an Iranian gas refinery. Failure Mode and Effect Analysis (FMEA used for identification of process equipments failures.   Results   Totally 30 failures identified and evaluated using FMEA. P-1 blower's blade breaking and sour gas pressure control valve bearing tight moving had maximum risk Priority number (RPN, P-1 body corrosion and increasing plug lower side angle of reach DEAlevel control valve  in tower - 1 were minimum calculated RPN.   Conclusion   By providing a reliable documentation system for equipment failures and  incidents recording, maintaining of basic information for later safety assessments would be  possible. Also, the probability of failures and effects could be minimized by conducting preventive maintenance.

A quantitative method for Failure Mode and Effects Analysis

NARCIS (Netherlands)

Braaksma, Anne Johannes Jan; Meesters, A.J.; Klingenberg, W.; Hicks, C.

2012-01-01

Failure Mode and Effects Analysis (FMEA) is commonly used for designing maintenance routines by analysing potential failures, predicting their effect and facilitating preventive action. It is used to make decisions on operational and capital expenditure. The literature has reported that despite its

Inhibition of N-type Ca2+ channels ameliorates an imbalance in cardiac autonomic nerve activity and prevents lethal arrhythmias in mice with heart failure.

Science.gov (United States)

Yamada, Yuko; Kinoshita, Hideyuki; Kuwahara, Koichiro; Nakagawa, Yasuaki; Kuwabara, Yoshihiro; Minami, Takeya; Yamada, Chinatsu; Shibata, Junko; Nakao, Kazuhiro; Cho, Kosai; Arai, Yuji; Yasuno, Shinji; Nishikimi, Toshio; Ueshima, Kenji; Kamakura, Shiro; Nishida, Motohiro; Kiyonaka, Shigeki; Mori, Yasuo; Kimura, Takeshi; Kangawa, Kenji; Nakao, Kazuwa

2014-10-01

Dysregulation of autonomic nervous system activity can trigger ventricular arrhythmias and sudden death in patients with heart failure. N-type Ca(2+) channels (NCCs) play an important role in sympathetic nervous system activation by regulating the calcium entry that triggers release of neurotransmitters from peripheral sympathetic nerve terminals. We have investigated the ability of NCC blockade to prevent lethal arrhythmias associated with heart failure. We compared the effects of cilnidipine, a dual N- and L-type Ca(2+) channel blocker, with those of nitrendipine, a selective L-type Ca(2+) channel blocker, in transgenic mice expressing a cardiac-specific, dominant-negative form of neuron-restrictive silencer factor (dnNRSF-Tg). In this mouse model of dilated cardiomyopathy leading to sudden arrhythmic death, cardiac structure and function did not significantly differ among the control, cilnidipine, and nitrendipine groups. However, cilnidipine dramatically reduced arrhythmias in dnNRSF-Tg mice, significantly improving their survival rate and correcting the imbalance between cardiac sympathetic and parasympathetic nervous system activity. A β-blocker, bisoprolol, showed similar effects in these mice. Genetic titration of NCCs, achieved by crossing dnNRSF-Tg mice with mice lacking CACNA1B, which encodes the α1 subunit of NCCs, improved the survival rate. With restoration of cardiac autonomic balance, dnNRSF-Tg;CACNA1B(+/-) mice showed fewer malignant arrhythmias than dnNRSF-Tg;CACNA1B(+/+) mice. Both pharmacological blockade of NCCs and their genetic titration improved cardiac autonomic balance and prevented lethal arrhythmias in a mouse model of dilated cardiomyopathy and sudden arrhythmic death. Our findings suggest that NCC blockade is a potentially useful approach to preventing sudden death in patients with heart failure. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

An observational study of the frequency, severity, and etiology of failures in postoperative care after major elective general surgery.

Science.gov (United States)

Symons, Nicholas R A; Almoudaris, Alex M; Nagpal, Kamal; Vincent, Charles A; Moorthy, Krishna

2013-01-01

To investigate the nature of process failures in postoperative care, to assess their frequency and preventability, and to explore their relationship to adverse events. Adverse events are common and are frequently caused by failures in the process of care. These processes are often evaluated independently using clinical audit. There is little understanding of process failures in terms of their overall frequency, relative risk, and cumulative effect on the surgical patient. Patients were observed daily from the first postoperative day until discharge by an independent surgeon. Field notes on the circumstances surrounding any nonroutine or atypical event were recorded. Field notes were assessed by 2 surgeons to identify failures in the process of care. Preventability, the degree of harm caused to the patient, and the underlying etiology of process failures were evaluated by 2 independent surgeons. Fifty patients undergoing major elective general surgery were observed for a total of 659 days of postoperative care. A total of 256 process failures were identified, of which 85% were preventable and 51% directly led to patient harm. Process failures occurred in all aspects of care, the most frequent being medication prescribing and administration, management of lines, tubes, and drains, and pain control interventions. Process failures accounted for 57% of all preventable adverse events. Communication failures and delays were the main etiologies, leading to 54% of process failures. Process failures are common in postoperative care, are highly preventable, and frequently cause harm to patients. Interventions to prevent process failures will improve the reliability of surgical postoperative care and have the potential to reduce hospital stay.

Importance of beta-blocker dose in prevention of ventricular tachyarrhythmias, heart failure hospitalizations, and death in primary prevention implantable cardioverter-defibrillator recipients

DEFF Research Database (Denmark)

Ruwald, A C; Gislason, G H; Vinther, M

2018-01-01

Aims: There is a paucity of studies investigating a dose-dependent association between beta-blocker therapy and risk of outcome. In a nationwide cohort of primary prevention implantable cardioverter-defibrillator (ICD) patients, we aimed to investigate the dose-dependent association between beta-blocker...... therapy and risk of ventricular tachyarrhythmias (VT/VF), heart failure (HF) hospitalizations, and death. Methods and results: Information on ICD implantation, endpoints, comorbidities, beta-blocker usage, type, and dose were obtained through Danish nationwide registers. The two major beta-blockers...... carvedilol and metoprolol were examined in three dose levels; low (metoprolol ≤ 25 mg; carvedilol ≤ 12.5 mg), intermediate (metoprolol 26-199 mg; carvedilol 12.6-49.9 mg), and high (metoprolol ≥ 200 mg; carvedilol ≥ 50 mg). Time to events was investigated utilizing multivariate Cox models with beta-blocker...

Circuit breaker operation and potential failure modes during an earthquake

International Nuclear Information System (INIS)

Lambert, H.E.; Budnitz, R.J.

1987-01-01

This study addresses the effect of a strong-motion earthquake on circuit breaker operation. It focuses on the loss of offsite power (LOSP) transient caused by a strong-motion earthquake at the Zion Nuclear Power Plant. This paper also describes the operator action necessary to prevent core melt if the above circuit breaker failure modes occur simultaneously on three 4.16 KV buses. Numerous circuit breakers important to plant safety, such as circuit breakers to diesel generators and engineered safety systems (ESS), must open and/or close during this transient while strong motion is occurring. Potential seismically-induced circuit-breaker failures modes were uncovered while the study was conducted. These failure modes include: circuit breaker fails to close; circuit breaker trips inadvertently; circuit breaker fails to reclose after trip. The causes of these failure modes include: Relay chatter causes the circuit breaker to trip; Relay chatter causes anti-pumping relays to seal-in which prevents automatic closure of circuit breakers; Load sequencer failures. The incorporation of these failure modes as well as other instrumentation and control failures into a limited scope seismic probabilistic risk assessment is also discussed in this paper

Controlling wear failure of graphite-like carbon film in aqueous environment: Two feasible approaches

International Nuclear Information System (INIS)

Wang Yongxin; Wang Liping; Xue Qunji

2011-01-01

Friction and wear behaviors of graphite-like carbon (GLC) films in aqueous environment were investigated by a reciprocating sliding tribo-meter with ball-on-disc contact. Film structures and wear scars were studied by scanning electron microscope (SEM), energy dispersive spectroscopy (EDS) and a non-contact 3D surface profiler. A comprehensive wear model of the GLC film in aqueous environment was established, and two feasible approaches to control critical factor to the corresponding wear failure were discussed. Results showed that wear loss of GLC films in aqueous environment was characterized by micro-plough and local delamination. Due to the significant material loss, local delamination of films was critical to wear failure of GLC film in aqueous environment if the film was not prepared properly. The initiation and propagation of micro-cracks within whole films closely related to the occurrence of the films delamination from the interface between interlayer and substrate. The increase of film density by adjusting the deposition condition would significantly reduce the film delamination from substrate, meanwhile, fabricating a proper interlayer between substrate and GLC films to prevent the penetration of water molecules into the interface between interlayer and substrate could effectively eliminate the delamination.

INTRUSION DETECTION PREVENTION SYSTEM (IDPS PADA LOCAL AREA NETWORK (LAN

Directory of Open Access Journals (Sweden)

Didit Suhartono

2015-02-01

Full Text Available Penelitian ini berjudul “Intrusion Detection Prevention System Local Area Network (LAN” yang bertujuan untuk memproteksi jaringan dari usaha- usaha penyusupan yang dilakukan oleh seorang intruder. Metode yang digunakan pada penelitian ini adalah menggunakan metode kerangka pikir sebagai acuan dari tahap- tahap penelitian yang penulis lakukan. IDS difungsikan sebagai pendeteksi adanya serangan sesuai rule yang ada kemudian pesan peringatan disimpan dalam database dan dikirim via sms kepada seorang network administrator, sedangkan Firewall digunakan sebagai packet filtering dengan cara menentukan security policy yang dinilai penting. Hasilnya adalah ketika IDS memberikanpesan peringatan ketika ada serangan, seorang network administrator dapat memblok adanya serangan tersebut dengan cara manual dengan firewall, ataupun firewall akan memblok sendiri serangan tersebut sesuai dengan security policy yang diterapkan oleh network adminisrator sebelumnya

L-arginine fails to prevent ventricular remodeling and heart failure in the spontaneously hypertensive rat.

Science.gov (United States)

Brooks, Wesley W; Conrad, Chester H; Robinson, Kathleen G; Colucci, Wilson S; Bing, Oscar H L

2009-02-01

The effects of long-term oral administration of L-arginine, a substrate for nitric oxide (NO) production, on left ventricular (LV) remodeling, myocardial function and the prevention of heart failure (HF) was compared to the angiotensin-converting enzyme (ACE) inhibitor captopril in a rat model of hypertensive HF (aged spontaneously hypertensive rat (SHR)). SHRs and age-matched normotensive Wistar-Kyoto (WKY) rats were assigned to either no treatment, treatment with L-arginine (7.5 g/l in drinking water) or captopril (1 g/l in drinking water) beginning at 14 months of age, a time when SHRs exhibit stable compensated hypertrophy with no hemodynamic impairment; animals were studied at 23 months of age or at the time of HF. In untreated SHR, relative to WKY, there was significant LV hypertrophy, myocardial fibrosis, and isolated LV muscle performance and response to isoproterenol (ISO) were depressed; and, 7 of 10 SHRs developed HF. Captopril administration to six SHRs attenuated hypertrophy and prevented impaired inotropic responsiveness to ISO, contractile dysfunction, fibrosis, increased passive stiffness, and HF. In contrast, L-arginine administration to SHR increased LV hypertrophy and myocardial fibrosis while cardiac performance was depressed; and 7 of 9 SHRs developed HF. In WKY, L-arginine treatment but not captopril resulted in increased LV weight and the contractile response to ISO was blunted. Neither L-arginine nor captopril treatment of WKY changed fibrosis and HF did not occur. These data demonstrate that in contrast to captopril, long-term treatment with L-arginine exacerbates age-related cardiac hypertrophy, fibrosis, and did not prevent contractile dysfunction or the development of HF in aging SHR.

Common cause failures of reactor pressure components

International Nuclear Information System (INIS)

Mankamo, T.

1978-01-01

The common cause failure is defined as a multiple failure event due to a common cause. The existence of common failure causes may ruin the potential advantages of applying redundancy for reliability improvement. Examples relevant to large mechanical components are presented. Preventive measures against common cause failures, such as physical separation, equipment diversity, quality assurance, and feedback from experience are discussed. Despite the large number of potential interdependencies, the analysis of common cause failures can be done within the framework of conventional reliability analysis, utilizing, for example, the method of deriving minimal cut sets from a system fault tree. Tools for the description and evaluation of dependencies between components are discussed: these include the model of conditional failure causes that are common to many components, and evaluation of the reliability of redundant components subjected to a common load. (author)

ATTIRE: Albumin To prevenT Infection in chronic liveR failurE: study protocol for a single-arm feasibility trial.

Science.gov (United States)

China, Louise; Muirhead, Nicola; Skene, Simon S; Shabir, Zainib; De Maeyer, Roel P H; Maini, Alexander A N; Gilroy, Derek W; O'Brien, Alastair J

2016-01-25

Circulating prostaglandin E2 levels are elevated in acutely decompensated cirrhosis and have been shown to contribute to immune suppression. Albumin binds and inactivates this hormone. Human albumin solution could thus be repurposed as an immune restorative drug in these patients.This feasibility study aims to determine whether it is possible and safe to restore serum albumin to >30 g/L and maintain it at this level in patients admitted with acute decompensated cirrhosis using repeated 20% human albumin infusions according to daily serum albumin levels. Albumin To prevenT Infection in chronic liveR failurE (ATTIRE) stage 1 is a multicentre, open label dose feasibility trial. Patients with acutely decompensated cirrhosis admitted to hospital with a serum albumin of albumin solution will be infused, according to serum albumin levels, for up to 14 days or discharge in all patients. The primary end point is daily serum albumin levels for the duration of the treatment period and the secondary end point is plasma-induced macrophage dysfunction. The trial will recruit 80 patients. Outcomes will be used to assist with study design for an 866 patient randomised controlled trial at more than 30 sites across the UK. Research ethics approval was given by the London-Brent research ethics committee (ref: 15/LO/0104). The clinical trials authorisation was issued by the medicines and healthcare products regulatory agency (ref: 20363/0350/001-0001). Will be disseminated through peer reviewed journals and international conferences. Recruitment of the first participant occurred on 26/05/2015. The trial is registered with the European Medicines Agency (EudraCT 2014-002300-24) and has been adopted by the NIHR (ISRCTN 14174793). This manuscript refers to V.4.0 of the protocol; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Reliability technology principles and practice of failure prevention in electronic systems

CERN Document Server

Pascoe, Norman

2011-01-01

A unique book that describes the practical processes necessary to achieve failure free equipment performance, for quality and reliability engineers, design, manufacturing process and environmental test engineers. This book studies the essential requirements for successful product life cycle management. It identifies key contributors to failure in product life cycle management and particular emphasis is placed upon the importance of thorough Manufacturing Process Capability reviews for both in-house and outsourced manufacturing strategies. The readers? attention is also drawn to the ma

Metabolic Response on Post-therapy FDG-PET Predicts Patterns of Failure After Radiotherapy for Cervical Cancer

International Nuclear Information System (INIS)

Schwarz, Julie K.; Siegel, Barry A.; Dehdashti, Farrokh; Grigsby, Perry W.

2012-01-01

Purpose: To determine the patterns of failure in patients with cervical cancer treated with definitive radiotherapy and evaluated for metabolic response with early posttherapy 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET). Methods and Materials: The records of 238 patients with cervical cancer were reviewed. All patients were treated with a combination of external radiotherapy and intracavitary brachytherapy. Two hundred and nineteen patients (92%) received concurrent chemotherapy. All patients underwent pretreatment FDG-PET, and posttherapy FDG-PET was performed within 8–16 weeks of the completion of radiotherapy. Posttherapy FDG-PET results were categorized as complete metabolic response (CMR), partial metabolic response (PMR), and progressive disease (PD). Failure patterns were categorized as none, isolated local failure (central pelvis ± pelvic lymph nodes), distant failure, or combined local plus distant failure. Results: Of the 91 patients (38%) who had a recurrence, 22 had isolated local failures, and 69 had distant failures (49 distant failures and 20 combined local plus distant failures). Of the 173 patients with a CMR, 40 (23%) experienced treatment failure. All 25 patients with PD experienced treatment failure, which was distant in 24 patients (96%). Among the 40 patients with PMR, no failure has been observed for 14 patients (35%). Of the 26 failures within the PMR group, 15 (58%) were limited to the pelvis. Differences in the patterns of failure between the three groups (CMR, PMR, PD) were statistically significant (chi-square test; p < 0.0001). Conclusions: The majority of failures after definitive radiotherapy for cervical cancer include distant failures, even in the setting of concurrent chemotherapy. PMR within the cervix or lymph nodes is more commonly associated with isolated local recurrence.

Core Competencies and the Prevention of School Failure and Early School Leaving

Science.gov (United States)

Bradshaw, Catherine P.; O'Brennan, Lindsey M.; McNeely, Clea A.

2008-01-01

There is an increasing awareness that school failure and early school leaving are processes, rather than discrete events, that often co-occur and can have lasting negative effects on children's development. Most of the literature has focused on risk factors for failure and dropout rather than on the promotion of competencies that can increase…

Failure Rate Prediction of Active Component Using PM Basis Database

International Nuclear Information System (INIS)

Kim, J. S.; Kim, H. W.; Park, J. S.; Jung, S. G.

2011-01-01

The safety security and efficient management of NPPs (Nuclear Power Plants) have been increased after the accident of TEPCO's Fukushima nuclear power stations. The needs for the safety and efficiency are becoming more important because about 90 percent of the NPPs all over the world are more than 20 operation years old. The preventive maintenance criteria need to be flexible, considering long-term development of the equipment performance and preventive maintenance. The PMBD (Preventive Maintenance Basis Database) program was widely used for optimization of the preventive maintenance criteria. PMBD program contains all kinds of failure mechanisms for each equipment that may occur in the power plant based on RCM(Reliability-Centered Maintenance) and numerically calculate the variation of reliability and failure rate based on PM interval changes. In this study, propriety evaluation of preventive maintenance task, cycle, technical basis for cost effective preventive maintenance strategy and an appropriate evaluation were suggested by the case application of PMBD for major components in the NPPs

Condition monitoring a key component in the preventive maintenance

International Nuclear Information System (INIS)

Isar, C.

2006-01-01

The preventive maintenance programs are necessary to ensure that nuclear safety significant equipment will function when it is supposed to. Diesel generator, pumps, motor operated valves and air operated control valves are typically operated every three months. When you drive a car, you depend on lot of sounds, the feel of the steering wheel and gauges to determine if the car is running correctly. Similarly with operating equipment for a power plant - sounds or vibration of the equipment or the gauges and test equipment indicate a problem or degradation, actions are taken to correct the deficiency. Due to safety and economical reason diagnostic and monitoring systems are of growing interest in all complex industrial production. Diagnostic systems are requested to detect, diagnose and localize faulty operating conditions at an early stage in order to prevent severe failures and to enable predictive and condition oriented maintenance. In this context it is a need for using various on-line and off-line condition monitoring and diagnostics, non-destructive inspection techniques and surveillance. The condition monitoring technique used in nuclear power plant Cernavoda are presented in this paper. The selection of components and parameters to be monitored, monitoring and diagnostics techniques used are incorporated into a preventive maintenance program. Modern measurement technique in combination with advanced computerized data processing and acquisition show new ways in the field of machine surveillance. The diagnostic capabilities of predictive maintenance technologies have increased recently year with advances made in sensor technologies. The paper will focus on the following condition monitoring technique: - oil analysis - acoustic leakage monitoring - thermography - valve diagnostics: motor operated valve, air operated valve and check valve - motor current signature - vibration monitoring and rotating machine monitoring and diagnostics For each condition monitoring

Anal canal carcinoma: Early-stage tumors ≤10 mm (T1 or Tis): Therapeutic options and original pattern of local failure after radiotherapy

International Nuclear Information System (INIS)

Ortholan, Cecile; Ramaioli, Alain; Peiffert, Didier; Lusinchi, Antoine; Romestaing, Pascale; Chauveinc, Laurent; Touboul, Emmanuel; Peignaux, Karine; Bruna, Antoine; La Roche, Guy de; Lagrange, Jean-Leon; Alzieu, Christian; Gerard, Jean Pierre

2005-01-01

Purpose: To investigate the clinical history, management, and pattern of recurrence of very early-stage anal canal cancer in a French retrospective survey. Methods: The study group consisted of 69 patients with Stage Tis and T1 anal canal carcinoma ≤1 cm treated between 1990 and 2000 (12 were in situ, 57 invasive, 66 Stage N0, and 3 Stage N1). The median patient age was 67 years (range, 27-83 years). Of the 69 patients, 66 received radiotherapy (RT) and 3 with in situ disease were treated by local excision alone without RT. Twenty-six patients underwent local excision before RT (12 with negative and 14 with positive surgical margins). Of the 66 patients who underwent RT, 8 underwent brachytherapy alone (median dose, 55 Gy), 38 underwent external beam RT (median dose, 45 Gy) plus a brachytherapy boost (median boost dose, 20 Gy), and 20 underwent external beam RT alone (median dose, 55 Gy). Results: Of the 69 patients, 68 had initial local control. Of the 66 patients treated by RT, 6 developed local recurrence at a median interval of 50 months (range, 13-78 months). Four patients developed local failure outside the initial tumor bed. Of the 3 patients with Tis treated by excision alone, 1 developed local recurrence. No relation was found among prior excision, dose, and local failure. The 5-year overall survival, colostomy-free survival, and disease-free survival rate was 94%, 85%, and 89%, respectively. The rate of late complications (Grade 1-3) was 28% and was 14% for those who received doses <60 Gy and 37% for those who received doses of ≥60 Gy (p = 0.04). Conclusion: Most recurrences occurred after a long disease-free interval after treatment and often outside the initial tumor site. These small anal cancers could be treated by RT using a small volume and moderate dose (40-50 Gy for subclinical lesions and 50-60 Gy for T1)

Hydriding failure in water reactor fuel elements

International Nuclear Information System (INIS)

Sah, D.N.; Ramadasan, E.; Unnikrishnan, K.

1980-01-01

Hydriding of the zircaloy cladding has been one of the important causes of failure in water reactor fuel elements. This report reviews the causes, the mechanisms and the methods for prevention of hydriding failure in zircaloy clad water reactor fuel elements. The different types of hydriding of zircaloy cladding have been classified. Various factors influencing zircaloy hydriding from internal and external sources in an operating fuel element have been brought out. The findings of post-irradiation examination of fuel elements from Indian reactors, with respect to clad hydriding and features of hydriding failure are included. (author)

Valve system incorporating single failure protection logic

Science.gov (United States)

Ryan, Rodger; Timmerman, Walter J. H.

1980-01-01

A valve system incorporating single failure protective logic. The system consists of a valve combination or composite valve which allows actuation or de-actuation of a device such as a hydraulic cylinder or other mechanism, integral with or separate from the valve assembly, by means of three independent input signals combined in a function commonly known as two-out-of-three logic. Using the input signals as independent and redundant actuation/de-actuation signals, a single signal failure, or failure of the corresponding valve or valve set, will neither prevent the desired action, nor cause the undesired action of the mechanism.

Nutrition in Heart Failure

Directory of Open Access Journals (Sweden)

Reci Meseri

2013-10-01

Full Text Available Heart failure is defined as decreased ability of heart due to various reasons. It%u2019s seen 2-3% but the prevalence increases sharply after the age of seventy. The objectives of nutrition therapy in heart failure are to prevent from water retention and edema, to avoid from hard digestion and to offer a balanced diet. In order to avoid fluid retention and edema, daily sodium and fluid intake must be monitored carefully. Main dilemma of the heart failure patients is the obesity-cachexia dilemma. Since one of the main reasons of heart failure is cardiovascular diseases, in first phase, the patient may be obese. In the later phases, cachexia may show up. It was shown that cachexia is associated with mortality. Within this period, patients should not be over-fed and the patient should pass from catabolic state to anabolic state slowly. If the gastrointestinal track is functional oral/enteral feeding must be preferred. Multi vitamin and mineral supportsmay be beneficial, which may replace the increased loss, increase anti-inflammatory response and be anti-oxidants. Large, controlled and well-designed studies must be conducted in order to evaluate the benefits of nutritional practices such as nutritional assessment, enteral feeding and nutrient supports in heart failure patients.

Triplexer Monitor Design for Failure Detection in FTTH System

Science.gov (United States)

Fu, Minglei; Le, Zichun; Hu, Jinhua; Fei, Xia

2012-09-01

Triplexer was one of the key components in FTTH systems, which employed an analog overlay channel for video broadcasting in addition to bidirectional digital transmission. To enhance the survivability of triplexer as well as the robustness of FTTH system, a multi-ports device named triplexer monitor was designed and realized, by which failures at triplexer ports can be detected and localized. Triplexer monitor was composed of integrated circuits and its four input ports were connected with the beam splitter whose power division ratio was 95∶5. By means of detecting the sampled optical signal from the beam splitters, triplexer monitor tracked the status of the four ports in triplexer (e.g. 1310 nm, 1490 nm, 1550 nm and com ports). In this paper, the operation scenario of the triplexer monitor with external optical devices was addressed. And the integrated circuit structure of the triplexer monitor was also given. Furthermore, a failure localization algorithm was proposed, which based on the state transition diagram. In order to measure the failure detection and localization time under the circumstance of different failed ports, an experimental test-bed was built. Experiment results showed that the detection time for the failure at 1310 nm port by the triplexer monitor was less than 8.20 ms. For the failure at 1490 nm or 1550 nm port it was less than 8.20 ms and for the failure at com port it was less than 7.20 ms.

Application of Machine Learning for Dragline Failure Prediction

Directory of Open Access Journals (Sweden)

Taghizadeh Amir

2017-01-01

Full Text Available Overburden stripping in open cast coal mines is extensively carried out by walking draglines. Draglines’ unavailability and unexpected failures result in delayed productions and increased maintenance and operating costs. Therefore, achieving high availability of draglines plays a crucial role for increasing economic feasibility of mining projects. Applications of methodologies which can forecast the failure type of dragline based on the available failure data not only help to reduce the maintenance and operating costs but also increase the availability and the production rate. In this study, Machine Learning approaches have been applied for data which has been gathered from an operating coal mine in Turkey. The study methodology consists of three algorithms as: i implementation of K-Nearest Neighbors, ii implementation of Multi-Layer Perceptron, and iii implementation of Radial Basis Function. The algorithms have been utilized for predicting the draglines’ failure types. In this sense, the input data, which are mean time-to-failure, and the output data, failure types, have been fed to the algorithms. The regression analysis of methodologies have been compared and showed the K- Nearest Neighbors has a higher rate of regression which is around 70 percent. Thus, the K-Nearest Neighbor algorithm can be applied in order to preventive components replacement which causes to minimized preventive and corrective cost parameters. The accurate prediction of failure type, indeed, causes to optimized number of inspections. The novelty of this study is application of machine learning approaches in draglines’ reliability subject for first time.

Uncertainties in container failure time predictions

International Nuclear Information System (INIS)

Williford, R.E.

1990-01-01

Stochastic variations in the local chemical environment of a geologic waste repository can cause corresponding variations in container corrosion rates and failure times, and thus in radionuclide release rates. This paper addresses how well the future variations in repository chemistries must be known in order to predict container failure times that are bounded by a finite time period within the repository lifetime. Preliminary results indicate that a 5000 year scatter in predicted container failure times requires that repository chemistries be known to within ±10% over the repository lifetime. These are small uncertainties compared to current estimates. 9 refs., 3 figs

Promoting success or preventing failure: cultural differences in motivation by positive and negative role models.

Science.gov (United States)

Lockwood, Penelope; Marshall, Tara C; Sadler, Pamela

2005-03-01

In two studies, cross-cultural differences in reactions to positive and negative role models were examined. The authors predicted that individuals from collectivistic cultures, who have a stronger prevention orientation, would be most motivated by negative role models, who highlight a strategy of avoiding failure; individuals from individualistic cultures, who have a stronger promotion focus, would be most motivated by positive role models, who highlight a strategy of pursuing success. In Study 1, the authors examined participants' reported preferences for positive and negative role models. Asian Canadian participants reported finding negative models more motivating than did European Canadians; self-construals and regulatory focus mediated cultural differences in reactions to role models. In Study 2, the authors examined the impact of role models on the academic motivation of Asian Canadian and European Canadian participants. Asian Canadians were motivated only by a negative model, and European Canadians were motivated only by a positive model.

Randomized clinical trial of prevention of seroma formation after mastectomy by local methylprednisolone injection

DEFF Research Database (Denmark)

Qvamme, G; Axelsson, C. K.; Lanng, C

2015-01-01

: This was a double-blind randomized placebo-controlled intervention study of a single dose of 80 mg methylprednisolone versus saline on seroma formation after mastectomy. Patients were further classified according to the surgical axillary procedure: mastectomy with sentinel lymph node biopsy (M + SLNB) or mastectomy......BACKGROUND: Seroma formation, the most prevalent postoperative complication after mastectomy, is an inflammatory process that is potentially preventable via local steroid administration. This study investigated the effect of local steroid administration on seroma formation. METHODS...... with level I-II axillary lymph node dissection (M + ALND). Treatments were administered into the wound cavity via the drain orifice following removal of the drain on the first day after surgery. The primary endpoint was seroma formation; secondary endpoints included the frequency of side...

The alteration of municipal terms in the local reform of 2013: chronicle of an announced failure

Directory of Open Access Journals (Sweden)

Eloisa Carbonell Porras

2018-04-01

Full Text Available The reform of the basic legislation of the local regime operated by Law 27/2013, of December 27, on Rationalization and Sustainability of Local Administration has affected the municipal structure in order to try to correct the problems of small municipalities in a double sense: on the one hand, the requirements to create municipalities by segregation have been hardened; and, on the other, measures to promote the merger of municipalities have been approved, by regulating the voluntary merger agreement. These modifications delimit the object of this study that analyzes the main legal problems that the interpretation of these changes imply as well as their real consequences. On its basis, it is concluded that, although the changes are relevant to prevent new municipalities, they have a very limited effectiveness in reducing the existing small municipalities.

Localization of Electrical Insulation Failures in Superconducting Collared Coils by Analysis of the Distortion of a Pulsed Magnetic Field

CERN Document Server

Komorowski, P A

2000-01-01

The localization of possible electrical faults in superconducting accelerator magnets may, in most cases, be a complex, expensive and time-consuming process. In particular, inter-turn short circuits and failures of the ground insulation are well detectable when the magnet is collared, but often disappear after disassembly for repair due to the release of the pre-stress in the coils. The fault localization method presented in this paper is based on the measurement and analysis of the magnetic field generated inside the magnet aperture by a high voltage pulse. The presence of the fault modifies the distribution of the current in the coils and produces a distortion of the magnetic field. The described method aims at locating both the longitudinal and azimuthal position of the fault-affected area. The test method, the transient case FEM models and the implemented experimental set-up are presented and discussed for the LHC dipole models.

Mediterranean Diet and Other Dietary Patterns in Primary Prevention of Heart Failure and Changes in Cardiac Function Markers: A Systematic Review

Directory of Open Access Journals (Sweden)

Karina Sanches Machado d’Almeida

2018-01-01

Full Text Available Background: Heart failure (HF is a complex syndrome and is recognized as the ultimate pathway of cardiovascular disease (CVD. Studies using nutritional strategies based on dietary patterns have proved to be effective for the prevention and treatment of CVD. Although there are studies that support the protective effect of these diets, their effects on the prevention of HF are not clear yet. Methods: We searched the Medline, Embase, and Cochrane databases for studies that examined dietary patterns, such as dietary approaches to stop hypertension (DASH diet, paleolithic, vegetarian, low-carb and low-fat diets and prevention of HF. No limitations were used during the search in the databases. Results: A total of 1119 studies were identified, 14 met the inclusion criteria. Studies regarding the Mediterranean, DASH, vegetarian, and Paleolithic diets were found. The Mediterranean and DASH diets showed a protective effect on the incidence of HF and/or worsening of cardiac function parameters, with a significant difference in relation to patients who did not adhere to these dietary patterns. Conclusions: It is observed that the adoption of Mediterranean or DASH-type dietary patterns may contribute to the prevention of HF, but these results need to be analyzed with caution due to the low quality of evidence.

Heart failure as a general pandemic in Asia.

Science.gov (United States)

Shimokawa, Hiroaki; Miura, Masanobu; Nochioka, Kotaro; Sakata, Yasuhiko

2015-09-01

Heart failure (HF) is an epidemic in healthcare worldwide, including Asia. It appears that HF will become more serious in the near future, with the epidemiological transition and ageing of the population. However, in contrast to Western countries, information on HF epidemiology is still limited in Asia, particularly in South Asia. In this review, we will briefly summarize available information regarding the current and future burden of HF in Asia, which indicates the importance of both primary prevention of underlying diseases of HF and secondary prevention, including management of ischaemic HF, HF with preserved EF, and HF in the elderly. © 2015 The Authors European Journal of Heart Failure © 2015 European Society of Cardiology.

Parathyroid scintigraphy in chronic renal failure

International Nuclear Information System (INIS)

Baulieu, J.L.; Houlier, S.; Baulieu, F.; Rousseau, C.

1995-01-01

The performances of the scintigraphic localization of parathyroid adenoma have improved with the use of technetium-99m radiolabeled tracers and the development of thyroid subtraction methods. By using methoxy--isobutyl-isonitrile (MIB) alone in two phases, sensitivity and specificity are respectively O.85 and 0.92. The interest of scintigraphy compared with ultrasonography is specially marked in the situations encountered in patients with renal failure: hyperplasia, multiple or ectopic adenoma, association with thyroid nodules. However, the localisation of adenoma remains more difficult in renal failure than in primary hyperthyroidism. Scintigraphy seems to be essential for localizing adenoma and eventually hyperplasia, before surgery in patients in bad conditions or before a second operation. (authors). 26 refs., 3 figs., 2 tabs

Assessing Injury and Violence Prevention in North Carolina's Local Health Departments.

