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Sample records for previous studies fail

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

    Science.gov (United States)

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

    2017-11-01

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

  2. Surgical Results of Trabeculectomy and Ahmed Valve Implantation Following a Previous Failed Trabeculectomy in Primary Congenital Glaucoma Patients

    OpenAIRE

    Lee, Naeun; Ma, Kyoung Tak; Bae, Hyoung Won; Hong, Samin; Seong, Gong Je; Hong, Young Jae; Kim, Chan Yun

    2015-01-01

    Purpose To compare the surgical results of trabeculectomy and Ahmed glaucoma valve implantation after a previous failed trabeculectomy. Methods A retrospective comparative case series review was performed on 31 eye surgeries in 20 patients with primary congenital glaucoma who underwent trabeculectomy or Ahmed glaucoma valve implantation after a previous failed trabeculectomy with mitomycin C. Results The preoperative mean intraocular pressure was 25.5 mmHg in the trabeculectomy group and 26.9...

  3. Transcaval TIPS in patients with failed revision of occluded previous TIPS

    Energy Technology Data Exchange (ETDEWEB)

    Seong, Chang Kyu; Kim, Yong Joo; Shin, Tae Beom; Park, Hyo Yong; Kim, Tae Hun; Kang, Duk Sik [Kyungpook National University School of Medicine, Daegu (Korea, Republic of)

    2001-12-01

    To determine the feasibility of transcaval transjugular intrahepatic portosystemic shunt (TIPS) in patients with occluded previous TIPS. Between February 1996 and December 2000 we performed five transcaval TIPS procedures in four patients with recurrent gastric cardiac variceal bleeding. All four had occluded TIPS, which was between the hepatic and portal vein. The interval between initial TIPS placement and revisional procedures with transcaval TIPS varied between three and 31 months; one patient underwent transcaval TIPS twice, with a 31-month interval. After revision of the occluded shunt failed, direct cavoportal puncture at the retrohepatic segment of the IVC was attempted. Transcaval TIPS placement was technically successful in all cases. In three, tractography revealed slight leakage of contrast materials into hepatic subcapsular or subdiaphragmatic pericaval space. There was no evidence of propagation of extravasated contrast materials through the retroperitoneal space or spillage into the peritoneal space. After the tract was dilated by a bare stent, no patient experienced trans-stent bleeding and no serious procedure-related complications occurred. After successful shunt creation, variceal bleeding ceased in all patients. Transcaval TIPS placement is an effective and safe alternative treatment in patients with occluded previous TIPS and no hepatic veins suitable for new TIPS.

  4. Surgical results of trabeculectomy and Ahmed valve implantation following a previous failed trabeculectomy in primary congenital glaucoma patients.

    Science.gov (United States)

    Lee, Naeun; Ma, Kyoung Tak; Bae, Hyoung Won; Hong, Samin; Seong, Gong Je; Hong, Young Jae; Kim, Chan Yun

    2015-04-01

    To compare the surgical results of trabeculectomy and Ahmed glaucoma valve implantation after a previous failed trabeculectomy. A retrospective comparative case series review was performed on 31 eye surgeries in 20 patients with primary congenital glaucoma who underwent trabeculectomy or Ahmed glaucoma valve implantation after a previous failed trabeculectomy with mitomycin C. The preoperative mean intraocular pressure was 25.5 mmHg in the trabeculectomy group and 26.9 mmHg in the Ahmed glaucoma valve implantation group (p = 0.73). The 48-month postoperative mean intraocular pressure was 19.6 mmHg in the trabeculectomy group and 20.2 mmHg in the Ahmed glaucoma valve implantation group (p = 0.95). The 12-month trabeculectomy success rate was 69%, compared with 64% for Ahmed glaucoma valve implantation, and the 48-month success rates were 42% and 36% for trabeculectomy and valve implantation, respectively. The success rates following the entire follow-up period were not significantly different between the two groups (p > 0.05 by log rank test). Postoperative complications occurred in 25% of the trabeculectomy-operated eyes and 9% of the Ahmed-implanted eyes (p = 0.38). There was no significant difference in surgical outcome between the trabeculectomy and Ahmed glaucoma valve implantation groups, neither of which had favorable results. However, the trabeculectomy group demonstrated a higher prevalence of adverse complications such as post-operative endophthalmitis.

  5. FAILED FUEL DISPOSITION STUDY

    International Nuclear Information System (INIS)

    THIELGES, J.R.

    2004-01-01

    In May 2004 alpha contamination was found on the lid of the pre-filter housing in the Sodium Removal Ion Exchange System during routine filter change. Subsequent investigation determined that the alpha contamination likely came from a fuel pin(s) contained in an Ident-69 (ID-69) type pin storage container serial number 9 (ID-69-9) that was washed in the Sodium Removal System (SRS) in January 2004. Because all evidence indicated that the wash water interacted with the fuel, this ID49 is designated as containing a failed fuel pin with gross cladding defect and was set aside in the Interim Examination and Maintenance (IEM) Cell until it could be determined how to proceed for long term dry storage of the fuel pin container. This ID49 contained fuel pins from the driver fuel assembly (DFA) 16392, which was identified as a Delayed Neutron Monitor (DNM) leaker assembly. However, this DFA was disassembled and the fuel pin that was thought to be the failed pin was encapsulated and was not located in this ID49 container. This failed fuel disposition study discusses two alternatives that could be used to address long term storage for the contents of ID-69-9. The first alternative evaluated utilizes the current method of identifying and storing DNM leaker fuel pin(s) in tubes and thus, verifying that the alpha contamination found in the SRS came from a failed pin in this pin container. This approach will require unloading selected fuel pins from the ID-69, visually examining and possibly weighing suspect fuel pins to identify the failed pin(s), inserting the failed pin(s) in storage tubes, and reloading the fuel pins into ID49 containers. Safety analysis must be performed to revise the 200 Area Interim Storage Area (ISA) Final Safety Analysis Report (FSAR) (Reference 1) for this fuel configuration. The second alternative considered is to store the failed fuel as-is in the ID-69. This was evaluated to determine if this approach would comply with storage requirements. This

  6. FAILED FUEL DISPOSITION STUDY

    Energy Technology Data Exchange (ETDEWEB)

    THIELGES, J.R.

    2004-12-20

    In May 2004 alpha contamination was found on the lid of the pre-filter housing in the Sodium Removal Ion Exchange System during routine filter change. Subsequent investigation determined that the alpha contamination likely came from a fuel pin(s) contained in an Ident-69 (ID-69) type pin storage container serial number 9 (ID-69-9) that was washed in the Sodium Removal System (SRS) in January 2004. Because all evidence indicated that the wash water interacted with the fuel, this ID49 is designated as containing a failed fuel pin with gross cladding defect and was set aside in the Interim Examination and Maintenance (IEM) Cell until it could be determined how to proceed for long term dry storage of the fuel pin container. This ID49 contained fuel pins from the driver fuel assembly (DFA) 16392, which was identified as a Delayed Neutron Monitor (DNM) leaker assembly. However, this DFA was disassembled and the fuel pin that was thought to be the failed pin was encapsulated and was not located in this ID49 container. This failed fuel disposition study discusses two alternatives that could be used to address long term storage for the contents of ID-69-9. The first alternative evaluated utilizes the current method of identifying and storing DNM leaker fuel pin(s) in tubes and thus, verifying that the alpha contamination found in the SRS came from a failed pin in this pin container. This approach will require unloading selected fuel pins from the ID-69, visually examining and possibly weighing suspect fuel pins to identify the failed pin(s), inserting the failed pin(s) in storage tubes, and reloading the fuel pins into ID49 containers. Safety analysis must be performed to revise the 200 Area Interim Storage Area (ISA) Final Safety Analysis Report (FSAR) (Reference 1) for this fuel configuration. The second alternative considered is to store the failed fuel as-is in the ID-69. This was evaluated to determine if this approach would comply with storage requirements. This

  7. A rare case of failed healing in previously burned skin after a secondary burns.

    Science.gov (United States)

    Goldie, Stephen J; Parsons, Shaun; Menezes, Hana; Ives, Andrew; Cleland, Heather

    2017-01-01

    Patients presenting with large surface area burns are common in our practice; however, patients with a secondary large burn on pre-existing burn scars and grafts are rare and not reported. We report on an unusual case of a patient sustaining a secondary large burn to areas previously injured by a burn from a different mechanism. We discuss the potential implications when managing a case like this and suggest potential biological reasons why the skin may behave differently. Our patient was a 33-year-old man who presented with a 5% TBSA burn on skin scarred by a previous 40% total body surface area (TBSA) burn and skin grafts. Initially assessed as superficial partial thickness in depth, the wounds were treated conservatively with dressings; however, they failed to heal and became infected requiring surgical management. Burns sustained in areas of previous burn scars and grafts may behave differently to normal patterns of healing, requiring more aggressive management and surgical intervention at an early stage.

  8. Revision allograft reconstruction of the lateral collateral ligament complex in elbows with previous failed reconstruction and persistent posterolateral rotatory instability.

    Science.gov (United States)

    Baghdadi, Yaser M K; Morrey, Bernard F; O'Driscoll, Shawn W; Steinmann, Scott P; Sanchez-Sotelo, Joaquin

    2014-07-01

    Primary reconstruction of the lateral collateral ligament complex (LCLC) using graft tissue restores elbow stability in many, but not all, elbows with acute or chronic posterolateral rotatory instability (PLRI). Revision reconstruction using a tendon allograft is occasionally considered for persistent PLRI, but the outcome of revision ligament reconstruction in this setting is largely unknown. We determined whether revision allograft ligament reconstruction can (1) restore the stability and (2) result in improved elbow scores for patients with persistent PLRI of the elbow after a previous failed primary reconstructive attempt and in the context of the diverse pathology being addressed. Between 2001 and 2011, 160 surgical elbow procedures were performed at our institution for the LCLC reconstruction using allograft tissue. Only patients undergoing revision allograft reconstruction of the LCLC for persistent PLRI with a previous failed primary reconstructive attempt using graft tissue and at least I year of followup were included in the study. Eleven patients (11 elbows) fulfilled our inclusion criteria and formed our study cohort. The cohort consisted of six female patients and five male patients. The mean age at the time of revision surgery was 36 years (range, 14-59 years). The revision allograft reconstruction was carried out after a mean of 3 years (range, 2.5 months to 9 years) from a failed attempted reconstruction of the LCLC. Osseous deficiency to some extent was identified in the preoperative radiographs of eight elbows. Mean followup was 5 years (range, 1-12 years). Revision allograft reconstruction of the LCLC restored elbow stability in eight of the 11 elbows; two of the three elbows with persistent instability were operated on a third time (at 6 and 7 months after allograft revision reconstruction). For elbows with no persistent instability, the mean Mayo Elbow Performance Score at most recent followup was 83 points (range, 60-100 points), and

  9. Design study and comparative evaluation of JSFR failed fuel detection system

    Energy Technology Data Exchange (ETDEWEB)

    Aizawa, K.; Chikazawa, Y.; Ishikawa, N. [Japan Atomic Energy Agency JAEA, 4002 Narita, Oarai, Higashi-ibaraki-gun, Ibaraki 311-1393 (Japan); Kubo, S. [Japan Atomic Power Company JAPC (Japan); Okazaki, H.; Mito, M. [Mitsubishi FBR Systems, Inc. MFBR (Japan); Tozawa, K. [Fuji Electric Co., Ltd. (Japan); Hayashi, M. [MitsubishiElectric Corporation (Japan)

    2012-07-01

    A conceptual design study of an advanced sodium-cooled fast reactor JSFR has progressed in the 'Fast Reactor Cycle Technology Development (FaCT) 'project in Japan. JSFR has two failed fuel detection systems in the core. One is a failed fuel detection (FFD) system which continuously monitors a fission product from failed fuel subassembly. The other is a failed fuel detection and location (FFDL) system which locates when it receives signals from FFD. The FFD system consists of a FFD-DN which detects delayed neutron (DN) in sodium and a FFD-CG which detects fission products in the cover gas of the reactor vessel. In this study, requirements to the FFD-DN and the FFD-DN design to meet the requirements were investigated for the commercial and demonstration JSFR. In the commercial JSFR, a sampling type FFD which collects sodium from the reactor vessel by sampling lines for DN detectors was adopted. The performances have been investigated and confirmed by a fluid analysis in the reactor upper plenum. In the demonstration JSFR, the performance of DN detectors installed on the primary cold-leg piping has been confirmed. For the FFDL systems, experiences in the previous fast reactors and the R and D of FFDL system for JSFR were investigated. This study focuses on the Selector-Valve and the Tagging-Gas FFDL systems. Operation experiences of the Selector-valve FFDL system were accumulated in PFR and Phenix. Tagging-gas system experiences were accumulated in EBR-II and FFTF. The feasibility of both FFDL systems for JSFR was evaluated. (authors)

  10. Outcome of the use of tension-free vaginal tape in women with mixed urinary incontinence, previous failed surgery, or low valsalva pressure.

    Science.gov (United States)

    Abdel-Hady, El-Said; Constantine, Glyn

    2005-02-01

    To assess the safety and efficacy of the use of tension-free vaginal tape (TVT) for the treatment of stress urinary incontinence (SUI) in women with mixed incontinence, previous failed incontinence surgery or low valsalva leak point pressure (VLPP). Six hundred and fifty-eight women with SUI underwent the TVT procedure. These included women with mixed stress and urge incontinence (n=128), previous surgery for SUI (n=118), low VLPP (n=80), and those over 70 years old (n=68). The procedure was carried out under spinal anesthetic and operative and immediate postoperative data was collected for all women. Six-month follow-up data was available on 454 women, with the first 300 women completing a quality of life (QOL) questionnaire before and after surgery. The overall subjective cure rate at 6 months was 91%, with 8% of women reporting significant (>50%) improvement in their symptoms. Subgroups with a body mass index > 30, age > 70 years, coexisting instability, previous failed surgery, and low VLPP showed cure rates of 81-89%. QOL improvements for all groups were highly significant. Significant complications included voiding difficulties in 29 women (4.4%), retropubic hematomas in four (0.6%), and thromboembolic episodes in three (0.5%). The simplicity and high efficacy of the TVT makes it the first choice for the treatment of women with SUI, including those with more complex problems or coexisting risk factors.

  11. Does previous failed ESWL have a negative impact of on the outcome of ureterorenoscopy? A matched pair analysis.

    Science.gov (United States)

    Philippou, Prodromos; Payne, David; Davenport, Kim; Timoney, Anthony G; Keeley, Francis X

    2013-11-01

    This study aims to evaluate the outcome of ureteroscopy/ureterorenoscopy (URS) as a salvage procedure for stones resistant to extracorporeal shock wave lithotripsy (ESWL). Between January 2009 and January 2012, 313 patients with upper tract lithiasis were treated by URS. Among them, 87 (27.8 %) had undergone URS after prior ESWL failed to achieve stone clearance (Salvage group). These patients were matched with a group of patients who underwent URS as first-line modality (Primary group). Stone-free rates and adjuvant procedures represented the primary points for comparison. Secondary points for comparison included complications, procedure duration, total laser energy used and length of hospitalization. Matching was possible in all cases. Stone clearance rates were 73.6 and 82.8 % for the Salvage and Primary group, respectively. The difference in stone clearance rates between the two groups was not statistically significant (p = 0.186). A total of 11 patients (12.6 %) in the Primary group and 18 patients (20.7 %) in the Salvage group underwent an adjuvant procedure (p = 0.154). No statistically significant differences were noted in terms of complications, procedure duration and length of hospitalization. In the Primary group, the laser energy used for stone fragmentation was higher (p = 0.043). The rate of ureteric stenting at the end of the procedure was higher for the Salvage group (p = 0.030). Previous failed ESWL is not a predictor for unfavorable outcome of URS. Salvage URS is associated, however, with an increased need for ureteric stenting at the end of the procedure.

  12. Retreatment with sofosbuvir/velpatasvir in cirrhotic patients with genotype-4 who failed a previous interferon-free regimen: a case series.

    Science.gov (United States)

    Boglione, Lucio; Pinna, Simone Mornese; Lupia, Tommaso; Cariti, Giuseppe; Di Perri, Giovanni

    2018-02-14

    The novel available interferon (IFN)-free regimens significantly improved the sustained virological response (SVR) in patients with chronic hepatitis C (CHC), without important side effects and with shorter duration of treatment. In a subset of patients, however, the treatment failure (TF) was due to the presence of resistance-associated substitutions (RAS) that lead to virological breakthrough (BT) or relapse. We analysed in this case series the role of RAS on the TF in cirrhotic patients with genotype (GT)4, treated with a previous IFN-free regimen, and retreated with the combination of sofosbuvir (SOF)/velpatasvir (VEL) for 12 or 24 weeks, without ribavirin (RBV). We included in this analysis all patients with GT4 who failed a previous IFN-free treatment, with the presence of RAS at BT or relapse. All patients were retreated with a fixed combination of SOF/VEL for 12/24 weeks, without RBV. We evaluated the SVR and the MELD score change after the treatment. Seven patients were described. All were cirrhotic, Child-Pugh A (n=5), B (n=2); baseline RAS were detected in 4/7 subjects; at post-treatment detection, NS5 RAS were: F28S (n=1), Q30K (n=2), S30G (n=1), NS3 were: S122R (n=1), S122G (n=2), D168V (n=3). All retreated patients gained SVR. MELD score improved in all subjects with a median change of 3 points. No significant side effects or adverse events were reported. The combination SOF/VEL could be considered for the retreatment of cirrhotic GT4 patients who failed a previous IFN-free treatment with the presence of RAS in NS3 or NS5 regions.

  13. Retreatment with sofosbuvir/velpatasvir in cirrhotic patients with genotype 4 who failed a previous interferon-free regimen: a case series.

    Science.gov (United States)

    Boglione, Lucio; Pinna, Simone Mornese; Lupia, Tommaso; Cariti, Giuseppe; Di Perri, Giovanni

    2018-02-14

    The novel available interferon (IFN)-free regimens significantly improved the sustained virological response (SVR) in patients with chronic hepatitis C (CHC), without important side-effects and with shorter duration of treatment. In a subset of patients, however, the treatment failure (TF) was due to the presence of resistance-associated substitutions (RAS) that lead to virological breakthrough (BT) or relapse. We analyzed in this case-series the role of RAS on the TF in cirrhotic patients with GT4, treated with a previous IFN-free regimen, and retreated with the combination of sofosbuvir (SOF)/velpatasvir (VEL) for 12 or 24 weeks, without ribavirin (RBV). We included in this analysis all patients with GT4 who failed a previous IFN-free treatment, with the presence of RAS at BT or relapse. All patients were retreated with a fixed combination of SOF/VEL for 12/24 weeks, without RBV. We evaluated the SVR and the MELD score change after the treatment. Seven patients were described. All were cirrhotic, Child-Pug A (n=5), B (n=2); baseline RAS were detected in 4/7 subjects; at post-treatment detection, NS5 RAS were: F28S (n=1), Q30K (n=2), S30G (n=1), NS3 were: S122R (n=1), S122G (n=2), D168V (n=3). All retreated patients gained the SVR. MELD score improved in all subjects with a median change of 3 points. No significant side-effects or adverse events were reported. The combination SOF/VEL could be considered for the retreatment of cirrhotic GT4 patients who failed a previous IFN-free treatment with the presence of RAS in NS3 or NS5 regions.

  14. Survival Prediction in Patients Undergoing Open-Heart Mitral Valve Operation After Previous Failed MitraClip Procedures.

    Science.gov (United States)

    Geidel, Stephan; Wohlmuth, Peter; Schmoeckel, Michael

    2016-03-01

    The objective of this study was to analyze the results of open heart mitral valve operations for survival prediction in patients with previously unsuccessful MitraClip procedures. Thirty-three consecutive patients who underwent mitral valve surgery in our institution were studied. At a median of 41 days, they had previously undergone one to five futile MitraClip implantations. At the time of their operations, patients were 72.6 ± 10.3 years old, and the calculated risk, using the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II, was a median of 26.5%. Individual outcomes were recorded, and all patients were monitored postoperatively. Thirty-day mortality was 9.1%, and the overall survival at 2.2 years was 60.6%. Seven cardiac-related and six noncardiac deaths occurred. Univariate survival regression models demonstrated a significant influence of the following variables on survival: EuroSCORE II (p = 0.0022), preoperative left ventricular end-diastolic dimension (p = 0.0052), left ventricular ejection fraction (p = 0.0249), coronary artery disease (p = 0.0385), and severe pulmonary hypertension (p = 0.0431). Survivors showed considerable improvements in their New York Heart Association class (p < 0.0001), left ventricular ejection fraction (p = 0.0080), grade of mitral regurgitation (p = 0.0350), and mitral valve area (p = 0.0486). Survival after mitral repair was not superior to survival after replacement. Indications for surgery after failed MitraClip procedures must be considered with the greatest of care. Variables predicting postoperative survival should be taken into account regarding the difficult decision as to whether to operate or not. Our data suggest that replacement of the pretreated mitral valve is probably the more reasonable concept rather than complex repairs. When the EuroSCORE II at the time of surgery exceeds 30%, conservative therapy is advisable. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc

  15. Five-year efficacy and safety of tenofovir-based salvage therapy for patients with chronic hepatitis B who previously failed LAM/ADV therapy.

    Science.gov (United States)

    Lim, Lucy; Thompson, Alexander; Patterson, Scott; George, Jacob; Strasser, Simone; Lee, Alice; Sievert, William; Nicoll, Amanda; Desmond, Paul; Roberts, Stuart; Marion, Kaye; Bowden, Scott; Locarnini, Stephen; Angus, Peter

    2017-06-01

    Multidrug-resistant HBV continues to be an important clinical problem. The TDF-109 study demonstrated that TDF±LAM is an effective salvage therapy through 96 weeks for LAM-resistant patients who previously failed ADV add-on or switch therapy. We evaluated the 5-year efficacy and safety outcomes in patients receiving long-term TDF±LAM in the TDF-109 study. A total of 59 patients completed the first phase of the TDF-109 study and 54/59 were rolled over into a long-term prospective open-label study of TDF±LAM 300 mg daily. Results are reported at the end of year 5 of treatment. At year 5, 75% (45/59) had achieved viral suppression by intent-to-treat analysis. Per-protocol assessment revealed 83% (45/54) were HBV DNA undetectable. Nine patients remained HBV DNA detectable, however 8/9 had very low HBV DNA levels (<264IU/mL) and did not meet virological criteria for virological breakthrough (VBT). One patient experienced VBT, but this was in the setting of documented non-compliance. The response was independent of baseline LAM therapy or mutations conferring ADV resistance. Four patients discontinued TDF, one patient was lost to follow-up and one died from hepatocellular carcinoma. Long-term TDF treatment appears to be safe and effective in patients with prior failure of LAM and a suboptimal response to ADV therapy. These findings confirm that TDF has a high genetic barrier to resistance is active against multidrug-resistant HBV, and should be the preferred oral anti-HBV agent in CHB patients who fail treatment with LAM and ADV. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Enhanced Morbidity of Pectoralis Major Myocutaneous Flap Used for Salvage after Previously Failed Oncological Treatment and Unsuccessful Reconstructive Head and Neck Surgery

    Directory of Open Access Journals (Sweden)

    Christiana Maria Ribeiro Salles Vanni

    2012-01-01

    Full Text Available Introduction. The reconstruction of complex cervicofacial defects arising from surgical treatment for cancer is a real challenge for head and neck surgeons, especially in salvage reconstruction surgery and/or failed previous reconstruction. The pectoralis major myocutaneous flap (PMMF has been widely used in these specific situations due to its reliability and low rate of failure or complications. Objectives. Identify factors that determine complications and influence the final outcome of the reconstructions with PMMF in salvage cancer surgery or in salvage reconstruction. Methods. A cross-sectional study design was used to evaluate a sample including 17 surgical patients treated over a period of ten years that met the inclusion criteria. Results. Reconstruction was successful in 13 cases (76.5%, with two cases of partial flap loss and no case of total loss. Complications occurred in 13 cases (76.5% and were specifically related to the flap in nine instances (52.9%. An association was identified between the development of major complications and reconstruction of the hypopharynx (=0.013 as well as in patients submitted to surgery in association with radiation therapy as a previous cancer treatment (=0.002. The former condition is also associated with major reconstruction failure (=0.018. An even lower incidence of major complications was noted in patients under the age of 53 (=0.044. Conclusion. Older patients, with hypopharyngeal defects and submitted to previous surgery plus radiation therapy, presented a higher risk of complications and reconstruction failure with PMMF.

  17. In Vitro Fertilization Outcomes After Placement of Essure Microinserts in Patients With Hydrosalpinges Who Previously Failed In Vitro Fertilization Treatment: A Multicenter Study.

    Science.gov (United States)

    Cohen, Shlomo B; Bouaziz, Jerome; Schiff, Eyal; Simon, Alexander; Nadjary, Michel; Goldenberg, Mordechai; Orvieto, Raoul; Revel, Ariel

    2016-01-01

    To investigate whether hysteroscopic proximal tubal occlusion with Essure microinserts (Conceptus Inc.; Bayer, AG, North Rhine-Westphalia, Germany) can improve pregnancy rates in patients with hydrosalpinges who had failed in vitro fertilization (IVF) treatment. A prospective cohort study. University-affiliated tertiary centers. Twenty-four consecutive women with hydrosalpinges who had failed IVF treatment were included. Hysteroscopic placement of Essure microinserts for hydrosalpinx blockage followed by IVF treatment. Ongoing pregnancy and live birth rates were recorded. Of the 24 patients undergoing a total of 42 IVF cycles after Essure insertion, 18 (75% of patients and 42.8% of IVF cycle attempts) conceived and 16 delivered live births (66.6% of patients and 38.1% of IVF cycle attempts). Hysteroscopic proximal occlusion of hydrosalpinges with Essure microinserts is a valuable alternative to laparoscopic salpingectomy, resulting in reasonable pregnancy rates. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

  18. Effect of a supplementation with myo-inositol plus melatonin on oocyte quality in women who failed to conceive in previous in vitro fertilization cycles for poor oocyte quality: a prospective, longitudinal, cohort study.

    Science.gov (United States)

    Unfer, Vittorio; Raffone, Emanuela; Rizzo, Piero; Buffo, Silvia

    2011-11-01

    Several factors can affect oocyte quality and therefore pregnancy outcome in assisted reproductive technology (ART) cycles. Recently, a number of studies have shown that the presence of several compounds in the follicular fluid positively correlates with oocyte quality and maturation (i.e., myo-inositol and melatonin). In the present study, we aim to evaluate the pregnancy outcomes after the administration of myo-inositol combined with melatonin in women who failed to conceive in previous in vitro fertilization (IVF) cycles due to poor oocyte quality. Forty-six women were treated with 4 g/day myo-inositol and 3 mg/day melatonin (inofolic® and inofolic® Plus, Lo.Lipharma, Rome) for 3 months and then underwent a new IVF cycle. After treatment, the number of mature oocytes, the fertilization rate, the number of both, total and top-quality embryos transferred were statistically higher compared to the previous IVF cycle, while there was no difference in the number of retrieved oocyte. After treatment, a total of 13 pregnancies occurred, 9 of them were confirmed echographically; four evolved in spontaneous abortion. The treatment with myo-inositol and melatonin improves ovarian stimulation protocols and pregnancy outcomes in infertile women with poor oocyte quality.

  19. Laparoscopic revision of failed antireflux operations.

    Science.gov (United States)

    Serafini, F M; Bloomston, M; Zervos, E; Muench, J; Albrink, M H; Murr, M; Rosemurgy, A S

    2001-01-01

    A small number of patients fail fundoplication and require reoperation. Laparoscopic techniques have been applied to reoperative fundoplications. We reviewed our experience with reoperative laparoscopic fundoplication. Reoperative laparoscopic fundoplication was undertaken in 28 patients, 19 F and 9 M, of mean age 56 years +/- 12. Previous antireflux procedures included 19 open and 12 laparoscopic antireflux operations. Symptoms were heartburn (90%), dysphagia (35%), and atypical symptoms (30%%). The mean interval from antireflux procedure to revision was 13 months +/- 4.2. The mean DeMeester score was 78+/-32 (normal 14.7). Eighteen patients (64%) had hiatal breakdown, 17 (60%) had wrap failure, 2 (7%) had slipped Nissen, 3 (11%) had paraesophageal hernias, and 1 (3%) had an excessively tight wrap. Twenty-five revisions were completed laparoscopically, while 3 patients required conversion to the open technique. Complications occurred in 9 of 17 (53%) patients failing previous open fundoplications and in 4 of 12 patients (33%) failing previous laparoscopic fundoplications and included 15 gastrotomies and 1 esophagotomy, all repaired laparoscopically, 3 postoperative gastric leaks, and 4 pneumothoraces requiring tube thoracostomy. No deaths occurred. Median length of stay was 5 days (range 2-90 days). At a mean follow-up of 20 months +/- 17, 2 patients (7%) have failed revision of their fundoplications, with the rest of the patients being essentially asymptomatic (93%). The results achieved with reoperative laparoscopic fundoplication are similar to those of primary laparoscopic fundoplications. Laparoscopic reoperations, particularly of primary open fundoplication, can be technically challenging and fraught with complications. Copyright 2001 Academic Press.

  20. Impulsivity moderates the relationship between previous quit failure and cue-induced craving.

    Science.gov (United States)

    Erblich, Joel; Michalowski, Alexandra

    2015-12-01

    Poor inhibitory control has been shown to be an important predictor of relapse to a number of drugs, including nicotine. Indeed, smokers who exhibit higher levels of impulsivity are thought to have impaired regulation of urges to smoke, and previous research has suggested that impulsivity may moderate cue-induced cigarette cravings. To that end, we conducted a study to evaluate the interplay between failed smoking cessation, cue-induced craving, and impulsivity. Current smokers (n=151) rated their cigarette cravings before and after laboratory to exposure to smoking cues, and completed questionnaires assessing impulsivity and previous failed quit attempts. Findings indicated that shorter duration of previous failed quit attempts was related to higher cue-induced cigarette craving, especially among smokers with higher levels of impulsivity. Results underscore the importance of considering trait impulsivity as a factor in better understanding the management of cue-induced cravings. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Completion pancreatectomy and islet cell autotransplantation as salvage therapy for patients failing previous operative interventions for chronic pancreatitis.

    Science.gov (United States)

    Wilson, Gregory C; Sutton, Jeffrey M; Smith, Milton T; Schmulewitz, Nathan; Salehi, Marzieh; Choe, Kyuran A; Levinsky, Nick C; Brunner, John E; Abbott, Daniel E; Sussman, Jeffrey J; Edwards, Michael J; Ahmad, Syed A

    2015-10-01

    Traditional decompressive and/or pancreatic resection procedures have been the cornerstone of operative therapy for refractory abdominal pain secondary to chronic pancreatitis. Management of patients that fail these traditional interventions represents a clinical dilemma. Salvage therapy with completion pancreatectomy and islet cell autotransplantation (CPIAT) is an emerging treatment option for this patient population; however, outcomes after this procedure have not been well-studied. All patients undergoing CPIAT after previous decompressive and/or pancreatic resection for the treatment of chronic pancreatitis at our institution were identified for inclusion in this single-center observational study. Study end points included islet yield, narcotic requirements, glycemic control, and quality of life (QOL). QOL was assessed using the Short Form (SF)-36 health questionnaire. Sixty-four patients underwent CPIAT as salvage therapy. The median age at time of CPIAT was 38 years (interquartile range [IQR], 14.7-65.4). The most common etiology of chronic pancreatitis was idiopathic pancreatitis (66%; n = 42) followed by genetically linked pancreatitis (9%; n = 6) and alcoholic pancreatitis (8%; n = 5). All of these patients had previously undergone prior limited pancreatic resection or decompressive procedure. The majority of patients (50%; n = 32) underwent prior pancreaticoduodenectomy, whereas the remainder had undergone distal pancreatectomy (17%; n = 11), Frey (13%; n = 8), Puestow (13%; n = 8), or Berne (8%; n = 5) procedures. Median time from initial surgical intervention to CPIAT was 28.1 months (IQR, 13.6-43.0). All of these patients underwent a successful CPIAT. Mean operative time was 502.2 minutes with average hospital duration of stay of 13 days. Islet cell isolation was feasible despite previous procedures with a mean islet yield of 331,304 islet cell equivalents, which totaled an islet cell autotransplantation of 4,737 ± 492 IEQ/kg body weight. Median

  2. Failing Failed States

    DEFF Research Database (Denmark)

    Holm, Hans-Henrik

    2002-01-01

    coverage. A Danish survey of newsrooms shows that the national world-view and prevalent news criteria prevent consistent coverage. It is argued that politicians are the ones who determine national agendas: it is from political initiatives, rather than media coverage, that failing states and humanitarian......When states are failing, when basic state functions are no longer carried out, and when people have no security, humanitarian crises erupt. In confronting this problem, the stronger states have followed an ad hoc policy of intervention and aid. In some cases, humanitarian disasters have resulted...... from inaction. Often, the media are blamed. Politicians complain about the media when they interfere (the CNN effect), and when they do not. This article looks at how the media do cover failing states. Sierra Leone and Congo are used as examples. The analysis shows that there is little independent...

  3. Automatic electromagnetic valve for previous vacuum

    International Nuclear Information System (INIS)

    Granados, C. E.; Martin, F.

    1959-01-01

    A valve which permits the maintenance of an installation vacuum when electric current fails is described. It also lets the air in the previous vacuum bomb to prevent the oil ascending in the vacuum tubes. (Author)

  4. Measuring motivation using the transtheoretical (stages of change) model: A follow-up study of people who failed an online hearing screening.

    Science.gov (United States)

    Ingo, Elisabeth; Brännström, K Jonas; Andersson, Gerhard; Lunner, Thomas; Laplante-Lévesque, Ariane

    2016-07-01

    Acceptance and readiness to seek professional help have shown to be important factors for favourable audiological rehabilitation outcomes. Theories from health psychology such as the transtheoretical (stages-of-change) model could help understand behavioural change in people with hearing impairment. In recent studies, the University of Rhode Island change assessment (URICA) has been found to have good predictive validity. In a previous study, 224 Swedish adults who had failed an online hearing screening completed URICA and two other measures of stages of change. This follow-up aimed to: (1) determine prevalence of help-seeking at a hearing clinic and hearing aid uptake, and (2) explore the predictive validity of the stages of change measures by a follow-up on the 224 participants who had failed a hearing screening 18 months previously. A total of 122 people (54%) completed the follow-up online questionnaire, including the three measures and questions regarding experience with hearing help-seeking and hearing aid uptake. Since failing the online hearing screening, 61% of participants had sought help. A good predictive validity for a one-item measure of stages of change was reported. The Staging algorithm was the stages of change measure with the best ability to predict help-seeking 18 months later.

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

    Directory of Open Access Journals (Sweden)

    Rashad MA

    2012-12-01

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

  6. Peroral endoscopic remyotomy for failed Heller myotomy: a prospective single-center study.

    Science.gov (United States)

    Zhou, P H; Li, Q L; Yao, L Q; Xu, M D; Chen, W F; Cai, M Y; Hu, J W; Li, L; Zhang, Y Q; Zhong, Y S; Ma, L L; Qin, W Z; Cui, Z

    2013-01-01

    Recurrence/persistence of symptoms occurs in approximately 20 % of patients after Heller myotomy for achalasia. Controversy exists regarding the therapy for patients in whom Heller myotomy has failed. The aim of the current study was to evaluate the efficacy and feasibility of peroral endoscopic myotomy (POEM), a new endoscopic myotomy technique, for patients with failed Heller myotomy. A total of 12 patients with recurrence/persistence of symptoms after Heller myotomy, as diagnosed by established methods and an Eckardt score of ≥ 4, were prospectively included. The primary outcome was symptom relief during follow-up, defined as an Eckardt score of ≤ 3. Secondary outcomes were procedure-related adverse events, lower esophageal sphincter (LES) pressure on manometry, reflux symptoms, and medication use before and after POEM. All 12 patients underwent successful POEM after a mean of 11.9 years (range 2 - 38 years) from the time of the primary Heller myotomy. No serious complications related to POEM were encountered. During a mean follow-up period of 10.4 months (range 5 - 14 months), treatment success was achieved in 11/12 patients (91.7 %; mean score pre- vs. post-treatment 9.2 vs. 1.3; P Heller myotomy resulting in short-term symptom relief in > 90 % of cases. Previous Heller myotomy may make subsequent endoscopic remyotomy more challenging, but does not prevent successful POEM. © Georg Thieme Verlag KG Stuttgart · New York.

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

    Science.gov (United States)

    Langenau, Erik E; Sandella, Jeanne M

    2011-07-01

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

  8. Identifying Demographic and Academic Issues that Influence the Passing or Failing of the Physiology Course in the Medicine Study Program of UCIMED (University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Juan Carlos Vanegas-Pissa

    2015-05-01

    Full Text Available (This paper, product of a research project, analyzes some academic and demographic issues that might influence students passing or failing Physiology in the Licentiate Study Program in Medicine and Surgery at UCIMED (University of Medical Sciences between 2008 and 2011. This was a retrospective cohort study. We analyzed the grades obtained by the students who were taking Physiology for the first, second or third time during the research period, the semesters in which the grades were obtained, who passed or failed the course, their sociodemographic characteristics, and other courses passed or failed previously with their corresponding grades. For the data analysis, we used the Stata 13 software (Data Analysis and Statistical Software with a logistic regression model to determine the variables, which explain the passing or failing of the Physiology course. The results showed that the variables with a greater effect on the probability of p

  9. When the science fails and the ethics works: 'Fail-safe' ethics in the FEM-PrEP study.

    Science.gov (United States)

    Kingori, Patricia

    2015-12-01

    This paper will explore the concept of 'fail safe' ethics in the FEM PrEP trial, and the practice of research and ethics on the ground. FEM-PrEP examined the efficacy of PrEP in African women after promising outcomes in research conducted with MSM. This was a hugely optimistic time and FEM-PrEP was mobilised using rights-based ethical arguments that women should have access to PrEP. This paper will present data collected during an ethnographic study of frontline research workers involved in FEM-PrEP. During our discussions, 'fail-safe' ethics emerged as concept that encapsulated their confidence that their ethics could not fail. However, in 2011, FEM-PrEP was halted and deemed a failure. The women involved in the study were held responsible because contrary to researcher's expectations they were not taking the oral PrEP being researched. This examination of FEM-PrEP will show that ethical arguments are increasingly deployed to mobilise, maintain and in some cases stop trials in ways which, at times, are superseded or co-opted by other interests. While promoting the interests of women, rights-based approaches are argued to indirectly justify the continuation of individualised, biomedical interventions which have been problematic in other women-centred trials. In this examination of FEM-PrEP, the rights-based approach obscured: ethical concerns beyond access to PrEP; the complexities of power relationships between donor and host countries; the operations of the HIV industry in research-saturated areas and the cumulative effect of unfilled expectations in HIV research and how this has shaped ideas of research and ethics.

  10. Impact of previous virological treatment failures and adherence on the outcome of antiretroviral therapy in 2007.

    Directory of Open Access Journals (Sweden)

    Marie Ballif

    Full Text Available BACKGROUND: Combination antiretroviral treatment (cART has been very successful, especially among selected patients in clinical trials. The aim of this study was to describe outcomes of cART on the population level in a large national cohort. METHODS: Characteristics of participants of the Swiss HIV Cohort Study on stable cART at two semiannual visits in 2007 were analyzed with respect to era of treatment initiation, number of previous virologically failed regimens and self reported adherence. Starting ART in the mono/dual era before HIV-1 RNA assays became available was counted as one failed regimen. Logistic regression was used to identify risk factors for virological failure between the two consecutive visits. RESULTS: Of 4541 patients 31.2% and 68.8% had initiated therapy in the mono/dual and cART era, respectively, and been on treatment for a median of 11.7 vs. 5.7 years. At visit 1 in 2007, the mean number of previous failed regimens was 3.2 vs. 0.5 and the viral load was undetectable (4 previous failures compared to 1 were 0.9 (95% CI 0.4-1.7, 0.8 (0.4-1.6, 1.6 (0.8-3.2, 3.3 (1.7-6.6 respectively, and 2.3 (1.1-4.8 for >2 missed cART doses during the last month, compared to perfect adherence. From the cART era, odds ratios with a history of 1, 2 and >2 previous failures compared to none were 1.8 (95% CI 1.3-2.5, 2.8 (1.7-4.5 and 7.8 (4.5-13.5, respectively, and 2.8 (1.6-4.8 for >2 missed cART doses during the last month, compared to perfect adherence. CONCLUSIONS: A higher number of previous virologically failed regimens, and imperfect adherence to therapy were independent predictors of imminent virological failure.

  11. Dams designed to fail

    Energy Technology Data Exchange (ETDEWEB)

    Penman, A. [Geotechnical Engineering Consultants, Harpenden (United Kingdom)

    2004-09-01

    New developments in geotechnical engineering have led to methods for designing and constructing safe embankment dams. Failed dams can be categorized as those designed to fail, and those that have failed unexpectedly. This presentation outlined 3 dam failures: the 61 m high Malpasset Dam in France in 1959 which killed 421; the 71 m high Baldwin Hills Dam in the United States in 1963 which killed 5; and, the Vajont Dam in Italy in 1963 which killed 2,600 people. Following these incidents, the International Commission for Large Dams (ICOLD) reviewed regulations on reservoir safety. The 3 dams were found to have inadequate spillways and their failures were due to faults in their design. Fuse plug spillways, which address this problem, are designed to fail if an existing spillway proves inadequate. They allow additional discharge to prevent overtopping of the embankment dam. This solution can only be used if there is an adjacent valley to take the additional discharge. Examples of fuse gates were presented along with their effect on dam safety. A research program is currently underway in Norway in which high embankment dams are being studied for overtopping failure and failure due to internal erosion. Internal erosion has been the main reason why dams have failed unexpectedly. To prevent failures, designers suggested the use of a clay blanket placed under the upstream shoulder. However, for dams with soft clay cores, these underblankets could provide a route for a slip surface and that could lead to failure of the upstream shoulder. It was concluded that a safe arrangement for embankment dams includes the use of tipping gates or overturning gates which always fail at a required flood water level. Many have been installed in old and new dams around the world. 14 refs., 19 figs.

  12. Failed Replication of Oxytocin Effects on Trust: The Envelope Task Case.

    Directory of Open Access Journals (Sweden)

    Anthony Lane

    Full Text Available The neurohormone Oxytocin (OT has been one of the most studied peptides in behavioral sciences over the past two decades. Many studies have suggested that OT could increase trusting behaviors. A previous study, based on the "Envelope Task" paradigm, where trust is assessed by the degree of openness of an envelope containing participant's confidential information, showed that OT increases trusting behavior and reported one of the most powerful effects of OT on a behavioral variable. In this paper we present two failed replications of this effect, despite sufficient power to replicate the original large effect. The non-significant results of these two failed replications clearly exclude a large effect of OT on trust in this paradigm but are compatible with either a null effect of OT on trust, or a small effect, undetectable with small sample size (N = 95 and 61 in Study 1 and 2, respectively. Taken together, our results question the purported size of OT's effect on trust and emphasize the need for replications.

  13. Why fish oil fails: a comprehensive 21st century lipids-based physiologic analysis.

    Science.gov (United States)

    Peskin, B S

    2014-01-01

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

  14. Value of the Gd-DTPA contrast enhanced MR in patients with failed back surgery syndrome

    International Nuclear Information System (INIS)

    Paprzycki, W.; Gradzki, J.; Sosnowski, P.; Stajgis, M.

    1994-01-01

    Gd-DTPA contrast - enhanced MR enables differentiation between postoperative scar and recurrent prolapse of nucleus pulposus (RPNP). Pre- and post-contrast MR studies in 40 patients with failed back surgery syndrome, previously treated surgically on 54 intervertebral levels, were evaluated. Presence of RPNP was confirmed on 4, postoperative scars on 35 and both condition on 15 invertebral levels. Correct interpretation of pathologic changes on 15 invertebral levels (28%) was only possible after contrast enhancement. Contrast enhancement of scar excluded the diagnosis of coexistence of RPNP and scar, based on pre-contrast MR studies. MR with Gd-DTPA contrast enhancement is the best diagnostic method in patients with failed back surgery syndrome (author)

  15. Long-term outcome of urethroplasty after failed urethrotomy versus primary repair.

    Science.gov (United States)

    Barbagli, G; Palminteri, E; Lazzeri, M; Guazzoni, G; Turini, D

    2001-06-01

    A urethral stricture recurring after repeat urethrotomy challenges even a skilled urologist. To address the question of whether to repeat urethrotomy or perform open reconstructive surgery, we retrospectively review a series of 93 patients comparing those who underwent primary repair versus those who had undergone urethrotomy and underwent secondary treatment. From 1975 to 1998, 93 males between age 13 and 78 years (mean 39) underwent surgical treatment for bulbar urethral stricture. In 46 (49%) of the patients urethroplasty was performed as primary repair, and in 47 (51%) after previously failed urethrotomy. The strictures were localized in the bulbous urethra without involvement of penile or membranous tracts. The etiology was ischemic in 37 patients, traumatic in 23, unknown in 17 and inflammatory in 16. To simplify evaluation of the results, the clinical outcome was considered either a success or a failure at the time any postoperative procedure was needed, including dilation. In our 93 patients primary urethroplasty had a final success rate of 85%, and after failed urethrotomy 87%. Previously failed urethrotomy did not influence the long-term outcome of urethroplasty. The long-term results of different urethroplasty techniques had a final success rate ranging from 77% to 96%. We conclude that failed urethrotomy does not condition the long-term result of surgical repair. With extended followup, the success rate of urethroplasty decreases with time but it is in fact still higher than that of urethrotomy.

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

    Science.gov (United States)

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

    2013-01-01

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

  17. Dialectical behaviour therapy and an added cognitive behavioural treatment module for eating disorders in women with borderline personality disorder and anorexia nervosa or bulimia nervosa who failed to respond to previous treatments. An open trial with a 15-month follow-up.

    Science.gov (United States)

    Kröger, Christoph; Schweiger, Ulrich; Sipos, Valerija; Kliem, Sören; Arnold, Ruediger; Schunert, Tanja; Reinecker, Hans

    2010-12-01

    There is evidence from case studies suggesting that adapted dialectical behavior therapy (DBT) for borderline personality disorder (BPD) and eating disorders (ED) might improve disorder related complaints. Twenty-four women with BPD (9 with comorbid anorexia nervosa [AN] and 15 with bulimia nervosa [BN]), who already had failed to respond to previous eating-disorder related inpatient treatments were consecutively admitted to an adapted inpatient DBT program. Assessment points were at pre-treatment, post-treatment, and 15-month follow-up. At follow-up, the remission rate was 54% for BN, and 33% for AN. Yet 44% of women with AN crossed over to BN and one woman additionally met the criteria of AN. For women with AN, the mean weight was not significantly increased at post-treatment, but had improved at follow-up. For women with BN, the frequency of binge-eating episodes was reduced at post-treatment as well as at follow-up. Self-rated eating-related complaints and general psychopathology, as well as ratings on global psychosocial functioning, were significantly improved at post-treatment and at follow-up. Although these findings support the assumption that the adapted DBT inpatient program is a potentially efficacious treatment for those who failed to respond to previous eating-disorder related inpatient treatments, remission rates and maintained eating-related psychopathology also suggest that this treatment needs further improvement. 2010 Elsevier Ltd. All rights reserved.

  18. Characteristics of Successful and Failed Mentoring Relationships: A Qualitative Study Across Two Academic Health Centers

    Science.gov (United States)

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

    2013-01-01

    Purpose To explore the mentor–mentee relationship with a focus on determining the characteristics of effective mentors and mentees and understanding the factors influencing successful and failed mentoring relationships. Method The authors completed a qualitative study through the Departments of Medicine at the University of Toronto Faculty of Medicine and the University of California, San Francisco, School of Medicine between March 2010 and January 2011. They conducted individual, semistructured interviews with faculty members from different career streams and ranks and analyzed transcripts of the interviews, drawing on grounded theory. Results The authors completed interviews with 54 faculty members and identified a number of themes, including the characteristics of effective mentors and mentees, actions of effective mentors, characteristics of successful and failed mentoring relationships, and tactics for successful mentoring relationships. Successful mentoring relationships were characterized by reciprocity, mutual respect, clear expectations, personal connection, and shared values. Failed mentoring relationships were characterized by poor communication, lack of commitment, personality differences, perceived (or real) competition, conflicts of interest, and the mentor’s lack of experience. Conclusions Successful mentorship is vital to career success and satisfaction for both mentors and mentees. Yet challenges continue to inhibit faculty members from receiving effective mentorship. Given the importance of mentorship on faculty members’ careers, future studies must address the association between a failed mentoring relationship and a faculty member’s career success, how to assess different approaches to mediating failed mentoring relationships, and how to evaluate strategies for effective mentorship throughout a faculty member’s career. PMID:23165266

  19. Closed External Fixation for Failing or Failed Femoral Shaft Plating in a Developing Country.

    Science.gov (United States)

    Aliakbar, Adil; Witwit, Ibrahim; Al-Algawy, Alaa A Hussein

    2017-08-01

    Femoral shaft fractures are one of the common injuries that is treated by open reduction, with internal fixation by plate and screws or intramedullary nailing, which can achieve a high union rate. To evaluate the outcome of using closed external fixation to augment a failing plate; with signs of screw loosening and increasing bone/plate gap; a failed plate; broken plate; screws completely out of bone with redisplacement of fracture. A retrospective study on 18 patients, aged between 17-42 years, who presented between 6-18 weeks after initial surgical fixation, with pain, difficulty in limb function, deformity and abnormal movement at fracture site, was done. X-Rays showed plating failure with acceptable amount of callus, which unfortunately had refractured. Cases associated with infection and no radiological evidence of callus formation were excluded from this study. Closed reduction was done by manipulation, then fracture fixation by AO external fixator. The patients were encouraged for full weight bearing as early as possible with dynamization later on. Of the 18 patients who underwent external fixation after close reduction, 15 cases showed bone healing in a period between 11-18 weeks (mean of 14.27 weeks) with good alignment (Radiologically). Removal of external fixator was done followed by physical therapy thereafter. Closed external fixation for treatment of failing or failed femoral plating, achieves good success rate and has less complications, is a short time procedure, especially in a hospital with limited resources.

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

    Directory of Open Access Journals (Sweden)

    B. S. Peskin

    2014-01-01

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

  1. Method for repairing failed fuel

    International Nuclear Information System (INIS)

    Shakudo, Taketomi.

    1986-01-01

    Purpose: To repair fuel elements that became failed during burnup in a reactor or during handling. Method: After the surface in the vicinity of a failed part of a fuel element is cleaned, a socket made of a shape-memory alloy having a ring form or a horseshoe form made by cutting a part of the ring form is inserted into the failed position according to the position of the failed fuel element. The shape memory alloy socket remembers a slightly larger inside diameter in its original phase (high-temperature side) than the outside diameter of the cladding tube and also a slightly larger inside diameter of the socket in the martensite phase (low-temperature side) than the outside diameter of the cladding tube, such that the socket can easily be inserted into the failed position. The socket, inserted into the failed part of the cladding tube, is heated by a heating jig. The socket recovers the original phase, and the shape also tends to recover a smaller diameter than the outside diameter of the cladding tube that has been remembered, and accordingly the failed part of the cladding tube is fastened with a great force and the failed part is fully closed with the socket, thus keeping radioactive materials from going out. (Horiuchi, T.)

  2. Failed tracheal intubation using a laryngoscope and intubating laryngeal mask.

    Science.gov (United States)

    Asai, T; Hirose, T; Shingu, K

    2000-04-01

    To report unexpected failed tracheal intubation using a laryngoscope and an intubating laryngeal mask, and difficult ventilation via a facemask, laryngeal mask and intubating laryngeal mask, in a patient with an unrecognized lingual tonsillar hypertrophy. A 63-yr-old woman, who had undergone clipping of an aneurysm seven weeks previously, was scheduled for ventriculo-peritoneal shunt. At the previous surgery, there had been no difficulty in ventilation or in tracheal intubation. Her trachea remained intubated nasally for 11 days after surgery. Preoperatively, her consciousness was impaired. There were no restrictions in head and neck movements or mouth opening. The thyromental distance was 7 cm. After induction of anesthesia, manual ventilation via a facemask with a Guedel airway was suboptimal and the chest expanded insufficiently. At laryngoscopy using a Macintosh or McCoy device, only the tip of the epiglottis, but not the glottis, could be seen, and tracheal intubation failed. There was a partial obstruction during manual ventilation through either the intubating laryngeal mask or conventional laryngeal mask; intubation through each device failed. Digital examination of the pharynx, after removal of the laryngeal mask, indicated a mass occupying the vallecula. Lingual tonsillar hypertrophy (1 x 1 x 2 cm) was found to be the cause of the failure. Awake fibrescope-aided tracheal intubation was accomplished. Unexpected lingual tonsillar hypertrophy can cause both ventilation and tracheal intubation difficult, and neither the laryngeal mask nor intubating laryngeal mask may be helpful in the circumstances.

  3. On the Tengiz petroleum deposit previous study

    International Nuclear Information System (INIS)

    Nysangaliev, A.N.; Kuspangaliev, T.K.

    1997-01-01

    Tengiz petroleum deposit previous study is described. Some consideration about structure of productive formation, specific characteristic properties of petroleum-bearing collectors are presented. Recommendation on their detail study and using of experience on exploration and development of petroleum deposit which have analogy on most important geological and industrial parameters are given. (author)

  4. Outcomes of Ahmed glaucoma valve implantation in advanced primary congenital glaucoma with previous surgical failure

    Science.gov (United States)

    Huang, Jingjing; Lin, Jialiu; Wu, Ziqiang; Xu, Hongzhi; Zuo, Chengguo; Ge, Jian

    2015-01-01

    Purpose The purpose of this study was to evaluate the intermediate surgical results of Ahmed glaucoma valve (AGV) implantation in patients less than 7 years of age, with advanced primary congenital glaucoma who have failed previous surgeries. Patients and methods Consecutive patients with advanced primary congenital glaucoma that failed previous operations and had undergone subsequent AGV implantation were evaluated retrospectively. Surgical success was defined as 1) intraocular pressure (IOP) ≥6 and ≤21 mmHg; 2) IOP reduction of at least 30% relative to preoperative values; and 3) without the need for additional surgical intervention for IOP control, loss of light perception, or serious complications. Results Fourteen eyes of eleven patients were studied. Preoperatively, the average axial length was 27.71±1.52 (25.56–30.80) mm, corneal diameter was 14.71±1.07 (13.0–16.0) mm, cup-to-disc ratio was 0.95±0.04 (0.9–1.0), and IOP was 39.5±5.7 (30–55) mmHg. The mean follow-up time was 18.29±10.96 (5–44, median 18) months. There were significant reductions in IOPs and the number of glaucoma medications (Pglaucoma unresponsive to previous surgical intervention, despite a relatively high incidence of severe surgical complications. PMID:26082610

  5. Engaging Future Failing States

    Science.gov (United States)

    2011-03-23

    military missions in the Middle East, the Balkans, Africa, Asia , and South America. There is an increasing proliferation of failed and failing states...disparity, overpopulation , food security, health services availability, migration pressures, environmental degradation, personal and 22 community

  6. Classifying previously undefined days from eleven years of aerosol-particle-size distribution data from the SMEAR II station, Hyytiälä, Finland

    Directory of Open Access Journals (Sweden)

    S. Buenrostro Mazon

    2009-01-01

    Full Text Available Studies of secondary aerosol-particle formation depend on identifying days in which new particle formation occurs and, by comparing them to days with no signs of particle formation, identifying the conditions favourable for formation. Continuous aerosol size distribution data has been collected at the SMEAR II station in a boreal forest in Hyytiälä, Finland, since 1996, making it the longest time series of aerosol size distributions available worldwide. In previous studies, the data have been classified as particle-formation event, nonevent, and undefined days, with almost 40% of the dataset classified as undefined. In the present study, eleven years (1996–2006 of undefined days (1630 days were reanalyzed and subdivided into three new classes: failed events (37% of all previously undefined days, ultrafine-mode concentration peaks (34%, and pollution-related concentration peaks (19%. Unclassified days (10% comprised the rest of the previously undefined days. The failed events were further subdivided into tail events (21%, where a tail of a formation event presumed to be advected to Hyytiälä from elsewhere, and quasi events (16% where new particles appeared at sizes 3–10 nm, but showed unclear growth, the mode persisted for less than an hour, or both. The ultrafine concentration peaks days were further subdivided into nucleation-mode peaks (24% and Aitken-mode peaks (10%, depending on the size range where the particles occurred. The mean annual distribution of the failed events has a maximum during summer, whereas the two peak classes have maxima during winter. The summer minimum previously found in the seasonal distribution of event days partially offsets a summer maximum in failed-event days. Daily-mean relative humidity and condensation sink values are useful in discriminating the new classes from each other. Specifically, event days had low values of relative humidity and condensation sink relative to nonevent days. Failed-event days

  7. Weeded Out? Gendered Responses to Failing Calculus.

    Science.gov (United States)

    Sanabria, Tanya; Penner, Andrew

    2017-06-01

    Although women graduate from college at higher rates than men, they remain underrepresented in science, technology, engineering, and mathematics (STEM) fields. This study examines whether women react to failing a STEM weed-out course by switching to a non-STEM major and graduating with a bachelor's degree in a non-STEM field. While competitive courses designed to weed out potential STEM majors are often invoked in discussions around why students exit the STEM pipeline, relatively little is known about how women and men react to failing these courses. We use detailed individual-level data from the National Educational Longitudinal Study (NELS) Postsecondary Transcript Study (PETS): 1988-2000 to show that women who failed an introductory calculus course are substantially less likely to earn a bachelor's degree in STEM. In doing so, we provide evidence that weed-out course failure might help us to better understand why women are less likely to earn degrees.