Science.gov (United States)

Mouw, Mary S; Counts, Jennifer; Fordham, Corinne; Francis, Molly Merrill; Bach, Laura E; Maman, Suzanne; Proescholdbell, Scott K

2016-01-01

Injury and violence-related morbidity and mortality present a major public health problem in North Carolina. However, the extent to which local health departments (LHDs) engage in injury and violence prevention (IVP) has not been well described. One objective of the current study is to provide a baseline assessment of IVP in the state's LHDs, describing capacity, priorities, challenges, and the degree to which programs are data-driven and evidence-based. The study will also describe a replicable, cost-effective method for systematic assessment of regional IVP. This is an observational, cross-sectional study that was conducted through a survey of North Carolina's 85 LHDs. Representatives from 77 LHDs (91%) responded. Nearly one-third (n = 23; 30%) reported that no staff members were familiar with evidence-based interventions in IVP, and over one-third (n = 29; 38%) reported that their LHD did not train staff in IVP. Almost one-half (n = 37; 48%) had no dedicated funding for IVP. On average, respondents said that about half of their programs were evidence-based; however, there was marked variation (mean, 52%; standard deviation = 41). Many collaborated with diverse partners including law enforcement, hospitals, and community-based organizations. There was discordance between injury and violence burden and programming. Overall, 53% of issues listed as top local problems were not targeted in their LHDs' programs. Despite funding constraints, North Carolina's LHDs engaged in a broad range of IVP activities. However, programming did not uniformly address state injury and violence priorities, nor local injury and violence burden. Staff members need training in evidence-based strategies that target priority areas. Multisector partnerships were common and increased LHDs' capacity. These findings are actionable at the state and local level. ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

High-Temperature Graphitization Failure of Primary Superheater Tube

Science.gov (United States)

Ghosh, D.; Ray, S.; Roy, H.; Mandal, N.; Shukla, A. K.

2015-12-01

Failure of boiler tubes is the main cause of unit outages of the plant, which further affects the reliability, availability and safety of the unit. So failure analysis of boiler tubes is absolutely essential to predict the root cause of the failure and the steps are taken for future remedial action to prevent the failure in near future. This paper investigates the probable cause/causes of failure of the primary superheater tube in a thermal power plant boiler. Visual inspection, dimensional measurement, chemical analysis, metallographic examination and hardness measurement are conducted as the part of the investigative studies. Apart from these tests, mechanical testing and fractographic analysis are also conducted as supplements. Finally, it is concluded that the superheater tube is failed due to graphitization for prolonged exposure of the tube at higher temperature.

Damage preventing measures for wind turbines. Phase 1- Reliability data

Energy Technology Data Exchange (ETDEWEB)

Carlsson, Fredrik; Eriksson, Emil; Dahlberg, Magnus

2010-08-15

The state of existing reliability and failure data in the public sources has been investigated. The prime goal has been to evaluate the data's usefulness for developing damage preventing measures. Some publicly available databases exist, and the data has been presented in several papers in the literature. The results from the investigation can seem quite negative. Detailed data are lacking and the level of detailed reporting has even been decreasing in recent years. Information on the impact of load condition on failures, which is an important question, are lacking throughout in the statistics. Some components dominate the failure statistics. These are for example the gearboxes, where failures lead to long down times. Failures of the electrical system lead to considerably shorter down times but the failure rate is much higher. Severe rotor failures seem to be rare, but they occur and the consequences can be dramatic. Operators and insurance companies are demanding improved insight in damage collection, maintenance and overall damage preventing measures. Closer cooperation with these parties could be a fruitful way of gathering more useful data. Improvements for future databases are suggested. A structure for damage collection is proposed. Comparing experience of damage preventing measures from other industries, knowledge about the nature of the damage mechanism and current practice in the wind industry will be an important tool in the evaluation of different damage preventing measures. This will be done in the following phases of this project

Failure and preventive costs of mastitis on Dutch dairy farms

NARCIS (Netherlands)

van Soest, Felix J S; Santman-Berends, Inge M G A; Lam, Theo J G M|info:eu-repo/dai/nl/14686820X; Hogeveen, Henk

2016-01-01

Mastitis is an important disease from an economic perspective, but most cost assessments of mastitis include only the direct costs associated with the disease (e.g., production losses, culling, and treatment), which we call failure costs (FC). However, farmers also invest time and money in

Geometry- and rate-dependent adhesive failure of micropatterned surfaces

NARCIS (Netherlands)

Bakker, H.; Lindstrom, S.B.; Sprakel, J.H.B.

2012-01-01

The dynamic nature of adhesive interface failure remains poorly understood, especially when the contact between the two surfaces is localized in microscopic points of adhesion. Here, we explore the dynamic failure of adhesive interfaces composed of a large number of micron-sized pillars against

Failure mode, effect and criticality analysis (FMECA) on mechanical subsystems of diesel generator at NPP

International Nuclear Information System (INIS)

Kim, Tae Woon; Singh, Brijendra; Sung, Tae Yong; Park, Jin Hee; Lee, Yoon Hwan

1996-06-01

Largely, the RCM approach can be divided in three phases; (1) Functional failure analysis (FFA) on the selected system or subsystem, (2) Failure mode, effect and criticality analysis (FMECA) to identify the impact of failure to plant safety or economics, (3) Logical tree analysis (LTA) to select appropriate preventive maintenance and surveillance tasks. This report presents FMECA results for six mechanical subsystems of the diesel generators of nuclear power plants. The six mechanical subsystems are Starting air, Lub oil, Governor, Jacket water cooling, Fuel, and Engine subsystems. Generic and plant-specific failure and maintenance records are reviewed to identify critical components/failure modes. FMECA was performed for these critical component/failure modes. After reviewing current preventive maintenance activities of Wolsung unit 1, draft RCM recommendations are developed. 6 tabs., 16 refs. (Author)

Failure mode, effect and criticality analysis (FMECA) on mechanical subsystems of diesel generator at NPP

Energy Technology Data Exchange (ETDEWEB)

Kim, Tae Woon; Singh, Brijendra; Sung, Tae Yong; Park, Jin Hee; Lee, Yoon Hwan [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

1996-06-01

Largely, the RCM approach can be divided in three phases; (1) Functional failure analysis (FFA) on the selected system or subsystem, (2) Failure mode, effect and criticality analysis (FMECA) to identify the impact of failure to plant safety or economics, (3) Logical tree analysis (LTA) to select appropriate preventive maintenance and surveillance tasks. This report presents FMECA results for six mechanical subsystems of the diesel generators of nuclear power plants. The six mechanical subsystems are Starting air, Lub oil, Governor, Jacket water cooling, Fuel, and Engine subsystems. Generic and plant-specific failure and maintenance records are reviewed to identify critical components/failure modes. FMECA was performed for these critical component/failure modes. After reviewing current preventive maintenance activities of Wolsung unit 1, draft RCM recommendations are developed. 6 tabs., 16 refs. (Author).

Reirradiation of Prostate Cancer Local Failures After Previous Curative Radiation Therapy: Long-Term Outcome and Tolerance

International Nuclear Information System (INIS)

Zilli, Thomas; Benz, Eileen; Dipasquale, Giovanna; Rouzaud, Michel; Miralbell, Raymond

2016-01-01

Purpose: To evaluate the safety, feasibility, side-effect profile, and proof of concept of external beam radiation therapy (EBRT) with or without a brachytherapy (BT) boost for salvage of exclusive local failure after primary EBRT for prostate cancer. Methods and Materials: Fourteen patients with presumed exclusive local recurrence after primary EBRT with or without BT were considered eligible for reirradiation. The median normalized total dose in 2-Gy fractions (NTD_2_G_y, α/β ratio = 1.5 Gy) was 74 Gy (range, 66-98.4 Gy) at first irradiation. Median time between the first irradiation and the reirradiation was 6.1 years (range, 4.7-10.2 years). Results: Between 2003 and 2008 salvage treatment was delivered with a median NTD_2_G_y of 85.1 Gy (range, 70-93.4) to the prostate with EBRT with (n=10) or without (n=4) BT. Androgen deprivation was given to 12 patients (median time of 12 months). No grade ≥3 toxicity was observed during and within 6 weeks after RT. After a median follow-up of 94 months (range, 48-172 months) after salvage RT, 5-year grade ≥3 genitourinary and gastrointestinal toxicity-free survival figures were 77.9% ± 11.3% and 57.1% ± 13.2%, respectively. Four patients presented with combined grade 4 genitourinary/gastrointestinal toxicity. The 5-year biochemical relapse-free, local relapse-free, distant metastasis-free, and cancer-specific survival rates were 35.7% ± 12.8%, 50.0% ± 13.4%, 85.7% ± 9.4%, and 100%, respectively. Conclusion: Salvage whole-gland reirradiation for patients with a suspicion of exclusive local recurrence after initial RT may be associated with a high rate of severe radiation-induced side effects and poor long-term biochemical and local control.

Light water reactor lower head failure analysis

International Nuclear Information System (INIS)

Rempe, J.L.; Chavez, S.A.; Thinnes, G.L.

1993-10-01

This document presents the results from a US Nuclear Regulatory Commission-sponsored research program to investigate the mode and timing of vessel lower head failure. Major objectives of the analysis were to identify plausible failure mechanisms and to develop a method for determining which failure mode would occur first in different light water reactor designs and accident conditions. Failure mechanisms, such as tube ejection, tube rupture, global vessel failure, and localized vessel creep rupture, were studied. Newly developed models and existing models were applied to predict which failure mechanism would occur first in various severe accident scenarios. So that a broader range of conditions could be considered simultaneously, calculations relied heavily on models with closed-form or simplified numerical solution techniques. Finite element techniques-were employed for analytical model verification and examining more detailed phenomena. High-temperature creep and tensile data were obtained for predicting vessel and penetration structural response

Light water reactor lower head failure analysis

Energy Technology Data Exchange (ETDEWEB)

Rempe, J.L.; Chavez, S.A.; Thinnes, G.L. [EG and G Idaho, Inc., Idaho Falls, ID (United States)] [and others

1993-10-01

This document presents the results from a US Nuclear Regulatory Commission-sponsored research program to investigate the mode and timing of vessel lower head failure. Major objectives of the analysis were to identify plausible failure mechanisms and to develop a method for determining which failure mode would occur first in different light water reactor designs and accident conditions. Failure mechanisms, such as tube ejection, tube rupture, global vessel failure, and localized vessel creep rupture, were studied. Newly developed models and existing models were applied to predict which failure mechanism would occur first in various severe accident scenarios. So that a broader range of conditions could be considered simultaneously, calculations relied heavily on models with closed-form or simplified numerical solution techniques. Finite element techniques-were employed for analytical model verification and examining more detailed phenomena. High-temperature creep and tensile data were obtained for predicting vessel and penetration structural response.

Failure to thrive in babies and toddlers.

Science.gov (United States)

Goh, Lay Hoon; How, Choon How; Ng, Kar Hui

2016-06-01

Failure to thrive in a child is defined as 'lack of expected normal physical growth' or 'failure to gain weight'. Diagnosis requires repeated growth measurements over time using local, age-appropriate growth centile charts. Premature babies with appropriate growth velocity and children with 'catch-down' growth, constitutional growth delay or familial short stature show normal growth variants, and usually do not require further evaluation. In Singapore, the most common cause of failure to thrive in children is malnutrition secondary to psychosocial and caregiver factors. 'Picky eating' is common in the local setting and best managed with an authoritative feeding style from caregivers. Other causes are malabsorption and existing congenital or chronic medical conditions. Child neglect or abuse should always be ruled out. Iron deficiency is the most common complication. The family doctor plays a pivotal role in early detection, timely treatment, appropriate referrals and close monitoring of 'catch-up' growth in these children. Copyright: © Singapore Medical Association.

Patterns of failure for glioblastoma multiforme following concurrent radiation and temozolomide

International Nuclear Information System (INIS)

Dobelbower, Michael C.; Burnett, Omer L. III; Haytt, Mark D.; Fiveash, John B.; Nordal, Robert A.; Nabors, Louis B.; Markert, James M.

2011-01-01

To analyse patterns of failure in patients with glioblastoma multiforme treated with concurrent radiation and temozolomide. A retrospective review of patients treated with concurrent radiation and temozolomide was performed. Twenty patients treated at the University of Alabama at Birmingham, with biopsy-proven disease, documented disease progression after treatment, and adequate radiation dosimetry and imaging records were included in the study. Patients generally received 46 Gy to the primary tumour and surrounding oedema plus 1 cm, and 60 Gy to the enhancing tumour plus 1 cm. MRIs documenting failure after therapy were fused to the original treatment plans. Contours of post-treatment tumour volumes were generated from MRIs showing tumour failure and were overlaid onto the original isodose curves. The recurrent tumours were classified as in-field, marginal or regional. Recurrences were also evaluated for distant failure. Of the 20 documented failures, all patients had some component of failure at the primary site. Eighteen patients (90%) failed in-field, 2 patients (10%) had marginal failures, and no regional failures occurred. Four patients (20%) had a component of distant failure in which an independent satellite lesion was located completely outside of the 95% isodose curve. Radiation concurrent with temozolomide appears to be associated with a moderate risk of distant brain failure in addition to the high rate of local failure. The risk of distant failure was consistent with that observed with radiation alone, suggesting that temozolomide does not act to reduce distant brain failure but to improve local control.

Residential PV system users' perception of profitability, reliability, and failure risk: An empirical survey in a local Japanese municipality

International Nuclear Information System (INIS)

Mukai, Toshihiro; Kawamoto, Shishin; Ueda, Yuzuru; Saijo, Miki; Abe, Naoya

2011-01-01

Although previous studies have addressed the reliability of residential PV systems in order to improve the dissemination of the systems among individual users and societies, few have examined users' perception of their own PV systems, which might contain solutions to firmly establish the system into society. First, the present paper examined the extent to which residential PV system users understand specification, reliability, and failure risk of their own systems. Second, causal factors affecting users' satisfaction with PV systems were examined. By analyzing data collected in Kakegawa City, this paper revealed that users did not appropriately understand the basic specifications of their residential PV systems, and in particular, the fact that the systems sometimes failed and therefore needed proper maintenance. Furthermore, a strong causal relationship between users' expectations of financial return from the system and their level of satisfaction was confirmed empirically. These results suggested that excessive focus on profitability and relatively low interest in the systems' reliability and failure risk should be addressed more to avoid problems that could potentially hamper the establishment of this technology into society. - Highlights: → We examined PV users' perception of its specification, reliability, and failure risk. → Data for analysis were collected by questionnaire survey in a Japanese local municipality. → We revealed users did not appropriately understand the basic specifications. → A strong causal relationship between users' expectations of financial return and their level of satisfaction was confirmed empirically.

Failure and preventive costs of mastitis on Dutch dairy farms

NARCIS (Netherlands)

Soest, van Felix J.S.; Santman-Berends, Inge M.G.A.; Lam, Theo J.G.M.; Hogeveen, Henk

2016-01-01

Mastitis is an important disease from an economic perspective, but most cost assessments of mastitis include only the direct costs associated with the disease (e.g., production losses, culling, and treatment), which we call failure costs (FC). However, farmers also invest time and money in

Failure rates in piping manufactured to different standards

International Nuclear Information System (INIS)

Barnes, R.W.; Cooper, G.D.

1995-11-01

Most non-nuclear process piping systems in Canada and the United States are constructed to the requirements of the piping codes of the American Society of Mechanical Engineers (ASME B31.1 and B31.3). Section III of the ASME Boiler and Pressure Vessel Code, has additional requirements for piping that are expected to provide further assurance of pressure boundary integrity. This project attempted to determine if the additional requirements of Section III were beneficial in preventing failure of the pressure boundary. The approach taken in the study was to determine the causes of failure of non-nuclear piping subjected to service similar to that experienced by piping in CANDU nuclear power plants. The study examined information on carbon steel piping systems filled with water/steam which operate up to a maximum temperature of 600 F and a maximum pressure of 1600 psi. The failure mechanisms were identified and analysed to determine whether application of the requirements of Section III would have prevented the failure. Through a process of interviews and literature search, 186 failures were identified and assembled into a reference database. Many of the records were incomplete; therefore, the reference database was trimmed to include a subset of 65 failure points supported by complete data. This subset formed the basis for this study. The results from the study of other databases assembled for similar purposes were reviewed and compared to the conclusions reached in this study. These reviews confirmed the conclusions reached in this study. (author). 48 refs., 20 tabs

Insulin Signaling and Heart Failure

Science.gov (United States)

Riehle, Christian; Abel, E. Dale

2016-01-01

Heart failure is associated with generalized insulin resistance. Moreover, insulin resistant states such as type 2 diabetes and obesity increases the risk of heart failure even after adjusting for traditional risk factors. Insulin resistance or type 2 diabetes alters the systemic and neurohumoral milieu leading to changes in metabolism and signaling pathways in the heart that may contribute to myocardial dysfunction. In addition, changes in insulin signaling within cardiomyocytes develop in the failing heart. The changes range from activation of proximal insulin signaling pathways that may contribute to adverse left ventricular remodeling and mitochondrial dysfunction to repression of distal elements of insulin signaling pathways such as forkhead (FOXO) transcriptional signaling or glucose transport which may also impair cardiac metabolism, structure and function. This article will review the complexities of insulin signaling within the myocardium and ways in which these pathways are altered in heart failure or in conditions associated with generalized insulin resistance. The implications of these changes for therapeutic approaches to treating or preventing heart failure will be discussed. PMID:27034277

Cascading failure in the wireless sensor scale-free networks

Science.gov (United States)

Liu, Hao-Ran; Dong, Ming-Ru; Yin, Rong-Rong; Han, Li

2015-05-01

In the practical wireless sensor networks (WSNs), the cascading failure caused by a failure node has serious impact on the network performance. In this paper, we deeply research the cascading failure of scale-free topology in WSNs. Firstly, a cascading failure model for scale-free topology in WSNs is studied. Through analyzing the influence of the node load on cascading failure, the critical load triggering large-scale cascading failure is obtained. Then based on the critical load, a control method for cascading failure is presented. In addition, the simulation experiments are performed to validate the effectiveness of the control method. The results show that the control method can effectively prevent cascading failure. Project supported by the Natural Science Foundation of Hebei Province, China (Grant No. F2014203239), the Autonomous Research Fund of Young Teacher in Yanshan University (Grant No. 14LGB017) and Yanshan University Doctoral Foundation, China (Grant No. B867).

Capturing strain localization behind a geosynthetic-reinforced soil wall

Science.gov (United States)

Lai, Timothy Y.; Borja, Ronaldo I.; Duvernay, Blaise G.; Meehan, Richard L.

2003-04-01

This paper presents the results of finite element (FE) analyses of shear strain localization that occurred in cohesionless soils supported by a geosynthetic-reinforced retaining wall. The innovative aspects of the analyses include capturing of the localized deformation and the accompanying collapse mechanism using a recently developed embedded strong discontinuity model. The case study analysed, reported in previous publications, consists of a 3.5-m tall, full-scale reinforced wall model deforming in plane strain and loaded by surcharge at the surface to failure. Results of the analysis suggest strain localization developing from the toe of the wall and propagating upward to the ground surface, forming a curved failure surface. This is in agreement with a well-documented failure mechanism experienced by the physical wall model showing internal failure surfaces developing behind the wall as a result of the surface loading. Important features of the analyses include mesh sensitivity studies and a comparison of the localization properties predicted by different pre-localization constitutive models, including a family of three-invariant elastoplastic constitutive models appropriate for frictional/dilatant materials. Results of the analysis demonstrate the potential of the enhanced FE method for capturing a collapse mechanism characterized by the presence of a failure, or slip, surface through earthen materials.

An investment plan for preventing child injuries using risk priority number of failure mode and effects analysis methodology and a multi-objective, multi-dimensional mixed 0-1 knapsack model

International Nuclear Information System (INIS)

Bas, Esra

2011-01-01

In this paper, a general framework for child injury prevention and a multi-objective, multi-dimensional mixed 0-1 knapsack model were developed to determine the optimal time to introduce preventive measures against child injuries. Furthermore, the model maximises the prevention of injuries with the highest risks for each age period by combining preventive measures and supervision as well as satisfying budget limits and supervision time constraints. The risk factors for each injury, variable, and time period were based on risk priority numbers (RPNs) obtained from failure mode and effects analysis (FMEA) methodology, and these risk factors were incorporated into the model as objective function parameters. A numerical experiment based on several different situations was conducted, revealing that the model provided optimal timing of preventive measures for child injuries based on variables considered.

Routine versus aggressive upstream rhythm control for prevention of early atrial fibrillation in heart failure: background, aims and design of the RACE 3 study.

Science.gov (United States)

Alings, M; Smit, M D; Moes, M L; Crijns, H J G M; Tijssen, J G P; Brügemann, J; Hillege, H L; Lane, D A; Lip, G Y H; Smeets, J R L M; Tieleman, R G; Tukkie, R; Willems, F F; Vermond, R A; Van Veldhuisen, D J; Van Gelder, I C

2013-07-01

Rhythm control for atrial fibrillation (AF) is cumbersome because of its progressive nature caused by structural remodelling. Upstream therapy refers to therapeutic interventions aiming to modify the atrial substrate, leading to prevention of AF. The Routine versus Aggressive upstream rhythm Control for prevention of Early AF in heart failure (RACE 3) study hypothesises that aggressive upstream rhythm control increases persistence of sinus rhythm compared with conventional rhythm control in patients with early AF and mild-to-moderate early systolic or diastolic heart failure undergoing electrical cardioversion. RACE 3 is a prospective, randomised, open, multinational, multicenter trial. Upstream rhythm control consists of angiotensin converting enzyme inhibitors and/or angiotensin receptor blockers, mineralocorticoid receptor antagonists, statins, cardiac rehabilitation therapy, and intensive counselling on dietary restrictions, exercise maintenance, and drug adherence. Conventional rhythm control consists of routine rhythm control therapy without cardiac rehabilitation therapy and intensive counselling. In both arms, every effort is made to keep patients in the rhythm control strategy, and ion channel antiarrhythmic drugs or pulmonary vein ablation may be instituted if AF relapses. Total inclusion will be 250 patients. If upstream therapy proves to be effective in improving maintenance of sinus rhythm, it could become a new approach to rhythm control supporting conventional pharmacological and non-pharmacological rhythm control.

A Randomized Trial to Evaluate the Effect of Local Endometrial Injury on the Clinical Pregnancy Rate of Frozen Embryo Transfer Cycles in Patients With Repeated Implantation Failure

Directory of Open Access Journals (Sweden)

Ensieh Shahrokh-Tehraninejad

2016-12-01

Full Text Available Objective: Repeated implantation failure (RIF is a condition in which the embryos implantation decreases in the endometrium. So, our aim was to evaluate the effect of local endometrial injury on embryo transfer results.Materials and methods: In this simple randomized clinical trial (RCT, a total of 120 patients were selected. The participants were less than 40 years old, and they are in their minimum two cycles of vitro fertilization (IVF. Patients were divided randomly into two groups of LEI (Local endometrial injury and a control group (n = 60 in each group. The first group had four small endometrial injuries from anterior, posterior, and lateral uterus walls which were obtained from people who were in 21th day of their previous IVF cycle. The second group was the patients who have not received any intervention.Results: The experimental and control patients were matched in the following factors. Regarding the clinical pregnancy rate, there was no significant difference noted between the experimental and the control group.Conclusion: Local endometrial injury in a preceding cycle does not increase the clinical pregnancy rate in the subsequent FET cycle of patients with repeated implantation failure.

Corrosion induced failure analysis of subsea pipelines

International Nuclear Information System (INIS)

Yang, Yongsheng; Khan, Faisal; Thodi, Premkumar; Abbassi, Rouzbeh

2017-01-01

Pipeline corrosion is one of the main causes of subsea pipeline failure. It is necessary to monitor and analyze pipeline condition to effectively predict likely failure. This paper presents an approach to analyze the observed abnormal events to assess the condition of subsea pipelines. First, it focuses on establishing a systematic corrosion failure model by Bow-Tie (BT) analysis, and subsequently the BT model is mapped into a Bayesian Network (BN) model. The BN model facilitates the modelling of interdependency of identified corrosion causes, as well as the updating of failure probabilities depending on the arrival of new information. Furthermore, an Object-Oriented Bayesian Network (OOBN) has been developed to better structure the network and to provide an efficient updating algorithm. Based on this OOBN model, probability updating and probability adaptation are performed at regular intervals to estimate the failure probabilities due to corrosion and potential consequences. This results in an interval-based condition assessment of subsea pipeline subjected to corrosion. The estimated failure probabilities would help prioritize action to prevent and control failures. Practical application of the developed model is demonstrated using a case study. - Highlights: • A Bow-Tie (BT) based corrosion failure model linking causation with the potential losses. • A novel Object-Oriented Bayesian Network (OOBN) based corrosion failure risk model. • Probability of failure updating and adaptation with respect to time using OOBN model. • Application of the proposed model to develop and test strategies to minimize failure risk.

Failure-probability driven dose painting

International Nuclear Information System (INIS)

Vogelius, Ivan R.; Håkansson, Katrin; Due, Anne K.; Aznar, Marianne C.; Kristensen, Claus A.; Rasmussen, Jacob; Specht, Lena; Berthelsen, Anne K.; Bentzen, Søren M.

2013-01-01

Purpose: To demonstrate a data-driven dose-painting strategy based on the spatial distribution of recurrences in previously treated patients. The result is a quantitative way to define a dose prescription function, optimizing the predicted local control at constant treatment intensity. A dose planning study using the optimized dose prescription in 20 patients is performed.Methods: Patients treated at our center have five tumor subvolumes from the center of the tumor (PET positive volume) and out delineated. The spatial distribution of 48 failures in patients with complete clinical response after (chemo)radiation is used to derive a model for tumor control probability (TCP). The total TCP is fixed to the clinically observed 70% actuarial TCP at five years. Additionally, the authors match the distribution of failures between the five subvolumes to the observed distribution. The steepness of the dose–response is extracted from the literature and the authors assume 30% and 20% risk of subclinical involvement in the elective volumes. The result is a five-compartment dose response model matching the observed distribution of failures. The model is used to optimize the distribution of dose in individual patients, while keeping the treatment intensity constant and the maximum prescribed dose below 85 Gy.Results: The vast majority of failures occur centrally despite the small volumes of the central regions. Thus, optimizing the dose prescription yields higher doses to the central target volumes and lower doses to the elective volumes. The dose planning study shows that the modified prescription is clinically feasible. The optimized TCP is 89% (range: 82%–91%) as compared to the observed TCP of 70%.Conclusions: The observed distribution of locoregional failures was used to derive an objective, data-driven dose prescription function. The optimized dose is predicted to result in a substantial increase in local control without increasing the predicted risk of toxicity

State and local law enforcement agency efforts to prevent sales to obviously intoxicated patrons.

Science.gov (United States)

Lenk, Kathleen M; Toomey, Traci L; Nelson, Toben F; Jones-Webb, Rhonda; Erickson, Darin J

2014-04-01

Alcohol sales to intoxicated patrons are illegal and may lead to public health issues such as traffic crashes and violence. Over the past several decades, considerable effort has been made to reduce alcohol sales to underage persons but less attention has been given to the issue of sales to obviously intoxicated patrons. Studies have found a high likelihood of sales to obviously intoxicated patrons (i.e., overservice), but little is known about efforts by enforcement agencies to reduce these sales. We conducted a survey of statewide alcohol enforcement agencies and local law enforcement agencies across the US to assess their strategies for enforcing laws prohibiting alcohol sales to intoxicated patrons at licensed alcohol establishments. We randomly sampled 1,631 local agencies (1,082 participated), and surveyed all 49 statewide agencies that conduct alcohol enforcement. Sales to obviously intoxicated patrons were reported to be somewhat or very common in their jurisdiction by 55 % of local agencies and 90 % of state agencies. Twenty percent of local and 60 % of state agencies reported conducting enforcement efforts to reduce sales to obviously intoxicated patrons in the past year. Among these agencies, fewer than half used specific enforcement strategies on at least a monthly basis to prevent overservice of alcohol. Among local agencies, enforcement efforts were more common among agencies that had a full-time officer specifically assigned to carry out alcohol enforcement efforts. Enforcement of laws prohibiting alcohol sales to obviously intoxicated patrons is an underutilized strategy to reduce alcohol-related problems, especially among local law enforcement agencies.

Assessing Injury and Violence Prevention in North Carolina’s Local Health Departments

Science.gov (United States)

Mouw, Mary S.; Counts, Jennifer; Fordham, Corinne; Francis, Molly Merrill; Bach, Laura E.; Maman, Suzanne; Proescholdbell, Scott K.

2016-01-01

Context Injury and violence-related morbidity and mortality present a major public health problem in North Carolina. However, the extent to which local health departments (LHDs) engage in injury and violence prevention (IVP) is not well described. Objectives 1) Provide a baseline assessment of IVP in the state’s LHDs, describing capacity, priorities, challenges, and the degree to which programs are data-driven and evidence-based. 2) Describe a replicable, cost-effective method for systematic assessment of regional IVP. Design An observational, cross-sectional study, through a survey of NC’s 85 LHDs. Results Representatives from 77 LHDs (91%) responded. Nearly a third (n=23, 30%) reported no staff were familiar with evidence-based interventions in IVP; over a third (n=29, 38%) reported their LHD did not train staff in IVP. Almost half (n=37, 46%) had no dedicated funding. On average, respondents said about half of their programs were evidence-based; however, there was marked variation (mean 52%, SD = 41). Many collaborated with diverse partners including law enforcement, hospitals, and community-based organizations. There was discordance between injury and violence burden and programming. Overall, 53% of issues listed as top local problems were not targeted in their LHDs’ programs. Conclusions Despite funding constraints, NC’s LHDs are engaged in a broad range of IVP activities. Programming did not uniformly address state injury and violence priorities, however, nor local injury and violence burden. Staff need training in evidence-based strategies targeting priority areas. Multi-sector partnerships were common and increased LHDs’ capacity. These findings are actionable at the state and local-level. PMID:27621337

Development of a Survey to Assess Local Health Department Organizational Processes and Infrastructure for Supporting Obesity Prevention.

Science.gov (United States)

Xiao, Ting; Stamatakis, Katherine A; McVay, Allese B

Local health departments (LHDs) have an important function in controlling the growing epidemic of obesity in the United States. Data are needed to gain insight into the existence of routine functions and structures of LHDs that support and sustain obesity prevention efforts. The purpose of this study was to develop and examine the reliability of measures to assess foundational LHD organizational processes and functions specific to obesity prevention. Survey measures were developed using a stratified, random sample of US LHDs to assess supportive organizational processes and infrastructure for obesity prevention representing different domains. Data were analyzed using weighted κ and intraclass correlation coefficient for assessing test-retest reliability. Most items and summary indices in the majority of survey domains had moderate/substantial or almost perfect reliability. The overall findings support this survey instrument to be a reliable measurement tool for a large number of processes and functions that comprise obesity prevention-related capacity in LHDs.

Assessment of cerebral microbleeds by susceptibility-weighted imaging at 3T in patients with end-stage organ failure.

Science.gov (United States)

Sparacia, Gianvincenzo; Cannella, Roberto; Lo Re, Vincenzina; Gambino, Angelo; Mamone, Giuseppe; Miraglia, Roberto

2018-02-17

Cerebral microbleeds (CMBs) are small rounded lesions representing cerebral hemosiderin deposits surrounded by macrophages that results from previous microhemorrhages. The aim of this study was to review the distribution of cerebral microbleeds in patients with end-stage organ failure and their association with specific end-stage organ failure risk factors. Between August 2015 and June 2017, we evaluated 15 patients, 9 males, and 6 females, (mean age 65.5 years). Patients population was subdivided into three groups according to the organ failure: (a) chronic kidney failure (n = 8), (b) restrictive cardiomyopathy undergoing heart transplantation (n = 1), and (c) end-stage liver failure undergoing liver transplantation (n = 6). The MR exams were performed on a 3T MR unit and the SWI sequence was used for the detection of CMBs. CMBs were subdivided in supratentorial lobar distributed, supratentorial non-lobar distributed, and infratentorial distributed. A total of 91 microbleeds were observed in 15 patients. Fifty-nine CMBs lesions (64.8%) had supratentorial lobar distribution, 17 CMBs lesions (18.8%) had supratentorial non-lobar distribution and the remaining 15 CMBs lesions (16.4%) were infratentorial distributed. An overall predominance of supratentorial multiple lobar localizations was found in all types of end-stage organ failure. The presence of CMBs was significantly correlated with age, hypertension, and specific end-stage organ failure risk factors (p failure. The improved detection of CMBs with SWI sequences may contribute to a more accurate identification of patients with cerebral risk factors to prevent complications during or after the organ transplantation.

Failure Analysis of Alumina Reinforced Aluminum Microtruss and Tube Composites

Science.gov (United States)

Chien, Hsueh Fen (Karen)

The energy absorption capacity of cellular materials can be dramatically increased by applying a structural coating. This thesis examined the failure mechanisms of alumina reinforced 3003 aluminum alloy microtrusses and tubes. Alumina coatings were produced by hard anodizing and by plasma electrolytic oxidation (PEO). The relatively thin and discontinuous oxide coating at the hinge acted as a localized weak spot which triggered a chain reaction of failure, including oxide fracture, oxide spallation, oxide penetration to the aluminum core and severe local plastic deformation of the core. For the PEO microtrusses, delamination occurred within the oxide coating resulting in a global strut buckling failure mode. A new failure mode for the anodized tubes was observed: (i) axisymmetric folding of the aluminum core, (ii) longitudinal fracture, and (iii) alumina pulverization. Overall, the alumina coating enhanced the buckling resistance of the composites, while the aluminum core supported the oxide during the damage propagation.

Looking good, but behaving badly: leader accountability and ethics failure.

Science.gov (United States)

Bruhn, John G

2005-01-01

Making the bottom line is a fact of life in the business and corporate world. However, when organizations and their leaders become fixated on the bottom line and ignore values, an environment conducive to ethics failure is nurtured. Ethics failure has focused almost exclusively on the behavior of organizational leaders. However, it is the interaction of the culture of organizations and the character of their leaders that create the environment and social situations conducive to ethics failure. Although ethics failure is not totally preventable, there are usually warning signs early in the recruitment process of prospective CEOs that predict ethics failure. The author suggests that specific up-front questions be asked to ascertain the ethical fitness of prospective CEOs.

Myostatin from the heart: local and systemic actions in cardiac failure and muscle wasting

Science.gov (United States)

Breitbart, Astrid; Auger-Messier, Mannix; Molkentin, Jeffery D.

2011-01-01

A significant proportion of heart failure patients develop skeletal muscle wasting and cardiac cachexia, which is associated with a very poor prognosis. Recently, myostatin, a cytokine from the transforming growth factor-β (TGF-β) family and a known strong inhibitor of skeletal muscle growth, has been identified as a direct mediator of skeletal muscle atrophy in mice with heart failure. Myostatin is mainly expressed in skeletal muscle, although basal expression is also detectable in heart and adipose tissue. During pathological loading of the heart, the myocardium produces and secretes myostatin into the circulation where it inhibits skeletal muscle growth. Thus, genetic elimination of myostatin from the heart reduces skeletal muscle atrophy in mice with heart failure, whereas transgenic overexpression of myostatin in the heart is capable of inducing muscle wasting. In addition to its endocrine action on skeletal muscle, cardiac myostatin production also modestly inhibits cardiomyocyte growth under certain circumstances, as well as induces cardiac fibrosis and alterations in ventricular function. Interestingly, heart failure patients show elevated myostatin levels in their serum. To therapeutically influence skeletal muscle wasting, direct inhibition of myostatin was shown to positively impact skeletal muscle mass in heart failure, suggesting a promising strategy for the treatment of cardiac cachexia in the future. PMID:21421824

Family Wellness, Not HIV Prevention

Science.gov (United States)

Swendeman, Dallas; Flannery, Diane

2010-01-01

HIV exceptionalism (and disease-specific programs generally) garner both unbalanced funding and the most talented personnel, distorting local health priorities. In support of HIV exceptionalism, the successful mobilization of significant global health sector resources was not possible prior to HIV. Both sides of the debate have merits; rather than perpetuating polarization, we suggest that sustained improvements in global health require creating a prevention infrastructure to meet multiple health challenges experienced by local communities. We propose four fundamental shifts in HIV and disease prevention: (1) horizontally integrating prevention at one site locally, with priorities tailored to local health challenges and managed by local community leaders; (2) using a family wellness metaphor for services, not disease prevention; (3) implementing evidence-based prevention programs (EBPP) based on common principles, factors, and processes, rather than replication of specific programs; and (4) utilizing the expertise of private enterprise to re-design EBPP into highly attractive, engaging, and accessible experiences. PMID:19148744

Aerobic exercise training prevents heart failure-induced skeletal muscle atrophy by anti-catabolic, but not anabolic actions.

Directory of Open Access Journals (Sweden)

Rodrigo W A Souza

Full Text Available Heart failure (HF is associated with cachexia and consequent exercise intolerance. Given the beneficial effects of aerobic exercise training (ET in HF, the aim of this study was to determine if the ET performed during the transition from cardiac dysfunction to HF would alter the expression of anabolic and catabolic factors, thus preventing skeletal muscle wasting.We employed ascending aortic stenosis (AS inducing HF in Wistar male rats. Controls were sham-operated animals. At 18 weeks after surgery, rats with cardiac dysfunction were randomized to 10 weeks of aerobic ET (AS-ET or to an untrained group (AS-UN. At 28 weeks, the AS-UN group presented HF signs in conjunction with high TNF-α serum levels; soleus and plantaris muscle atrophy; and an increase in the expression of TNF-α, NFκB (p65, MAFbx, MuRF1, FoxO1, and myostatin catabolic factors. However, in the AS-ET group, the deterioration of cardiac function was prevented, as well as muscle wasting, and the atrophy promoters were decreased. Interestingly, changes in anabolic factor expression (IGF-I, AKT, and mTOR were not observed. Nevertheless, in the plantaris muscle, ET maintained high PGC1α levels.Thus, the ET capability to attenuate cardiac function during the transition from cardiac dysfunction to HF was accompanied by a prevention of skeletal muscle atrophy that did not occur via an increase in anabolic factors, but through anti-catabolic activity, presumably caused by PGC1α action. These findings indicate the therapeutic potential of aerobic ET to block HF-induced muscle atrophy by counteracting the increased catabolic state.

Advanced Materials and Process Technology for Mechanical Failure Prevention (Proceedings of the Meeting of the Mechanical Failures Prevention Group (48th) Held in Wakefield, Massachusetts on 19-21 April 1994,

Science.gov (United States)

1994-04-21

stress rupture fractured specimens (a) as- ROC’ed, (b) beat treated by schedule 2. (a) (b) (c) (d) Figure 6: SEM fractographs of super-a, tensile... beat 195 - - . -i The microstructure in the weld region and at the fatigue failures was studied and related o the observed failures.Fati ue data are...inspector also can use one or two audio output channels for either mono or stereo ( binaural ) presentation of the aural information. Auralkatlon of

Failure Analysis of High-Power Piezoelectric Transducers

National Research Council Canada - National Science Library

Gabrielson, T. B

2005-01-01

... and stress in a piezoelectric material. For a transducer operated near resonance, there will be "hot spots" or regions of locally intense stress and electric field that precipitate premature failure...

Impact of biochemical failure on overall survival after radiation therapy for localized prostate cancer in the PSA era

International Nuclear Information System (INIS)

Kupelian, Patrick A.; Buchsbaum, Jeffrey C.; Patel, Chandrika; Elshaikh, Mohamed; Reddy, Chandana A.; Zippe, Craig; Klein, Eric A.

2002-01-01

Purpose: To study the impact of biochemical failure on overall survival rates during the first 10 years after definitive radiotherapy for localized prostate cancer. Methods and Materials: The analysis was performed on 936 cases treated at a single institution between 1986 and 1998 with definitive radiotherapy. The median age of treatment was 69 years (range: 46-86 years). Pretreatment PSA levels (iPSA) and biopsy Gleason scores (bGS) were available for all cases. The clinical stage was T1/T2A in 63%, T2B/C in 27%, and T3 in 10%. The median iPSA level was 9.6 ng/mL (range: 0.4-692.9 ng/mL). The iPSA was ≤10 in 53% and >10 in 47%. The bGS was ≤6 in 59% and ≥7 in 41%. Androgen deprivation (AD) was administered in 181 cases (19%) for a median duration of 6 months (range: 1-6 months). All 181 cases received AD neoadjuvantly, i.e., before and/or during the radiotherapy. No AD was delivered after the completion of radiation. The median radiation dose was 70 Gy (range: 60-78 Gy). The radiotherapy technique was conformal in 376 (40%) cases. The American Society of Therapeutic Radiology and Oncology definition of biochemical failure (bF) was used; 316 cases (34%) had failed biochemically, and 620 (66%) had not. The end point was overall survival (OS). Time to death was determined from the time of definitive radiotherapy. The median PSA follow-up was 58 months. The median follow-up times for bF vs. no-bF cases were 77 and 49 months, respectively. A multivariate analysis of factors affecting OS using the proportional hazards model was performed for all cases using the following variables: age (>65 vs. ≤65 years), race (African-American vs. Caucasian), clinical T stage (T1-2A vs. T2B-C vs. T3), bGS (≤6 vs. 7 vs. ≥8), iPSA (continuous variable), use of AD (yes vs. no), year of therapy (continuous variable), radiation dose (continuous variable), radiation technique (conformal vs. standard), and biochemical failure (yes vs. no). Results: The 5-year OS rate for the

Failure analysis of vise jaw holders for hacksaw machine

Directory of Open Access Journals (Sweden)

Essam Ali Al-Bahkali

2018-01-01

Full Text Available Failure analysis in mechanical components has been investigated in many studies in the last few years. Failure analysis and prevention are important functions in all engineering disciplines. Materials engineers are often the lead role in the analysis of failures, where a component or product fails in service or if a failure occurs during manufacturing or production processing. In any case, one must determine the cause of the failure to prevent future occurrences and/or to improve the performance of the device, component or structure. For example, the vise jaw holders of hacksaws can break due to accidental heavy loads or machine misuse. The parts that break are the stationary and movable vise jaw holders and the connecter power screw between the holders. To investigate the failure of these components, a three-dimensional finite element model for stress analysis was performed. First, the analysis identified the broken components of the hacksaw machine. In addition, the type of materials of the broken parts was identified, a CAD model was built, and the hacksaw mechanism was analyzed to determine the accurate applied loads on the broken parts. After analyzing the model using Abaqus CAE software, the results showed that the location of the high stresses was identical with the high-stress locations in the original, broken parts. Furthermore, the power screw was subjected to a high load, which deformed the power screw. Also, the stationary vise jaw holder was broken by impact because it was not touched by the power screw until the movable vise jaw holder broke. A conclusion is drawn from the failure analysis and a way to improve the design of the broken parts is suggested.

Disease prevention policy under Medicare: a historical and political analysis.

Science.gov (United States)

Schauffler, H H

1993-01-01

I review the history and politics of Medicare disease prevention policy and identify factors associated with the success or failure of legislative initiatives to add preventive services benefits to Medicare. Between 1965 and 1990, 453 bills for Medicare preventive services were introduced in the U.S. Congress, but not until 1980, after 350 bills had failed, was the first preventive service added to the Medicare program. Medicare currently pays for only four of the 44 preventive services recommended for the elderly by the U.S. Preventive Services Task Force (pneumococcal and hepatitis B vaccinations, Pap smears, and mammography). In addition, Congress has funded demonstration programs for the influenza vaccine and comprehensive preventive services. The preventive services added to Medicare reflect the bias of the biomedical model toward screening and immunizations. Counseling services have received the least legislative attention. Factors associated with successful enactment include single-benefit bills, incorporation into budget-deficit reduction legislation, documented evidence of cost-effectiveness, public hearings, sponsorship by chairs of key congressional committees, and persistent congressional leadership. Factors associated with failure include lack of support from Medicare beneficiaries, lack of professional support, impact on total Medicare expenditures, disagreement over or failure to address payment and financing mechanisms, and competing congressional priorities.

Optimizing preventive maintenance

International Nuclear Information System (INIS)

DiCola, F.E.

1988-01-01

The traditional approach to preventive maintenance (PM) is based on adherence to manufacturers's requirements and recommended frequencies. When equipment fails, either new procedures are established or the frequency is increased. This leads to an increase in the number of PM activities, overloading not only maintenance resources, but support as well. There is no correlation between more PM and an increase in equipment reliability. More PM may actually induce failures. Reliability-centered maintenance, a new concept in utility maintenance, is based on identifying system/subsystem functions, failures, and dominant failure modes to develop or revise PM tasks. The activities described in this paper are based on actual implementation of this concept on an ongoing project to upgrade the PM program at one of the largest electric utilities in the country. Optimum PM activities are those that, when implemented, will minimize factors that c cause equipment to fail. One technique described illustrates how equipment performance, failure modes, and causes can be related to minimize the occurrence of failures. Operating history and service life of a component are key factors in determining the most effective PM activities, provided that the factors are related to failure modes and causes

Erythrocyte Membrane Failure by Electromechanical Stress

Directory of Open Access Journals (Sweden)

E Du

2018-01-01

Full Text Available We envision that electrodeformation of biological cells through dielectrophoresis as a new technique to elucidate the mechanistic details underlying membrane failure by electrical and mechanical stresses. Here we demonstrate the full control of cellular uniaxial deformation and tensile recovery in biological cells via amplitude-modified electric field at radio frequency by an interdigitated electrode array in microfluidics. Transient creep and cyclic experiments were performed on individually tracked human erythrocytes. Observations of the viscoelastic-to-viscoplastic deformation behavior and the localized plastic deformations in erythrocyte membranes suggest that electromechanical stress results in irreversible membrane failure. Examples of membrane failure can be separated into different groups according to the loading scenarios: mechanical stiffening, physical damage, morphological transformation from discocyte to echinocyte, and whole cell lysis. These results show that this technique can be potentially utilized to explore membrane failure in erythrocytes affected by other pathophysiological processes.

Dopamine in heart failure and critical care

NARCIS (Netherlands)

Smit, AJ

Dopamine is widely used in critical care to prevent renal function loss. Nevertheless sufficient evidence is still lacking of reduction in end points like mortality or renal replacement therapy. Dopaminergic treatment in chronic heart failure (CHF) has provided an example of unexpected adverse

Electric motor predictive and preventive maintenance guide

International Nuclear Information System (INIS)

Oliver, J.A.

1992-07-01

Electric motor performance is vital to the reliable and efficient operation of power plants. The failure of one or more critical motors could cause lost capacity and excessive repair and maintenance cost. However, existing maintenance recommendations proposed by vendors for electric motors have sometimes encouraged many overly conservative maintenance practices. These practices have lead to excessive maintenance activities and costs which have provided no extra margin of operability. EPRI has sponsored RP2814-35 to develop a guide which provides power plants with information and guidance for establishing an effective maintenance program which will aid in preventing unexpected motor failures and assist in planning motor maintenance efforts. The guide includes a technical description which summarizes technical data relative to the four basic types of motors and their components in general use in power plants. The significant causes of motor failures are investigated and described in detail and methods to optimize service life and minimize maintenance cost through appropriate preventive maintenance and conditioning program are presented. This guide provides a foundation for an effective electric motor maintenance program and simplifies the selection of predictive and preventive maintenance tasks. Its use will enable maintenance personnel in nuclear and fossil plants to plan motor repairs during scheduled outages and avoid costly unexpected failures

The Effect of Education on Preventive Behaviors of Failure to Thrive in Mothers with Children Aged One to Five Years: Applied Health Belief Model

Directory of Open Access Journals (Sweden)

Mahtab Navabi

2017-04-01

Full Text Available Abstract Background: One of the common and important health problems is failure to thrive in childhood. The purpose of this study was to determine the effect of education on preventive behaviors of failure to thrive in mothers with children based on health belief model. Materials and Methods: This study is an interventional one in which 100 mothers with children one to five years involved (samples divided into two case and control groups, each of 50 sampling was done by a simple random method. For collecting information, a researcher-made questionnaire based on the health belief model and performance check list were used. Then, case group was trained for one month. 3 months after training, data were gathered and analyzed by Spss20 software. In addition to descriptive statistics, tests such as Chi-square, paired t-test and independent T-test were used. Results: The mean age of case and control was 29.98±5.51 and 25.35±5.30 years old, respectively. The average age of children was 23.31 ± 13.14 and 27.55 ± 14.01months, respectively. Before the intervention, no significant difference was seen between groups. The average score in case group before intervention was as: knowledge(31.87±14.24, perceived susceptibility(64.23±5.86, perceived severity(64.41±9.34, perceived benefits(61.75±6.79, perceived barriers(67.91±8.14, self-efficacy(68.00±7.87, cues to action(44.53±6.82 and action(70.00±9.77. However, after the intervention, significant differences between groups in all variables were obserred. Conclusion: According to the results, education based on health belief model is recommended for promoting preventive behaviors of failure to thrive.

Analytical Study of different types Of network failure detection and possible remedies

Science.gov (United States)

Saxena, Shikha; Chandra, Somnath

2012-07-01

Faults in a network have various causes,such as the failure of one or more routers, fiber-cuts, failure of physical elements at the optical layer, or extraneous causes like power outages. These faults are usually detected as failures of a set of dependent logical entities and the links affected by the failed components. A reliable control plane plays a crucial role in creating high-level services in the next-generation transport network based on the Generalized Multiprotocol Label Switching (GMPLS) or Automatically Switched Optical Networks (ASON) model. In this paper, approaches to control-plane survivability, based on protection and restoration mechanisms, are examined. Procedures for the control plane state recovery are also discussed, including link and node failure recovery and the concepts of monitoring paths (MPs) and monitoring cycles (MCs) for unique localization of shared risk linked group (SRLG) failures in all-optical networks. An SRLG failure is a failure of multiple links due to a failure of a common resource. MCs (MPs) start and end at same (distinct) monitoring location(s). They are constructed such that any SRLG failure results in the failure of a unique combination of paths and cycles. We derive necessary and sufficient conditions on the set of MCs and MPs needed for localizing an SRLG failure in an arbitrary graph. Procedure of Protection and Restoration of the SRLG failure by backup re-provisioning algorithm have also been discussed.

Prevention of brittle fracture of steel structures by controlling the local stress and strain fields

Directory of Open Access Journals (Sweden)

Moyseychik Evgeniy Alekseevich

Full Text Available In the article the author offers a classification of the methods to increase the cold resistance of steel structural shapes with a focus on the regulation of local fields of internal stresses and strains to prevent brittle fracture of steel structures. The need of a computer thermography is highlighted not only for visualization of temperature fields on the surface, but also to control the fields of residual stresses and strains in a controlled element.

Use of Local Stone: Successes, Failures and Considerations

Science.gov (United States)

Gerns, Edward; Will, Rachel

2015-04-01

Stone has been used in construction for thousands of years. Until relatively recently, local stone was used almost exclusively due to limited transportation options and to reduce costs. . Historically, the stone was often taken from nearby fields, known as fieldstone, without any specific quarrying operations and used to create unique assemblages of vernacular buildings. Stone, perhaps more than any other natural building material, has numerous varieties and characteristics within the broader classifications of stone: sedimentary, igneous and metamorphic. In exterior applications, stone historically has been used for foundations, localized cladding elements and in some instances entire building facades. Many of these local stones are appropriate for foundations, but not necessarily for cladding systems, particularly once the stone was quarried and modified rather than used in its natural form. These issues tended to be less significant in historic buildings when wall systems were much thicker and had more redundancies in the cladding systems Since around 1880, the use of these thinner applications of quarried stones as more traditional cladding systems (rather than cladding and structure) has resulted in challenges including unanticipated weathering characteristics, residual stresses and detrimental inclusions. These conditions can result in expensive and extensive repairs and maintenance. Often the options to address these characteristics are limited or potentially drastic depending on the scale of installation. It is important to understand the cause of the issues, understand if these issues are significant and finally how to address them appropriately. Where and how these unique local stones are installed as well as climate and weathering patterns certainly contribute to the potential unanticipated conditions. This presentation will be divided into two general parts. The first will address various stones used historically throughout regions within the United

The less familiar side of heart failure: symptomatic diastolic dysfunction.

Science.gov (United States)

Morris, Spencer A; Van Swol, Mark; Udani, Bela

2005-06-01

Arrange for echocardiography or radionuclide angiography within 72 hours of a heart failure exacerbation. An ejection fraction >50% in the presence of signs and symptoms of heart failure makes the diagnosis of diastolic heart failure probable. To treat associated hypertension, use angiotensin receptor blockers (ARBs), angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, calcium channel blockers, or diuretics to achieve a blood pressure goal of <130/80 mm Hg. When using beta-blockers to control heart rate, titrate doses more aggressively than would be done for systolic failure, to reach a goal of 60 to 70 bpm. Use ACE inhibitors/ARBs to decrease hospitalizations, decrease symptoms, and prevent left ventricular remodeling.

On the relation between orbital-localization and self-interaction errors in the density functional theory treatment of organic semiconductors.

Science.gov (United States)

Körzdörfer, T

2011-03-07

It is commonly argued that the self-interaction error (SIE) inherent in semilocal density functionals is related to the degree of the electronic localization. Yet at the same time there exists a latent ambiguity in the definitions of the terms "localization" and "self-interaction," which ultimately prevents a clear and readily accessible quantification of this relationship. This problem is particularly pressing for organic semiconductor molecules, in which delocalized molecular orbitals typically alternate with localized ones, thus leading to major distortions in the eigenvalue spectra. This paper discusses the relation between localization and SIEs in organic semiconductors in detail. Its findings provide further insights into the SIE in the orbital energies and yield a new perspective on the failure of self-interaction corrections that identify delocalized orbital densities with electrons. © 2011 American Institute of Physics.

When things go wrong: how health care organizations deal with major failures.

Science.gov (United States)

Walshe, Kieran; Shortell, Stephen M

2004-01-01

Concern about patient safety, caused in part by high-profile major failures in which many patients have been harmed, is rising worldwide. This paper draws on examples of such failures from several countries to analyze how these events are dealt with and to identify lessons and recommendations for policy. Better systems are needed for reporting and investigating failures and for implementing the lessons learned. The culture of secrecy, professional protectionism, defensiveness, and deference to authority is central to such major failures, and preventing future failures depends on cultural as much as structural change in health care systems and organizations.

An engineering approach to common mode failure analysis

International Nuclear Information System (INIS)

Gangloff, W.C.; Franke, T.H.

1975-01-01

Safety systems for nuclear reactors can be designed using standard reliability engineering techniques such that system failure due to random component faults is extremely unlikely. However, the common-mode failure where several components fail together from a common cause is not susceptible to prevention by the usual tactics. In systems where a high degree of redundancy has been employed, the actual reliability of the system in service may be limited by common-mode failures. A methodical and thorough procedure for evaluation of system vulnerability to common-mode failures is presented. This procedure was developed for use in nuclear reactor safety systems and has been applied specifically to reactor protection. The method offers a qualitative assessment of a system whereby weak points can be identified and the resistance to common-mode failure can be judged. It takes into account all factors influencing system performance including design, manufacturing, installation, operation, testing, and maintenance. It is not a guarantee or sure solution, but rather a practical tool which can provide good assurance that the probability of common-mode protection failure has been made acceptably low. (author)

Usage of Failure Mode & EffectAnalysis Method (FMEA forsafety assessment in a drug manufacture

Directory of Open Access Journals (Sweden)

Y Nazari

2006-04-01

Full Text Available Background and Aims: This study was hold in purpose of recognizing and controlling workplacehazards in production units of a drag ManufactureMethod:So for recognition and assessment of hazards, FMEA Method was used. FMEASystematically investigates the effects of equipment and system failures leading often toequipment design improvements. At first the level of the study defined as system. Then accordingto observations, accident statistic, and interview with managers, supervisory, and workers highrisk system were determiner. So the boundaries of the system established and informationregarding the relevant Components, their function and interactions gathered. To preventConfusion between Similar pieces of equipment, a unique system identifier developed. After thatall failure modes and their causes for each equipment or system listed, the immediate effects ofeach failure mode and interactive effect on other equipment or system was described too. Riskpriority number was determined according to global and local criteriaResults: After all some actions and solution proposed to reduce the likelihood and severity offailures and raise their delectability.Conclusion :This study illustrated that although of the first step drug manufacture may seem safe,but there are still many hazardous condition that could cause serious accidents, The result proposedit is necessary: (1 to develop comprehensive manual for periodical and regular inspection ofinstruments of workplaces in purpose of recognize unknown failures and their causes, (2 developa comprehensive program for systems maintenance and repair, and (3 conduct worker training.

Seismic ratchet-fatigue failure of piping systems

International Nuclear Information System (INIS)

Severud, L.K.; Anderson, M.J.; Lindquist, M.R.; Weiner, E.O.

1986-01-01

Failures of piping systems during earthquakes have been rare. Those that have failed were either made of brittle material such as cast iron, were rigid systems between major components where component relative seismic motions tore the pipe out of the component, or were high pressure systems where a ratchet-fatigue fracture followed a local bulging of the pipe diameter. Tests to failure of an unpressurized 3-in. and a pressurized 6-in. diameter carbon steel nuclear pipe systems subjected to high level shaking have been accomplished. Failure analyses of these tests are presented and correlated to the test results. It was found that failure of the unpressurized system could be correlated well with standard ASME type fatigue analysis predictions. Moreover, the pressurized system failure occurred in significantly less load cycles than predicted by standard fatigue analysis. However, a ratchet-fatigue and ductility exhaustion analysis of the pressurized system did correlate very well. These findings indicate modifications to design analysis methods and the present ASME Code piping design rules may be appropriate to cover the ratchet-fatigue failure mode

Cardiac Cachexia: Perspectives for Prevention and Treatment.

Science.gov (United States)

Okoshi, Marina Politi; Capalbo, Rafael Verardino; Romeiro, Fernando G; Okoshi, Katashi

2017-01-01

Cachexia is a prevalent pathological condition associated with chronic heart failure. Its occurrence predicts increased morbidity and mortality independent of important clinical variables such as age, ventricular function, or heart failure functional class. The clinical consequences of cachexia are dependent on both weight loss and systemic inflammation, which accompany cachexia development. Skeletal muscle wasting is an important component of cachexia; it often precedes cachexia development and predicts poor outcome in heart failure. Cachexia clinically affects several organs and systems. It is a multifactorial condition where underlying pathophysiological mechanisms are not completely understood making it difficult to develop specific prevention and treatment therapies. Preventive strategies have largely focused on muscle mass preservation. Different treatment options have been described, mostly in small clinical studies or experimental settings. These include nutritional support, neurohormonal blockade, reducing intestinal bacterial translocation, anemia and iron deficiency treatment, appetite stimulants, immunomodulatory agents, anabolic hormones, and physical exercise regimens. Currently, nonpharmacological therapy such as nutritional support and physical exercise are considered central to cachexia prevention and treatment.

Re-distribution of brachytherapy dose using a differential dose prescription adapted to risk of local failure in low-risk prostate cancer patients

DEFF Research Database (Denmark)

Rylander, Susanne; Polders, Daniel; Steggerda, Marcel J

2015-01-01

BACKGROUND AND PURPOSE: We investigated the application of a differential target- and dose prescription concept for low-dose-rate prostate brachytherapy (LDR-BT), involving a re-distribution of dose according to risk of local failure and treatment-related morbidity. MATERIAL AND METHODS: Our study......- and dose prescription concept of prescribing a lower dose to the whole gland and an escalated dose to the GTV using LDR-BT seed planning was technically feasible and resulted in a significant dose-reduction to urethra and bladder neck....

Paraoxonase 2 prevents the development of heart failure.

Science.gov (United States)

Li, Wei; Kennedy, David; Shao, Zhili; Wang, Xi; Kamdar, Andre Klaassen; Weber, Malory; Mislick, Kayla; Kiefer, Kathryn; Morales, Rommel; Agatisa-Boyle, Brendan; Shih, Diana M; Reddy, Srinivasa T; Moravec, Christine S; Tang, W H Wilson

2018-05-02

Mitochondrial oxidation is a major source of reactive oxygen species (ROS) and mitochondrial dysfunction plays a central role in development of heart failure (HF). Paraoxonase 2 deficient (PON2-def) mitochondria are impaired in function. In this study, we tested whether PON2-def aggravates HF progression. Using qPCR, immunoblotting and lactonase activity assay, we demonstrate that PON2 activity was significantly decreased in failing hearts despite increased PON2 expression. To determine the cardiac-specific function of PON2, we performed heart transplantations in which PON2-def and wild type (WT) donor hearts were implanted into WT recipient mice. Beating scores of the donor hearts, assessed at 4 weeks post-transplantation, were significantly decreased in PON2-def hearts when compared to WT donor hearts. By using a transverse aortic constriction (TAC) model, we found PON2 deficiency significantly exacerbated left ventricular remodeling and cardiac fibrosis post-TAC. We further demonstrated PON2 deficiency significantly enhanced ROS generation in heart tissues post-TAC. ROS generation was measured through dihydroethidium (DHE) using high-pressure liquid chromatography (HPLC) with a fluorescent detector. By using neonatal cardiomyocytes treated with CoCl 2 to mimic hypoxia, we found PON2 deficiency dramatically increased ROS generation in the cardiomyocytes upon CoCl 2 treatment. In response to a short CoCl 2 exposure, cell viability and succinate dehydrogenase (SDH) activity assessed by MTT assay were significantly diminished in PON2-def cardiomyocytes compared to those in WT cardiomyocytes. PON2-def cardiomyocytes also had lower baseline SDH activity. By using adult mouse cardiomyocytes and mitochondrial ToxGlo assay, we found impaired cellular ATP generation in PON2-def cells compared to that in WT cells, suggesting that PON2 is necessary for proper mitochondrial function. Our study suggests a cardioprotective role for PON2 in both experimental and human heart

Failure analysis of prestressed concrete beam under impact loading

International Nuclear Information System (INIS)

Ishikawa, N.; Sonoda, Y.; Kobayashi, N.

1993-01-01

This paper presents a failure analysis of prestressed concrete (PC) beam under impact loading. At first, the failure analysis of PC beam section is performed by using the discrete section element method in order to obtain the dynamic bending moment-curvature relation. Secondary, the failure analysis of PC beam is performed by using the rigid panel-spring model. Finally, the numerical calculation is executed and is compared with the experimental results. It is found that this approach can simulate well the experiments at the local and overall failure of the PC beam as well as the impact load and the displacement-time relations. (author)

Review Article Heart failure - an inflammatory paradigm

African Journals Online (AJOL)

1999-02-01

Feb 1, 1999 ... Together with the growing clinical problem of heart failure, new information at a .... nificantly raised in the prevention as well as the treatment arms when .... tricular dysfunction and pulmonary oedema in humans; experimentally ... adenine dinucleotide (reduced) and the rate-limiting amino acid (L-arginine).

Analyzing the Risk of Well Plug Failure after Abandonment

International Nuclear Information System (INIS)

Mainguy, M.; Longuemare, P.; Audibert, A.; Lecolier, E.

2007-01-01

All oil and gas wells will have to be plugged and abandoned at some time. The plugging and abandonment procedure must provide an effective isolation of the well fluids all along the well to reduce environmental risks of contamination and prevent from costly remedial jobs. Previous works have analyzed the plug behavior when submitted to local pressure or thermal changes but no work has looked to the effects of external pressure, thermal and stress changes resulting from a global equilibrium restoration in a hydrocarbon reservoir once production has stopped. This work estimates those changes after abandonment on a reservoir field case using a reservoir simulator in conjunction with a geomechanical simulator. Such simulations provide the pressure and thermal changes and the maximum effective stress changes in the reservoir cap rock where critical plugs are put in place for isolating the production intervals. These changes are used as loads in a well bore stress model that explicitly models an injector well and predict stress rearrangements in the plug after abandonment. Results obtained with the well bore stress model for a conventional class G cement plug show that the main risk of failure is tensile failure because of the low tensile strength of the cement. Actually, soft sealing materials or initially pre-stressed plug appears to be more adapted to the downhole conditions changes that may occurs after well plugging and abandonment. (authors)

Prevention of iodine deficiency in the Tyumen region: success or failure?

Directory of Open Access Journals (Sweden)

Ludmila Aleksandrovna Suplotova

2015-10-01

Full Text Available Aim. To evaluate the effectiveness of regional programs for the prevention of iodine deficiency in the Tyumen region and explore the awareness and behaviors of different groups of the population in matters of iodine prophylaxis in the conditions absence of federal law on universal salt iodization. Materials and methods. The results are presented of the realization of regional programs for the prevention of iodine deficiency in the Tyumen region for the period 1994–2014 years. As part of the medical monitoring examined 18,906 prepubertal children 8–12 years with the use of a unified system of identification of iodine deficiency. The results of sociological research are presented, as part of a public health monitoring conducted by surveying students (n = 744 and their parents (n = 677 on a representative sample. Results. Iodine nutrition use was normalization through 3 years against the background of the realization regional program of iodine prophylaxis since 1997 in the Tyumen region, as evidenced by normalization of urinary iodine excretion in prepubertal children. The median urinary iodine in prepubertal children significantly increased from baseline 71.4 mg/l to 142 mg/l in 2009, and as a result decreased the frequency of goiter in children 8–10 years from 87% to 8%, which corresponds to mild endemic goiter region. It noted a lack of awareness of parents of iodine deficiency in the area of residence (54.8% informed their parents of schoolchildren; indicator is linked to gender, age (p < 0.01, education (p < 0.001, and where do you live respondents (p < 0.001. Knowledge of the existence and availability of prevention of iodine deficiency showed 75% of parents and 46.6% of students. Regular use of iodized salt in the home diet (“always used” and “often iodized salt than non-iodised” 57.4% of parents say. To identify various models of preventive behaviors of parents of schoolchildren in the prevention of iodine deficiency

The antioxidant acetylcysteine reduces cardiovascular events in patients with end-stage renal failure: a randomized, controlled trial

DEFF Research Database (Denmark)

Tepel, Martin; van der Giet, Markus; Statz, Mario

2003-01-01

Patients with end-stage renal failure have increased oxidative stress and show elevated cardiovascular mortality. Whether increased cardiovascular events can be prevented by the administration of antioxidants is unknown.......Patients with end-stage renal failure have increased oxidative stress and show elevated cardiovascular mortality. Whether increased cardiovascular events can be prevented by the administration of antioxidants is unknown....

Failure of preventive measures against radon penetration from the ground in a new-built family house - a case study

International Nuclear Information System (INIS)

Neznal, M.; Neznal, M.; Jiranek, M.; Fronka, A.