  8. Untrained chimpanzees (Pan troglodytes schweinfurthii fail to imitate novel actions.

    Directory of Open Access Journals (Sweden)

    Claudio Tennie

    Full Text Available Social learning research in apes has focused on social learning in the technical (problem solving domain - an approach that confounds action and physical information. Successful subjects in such studies may have been able to perform target actions not as a result of imitation learning but because they had learnt some technical aspect, for example, copying the movements of an apparatus (i.e., different forms of emulation learning.Here we present data on action copying by non-enculturated and untrained chimpanzees when physical information is removed from demonstrations. To date, only one such study (on gesture copying in a begging context has been conducted--with negative results. Here we have improved this methodology and have also added non-begging test situations (a possible confound of the earlier study. Both familiar and novel actions were used as targets. Prior to testing, a trained conspecific demonstrator was rewarded for performing target actions in view of observers. All but one of the tested chimpanzees already failed to copy familiar actions. When retested with a novel target action, also the previously successful subject failed to copy--and he did so across several contexts.Chimpanzees do not seem to copy novel actions, and only some ever copy familiar ones. Due to our having tested only non-enculturated and untrained chimpanzees, the performance of our test subjects speak more than most other studies of the general (dis-ability of chimpanzees to copy actions, and especially novel actions.

  9. Untrained Chimpanzees (Pan troglodytes schweinfurthii) Fail to Imitate Novel Actions

    Science.gov (United States)

    Tennie, Claudio; Call, Josep; Tomasello, Michael

    2012-01-01

    Background Social learning research in apes has focused on social learning in the technical (problem solving) domain - an approach that confounds action and physical information. Successful subjects in such studies may have been able to perform target actions not as a result of imitation learning but because they had learnt some technical aspect, for example, copying the movements of an apparatus (i.e., different forms of emulation learning). Methods Here we present data on action copying by non-enculturated and untrained chimpanzees when physical information is removed from demonstrations. To date, only one such study (on gesture copying in a begging context) has been conducted – with negative results. Here we have improved this methodology and have also added non-begging test situations (a possible confound of the earlier study). Both familiar and novel actions were used as targets. Prior to testing, a trained conspecific demonstrator was rewarded for performing target actions in view of observers. All but one of the tested chimpanzees already failed to copy familiar actions. When retested with a novel target action, also the previously successful subject failed to copy – and he did so across several contexts. Conclusion Chimpanzees do not seem to copy novel actions, and only some ever copy familiar ones. Due to our having tested only non-enculturated and untrained chimpanzees, the performance of our test subjects speak more than most other studies of the general (dis-)ability of chimpanzees to copy actions, and especially novel actions. PMID:22905102

  10. Failed endotracheal intubation

    Directory of Open Access Journals (Sweden)

    Sheykhol Islami V

    1995-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Boris Chertin

    2011-01-01

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

  12. Log-binomial models: exploring failed convergence.

    Science.gov (United States)

    Williamson, Tyler; Eliasziw, Misha; Fick, Gordon Hilton

    2013-12-13

    Relative risk is a summary metric that is commonly used in epidemiological investigations. Increasingly, epidemiologists are using log-binomial models to study the impact of a set of predictor variables on a single binary outcome, as they naturally offer relative risks. However, standard statistical software may report failed convergence when attempting to fit log-binomial models in certain settings. The methods that have been proposed in the literature for dealing with failed convergence use approximate solutions to avoid the issue. This research looks directly at the log-likelihood function for the simplest log-binomial model where failed convergence has been observed, a model with a single linear predictor with three levels. The possible causes of failed convergence are explored and potential solutions are presented for some cases. Among the principal causes is a failure of the fitting algorithm to converge despite the log-likelihood function having a single finite maximum. Despite these limitations, log-binomial models are a viable option for epidemiologists wishing to describe the relationship between a set of predictors and a binary outcome where relative risk is the desired summary measure. Epidemiologists are encouraged to continue to use log-binomial models and advocate for improvements to the fitting algorithms to promote the widespread use of log-binomial models.

  13. Why Companies Fail? The Boiling Frog Syndrome

    OpenAIRE

    Ozcan, Rasim

    2018-01-01

    Why nations fail? An answer is given by Acemoglu and Robinson (2012) by pointing out the importance of institutions for an economy that leads to innovations for economic growth. Christensen (2012) asks a similar question for a firm and diagnoses why companies fail. In this study, I relate Acemoglu and Robinson (2012) with Christensen (2012) in order to better understand how to make companies more prosperous, more powerful, healthier, and live longer via innovations.

  14. Outcomes of Ahmed glaucoma valve implantation in advanced primary congenital glaucoma with previous surgical failure.

    Science.gov (United States)

    Huang, Jingjing; Lin, Jialiu; Wu, Ziqiang; Xu, Hongzhi; Zuo, Chengguo; Ge, Jian

    2015-01-01

    The purpose of this study was to evaluate the intermediate surgical results of Ahmed glaucoma valve (AGV) implantation in patients less than 7 years of age, with advanced primary congenital glaucoma who have failed previous surgeries. Consecutive patients with advanced primary congenital glaucoma that failed previous operations and had undergone subsequent AGV implantation were evaluated retrospectively. Surgical success was defined as 1) intraocular pressure (IOP) ≥6 and ≤21 mmHg; 2) IOP reduction of at least 30% relative to preoperative values; and 3) without the need for additional surgical intervention for IOP control, loss of light perception, or serious complications. Fourteen eyes of eleven patients were studied. Preoperatively, the average axial length was 27.71±1.52 (25.56-30.80) mm, corneal diameter was 14.71±1.07 (13.0-16.0) mm, cup-to-disc ratio was 0.95±0.04 (0.9-1.0), and IOP was 39.5±5.7 (30-55) mmHg. The mean follow-up time was 18.29±10.96 (5-44, median 18) months. There were significant reductions in IOPs and the number of glaucoma medications (Pvalve success were 85.7%, 71.4%, and 71.4% at 6, 12, and 18 months, respectively. Severe surgical complications, including erosion of tube, endophthalmitis, retinal detachment, choroidal detachment, and delayed suprachoroidal hemorrhage, occurred in 28.6% cases. AGV implantation remains a viable option for patients with advanced primary congenital glaucoma unresponsive to previous surgical intervention, despite a relatively high incidence of severe surgical complications.

  15. Development of failed fuel detection and location system in sodium-cooled large reactor. Sampling method of failed fuels under the slit

    International Nuclear Information System (INIS)

    Aizawa, Kousuke; Fujita, Kaoru; Kamide, Hideki; Kasahara, Naoto

    2010-01-01

    A conceptual design study of Japan Sodium-cooled Fast Reactor (JSFR) is in progress as an issue of the 'Fast Reactor Cycle Technology Development (FaCT)' project in Japan. JSFR adopts a Selector-Valve mechanism for the failed fuel detection and location (FFDL) system. The Selector-Valve FFDL system identifies failed fuel subassemblies by sampling sodium from each fuel subassembly outlet and detecting fission product. One of the JSFR design features is employing an upper internal structure (UIS) with a radial slit, in which an arm of fuel handling machine can move and access the fuel assemblies under the UIS. Thus, JSFR cannot place sampling nozzles right above the fuel subassemblies located under the slit. In this study, the sampling method for indentifying under-slit failed fuel subassemblies has been demonstrated by water experiments. (author)

  16. Critical thinking: are the ideals of OBE failing us or are we failing the ...

    African Journals Online (AJOL)

    Critical thinking: are the ideals of OBE failing us or are we failing the ideals of OBE? K Lombard, M Grosser. Abstract. No Abstract. South African Journal of Education Vol. 28 (4) 2008: pp. 561-580. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  17. 40 CFR 152.93 - Citation of a previously submitted valid study.

    Science.gov (United States)

    2010-07-01

    ... Data Submitters' Rights § 152.93 Citation of a previously submitted valid study. An applicant may demonstrate compliance for a data requirement by citing a valid study previously submitted to the Agency. The... the original data submitter, the applicant may cite the study only in accordance with paragraphs (b...

  18. Patients with a failed renal transplant.

    Science.gov (United States)

    Marcén, R; Teruel Briones, J L

    2011-03-01

    Despite the advances in the care of recipients and in immunosuppression, long-term graft survival has experienced little improvement in the last 10 years. An important number of recipients present progressive loss of graft function and have to be readmitted on dialysis therapy. Before starting dialysis, these patients are re-exposed to the complications of chronic renal failure but there are no specific guidelines for their treatment. The Kidney Disease Quality Initiative Advisory Board clinical practice guidelines given for the non-transplant chronic kidney disease patients have been recommended for ameliorating their clinical situation and the rate of progression of graft failure. The time when dialysis has to be restarted and the type of dialysis procedure, hemodialysis or peritoneal dialysis, are under discusion. But there is no evidence about the superiority of either type of dialysis procedure. Systematic graft nephrectomy has been considered to improve the inflammatory status of the patients with a failed graft which could contribute to a worse control of some complications such as anemia and to the increased rates of cardiovascular mortality. As in the patients with primary end-stage renal disease, retransplantation is the best treatment for a patient with a failed graft. Due to the shortage of organs for transplantation the number of patients who are retransplanted has remained stable. Recurrent diseases such as glomerulonephritis, lyphoproliferative diseases, BK virus nephopathy and previous non-adherence to the treatment do not necessarily preclude retransplantation.

  19. Does local endometrial injury in the nontransfer cycle improve the IVF-ET outcome in the subsequent cycle in patients with previous unsuccessful IVF? A randomized controlled pilot study

    Directory of Open Access Journals (Sweden)

    Sachin A Narvekar

    2010-01-01

    Full Text Available Background: Management of repeated implantation failure despite transfer of good-quality embryos still remains a dilemma for ART specialists. Scrapping of endometrium in the nontransfer cycle has been shown to improve the pregnancy rate in the subsequent IVF/ET cycle in recent studies. Aim: The objective of this randomized controlled trial (RCT was to determine whether endometrial injury caused by Pipelle sampling in the nontransfer cycle could improve the probability of pregnancy in the subsequent IVF cycle in patients who had previous failed IVF outcome. Setting: Tertiary assisted conception center. Design: Randomized controlled study. Materials and Methods: 100 eligible patients with previous failed IVF despite transfer of good-quality embryos were randomly allocated to the intervention group and control groups. In the intervention group, Pipelle endometrial sampling was done twice: One in the follicular phase and again in the luteal phase in the cycle preceding the embryo transfer cycle. Outcome Measure: The primary outcome measure was live birth rate. The secondary outcome measures were implantation and clinical pregnancy rates. Results: The live birth rate was significantly higher in the intervention group compared to control group (22.4% and 9.8% P = 0.04. The clinical pregnancy rate in the intervention group was 32.7%, while that in the control group was 13.7%, which was also statistically significant ( P = 0.01. The implantation rate was significantly higher in the intervention group as compared to controls (13.07% vs 7.1% P = 0.04. Conclusions: Endometrial injury in nontransfer cycle improves the live birth rate,clinical pregnancy and implantation rates in the subsequent IVF-ET cycle in patients with previous unsuccessful IVF cycles.

  20. The use of a prosthetic inlay resurfacing as a salvage procedure for a failed cartilage repair.

    Science.gov (United States)

    Dhollander, Aad Alfons Maria; Almqvist, Karl Fredrik; Moens, Kris; Vandekerckhove, Pieter-Jan; Verdonk, René; Verdonk, Peter; Victor, Jan

    2015-08-01

    This study was designed to describe the clinical and radiographical outcome of the HemiCAP(®) resurfacing system as a salvage treatment for a failed index cartilage procedure. Fourteen patients were treated consecutively and clinically prospectively followed for a mean period of 26.1 ± 12.8 months. All patients were previously treated for their cartilage lesion. Radiographical data were analysed based on the Kellgren and Lawrence system. The patients involved in this study demonstrated a gradual clinical improvement in time. However, radiographically significant osteoarthritic changes were observed during the follow-up period. The position of the HemiCAP(®) resurfacing system was adequate in all cases, and no signs of loosening were observed during the follow-up period. The HemiCAP(®) resurfacing system is feasible as a salvage treatment for a failed index cartilage procedure and resulted in a gradual clinical improvement. However, the favourable clinical outcome was not confirmed by the radiographical findings. IV.

  1. Peginterferon alfa-2b and ribavirin: effective in patients with hepatitis C who failed interferon alfa/ribavirin therapy.

    Science.gov (United States)

    Poynard, Thierry; Colombo, Massimo; Bruix, Jordi; Schiff, Eugene; Terg, Ruben; Flamm, Steven; Moreno-Otero, Ricardo; Carrilho, Flair; Schmidt, Warren; Berg, Thomas; McGarrity, Thomas; Heathcote, E Jenny; Gonçales, Fernando; Diago, Moises; Craxi, Antonio; Silva, Marcelo; Bedossa, Pierre; Mukhopadhyay, Pabak; Griffel, Louis; Burroughs, Margaret; Brass, Clifford; Albrecht, Janice

    2009-05-01

    Treatment with peginterferon alfa and ribavirin produces a sustained virologic response (SVR) in approximately 60% of hepatitis C virus (HCV)-infected patients. Alternate options are needed for patients who relapse or do not respond to therapy. This prospective, international, multicenter, open-label study evaluated efficacy and safety of peginterferon alfa-2b (1.5 microg/kg/wk) plus weight-based ribavirin (800-1400 mg/day) in 2333 chronic HCV-infected patients with significant fibrosis/cirrhosis whose previous interferon alfa/ribavirin therapy failed. Patients with undetectable HCV-RNA at treatment week (TW) 12 received 48 weeks of therapy; patients with detectable HCV-RNA at TW12 could enter maintenance studies at TW18; 188 patients with low/detectable HCV-RNA at TW12 continued therapy at the investigator's request. Overall, 22% of the patients attained SVR (56% with undetectable HCV-RNA and 12% with low/detectable HCV-RNA at TW12). SVR was better in relapsers (38%) than nonresponders (14%), regardless of previous treatment, and in patients previously treated with interferon-alfa/ribavirin (25%) than peginterferon alfa-ribavirin (17%). Predictors of response in patients with undetectable HCV-RNA at TW12 were genotype (2/3 vs 1, respectively; odds ratio [OR] 2.4; P 600,000 IU/mL; OR, 1.4; P = .0223). These factors plus previous treatment and response were overall predictors of SVR. Safety was similar among fibrosis groups. Peginterferon alfa-2b plus weight-based ribavirin is effective and safe in patients who failed interferon alfa/ribavirin therapy. Genotype, baseline viral load, and fibrosis stage were predictors of response.

  2. Spinal Cord Stimulation in Failed Back Surgery Syndrome: Effects on Posture and Gait—A Preliminary 3D Biomechanical Study

    Directory of Open Access Journals (Sweden)

    L. Brugliera

    2017-01-01

    Full Text Available We studied 8 patients with spinal cord stimulation (SCS devices which had been previously implanted to treat neuropathic chronic pain secondary to Failed Back Surgery Syndrome. The aim of our study was to investigate the effects of SCS on posture and gait by means of clinical scales (Short Form Health Survey-36, Visual Analogue Scale for pain, and Hamilton Depression Rating Scale and instrumented evaluation with 3D Gait Analysis using a stereophotogrammetric system. The latter was performed with the SCS device turned both OFF and ON. We recorded gait and posture using the Davis protocol and also trunk movement during flexion-extension on the sagittal plane, lateral bending on the frontal plane, and rotation on the transversal plane. During and 30 minutes after the stimulation, not only the clinical scales but also spatial-temporal gait parameters and trunk movements improved significantly. Improvement was not shown under stimulation-OFF conditions. Our preliminary data suggest that SCS has the potential to improve posture and gait and to provide a window of pain-free opportunity to optimize rehabilitation interventions.

  3. Efficacy of pneumodilation in achalasia after failed Heller myotomy.

    Science.gov (United States)

    Saleh, C M G; Ponds, F A M; Schijven, M P; Smout, A J P M; Bredenoord, A J

    2016-11-01

    Heller myotomy is an effective treatment for the majority of achalasia patients. However, a small proportion of patients suffer from persistent or recurrent symptoms after surgery and they are usually subsequently treated with pneumodilation (PD). Data on the efficacy of PD as secondary treatment for achalasia are scarce. Therefore, this study aimed to investigate the efficacy of PD as treatment for achalasia patients suffering from persistent or recurrent symptoms after Heller myotomy. Patients with recurrent or persistent symptoms (Eckardt score >3) after Heller myotomy were selected. Patients were treated with PD, using a graded distension protocol with balloon sizes ranging from 30 to 40 mm. After each dilation symptoms were assessed to evaluate whether a subsequent dilation with a larger balloon size was required. Patients with recurrent or persistent symptoms (Eckardt score >3) after treatment with a 40-mm balloon were identified as failures. Twenty-four patients were included in total; 15 patients with achalasia type I, seven with achalasia type II and two with achalasia type III. Median relapse time was 2.5 years after Heller myotomy (IQR: 9 years and 3 months). Three patients were not suitable for PD; one patient was morbidly obese and not fit for any form of sedation and two had a siphon-shaped esophagus leaving 21 patients to treat. Eight patients were successfully treated with a single 30-mm balloon dilation (median follow-up time: 6.5 years; IQR: 7.5 years). Four patients required dilations with 30- and 35-mm balloons (median follow-up time: 11 years; IQR: 3 years). Nine patients failed on the 35-mm balloon dilation and underwent a subsequent dilation with a 40-mm balloon, and all failed on this balloon as well. Thus, PD was successful in 12 of the 21 treatable patients, resulting in a success rate of 57% for treatable patients or 50% for all patients. Baseline Eckardt scores were also higher in those that failed (median: 8; IQR: 2) than those that

  4. Local endometrial scratching under ultrasound-guidance after failed intrauterine insemination and cycle outcome: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Badeea S. Soliman

    2017-03-01

    Full Text Available Background: Interaction between the embryo and endometrium plus endometrial receptivity is considered as two strong issues affecting the implantation outcome. Purpose: To investigate the effect of local endometrial scratching on pregnancy rate after failed previous intra uterine insemination. Study design: A prospective, randomized, control trial. Setting: At Cytogenetic and Endoscopy Unit, Zagazig University Hospital. Patients and methods: A total of 226 women either with unexplained or with mild male factor infertility were divided randomly into approximately two groups: in study group, 114 women and in control group, 112 women. For both groups, folliculometry was started at cycle day 7 additionally and at the same setting; endometrial scratching was done only for the study group. Outcome results: Biochemical and clinical pregnancy rates. Results: The biochemical and clinical pregnancy rates were significantly higher in the endometrial scratching group compared to the control group [27/106 (25.5% vs. 15/106 (14.1% p = 0.03 and 24/106 (22.6% vs. 12/106 (11.3%; p = 0.02] respectively. Also, ongoing pregnancy rate was statistically significantly different between both groups [22/106 (20.7% vs. 11/106 (10.4%; p = 0.03]. Conclusion: Endometrial scratching is useful in increasing pregnancy rates after failed previous intra uterine insemination trials when it is performed in the mid proliferative phase.

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

    Directory of Open Access Journals (Sweden)

    Rajesh Botchu

    2012-01-01

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

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

    Science.gov (United States)

    Botchu, Rajesh; Khan, Aman; Jeyapalan, Kanagaratnam

    2012-01-01

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

  7. Etiologic analysis of 100 anatomically failed dacryocystorhinostomies

    Science.gov (United States)

    Dave, Tarjani Vivek; Mohammed, Faraz Ali; Ali, Mohammad Javed; Naik, Milind N

    2016-01-01

    Background The aim of this study was to assess the etiological factors contributing to the failure of a dacryocystorhinostomy (DCR). Patients and methods Retrospective review was performed in 100 consecutive patients who were diagnosed with anatomically failed DCR at presentation to a tertiary care hospital over a 5-year period from 2010 to 2015. Patient records were reviewed for demographic data, type of past surgery, preoperative endoscopic findings, previous use of adjuvants such as intubation and mitomycin C, and intraoperative notes during the re-revision. The potential etiological factors for failure were noted. Results Of the 100 patients with failed DCRs, the primary surgery was an external DCR in 73 and endoscopic DCR in 27 patients. Six patients in each group had multiple revisions. The mean ages at presentation in the external and endoscopic groups were 39.41 years and 37.19 years, respectively. All patients presented with epiphora. The most common causes of failure were inadequate osteotomy (69.8% in the external group and 85.1% in the endoscopic group, P=0.19) followed by inadequate or inappropriate sac marsupialization (60.2% in the external group and 77.7% in the endoscopic group, P=0.16) and cicatricial closure of the ostium (50.6% in the external group and 55.5% in the endoscopic group, P=0.83). The least common causes such as ostium granulomas and paradoxical middle turbinate (1.37%, n=1) were noted in the external group only. Conclusion Inadequate osteotomy, incomplete sac marsupialization, and cicatricial closure of the ostium were the most common causes of failure and did not significantly differ in the external and endoscopic groups. Meticulous evaluation to identify causative factors for failure and addressing them are crucial for subsequent successful outcomes. PMID:27555748

  8. Failing Decision

    DEFF Research Database (Denmark)

    Knudsen, Morten

    2014-01-01

    Recently the Danish subway trains have begun to announce “on time” when they arrive at a station on time. This action reflects a worrying acceptance of the normality of failure. If trains were generally expected to be on time, there would be no reason to – triumphantly – announce it. This chapter...... by an interest in failure as one way of improving understanding of present-day decision making in organizations.......Recently the Danish subway trains have begun to announce “on time” when they arrive at a station on time. This action reflects a worrying acceptance of the normality of failure. If trains were generally expected to be on time, there would be no reason to – triumphantly – announce it. This chapter...... deals not with traffic delays, but with failing decisions in organizations. The assumption of this chapter is that failing decisions today are as normal as delayed trains. Instead of being the exception, failure is part of the everyday reproduction of organizations – as an uncontrolled effect but also...

  9. Simulating fail-stop in asynchronous distributed systems

    Science.gov (United States)

    Sabel, Laura; Marzullo, Keith

    1994-01-01

    The fail-stop failure model appears frequently in the distributed systems literature. However, in an asynchronous distributed system, the fail-stop model cannot be implemented. In particular, it is impossible to reliably detect crash failures in an asynchronous system. In this paper, we show that it is possible to specify and implement a failure model that is indistinguishable from the fail-stop model from the point of view of any process within an asynchronous system. We give necessary conditions for a failure model to be indistinguishable from the fail-stop model, and derive lower bounds on the amount of process replication needed to implement such a failure model. We present a simple one-round protocol for implementing one such failure model, which we call simulated fail-stop.

  10. Comparison of nutritional status in hemodialysis patients with and without failed renal allografts.

    Science.gov (United States)

    Yelken, B M; Gorgulu, N; Caliskan, Y; Yazici, H; Turkmen, A; Yildiz, A; Sever, M S

    2010-01-01

    The survival of patients returning to hemodialysis (HD) following kidney transplant failure is unfavorable. However, the factors responsible for this poor outcome are largely unknown; chronic inflammation due to failed allograft and malnutrition may contribute to morbidity and mortality. We aimed to compare the nutritional status and its relation with inflammation in patients on HD with and without previous kidney transplantation. Forty-three patients with failed renal allografts (27 males; mean age 36±9 yr) and 40 never transplanted HD patients (24 males; mean age 39±9 yr) were included in the study. Body weight, triceps (TSF), biceps (BSF), subscapular (SSSF), and suprailiac skinfold thicknesses (SISF); mid-arm, mid-arm muscle, hip and waist circumferences; as well as body mass indices (BMIs) were determined as anthropometric parameters. Moreover, biochemical markers of nutritional status, including serum cholesterol and albumin as well as high-sensitive C-reactive protein (hs-CRP), as a marker of inflammation, were measured. Associations among these variables were analyzed. There were no significant differences considering age, gender or duration of renal replacement therapy between the two groups. The TSF (pfailed renal allografts were significantly lower than those of the never transplanted HD patients. Waist circumference was significantly lower as well (p=0.028). Patients with failed transplants were characterized by lower serum albumin (pfailed allografts may induce chronic inflammation in chronic HD patients which may result in a worse nutritional status. © 2009 John Wiley & Sons A/S.

  11. Biceps tenodesis is a viable option for salvage of failed SLAP repair.

    Science.gov (United States)

    Werner, Brian C; Pehlivan, Hakan C; Hart, Joseph M; Lyons, Matthew L; Gilmore, C Jan; Garrett, Cara B; Carson, Eric W; Diduch, David R; Miller, Mark D; Brockmeier, Stephen F

    2014-08-01

    Outcomes of arthroscopic superior labral anterior-posterior (SLAP) repairs have been well reported with generally favorable outcomes. Unfortunately, a percentage of patients remain dissatisfied or suffer further injury after SLAP repair and may seek additional treatment. The purpose of this study was to evaluate the surgical outcomes of biceps tenodesis for failed SLAP repairs. A retrospective review of all patients undergoing biceps tenodesis was completed. Inclusion criteria were previous SLAP repair and subsequent revision biceps tenodesis. Exclusion criteria were additional shoulder procedures including rotator cuff repair, instability procedures, and preoperative frozen shoulder. Objective outcomes were postoperative assessments with Constant score, American Shoulder and Elbow Surgeons score, Single Assessment Numeric Evaluation, Simple Shoulder Test, and Veterans RAND 36-Item Health Survey. Physical examination was conducted to determine postoperative range of motion and strength compared with the nonoperative shoulder. A cohort of 24 patients was identified, and of these, 17 patients (71%) completed the study at 2 years' follow-up. The average postoperative Constant score was 84.4; American Shoulder and Elbow Surgeons score, 75.5; Single Assessment Numeric Evaluation score, 73.1%; Simple Shoulder Test score, 9.2; and Veterans RAND 36-Item Health Survey score, 76.1. Postoperative range of motion of the operative shoulder returned to near that of the asymptomatic nonoperative shoulder. Workers' compensation status led to inferior results. Options for patients with a failed prior SLAP repair are limited. As a salvage operation for failed SLAP repair, biceps tenodesis serves the majority of patients well, with favorable outcomes by validated measures and excellent shoulder range of motion and elbow strength at 2 years' follow-up. Workers' compensation status may predispose patients to poorer outcomes. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board

  12. Should We Pursue Patients Who Fail to Attend Colorectal Clinics? A 9-Year Study

    Science.gov (United States)

    John, SKP; Jones, OM; Fay, H; Howell, RD; Fozard, JBJ

    2007-01-01

    INTRODUCTION No uniform protocol exists on how to deal with patients who fail to attend colorectal clinics. Our aim was to identify whether the tendency to ‘failure to attend’ (FTA) in the colorectal clinic was associated with FTA in other clinics and also whether FTA patients have serious pathology. PATIENTS AND METHODS This was a retrospective study of a prospectively recorded list of FTA patients, in colorectal urgent or two-week wait clinics from 1996–2004. RESULTS A total of 151 patients, who failed to attend their first appointment, were included in the study. Of these, 61 (40.4%) were colorectal referrals, 76 (50.3%) were general surgical referrals, and for 14 (9.3%) case notes were not available. There were 59 FTA episodes in 61 colorectal patients associated with 59 FTA episodes in other clinics (Pearson correlation: r = 0.411; P = 0.01, two-tailed, SPSS v.12). Of 58 colorectal outcomes, five (8.6%) colorectal cancers (CRC) were diagnosed, 23 (39.6%) were persistent non-attendees, 16 (27.5%) had benign colorectal pathology, two (3.4%) benign non-colorectal outcomes and 12 (20.6%) normal outcomes. CONCLUSIONS Tendency to FTA is habitual. Care needs to be exercised in the management of FTAs to avoid delayed presentation of colorectal cancer. PMID:17688719

  13. Triggered activity and automaticity in ventricular trabeculae of failing human and rabbit hearts

    NARCIS (Netherlands)

    Vermeulen, J. T.; McGuire, M. A.; Opthof, T.; Coronel, R.; de Bakker, J. M.; Klöpping, C.; Janse, M. J.

    1994-01-01

    The aim of the study was to assess the occurrence of triggered activity and automaticity in ventricular trabeculae from failing human hearts and normal and failing rabbit hearts during exposure to a normal and altered extracellular environment. Ventricular trabeculae were harvested from failing

  14. Why did occidental modernity fail in the Arab Middle East: the failed modern state?

    OpenAIRE

    Sardar, Aziz

    2011-01-01

    This thesis asks a straightforward but nevertheless a complex question, that is: Why did modernity fail in the Arab Middle East? The notion of modernity in this thesis signifies the occidental modernity which reached the region in many different forms and through various channels. This occidental modernity had an impact on many areas and changed the societies and politics of the region. But these changes stopped short of reaching modernity, in other words it failed to change the society from ...

  15. Use of flow-diverting stents as salvage treatment following failed stent-assisted embolization of intracranial aneurysms.

    Science.gov (United States)

    Heiferman, Daniel M; Billingsley, Joshua T; Kasliwal, Manish K; Johnson, Andrew K; Keigher, Kiffon M; Frudit, Michel E; Moftakhar, Roham; Lopes, Demetrius K

    2016-07-01

    Flow-diverting stents, including the Pipeline embolization device (PED) and Silk, have been beneficial in the treatment of aneurysms previously unable to be approached via endovascular techniques. Recurrent aneurysms for which stent-assisted embolization has failed are a therapeutic challenge, given the existing intraluminal construct with continued blood flow into the aneurysm. We report our experience using flow-diverting stents in the repair of 25 aneurysms for which stent-assisted embolization had failed. Nineteen (76%) of these aneurysms at the 12-month follow-up showed improved Raymond class occlusion, with 38% being completely occluded, and all aneurysms demonstrated decreased filling. One patient developed a moderate permanent neurologic deficit. Appropriate stent sizing, proximal and distal construct coverage, and preventing flow diverter deployment between the previously deployed stent struts are important considerations to ensure wall apposition and prevention of endoleak. Flow diverters are shown to be a reasonable option for treating previously stented recurrent cerebral aneurysms. 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/

  16. Neglected City Narratives And Failed Rebranding

    DEFF Research Database (Denmark)

    Mousten, Birthe; Locmele, Gunta

    2017-01-01

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

  17. When Organization Fails: Why Authority Matters

    DEFF Research Database (Denmark)

    Blaschke, Steffen

    2015-01-01

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

  18. VAGINAL BIRTH AFTER A PREVIOUS CAESAREAN SECTION: CURRENT TRENDS AND OUTLOOK IN GHANA.

    Science.gov (United States)

    Seffah, J D; Adu-Bonsaffoh, K

    2014-01-01

    The optimal mode of subsequent delivery of women with prior caesarean birth remains a subject of intense research and debate in contemporary obstetric practice especially in low resource settings like West Africa where there are obvious systemic and management-related challenges associated with trial of scar. However, there is evidence that vaginal birth after caesarean section (VBAC) is safe in appropriately selected women in addition to adequate intrapartum monitoring and ready access to theatre when emergency CS is indicated. The primary objective of the study was to determine the current trends and performance of VBAC in Ghana after decades of practice of trial of labour after caesarean section (TOLAC) in the mist of inherent challenges in deciding the optimal mode of childbirth for women with a previous caesarean birth. The secondary objective was to relate evidence based practice of TOLAC to obstetric practice in low resource settings like Ghana and provide recommendations for improving maternal and newborn health among women with prior caesarean birth. This was a retrospective study of the records of patients who had had a prior caesarean delivery and who then proceeded to deliver the next babies at the Korle Bu Teaching Hospital (KBTH) between Jan 2010 and Dec 2014. The data on demography, antenatal care, labour and delivery and outcomes were collected from the Labour and Recovery wards and the Biostatistics unit of the Maternity unit of the Hospital. Excluded were women with a previous CS who had multiple pregnancies and those with incomplete notes as well as those whose delivery plans were not predetermined antenatally.. The data were analyzed using SPSS version 20. There were 53,581 deliveries during the study period. Vaginal delivery was obtained in 31,870 (59.5%) pregnancies and 21,711(40.5%) had CS. Also, 6261 (11.7%) had had a prior CS and 2472 (39.5%) of these were selected for TOLAC while 2119 (33.8) were scheduled for planned repeat CS. There was

  19. 7 CFR 983.52 - Failed lots/rework procedure.

    Science.gov (United States)

    2010-01-01

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

  20. Relationship of pass/fail grading and curriculum structure with well-being among preclinical medical students: a multi-institutional study.

    Science.gov (United States)

    Reed, Darcy A; Shanafelt, Tait D; Satele, Daniel W; Power, David V; Eacker, Anne; Harper, William; Moutier, Christine; Durning, Steven; Massie, F Stanford; Thomas, Matthew R; Sloan, Jeff A; Dyrbye, Liselotte N

    2011-11-01

    Psychological distress is common among medical students. Curriculum structure and grading scales are modifiable learning environment factors that may influence student well-being. The authors sought to examine relationships among curriculum structures, grading scales, and student well-being. The authors surveyed 2,056 first- and second-year medical students at seven U.S. medical schools in 2007. They used the Perceived Stress Scale, Maslach Burnout Inventory, and Medical Outcomes Study Short Form (SF-8) to measure stress, burnout, and quality of life, respectively. They measured curriculum structure using hours spent in didactic, clinical, and testing experiences. Grading scales were categorized as two categories (pass/fail) versus three or more categories (e.g., honors/pass/fail). Of the 2,056 students, 1,192 (58%) responded. In multivariate analyses, students in schools using grading scales with three or more categories had higher levels of stress (beta 2.65; 95% CI 1.54-3.76, Pstudents in schools using pass/fail grading. There were no relationships between time spent in didactic and clinical experiences and well-being. How students are evaluated has a greater impact than other aspects of curriculum structure on their well-being. Curricular reform intended to enhance student well-being should incorporate pass/fail grading.

  1. Imaging studies for failed back surgery syndrome

    International Nuclear Information System (INIS)

    Cosnard, G.; Cordoliani, Y.S.; Sarrazin, J.L.; Soulie, D.

    1995-01-01

    In patients with failed back surgery syndrome, magnetic resonance imaging (MRI) can be the best first-line imaging study because it simplifies the diagnosis. This update is based on over 600 cases. MRI shows the scar tissue at the surgical site, persistent evidence of disk herniation for several weeks after surgery, and evidence of local and regional edema in one-fourth of cases. The edema is most marked between two months and two years after the operation and can misleadingly suggest discitis. MRI is the best investigation for detecting recurrent herniation at the same vertebral level or another level. Herniated disk material is seen as a mass that does not enhance after gadolinium, in contrast to the vascularized scar tissue. Free fragments are often clearly visible within the scar tissue. Fragments that migrate to the epidural space can give rise to granulomatous reactions. Scar tissue can be seen in the epidural space and within the disk; it can show enhancement after gadolinium for several years. The scar can be atrophic or hypertrophic and can encase or impinge on the dural sac and nerve roots. Pathological fibrosis cannot be differentiated from ordinary scar tissue. Arachnoiditis causing adherence of the nerve roots to the dura mater or to each other occurs in 5 % to 10 % of cases. Nerve root enhancement after gadolinium is seen in three-fourths of cases. Bone lesions are common, especially some time after surgery; they are usually accompanied with other lesions. Hematomas are seen in less than 10 % of cases. Infections are similarly rare (0.25 % each for discitis and epiduritis). The diagnosis of discitis is difficult and requires percutaneous biopsy of the disk, especially when MRI shows fluid within the disk, with decreased signal intensity on T2 images, and non enhancement after intravenous gadolinium. (authors). 19 refs., 7 figs

  2. Failed fuel detector

    International Nuclear Information System (INIS)

    Martucci, J.A.

    1975-01-01

    A failed fuel detection apparatus is described for a nuclear reactor having a liquid cooled core comprising a gas collection hood adapted to engage the top of the suspect assembly and means for delivering a stripping gas to the vicinity of the bottom of the suspect fuel assembly. (U.S.)

  3. Assessing the potential cost of a failed Doha round

    OpenAIRE

    Antoine Bouet

    2010-01-01

    This study offers new conclusions on the economic cost of a failed Doha Development Agenda (DDA). We assess potential outcome of the Doha Round as well as four protectionist scenarios using the MIRAGE Computable General Equilibrium (CGE) model. In a scenario where applied tariffs of World Trade Organization (WTO) economies would go up to currently bound tariff rates, world trade would decrease by 7.7 % and world welfare by US$353 billion. The economic cost of a failed DDA is here evaluated by...

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

    DEFF Research Database (Denmark)

    Herslund, Mai-Britt; Jørgensen, N O

    2003-01-01

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

  5. Failed fuel detection method

    International Nuclear Information System (INIS)

    Utamura, Motoaki; Urata, Megumu.

    1976-01-01

    Object: To detect failed fuel element in a reactor with high precision by measuring the radioactivity concentrations for more than one nuclides of fission products ( 131 I and 132 I, for example) contained in each sample of coolant in fuel channel. Method: The radioactivity concentrations in the sampled coolant are obtained from gamma spectra measured by a pulse height analyser after suitable cooling periods according to the half-lives of the fission products to be measured. The first measurement for 132 I is made in two hours after sampling, and the second for 131 I is started one day after the sampling. Fuel element corresponding to the high radioactivity concentrations for both 131 I and 132 I is expected with certainty to have failed

  6. Pass-fail grading: laying the foundation for self-regulated learning.

    Science.gov (United States)

    White, Casey B; Fantone, Joseph C

    2010-10-01

    Traditionally, medical schools have tended to make assumptions that students will "automatically" engage in self-education effectively after graduation and subsequent training in residency and fellowships. In reality, the majority of medical graduates out in practice feel unprepared for learning on their own. Many medical schools are now adopting strategies and pedagogies to help students become self-regulating learners. Along with these changes in practices and pedagogy, many schools are eliminating a cornerstone of extrinsic motivation: discriminating grades. To study the effects of the switch from discriminating to pass-fail grading in the second year of medical school, we compared internal and external assessments and evaluations for a second-year class with a discriminating grading scale (Honors, High Pass, Pass, Fail) and for a second-year class with a pass-fail grading scale. Of the measures we compared (MCATs, GPAs, means on second-year examinations, USMLE Step 1 scores, residency placement, in which there were no statistically significant changes), the only statistically significant decreases (lower performance with pass fail) were found in two of the second-year courses. Performance in one other course also improved significantly. Pass-fail grading can meet several important intended outcomes, including "leveling the playing field" for incoming students with different academic backgrounds, reducing competition and fostering collaboration among members of a class, more time for extracurricular interests and personal activities. Pass-fail grading also reduces competition and supports collaboration, and fosters intrinsic motivation, which is key to self-regulated, lifelong learning.

  7. Contribution of targeted saliva screening for congenital CMV-related hearing loss in newborns who fail hearing screening.

    Science.gov (United States)

    Ari-Even Roth, Daphne; Lubin, Daniel; Kuint, Jacob; Teperberg-Oikawa, Michal; Mendelson, Ella; Strauss, Tzipora; Barkai, Galia

    2017-11-01

    We previously reported a 2.2% rate of infants born with sensorineural hearing loss (SNHL) due to congenital cytomegalovirus (cCMV) infection identified by universal neonatal screen for cCMV using saliva. To evaluate the contribution of targeted saliva screening for cCMV to the detection of infants born with cCMV-related SNHL who failed universal newborn hearing screening (UNHS). We retrospectively reviewed the audiological and medical records of infants who failed UNHS and were tested for cCMV using saliva sample prior to discharge at Sheba Medical Center between 2014 and 2015. Positive cases were confirmed by urine sample. Two hundred (1%) of the 19 830 infants tested during the study period failed in-hospital hearing screening. A saliva specimen was obtained prior to discharge in 187 infants (93.5% of those who failed UNHS). In 178 infants saliva testing was performed at ≤21 days of chronological age and yielded results. cCMV infection was identified in 4/178 tested infants (2.25%, 95% CI 0.8% to 5.3%), of whom three were diagnosed with SNHL (1.7%, 95% CI 0.5% to 4.4%) and offered antiviral treatment. Two of the tested infants (1.12%, 95% CI 0.2% to 3.6%) were diagnosed with cCMV solely due to failure in UNHS. Occult central nervous system (CNS) symptoms of cCMV infection were detected in 2/4 infants following targeted investigation. Targeted cCMV screening in newborns who failed UNHS contributed to the early detection of infants born with cCMV-related isolated SNHL or with occult CNS symptoms who could potentially benefit from antiviral treatment. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. Method of detecting a failed fuel

    International Nuclear Information System (INIS)

    Utamura, Motoaki; Urata, Megumi; Uchida, Shunsuke.

    1976-01-01

    Object: To improve detection accuracy of a failed fuel by eliminating a coolant temperature distribution in a fuel assembly. Structure: A failed fuel is detected from contents of nuclear fission products in a coolant by shutting off an upper portion of a fuel assembly provided in the coolant and by sampling the coolant in the fuel assembly. Temperature distribution in the fuel assembly is eliminated, by injecting the higher temperature coolant than that of the coolant inside and outside the fuel assembly when sampling, and thereby replacing the existing coolant in the fuel assembly for the higher temperature coolant. The failed fuel is detected from contents of the fission products existing in the coolant, by sampling the higher temperature coolant of the fuel assembly after a temperature passed. (Moriyama, K.)

  9. Failed fuel rod detector

    Energy Technology Data Exchange (ETDEWEB)

    Uchida, Katsuya; Matsuda, Yasuhiko

    1984-05-02

    The purpose of the project is to enable failed fuel rod detection simply with no requirement for dismantling the fuel assembly. A gamma-ray detection section is arranged so as to attend on the optional fuel rods in the fuel assembly. The fuel assembly is adapted such that a gamma-ray shielding plate is detachably inserted into optional gaps of the fuel rods or, alternatively, the fuel assembly can detachably be inserted to the gamma-ray shielding plate. In this way, amount of gaseous fission products accumulated in all of the plenum portions in the fuel rods as the object of the measurement can be determined without dismantling the fuel assembly. Accordingly, by comparing the amounts of the gaseous fission products, the failed fuel rod can be detected.

  10. Subconjunctival bevacizumab to augment trabeculectomy with mitomycin C in the management of failed glaucoma surgery

    Directory of Open Access Journals (Sweden)

    Saeed AM

    2014-09-01

    Full Text Available Ahmed M Saeed, Tarek Tawfeek AboulNasrOphthalmology Department, Benha University, Egypt Purpose: To provide a feasible solution to the problem of failed glaucoma surgery. The aim was to evaluate the efficacy and safety of the additional effects of a combined surgical approach. This approach augments the application of trabeculectomy with mitomycin C (MMC by adding subconjunctival bevacizumab injection. The results were compared with those of trabeculectomy with only adjunctive MMC. Methods: A randomized controlled prospective clinical trial included 28 eyes diagnosed with failed scarred bleb of a previous trabeculectomy. The eyes were divided into two equal groups: combined group A, “trabeculectomy with adjunctive MMC and subconjunctival bevacizumab,” and control group B, “trabeculectomy with adjunctive MMC only.” The main outcome results included the cumulative probability of surgical success, intraocular pressure (IOP values, and number of IOP-lowering medications needed to achieve the target IOP.Results: Group A achieved a cumulative probability of complete success of 0.769 and of qualified success of 0.231 at the end of the 24 month study period; group B achieved cumulative probabilities of 0.538 and 0.308, respectively. Group A achieved a lower mean IOP value than group B, with fewer antiglaucoma drugs at all postoperative visits, but this lower value did not reach a statistically significant level (P>0.05. There was no statistically significant difference between both groups regarding best corrected visual acuity, visual field parameters, operative and/or postoperative complications, and additional interventions. No significant adverse effects were caused by this combined approach.Conclusion: Bevacizumab was not found to add much to the favorable long-term outcome of conventional trabeculectomy with MMC as a solution to the problem of scarred failed bleb. Keywords: glaucoma, bevacizumab, mitomycin C, failed trabeculectomy

  11. Study of functional-performance deficits in athletes with previous ankle sprains

    Directory of Open Access Journals (Sweden)

    hamid Babaee

    2008-04-01

    Full Text Available Abstract Background: Despite the importance of functional-performance deficits in athletes with history of ankle sprain few, studies have been carried out in this area. The aim of this research was to study relationship between previous ankle sprains and functional-performance deficits in athletes. Materials and methods: The subjects were 40 professional athletes selected through random sampling among volunteer participants in soccer, basketball, volleyball and handball teams of Lorestan province. The subjects were divided into 2 groups: Injured group (athletes with previous ankle sprains and healthy group (athletes without previous ankle sprains. In this descriptive study we used Functional-performance tests (figure 8 hop test and side hop test to determine ankle deficits and limitations. They participated in figure 8 hop test including hopping in 8 shape course with the length of 5 meters and side hop test including 10 side hop repetitions in course with the length of 30 centimeters. Time were recorded via stopwatch. Results: After data gathering and assessing information distributions, Pearson correlation was used to assess relationships, and independent T test to assess differences between variables. Finally the results showed that there is a significant relationship between previous ankle sprains and functional-performance deficits in the athletes. Conclusion: The athletes who had previous ankle sprains indicated functional-performance deficits more than healthy athletes in completion of mentioned functional-performance tests. The functional-performance tests (figure 8 hop test and side hop test are sensitive and suitable to assess and detect functional-performance deficits in athletes. Therefore we can use the figure 8 hop and side hop tests for goals such as prevention, assessment and rehabilitation of ankle sprains without spending too much money and time.

  12. Comparison of The Effectiveness of Clomiphene Citrate versus Letrozole in Mild IVF in Poor Prognosis Subfertile Women with Failed IVF Cycles

    Directory of Open Access Journals (Sweden)

    Mesut Oktem

    2015-10-01

    Full Text Available Background: Our objective was to evaluate the effectiveness of clomiphene citrate (CC vs. letrozole (L plus human menopausal gonadotropin (hMG in gonadotropin releasing hormone (GnRH antagonist protocol in poor prognosis women with previous failed ovarian stimulation undergoing intracytoplasmic sperm injection (ICSI. Materials and Methods: This retrospective cohort study included cycles with CC and L plus hMG/GnRH antagonist protocols of 32 poor responders who had failed to have ideal follicles to be retrieved during oocyte pick-up (OPU or embryo transfer (ET at least for 2 previous in vitro fertilization (IVF cycles with microdose flare protocol or GnRH antagonist protocol from January 2006 to December 2009. Main outcome measures were implantation, clinical pregnancy and live birth rates per cycle. Duration of stimulation, mean gonadotropin dose used, endometrial thickness, number of mature follicles, serum estradiol (E2 and progesterone (P levels on the day of human chorionic gonadotropin (hCG administration, number of retrieved oocytes and fertilization rates were also evaluated. Results: A total number of 42 cycles of 32 severe poor responders were evaluated. Total gonadotropin consumption was significantly lower (1491 ± 873 vs. 2808 ± 1581 IU, P=0.005 and mean E2 level on the day of hCG injection were significantly higher in CC group than L group (443.3 ± 255.2 vs. 255.4 ± 285.2 pg/mL, P=0.03. ET, overall pregnancy and live birth rates per cycle were significantly higher in CC than L protocol (27.2 vs. 15%, 13.6 vs. 0% and 4.5 vs. 0%, respectively, P<0.05. Conclusion: Severe poor responders who had previously failed to respond to microdose or GnRH antagonist protocols may benefit from CC plus hMG/GnRH antagonist protocol despite high cancellation rate.

  13. Personality disorders in previously detained adolescent females: a prospective study

    NARCIS (Netherlands)

    Krabbendam, A.; Colins, O.F.; Doreleijers, T.A.H.; van der Molen, E.; Beekman, A.T.F.; Vermeiren, R.R.J.M.

    2015-01-01

    This longitudinal study investigated the predictive value of trauma and mental health problems for the development of antisocial personality disorder (ASPD) and borderline personality disorder (BPD) in previously detained women. The participants were 229 detained adolescent females who were assessed

  14. Failed fuel detection device

    International Nuclear Information System (INIS)

    Sudo, Takayuki.

    1983-01-01

    Purpose: To enable early and sure detection of failed fuels by automatically changing the alarm set value depending on the operation states of a nuclear reactor. Constitution: Gaseous fission products released into coolants are transferred further into cover gases and then introduced through a pipeway to a failed fuel detector. The cover gases introduced from the pipeway to the pipeway or chamber within the detection device are detected by a radiation detector for the radiation dose of the gaseous fission products contained therein. The detected value is converted and amplified as a signal and inputted to a comparator. While on the other hand, a signal corresponding to the reactor power is converted by an alarm setter into a set value and inputted to the comparator. In such a structure, early and sure detection can be made for the fuel failures. (Yoshino, Y.)

  15. High risk for revision after shoulder arthroplasty for failed osteosynthesis of proximal humeral fractures

    DEFF Research Database (Denmark)

    Kristensen, Marc Randall; Rasmussen, Jeppe Vejlgaard; Elmengaard, Brian

    2018-01-01

    Background and purpose - It is unclear whether previous osteosynthesis is a risk factor for inferior outcome following shoulder arthroplasty for a proximal humeral fracture. We used data from the Danish Shoulder Arthroplasty Registry (DSR) to examine this question. Patients and methods - All 285...... patients treated with a shoulder arthroplasty after failed osteosynthesis of a proximal humeral fracture reported to DSR from 2006 to 2013 were included. Each case was matched with 2 controls (570) treated with a primary shoulder arthroplasty for an acute proximal humeral fracture. Patient reported outcome...... for a shoulder arthroplasty after failed osteosynthesis was 2 with a primary arthroplasty for fracture as reference. In a separate analysis of patients treated by locking plate the mean WOOS was 46 (24), with a relative risk of revision at 1.5 with a primary arthroplasty as reference. Interpretation - Compared...

  16. Failed fuel action plan guidelines: Special report

    International Nuclear Information System (INIS)

    1987-11-01

    The objective of this document is to provide a generic guideline that can be used to formulate a failed fuel action plan (FFAP) for specific application by a utility. This document is intended to be part of a comprehensive fuel reliability monitoring, management, and improvement program. The utilities may utilize this document as one resource in developing a failed fuel action plan. This document is not intended to be used as a failed fuel action plan standard. This document is intended to provide guidance on: management responsibilities; fuel performance parameters; cost/benefit analysis; action levels; long-term improvement methods; and data collection, analysis, and trending. 3 refs., 4 figs., 6 tabs

  17. Securing Failed Inner-City Communities: The Military's Role

    National Research Council Canada - National Science Library

    Khan, Oral

    1997-01-01

    This study examines the threat to internal security posed by violent gangs. This threat was found to be particularly acute in inner-city communities that have over time devolved to a status that the author classified as failed communities...

  18. Evaluation of secondary surgery to enlarge the peeling of the internal limiting membrane following the failed surgery of idiopathic macular holes.

    Science.gov (United States)

    Che, Xin; He, Fanglin; Lu, Linna; Zhu, Dongqing; Xu, Xiaofang; Song, Xin; Fan, Xianqun; Wang, Zhiliang

    2014-03-01

    The aim of the present study was to evaluate the clinical results of pars plana vitrectomy (PPV) combined with the surgical enlargement of internal limiting membrane (ILM) peeling in patients who had previously undergone failed idiopathic macular hole (IMH) surgery. In the study, 134 eyes from 130 IMH patients who had received PPV combined with ILM peeling surgery (2 disk diameters) were analyzed. Within this cohort, 14 eyes had IMHs that were not closed, of which 13 eyes underwent a second surgery involving enlargement of the ILM peeling. The extent of the ILM peeling was increased to the vascular arcades of the posterior fundus in the secondary surgery. Of the 13 eyes that underwent secondary surgery, five were in stage III and nine were in stage IV. The second surgery successfully achieved IMH closure in 61.5% (8/13) of the eyes. The IMH was completely closed following surgery and the logMAR vision increased from 0.98 to 0.84 (P=0.013) in the 8 successfully treated cases. The surgical enlargement of ILM peeling closed the IMHs and improved vision in the majority of patients. In addition, the procedures were safe. Therefore, the results of the present study indicate that enlargement of ILM peeling may be an effective therapy for patients who have previously undergone the failed surgical correction of an IMH.

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

    Directory of Open Access Journals (Sweden)

    Adam K Fetterman

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

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

    Science.gov (United States)

    Fetterman, Adam K; Sassenberg, Kai

    2015-01-01

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

  1. The failing firm defence: merger policy and entry

    OpenAIRE

    Mason, Robin; Weeds, Helen

    2003-01-01

    This Paper considers the 'failing firm defence'. Under this principle, found in most antitrust jurisdictions, a merger that would otherwise be blocked due to its adverse effect on competition is permitted when the firm to be acquired is a failing firm, and an alternative, less detrimental merger is unavailable. Competition authorities have shown considerable reluctance to accept the failing firm defence, and it has been successfully used in just a handful of cases. The Paper considers the def...

  2. Coping Styles of Failing Brunei Vocational Students

    Science.gov (United States)

    Mundia, Lawrence; Salleh, Sallimah

    2017-01-01

    Purpose: The purpose of this paper is to determine the prevalence of two types of underachieving students (n = 246) (active failing (AF) and passive failing (PF)) in Brunei vocational and technical education (VTE) institutions and their patterns of coping. Design/methodology/approach: The field survey method was used to directly reach many…

  3. Clinical analyses of successful and previously failed intracytoplasmic sperm injection cycle parameters in patients with poor ovarian reserve

    Directory of Open Access Journals (Sweden)

    Tayfun Kutlu

    2017-03-01

    Full Text Available Objective: To determine some major characteristic differences between two consecutive successful and unsuccessful intracytoplasmic sperm injection (ICSI cycles in poor responders. Materials and Methods: Sixty women with poor ovarian response as determined using the Bologna criteria underwent ICSI cycles following an unsuccessful trial. Some parameters of both cycles including age, body mass index (BMI, serum follicle-stimulating hormone (FSH and estradiol levels, antral follicle count, gonadotropin dosage, duration of stimulation, antagonist starting day, duration of antagonist administration, endometrial thickness at trigger day, number of total and fertilized oocytes, embryo transfer day, number of embryo cells, and fertilization rate were compared in the same patients to identify predictors of cycles with clinical pregnancy. Results: The mean age, BMI, serum FSH, estradiol concentrations, and antral follicle count were 35.9 years (range, 30-42 years, 25.9 kg/m2 (range, 18.4-33.5 kg/m2, 10.9 IU/mL (range, 7-13 IU/mL, 52.9 pg/mL (range, 11.6-75 pg/mL, and 4.7 (range, 2-10, respectively. A comparison of cycle characteristics showed a significantly higher total number of mature and fertilized oocytes in successful cycles. The fertilization rate was also significantly higher in cycles with clinical pregnancy. Early initiation of antagonist was shown to result in favorable outcomes. A comparison of embryo characteristics showed that transfer of higher-stage embryos and embryos with higher numbers of cells had a significant impact on cycle outcomes. Conclusion: Our comparison of parameters of failed and successful ICSI cycles in poor responders revealed significantly earlier antagonist initiation, higher total number of mature and fertilized oocytes, fertilization rate, and significantly higher stage of embryo development and cell numbers at transfer in cycles that resulted in clinical pregnancy.

  4. Salvage reconstruction of failed interposition arthroplasty at the base of the thumb.

    Science.gov (United States)

    Braun, Richard M; Rechnic, Mark; Shah, Kalpit N

    2012-12-01

    We present an operative procedure designed to revise a failed arthroplasty at the base of the thumb. This report describes a reliable operation that corrects residual instability and malignment which results in thumbs that are weak and painful despite a previous procedure. The operation has also been used as a primary procedure for arthritis of the trapeziometacarpal joint where instability and subluxation was a major component of the problem requiring joint reconstruction. The unique features of this procedure include a reinforced double-thickness tendon graft, a unique tendon anchor, and a fascia lata allograft spacer. Significant functional improvement is anticipated when joint reconstruction provides increased proximal stability. Pinch and grip measurements improve. Pain scores also diminish after the operation. Hand function and patient satisfaction can be substantially improved with revision arthroplasty when the initial operation has failed to provide a thumb that is mobile, stable, and pain free. The technical features of the procedure address reduction of malignment, restoring of anatomic balance, and secure fixation of the proximal apex of the thumb metacarpal which restores thumb reduction position and digital balance.

  5. Editorial Commentary: In a World of Endless Options, Is There a Single Solution? Management Options for Failed Anterior Instability Surgery in Athletes.

    Science.gov (United States)

    Matzkin, Elizabeth

    2018-05-01

    There are many options to manage anterior instability of the shoulder. The management of athletes who have failed previous operative stabilization can make choosing a treatment solution difficult. A modified Latarjet without capsulolabral repair has been demonstrated to be a good choice when treating failed stabilization in a high-risk population with sufficient return to play and outcomes. Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  6. Who Really Failed? Commentary

    Science.gov (United States)

    Maiuri, Katherine M.; Leon, Raul A.

    2012-01-01

    Scott Jaschik's (2010) article "Who Really Failed?" details the experience of Dominique Homberger, a tenured faculty member at Louisiana State University (LSU) who was removed from teaching her introductory biology course citing student complaints in regards to "the extreme nature" of the grading policy. This removal has…

  7. Abortion: Strong's counterexamples fail

    DEFF Research Database (Denmark)

    Di Nucci, Ezio

    2009-01-01

    This paper shows that the counterexamples proposed by Strong in 2008 in the Journal of Medical Ethics to Marquis's argument against abortion fail. Strong's basic idea is that there are cases--for example, terminally ill patients--where killing an adult human being is prima facie seriously morally...