2006-01-01

A system of preventive protection of houses against radon penetration from the ground [1] has been in operation for more than 15 years in the Czech Republic. The determination of a so-called radon index of the building site represents the first step. The assessment is based on measurements of soil gas radon concentration and on the determination of soil permeability. During the years, the method was modified several times, especially the recommendation dealing with the classification of soil permeability, but the base remains stable: The soil characteristics are measured in-situ and protective measures are designed with respect to the measured properties of the soil and to the dwelling design. The site-specific, individual approach should enable to propose an optimal preventive strategy corresponding to local conditions. If the radon index is other than low (i.e. medium, or high), the building must be protected against radon in accordance with the Czech Atomic Law. Protective measures should be designed and installed according to the Czech National Standard [2]. Basic principles of the protection can be summarized in the following way: If the radon index of a building site is low, no special provisions are required. Normal damp-proofing that is designed in accordance with hydro-geological conditions provides sufficient building protection. Nevertheless, the insulation has to be installed over the whole ground area of the building. It is also recommended that the corridor with stairs leading from the underground floor to the upper floors should be separated by the door. In case of medium radon index of a building site, each high-quality and long life damp-proofing, with the measured radon diffusion coefficient, may be considered as radon-proof insulation in compliance with C.S.N. 73 06 01. A required insulation thickness is calculated using the known value of radon diffusion coefficient. The insulation must be laid down continuously on the whole area of the

Compressive Failure Mechanisms in Layered Materials

DEFF Research Database (Denmark)

Sørensen, Kim Dalsten

Two important failure modes in fiber reinforced composite materials in cluding layers and laminates occur under loading conditions dominated by compression in the layer direction. These two distinctly different failure modes are 1. buckling driven delamination 2. failure by strain localization...... or on cylindrical substrates modeling the delamination as an interface fracture mechanical problem. Here attention is directed towards double-curved substrates, which introduces a new non-dimensional combination of geometric parameters. It is shown for a wide range of parameters that by choosing the two....... This has some impact on the convergence rate for decreasing mesh size in the load vs. end shortening response for a rectangular block of material. Especially in the immediate post critical range the convergence rate may be slow. The capabilities of the model to deal with more complicated structural...

Spectrum-based Fault Localization in Embedded Software

NARCIS (Netherlands)

Abreu, R.

2009-01-01

Locating software components that are responsible for observed failures is a time-intensive and expensive phase in the software development cycle. Automatic fault localization techniques aid developers/testers in pinpointing the root cause of software failures, as such reducing the debugging effort.

The use of failure mode and effects analysis to construct an effective disposal and prevention mechanism for infectious hospital waste

International Nuclear Information System (INIS)

Ho, Chao Chung; Liao, Ching-Jong

2011-01-01

Highlights: → This study is based on a real case in a regional teaching hospital in Taiwan. → We use Failure mode and effects analysis (FMEA) as the evaluation method. → We successfully identify the risk factors of infectious waste disposal. → We propose plans for the detection of exceptional cases of infectious waste. - Abstract: In recent times, the quality of medical care has been continuously improving in medical institutions wherein patient-centred care has been emphasized. Failure mode and effects analysis (FMEA) has also been promoted as a method of basic risk management and as part of total quality management (TQM) for improving the quality of medical care and preventing mistakes. Therefore, a study was conducted using FMEA to evaluate the potential risk causes in the process of infectious medical waste disposal, devise standard procedures concerning the waste, and propose feasible plans for facilitating the detection of exceptional cases of infectious waste. The analysis revealed the following results regarding medical institutions: (a) FMEA can be used to identify the risk factors of infectious waste disposal. (b) During the infectious waste disposal process, six items were scored over 100 in the assessment of uncontrolled risks: erroneous discarding of infectious waste by patients and their families, erroneous discarding by nursing staff, erroneous discarding by medical staff, cleaning drivers pierced by sharp articles, cleaning staff pierced by sharp articles, and unmarked output units. Therefore, the study concluded that it was necessary to (1) provide education and training about waste classification to the medical staff, patients and their families, nursing staff, and cleaning staff; (2) clarify the signs of caution; and (3) evaluate the failure mode and strengthen the effects.

Failure Prediction And Detection In Cloud Datacenters

Directory of Open Access Journals (Sweden)

Purvil Bambharolia

2017-09-01

Full Text Available Cloud computing is a novel technology in the field of distributed computing. Usage of Cloud computing is increasing rapidly day by day. In order to serve the customers and businesses satisfactorily fault occurring in datacenters and servers must be detected and predicted efficiently in order to launch mechanisms to tolerate the failures occurred. Failure in one of the hosted datacenters may propagate to other datacenters and make the situation worse. In order to prevent such situations one can predict a failure proliferating throughout the cloud computing system and launch mechanisms to deal with it proactively. One of the ways to predict failures is to train a machine to predict failure on the basis of messages or logs passed between various components of the cloud. In the training session the machine can identify certain message patterns relating to failure of data centers. Later on the machine can be used to check whether a certain group of message logs follow such patterns or not. Moreover each cloud server can be defined by a state which indicates whether the cloud is running properly or is facing some failure. Parameters such as CPU usage memory usage etc. can be maintained for each of the servers. Using this parameters we can add a layer of detection where in we develop a decision tree based on these parameters which can classify whether the passed in parameters to the decision tree indicate failure state or proper state.

Building the Capacity of States to Ensure Inclusion of Rural Communities in State and Local Primary Violence Prevention Planning

Science.gov (United States)

Cook-Craig, Patricia G.; Lane, Karen G.; Siebold, Wendi L.

2010-01-01

Rural, frontier, and geographically isolated communities face unique challenges associated with ensuring that they are equal partners in capacity-building and prevention planning processes at the state and local level despite barriers that can inhibit participation. By their nature, rural, frontier, and geographically isolated communities and…

Analytical work on local faults in LMFBR subassembly

International Nuclear Information System (INIS)

Yoshikawa, H.; Miyaguchi, K.; Hirata, N.; Kasahara, F.

1979-01-01

Analytical codes have been developed for evaluating various severe but highly unlikely events of local faults in the LMFBR subassembly (S/A). These include: (1) local flow blockage, (2) two-phase thermohydraulics under fission gas release, and (3) inter-S/A failure propagation. A simple inter-S/A thermal failure propagation analysis code, FUMES, is described that allows an easy parametric study of propagation potential of fuel fog in a S/A. 7 refs

Failure mode and effects analysis applied to the administration of liquid medication by oral syringes

Directory of Open Access Journals (Sweden)

Eva María Guerra-Alia

2017-11-01

Full Text Available To carry out a Failure Mode and Effects Analysis (FMEA to the use of oral syringes. Methods: A multidisciplinary team was assembled within the Safety Committee. The stages of oral administration process of liquid medication were analysed, identifying the most critical and establishing the potential modes of failure that can cause errors. The impact associated with each mode of failure was calculated using the Risk Priority Number (RPN. Preventive actions were proposed. Results: Five failure modes were identified, all classified as high risk (RPN> 100. Seven of the eight preventive actions were implemented. Conclusions: The FMEA methodology was a useful tool. It has allowed to know the risks, analyse the causes that cause them, their effects on patient safety and the measures to reduce them

Optimizing preventive maintenance with maintenance templates

International Nuclear Information System (INIS)

Dozier, I.J.

1996-01-01

Rising operating costs has caused maintenance professionals to rethink their strategy for preventive maintenance (PM) programs. Maintenance Templates are pre-engineered PM task recommendations for a component type based on application of the component. Development of the maintenance template considers the dominant failure cause of the component and the type of preventive maintenance that can predict or prevent the failure from occurring. Maintenance template development also attempts to replace fixed frequency tasks with condition monitoring tasks such as vibration analysis or thermography. For those components that have fixed frequency PM intervals, consideration is given to the maintenance drivers such as criticality, environment and usage. This helps to maximize the PM frequency intervals and maximize the component availability. Maintenance Templates have been used at PECO Energy's Limerick Generating Station during the Reliability Centered Maintenance (RCM) Process to optimize their PM program. This paper describes the development and uses of the maintenance templates

A hybrid Radio-vision fault tolerant localization for mini UAV flying in swarm

DEFF Research Database (Denmark)

Latroch, Maamar; Abdelhafid, Omari; Koivo, Heikki N.

2013-01-01

This paper discuss the localization of one Unmanned Aerial Vehicle (UAV) when a failure of its GPS occurs and will propose a new solution based on the information collected by the swarm to localize it. we propose here an architecture for localization of a UAV with GPS signal failure in three...

Graphene coating for anti-corrosion and the investigation of failure mechanism

International Nuclear Information System (INIS)

Zhu, Y X; Duan, C Y; Chen, Y F; Wang, Y; Liu, H Y

2017-01-01

Graphene produced by chemical vapor deposition (CVD) methods has been considered as a promising corrosion prevention layer because of its exceptional structure and impermeability. However, the anti-corrosion performance and the failure mechanism are still controversial. In this study, graphene layers with different quality levels, crystallite sizes, and layer numbers were prepared on the surface of Cu by a CVD process. The effects of grain boundaries (GBs) on the failure of graphene layers to provide adequate protection were investigated in detail by combining graphene transfer techniques, computation, and anti-corrosion measurements. Our results reveal that corrosion rates decrease marginally upon the increase of graphene layer number, and this rather weak dependence on thickness likely arises from the aligned nature of the GBs in CVD-grown few-layer graphene. This problem can potentially be overcome by layer-by-layer graphene transfer technique, in which corrosion is found to be arrested locally when transferred graphene is present on top of the as-grown graphene. However, this advantage is not reflected in corrosion studies performed on large-scale samples, where cracks or imperfect interfaces could offset the advantages of GB misalignment. With improvements in technology, the layer-by-layer assembly technique could be used to develop an effective anti-corrosion barrier. (paper)

Seismic ratchet-fatigue failure of piping systems

International Nuclear Information System (INIS)

Severud, L.K.; Anderson, M.J.; Lindquist, M.R.; Weiner, E.O.

1987-01-01

Failures of piping systems during earthquakes have been rare. Those that have failed were either made of brittle material such as cast iron, were rigid systems between major components where component relative seismic motions tore the pipe out of the component, or were high pressure systems where a ratchet-fatigue fracture followed a local bulging of the pipe diameter. Tests to failure of an unpressurized 3-inch and a pressurized 6-inch diameter carbon steel nuclear pipe systems subjected to high-level shaking have been accomplished. The high-level shaking loads needed to cause failure were much higher than ASME Code rules would permit with present design limits. Failure analyses of these tests are presented and correlated to the test results. It was found that failure of the unpressurized system could be correlated well with standard ASME type fatigue analysis predictions. Moreover, the pressurized system failure occured in significantly less load cycles than predicted by standard fatigue analysis. However, a ratchet-fatigue and ductility exhaustion analysis of the pressurized system did correlate reasonably well. These findings indicate modifications to design analysis methods and the present ASME Code piping design rules to reduce unneeded conservatisms and to cover the ratchet-fatigue failure mode may be appropriate

European nursing students' academic success or failure: a post-Bologna Declaration systematic review.

Science.gov (United States)

Dante, Angelo; Petrucci, Cristina; Lancia, Loreto

2013-01-01

The aim of this systematic review is to synthesise the available evidence in the European scientific literature produced after the Bologna Declaration and to evaluate studies that quantify and examine the factors associated with the academic success or failure of nursing students. A systematic review of the literature was conducted. Major health literature databases were searched for studies published from 2000 to 2011. This review includes only European observational studies that were submitted to a quality assessment by two researchers before inclusion. Only five studies were included in this review. There are discordant results regarding the predictors of success or failure, which were common objects of study (gender, age, qualification on entry, ethnic group). other factors were studied individually (student personality, gendered view of nursing careers, intention to leave, family commitments, working while on course, student performance, clinical learning environment) need to be confirmed in additional studies. Although the predictors may be relevant at the local level, given their low external validity and the conflicting results, it is not possible to state with certainty that these factors are effectively predictive of success or failure in the context of post-Bologna Declaration Europe. This review showed that over the last ten years, in the European context, only a few high-quality observational studies have been performed. In this regard, given the small number and heterogeneity of the available studies, there is little useful evidence available for Higher Education Institutions (HEIs) to effectively address the problem. In the future, European researchers should focus not only on the documentation of the predictors but also on the documentation of the outcomes produced by the HEI strategies that have been implemented to prevent avoidable academic failure and contain physiological academic failure. Copyright © 2012 Elsevier Ltd. All rights reserved.

Worsening renal function in heart failure: the need for a consensus definition.

Science.gov (United States)

Sheerin, Noella J; Newton, Phillip J; Macdonald, Peter S; Leung, Dominic Y C; Sibbritt, David; Spicer, Stephen Timothy; Johnson, Kay; Krum, Henry; Davidson, Patricia M

2014-07-01

Acute decompensated heart failure is a common cause of hospitalisation. This is a period of vulnerability both in altered pathophysiology and also the potential for iatrogenesis due to therapeutic interventions. Renal dysfunction is often associated with heart failure and portends adverse outcomes. Identifying heart failure patients at risk of renal dysfunction is important in preventing progression to chronic kidney disease or worsening renal function, informing adjustment to medication management and potentially preventing adverse events. However, there is no working or consensus definition in international heart failure management guidelines for worsening renal function. In addition, there appears to be no concordance or adaptation of chronic kidney disease guidelines by heart failure guideline development groups for the monitoring of chronic kidney disease in heart failure. Our aim is to encourage the debate for an agreed definition given the prognostic impact of worsening renal function in heart failure. We present the case for the uptake of the Acute Kidney Injury Network criteria for acute kidney injury with some minor alterations. This has the potential to inform study design and meta-analysis thereby building the knowledgebase for guideline development. Definition consensus supports data element, clinical registry and electronic algorithm innovation as instruments for quality improvement and clinical research for better patient outcomes. In addition, we recommend all community managed heart failure patients have their baseline renal function classified and routinely monitored in accordance with established renal guidelines to help identify those at increased risk for worsening renal function or progression to chronic kidney disease. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The Financial Benefits of Various Catastrophic Failure Prevention Strategies in a Wind Farm: Two market studies (UK-Spain)

Science.gov (United States)

Yürüşen, N. Y.; Tautz-Weinert, J.; Watson, S. J.; Melero, J. J.

2017-11-01

Operation of wind farms is driven by the overall aim of minimising costs while maximising energy sales. However, in certain circumstances investments are required to guarantee safe operation and survival of an asset. In this paper, we discuss the merits of various catastrophic failure prevention strategies in a Spanish wind farm. The wind farm operator was required to replace blades in two phases: temporary and final repair. We analyse the power performance of the turbine in the different states and investigate four scenarios with different timing of temporary and final repair during one year. The financial consequences of the scenarios are compared with a baseline by using a discounted cash flow analysis that considers the wholesale electricity market selling prices and interest rates. A comparison with the UK electricity market is conducted to highlight differences in the rate of return in the two countries.

Organ failure avoidance and mitigation strategies in surgery.

Science.gov (United States)

McConnell, Kevin W; Coopersmith, Craig M

2012-04-01

Postoperative organ failure is a challenging disease process that is better prevented than treated. Providers should use close observation and clinical judgment, and checklists of best practices to minimize the risk of organ failure in their patients. The treatment of multiorgan dysfunction syndrome (MODS) generally remains supportive, outside of rapid initiation of source control (when appropriate) and targeted antibiotic therapy. More specific treatments may be developed as the complex pathophysiology of MODS is better understood and more homogenous patient populations are selected for study. Copyright © 2012 Elsevier Inc. All rights reserved.

[Orthognathic surgery: surgical failures and complications].

Science.gov (United States)

Guyot, Laurent

2016-03-01

Orthognathic surgery procedures mark the endpoint of lengthy orthodontic-surgical preparations and herald the completion of treatment for patients and their families. The main types of procedure are full maxillary Le Fort I osteotomies, mandibular osteotomies and chin surgery. To ensure a successful outcome, all require a favorable environment and extreme technical skill. But, like all surgical operations, they are also subject to peri- and post-operative complications resulting from treatment hazards or errors. Whatever the cause, surgical complications can entail failures in the management of the malformation. By seeking to understand and analyzing these complications, we can already help to prevent and reduce the contingent risks of failure. © EDP Sciences, SFODF, 2016.

Efficacy and predictors of success of noninvasive ventilation for prevention of extubation failure in critically ill children with heart disease.

Science.gov (United States)

Gupta, Punkaj; Kuperstock, Jacob E; Hashmi, Sana; Arnolde, Vickie; Gossett, Jeffrey M; Prodhan, Parthak; Venkataraman, Shekhar; Roth, Stephen J

2013-04-01

The study aimed primarily to evaluate the efficacy of noninvasive ventilation (NIV) and to identify possible predictors for success of NIV therapy in preventing extubation failure in critically ill children with heart disease. The secondary objectives of this study were to assess the efficacy of prophylactic NIV therapy initiated immediately after tracheal extubation and to determine the characteristics, outcomes, and complications associated with NIV therapy in pediatric cardiac patients. A retrospective review examined the medical records of all children between the ages 1 day and 18 years who sustained acute respiratory failure (ARF) that required NIV in the cardiovascular intensive care unit (CVICU) at Lucile Packard Children's Hospital between January 2008 and June 2010. Patients were assigned to a prophylactic group if NIV was started directly after extubation and to a nonprophylactic group if NIV was started after signs and symptoms of ARF developed. Patients were designated as responders if they received NIV and did not require reintubation during their CVICU stay and nonresponders if they failed NIV and reintubation was performed. The data collected included demographic data, preexisting conditions, pre-event characteristics, event characteristics, and outcome data. The outcome data evaluated included success or failure of NIV, duration of NIV, CVICU length of stay (LOS), hospital LOS, and hospital mortality. The two complications of NIV assessed in the study included nasal bridge or forehead skin necrosis and pneumothorax. The 221 eligible events during the study period involved 172 responders (77.8 %) and 49 nonresponders (22.2 %). A total of 201 events experienced by the study cohort received continuous positive airway pressure (CPAP), with 156 responders (78 %), whereas 20 events received bilevel positive airway pressure (BiPAP), with 16 responders (80 %). In the study, 58 events (26.3 %) were assigned to the prophylactic group and 163 events (73

A preventive maintenance model with a two-level inspection policy based on a three-stage failure process

International Nuclear Information System (INIS)

Wang, Wenbin; Zhao, Fei; Peng, Rui

2014-01-01

Inspection is always an important preventive maintenance (PM) activity and can have different depths and cover all or part of plant systems. This paper introduces a two-level inspection policy model for a single component plant system based on a three-stage failure process. Such a failure process divides the system′s life into three stages: good, minor defective and severe defective stages. The first level of inspection, the minor inspection, can only identify the minor defective stage with a certain probability, but can always reveal the severe defective stage. The major inspection can however identify both defective stages perfectly. Once the system is found to be in the minor defective stage, a shortened inspection interval is adopted. If however the system is found to be in the severe defective stage, we may delay the maintenance action if the time to the next planned PM window is less than a threshold level, but otherwise, replace immediately. This corresponds to the well adopted maintenance policy in practice such as periodic inspections with planned PMs. A numerical example is presented to demonstrate the proposed model by comparing with other models. - Highlights: • The system′s deterioration goes through a three-stage process, namely, normal, minor defective and severe defective. • Two levels of inspections are proposed, e.g., minor and major inspections. • Once the minor defective stage is found, instead of taking a maintenance action, a shortened inspection interval is recommended. • When the severe defective stage is found, we delay the maintenance according to the threshold to the next PM. • The decision variables are the inspection intervals and the threshold to PM

In-core failure of the instrumented BWR rod by locally induced high coolant temperature

International Nuclear Information System (INIS)

Yanagisawa, Kazuaki

1985-12-01

In the BWR type light water loop instrumented in HBWR, a current BWR type fuel rod pre-irradiated up to 5.6 MWd/kgU was power ramped to 50 kW/m. During the ramp, the diameter of the rod was expanded significantly at the bottom end. The behaviour was different from which caused by pellet-cladding interaction (PCI). In the post-irradiation examination, the rod was found to be failed. In this paper, the cause of the failure was studied and obtained the followings. (1) The significant expansion of the rod diameter was attributed to marked oxidation of cladding outer diameter, appeared in the direction of 0 0 -180 0 degree with a shape of nodular. (2) The cladding in the place was softened by high coolant temperature. Coolant pressure, 7MPa intruded the cladding into inside chamfer void at pellet interface. (3) At the place of the significant oxidation, an instrumented transformer was existed and the coolant flow area was very little. The reduction of the coolant flow was enhanced by the bending of the cladding which was caused in pre-irradiation stage. They are considered to be a principal cause of local closure of coolant flow and resultant high temperature in the place. (author)

The role of intestinal endotoxemia in liver failure and its complications

Directory of Open Access Journals (Sweden)

GAO Fangyuan

2014-08-01

Full Text Available Recent studies have found that endotoxin not only activates immune response, exacerbates liver injury, and induces liver failure, but also plays an important role in the development of hepatic encephalopathy, hepatorenal syndrome, spontaneous bacterial peritonitis, and other fatal complications. The recent progress in research on the pathogenesis of intestinal endotoxemia (IETM and its impact on the development and progression of liver failure is reviewed and summarized. It is suggested that seeking effective methods to prevent and control IETM holds promise as the key to treating severe liver disease and liver failure successfully.

Infection and microleakage the caused of endodontic failure

Directory of Open Access Journals (Sweden)

Kurniasri Amas Achiar

2008-03-01

Full Text Available The success of endodontic treatment depends on the quality of endodontic treatment and the final restoration. The mean reason for endodontic treatment failure is usually microleakage. That is why it becomes one of the priorities for dental research to prevent microleakage. Infection during the root canal treatment can be prevented. First, by employing strict aseptic clinical techniques follows by cleaning all bacteria and preoperative necrotic pulp-tissue remnants from the root canal. Irrigants are essential in this phase. The shaping of the canal is also an important prerequisite for endodontic success. Removal of the smear layer can enhance seal ability. Second, obturation of the root canal should leave the tooth in the most biological inert condition possible, and it must prevent reinfection as well as the growth of any microorganisms remaining in the canal. The application of an antibacterial dressing between appointments is absolutely necessary or the root canal has to be obturated at the first appointment in order to deprive the microorganisms of nutrients and space to multiply. The temporary filling must be at least 3.5 mm thick. Failure occurs because of missed canals, iatrogenic events and radicular fractures have to be avoided. At the end, clinicians have to confirm that the root canal is cleaned and hermetically obturated because hermetic root canal filling will prevent the leakage of an irritant to the apical area.

To prevent, react, and rebuild: health research and the prevention of genocide.

Science.gov (United States)

Adler, Reva N; Smith, James; Fishman, Paul; Larson, Eric B

2004-12-01

To develop an approach to the primary prevention of genocide, based on established public health-based violence prevention methods derived from a variety of high-risk settings. (1) Peer-reviewed literature in the fields of public health, violence/injury prevention, medicine, economics, sociology, psychology, history, and genocide studies, (2) demographic and health data bases made available by governments and international organizations, (3) reports on recent episodes of genocide published by international and nongovernmental organizations, (4) newspaper and journalistic accounts of recent and past genocides, (5) archival testimonies of genocide victims and perpetrators, and (6) court transcripts of international genocide prosecutions. The research was conducted as a medical-historical policy analysis synthesizing data within the following framework: (1) Assessment of current violence and injury prevention models for suitability in the prevention of extreme, population-wide violence, (2) analysis of morbidity and mortality data to quantify the impact of genocide on the health of populations, (3) making an inventory of the known societal risk factors for genocidal violence, (4) identification of the theorized, modifiable attitudinal risk factors for genocidal behavior within a population health model, and (5) assessment of existing projects targeting primary violence and injury prevention in high risk jurisdictions, for future adaptation within a structured, public health approach. Mortality rates due to genocidal violence are far in excess of other public health emergencies including malaria and HIV/AIDS. The immediate and long-range health consequences of genocide include the sequelae of infectious diseases, organ system failure, and psychiatric disorders, conferring an increased burden of disease on affected populations for multiple subsequent generations. The impact of genocide on local health economies is catastrophic, and the opportunity costs of diverting

Ductile failure analysis of defective API X65 pipes based on stress-modified fracture strain criterion

International Nuclear Information System (INIS)

Oh, Chang Kyun; Kim, Yun Jae; Baek, Jong Hyun; Kim, Young Pyo; Kim, Woo Sik

2006-01-01

A local failure criterion for the API X65 steel is applied to predict ductile failure of full-scale API X65 pipes with simulated corrosion and gouge defects under internal pressure. The local failure criterion is the stress-modified fracture strain for the API X65 steel as a function of the stress triaxiality (defined by the ratio of the hydrostatic stress to the effective stress). Based on detailed FE analyses with the proposed local failure criteria, burst pressures of defective pipes are estimated and compared with experimental data. The predicted burst pressures are in good agreement with experimental data. Noting that an assessment equation against the gouge defect is not yet available, parametric study is performed, from which a simple equation is proposed to predict burst pressure for API X65 pipes with gouge defects

Assessing Knowledge and Perceptions Related to Preventive Methods and Treatment of Malaria in the Local Endemic Area of Trujillo, Honduras.

Science.gov (United States)

Campodonico, Joanna; Sevilla-Martir, Javier; Arrizabalaga, Gustavo; Kochhar, Komal

2015-01-01

Malaria in Honduras is endemic and accounts for 40% of the total cases in Central America. Our goal was to assess knowledge of preventive methods and current treatment of malaria among the affected community of Trujillo, Honduras. A cross-sectional survey was administered to 71 individuals. Most respondents had a good understanding about common malaria symptoms but not about the complications associated with severe cases. More important, we found that less than 20% of the respondents recognized indoor residual sprays and insecticide-treated nets as effective preventive measures, which are the most efficient preventive methods. Our study highlights the perceptions the people of Trujillo have about malaria. From our observations, we put forward recommendations to implement a comprehensive campaign to educate the Trujillo population about malaria preventive methods and to recruit local and international efforts to distribute insecticide-treated nets.

Intraoperative Radiotherapy (IORT) for Locally Advanced Colorectal Cancer

International Nuclear Information System (INIS)

Kim, Myung Se; Kim, Sung Kyu; Kim, Jae Hwang; Kwan, Koing Bo; Kim, Heung Dae

1991-01-01

Colorectal cancer is the second most frequent malignant tumor in the United States and fourth most frequent tumor in Korea. Surgery has been used as a primary treatment modality but reported overall survivals after curative resection were from 20% to 50%. Local recurrence is the most common failure in the treatment of locally advanced colorectal cancer. Once recurrence has developed, surgery has rarely the role and the five year survival of locally advanced rectal cancer is less than 5%, this indicated that significant improvement of local control could be achieved. We performed 6 cases of IORT for locally advanced colorectal cancer which is he first experience in Korea. Patient's eligibility, treatment applicator, electron energy, dose distribution on the surface and depth within the treatment field and detailed skills are discussed. We hope that our IORT protocol can reduce local failure and increase the long term survival significantly

Failure of Sierra White granite under general states of stress

Science.gov (United States)

Ingraham, M. D.; Dewers, T. A.; Lee, M.; Holdman, O.; Cheung, C.; Haimson, B. C.

2017-12-01

The effect of the intermediate principal stress on the failure of Sierra White granite was investigated by performing tests under true triaxial states of stress. Tests were performed under constant Lode angle conditions with Lode angles ranging from 0 to 30°, pure shear to axisymmetric compression. Results show that the failure of Sierra White granite is heavily dependent on the intermediate principal stress which became more dramatic as the mean stress increased. An analysis of the shear bands formed at failure was performed using an associated flow rule and the Rudnicki and Rice (1975) localization criteria. The localization analysis showed excellent agreement with experimental results. Sandia National Laboratories is a multimission laboratory managed and operated by National Technology and Engineering Solutions of Sandia LLC, a wholly owned subsidiary of Honeywell International Inc. for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-NA0003525.

Heart failure in sub-Saharan Africa: A literature review with emphasis on individuals with diabetes

Directory of Open Access Journals (Sweden)

Andre Pascal Kengne

2008-02-01

Full Text Available Andre Pascal Kengne1, Anastase Dzudie2, Eugene Sobngwi31The George Institute for International Health, University of Sydney, Australia; 2Heart failure and transplantation Unit, Louis Pradel’s Cardiovascular Hospital, Lyon, France; 3National Obesity Centre, Yaounde Central Hospital, CameroonPurpose: Heart failure is the ultimate complication of cardiac involvements in diabetes. The purpose of this review was to summarize current literature on heart failure among people with diabetes mellitus in sub-Saharan Africa (SSA.Method: Bibliographic search of published data on heart failure and diabetes in sub-Saharan Africa over the past 26 years.Results: Heart failure remains largely unexplored in general population and among people with diabetes in Africa. Heart failure accounts for over 30% of hospital admission in specialized cardiovascular units and 3%–7% in general internal medicine. Over 11% of adults with heart failure have diabetes. Risk factors for heart failure among those with diabetes include classical cardiovascular risk factors, without evidence of diabetes distinctiveness for other predictors common in Africa. Prevention, management, and outcomes of heart failure are less well known; recent data suggest improvement in the management of risk factors in clinical settings.Conclusions: Diabetes mellitus is growing in SSA. Related cardiovascular diseases are emerging as potential health problem. Heart failure as cardiovascular complication remains largely unexplored. Efforts are needed through research to improve our knowledge of heart failure at large in Africa. Multilevel preventive measures, building on evidences from other parts of the world must go along side.Keywords: diabetes mellitus, cardiovascular diseases, heart failure, sub-Saharan Africa

Pathogenesis of apical periodontitis and the causes of endodontic failures.

Science.gov (United States)

Nair, P N R

2004-11-01

Apical periodontitis is a sequel to endodontic infection and manifests itself as the host defense response to microbial challenge emanating from the root canal system. It is viewed as a dynamic encounter between microbial factors and host defenses at the interface between infected radicular pulp and periodontal ligament that results in local inflammation, resorption of hard tissues, destruction of other periapical tissues, and eventual formation of various histopathological categories of apical periodontitis, commonly referred to as periapical lesions. The treatment of apical periodontitis, as a disease of root canal infection, consists of eradicating microbes or substantially reducing the microbial load from the root canal and preventing re-infection by orthograde root filling. The treatment has a remarkably high degree of success. Nevertheless, endodontic treatment can fail. Most failures occur when treatment procedures, mostly of a technical nature, have not reached a satisfactory standard for the control and elimination of infection. Even when the highest standards and the most careful procedures are followed, failures still occur. This is because there are root canal regions that cannot be cleaned and obturated with existing equipments, materials, and techniques, and thus, infection can persist. In very rare cases, there are also factors located within the inflamed periapical tissue that can interfere with post-treatment healing of the lesion. The data on the biological causes of endodontic failures are recent and scattered in various journals. This communication is meant to provide a comprehensive overview of the etio-pathogenesis of apical periodontitis and the causes of failed endodontic treatments that can be visualized in radiographs as asymptomatic post-treatment periapical radiolucencies.

An Investigation of Digital Instrumentation and Control System Failure Modes

International Nuclear Information System (INIS)

Korsah, Kofi; Cetiner, Mustafa Sacit; Muhlheim, Michael David; Poore, Willis P. III

2010-01-01

A study sponsored by the Nuclear Regulatory Commission study was conducted to investigate digital instrumentation and control (DI and C) systems and module-level failure modes using a number of databases both in the nuclear and non-nuclear industries. The objectives of the study were to obtain relevant operational experience data to identify generic DI and C system failure modes and failure mechanisms, and to obtain generic insights, with the intent of using results to establish a unified framework for categorizing failure modes and mechanisms. Of the seven databases studied, the Equipment Performance Information Exchange database was found to contain the most useful data relevant to the study. Even so, the general lack of quality relative to the objectives of the study did not allow the development of a unified framework for failure modes and mechanisms of nuclear I and C systems. However, an attempt was made to characterize all the failure modes observed (i.e., without regard to the type of I and C equipment under consideration) into common categories. It was found that all the failure modes identified could be characterized as (a) detectable/preventable before failures, (b) age-related failures, (c) random failures, (d) random/sudden failures, or (e) intermittent failures. The percentage of failure modes characterized as (a) was significant, implying that a significant reduction in system failures could be achieved through improved online monitoring, exhaustive testing prior to installation, adequate configuration control or verification and validation, etc.

Antioxidative vitamines for prevention of cardiovascular disease for patients after renal transplantation and patients with chronic renal failure

Directory of Open Access Journals (Sweden)

Wasem, Jürgen

2006-07-01

Full Text Available Introduction: The mortality from cardiovascular disease in patients with chronic renal failure is much higher than in the general population. In particular, patients with chronic renal failure with replacement therapies (dialysis patients and patients with renal transplantation show both increased traditional risk factors and risk factors due to the dysfunction of the renal system. In combination with necessary medication for renal insufficiency oxidative stress is elevated. Progression of atherosclerosis is promoted due to increased oxidation of lipids and endothelium damage. This link between lipid oxidation and artherogenesis provides the rationale for the supposed beneficial effect of supplementation with antioxidative vitamins (vitamin A, C and E. Such an effect could not be demonstrated for patients with a history of cardiovascular disease and without kidney diseases. However, in high risk patients with chronic renal failure and renal replacement therapies this could be different. Objectives: The objective of this systematic literature review was to assess the clinical effectiveness and cost-effectiveness of supplementation with antioxidative vitamins A, C or E to reduce cardiovascular events in patients with chronic kidney diseases, dialysis-requiring patients and patients after a renal transplantation with or without cardiovascular diseases. Methods: A systematic literature review was conducted with documented search and selection of the literature, using a priori defined inclusion and exclusion criteria as well as a documented extraction and assessment of the literature according to the methods of evidence-based medicine. Results: 21 publications met the inclusion criteria for the evaluation of clinical effectiveness. No study could be identified for the economic evaluation. Two studies (four publications analysed the effect of oral supplementation on the secondary prevention of clinical cardiovascular endpoints. Studies analysing the

Patterns of failure following treatment for medulloblastoma: is it necessary to treat the entire posterior fossa?

International Nuclear Information System (INIS)

Fukunaga-Johnson, Nina; Lee, Jason H.; Robertson, Patricia; Sandler, Howard M.; McNeil, Elizabeth; Goldwein, Joel W.