  8. A study of complex defects failing by fatigue, ductile tearing and cleavage

    International Nuclear Information System (INIS)

    Bezensek, B.; Ren, Z.; Hancock, J.W.

    2001-01-01

    Defect assessment procedures ensure the structural integrity of plant, which may contain complex defects. The present work addresses complex defects with re-entrant sectors, which develop from the interaction of two co-planar surface breaking defects in fatigue. Experimental studies show rapid fatigue growth and amplified crack driving forces in the re-entrant sector. This leads to the rapid evolution of the complex crack into a bounding semielliptical defect. Experiments involving ductile tearing of cracks with a re-entrant sector show that tearing initiates in the re-entrant sector and that the defect evolves into a bounding semielliptical defect. Cleavage failures of defects with re-entrant sectors indicate the re-characterisation procedure is only conservative after invoking constraint arguments. The study confirms the conservatism inherent in the re-characterisation rules of assessment procedures, such as BS 7910 [1] and ASME Section XI [2] for complex defects extending by fatigue or ductile tearing. A potentially non-conservative situation exists for defects with re-entrant sectors failing by cleavage at small fractions of the limit load.(author)

  9. Breaking the Failed-State Cycle

    National Research Council Canada - National Science Library

    Haims, Marla C; Gompert, David C; Treverton, Gregory F; Stearns, Brooke K

    2008-01-01

    In their research and field experience, the authors have observed a wide gulf separating the treatment of the security problems of failed states from the treatment of those states economic problems...

  10. Hip arthroplasty in failed intertrochanteric fractures in elderly

    Directory of Open Access Journals (Sweden)

    Javahir A Pachore

    2013-01-01

    Full Text Available Background: Failed intertrochanteric fractures in elderly patients are surgical challenge with limited options. Hip arthroplasty is a good salvage procedure even though it involves technical issues such as implant removal, bone loss, poor bone quality, trochanteric nonunion and difficulty of surgical exposure. Materials and Methods: 30 patients of failed intertrochanteric fractures where hip arthroplasty was done between May 2008 and December 2011 were included in study. 13 were males and 17 were females with average age of 67.3 years. There were 2 cemented bipolar arthroplasties, 19 uncemented bipolar, 4 cemented total hip arthroplasty and 5 uncemented total hip arthroplasties. 16 patients had a trochanteric nonunion, which was treated by tension band principles. Total hip was considered where there was acetabular damage due to the penetration of implant. Results: The average followup was 20 months (range 6-48 months. Patients were followed up from 6 to 48 months with average followup of 20 months. None of the patients were lost to followup. There was no dislocation. All patients were ambulatory at the final followup. Conclusion: A predictable functional outcome can be achieved by hip arthroplasty in elderly patients with failed intertrochanteric fractures. Though technically demanding, properly performed hip arthroplasty can be a good salvage option for this patient group.

  11. Development of failed fuel detection system for PWR (III)

    International Nuclear Information System (INIS)

    Hwang, Churl Kew; Kang, Hee Dong; Jeong, Seung Ho; Cho, Byung Sub; Yoon, Byeong Joo; Yoon, Jae Seong

    1987-12-01

    Ultrasonic transducers satisfying the conditions for failed fuel rod detection for failed fuel rod detection have been designed and built. And performance tests for them have been carried out. Ultrasonic signal processing units, a manipulator guiding the ultrasonic probe through the fuel assembly lanes and its control units have been constructed. The performance of the system has been verified experimentally to be successful in failed fuel rod detection. (Author)

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

    Science.gov (United States)

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

    2006-06-01

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

  13. 77 FR 9846 - Source of Income From Qualified Fails Charges

    Science.gov (United States)

    2012-02-21

    ... temporary regulations noted that no trading practice existed at that time for fails charges on securities other than Treasuries, but that if a fails charge trading practice pertaining to other securities was... sources within the United States, and the income from the qualified fails charge is treated as effectively...

  14. Incidence and related factors for intraoperative failed spinal anaesthesia for lower limb arthroplasty

    DEFF Research Database (Denmark)

    Aasvang, E K; Laursen, M B; Madsen, J

    2018-01-01

    include the risk for intraoperative failed spinal anaesthesia with associated pain, discomfort and suboptimal settings for airway management. Small-scale studies suggest incidences from 1 to 17%; however, no multi-institutional large data exists on failed spinal incidence and related factors during THA....../TKA, hindering evidence-based information and potential anaesthesia stratification. METHODS: In a sub-analysis, data from a prospective study on spinal anaesthesia for THA/TKA were examined for incidence of intraoperative conversion to general anaesthesia. Potential perioperative factors (age, gender, American...... Society of Anaesthesiologist (ASA) score, height, weight, BMI, procedure, bupivacaine dosage and duration of time from spinal administration until end of surgery) were analysed with logistic regression for relation to failed spinal anaesthesia. RESULTS: In all, 1451 patients were included for analysis...

  15. Detecting failed elements on phased array ultrasound transducers using the Edinburgh Pipe Phantom

    Science.gov (United States)

    Inglis, Scott; Pye, Stephen D

    2016-01-01

    Aims Imaging faults with ultrasound transducers are common. Failed elements on linear and curvilinear array transducers can usually be detected with a simple image uniformity or ‘paperclip’ test. However, this method is less effective for phased array transducers, commonly used in cardiac imaging. The aim of this study was to assess whether the presence of failed elements could be detected through measurement of the resolution integral (R) using the Edinburgh Pipe Phantom. Methods A 128-element paediatric phased array transducer was studied. Failed elements were simulated using layered polyvinyl chloride (PVC) tape as an attenuator and measurements of resolution integral were carried out for several widths of attenuator. Results All widths of attenuator greater than 0.5 mm resulted in a significant reduction in resolution integral and low contrast penetration measurements compared to baseline (p tests to detect failed elements on phased array transducers. Particularly encouraging is the result for low contrast penetration as this is a quick and simple measurement to make and can be performed with many different test objects, thus enabling ‘in-the-field’ checks. PMID:27482276

  16. Matched cohort study of external cephalic version in women with previous cesarean delivery.

    Science.gov (United States)

    Keepanasseril, Anish; Anand, Keerthana; Soundara Raghavan, Subrahmanian

    2017-07-01

    To evaluate the efficacy and safety of external cephalic version (ECV) among women with previous cesarean delivery. A retrospective study was conducted using data for women with previous cesarean delivery and breech presentation who underwent ECV at or after 36 weeks of pregnancy during 2011-2016. For every case, two multiparous women without previous cesarean delivery who underwent ECV and were matched for age and pregnancy duration were included. Characteristics and outcomes were compared between groups. ECV was successful for 32 (84.2%) of 38 women with previous cesarean delivery and 62 (81.6%) in the control group (P=0.728). Multivariate regression analysis confirmed that previous cesarean was not associated with ECV success (odds ratio 1.89, 95% confidence interval 0.19-18.47; P=0.244). Successful vaginal delivery after successful ECV was reported for 19 (59.4%) women in the previous cesarean delivery group and 52 (83.9%) in the control group (P<0.001). No ECV-associated complications occurred in women with previous cesarean delivery. To avoid a repeat cesarean delivery, ECV can be offered to women with breech presentation and previous cesarean delivery who are otherwise eligible for a trial of labor. © 2017 International Federation of Gynecology and Obstetrics.

  17. Salvage of Failed Protein Targets by Reductive Alkylation

    Science.gov (United States)

    Tan, Kemin; Kim, Youngchang; Hatzos-Skintges, Catherine; Chang, Changsoo; Cuff, Marianne; Chhor, Gekleng; Osipiuk, Jerzy; Michalska, Karolina; Nocek, Boguslaw; An, Hao; Babnigg, Gyorgy; Bigelow, Lance; Joachimiak, Grazyna; Li, Hui; Mack, Jamey; Makowska-Grzyska, Magdalena; Maltseva, Natalia; Mulligan, Rory; Tesar, Christine; Zhou, Min; Joachimiak, Andrzej

    2014-01-01

    The growth of diffraction-quality single crystals is of primary importance in protein X-ray crystallography. Chemical modification of proteins can alter their surface properties and crystallization behavior. The Midwest Center for Structural Genomics (MCSG) has previously reported how reductive methylation of lysine residues in proteins can improve crystallization of unique proteins that initially failed to produce diffraction-quality crystals. Recently, this approach has been expanded to include ethylation and isopropylation in the MCSG protein crystallization pipeline. Applying standard methods, 180 unique proteins were alkylated and screened using standard crystallization procedures. Crystal structures of 12 new proteins were determined, including the first ethylated and the first isopropylated protein structures. In a few cases, the structures of native and methylated or ethylated states were obtained and the impact of reductive alkylation of lysine residues was assessed. Reductive methylation tends to be more efficient and produces the most alkylated protein structures. Structures of methylated proteins typically have higher resolution limits. A number of well-ordered alkylated lysine residues have been identified, which make both intermolecular and intramolecular contacts. The previous report is updated and complemented with the following new data; a description of a detailed alkylation protocol with results, structural features, and roles of alkylated lysine residues in protein crystals. These contribute to improved crystallization properties of some proteins. PMID:24590719

  18. Salvage of failed protein targets by reductive alkylation.

    Science.gov (United States)

    Tan, Kemin; Kim, Youngchang; Hatzos-Skintges, Catherine; Chang, Changsoo; Cuff, Marianne; Chhor, Gekleng; Osipiuk, Jerzy; Michalska, Karolina; Nocek, Boguslaw; An, Hao; Babnigg, Gyorgy; Bigelow, Lance; Joachimiak, Grazyna; Li, Hui; Mack, Jamey; Makowska-Grzyska, Magdalena; Maltseva, Natalia; Mulligan, Rory; Tesar, Christine; Zhou, Min; Joachimiak, Andrzej

    2014-01-01

    The growth of diffraction-quality single crystals is of primary importance in protein X-ray crystallography. Chemical modification of proteins can alter their surface properties and crystallization behavior. The Midwest Center for Structural Genomics (MCSG) has previously reported how reductive methylation of lysine residues in proteins can improve crystallization of unique proteins that initially failed to produce diffraction-quality crystals. Recently, this approach has been expanded to include ethylation and isopropylation in the MCSG protein crystallization pipeline. Applying standard methods, 180 unique proteins were alkylated and screened using standard crystallization procedures. Crystal structures of 12 new proteins were determined, including the first ethylated and the first isopropylated protein structures. In a few cases, the structures of native and methylated or ethylated states were obtained and the impact of reductive alkylation of lysine residues was assessed. Reductive methylation tends to be more efficient and produces the most alkylated protein structures. Structures of methylated proteins typically have higher resolution limits. A number of well-ordered alkylated lysine residues have been identified, which make both intermolecular and intramolecular contacts. The previous report is updated and complemented with the following new data; a description of a detailed alkylation protocol with results, structural features, and roles of alkylated lysine residues in protein crystals. These contribute to improved crystallization properties of some proteins.

  19. Active Fail-Safe Micro-Array Flow Control for Advanced Embedded Propulsion Systems

    Science.gov (United States)

    Anderson, Bernhard H.; Mace, James L.; Mani, Mori

    2009-01-01

    The primary objective of this research effort was to develop and analytically demonstrate enhanced first generation active "fail-safe" hybrid flow-control techniques to simultaneously manage the boundary layer on the vehicle fore-body and to control the secondary flow generated within modern serpentine or embedded inlet S-duct configurations. The enhanced first-generation technique focused on both micro-vanes and micro-ramps highly-integrated with micro -jets to provide nonlinear augmentation for the "strength' or effectiveness of highly-integrated flow control systems. The study focused on the micro -jet mass flow ratio (Wjet/Waip) range from 0.10 to 0.30 percent and jet total pressure ratios (Pjet/Po) from 1.0 to 3.0. The engine bleed airflow range under study represents about a 10 fold decrease in micro -jet airflow than previously required. Therefore, by pre-conditioning, or injecting a very small amount of high-pressure jet flow into the vortex generated by the micro-vane and/or micro-ramp, active flow control is achieved and substantial augmentation of the controlling flow is realized.

  20. Failed rib region prediction in a human body model during crash events with precrash braking.

    Science.gov (United States)

    Guleyupoglu, B; Koya, B; Barnard, R; Gayzik, F S

    2018-02-28

    The objective of this study is 2-fold. We used a validated human body finite element model to study the predicted chest injury (focusing on rib fracture as a function of element strain) based on varying levels of simulated precrash braking. Furthermore, we compare deterministic and probabilistic methods of rib injury prediction in the computational model. The Global Human Body Models Consortium (GHBMC) M50-O model was gravity settled in the driver position of a generic interior equipped with an advanced 3-point belt and airbag. Twelve cases were investigated with permutations for failure, precrash braking system, and crash severity. The severities used were median (17 kph), severe (34 kph), and New Car Assessment Program (NCAP; 56.4 kph). Cases with failure enabled removed rib cortical bone elements once 1.8% effective plastic strain was exceeded. Alternatively, a probabilistic framework found in the literature was used to predict rib failure. Both the probabilistic and deterministic methods take into consideration location (anterior, lateral, and posterior). The deterministic method is based on a rubric that defines failed rib regions dependent on a threshold for contiguous failed elements. The probabilistic method depends on age-based strain and failure functions. Kinematics between both methods were similar (peak max deviation: ΔX head = 17 mm; ΔZ head = 4 mm; ΔX thorax = 5 mm; ΔZ thorax = 1 mm). Seat belt forces at the time of probabilistic failed region initiation were lower than those at deterministic failed region initiation. The probabilistic method for rib fracture predicted more failed regions in the rib (an analog for fracture) than the deterministic method in all but 1 case where they were equal. The failed region patterns between models are similar; however, there are differences that arise due to stress reduced from element elimination that cause probabilistic failed regions to continue to rise after no deterministic failed region would be

  1. 7 CFR 983.152 - Failed lots/rework procedure.

    Science.gov (United States)

    2010-01-01

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

  2. Failed magnetic resonance imaging examinations due to claustrophobia

    International Nuclear Information System (INIS)

    Sarji, S.A.; Abdullah, B.J.J.; Kumar, G.; Tan, A.H.; Narayanan, P.

    1998-01-01

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

  3. Failed surrogate conceptions: social and ethical aspects of preconception disruptions during commercial surrogacy in India.

    Science.gov (United States)

    Mitra, Sayani; Schicktanz, Silke

    2016-09-19

    During a commercial surrogacy arrangement, the event of embryo transfer can be seen as the formal starting point of the arrangement. However, it is common for surrogates to undergo a failed attempt at pregnancy conception or missed conception after an embryo transfer. This paper attempts to argue that such failed attempts can be understood as a loss. It aims to reconstruct the experiences of loss and grief of the surrogates and the intended parents as a consequence of their collective failure to conceive a surrogate pregnancy. Drawing on a qualitative study conducted over a period of eight months between 2014 and 2015 at two fertility clinics in Delhi and two in Kolkata, India, this paper examines the experiences of the surrogates and the intended parents when faced with missed conceptions or failed conceptions during a surrogacy arrangement. We argue that while the surrogate grieves the non-arrival of a 'good news' as an uncertain loss, the intended parents experience yet another, failure in addition to the losses they might have incurred during their previous fertility treatments. The body of the surrogate becomes a site of 'a lost opportunity'. The surrogate embodies a loss in her quest to achieve social mobility and the intended parents experience a disembodied pregnancy loss. This very emotional experience stands in stark contrast to the conceptualisation of such failed attempts as non-events within the discourse of the surrogacy industry. The experience of loss of the intended parents is recognised but their grief is given no space. We argue that such ambiguity around the nature of losses resulting out of a missed or failed conception during surrogacy is an outcome of lack of interpersonal relationship between the surrogate and the intended parents. Since commercial surrogacy is a relational process, the only way in which the experiences of losses and failures of the actors at the preconception stage can be better addressed is through developing close

  4. Ultrasonics aids the identification of failed fuel rods

    International Nuclear Information System (INIS)

    Anon.

    1985-01-01

    Over a number of years Brown Boveri Reaktor of West Germany has developed and commercialized an ultrasonic failed fuel rod detection system. Sipping has up to now been the standard technique for failed fuel detection, but sipping can only indicate whether or not an assembly contains defective rods; the BBR system can tell which rod is defective. (author)

  5. Utility of Covered Stents for Revision of Aging Failing Synthetic Hemodialysis Grafts: A Report of Three Cases

    International Nuclear Information System (INIS)

    Silas, Anne M.; Bettmann, Michael A.

    2003-01-01

    Three aging failing hemodialysis polytetrafluoroethylene bypass shunts, average age 44 months, previously percutaneously revised with balloon angioplasty, presented with pseudoaneurysms and recurrent thrombosis. All were treated with percutaneous covered stent placement within their affected limbs. One graft was ligated 1 month after treatment for infected overlying skin ulcer, though this graft was subsequently surgically revised with interposition graft and the covered stent portion remains functional at 19 month follow-up. The 18- and 13- month follow- up of the remaining 2 patients shows that the covered stents remained patent and they are functional and being successfully and routinely punctured for dialysis. In this elderly population, the use of covered stents may prolong the functional life of failing hemodialysis bypass grafts, reducing the number of percutaneous and surgical interventions and further sparing other vascular access sites

  6. Reliability testing of failed fuel location system

    International Nuclear Information System (INIS)

    Vieru, G.

    1996-01-01

    This paper presents the experimental reliability tests performed in order to prove the reliability parameters for Failed Fuel Location System (FFLS), equipment used to detect in which channel of a particular heat transport loop a fuel failure is located, and to find in which channel what particular bundle pair is failed. To do so, D20 samples from each reactor channel are sequentially monitored to detect a comparatively high level of delayed neutron activity. 15 refs, 8 figs, 2 tabs

  7. Comparison of two inductive learning methods: A case study in failed fuel identification

    Energy Technology Data Exchange (ETDEWEB)

    Reifman, J. [Argonne National Lab., IL (United States); Lee, J.C. [Michigan Univ., Ann Arbor, MI (United States). Dept. of Nuclear Engineering

    1992-05-01

    Two inductive learning methods, the ID3 and Rg algorithms, are studied as a means for systematically and automatically constructing the knowledge base of expert systems. Both inductive learning methods are general-purpose and use information entropy as a discriminatory measure in order to group objects of a common class. ID3 constructs a knowledge base by building decision trees that discriminate objects of a data set as a function of their class. Rg constructs a knowledge base by grouping objects of the same class into patterns or clusters. The two inductive methods are applied to the construction of a knowledge base for failed fuel identification in the Experimental Breeder Reactor II. Through analysis of the knowledge bases generated, the ID3 and Rg algorithms are compared for their knowledge representation, data overfitting, feature space partition, feature selection, and search procedure.

  8. Comparison of two inductive learning methods: A case study in failed fuel identification

    Energy Technology Data Exchange (ETDEWEB)

    Reifman, J. (Argonne National Lab., IL (United States)); Lee, J.C. (Michigan Univ., Ann Arbor, MI (United States). Dept. of Nuclear Engineering)

    1992-01-01

    Two inductive learning methods, the ID3 and Rg algorithms, are studied as a means for systematically and automatically constructing the knowledge base of expert systems. Both inductive learning methods are general-purpose and use information entropy as a discriminatory measure in order to group objects of a common class. ID3 constructs a knowledge base by building decision trees that discriminate objects of a data set as a function of their class. Rg constructs a knowledge base by grouping objects of the same class into patterns or clusters. The two inductive methods are applied to the construction of a knowledge base for failed fuel identification in the Experimental Breeder Reactor II. Through analysis of the knowledge bases generated, the ID3 and Rg algorithms are compared for their knowledge representation, data overfitting, feature space partition, feature selection, and search procedure.

  9. Comparison of two inductive learning methods: A case study in failed fuel identification

    International Nuclear Information System (INIS)

    Reifman, J.; Lee, J.C.

    1992-01-01

    Two inductive learning methods, the ID3 and Rg algorithms, are studied as a means for systematically and automatically constructing the knowledge base of expert systems. Both inductive learning methods are general-purpose and use information entropy as a discriminatory measure in order to group objects of a common class. ID3 constructs a knowledge base by building decision trees that discriminate objects of a data set as a function of their class. Rg constructs a knowledge base by grouping objects of the same class into patterns or clusters. The two inductive methods are applied to the construction of a knowledge base for failed fuel identification in the Experimental Breeder Reactor II. Through analysis of the knowledge bases generated, the ID3 and Rg algorithms are compared for their knowledge representation, data overfitting, feature space partition, feature selection, and search procedure

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

    DEFF Research Database (Denmark)

    Brix, Jacob

    2015-01-01

    Almost three quarters of all innovation projects disappoint or fail. Instead of 'wasting' human and financial resources on energy projects that end up being terminated or ineffectual, this study offers a potential antidote coined the 'Origins of Failure in Energy Innovation' (OFEI) model. Based o...

  11. Failing by design.

    Science.gov (United States)

    McGrath, Rita Gunther

    2011-04-01

    It's hardly news that business leaders work in increasingly uncertain environments, where failures are bound to be more common than successes. Yet if you ask executives how well, on a scale of one to 10, their organizations learn from failure, you'll often get a sheepish "Two-or maybe three" in response. Such organizations are missing a big opportunity: Failure may be inevitable but, if managed well, can be very useful. A certain amount of failure can help you keep your options open, find out what doesn't work, create the conditions to attract resources and attention, make room for new leaders, and develop intuition and skill. The key to reaping these benefits is to foster "intelligent failure" throughout your organization. McGrath describes several principles that can help you put intelligent failure to work. You should decide what success and failure would look like before you start a project. Document your initial assumptions, test and revise them as you go, and convert them into knowledge. Fail fast-the longer something takes, the less you'll learn-and fail cheaply, to contain your downside risk. Limit the number of uncertainties in new projects, and build a culture that tolerates, and sometimes even celebrates, failure. Finally, codify and share what you learn. These principles won't give you a means of avoiding all failures down the road-that's simply not realistic. They will help you use small losses to attain bigger wins over time.

  12. In-core sipping method for the identification of failed fuel assemblies

    International Nuclear Information System (INIS)

    Wu Zhongwang; Zhang Yajun

    2000-01-01

    The failed fuel assembly identification system is an important safety system which ensures safe operations of reactor and immediate treatment of failed fuel rod cladding. The system uses an internationally recognized method to identify failed fuel assemblies in a reactor with fuel element cases. The in-core sipping method is customary used to identify failed fuel assemblies during refueling or after fuel rod cladding failure accidents. The test is usually performed after reactor shutdown by taking samples from each fuel element case while the cases are still in their original core positions. The sample activity is then measured to identify failed fuel assemblies. A failed fuel assembly identification system was designed for the NHR-200 based on the properties of the NHR-200 and national requirements. the design provides an internationally recognized level of safety to ensure the safety of NHR-200

  13. Closure of oroantral communication with buccal fat pad after removing bilateral failed zygomatic implants: A case report and 6-month follow-up.

    Science.gov (United States)

    Peñarrocha-Oltra, David; Alonso-González, Rocio; Pellicer-Chover, Hilario; Aloy-Prósper, Amparo; Peñarrocha-Diago, María

    2015-02-01

    The aim of this study was to assess the use of buccal fat pad (BFP) technique as an option to close oroantral communications (OAC) after removing failed zygomatic implants in a patient with a severely resorbed maxilla, and to determine the degree of patient satisfaction. A 64-year-old woman presented recurrent sinusitis and permanent oroantral communication caused by bilateral failed zygomatic implants, 3 years after prosthetic loading. Zygomatic implants were removed previous antibiotic treatment and the BFP flap technique was used to treat the OAC and maxillary defect. The degree of patient satisfaction after treatment was assessed through a visual analogue scale (VAS). At 6-months follow-up, patient showed complete healing and good function and the results in terms of phonetics, aesthetics and chewing were highly rated by the patient. Key words:Bichat fat pad, buccal fat pad, zygomatic implants, oroantral communication.

  14. DECOFF Probabilities of Failed Operations

    DEFF Research Database (Denmark)

    Gintautas, Tomas

    2015-01-01

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

  15. Failed fuel detection device

    International Nuclear Information System (INIS)

    Kawai, Masayoshi; Hayashida, Yoshihisa; Niidome, Jiro.

    1985-01-01

    Purpose: To prevent intrusion of background neutrons to neutron detectors thereby improve the S/N ratio of the detectors in the failed fuel detection device of LMFBR type reactors. Constitution: Neutrons from the reactor core pass through the gaps around the penetration holes in which the primary pipeways pass through the concrete shielding walls and pass through the gaps between the thermal shielding members and the neutron moderating shielding members of the failed fuel detection device and then intrude into the neutron detectors. In view of the above, inner neutron moderating shielding members and movable or resilient neutron shielding members are disposed to the inside of the neutron moderating shielding member. Graphite or carbon hydrides such as paraffin or synthetic resin with a large neutron moderation effect are used as the outer moderating shielding member and materials such as boron or carbon are used for the inner members. As a result, the background neutrons are shielded by the inner neutron moderating shielding members and the resilient neutron shielding members, by which the S/N ratio of the neutron detectors can be increased to 2 - 4 times. (Moriyama, K.)

  16. Failed fuel detector

    International Nuclear Information System (INIS)

    Kogure, Sumio; Seya, Toru; Watanabe, Masaaki.

    1976-01-01

    Purpose: To enhance the reliability of a failed fuel detector which detects radioactivity of nuclear fission products leaked out from fuel elements in cooling water. Constitution: Collected specimen is introduced into a separator and co-existing material considered to be an impediment is separated and removed by ion exchange resins, after which this specimen is introduced into a container housing therein a detector to systematically measure radioactivity. Thereby, it is possible to detect a signal lesser in variation in background, and inspection work also becomes simple. (Kawakami, Y.)

  17. Why did the League of Nations fail?

    OpenAIRE

    Jari Eloranta

    2011-01-01

    Why did the League of Nations ultimately fail to achieve widespread disarmament, its most fundamental goal? This article shows that the failure of the League of Nations had two important dimensions: (1) the failure to provide adequate security guarantees for its members (like an alliance); (2) the failure of this organization to achieve the disarmament goals it set out in the 1920s and 1930s. Thus, it was doomed from the outset to fail, due to built-in institutional contradictions. It can als...

  18. Trial of labour and vaginal birth after previous caesarean section: A population based study of Eastern African immigrants in Victoria, Australia.

    Science.gov (United States)

    Belihu, Fetene B; Small, Rhonda; Davey, Mary-Ann

    2017-03-01

    Variations in caesarean section (CS) between some immigrant groups and receiving country populations have been widely reported. Often, African immigrant women are at higher risk of CS than the receiving population in developed countries. However, evidence about subsequent mode of birth following CS for African women post-migration is lacking. The objective of this study was to examine differences in attempted and successful vaginal birth after previous caesarean (VBAC) for Eastern African immigrants (Eritrea, Ethiopia, Somalia and Sudan) compared with Australian-born women. A population-based observational study was conducted using the Victorian Perinatal Data Collection. Pearson's chi-square test and logistic regression analysis were performed to generate adjusted odds ratios for attempted and successful VBAC. Victoria, Australia. 554 Eastern African immigrants and 24,587 Australian-born eligible women with previous CS having singleton births in public care. 41.5% of Eastern African immigrant women and 26.1% Australian-born women attempted a VBAC with 50.9% of Eastern African immigrants and 60.5% of Australian-born women being successful. After adjusting for maternal demographic characteristics and available clinical confounding factors, Eastern African immigrants were more likely to attempt (OR adj 1.94, 95% CI 1.57-2.47) but less likely to succeed (OR adj 0.54 95% CI 0.41-0.71) in having a VBAC. There are disparities in attempted and successful VBAC between Eastern African origin and Australian-born women. Unsuccessful VBAC attempt is more common among Eastern African immigrants, suggesting the need for improved strategies to select and support potential candidates for vaginal birth among these immigrants to enhance success and reduce potential complications associated with failed VBAC attempt. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Ashraf Eskandr

    2016-01-01

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

  20. Benefits of extra begging fail to compensate for immunological costs in southern shrike (Lanius meridionalis nestlings.

    Directory of Open Access Journals (Sweden)

    Gregorio Moreno-Rueda

    Full Text Available Theoretical models aimed at explaining the evolution of honest, informative begging signals employed by nestling birds to solicit food from their parents, require that dishonest signalers incur a net viability cost in order to prevent runaway escalation of signal intensity over evolutionary time. Previous attempts to determine such a cost empirically have identified two candidate physiological costs associated with exaggerated begging: a growth and an immunological cost. However, they failed to take into account the fact that those costs are potentially offset by the fact that nestlings that invest more in begging are also likely to obtain more food. In this study, we test experimentally whether a 25% increase in ingested food compensates for growth and immunological costs of extra begging in southern shrike (Lanius meridionalis nestlings. Three nestmates matched by size were given three treatments: low begging, high begging-same food intake, and high begging-extra food intake. We found that, while a higher food intake did effectively compensate for the growth cost, it failed to compensate for the immunological cost, measured as T-cell mediated immune response against an innocuous mitogen. Thus, we show for the first time that escalated begging has an associated physiological net cost likely to affect nestling survival negatively.

  1. Is laparoscopic reoperation for failed antireflux surgery feasible?

    Science.gov (United States)

    Floch, N R; Hinder, R A; Klingler, P J; Branton, S A; Seelig, M H; Bammer, T; Filipi, C J

    1999-07-01

    Laparoscopic techniques can be used to treat patients whose antireflux surgery has failed. Case series. Two academic medical centers. Forty-six consecutive patients, of whom 21 were male and 25 were female (mean age, 55.6 years; range, 15-80 years). Previous antireflux procedures were laparoscopic (21 patients), laparotomy (21 patients), thoracotomy (3 patients), and thoracoscopy (1 patient). The cause of failure, operative and postoperative morbidity, and the level of follow-up satisfaction were determined for all patients. The causes of failure were hiatal herniation (31 patients [67%]), fundoplication breakdown (20 patients [43%]), fundoplication slippage (9 patients [20%]), tight fundoplication (5 patients [11%]), misdiagnosed achalasia (2 patients [4%]), and displaced Angelchik prosthesis (2 patients [4%]). Twenty-two patients (48%) had more than 1 cause. Laparoscopic reoperative procedures were Nissen fundoplication (n = 22), Toupet fundoplication (n = 13), paraesophageal hernia repair (n = 4), Dor procedure (n = 2), Angelchik prosthesis removal (n = 2), Heller myotomy (n = 2), and the takedown of a wrap (n = 1). In addition, 18 patients required crural repair and 13 required paraesophageal hernia repair. The mean +/- SEM duration of surgery was 3.5+/-1.1 hours. Operative complications were fundus tear (n = 8), significant bleeding (n = 4), bougie perforation (n = 1), small bowel enterotomy (n = 1), and tension pneumothorax (n = 1). The conversion rate (from laparoscopic to an open procedure) was 20% overall (9 patients) but 0% in the last 10 patients. Mortality was 0%. The mean +/- SEM hospital stay was 2.3+/-0.9 days for operations completed laparoscopically. Follow-up was possible in 35 patients (76%) at 17.2+/-11.8 months. The well-being score (1 best; 10, worst) was 8.6+/-2.1 before and 2.9+/-2.4 after surgery (Papproach may be used successfully to treat patients with failed antireflux operations. Good results were achieved despite the technical

  2. Failed total carpometacarpal joint prosthesis of the thumb

    DEFF Research Database (Denmark)

    Hansen, Torben Bæk; Homilius, Morten

    2010-01-01

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

  3. Economy Over Security: Why Crises Fail to Impact Economic Behavior in East Asia

    Science.gov (United States)

    2017-12-01

    SECURITY: WHY CRISES FAIL TO IMPACT ECONOMIC BEHAVIOR IN EAST ASIA by Aaron R. Sipos December 2017 Thesis Advisor: Michael Glosny Second...REPORT TYPE AND DATES COVERED Master’s thesis 4. TITLE AND SUBTITLE ECONOMY OVER SECURITY: WHY CRISES FAIL TO IMPACT ECONOMIC BEHAVIOR IN EAST...release. Distribution is unlimited. 12b. DISTRIBUTION CODE 13. ABSTRACT (maximum 200 words) This study examines changes in economic behavior in

  4. Previously unidentified changes in renal cell carcinoma gene expression identified by parametric analysis of microarray data

    International Nuclear Information System (INIS)

    Lenburg, Marc E; Liou, Louis S; Gerry, Norman P; Frampton, Garrett M; Cohen, Herbert T; Christman, Michael F

    2003-01-01

    Renal cell carcinoma is a common malignancy that often presents as a metastatic-disease for which there are no effective treatments. To gain insights into the mechanism of renal cell carcinogenesis, a number of genome-wide expression profiling studies have been performed. Surprisingly, there is very poor agreement among these studies as to which genes are differentially regulated. To better understand this lack of agreement we profiled renal cell tumor gene expression using genome-wide microarrays (45,000 probe sets) and compare our analysis to previous microarray studies. We hybridized total RNA isolated from renal cell tumors and adjacent normal tissue to Affymetrix U133A and U133B arrays. We removed samples with technical defects and removed probesets that failed to exhibit sequence-specific hybridization in any of the samples. We detected differential gene expression in the resulting dataset with parametric methods and identified keywords that are overrepresented in the differentially expressed genes with the Fisher-exact test. We identify 1,234 genes that are more than three-fold changed in renal tumors by t-test, 800 of which have not been previously reported to be altered in renal cell tumors. Of the only 37 genes that have been identified as being differentially expressed in three or more of five previous microarray studies of renal tumor gene expression, our analysis finds 33 of these genes (89%). A key to the sensitivity and power of our analysis is filtering out defective samples and genes that are not reliably detected. The widespread use of sample-wise voting schemes for detecting differential expression that do not control for false positives likely account for the poor overlap among previous studies. Among the many genes we identified using parametric methods that were not previously reported as being differentially expressed in renal cell tumors are several oncogenes and tumor suppressor genes that likely play important roles in renal cell

  5. Thermal analysis of the failed equipment storage vault system

    International Nuclear Information System (INIS)

    Jerrell, J.; Lee, S.Y.; Shadday, A.

    1995-07-01

    A storage facility for failed glass melters is required for radioactive operation of the Defense Waste Processing Facility (DWPF). It is currently proposed that the failed melters be stored in the Failed Equipment Storage Vaults (FESV's) in S area. The FESV's are underground reinforced concrete structures constructed in pairs, with adjacent vaults sharing a common wall. A failed melter is to be placed in a steel Melter Storage Box (MSB), sealed, and lowered into the vault. A concrete lid is then placed over the top of the FESV. Two melters will be placed within the FESV/MSB system, separated by the common wall. There is no forced ventilation within the vault so that the melter is passively cooled. Temperature profiles in the Failed Equipment Storage Vault Structures have been generated using the FLOW3D software to model heat conduction and convection within the FESV/MSB system. Due to complexities in modeling radiation with FLOW3D, P/THERMAL software has been used to model radiation using the conduction/convection temperature results from FLOW3D. The final conjugate model includes heat transfer by conduction, convection, and radiation to predict steady-state temperatures. Also, the FLOW3D software has been validated as required by the technical task request

  6. Estrogen supplementation failed to attenuate biochemical indices of neutrophil infiltration or damage in rat skeletal muscles following ischemia.

    Science.gov (United States)

    Tiidus, Peter M; Deller, Mirada; Bombardier, Eric; Gül, Mustafa; Liu, X Linda

    2005-01-01

    This study examined the effects of estrogen supplementation on markers of neutrophil infiltration and damage in skeletal muscle of rats following ischemia. Male and female gonad-intact rats, with or without 14 days of estrogen supplementation were subjected to two hours of hind-limb ischemia and sacrificed at 24, 48 or 72 hours post-ischemia. Control animals were sacrificed without ischemia. Plantaris and red and white gastrocneimus muscles were removed and assayed for myeloperoxidase (MPO), a marker of neutrophil infiltration, and glucose-6-phosphate dehydrogenase (G6PD) and beta-glucuronidase (betaGLU), as markers of muscle damage. Significant elevations of MPO, G6PD and betaGLU activities were observed at various time points post-ischemia. No systematic differences between genders were noted in any of the measures. Estrogen supplementation in both male and female animals failed to significantly attenuate post-ischemia increases in MPO, G6PD and betaGLU activities in any of the muscles studied and in some cases accentuated activities of some of these measures. Unlike previous findings following exercise in skeletal muscle, this study failed to demonstrate estrogen-induced attenuation of indices of neutrophil infiltration or damage in skeletal muscles of rats up to 72 hours following ischemia. This demonstrates that estrogen may not consistently attenuate neutrophil infiltration and that a number of variables including damage modality, tissue or estrogen level may influence this.

  7. Estrogen supplementation failed to attenuate biochemical indices of neutrophil infiltration or damage in rat skeletal muscles following ischemia

    Directory of Open Access Journals (Sweden)

    PETER M TIIDUS

    2005-01-01

    Full Text Available This study examined the effects of estrogen supplementation on markers of neutrophil infiltration and damage in skeletal muscle of rats following ischemia. Male and female gonad-intact rats, with or without 14 days of estrogen supplementation were subjected to two hours of hind-limb ischemia and sacrificed at 24, 48 or 72 hours post-ischemia. Control animals were sacrificed without ischemia. Plantaris and red and white gastrocneimus muscles were removed and assayed for myeloperoxidase (MPO, a marker of neutrophil infiltration, and glucose-6-phosphate dehydrogenase (G6PD and ß-glucuronidase (GLU, as markers of muscle damage. Significant elevations of MPO, G6PD and GLU activities were observed at various time points post-ischemia. No systematic differences between genders were noted in any of the measures. Estrogen supplementation in both male and female animals failed to significantly attenuate post-ischemia increases in MPO, G6PD and GLU activities in any of the muscles studied and in some cases accentuated activities of some of these measures. Unlike previous findings following exercise in skeletal muscle, this study failed to demonstrate estrogen-induced attenuation of indices of neutrophil infiltration or damage in skeletal muscles of rats up to 72 hours following ischemia. This demonstrates that estrogen may not consistently attenuate neutrophil infiltration and that a number of variables including damage modality, tissue or estrogen level may influence this.

  8. Placenta Percreta in First Trimester after Multiple Rounds of Failed Medical Management for a Missed Abortion

    Directory of Open Access Journals (Sweden)

    Jaimin Shah

    2017-01-01

    Full Text Available Background. The detection of a morbidly adherent placenta (MAP in the first trimester is rare. Risk factors such as multiparity, advanced maternal age, prior cesarean delivery, prior myomectomy, placenta previa, or previous uterine evacuation place patients at a higher risk for having abnormal placental implantation. If these patients have a first trimester missed abortion and fail medical management, it is important that providers have a heightened suspicion for a MAP. Case. A 24-year-old G4P3003 with 3 prior cesarean deliveries underwent multiple rounds of failed medical management for a missed abortion. She had a dilation and curettage that was complicated by a significant hemorrhage and ultimately required an urgent hysterectomy. Conclusion. When patients fail medical management for a missed abortion, providers need to assess the patient’s risk factors for a MAP. If risk factors are present, a series of specific evaluations should be triggered to rule out a MAP and help further guide management. Early diagnosis of a MAP allows providers to coordinate a multidisciplinary treatment approach and thoroughly counsel patients. Ensuring adequate resources and personnel at a tertiary hospital is essential to provide the highest quality of care and improve outcomes.

  9. Analysis of failed nuclear plant components

    International Nuclear Information System (INIS)

    Diercks, D.R.

    1993-01-01

    Argonne National Laboratory has conducted analyses of failed components from nuclear power-generating stations since 1974. The considerations involved in working with an analyzing radioactive components are reviewed here, and the decontamination of these components is discussed. Analyses of four failed components from nuclear plants are then described to illustrate the kinds of failures seen in service. The failures discussed are (1) intergranular stress-corrosion cracking of core spray injection piping in a boiling water reactor, (2) failure of canopy seal welds in adapter tube assemblies in the control rod drive head of a pressurized water reactor, (3) thermal fatigue of a recirculation pump shaft in a boiling water reactor, and (4) failure of pump seal wear rings by nickel leaching in a boiling water reactor

  10. Analysis of failed nuclear plant components

    International Nuclear Information System (INIS)

    Diercks, D.R.

    1992-07-01

    Argonne National Laboratory has conducted analyses of failed components from nuclear power generating stations since 1974. The considerations involved in working with and analyzing radioactive components are reviewed here, and the decontamination of these components is discussed. Analyses of four failed components from nuclear plants are then described to illustrate the kinds of failures seen in service. The failures discussed are (a) intergranular stress corrosion cracking of core spray injection piping in a boiling water reactor, (b) failure of canopy seal welds in adapter tube assemblies in the control rod drive head of a pressure water reactor, (c) thermal fatigue of a recirculation pump shaft in a boiling water reactor, and (d) failure of pump seal wear rings by nickel leaching in a boiling water reactor

  11. Delay factors in failed construction projects in southwestern Nigeria ...

    African Journals Online (AJOL)

    This study was carried out with a view to showing the contribution of delay factors in the overall consideration of failed construction projects in south western Nigeria. This is considered necessary because the traditional view of construction project failure as consisting mainly of structural or functional failures tends to excuse ...

  12. Outcomes of Ahmed glaucoma valve implantation in advanced primary congenital glaucoma with previous surgical failure

    Directory of Open Access Journals (Sweden)

    Huang J

    2015-06-01

    Full Text Available Jingjing Huang,1 Jialiu Lin,1 Ziqiang Wu,2 Hongzhi Xu,3 Chengguo Zuo,1 Jian Ge1 1State Key Laboratory of Ophthalmology, Department of Glaucoma, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People’s Republic of China; 2Center for Advanced Eye Care, Carson City, NV, USA; 3Institute of Child Health Policy, University of Florida, Gainesville, FL, USA Purpose: The purpose of this study was to evaluate the intermediate surgical results of Ahmed glaucoma valve (AGV implantation in patients less than 7 years of age, with advanced primary congenital glaucoma who have failed previous surgeries.Patients and methods: Consecutive patients with advanced primary congenital glaucoma that failed previous operations and had undergone subsequent AGV implantation were evaluated retrospectively. Surgical success was defined as 1 intraocular pressure (IOP ≥6 and ≤21 mmHg; 2 IOP reduction of at least 30% relative to preoperative values; and 3 without the need for additional surgical intervention for IOP control, loss of light perception, or serious complications.Results: Fourteen eyes of eleven patients were studied. Preoperatively, the average axial length was 27.71±1.52 (25.56–30.80 mm, corneal diameter was 14.71±1.07 (13.0–16.0 mm, cup-to-disc ratio was 0.95±0.04 (0.9–1.0, and IOP was 39.5±5.7 (30–55 mmHg. The mean follow-up time was 18.29±10.96 (5–44, median 18 months. There were significant reductions in IOPs and the number of glaucoma medications (P<0.001 postoperatively. The IOPs after operation were 11.3±3.4, 13.6±5.1, 16.3±2.7, and 16.1±2.6 mmHg at 1 month, 6 months, 12 months, and 18 months, respectively. Kaplan–Meier estimates of the cumulative probability of valve success were 85.7%, 71.4%, and 71.4% at 6, 12, and 18 months, respectively. Severe surgical complications, including erosion of tube, endophthalmitis, retinal detachment, choroidal detachment, and delayed suprachoroidal hemorrhage, occurred in 28

  13. Failing States or Failing Models?: Accounting for the Incidence of State Collapse

    OpenAIRE

    Martin Doornbos

    2010-01-01

    In recent years the notion and phenomenon of .failingÿ states - states deemed incapable to fulfil the basic tasks of providing security for their populace -, has been rapidly drawing attention. I will start off with a closer look at the inci- dence of fragile states and state failure, more specifically of state collapse. Connected with this, I will raise the question of differential degrees of propensity to failure and collapse among contemporary state systems, and to point to apparent region...

  14. How Hedstrom files fail during clinical use? A retrieval study based on SEM, optical microscopy and micro-XCT analysis.

    Science.gov (United States)

    Zinelis, Spiros; Al Jabbari, Youssef S

    2018-05-01

    This study was conducted to evaluate the failure mechanism of clinically failed Hedstrom (H)-files. Discarded H-files (n=160) from #8 to #40 ISO sizes were collected from different dental clinics. Retrieved files were classified according to their macroscopic appearance and they were investigated under scanning electron microscopy (SEM) and X-ray micro-computed tomography (mXCT). Then the files were embedded in resin along their longitudinal axis and after metallographic grinding and polishing, studied under an incident light microscope. The macroscopic evaluation showed that small ISO sizes (#08-#15) failed by extensive plastic deformation, while larger sizes (≥#20) tended to fracture. Light microscopy and mXCT results coincided showing that unused and plastically deformed files were free of internal defects, while fractured files demonstrate the presence of intense cracking in the flute region. SEM analysis revealed the presence of striations attributed to the fatigue mechanism. Secondary cracks were also identified by optical microscopy and their distribution was correlated to fatigue under bending loading. Experimental results demonstrated that while overloading of cutting instruments is the predominating failure mechanism of small file sizes (#08-#15), fatigue should be considered the fracture mechanism for larger sizes (≥#20).

  15. Peroral endoscopic myotomy is a viable option for failed surgical esophagocardiomyotomy instead of redo surgical Heller myotomy: a single center prospective study.

    Science.gov (United States)

    Onimaru, Manabu; Inoue, Haruhiro; Ikeda, Haruo; Yoshida, Akira; Santi, Esperanza Grace; Sato, Hiroki; Ito, Hiroaki; Maselli, Roberta; Kudo, Shin-ei

    2013-10-01

    Surgical Heller myotomy has high rates of successful long-term results, but failed cases still remain. Moreover, the treatment strategy in patients with surgical myotomy failure is controversial. Recently, peroral endscopic myotomy (POEM) was reported to be efficient and safe in primary treatment of achalasia. In this study, we aimed to evaluate the efficacy and safety of POEM for surgical myotomy failure as a rescue second-line treatment, and we discuss the treatment options adapted in achalasia recurrence. A total of 315 consecutive achalasia patients received POEM from September 2008 to December 2012 in our hospital. Eleven (3.5%) patients who had persistent or recurrent achalasia and had received surgical myotomy as a first-line treatment from other hospitals were included in this study. Patient background, barium swallow studies, esophagogastroduodenoscopy (EGD), manometry, and symptom scores were prospectively evaluated. In principle, all patients in whom surgical myotomy failed received pneumatic balloon dilatation (PBD) as the first line "rescue" treatment, and only if PBD failed were patients considered for rescue POEM. The PBD alone was effective in 1 patient, and in the remaining 10 patients, rescue POEM was performed successfully without complications. Three months after rescue POEM, significant reduction in lower esophageal sphincter (LES) resting pressures (22.1 ± 6.6 mmHg vs 10.9 ± 4.5 mmHg, p myotomy were excellent. Long-term results are awaited. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  16. Analysis of failed nuclear plant components

    Science.gov (United States)

    Diercks, D. R.

    1993-12-01

    Argonne National Laboratory has conducted analyses of failed components from nuclear power- gener-ating stations since 1974. The considerations involved in working with and analyzing radioactive compo-nents are reviewed here, and the decontamination of these components is discussed. Analyses of four failed components from nuclear plants are then described to illustrate the kinds of failures seen in serv-ice. The failures discussed are (1) intergranular stress- corrosion cracking of core spray injection piping in a boiling water reactor, (2) failure of canopy seal welds in adapter tube assemblies in the control rod drive head of a pressurized water reactor, (3) thermal fatigue of a recirculation pump shaft in a boiling water reactor, and (4) failure of pump seal wear rings by nickel leaching in a boiling water reactor.

  17. Considerations on Fail Safe Design for Design Basis Accident (DBA) vs. Design Extension Condition (DEC): Lesson Learnt from the Fukushima Accident

    International Nuclear Information System (INIS)

    Ha, Jun Su; Kim, Sungyeop

    2014-01-01

    The fail safety design is referred to as an inherently safe design concept where the failure of an SSC (System, Structure or Component) leads directly to a safe condition. Usually the fail safe design has been devised based on the design basis accident (DBAs), because the nuclear safety has been assured by securing the capability to safely cope with DBAs. Currently regards have been paid to the DEC (Design Extension Condition) as an extended design consideration. Hence additional attention should be paid to the concept of the fail safe design in order to consider the DEC, accordingly. In this study, a case chosen from the Fukushima accident is studied to discuss the issue associated with the fail safe design in terms of DBA and DEC standpoints. For the fail safe design to be based both on the DBA and the DEC, a Mode Changeable Fail Safe Design (MCFSD) is proposed in this study. Additional discussions on what is needed for the MCFSD to be applied in the nuclear safety are addressed as well. One of the lessons learnt from the Fukushima accident should include considerations on the fail-safe design in a changing regulatory framework. Currently the design extension condition (DEC) including severe accidents should be considered during designing and licensing NPPs. Hence concepts on the fail safe design need to be changed to be based on not only the DBA but also the DEC. In this study, a case on a fail-safe design chosen from the Fukushima accident is studied to discuss the issue associated with the fail safe design in terms of DBA and DEC conditions. For the fail safe design to be based both on the DBA and the DEC, a Mode Changeable Fail Safe Design (MCFSD) is proposed in this study. Additional discussions on what is needed for the MCFSD to be applied in the nuclear safety are addressed as well

  18. Experience with failed or damaged spent fuel and its impacts on handling

    International Nuclear Information System (INIS)

    Bailey, W.J.

    1989-12-01

    Spent fuel management planning needs to include consideration of failed or damaged spent light-water reactor (LWR) fuel. Described in this paper, which was prepared under the Commercial Spent Fuel Management (CSFM) Program that is sponsored by the US Department of Energy (DOE), are the following: the importance of fuel integrity and the behavior of failed fuel, the quantity and burnup of failed or damaged fuel in storage, types of defects, difficulties in evaluating data on failed or damaged fuel, experience with wet storage, experience with dry storage, handling of failed or damaged fuel, transporting of fuel, experience with higher burnup fuel, and conclusions. 15 refs

  19. I Failed the edTPA

    Science.gov (United States)

    Kuranishi, Adam; Oyler, Celia

    2017-01-01

    In this article, co-written by a teacher and a professor, the authors examine possible explanations for why Adam (first author), a New York City public school special educator, failed the edTPA, a teacher performance assessment required by all candidates for state certification. Adam completed a yearlong teaching residency where he was the special…

  20. Method of detecting failed fuels

    International Nuclear Information System (INIS)

    Ishizaki, Hideaki; Suzumura, Takeshi.

    1982-01-01

    Purpose: To enable the settlement of the temperature of an adequate filling high temperature pure water by detecting the outlet temperature of a high temperature pure water filling tube to a fuel assembly to control the heating of the pure water and detecting the failed fuel due to the sampling of the pure water. Method: A temperature sensor is provided at a water tube connected to a sipping cap for filling high temperature pure water to detect the temperature of the high temperature pure water at the outlet of the tube, and the temperature is confirmed by a temperature indicator. A heater is controlled on the basis of this confirmation, an adequate high temperature pure water is filled in the fuel assembly, and the pure water is replaced with coolant. Then, it is sampled to settle the adequate temperature of the high temperature coolant used for detecting the failure of the fuel assembly. As a result, the sipping effect does not decrease, and the failed fuel can be precisely detected. (Yoshihara, H.)

  1. Vitamin D fails to prevent serum starvation- or staurosporine-induced apoptosis in human and rat osteosarcoma-derived cell lines

    International Nuclear Information System (INIS)

    Witasp, Erika; Gustafsson, Ann-Catrin; Cotgreave, Ian; Lind, Monica; Fadeel, Bengt

    2005-01-01

    Previous studies have suggested that 1,25(OH) 2 D 3 , the active form of vitamin D 3 , may increase the survival of bone-forming osteoblasts through an inhibition of apoptosis. On the other hand, vitamin D 3 has also been shown to trigger apoptosis in human cancer cells, including osteosarcoma-derived cell lines. In the present study, we show that 1,25(OH) 2 D 3 induces a time- and dose-dependent loss of cell viability in the rat osteosarcoma cell line, UMR-106, and the human osteosarcoma cell line, TE-85. We were unable, however, to detect nuclear condensation, phosphatidylserine externalization, or other typical signs of apoptosis in this model. Moreover, 1,25(OH) 2 D 3 failed to protect against apoptosis induced by serum starvation or incubation with the protein kinase inhibitor, staurosporine. These in vitro findings are thus at variance with several previous reports in the literature and suggest that induction of or protection against apoptosis of bone-derived cells may not be a primary function of vitamin D 3

  2. Augmentation of failed human vertebrae with critical un-contained lytic defect restores their structural competence under functional loading: An experimental study.

    Science.gov (United States)

    Alkalay, Ron N; von Stechow, Dietrich; Hackney, David B

    2015-07-01

    Lytic spinal lesions reduce vertebral strength and may result in their fracture. Vertebral augmentation is employed clinically to provide mechanical stability and pain relief for vertebrae with lytic lesions. However, little is known about its efficacy in strengthening fractured vertebrae containing lytic metastasis. Eighteen unembalmed human lumbar vertebrae, having simulated uncontained lytic defects and tested to failure in a prior study, were augmented using a transpedicular approach and re-tested to failure using a wedge fracture model. Axial and moment based strength and stiffness parameters were used to quantify the effect of augmentation on the structural response of the failed vertebrae. Effects of cement volume, bone mineral density and vertebral geometry on the change in structural response were investigated. Augmentation increased the failed lytic vertebral strength [compression: 85% (Paugmentation is effective in bolstering the failed lytic vertebrae compressive and axial structural competence, showing strength estimates up to 50-90% of historical values of osteoporotic vertebrae without lytic defects. This modest increase suggests that lytic vertebrae undergo a high degree of structural damage at failure, with strength only partially restored by vertebral augmentation. The positive effect of cement volume is self-limiting due to extravasation. Copyright © 2015. Published by Elsevier Ltd.

  3. Plasma Brightenings in a Failed Solar Filament Eruption

    Energy Technology Data Exchange (ETDEWEB)

    Li, Y.; Ding, M. D., E-mail: yingli@nju.edu.cn [School of Astronomy and Space Science, Nanjing University, Nanjing 210023 (China)

    2017-03-20

    Failed filament eruptions are solar eruptions that are not associated with coronal mass ejections. In a failed filament eruption, the filament materials usually show some ascending and falling motions as well as generating bright EUV emissions. Here we report a failed filament eruption (SOL2016-07-22) that occurred in a quiet-Sun region observed by the Atmospheric Imaging Assembly on board the Solar Dynamics Observatory . In this event, the filament spreads out but gets confined by the surrounding magnetic field. When interacting with the ambient magnetic field, the filament material brightens up and flows along the magnetic field lines through the corona to the chromosphere. We find that some materials slide down along the lifting magnetic structure containing the filament and impact the chromosphere, and through kinetic energy dissipation, cause two ribbon-like brightenings in a wide temperature range. There is evidence suggesting that magnetic reconnection occurs between the filament magnetic structure and the surrounding magnetic fields where filament plasma is heated to coronal temperatures. In addition, thread-like brightenings show up on top of the erupting magnetic fields at low temperatures, which might be produced by an energy imbalance from a fast drop of radiative cooling due to plasma rarefaction. Thus, this single event of a failed filament eruption shows the existence of a variety of plasma brightenings that may be caused by completely different heating mechanisms.

  4. Revision surgery for failed thermal capsulorrhaphy.

    Science.gov (United States)

    Park, Hyung Bin; Yokota, Atsushi; Gill, Harpreet S; El Rassi, George; McFarland, Edward G

    2005-09-01

    With the failure of thermal capsulorrhaphy for shoulder instability, there have been concerns with capsular thinning and capsular necrosis affecting revision surgery. To report the findings at revision surgery for failed thermal capsulorrhaphy and to evaluate the technical effects on subsequent revision capsular plication. Case series; Level of evidence, 4. Fourteen patients underwent arthroscopic evaluation and open reconstruction for a failed thermal capsulorrhaphy. The cause of the failure, the quality of the capsule, and the ability to suture the capsule were recorded. The patients were evaluated at follow-up for failure, which was defined as recurrent subluxations or dislocations. The origin of the instability was traumatic (n = 6) or atraumatic (n = 8). At revision surgery in the traumatic group, 4 patients sustained failure of the Bankart repair with capsular laxity, and the others experienced capsular laxity alone. In the atraumatic group, all patients experienced capsular laxity as the cause of failure. Of the 14 patients, the capsule quality was judged to be thin in 5 patients and ablated in 1 patient. A glenoid-based capsular shift could be accomplished in all 14 patients. At follow-up (mean, 35.4 months; range, 22 to 48 months), 1 patient underwent revision surgery and 1 patient had a subluxation, resulting in a failure rate of 14%. Recurrent capsular laxity after failed thermal capsular shrinkage is common and frequently associated with capsular thinning. In most instances, the capsule quality does not appear to technically affect the revision procedure.

  5. National intelligence estimates and the Failed State Index.

    Science.gov (United States)

    Voracek, Martin

    2013-10-01

    Across 177 countries around the world, the Failed State Index, a measure of state vulnerability, was reliably negatively associated with the estimates of national intelligence. Psychometric analysis of the Failed State Index, compounded of 12 social, economic, and political indicators, suggested factorial unidimensionality of this index. The observed correspondence of higher national intelligence figures to lower state vulnerability might arise through these two macro-level variables possibly being proxies of even more pervasive historical and societal background variables that affect both.

  6. Failed State and the Mandate of Peacekeeping Operations

    OpenAIRE

    Eka Nizmi, Yusnarida

    2011-01-01

    By 1990, Somalia had become a good example of what was becoming known as a “failed state”- a people without a government strong enough to govern the country or represent it in International organizations; a country whose poverty, disorganization, refugee flows, political instability, and random warfare had the potential to spread across borders and threaten the stability of other states and the peace of the region.[1] At the end of the cold war there were several such failed states in Africa,...

  7. A public policy aid for bioenergy investment: Case study of failed plants

    International Nuclear Information System (INIS)

    Gonzalez, Asa O.; Karali, Berna; Wetzstein, Michael E.

    2012-01-01

    Recent failures of renewable energy plants have raised concerns regarding government's role in providing credit subsidies and have harmed the long-run development of renewable energy. The major reason for these failures lies in government loan appraisers not having a model that addresses these root causes and instead relying on traditional net present value (NPV) analysis. What is required is a model representing entrepreneurs' investment decision processes when faced with uncertainty, irreversibility, and flexibility that characterize renewable energy investments. The aim is to develop such a model with a real options analysis (ROA) criterion as the foundation. A case study comparing NPV with ROA decisions for 50 and 100 million gallon ethanol plants is used as a basis for future development of a template government loan appraisers can use for evaluating the feasibility of renewable energy investments. - Highlights: ► The role net present value (NPV) analysis is investigated in failed ethanol plants. ► NPV optimal entry and exit margins are compared to real options approach (ROA). ► The entry–exit margin gap is smaller under the NPV than it is under the ROA. ► Government policymakers employing NPV tend to react aggressively to margin stimuli.

  8. A method of failed fuel detection

    International Nuclear Information System (INIS)

    Uchida, Shunsuke; Utamura, Motoaki; Urata, Megumu.

    1976-01-01

    Object: To keep the coolant fed to a fuel assembly at a level below the temperature of existing coolant to detect a failed fuel with high accuracy without using a heater. Structure: When a coolant in a coolant pool disposed at the upper part of a reactor container is fed by a coolant feed system into a fuel assembly through a cap to fill therewith and exchange while forming a boundary layer between said coolant and the existing coolant, the temperature distribution of the feed coolant is heated by fuel rods so that the upper part is low whereas the lower part is high. Then, the lower coolant is upwardly moved by the agitating action and fission products leaked through a failed opening at the lower part of the fuel assembly and easily extracted by the sampling system. (Yoshino, Y.)

  9. Solutions for Failing High Schools: Converging Visions and Promising Models.

    Science.gov (United States)

    Legters, Nettie; Balfanz, Robert; McPartland, James

    Promising solutions to the failings of traditional comprehensive high schools were reviewed to identify basic principles and strategies for improving high schools nationwide. Selected research studies, policy documents, and promising high school programs were reviewed. The review revealed the following principles for helping high schools better…

  10. How to rule with ideas: study of the notion of Failed State

    OpenAIRE

    Chapaux, Vincent

    2011-01-01

    Depuis la fin de la guerre froide, la notion de Failed State est utilisée dans les relations internationales pour décrire des États rencontrant des difficultés à exercer un monopole de la violence légitime sur leur territoire. La thèse se pose la question de savoir dans quelle mesure cette notion a pu jouer un rôle dans les rapports de domination en cours dans les relations internationales. L’étude montre que la notion a été créée par un communauté épistémique et des entrepreneurs de sens ava...

  11. Studies on modeling to failed fuel detection system response in LMFBR

    International Nuclear Information System (INIS)

    Miyazawa, T.; Saji, G.; Mitsuzuku, N.; Hikichi, T.; Odo, T.; Rindo, H.

    1981-05-01

    Failed Fuel Detection (FFD) system with Fission Products (FP) detection is considered to be the most promissing method, since FP provides direct information against fuel element failure. For designing FFD system and for evaluating FFD signals, some adequate FFD signal response to fuel failure have been required. But few models are available in nowadays. Thus Power Reactor and Nuclear Fuel Development Corporation (PNC) had developed FFD response model with computer codes, based on several fundamental investigations on FP release and FP behavior, and referred to foreign country experiences on fuel failure. In developing the model, noble gas and halogen FP release and behavior were considered, since FFD system would be composed of both cover gas monitoring and delayed neutron monitoring. The developed model can provide typical fuel failure response and detection limit which depends on various background signals at cover gas monitoring and delayed neutron monitoring. According to the FFD response model, we tried to assume fuel failure response and detection limit at Japan experimental fast reactor ''JOYO''. The detection limit of JOYO FFD system was estimated by measuring the background signals. Followed on the studies, a complete computer code has been now made with some improvement. On the paper, the details of the model, out line of developed computer code, status of JOYO FFD system, and trial assumption of JOYO FFD response and detection limit. (author)

  12. Fail-safe reactivity compensation method for a nuclear reactor

    Science.gov (United States)

    Nygaard, Erik T.; Angelo, Peter L.; Aase, Scott B.

    2018-01-23

    The present invention relates generally to the field of compensation methods for nuclear reactors and, in particular to a method for fail-safe reactivity compensation in solution-type nuclear reactors. In one embodiment, the fail-safe reactivity compensation method of the present invention augments other control methods for a nuclear reactor. In still another embodiment, the fail-safe reactivity compensation method of the present invention permits one to control a nuclear reaction in a nuclear reactor through a method that does not rely on moving components into or out of a reactor core, nor does the method of the present invention rely on the constant repositioning of control rods within a nuclear reactor in order to maintain a critical state.

  13. Earthquake recurrence models fail when earthquakes fail to reset the stress field

    Science.gov (United States)

    Tormann, Thessa; Wiemer, Stefan; Hardebeck, Jeanne L.

    2012-01-01

    Parkfield's regularly occurring M6 mainshocks, about every 25 years, have over two decades stoked seismologists' hopes to successfully predict an earthquake of significant size. However, with the longest known inter-event time of 38 years, the latest M6 in the series (28 Sep 2004) did not conform to any of the applied forecast models, questioning once more the predictability of earthquakes in general. Our study investigates the spatial pattern of b-values along the Parkfield segment through the seismic cycle and documents a stably stressed structure. The forecasted rate of M6 earthquakes based on Parkfield's microseismicity b-values corresponds well to observed rates. We interpret the observed b-value stability in terms of the evolution of the stress field in that area: the M6 Parkfield earthquakes do not fully unload the stress on the fault, explaining why time recurrent models fail. We present the 1989 M6.9 Loma Prieta earthquake as counter example, which did release a significant portion of the stress along its fault segment and yields a substantial change in b-values.

  14. Failed back surgery syndrome: review and new hypotheses

    OpenAIRE

    Bordoni, Bruno; Marelli,Fabiola

    2016-01-01

    Bruno Bordoni,1,2 Fabiola Marelli2 1Department of Cardiology, Foundation Don Carlo Gnocchi, IRCCS, Institute of Hospitalization and Care, S Maria Nascente, Milan, 2School CRESO, Osteopathic Centre for Research and Studies, Falconara Marittima, Ancona, Italy Abstract: Failed back surgery syndrome (FBSS) is a term used to define an unsatisfactory outcome of a patient who underwent spinal surgery, irrespective of type or intervention area, with persistent pain in the lumbosacral region with or ...

  15. Establishing Pass/Fail Criteria for Bronchoscopy Performance

    DEFF Research Database (Denmark)

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

    2012-01-01

    Background: Several tools have been created to assess competence in bronchoscopy. However, educational guidelines still use an arbitrary number of performed procedures to decide when basic competency is acquired. Objectives: The purpose of this study was to define pass/fail scores for two...... method. In the first we compared bronchoscopy performance scores of 14 novices with the scores of 14 experienced consultants to find the score that best discriminated between the two groups. In the second we asked an expert group of 7 experienced bronchoscopists to judge how a borderline trainee would...

  16. Radiological evaluation of failed total hip replacement

    International Nuclear Information System (INIS)

    Raspa, V.; Aldrovandi, S.; Pompei, G.

    1988-01-01

    The retrospective study of 50 operated cases of cemented total hip replacement and a review of the literature enabled the authors to define the radiological features of the above-mentioned condition. These features include one or more of the following signs: calcar reabsorption, lacunar erosions, modified relatioships between the prosthesis components, sepsis and loosening, periarticular calcifications dislocation and fracture of prosthesis components. Careful evaluation of these radiological features is extremely important for both an early diagnosis of failed total hip replacement and the choice of an adequate surgical treatment

  17. Fail-safe first wall for preclusion of little leakage

    International Nuclear Information System (INIS)

    Shibui, Masanao; Nakahira, Masataka; Tada, Eisuke; Takatsu, Hideyuki

    1994-05-01

    Leakages although excluded by design measures would occur most probably in highly stressed areas, weldments and locations without possibility to classify the state by in-service inspection. In a water-cooled first wall, allowable leak rate of water is generally very small, and therefore, locating of the leak portion under highly activated environment will be very difficult and be time-consuming. The double-wall concept is promising for the ITER first wall, because it can be made fail-safe by the application of the leak-before-break and the multiple load path concepts, and because it has a potential capability to solve the little leak problem. When the fail safe strength is well defined, subcritical crack growth in the damaged wall can be permitted. This will enable to detect stable leakage of coolant without deteriorating plasma operation. The paper deals with the little leak problem and presents method for evaluating small leak rate of a liquid coolant from crack-like defects. The fail-safe first wall with the double-wall concept is also proposed for preclusion of little leakage and its fail-safety is discussed. (author)

  18. Winning Connections? Special Interests and the Sale of Failed Banks

    NARCIS (Netherlands)

    D. Igan (Deniz); T. Lambert (Thomas); W.B. Wagner (Wolf); Q. Zhang (Quxian)

    2017-01-01

    textabstractWe study how lobbying affects the resolution of failed banks, using a sample of FDIC auctions between 2007 and 2014. We show that bidding banks that lobby regulators have a higher probability of winning an auction. In addition, the FDIC incurs higher costs in such auctions, amounting to

  19. Failed fuel detector

    International Nuclear Information System (INIS)

    Onodera, Koichi.

    1981-01-01

    Purpose: To improve the reliability of detecting the failure of a fuel rod by imparting a wire disconnection detecting function to a central electrode at the center of a failure mode thereto. Constitution: A wire disconnection detecting terminal is provided at the terminal opposite to the signal output terminal of a central electrode in a failed fuel detector used for detecting the failure of a fuel rod in an atomic power plant using liquid metal as a coolant, and a voltage monitor for monitoring the terminal voltage is connected to the terminal. The disconnection of the central electrode is detected by the failure of the output of the voltage monitor, and an alarm is thus generated. (Aizawa, K.)

  20. Method for detecting a failed fuel

    International Nuclear Information System (INIS)

    Utamura, Motoaki; Urata, Megumu; Uchida, Shunsuke.

    1976-01-01

    Purpose: To provide a method for the detection of failed fuel by pouring hot water, in which pouring speed of liquid to be poured and temperature of the liquid are controlled to prevent the leakage of the liquid. Constitution: The method comprises blocking the top of a fuel assembly arranged in coolant to stop a flow of coolant, pouring a liquid higher in temperature than that of coolant into the fuel assembly, sampling the liquid poured, and measuring the concentration of radioactivity of coolant already subjected to sampling to detect a failed fuel. At this time, controlling is made so that the pouring speed of the poured liquid is set to about 25 l/min, and an increased portion of temperature from the temperature of liquid to the temperature of coolant is set to a level less than about 15 0 C. (Furukawa, Y.)

  1. Fail-safe logic elements for use with reactor safety systems

    International Nuclear Information System (INIS)

    Bobis, J.P.; McDowell, W.P.

    1976-01-01

    A complete fail-safe trip circuit is described which utilizes fail-safe logic elements. The logic elements used are analog multipliers and active bandpass filter networks. These elements perform Boolean operations on a set of AC signals from the output of a reactor safety-channel trip comparator

  2. Systems with randomly failing repairable components

    DEFF Research Database (Denmark)

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

    2005-01-01

    Closed-form expressions are derived for the steady-state availability, mean rate of failure, mean duration of downtime and reliability of a general system with randomly and independently failing repairable components. Component failures are assumed to be homogeneous Poisson events in time and rep...

  3. Setting and validating the pass/fail score for the NBDHE.

    Science.gov (United States)

    Tsai, Tsung-Hsun; Dixon, Barbara Leatherman

    2013-04-01

    This report describes the overall process used for setting the pass/fail score for the National Board Dental Hygiene Examination (NBDHE). The Objective Standard Setting (OSS) method was used for setting the pass/fail score for the NBDHE. The OSS method requires a panel of experts to determine the criterion items and proportion of these items that minimally competent candidates would answer correctly, the percentage of mastery and the confidence level of the error band. A panel of 11 experts was selected by the Joint Commission on National Dental Examinations (Joint Commission). Panel members represented geographic distribution across the U.S. and had the following characteristics: full-time dental hygiene practitioners with experience in areas of preventive, periodontal, geriatric and special needs care, and full-time dental hygiene educators with experience in areas of scientific basis for dental hygiene practice, provision of clinical dental hygiene services and community health/research principles. Utilizing the expert panel's judgments, the pass/fail score was set and then the score scale was established using the Rasch measurement model. Statistical and psychometric analysis shows the actual failure rate and the OSS failure rate are reasonably consistent (2.4% vs. 2.8%). The analysis also showed the lowest error of measurement, an index of the precision at the pass/fail score point and that the highest reliability (0.97) are achieved at the pass/fail score point. The pass/fail score is a valid guide for making decisions about candidates for dental hygiene licensure. This new standard was reviewed and approved by the Joint Commission and was implemented beginning in 2011.

  4. MLEP-Fail calibration for 1/8 inch thick cast plate of 17-4 steel.

    Energy Technology Data Exchange (ETDEWEB)

    Corona, Edmundo [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2018-02-01

    The purpose of the work presented in this memo was to calibrate the Sierra material model Multilinear Elastic-Plastic Hardening Model with Failure (MLEP-Fail) for 1/8 inch thick cast plate of 17-4 steel. The calibration approach is essentially the same as that recently used in a previous memo using data from smooth and notched tensile specimens. The notched specimens were manufactured with three notch radii R = 1=8, 1/32 and 1/64 inches. The dimensions of the smooth and notched specimens are given in the prints in Appendix A. Two cast plates, Plate 3 and Plate 4, with nominally identical properties were considered.

  5. Two simple strategies (adding a logo or a senior faculty's signature) failed to improve patient participation rates in a cohort study: randomized trial

    NARCIS (Netherlands)

    van Wonderen, Karina E.; Mohrs, Jacob; Jff, Machteld I.; Bindels, Patrick J. E.; ter Riet, Gerben

    2008-01-01

    Background: Patient participation in research studies is often difficult to achieve, and efforts to increase participation rates fail frequently. Given the paucity of evidence on interventions aimed at improving patient participation, we conducted a randomized trial. Objectives: The first was to

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

    Science.gov (United States)

    Siew, Melissa L.; van Vonderen, Jeroen J.; Hooper, Stuart B.; te Pas, Arjan B.

    2015-01-01

    Objective To investigate the differences in breathing pattern and effort in infants at birth who failed or succeeded on continuous positive airway pressure (CPAP) during the first 48 hours after birth. Methods Respiratory function recordings of 32 preterm infants were reviewed of which 15 infants with a gestational age of 28.6 (0.7) weeks failed CPAP and 17 infants with a GA of 30.1 (0.4) weeks did not fail CPAP. Frequency, duration and tidal volumes (VT) of expiratory holds (EHs), peak inspiratory flows, CPAP-level and FiO2-levels were analysed. Results EH incidence increased CPAP-fail and CPAP-success infants. At 9-12 minutes, CPAP-fail infants more frequently used smaller VTs, 0-9 ml/kg and required higher peak inspiratory flows. However, CPAP-success infants often used large VTs (>9 ml/kg) with higher peak inspiratory flows than CPAP-fail infants (71.8 ± 15.8 vs. 15.5 ± 5.2 ml/kg.s, p CPAP-fail infants required higher FiO2 (0.31 ± 0.03 vs. 0.21 ± 0.01), higher CPAP pressures (6.62 ± 0.3 vs. 5.67 ± 0.26 cmH2O) and more positive pressure-delivered breaths (45 ± 12 vs. 19 ± 9%) (p CPAP-fail infants more commonly used lower VTs and required higher peak inspiratory flow rates while receiving greater respiratory support. VT was less variable and larger VT was infrequently used reflecting early signs of fatigue. PMID:26052947

  7. Predictive value of CHA2DS2-VASc and CHA2DS2-VASc-HS scores for failed reperfusion after thrombolytic therapy in patients with ST-elevation myocardial ınfarction.

    Science.gov (United States)

    Kilic, Salih; Kocabas, Umut; Can, Levent Hurkan; Yavuzgil, Oğuz; Çetin, Mustafa; Zoghi, Mehdi

    2018-03-07

    Thrombolytic therapy is recommended for patients with acute ST-segment elevation myocardial infarction (STEMI) who cannot undergo primary percutaneous coronary intervention within the first 120 min. The aim of this study wasz to demonstrate the value of CHA₂DS₂-VASc and CHA₂DS₂-VASc-HS scores in predicting failed reperfusion in STEMI patients treated with thrombolytic therapy. A total of 537 consecutive patients were enrolled in the study; 139 had failed thrombolysis while the remaining 398 fulfilled the criteria for successful thrombolysis. Thrombolysis failure was defined with the lack of symptom relief, < 50% ST resolution-related electrocardiography within 90 min from initiation of the thrombolytic therapy, presence of hemodynamic or electrical instability or in-hospital mortality. CHA₂DS₂-VASc and CHA₂DS₂-VASc-HS scores, which incorporate hyperlipidemia, smoking, switches between female and male gender, were previously shown to be markers of the severity of coronary artery disease (CAD). History of hypertension, diabetes mellitus, hyperlipidemia, heart failure, smoking, and CAD were significantly common in failed reperfusion patients (for all; p < 0.05). For prediction of failed reperfusion, the cut-off value of CHA₂DS₂-VASc score was ≥ 2 with a sensitivity of 80.90% and a specificity of 41.01% (area under curve [AUC] 0.660; 95% confidence interval [CI] 0.618-0.700; p < 0.001) and the cut-off value of CHA₂DS₂-VASc-HS score was ≥ 3 with a sensitivity of 76.13% and a specificity of 67.63% (AUC 0.764; 95% CI 0.725-0.799; p < 0.001). The CHA₂DS₂-VASc-HS score was found to be statistically and significantly better than CHA₂DS₂-VASc score to predict failed reperfusion (p < 0.001). The findings suggest that the CHA₂DS₂-VASc and especially CHA₂DS₂-VASc-HS scores could be considered as predictors of risk of failed reperfusion in STEMI patients.

  8. Detection device for the failed position in fuels

    International Nuclear Information System (INIS)

    Tokunaga, Kensuke; Nomura, Teiji; Hiruta, Koji

    1985-01-01

    Purpose: To detect the failed position of a fuel assembly with ease and safety. Constitution: A fuel assembly is tightly closed in a sipper tube equipped with a gas supply tube and a gas exhaust tube at the upper portion and a purified water injection tube and a draining tube at the lower end. Then, water in the sipper tube is drained to the lower portion of the fuel assembly by the pressure of gases while opening the gas supply tube and the draining tube, and closing the exhaust tube and the injection tube. Then, after closing the gas supply tube and the draining tube while opening theexhaust tube and the injection tube, purified water is injected into the sipper tube from the injection tube to an optional height till the fuel assembly is immersed. Then, after leaving for a predetermined of time, water is sampled and the radioactive material density therein is measured. By changing the injection level of the purified water, since the radioactive material density changes at the failed position, the failed position can be detected with ease. (Sekiya, K.)

  9. Underachievement, Failing Youth and Moral Panics

    Science.gov (United States)

    Smith, Emma

    2010-01-01

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

  10. The cost of operating with failed fuel at Virginia power

    International Nuclear Information System (INIS)

    Ford, C.A.

    1988-01-01

    Virginia Power has completed a study of the costs incurred due to fuel failures in its pressurized water reactors. This study was prompted by histories of high primary coolant activity and subsequent fuel inspections at the North Anna and Surry power stations. The study included an evaluation of the total costs of fuel failures as well as an evaluation of the economics of postirradiation fuel inspections. The major costs of fuel failures included personnel radiation exposure, permanently discharged failed fuel, radwaste generation, increased labor requirements, containment entry delays due to airborne radioactivity, and ramp rate restrictions. Although fuel failures affect a utility in several other areas, the items evaluated in the study were thought to be the most significant of the costs. The study indicated that performing a postirradiation failed fuel examination can be economically justified at tramp-corrected 131 I levels of > 0.015 μCi/g. The savings to the utility can be on the order of several million dollars. Additionally, the cost penalty of performing a fuel inspection at lower iodine levels is generally in the range of $200,000. This economic penalty is expected to be outweighed by the intangible benefits of operating with a defect-free core

  11. The potential cost of a failed doha round:

    OpenAIRE

    Bouet, Antoine; Debucquet, David Laborde

    2009-01-01

    "In times of economic turmoil, countries might decide to increase current tariff rates to protect domestic industries or raise revenues in order to finance domestic programs. Using the highest applied or bound rate imposed by countries from 1995 to 2008 as an indicator, this study presents several scenarios regarding the economic costs of a failed Doha Round and a subsequent rush into protectionism. For example, in a scenario where the applied tariffs of major economies would go all the way u...

  12. Failed fuel detection and location of LMFBR

    International Nuclear Information System (INIS)

    Mimoto, Yasuhide; Hukuda, Tooru; Nakamoto, Koichiro

    1974-01-01

    This is a summary report on Failed Fuel Detection and Location Methods of liquid metal cooled fast breeder reactors, and describes an outline of related research and development conducted by PNC. (auth.)

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

    National Research Council Canada - National Science Library

    Wyler, Liana S

    2008-01-01

    .... national security goal since the end of the Cold War. Numerous U.S. government documents point to several threats emanating from states that are variously described as weak, fragile, vulnerable, failing, precarious, failed, in crisis, or collapsed...

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

    Science.gov (United States)

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

    2015-01-01

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

  15. "To big to fail"-doktrinen står for fald?

    DEFF Research Database (Denmark)

    Grosen, Anders

    2010-01-01

    Hvis præsident Barack Obama får sin vilje, skal den klassiske "too big to fail"-bankdoktrin afløses af en "small enough to fail"-doktrin. Det fremgår af præsidentens planer om at opdele storbankerne i mindre enheder og forbyde bankernes handelsaktiviteter for egen regning. Hvis Barack Obama får...

  16. [Fractographic analysis of clinically failed anterior all ceramic crowns].

    Science.gov (United States)

    DU, Qian; Zhou, Min-bo; Zhang, Xin-ping; Zhao, Ke

    2012-04-01

    To identify the site of crack initiation and propagation path of clinically failed all ceramic crowns by fractographic analysis. Three clinically failed anterior IPS Empress II crowns and two anterior In-Ceram alumina crowns were retrieved. Fracture surfaces were examined using both optical stereo and scanning electron microscopy. Fractographic theory and fracture mechanics principles were applied to disclose the damage characteristics and fracture mode. All the crowns failed by cohesive failure within the veneer on the labial surface. Critical crack originated at the incisal contact area and propagated gingivally. Porosity was found within the veneer because of slurry preparation and the sintering of veneer powder. Cohesive failure within the veneer is the main failure mode of all ceramic crown. Veneer becomes vulnerable when flaws are present. To reduce the chances of chipping, multi-point occlusal contacts are recommended, and layering and sintering technique of veneering layer should also be improved.

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

    Directory of Open Access Journals (Sweden)

    A. Schoeman

    2008-07-01

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

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

    Science.gov (United States)

    Kiprianos, Pandelis

    2013-01-01

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

  19. A Scientific Investigation into why Firms Fail: A Model of corporate ...

    African Journals Online (AJOL)

    A Scientific Investigation into why Firms Fail: A Model of corporate health trajectory. ... to analyse the data of 20 banks, 10 which failed and 10 that is successful. Key words: Corporate collapse, trajectories of failure, bank failure, bank distress, ...

  20. Avascular Necrosis of Acetabulum: The Hidden Culprit of Resistant Deep Wound Infection and Failed Fixation of Fracture Acetabulum - A Case Report.

    Science.gov (United States)

    K, Kandhari V; M, Desai M; S, Bava S; N, Wade R

    2015-01-01

    Chances of avascular necrosis of acetabulum are rare as it enjoys a rich blood supply. But cases of post - traumatic avascular necrosis of acetabulum following fracture of posterior column have been well documented. Importance of identifying and suspecting the avascular necrosis of acetabulum is essential in cases of failed fixation of fracture acetabulum, previously operated using extensile approach to acetabulum; either extended anterior ilio - femoral or tri - radiate approach. Such patients usually present with repeated deep bone infection or with early failure of fixation with aseptic loosening and migration of its components. We present a similar case. 40 years female presented with inadequately managed transverse fracture of left acetabulum done by anterior extended ilio-inguinal approach. The fixation failed. She presented 6 months later with painful hip. Cemented total hip replacement was performed with reconstruction of acetabulum by posterior column plating. Six months postoperatively patient presented with dislodgement of cup, pelvic discontinuity and sinus in the thigh. Two stage revision surgery was planned. First implant, removal; debridement and antibiotic spacer surgery was performed. At second stage of revision total hip replacement, patient had Paprosky grade IIIb defect in acetabulum. Spacer was removed through the posterior approach. Anterior approach was taken for anterior plating. Intra-operatively external iliac pulsations were found to be absent so procedure was abandoned after expert opinion. Postoperatively digital subtraction angiography demonstrated a chronic block in the external iliac artery and corona mortis was the only patent vascular channel providing vascular to the left lower limb. Thus, peripheral limb was stealing blood supply from the acetabulum to maintain perfusion. Patient was ultimately left with pelvic discontinuity, excision arthroplasty and pseudoarthrosis of the left hip. Avascular necrosis of acetabulum is a rare

  1. Management of the failed posterior/multidirectional instability patient.

    Science.gov (United States)

    Forsythe, Brian; Ghodadra, Neil; Romeo, Anthony A; Provencher, Matthew T

    2010-09-01

    Although the results of operative treatment of posterior and multidirectional instability (P-MDI) of the shoulder have improved, they are not as reliable as those treated for anterior instability of the shoulder. This may be attributed to the complexities in the classification, etiology, and physical examination of a patient with suspected posterior and multidirectional instability. Failure to address the primary and concurrent lesion adequately and the development of pain and/or stiffness are contributing factors to the failure of P-MDI procedures. Other pitfalls include errors in history and physical examination, failure to recognize concomitant pathology, and problems with the surgical technique or implant failure. Patulous capsular tissues and glenoid version also play in role management of failed P-MDI patients. With an improved understanding of pertinent clinical complaints and physical examination findings and the advent of arthroscopic techniques and improved implants, successful strategies for the nonoperative and operative management of the patient after a failed posterior or multidirectional instability surgery may be elucidated. This article highlights the common presentation, physical findings, and radiographic workup in a patient that presents after a failed P-MDI repair and offers strategies for revision surgical repair.

  2. Myocardial pre-synaptic sympathetic function correlates with glucose uptake in the failing human heart

    International Nuclear Information System (INIS)

    Mongillo, Marco; Leccisotti, Lucia; John, Anna S.; Pennell, Dudley J.; Camici, Paolo G.

    2007-01-01

    We have previously shown that the myocardium of patients with heart failure (HF) is insulin resistant. Chronic β-adrenergic stimulation has been implicated in insulin resistance in cultured cardiomyocytes in vitro, where sustained noradrenaline stimulation inhibited insulin-modulated glucose uptake. As the failing heart is characterized by increased sympathetic drive, we hypothesized that there is a correlation between pre-synaptic sympathetic function and insulin sensitivity in the myocardium of patients with HF. Eight patients (aged 67 ± 7 years) with coronary artery disease and left ventricular dysfunction (ejection fraction 44 ± 10%) underwent function and viability assessment with cardiovascular magnetic resonance. Myocardial glucose utilization (MGU) was measured using positron emission tomography (PET) with 18 F-fluorodeoxyglucose (FDG). Pre-synaptic noradrenaline re-uptake was measured by calculating [ 11 C]meta-hydroxy-ephedrine (HED) volume of distribution (V d ) with PET. Two groups of healthy volunteers served as controls for the FDG (n = 8, aged 52 ± 4 years, p -1 .g -1 ) and dysfunctional (0.49 ± 0.14 μmol.min -1 .g -1 ) segments compared with controls (0.61 ± 0.7 μmol.min -1 .g -1 ; p d was reduced in dysfunctional segments of patients (38.9 ± 21.2 ml.g -1 ) compared with normal segments (52.2 ± 19.6 ml.g -1 ) and compared with controls (62.7 ± 11.3 ml.g -1 ). In patients, regional MGU was correlated with HED V d . The results of this study provide novel evidence of a correlation between cardiac sympathetic function and insulin sensitivity, which may represent one of the mechanisms contributing to insulin resistance in failing human hearts. (orig.)

  3. 7 CFR 1951.264 - Action when borrower fails to cooperate, respond or graduate.

    Science.gov (United States)

    2010-01-01

    ... Analyzing Credit Needs and Graduation of Borrowers § 1951.264 Action when borrower fails to cooperate, respond or graduate. (a) When borrowers with other than FCP loans fail to: (1) Provide information... appeal the decision. (b) If an FCP borrower fails to cooperate after a lender expresses a willingness to...

  4. Abnormal mitochondrial respiration in failed human myocardium.

    Science.gov (United States)

    Sharov, V G; Todor, A V; Silverman, N; Goldstein, S; Sabbah, H N

    2000-12-01

    Chronic heart failure (HF) is associated with morphologic abnormalities of cardiac mitochondria including hyperplasia, reduced organelle size and compromised structural integrity. In this study, we examined whether functional abnormalities of mitochondrial respiration are also present in myocardium of patients with advanced HF. Mitochondrial respiration was examined using a Clark electrode in an oxygraph cell containing saponin-skinned muscle bundles obtained from myocardium of failed explanted human hearts due to ischemic (ICM, n=9) or idiopathic dilated (IDC, n=9) cardiomyopathy. Myocardial specimens from five normal donor hearts served as controls (CON). Basal respiratory rate, respiratory rate after addition of the substrates glutamate and malate (V(SUB)), state 3 respiration (after addition of ADP, V(ADP)) and respiration after the addition of atractyloside (V(AT)) were measured in scar-free muscle bundles obtained from the subendocardial (ENDO) and subepicardial (EPI) thirds of the left ventricular (LV) free wall, interventricular septum and right ventricular (RV) free wall. There were no differences in basal and substrate-supported respiration between CON and HF regardless of etiology. V(ADP)was significantly depressed both in ICM and IDC compared to CON in all the regions studied. The respiratory control ratio, V(ADP)/V(AT), was also significantly decreased in HF compared to CON. In both ICM and IDC, V(ADP)was significantly lower in ENDO compared to EPI. The results indicate that mitochondrial respiration is abnormal in the failing human heart. The findings support the concept of low myocardial energy production in HF via oxidative phosphorylation, an abnormality with a potentially impact on global cardiac performance. Copyright 2000 Academic Press.

  5. Synthesis Report on the understanding of failed LMFBR fuel element performance

    International Nuclear Information System (INIS)

    Plitz, H.; Bagley, K.; Harbourne, B.

    1990-07-01

    In the coarse of LMFBR operation fuel element failures cannot entirely be avoided as experienced during the operation of PFR, PHENIX and KNK II, where 44 failed fuel elements have been registered between 1978 and 1989. In earlier irradiations, post irradiation examinations showed mixed oxide pin diameter increases up to pin pitch distance, urging to stress reactor safety questions on the potential of fuel pin failure propagation within pin bundles. The chemical interaction of sodium with mixed oxide fuel is regarded to be the key for the understanding of failed fuel behavior. Valuable results on the failed fuel pin behavior during operation were obtained from the SILOE sodium loop test. Based on the bulk of experience with the detection of fuel pin failures, with the continued operation and with the handling of failed pins respectively elements, one can state: 1. All fuel pin failures have been detected securely in time and have been located. 2. Small defects are developing slowly. 3. Even large defects at end-of-life pins resulted in limited fuel loss. 4. Clad failures behave benign in main aspects. 5. The chemical interaction of sodium with mixed oxide is an important factor in the behavior of failed fuel pins, especially at high burnup. 6. Despite different pin designs and different operation conditions, on the basis of 44 failed elements in PFR, PHENIX and KNK II no pin-to-pin propagation was observed and fuel release was rather low, often not detectable. 7. In no case hazard conditions affecting reactor safety have been experienced

  6. Fire-Side Corrosion: A Case Study of Failed Tubes of a Fossil Fuel Boiler

    OpenAIRE

    Asnavandi, Majid; Kahram, Mohaddeseh; Rezaei, Milad; Rezakhani, Davar

    2017-01-01

    The failures of superheater and reheater boiler tubes operating in a power plant utilizing natural gas or mazut as a fuel have been analysed and the fire-side corrosion has been suggested as the main reason for the failure in boiler tubes. The tubes have been provided by a fossil fuel power plant in Iran and optical and electron microscopy investigations have been performed on the tubes as well as the corrosion products on their surfaces. The results showed that the thickness of the failed tu...

  7. Study of some physical aspects previous to design of an exponential experiment

    International Nuclear Information System (INIS)

    Caro, R.; Francisco, J. L. de

    1961-01-01

    This report presents the theoretical study of some physical aspects previous to the design of an exponential facility. The are: Fast and slow flux distribution in the multiplicative medium and in the thermal column, slowing down in the thermal column, geometrical distribution and minimum needed intensity of sources access channels and perturbations produced by possible variations in its position and intensity. (Author) 4 refs

  8. When Does Maluma/Takete Fail? Two Key Failures and a Meta-Analysis Suggest That Phonology and Phonotactics Matter.

    Science.gov (United States)

    Styles, Suzy J; Gawne, Lauren

    2017-01-01

    Eighty-seven years ago, Köhler reported that the majority of students picked the same answer in a quiz: Which novel word form ('maluma' or 'takete') went best with which abstract line drawing (one curved, one angular). Others have consistently shown the effect in a variety of contexts, with only one reported failure by Rogers and Ross. In the spirit of transparency, we report our own failure in the same journal. In our study, speakers of Syuba, from the Himalaya in Nepal, do not show a preference when matching word forms 'kiki' and 'bubu' to spiky versus curvy shapes. We conducted a meta-analysis of previous studies to investigate the relationship between pseudoword legality and task effects. Our combined analyses suggest a common source for both of the failures: 'wordiness' - We believe these tests fail when the test words do not behave according to the sound structure of the target language.

  9. Fail-safe system for activity cooled supersonic and hypersonic aircraft. [using liquid hydrogen fuel

    Science.gov (United States)

    Jones, R. A.; Braswell, D. O.; Richie, C. B.

    1975-01-01

    A fail-safe-system concept was studied as an alternative to a redundant active cooling system for supersonic and hypersonic aircraft which use the heat sink of liquid-hydrogen fuel for cooling the aircraft structure. This concept consists of an abort maneuver by the aircraft and a passive thermal protection system (TPS) for the aircraft skin. The abort manuever provides a low-heat-load descent from normal cruise speed to a lower speed at which cooling is unnecessary, and the passive TPS allows the aircraft skin to absorb the abort heat load without exceeding critical skin temperature. On the basis of results obtained, it appears that this fail-safe-system concept warrants further consideration, inasmuch as a fail-safe system could possibly replace a redundant active cooling system with no increase in weight and would offer other potential advantages.

  10. Radon anomalies prior to earthquakes (1). Review of previous studies

    International Nuclear Information System (INIS)

    Ishikawa, Tetsuo; Tokonami, Shinji; Yasuoka, Yumi; Shinogi, Masaki; Nagahama, Hiroyuki; Omori, Yasutaka; Kawada, Yusuke

    2008-01-01

    The relationship between radon anomalies and earthquakes has been studied for more than 30 years. However, most of the studies dealt with radon in soil gas or in groundwater. Before the 1995 Hyogoken-Nanbu earthquake, an anomalous increase of atmospheric radon was observed at Kobe Pharmaceutical University. The increase was well fitted with a mathematical model related to earthquake fault dynamics. This paper reports the significance of this observation, reviewing previous studies on radon anomaly before earthquakes. Groundwater/soil radon measurements for earthquake prediction began in 1970's in Japan as well as foreign countries. One of the most famous studies in Japan is groundwater radon anomaly before the 1978 Izu-Oshima-kinkai earthquake. We have recognized the significance of radon in earthquake prediction research, but recently its limitation was also pointed out. Some researchers are looking for a better indicator for precursors; simultaneous measurements of radon and other gases are new trials in recent studies. Contrary to soil/groundwater radon, we have not paid much attention to atmospheric radon before earthquakes. However, it might be possible to detect precursors in atmospheric radon before a large earthquake. In the next issues, we will discuss the details of the anomalous atmospheric radon data observed before the Hyogoken-Nanbu earthquake. (author)

  11. Targeted Gene-Silencing Reveals the Functional Significance of Myocardin Signaling in the Failing Heart

    Science.gov (United States)

    Torrado, Mario; Iglesias, Raquel; Centeno, Alberto; López, Eduardo; Mikhailov, Alexander T.

    2011-01-01

    Background Myocardin (MYOCD), a potent transcriptional coactivator of smooth muscle (SM) and cardiac genes, is upregulated in failing myocardium in animal models and human end-stage heart failure (HF). However, the molecular and functional consequences of myocd upregulation in HF are still unclear. Methodology/Principal Findings The goal of the present study was to investigate if targeted inhibition of upregulated expression of myocd could influence failing heart gene expression and function. To this end, we used the doxorubicin (Dox)-induced diastolic HF (DHF) model in neonatal piglets, in which, as we show, not only myocd but also myocd-dependent SM-marker genes are highly activated in failing left ventricular (LV) myocardium. In this model, intra-myocardial delivery of short-hairpin RNAs, designed to target myocd variants expressed in porcine heart, leads on day 2 post-delivery to: (1) a decrease in the activated expression of myocd and myocd-dependent SM-marker genes in failing myocardium to levels seen in healthy control animals, (2) amelioration of impaired diastolic dysfunction, and (3) higher survival rates of DHF piglets. The posterior restoration of elevated myocd expression (on day 7 post-delivery) led to overexpression of myocd-dependent SM-marker genes in failing LV-myocardium that was associated with a return to altered diastolic function. Conclusions/Significance These data provide the first evidence that a moderate inhibition (e.g., normalization) of the activated MYOCD signaling in the diseased heart may be promising from a therapeutic point of view. PMID:22028870

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

    Directory of Open Access Journals (Sweden)

    Mario Torrado

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

  13. Diggers failing to become diggers

    DEFF Research Database (Denmark)

    Jensen, Lars

    Mining has in recent years emerged as a national discourse in Australia as the combined result of the mining boom and national anxieties over the GFC featured prominently in references to Australia as a failed competitive state (the folding of manufacturing, where the closure of car factories pla...... to the broader issue of how mining relates to the question of the society Australia wants to be – on the scale from ecological sanctuary to global quarry....

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

    Science.gov (United States)

    Roegner, Katherine

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ai-Chin Cheng

    2011-12-01

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

  16. Barriers to treatment of failed or interferon ineligible patients in the era of DAA: single center study

    Directory of Open Access Journals (Sweden)

    Kwang Il Seo

    2017-03-01

    Full Text Available Background/Aims Interferon-based treatment is not appropriate for a large number of patients with chronic hepatitis C for various medical and social reasons. Newly developed directly acting antivirals (DAAs have been used to treat chronic hepatitis C without severe adverse effects and have achieved a sustained viral response (SVR rate of 80-90% with short treatment duration. We were interested to determine whether all patients who failed to respond to or were ineligible for interferon-based therapy could be treated with DAAs. Methods Medical records of patients with positive serum anti-hepatitis C virus (HCV or HCV RNA between January 2009 and December 2013 were reviewed. Demographic, clinical, and treatment data were collected for analysis. Results A total of 876 patients were positive for both anti-HCV and HCV RNA. Of these, 244 patients were eligible for interferon, although this was associated with relapse in 39 (16% of patients. In total, 130 patients stopped interferon therapy (67% adverse effects, 28% non-adherent, 4% malignancy, 1% alcohol abuse and 502 patients were ineligible (66% medical contraindications, 25% non-adherent, 5% socioeconomic problems. Among 671 patients who were ineligible for or failed to respond to interferon therapy, more than 186 (27.7% could not be treated with DAA due to financial, social, or cancer-related conditions. Conclusions Newly developed DAAs are a promising treatment for patients with chronic hepatitis C who are ineligible for or failed to respond to interferon-based therapy. Nevertheless, not all chronic hepatitis C patients can be treated with DAAs due to various reasons.

  17. Examination of a failed fifth wheel coupling

    CSIR Research Space (South Africa)

    Fernandes, PJL

    1998-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Melissa L Siew

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

  19. An experience of bronchotomy and resectional procedures after failed bronchoscopic foerign body retrieval

    International Nuclear Information System (INIS)

    Khan, Y.S.; Majeed, F.A.

    2015-01-01

    Foreign body bronchus is a surgical emergency and is associated with a high mortality if neglected or complicated. The objective of this study was to analyse the outcome of bronchotomy and resectional procedures after failed bronchoscopic foreign body retrieval. Methods: This study of 24 cases of bronchotomy and resectional procedures after failed bronchoscopic foreign body retrieval was done from June 2008 to June 2009 and March 2010 to Sep 2013. Patients after failed retrieval of foreign body by bronchoscopy either by ENT specialists or thoracic surgeons underwent bronchotomy or resectional procedures were included in the study. We used the posterolateral thoracotomy approach for the surgical procedures. Results: Bronchotomy and resectional procedures were done in 24 cases. Age of patients ranged from 2 years to 51 years. Most patients were children and right side was mostly involved. Bronchotomy procedures were 10 (41%) and resectional surgeries were 13 (58%). Emergency lobectomies were 3 out of 13 resectional surgeries. Right intermedius bronchus was opened up and incision was extended in the direction of foreign body in 6 cases and left bronchus intermedius was opened in 4 cases. Haemoptysis was the main symptom in late presenters. Range of objects retrieved in our study was from pins, needles to whistles. Conclusion: Retention causes endobronchial obstruction with stasis leading to irreversible damaged parenchyma. Foreign body with structural changes require resection, others can be offered bronchotomy which is a safe procedure for retained non retrievable foreign bodies. (author)

  20. Resitting or Compensating a Failed Examination: Does It Affect Subsequent Results?

    Science.gov (United States)

    Arnold, Ivo

    2017-01-01

    Institutions of higher education commonly employ a conjunctive standard setting strategy, which requires students to resit failed examinations until they pass all tests. An alternative strategy allows students to compensate a failing grade with other test results. This paper uses regression discontinuity design to compare the effect of first-year…

  1. Intrauterine adhesions as a risk factor for failed first-trimester pregnancy termination.

    Science.gov (United States)

    Luk, Janelle; Allen, Rebecca H; Schantz-Dunn, Julianna; Goldberg, Alisa B

    2007-10-01

    Risk factors for failed first-trimester surgical abortion include endometrial distortion caused by leiomyomas, uterine anomalies and malposition and cervical stenosis. This report introduces intrauterine adhesions as an additional risk factor. A multiparous woman presented for pregnancy termination at 6 weeks' gestation. Three suction-curettage attempts failed to remove what appeared to be an intrauterine pregnancy. Rising beta-hCG levels and concern for an interstitial ectopic pregnancy prompted a diagnostic laparoscopy and exploratory laparotomy without the identification of an ectopic pregnancy. After methotrexate treatment failed, the patient underwent ultrasound-guided hysteroscopy and suction curettage using a cannula with a whistle-cut aperture for the successful removal of a pregnancy implanted behind intrauterine adhesions. Intrauterine adhesions are a cause of failed surgical abortion. Ultrasound-guided hysteroscopy may be required for diagnosis.

  2. Post-deportation risks for failed asylum seekers

    Directory of Open Access Journals (Sweden)

    Jill Alpes

    2017-02-01

    Full Text Available What happens to people who are deported after their asylum applications have failed? Many who are deported are at risk of harm when they return to their country of origin but there is little monitoring done of deportation outcomes.

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

    Science.gov (United States)

    Hirschfeld, Katherine

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

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

    Science.gov (United States)

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

    2012-01-01

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

  5. Identify too big to fail banks and capital insurance: An equilibrium approach

    OpenAIRE

    Katerina Ivanov

    2017-01-01

    The objective of this paper is develop a rational expectation equilibrium model of capital insurance to identify too big to fail banks. The main results of this model include (1) too big to fail banks can be identified explicitly by a systemic risk measure, loss betas, of all banks in the entire financial sector; (2) the too big to fail feature can be largely justified by a high level of loss beta; (3) the capital insurance proposal benefits market participants and reduces the systemic risk; ...

  6. Fail-safe computer-based plant protection systems

    International Nuclear Information System (INIS)

    Keats, A.B.

    1983-01-01

    A fail-safe mode of operation for computers used in nuclear reactor protection systems was first evolved in the UK for application to a sodium cooled fast reactor. The fail-safe properties of both the hardware and the software were achieved by permanently connecting test signals to some of the multiplexed inputs. This results in an unambiguous data pattern, each time the inputs are sequentially scanned by the multiplexer. The ''test inputs'' simulate transient excursions beyond defined safe limits. The alternating response of the trip algorithms to the ''out-of-limits'' test signals and the normal plant measurements is recognised by hardwired pattern recognition logic external to the computer system. For more general application to plant protection systems, a ''Test Signal Generator'' (TSG) is used to compute and generate test signals derived from prevailing operational conditions. The TSG, from its knowledge of the sensitivity of the trip algorithm to each of the input variables, generates a ''test disturbance'' which is superimposed upon each variable in turn, to simulate a transient excursion beyond the safe limits. The ''tripped'' status yielded by the trip algorithm when using data from a ''disturbed'' input forms part of a pattern determined by the order in which the disturbances are applied to the multiplexer inputs. The data pattern formed by the interleaved test disturbances is again recognised by logic external to the protection system's computers. This fail-safe mode of operation of computer-based protection systems provides a powerful defence against common-mode failure. It also reduces the importance of software verification in the licensing procedure. (author)

  7. Proteomic analysis identifies mitochondrial metabolic enzymes as major discriminators between different stages of the failing human myocardium

    DEFF Research Database (Denmark)

    Urbonavicius, Sigitas; Wiggers, Henrik; Bøtker, Hans Erik

    2009-01-01

    Our aim was to identify patterns in differentially regulated proteins associated with the progression of chronic heart failure. We specifically studied proteomics in chronic reversibly (RDM) and irreversibly dysfunctional myocardium (IRDM), as well as end-stage failing myocardium (ESFM).......Our aim was to identify patterns in differentially regulated proteins associated with the progression of chronic heart failure. We specifically studied proteomics in chronic reversibly (RDM) and irreversibly dysfunctional myocardium (IRDM), as well as end-stage failing myocardium (ESFM)....

  8. Merger incentives and the failing firm defense

    NARCIS (Netherlands)

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

    2014-01-01

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

  9. Summary of Previous Chamber or Controlled Anthrax Studies and Recommendations for Possible Additional Studies

    Energy Technology Data Exchange (ETDEWEB)

    Piepel, Gregory F.; Amidan, Brett G.; Morrow, Jayne B.

    2010-12-29

    This report and an associated Excel file(a) summarizes the investigations and results of previous chamber and controlled studies(b) to characterize the performance of methods for collecting, storing and/or transporting, extracting, and analyzing samples from surfaces contaminated by Bacillus anthracis (BA) or related simulants. This report and the Excel are the joint work of the Pacific Northwest National Laboratory (PNNL) and the National Institute of Standards and Technology (NIST) for the Department of Homeland Security, Science and Technology Directorate. The report was originally released as PNNL-SA-69338, Rev. 0 in November 2009 with limited distribution, but was subsequently cleared for release with unlimited distribution in this Rev. 1. Only minor changes were made to Rev. 0 to yield Rev. 1. A more substantial update (including summarizing data from other studies and more condensed summary tables of data) is underway

  10. Considerations for handling failed fuel at the Barnwell Nuclear Fuel Plant

    International Nuclear Information System (INIS)

    Anderson, R.T.; Cholister, R.J.

    1982-05-01

    The impact of failed fuel receipt on reprocessing operations is qualitatively described. It appears that extended storage of fuel, particularly with advanced storage techniques, will increase the quantity of failed fuel, the nature and possibly the configuration of the fuel. The receipt of failed fuel at the BNFP increases handling problems, waste volumes, and operator exposure. If it is necessary to impose special operating precautions to minimize this impact, a loss in plant throughput will result. Hence, ideally, the reprocessing plant operator would take every reasonable precaution so that no failed fuel is received. An alternative policy would be to require that failed fuel be placed in a sealed canister. In the latter case the canister must be compatible with the shipping cask and suitable for in-plant storage. A required inspection of bare fuel would be made at the reactor prior to shipping off-site. This would verify fuel integrity. These requirements are obviously idealistic. Due to the current uncertain status of reprocessing and the need to keep reactors operating, business or governmental policy may be enacted resulting in the receipt of a negotiated quantity of non-standard fuel (including failed fuel). In this situation, BNFP fuel receiving policy based soley on fuel cladding integrity would be difficult to enforce. There are certain areas where process incompatibility does exist and where a compromise would be virtually impossible, e.g., canned fuel for which material or dimensional conflicts exist. This fuel would have to be refused or the fuel would require recanning prior to shipment. In other cases, knowledge of the type and nature of the failure may be acceptable to the operator. A physical inspection of the fuel either before shipment or after the cask unloading operation would be warranted. In this manner, concerns with pool contamination can be identified and the assembly canned if deemed necessary

  11. An fMRI study of neuronal activation in schizophrenia patients with and without previous cannabis use

    Directory of Open Access Journals (Sweden)

    Else-Marie eLøberg

    2012-10-01

    Full Text Available Previous studies have mostly shown positive effects of cannabis use on cognition in patients with schizophrenia, which could reflect lower neurocognitive vulnerability. There are however no studies comparing whether such cognitive differences have neuronal correlates. Thus, the aim of the present study was to compare whether patients with previous cannabis use differ in brain activation from patients who has never used cannabis. The patients groups were compared on the ability to up-regulate an effort mode network during a cognitive task and down-regulate activation in the same network during a task-absent condition. Task-present and task-absent brain activation was measured by functional magnetic resonance neuroimaging (fMRI. Twenty-six patients with a DSM-IV and ICD-10 diagnosis of schizophrenia were grouped into a previous cannabis user group and a no-cannabis group. An auditory dichotic listening task with instructions of attention focus on either the right or left ear stimulus was used to tap verbal processing, attention and cognitive control, calculated as an aggregate score. When comparing the two groups, there were remaining activations in the task-present condition for the cannabis group, not seen in the no-cannabis group, while there was remaining activation in the task-absent condition for the no-cannabis group, not seen in the cannabis group. Thus, the patients with previous cannabis use showed increased activation in an effort mode network and decreased activation in the default mode network as compared to the no-cannabis group. It is concluded that the present study show some differences in brain activation to a cognitively challenging task between previous cannabis and no-cannabis schizophrenia patients.

  12. More than 100 Colleges Fail Education Department's Test of Financial Strength

    Science.gov (United States)

    Blumenstyk, Goldie

    2009-01-01

    A newly compiled analysis by the U.S. Department of Education and obtained by "The Chronicle" shows that 114 private nonprofit degree-granting colleges were in such fragile financial condition at the end of their last fiscal year that they failed the department's financial-responsibility test. Colleges that fail the test are subject to extra…

  13. Perceived adherence barriers among patients failing second-line ...

    African Journals Online (AJOL)

    Perceived adherence barriers among patients failing second-line antiretroviral therapy in Khayelitsha, South Africa. W Barnett, G Patten, B Kerschberger, K Conradie, DB Garone, G van Cutsem, CJ Colvin ...

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

    Science.gov (United States)

    Moulaison, Heather Lea; Stanley, Susan Nicole

    2013-01-01

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

  15. Modified rerouting procedure for failed peroneal tendon dislocation surgery.

    Science.gov (United States)

    Gaulke, R; Hildebrand, F; Panzica, M; Hüfner, T; Krettek, C

    2010-04-01

    Recurrent dislocation of the peroneal tendons following operative treatment is relatively uncommon, but can be difficult to treat. We asked whether subligamental transposition of the peroneus brevis tendon, fibular grooving, and reattachment of the superior peroneal retinaculum for failed peroneal tendon dislocation surgery would achieve a stable fixation of the peroneal tendons and whether there would be restrictions of ROM or instability of the hindfoot. We reviewed six female patients (mean age, 24.5 years) with general laxity of joints preoperatively and at 6 weeks and 3, 6, and 12 months postoperatively. Within 1 year postoperatively no recurrence was found. In two ankles the extension was restricted 5 degrees to 10 degrees . In another pronation and supination was restricted 5 degrees each. Stability of the ankle increased in four patients and stayed unchanged in two. AOFAS score increased from a mean value of 36 +/- 20.6 preoperatively to 90 +/- 7 postoperatively at 1 year. We conclude transposition of the peroneus brevis tendon is a reasonable treatment for failed peroneal tendon dislocation surgery. Level IV, therapeutic study (prospective case series). See Guidelines for Authors for a complete description of levels of evidence.

  16. Neutralizing antibody fails to impact the course of Ebola virus infection in monkeys.

    Directory of Open Access Journals (Sweden)

    Wendelien B Oswald

    2007-01-01

    Full Text Available Prophylaxis with high doses of neutralizing antibody typically offers protection against challenge with viruses producing acute infections. In this study, we have investigated the ability of the neutralizing human monoclonal antibody, KZ52, to protect against Ebola virus in rhesus macaques. This antibody was previously shown to fully protect guinea pigs from infection. Four rhesus macaques were given 50 mg/kg of neutralizing human monoclonal antibody KZ52 intravenously 1 d before challenge with 1,000 plaque-forming units of Ebola virus, followed by a second dose of 50 mg/kg antibody 4 d after challenge. A control animal was exposed to virus in the absence of antibody treatment. Passive transfer of the neutralizing human monoclonal antibody not only failed to protect macaques against challenge with Ebola virus but also had a minimal effect on the explosive viral replication following infection. We show that the inability of antibody to impact infection was not due to neutralization escape. It appears that Ebola virus has a mechanism of infection propagation in vivo in macaques that is uniquely insensitive even to high concentrations of neutralizing antibody.

  17. Biomarker-driven trial in metastatic pancreas cancer: feasibility in a multicenter study of saracatinib, an oral Src inhibitor, in previously treated pancreatic cancer

    International Nuclear Information System (INIS)

    Arcaroli, John; Quackenbush, Kevin; Dasari, Arvind; Powell, Rebecca; McManus, Martine; Tan, Aik-Choon; Foster, Nathan R; Picus, Joel; Wright, John; Nallapareddy, Sujatha; Erlichman, Charles; Hidalgo, Manuel; Messersmith, Wells A

    2012-01-01

    Src tyrosine kinases are overexpressed in pancreatic cancers, and the oral Src inhibitor saracatinib has shown antitumor activity in preclinical models of pancreas cancer. We performed a CTEP-sponsored Phase II clinical trial of saracatinib in previously treated pancreas cancer patients, with a primary endpoint of 6-month survival. A Simon MinMax two-stage phase II design was used. Saracatinib (175 mg/day) was administered orally continuously in 28-day cycles. In the unselected portion of the study, 18 patients were evaluable. Only two (11%) patients survived for at least 6 months, and three 6-month survivors were required to move to second stage of study as originally designed. The study was amended as a biomarker-driven trial (leucine rich repeat containing protein 19 [LRRC19] > insulin-like growth factor-binding protein 2 [IGFBP2] “top scoring pairs” polymerase chain reaction [PCR] assay, and PIK3CA mutant) based on preclinical data in a human pancreas tumor explant model. In the biomarker study, archival tumor tissue or fresh tumor biopsies were tested. Biomarker-positive patients were eligible for the study. Only one patient was PIK3CA mutant in a 3′ untranslated region (UTR) portion of the gene. This patient was enrolled in the study and failed to meet the 6-month survival endpoint. As the frequency of biomarker-positive patients was very low (<3%), the study was closed. Although we were unable to conclude whether enriching for a subset of second/third line pancreatic cancer patients treated with a Src inhibitor based on a biomarker would improve 6-month survival, we demonstrate that testing pancreatic tumor samples for a biomarker-driven, multicenter study in metastatic pancreas cancer is feasible

  18. What if the Doha Round Fails? Implications for Canadian Agriculture

    OpenAIRE

    Gifford, Michael N.; McCalla, Alex F.; Meilke, Karl D.

    2008-01-01

    Many commentators assume that the WTO Doha Round negotiations have already failed and that this failure will not matter for Canadian agriculture. Neither view is correct. Most countries appear willing to make the effort needed to bring the negotiations to a make or break point in early 2008. If the Doha Round does eventually fail, an important opportunity to make the agricultural trading system significantly less distorted, more open and fair will have been lost. For Canadian agriculture, the...

  19. "Too big to fail" or "Too non-traditional to fail"?: The determinants of banks' systemic importance

    OpenAIRE

    Moore, Kyle; Zhou, Chen

    2013-01-01

    This paper empirically analyzes the determinants of banks' systemic importance. In constructing a measure on the systemic importance of financial institutions we find that size is a leading determinant. This confirms the usual "Too big to fail'' argument. Nevertheless, banks with size above a sufficiently high level have equal systemic importance. In addition to size, we find that the extent to which banks engage in non-traditional banking activities is also positively related to ...