1997-01-01

Purpose: Craniospinal radiation (CSRT) followed by a boost to the entire posterior fossa (PF) is standard post-operative therapy for patients with medulloblastoma. A large proportion of recurrences after treatment are local with approximately 50-70% of recurrences occurring in the PF. It is unclear, however, whether these failures are occurring in the original tumor bed, or outside the tumor bed but still within the PF. With improved diagnostic imaging, better definition of tumor volumes, and the use of 3D conformal therapy, we may be able to restrict the boost volume to the tumor bed plus a margin without compromising local control. This retrospective study analyzes the patterns of failure within the PF of a series of patients treated with radiation therapy (RT). Methods: From (7(86)) through (2(96)), 27 of 114 (24%) patients > 18 mo and < 18 yr with medulloblastoma, who were treated at the University of Michigan and Children's Hospital of Philadelphia, with RT following surgical resection were found to have a recurrence. RT consisted of CSRT followed by a boost to the entire posterior fossa. Patient's preoperative MRI and/or CT studies were used to compare the original tumor volume with the specific region of local relapse. Failure was defined as MRI or CT evidence of recurrence or positive cerebrospinal fluid cytology. Relapse was scored as local, if it was within the original tumor bed and regional, if it was outside of the tumor bed but still within the PF. Results: The median age of the patients was 8.6 years. Three patients were < 3 years old. (21(27)) had disease localized to the PF. (19(21)) patients received chemotherapy during their treatment regimen; 6 patients did not have information on systemic treatment. The median dose of RT to the craniospinal axis was 32.5 Gy and to the PF was 55.2 Gy. The median time to recurrence was 19.5 months. Local failure within the tumor bed as any component of first failure occurred in 52% ((14(27))) of all failures but

Project configured supply networks: Governance of delivery and failures in operations

DEFF Research Database (Denmark)

Koch, Christian

2008-01-01

of delivery types; parts, components and subsystems. The project configuration and orchestrated governance forms are not always successful, and failures emerge. The paper aims at studying governance forms in delivery networks using operational failures as litmus. Operation management approaches is used...... failures occurred during three month observation. The costs were 8 pct. of the production budget. None of the mobilised governance forms fully prevented failures, especially subsystem delivery and internal integration was underperforming.......  Supply networks in complex B2B- construction deliver knowledge, materials, components, subsystems, competences, workforce and management. The delivery network and its governance forms are partly permanent, partly project specific. Integration upstream varies by project, constituting a range...

Relief and Recurrence of Congestion During and After Hospitalization for Acute Heart Failure: Insights From Diuretic Optimization Strategy Evaluation in Acute Decompensated Heart Failure (DOSE-AHF) and Cardiorenal Rescue Study in Acute Decompensated Heart Failure (CARESS-HF).

Science.gov (United States)

Lala, Anuradha; McNulty, Steven E; Mentz, Robert J; Dunlay, Shannon M; Vader, Justin M; AbouEzzeddine, Omar F; DeVore, Adam D; Khazanie, Prateeti; Redfield, Margaret M; Goldsmith, Steven R; Bart, Bradley A; Anstrom, Kevin J; Felker, G Michael; Hernandez, Adrian F; Stevenson, Lynne W

2015-07-01

Congestion is the most frequent cause for hospitalization in acute decompensated heart failure. Although decongestion is a major goal of acute therapy, it is unclear how the clinical components of congestion (eg, peripheral edema, orthopnea) contribute to outcomes after discharge or how well decongestion is maintained. A post hoc analysis was performed of 496 patients enrolled in the Diuretic Optimization Strategy Evaluation in Acute Decompensated Heart Failure (DOSE-AHF) and Cardiorenal Rescue Study in Acute Decompensated Heart Failure (CARRESS-HF) trials during hospitalization with acute decompensated heart failure and clinical congestion. A simple orthodema congestion score was generated based on symptoms of orthopnea (≥2 pillows=2 points, fails to relieve orthodema during hospitalization or to prevent recurrence after discharge. URL: http://www.clinicaltrials.gov. Unique identifiers: NCT00608491, NCT00577135. © 2015 American Heart Association, Inc.

Imperfect Preventive Maintenance Model Study Based On Reliability Limitation

Directory of Open Access Journals (Sweden)

Zhou Qian

2016-01-01

Full Text Available Effective maintenance is crucial for equipment performance in industry. Imperfect maintenance conform to actual failure process. Taking the dynamic preventive maintenance cost into account, the preventive maintenance model was constructed by using age reduction factor. The model regards the minimization of repair cost rate as final target. It use allowed smallest reliability as the replacement condition. Equipment life was assumed to follow two parameters Weibull distribution since it was one of the most commonly adopted distributions to fit cumulative failure problems. Eventually the example verifies the rationality and benefits of the model.

Failure analysis of the boiler water-wall tube

Directory of Open Access Journals (Sweden)

S.W. Liu

2017-10-01

Full Text Available Failure analysis of the boiler water-wall tube is presented in this work. In order to examine the causes of failure, various techniques including visual inspection, chemical analysis, optical microscopy, scanning electron microscopy and energy dispersive spectroscopy were carried out. Tube wall thickness measurements were performed on the ruptured tube. The fire-facing side of the tube was observed to have experienced significant wall thinning. The composition of the matrix material of the tube meets the requirements of the relevant standards. Microscopic examinations showed that the spheroidization of pearlite is not very obvious. The failure mechanism is identified as a result of the significant localized wall thinning of the boiler water-wall tube due to oxidation.

Efficient surrogate models for reliability analysis of systems with multiple failure modes

International Nuclear Information System (INIS)

Bichon, Barron J.; McFarland, John M.; Mahadevan, Sankaran

2011-01-01

Despite many advances in the field of computational reliability analysis, the efficient estimation of the reliability of a system with multiple failure modes remains a persistent challenge. Various sampling and analytical methods are available, but they typically require accepting a tradeoff between accuracy and computational efficiency. In this work, a surrogate-based approach is presented that simultaneously addresses the issues of accuracy, efficiency, and unimportant failure modes. The method is based on the creation of Gaussian process surrogate models that are required to be locally accurate only in the regions of the component limit states that contribute to system failure. This approach to constructing surrogate models is demonstrated to be both an efficient and accurate method for system-level reliability analysis. - Highlights: → Extends efficient global reliability analysis to systems with multiple failure modes. → Constructs locally accurate Gaussian process models of each response. → Highly efficient and accurate method for assessing system reliability. → Effectiveness is demonstrated on several test problems from the literature.

Higher-Than-Conventional Radiation Doses in Localized Prostate Cancer Treatment: A Meta-analysis of Randomized, Controlled Trials

International Nuclear Information System (INIS)

Viani, Gustavo Arruda; Stefano, Eduardo Jose; Afonso, Sergio Luis

2009-01-01

Purpose: To determine in a meta-analysis whether the outcomes in men with localized prostate cancer treated with high-dose radiotherapy (HDRT) are better than those in men treated with conventional-dose radiotherapy (CDRT), by quantifying the effect of the total dose of radiotherapy on biochemical control (BC). Methods and Materials: The MEDLINE, EMBASE, CANCERLIT, and Cochrane Library databases, as well as the proceedings of annual meetings, were systematically searched to identify randomized, controlled studies comparing HDRT with CDRT for localized prostate cancer. To evaluate the dose-response relationship, we conducted a meta-regression analysis of BC ratios by means of weighted linear regression. Results: Seven RCTs with a total patient population of 2812 were identified that met the study criteria. Pooled results from these RCTs showed a significant reduction in the incidence of biochemical failure in those patients with prostate cancer treated with HDRT (p 2 gastrointestinal toxicity after HDRT than after CDRT. In the subgroup analysis, patients classified as being at low (p = 0.007), intermediate (p < 0.0001), and high risk (p < 0.0001) of biochemical failure all showed a benefit from HDRT. The meta-regression analysis also detected a linear correlation between the total dose of radiotherapy and biochemical failure (BC = -67.3 + [1.8 x radiotherapy total dose in Gy]; p = 0.04). Conclusions: Our meta-analysis showed that HDRT is superior to CDRT in preventing biochemical failure in low-, intermediate-, and high-risk prostate cancer patients, suggesting that this should be offered as a treatment for all patients, regardless of their risk status.

Preventing Weight Gain

Science.gov (United States)

... Local Programs Related Topics Diabetes Nutrition Preventing Weight Gain Language: English (US) Español (Spanish) Recommend on Facebook ... cancer. Choosing an Eating Plan to Prevent Weight Gain So, how do you choose a healthful eating ...

Steel Fibres: Effective Way to Prevent Failure of the Concrete Bonded with FRP Sheets

Directory of Open Access Journals (Sweden)

V. Gribniak

2016-01-01

Full Text Available Although the efficiency of steel fibres for improving mechanical properties (cracking resistance and failure toughness of the concrete has been broadly discussed in the literature, the number of studies dedicated to the fibre effect on structural behaviour of the externally bonded elements is limited. This experimental study investigates the influence of steel fibres on the failure character of concrete elements strengthened with external carbon fibre reinforced polymer sheets. The elements were subjected to different loading conditions. The test data of four ties and eight beams are presented. Different materials were used for the internal bar reinforcement: in addition to the conventional steel, high-grade steel and glass fibre reinforced polymer bars were also considered. The experimental results indicated that the fibres, by significantly increasing the cracking resistance, alter the failure character from splitting of the concrete to the bond loss of the external sheets and thus noticeably increase the load bearing capacity of the elements.

Infection prevention efforts of pulmonary tuberculosis patients in the local government clinic of Kuta Baro Aceh Besar

Science.gov (United States)

Andika, Fauziah; Syahputra, Muhammad Yusrizal; Marniati

2017-09-01

Pulmonary tuberculosis is one of the infectious diseases that has been known and is still the leading cause of death in the world. It is an old disease which is a global problem in the world and estimated that a third of the world's population has been infected by this bacterium. The purpose of this study was to determine the factors related with the infection prevention efforts of pulmonary tuberculosis patients in the local goverment clinic of Kuta Baro Aceh Besar. This research is descriptive analytic survey using cross sectional design. It used univariate analysis to see the frequency distribution and the percentage of each variable. Meanwhile, the bivariate analysis used chi square test with CI (Confident Interval) of 95%. The samples in this study are 34 people. The research results obtained with good infection prevention efforts of pulmonary tuberculosis is 41.2%, 5.9% for teenagers, 47.1% for knowledgeable people, 17.6% for people who do not work and 44.1% for those who have a positive behavior. The results of the bivariate obtained there is correlation between the prevention of pulmonary tuberculosis infection with age (p = 0.087), Occupation (p = 0.364), knowledge (p = 0.006) and behavior (p = 0.020). To conclude, there is a correlation between knowledge and behaviors with the infection prevention efforts of pulmonary tuberculosis patients and there is no correlation between age and occupation with infection prevention efforts of pulmonary tuberculosis patients. It is expected that the respondents to hold consultations to health officials about a mechanism of prevention to avoid the disease.

A comparison of predictive algorithms for failure prevention in smart environment applications

NARCIS (Netherlands)

Warriach, E.U.; Ozcelebi, T.; Lukkien, J.J.

2015-01-01

The functional correctness and the performance of smart environment applications can be hampered by faults. Fault tolerance solutions aim to achieve graceful performance degradation in the presence of faults, ideally without leading to application failures. This is a reactive approach and, by

Nonfasting Triglycerides, Low-Density Lipoprotein Cholesterol, and Heart Failure Risk

DEFF Research Database (Denmark)

Varbo, Anette; Nordestgaard, Børge G

2018-01-01

OBJECTIVE: The prevalence of heart failure is increasing in the aging population, and heart failure is a disease with large morbidity and mortality. There is, therefore, a need for identifying modifiable risk factors for prevention. We tested the hypothesis that high concentrations of nonfasting...... triglycerides and low-density lipoprotein cholesterol are associated with higher risk of heart failure in the general population. APPROACH AND RESULTS: We included 103 860 individuals from the Copenhagen General Population Study and 9694 from the Copenhagen City Heart Study in 2 prospective observational...... association studies. Nonfasting triglycerides and low-density lipoprotein cholesterol were measured at baseline. Individuals were followed for ≤23 years, during which time 3593 were diagnosed with heart failure. Hazard ratios were estimated using Cox proportional hazard regression models. In the Copenhagen...

New insights into the gut as the driver of critical illness and organ failure.

Science.gov (United States)

Meng, Mei; Klingensmith, Nathan J; Coopersmith, Craig M

2017-04-01

The gut has long been hypothesized to be the 'motor' of multiple organ dysfunction syndrome. This review serves as an update on new data elucidating the role of the gut as the propagator of organ failure in critical illness. Under basal conditions, the gut absorbs nutrients and serves as a barrier that prevents approximately 40 trillion intraluminal microbes and their products from causing host injury. However, in critical illness, gut integrity is disrupted with hyperpermeability and increased epithelial apoptosis, allowing contamination of extraluminal sites that are ordinarily sterile. These alterations in gut integrity are further exacerbated in the setting of preexisting comorbidities. The normally commensal microflora is also altered in critical illness, with increases in microbial virulence and decreases in diversity, which leads to further pathologic responses within the host. All components of the gut are adversely impacted by critical illness. Gut injury can not only propagate local damage, but can also cause distant injury and organ failure. Understanding how the multifaceted components of the gut interact and how these are perturbed in critical illness may play an important role in turning off the 'motor' of multiple organ dysfunction syndrome in the future.

Failure Investigation of Radiant Platen Superheater Tube of Thermal Power Plant Boiler

Science.gov (United States)

Ghosh, D.; Ray, S.; Mandal, A.; Roy, H.

2015-04-01

This paper highlights a case study of typical premature failure of a radiant platen superheater tube of 210 MW thermal power plant boiler. Visual examination, dimensional measurement and chemical analysis, are conducted as part of the investigations. Apart from these, metallographic analysis and fractography are also conducted to ascertain the probable cause of failure. Finally it has been concluded that the premature failure of the super heater tube can be attributed to localized creep at high temperature. The corrective actions has also been suggested to avoid this type of failure in near future.

Asymptotic failure rate of a continuously monitored system

International Nuclear Information System (INIS)

Grall, A.; Dieulle, L.; Berenguer, C.; Roussignol, M.

2006-01-01

This paper deals with a perfectly continuously monitored system which gradually and stochastically deteriorates. The system is renewed by a delayed maintenance operation, which is triggered when the measured deterioration level exceeds an alarm threshold. A mathematical model is developed to study the asymptotic behavior of the reliability function. A procedure is proposed which allows us to identify the asymptotic failure rate of the maintained system. Numerical experiments illustrate the efficiency of the proposed procedure and emphasize the relevance of the asymptotic failure rate as an interesting indicator for the evaluation of the control-limit preventive replacement policy

Asymptotic failure rate of a continuously monitored system

Energy Technology Data Exchange (ETDEWEB)

Grall, A. [Institut des Sciences et Technologies de l' Information de Troyes (CNRS-FRE 2732), Equipe de Modelisation et de Surete des Systemes, Universite de Technologie de Troyes, 12 rue Marie Curie, BP 2060, 10010 Troyes Cedex (France)]. E-mail: antoine.grall@utt.fr; Dieulle, L. [Institut des Sciences et Technologies de l' Information de Troyes (CNRS-FRE 2732), Equipe de Modelisation et de Surete des Systemes, Universite de Technologie de Troyes, 12 rue Marie Curie, BP 2060, 10010 Troyes Cedex (France)]. E-mail: laurence.dieulle@utt.fr; Berenguer, C. [Institut des Sciences et Technologies de l' Information de Troyes (CNRS-FRE 2732), Equipe de Modelisation et de Surete des Systemes, Universite de Technologie de Troyes, 12 rue Marie Curie, BP 2060, 10010 Troyes Cedex (France)]. E-mail: christophe.berenguer@utt.fr; Roussignol, M. [Laboratoire d' Analyse et de Mathematiques Appliquees, Universite de Marne la Vallee, 5 bd Descartes, Champs sur Marne, 77454 Marne la Vallee, Cedex 2 (France)]. E-mail: michel.roussignol@univ-mlv.fr

2006-02-01

This paper deals with a perfectly continuously monitored system which gradually and stochastically deteriorates. The system is renewed by a delayed maintenance operation, which is triggered when the measured deterioration level exceeds an alarm threshold. A mathematical model is developed to study the asymptotic behavior of the reliability function. A procedure is proposed which allows us to identify the asymptotic failure rate of the maintained system. Numerical experiments illustrate the efficiency of the proposed procedure and emphasize the relevance of the asymptotic failure rate as an interesting indicator for the evaluation of the control-limit preventive replacement policy.

Prediction of failure of highly irradiated Zircaloy clad tubes under reactivity initiated accidents

International Nuclear Information System (INIS)

Jernkvist, L.O.

2003-01-01

This paper deals with failure of irradiated Zircaloy tubes under the heat-up stage of a reactivity initiated accident (RIA). More precisely, by use of a model for plastic strain localization and necking failure, we theoretically analyse the effects of local surface defects on clad ductility and survivability under RIA. The results show that even very shallow surface defects, e.g. arising from a non-uniform or partially spilled oxide layer, have a strong limiting effect on clad ductility. Moreover, in presence of surface defects, the ability of the clad tube to expand radially without necking failure is found to be extremely sensitive to the stress biaxiality ratio σ zz /σ θθ , which is here assumed to be in the range from 0 to 1. The results of our analysis are compared with clad ductility data available in literature, and their consequences for clad failure prediction under RIA are discussed. In particular, the results raise serious concerns regarding the applicability of failure criteria, which are based on clad strain energy density. These criteria do not capture the observed sensitivity to stress biaxiality on clad failure propensity. (author)

Contrast-induced nephropathy: risks, pathogenetic, prevention

International Nuclear Information System (INIS)

Paskalev, D.; Balev, B.

2006-01-01

Full text: The aim of the presentation is to review the contrast induced nephropathy ? nature, mechanisms of development, risk factors. Summary of the most important ways of prevention, diagnostics and treatment. The definition of CIN according the European Association of Urogenital Radiology is: 'A condition, in which renal function is impaired (elevation of serum creatinine with more than 25% or 44 μmol/l above the initial level) due to intravasal application of contrast media (CM) within 3 days following the application and when no other etiology factors are present'. We summarize the main risk factors of developing CIN - renal failure, diabetic nephropathy, dehydration, congestive heart failure, high blood pressure, age above 70 yrs, nephrotoxic medicines. The most effective ways of preventing CIN are the good hydratation of the patients and the usage of low-osmolar or iso-osmolar CM. Therapeutic treatment is with no proven preventive effect and currently is not routinely recommended. An early hem dialysis does not decrease the risk level of CIN development in patients with chronic renal failure (CRF). In such patients complete elimination of CM is achieved only after several hem dialyses. Hem filtration reliably decreases the risk of CIN in CRF patients, but is expensive and not widely available. We present a case from our hospital of a patient with diabetic nephropathy, who developed CIN following a coronary angiography

Atomistic explanation of brittle failure of thermoelectric skutterudite CoSb3

International Nuclear Information System (INIS)

Li, Guodong; An, Qi; Goddard, William A.; Hanus, Riley; Zhai, Pengcheng; Zhang, Qingjie; Snyder, G. Jeffrey

2016-01-01

CoSb 3 based skutterudite thermoelectric material has superior thermoelectric properties, but the low fracture toughness prevents its widespread commercial application. To determine the origin of its brittle failure, we examined the response of shear deformation in CoSb 3 along the most plausible slip system (010)/<100>, using large-scale molecular dynamics simulations. We find that the brittle failure of CoSb 3 arises from the formation of shear bands due to the destruction of Sb4-rings and the slippage of Co-octahedraes. This leads to the breakage of Co-octahedraes and cavitation, resulting in the crack opening and mechanical failure.

Load-redistribution strategy based on time-varying load against cascading failure of complex network

International Nuclear Information System (INIS)

Liu Jun; Shi Xin; Wang Kai; Shi Wei-Ren; Xiong Qing-Yu

2015-01-01

Cascading failure can cause great damage to complex networks, so it is of great significance to improve the network robustness against cascading failure. Many previous existing works on load-redistribution strategies require global information, which is not suitable for large scale networks, and some strategies based on local information assume that the load of a node is always its initial load before the network is attacked, and the load of the failure node is redistributed to its neighbors according to their initial load or initial residual capacity. This paper proposes a new load-redistribution strategy based on local information considering an ever-changing load. It redistributes the loads of the failure node to its nearest neighbors according to their current residual capacity, which makes full use of the residual capacity of the network. Experiments are conducted on two typical networks and two real networks, and the experimental results show that the new load-redistribution strategy can reduce the size of cascading failure efficiently. (paper)

Prevention and management of brain edema in patients with acute liver failure

DEFF Research Database (Denmark)

Wendon, J.; Larsen, Finn Stolze

2008-01-01

1. Intracranial pressure is the pressure exerted by the cranial contents on the dural envelope and consists of the partial pressures of the brain, blood, and cerebrospinal fluid. 2. Severe cases of acute liver failure are frequently complicated by brain edema (due to cytotoxic edema...

The case for statin therapy in chronic heart failure

NARCIS (Netherlands)

van der Harst, Pim; Boehm, Michael; van Gilst, Wiek H.; van Veldhuisen, Dirk J.

Both primary and secondary prevention studies have provided a wealth of evidence that statin therapy effectively reduces cardiovascular events. However, this general statement on the efficacy and safety of statin treatment has not been validated in patients with chronic heart failure (CHF).

Crime-prevention

DEFF Research Database (Denmark)

Brønsted, Lone

In Denmark, crime prevention is embedded in state professional practices in kindergartens, schools and youth clubs. These welfare institutions are conceived as safe places that safeguard children and young people through inclusive learning environments, warm and empathic relationships between......-sectional cooperation called “SSP”. SSP is a locally anchored cooperation of the school (S), the social services (S) and the police (P) and its aim is to create a coordinated system of prevention, e.g., to prevent crime or school drop outs. In continuation of this, crime preventive work is understood as a practice...

Failure of Local Thermal Equilibrium in Quantum Friction

Science.gov (United States)

Intravaia, F.; Behunin, R. O.; Henkel, C.; Busch, K.; Dalvit, D. A. R.

2016-09-01

Recent progress in manipulating atomic and condensed matter systems has instigated a surge of interest in nonequilibrium physics, including many-body dynamics of trapped ultracold atoms and ions, near-field radiative heat transfer, and quantum friction. Under most circumstances the complexity of such nonequilibrium systems requires a number of approximations to make theoretical descriptions tractable. In particular, it is often assumed that spatially separated components of a system thermalize with their immediate surroundings, although the global state of the system is out of equilibrium. This powerful assumption reduces the complexity of nonequilibrium systems to the local application of well-founded equilibrium concepts. While this technique appears to be consistent for the description of some phenomena, we show that it fails for quantum friction by underestimating by approximately 80% the magnitude of the drag force. Our results show that the correlations among the components of driven, but steady-state, quantum systems invalidate the assumption of local thermal equilibrium, calling for a critical reexamination of this approach for describing the physics of nonequilibrium systems.

Driving force of PCMI failure under reactivity initiated accident conditions and influence of hydrogen embrittlement on failure limit

International Nuclear Information System (INIS)

Tomiyasu, Kunihiko; Sugiyama, Tomoyuki; Nakamura, Takehiko; Fuketa, Toyoshi

2005-09-01

In order to clarify the driving force of PCMI (Pellet/Cladding Mechanical Interaction) failure on high burnup fuels and to investigate the influence of hydrogen embrittlement on failure limit under RIA (Reactivity Initiated Accident) conditions, RIA-simulation experiments were performed on fresh fuel rods in the NSRR (Nuclear Safety Research Reactor). The driving force of PCMI was restricted only to thermal expansion of pellet by using fresh UO 2 pellets. Fresh claddings were pre-hydrided to simulate hydrogen absorption of high burnup fuel rods. In seven experiments out of fourteen, test rods resulted in PCMI failure, which has been observed in the NSRR tests on high burnup PWR fuels, in terms of the transient behavior and the fracture configuration. This indicates that the driving force of PCMI failure is sufficiently explained with thermal expansion of pellet and a contribution of fission gas on it is small. A large number of incipient cracks were generated in the outer surface of the cladding even on non-failed fuel rods, and they stopped at the boundary between hydride rim, which was a hydride layer localized in the periphery of the cladding, and metallic layer. It suggests that the integrity of the metallic layer except for the hydride rim has particular importance for failure limit. Fuel enthalpy at failure correlates with the thickness of hydride rim, and tends to decrease with thicker hydride layer. (author)

A Case Study of Environmental Injustice: The Failure in Flint

Directory of Open Access Journals (Sweden)

Carla Campbell

2016-09-01

Full Text Available The failure by the city of Flint, Michigan to properly treat its municipal water system after a change in the source of water, has resulted in elevated lead levels in the city’s water and an increase in city children’s blood lead levels. Lead exposure in young children can lead to decrements in intelligence, development, behavior, attention and other neurological functions. This lack of ability to provide safe drinking water represents a failure to protect the public’s health at various governmental levels. This article describes how the tragedy happened, how low-income and minority populations are at particularly high risk for lead exposure and environmental injustice, and ways that we can move forward to prevent childhood lead exposure and lead poisoning, as well as prevent future Flint-like exposure events from occurring. Control of the manufacture and use of toxic chemicals to prevent adverse exposure to these substances is also discussed. Environmental injustice occurred throughout the Flint water contamination incident and there are lessons we can all learn from this debacle to move forward in promoting environmental justice.

Influenza infection and heart failure-vaccination may change heart failure prognosis?

Science.gov (United States)

Kadoglou, Nikolaos P E; Bracke, Frank; Simmers, Tim; Tsiodras, Sotirios; Parissis, John

2017-05-01

The interaction of influenza infection with the pathogenesis of acute heart failure (AHF) and the worsening of chronic heart failure (CHF) is rather complex. The deleterious effects of influenza infection on AHF/CHF can be attenuated by specific immunization. Our review aimed to summarize the efficacy, effectiveness, safety, and dosage of anti-influenza vaccination in HF. In this literature review, we searched MEDLINE and EMBASE from January 1st 1966 to December 31st, 2016, for studies examining the association between AHF/CHF, influenza infections, and anti-influenza immunizations. We used broad criteria to increase the sensitivity of the search. HF was a prerequisite for our search. The search fields used included "heart failure," "vaccination," "influenza," "immunization" along with variants of these terms. No restrictions on the type of study design were applied. The most common clinical scenario is exacerbation of pre-existing CHF by influenza infection. Scarce evidence supports a potential positive association of influenza infection with AHF. Vaccinated patients with pre-existing CHF have reduced all-cause morbidity and mortality, but effects are not consistently documented. Immunization with higher antigen quantity may confer additional protection, but such aggressive approach has not been generally advocated. Further studies are needed to delineate the role of influenza infection on AHF/CHF pathogenesis and maintenance. Annual anti-influenza vaccination appears to be an effective measure for secondary prevention in HF. Better immunization strategies and more efficacious vaccines are urgently necessary.

Newly discovered failure mode in high energy density, energy storage capacitors

International Nuclear Information System (INIS)

Boicourt, G.P.; Kemp, E.L.

1978-07-01

High energy density pulse capacitors, typified by the 10-kV, 170-μF unit, have become widely used in recent years. These units primarily were designed for lower cost and higher energy per unit volume. The life characteristics of these units have never been determined fully, but they have already been shown capable of lives much longer than originally expected. The Los Alamos Scientific Laboratory is now conducting an extended program to determine the long-term capabilities of these capacitors. This program is aimed not only at finding the statistical parameters of the failure distribution but also at determining the physical failure modes characteristic of such units. Recently, a new failure mode was found. This failure mode has prevented test samples of polypropylene-paper-dioctyl phthalate units from actually reaching the true potential life of the insulation. In this report, the new failure mechanism is examined and suggestions are made that could eliminate the failure mode

Stratification of the Risk of Sudden Death in Nonischemic Heart Failure

Directory of Open Access Journals (Sweden)

Maurício Pimentel

2014-10-01

Full Text Available Despite significant therapeutic advancements, heart failure remains a highly prevalent clinical condition associated with significant morbidity and mortality. In 30%-40% patients, the etiology of heart failure is nonischemic. The implantable cardioverter-defibrillator (ICD is capable of preventing sudden death and decreasing total mortality in patients with nonischemic heart failure. However, a significant number of patients receiving ICD do not receive any kind of therapy during follow-up. Moreover, considering the situation in Brazil and several other countries, ICD cannot be implanted in all patients with nonischemic heart failure. Therefore, there is an urgent need to identify patients at an increased risk of sudden death because these would benefit more than patients at a lower risk, despite the presence of heart failure in both risk groups. In this study, the authors review the primary available methods for the stratification of the risk of sudden death in patients with nonischemic heart failure.

Boiler and HRSG tube failures. Lesson 4: Hydrogen damage

Energy Technology Data Exchange (ETDEWEB)

Dooley, R. Barry; Bursik, Albert

2010-02-15

University 101 courses are typically designed to help incoming first-year undergraduate students to adjust to the university, develop a better understanding of the college environment, and acquire essential academic success skills. Why are we offering a special Boiler and HRSG Tube Failures PPChem 101? The answer is simple, yet very conclusive: There is a lack of knowledge on the identification of tube failure mechanisms and for the implementation of adequate counteractions in many power plants, particularly at industrial power and steam generators. There is a lack of knowledge to prevent repeat tube failures. The vast majority of BTF/HTF have been, and continue to be, repeat failures. It is hoped that the information about the failure mechanisms of BTF supplied in this course will help to put plant engineers and chemists on the right track. The major goal of this course is the avoidance of repeat BTF. This fourth lesson is focused on hydrogen damage of water-touched tubes in conventional boilers and in the high-pressure evaporators of heat recovery steam generators. (orig.)

Boiler and HRSG tube failures. Lesson 5. Caustic gouging

Energy Technology Data Exchange (ETDEWEB)

Dooley, Barry R.; Bursik, Albert

2010-03-15

University 101 courses are typically designed to help incoming first-year undergraduate students to adjust to the university, develop a better understanding of the college environment, and acquire essential academic success skills. Why are we offering a special Boiler and HRSG Tube Failures PPChem 101? The answer is simple, yet very conclusive: - There is a lack of knowledge on the identification of tube failure mechanisms and for the implementation of adequate counteractions in many power plants, particularly at industrial power and steam generators. - There is a lack of knowledge to prevent repeat tube failures. The vast majority of BTF/HTF have been, and continue to be, repeat failures. It is hoped that the information about the failure mechanisms of BTF supplied in this course will help to put plant engineers and chemists on the right track. The major goal of this course is the avoidance of repeat BTF. This fifth lesson is focused on caustic gouging of water-touched tubes in conventional boilers and in the high-pressure evaporators of heat recovery steam generators. (orig.)

Prevention of vocal fold scarring by local application of basic fibroblast growth factor in a rat vocal fold injury model.

Science.gov (United States)

Suzuki, Ryo; Kawai, Yoshitaka; Tsuji, Takuya; Hiwatashi, Nao; Kishimoto, Yo; Tateya, Ichiro; Nakamura, Tatsuo; Hirano, Shigeru

2017-02-01

Vocal fold scarring, which causes severe hoarseness, is intractable. The optimal treatment for vocal fold scarring has not been established; therefore, prevention of scarring is important. The aim of this study was to clarify the effectiveness of basic fibroblast growth factor (bFGF) for prevention of postsurgical vocal fold scarring. Prospective animal experiments with controls. The vocal folds of Sprague-Dawley rats were injured unilaterally or bilaterally after local application of a 10 μL solution of bFGF. Larynges ware harvested for histological and immunohistochemical examination 2 months postoperation and for quantitative real-time polymerase chain reaction (qRT-PCR) analysis 1 week postoperation. Histological examination showed significantly increased hyaluronic acid and decreased deposition of dense collagen in the bFGF-treated group at 100 ng/10 μL compared with the sham-treated group. Immunohistochemical examination showed significantly decreased collagen type III deposition in the bFGF-treated group at 100 ng/10 μL compared with the sham-treated group. qRT-PCR revealed that hyaluronan synthase 2 (Has2), Has3, and hepatocyte growth factor were upregulated in bFGF-treated groups compared with sham-treated group. The current results suggest that local application of bFGF at the time of injury has the potential to prevent vocal fold scarring. Preventive injection of bFGF could be applied at the time of phonomicrosurgery to avoid postoperative scar formation. N/A. Laryngoscope, 2016 127:E67-E74, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Comparison of mode of failure between primary and revision total knee arthroplasties.

Science.gov (United States)

Liang, H; Bae, J K; Park, C H; Kim, K I; Bae, D K; Song, S J

2018-04-01

Cognizance of common reasons for failure in primary and revision TKA, together with their time course, facilitates prevention. However, there have been few reports specifically comparing modes of failure for primary vs. revision TKA using a single prosthesis. The goal of the study was to compare the survival rates, modes of failure, and time periods associated with each mode of failure, of primary vs. revision TKA. The survival rates, modes of failure, time period for each mode of failure, and risk factors would differ between primary and revision TKA. Data from a consecutive cohort comprising 1606 knees (1174 patients) of primary TKA patients, and 258 knees (224 patients) of revision TKA patients, in all of whom surgery involved a P.F.C ® prosthesis (Depuy, Johnson & Johnson, Warsaw, IN), was retrospectively reviewed. The mean follow-up periods of primary and revision TKAs were 9.2 and 9.8 years, respectively. The average 10- and 15-year survival rates for primary TKA were 96.7% (CI 95%,±0.7%) and 85.4% (CI 95%,±2.0%), and for revision TKA 91.4% (CI 95%,±2.5%) and 80.5% (CI 95%,±4.5%). Common modes of failure included polyethylene wear, loosening, and infection. The most common mode of failure was polyethylene wear in primary TKA, and infection in revision TKA. The mean periods (i.e., latencies) of polyethylene wear and loosening did not differ between primary and revision TKAs, but the mean period of infection was significantly longer for revision TKA (1.2 vs. 4.8 years, P=0.003). Survival rates decreased with time, particularly more than 10 years post-surgery, for both primary and revision TKAs. Continuous efforts are required to prevent and detect the various modes of failure during long-term follow-up. Greater attention is necessary to detect late infection-induced failure following revision TKA. Case-control study, Level III. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Linguistic Evidence for the Failure Mindset as a Predictor of Life Span Longevity.