  20. Laparoscopy After Previous Laparotomy

    Directory of Open Access Journals (Sweden)

    Zulfo Godinjak

    2006-11-01

    Full Text Available Following the abdominal surgery, extensive adhesions often occur and they can cause difficulties during laparoscopic operations. However, previous laparotomy is not considered to be a contraindication for laparoscopy. The aim of this study is to present that an insertion of Veres needle in the region of umbilicus is a safe method for creating a pneumoperitoneum for laparoscopic operations after previous laparotomy. In the last three years, we have performed 144 laparoscopic operations in patients that previously underwent one or two laparotomies. Pathology of digestive system, genital organs, Cesarean Section or abdominal war injuries were the most common causes of previouslaparotomy. During those operations or during entering into abdominal cavity we have not experienced any complications, while in 7 patients we performed conversion to laparotomy following the diagnostic laparoscopy. In all patients an insertion of Veres needle and trocar insertion in the umbilical region was performed, namely a technique of closed laparoscopy. Not even in one patient adhesions in the region of umbilicus were found, and no abdominal organs were injured.

  1. [Hospitals failing minimum volumes in 2004: reasons and consequences].

    Science.gov (United States)

    Geraedts, M; Kühnen, C; Cruppé, W de; Blum, K; Ohmann, C

    2008-02-01

    In 2004 Germany introduced annual minimum volumes nationwide on five surgical procedures: kidney, liver, stem cell transplantation, complex oesophageal, and pancreatic interventions. Hospitals that fail to reach the minimum volumes are no longer allowed to perform the respective procedures unless they raise one of eight legally accepted exceptions. The goal of our study was to investigate how many hospitals fell short of the minimum volumes in 2004, whether and how this was justified, and whether hospitals that failed the requirements experienced any consequences. We analysed data on meeting the minimum volume requirements in 2004 that all German hospitals were obliged to publish as part of their biannual structured quality reports. We performed telephone interviews: a) with all hospitals not achieving the minimum volumes for complex oesophageal, and pancreatic interventions, and b) with the national umbrella organisations of all German sickness funds. In 2004, one quarter of all German acute care hospitals (N=485) performed 23,128 procedures where minimum volumes applied. 197 hospitals (41%) did not meet at least one of the minimum volumes. These hospitals performed N=715 procedures (3.1%) where the minimum volumes were not met. In 43% of these cases the hospitals raised legally accepted exceptions. In 33% of the cases the hospitals argued using reasons that were not legally acknowledged. 69% of those hospitals that failed to achieve the minimum volumes for complex oesophageal and pancreatic interventions did not experience any consequences from the sickness funds. However, one third of those hospitals reported that the sickness funds addressed the issue and partially announced consequences for the future. The sickness funds' umbrella organisations stated that there were only sparse activities related to the minimum volumes and that neither uniform registrations nor uniform proceedings in case of infringements of the standards had been agreed upon. In spite of the

  2. Data from studies of previous radioactive waste disposal in Massachusetts Bay

    International Nuclear Information System (INIS)

    Curtis, W.R.; Mardis, H.M.

    1984-12-01

    This report presents the results of studies conducted in Massachusetts Bay during 1981 and 1982. Included are data from: (1) a side scan sonar survey of disposal areas in the Bay that was carried out by the National Oceanic and Atmospheric Administration (NOAA) for EPA; (2) Collections of sediment and biota by NOAA for radiochemical analysis by EPA; (3) collections of marketplace seafood samples by the Food and Drug Administration (FDA) for radioanalysis by both FDA and EPA; and (4) a radiological monitoring survey of LLW disposal areas by EPA to determine whether there should be any concern for public health resulting from previous LLW disposals in the Bay

  3. Recall versus familiarity when recall fails for words and scenes: the differential roles of the hippocampus, perirhinal cortex, and category-specific cortical regions.

    Science.gov (United States)

    Ryals, Anthony J; Cleary, Anne M; Seger, Carol A

    2013-01-25

    This fMRI study examined recall and familiarity for words and scenes using the novel recognition without cued recall (RWCR) paradigm. Subjects performed a cued recall task in which half of the test cues resembled studied items (and thus were familiar) and half did not. Subjects also judged the familiarity of the cue itself. RWCR is the finding that, among cues for which recall fails, subjects generally rate cues that resemble studied items as more familiar than cues that do not. For words, left and right hippocampal activity increased when recall succeeded relative to when it failed. When recall failed, right hippocampal activity was decreased for familiar relative to unfamiliar cues. In contrast, right Prc activity increased for familiar cues for which recall failed relative to both familiar cues for which recall succeeded and to unfamiliar cues. For scenes, left hippocampal activity increased when recall succeeded relative to when it failed but did not differentiate familiar from unfamiliar cues when recall failed. In contrast, right Prc activity increased for familiar relative to unfamiliar cues when recall failed. Category-specific cortical regions showed effects unique to their respective stimulus types: The visual word form area (VWFA) showed effects for recall vs. familiarity specific to words, and the parahippocampal place area (PPA) showed effects for recall vs. familiarity specific to scenes. In both cases, these effects were such that there was increased activity occurring during recall relative to when recall failed, and decreased activity occurring for familiar relative to unfamiliar cues when recall failed. Copyright © 2012 Elsevier B.V. All rights reserved.

  4. Recall versus familiarity when recall fails for words and scenes: The differential roles of the hippocampus, perirhinal cortex, and category-specific cortical regions☆

    Science.gov (United States)

    Ryals, Anthony J.; Cleary, Anne M.; Seger, Carol A.

    2013-01-01

    This fMRI study examined recall and familiarity for words and scenes using the novel recognition without cued recall (RWCR) paradigm. Subjects performed a cued recall task in which half of the test cues resembled studied items (and thus were familiar) and half did not. Subjects also judged the familiarity of the cue itself. RWCR is the finding that, among cues for which recall fails, subjects generally rate cues that resemble studied items as more familiar than cues that do not. For words, left and right hippocampal activity increased when recall succeeded relative to when it failed. When recall failed, right hippocampal activity was decreased for familiar relative to unfamiliar cues. In contrast, right Prc activity increased for familiar cues for which recall failed relative to both familiar cues for which recall succeeded and to unfamiliar cues. For scenes, left hippocampal activity increased when recall succeeded relative to when it failed but did not differentiate familiar from unfamiliar cues when recall failed. In contrast, right Prc activity increased for familiar relative to unfamiliar cues when recall failed. Category-specific cortical regions showed effects unique to their respective stimulus types: The visual word form area (VWFA) showed effects for recall vs. familiarity specific to words, and the parahippocampal place area (PPA) showed effects for recall vs. familiarity specific to scenes. In both cases, these effects were such that there was increased activity occurring during recall relative to when recall failed, and decreased activity occurring for familiar relative to unfamiliar cues when recall failed. PMID:23142268

  5. Identify too big to fail banks and capital insurance: An equilibrium approach

    Directory of Open Access Journals (Sweden)

    Katerina Ivanov

    2017-09-01

    Full Text Available The objective of this paper is develop a rational expectation equilibrium model of capital insurance to identify too big to fail banks. The main results of this model include (1 too big to fail banks can be identified explicitly by a systemic risk measure, loss betas, of all banks in the entire financial sector; (2 the too big to fail feature can be largely justified by a high level of loss beta; (3 the capital insurance proposal benefits market participants and reduces the systemic risk; (4 the implicit guarantee subsidy can be estimated endogenously; and lastly, (5 the capital insurance proposal can be used to resolve the moral hazard issue. We implement this model and document that the too big to fail issue has been considerably reduced in the pro-crisis period. As a result, the capital insurance proposal could be a useful macro-regulation innovation policy tool

  6. Categorization of failed and damaged spent LWR [light-water reactor] fuel currently in storage

    International Nuclear Information System (INIS)

    Bailey, W.J.

    1987-11-01

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

  7. Posterior transpedicular approach with circumferential debridement and anterior reconstruction as a salvage procedure for symptomatic failed vertebroplasty

    OpenAIRE

    Chiu, Yen-Chun; Yang, Shih-Chieh; Chen, Hung-Shu; Kao, Yu-Hsien; Tu, Yuan-Kun

    2015-01-01

    Background Complications and failure of vertebroplasty, such as cement dislodgement, cement leakage, or spinal infection, usually result in spinal instability and neural element compression. Combined anterior and posterior approaches are the most common salvage procedure for symptomatic failed vertebroplasty. The purpose of this study is to evaluate the feasibility and efficacy of a single posterior approach technique for the treatment of patients with symptomatic failed vertebroplasty. Metho...

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

    Directory of Open Access Journals (Sweden)

    Hong-Bin Li

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-05-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-07-15

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

  11. Failed anti-tachycardia pacing can be used to differentiate atrial arrhythmias from ventricular tachycardia in implantable cardioverter-defibrillators.

    Science.gov (United States)

    Michael, Kevin A; Enriquez, Andres; Baranchuk, Adrian; Haley, Charlotte; Caldwell, Jane; Simpson, Christopher S; Abdollah, Hoshiar; Redfearn, Damian P

    2015-01-01

    Atrial fibrillation/tachycardia (AF/AT) may result in inappropriate therapies in implantable cardioverter-defibrillators (ICDs). The post-pacing interval (PPI) and tachycardia cycle length difference (PPI - TCL) has been previously demonstrated to indicate the proximity of the pacing site to a tachycardia origin. We postulated that the PPI and PPI - TCL would be greater in AT/AF vs. ventricular tachycardia (VT) after episodes of failed anti-tachycardia pacing (ATP). This was a single-centre, retrospective study evaluating consecutive patients implanted with dual (DR)/biventricular (BIV) ICDs. Stored electrograms were used to determine whether the ATP captured the arrhythmia and the arrhythmia did not present with primary or secondary termination. Measurements were done using manual calipers. A total of 155 patients were included. There were 79 BIV and 76 DR devices. In total, 39 episodes were identified in 20 patients over a 23-month follow-up period. A total of 76 sequences of ATP (burst/ramp) were delivered, 28 (37%) of them inappropriate. Fifty-one events (18 AT/AF and 33 VT) were compared. The mean PPI was 693 ± 96 vs. 512 ± 88 ms (P failed ATP differs significantly between AF/AT and VT and are therefore useful indices to discriminate between supraventricular tachycardia and VT in ICDs. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  12. Factors associated with the failed induction of labour in post-term pregnancy at a tertiary care hospital in karachi, pakistan

    International Nuclear Information System (INIS)

    Makhijani, P.; Kazi, S.; Rabia, S.

    2017-01-01

    Objective: To determine the factors associated with failed induction of labour in post-term pregnancies attending a tertiary care hospital in Karachi, Pakistan. Mehtods: This cross-sectional study was conducted at the Department of Gynecology and Obstetrics, Unit II, Civil Hospital, Karachi. During January to July, 2016. Women with a gestational age of 40 weeks + 6 days to 41weeks + 0 days were included in the study. Obstetric history, maternal age, BMI, gestational age, Bishop score, induction to delivery interval and mode of delivery were noted. Failed induction of labour was considered when patients delivered abdominally. Descriptive statistics were calculated and chi-square test was applied post stratification where p-value < 0.05 was considered statistically significant. Results: 140 women met the inclusion criteria. The mean age of study subjects was 32.1 ± 2.9 years. Induction of labour failed in 78.6% of patients. Prolonged latent phase of labour was observed in 27.9% and a prolonged 2nd stage of labour obsereved in 17.1%. A Bishop score > 5 was in 81.4%. BMI > 24.9 was in 47.1%. Spontaneous rupture of membrane (SROM) was in 27.1%. Conclusion: Induction of labour failed in 78.6% of post-term pregnancies in our study. A prolonged latent phase of the first stage of labour showed a significant association with failed induction of labour. (author)

  13. Modified Mathieu repair for failed surgery for hypospadias ...

    African Journals Online (AJOL)

    A.Z.M. Anwar

    Received 24 June 2014; received in revised form 3 August 2014; accepted 31 August ... Objectives: To present our experience with the use of modified Mathieu urethroplasty for failed hypospadias ... Overall success was achieved in 31/38.

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

    OpenAIRE

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

    2014-01-01

    Objectives: Arthroscopic instability repair has supplanted open techniques to anatomically reconstruct anteroinferior instability pathology. Arthroscopic technique can fail for a variety of reasons. We have utilized the Latarjet as a revision option in failed arthroscopic instability repairs when there is altered surgical anatomy, capsular deficiency and/or glenoid bone compromise and recurrent glenohumeral instability. Methods: We reviewed 51 shoulders (40 ?, 11?) that underwent Latarjet cor...

  15. Regionalism in Services : A Study of ASEAN

    OpenAIRE

    Gootiiz, Batshur; Mattoo, Aaditya

    2015-01-01

    Can regionalism do what multilateralism has so far failed to do—promote greater openness of services markets? Although previous research has pointed to the wider and deeper legal commitments under regional agreements as proof that it can, no previous study has assessed the impact of such agreements on applied policies. This paper focuses on the Association of Southeast Asian Nations (ASEAN), where ...

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

    Science.gov (United States)

    Mascret, Nicolas

    2011-01-01

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

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

    LENUS (Irish Health Repository)

    White, A

    2012-01-01

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

  18. Radiolysis effects on fuel corrosion within a failed nuclear waste container

    International Nuclear Information System (INIS)

    Sunder, S.; Shoeshmith, D.W.; Christensen, H.C.

    2003-01-01

    The concept of geological disposal of used nuclear fuel in corrosion resistant containers is being investigated in several countries. In the Canadian Nuclear Fuel Waste Management Program (CNFWMP), it is assumed that the used fuel will be disposed of in copper containers. Since the predicted lifetimes of these containers are very long (>106 years), only those containers emplaced with an undetected defect will fail within the period for which radionuclide release from the fuel must be considered. Early failure could lead to the entry of water into the container and subsequent release of radionuclides. The release rate of radionuclides from the used fuel will depend upon its dissolution rate. The primary mechanism for release will be the corrosion of the fuel driven by radiolytically-produced oxidants. The studies carried out to determine the effects of water radiolysis on fuel corrosion are reviewed, and some of the procedures used to predict corrosion rates of used fuel in failed nuclear waste containers described. (author)

  19. Replacing a failed mini-implant with a miniplate to prevent interruption during orthodontic treatment.

    Science.gov (United States)

    Lee, Jin-Hwa; Choo, Hyeran; Kim, Seong-Hun; Chung, Kyu-Rhim; Giannuzzi, Lucille A; Ngan, Peter

    2011-06-01

    When mini-implants fail during orthodontic treatment, there is a need to have a backup plan to either replace the failed implant in the adjacent interradicular area or wait for the bone to heal before replacing the mini-implant. We propose a novel way to overcome this problem by replacement with a miniplate so as not to interrupt treatment or prolong treatment time. The indications, advantages, efficacy, and procedures for switching from a mini-implant to a miniplate are discussed. Two patients who required replacement of failed mini-implants are presented. In the first patient, because of the proximity of the buccal vestibule to the mini-implant, it was decided to replace the failed mini-implant by an I-shaped C-tube miniplate. In the second patient, radiolucencies were found around the failed mini-implants, making the adjacent alveolar bone unavailable for immediate placement of another mini-implant. In addition, the maxillary sinus pneumatization was expanded deeply into the interradicular spaces; this further mandated an alternative placement site. One failed mini-implant was examined under a scanning electron microscope for bone attachment. Treatment was completed in both patients after replacement with miniplates without interrupting the treatment mechanics or prolonging the treatments. Examination under the scanning electron microscope showed partial bone growth into the coating pores and titanium substrate interface even after thorough cleaning and sterilization. Replacement with a miniplate is a viable solution for failed mini-implants during orthodontic treatment. The results from microscopic evaluation of the failed mini-implant suggest that stringent guidelines are needed for recycling used mini-implants. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  20. Development of failed element monitoring system for PWR

    International Nuclear Information System (INIS)

    Liu Yupu; Liu Haojie

    2005-01-01

    Aiming at the existent problems of failed element monitoring system in the PWR, the detector, the spiral tube, the neutron-moderator and the shielding of neutron bas improved on in this task. These improvements decrease the backgrounds effectively, raise the work stability of the detectors and resolve the failed element error action problem which can not be resolved for the long time, and the detecting sensitivity is raise ten times. The γ-ray detector is arranged spiral with outside, so the γ-rays with shorter half-life can be detected. The structure of gross gamma detection station has improved, so the solid angle is expanded, the transmissivity of γ-rays and β-rays are increased, and the ratio of signal to background is raised. The measurement instrument has been intellectualized. This system is above criticism for the users in operation. (authors)

  1. The Art of Saving a Failing School

    Science.gov (United States)

    Stein, Les

    2012-01-01

    While the debate continues over whether to close failing schools or attempt fixing them, the author asserts that the solution most often lies in assigning strong leaders to them who will take definite and immediate action. Reviewing his own success turning around schools, he says creating a sense of urgency, unloading poor performing staff, and…

  2. Percutaneous Gastrostomy in Patients Who Fail or Are Unsuitable for Endoscopic Gastrostomy

    International Nuclear Information System (INIS)

    Thornton, Frank J.; Varghese, Jose C.; Haslam, Philip J.; McGrath, Frank P.; Keeling, Frank; Lee, Michael J.

    2000-01-01

    Purpose: Percutaneous endoscopic gastrostomy (PEG) is not possible or fails in some patients. We aimed to categorize the reasons for PEG failure, to study the success of percutaneous radiologic gastrostomy (PRG) in these patients, and to highlight the associated technical difficulties and complications.Methods: Forty-two patients (28 men, 14 women; mean age 60 years, range 18-93 years) in whom PEG failed or was not possible, underwent PRG. PEG failure or unsuitability was due to upper gastrointestinal tract obstruction or other pathology precluding PEG in 15 of the 42 patients, suboptimal transillumination in 22 of 42 patients, and advanced cardiorespiratory decompensation precluding endoscopy in five of 42 patients. T-fastener gastropexy was used in all patients and 14-18 Fr catheters were inserted.Results: PRG was successful in 41 of 42 patients (98%). CT guidance was required in four patients with altered upper gastrointestinal anatomy. PRG failed in one patient despite CT guidance. In the 16 patients with high subcostal stomachs who failed PEG because of inadequate transillumination, intercostal tube placement was required in three and cephalad angulation under the costal margin in six patients. Major complications included inadvertent placement of the tube in the peritoneal cavity. There was one case of hemorrhage at the gastrostomy site requiring transfusion and one case of superficial gastrostomy site infection requiring tube removal. Minor complications included superficial wound infection in six patients, successfully treated with routine wound toilette.Conclusion: We conclude that PRG is a safe, well-tolerated and successful method of gastrostomy and gastrojejunostomy insertion in the technically difficult group of patients who have undergone an unsuccessful PEG. In many such cases optimal clinical evaluation will suggest primary referral for PRG as the preferred option

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

    Science.gov (United States)

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

    2016-04-15

    Early warning systems are widely used to safeguard water security, but their effectiveness has raised many questions. To understand why conventional detection methods fail to identify contamination events, this study evaluates the performance of three contamination detection methods using data from a real contamination accident and two artificial datasets constructed using a widely applied contamination data construction approach. Results show that the Pearson correlation Euclidean distance (PE) based detection method performs better for real contamination incidents, while the Euclidean distance method (MED) and linear prediction filter (LPF) method are more suitable for detecting sudden spike-like variation. This analysis revealed why the conventional MED and LPF methods failed to identify existence of contamination events. The analysis also revealed that the widely used contamination data construction approach is misleading. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Preoperative screening: value of previous tests.

    Science.gov (United States)

    Macpherson, D S; Snow, R; Lofgren, R P

    1990-12-15

    To determine the frequency of tests done in the year before elective surgery that might substitute for preoperative screening tests and to determine the frequency of test results that change from a normal value to a value likely to alter perioperative management. Retrospective cohort analysis of computerized laboratory data (complete blood count, sodium, potassium, and creatinine levels, prothrombin time, and partial thromboplastin time). Urban tertiary care Veterans Affairs Hospital. Consecutive sample of 1109 patients who had elective surgery in 1988. At admission, 7549 preoperative tests were done, 47% of which duplicated tests performed in the previous year. Of 3096 previous results that were normal as defined by hospital reference range and done closest to the time of but before admission (median interval, 2 months), 13 (0.4%; 95% CI, 0.2% to 0.7%), repeat values were outside a range considered acceptable for surgery. Most of the abnormalities were predictable from the patient's history, and most were not noted in the medical record. Of 461 previous tests that were abnormal, 78 (17%; CI, 13% to 20%) repeat values at admission were outside a range considered acceptable for surgery (P less than 0.001, frequency of clinically important abnormalities of patients with normal previous results with those with abnormal previous results). Physicians evaluating patients preoperatively could safely substitute the previous test results analyzed in this study for preoperative screening tests if the previous tests are normal and no obvious indication for retesting is present.

  5. Counselor Liability for Failing to Report Child Abuse.

    Science.gov (United States)

    Knapp, Samuel

    1983-01-01

    Describes the laws regarding counselor liability for failure to report child abuse and state laws designating mandated reporters of suspected child abuse. Notes how the law protects mandated reporters. Discusses criminal penalties for those who fail to report suspected abuse. (RC)

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

    Science.gov (United States)

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

    2001-02-01

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

  7. Survey of Accepted Practice following Failed Intubation for Emergency Caesarean Delivery

    Directory of Open Access Journals (Sweden)

    Daniel Soltanifar

    2015-01-01

    Full Text Available Background. There is no consensus on the optimum management of failed tracheal intubation in emergency cesarean delivery performed for fetal compromise. The decision making process on whether to wake the patient or continue anesthesia with a supraglottic airway device is an underexplored area. This survey explores perceptions and experiences of obstetric anesthetists managing failed intubation. Methods. Anesthetists attending the Group of Obstetric Anaesthetists London (GOAL Meeting in April 2014 were surveyed. Results. Ninety-three percent of anesthetists surveyed would not always wake the patient in the event of failed intubation for emergency cesarean delivery performed for fetal compromise. The median (interquartile range of perceived acceptability of continuing anesthesia with a well-fitting supraglottic airway device, assessed using a visual analogue scale (0–100; 0 completely unacceptable; 100 completely acceptable, was 90 [22.5]. Preoperative patient consent regarding the use of a supraglottic airway device for surgery in the event of failed intubation would affect the decision making of 40% of anaesthetists surveyed. Conclusion. These results demonstrate that a significant body of anesthetists with a subspecialty interest in obstetric anesthesia in the UK would not always wake up the patient and would continue with anesthesia and surgery with a supraglottic airway device in this setting.

  8. Management of failed spinal anaesthesia for caesarean section

    African Journals Online (AJOL)

    based on an intent-to-treat analysis. Of these, 10 ... testing the level of a spinal block, nor is there an algorithm on how ... scenarios of failed spinal anaesthesia was distributed to 51 government hospitals in KwaZulu-Natal, South Africa (SA).

  9. Why does Centralisation fail to internalise Policy Externalities?

    NARCIS (Netherlands)

    A.J. Dur (Robert); H.J. Roelfsema (Hein)

    2002-01-01

    textabstractCentralisation of political decision making often fails to produce the desired results. For instance, it is frequently argued that decision making within the European Union results in overspending and overregulation in some policy areas, while too low spending and too little regulation

  10. Clinical Outcomes Associated with a Failed Infant Car Seat Challenge.

    Science.gov (United States)

    Shah, Malika D; Dookeran, Keith A; Khan, Janine Y

    2017-01-01

    To assess comorbid conditions and clinical outcomes among late preterm and low birth weight term infants (Baby Unit. This was a retrospective chart review of consecutive infants who failed ICSC on the Mother-Baby Unit and were subsequently admitted to the neonatal intensive care unit at Prentice Women's Hospital between January 1, 2009, and December 31, 2015. Regression models were used to estimate risk differences (RDs) with 95% CIs for factors related to length of stay. A total of 148 infants were studied (43% male; 37% delivered via cesarean). ICSC failure in the Mother-Baby Unit was due to desaturation, bradycardia, and tachypnea in 59%, 37%, and 4% of infants, respectively. During monitoring on the neonatal intensive care unit, 39% of infants experienced apnea (48% in preterm vs 17% in term infants) in the supine position, 19% received phototherapy, and 2% and 6.8% received nasogastric and thermoregulatory support, respectively. Univariate predictors of increased duration of stay (days) were younger gestational age, apnea, nasogastric support, intravenous fluids, and antibiotics (all P < .05). In multivariable analysis adjusted for gestational age and discharge weight, only apnea (RD, 4.87; 95% CI, 2.99-6.74; P < .001), administration of antibiotics (RD, 3.25; 95% CI, 0.29-6.21; P < .032), and intravenous fluid support (RD, 4.87; 95% CI, 0.076-9.66; P < .047) remained independent predictors of a longer duration of stay. Infants who failed ICSC were at risk for comorbid conditions that prolonged hospital stay beyond the neonatal intensive care unit observation period. Almost one-half of late preterm infants who failed ICSC had apnea events in the supine position. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Eden-Hybinette and Pectoralis Major Transfer for Recurrent Shoulder Instability Due to Failed Latarjet and Chronic Subscapularis Rupture.

    Science.gov (United States)

    Li, Xinning; Cusano, Antonio; Eichinger, Josef

    2017-01-01

    Shoulder dislocations are a common injury, with anterior shoulder dislocation among male patients being the most common presentation. A patient with recurrent shoulder instability, anterior-superior escape, and chronic subscapularis tendon rupture following multiple shoulder stabilization surgeries presents the surgeon with a complex and challenging case. This report describes a 40-year-old man with an extensive left shoulder history that included a failed Latarjet procedure, an irreparable, chronic subscapularis tear with grade 4 Goutallier fatty infiltration, and associated anterior-superior escape. Given his marked dysfunction, weakness, pain, and recurrent instability in the absence of glenohumeral arthritis, he underwent an open Eden-Hybinette procedure (iliac crest autograft), a pectoralis major transfer, and an anterior capsule repair. The patient returned to his previous work activities without limitations. To the authors' knowledge, this is the first report describing a combination of anterior glenoid bone grafting with a full pectoralis major muscle transfer for a patient with chronic subscapularis rupture and anterior-superior escape after a failed Latarjet procedure with minimum glenoid bone loss. Furthermore, the authors provide a biomechanical rationale for the reconstruction used for this problem. [Orthopedics. 2017; 40(1):e182-e187.]. Copyright 2016, SLACK Incorporated.

  12. Failed pelvic pouch substituted by continent ileostomy.

    Science.gov (United States)

    Wasmuth, H H; Tranø, G; Wibe, A; Endreseth, B H; Rydning, A; Myrvold, H E

    2010-07-01

    The long-term failure rate of ileal pouch-anal anastomosis (IPAA) is 10-15%. When salvage surgery is unsuccessful, most surgeons prefer pouch excision with conventional ileostomy, thus sacrificing 40-50 cm of ileum. Conversion of a pelvic pouch to a continent ileostomy (CI, Kock pouch) is an alternative that preserves both the ileal surface and pouch properties. The aim of the study was to evaluate clinical outcome after the construction of a CI following a failed IPAA. During 1984-2007, 317 patients were operated with IPAA at St Olavs Hospital and evaluated for failure, treatment and outcome. Seven patients with IPAA failure had CI. Four patients with IPAA failure referred from other hospitals underwent conversion to CI and are included in the final analysis. Seven patients had a CI constructed from the transposing pelvic pouch and four had the pelvic pouch removed and a new continent pouch constructed from the distal ileum. Median follow up after conversion to CI was 7 years (0-17 years). Two CI had to be removed due to fistulae. One patient needed a revision of the nipple valve due to pouch loosening. At the end of follow-up, 8 of the 11 patients were fully continent. One patient with Crohn's disease had minor leakage. In patients with pelvic pouch failure, the possibility of conversion to CI should be presented to the patient as an alternative to pouch excision and permanent ileostomy. The advantage is the continence and possibly a better body image. Construction of a CI on a new ileal segment may be considered, but the consequences of additional small bowel loss and risk of malnutrition if the Kock pouch fails should be appraised.

  13. ISAT promises fail-safe computer-based reactor protection

    International Nuclear Information System (INIS)

    Anon.

    1989-01-01

    AEA Technology's ISAT system is a multiplexed microprocessor-based reactor protection system which has very extensive self-monitoring capabilities and is inherently fail safe. It provides a way of addressing software reliability problems that have tended to hamper widespread introduction of computer-based reactor protection. (author)

  14. An optimal inspection strategy for randomly failing equipment

    International Nuclear Information System (INIS)

    Chelbi, Anis; Ait-Kadi, Daoud

    1999-01-01

    This paper addresses the problem of generating optimal inspection strategies for randomly failing equipment where imminent failure is not obvious and can only be detected through inspection. Inspections are carried out following a condition-based procedure. The equipment is replaced if it has failed or if it shows imminent signs of failure. The latter state is indicated by measuring certain predetermined control parameters during inspection. Costs are associated with inspection, idle time and preventive or corrective actions. An optimal inspection strategy is defined as the inspection sequence minimizing the expected total cost per time unit over an infinite span. A mathematical model and a numerical algorithm are developed to generate an optimal inspection sequence. As a practical example, the model is applied to provide a machine tool operator with a time sequence for inspecting the cutting tool. The tool life time distribution and the trend of one control parameter defining its actual condition are supposed to be known

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

    Science.gov (United States)

    Porteous, John W

    2004-08-16

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

  16. Social Studies Fail on Protectionism.

    Science.gov (United States)

    Miller, Steven L.

    1988-01-01

    Examines the costs of protectionism and the benefits of specialization and trade and concludes that current popular support for protectionist policies suggests a poor performance by social studies educators. (GEA)

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

    Directory of Open Access Journals (Sweden)

    Muhamad S. B. Yusoff

    2013-02-01

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

  18. Assessment of Snared-Loop Technique When Standard Retrieval of Inferior Vena Cava Filters Fails

    International Nuclear Information System (INIS)

    Doody, Orla; Noe, Geertje; Given, Mark F.; Foley, Peter T.; Lyon, Stuart M.

    2009-01-01

    Purpose To identify the success and complications related to a variant technique used to retrieve inferior vena cava filters when simple snare approach has failed. Methods A retrospective review of all Cook Guenther Tulip filters and Cook Celect filters retrieved between July 2006 and February 2008 was performed. During this period, 130 filter retrievals were attempted. In 33 cases, the standard retrieval technique failed. Retrieval was subsequently attempted with our modified retrieval technique. Results The retrieval was successful in 23 cases (mean dwell time, 171.84 days; range, 5-505 days) and unsuccessful in 10 cases (mean dwell time, 162.2 days; range, 94-360 days). Our filter retrievability rates increased from 74.6% with the standard retrieval method to 92.3% when the snared-loop technique was used. Unsuccessful retrieval was due to significant endothelialization (n = 9) and caval penetration by the filter (n = 1). A single complication occurred in the group, in a patient developing pulmonary emboli after attempted retrieval. Conclusion The technique we describe increased the retrievability of the two filters studied. Hook endothelialization is the main factor resulting in failed retrieval and continues to be a limitation with these filters.

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

    Science.gov (United States)

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

    2016-09-01

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

  20. Associations of pass-fail outcomes with psychological health of first-year medical students in a malaysian medical school.

    Science.gov (United States)

    Yusoff, Muhamad S B

    2013-02-01

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

  1. Open Bankart repair for revision of failed prior stabilization: outcome analysis at a mean of more than 10 years.

    Science.gov (United States)

    Neviaser, Andrew S; Benke, Michael T; Neviaser, Robert J

    2015-06-01

    The purpose of this study was to analyze the outcome of open Bankart repair for failed stabilization surgery at a mean follow-up of >10 years. Thirty patients underwent revision open Bankart repair by a single surgeon for failed prior stabilization surgery, with a standard technique and postoperative rehabilitation. All patients were referred by other surgeons. Evaluation was by an independent examiner, at a mean follow-up of 10.2 years. Evaluation included a history, physical examination for range of motion, outcome scores, recurrence, return to athletics, and radiographic examination. All cases had persistent Bankart and Hill-Sachs lesions. Failures included 14 patients with a failed single arthroscopic Bankart repair; 1 patient with 2 failed arthroscopic Bankart repairs; 1 patient with an arthroscopic failure and an open Bankart repair; 7 patients with failed open Bankart repairs; and 1 patient with a failed open Bankart repair, then a failed arthroscopic attempt. Two patients had had thermal capsulorrhaphy; 2 others had staple capsulorrhaphy, 1 with an open capsular shift and 1 after a failed arthroscopic Bankart repair, an open Bankart repair, and then a coracoid transfer. All arthroscopic Bankart repairs had anchors placed medial and superior on the glenoid neck. Mean motion loss compared with the normal contralateral side was as follows: elevation 1.15°, abduction 4.2°, external rotation at the side 3.2°, external rotation in abduction 5.1°, and internal rotation 0.6 vertebral levels (NS). No patient had an apprehension sign, pain, or instability. Of 23 who played sports, 22 resumed after. Outcomes scores were as follows: American Shoulder and Elbow Surgeons, 89.44; Rowe, 86.67; Western Ontario Shoulder Instability Index, 476.26. On radiographic examination, there were 13 normal radiographs and 7 with mild, 2 with moderate, and 0 with severe arthritic changes. The open Bankart repair offers a reliable, consistently successful option for revision of

  2. Horses fail to use social learning when solving spatial detour tasks

    DEFF Research Database (Denmark)

    Rørvang, Maria Vilain; Peerstrup Ahrendt, Line; Christensen, Janne Winther

    2015-01-01

    Social animals should have plenty of opportunities to learn from conspecifics, but most studies have failed to document social learning in horses. This study investigates whether young Icelandic horses can learn a spatial detour task through observation of a trained demonstrator horse of either...... the same age (Experiments 1 and 2, n = 22) or older (Experiment 3, n = 24). Observer horses were allowed to observe the demonstrator being led three times through the detour route immediately before being given the opportunity to solve the task themselves. Controls were allowed only to observe...

  3. Post-irradiation examination of a failed PHWR fuel bundle of KAPS-2

    International Nuclear Information System (INIS)

    Mishra, Prerna; Unnikrishnan, K.; Viswanathan, U.K.; Shriwastaw, R.S.; Singh, J.L.; Ouseph, P.M.; Alur, V.D.; Singh, H.N.; Anantharaman, S.; Sah, D.N.

    2006-08-01

    Detailed post irradiation examination was carried out on a PHWR fuel bundle irradiated at Kakrapar Atomic Power Station unit 2 (KAPS-2). The fuel bundle had failed early in life at a low burnup of 387 MWd/T. Non destructive and destructive examination was carried out to identify the cause of fuel failure. Visual examination and leak testing indicated failure in two fuel pins of the outer ring of the bundle in the form of axial cracks near the end plug location. Ultrasonic testing of the end cap weld indicated presence of lack of fusion type defect in the two fuel pins. No defect was found in other fuel pins of the bundle. Metallographic examination of fuel sections taken from the crack location in the failed fuel pin showed extensive restructuring of fuel. The centre temperature of the fuel had exceeded 1700 degC at this location in the failed fuel pin, whereas fuel centre temperature in the un-failed fuel pin was only about 1300 degC. Severe fuel clad interaction was observed in the failed fuel pin at and near the location of failure but no such interaction was observed in the un-failed fuel pins. Several incipient cracks originating from the inside surface were found in the cladding near failure location in addition to the main through wall crack. The incipient cracks were filled with interaction products and hydride platelets were present at tip of the cracks. It was concluded from the observations that the primary cause of failure was the presence of a part-wall defect in the end cap weld of the fuel pins. These defects opened up during reactor operation leading to steam ingress into the fuel, which caused high fuel centre temperature and severe fuel-cladding interaction resulting in secondary failures. A more stringent inspection and quality control of end plug weld during fabrication using ultrasonic test has been recommended to avoid such failure. (author)

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

    International Nuclear Information System (INIS)

    Gayer, Gabriela; Apter, Sara; Katz, Rama; Ben-David, Aharon; Katzir, Ze'ev; Hertz, Marjorie

    2000-01-01

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

  5. Myocardial pre-synaptic sympathetic function correlates with glucose uptake in the failing human heart

    Energy Technology Data Exchange (ETDEWEB)

    Mongillo, Marco; Leccisotti, Lucia [Hammersmith Hospital, Medical Research Council Clinical Sciences Centre, Imperial College Faculty of Medicine, London (United Kingdom); John, Anna S. [Hammersmith Hospital, National Heart and Lung Institute, Imperial College, London (United Kingdom); Pennell, Dudley J. [Royal Brompton Hospital, National Heart and Lung Institute, Imperial College, London (United Kingdom); Camici, Paolo G. [Hammersmith Hospital, Medical Research Council Clinical Sciences Centre, Imperial College Faculty of Medicine, London (United Kingdom); Hammersmith Hospital, National Heart and Lung Institute, Imperial College, London (United Kingdom)

    2007-08-15

    We have previously shown that the myocardium of patients with heart failure (HF) is insulin resistant. Chronic {beta}-adrenergic stimulation has been implicated in insulin resistance in cultured cardiomyocytes in vitro, where sustained noradrenaline stimulation inhibited insulin-modulated glucose uptake. As the failing heart is characterized by increased sympathetic drive, we hypothesized that there is a correlation between pre-synaptic sympathetic function and insulin sensitivity in the myocardium of patients with HF. Eight patients (aged 67 {+-} 7 years) with coronary artery disease and left ventricular dysfunction (ejection fraction 44 {+-} 10%) underwent function and viability assessment with cardiovascular magnetic resonance. Myocardial glucose utilization (MGU) was measured using positron emission tomography (PET) with {sup 18}F-fluorodeoxyglucose (FDG). Pre-synaptic noradrenaline re-uptake was measured by calculating [{sup 11}C]meta-hydroxy-ephedrine (HED) volume of distribution (V{sub d}) with PET. Two groups of healthy volunteers served as controls for the FDG (n = 8, aged 52 {+-} 4 years, p < 0.01 vs patients) and HED (n = 8, aged 40 {+-} 6 years, p < 0.01 vs patients) data. MGU in patients was reduced in both normal remote (0.44 {+-} 0.14 {mu}mol.min{sup -1}.g{sup -1}) and dysfunctional (0.49 {+-} 0.14 {mu}mol.min{sup -1}.g{sup -1}) segments compared with controls (0.61 {+-} 0.7 {mu}mol.min{sup -1}.g{sup -1}; p < 0.001 vs both). HED V{sub d} was reduced in dysfunctional segments of patients (38.9 {+-} 21.2 ml.g{sup -1}) compared with normal segments (52.2 {+-} 19.6 ml.g{sup -1}) and compared with controls (62.7 {+-} 11.3 ml.g{sup -1}). In patients, regional MGU was correlated with HED V{sub d}. The results of this study provide novel evidence of a correlation between cardiac sympathetic function and insulin sensitivity, which may represent one of the mechanisms contributing to insulin resistance in failing human hearts. (orig.)

  6. Why good projects fail anyway.

    Science.gov (United States)

    Matta, Nadim F; Ashkenas, Ronald N

    2003-09-01

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

  7. Percutaneous anterior C1/2 transarticular screw fixation: salvage of failed percutaneous odontoid screw fixation for odontoid fracture

    OpenAIRE

    Wu, Ai-Min; Jin, Hai-Ming; Lin, Zhong-Ke; Chi, Yong-Long; Wang, Xiang-Yang

    2017-01-01

    Background The objective of this study is to investigate the outcomes and safety of using percutaneous anterior C1/2 transarticular screw fixation as a salvage technique for odontoid fracture if percutaneous odontoid screw fixation fails. Methods Fifteen in 108 odontoid fracture patients (planned to be treated by percutaneous anterior odontoid screw fixation) were failed to introduce satisfactory odontoid screw trajectory. To salvage this problem, we chose the percutaneous anterior C1/2 trans...

  8. Online failed fuel identification using delayed neutron detector signals in pool type reactors

    International Nuclear Information System (INIS)

    Upadhyay, Chandra Kant; Sivaramakrishna, M.; Nagaraj, C.P.; Madhusoodanan, K.

    2011-01-01

    In todays world, nuclear reactors are at the forefront of modern day innovation and reactor designs are increasingly incorporating cutting edge technology. It is of utmost importance to detect failure or defects in any part of a nuclear reactor for healthy operation of reactor as well as the safety aspects of the environment. Despite careful fabrication and manufacturing of fuel pins, there is a chance of clad failure. After fuel pin clad rupture takes place, it allows fission products to enter in to sodium pool. There are some potential consequences due to this such as Total Instantaneous Blockage (TIB) of coolant and primary component contamination. At present, the failed fuel detection techniques such as cover gas monitoring (alarming the operator), delayed neutron detection (DND-automatic trip) and standalone failed fuel localization module (FFLM) are exercised in various reactors. The first technique is a quantitative measurement of increase in the cover gas activity background whereas DND system causes automatic trip on detecting certain level of activity during clad wet rupture. FFLM is subsequently used to identify the failed fuel subassembly. The later although accurate, but mainly suffers from downtime and reduction in power during identification process. The proposed scheme, reported in this paper, reduces the operation of FFLM by predicting the faulty sector and therefore reducing reactor down time and thermal shocks. The neutron evolution pattern gets modulated because fission products are the delay neutron precursors. When they travel along with coolant to Intermediate heat Exchangers, experienced three effects i.e. delay; decay and dilution which make the neutron pulse frequency vary depending on the location of failed fuel sub assembly. This paper discusses the method that is followed to study the frequency domain properties, so that it is possible to detect exact fuel subassembly failure online, before the reactor automatically trips. (author)

  9. Evolution of drug resistance in HIV infected patients remaining on a virologically failing cART regimen

    DEFF Research Database (Denmark)

    Cozzi-Lepri, A; Phillips, AN; Ruiz, L

    2007-01-01

    OBJECTIVE: To estimate the extent of drug resistance accumulation in patients kept on a virologically failing regimen and its determinants in the clinical setting. DESIGN: The study focused on 110 patients of EuroSIDA on an unchanged regimen who had two genotypic tests performed at two time points...... (t0 and t1) when viral load was > 400 copies/ml. METHODS: Accumulation of resistance between t0 and t1 was measured using genotypic susceptibility scores (GSS) obtained by counting the total number of active drugs (according to the Rega system v6.4.1) among all licensed antiretrovirals as of 1...... January 2006. Patients were grouped according to the number of active drugs in the failing regimen at t0 (GSS_f-t0). RESULTS: At t0, patients had been on the failing combination antiretroviral therapy (cART) for a median of 11 months (range, 6-50 months). Even patients with extensive resistance...

  10. A study of fission product transport from failed fuel during N reactor postulated accidents

    International Nuclear Information System (INIS)

    Hagrman, D.L.

    1989-09-01

    This report presents a study of fission product transport behavior in N Reactor during a severe accident. More detail about fission product behavior than has previously been available is provided and key parameters that control this behavior are identified. The current report is an extension to a previous interum study that has added an aerosol formation model, replaced an older aerosol deposition model with an improved correlation, and incorporated results of a revised analysis of the process tubes. The LACE LA1 and LA3 tests are used to assess the revised model applied to determine aerosol deposition. The study concludes that a cesium iodide aerosol is likely to form near the downstream end of the process tubes. Transport of most of the released cesium and iodine as well as less volatile material depends on the behavior of this aerosol and the behavior is sensitive to several parameters that are not well known. If the environment is very clean and effluent flow is sufficient to support oxidation of the zircaloy and uranium of the process tubes, almost none of the aerosol deposits in the riser. Reduction of the effluent flow or the presence of high concentrations of aerosols of very low volatile material like zirconium, uranium, or their oxides causes deposition of the fission products in the riser piping. 24 refs., 18 figs., 11 tabs

  11. 'Pseudofailure' of spinal cord stimulation for neuropathic pain following a new severe noxious stimulus: learning points from a case series of failed spinal cord stimulation for complex regional pain syndrome and failed back surgery syndrome.

    Science.gov (United States)

    Muquit, Samiul; Moussa, Ahmad Abdelhai; Basu, Surajit

    2016-05-01

    Failure of spinal cord stimulation (SCS) may be due to hardware problems, migration of electrodes and, in the long-term, plasticity in the spinal cord with habituation to the stimulation current. We describe a series of seven patients who experienced acute therapeutic loss of SCS effects following an acute nociceptive event unrelated to primary pathology. There were no hardware problems. We called this 'Pseudofailure', as the effective stimulation returned in all patients following a period off stimulation or reprogramming. This phenomenon has not been reported previously in the literature. Over a 4-year period, we managed seven patients with this feature: four had received SCS for complex regional pain syndrome and three for failed back surgery syndrome. In all seven cases, there was cessation of the pain relief afforded by SCS following an acute painful event: four patients had trauma, two patients had domestic electric shock and one patient suffered shingles (varicella zoster infection). We excluded hardware-related problems in all cases. In two patients, SCS effects could be regained by an initial attempt at reprogramming. In the remaining five cases reprogramming was unsuccessful, and stimulation was switched off for several months before recommencing, when we discovered a return of good therapeutic effect. We conclude that SCS may seem to fail following a separate strong nociceptive stimulus. Stimulation may be regained with reprogramming or following a period with stimulation switched off. We would, therefore, advise against removal of SCS hardware in the first instance.

  12. Intranasal Oxytocin Failed to Affect Chimpanzee (Pan troglodytes) Social Behavior

    Science.gov (United States)

    Calcutt, Sarah E.; Burke, Kimberly; de Waal, Frans B. M.

    2017-01-01

    Oxytocin has been suggested as a treatment to promote positive social interactions in people with Autism Spectrum Disorders (ASD). However, it is difficult to test this effect outside of the laboratory in realistic social situations. One way to resolve this issue is to study behavioral changes in closely related species with complex social relationships, such as chimpanzees. Here, we use captive, socially housed chimpanzees to evaluate the effects of oxytocin in a socially complex environment. After administering intranasal oxytocin or a placebo to an individual chimpanzee (total n = 8), she was returned to her social group. An experimenter blind to the condition measured the subject's social behavior. We failed to find a behavioral difference between conditions. As one of the goals for oxytocin administration as a treatment for ASD is increasing prosocial behaviors during ‘real world’ encounters, it is problematic that we failed to detect behavioral changes in our closest living relatives. However, our null findings may be related to methodological challenges such as determining an effective dose of oxytocin for chimpanzees and how long oxytocin takes to cross the blood-brain barrier. Thus, more research on intranasal oxytocin dosing and uptake are needed to continue exploring whether oxytocin changes social behavior in naturalistic settings and as a treatment for ASD. PMID:28845444

  13. BENEFITS OF SHIRODKAR STITCH IN WOMEN WITH FAILED ...

    African Journals Online (AJOL)

    2011-06-06

    Jun 6, 2011 ... This is a case series presentation of 14 cases where Shirodkar stitch was inserted after failed McDonald stitch. The patients were either self referrals or from Obstetricians in Eastern Africa region. All the patients were able to carry the pregnancies to term and were delivered by Caesarean section.

  14. Estimating the effect of current, previous and never use of drugs in studies based on prescription registries

    DEFF Research Database (Denmark)

    Nielsen, Lars Hougaard; Løkkegaard, Ellen; Andreasen, Anne Helms

    2009-01-01

    of this misclassification for analysing the risk of breast cancer. MATERIALS AND METHODS: Prescription data were obtained from Danish Registry of Medicinal Products Statistics and we applied various methods to approximate treatment episodes. We analysed the duration of HT episodes to study the ability to identify......PURPOSE: Many studies which investigate the effect of drugs categorize the exposure variable into never, current, and previous use of the study drug. When prescription registries are used to make this categorization, the exposure variable possibly gets misclassified since the registries do...... not carry any information on the time of discontinuation of treatment.In this study, we investigated the amount of misclassification of exposure (never, current, previous use) to hormone therapy (HT) when the exposure variable was based on prescription data. Furthermore, we evaluated the significance...

  15. Failed Ventriculoperitoneal Shunt: Is Retrograde Ventriculosinus Shunt a Reliable Option?

    Science.gov (United States)

    Oliveira, Matheus Fernandes de; Teixeira, Manoel Jacobsen; Reis, Rodolfo Casimiro; Petitto, Carlo Emanuel; Gomes Pinto, Fernando Campos

    2016-08-01

    Currently, the treatment of hydrocephalus is mainly carried out through a ventriculoperitoneal shunt (VPS) insertion. However, in some cases, there may be surgical revisions and requirement of an alternative distal site for shunting. There are several described distal sites, and secondary options after VPS include ventriculopleural and ventriculoatrial shunt, which have technical difficulties and harmful complications. In this preliminary report we describe our initial experience with retrograde ventriculosinus shunt (RVSS) after failed VPS. In 3 consecutive cases we applied RVSS to treat hydrocephalus in shunt-dependent patients who had previously undergone VPS revision and in which peritoneal space was full of adhesions and fibrosis. RVSS was performed as described by Shafei et al., with some modifications to each case. All 3 patients kept the same clinical profile after RVSS, with no perioperative or postoperative complications. However, revision surgery was performed in the first operative day in 1 out of 3 patients, in which the catheter was not positioned in the superior sagittal sinus. We propose that in cases where VPS is not feasible, RVSS may be a safe and applicable second option. Nevertheless, the long-term follow-up of patients and further learning curve must bring stronger evidence. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. A fail-safe design for X-ray safety shutters

    International Nuclear Information System (INIS)

    Cramer, W.E.; Port, E.A.

    1982-01-01

    The purpose of any safety shutter device is to help minimize radiation exposure to personnel. Many such devices for analytical X-ray work may fail in a mode with great potential for injury. The authors present a design that may be used to modify any existing mechanical or electro-mechanical system that utilizes a gate which blocks an aperture to control exposure. The system is of 'fail-safe' design, as defined in the National Bureau of Standards Handbook 111 (American National Standards Institute, 1972); One in which all reasonable anticipated failures of indicator or safety components will cause the equipment to respond in a mode ensuring that personnel are safe from exposure to radiation. The system has visible indicators that make the user aware that a particular failure has occurred; in addition, X-ray generation ceases. (Auth.)

  17. Statistical Requirements For Pass-Fail Testing Of Contraband Detection Systems

    International Nuclear Information System (INIS)

    Gilliam, David M.

    2011-01-01

    Contraband detection systems for homeland security applications are typically tested for probability of detection (PD) and probability of false alarm (PFA) using pass-fail testing protocols. Test protocols usually require specified values for PD and PFA to be demonstrated at a specified level of statistical confidence CL. Based on a recent more theoretical treatment of this subject [1], this summary reviews the definition of CL and provides formulas and spreadsheet functions for constructing tables of general test requirements and for determining the minimum number of tests required. The formulas and tables in this article may be generally applied to many other applications of pass-fail testing, in addition to testing of contraband detection systems.

  18. 14C release from failed spent fuel containers

    International Nuclear Information System (INIS)

    Pescatore, C.

    1990-01-01

    Partially failed containers may provide a meaningful barrier to the release of gaseous radionuclides. A modeling approach is outlined and sample calculations are provided that show the effects on release due to a limited perforation area, to decreasing temperature, and to the partial occlusion of the perforated area by corrosion products. 8 refs., 2 tabs

  19. Mass ejection in failed supernovae: variation with stellar progenitor

    Science.gov (United States)

    Fernández, Rodrigo; Quataert, Eliot; Kashiyama, Kazumi; Coughlin, Eric R.

    2018-05-01

    We study the ejection of mass during stellar core-collapse when the stalled shock does not revive and a black hole forms. Neutrino emission during the protoneutron star phase causes a decrease in the gravitational mass of the core, resulting in an outward going sound pulse that steepens into a shock as it travels out through the star. We explore the properties of this mass ejection mechanism over a range of stellar progenitors using spherically symmetric, time-dependent hydrodynamic simulations that treat neutrino mass-loss parametrically and follow the shock propagation over the entire star. We find that all types of stellar progenitor can eject mass through this mechanism. The ejected mass is a decreasing function of the surface gravity of the star, ranging from several M⊙ for red supergiants to ˜0.1 M⊙ for blue supergiants and ˜10-3 M⊙ for Wolf-Rayet stars. We find that the final shock energy at the surface is a decreasing function of the core-compactness, and is ≲ 1047-1048 erg in all cases. In progenitors with a sufficiently large envelope, high core-compactness, or a combination of both, the sound pulse fails to unbind mass. Successful mass ejection is accompanied by significant fallback accretion that can last from hours to years. We predict the properties of shock breakout and thermal plateau emission produced by the ejection of the outer envelope of blue supergiant and Wolf-Rayet progenitors in otherwise failed supernovae.

  20. Mechanical and Spectroscopic Analysis of Retrieved/Failed Dental Implants

    Directory of Open Access Journals (Sweden)

    Umer Daood

    2017-11-01

    Full Text Available The purpose of this study was to examine surface alterations and bone formation on the surface of failed dental implants (Straumann [ST] and TiUnite [TiUn] removed due to any biological reason. In addition, failure analysis was performed to test mechanical properties. Dental implants (n = 38 from two manufacturers were collected and subjected to chemical cleaning. The presence of newly formed hydroxyapatite bone around failed implants was evaluated using micro-Raman spectroscopy. Scanning electron microscopy was used to identify surface defects. Mechanical testing was performed using a Minneapolis servo-hydraulic system (MTS along with indentation using a universal testing machine and average values were recorded. A statistical analysis of mechanical properties was done using an unpaired t test, and correlation between observed defects was evaluated using Chi-square (p = 0.05. Apatite-formation was evident in both implants, but was found qualitatively more in the ST group. No significant difference was found in indentation between the two groups (p > 0.05. The percentage of “no defects” was significantly lower in the ST group (71%. Crack-like and full-crack defects were observed in 49% and 39% of TiUn. The ST group showed 11,061 cycles to failure as compared with 10,021 cycles in the TiUnite group. Implant failure mechanisms are complex with a combination of mechanical and biological reasons and these factors are variable with different implant systems.

  1. In situ repair of a failed compression fitting

    Science.gov (United States)

    Wolbert, Ronald R.; Jandrasits, Walter G.

    1986-01-01

    A method and apparatus for the in situ repair of a failed compression fitg is provided. Initially, a portion of a guide tube is inserted coaxially in the bore of the compression fitting and locked therein. A close fit dethreading device is then coaxially mounted on the guide tube to cut the threads from the fitting. Thereafter, the dethreading device and guide tube are removed and a new fitting is inserted onto the dethreaded fitting with the body of the new fitting overlaying the dethreaded portion. Finally, the main body of the new fitting is welded to the main body of the old fitting whereby a new threaded portion of the replacement fitting is precisely coaxial with the old threaded portion. If needed, a bushing is located on the dethreaded portion which is sized to fit snugly between the dethreaded portion and the new fitting. Preferably, the dethreading device includes a cutting tool which is moved incrementally in a radial direction whereby the threads are cut from the threaded portion of the failed fitting in increments.

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

    Directory of Open Access Journals (Sweden)

    Porteous John W

    2004-08-01

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

  3. Memory outcome following left anterior temporal lobectomy in patients with a failed Wada test.

    Science.gov (United States)

    Rathore, Chaturbhuj; Alexander, Aley; Sarma, P Sankara; Radhakrishnan, Kurupath

    2015-03-01

    This study aimed to compare the memory outcome following left anterior temporal lobectomy (ATL) between patients with a failed Wada test and patients who passed the Wada test. From 1996 to 2002, we performed the Wada test on all patients with unilateral left mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) and concordant electroclinical data before ATL. We used a 12-item recognition paradigm for memory testing and awarded a score of +1 for each correct response and -0.5 for each incorrect response. No patient was denied surgery on the basis of Wada scores. We assessed cognitive and memory functions using the Wechsler Adult Intelligence Scale and the Wechsler Memory Scale preoperatively and at one year after ATL. We compared the number of patients who showed decline in memory scores, as per the published reliable change indices, between the patients with a failed Wada test and the patients who passed the Wada test. Out of the 116 eligible patients with left MTLE-HS, 88 underwent bilateral Wada test, while 28 underwent ipsilateral Wada test. None of them developed postoperative amnesia. Approximately, one-third of patients with a failed Wada memory test when the failure was defined as a contralateral score of 8, and as an asymmetry score of failed Wada memory test and the group who passed the Wada memory test. The results remained the same when analyses were repeated at various other cutoff points. The patients with left MTLE-HS with concordant electroclinical, MRI, and neuropsychological data should not be denied ATL solely on the basis of Wada memory test results. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Failed fuel detection device

    International Nuclear Information System (INIS)

    Doi, Akira.

    1994-01-01

    The device of the present invention concerns a failed fuel detection device for a nuclear reactor, such as an FBR type reactor, using electroconductive coolants. A sampling port is disposed at the upper portion of the fuel assembly so as to cover the assembly, so that coolants in the fuel assembly are sampled to improve a device for detecting fuel failure. That is, when coolants in the fuel assembly are sampled from the sampling port, the flow of electroconductive coolants in an sampling tube is detected by a flowmeter, to control an electromagnetic pump. The flow of electroconductive coolants is stopped against the waterhead pressure and dynamic pressure of the conductive coolants, and a predetermined amount of the coolants is pumped up to the sampling tank. Gas is supplied to the pumped up coolants so that fissile products are transferred from the coolants to a gas phase. Radiation in the gas in a gas recycling system is measured to detect presence of fuel failure. (I.S.)

  5. Polycose taste pre-exposure fails to influence behavioral and neural indices of taste novelty.

    Science.gov (United States)

    Barot, Sabiha K; Bernstein, Ilene L

    2005-12-01

    Taste novelty can strongly modulate the speed and efficacy of taste aversion learning. Novel sweet tastes enhance c-Fos-like immunoreactivity (FLI) in the central amygdala and insular cortex. The present studies examined whether this neural correlate of novelty extends to different taste types by measuring FLI signals after exposure to novel and familiar polysaccharide (Polycose) and salt (NaCl) tastes. Novel Polycose not only failed to elevate FLI expression in central amygdala and insular cortex, but also failed to induce stronger taste aversion learning than familiar Polycose. Novel NaCl, on the other hand, showed patterns of FLI activation and aversion learning similar to that of novel sweet tastes. Possible reasons for the resistance of Polycose to typical pre-exposure effects are discussed. Copyright (c) 2006 APA, all rights reserved.

  6. 14C release from failed spent fuel containers

    International Nuclear Information System (INIS)

    Pescatore, C.

    1989-01-01

    Partially failed containers may provide a meaningful barrier to the release of gaseous 14 CO 2 . A modeling approach is outlined and sample calculations are provided that show the effect on release due to a limited perforation area, to decreasing temperature, and to partial occlusion of the perforated area by corrosion products. 5 refs., 4 tabs

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

    NARCIS (Netherlands)

    Vermeulen, P.A.M.; Ansari, S.; Lounsbury, M.; Gehman, J.; Lounsbury, M.; Greenwood, R.

    2017-01-01

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

  8. The Failed Image and the Possessed

    DEFF Research Database (Denmark)

    Suhr, Christian

    2015-01-01

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

  9. Decision-Tree Analysis for Predicting First-Time Pass/Fail Rates for the NCLEX-RN® in Associate Degree Nursing Students.

    Science.gov (United States)

    Chen, Hsiu-Chin; Bennett, Sean

    2016-08-01

    Little evidence shows the use of decision-tree algorithms in identifying predictors and analyzing their associations with pass rates for the NCLEX-RN(®) in associate degree nursing students. This longitudinal and retrospective cohort study investigated whether a decision-tree algorithm could be used to develop an accurate prediction model for the students' passing or failing the NCLEX-RN. This study used archived data from 453 associate degree nursing students in a selected program. The chi-squared automatic interaction detection analysis of the decision trees module was used to examine the effect of the collected predictors on passing/failing the NCLEX-RN. The actual percentage scores of Assessment Technologies Institute®'s RN Comprehensive Predictor(®) accurately identified students at risk of failing. The classification model correctly classified 92.7% of the students for passing. This study applied the decision-tree model to analyze a sequence database for developing a prediction model for early remediation in preparation for the NCLEXRN. [J Nurs Educ. 2016;55(8):454-457.]. Copyright 2016, SLACK Incorporated.

  10. [Tadalafil combined with behavior therapy for semen collection from infertile males in whom masturbation fails].

    Science.gov (United States)

    Tang, Wen-Hao; Jiang, Hui; Ma, Lu-Lin; Hong, Kai; Zhao, Lian-Ming; Liu, De-Feng; Mao, Jia-Ming; Yang, Yi; Zhang, Ju; Gao, Ling; Qiao, Jie

    2013-05-01

    To study the effect of Tadalafil combined with behavior therapy in helping obtain semen from infertile men in whom masturbation has failed. Sixty male infertile patients from whom masturbation had failed to obtain semen were equally assigned to receive Tadalafil combined with behavior therapy (combination group) or Tadalafil only (control group). All the patients took Tadalafil 20 mg orally the night before the day of semen collection by masturbation. Before this procedure, the patients of the combination group practiced masturbation 16 - 24 times at home. The average ages of the patients were (37.0 +/- 5.1) yr and (37.5 +/- 5.2) yr and their IIEF-5 scores were 16.50 +/- 1.25 and 16.90 +/- 1.09 in the combination and the control group, respectively, neither with statistically significant difference between the two groups. Semen was successfully obtained from 9 patients (30.0%) of the combination group and 1 patient (3.33%) of the control group, with statistically significant difference between the two groups (chi2 = 7.680, P masturbation, Tadalafil combined with behavior therapy can significantly increase the success rate of semen collection from the male infertile patients in whom masturbation fails.

  11. Role of laparohysteroscopy in women with normal pelvic imaging and failed ovulation stimulation with intrauterine insemination

    Directory of Open Access Journals (Sweden)

    K Jayakrishnan

    2010-01-01

    Full Text Available Context: Women with primary infertility and no obvious pelvic pathology on clinical evaluation and imaging are either treated empirically or further investigated by laparoscopy. Aims: The role of diagnostic laparoscopy in women who fail to conceive after empirical treatment with ovulation induction and intrauterine insemination was evaluated. Settings and Design: Retrospective study at a private infertility center. Materials and Methods: A study of patients who underwent diagnostic laparoscopy between 1 st January 2001 and 31 st December 2008 was performed. Those patients who had no detectable pathology based on history, physical examination, and ultrasound and had treatment for three or more cycles in the form of ovulation induction and IUI were included in the study. Moderate and severe male factor infertility and history of any previous surgery were exclusion criteria. Statistical Analysis Used: Data were statistically analyzed using Statistics Package for Social Sciences (ver. 16.0; SPSS Inc., Chicago. Results: Of the 127 women who underwent diagnostic laparoscopy and hysteroscopy, 87.4% ( n= 111 of patients had positive findings. Significant pelvic pathology (moderate endometriosis, pelvic inflammatory disease, and tubal pathology was seen in 26.8% of cases. Conclusion: One in four women had significant pelvic pathology where treatment could possibly improve future fertility. Diagnostic laparoscopy has a role in infertile women with no obvious abnormality before they proceed to more aggressive treatments.

  12. Patterns and Predictors of Failed and Sustained Return-to-Work in Transport Injury Insurance Claimants.

    Science.gov (United States)

    Gray, Shannon E; Hassani-Mahmooei, Behrooz; Cameron, Ian D; Kendall, Elizabeth; Kenardy, Justin; Collie, Alex

    2018-02-12

    Purpose To determine the incidence of employed people who try and fail to return-to-work (RTW) following a transport crash. To identify predictors of RTW failure. A historical cohort study was conducted in the state of Victoria, Australia. People insured through the state-based compulsory third party transport accident compensation scheme were included. Inclusion criteria included date of crash between 2003 and 2012 (inclusive), age 15-70 years at the time of crash, sustained a non-catastrophic injury and received at least 1 day of income replacement. A matrix was created from an administrative payments dataset that mapped their RTW pattern for each day up to 3 years' post-crash. A gap of 7 days of no payment followed by resumption of a payment was considered a RTW failure and was flagged. These event flags were then entered into a regression analysis to determine the odds of having a failed RTW attempt. 17% of individuals had a RTW fail, with males having 20% lower odds of experiencing RTW failure. Those who were younger, had minor injuries (sprains, strains, contusions, abrasions, non-limb fractures), or were from more advantaged socio-economic group, were less likely to experience a RTW failure. Most likely to experience a RTW failure were individuals with whiplash, dislocations or particularly those admitted to hospital. Understanding the causes and predictors of failed RTW can help insurers, employers and health systems identify at-risk individuals. This can enable earlier and more targeted support and more effective employment outcomes.

  13. MRI in 'failed back surgery syndrome': Comparison to computed tomography

    International Nuclear Information System (INIS)

    Trattnig, S.; Ungersboeck, K.; Cech, T.; Schindler, E.

    1990-01-01

    The term 'failed back surgery syndrome' (FBSS) includes a variety of clinical-neurological symptoms following disc surgery. In a prospective study 18 patients suffering from monoradicular symptoms after disc surgery were examined by MRI and CT (both prior to and following intravenous application of contrast material). Findings were then compared to microsurgery. MRI produced correct diagnoses in 17 cases, CT in 13 cases. Recurrent disc herniation caused symptoms four times, and epidural scar formation twice. In twelve cases there was herniated disc material as well as an epidural scar present; disc material preponderated nine times, scar formation in three instances. (orig.) [de

  14. Evolution of drug resistance in HIV-infected patients remaining on a virologically failing combination antiretroviral therapy regimen

    DEFF Research Database (Denmark)

    Cozzi-Lepri, Alessandro; Phillips, Andrew N; Ruiz, Lidia

    2007-01-01

    OBJECTIVE: To estimate the extent of drug resistance accumulation in patients kept on a virologically failing regimen and its determinants in the clinical setting. DESIGN: The study focused on 110 patients of EuroSIDA on an unchanged regimen who had two genotypic tests performed at two time points...... (t0 and t1) when viral load was > 400 copies/ml. METHODS: Accumulation of resistance between t0 and t1 was measured using genotypic susceptibility scores (GSS) obtained by counting the total number of active drugs (according to the Rega system v6.4.1) among all licensed antiretrovirals as of 1...... January 2006. Patients were grouped according to the number of active drugs in the failing regimen at t0 (GSS_f-t0). RESULTS: At t0, patients had been on the failing combination antiretroviral therapy (cART) for a median of 11 months (range, 6-50 months). Even patients with extensive resistance...

  15. Examination of a failed reactor coolant pump rotating assembly from Crystal River Unit 3

    International Nuclear Information System (INIS)

    Hayner, G.O.; Lubnow, T.; Clary, M.

    1990-01-01

    On January 18, 1989, the A reactor coolant pump rotating assembly at the Crystal River Unit 3 Nuclear Power Plant failed during operation. A rotating assembly from this pump had previously failed in 1986. The reactor coolant pump was fabricated by Byron Jackson Pump Division of Borg-Warner Ind. Products, Inc. from UNS S66286 superalloy (Alloy A286). A root cause failure analysis examination was performed on the pump shaft and other components. The failure analysis included shaft vibrational mode and stress analyses, pump clearance and alignment analyses, and detailed destructive examination of the shaft and hydrostatic bearing assemblies. Based on the detailed physical examination of the shaft it was concluded that cracks initiated in the pump shaft at two sites approximately 180 0 apart in a band of shallow, thermally induced fatigue cracks. The cracks initiated at the bottom edge of the motor end shrink fit pad under the shrink fit sleeve supporting the hydrostatic bearing journal. The band of thermally induced fatigue cracks was apparently caused by mixing of cold seal injection water and hot reactor coolant in gaps between the pump shaft and sleeve. The motor end shrink fit was apparently not effective in preventing introduction of the seal injection water to this area. Initial crack propagation occurred by fatigue due to lateral vibration; however, the majority of crack propagation occurred by abnormal torsional fatigue loading induced by contact and sticking between the rotating and stationary portions of the hydrostatic bearing. Final fracture of the shaft occurred by torsional overload. Metallurgical characteristics and mechanical properties of the shaft were within design specification and probably did not significantly influence the cracking process

  16. Previous Education, Sociodemographic Characteristics, and Nursing Cumulative Grade Point Average as Predictors of Success in Nursing Licensure Examinations

    Directory of Open Access Journals (Sweden)

    Isaac Amankwaa

    2015-01-01

    Full Text Available Introduction. Success in the licensure examination is the only legal prerequisite to practice as a nurse in Ghana. However, a large percentage of nursing students who sit fail this examination for the first time. This study sought to unravel whether prior education, sociodemographic characteristics, and nursing Cumulative Grade Point Average (CGPA could predict performance in the licensure examinations. Methods. The study was a descriptive cross-sectional survey conducted from November 2014 to April 2015 in the Kumasi metropolis, Ghana on 176 past nursing students. Data was collected using questionnaires and analyzed using SPSS version 22. A logistic regression model was fitted to look at the influence of the explanatory variables on the odds of passing the licensure examinations. All statistical significances were tested at p value of <0.05. Results. Majority, 56.3%, were females and 86.4% were between the ages of 25 and 31 years. Most of the students (88.6% entered the nursing training colleges with a WASSCE qualification and 38% read general science. 73.9% passed the licensure examinations and the mean CGPA of the students was 2.89 SD=0.37. Sociodemographic characteristics and previous education had no influence on performance in the licensure examinations. CGPA had strong positive relationship with performance in licensure examinations (AOR = 15.27; 95% CI = 6.28, 27.11. Conclusion. Students CGPA could be a good predictor of their performance in the licensure examinations. On the other hand, students’ sociodemographic and previous educational characteristics might not be important factors to consider in admitting students into the nursing training programme.

  17. Previous Education, Sociodemographic Characteristics, and Nursing Cumulative Grade Point Average as Predictors of Success in Nursing Licensure Examinations.

    Science.gov (United States)

    Amankwaa, Isaac; Agyemang-Dankwah, Anabella; Boateng, Daniel

    2015-01-01

    Introduction. Success in the licensure examination is the only legal prerequisite to practice as a nurse in Ghana. However, a large percentage of nursing students who sit fail this examination for the first time. This study sought to unravel whether prior education, sociodemographic characteristics, and nursing Cumulative Grade Point Average (CGPA) could predict performance in the licensure examinations. Methods. The study was a descriptive cross-sectional survey conducted from November 2014 to April 2015 in the Kumasi metropolis, Ghana on 176 past nursing students. Data was collected using questionnaires and analyzed using SPSS version 22. A logistic regression model was fitted to look at the influence of the explanatory variables on the odds of passing the licensure examinations. All statistical significances were tested at p value of <0.05. Results. Majority, 56.3%, were females and 86.4% were between the ages of 25 and 31 years. Most of the students (88.6%) entered the nursing training colleges with a WASSCE qualification and 38% read general science. 73.9% passed the licensure examinations and the mean CGPA of the students was 2.89 (SD = 0.37). Sociodemographic characteristics and previous education had no influence on performance in the licensure examinations. CGPA had strong positive relationship with performance in licensure examinations (AOR = 15.27; 95% CI = 6.28, 27.11). Conclusion. Students CGPA could be a good predictor of their performance in the licensure examinations. On the other hand, students' sociodemographic and previous educational characteristics might not be important factors to consider in admitting students into the nursing training programme.

  18. Fail marketing, marketingová technika plánované krizové komunikace

    OpenAIRE

    Kolek, Ondřej

    2014-01-01

    The aim of the bachelor thesis "Fail marketing, marketing technique of planned crisis communication" is a describtion of a theoretical foundation of working mechanics this marketing technique posseses with use of case studies and confirmation or disproof of technique's existence. Theoretical basis consists of a detail analysis of crisis communication, spin doctoring and customer psychology. Communication activies of McDonald's ČR spol. s. r. o. and Domino's Pizza, Inc., which caused or used n...

  19. Detector for failed fuel elements

    International Nuclear Information System (INIS)

    Ito, Masaru.

    1979-01-01

    Purpose: To provide automatic monitor for the separation or reactor water and sampling water, in a failed fuel element detector using a sipping chamber. Constitution: A positional detector for the exact mounting of a sipping chamber on a channel box and a level detector for the detection of complete discharge of cooling water in the sipping chamber are provided in the sipping chamber. The positional detector is contacted to the upper end of the channel box and operated when the sipping chamber is correctly mounted to the fuel assemblies. The level detector comprises a float and a limit switch and it is operated when the water in the sipping chamber is discharged by a predetermined amount. Isolation of reactor water and sampling water are automatically monitored by the signal from these two detectors. (Ikeda, J.)

  20. Evaluation and Management of Failed Shoulder Instability Surgery.

    Science.gov (United States)

    Cartucho, António; Moura, Nuno; Sarmento, Marco

    2017-01-01

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

  1. Implant breast reconstruction after salvage mastectomy in previously irradiated patients.

    Science.gov (United States)

    Persichetti, Paolo; Cagli, Barbara; Simone, Pierfranco; Cogliandro, Annalisa; Fortunato, Lucio; Altomare, Vittorio; Trodella, Lucio

    2009-04-01

    The most common surgical approach in case of local tumor recurrence after quadrantectomy and radiotherapy is salvage mastectomy. Breast reconstruction is the subsequent phase of the treatment and the plastic surgeon has to operate on previously irradiated and manipulated tissues. The medical literature highlights that breast reconstruction with tissue expanders is not a pursuable option, considering previous radiotherapy a contraindication. The purpose of this retrospective study is to evaluate the influence of previous radiotherapy on 2-stage breast reconstruction (tissue expander/implant). Only patients with analogous timing of radiation therapy and the same demolitive and reconstructive procedures were recruited. The results of this study prove that, after salvage mastectomy in previously irradiated patients, implant reconstruction is still possible. Further comparative studies are, of course, advisable to draw any conclusion on the possibility to perform implant reconstruction in previously irradiated patients.

  2. Challenges and achievements of instrumentation for failed fuel identification in PFBR

    International Nuclear Information System (INIS)

    Upadhyay, Chandra Kant; Sivaramakrishna, M.; Nageswaran, A.; Nagaraj, C.P.; Madhusoodanan, K.; Krishnakumar, B.

    2010-01-01

    Failed fuel identification system is provided to locate and remove the failed fuel sub assembly. It comprises of selector valve mechanism to sample the flow from each assembly and associated instrumentation to detect the activity in the sample, indicating the clad failure of the respective subassembly. The development includes sampling pump, its power supply, motor to rotate the selector valve, encoder, brake, gear box, neutron detectors and Instrumentation and Control for all these with interlocks and related logic. These systems are expected to work under many physical constraints and in harsh environmental conditions, such as high temperature. This paper discusses the various challenges and achievements towards this system design. (author)

  3. A PKM2 signature in the failing heart

    Science.gov (United States)

    Rees, Meredith L.; Subramaniam, Janani; Li, Yuanteng; Hamilton, Dale J.; Frazier, O. Howard; Taegtmeyer, Heinrich

    2015-01-01

    A salient feature of the failing heart is metabolic remodeling towards predominant glucose metabolism and activation of the fetal gene program. Sunitinib is a multitargeted receptor tyrosine kinase inhibitor used for the treatment of highly vascularized tumors. In diabetic patients, sunitinib significantly decreases blood glucose. However, a considerable proportion of sunitinib-treated patients develop cardiac dysfunction or failure. We asked whether sunitinib treatment results in shift towards glycolysis in the heart. Glucose uptake by the heart was increased fivefold in mice treated with sunitinib. Transcript analysis by qPCR revealed an induction of genes associated with glycolysis and reactivation of the fetal gene program. Additionally, we observed a shift in the enzyme pyruvate kinase from the adult M1 (PKM1) isoform to the fetal M2 (PKM2) isoform, a hallmark of the Warburg Effect. This novel observation led us to examine whether a similar shift occurs in human heart failure. Examination of tissue from patients with heart failure similarly displayed an induction of PKM2. Moreover, this phenomenon was partially reversed following mechanical unloading. We propose that pyruvate kinase isoform switching represents a novel feature of the fetal gene program in the failing heart. PMID:25735978

  4. 49 CFR 26.47 - Can recipients be penalized for failing to meet overall goals?

    Science.gov (United States)

    2010-10-01

    ... Goals, Good Faith Efforts, and Counting § 26.47 Can recipients be penalized for failing to meet overall... administer your program in good faith. (b) If you do not have an approved DBE program or overall goal, or if you fail to implement your program in good faith, you are in noncompliance with this part. ...

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

    NARCIS (Netherlands)

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

    2008-01-01

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

  6. Inhibition of GABA transporters fails to afford significant protection following focal cerebral ischemia

    DEFF Research Database (Denmark)

    Lie, Maria Ek; Gowing, Emma K; Clausen, Rasmus P

    2017-01-01

    Brain ischemia triggers excitotoxicity and cell death, yet no neuroprotective drugs have made it to the clinic. While enhancing GABAergic signaling to counterbalance excitotoxicity has shown promise in animal models, clinical studies have failed. Blockade of GABA transporters (GATs) offers...... show that tiagabine can promote protection, our findings indicate that caution should be had when using GAT1 and GAT3 inhibitors for conditions of brain ischemia....

  7. Rescue EUS-guided intrahepatic biliary drainage for malignant hilar biliary stricture after failed transpapillary re-intervention.

    Science.gov (United States)

    Minaga, Kosuke; Takenaka, Mamoru; Kitano, Masayuki; Chiba, Yasutaka; Imai, Hajime; Yamao, Kentaro; Kamata, Ken; Miyata, Takeshi; Omoto, Shunsuke; Sakurai, Toshiharu; Watanabe, Tomohiro; Nishida, Naoshi; Kudo, Masatoshi

    2017-11-01

    Treatment of unresectable malignant hilar biliary stricture (UMHBS) is challenging, especially after failure of repeated transpapillary endoscopic stenting. Endoscopic ultrasonography-guided intrahepatic biliary drainage (EUS-IBD) is a recent technique for intrahepatic biliary decompression, but indications for its use for complex hilar strictures have not been well studied. The aim of this study was to assess the feasibility and safety of EUS-IBD for UMHBS after failed transpapillary re-intervention. Retrospective analysis of all consecutive patients with UMHBS of Bismuth II grade or higher who, between December 2008 and May 2016, underwent EUS-IBD after failed repeated transpapillary interventions. The technical success, clinical success, and complication rates were evaluated. Factors associated with clinical ineffectiveness of EUS-IBD were explored. A total of 30 patients (19 women, median age 66 years [range 52-87]) underwent EUS-IBD for UMHBS during the study period. Hilar biliary stricture morphology was classified as Bismuth II, III, or IV in 5, 13, and 12 patients, respectively. The median number of preceding endoscopic interventions was 4 (range 2-14). EUS-IBD was required because the following procedures failed: duodenal scope insertion (n = 4), accessing the papilla after duodenal stent insertion (n = 5), or achieving desired intrahepatic biliary drainage (n = 21). Technical success with EUS-IBD was achieved in 29 of 30 patients (96.7%) and clinical success was attained in 22 of these 29 (75.9%). Mild peritonitis occurred in three of 30 (10%) and was managed conservatively. Stent dysfunction occurred in 23.3% (7/30). There was no procedure-related mortality. On multivariable analysis, Bismuth IV stricture predicted clinical ineffectiveness (odds ratio = 12.7, 95% CI 1.18-135.4, P = 0.035). EUS-IBD may be a feasible and effective rescue alternative with few major complications after failed transpapillary endoscopic re-intervention in patients

  8. Failed magmatic eruptions: Late-stage cessation of magma ascent

    Science.gov (United States)

    Moran, S.C.; Newhall, C.; Roman, D.C.

    2011-01-01

    When a volcano becomes restless, a primary question is whether the unrest will lead to an eruption. Here we recognize four possible outcomes of a magmatic intrusion: "deep intrusion", "shallow intrusion", "sluggish/viscous magmatic eruption", and "rapid, often explosive magmatic eruption". We define "failed eruptions" as instances in which magma reaches but does not pass the "shallow intrusion" stage, i. e., when magma gets close to, but does not reach, the surface. Competing factors act to promote or hinder the eventual eruption of a magma intrusion. Fresh intrusion from depth, high magma gas content, rapid ascent rates that leave little time for enroute degassing, opening of pathways, and sudden decompression near the surface all act to promote eruption, whereas decreased magma supply from depth, slow ascent, significant enroute degassing and associated increases in viscosity, and impingement on structural barriers all act to hinder eruption. All of these factors interact in complex ways with variable results, but often cause magma to stall at some depth before reaching the surface. Although certain precursory phenomena, such as rapidly escalating seismic swarms or rates of degassing or deformation, are good indicators that an eruption is likely, such phenomena have also been observed in association with intrusions that have ultimately failed to erupt. A perpetual difficulty with quantifying the probability of eruption is a lack of data, particularly on instances of failed eruptions. This difficulty is being addressed in part through the WOVOdat database. Papers in this volume will be an additional resource for scientists grappling with the issue of whether or not an episode of unrest will lead to a magmatic eruption.

  9. Reverse arthroplasty for osteoarthritis and rotator cuff deficiency after previous surgery for recurrent anterior shoulder instability.

    Science.gov (United States)

    Raiss, Patric; Zeifang, Felix; Pons-Villanueva, Juan; Smithers, Christopher J; Loew, Markus; Walch, Gilles

    2014-07-01

    Osteoarthritis in combination with rotator cuff deficiency following previous shoulder stabilisation surgery and after failed surgical treatment for chronic anterior shoulder dislocation is a challenging condition. The aim of this study was to analyse the results of reverse shoulder arthroplasty in such patients. Thirteen patients with a median follow-up of 3.5 (range two to eight) years and a median age of 70 (range 48-82) years were included. In all shoulders a tear of at least one rotator cuff tendon in combination with osteoarthritis was present at the time of arthroplasty. The Constant score, shoulder flexion and external and internal rotation with the elbow at the side were documented pre-operatively and at the final follow-up. Pre-operative, immediate post-operative and final follow-up radiographs were analysed. All complications and revisions were documented. Twelve patients were either satisfied or very satisfied with the procedure. The median Constant score increased from 26 points pre-operatively to 67 points at the final follow-up (p = 0.001). The median shoulder flexion increased significantly from 70° to 130° and internal rotation from two to four points (p = 0.002). External rotation did not change significantly (p = 0.55). Glenoid notching was present in five cases and was graded as mild in three cases and moderate in two. One complication occurred leading to revision surgery. Reverse arthroplasty leads to high satisfaction rates for patients with osteoarthritis and rotator cuff deficiency who had undergone previous shoulder stabilisation procedures. The improvements in clinical outcome as well as the radiographic results seem to be comparable with those of other studies reporting on the outcome of reverse shoulder arthroplasty for other conditions.

  10. FSHD myoblasts fail to downregulate intermediate filament protein vimentin during myogenic differentiation.

    Directory of Open Access Journals (Sweden)

    Lipinski M.

    2011-10-01

    Full Text Available Facioscapulohumeral muscular dystrophy (FSHD is an autosomal dominant hereditary neuromuscular disorder. The clinical features of FSHD include weakness of the facial and shoulder girdle muscles followed by wasting of skeletal muscles of the pelvic girdle and lower extremities. Although FSHD myoblasts grown in vitro can be induced to differentiate into myotubes by serum starvation, the resulting FSHD myotubes have been shown previously to be morphologically abnormal. Aim. In order to find the cause of morphological anomalies of FSHD myotubes we compared in vitro myogenic differentiation of normal and FSHD myoblasts at the protein level. Methods. We induced myogenic differentiation of normal and FSHD myoblasts by serum starvation. We then compared protein extracts from proliferating myoblasts and differentiated myotubes using SDS-PAGE followed by mass spectrometry identification of differentially expressed proteins. Results. We demonstrated that the expression of vimentin was elevated at the protein and mRNA levels in FSHD myotubes as compared to normal myotubes. Conclusions. We demonstrate for the first time that in contrast to normal myoblasts, FSHD myoblasts fail to downregulate vimentin after induction of in vitro myogenic differentiation. We suggest that vimentin could be an easily detectable marker of FSHD myotubes

  11. [Results of revision after failed surgical treatment for traumatic anterior shoulder instability].

    Science.gov (United States)

    Lópiz-Morales, Y; Alcobe-Bonilla, J; García-Fernández, C; Francés-Borrego, A; Otero-Fernández, R; Marco-Martínez, F

    2013-01-01

    Persistent or recurrent glenohumeral instability after a previous operative stabilization can be a complex problem. Our aim is to establish the incidence of recurrence and its revision surgery, and to analyse the functional results of the revision instability surgery, as well as to determine surgical protocols to perform it. A retrospective analysis was conducted on 16 patients with recurrent instability out of 164 patients operated on between 1999 and 2011. The mean follow-up was 57 months and the mean age was 29 years. To evaluate functional outcome we employed Constant, Rowe, UCLA scores and the visual analogue scale. Of the 12 patients who failed the initial arthroscopic surgery, 6 patients underwent an arthroscopic antero-inferior labrum repair technique, 4 using open labrum repair techniques, and 2 coracoid transfer. The two cases of open surgery with recurrences underwent surgery for coracoid transfer. Results of the Constant score were excellent or good in 64% of patients. Surgical revision of instability is a complex surgery essentially for two reasons: the difficulty in recognising the problem, and the technical demand (greater variety and the increasingly complex techniques). Copyright © 2012 SECOT. Published by Elsevier Espana. All rights reserved.

  12. Revision of failed shoulder hemiarthroplasty to reverse total arthroplasty: analysis of 157 revision implants.

    Science.gov (United States)

    Merolla, Giovanni; Wagner, Eric; Sperling, John W; Paladini, Paolo; Fabbri, Elisabetta; Porcellini, Giuseppe

    2018-01-01

    There remains a paucity of studies examining the conversion of failed hemiarthroplasty (HA) to reverse total shoulder arthroplasty (RTSA). Therefore, the purpose of this study was to examine a large series of revision HA to RTSA. A population of 157 patients who underwent conversion of a failed HA to a revision RTSA from 2006 through 2014 were included. The mean follow-up was 49 months (range, 24-121 months). The indications for revision surgery included instability with rotator cuff insufficiency (n = 127) and glenoid wear (n = 30); instability and glenoid wear were associated in 38 cases. Eight patients with infection underwent 2-stage reimplantation. Patients experienced significant improvements in their preoperative to postoperative pain and shoulder range of motion (P surgeries, secondary to glenoid component loosening (n = 3), instability (n = 3), humeral component disassembly (n = 2), humeral stem loosening (n = 1), and infection (n = 2). Implant survivorship was 95.5% at 2 years and 93.3% at 5 years. There were 4 reoperations including axillary nerve neurolysis (n = 2), heterotopic ossification removal (n = 1), and hardware removal for rupture of the metal cerclage for an acromial fracture (n = 1). At final follow-up, there were 5 "at-risk" glenoid components. Patients experience satisfactory pain relief and recovery of reasonable shoulder function after revision RTSA from a failed HA. There was a relatively low revision rate, with glenoid loosening and instability being the most common causes. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  13. Approaches to Studying and Academic Performance in Short Essay Exams

    Science.gov (United States)

    Minbashian, Amirali; Huon, Gail F.; Bird, Kevin D.

    2004-01-01

    Previous research has generally failed to find a relation between the way students approach the task of studying and their exam grades. The present study investigated why it is that a deep approach to studying, which has been shown to result in a higher quality of learning, does not consistently result in higher exam grades. The participants in…

  14. Case-control study for colorectal cancer genetic susceptibility in EPICOLON: previously identified variants and mucins

    Directory of Open Access Journals (Sweden)

    Moreno Victor

    2011-08-01

    Full Text Available Abstract Background Colorectal cancer (CRC is the second leading cause of cancer death in developed countries. Familial aggregation in CRC is also important outside syndromic forms and, in this case, a polygenic model with several common low-penetrance alleles contributing to CRC genetic predisposition could be hypothesized. Mucins and GALNTs (N-acetylgalactosaminyltransferase are interesting candidates for CRC genetic susceptibility and have not been previously evaluated. We present results for ten genetic variants linked to CRC risk in previous studies (previously identified category and 18 selected variants from the mucin gene family in a case-control association study from the Spanish EPICOLON consortium. Methods CRC cases and matched controls were from EPICOLON, a prospective, multicenter, nationwide Spanish initiative, comprised of two independent stages. Stage 1 corresponded to 515 CRC cases and 515 controls, whereas stage 2 consisted of 901 CRC cases and 909 controls. Also, an independent cohort of 549 CRC cases and 599 controls outside EPICOLON was available for additional replication. Genotyping was performed for ten previously identified SNPs in ADH1C, APC, CCDN1, IL6, IL8, IRS1, MTHFR, PPARG, VDR and ARL11, and 18 selected variants in the mucin gene family. Results None of the 28 SNPs analyzed in our study was found to be associated with CRC risk. Although four SNPs were significant with a P-value ADH1C (OR = 1.63, 95% CI = 1.06-2.50, P-value = 0.02, recessive, rs1800795 in IL6 (OR = 1.62, 95% CI = 1.10-2.37, P-value = 0.01, recessive, rs3803185 in ARL11 (OR = 1.58, 95% CI = 1.17-2.15, P-value = 0.007, codominant, and rs2102302 in GALNTL2 (OR = 1.20, 95% CI = 1.00-1.44, P-value = 0.04, log-additive 0, 1, 2 alleles], only rs3803185 achieved statistical significance in EPICOLON stage 2 (OR = 1.34, 95% CI = 1.06-1.69, P-value = 0.01, recessive. In the joint analysis for both stages, results were only significant for rs3803185 (OR = 1

  15. Case-control study for colorectal cancer genetic susceptibility in EPICOLON: previously identified variants and mucins

    International Nuclear Information System (INIS)

    Abulí, Anna; Morillas, Juan D; Rigau, Joaquim; Latorre, Mercedes; Fernández-Bañares, Fernando; Peña, Elena; Riestra, Sabino; Payá, Artemio; Jover, Rodrigo; Xicola, Rosa M; Llor, Xavier; Fernández-Rozadilla, Ceres; Carvajal-Carmona, Luis; Villanueva, Cristina M; Moreno, Victor; Piqué, Josep M; Carracedo, Angel; Castells, Antoni; Andreu, Montserrat; Ruiz-Ponte, Clara; Castellví-Bel, Sergi; Alonso-Espinaco, Virginia; Muñoz, Jenifer; Gonzalo, Victoria; Bessa, Xavier; González, Dolors; Clofent, Joan; Cubiella, Joaquin

    2011-01-01

    Colorectal cancer (CRC) is the second leading cause of cancer death in developed countries. Familial aggregation in CRC is also important outside syndromic forms and, in this case, a polygenic model with several common low-penetrance alleles contributing to CRC genetic predisposition could be hypothesized. Mucins and GALNTs (N-acetylgalactosaminyltransferase) are interesting candidates for CRC genetic susceptibility and have not been previously evaluated. We present results for ten genetic variants linked to CRC risk in previous studies (previously identified category) and 18 selected variants from the mucin gene family in a case-control association study from the Spanish EPICOLON consortium. CRC cases and matched controls were from EPICOLON, a prospective, multicenter, nationwide Spanish initiative, comprised of two independent stages. Stage 1 corresponded to 515 CRC cases and 515 controls, whereas stage 2 consisted of 901 CRC cases and 909 controls. Also, an independent cohort of 549 CRC cases and 599 controls outside EPICOLON was available for additional replication. Genotyping was performed for ten previously identified SNPs in ADH1C, APC, CCDN1, IL6, IL8, IRS1, MTHFR, PPARG, VDR and ARL11, and 18 selected variants in the mucin gene family. None of the 28 SNPs analyzed in our study was found to be associated with CRC risk. Although four SNPs were significant with a P-value < 0.05 in EPICOLON stage 1 [rs698 in ADH1C (OR = 1.63, 95% CI = 1.06-2.50, P-value = 0.02, recessive), rs1800795 in IL6 (OR = 1.62, 95% CI = 1.10-2.37, P-value = 0.01, recessive), rs3803185 in ARL11 (OR = 1.58, 95% CI = 1.17-2.15, P-value = 0.007, codominant), and rs2102302 in GALNTL2 (OR = 1.20, 95% CI = 1.00-1.44, P-value = 0.04, log-additive 0, 1, 2 alleles], only rs3803185 achieved statistical significance in EPICOLON stage 2 (OR = 1.34, 95% CI = 1.06-1.69, P-value = 0.01, recessive). In the joint analysis for both stages, results were only significant for rs3803185 (OR = 1.12, 95% CI = 1

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

    Science.gov (United States)

    New York State Dept. of Labor, Albany.

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

  17. MAGNETIC RESONANCE IMAGING IN FAILED BACK SURGERY SYNDROME

    OpenAIRE

    SEN, KK; SINGH, AMARJIT

    1999-01-01

    The failed back surgery syndrome (FBSS) is a severe, long-lasting, disabling and relatively frequent (5-10%) complication of lumbosacral spine surgery. Wrong level surgery, inadequate surgical techniques, vertebral instability, recurrent disc herniation, and lumbosacral fibrosis are the most frequent causes of FBSS. The results after repeated surgery on recurrent disc herniations are comparable to those after the first intervention, whereas repeated surgery for fibrosis gives only 30-35% succ...

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

    Directory of Open Access Journals (Sweden)

    A. Panagopoulos

    2013-01-01

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

  19. Contemporary management of patients with high-risk non-muscle-invasive bladder cancer who fail intravesical BCG therapy.

    Science.gov (United States)

    Yates, D R; Rouprêt, M

    2011-08-01

    It is advocated that patients with high-risk non-muscle-invasive bladder cancer (NMIBC) receive an adjuvant course of intravesical Bacille Calmette-Guerin (BCG) as first-line treatment. However, a substantial proportion of patients will 'fail' BCG, either early with persistent (refractory) disease or recur late after a long disease-free interval (relapsing). Guideline recommendation in the 'refractory' setting is radical cystectomy, but there are situations when extirpative surgery is not feasible due to competing co-morbidity, a patient's desire for bladder preservation or reluctance to undergo surgery. In this review, we discuss the contemporary management of NMIBC in patients who have failed prior BCG and are not suitable for radical surgery and highlight the potential options available. These options can be categorised as immunotherapy, chemotherapy, device-assisted therapy and combination therapy. However, the current data are still inadequate to formulate definitive recommendations, and data from ongoing trials and maturing studies will give us an insight into whether there is a realistic efficacious second-line treatment for patients who fail intravesical BCG but are not candidates for definitive surgery.

  20. Posterior transpedicular approach with circumferential debridement and anterior reconstruction as a salvage procedure for symptomatic failed vertebroplasty.

    Science.gov (United States)

    Chiu, Yen-Chun; Yang, Shih-Chieh; Chen, Hung-Shu; Kao, Yu-Hsien; Tu, Yuan-Kun

    2015-02-10

    Complications and failure of vertebroplasty, such as cement dislodgement, cement leakage, or spinal infection, usually result in spinal instability and neural element compression. Combined anterior and posterior approaches are the most common salvage procedure for symptomatic failed vertebroplasty. The purpose of this study is to evaluate the feasibility and efficacy of a single posterior approach technique for the treatment of patients with symptomatic failed vertebroplasty. Ten patients with symptomatic failed vertebroplasty underwent circumferential debridement and anterior reconstruction surgery through a single-stage posterior transpedicular approach (PTA) from January 2009 to December 2011 at our institution. The differences of visual analog scale (VAS), neurologic status, and vertebral body reconstruction before and after surgery were recorded. The clinical outcomes of patients were categorized as excellent, good, fair, or poor based on modified Brodsky's criteria. The symptomatic failed vertebroplasty occurred between the T11 and L3 vertebrae with one- or two-level involvement. The average VAS score was 8.3 (range, 7 to 9) before surgery, significantly decreased to 3.2 (range, 2 to 4) after surgery (p surgery was 17.3° (range, 4° to 35°) (p surgery was 1 mm (range, 0 to 2). The neurologic status of Frankel's scale significantly improved after surgery (p = 0.014) and at 1 year after surgery (p = 0.046). No one experienced severe complications such as deep wound infection or neurologic deterioration. All patients achieved good or excellent outcomes after surgery based on modified Brodsky's criteria (p surgery with circumferential debridement and anterior reconstruction technique provides good clinical outcomes and low complication rate, which can be considered as an alternative method to combined anterior and posterior approaches for patients with symptomatic failed vertebroplasty.

  1. Protein dynamics associated with failed and rescued learning in the Ts65Dn mouse model of Down syndrome.

    Directory of Open Access Journals (Sweden)

    Md Mahiuddin Ahmed

    Full Text Available Down syndrome (DS is caused by an extra copy of human chromosome 21 (Hsa21. Although it is the most common genetic cause of intellectual disability (ID, there are, as yet, no effective pharmacotherapies. The Ts65Dn mouse model of DS is trisomic for orthologs of ∼55% of Hsa21 classical protein coding genes. These mice display many features relevant to those seen in DS, including deficits in learning and memory (L/M tasks requiring a functional hippocampus. Recently, the N-methyl-D-aspartate (NMDA receptor antagonist, memantine, was shown to rescue performance of the Ts65Dn in several L/M tasks. These studies, however, have not been accompanied by molecular analyses. In previous work, we described changes in protein expression induced in hippocampus and cortex in control mice after exposure to context fear conditioning (CFC, with and without memantine treatment. Here, we extend this analysis to Ts65Dn mice, measuring levels of 85 proteins/protein modifications, including components of MAP kinase and MTOR pathways, and subunits of NMDA receptors, in cortex and hippocampus of Ts65Dn mice after failed learning in CFC and after learning was rescued by memantine. We show that, compared with wild type littermate controls, (i of the dynamic responses seen in control mice in normal learning, >40% also occur in Ts65Dn in failed learning or are compensated by baseline abnormalities, and thus are considered necessary but not sufficient for successful learning, and (ii treatment with memantine does not in general normalize the initial protein levels but instead induces direct and indirect responses in approximately half the proteins measured and results in normalization of the endpoint protein levels. Together, these datasets provide a first view of the complexities associated with pharmacological rescue of learning in the Ts65Dn. Extending such studies to additional drugs and mouse models of DS will aid in identifying pharmacotherapies for effective

  2. 30 CFR 75.803 - Fail safe ground check circuits on high-voltage resistance grounded systems.

    Science.gov (United States)

    2010-07-01

    ... High-Voltage Distribution § 75.803 Fail safe ground check circuits on high-voltage resistance grounded systems. [Statutory Provisions] On and after September 30, 1970, high-voltage, resistance grounded systems... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Fail safe ground check circuits on high-voltage...

  3. Placed Parenting, locating unrest: failed femininities, troubled mothers and rioting subjects

    Directory of Open Access Journals (Sweden)

    Kim Allen

    2012-07-01

    Full Text Available Critical attention has been given to the consolidation of classed forms of 'placed personhood', as compelling future-orientated and self-regulating subjects that 'fit' into contemporary economic and social formation. These forms of personhood, spoken of as moral character and behavioural 'traits', are increasingly attached to placed parenthood: as that which (selflocates in the right moral and material terrain. Good subjects – made through good parenting and in particular via 'good mothers' – are tasked with self-optimizing and bringing forward their own futures and those of their families (Allen and Osgood 2009; Armstrong 2010; Evans 2010, Gillies 2007; Lawler 2000; Taylor 2012a; Taylor and Addison 2011. A broader 'public' as concerned with equity, welfare and redistribution is dis-placed and entirely re-placed with a self-orientated 'enterprising' privatized response. This limited response is self-congratulating of its own 'responsibility' and condemning of those who 'fail' heightened efforts (in times of 'cutting back' parent-citizens are told simply to be more 'efficient'. 'Necessity' and 'austerity' are, as the editors of this special issue highlight, invoked to re-do all kind of classed and gendered violence, where the most privileged sections of society are evacuated from blame in times of economic crisis: in contrast, what re-circulates is a stated need for poor, 'failing mothers' to 'step-up' for all our sakes. Those who cannot bring themselves forward and propel into this neo-liberal future are increasingly condemned as the wrong kind of parents. This piece aims to chart some of the 'ugliness of parenting' (Taylor 2009, 2012b as placed parenthood attaches to specific classed locales and subjects as that which 'fails' and 'troubles' the future. This is witnessed in the example of and responses to the English Riots of 2011, which is placed as a case study casting light on intersections of class, race, gender and sexuality in forms

  4. Summary of failed reactor coolant pump rotating assembly experience at Crystal River Unit 3

    International Nuclear Information System (INIS)

    Hayner, G.O.; Clary, M.D.

    1992-01-01

    Four reactor coolant pump (RCP) rotating assemblies (shafts) have failed or have severely cracked during operation at the Crystal River Unit 3 (CR-3) Nuclear Power Plant. The two failed shafts removed from RCP-1A have been extensively examined. All of the RCP shafts (except the D shaft) were fabricated from UNS S66286 superalloy (Alloy A-286). The D shaft was fabricated from UNS S20910 (Alloy XM-19/Nitronic 50). Torsional strain gauge analysis was performed on the RCP-1A shaft during the 1990 refueling outage. This type of analysis has not been performed previously on an operating RCP. Several results were found including: (1) the primary components of alternating torsional stress during normal RCP operation are impeller vane pass and a sub-2X torsional resonance with maximum components of ∼±0.8 ksi; (2) a typical vane pass cycle is initiated by an abrupt unloading of the shaft followed by a reload past equilibrium and a damped return to equilibrium; (3) a higher (compared to normal four pump operation) alternating torsional stress range resulted from solo operation of RCP-1A at low temperature and pressure (normal startup conditions); (4) the 2/0 combination produced the highest mean torsional stresses and the lowest alternating stresses and (5) a startup of a secured RCP with three operating pumps results in significantly higher alternating stress than a cold startup. The root cause RCP failure mechanism appears to involve RCP startup sequence at CR-3, peculiarities that necessitate this sequence and complex shaft stresses just above or under the journal bearing. The 1986 impeller bolt failure is not considered to be a root cause effect. It was also determined that fatigue cracking has always been responsible for both shaft initiation and propagation mechanisms and cracking can occur independent of shaft material

  5. Effectiveness of a calcium hydroxide and chlorhexidine digluconate mixture as disinfectant during retreatment of failed endodontic cases.

    Science.gov (United States)

    Zerella, Joseph A; Fouad, Ashraf F; Spångberg, Larz S W

    2005-12-01

    The purpose of this in vivo investigation is to compare the effect of a slurry of Ca(OH)2 mixed in aqueous 2% chlorhexidine (CHX) versus aqueous Ca(OH)2 slurry alone on the disinfection of the pulp space of failed root-filled teeth during endodontic retreatment. Forty single-rooted previously root-filled teeth with associated periradicular lesions were included. The teeth were nonsurgically retreated and medicated over 3 treatment visits with 7-10-day intervals with either Ca(OH)2 in water or Ca(OH)2 in 2% aqueous CHX. Root canal cultures were collected in fluid thioglycollate, and bacterial growth was assessed by turbidity daily for 1 week, then weekly for an additional 3 weeks. The presence of enterococci in the root canals at the initial treatment session was determined. Of the total sample population, 12 of 40 (30%) were positive for bacteria before root filling. The control medication disinfected 12 of 20 (60%) teeth including 2 of 4 teeth originally diagnosed with enterococci. The experimental medication resulted in disinfected 16 of 20 (80%) teeth at the beginning of the third appointment. None of the teeth originally containing enterococci showed remaining growth. This difference between the overall positive cultures was not statistically significant (P > .05). Canal dressing with a mixture of 2% CHX and Ca(OH)2 slurry is as efficacious as aqueous Ca(OH)2 on the disinfection of failed root-filled teeth.

  6. Vaccination with lipid core peptides fails to induce epitope-specific T cell responses but confers non-specific protective immunity in a malaria model.

    Directory of Open Access Journals (Sweden)

    Simon H Apte

    Full Text Available Vaccines against many pathogens for which conventional approaches have failed remain an unmet public health priority. Synthetic peptide-based vaccines offer an attractive alternative to whole protein and whole organism vaccines, particularly for complex pathogens that cause chronic infection. Previously, we have reported a promising lipid core peptide (LCP vaccine delivery system that incorporates the antigen, carrier, and adjuvant in a single molecular entity. LCP vaccines have been used to deliver several peptide subunit-based vaccine candidates and induced high titre functional antibodies and protected against Group A streptococcus in mice. Herein, we have evaluated whether LCP constructs incorporating defined CD4(+ and/or CD8(+ T cell epitopes could induce epitope-specific T cell responses and protect against pathogen challenge in a rodent malaria model. We show that LCP vaccines failed to induce an expansion of antigen-specific CD8(+ T cells following primary immunization or by boosting. We further demonstrated that the LCP vaccines induced a non-specific type 2 polarized cytokine response, rather than an epitope-specific canonical CD8(+ T cell type 1 response. Cytotoxic responses of unknown specificity were also induced. These non-specific responses were able to protect against parasite challenge. These data demonstrate that vaccination with lipid core peptides fails to induce canonical epitope-specific T cell responses, at least in our rodent model, but can nonetheless confer non-specific protective immunity against Plasmodium parasite challenge.

  7. 'HAs fail to consult Irish people in UK'.

    Science.gov (United States)

    1992-11-10

    Health authorities are failing to consult local people on their health needs, a conference on the mental health of Irish people living in the UK heard last week. Consulting Irish people was often only 'symbolic', despite the requirements of the NHS and Community Care Act, conference Chair Padraic Kenna, Director of Innisfree Housing Association, told delegates. 'The Irish caught the boat in the 1950s only to miss the boat ever since,' he said.

  8. A dynamic fail-safe approach to the design of computer-based safety systems

    International Nuclear Information System (INIS)

    Smith, I.C.; Miller, M.

    1994-01-01

    For over 30 years AEA Technology has carried out research and development in the field of nuclear instrumentation and protection systems. Throughout the course of this extensive period of research and development the dominant theme has been the achievement of fully fail-safe designs. These are defined as designs in which the failure of any single component will result in the unit output reverting to a demand for trip action status. At an early stage it was recognized that the use of dynamic rather than static logic could ease the difficulties inherent in achieving a fail-safe design. The first dynamic logic systems coupled logic elements magnetically. The paper outlines the evolution from these early concepts of a dynamic fail-safe approach to the design of computer-based safety systems. Details are given of collaboration between AEA Technology and Duke Power Co. to mount an ISAT TM demonstration at Duke's Oconee Nuclear Power Station

  9. Overcoming limitations in previous research on exercise as a smoking cessation treatment: rationale and design of the "Quit for Health" trial.

    Science.gov (United States)

    Williams, David M; Ussher, Michael; Dunsiger, Shira; Miranda, Robert; Gwaltney, Chad J; Monti, Peter M; Emerson, Jessica

    2014-01-01

    Aerobic exercise has been proposed as a stand-alone or adjunct smoking cessation treatment, but findings have been mixed. Laboratory studies have shown that individual exercise sessions lead to decreases in withdrawal symptoms and cigarette cravings, but findings are limited by lack of follow-up and artificial settings. On the other hand, smoking cessation treatment RCTs have generally failed to show positive effects of exercise on smoking cessation, but have been plagued by poor and/or unverified compliance with exercise programs. This paper describes the rationale and design for Quit for Health (QFH)--an RCT designed to determine the efficacy of aerobic exercise as an adjunct smoking cessation treatment among women. To overcome limitations of previous research, compliance with the exercise (and wellness contact control) program is incentivized and directly observed, and ecological momentary assessment is used to examine change over time in withdrawal symptoms and cigarette cravings in participants' natural environments. Copyright © 2013 Elsevier Inc. All rights reserved.

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

    NARCIS (Netherlands)

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

    2010-01-01

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

  11. Monte Carlo modeling for realizing optimized management of failed fuel replacement

    International Nuclear Information System (INIS)

    Morishita, Kazunori; Yamamoto, Yasunori; Nakasuji, Toshiki

    2014-01-01

    Fuel cladding is one of the key components in a fission reactor to keep confining radioactive materials inside a fuel tube. During reactor operation, the cladding is however sometimes breached and radioactive materials leak from the fuel ceramic pellet into the coolant water through the breach. The primary coolant water is therefore monitored so that any leak is quickly detected, where the coolant water is periodically sampled and the concentration of, for example the radioactive iodine 131 (I-131), is measured. Depending on the measured concentration, the faulty fuel assembly with leaking rod is removed from the reactor and replaced by new one immediately or at the next refueling. In the present study, an effort has been made to develop a methodology to optimize the management for replacement of failed fuels due to cladding failures using the I-131 concentration measured in the sampled coolant water. A model numerical equation is proposed to describe the time evolution of I-131 concentration due to fuel leaks, and is then solved using the Monte-Carlo method as a function of sampling rate. Our results have indicated that, in order to achieve the rationalized management of failed fuels, higher resolution to detect a small amount of I-131 is not necessarily required but more frequent sampling is favorable. (author)

  12. Transportation of failed or damaged foreign research reactor spent nuclear fuel

    International Nuclear Information System (INIS)

    Messick, C.E.; Mustin, T.P.; Massey, C.D.

    1998-01-01

    Since resuming the Foreign Research Reactor Spent Nuclear Fuel (FRR SNF) Acceptance Program in 1996, the Program has had to deal with difficult issues associated with the transportation of failed or damaged spent fuel. In several instances, problems with failed or damaged fuel have prevented the acceptance of the fuel at considerable cost to both the Department of Energy (DOE) and research reactor operators. In response to the problems faced by the Acceptance Program, DOE has undertaken significant steps to better define the spent fuel acceptance criteria. DOE has worked closely with the U.S. Nuclear Regulatory Commission to address failed or damaged research reactor spent fuel and to identify cask certificate issues which must be resolved by cask owners and foreign regulatory authorities. The specific issues associated with the transport of Materials Testing Reactor (MTR)-type FRR SNF will be discussed. The information presented will include U.S. Nuclear Regulatory Commission regulatory issues, cask certificate issues, technical constraints, and lessons learned. Specific information will also be provided on the latest efforts to revise DOE's Appendix B, Transport Package (Cask) Acceptance Criteria. The information presented in this paper will be important to foreign research reactor operators, shippers, and cask vendors, so that appropriate amendments to the Certificate of Compliance for spent fuel casks can be submitted in a timely manner to facilitate the safe and scheduled transport of FRR SNF

  13. HIV-2 integrase polymorphisms and longitudinal genotypic analysis of HIV-2 infected patients failing a raltegravir-containing regimen.

    Science.gov (United States)

    Cavaco-Silva, Joana; Abecasis, Ana; Miranda, Ana Cláudia; Poças, José; Narciso, Jorge; Águas, Maria João; Maltez, Fernando; Almeida, Isabel; Germano, Isabel; Diniz, António; Gonçalves, Maria de Fátima; Gomes, Perpétua; Cunha, Celso; Camacho, Ricardo Jorge

    2014-01-01

    To characterize the HIV-2 integrase gene polymorphisms and the pathways to resistance of HIV-2 patients failing a raltegravir-containing regimen, we studied 63 integrase strand transfer inhibitors (INSTI)-naïve patients, and 10 heavily pretreated patients exhibiting virological failure while receiving a salvage raltegravir-containing regimen. All patients were infected by HIV-2 group A. 61.4% of the integrase residues were conserved, including the catalytic motif residues. No INSTI-major resistance mutations were detected in the virus population from naïve patients, but two amino acids that are secondary resistance mutations to INSTIs in HIV-1 were observed. The 10 raltegravir-experienced patients exhibited resistance mutations via three main genetic pathways: N155H, Q148R, and eventually E92Q - T97A. The 155 pathway was preferentially used (7/10 patients). Other mutations associated to raltegravir resistance in HIV-1 were also observed in our HIV-2 population (V151I and D232N), along with several novel mutations previously unreported. Data retrieved from this study should help build a more robust HIV-2-specific algorithm for the genotypic interpretation of raltegravir resistance, and contribute to improve the clinical monitoring of HIV-2-infected patients.

  14. Hydraulic experiments on the failed fuel location module of prototype fast breeder reactor

    International Nuclear Information System (INIS)

    Rajesh, K.; Kumar, S.; Padmakumar, G.; Prakash, V.; Vijayashree, R.; Rajan Babu, V.; Govinda Rajan, S.; Vaidyanathan, G.; Prabhaker, R.

    2003-01-01

    The design of Prototype Fast Breeder Reactor (PFBR) is based on sound design concepts with emphasis on intrinsic safety. The uncertainties involved in the design of various components, which are difficult to assess theoretically, are experimentally verified before design is validated. In PFBR core, the coolant (liquid sodium) enters the bottom of the fuel subassembly, passes over the fuel pins picking up the fission heat and issues in to a hot pool. If there is any breach in the fuel pins, the fission products come in direct contact with the coolant. This is undesirable and it is necessary to locate the subassembly with the failed fuel pin and to isolate it. A component called Failed Fuel Location Module (FFLM) is employed for locating the failed SA by monitoring the coolant samples coming out of each Subassembly. The coolant sample from each Subassembly is drawn by FFLM using an EM pump through sampling tube and selector valve and is monitored for the presence of delayed neutrons which is an indication of failure of the Subassembly. The pressure drop across the selector valve determines the rating of the EM Pump. The dilution of the coolant sample across the selector valve determines the effectiveness of monitoring for contamination. It is not possible to predict pressure drop across the selector valve and dilution of the coolant sample theoretically. These two parameters are determined using a hydraulic experiment on the FFLM. The experiment was carried out in conditions that simulate the reactor conditions following appropriate similarity laws. The paper discusses the details of the model, techniques of experiments and the results from the studies

  15. Can the failing firm defence rule be counterproductive?

    OpenAIRE

    Helder Vasconcelos

    2013-01-01

    The present paper investigates the role of the failing firm defence (FFD) concept in the merger control process within a Cournot setting where (i) endogenous mergers are motivated by prospective efficiency gains and (ii) mergers must be submitted to an antitrust authority that might demand partial divestiture for approval. The findings show that when the FFD concept is one of the tools available for controlling the merger process, firms can strategically embark on a merger that makes other fi...

  16. Why Do Large Infrastructure Projects Often Fail?

    DEFF Research Database (Denmark)

    Lando, Henrik

    The paper reports, in a systematic manner, the views of a group of experienced practitioners on why large infrastructure projects often fail. The views, centering on the role played by the Owner (the Client or Buyer), can be summarized as follows:The owner should be aware of the need of clarity...... when it comes to own priorities, requirements, decision making authority, and risk allocation, and such clarity together with measures intended to secure a cooperative spirit, including a balanced sharing of risk and conflict resolution schemes that secure a quick resolution of conflicts, are central...... elements in securing successful projects....

  17. Re-enactment of power economy legislation failed

    International Nuclear Information System (INIS)

    Heller, W.

    2002-01-01

    Comment on the failed vote in the German Federal Parliament about the re-enactment of power economy legislation. The amendments were mainly intended to translate into national law the EU Single Market Directive of June 22, 1998 about common regulations of the gas market. The legislative process had included a mediation procedure between the two chambers of parliament, i.e. the Bundestag and the Bundesrat, had been rejected once more by the Bundesrat, and was to have been adopted by an absolute majority vote of the Bundestag, the so-called Chancellor's majority, still in this parliamentary term. (orig.)