Science.gov (United States)

Penzel, Ian B; Persich, Michelle R; Boyd, Ryan L; Robinson, Michael D

2017-06-01

When people think that their efforts will fail to achieve positive outcomes, they sometimes give up their efforts after control, which can have negative health consequences. Problematic orientations of this type, such as pessimism, helplessness, or fatalism, seem likely to be associated with a cognitive mindset marked by higher levels of accessibility for failure words or concepts. Thus, the purpose of the present research was to determine whether there are individual differences in the frequency with which people think about failure, which in turn are likely to impact health across large spans of time. Following self-regulatory theories of health and the learned helplessness tradition, two archival studies (total n = 197) scored texts (books or speeches) for their use of failure words, a category within the Harvard IV dictionary of the General Inquirer. People who used failure words more frequently exhibited shorter subsequent life spans, and this relationship remained significant when controlling for birth year. Furthermore, study 2 implicated behavioral factors. For example, the failure/longevity relationship was numerically stronger among people whose causes of death appeared to be preventable rather than non-preventable. These results significantly extend our knowledge of the personality/longevity relationship while highlighting the value of individual differences in word usage as predictors of health and mortality.

End face seals in high pressure water - learning from those failures

International Nuclear Information System (INIS)

Metcalfe, R.

1976-08-01

End face seals are complex devices which are used widely in shaft sealing of rotating equipment. In the nuclear industry, working at the limits of present sealing technlogy with a massive economic dependence on reliability, the importance of scrutinizing seal failures and thereby attempting to prevent premature failures from recurring was fully realized. This paper describes Canadian nuclear sealing experience. Failed seal data is presented; practical examples are categorized as to cause and type. (author)

[Protective factors for preventing the use of drugs in the families of a Colombia locality].

Science.gov (United States)

Arias, Núbia Medina; Ferriani, Maria das Graças Carvalho

2010-01-01

The aim of this study was to analyze the protective factors that prevent drug use in the families of children who attend Community Homes of Family Well-being in a small Colombian locality. This was a quantitative, descriptive, transversal study, with 256 families constituting the sample. Data were collected through a self-applied questionnaire throughout March and April 2007. Protective factors found included demonstrations of affection toward the children, playing with them and talking to them about things they like, open communication, decision making as a couple, flexibility of the nursing process, and establishment of rules. However, some risk factors were also found, such as consumption of legal drugs such as cigarettes and alcohol, and in a low percentage, consumption of illicit drugs. A high percentage of families consider that drug use must be prevented in the first years of life, by the parents. The protective factors found require reinforcement as they are not very strong, and the risk factors must be controlled to turn them into protective factors.

Synthetic Sling Failure - Evaluations and Recommendations

Energy Technology Data Exchange (ETDEWEB)

Henderson, C. S. [Washington River Protection Solutions, Richland, WA (United States); Mackey, Thomas C. [Washington River Protection Solutions, Richland, WA (United States)

2009-10-26

The information and evaluations provided in this report were compiled to address the recurring problem of synthetic sling failure. As safety is the number one priority in all work aspects, a solution must be devised to prevent accidents from occurring. A total of thirteen cases regarding synthetic sling failure were evaluated in order to determine their causes, effects, and preventative measures. From the collected data, it was found that all cases in which the synthetic sling contacted the edge of its load resulted in sling failure. It is required that adequate synthetic sling protection devices be used to protect slings in any lift where the sling comes in direct contact with the edge or corner of its load. However, there are no consensus codes or standards stating the type, material, or purpose of the type of protective device used to protect the sling from being cut. Numerous industry standards and codes provide vague descriptions on how to protect synthetic slings. Without a clear, concise statement of how to protect synthetic slings, it is common for inadequate materials and sling protection devices to be used in an attempt to meet the intent of these requirements. The use of an inadequate sling protection device is the main cause of synthetic sling failure in all researched cases. Commercial sling protection devices come in many shapes and sizes, and have a variety of names, as well as advertised uses. 'Abrasion pads' and 'wear protectors' are two different names for products with the same intended purpose. There is no distinguishable way to determine the extent of sling protection which these devices will provide, or what specific scenarios they are made for. This creates room for error in a field where error is unacceptable. This report provides a recommended action for hoisting and rigging activities which require synthetic slings to contact a load, as well as recommended changes to industry standards which will benefit overall

Role of scanning electron microscope )SEM) in metal failure analysis

International Nuclear Information System (INIS)

Shaiful Rizam Shamsudin; Hafizal Yazid; Mohd Harun; Siti Selina Abd Hamid; Nadira Kamarudin; Zaiton Selamat; Mohd Shariff Sattar; Muhamad Jalil

2005-01-01

Scanning electron microscope (SEM) is a scientific instrument that uses a beam of highly energetic electrons to examine the surface and phase distribution of specimens on a micro scale through the live imaging of secondary electrons (SE) and back-scattered electrons (BSE) images. One of the main activities of SEM Laboratory at MINT is for failure analysis on metal part and components. The capability of SEM is excellent for determining the root cause of metal failures such as ductility or brittleness, stress corrosion, fatigue and other types of failures. Most of our customers that request for failure analysis are from local petrochemical plants, manufacturers of automotive components, pipeline maintenance personnel and engineers who involved in the development of metal parts and component. This paper intends to discuss some of the technical concepts in failure analysis associated with SEM. (Author)

OBSTETRIC RENAL FAILURE

Directory of Open Access Journals (Sweden)

Rajeshwari

2015-11-01

common reasons were pregnancy induced hypertension, HELLP syndrome and obstetric haemorrhage and resulted in high risk condition for fetal and maternal mortality. The most effective measures still remain the careful prevention and the aggressive management of the obstetric complications. Ideal care for women with acute renal failure in pregnancy or post-partum requires a multidisciplinary approach that includes maternal-fetal medicine, critical care medicine, nephrology and neonatology specialties.

Local youth policy

NARCIS (Netherlands)

R. Gilsing

1999-01-01

Original title: Lokaal jeugdbeleid. Local authorities have been given an important role in youth policy in the Netherlands. They are expected to develop preventive youth policy to increase the opportunities of young people and prevent them dropping out from society. At the request of the

Loads on EPR containment after RPV failure at high pressure

International Nuclear Information System (INIS)

Jacobs, G.

1995-01-01

As regards the desgin of the EPR, the general strategy is to eliminate, the vessel failure at high pressure by preventive and mitigative measures. The design proposals involved trust in the reliability of dedicated devices (relief valves) for rapid depressurization. The aim is to attain a lower pressure level at the moment of vessel failure, so that the containment is capable to cope with the blowdown impact on the pit walls and the vessel supporting structures. Nevertheless, the potential of a high-pressure failure of the vessel must be kept in mind, whatever well thought-out and reliable preventive depressurization measures might be. Therefore, the reactor pressure blowdown has been studied in order to quantify the ultimate containment load, which might support future design requirements. The calculations were performed with the LWR transient analysis thermal-hydraulics computer code REALAP5/MOD3. In previous analyses, the nodalization of the problem was based on the geometrical conditions of a typical German 1300 MW(e) NPP. In the present analysis a new input model has been used, which was based on the EPR conditions. (orig./HP)

LMFBR operational and experimental local-fault experience, primarily with oxide fuel elements

International Nuclear Information System (INIS)

Warinner, D.K.

1980-01-01

Case-by-case reviews of selective world experience with severe local faults, particularly fuel failure and fuel degradation, are reviewed for two sodium-cooled thermal reactors, several LMFBRs, and LMFBR-fuels experiments. The review summarizes fuel-failure frequency and illustrates the results of the most damaging LMFBR local-fault experiences of the last 20 years beginning with BR-5 and including DFR, BOR-60, BR2's MFBS- and Mol-loops experiments, Fermi, KNK, Rapsodie, EBR-II, and TREAT-D2. Local-fault accommodation is demonstrated and a need to more thoroughly investigate delayed-neutron and gaseous-fission-product signals is highlighted in view of uranate formation, observed blockages, and slow fuel-element failure-propagation

To Prevent, React, and Rebuild: Health Research and the Prevention of Genocide

Science.gov (United States)

Adler, Reva N; Smith, James; Fishman, Paul; Larson, Eric B

2004-01-01

Objective To develop an approach to the primary prevention of genocide, based on established public health-based violence prevention methods derived from a variety of high-risk settings. Data Sources (1) Peer-reviewed literature in the fields of public health, violence/injury prevention, medicine, economics, sociology, psychology, history, and genocide studies, (2) demographic and health data bases made available by governments and international organizations, (3) reports on recent episodes of genocide published by international and nongovernmental organizations, (4) newspaper and journalistic accounts of recent and past genocides, (5) archival testimonies of genocide victims and perpetrators, and (6) court transcripts of international genocide prosecutions. Study Design The research was conducted as a medical-historical policy analysis synthesizing data within the following framework: (1) Assessment of current violence and injury prevention models for suitability in the prevention of extreme, population-wide violence, (2) analysis of morbidity and mortality data to quantify the impact of genocide on the health of populations, (3) making an inventory of the known societal risk factors for genocidal violence, (4) identification of the theorized, modifiable attitudinal risk factors for genocidal behavior within a population health model, and (5) assessment of existing projects targeting primary violence and injury prevention in high risk jurisdictions, for future adaptation within a structured, public health approach. Principal Findings Mortality rates due to genocidal violence are far in excess of other public health emergencies including malaria and HIV/AIDS. The immediate and long-range health consequences of genocide include the sequelae of infectious diseases, organ system failure, and psychiatric disorders, conferring an increased burden of disease on affected populations for multiple subsequent generations. The impact of genocide on local health economies is

Development and testing of an algorithm to detect implantable cardioverter-defibrillator lead failure.

Science.gov (United States)

Gunderson, Bruce D; Gillberg, Jeffrey M; Wood, Mark A; Vijayaraman, Pugazhendhi; Shepard, Richard K; Ellenbogen, Kenneth A

2006-02-01

Implantable cardioverter-defibrillator (ICD) lead failures often present as inappropriate shock therapy. An algorithm that can reliably discriminate between ventricular tachyarrhythmias and noise due to lead failure may prevent patient discomfort and anxiety and avoid device-induced proarrhythmia by preventing inappropriate ICD shocks. The goal of this analysis was to test an ICD tachycardia detection algorithm that differentiates noise due to lead failure from ventricular tachyarrhythmias. We tested an algorithm that uses a measure of the ventricular intracardiac electrogram baseline to discriminate the sinus rhythm isoelectric line from the right ventricular coil-can (i.e., far-field) electrogram during oversensing of noise caused by a lead failure. The baseline measure was defined as the product of the sum (mV) and standard deviation (mV) of the voltage samples for a 188-ms window centered on each sensed electrogram. If the minimum baseline measure of the last 12 beats was algorithm to detect lead failures. The minimum baseline measure for the 24 lead failure episodes (0.28 +/- 0.34 mV-mV) was smaller than the 135 ventricular tachycardia (40.8 +/- 43.0 mV-mV, P <.0001) and 55 ventricular fibrillation episodes (19.1 +/- 22.8 mV-mV, P <.05). A minimum baseline <0.35 mV-mV threshold had a sensitivity of 83% (20/24) with a 100% (190/190) specificity. A baseline measure of the far-field electrogram had a high sensitivity and specificity to detect lead failure noise compared with ventricular tachycardia or fibrillation.

What Is New in Heart Failure Management in 2017? Update on ACC/AHA Heart Failure Guidelines.

Science.gov (United States)

Bozkurt, Biykem

2018-04-17

The goal of this paper is to provide a summary of the new recommendations in the most recent 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. The intent is to provide the background and the supporting evidence for the recommendations and to provide practical guidance for management strategies in treatment of heart failure patients. In the 2017 ACC/AHA/HFSA Focused Update of HF guidelines, important additions include new information on biomarkers, specifically on the topics of the diagnostic, prognostic role of natriuretic peptides in heart failure, and the role of natriuretic peptides in screening in patients high risk for HF and prevention of HF. There are important recommendations for treatment of patients with HF with reduced EF (HFrEF), including the beneficial role of angiotensin receptor blocker and neprilysin inhibition (ARNI) treatment in reducing outcomes including mortality, ivabradine in reducing heart failure hospitalizations in stable HFrEF patients with sinus rhythm and heart rate ≥ 70 bpm despite β-blockers. In patients with HF with preserved EF (HFpEF), though there are no studies demonstrating survival benefit, potential benefit with aldosterone antagonism in reducing HF hospitalizations is noted. In treatment of comorbidities, optimization of blood pressure control to less than 130 mmHg is recommended in hypertensive patients to prevent HF or in patients with hypertension and HFrEF or HFpEF. In addition to recognition on the potential role of treatment of iron deficiency anemia to improve symptoms and functional capacity, caution against use of adaptive servo-ventilation in patients with HFrEF and central sleep apnea and against use of erythropoietin stimulating agents in patients with HFrEF is provided. There are new treatment

Failure rate and reliability of the KOMATSU hydraulic excavator in surface limestone mine

Science.gov (United States)

Harish Kumar N., S.; Choudhary, R. P.; Murthy, Ch. S. N.

2018-04-01

The model with failure rate function of bathtub-shaped is helpful in reliability analysis of any system and particularly in reliability associated privative maintenance. The usual Weibull distribution is, however, not capable to model the complete lifecycle of the any with a bathtub-shaped failure rate function. In this paper, failure rate and reliability analysis of the KOMATSU hydraulic excavator/shovel in surface mine is presented and also to improve the reliability and decrease the failure rate of each subsystem of the shovel based on the preventive maintenance. The model of the bathtub-shaped for shovel can also be seen as a simplification of the Weibull distribution.

Breast conservation treatment of early stage breast cancer: patterns of failure

Energy Technology Data Exchange (ETDEWEB)

Leborgne, Felix; Leborgne, Jose H; Ortega, Bettys; Doldan, Raquel; Zubizarreta, Eduardo

1995-02-15

Purpose: This study retrospectively assesses the patterns of failure in conservatively treated early stage breast cancer patients by correlating various clinical, pathologic, and treatment-related factors with local, axillary, and distant relapse. Methods and Materials: Between 1973 and 1990, 796 patients (817 breasts) received breast conservation surgery followed by radiotherapy. Local recurrences were counted as events even if they occurred simultaneously or after the appearance of axillary or distant metastases. Results: The 10-year actuarial relative disease-free survival (DFS) rate for T1N0, T2N0, and T1-2N1 was 82%, 71%, and 54%, respectively. Stage N0 patients had a significant DFS advantage over N1 patients (p = 0.02). The 15-year actuarial local recurrence-free rate for T1 and T2 tumors was 82% and 87%, respectively (p = nonsignificant). Univariate analysis identified three significant risk factors for local relapse: (a) 48 breasts with tumors showing an extensive intraductal component had a crude local recurrence rate of 23% compared to 8% for 769 breasts without intraductal component (p 0.0016); (b) the actuarial 10-year local recurrence-free rate for patients under age 40 years was 64% compared to 88% for patients over 40 years (p < 0.0001); (c) the 10-year actuarial local recurrence-free rate for 416 postmenopausal women without adjuvant tamoxifen was 83% compared to 97% for 107 postmenopausal women with tamoxifen (p = 0.0479). Salvage therapy for operable local recurrent patients resulted in a 8-year actuarial DFS rate of 47%, significantly lower than that obtained with primary treatment. The incidence of axillary relapse as the first sign of recurrence was 2%, and could be correlated with the lack of axillary dissection (p < 0.0000005) and primary tumor size (p = 0.03). Radiotherapy to the axilla did not influence axillary relapse. Actuarial 5-year DFS rate after treatment of isolated axillary recurrence was 27%. Axillary failure was a marker for

Breast conservation treatment of early stage breast cancer: patterns of failure

International Nuclear Information System (INIS)

Leborgne, Felix; Leborgne, Jose H.; Ortega, Bettys; Doldan, Raquel; Zubizarreta, Eduardo

1995-01-01

Purpose: This study retrospectively assesses the patterns of failure in conservatively treated early stage breast cancer patients by correlating various clinical, pathologic, and treatment-related factors with local, axillary, and distant relapse. Methods and Materials: Between 1973 and 1990, 796 patients (817 breasts) received breast conservation surgery followed by radiotherapy. Local recurrences were counted as events even if they occurred simultaneously or after the appearance of axillary or distant metastases. Results: The 10-year actuarial relative disease-free survival (DFS) rate for T1N0, T2N0, and T1-2N1 was 82%, 71%, and 54%, respectively. Stage N0 patients had a significant DFS advantage over N1 patients (p = 0.02). The 15-year actuarial local recurrence-free rate for T1 and T2 tumors was 82% and 87%, respectively (p = nonsignificant). Univariate analysis identified three significant risk factors for local relapse: (a) 48 breasts with tumors showing an extensive intraductal component had a crude local recurrence rate of 23% compared to 8% for 769 breasts without intraductal component (p 0.0016); (b) the actuarial 10-year local recurrence-free rate for patients under age 40 years was 64% compared to 88% for patients over 40 years (p < 0.0001); (c) the 10-year actuarial local recurrence-free rate for 416 postmenopausal women without adjuvant tamoxifen was 83% compared to 97% for 107 postmenopausal women with tamoxifen (p = 0.0479). Salvage therapy for operable local recurrent patients resulted in a 8-year actuarial DFS rate of 47%, significantly lower than that obtained with primary treatment. The incidence of axillary relapse as the first sign of recurrence was 2%, and could be correlated with the lack of axillary dissection (p < 0.0000005) and primary tumor size (p = 0.03). Radiotherapy to the axilla did not influence axillary relapse. Actuarial 5-year DFS rate after treatment of isolated axillary recurrence was 27%. Axillary failure was a marker for

Potential of resveratrol in the treatment of heart failure.

Science.gov (United States)

Raj, Pema; Louis, Xavier Lieben; Thandapilly, Sijo Joseph; Movahed, Ali; Zieroth, Shelley; Netticadan, Thomas

2014-01-30

The concept of food has expanded beyond its traditional role of survival and hunger satisfaction, to include a role in the prevention and treatment of disease. Polyphenols are classes of compounds that are synthesized by plants to serve a wide variety of functions including growth pollination and defense. These compounds have recently received increased attention in medical research. In this group, one of the most studied has been resveratrol (3,5,4,-trihydroxystilbene), a polyphenol, which is found predominantly in grapes and berries. Over the past two decades, researchers have studied the ability of resveratrol to prevent or reverse the development of abnormalities in heart structure and function in animal models of heart disease and heart failure. The results from animal studies have been promising, and very recently, this knowledge has been translated into examining the efficacy of resveratrol in humans with heart disease/failure. In this review we will discuss the current status of resveratrol research on cardioprotection. Copyright © 2013 Elsevier Inc. All rights reserved.

Analysis of events with common cause failures (CCF) from the international common cause failure date exchange (ICDE); Analyse von Ereignissen mit gemeinsam verursachten Ausfaellen (GVA) aus dem internationalen GVA-Datenaustauschprojekt ICDE

Energy Technology Data Exchange (ETDEWEB)

Brueck, Benjamin; Kreuser, Albert; Simon, Julia; Stiller, Jan

2014-08-15

Common-cause-failure (CCF) events can significantly impact the availability of safety systems of nuclear power plants. In recognition of this, CCF data are systematically being collected and analyzed in several countries. A comprehensive evaluation of CCF events derived only from the operating experience in German nuclear power plants is not sufficient due to the low probability of occurrence of such events. Therefore it is necessary to make use of the operating experience of other countries using similar technology. In order to be able to use the CCF operating experience from other countries in the aim to carry on the development of the bases for evaluation of CCF GRS decisively co-initiated the setting up of an international common-cause failure working group. This working group has elaborated the project ''International Common-Cause Failure Data Exchange'' (ICDE). The project's objective is to organize a broad exchange of information concerning observed events with relevance to common-cause failures. The tasks for preparation and evaluation of information of the ICDE working group serve for confirmation and extension of the common-cause failure knowledge with regards to probabilistic safety analyses, the better understanding of causes and mechanisms of common-cause failures and the evaluation of preventive measures against the occurrence of common-cause failures. The objectives of the exchange on a long term basis are to - improve the comprehension of CCF events and their causes and their prevention, - generate qualitative insights into the root causes of CCF events which can then be used to derive and assess preventive measures against the occurrence of such events or their consequences, - establish an efficient feedback of experience gained in connection with observed common-cause failure phenomena which could be used e.g. for the development of indicators for risk based inspections, - provide quantitative information regarding the

Local behavior of reinforced concrete slabs to aircraft engine projectile impact

International Nuclear Information System (INIS)

Yoo, Hyeon Kyeong; Choi, Hyun; Chung, Chul Hun; Lee, Jung Whee; Kim, Sang Yun

2011-01-01

Structural safety evaluation of nuclear power plant considers two distinct types of structural failure, local failure and global failure. In the local failure evaluation, considered projectiles can be divided as internal and external projectile according to the impact location, and they also can be divided as rigid and soft projectile according to the deformation level after impact. Frequently considered projectiles are aircraft engine, tornado, and turbine projectile. When the speed and weight of the projectiles are considered, the most influential projectile is aircraft engine, which is one of the soft projectiles. Sugano et al. performed impact test using an engine model projectile, which is derived from GE-J79 engine and concentrated mass-spring model idealization. Kojima and Sugano et al. demonstrated from their experiments that steel liner on the rear side of the concrete wall reduces impact induced damage and suppresses debris scattering. Chung et al. performed comparison study of various formulae suggested for local damage evaluation using previously performed numerous local impact test results. Also, they validated a methodology of numerical analysis for impact simulation using LS-DYNA. Previously suggested formulae and research results do not consider the effect of liner plate or curved shape of the containment building walls on the local damage. In this research, flat wall and curved wall are individually modeled using the same curvature of nuclear power plants, and the effects of curvature and liner plates on the local damage are analytically investigated

Renal function monitoring in heart failure - what is the optimal frequency? A narrative review.

Science.gov (United States)

Al-Naher, Ahmed; Wright, David; Devonald, Mark Alexander John; Pirmohamed, Munir

2018-01-01

The second most common cause of hospitalization due to adverse drug reactions in the UK is renal dysfunction due to diuretics, particularly in patients with heart failure, where diuretic therapy is a mainstay of treatment regimens. Therefore, the optimal frequency for monitoring renal function in these patients is an important consideration for preventing renal failure and hospitalization. This review looks at the current evidence for optimal monitoring practices of renal function in patients with heart failure according to national and international guidelines on the management of heart failure (AHA/NICE/ESC/SIGN). Current guidance of renal function monitoring is in large part based on expert opinion, with a lack of clinical studies that have specifically evaluated the optimal frequency of renal function monitoring in patients with heart failure. Furthermore, there is variability between guidelines, and recommendations are typically nonspecific. Safer prescribing of diuretics in combination with other antiheart failure treatments requires better evidence for frequency of renal function monitoring. We suggest developing more personalized monitoring rather than from the current medication-based guidance. Such flexible clinical guidelines could be implemented using intelligent clinical decision support systems. Personalized renal function monitoring would be more effective in preventing renal decline, rather than reacting to it. © 2017 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.

Local Action Plans for Forest Fire Prevention in Greece: Existing situation and a Proposed Template based on the Collaboration of Academics and Public Policy Makers

Science.gov (United States)

Papanikolaou, Dimitrios; Arvanitakis, Spyridon; Papanikolaou, , Ioannis; Lozios, Stylianos; Diakakis, Michalis; Deligiannakis, Georgios; Dimitropoulou, Margarita; Georgiou, Konstantinos

2013-04-01

Wildfires are a major hazard in Greece suffering on average 1,509 wildfires and 36,151 burned hectares of forestlands every year. Since 1998 the Greek Fire Service is responsible for wildfires suppression and response, while prevention and mitigation yearly directives are also being released by the General Secretariat of Civil Protection. The 3013/2002 Act introduced a major transfer of responsibilities from the national to local municipal and regional authorities, which are accompanied by supplementary financial support. Significant new features were established such as the operation of local coordination councils, the foundation of municipality civil protection offices, the establishment of the annually prevention planning for forest fires and the development of local action plans. The University of Athens has developed a Local Action Plan template for municipality administrative levels, integrating scientific techniques and technologies to public government management. The Local Action Plan for Forest Fire Prevention is the main handbook and primary tool of every municipality for reducing the risk of wildfires. Fire prevention and risk analysis are the principal aims of this Plan, which also emphasizes on the important role of the volunteer organizations on forest fire prevention. The 7 chapters of the Action Plan include the legal framework, the risk analysis parameters, the risk analysis using GIS, the prevention planning, the manpower and available equipment of services involved, along with operational planning and evaluation of the previous year's forest fire prevention actions. Multiple information layers, such as vegetation types, road network, power lines and landfills are combined in GIS environment and transformed into qualitative multiparameter as well as quantitative combinational fire hazard maps. These maps are essential in wildfire risk analysis as they display the areas that need the highest attention during the fire season. Moreover, the separate

Alzheimer's disease prevention: A way forward.

Science.gov (United States)

Bermejo-Pareja, F; Llamas-Velasco, S; Villarejo-Galende, A

2016-12-01

This review proposes a more optimistic view of Alzheimer's disease (AD), in contrast to that contributed by the ageing of the population and the failure of potentially curative therapies (vaccines and others). Treatment failure is likely due to the fact that AD gestates in the brain for decades but manifests in old age. This review updates the concept of AD and presents the results of recent studies that show that primary prevention can reduce the incidence and delay the onset of the disease. Half of all cases of AD are potentially preventable through education, the control of cardiovascular risk factors, the promotion of healthy lifestyles and specific drug treatments. These approaches could substantially reduce the future incidence rate of this disease. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Size effects on failure behaviour of reactor pressure vessel steel and their dependence on deformation inhomogeneity

International Nuclear Information System (INIS)

Aktaa, J.; Klotz, M.; Schmitt, R.

2003-01-01

The investigation of the size dependence of the material behaviour and particularly of the failure strain is the main objective of the European research project LISSAC (Limit Strains for Severe Accident Conditions). Within our activities in LISSAC, tensile test series with specimens of similar geometry and different sizes are performed. The specimens, cut from the wall of a real reactor vessel, are flat with a central hole, flat with a double edge notch as well as round with a circumferential notch in order to obtain inhomogeneous deformation with high strain gradients, which will be higher in the smaller specimens and might be responsible for size effects. An additional variation of the strain gradient is obtained by varying the central hole radius of the flat specimens, with three different hole geometries being considered: round hole, increased round hole and slot. During the tests optical methods are used for measuring local deformations and partly local strain gradients. The results obtained show a size effect neither on the global nor on the local deformation behaviour, whereas the damage and failure behaviour is influenced significantly by the size of the specimen. On the basis of the surface deformation measurements, finite element calculations are performed to estimate the local failure strains as well as the corresponding strain gradients. A clear dependence of local failure strains on strain gradients is obtained. (author)

On the prediction of ductile fracture by void coalescence and strain localization

Science.gov (United States)

Luo, Tuo; Gao, Xiaosheng

2018-04-01

This paper presents a unit cell model based on the observation that ductile fracture occurs when plastic flow is localized in a band. The unit cell consists of three void containing material units stacked in the direction normal to the localization plane. Localization takes place in the middle material unit while the two outer units undergo elastic recovery after failure occurs. Thus a failure criterion is established as when the macroscopic effective strain of the outer material units reaches the maximum value. Analyses are conducted to demonstrate the effect of the voids existing outside the localization band. Comparisons of the present model with several previous models suggest that the present model is not only easy to implement in finite element analysis but also more suitable to robustly determine the failure strain. A series of unit cell analyses are conducted for various macroscopic stress triaxialities and Lode parameters. The analysis results confirm that for a fixed Lode parameter, the failure strain decreases exponentially with the stress triaxiality and for a given stress triaxiality, it increases as the stress state approaches the generalized tension and generalized compression. The analysis results also reveal the effect of the stress state on the deformed void shape within and near the localization band.

Analytical method for optimization of maintenance policy based on available system failure data

International Nuclear Information System (INIS)

Coria, V.H.; Maximov, S.; Rivas-Dávalos, F.; Melchor, C.L.; Guardado, J.L.

2015-01-01

An analytical optimization method for preventive maintenance (PM) policy with minimal repair at failure, periodic maintenance, and replacement is proposed for systems with historical failure time data influenced by a current PM policy. The method includes a new imperfect PM model based on Weibull distribution and incorporates the current maintenance interval T 0 and the optimal maintenance interval T to be found. The Weibull parameters are analytically estimated using maximum likelihood estimation. Based on this model, the optimal number of PM and the optimal maintenance interval for minimizing the expected cost over an infinite time horizon are also analytically determined. A number of examples are presented involving different failure time data and current maintenance intervals to analyze how the proposed analytical optimization method for periodic PM policy performances in response to changes in the distribution of the failure data and the current maintenance interval. - Highlights: • An analytical optimization method for preventive maintenance (PM) policy is proposed. • A new imperfect PM model is developed. • The Weibull parameters are analytically estimated using maximum likelihood. • The optimal maintenance interval and number of PM are also analytically determined. • The model is validated by several numerical examples

Main factors for fatigue failure probability of pipes subjected to fluid thermal fluctuation

International Nuclear Information System (INIS)

Machida, Hideo; Suzuki, Masaaki; Kasahara, Naoto

2015-01-01

It is very important to grasp failure probability and failure mode appropriately to carry out risk reduction measures of nuclear power plants. To clarify the important factors for failure probability and failure mode of pipes subjected to fluid thermal fluctuation, failure probability analyses were performed by changing the values of a stress range, stress ratio, stress components and threshold of stress intensity factor range. The important factors for the failure probability are range, stress ratio (mean stress condition) and threshold of stress intensity factor range. The important factor for the failure mode is a circumferential angle range of fluid thermal fluctuation. When a large fluid thermal fluctuation acts on the entire circumferential surface of the pipe, the probability of pipe breakage increases, calling for measures to prevent such a failure and reduce the risk to the plant. When the circumferential angle subjected to fluid thermal fluctuation is small, the failure mode of piping is leakage and the corrective maintenance might be applicable from the viewpoint of risk to the plant. (author)

Con Edison power failure of July 13 and 14, 1977. Final staff report

Energy Technology Data Exchange (ETDEWEB)

None

1978-06-01

On July 13, 1977 the entire electric load of the Con Edison system was lost, plunging New York City and Westchester County into darkness. The collapse resulted from a combination of natural events, equipment malfunctions, questionable system-design features, and operating errors. An attempt is made in this report to answer the following: what were the specific causes of the failure; if equipment malfunctions and operator errors contributed, could they have been prevented; to what extent was Con Edison prepared to handle such an emergency; and did Con Edison plan prudently reserve generation, for reserve transmission capability, for automatic equipment to protect its system, and for proper operator response to a critical situation. Following the introductory and summary section, additional sections include: the Consolidated Edison system; prevention of bulk power-supply interruptions; the sequence of failure and restoration; analysis of the July 1977 power failure; restoration sequence and equipment damage assessment; and other investigations of the blackout. (MCW)

[HIV prevention program for young people--the WYSH Project as a model of "combination prevention"].

Science.gov (United States)

Ono-Kihara, Masako

2010-03-01

In face of the HIV pandemic that still grows, unsuccessful efforts of developing biomedical control measures or the failure of cognitive-behavioral approach to show sustained social level effectiveness, behavioral strategy is now expected to evolve into a structural prevention ("combination prevention") that involves multiple behavioral goals and multilevel approaches. WYSH Project is a combination prevention project for youth developed through socio-epidemiological approach that integrates epidemiology with social science such as social marketing and mixed method. WYSH Project includes mass education programs for youth in schools and programs for out-of-school youth through cyber network and peer communication. Started in 2002, it expanded nationwide with supports from related ministries and parent-teacher associations and has grown into a single largest youth prevention project in Japan.

External beam radiation for retinoblastoma: Results, patterns of failure, and a proposal for treatment guidelines

International Nuclear Information System (INIS)

Hernandez, J. Carlos; Brady, Luther W.; Shields, Jerry A.; Shields, Carol L.; Potter, Patrick de; Karlsson, Ulf L.; Markoe, Arnold M.; Amendola, Beatriz E.; Singh, Arun

1996-01-01

Purpose: To analyze treatment results and patterns of failure following external beam radiation for retinoblastoma and propose treatment guidelines according to specific clinical variables. Methods and Materials: We analyzed 27 patients (34 eyes) with retinoblastoma who received external beam radiation as initial treatment at Hahnemann University Hospital from October 1980 to December 1991 and have been followed for at least 1 year. Of the 34 eyes, 14 were Groups I-II (Reese-Ellsworth classification), 7 were Group III, and 13 were Groups IV-V. Doses ranged from 34.5-49.5 Gy (mean 44.3 Gy, median 45 Gy) in 1.5-2.0 Gy fractions generally delivered through anterior and lateral wedged pair fields. Results: At a mean follow up of 35.2 months (range 12-93 months), local tumor control was obtained in 44% (15 out of 34) of eyes with external beam radiation alone. Salvage therapy (plaque brachytherapy, cryotherapy, and/or photocoagulation) controlled an additional 10 eyes (29.5%), so that overall ocular survival has been 73.5%. Local tumor control with external beam radiotherapy alone was obtained in 78.5% (11 out of 14) of eyes in Groups I-II, but in only 20% (4 out of 20) of eyes in Groups III-V. A total of 67 existing tumors were identified prior to treatment in the 34 treated eyes and local control with external beam radiation alone was obtained in 87% (46 out of 53) of tumors measuring 15 mm or less and in 50% (7 out of 14) of tumors measuring more than 15 mm. When analyzing patterns of failure in the 19 eyes that relapsed, a total of 28 failure sites were identified and consisted of progression of vitreous seeds in seven instances (25% of failure sites) recurrences from previously existing tumors in 10 instances (36% of failure sites) and development of new tumors in previously uninvolved retina in 11 instances (39% of failure sites). Conclusions: 1) We find that external beam radiation to a dose of 45 Gy in fractions of 1.5 to 2.0 Gy provides adequate tumor control

Two-port Laparoscopic-assisted Appendicectomy Under Local ...

African Journals Online (AJOL)

Journal of Surgical Technique and Case Report | Jul-Dec 2011 | Vol-3 | Issue-2. 84. Two-port Laparoscopic-assisted ... appendicectomy (LAA) using the two-port technique under local anesthesia in adults. As a pilot study we .... of failure are the reasons for avoidance of using local anesthesia for surgical procedures.

Rate of PSA rise predicts metastatic versus local recurrence after definitive radiotherapy

International Nuclear Information System (INIS)

Sartor, C.I.; Strawderman, M.H.; Lin, X.; Kish, K.E.; McLaughlin, P.W.; Lichter, A.S.; Sandler, H.S.

1995-01-01

Objective: A rising PSA following treatment for adenocarcinoma of the prostate indicates eventual clinical failure, but the rate of rise can be quite different from patient to patient, as can the pattern of clinical failure. We sought to determine whether the rate of PSA rise could differentiate future local vs. metastatic failure. Materials and Methods: PSA values from our series of 671 patients treated between 1987 and 1994 with 3-D conformal radiotherapy for localized adenocarcinoma were analyzed. Patients who had a pre-treatment PSA and >4 post-treatment PSA values available, had received no hormonal therapy, and had information detailing clinical outcome were used in this analysis. First site of failure was determined by abnormal DRE or biopsy, abnormal bone scan or radiographic evidence of metastasis as directed by clinical symptoms or follow-up clinical exam. Each patient's PSA pattern was defined by the function PSA(t)=C 1 e - a 1 (t) + C 2 e a 2 (t) where -a 1 relates to the rate of decline and a 2 to the rate of rise, if any. Univariate analysis was used to determine the correlation between initial PSA or rising PSA and clinical failure. Adjacent category logistic regression analysis was used to analyze the rate of rise and pattern of clinical failure. Results: 671 patients were reviewed; 401 patients met the requirements and 2667 PSA values were analyzed. We confirmed the finding of others that pre-treatment PSA is a prognostic indicator: patients presenting with PSA 3-20ng/ml had a relative risk of 9 (p=0.03) and PSA>20ng/ml had a RR of 26 (p=0.002) for clinical failure when compared to presenting PSA 2 >1.5/year predicted metastatic as opposed to local failure when compared to PSA rise with a 2 between 0.5-1.5/yr or 1.5 log(ng/ml)/year vs. 0.5-1.5 log(ng/ml)/yr or <0.5 log(ng/ml)/yr. Conclusions: The rate of rise of PSA following definitive radiotherapy can predict clinical failure patterns, with a rapidly rising PSA indicating metastatic as opposed to

On the importance of analyzing flood defense failures

Directory of Open Access Journals (Sweden)

Özer Işıl Ece

2016-01-01

Full Text Available Flood defense failures are rare events but when they do occur lead to significant amounts of damage. The defenses are usually designed for rather low-frequency hydraulic loading and as such typically at least high enough to prevent overflow. When they fail, flood defenses like levees built with modern design codes usually either fail due to wave overtopping or geotechnical failure mechanisms such as instability or internal erosion. Subsequently geotechnical failures could trigger an overflow leading for the breach to grow in size Not only the conditions relevant for these failure mechanisms are highly uncertain, also the model uncertainty in geomechanical, internal erosion models, or breach models are high compared to other structural models. Hence, there is a need for better validation and calibration of models or, in other words, better insight in model uncertainty. As scale effects typically play an important role and full-scale testing is challenging and costly, historic flood defense failures can be used to provide insights into the real failure processes and conditions. The recently initiated SAFElevee project at Delft University of Technology aims to exploit this source of information by performing back analysis of levee failures at different level of detail. Besides detailed process based analyses, the project aims to investigate spatial and temporal patterns in deformation as a function of the hydrodynamic loading using satellite radar interferometry (i.e. PS-InSAR in order to examine its relation with levee failure mechanisms. The project aims to combine probabilistic approaches with the mechanics of the various relevant failure mechanisms to reduce model uncertainty and propose improvements to assessment and design models. This paper describes the approach of the study to levee breach analysis and the use of satellites for breach initiation analysis, both adopted within the SAFElevee project.

Genetic determinants of heart failure: facts and numbers.

Science.gov (United States)

Czepluch, Frauke S; Wollnik, Bernd; Hasenfuß, Gerd

2018-06-01

The relevance of gene mutations leading to heart diseases and hence heart failure has become evident. The risk for and the course of heart failure depends on genomic variants and mutations underlying the so-called genetic predisposition. Genetic contribution to heart failure is highly heterogenous and complex. For any patient with a likely inherited heart failure syndrome, genetic counselling is recommended and important. In the last few years, novel sequencing technologies (named next-generation sequencing - NGS) have dramatically improved the availability of molecular testing, the efficiency of genetic analyses, and moreover reduced the cost for genetic testing. Due to this development, genetic testing has become increasingly accessible and NGS-based sequencing is now applied in clinical routine diagnostics. One of the most common reasons of heart failure are cardiomyopathies such as the dilated or the hypertrophic cardiomyopathy. Nearly 100 disease-associated genes have been identified for cardiomyopathies. The knowledge of a pathogenic mutation can be used for genetic counselling, risk and prognosis determination, therapy guidance and hence for a more effective treatment. Besides, family cascade screening for a known familial, pathogenic mutation can lead to an early diagnosis in affected individuals. At that timepoint, a preventative intervention could be used to avoid or delay disease onset or delay disease progression. Understanding the cellular basis of genetic heart failure syndromes in more detail may provide new insights into the molecular biology of physiological and impaired cardiac (cell) function. As our understanding of the molecular and genetic pathophysiology of heart failure will increase, this might help to identify novel therapeutic targets and may lead to the development of new and specific treatment options in patients with heart failure. © 2018 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European

Concepts for measuring maintenance performance and methods for analysing competing failure modes

International Nuclear Information System (INIS)

Cooke, Roger; Paulsen, Jette

1997-01-01

Measurement of maintenance performance is done on the basis of component history data in which service sojourns are distinguished according to whether they terminate in corrective or preventive maintenance. From the viewpoint of data analysis, corrective and preventive maintenance constitute competing failure nudes. This article examines ways to assess maintenance performance without introducing statistical assumptions, then introduces a plausible statistical model for describing the interaction of preventive and corrective maintenance, and finally illustrates these with examples from the Nordic TUD data system

Hippo pathway deficiency reverses systolic heart failure after infarction.

Science.gov (United States)

Leach, John P; Heallen, Todd; Zhang, Min; Rahmani, Mahdis; Morikawa, Yuka; Hill, Matthew C; Segura, Ana; Willerson, James T; Martin, James F

2017-10-12

Mammalian organs vary widely in regenerative capacity. Poorly regenerative organs, such as the heart are particularly vulnerable to organ failure. Once established, heart failure commonly results in mortality. The Hippo pathway, a kinase cascade that prevents adult cardiomyocyte proliferation and regeneration, is upregulated in human heart failure. Here we show that deletion of the Hippo pathway component Salvador (Salv) in mouse hearts with established ischaemic heart failure after myocardial infarction induces a reparative genetic program with increased scar border vascularity, reduced fibrosis, and recovery of pumping function compared with controls. Using translating ribosomal affinity purification, we isolate cardiomyocyte-specific translating messenger RNA. Hippo-deficient cardiomyocytes have increased expression of proliferative genes and stress response genes, such as the mitochondrial quality control gene, Park2. Genetic studies indicate that Park2 is essential for heart repair, suggesting a requirement for mitochondrial quality control in regenerating myocardium. Gene therapy with a virus encoding Salv short hairpin RNA improves heart function when delivered at the time of infarct or after ischaemic heart failure following myocardial infarction was established. Our findings indicate that the failing heart has a previously unrecognized reparative capacity involving more than cardiomyocyte renewal.

Local Control After Intensity-Modulated Radiotherapy for Head-and-Neck Rhabdomyosarcoma

International Nuclear Information System (INIS)

Curtis, Amarinthia E.; Okcu, M. Fatih; Chintagumpala, Murali; Teh, Bin S.; Paulino, Arnold C.

2009-01-01

Purpose: To examine the patterns of failure in patients treated with intensity-modulated radiotherapy (IMRT) for head-and-neck rhabdomyosarcoma (RMS). Methods and Materials: Between 1998 and 2005, 19 patients with a diagnosis of head-and-neck RMS received IMRT at The Methodist Hospital. There were 11 male and 8 female patients, with a median age of 6 years at time of irradiation. Tumor location was parameningeal in 7, orbital in 6, and other head-and-neck RMS in 6. Chemotherapy was given to all patients, with vincristine, actinomycin D, and cyclophosphamide being the most common regimen (n = 18). The median prescribed dose was 5040 cGy. The clinical target volume included the gross tumor volume with a 1.5-cm margin. The median duration of follow-up for surviving patients was 56 months. Results: The 4-year overall survival and local control rates were 76% and 92.9%, respectively. One patient developed a local failure in the high-dose region of the radiation field; there were no marginal failures. Distant metastasis was seen in 4 patients. Overall survival was 42.9% for parameningeal sites and 100% for other sites (p < 0.01). Late toxicities were seen in 7 patients. Two secondary malignancies occurred in 1 child with embryonal RMS of the face and a p53 mutation. Conclusions: Local control was excellent in patients receiving IMRT for head-and-neck RMS. Patterns of local failure reveal no marginal failures in this group of patients

Diversification and localization of energy systems for sustainable development and energy security

International Nuclear Information System (INIS)

Xianguo Li

2005-01-01

The dominance of a single-energy system inevitably leads to excessive burden on, and eventually weakening, a particular aspect of the environment, and can cause environmental fatigue and failure (permanent damage) or even catastrophe if dominated for too long; thus it inevitably poses the health and environmental risk. This is the case for our currently fossil-fuel-based energy systems. In fact, each energy system, including renewables and alternative fuels, has its own unique adverse impact on the environment, as dictated by the second law of thermodynamics. A truly sustainable development may be achieved with the diversification and localization of energy sources and systems if the adverse impact of each energy system is sufficiently small and well within the tolerance limit of the environment. Energy diversification and localization would also provide a security for the energy supply and distribution as well for the energy consumers - a specifically important issue in the wake of blackout (electric power failure) in the Northeastern states to the Midwest of the United States and part of Canada on August 14, 2003. The idea of diversified energy systems for the good of humanity and environment is similar to many analogies in other fields, such as bio-diversity is the best means to prevent the spread and damage of diseases and pests, and diversified investment is the best strategy to guarantee the overall best investment return. It is concluded that the diversification and localization of energy systems is the best future energy systems that would be environmentally compatible, and allow for sustainable development as well as energy security for both supply and distribution to the energy consumers. (Author)

Diversification and localization of energy systems for sustainable development and energy security

International Nuclear Information System (INIS)

Li Xianguo

2005-01-01

The dominance of a single-energy system inevitably leads to excessive burden on, and eventually weakening, a particular aspect of the environment, and can cause environmental fatigue and failure (permanent damage) or even catastrophe if dominated for too long; thus it inevitably poses the health and environmental risk. This is the case for our currently fossil-fuel-based energy systems. In fact, each energy system, including renewables and alternative fuels, has its own unique adverse impact on the environment, as dictated by the second law of thermodynamics. A truly sustainable development may be achieved with the diversification and localization of energy sources and systems if the adverse impact of each energy system is sufficiently small and well within the tolerance limit of the environment. Energy diversification and localization would also provide a security for the energy supply and distribution as well for the energy consumers - a specifically important issue in the wake of blackout (electric power failure) in the Northeastern states to the Midwest of the United States and part of Canada on August 14, 2003. The idea of diversified energy systems for the good of humanity and environment is similar to many analogies in other fields, such as bio-diversity is the best means to prevent the spread and damage of diseases and pests, and diversified investment is the best strategy to guarantee the overall best investment return. It is concluded that the diversification and localization of energy systems is the best future energy systems that would be environmentally compatible, and allow for sustainable development as well as energy security for both supply and distribution to the energy consumers

A Competing Risk Model of First Failure Site after Definitive Chemoradiation Therapy for Locally Advanced Non-Small Cell Lung Cancer.

Science.gov (United States)

Nygård, Lotte; Vogelius, Ivan R; Fischer, Barbara M; Kjær, Andreas; Langer, Seppo W; Aznar, Marianne C; Persson, Gitte F; Bentzen, Søren M

2018-04-01

The aim of the study was to build a model of first failure site- and lesion-specific failure probability after definitive chemoradiotherapy for inoperable NSCLC. We retrospectively analyzed 251 patients receiving definitive chemoradiotherapy for NSCLC at a single institution between 2009 and 2015. All patients were scanned by fludeoxyglucose positron emission tomography/computed tomography for radiotherapy planning. Clinical patient data and fludeoxyglucose positron emission tomography standardized uptake values from primary tumor and nodal lesions were analyzed by using multivariate cause-specific Cox regression. In patients experiencing locoregional failure, multivariable logistic regression was applied to assess risk of each lesion being the first site of failure. The two models were used in combination to predict probability of lesion failure accounting for competing events. Adenocarcinoma had a lower hazard ratio (HR) of locoregional failure than squamous cell carcinoma (HR = 0.45, 95% confidence interval [CI]: 0.26-0.76, p = 0.003). Distant failures were more common in the adenocarcinoma group (HR = 2.21, 95% CI: 1.41-3.48, p failure showed that primary tumors were more likely to fail than lymph nodes (OR = 12.8, 95% CI: 5.10-32.17, p failure (OR = 1.26 per unit increase, 95% CI: 1.12-1.40, p failure site-specific competing risk model based on patient- and lesion-level characteristics. Failure patterns differed between adenocarcinoma and squamous cell carcinoma, illustrating the limitation of aggregating them into NSCLC. Failure site-specific models add complementary information to conventional prognostic models. Copyright © 2018 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

A hybrid local/non-local framework for the simulation of damage and fracture

KAUST Repository

Azdoud, Yan

2014-01-01

Recent advances in non-local continuum models, notably peridynamics, have spurred a paradigm shift in solid mechanics simulation by allowing accurate mathematical representation of singularities and discontinuities. This doctoral work attempts to extend the use of this theory to a community more familiar with local continuum models. In this communication, a coupling strategy - the morphing method -, which bridges local and non-local models, is presented. This thesis employs the morphing method to ease use of the non-local model to represent problems with failure-induced discontinuities. First, we give a quick review of strategies for the simulation of discrete degradation, and suggest a hybrid local/non-local alternative. Second, we present the technical concepts involved in the morphing method and evaluate the quality of the coupling. Third, we develop a numerical tool for the simulation of the hybrid model for fracture and damage and demonstrate its capabilities on numerical model examples

Failure to Achieve a PSA Level ≤1 ng/mL After Neoadjuvant LHRHA Therapy Predicts for Lower Biochemical Control Rate and Overall Survival in Localized Prostate Cancer Treated With Radiotherapy

International Nuclear Information System (INIS)

Mitchell, Darren M.; McAleese, Jonathan; Park, Richard M.; Stewart, David P.; Stranex, Stephen; Eakin, Ruth L.; Houston, Russell F.; O'Sullivan, Joe M.

2007-01-01

Purpose: To investigate whether failure to suppress the prostate-specific antigen (PSA) level to ≤1 ng/mL after ≥2 months of neoadjuvant luteinizing hormone-releasing hormone agonist therapy in patients scheduled to undergo external beam radiotherapy for localized prostate carcinoma is associated with reduced biochemical failure-free survival. Methods and Materials: A retrospective case note review of consecutive patients with intermediate- or high-risk localized prostate cancer treated between January 2001 and December 2002 with neoadjuvant hormonal deprivation therapy, followed by concurrent hormonal therapy and radiotherapy was performed. Patient data were divided for analysis according to whether the PSA level in Week 1 of radiotherapy was ≤1.0 ng/mL. Biochemical failure was determined using the American Society for Therapeutic Radiology and Oncology (Phoenix) definition. Results: A total of 119 patients were identified. The PSA level after neoadjuvant hormonal deprivation therapy was ≤1 ng/mL in 67 patients and >1 ng/mL in 52. At a median follow-up of 49 months, the 4-year actuarial biochemical failure-free survival rate was 84% vs. 60% (p = 0.0016) in favor of the patients with a PSA level after neoadjuvant hormonal deprivation therapy of ≤1 ng/mL. The overall survival rate was 94% vs. 77.5% (p = 0.0045), and the disease-specific survival rate at 4 years was 98.5% vs. 82.5%. Conclusions: The results of our study have shown that patients with a PSA level >1 ng/mL at the beginning of external beam radiotherapy after ≥2 months of neoadjuvant luteinizing hormone-releasing hormone agonist therapy have a significantly greater rate of biochemical failure and lower survival rate compared with those with a PSA level of ≤1 ng/mL. Patients without adequate PSA suppression should be considered a higher risk group and considered for dose escalation or the use of novel treatments

Effects of intravenous home dobutamine in palliative end-stage heart failure on quality of life, heart failure hospitalization, and cost expenditure.

Science.gov (United States)

Martens, Pieter; Vercammen, Jan; Ceyssens, Wendy; Jacobs, Linda; Luwel, Evert; Van Aerde, Herwig; Potargent, Peter; Renaers, Monique; Dupont, Matthias; Mullens, Wilfried

2018-01-17

In patients with palliative end-stage heart failure, interventions that could provide symptomatic relief and prevent hospital admissions are important. Ambulatory continuous intravenous inotropes have been advocated by guidelines for such a purpose. We sought to determine the effect of intravenous dobutamine on symptomatic status, hospital stay, mortality, and cost expenditure. All consecutive end-stage heart failure patients not amenable for advanced therapies and discharged with continuous intravenous home dobutamine from a single tertiary centre between April 2011 and January 2017 were retrospectively analysed. Dobutamine (fixed dose) was infused through a single-lumen central venous catheter with a small pump that was refilled by a nurse on a daily basis. Symptomatic status was longitudinally assessed as the change in New York Heart Association class and patient global assessment scale. Antecedent and incident heart failure hospitalizations were determined in a paired fashion, and cost impact was assessed. A total of 21 patients (age 77 ± 9 years) were followed up for 869 ± 647 days. At first follow-up (6 ± 1 weeks) after the initiation of dobutamine, patients had a significant improvement in New York Heart Association class (-1.29 ± 0.64; P heart failure hospitalizations assessed at 3, 6, and 12 months were significantly reduced (P heart failure hospitalizations over the same time period. Cost expenditure was significantly lower at 3 (P heart failure is feasible and associated with improved symptomatic status, heart failure hospitalizations, and health-care-related costs. Nevertheless, results should be interpreted in the context of the small and retrospective design. Larger studies are necessary to evaluate the effect of dobutamine in palliative end-stage heart failure. © 2018 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

[Memorandum on sustainable reinforcement of prevention and health promotion: challenges at the federal, state and local level].

Science.gov (United States)

Walter, U; Nöcker, G; Pawils, S; Robra, B-P; Trojan, A; Franz, M; Grossmann, B; Schmidt, T-A; Lehmann, H; Bauer, U; Göpel, E; Janz, A; Kuhn, J; Naegele, G; Müller-Kohlenberg, H; Plaumann, M; Stender, K-P; Stolzenberg, R; Süß, W; Trenker, M; Wanek, V; Wildner, M

2015-05-01

Research-based evidence and practice-based experience are core requirements for the effective implementation of preventive interventions. The knowledge gained in the Prevention Research Funding Initiative of the German Federal Ministry of Education and Research (2004-2013) was therefore amalgamated, reflected and consolidated in the Cooperation for Sustainable Prevention Research (KNP) meta-project. In annual strategy meetings, researchers and practitioners from the field and other experts developed 3 memoranda providing recommendations for the further development of research and practice in the field of prevention and health promotion. Memorandum III is primarily aimed at decision-makers in politics and administration at the federal, state and local level, in civil society and in the workplace. Its recommendations show that structuring efforts are urgently needed to achieve sustainable policy, particularly in the fields of health, education, employment and social affairs. Memorandum III brings together the knowledge extracted and problems identified in research projects. More so than its 2 predecessors, Memorandum III abstracts knowledge from the individual projects and attempts to derive guidance for action and decision-making, as shown by the 7 recommendations that appear to useful for consensus-building in practice and research. Value judgments are inevitable. Prevention and health promotion are an investment in the future: of social health, social capital and social peace. Improvement of the framework conditions is needed to achieve the harmonized awareness and the sustained effectiveness of these structure-building efforts in different policy areas, spheres of life, fields of action, and groups of actors. This includes the implementation of an overall national strategy as well as the expansion of sources of funding, extension of the legal framework, overarching coordination, and the establishment of a National Center of Excellence to develop and safeguard

Technology integration box beam failure study

Science.gov (United States)

Shuart, M. J.; Ambur, Damodar R.; Davis, D. D., Jr.; Davis, R. C.; Farley, G. L.; Lotts, C. G.; Wang, J. T.

1993-01-01

Composite structures have the potential to be cost-effective, structurally efficient primary aircraft structures. The Advanced Composites Technology (ACT) Program has the goal to develop the technology to exploit this potential for heavily loaded aircraft structures. As part of the ACT Program, Lockheed Aeronautical Systems Company completed the design and fabrication of the Technology Integration Box Beam (TIBB). The TIBB is an advanced composite prototype structure for the center wing section of the C-130 aircraft. Lockheed subjected the TIBB to downbending, upbending, torsion and combined upbending and torsion load conditions to verify the design. The TIBB failed at 83 percent of design ultimate load for the combined upbending and torsion load condition. The objective of this paper is to describe the mechanisms that led to the failure of the TIBB. The results of a comprehensive analytical and experimental study are presented. Analytical results include strain and deflection results from both a global analysis of the TIBB and a local analysis of the failure region. These analytical results are validated by experimental results from the TIBB tests. The analytical and experimental results from the TIBB tests are used to determine a sequence of events that resulted in failure of the TIBB. A potential cause of failure is high stresses in a stiffener runout region. Analytical and experimental results are also presented for a stiffener runout specimen that was used to simulate the TIBB failure mechanisms.

Experiments and modeling of ballistic penetration using an energy failure criterion

Directory of Open Access Journals (Sweden)

Dolinski M.

2015-01-01

Full Text Available One of the most intricate problems in terminal ballistics is the physics underlying penetration and perforation. Several penetration modes are well identified, such as petalling, plugging, spall failure and fragmentation (Sedgwick, 1968. In most cases, the final target failure will combine those modes. Some of the failure modes can be due to brittle material behavior, but penetration of ductile targets by blunt projectiles, involving plugging in particular, is caused by excessive localized plasticity, with emphasis on adiabatic shear banding (ASB. Among the theories regarding the onset of ASB, new evidence was recently brought by Rittel et al. (2006, according to whom shear bands initiate as a result of dynamic recrystallization (DRX, a local softening mechanism driven by the stored energy of cold work. As such, ASB formation results from microstructural transformations, rather than from thermal softening. In our previous work (Dolinski et al., 2010, a failure criterion based on plastic strain energy density was presented and applied to model four different classical examples of dynamic failure involving ASB formation. According to this criterion, a material point starts to fail when the total plastic strain energy density reaches a critical value. Thereafter, the strength of the element decreases gradually to zero to mimic the actual material mechanical behavior. The goal of this paper is to present a new combined experimental-numerical study of ballistic penetration and perforation, using the above-mentioned failure criterion. Careful experiments are carried out using a single combination of AISI 4340 FSP projectiles and 25[mm] thick RHA steel plates, while the impact velocity, and hence the imparted damage, are systematically varied. We show that our failure model, which includes only one adjustable parameter in this present work, can faithfully reproduce each of the experiments without any further adjustment. Moreover, it is shown that the

The Failure Patterns of Oral Cavity Squamous Cell Carcinoma After Intensity-Modulated Radiotherapy-University of Iowa Experience

International Nuclear Information System (INIS)

Yao Min; Chang, Kristi; Funk, Gerry F.; Lu Heming; Tan Huaming; Wacha, Judith C; Dornfeld, Kenneth J.; Buatti, John M.

2007-01-01

Purpose: Determine the failure patterns of oral cavity squamous cell carcinoma (SCC) treated with intensity-modulated radiotherapy (IMRT). Methods and Materials: Between May 2001 and July 2005, 55 patients with oral cavity SCC were treated with IMRT for curative intent. Forty-nine received postoperative IMRT, 5 definitive IMRT, and 1 neoadjuvant. Three target volumes were defined (clinical target CTV1, CTV2, and CTV3). The failure patterns were determined by coregistration or comparison of the treatment planning computed tomography to the images obtained at the time of recurrence. Results: The median follow-up for all patients was 17.1 months (range, 0.27-59.3 months). The median follow-up for living patients was 23.9 months (range, 9.3-59.3 months). Nine patients had locoregional failures: 4 local failures only, 2 regional failures only, and 3 had both local and regional failures. Five patients failed distantly; of these, 3 also had locoregional failures. The 2-year overall survival, disease-specific survival, local recurrence-free survival, locoregional recurrence-free survival, and distant disease-free survival was 68%, 74%, 85%, 82%, and 89%, respectively. The median time from treatment completion to locoregional recurrence was 4.1 months (range, 3.0-12.1 months). Except for 1 patient who failed in contralateral lower neck outside the radiation field, all failed in areas that had received a high dose of radiation. The locoregional control is strongly correlated with extracapsular extension. Conclusions: Intensity-modulated RT is effective for oral cavity SCC. Most failures are in-field failures. Further clinical studies are necessary to improve the outcomes of patients with high-risk features, particularly for those with extracapsular extension

System reliability analysis using dominant failure modes identified by selective searching technique

International Nuclear Information System (INIS)

Kim, Dong-Seok; Ok, Seung-Yong; Song, Junho; Koh, Hyun-Moo

2013-01-01

The failure of a redundant structural system is often described by innumerable system failure modes such as combinations or sequences of local failures. An efficient approach is proposed to identify dominant failure modes in the space of random variables, and then perform system reliability analysis to compute the system failure probability. To identify dominant failure modes in the decreasing order of their contributions to the system failure probability, a new simulation-based selective searching technique is developed using a genetic algorithm. The system failure probability is computed by a multi-scale matrix-based system reliability (MSR) method. Lower-scale MSR analyses evaluate the probabilities of the identified failure modes and their statistical dependence. A higher-scale MSR analysis evaluates the system failure probability based on the results of the lower-scale analyses. Three illustrative examples demonstrate the efficiency and accuracy of the approach through comparison with existing methods and Monte Carlo simulations. The results show that the proposed method skillfully identifies the dominant failure modes, including those neglected by existing approaches. The multi-scale MSR method accurately evaluates the system failure probability with statistical dependence fully considered. The decoupling between the failure mode identification and the system reliability evaluation allows for effective applications to larger structural systems

Framing the Local Context and Estimating the Health Impact of CPPW Obesity Prevention Strategies in Los Angeles County, 2010-2012.

Science.gov (United States)

Kuo, Tony; Robles, Brenda; Trogdon, Justin G; Ferencik, Rachel; Simon, Paul A; Fielding, Jonathan E

2016-01-01

Few studies have described the range and health impacts of obesity prevention strategies in local communities supported by the Communities Putting Prevention to Work program. To address this gap, we reviewed implemented strategies in Los Angeles County (LAC) for 3 program focus areas: physical activity-promotion, health marketing, and creation of healthy food environments. Local context and results from an impact simulation are presented. Information on population reach and program milestones was synthesized to describe historical and programmatic progress of the obesity prevention efforts during 2010-2012. To forecast health impacts, the Prevention Impacts Simulation Model (PRISM) was used to simulate population health outcomes, including projected changes in obesity burden and health behaviors 30 years into the future. LAC with more than 9.8 million residents. Low-income adults and youth who were the intended audiences of the Communities Putting Prevention to Work program in LAC. Implemented strategies for the 3 focus areas. Documentation of program reach and PRISM forecasting of obesity rates and health impacts. Implemented strategies in LAC ranged from best practices in healthy food procurement (estimated reach: 600 000 students, 300 000 meals per day) to completed shared-use agreements (10+ agreements across 5 school districts) to a series of strategically designed health marketing campaigns on healthy eating (>515 million impressions). On the basis of PRISM simulations, these highlighted program activities have the potential to reduce by 2040 the number of youth (-29 870) and adults (-94 136) with obesity, youth (-112 453) and adults (-855 855) below recommended levels of physical activity, and youth (-14 544) and adults (-28 835) who consumed excess junk food, as compared with baseline (2010-2011). Program context and PRISM-simulated health impacts showed modest but promising results in LAC, which may lead to further population health improvements in the

Statistical evaluation of failures and repairs of the V-1 measuring and control system

International Nuclear Information System (INIS)

Laurinec, R.; Korec, J.; Mitosinka, J.; Zarnovican, V.

1984-01-01

A failure record card system was introduced for evaluating the reliability of the measurement and control equipment of the V-1 nuclear power plant. The SPU-800 microcomputer system is used for recording data on magnetic tape and their transmission to the central data processing department. The data are used for evaluating the reliability of components and circuits and a selection is made of the most failure-prone components, and the causes of failures are evaluated as are failure identification, repair and causes of outages. The system provides monthly, annual and total assessment data since the system was commissioned. The results of the statistical evaluation of failures are used for planning preventive maintenance and for determining optimal repair intervals. (E.S.)

Ascending uretero-pyelography in renal failure.

Science.gov (United States)

Kingston, R D; Shah, K J; Dawson-Edwards, P

1977-09-01

Ascending uretero-pyelography has been carried out over a period of 13 years in 97 consecutive patients with undiagnosed renal failure. Sixty-nine were in a non-obstructive uropathy group while 26 had ureteric obstructions. There were two failures. Over 60% of examinations were performed under local anaesthesia, each examination taking an average of 20 min. There has been no mortality and two anaesthetic complications have been the only significant morbidity. Ureteric injury, urinary infection and renal function have all been investigated and recorded. Five per cent of patients developed urinary infection following AUP but without any major consequences. No significant ureteric injury occurred and no late sequelae were noted. Neither any reaction to contrast medium nor any further deterioration in renal function was observed; AUP was diagnostic in 46% of patients. In the remainder it ruled out obstructive uropathy and gave useful information about the kidneys, ureters and bladder. In experienced hands and with proper facilities AUP is safe and can be helpful in the diagnosis and management of patients in renal failure.

Imported Zika Virus in a European City: How to Prevent Local Transmission?

Directory of Open Access Journals (Sweden)

Joan-Pau Millet

2017-07-01

prevention of autochthonous transmission of arbovirosis that may have a great impact on Public Health.The good coordination between epidemiologists, entomologists, microbiologists, and clinicians is a priority in a touristic city with an intense relationship with endemic countries to minimize the risk of local transmission by competent vectors.

Basic concepts in metal work failure after metastatic spine tumour surgery.

Science.gov (United States)

Kumar, Naresh; Patel, Ravish; Wadhwa, Anshuja Charvi; Kumar, Aravind; Milavec, Helena Maria; Sonawane, Dhiraj; Singh, Gurpal; Benneker, Lorin Michael

2018-04-01

The development of spinal implants marks a watershed in the evolution of metastatic spine tumour surgery (MSTS), which has evolved from standalone decompressive laminectomy to instrumented stabilization and decompression with reconstruction when necessary. Fusion may not be feasible after MSTS due to poor quality of graft host bed along with adjunct chemotherapy and/or radiotherapy postoperatively. With an increase in the survival of patients with spinal tumours, there is a probability of an increase in the rate of implant failure. This review aims to help establish a clear understanding of implants/constructs used in MSTS and to highlight the fundamental biomechanics of implant/construct failures. Published literature on implant failure after spine surgery and MSTS has been reviewed. The evolution of spinal implants and their role in MSTS has been briefly described. The review defines implant/construct failures using radiological parameters that are practical, feasible, and derived from historical descriptions. We have discussed common modes of implant/construct failure after MSTS to allow further understanding, interception, and prevention of catastrophic failure. Implant failure rates in MSTS are in the range of 2-8%. Variability in patterns of failure has been observed based on anatomical region and the type of constructs used. Patients with construct/implant failures may or may not be symptomatic and present either as early (failures (> 3months). It has been noted that not all the implant failures after MSTS result in revisions. Based on the observed radiological criteria and clinical presentations, we have proposed a clinico-radiological classification for implant/construct failure after MSTS.

Vitamin B1 analog benfotiamine prevents diabetes-induced diastolic dysfunction and heart failure through Akt/Pim-1-mediated survival pathway.

Science.gov (United States)

Katare, Rajesh G; Caporali, Andrea; Oikawa, Atsuhiko; Meloni, Marco; Emanueli, Costanza; Madeddu, Paolo

2010-03-01

The increasing incidence of diabetes mellitus will result in a new epidemic of heart failure unless novel treatments able to halt diabetic cardiomyopathy early in its course are introduced. This study aimed to determine whether the activity of the Akt/Pim-1 signaling pathway is altered at critical stages of diabetic cardiomyopathy and whether supplementation with vitamin B1 analog benfotiamine (BFT) helps to sustain the above prosurvival mechanism, thereby preserving cardiomyocyte viability and function. Untreated streptozotocin-induced type 1 or leptin-receptor mutant type 2 diabetic mice showed diastolic dysfunction evolving to contractile impairment and cardiac dilatation and failure. BFT (70 mg/kg(-1)/d(-1)) improved diastolic and systolic function and prevented left ventricular end-diastolic pressure increase and chamber dilatation in both diabetic models. Moreover, BFT improved cardiac perfusion and reduced cardiomyocyte apoptosis and interstitial fibrosis. In hearts of untreated diabetic mice, the expression and activity of Akt/Pim-1 signaling declined along with O-N-acetylglucosamine modification of Akt, inhibition of pentose phosphate pathway, activation of oxidative stress, and accumulation of glycation end products. Furthermore, diabetes reduced pSTAT3 independently of Akt. BFT inhibited these effects of diabetes mellitus, thereby conferring cardiomyocytes with improved resistance to high glucose-induced damage. The phosphoinositide-3-kinase inhibitor LY294002 and dominant-negative Akt inhibited antiapoptotic action of BFT-induced and Pim-1 upregulation in high glucose-challenged cardiomyocytes. These results show that BFT protects from diabetes mellitus-induced cardiac dysfunction through pleiotropic mechanisms, culminating in the activation of prosurvival signaling pathway. Thus, BFT merits attention for application in clinical practice.