  18. Management of the athlete with a failed shoulder instability procedure.

    Science.gov (United States)

    Gwathmey, F Winston; Warner, Jon J P

    2013-10-01

    The athlete with a failed instability procedure requires a thoughtful and systematic approach to achieve a good outcome. Goals of treatment should be defined and realistic expectations should be set. Revision stabilization has a high rate of recurrent instability, low rates of return to play, and low clinical outcome scores. Fundamental to successful revision surgery is choosing the correct procedure. The decision is straightforward in athletes with clear factors that predict recurrence (significant glenoid bone loss, engaging Hill-Sachs lesions) because only a bony procedure can restore the articular arc of the glenoid. Arthroscopic revision Bankart repair may be appropriate in those athletes who have an obvious Bankart tear and no bone loss after a traumatic reinjury. The challenge for the shoulder surgeon is identifying the best surgery for the athlete who does not have such clear-cut indications. Each factor that has the potential to lead to a poor outcome needs to be collected and calculated. Patient factors (age, laxity, type and level of sport), injury factors (mechanism of injury, capsulolabral injury, glenoid bone loss, Hill-Sachs lesion), and technical factors (previous surgery performed, integrity of repair, scarring) must be integrated into the treatment algorithm. Based on this collection of factors, the shoulder surgeon should be prepared to provide the athlete with the surgery that provides the best chance to return to playing sports and the lowest risk of recurrent instability. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Polychlorinated biphenyl exposure, diabetes and endogenous hormones: a cross-sectional study in men previously employed at a capacitor manufacturing plant.

    Science.gov (United States)

    Persky, Victoria; Piorkowski, Julie; Turyk, Mary; Freels, Sally; Chatterton, Robert; Dimos, John; Bradlow, H Leon; Chary, Lin Kaatz; Burse, Virlyn; Unterman, Terry; Sepkovic, Daniel W; McCann, Kenneth

    2012-08-29

    Studies have shown associations of diabetes and endogenous hormones with exposure to a wide variety of organochlorines. We have previously reported positive associations of polychlorinated biphenyls (PCBs) and inverse associations of selected steroid hormones with diabetes in postmenopausal women previously employed in a capacitor manufacturing plant. This paper examines associations of PCBs with diabetes and endogenous hormones in 63 men previously employed at the same plant who in 1996 underwent surveys of their exposure and medical history and collection of bloods and urine for measurements of PCBs, lipids, liver function, hematologic markers and endogenous hormones. PCB exposure was positively associated with diabetes and age and inversely associated with thyroid stimulating hormone and triiodothyronine-uptake. History of diabetes was significantly related to total PCBs and all PCB functional groupings, but not to quarters worked and job score, after control for potential confounders. None of the exposures were related to insulin resistance (HOMA-IR) in non-diabetic men. Associations of PCBs with specific endogenous hormones differ in some respects from previous findings in postmenopausal women employed at the capacitor plant. Results from this study, however, do confirm previous reports relating PCB exposure to diabetes and suggest that these associations are not mediated by measured endogenous hormones.

  20. Evolution of drug resistance in HIV infected patients remaining on a virologically failing cART regimen

    DEFF Research Database (Denmark)

    Cozzi-Lepri, A; Phillips, AN; Ruiz, L

    2007-01-01

    OBJECTIVE: To estimate the extent of drug resistance accumulation in patients kept on a virologically failing regimen and its determinants in the clinical setting. DESIGN: The study focused on 110 patients of EuroSIDA on an unchanged regimen who had two genotypic tests performed at two time points...

  1. Risk factors for failed conversion of labor epidural analgesia to cesarean delivery anesthesia: a systematic review and meta-analysis of observational trials.

    Science.gov (United States)

    Bauer, M E; Kountanis, J A; Tsen, L C; Greenfield, M L; Mhyre, J M

    2012-10-01

    This systematic review and meta-analysis evaluates evidence for seven risk factors associated with failed conversion of labor epidural analgesia to cesarean delivery anesthesia. Online scientific literature databases were searched using a strategy which identified observational trials, published between January 1979 and May 2011, which evaluated risk factors for failed conversion of epidural analgesia to anesthesia or documented a failure rate resulting in general anesthesia. 1450 trials were screened, and 13 trials were included for review (n=8628). Three factors increase the risk for failed conversion: an increasing number of clinician-administered boluses during labor (OR=3.2, 95% CI 1.8-5.5), greater urgency for cesarean delivery (OR=40.4, 95% CI 8.8-186), and a non-obstetric anesthesiologist providing care (OR=4.6, 95% CI 1.8-11.5). Insufficient evidence is available to support combined spinal-epidural versus standard epidural techniques, duration of epidural analgesia, cervical dilation at the time of epidural placement, and body mass index or weight as risk factors for failed epidural conversion. The risk of failed conversion of labor epidural analgesia to anesthesia is increased with an increasing number of boluses administered during labor, an enhanced urgency for cesarean delivery, and care being provided by a non-obstetric anesthesiologist. Further high-quality studies are needed to evaluate the many potential risk factors associated with failed conversion of labor epidural analgesia to anesthesia for cesarean delivery. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Characteristics of failed fertilized oocytes in patients with severe obesity

    Directory of Open Access Journals (Sweden)

    E A Pigarova

    2012-12-01

    Full Text Available Реферат по статье: Machtinger R, Combelles CM, Missmer SA, Correia KF, Fox JH, Racowsky C. The association between severe obesity and characteristics of failed fertilized oocytes. Hum Reprod. 2012 Nov;27(11:3198-207.

  3. Ultrastructure and regulation of lateralized connexin43 in the failing heart.

    Science.gov (United States)

    Hesketh, Geoffrey G; Shah, Manish H; Halperin, Victoria L; Cooke, Carol A; Akar, Fadi G; Yen, Timothy E; Kass, David A; Machamer, Carolyn E; Van Eyk, Jennifer E; Tomaselli, Gordon F

    2010-04-02

    Gap junctions mediate cell-to-cell electric coupling of cardiomyocytes. The primary gap junction protein in the working myocardium, connexin43 (Cx43), exhibits increased localization at the lateral membranes of cardiomyocytes in a variety of heart diseases, although the precise location and function of this population is unknown. To define the subcellular location of lateralized gap junctions at the light and electron microscopic level, and further characterize the biochemical regulation of gap junction turnover. By electron microscopy, we characterized gap junctions formed between cardiomyocyte lateral membranes in failing canine ventricular myocardium. These gap junctions were varied in structure and appeared to be extensively internalizing. Internalized gap junctions were incorporated into multilamellar membrane structures, with features characteristic of autophagosomes. Intracellular Cx43 extensively colocalized with the autophagosome marker GFP-LC3 when both proteins were exogenously expressed in HeLa cells, and endogenous Cx43 colocalized with GFP-LC3 in neonatal rat ventricular myocytes. Furthermore, a distinct phosphorylated form of Cx43, as well as the autophagosome-targeted form of LC3 (microtubule-associated protein light chain 3) targeted to lipid rafts in cardiac tissue, and both were increased in heart failure. Our data demonstrate a previously unrecognized pathway of gap junction internalization and degradation in the heart and identify a cellular pathway with potential therapeutic implications.

  4. Case study of ILVA, Italy:The impact of failing to consider sustainability as a driver of business model evolution

    OpenAIRE

    Tonelli, Flavio; Short, Samuel; Taticchi, Paolo

    2013-01-01

    Part of: Seliger, Günther (Ed.): Innovative solutions : proceedings / 11th Global Conference on Sustainable Manufacturing, Berlin, Germany, 23rd - 25th September, 2013. - Berlin: Universitätsverlag der TU Berlin, 2013. - ISBN 978-3-7983-2609-5 (online). - http://nbn-resolving.de/urn:nbn:de:kobv:83-opus4-40276. - pp. 25–30. The case of ILVA steel works in Taranto, Italy demonstrates the potential impacts associated with failing toadequately consider environmental and social sustainabilit...

  5. Conversion of failed hemiarthroplasty to total hip arthroplasty: A short to mid-term follow-up study

    Directory of Open Access Journals (Sweden)

    Pankaj Amite

    2008-01-01

    Full Text Available Background: The conversion of hemiarthroplasty (unipolar or bipolar of the hip to total hip replacement has been reported to be associated with very high rates of intra- and postoperative complications. We present a prospective analysis of the outcome of conversion surgery in patients with failed hemiarthroplasty. Materials and Methods: Forty-four cases, 30 women and 14 men, average age 62 years (range 42-75 years of failed hemiarthroplasty were converted to total hip replacement between January 1998 and December 2004. Groin pain was the main presenting complaint in the majority of the patients (24 out of 44. Six patients had infection and were operated with staged procedure. All acetabular and the majority (86.5% of femoral components used in our series were uncemented. Results: After an average follow-up of 6.4 years (range, two to nine years Harris hip scores improved from 38 (range 15-62 preoperatively to 86 (range 38 to 100 and 22 (50% patients were community ambulators without support while 17 (38% needed minimal support of cane. Fifteen out of 18 (83% patients who had isolated groin pain preoperatively experienced no pain postoperatively while three patients (17% reported only partial improvement. Intraoperative and postoperative complications included iatrogenic fracture of the femur in two, femoral perforation in two, partial trochanteric avulsion in two, fracture of the acetabular floor in three hips, and postoperative dislocation in one. None of these complications resulted in a poor long-term outcome. The rate of loosening in our series was 2.3% (one out of 44 after a mean follow-up of 6.4 years with a mean survival of 97.4% at 72 months. Conclusion: Conversion of symptomatic hemiarthroplasty to total hip arthroplasty is a safe option that gives good functional results, with marginally higher rates of intra-operative complications. The patients should be warned of the possibility of incomplete relief of groin pain postoperatively.

  6. Overcoming Limitations in Previous Research on Exercise as a Smoking Cessation Treatment: Rationale and Design of the “Quit for Health” Trial

    Science.gov (United States)

    Williams, David M.; Ussher, Michael; Dunsiger, Shira; Miranda, Robert; Gwaltney, Chad J.; Monti, Peter M.; Emerson, Jessica

    2013-01-01

    Aerobic exercise has been proposed as a stand-alone or adjunct smoking cessation treatment, but findings have been mixed. Laboratory studies have shown that individual exercise sessions lead to decreases in withdrawal symptoms and cigarette cravings, but findings are limited by lack of follow-up and artificial settings. On the other hand, smoking cessation treatment RCTs have generally failed to show positive effects of exercise on smoking cessation, but have been plagued by poor and/or unverified compliance with exercise programs. This paper describes the rationale and design for Quit for Health (QFH)—an RCT designed to determine the efficacy of aerobic exercise as an adjunct smoking cessation treatment among women. To overcome limitations of previous research, compliance with the exercise (and wellness contact control) program is incentivized and directly observed, and ecological momentary assessment is used to examine change over time in withdrawal symptoms and cigarette cravings in participants’ natural environments. PMID:24246818

  7. Why the NEA and AFT Sought To Merge--and Failed.

    Science.gov (United States)

    Fusarelli, Lance D.; Cooper, Bruce S.

    1999-01-01

    Four key reasons underlie the push for teacher union solidarity in 1998: desire to fulfill Al Shanker's dream of a unified mission, to end union competition, to bolster Democratic Party weaknesses, and to stop privatization. The NEA/AFT merger failed because of conflicting organizational cultures and teachers' gradualist, localist, and…

  8. Transportation of failed or damaged foreign research reactor spent nuclear fuel

    International Nuclear Information System (INIS)

    Messick, Charles E.; Mustin, Tracy P.; Massey, Charles D.

    1999-01-01

    Since initiating the Foreign Research Reactor Spent Nuclear Fuel (FRR SNF) Acceptance Program in 1996, the Program has had to deal with difficult issues associated with the transportation of failed or damaged spent fuel. In several instances, problems with failed or damaged fuel have prevented the acceptance of the fuel at considerable cost to both the Department of Energy and research reactor operators. In response to the problems faced by the Acceptance Program, DOE has undertaken significant steps to better define the spent fuel acceptance criteria. DOE has worked closely with the U.S. Nuclear Regulatory Commission to address failed or damaged research reactor spent fuel causing a degradation of the fuel assembly exposing fuel meat and to identify cask certificate issues which must be resolved by cask owners and foreign regulatory authorities. The specific issues and implementation challenges associated with the transport of MTR type FRR SNF will be discussed. The information presented will include U.S. Nuclear Regulatory Commission regulatory issues, cask certificate issues, technical constraints, implementation status, and lessons learned. Specific information will also be provided on the latest efforts to revise DOE's Appendix B, Transport Package (Cask) Acceptance Criteria. The information presented in this paper will be of interest to foreign research reactor operators, shippers, and cask vendors in evaluating the condition of their fuel to ensure it can be transported in accordance with appropriate cask certificate requirements. (author)

  9. Fears for literacy and numeracy as new nurses fail basic tests.

    Science.gov (United States)

    Learner, Sue

    2006-08-16

    The Nursing and Midwifery Council (NMC) has voiced concern over nurses' poor levels of English and maths after a third of newly qualified nurses failed a basic test set by a hospital as part of anew selection process.

  10. Fresh osteochondral allografts in the knee: comparison of primary transplantation versus transplantation after failure of previous subchondral marrow stimulation.

    Science.gov (United States)

    Gracitelli, Guilherme C; Meric, Gokhan; Briggs, Dustin T; Pulido, Pamela A; McCauley, Julie C; Belloti, João Carlos; Bugbee, William D

    2015-04-01

    In most treatment algorithms, osteochondral allograft (OCA) transplantation is regarded as an alternative salvage procedure when other, previous reparative treatments have failed. To compare the outcomes of a retrospective matched-pair cohort of (1) primary OCA transplantation and (2) OCA transplantation after failure of previous subchondral marrow stimulation. Cohort study; Level of evidence, 3. An OCA database was used to identify 46 knees that had OCA transplantation performed as a primary treatment (group 1) and 46 knees that underwent OCA transplantation after failure of previous subchondral marrow stimulation (group 2). All patients had a minimum of 2 years' follow-up. Patients in each group were matched for age (±5 years), diagnosis (osteochondral lesion, degenerative chondral lesion, traumatic chondral injury), and graft size (small, 10 cm2). The groups had similar body mass indexes, sex distributions, and graft locations (femoral condyle, patella, and trochlea. The number and type of further surgeries after the OCA transplantation were assessed; failure was defined as any reoperation resulting in removal of the graft. Functional outcomes were evaluated by use of the modified Merle d'Aubigné-Postel (18-point) scale, International Knee Documentation Committee (IKDC) subjective knee evaluation form, Knee injury and Osteoarthritis Outcomes Score (KOOS), and the Knee Society function (KS-F) scale. Patient satisfaction, according to a 5-point scale from "extremely satisfied" to "dissatisfied," was recorded at the latest follow-up. Eleven of 46 knees (24%) in group 1 had reoperations, compared with 20 of 46 knees (44%) in group 2 (P = .04). The OCA was classified as a failure in 5 knees (11%) in group 1 and 7 knees (15%) in group 2 (P = .53). At 10 years of follow-up, survivorship of the graft was 87.4% and 86% in groups 1 and 2, respectively. Both groups showed improvement in pain and function on all subjective scores from preoperatively to the latest follow

  11. Methamphetamine fails to alter the noradrenergic integrity of the heart.

    Science.gov (United States)

    Ruffoli, Riccardo; Soldani, Paola; Pasquali, Livia; Ruggieri, Stefano; Paparelli, Antonio; Fornai, Francesco

    2008-10-01

    The chronic use of methamphetamine leads to cardiomyopathy and a nigrostriatal dopamine deficiency that partly mimics what occurs in Parkinson's disease. This study examines the cardiac effects occurring after chronic administration of methamphetamine and parkinsonism-inducing neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine. Despite the similarities concerning the nigrostriatal dopamine denervation, methamphetamine failed to produce chronic norepinephrine depletion in the heart, thus contrasting with what occurs in Parkinson's disease or after administration of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine. These data suggest that the chronic cardiovascular effects induced by methamphetamine rely on biochemical changes which differ from those activated by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine or during the course of Parkinson's disease.

  12. Trending a New Normal: Is Nigeria becoming a failed Nation?

    Directory of Open Access Journals (Sweden)

    Emmanuel Olusegun Stober

    2017-06-01

    Full Text Available Judging from every economic parameter, Nigeria will suggest being a failed nation. Not so long ago international investors identified Nigeria as one of the world’s most promising investment opportunities, but things have changed drastically in the meantime. The slump in the price of crude oil has hit Nigerian economy hard, the twin curses of insecurity and corruption have not gone away either. The Nigerian currency - naira has also lost its value by 170% from its value in 2015. The question most analysts and citizens are now asking is if Nigeria will ever fulfil its potential. This study empirically analyses the current economic situation of Nigeria, and gives recommendations on what government should do in getting the country out of recession.

  13. Why e-return services fail: a psychological contract violation approach.

    Science.gov (United States)

    Hsieh, Pei-Ling

    2012-12-01

    This study elucidates why and how e-return services (e-RS) fail, representing a preliminary attempt to explain the critical role of psychological contract violation (PCV) and explore its antecedents and outcomes in e-RS research. Based on marketing, psychology, and information systems-related studies, a theoretical framework is developed to correlate perceived fairness (PF), causal attribution (CA), and magnitude of negative outcome (MNO) with customers' PCV. Additionally, based on trust (TR), exactly how PCV further influences customers' stickiness intention (SI) is examined as well. Analysis results indicate that PF, CA, and MNO influence customers during both the evaluation stage and the customer receipt of e-RS, subsequently deriving PCV. These factors contribute to the subsequent success of e-RS, especially, customers' TR and SI. Furthermore, recommendations are made on how firms should evaluate PCV and its influencing factors to prevent e-RS failure.

  14. Methodology of failed section location in case of leaks in PGN-200M sectional steam generator

    International Nuclear Information System (INIS)

    Kuznetsov, A.A.; Govorov, P.P.; Nosov, Yu.V.; Karavaev, A.P.

    2009-01-01

    The article considers a way of the failed section location when indications of water-sodium reaction emerge in PGN-200M sectional steam generator of the BN-600 power unit. The selection of diagnostic parameters used to locate the failed section is justified. Various alternative locations of leaks have been simulated [ru

  15. Semi-elective intraosseous infusion after failed intravenous access in pediatric anesthesia.

    Science.gov (United States)

    Neuhaus, Diego; Weiss, Markus; Engelhardt, Thomas; Henze, Georg; Giest, Judith; Strauss, Jochen; Eich, Christoph

    2010-02-01

    Intraosseous (IO) infusion is a well-established intervention to obtain vascular access in pediatric emergency medicine but is rarely used in routine pediatric anesthesia. In this observational study, we report on a series of 14 children in whom semi-elective IO infusion was performed under inhalational anesthesia after peripheral intravenous (IV) access had failed. Patient and case characteristics, technical details, and estimated timings of IO infusion as well as associated complications were reviewed. Data are median and range. IO infusion was successfully established in fourteen children [age: 0.1-6.00 years (median 0.72 years); weight: 3.5-12.0 kg (median 7.0 kg)]. The majority suffered from chronic cardiac, metabolic, or dysmorphic abnormalities. Estimated time taken from inhalational induction of anesthesia until insertion of an intraosseous needle was 26.5 min (15-65 min). The proximal tibia was cannulated in all patients. The automated EZIO IO system was used in eight patients and the manual COOK system in six patients. Drugs administered included hypnotics, opioids, neuromuscular blocking agents and reversals, cardiovascular drugs, antibiotics, and IV fluids. The IO cannulas were removed either in the operating theatre (n = 5), in the recovery room (n = 5), or in the ward (n = 4), after 73 min (19-225 min) in situ. There were no significant complications except one accidental postoperative dislocation. IO access represents a quick and reliable alternative for pediatric patients with prolonged difficult or failed IV access after inhalational induction of anesthesia.

  16. Failed medial patellofemoral ligament reconstruction: Causes and surgical strategies

    OpenAIRE

    Sanchis-Alfonso, Vicente; Montesinos-Berry, Erik; Ramirez-Fuentes, Cristina; Leal Blanquet, Joan; Gelber, Pablo-Eduardo; Monllau García, Juan Carlos

    2017-01-01

    Patellar instability is a common clinical problem encountered by orthopedic surgeons specializing in the knee. For patients with chronic lateral patellar instability, the standard surgical approach is to stabilize the patella through a medial patellofemoral ligament (MPFL) reconstruction. Foreseeably, an increasing number of revision surgeries of the reconstructed MPFL will be seen in upcoming years. In this paper, the causes of failed MPFL reconstruction are analyzed: (1) incorrect surgical ...

  17. Subsequent pregnancy outcome after previous foetal death

    NARCIS (Netherlands)

    Nijkamp, J. W.; Korteweg, F. J.; Holm, J. P.; Timmer, A.; Erwich, J. J. H. M.; van Pampus, M. G.

    Objective: A history of foetal death is a risk factor for complications and foetal death in subsequent pregnancies as most previous risk factors remain present and an underlying cause of death may recur. The purpose of this study was to evaluate subsequent pregnancy outcome after foetal death and to

  18. Field experience with failed-fuel detection - PWRs [pressurized water reactors

    International Nuclear Information System (INIS)

    File, P.

    1990-01-01

    Industry sensitivity to in-reactor fuel reliability has been heightened recently for several reasons: increased Institute of Nuclear Power Operations attention (fuel reliability indicator), impact of fuel failures on operating and maintenance costs, and concern about personnel contaminations caused by small radioactive particles (often fragments from failed rods). As a result, utilities often perform inspection and repair campaigns at the end of a cycle where fuel failures have been evident in order to avoid experiencing the effects of those failures during the subsequent cycle. At Calvert Cliffs, the first full-core inspection associated with concern over fuel integrity occurred in early 1984 after unit 2 cycle 5. Lessons learned from this campaign are discussed in this paper. While significant improvement has been made relative to the ability to discern failed rods from sound rods, ultrasonic testing should be evaluated by people experienced with mechanisms that can produce questionable indications. The speed and accuracy of UT systems make UT a practical tool for performing inspections with minimal impact on the schedule

  19. Fire-Side Corrosion: A Case Study of Failed Tubes of a Fossil Fuel Boiler

    Directory of Open Access Journals (Sweden)

    Majid Asnavandi

    2017-01-01

    Full Text Available The failures of superheater and reheater boiler tubes operating in a power plant utilizing natural gas or mazut as a fuel have been analysed and the fire-side corrosion has been suggested as the main reason for the failure in boiler tubes. The tubes have been provided by a fossil fuel power plant in Iran and optical and electron microscopy investigations have been performed on the tubes as well as the corrosion products on their surfaces. The results showed that the thickness of the failed tubes is not uniform which suggests that fire-side corrosion has happened on the tubes. Fire-side corrosion is caused by the reaction of combustion products with oxide layers on the tube surface resulting in metal loss and consequently tubes fracture. However, the tubes corrosion behaviour did not follow the conventional models of the fire-side corrosion. Given that, using the corrosion monitoring techniques for these boiler tubes seems essential. As a result, the thickness of the boiler tubes in different parts of the boiler has been recorded and critical points are selected accordingly. Such critical points are selected for installation of corrosion monitoring probes.

  20. The biomechanics of running in athletes with previous hamstring injury: A case-control study.

    Science.gov (United States)

    Daly, C; Persson, U McCarthy; Twycross-Lewis, R; Woledge, R C; Morrissey, D

    2016-04-01

    Hamstring injury is prevalent with persistently high reinjury rates. We aim to inform hamstring rehabilitation by exploring the electromyographic and kinematic characteristics of running in athletes with previous hamstring injury. Nine elite male Gaelic games athletes who had returned to sport after hamstring injury and eight closely matched controls sprinted while lower limb kinematics and muscle activity of the previously injured biceps femoris, bilateral gluteus maximus, lumbar erector spinae, rectus femoris, and external oblique were recorded. Intergroup comparisons of muscle activation ratios and kinematics were performed. Previously injured athletes demonstrated significantly reduced biceps femoris muscle activation ratios with respect to ipsilateral gluteus maximus (maximum difference -12.5%, P = 0.03), ipsilateral erector spinae (maximum difference -12.5%, P = 0.01), ipsilateral external oblique (maximum difference -23%, P = 0.01), and contralateral rectus femoris (maximum difference -22%, P = 0.02) in the late swing phase. We also detected sagittal asymmetry in hip flexion (maximum 8°, P = 0.01), pelvic tilt (maximum 4°, P = 0.02), and medial rotation of the knee (maximum 6°, P = 0.03) effectively putting the hamstrings in a lengthened position just before heel strike. Previous hamstring injury is associated with altered biceps femoris associated muscle activity and potentially injurious kinematics. These deficits should be considered and addressed during rehabilitation. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Endoscopic foraminal decompression for failed back surgery syndrome under local anesthesia.

    Science.gov (United States)

    Yeung, Anthony; Gore, Satishchandra

    2014-01-01

    The most common causes of failed back surgery are residual or recurrent herniation, foraminal fibrosis and foraminal stenosis that is ignored, untreated, or undertreated. Residual back ache may also be from facetal causes or denervation and scarring of the paraspinal muscles.(1-6) The original surgeon may advise his patient that nothing more can be done on the basis of his opinion that the nerve was visually decompressed by the original surgery, supported by improved post-op imaging and follow-up studies such as EMG and conduction velocity studies. Post-op imaging or electrophysiological assessment may be inadequate to explain all the reasons for residual or recurrent symptoms. Treatment of Failed back surgery by repeat traditional open revision surgery usually incorporates more extensive decompression causing increased instability and back pain, therefore necessitating fusion. The authors, having limited their practice to endoscopic MIS surgery over the last 15-20 years, report on their experience gained during that period to relieve pain by endoscopically visualizing and treating unrecognized causative patho-anatomy in FBSS.(7.) Thirty consecutive patients with FBSS presenting with back and leg pain that had supporting imaging diagnosis of lateral stenosis and /or residual / recurrent disc herniation, or whose pain complaint was supported by relief from diagnostic and therapeutic injections (Figure 1), were offered percutaneous transforaminal endoscopic discectomy and foraminoplasty over a repeat open procedure. Each patient sought consultation following a transient successful, partially successful or unsuccessful open translaminar surgical treatment for disc herniation or spinal stenosis. Endoscopic foraminoplasty was also performed to either decompress the bony foramen for foraminal stenosis, or foraminoplasty to allow for endoscopic visual examination of the affected traversing and exiting nerve roots in the axilla, also known as the "hidden zone" of Macnab

  2. When modularization fails to occur: a developmental perspective.

    Science.gov (United States)

    D'Souza, Dean; Karmiloff-Smith, Annette

    2011-05-01

    We argue that models of adult cognition defined in terms of independently functioning modules cannot be applied to development, whether typical or atypical. The infant brain starts out highly interconnected, and it is only over developmental time that neural networks become increasingly specialized-that is, relatively modularized. In the case of atypical development, even when behavioural scores fall within the normal range, they are frequently underpinned by different cognitive and neural processes. In other words, in neurodevelopmental disorders the gradual process of relative modularization may fail to occur.

  3. Dexamethasone intravitreal implant in previously treated patients with diabetic macular edema : Subgroup analysis of the MEAD study

    OpenAIRE

    Augustin, A.J.; Kuppermann, B.D.; Lanzetta, P.; Loewenstein, A.; Li, X.; Cui, H.; Hashad, Y.; Whitcup, S.M.; Abujamra, S.; Acton, J.; Ali, F.; Antoszyk, A.; Awh, C.C.; Barak, A.; Bartz-Schmidt, K.U.

    2015-01-01

    Background Dexamethasone intravitreal implant 0.7?mg (DEX 0.7) was approved for treatment of diabetic macular edema (DME) after demonstration of its efficacy and safety in the MEAD registration trials. We performed subgroup analysis of MEAD study results to evaluate the efficacy and safety of DEX 0.7 treatment in patients with previously treated DME. Methods Three-year, randomized, sham-controlled phase 3 study in patients with DME, best-corrected visual acuity (BCVA) of 34?68 Early Treatment...

  4. Subsequent childbirth after a previous traumatic birth.

    Science.gov (United States)

    Beck, Cheryl Tatano; Watson, Sue

    2010-01-01

    Nine percent of new mothers in the United States who participated in the Listening to Mothers II Postpartum Survey screened positive for meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for posttraumatic stress disorder after childbirth. Women who have had a traumatic birth experience report fewer subsequent children and a longer length of time before their second baby. Childbirth-related posttraumatic stress disorder impacts couples' physical relationship, communication, conflict, emotions, and bonding with their children. The purpose of this study was to describe the meaning of women's experiences of a subsequent childbirth after a previous traumatic birth. Phenomenology was the research design used. An international sample of 35 women participated in this Internet study. Women were asked, "Please describe in as much detail as you can remember your subsequent pregnancy, labor, and delivery following your previous traumatic birth." Colaizzi's phenomenological data analysis approach was used to analyze the stories of the 35 women. Data analysis yielded four themes: (a) riding the turbulent wave of panic during pregnancy; (b) strategizing: attempts to reclaim their body and complete the journey to motherhood; (c) bringing reverence to the birthing process and empowering women; and (d) still elusive: the longed-for healing birth experience. Subsequent childbirth after a previous birth trauma has the potential to either heal or retraumatize women. During pregnancy, women need permission and encouragement to grieve their prior traumatic births to help remove the burden of their invisible pain.

  5. Failed Pavlik harness treatment for DDH as a risk factor for avascular necrosis.

    Science.gov (United States)

    Tiruveedhula, Madhu; Reading, Isabel C; Clarke, Nicholas M P

    2015-03-01

    Avascular necrosis (AVN) of the femoral head is an irreversible complication seen in the treatment of developmental dysplasia of hip (DDH) with the Pavlik harness. Its incidence is reported to be low after successful reduction of the hip but high if the hip is not concentrically relocated. We aim to investigate its incidence after failed Pavlik harness treatment. We prospectively followed up a group of children who failed Pavlik harness treatment for DDH treated at our institution by the senior author between 1988 and 2001 and compared their rates of AVN with a group of children who presented late and hence were treated surgically. AVN was graded as described by Kalamchi and MacEwen and only grade 2 to 4 AVN was considered significant and included in the analysis. Thirty-seven hips were included in the failed Pavlik group (group 1) and 86 hips in the no Pavlik group (group 2). Ten hips in group 1 developed AVN (27%), whereas only 7 hips in group 2 (8%) developed AVN; the odds of developing AVN after failed Pavlik treatment was 4.7 (95% confidence interval, 1.3-14.1) (P=0.009) with a relative risk of 3.32 (range, 1.37 to 8.05). There was no statistically significant association observed with duration of splintage and severity of AVN (Spearman's correlation, -0.46; P=0.18). However, there was a positive correlation noted with age at presentation and severity of AVN. Therefore, we advise close monitoring of hips in the Pavlik harness and discontinue its use if the hips are not reduced within 3 weeks. Level III.

  6. Rate Control Efficacy in Permanent Atrial Fibrillation : Successful and Failed Strict Rate Control Against a Background of Lenient Rate Control

    NARCIS (Netherlands)

    Groenveld, Hessel F.; Tijssen, Jan G. P.; Crijns, Harry J. G. M.; Van den Berg, Maarten P.; Hillege, Hans L.; Alings, Marco; Van Veldhuisen, Dirk J.; Van Gelder, Isabelle C.

    2013-01-01

    Objectives This study sought to investigate differences in outcome between patients treated with successful strict, failed strict, and lenient rate control. Background The RACE II (Rate Control Efficacy in Permanent Atrial Fibrillation) study showed no difference in outcome between lenient and

  7. Cryopreserved embryo transfer: adjacent or non-adjacent to failed fresh long GnRH-agonist protocol IVF cycle.

    Science.gov (United States)

    Volodarsky-Perel, Alexander; Eldar-Geva, Talia; Holzer, Hananel E G; Schonberger, Oshrat; Reichman, Orna; Gal, Michael

    2017-03-01

    The optimal time to perform cryopreserved embryo transfer (CET) after a failed oocyte retrieval-embryo transfer (OR-ET) cycle is unknown. Similar clinical pregnancy rates were recently reported in immediate and delayed CET, performed after failed fresh OR-ET, in cycles with the gonadotrophin-releasing hormone (GnRH) antagonist protocol. This study compared outcomes of CET performed adjacently (<50 days, n = 67) and non-adjacently (≥50 to 120 days, n = 62) to the last OR-day of cycles with the GnRH agonist down-regulation protocol. Additional inclusion criteria were patients' age 20-38 years, the transfer of only 1-2 cryopreserved embryos, one treatment cycle per patient and artificial preparation for CET. Significantly higher implantation, clinical pregnancy and live birth rates were found in the non-adjacent group than in the adjacent group: 30.5% versus 11.3% (P = 0.001), 41.9% versus 17.9% (P = 0.003) and 32.3% versus 13.4% (P = 0.01), respectively. These results support the postponement of CET after a failed OR-ET for at least one menstrual cycle, when a preceding long GnRH-agonist protocol is used. Copyright © 2016 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  8. The SVZ method: Why it works and why it fails

    International Nuclear Information System (INIS)

    Durand, B.; Whitenton, J.B.; Durand, L.

    1983-01-01

    We show in the context of potential theory, first, why the SVZ procedure for calculating hadronic masses succeeds phenomenologically: it provides a semiclassical interpolating formula which correctly relates input masses to output masses; and second, why it fails theoretically: the potential (or QCD) parameters derived from fits to masses are necessarily different from the true parameters. (orig.)

  9. Architectural design and reliability analysis of a fail-operational brake-by-wire system from ISO 26262 perspectives

    International Nuclear Information System (INIS)

    Sinha, Purnendu

    2011-01-01

    Next generation drive-by-wire automotive systems enabling autonomous driving will build on the fail-operational capabilities of electronics, control and software (ECS) architectural solutions. Developing such architectural designs that would meet dependability requirements and satisfy other system constraints is a challenging task and will possibly lead to a paradigm shift in automotive ECS architecture design and development activities. This aspect is becoming quite relevant while designing battery-driven electric vehicles with integrated in-wheel drive-train and chassis subsystems. In such highly integrated dependable systems, many of the primary features and functions are attributed to the highest safety critical ratings. Brake-by-wire is one such system that interfaces with active safety features built into an automobile, and which in turn is expected to provide fail-operational capabilities. In this paper, building up on the basic concepts of fail-silent and fail-operational systems design we propose a system-architecture for a brake-by-wire system with fail-operational capabilities. The design choices are supported with proper rationale and design trade-offs. Safety and reliability analysis of the proposed system architecture is performed as per the ISO 26262 standard for functional safety of electrical/electronic systems in road vehicles.

  10. Ahmed glaucoma valve implantation for refractory glaucoma after sequential failed trabeculectomy

    Directory of Open Access Journals (Sweden)

    Zhi-Qin Wu

    2016-07-01

    Full Text Available AIM: To evaluate the safety and efficacy of Ahmed glaucoma valve implantation for refractory glaucoma after sequential failed trabeculectomy. METHODS: Thirty-six patients(36 eyeswith prior failed sequential trabeculectomy who underwent Ahmed glaucoma valve implantation were included. The intraocular pressure(IOP, best corrected visual acuity(BCVAand complications were ovserved and all the patients were followed up at least for 12mo. RESULTS: Mean preoperative IOP was 35.20±7.28mmHg and reduced to 10.15±3.34, 11.23±3.56, 15.63±5.72, 17.17±5.47, 17.73±6.23,19.76±5.43mmHg at 1, 2wk, 1, 3, 6 and 12mo after surgery, which was significant different from the preoperative level(t=12.643, 11.837, 10.324, 8.839, 8.462, 8.046, all PZ=-0.420, P>0.05. At 12mo after operation, the complete success rate reached 78% and the conditional success rate reached 92%. There were 5 eyes complicated with shallow anterior chamber, 3 eye complicated with anterior chamber hemorrhage, which all recovered after additional treatments. Late complications included valve exposure and encapsulated cystic blebs around the plate. Severe corneal endothelium loss occurred in 1 patient. CONCLUSION: Ahmed glaucoma valve implantation is effective in reducing IOP at 1-year follow-up in refractory glaucoma patients with prior sequential failed trabeculectomy, but we should fully understand and attach great importance to all kinds of complications that may occur.

  11. 40 CFR 1068.430 - What happens if a family fails an SEA?

    Science.gov (United States)

    2010-07-01

    ... POLLUTION CONTROLS GENERAL COMPLIANCE PROVISIONS FOR ENGINE PROGRAMS Selective Enforcement Auditing § 1068... family if it fails the SEA under § 1068.420. The suspension may apply to all facilities producing engines...

  12. Neodymium-YAG laser core through urethrotomy in obliterative posttraumatic urethral strictures after failed initial urethroplasty.

    Science.gov (United States)

    Dogra, P N; Nabi, G

    2002-01-01

    To assess the feasibility, problems and results of Nd-YAG laser core through urethrotomy in the management of failed urethroplasty for posttraumatic bulbomembranous urethral strictures. 61 patients with obliterative posttraumatic urethral strictures were treated by Nd-YAG laser core through urethrotomy between May 1997 to April 2000. Of these, 5 patients had failed end-to-end urethroplasty done as an initial procedure at various periods of time. The procedure was performed as day care and patients were discharged within 6 h of procedure. At 24-30 months of follow-up, all patients are voiding well and are continent. Auxiliary procedures were required in 2 cases. Nd-YAG laser core through urethrotomy is a feasible day care option for patients of obliterative urethral strictures following failed initial urethroplasty with successful outcome. Copyright 2002 S. Karger AG, Basel

  13. Politické násilí a koncept failed state - komparace Iráku a Somálska

    OpenAIRE

    Nemešová, Lucie

    2011-01-01

    There is recently growing interest, and also the political and academic debate connected to it, in the so called failed states. The problem of state failure in some of the world regions was securitized, particularly after the 9/11 terrorist attacks, and the failed states began being understood as a security threat by the international community. This change in perception of the failed states reflects the concerns that such states' areas could serve as a "safe havens" of various terrorist grou...

  14. Experimental immunologically mediated aplastic anemia (AA) in mice: cyclosporin A fails to protect against AA

    International Nuclear Information System (INIS)

    Knospe, W.H.; Steinberg, D.; Gratwohl, A.; Speck, B.

    1984-01-01

    Immunologically mediated aplastic anemia (AA) in mice was induced by the i.v. injection of 10(7) lymph node cells (LNC) from H-2k identical but Mls mismatched CBA/J donor mice into previously irradiated (600 rad total body gamma) C3H/HeJ mice. Cyclosporin A (CsA), 25 mg/kg, was administered subcutaneously from day -1 to day 30. Control mice included C3H/HeJ mice which received 600 rad alone, C3H/HeJ mice which received 600 rad plus CsA as above, and C3H/HeJ mice which received 600 rad total body irradiation followed by 10(7) LNC from CBA/J donors. CsA failed to prevent lethal AA. These results suggest that the pathogenetic mechanisms operating in immunologically mediated AA differ from the mechanisms operating in rodents transplanted with allogeneically mismatched marrow or spleen cells which develop graft-versus-host disease. The results are consistent with a non-T cell-dependent mechanism causing the AA

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

    NARCIS (Netherlands)

    Van Gijssel, A.

    2013-01-01

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

  16. Challenging previous conceptions of vegetarianism and eating disorders.

    Science.gov (United States)

    Fisak, B; Peterson, R D; Tantleff-Dunn, S; Molnar, J M

    2006-12-01

    The purpose of this study was to replicate and expand upon previous research that has examined the potential association between vegetarianism and disordered eating. Limitations of previous research studies are addressed, including possible low reliability of measures of eating pathology within vegetarian samples, use of only a few dietary restraint measures, and a paucity of research examining potential differences in body image and food choice motives of vegetarians versus nonvegetarians. Two hundred and fifty-six college students completed a number of measures of eating pathology and body image, and a food choice motives questionnaire. Interestingly, no significant differences were found between vegetarians and nonvegetarians in measures of eating pathology or body image. However, significant differences in food choice motives were found. Implications for both researchers and clinicians are discussed.

  17. Polycose Taste Pre-Exposure Fails to Influence Behavioral and Neural Indices of Taste Novelty

    OpenAIRE

    Barot, Sabiha K.; Bernstein, Ilene L.

    2005-01-01

    Taste novelty can strongly modulate the speed and efficacy of taste aversion learning. Novel sweet tastes enhance c-Fos-like immunoreactivity (FLI) in the central amygdala and insular cortex. The present studies examined whether this neural correlate of novelty extends to different taste types by measuring FLI signals after exposure to novel and familiar polysaccharide (Polycose®) and salt (NaCl) tastes. Novel Polycose not only failed to elevate FLI expression in central amygdala and insular ...

  18. A previous hamstring injury affects kicking mechanics in soccer players.

    Science.gov (United States)

    Navandar, Archit; Veiga, Santiago; Torres, Gonzalo; Chorro, David; Navarro, Enrique

    2018-01-10

    Although the kicking skill is influenced by limb dominance and sex, how a previous hamstring injury affects kicking has not been studied in detail. Thus, the objective of this study was to evaluate the effect of sex and limb dominance on kicking in limbs with and without a previous hamstring injury. 45 professional players (males: n=19, previously injured players=4, age=21.16 ± 2.00 years; females: n=19, previously injured players=10, age=22.15 ± 4.50 years) performed 5 kicks each with their preferred and non-preferred limb at a target 7m away, which were recorded with a three-dimensional motion capture system. Kinematic and kinetic variables were extracted for the backswing, leg cocking, leg acceleration and follow through phases. A shorter backswing (20.20 ± 3.49% vs 25.64 ± 4.57%), and differences in knee flexion angle (58 ± 10o vs 72 ± 14o) and hip flexion velocity (8 ± 0rad/s vs 10 ± 2rad/s) were observed in previously injured, non-preferred limb kicks for females. A lower peak hip linear velocity (3.50 ± 0.84m/s vs 4.10 ± 0.45m/s) was observed in previously injured, preferred limb kicks of females. These differences occurred in the backswing and leg-cocking phases where the hamstring muscles were the most active. A variation in the functioning of the hamstring muscles and that of the gluteus maximus and iliopsoas in the case of a previous injury could account for the differences observed in the kicking pattern. Therefore, the effects of a previous hamstring injury must be considered while designing rehabilitation programs to re-educate kicking movement.

  19. Immediate Reconstruction of Failed Implants in the Esthetic Zone Using a Flapless Technique and Autogenous Composite Tuberosity Graft

    NARCIS (Netherlands)

    Raghoebar, Gerry M; Meijer, Henny J A; van Minnen, Baucke; Vissink, Arjan

    We describe a technique for immediate reconstruction of bone after removal of failed dental implants in the esthetic region to optimize the esthetic outcome of retreatment. We conducted a study of 16 consecutive patients in whom the bony defect resulting from implant removal was immediately

  20. Outcomes of reintervention after failed urethroplasty.

    Science.gov (United States)

    Ekerhult, Teresa Olsen; Lindqvist, Klas; Peeker, Ralph; Grenabo, Lars

    2017-02-01

    Urethroplasty is a procedure that has a high success rate. However, there exists a small subgroup of patients who require multiple procedures to achieve an acceptable result. This study analyses the outcomes of a series of patients with failed urethroplasty. This is a retrospective review of 82 failures out of 407 patients who underwent urethroplasty due to urethral stricture during the period 1999-2013. Failure was defined as the need for an additional surgical procedure. Of the failures, 26 patients had penile strictures and 56 had bulbar strictures. Meatal strictures were not included. The redo procedures included one or multiple direct vision internal urethrotomies, dilatations or new urethroplasties, all with a long follow-up time. The patients underwent one to seven redo surgeries (mean 2.4 procedures per patient). In the present series of patients, endourological procedures cured 34% (28/82) of the patients. Ten patients underwent multiple redo urethroplasties until a satisfactory outcome was achieved; the penile strictures were the most difficult to cure. In patients with bulbar strictures, excision with anastomosis and substitution urethroplasty were equally successful. Nevertheless, 18 patients were defined as treatment failures. Of these patients, nine ended up with clean intermittent self-dilatation as a final solution, five had perineal urethrostomy and four are awaiting a new reintervention. Complicated cases need centralized professional care. Despite the possibility of needing multiple reinterventions, the majority of patients undergoing urethroplasty have a good chance of successful treatment.

  1. High dose infusion of activated protein C (rhAPC) fails to improve neuronal damage and cognitive deficit after global cerebral ischemia in rats.

    Science.gov (United States)

    Brückner, Melanie; Lasarzik, Irina; Jahn-Eimermacher, Antje; Peetz, Dirk; Werner, Christian; Engelhard, Kristin; Thal, Serge C

    2013-09-13

    Recent studies demonstrated anticoagulatory, antiinflammatory, antiapoptotic, and neuroprotective properties of activated protein C (APC) in rodent models of acute neurodegenerative diseases, suggesting APC as promising broad acting therapeutic agent. Unfortunately, continuous infusion of recombinant human APC (rhAPC) failed to improve brain damage following cardiac arrest in rats. The present study was designed to investigate the neuroprotective effect after global cerebral ischemia (GI) with an optimized infusion protocol. Rats were subjected to bilateral clip occlusion of the common carotid arteries (BCAO) and controlled hemorrhagic hypotension to 40 mm Hg for 14 min and a subsequent 5h-infusion of rhAPC (2mg/kg bolus+6 mg/kg/h continuous IV) or vehicle (0.9% NaCl). The dosage was calculated to maintain plasma hAPC activity at 150%. Cerebral inflammation, apoptosis and neuronal survival was determined at day 10. rhAPC infusion did not influence cortical cerebral perfusion during reperfusion and failed to reduce neuronal cell loss, microglia activation, and caspase 3 activity. Even an optimized rhAPC infusion protocol designed to maintain a high level of APC plasma activity failed to improve the sequels following GI. Despite positive reports about protective effects of APC following, e.g., ischemic stroke, the present study supports the notion that infusion of APC during the early reperfusion phase does not result in sustained neuroprotection and fails to improve outcome after global cerebral ischemia. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  2. Dynamically reassigning a connected node to a block of compute nodes for re-launching a failed job

    Science.gov (United States)

    Budnik, Thomas A [Rochester, MN; Knudson, Brant L [Rochester, MN; Megerian, Mark G [Rochester, MN; Miller, Samuel J [Rochester, MN; Stockdell, William M [Byron, MN

    2012-03-20

    Methods, systems, and products for dynamically reassigning a connected node to a block of compute nodes for re-launching a failed job that include: identifying that a job failed to execute on the block of compute nodes because connectivity failed between a compute node assigned as at least one of the connected nodes for the block of compute nodes and its supporting I/O node; and re-launching the job, including selecting an alternative connected node that is actively coupled for data communications with an active I/O node; and assigning the alternative connected node as the connected node for the block of compute nodes running the re-launched job.

  3. 76 FR 73521 - Statutory Bar to Appointment of Persons Who Fail To Register Under Selective Service Law

    Science.gov (United States)

    2011-11-29

    ... 3206-AM06 Statutory Bar to Appointment of Persons Who Fail To Register Under Selective Service Law... statutory bar on employment in an Executive agency of an individual who was required to register with the... as follows: Subpart G--Statutory Bar to Appointment of Persons Who Fail To Register Under the...

  4. Detection method of a failed fuel

    International Nuclear Information System (INIS)

    Urata, Megumu; Uchida, Shunsuke; Utamura, Motoaki.

    1976-01-01

    Object: To divide a tank arrangement into a heating tank for the exclusive use of heating and a mixing tank for the exclusive use of mixing to thereby minimize the purifying amount of reactor water pumped from the interior of reactor and to considerably minimize the capacity of a purifier. Structure: In a detection method of a failed fuel comprising stopping a flow of coolant within fuel assemblies arranged in the coolant in a reactor container, sampling said coolant within the fuel assemblies, and detecting a radioactivity level of sampling liquid, the improvement of the method comprising the steps of heating a part of said coolant removed from the interior of said reactor container, mixing said heated coolant into the remainder of said removed coolant, pouring said mixed liquid into said fuel assemblies, and after a lapse of given time, sampling the liquid poured into said fuel assemblies. (Kawakami, Y.)

  5. Role of suppression of the inward rectifier current in terminal action potential repolarization in the failing heart.

    Science.gov (United States)

    Klein, Michael G; Shou, Matie; Stohlman, Jayna; Solhjoo, Soroosh; Haigney, Myles; Tidwell, Richard R; Goldstein, Robert E; Flagg, Thomas P; Haigney, Mark C

    2017-08-01

    The failing heart exhibits an increased arrhythmia susceptibility that is often attributed to action potential (AP) prolongation due to significant ion channel remodeling. The inwardly rectifying K + current (I K1 ) has been reported to be reduced, but its contribution to shaping the AP waveform and cell excitability in the failing heart remains unclear. The purpose of this study was to define the effect of I K1 suppression on the cardiac AP and excitability in the normal and failing hearts. We used electrophysiological and pharmacological approaches to investigate I K1 function in a swine tachy-pacing model of heart failure (HF). Terminal repolarization of the AP (TRAP; the time constant of the exponential fit to terminal repolarization) was markedly prolonged in both myocytes and arterially perfused wedges from animals with HF. TRAP was increased by 54.1% in HF myocytes (P < .001) and 26.2% in HF wedges (P = .014). The increase in TRAP was recapitulated by the potent and specific I K1 inhibitor, PA-6 (pentamidine analog 6), indicating that I K1 is the primary determinant of the final phase of repolarization. Moreover, we find that I K1 suppression reduced the ratio of effective refractory period to AP duration at 90% of repolarization, permitting re-excitation before full repolarization, reduction of AP upstroke velocity, and likely promotion of slow conduction. Using an objective measure of terminal repolarization, we conclude that I K1 is the major determinant of the terminal repolarization time course. Moreover, suppression of I K1 prolongs repolarization and reduces postrepolarization refractoriness without marked effects on the overall AP duration. Collectively, these findings demonstrate how I K1 suppression may contribute to arrhythmogenesis in the failing heart. Published by Elsevier Inc.

  6. Considerations for U.S. Policy Toward Conventional Arms Manufacturers in Post-Conflict or Failed-State Environments

    Science.gov (United States)

    2014-06-13

    industrialists in post-conflict or failed-state environments. The market for their expertise has grown substantially and unemployment puts them at risk for...failed-state environments. The market for their expertise has grown substantially and unemployment puts them at risk for recruitment. The U.S. should...Reduction FSU Former Soviet Union IED Improvised Explosive Device MIC Military Industrialization Commission NAS National Academy of Sciences STE

  7. Ranking nodes in growing networks: When PageRank fails.

    Science.gov (United States)

    Mariani, Manuel Sebastian; Medo, Matúš; Zhang, Yi-Cheng

    2015-11-10

    PageRank is arguably the most popular ranking algorithm which is being applied in real systems ranging from information to biological and infrastructure networks. Despite its outstanding popularity and broad use in different areas of science, the relation between the algorithm's efficacy and properties of the network on which it acts has not yet been fully understood. We study here PageRank's performance on a network model supported by real data, and show that realistic temporal effects make PageRank fail in individuating the most valuable nodes for a broad range of model parameters. Results on real data are in qualitative agreement with our model-based findings. This failure of PageRank reveals that the static approach to information filtering is inappropriate for a broad class of growing systems, and suggest that time-dependent algorithms that are based on the temporal linking patterns of these systems are needed to better rank the nodes.

  8. Ranking nodes in growing networks: When PageRank fails

    Science.gov (United States)

    Mariani, Manuel Sebastian; Medo, Matúš; Zhang, Yi-Cheng

    2015-11-01

    PageRank is arguably the most popular ranking algorithm which is being applied in real systems ranging from information to biological and infrastructure networks. Despite its outstanding popularity and broad use in different areas of science, the relation between the algorithm’s efficacy and properties of the network on which it acts has not yet been fully understood. We study here PageRank’s performance on a network model supported by real data, and show that realistic temporal effects make PageRank fail in individuating the most valuable nodes for a broad range of model parameters. Results on real data are in qualitative agreement with our model-based findings. This failure of PageRank reveals that the static approach to information filtering is inappropriate for a broad class of growing systems, and suggest that time-dependent algorithms that are based on the temporal linking patterns of these systems are needed to better rank the nodes.

  9. The ambivert: A failed attempt at a normal personality.

    Science.gov (United States)

    Davidson, Ian J

    2017-09-01

    Recently, attention has been drawn toward an overlooked and nearly forgotten personality type: the ambivert. This paper presents a genealogy of the ambivert, locating the various contexts it traversed in order to highlight the ways in which these places and times have interacted and changed-ultimately elucidating our current situation. Proposed by Edmund S. Conklin in 1923, the ambivert only was meant for normal persons in between the introvert and extravert extremes. Although the ambivert could have been taken up by early personality psychologists who were transitioning from the study of the abnormal to the normal, it largely failed to gain traction. Whether among psychoanalysts, psychiatrists, or applied and personality psychologists, the ambivert was personality non grata. It was only within the context of Eysenck's integrative view of types and traits that the ambivert marginally persisted up to the present day and is now the focus of sales management and popular psychology. © 2017 Wiley Periodicals, Inc.

  10. How energy efficiency fails in the building industry

    International Nuclear Information System (INIS)

    Ryghaug, Marianne; Sorensen, Knut H.

    2009-01-01

    This paper examines how energy efficiency fails in the building industry based on many years of research into the integration of energy efficiency in the construction of buildings and sustainable architecture in Norway. It argues that energy-efficient construction has been seriously restrained by three interrelated problems: (1) deficiencies in public policy to stimulate energy efficiency, (2) limited governmental efforts to regulate the building industry, and (3) a conservative building industry. The paper concludes that innovation and implementation of new, energy-efficient technologies in the building industry requires new policies, better regulations and reformed practices in the industry itself

  11. Sipping test on a failed MTR fuel element

    International Nuclear Information System (INIS)

    Terremoto, Luis Antonio Albiac; Zeituni, Carlos Alberto; Silva, Antonio Teixeira e; Perrotta, Jose Augusto; Silva, Jose Eduardo Rosa da

    2002-01-01

    This work describes sipping tests performed on MTR fuel elements of the IEA-R1 research reactor, in order to determinate which one failed in the core during a routine operation of the reactor. radioactive iodine isotopes 131 I and 133 I, employed as failure indicators, were detected in samples corresponding to the fuel element IEA-156. The specific activity of each sample, as well as the average leaking rate, were measured for 137 Cs. The nuclear fuels U 3 O 8 - Al dispersion and U - Al alloy were compared concerning their measured average leaking rates of 137 Cs. (author)

  12. Prognostic factors for the success of endometrial ablation in the treatment of menorrhagia with special reference to previous cesarean section

    NARCIS (Netherlands)

    Peeters, Jos A. H.; Penninx, Josien P. M.; Mol, Ben Willem; Bongers, Marlies Y.

    2013-01-01

    To assess whether, among other prognostic factors, a history of Cesarean section is associated with endometrial ablation failure in the treatment of menorrhagia. Study design We compared women who had failed ablation to women who had successful ablation for menorrhagia in a case-control study.

  13. Acceptance of failed SNF [spent nuclear fuel] assemblies by the Federal Waste Management System

    International Nuclear Information System (INIS)

    1990-03-01

    This report is one of a series of eight prepared by E. R. Johnson Associates, Inc. (JAI) under ORNL's contract with DOE's OCRWM Systems Integration Program and in support of the Annual Capacity Report (ACR) Issue Resolution Process. The report topics relate specifically to the list of high priority technical waste acceptance issues developed jointly by DOE and a utility-working group. JAI performed various analyses and studies on each topic to serve as starting points for further discussion and analysis leading eventually to finalizing the process by which DOE will accept spent fuel and waste into its waste management system. The eight reports are concerned with the conditions under which spent fuel and high level waste will be accepted in the following categories: failed fuel; consolidated fuel and associated structural parts; non-fuel-assembly hardware; fuel in metal storage casks; fuel in multi-element sealed canisters; inspection and testing requirements for wastes; canister criteria; spent fuel selection for delivery; and defense and commercial high-level waste packages. This document discusses acceptance of failed spent fuel assemblies by the Federal Waste Management System. 18 refs., 7 figs., 25 tabs

  14. No discrimination against previous mates in a sexually cannibalistic spider

    Science.gov (United States)

    Fromhage, Lutz; Schneider, Jutta M.

    2005-09-01

    In several animal species, females discriminate against previous mates in subsequent mating decisions, increasing the potential for multiple paternity. In spiders, female choice may take the form of selective sexual cannibalism, which has been shown to bias paternity in favor of particular males. If cannibalistic attacks function to restrict a male's paternity, females may have little interest to remate with males having survived such an attack. We therefore studied the possibility of female discrimination against previous mates in sexually cannibalistic Argiope bruennichi, where females almost always attack their mate at the onset of copulation. We compared mating latency and copulation duration of males having experienced a previous copulation either with the same or with a different female, but found no evidence for discrimination against previous mates. However, males copulated significantly shorter when inserting into a used, compared to a previously unused, genital pore of the female.

  15. Abiraterone in metastatic prostate cancer without previous chemotherapy

    NARCIS (Netherlands)

    Ryan, Charles J.; Smith, Matthew R.; de Bono, Johann S.; Molina, Arturo; Logothetis, Christopher J.; de Souza, Paul; Fizazi, Karim; Mainwaring, Paul; Piulats, Josep M.; Ng, Siobhan; Carles, Joan; Mulders, Peter F. A.; Basch, Ethan; Small, Eric J.; Saad, Fred; Schrijvers, Dirk; van Poppel, Hendrik; Mukherjee, Som D.; Suttmann, Henrik; Gerritsen, Winald R.; Flaig, Thomas W.; George, Daniel J.; Yu, Evan Y.; Efstathiou, Eleni; Pantuck, Allan; Winquist, Eric; Higano, Celestia S.; Taplin, Mary-Ellen; Park, Youn; Kheoh, Thian; Griffin, Thomas; Scher, Howard I.; Rathkopf, Dana E.; Boyce, A.; Costello, A.; Davis, I.; Ganju, V.; Horvath, L.; Lynch, R.; Marx, G.; Parnis, F.; Shapiro, J.; Singhal, N.; Slancar, M.; van Hazel, G.; Wong, S.; Yip, D.; Carpentier, P.; Luyten, D.; de Reijke, T.