Flipping the Mindset: Reframing Fear and Failure to Catalyze Development

Science.gov (United States)

Boyd, Diane E.; Baudier, Josie; Stromie, Traci

2015-01-01

Despite the attempts to target success and predisposition to taking risks to promote innovation, sometimes educational developers encounter moments where they fail to meet expectations set forth--by their institutions, colleagues, or themselves. Attempts to avoid potential failures can stymie the creative process, preventing them from meeting…

X-framework: Space system failure analysis framework

Science.gov (United States)

Newman, John Steven

failures, and generating better and more consistent reports. Through this approach failures can be more fully understood, existing programs can be evaluated and future failures avoided. The x-fw development involved a review of the historical failure analysis and prevention literature, coupled with examination of numerous failure case studies. Analytical approaches included use of a relational failure "knowledge base" for classification and sorting of x-fw elements and attributes for each case. In addition a novel "management mapping" technique was developed as a means of displaying an integrated snapshot of indirect causes within the management chain. Further research opportunities will extend the depth of knowledge available for many of the component level cases. In addition, the x-fw has the potential to expand the scope of space sector lessons learned, and contribute to knowledge management and organizational learning.

Definition of ACLF and inclusion criteria for extra-hepatic organ failure.

Science.gov (United States)

Wang, Xiaojing; Sarin, Shiv Kumar; Ning, Qin

2015-07-01

A prominent characteristic of ACLF is rapid hepatic disease progression with subsequent extra-hepatic organ failure, manifesting as either hepatic coma or hepatorenal syndrome, which is associated with a high mortality rate in a short time. The APASL definition mainly emphasizes recognizing patients with hepatic failure. These patients may subsequently develop extra-hepatic multisystem organ failure leading to high mortality. It is therefore worthwhile to identify the short interim period between the development of liver failure and the onset of extra-hepatic organ failure, the potential therapeutic 'golden window.' Interventions during this period may prevent the development of complications and eventually change the course of the illness. Organ failure is suggested to be a central component of ACLF and may behave differently from chronic decompensated liver disease. Clear and practical criteria for the inclusion of organ failure are urgently needed so that patients with these life-threatening complications can be treated in a timely and appropriate manner. Recent studies suggested that the scoring systems evaluating organ failure [acute physiology, age and chronic health evaluation (APACHE) and sequential organ failure assessment (SOFA) scores] work better than those addressing the severity of liver disease [Child-Pugh and model of end-stage liver disease (MELD) scores] in ACLF. However, a key problem remains that the former scoring systems are reflective of organ failure and not predictive, thus limiting their value as an early indication for intervention.

FAILURE OF RADIOACTIVE IODINE IN TREATMENT OF HYPERTHYROIDISM

Science.gov (United States)

Schneider, David F.; Sonderman, Philip E.; Jones, Michaela F.; Ojomo, Kristin A.; Chen, Herbert; Jaume, Juan C.; Elson, Diane F.; Perlman, Scott B.; Sippel, Rebecca S.

2015-01-01

Introduction Persistent or recurrent hyperthyroidism after treatment with radioactive iodine (RAI) is common, and many patients require either additional doses or surgery before they are cured. The purpose of this study was to identify patterns and predictors of failure of RAI in patients with hyperthyroidism. Methods We conducted a retrospective review of patients treated with RAI from 2007–2010. Failure of RAI was defined as receipt of additional dose(s) and/or total thyroidectomy. Using a Cox proportional hazards model, we conducted univariate analysis to identify factors associated with failure of RAI. A final multivariate model was then constructed with significant (p treatment. 53 (71.6%) received additional RAI, 13 (17.6%) received additional RAI followed by surgery, and the remaining 8 (10.8%) were cured after thyroidectomy. The percentage of patients who failed decreased in a step-wise fashion as RAI dose increased. Similarly, the incidence of failure increased as the presenting T3 level increased. Sensitivity analysis revealed that RAI doses treatment (HR 2.55, 95% CI 1.22–5.33, p=0.01) were associated with failure. Conclusions Laboratory values at presentation can predict which patients with hyperthyroidism are at risk for failing RAI treatment. Higher doses of RAI or surgical referral may prevent the need for repeat RAI in selected patients. PMID:25001092

Expansive failure reactions and their prevention in the encapsulation of phenol formaldehyde type ion exchange resins in cement based systems

Energy Technology Data Exchange (ETDEWEB)

Constable, M.; Howard, C.G.; Johnson, M.A.; Jolliffe, C.B. (AEA Decommissioning and Waste Management, Winfrith (United Kingdom)); Sellers, R.M. (Nuclear Electric plc, Barnwood (United Kingdom))

1992-01-01

Lewatit DN is a phenol formaldehyde based ion exchange resin used to remove radioactive caesium from liquid waste streams such as fuel cooling ponds and effluents. This paper presents the results of a study of the encapsulation of the bead form of the resin in cement with particular reference to the mechanisms of its interaction with the encapsulant. When incorporated in pure ordinary Portland cement (OPC) at loadings in excess of 15 wt % an unstable product results due to expansion of the systems and at higher waste loadings failure results after only a few days. Evidence from differential scanning calorimetry, X-ray diffraction and scanning electron microscopy all indicate the cause of the expansive reaction to be the formation of crystals of calcium salts around and within the resin beads. Addition of BFS and sodium hydroxide prevent the formation of these salts by removal of calcium hydroxide from the system in other reactions. (author).

Investigation into Cause of High Temperature Failure of Boiler Superheater Tube

Science.gov (United States)

Ghosh, D.; Ray, S.; Roy, H.; Shukla, A. K.

2015-04-01

The failure of the boiler tubes occur due to various reasons like creep, fatigue, corrosion and erosion. This paper highlights a case study of typical premature failure of a final superheater tube of 210 MW thermal power plant boiler. Visual examination, dimensional measurement, chemical analysis, oxide scale thickness measurement, microstructural examination are conducted as part of the investigations. Apart from these investigations, sulfur print, Energy Dispersive spectroscopy (EDS) and X ray diffraction analysis (XRD) are also conducted to ascertain the probable cause of failure of final super heater tube. Finally it has been concluded that the premature failure of the super heater tube can be attributed to the combination of localized high tube metal temperature and loss of metal from the outer surface due to high temperature corrosion. The corrective actions have also been suggested to avoid this type of failure in near future.

LMFBR operational and experimental in-core local-fault experience, primarily with oxide fuel elements

International Nuclear Information System (INIS)

Warinner, D.K.

Case-by-case reviews of selective world experience with severe local faults, particularly fuel failure and fuel degradation, are reviewed for two sodium-cooled thermal reactors, several LMFBRs, and LMFBR-fuels experiments. The review summarizes fuel-failure frequency and illustrates the results of the most damaging LMFBR local-fault experiences of the last 20 years beginning with BR-5 and including DFR, BOR-60, BR2's MFBS-and Mol-loops experiments, Fermi, KNK, Rapsodie, EBR-II, and TREAT-D2. Local-fault accommodation is demonstrated and a need to more thoroughly investigate delayed-neutron and gaseous-fission-product signals is highlighted in view of uranate formation, observed blockages, and slow fuel-element failure-propagation

Study on structural failure of RPV with geometric discontinuity under severe accident

Energy Technology Data Exchange (ETDEWEB)

Mao, J.F., E-mail: jianfeng-mao@163.com [Institute of Process Equipment and Control Engineering, Zhejiang University of Technology, Hangzhou, Zhejiang 310032 (China); Engineering Research Center of Process Equipment and Re-manufacturing, Ministry of Education (China); Zhu, J.W. [Institute of Process Equipment and Control Engineering, Zhejiang University of Technology, Hangzhou, Zhejiang 310032 (China); Department of Mechanical and Electrical engineering, Huzhou Vocational & Technical College Huzhou, Zhejiang 313000 (China); Bao, S.Y., E-mail: bsy@zjut.edu.cn [Institute of Process Equipment and Control Engineering, Zhejiang University of Technology, Hangzhou, Zhejiang 310032 (China); Engineering Research Center of Process Equipment and Re-manufacturing, Ministry of Education (China); Luo, L.J. [Institute of Process Equipment and Control Engineering, Zhejiang University of Technology, Hangzhou, Zhejiang 310032 (China); Gao, Z.L. [Institute of Process Equipment and Control Engineering, Zhejiang University of Technology, Hangzhou, Zhejiang 310032 (China); Engineering Research Center of Process Equipment and Re-manufacturing, Ministry of Education (China)

2016-10-15

Highlights: • The RPV failure is investigated in depth under severe accident. • The creep and plastic damage are the major contributor to RPV failure. • A elastic core is found at the midpoint of the highly-eroded region. • Weakest location has some ‘accommodating’ quality to prevent ductile tearing. • The internal pressure is critical for the determination of structural failure. - Abstract: A severe accident management strategy known as ‘in-vessel retention (IVR)’ is widely adopted in most of advanced nuclear power plants. The IVR mitigation is assumed to be able to arrest the degraded melting core and maintain the structural integrity of reactor pressure vessel (RPV) within a prescribed period of time. This traditional concept of IVR without consideration of internal pressure effect wasn’t challenged until the occurrence of Fukushima accident on 2011, which showed that the structural behavior had not been appropriately assessed, and a certain pressure (up to 8.0 MPa) still existed inside the RPV. Accordingly, the paper tries to address the related issue on whether lower head (LH) integrity can be maintained, when the LH is subjected to the thermal-mechanical loads created during such a severe accident. Because of the presence of the high temperature melt (∼1300 °C) on the inside of RPV, some local material is melted down to create a unique RPV with geometric discontinuity, while the outside of RPV submerged in cavity water will remain in nucleate boiling (at ∼150 °C). Therefore, the failure mechanisms of RPV can span a wide range of structural behaviors, such as melt-through, creep damage, plastic yielding as well as thermal expansion. Through meticulous investigation, it is found that the RPV failure is mainly caused by creep and plasticity, especially for the inside of highly-eroded region. The elastic core (or layer) is found to exist in the proximity of mid-section of the highly-eroded wall. However, the elastic core is squeezed into

Failure mode and effect analysis in asset maintenance : a multiple case study in the process industry

NARCIS (Netherlands)

Braaksma, Jan; Klingenberg, W.; Veldman, J.

2013-01-01

Failure mode and effect analysis (FMEA) is an important method for designing and prioritising preventive maintenance activities and is often used as the basis for preventive maintenance planning. Although FMEA was studied extensively, most of the published work so far covers FMEA concept design.

Failure mode and effect analysis in asset maintenance: a multiple case study in the process industry

NARCIS (Netherlands)

Braaksma, Anne Johannes Jan; Klingenberg, W.; Veldman, Jasper

2013-01-01

Failure mode and effect analysis (FMEA) is an important method for designing and prioritising preventive maintenance activities and is often used as the basis for preventive maintenance planning. Although FMEA was studied extensively, most of the published work so far covers FMEA concept design.

Failure Mode and Effect Analysis for remote handling transfer systems of ITER

International Nuclear Information System (INIS)

Pinna, T.; Caporali, R.; Tesini, A.

2008-01-01

A Failure Mode and Effect Analysis (FMEA) at component level was done to study safety-relevant implications arising from possible failures in performing remote handling (RH) operations at ITER facility . Autonomous air cushion transporter, pallet, sealed casks and tractor movers needed for port plug mounting/dismantling operation were analysed. For each sub-system, the breakdown of significant components was outlined and, for each component, possible failure modes have been investigated pointing out possible causes, possible actions to prevent the causes, consequences and actions to prevent or mitigate consequences. Off-normal events which may result in hazardous consequences to the public and the environment have been defined as Postulated Initiating Events (PIEs). Two safety-relevant PIEs have been defined by assessing elementary failures related to the analysed system. Each PIE has been discussed in order to qualitatively identify accident sequences arising from each of them. As an output of this FMEA study, possible incidental scenarios, where the intervention of rescue RH equipments is required to overcome critical situations determined by fault of RH components, were defined as well. Being rescue scenarios of main concern for ITER remote handling activities, such families could be helpful in defining the design requirements of port handling systems in general and on RH transfer system in particular. Furthermore, they could be useful in defining casks and vehicles to be used for rescue activities

Astragalus Granule Prevents Ca2+ Current Remodeling in Heart Failure by the Downregulation of CaMKII

Directory of Open Access Journals (Sweden)

Sinai Li

2017-01-01

Full Text Available Background. Astragalus was broadly used for treating heart failure (HF and arrhythmias in East Asia for thousands of years. Astragalus granule (AG, extracted from Astragalus, shows beneficial effect on the treatment of HF in clinical research. We hypothesized that administration of AG prevents the remodeling of L-type Ca2+ current (ICa-L in HF mice by the downregulation of Ca2+/calmodulin-dependent protein kinase II (CaMKII. Methods. HF mice were induced by thoracic aortic constriction (TAC. After 4 weeks of AG treatment, cardiac function and QT interval were evaluated. Single cardiac ventricular myocyte was then isolated and whole-cell patch clamp was used to record action potential (AP and ICa-L. The expressions of L-type calcium channel alpha 1C subunit (Cav1.2, CaMKII, and phosphorylated protein kinase A (p-PKA were examined by western blot. Results. The failing heart manifested distinct electrical remodeling including prolonged repolarization time and altered ICa-L kinetics. AG treatment attenuated this electrical remodeling, supported by AG-related shortened repolarization time, decreased peak ICa-L, accelerated ICa-L inactivation, and positive frequency-dependent ICa-L facilitation. In addition, AG treatment suppressed the overexpression of CaMKII, but not p-PKA, in the failing heart. Conclusion. AG treatment protected the failing heart against electrical remodeling and ICa-L remodeling by downregulating CaMKII.

Medical costs in patients with heart failure after acute heart failure events: one-year follow-up study.

Science.gov (United States)

Kim, Eugene; Kwon, Hye-Young; Baek, Sang Hong; Lee, Haeyoung; Yoo, Byung-Su; Kang, Seok-Min; Ahn, Youngkeun; Yang, Bong-Min

2018-03-01

This study investigated annual medical costs using real-world data focusing on acute heart failure. The data were retrospectively collected from six tertiary hospitals in South Korea. Overall, 330 patients who were hospitalized for acute heart failure between January 2011 and July 2012 were selected. Data were collected on their follow-up medical visits for 1 year, including medical costs incurred toward treatment. Those who died within the observational period or who had no records of follow-up visits were excluded. Annual per patient medical costs were estimated according to the type of medical services, and factors contributing to the costs using Gamma Generalized Linear Models (GLM) with log link were analyzed. On average, total annual medical costs for each patient were USD 6,199 (±9,675), with hospitalization accounting for 95% of the total expenses. Hospitalization cost USD 5,904 (±9,666) per patient. Those who are re-admitted have 88.5% higher medical expenditure than those who have not been re-admitted in 1 year, and patients using intensive care units have 19.6% higher expenditure than those who do not. When the number of hospital days increased by 1 day, medical expenses increased by 6.7%. Outpatient drug costs were not included. There is a possibility that medical expenses for AHF may have been under-estimated. It was found that hospitalization resulted in substantial costs for treatment of heart failure in South Korea, especially in patients with an acute heart failure event. Prevention strategies and appropriate management programs that would reduce both frequency of hospitalization and length of stay for patients with the underlying risk of heart failure are needed.

A preventive maintenance policy based on dependent two-stage deterioration and external shocks

International Nuclear Information System (INIS)

Yang, Li; Ma, Xiaobing; Peng, Rui; Zhai, Qingqing; Zhao, Yu

2017-01-01

This paper proposes a preventive maintenance policy for a single-unit system whose failure has two competing and dependent causes, i.e., internal deterioration and sudden shocks. The internal failure process is divided into two stages, i.e. normal and defective. Shocks arrive according to a non-homogeneous Poisson process (NHPP), leading to the failure of the system immediately. The occurrence rate of a shock is affected by the state of the system. Both an age-based replacement and finite number of periodic inspections are schemed simultaneously to deal with the competing failures. The objective of this study is to determine the optimal preventive replacement interval, inspection interval and number of inspections such that the expected cost per unit time is minimized. A case study on oil pipeline maintenance is presented to illustrate the maintenance policy. - Highlights: • A maintenance model based on two-stage deterioration and sudden shocks is developed. • The impact of internal system state on external shock process is studied. • A new preventive maintenance strategy combining age-based replacements and periodic inspections is proposed. • Postponed replacement of a defective system is provided by restricting the number of inspections.

Bladder Cancer Patterns of Pelvic Failure: Implications for Adjuvant Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Baumann, Brian C. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Guzzo, Thomas J. [Department of Urology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); He Jiwei [Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Vaughn, David J.; Keefe, Stephen M. [Department of Medical Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Vapiwala, Neha; Deville, Curtiland; Bekelman, Justin E.; Tucker, Kai [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Hwang, Wei-Ting [Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Malkowicz, S. Bruce [Department of Urology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Christodouleas, John P., E-mail: christojo@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)

2013-02-01

Purpose: Local-regional failures (LFs) after cystectomy with or without chemotherapy are common in locally advanced disease. Adjuvant radiation therapy (RT) could reduce LFs, but toxicity has discouraged its use. Modern RT techniques with improved normal tissue sparing have rekindled interest but require knowledge of pelvic failure patterns to design treatment volumes. Methods and Materials: Five-year LF rates after radical cystectomy plus pelvic node dissection with or without chemotherapy were determined for 8 pelvic sites among 442 urothelial bladder carcinoma patients. The impact of pathologic stage, margin status, nodal involvement, and extent of node dissection on failure patterns was assessed using competing risk analysis. We calculated the percentage of patients whose sites of LF would have been completely encompassed within various hypothetical clinical target volumes (CTVs) for postoperative radiation. Results: Compared with stage {<=}pT2, stage {>=}pT3 patients had higher 5-year LF rates in virtually all pelvic sites. Among stage {>=}pT3 patients, margin status significantly altered the failure pattern whereas extent of node dissection and nodal positivity did not. In stage {>=}pT3 patients with negative margins, failure occurred predominantly in the iliac/obturator nodes and uncommonly in the cystectomy bed and/or presacral nodes. Of these patients in whom failure subsequently occurred, 76% would have had all LF sites encompassed within CTVs covering only the iliac/obturator nodes. In stage {>=}pT3 with positive margins, cystectomy bed and/or presacral nodal failures increased significantly. Only 57% of such patients had all LF sites within CTVs limited to the iliac/obturator nodes, but including the cystectomy bed and presacral nodes in the CTV when margins were positive increased the percentage of LFs encompassed to 91%. Conclusions: Patterns of failure within the pelvis are summarized to facilitate design of adjuvant RT protocols. These data suggest

A systematic review of economic evaluations of local authority commissioned preventative public health interventions in overweight and obesity, physical inactivity, alcohol and illicit drugs use and smoking cessation in the United Kingdom.

Science.gov (United States)

White, Pam; Skirrow, Helen; George, Abraham; Memon, Anjum

2018-02-16

Since 2013, local authorities in England have been responsible for commissioning preventative public health interventions. The aim of this systematic review was to support commissioning by collating published data on economic evaluations and modelling of local authority commissioned public health preventative interventions in the UK. Following the PRISMA protocol, we searched for economic evaluations of preventative intervention studies in four different areas: overweight and obesity, physical inactivity, alcohol and illicit drugs use and smoking cessation. The systematic review identified studies between January 1994 and February 2015, using five databases. We synthesized the studies to identify the key methods and examined results of the economic evaluations. The majority of the evaluations related to cost-effectiveness, rather than cost-benefit analyses or cost-utility analyses. These analyses found preventative interventions to be cost effective, though the context of the interventions differed between the studies. Preventative public health interventions in general are cost-effective. There is a need for further studies to support justification of continued and/or increased funding for public health interventions. There is much variation between the types of economically evaluated preventative interventions in our review. Broader studies incorporating different contexts may help support funding for local authority-sponsored public health initiatives.

Suicide and attempted suicide: epidemiological surveillance as a crucial means of a local suicide prevention project in Trento's Province.

Science.gov (United States)

Di Napoli, Wilma Angela; Della Rosa, Alberto

2015-09-01

The World Health Organization identifies suicide among the top 10 causes of death in many countries with an overall mortality rate of 16 per 100,000 inhabitants. Furthermore suicide attempts present a frequency 4-10 times greater than the suicidal events, representing also one of the main risk factors to lead to recurrent attempts of suicide. In 2008 the Autonomous Province of Trento launched a suicide prevention pogram called "Invitation to Life" which includes various interventions intended to counter the phenomenon of suicide in the region. Actually the epidemiological research upon the phenomenon of suicide in Trentino region is one of the main pillars of the project: it represents a fundamental requirement to identify risk and protective factors in the population in order to adopt more specific and effective preventive strategies. This article aims to present methods and instruments for epidemiological monitoring of suicide and attempted suicide which are applied in Trentino and to describe results after seven years from the beginning of the local prevention program "Invitation to life".

The failure of earthquake failure models

Science.gov (United States)

Gomberg, J.

2001-01-01

In this study I show that simple heuristic models and numerical calculations suggest that an entire class of commonly invoked models of earthquake failure processes cannot explain triggering of seismicity by transient or "dynamic" stress changes, such as stress changes associated with passing seismic waves. The models of this class have the common feature that the physical property characterizing failure increases at an accelerating rate when a fault is loaded (stressed) at a constant rate. Examples include models that invoke rate state friction or subcritical crack growth, in which the properties characterizing failure are slip or crack length, respectively. Failure occurs when the rate at which these grow accelerates to values exceeding some critical threshold. These accelerating failure models do not predict the finite durations of dynamically triggered earthquake sequences (e.g., at aftershock or remote distances). Some of the failure models belonging to this class have been used to explain static stress triggering of aftershocks. This may imply that the physical processes underlying dynamic triggering differs or that currently applied models of static triggering require modification. If the former is the case, we might appeal to physical mechanisms relying on oscillatory deformations such as compaction of saturated fault gouge leading to pore pressure increase, or cyclic fatigue. However, if dynamic and static triggering mechanisms differ, one still needs to ask why static triggering models that neglect these dynamic mechanisms appear to explain many observations. If the static and dynamic triggering mechanisms are the same, perhaps assumptions about accelerating failure and/or that triggering advances the failure times of a population of inevitable earthquakes are incorrect.

Treatment and prevention of hepatic failure in acute biliary pancreatitis in patients with diabetes mellitus

Directory of Open Access Journals (Sweden)

S.I. Savoliuk

2017-10-01

the products of purine nucleotide catabolism (xanthine oxidase, xanthine dehydrogenase capable of producing reactive oxygen species, stimulating oxidative stress. Conclusions. The course of acute biliary pancreatitis in patients with diabetes mellitus is accompanied by regular changes in the markers of the syndrome of cytopathic hypoxia, the erythron system and iron metabolism, the severity of these disorders has a direct correlation with the area of morphological changes in the pancreas and the dynamics of markers of liver failure. Using the methods of protocol therapy, you can not carry out preventive correction of existing metabolic disorders that requires the inclusion into the standard conservative treatment for edema form of acute biliary pancreatitis of systemic multifunctional metabolic corrector (Berlithion® for systemic preventive correction of homeostasis and mechanisms of escalation of hepatic insufficiency manifestations, which, in the presence of necrotic forms, requires additional application of low molecular weight heparins (Zibor® for the restoration of hemorheological and hemocoalogulative disorders on the systemic and intraorganic levels.

Failure of radioactive iodine in the treatment of hyperthyroidism.

Science.gov (United States)

Schneider, David F; Sonderman, Philip E; Jones, Michaela F; Ojomo, Kristin A; Chen, Herbert; Jaume, Juan C; Elson, Diane F; Perlman, Scott B; Sippel, Rebecca S

2014-12-01

Persistent or recurrent hyperthyroidism after treatment with radioactive iodine (RAI) is common and many patients require either additional doses or surgery before they are cured. The purpose of this study was to identify patterns and predictors of failure of RAI in patients with hyperthyroidism. We conducted a retrospective review of patients treated with RAI from 2007 to 2010. Failure of RAI was defined as receipt of additional dose(s) and/or total thyroidectomy. Using a Cox proportional hazards model, we conducted univariate analysis to identify factors associated with failure of RAI. A final multivariate model was then constructed with significant (p treatment, 53 (71.6 %) received additional RAI, 13 (17.6 %) received additional RAI followed by surgery, and the remaining 8 (10.8 %) were cured after thyroidectomy. The percentage of patients who failed decreased in a stepwise fashion as RAI dose increased. Similarly, the incidence of failure increased as the presenting T3 level increased. Sensitivity analysis revealed that RAI doses treatment (HR 2.55; 95 % CI 1.22-5.33; p = 0.01) were associated with failure. Laboratory values at presentation can predict which patients with hyperthyroidism are at risk for failing RAI treatment. Higher doses of RAI or surgical referral may prevent the need for repeat RAI in selected patients.

Concepts for measuring maintenance performance and methods for analysing competing failure modes

DEFF Research Database (Denmark)

Cooke, R.; Paulsen, J.L.

1997-01-01

competing failure modes. This article examines ways to assess maintenance performance without introducing statistical assumptions, then introduces a plausible statistical model for describing the interaction of preventive and corrective maintenance, and finally illustrates these with examples from...

Pretreatment of Sialic Acid Efficiently Prevents Lipopolysaccharide-Induced Acute Renal Failure and Suppresses TLR4/gp91-Mediated Apoptotic Signaling

Directory of Open Access Journals (Sweden)

Shih-Ping Hsu

2016-05-01

Full Text Available Background/Aims: Lipopolysaccharides (LPS binding to Toll-like receptor 4 (TLR4 activate NADPH oxidase gp91 subunit-mediated inflammation and oxidative damage. Recognizing the high binding affinity of sialic acid (SA with LPS, we further explored the preventive potential of SA pretreatment on LPS-evoked acute renal failure (ARF. Methods: We determined the effect of intravenous SA 30 min before LPS-induced injury in urethane-anesthetized female Wistar rats by evaluating kidney reactive oxygen species (ROS responses, renal and systemic hemodynamics, renal function, histopathology, and molecular mechanisms. Results: LPS time-dependently reduced arterial blood pressure, renal microcirculation, and increased blood urea nitrogen and creatinine in the rats. LPS enhanced monocyte/macrophage infiltration and ROS production, and subsequently impaired kidneys with the enhancement of TLR4/NADPH oxidase gp91/Caspase 3/poly-(ADP-ribose-polymerase (PARP-mediated apoptosis in the kidneys. SA pretreatment effectively alleviated LPS-induced ARF. The levels of LPS-increased ED-1 infiltration and ROS production in the kidney were significantly depressed by SA pretreatment. Furthermore, SA pretreatment significantly depressed TLR4 activation, gp91 expression, and Caspase 3/PARP induced apoptosis in the kidneys. Conclusion: We suggest that pretreatment of SA significantly and preventively attenuated LPS-induced detrimental effects on systemic and renal hemodynamics, renal ROS production and renal function, as well as, LPS-activated TLR4/gp91/Caspase3 mediated apoptosis signaling.

Impact of primary para-aortic lymphadenectomy on distant failure in locally advanced cervical cancer patients treated in the era of image-guided adaptive brachytherapy.

Science.gov (United States)

Chargari, Cyrus; Mazeron, Renaud; Dunant, Ariane; Gouy, Sébastien; Petit, Claire; Maroun, Pierre; Uzan, Catherine; Annede, Pierre; Bentivegna, Enrica; Balleyguier, Corinne; Genestie, Catherine; Pautier, Patricia; Leary, Alexandra; Lhomme, Catherine; Deutsch, Eric; Morice, Philippe; Haie-Meder, Christine

2016-12-01

To investigate the impact of a primary para-aortic lymphadenectomy (PAL) in locally advanced cervical cancer patients receiving definitive chemoradiation, we reviewed the clinical records of consecutive patients treated in our Institution and receiving an external beam irradiation followed with an image-guided adaptive brachytherapy for a locally advanced cervical cancer. We examined the impact of performing a primary PAL as part of primary staging for guiding irradiation fields in patients without extra-pelvic PET uptake. The outcome of patients presenting para-aortic lymph node uptake (PALNU) was also examined. 186 patients were identified. Median follow-up was 44.4 months. Patients receiving a primary PAL (PAL group) and those who received upfront pelvic chemoradiation (no-PAL group) did not significantly differ for loco-regional failures. Survival without distant failure (DFFS), including para-aortic relapses, was at 3 years 87 % (95 % CI 84-90 %) in PAL group, 67 % (95 % CI 59-85 %) in the no-PAL group and 44 % (95 % CI 32-66 %) in the PALNU group (p = 0.04 for comparison between PAL and no-PAL groups). In a multivariate model including para-aortic lymphadenectomy, pelvic nodal uptake and high-risk clinical target volume as adjustment variables, a para-aortic lymphadenectomy was significant for DFS (HR = 0.47, 95 % CI 0.26-0.84, p = 0.01). Although confounding factors could account for these retrospective results, a primary PAL with tailored irradiation fields based on para-aortic histological findings seems to be associated with a better control for distant metastases. A randomized trial is testing the benefit of this strategy.

Extensive feedwater quality control and monitoring concept for preventing chemistry-related failures of boiler tubes in a subcritical thermal power plant

International Nuclear Information System (INIS)

Vidojkovic, Sonja; Onjia, Antonije; Matovic, Branko; Grahovac, Nebojsa; Maksimovic, Vesna; Nastasovic, Aleksandra

2013-01-01

Prevention and minimizing corrosion processes on steam generating equipment is highly important in the thermal power industry. The maintenance of feedwater quality at a level corresponding to the standards of technological designing, followed by timely respond to the fluctuation of measured parameters, has a decisive role in corrosion prevention. In this study, the comprehensive chemical control of feedwater quality in 210 MW Thermal Power Plant (TPP) was carried out in order to evaluate its potentiality to assure reliable function of the boiler and discover possible irregularity that might be responsible for frequent boiler tube failures. Sensitive on-line and off-line analytical instruments were used for measuring key and diagnostic parameters considered to be crucial for boiler safety and performances. Obtained results provided evidences for exceeded levels of oxygen, silica, sodium, chloride, sulfate, copper, and conductivity what distinctly demonstrated necessity of feedwater control improvement. Consequently, more effective feedwater quality monitoring concept was recommended. In this paper, the explanation of presumable root causes of corrosive contaminants was given including basic directions for their maintenance in proscribed limits. -- Highlights: • Feedwater quality monitoring practice in a thermal power plant has been evaluated. • The more efficient feedwater quality control have been applied. • Analysis of feedwater quality parameters has been performed. • Exceeded levels of corrosive contaminants were found. • Recommendations for their maintenance at proscribed values were given

Highway pavement failure induced by poor soil geotechnical ...

African Journals Online (AJOL)

X-ray diffraction studies showed the presence of abundant kaolinite peaks and a subdued goethite peak without any trace of montmorrilonite. The presence of excess fines in the pavement construction materials (soils) contributed to the failure of the highway pavement at this locality. The low CBR value is also a noted cause ...

Propagated failure analysis for non-repairable systems considering both global and selective effects

International Nuclear Information System (INIS)

Wang Chaonan; Xing Liudong; Levitin, Gregory

2012-01-01

This paper proposes an algorithm for the reliability analysis of non-repairable binary systems subject to competing failure propagation and failure isolation events with both global and selective failure effects. A propagated failure that originates from a system component causes extensive damage to the rest of the system. Global effect happens when the propagated failure causes the entire system to fail; whereas selective effect happens when the propagated failure causes only failure of a subset of system components. In both cases, the failure propagation that originates from some system components (referred to as dependent components) can be isolated because of functional dependence between the dependent components and a component that prevents the failure propagation (trigger components) when the failure of the trigger component happens before the occurrence of the propagated failure. Most existing studies focus on the analysis of propagated failures with global effect. However, in many cases, propagated failures affect only a subset of system components not the entire system. Existing approaches for analyzing propagated failures with selective effect are limited to series-parallel systems. This paper proposes a combinatorial method for the propagated failure analysis considering both global and selective effects as well as the competition with the failure isolation in the time domain. The proposed method is not limited to series-parallel systems and has no limitation on the type of time-to-failure distributions for the system components. The method is verified using the Markov-based method. An example of computer memory systems is analyzed to demonstrate the application of the proposed method.

Availability analysis of subsea blowout preventer using Markov model considering demand rate

Directory of Open Access Journals (Sweden)

Sunghee Kim

2014-12-01

Full Text Available Availabilities of subsea Blowout Preventers (BOP in the Gulf of Mexico Outer Continental Shelf (GoM OCS is investigated using a Markov method. An updated β factor model by SINTEF is used for common-cause failures in multiple redundant systems. Coefficient values of failure rates for the Markov model are derived using the β factor model of the PDS (reliability of computer-based safety systems, Norwegian acronym method. The blind shear ram preventer system of the subsea BOP components considers a demand rate to reflect reality more. Markov models considering the demand rate for one or two components are introduced. Two data sets are compared at the GoM OCS. The results show that three or four pipe ram preventers give similar availabilities, but redundant blind shear ram preventers or annular preventers enhance the availability of the subsea BOP. Also control systems (PODs and connectors are contributable components to improve the availability of the subsea BOPs based on sensitivity analysis.