    2013-01-01

    Abiraterone acetate, an androgen biosynthesis inhibitor, improves overall survival in patients with metastatic castration-resistant prostate cancer after chemotherapy. We evaluated this agent in patients who had not received previous chemotherapy. In this double-blind study, we randomly assigned

  16. Disorganized junior doctors fail the MRCP (UK).

    Science.gov (United States)

    Stanley, Adrian G; Khan, Khalid M; Hussain, Walayat; Tweed, Michael

    2006-02-01

    Career progression during undergraduate and early postgraduate years is currently determined by successfully passing examinations. Both academic factors (secondary school examination results, learning style and training opportunities) and non-academic factors (maturity, ethnic origin, gender and motivation) have been identified as predicting examination outcome. Few studies have examined organization skills. Disorganized medical students are more likely to perform poorly in end-of-year examinations but this observation has not been examined in junior doctors. This study asked whether organization skills relate to examination outcome amongst junior doctors taking the clinical Part II examination for the Membership of the Royal College of Physicians (Practical Assessment of Clinical Examination Skills). The study was conducted prospectively at four consecutive clinical courses that provided clinical teaching and practice to prepare trainees for the examination. Arrival time at registration for the course was the chosen surrogate for organization skills. Trainees were advised that they should arrive promptly at 8.00 a.m. for registration and it was explained that the course would start at 8.30 a.m. Recorded arrival times were compared with the pass lists published by the Royal College of Physicians. The mean arrival time was 8.17 a.m. A total of 81 doctors (53.3%) passed the examination with a mean arrival time of 8.14 a.m. However, 71 doctors failed the exam and arrived, on average, six minutes later than doctors who passed (p?=?0.006). Better-prepared junior doctors were more likely to pass the final examination. Arriving on time represents a composite of several skills involved in the planning of appropriate travel arrangements and is therefore a valid marker of organization skills and preparation. This novel study has shown that good time-keeping skills are positively associated with examination outcome.

  17. Secondary recurrent miscarriage is associated with previous male birth.

    LENUS (Irish Health Repository)

    Ooi, Poh Veh

    2012-01-31

    Secondary recurrent miscarriage (RM) is defined as three or more consecutive pregnancy losses after delivery of a viable infant. Previous reports suggest that a firstborn male child is associated with less favourable subsequent reproductive potential, possibly due to maternal immunisation against male-specific minor histocompatibility antigens. In a retrospective cohort study of 85 cases of secondary RM we aimed to determine if secondary RM was associated with (i) gender of previous child, maternal age, or duration of miscarriage history, and (ii) increased risk of pregnancy complications. Fifty-three women (62.0%; 53\\/85) gave birth to a male child prior to RM compared to 32 (38.0%; 32\\/85) who gave birth to a female child (p=0.002). The majority (91.7%; 78\\/85) had uncomplicated, term deliveries and normal birth weight neonates, with one quarter of the women previously delivered by Caesarean section. All had routine RM investigations and 19.0% (16\\/85) had an abnormal result. Fifty-seven women conceived again and 33.3% (19\\/57) miscarried, but there was no significant difference in failure rates between those with a previous male or female child (13\\/32 vs. 6\\/25, p=0.2). When patients with abnormal results were excluded, or when women with only one previous child were considered, there was still no difference in these rates. A previous male birth may be associated with an increased risk of secondary RM but numbers preclude concluding whether this increases recurrence risk. The suggested association with previous male birth provides a basis for further investigations at a molecular level.

  18. Secondary recurrent miscarriage is associated with previous male birth.

    LENUS (Irish Health Repository)

    Ooi, Poh Veh

    2011-01-01

    Secondary recurrent miscarriage (RM) is defined as three or more consecutive pregnancy losses after delivery of a viable infant. Previous reports suggest that a firstborn male child is associated with less favourable subsequent reproductive potential, possibly due to maternal immunisation against male-specific minor histocompatibility antigens. In a retrospective cohort study of 85 cases of secondary RM we aimed to determine if secondary RM was associated with (i) gender of previous child, maternal age, or duration of miscarriage history, and (ii) increased risk of pregnancy complications. Fifty-three women (62.0%; 53\\/85) gave birth to a male child prior to RM compared to 32 (38.0%; 32\\/85) who gave birth to a female child (p=0.002). The majority (91.7%; 78\\/85) had uncomplicated, term deliveries and normal birth weight neonates, with one quarter of the women previously delivered by Caesarean section. All had routine RM investigations and 19.0% (16\\/85) had an abnormal result. Fifty-seven women conceived again and 33.3% (19\\/57) miscarried, but there was no significant difference in failure rates between those with a previous male or female child (13\\/32 vs. 6\\/25, p=0.2). When patients with abnormal results were excluded, or when women with only one previous child were considered, there was still no difference in these rates. A previous male birth may be associated with an increased risk of secondary RM but numbers preclude concluding whether this increases recurrence risk. The suggested association with previous male birth provides a basis for further investigations at a molecular level.

  19. Arteriojejunal Fistula Presenting with Recurrent Obscure GI Hemorrhage in a Patient with a Failed Pancreas Allograft

    Directory of Open Access Journals (Sweden)

    Nirmit Desai

    2013-01-01

    Full Text Available We present a case of a patient with a failed pancreaticoduodenal allograft with exocrine enteric-drainage who developed catastrophic gastrointestinal (GI hemorrhage. Over the course of a week, she presented with recurrent GI bleeds of obscure etiology. Multiple esophago-gastro-duodenoscopic (EGD and colonoscopic evaluations failed to reveal the source of the hemorrhage. A capsule endoscopy and a technetium-labeled red blood cells (RBC imaging study were similarly unrevealing for source of bleeding. She subsequently developed hemorrhagic shock requiring emergent superior mesenteric arteriography. Run off images revealed an external iliac artery aneurysm with fistulization into the jejunum. Coiled embolization was attempted but abandoned because of hemodynamic instability. Deployment of a covered endovascular stent into the right external iliac artery over the fistula site resulted in immediate hemodynamic stabilization. A high index of suspicion for arterioenteric fistulae is needed for diagnosis of this uncommon but eminently treatable form of GI hemorrhage in this patient population.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-10-15

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

  1. The effect of platelet-rich plasma injection on lateral epicondylitis following failed conservative management.

    Science.gov (United States)

    Brkljac, Milos; Kumar, Shyam; Kalloo, Dale; Hirehal, Kiran

    2015-12-01

    We assessed the effect PRP injection on pain and function in patients with lateral epicondylitis where conservative management had failed. We prospectively reviewed 34 patients. The mean follow-up was 26 weeks (range 6-114 weeks). We used the Oxford Elbow Score (OES) and progression to surgery to assess outcomes. 88.2% improved their OES. 8.8% reported symptom progression. One patient had no change. No patients suffered adverse reactions. Two patients underwent an open release procedure. One had the injection repeated. An injection of PRP improves pain and function in patients suffering from LE where conservative management has failed.

  2. MRI as a problem-solving tool in unexplained failed total hip replacement following conventional assessment

    International Nuclear Information System (INIS)

    Johnston, Ciaran; Kerr, Jennifer; Ford, Stephanie; Eustace, Stephen; O'Byrne, John

    2007-01-01

    To evaluate MRI as a problem-solving tool for patients with an unexplained failed total hip replacement following conventional radiological assessment. Patients' informed consent was obtained in all cases. Institutional review board approval was obtained. Twenty-eight patients with unexplained failed total hip replacements following conventional radiological assessment underwent additional MR imaging with an optimised turbo-spin echo sequence. Images were reviewed by two musculoskeletal radiologists by consensus and compared with findings at surgery, or following response to image-guided intervention or clinical follow-up. Of the 28 patients, MRI revealed an unsuspected diagnosis explaining the cause of prosthesis failure in 15 patients. In eight of 15 patients in this group, subsequent minimally invasive image-guided intervention obviated the need for revision total hip replacement. No cause for prosthesis failure was identified in 13 patients. MRI may be successfully undertaken in patients following total hip replacement, and, when performed, it frequently leads to an unsuspected diagnosis, allowing informed patient treatment. In this study it allowed the identification of an unsuspected diagnosis in over 50% of cases. (orig.)

  3. Intralesional Osteophyte Regrowth Following Autologous Chondrocyte Implantation after Previous Treatment with Marrow Stimulation Technique.

    Science.gov (United States)

    Demange, Marco Kawamura; Minas, Tom; von Keudell, Arvind; Sodha, Sonal; Bryant, Tim; Gomoll, Andreas H

    2017-04-01

    Objective Bone marrow stimulation surgeries are frequent in the treatment of cartilage lesions. Autologous chondrocyte implantation (ACI) may be performed after failed microfracture surgery. Alterations to subchondral bone as intralesional osteophytes are commonly seen after previous microfracture and removed during ACI. There have been no reports on potential recurrence. Our purpose was to evaluate the incidence of intralesional osteophyte development in 2 cohorts: existing intralesional osteophytes and without intralesional osteophytes at the time of ACI. Study Design We identified 87 patients (157 lesions) with intralesional osteophytes among a cohort of 497 ACI patients. Osteophyte regrowth was analyzed on magnetic resonance imaging and categorized as small or large (less or more than 50% of the cartilage thickness). Twenty patients (24 defects) without intralesional osteophytes at the time of ACI acted as control. Results Osteophyte regrowth was observed in 39.5% of lesions (34.4% of small osteophytes and 5.1% of large osteophytes). In subgroup analyses, regrowth was observed in 45.8% of periosteal-covered defects and in 18.9% of collagen membrane-covered defects. Large osteophyte regrowth occurred in less than 5% in either group. Periosteal defects showed a significantly higher incidence for regrowth of small osteophytes. In the control group, intralesional osteophytes developed in 16.7% of the lesions. Conclusions Even though intralesional osteophytes may regrow after removal during ACI, most of them are small. Small osteophyte regrowth occurs almost twice in periosteum-covered ACI. Large osteophytes occur only in 5% of patients. Intralesional osteophyte formation is not significantly different in preexisting intralesional osteophytes and control groups.

  4. Management of failed rotator cuff repair: a systematic review

    Science.gov (United States)

    Lädermann, Alexandre; Denard, Patrick J; Burkhart, Stephen S

    2016-01-01

    Importance Recurrent tear after rotator cuff repair (RCR) is common. Conservative, and open and arthroscopic revisions, have been advocated to treat these failures. Aim or objective The purpose of this systematic review was to evaluate the different options for managing recurrent rotator cuff tears. Evidence review A search was conducted of level I through 4 studies from January 2000 to October 2015, to identify studies reporting on failed RCR. 10 articles were identified. The overall quality of evidence was very low. Findings Mid-term to long-term follow-up of patients treated conservatively revealed acceptable results; a persistent defect is a well-tolerated condition that only occasionally requires subsequent surgery. Conservative treatment might be indicated in most patients, particularly in case of posterosuperior involvement and poor preoperative range of motion. Revision surgery might be indicated in a young patient with a repairable lesion, a 3 tendon tear, and in those with involvement of the subscapularis. Conclusions and relevance The current review indicates that arthroscopic revision RCR can lead to improvement in functional outcome despite a high retear rate. Further studies are needed to develop specific rehabilitation in the case of primary rotator cuff failure, to better understand the place of each treatment option, and, in case of repair, to optimise tendon healing. PMID:27134759

  5. An Eleven Year Review of Failed Female Sterilisation in Ile-Ife, Nigeria

    African Journals Online (AJOL)

    An Eleven Year Review of Failed Female Sterilisation in Ile-Ife, Nigeria. ... Teaching Hospitals Complex, Ile-Ife, Nigeria from October 1 1987 to September 30 1998. ... (Tropical Journal of Obstetrics and Gynaecology, 2001, 18(1): 8-11) ...

  6. Endoscopic Ultrasound-Guided Rendezvous Technique for Failed Biliary Cannulation in Benign and Resectable Malignant Biliary Disorders.

    Science.gov (United States)

    Shiomi, Hideyuki; Yamao, Kentaro; Hoki, Noriyuki; Hisa, Takeshi; Ogura, Takeshi; Minaga, Kosuke; Masuda, Atsuhiro; Matsumoto, Kazuya; Kato, Hironari; Kamada, Hideki; Goto, Daisuke; Imai, Hajime; Takenaka, Mamoru; Noguchi, Chishio; Nishikiori, Hidefumi; Chiba, Yasutaka; Kutsumi, Hiromu; Kitano, Masayuki

    2018-03-01

    Endoscopic ultrasound-guided rendezvous technique (EUS-RV) has emerged as an effective salvage method for unsuccessful biliary cannulation. However, its application for benign and resectable malignant biliary disorders has not been fully evaluated. To assess the efficacy and safety of EUS-RV for benign and resectable malignant biliary disorders. This was a multicenter prospective study from 12 Japanese referral centers. Patients who underwent EUS-RV after failed biliary cannulation for biliary disorder were candidates for this study. Inclusion criteria were unsuccessful biliary cannulation for therapeutic endoscopic retrograde cholangiopancreatography with benign and potentially resectable malignant biliary obstruction. Exclusion criteria included unresectable malignant biliary obstruction, inaccessible papillae due to surgically altered upper gastrointestinal anatomy or duodenal stricture, and previous sphincterotomy and/or biliary stent placement. The primary outcome was the technical success rate of biliary cannulation; procedure time, adverse events, and clinical outcomes were secondary outcomes. Twenty patients were prospectively enrolled. The overall technical success rate and median procedure time were 85% and 33 min, respectively. Guidewire manipulation using a 4-Fr tapered tip catheter contributed to the success in advancing the guidewire into the duodenum. Adverse events were identified in 15% patients, including 2 with biliary peritonitis and 1 mild pancreatitis. EUS-RV did not affect surgical maneuvers or complications associated with surgery, or postoperative course. EUS-RV may be a safe and feasible salvage method for unsuccessful biliary cannulation for benign or resectable malignant biliary disorders. Use of a 4-Fr tapered tip catheter may improve the overall EUS-RV success rate.

  7. Failed induction in a rudimentary horn of uterus with sacculation: A ...

    African Journals Online (AJOL)

    Pregnancy in a non-communicating horn of the uterus, though rare should always be suspected in cases of failed ripening/induction of labour. This case revealed the significant morbidity that such patients may go through in vain attempts to deliver them vaginally. Despite the repeat Ultrasound scan and Doppler ...

  8. Failed fuel diagnosis during WWER reactor operation using the RTOP-CA code

    International Nuclear Information System (INIS)

    Likhanskii, V.; Afanasieva, E.; Sorokin, A.; Evdokimov, I.; Kanukova, V.; Khromov, A.

    2006-01-01

    The mechanistic code RTOP-CA is developed for objectives of failed fuel diagnosis during WWER reactor operation. The RTOP-CA code enables to solve a direct problem: modelling the failed fuel behavior and prediction of primary coolant activity if characteristics of failures in the reactor core are known. Results of verification of the RTOP-CA code are presented. Separate physical models were verified on small-scale in-pile and out-of-pile experiments. Integral verification cases included data obtained at research reactors and at nuclear power plants. The RTOP-CA code is used for development of a neural-network approach to the inverse problem: detection of failure characteristics on the base of data on primary coolant activity during reactor operation. Preliminary results of application of the neural-network approach for evaluation of fuel failure characteristics are presented. (authors)

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

    LENUS (Irish Health Repository)

    O'Brien, Sinead M

    2012-02-03

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

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

    International Nuclear Information System (INIS)

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

    1976-11-01

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

  11. A longitudinal study of plasma insulin and glucagon in women with previous gestational diabetes

    DEFF Research Database (Denmark)

    Damm, P; Kühl, C; Hornnes, P

    1995-01-01

    OBJECTIVE: To investigate whether plasma insulin or glucagon predicts later development of diabetes in women with gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS: The subjects studied were 91 women with diet-treated GDM and 33 healthy women. Plasma insulin and glucagon during a 50...... at follow-up (2 had insulin-dependent diabetes mellitus, 13 had non-insulin-dependent diabetes mellitus, and 12 had impaired glucose tolerance). Compared with the control subjects, women with previous GDM had relatively impaired insulin secretion (decreased insulinogenic index and delayed peak insulin...... for subsequent development of overt diabetes (logistic regression analysis). CONCLUSIONS: Women who develop GDM have a relative insulin secretion deficiency, the severity of which is predictive for later development of diabetes. Furthermore, our data indicate that their relatively reduced beta-cell function may...

  12. DOES GARP REALLY FAIL MISERABLY? A RESPONSE TO STOCKMAN ET AL. (2006)

    Science.gov (United States)

    Stockman et al. (2006) found that ecological niche models built using DesktopGARP 'failed miserably' to predict trapdoor spider (genus Promyrmekiaphila) distributions in California. This apparent failure of GARP (Genetic Algorithm for Rule-Set Production) was actually a failure ...

  13. Laparoscopic sleeve gastrectomy after failed gastric banding: is it really effective? Six years of follow-up.

    Science.gov (United States)

    Carandina, Sergio; Genser, Laurent; Bossi, Manuela; Polliand, Claude; Tabbara, Malek; Barrat, Christophe

    2017-07-01

    Laparoscopic sleeve gastrectomy (LSG) has become a valuable surgical option to rescue laparoscopic adjustable gastric banding (LAGB) failures. The aim of this study was to determine whether conversion to LSG after failed LAGB (CLSG) is a well-tolerated and effective rescue procedure compared with primary LSG (PLSG) in the long term. University hospital, France. A retrospective review of data concerning consecutive patients receiving a LSG between February 2008 and December 2014 was conducted. Mortality, postoperative complications, and weight loss outcomes were analyzed. Of 701 LSG, 601 (85.7%) were PLSG and 100 (14.3%) were CLSG. The mortality rate was 0%. Overall morbidity was comparable between the primary and conversion group (10% versus 6%, P = .27). The mean percentage of excess weight loss at 3, 36, and 72 months was 34.9%, 72.1%, and 57.2% after PLSG and 22.6%, 51.2% and 29.8% after CLSG (P<.05). The failure rate (mean percentage of excess weight loss<50%) was higher in the CLSG group during the first 5 postoperative years (P < .001) with more than two thirds of the CLSG considered as having failed at 60 months. Patients who underwent band ablation as a result of insufficient weight loss or weight regain presented the worst results after conversion to LSG. In this study, the conversion of failed LAGB to LSG in 2 steps indicated a safety profile comparable to that of primary LSG but was significantly less effective from the early postoperative course (3 mo) up to 6 years postoperatively. CLSG may not be the best option because a third operation may be needed as a result of insufficient weight loss. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  14. BLACK HOLE FORMATION IN FAILING CORE-COLLAPSE SUPERNOVAE

    International Nuclear Information System (INIS)

    O'Connor, Evan; Ott, Christian D.

    2011-01-01

    We present results of a systematic study of failing core-collapse supernovae and the formation of stellar-mass black holes (BHs). Using our open-source general-relativistic 1.5D code GR1D equipped with a three-species neutrino leakage/heating scheme and over 100 presupernova models, we study the effects of the choice of nuclear equation of state (EOS), zero-age main sequence (ZAMS) mass and metallicity, rotation, and mass-loss prescription on BH formation. We find that the outcome, for a given EOS, can be estimated, to first order, by a single parameter, the compactness of the stellar core at bounce. By comparing protoneutron star (PNS) structure at the onset of gravitational instability with solutions of the Tolman-Oppenheimer-Volkof equations, we find that thermal pressure support in the outer PNS core is responsible for raising the maximum PNS mass by up to 25% above the cold NS value. By artificially increasing neutrino heating, we find the critical neutrino heating efficiency required for exploding a given progenitor structure and connect these findings with ZAMS conditions, establishing, albeit approximately, for the first time based on actual collapse simulations, the mapping between ZAMS parameters and the outcome of core collapse. We also study the effect of progenitor rotation and find that the dimensionless spin of nascent BHs may be robustly limited below a* = Jc/GM 2 = 1 by the appearance of nonaxisymmetric rotational instabilities.

  15. Failed Induction in Second Trimester Due to Pregnancy in an Uncommunicated Rudimentary Horn: Case report

    Directory of Open Access Journals (Sweden)

    Fatemeh Bahadori

    2009-09-01

    Full Text Available Pregnancy in the rudimentary horn of uterus is rare. Uterine rupture is a rare obstetrical catastrophe that occurs before 20 weeks’ gestation in 70% of unicornate uterus cases. A 24-year-old primigravida woman was referred to our hospital due to failed induction-in-17th-weeks-of-her-pregnancy. Fetal-death was confirmed on abdominal ultrasound. Examination under-anaesthesia revealed -pregnancy-in thetrudimentary-horn.-It is concluded that careful-evaluation of probable-mullerian-anomaly-should-be-considered in every failed-induction.

  16. A study about the interest and previous contact of high school students with Astronomy

    Science.gov (United States)

    Carvalho, C. L.; Zanitti, M. H. R.; Felicidade, B. L.; Gomes, A. D. T.; Dias, E. W.; Coelho, F. O.

    2016-04-01

    The currently problems in Astronomy teaching in Brazilian Basic Education contrast with the space, and the popularity that astronomical themes have in various media in the country. In this work, we present the results of a study about the interest, and previous contact of high school students from a public school in the city of "São João del-Rei"/MG with topics related to Astronomy. The study and the pedagogical intervention were carried out by students of the PIBID/CAPES/UFSJ. The intervention was performed through an oral exposition with the students' participation, followed by the use of the Stellarium program. The results suggest the majority of students surveyed are interested in Astronomy, and have had some contact with the area. However, some inconsistencies in their responses were identified and examined. The implications for research and for Astronomy Education are discussed. We also make some considerations about relationship between the lack of specific knowledge and the misinformation as one possible reason for the little interest of students in various areas of Science.

  17. Failed healing of rotator cuff repair correlates with altered collagenase and gelatinase in supraspinatus and subscapularis tendons.

    Science.gov (United States)

    Robertson, Catherine M; Chen, Christopher T; Shindle, Michael K; Cordasco, Frank A; Rodeo, Scott A; Warren, Russell F

    2012-09-01

    Despite improvements in arthroscopic rotator cuff repair technique and technology, a significant rate of failed tendon healing persists. Improving the biology of rotator cuff repairs may be an important focus to decrease this failure rate. The objective of this study was to determine the mRNA biomarkers and histological characteristics of repaired rotator cuffs that healed or developed persistent defects as determined by postoperative ultrasound. Increased synovial inflammation and tendon degeneration at the time of surgery are correlated with the failed healing of rotator cuff tendons. Case-control study; Level of evidence, 3. Biopsy specimens from the subscapularis tendon, supraspinatus tendon, glenohumeral synovium, and subacromial bursa of 35 patients undergoing arthroscopic rotator cuff repair were taken at the time of surgery. Expression of proinflammatory cytokines, tissue remodeling genes, and angiogenesis factors was evaluated by quantitative real-time polymerase chain reaction. Histological characteristics of the affected tissue were also assessed. Postoperative (>6 months) ultrasound was used to evaluate the healing of the rotator cuff. General linear modeling with selected mRNA biomarkers was used to predict rotator cuff healing. Thirty patients completed all analyses, of which 7 patients (23%) had failed healing of the rotator cuff. No differences in demographic data were found between the defect and healed groups. American Shoulder and Elbow Surgeons shoulder scores collected at baseline and follow-up showed improvement in both groups, but there was no significant difference between groups. Increased expression of matrix metalloproteinase 1 (MMP-1) and MMP-9 was found in the supraspinatus tendon in the defect group versus the healed group (P = .006 and .02, respectively). Similar upregulation of MMP-9 was also found in the subscapularis tendon of the defect group (P = .001), which was consistent with the loss of collagen organization as determined by

  18. 75 FR 52250 - Airworthiness Directives; Aircraft Industries a.s. (Type Certificate G24EU Previously Held by...

    Science.gov (United States)

    2010-08-25

    ... wing failed near the root due to positive load. The right wing detached from the aircraft and the...[Iacute]K sailplane, in which the main spar of the right wing failed near the root due to positive load... substance. But we might have found it necessary to use different words from those in the MCAI to ensure the...

  19. Distribution of beta-adrenergic receptors in failing human myocardium. Implications for mechanisms of down-regulation

    International Nuclear Information System (INIS)

    Murphree, S.S.; Saffitz, J.E.

    1989-01-01

    The density of beta-adrenergic receptors is reduced in crude membranes prepared from failing human myocardium. We used quantitative autoradiography of radioligand binding sites in intact tissue slices to determine whether the total tissue content of receptors is reduced and to characterize the transmural distribution of receptors in cardiac myocytes and the coronary vasculature in hearts obtained from nine cardiac transplant patients with severe congestive failure. Binding of [125Iodo]cyanopindolol to transmural slices of human myocardium was rapid, saturable, stereoselective, and displaceable by agonists and antagonists with an appropriate rank order of potency. Binding isotherms in four normal and nine failing ventricles showed a significant reduction in the total tissue content of beta-receptors in failing myocardium (38.3 +/- 2.0 fmol/mg protein) compared with normal tissue (52.4 +/- 1.7 fmol/mg protein, p = 0.038). In the normal ventricles, the greatest receptor density was observed autoradiographically in myocytic regions of the subendocardium. Receptor density of the coronary arterioles was approximately 70% of that in adjacent myocytic regions. The density of binding sites in both myocytic regions and arterioles was diminished in all regions of the failing ventricles, but down-regulation was due primarily to a selective reduction of beta-receptors of subendocardial myocytes (63 +/- 5% of subepicardial receptor density vs. 115 +/- 6% in controls, p less than 0.0001). These observations indicate that down-regulation occurs nonuniformly in the transmural distribution and thus is likely not related simply to elevated circulating catecholamine levels

  20. Ifosfamide in previously untreated disseminated neuroblastoma. Results of Study 3A of the European Neuroblastoma Study Group.

    Science.gov (United States)

    Kellie, S J; De Kraker, J; Lilleyman, J S; Bowman, A; Pritchard, J

    1988-05-01

    A prospective study of the effectiveness of ifosfamide as a single agent in the management of previously untreated patients with Evans stage IV neuroblastoma was undertaken. Eighteen children aged more than 1 year were treated with ifosfamide (IFX) 3 g/m2 daily for 2 days immediately after diagnosis and 3 weeks later. Treatment was continued with combination chemotherapy using vincristine, cyclophosphamide, cisplatinum and etoposide (OPEC) or a variant. Mesna (2-mercaptoethane sulphonate) was given to all patients during IFX treatment to prevent urotoxicity. Eight of the 18 patients (44%) responded to IFX. Nine had greater than 66% reduction in baseline tumor volume. Of 15 evaluable patients with raised pre-treatment urinary catecholamine excretion, six (40%) achieved greater than 50% reduction in pretreatment levels. Two of 10 patients evaluable for bone marrow response had complete clearance. Toxicity was mild in all patients. Upon completing 'first line' therapy, only four patients (22%) achieved a good partial remission (GPR) or complete response (CR). Median survival was 11 months. There was a lower rate of attaining GPR and shortened median survival in patients receiving phase II IFX before OPEC or variant, compared to patients with similar pre-treatment characteristics treated with OPEC from diagnosis in an earlier study.

  1. Why have we failed to cure Alzheimer's disease?

    Science.gov (United States)

    Korczyn, Amos D

    2012-01-01

    There is widespread recognition in the urgency to understand the causes and mechanisms of senile dementia. Attempts to find cures for Alzheimer's disease (AD) have, however, failed so far, in spite of enormous investments, intellectual and financial. We therefore have to reconsider the problem from new angles. AD is regarded as a disease because of its clinical manifestations and underlying pathology. However, this combination does not define a disease but rather a syndrome, just like hepatic cirrhosis in which liver pathology causes metabolic changes, but which can result from many different etiologies. It is unlikely that attacking a downstream phenomenon, like apoptosis or amyloid-β accumulation, can cure AD, or prevent the progression of the disease. It is probable that senile dementia is the result of a combination of several processes, working differently in each person. Epidemiological studies have identified many risk factors for "senile dementia of the Alzheimer type", some genetic but most environmental and therefore modifiable. Thus, a concerted action to fight the dementia epidemic must be made by aggressive action against its risk factors, and this battle must begin in midlife, not in old age.

  2. Sezary syndrome cells unlike normal circulating T lymphocytes fail to migrate following engagement of NT1 receptor.

    Science.gov (United States)

    Magazin, Marilyn; Poszepczynska-Guigné, Ewa; Bagot, Martine; Boumsell, Laurence; Pruvost, Christelle; Chalon, Pascale; Culouscou, Jean-Michel; Ferrara, Pascual; Bensussan, Armand

    2004-01-01

    Circulating malignant Sezary cells are a clonal proliferation of CD4+CD45RO+ T lymphocytes primarily involving the skin. To study the biology of these malignant T lymphocytes, we tested their ability to migrate in chemotaxis assays. Previously, we had shown that the neuropeptide neurotensin (NT) binds to freshly isolated Sezary malignant cells and induces through NT1 receptors the cell migration of the cutaneous T cell lymphoma cell line Cou-L. Here, we report that peripheral blood Sezary cells as well as the Sezary cell line Pno fail to migrate in response to neurotensin although they are capable of migrating to the chemokine stromal-cell-derived factor 1 alpha. This is in contrast with normal circulating CD4+ or CD8+ lymphocytes, which respond to both types of chemoattractants except after ex vivo short-time anti-CD3 monoclonal antibody activation, which abrogates the neurotensin-induced lymphocyte migration. Furthermore, we demonstrate that neurotensin-responsive T lymphocytes express the functional NT1 receptor responsible for chemotaxis. In these cells, but not in Sezary cells, neurotensin induces recruitment of phosphatidylinositol-3 kinase, and redistribution of phosphorylated cytoplasmic tyrosine kinase focal adhesion kinase and filamentous actin. Taken together, these results, which show functional distinctions between normal circulating lymphocytes and Sezary syndrome cells, contribute to further understanding of the physiopathology of these atypical cells.

  3. Designed to Fail: Modeling Terrorism’s Losing Battle

    Directory of Open Access Journals (Sweden)

    Giti Zahedzadeh

    2017-05-01

    Full Text Available Terrorism is costly and unlikely to survive any selection process that favors behaviors with higher payoffs. Our evolutionary game model and agent based computer simulations show that group benefits offset the within-group behavioral selection against terrorism. Only those displaying the fittest strategy choices will thrive and multiply. By increasing the number of alliances and the size of their membership, terror groups can contribute to their longevity. Fitness reducing strategies fail to pass on to the new generation. We conclude that costly terror campaigns may reduce popular support among terror organizations’ potential constituency and thus, hasten the demise of terror groups.

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

    Directory of Open Access Journals (Sweden)

    Scherer, F. M.

    2010-12-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  6. Some methods of failed fuel element detection in water cooled reactors

    International Nuclear Information System (INIS)

    Strindehag, O.M.

    1976-01-01

    The methods are surveyed using fission products released in the coolant for the detection of failed fuel elements in water cooled reactors. The classification of the detection methods is made with respect to fission product detection in the coolant and to gaseous fission product detection. The detection systems are listed used for the AGESTA power reactor and for the experimental loops of the RA research reactor based on the detection of either gaseous fission products or gaseous daughter products. The AGESTA reactor detection systems using electrostatic precipitators consist of five precipitator channels of which three are intended for detection and two for localization. A special detection unit was developed for the failed fuel element detection in the R-2 reactor experimental steam loop. Its description is listed. In the reactor pressurized-water loop a Cherenkov counter was used in the detection of fission products. An ion exchange monitor whose application is described was used in the total measurement of the main coolant flow in the AGESTA reactor. (J.P.)

  7. A New Animal Model for Investigation of Mechanical Unloading in Hypertrophic and Failing Hearts: Combination of Transverse Aortic Constriction and Heterotopic Heart Transplantation.

    Directory of Open Access Journals (Sweden)

    Andreas Schaefer

    Full Text Available Previous small animal models for simulation of mechanical unloading are solely performed in healthy or infarcted hearts, not representing the pathophysiology of hypertrophic and dilated hearts emerging in heart failure patients. In this article, we present a new and economic small animal model to investigate mechanical unloading in hypertrophic and failing hearts: the combination of transverse aortic constriction (TAC and heterotopic heart transplantation (hHTx in rats.To induce cardiac hypertrophy and failure in rat hearts, three-week old rats underwent TAC procedure. Three and six weeks after TAC, hHTx with hypertrophic and failing hearts in Lewis rats was performed to induce mechanical unloading. After 14 days of mechanical unloading animals were euthanatized and grafts were explanted for further investigations.50 TAC procedures were performed with a survival of 92% (46/50. When compared to healthy rats left ventricular surface decreased to 5.8±1.0 mm² (vs. 9.6± 2.4 mm² (p = 0.001 after three weeks with a fractional shortening (FS of 23.7± 4.3% vs. 28.2± 1.5% (p = 0.01. Six weeks later, systolic function decreased to 17.1± 3.2% vs. 28.2± 1.5% (p = 0.0001 and left ventricular inner surface increased to 19.9±1.1 mm² (p = 0.0001. Intraoperative graft survival during hHTx was 80% with 46 performed procedures (37/46. All transplanted organs survived two weeks of mechanical unloading.Combination of TAC and hHTx in rats offers an economic and reproducible small animal model enabling serial examination of mechanical unloading in a truly hypertrophic and failing heart, representing the typical pressure overloaded and dilated LV, occurring in patients with moderate to severe heart failure.

  8. Youth suicide: an insight into previous hospitalisation for injury and sociodemographic conditions from a nationwide cohort study.

    Science.gov (United States)

    Zambon, Francesco; Laflamme, Lucie; Spolaore, Paolo; Visentin, Cristiana; Hasselberg, Marie

    2011-06-01

    This study investigates the degree to which a previous hospitalisation for injury of any intent is a risk of subsequent youth suicide and whether this association is influenced by family socioeconomic status or economic stress. A nationwide register-based cohort study was conducted covering all Swedish subjects born between January 1977 and December 1991 (N=1,616,342, male/female ratio=1.05). The cohort subjects were followed-up from January 1998 to December 2003, when aged 7-26 years. Poisson regression and the likelihood ratio test (95% CI) were used to assess the age-adjusted effect of hospitalisation for injuries of various intent on youth suicide and its effect once adjusted for family sociodemographic and social circumstances. Each set of exposures was associated independently and significantly with suicide mortality. Being hospitalised for self-inflicted injuries or injuries of undetermined intent was associated with a risk of suicide 36 to 47 times, respectively, that of subjects never hospitalised in the period under study (95% CI 28.36 to 45.58 and 26.67 to 83.87 for self-inflicted injuries and for events of undetermined intent, respectively; overall psuicide (RR 3.08; 95% CI 2.26 to 4.19). These effects were solid and not substantially altered after adjustment for family demographic and socioeconomic circumstances. A strong association exists between previous hospitalisation for injury of any intent and youth suicide. The association is robust and unaltered by family socioeconomic circumstances.

  9. 75 FR 39795 - Airworthiness Directives; Aircraft Industries a.s. (Type Certificate G60EU Previously Held by...

    Science.gov (United States)

    2010-07-13

    ... failed near the root due to positive load. The right wing detached from the aircraft and the pilots lost... spar of the right wing failed near the root due to positive load. The right wing detached from the... have found it necessary to use different words from those in the MCAI to ensure the AD is clear for U.S...

  10. Limb Salvage After Failed Initial Operative Management of Bimalleolar Ankle Fractures in Diabetic Neuropathy.

    Science.gov (United States)

    Vaudreuil, Nicholas J; Fourman, Mitchell S; Wukich, Dane K

    2017-03-01

    Ankle fractures in patients with diabetes mellitus (DM) can be difficult to manage, especially in the presence of peripheral neuropathy. In patients who fail initial operative management, attempts at limb salvage can be challenging, and no clear treatment algorithm exists. This study examined outcomes of different procedures performed for limb salvage in this population. This study retrospectively reviewed 17 patients with DM complicated by peripheral neuropathy who sustained a bimalleolar ankle fracture and failed initial operative management. Patients were treated with revision open reduction internal fixation (ORIF) (3/17), closed reduction external fixation (CREF) (8/17), or primary ankle joint fusion (3/17 tibiotalocalcaneal fusion with hindfoot nail [TTCN] and 3/17 with tibiotalar arthrodesis using plates and screws [TTA]). Median follow-up was 20 months. The overall rate of limb salvage was 82.3% (14/17). All patients who went on to amputation presented with infection and were treated initially with CREF (3/3). All patients who achieved successful limb salvage ended up with a clinically fused ankle joint (14/14); 9 underwent a primary or delayed formal fusion and 5 had a clinically fused ankle joint at study conclusion after undergoing revision ORIF or CREF with adjunctive procedures. This small study suggests that in this complicated group of patients it is difficult to achieve limb salvage with an end result of a functional ankle joint. CREF can be a viable option in cases where underlying infection or poor bone quality is present. Treatment with revision ORIF frequently requires supplementary external fixator or tibiotalar Steinman pin placement for additional stability. All patients who underwent revision ORIF ended up with clinically fused ankle joints at the end of the study period. Primary fusion procedures (TTA, TTCN) were associated with a high rate of limb salvage and a decreased number of operations. Level III, retrospective case series.

  11. A Physical Model of Mass Ejection in Failed Supernovae

    Science.gov (United States)

    Coughlin, Eric R.; Quataert, Eliot; Fernández, Rodrigo; Kasen, Daniel

    2018-03-01

    During the core collapse of massive stars, the formation of the protoneutron star is accompanied by the emission of a significant amount of mass-energy (˜0.3 M⊙) in the form of neutrinos. This mass-energy loss generates an outward-propagating pressure wave that steepens into a shock near the stellar surface, potentially powering a weak transient associated with an otherwise-failed supernova. We analytically investigate this mass-loss-induced wave generation and propagation. Heuristic arguments provide an accurate estimate of the amount of energy contained in the outgoing sound pulse. We then develop a general formalism for analyzing the response of the star to centrally concentrated mass loss in linear perturbation theory. To build intuition, we apply this formalism to polytropic stellar models, finding qualitative and quantitative agreement with simulations and heuristic arguments. We also apply our results to realistic pre-collapse massive star progenitors (both giants and compact stars). Our analytic results for the sound pulse energy, excitation radius, and steepening in the stellar envelope are in good agreement with full time-dependent hydrodynamic simulations. We show that prior to the sound pulses arrival at the stellar photosphere, the photosphere has already reached velocities ˜20 - 100% of the local sound speed, thus likely modestly decreasing the stellar effective temperature prior to the star disappearing. Our results provide important constraints on the physical properties and observational appearance of failed supernovae.

  12. Integrated identification and control for nanosatellites reclaiming failed satellite

    Science.gov (United States)

    Han, Nan; Luo, Jianjun; Ma, Weihua; Yuan, Jianping

    2018-05-01

    Using nanosatellites to reclaim a failed satellite needs nanosatellites to attach to its surface to take over its attitude control function. This is challenging, since parameters including the inertia matrix of the combined spacecraft and the relative attitude information of attached nanosatellites with respect to the given body-fixed frame of the failed satellite are all unknown after the attachment. Besides, if the total control capacity needs to be increased during the reclaiming process by new nanosatellites, real-time parameters updating will be necessary. For these reasons, an integrated identification and control method is proposed in this paper, which enables the real-time parameters identification and attitude takeover control to be conducted concurrently. Identification of the inertia matrix of the combined spacecraft and the relative attitude information of attached nanosatellites are both considered. To guarantee sufficient excitation for the identification of the inertia matrix, a modified identification equation is established by filtering out sample points leading to ill-conditioned identification, and the identification performance of the inertia matrix is improved. Based on the real-time estimated inertia matrix, an attitude takeover controller is designed, the stability of the controller is analysed using Lyapunov method. The commanded control torques are allocated to each nanosatellite while the control saturation constraint being satisfied using the Quadratic Programming (QP) method. Numerical simulations are carried out to demonstrate the feasibility and effectiveness of the proposed integrated identification and control method.

  13. A physical model of mass ejection in failed supernovae

    Science.gov (United States)

    Coughlin, Eric R.; Quataert, Eliot; Fernández, Rodrigo; Kasen, Daniel

    2018-06-01

    During the core collapse of massive stars, the formation of the proto-neutron star is accompanied by the emission of a significant amount of mass energy (˜0.3 M⊙) in the form of neutrinos. This mass-energy loss generates an outward-propagating pressure wave that steepens into a shock near the stellar surface, potentially powering a weak transient associated with an otherwise-failed supernova. We analytically investigate this mass-loss-induced wave generation and propagation. Heuristic arguments provide an accurate estimate of the amount of energy contained in the outgoing sound pulse. We then develop a general formalism for analysing the response of the star to centrally concentrated mass loss in linear perturbation theory. To build intuition, we apply this formalism to polytropic stellar models, finding qualitative and quantitative agreement with simulations and heuristic arguments. We also apply our results to realistic pre-collapse massive star progenitors (both giants and compact stars). Our analytic results for the sound pulse energy, excitation radius, and steepening in the stellar envelope are in good agreement with full time-dependent hydrodynamic simulations. We show that prior to the sound pulses arrival at the stellar photosphere, the photosphere has already reached velocities ˜ 20-100 per cent of the local sound speed, thus likely modestly decreasing the stellar effective temperature prior to the star disappearing. Our results provide important constraints on the physical properties and observational appearance of failed supernovae.

  14. National Courts of Last Instance Failing to Make a Preliminary Reference

    DEFF Research Database (Denmark)

    Broberg, Morten

    2016-01-01

    are the consequences if a Member State court fails to make a preliminary reference in a situation where it was legally obliged to do so? The article shows that such failure may constitute an infringement of the right to a fair trial as laid down in Article 6(1) of the European Convention of Human Rights. It may also...

  15. Why nuclear power failed the market test in the UK

    International Nuclear Information System (INIS)

    Chesshire, J.

    1992-01-01

    The Conservative Party's manifesto for the general election of May 1987 contained two pledges of relevance to the UK electricity supply industry (ESI). These were to privatize the industry; and to continue to support the development of civil nuclear power in the private sector. As anticipated by some independent commentators, in the event these objectives proved incompatible. The costs of nuclear power have long been a vexed issue and UK nuclear costs have been higher than those in many other countries. While most of the UK ESI has now been privatized, nuclear generation remains in the public sector. This article seeks to explore the reasons for this fundamental and politically embarrassing policy reversal, a rarity under three successive Conservative administrations since 1979. It would be incorrect to argue that private ownership and nuclear power are inherently incompatible. Rather the specific - competitive - form of privatization proposed for the UK failed to provide sufficient guarantees for the London capital market. Thus, at least in this specific case, nuclear power failed the market test. The implications of this for the UK nuclear industry have been profound. As a result, the UK case has wider international lessons as the pressures for privatization, liberalization and greater cost transparency bear down upon electric utilities in other countries. (author)

  16. Outcome of trial of scar in patients with previous caesarean section

    International Nuclear Information System (INIS)

    Khan, B.; Bashir, R.; Khan, W.

    2016-01-01

    Medical evidence indicates that 60-80% of women can achieve vaginal delivery after a previous lower segment caesarean section. Proper selection of patients for trial of scar and vigilant monitoring during labour will achieve successful maternal and perinatal outcome. The objective of our study is to establish the fact that vaginal delivery after one caesarean section has a high success rate in patients with previous one caesarean section for non-recurrent cause. Methods: The study was conducted in Ayub Teaching Abbottabad, Gynae-B Unit. All labouring patients, during the study period of five years, with previous one caesarean section and between 37 weeks to 41 weeks of gestation for a non-recurrent cause were included in the study. Data was recorded on special proforma designed for the purpose. Patients who had previous classical caesarean section, more than one caesarean section, and previous caesarean section with severe wound infection, transverse lie and placenta previa in present pregnancy were excluded. Foetal macrosomia (wt>4 kg) and severe IUGR with compromised blood flow on Doppler in present pregnancy were also not considered suitable for the study. Patients who had any absolute contraindication for vaginal delivery were also excluded. Results: There were 12505 deliveries during the study period. Total vaginal deliveries were 8790 and total caesarean sections were 3715. Caesarean section rate was 29.7%. Out of these 8790 patients, 764 patients were given a trial of scar and 535 patients delivered successfully vaginally (70%). Women who presented with spontaneous onset of labour were more likely to deliver vaginally (74.8%) as compared to induction group (27.1%). Conclusion: Trial of vaginal birth after caesarean (VBAC) in selected cases has great importance in the present era of the rising rate of primary caesarean section. (author)

  17. Sudden unexpected death in children with a previously diagnosed cardiovascular disorder

    NARCIS (Netherlands)

    Polderman, Florens N.; Cohen, Joeri; Blom, Nico A.; Delhaas, Tammo; Helbing, Wim A.; Lam, Jan; Sobotka-Plojhar, Marta A.; Temmerman, Arno M.; Sreeram, Narayanswani

    2004-01-01

    BACKGROUND: It is known that children with previously diagnosed heart defects die suddenly. The causes of death are often unknown. OBJECTIVE: The aim of the study was to identify all infants and children within the Netherlands with previously diagnosed heart disease who had a sudden unexpected death

  18. Sudden unexpected death in children with a previously diagnosed cardiovascular disorder

    NARCIS (Netherlands)

    Polderman, F.N.; Cohen, Joeri; Blom, N.A.; Delhaas, T.; Helbing, W.A.; Lam, J.; Sobotka-Plojhar, M.A.; Temmerman, Arno M.; Sreeram, N.

    2004-01-01

    Background: It is known that children with previously diagnosed heart defects die suddenly. The causes of death are often unknown. Objective: The aim of the study was to identify all infants and children within the Netherlands with previously diagnosed heart disease who had a sudden unexpected death

  19. Failed manual removal of the placenta after vaginal delivery

    DEFF Research Database (Denmark)

    Bjurström, Johanna; Collins, Sally; Langhoff-Roos, Jens

    2018-01-01

    PURPOSE: A retained placenta after vaginal delivery where manual removal of placenta fails is a clinical challenge. We present six cases that illustrate the heterogeneity of the condition and discuss the etiology and terminology as well as the clinical management. METHODS: Members of the European...... and the UK provide examples of various treatment strategies such as ultrasound-guided vaginal removal, removal of the placenta through a hysterotomy and just leaving the placenta in situ. The placentas were all retained, but it was only possible to diagnose abnormal invasion in the one case, which had...

  20. Phase II open-label study of nintedanib in patients with recurrent glioblastoma multiforme

    DEFF Research Database (Denmark)

    Muhic, Aida; Poulsen, Hans Skovgaard; Mau-Sørensen, Paul Morten

    2013-01-01

    glioblastoma multiforme (GBM) who had previously failed radiotherapy plus temozolomide as first-line therapy (STUPP), or the same regimen with subsequent bevacizumab-based therapy as second-line treatment (BEV). Patients with a performance status of 0-1, histologically proven GBM, and measurable disease (by...... GBM who had failed 1-2 prior lines of therapy....

  1. 'Normal' and 'failing' mothers: Women's constructions of maternal subjectivity while living with multiple sclerosis.

    Science.gov (United States)

    Parton, Chloe; Katz, Terri; Ussher, Jane M

    2017-10-01

    Multiple sclerosis causes physical and cognitive impairment that can impact women's experiences of motherhood. This study examined how women construct their maternal subjectivities, or sense of self as a mother, drawing on a framework of biographical disruption. A total of 20 mothers with a multiple sclerosis diagnosis took part in semi-structured interviews. Transcripts were analysed using thematic decomposition to identify subject positions that women adopted in relation to cultural discourses of gender, motherhood and illness. Three main subject positions were identified: 'The Failing Mother', 'Fear of Judgement and Burdening Others' and 'The Normal Mother'. Women's sense of self as the 'Failing Mother' was attributed to the impact of multiple sclerosis, contributing to biographical disruption and reinforced through 'Fear of Judgement and Burdening Others' within social interactions. In accounts of the 'Normal Mother', maternal subjectivity was renegotiated by adopting strategies to manage the limitations of multiple sclerosis on mothering practice. This allowed women to self-position as 'good' mothers. Health professionals can assist women by acknowledging the embodied impact of multiple sclerosis on maternal subjectivities, coping strategies that women employ to address potential biographical disruption, and the cultural context of mothering, which contributes to women's experience of subjectivity and well-being when living with multiple sclerosis.

  2. Periodontitis in older Swedish individuals fails to predict mortality.

    Science.gov (United States)

    Renvert, Stefan; Wallin-Bengtsson, Viveca; Berglund, Johan; Persson, Rutger G

    2015-03-01

    This study aims to assess mortality risk and its association to health aspects in dentate individuals 60 years of age and older. Medical and periodontal data from 870 dentate individuals (age range 60–96) participating in the Swedish National Study on Aging and Care in Blekinge (SNACBlekinge)with survival statistics over 6 years were studied. During 6 years of follow-up, 42/474 of the individuals(8.9 %), who at baseline were between age 60 and 75, and 134/396 individuals of the individuals (33.9 %), who at baseline were ≥75 years, died. Surviving dentate individuals had more teeth (mean 19.3, S.D.±7.9) than those who died (mean 15.9,S.D.±7.3; mean diff 3,3; S.E. mean diff 0.7; 95 % CI 2.0, 4.6;p=0.001). A self-reported history of high blood pressure (F=15.0, pheart failure (F=24.5, pheart disease, diabetes, any form of cancer,or periodontitis failed to predict mortality. A self-reported history of angina pectoris, chronic heart failure, elevated serum HbA1c, and few remaining teeth were associated with mortality risk. A professional diagnosis of cardiovascular disease, diabetes, cancer, or periodontitis was not predictive of mortality. Self-health reports are important to observe in the assessment of disease and survival in older individual.

  3. SU-E-T-479: IMRT Plan Recalculation in Patient Based On Dynalog Data and the Effect of a Single Failing MLC Motor

    International Nuclear Information System (INIS)

    Morcos, M; Mitrou, E

    2015-01-01

    Purpose: Using Linac dynamic logs (Dynalogs) we evaluate the impact of a single failing MLC motor on the deliverability of an IMRT plan by assessing the recalculated dose volume histograms (DVHs) taking the delivered MLC positions and beam hold-offs into consideration. Methods: This is a retrospective study based on a deteriorating MLC motor (leaf 36B) which was observed to be failing via Dynalog analysis. To investigate further, Eclipse-importable MLC files were generated from Dynalogs to recalculate the actual delivered dose and to assess the clinical impact through DVHs. All deliveries were performed on a Varian 21EX linear accelerator equipped with Millennium-120 MLC. The analysis of Dynalog files and subsequent conversion to Eclipse-importable MLC files were all performed by in-house programming in Python. Effects on plan DVH are presented in the following section on a particular brain-IMRT plan which was delivered with a failing MLC motor which was then replaced. Results: Global max dose increased by 13.5%, max dose to the brainstem PRV increased by 8.2%, max dose to the optic chiasm increased by 7.6%, max dose to optic nerve increased by 8.8% and the mean dose to the PTV increased by 7.9% when comparing the original plan to the fraction with the failing MLC motor. The reason the dose increased was due to the failure being on the B-bank which is the lagging side on a sliding window delivery, therefore any failures on this side will cause an over-irradiation as the B-bank leaves struggles to keep the window from growing. Conclusion: Our findings suggest that a single failing MLC motor may jeopardize the entire delivery. This may be due to the bad MLC motor drawing too much current causing all MLCs on the same bank to underperform. This hypothesis will be investigated in a future study

  4. SU-E-T-479: IMRT Plan Recalculation in Patient Based On Dynalog Data and the Effect of a Single Failing MLC Motor

    Energy Technology Data Exchange (ETDEWEB)

    Morcos, M [Vantage Oncology, San Bernardino, CA (United States); Mitrou, E [Centre Hospitalier de l’Universite de Montreal, Montreal, QC (Canada)

    2015-06-15

    Purpose: Using Linac dynamic logs (Dynalogs) we evaluate the impact of a single failing MLC motor on the deliverability of an IMRT plan by assessing the recalculated dose volume histograms (DVHs) taking the delivered MLC positions and beam hold-offs into consideration. Methods: This is a retrospective study based on a deteriorating MLC motor (leaf 36B) which was observed to be failing via Dynalog analysis. To investigate further, Eclipse-importable MLC files were generated from Dynalogs to recalculate the actual delivered dose and to assess the clinical impact through DVHs. All deliveries were performed on a Varian 21EX linear accelerator equipped with Millennium-120 MLC. The analysis of Dynalog files and subsequent conversion to Eclipse-importable MLC files were all performed by in-house programming in Python. Effects on plan DVH are presented in the following section on a particular brain-IMRT plan which was delivered with a failing MLC motor which was then replaced. Results: Global max dose increased by 13.5%, max dose to the brainstem PRV increased by 8.2%, max dose to the optic chiasm increased by 7.6%, max dose to optic nerve increased by 8.8% and the mean dose to the PTV increased by 7.9% when comparing the original plan to the fraction with the failing MLC motor. The reason the dose increased was due to the failure being on the B-bank which is the lagging side on a sliding window delivery, therefore any failures on this side will cause an over-irradiation as the B-bank leaves struggles to keep the window from growing. Conclusion: Our findings suggest that a single failing MLC motor may jeopardize the entire delivery. This may be due to the bad MLC motor drawing too much current causing all MLCs on the same bank to underperform. This hypothesis will be investigated in a future study.

  5. After Big Data Failed: The Enduring Allure of Numbers in the Wake of the 2016 US Election

    Directory of Open Access Journals (Sweden)

    Yanni Loukissas

    2017-02-01

    Full Text Available When widespread polling failed to accurately predict the 2016 US presidential election, producers and consumers of data didn’t abandon faith in numbers. Instead, they have reconfigured their relationships with big data. Producers are formulating redemption narratives, blaming specific datasets or poor interpretation, and the broader reception looks similar. Seeking an explanation for Trump’s unexpected victory, news audiences are calling out failed pre-election polling numbers, while at the same time embracing empirically dubious exit polls. This Critical Engagement piece argues that Science and Technology Studies scholarship has prepared us to see that polling errors would not undo the prestige and power of quantitative methods, but rather reveal the intensity of our attachment to data as a readily available arbiter. We show that data’s ambivalent qualities make it a durable ground for claims-making, with the capacity to be mobilized to do different kinds of work: blame, exoneration, and broader sense-making.

  6. Endovascular recanalization of native chronic total occlusions in patients with failed lower-extremity bypass grafts.

    Science.gov (United States)

    Wrigley, Clinton W; Vance, Ansar; Niesen, Timothy; Grilli, Christopher; Velez, J Daniel; Agriantonis, Demetrios J; Kimbiris, George; Garcia, Mark J; Leung, Daniel A

    2014-09-01

    To investigate the feasibility, safety, and outcome of endovascular recanalization of native chronic total occlusions (CTOs) in patients with failed lower-extremity bypass grafts. Retrospective review of 19 limbs in 18 patients with failed lower-extremity bypass grafts that underwent recanalization of native arterial occlusions between February 2009 and April 2013 was performed. Nine of the limbs presented with acute ischemia and 10 presented with chronic ischemia, including eight with critical limb ischemia and two with disabling claudication. The mean patency of the failed bypass grafts (63% venous) was 27 months. All limbs had Transatlantic Inter-Society Consensus class D lesions involving the native circulation. Technical success of the endovascular recanalization procedure was achieved in all but one limb (95%). The mean ankle brachial indices before and after treatment were 0.34 and 0.73, respectively. There were no major complications or emergency amputations. Mean patient follow-up was 64 weeks, and two patients were lost to follow-up. Primary patency rates at 3, 6, and 12 months were 87%, 48%, and 16%, respectively. Successful secondary procedures were performed in seven patients, with secondary patency rates at 3, 6, and 12 months of 88%, 73%, and 44%, respectively. Limb salvage rates at 12 and 24 months were 94% and 65%, and amputation-free survival rates at 12 and 24 months were 87% and 60%, respectively. Endovascular recanalization of native CTOs in patients with failed lower-extremity bypass grafts is technically feasible and safe and results in acceptable limb salvage. Copyright © 2014 SIR. Published by Elsevier Inc. All rights reserved.

  7. Everolimus for Previously Treated Advanced Gastric Cancer: Results of the Randomized, Double-Blind, Phase III GRANITE-1 Study

    Science.gov (United States)

    Ohtsu, Atsushi; Ajani, Jaffer A.; Bai, Yu-Xian; Bang, Yung-Jue; Chung, Hyun-Cheol; Pan, Hong-Ming; Sahmoud, Tarek; Shen, Lin; Yeh, Kun-Huei; Chin, Keisho; Muro, Kei; Kim, Yeul Hong; Ferry, David; Tebbutt, Niall C.; Al-Batran, Salah-Eddin; Smith, Heind; Costantini, Chiara; Rizvi, Syed; Lebwohl, David; Van Cutsem, Eric

    2013-01-01

    Purpose The oral mammalian target of rapamycin inhibitor everolimus demonstrated promising efficacy in a phase II study of pretreated advanced gastric cancer. This international, double-blind, phase III study compared everolimus efficacy and safety with that of best supportive care (BSC) in previously treated advanced gastric cancer. Patients and Methods Patients with advanced gastric cancer that progressed after one or two lines of systemic chemotherapy were randomly assigned to everolimus 10 mg/d (assignment schedule: 2:1) or matching placebo, both given with BSC. Randomization was stratified by previous chemotherapy lines (one v two) and region (Asia v rest of the world [ROW]). Treatment continued until disease progression or intolerable toxicity. Primary end point was overall survival (OS). Secondary end points included progression-free survival (PFS), overall response rate, and safety. Results Six hundred fifty-six patients (median age, 62.0 years; 73.6% male) were enrolled. Median OS was 5.4 months with everolimus and 4.3 months with placebo (hazard ratio, 0.90; 95% CI, 0.75 to 1.08; P = .124). Median PFS was 1.7 months and 1.4 months in the everolimus and placebo arms, respectively (hazard ratio, 0.66; 95% CI, 0.56 to 0.78). Common grade 3/4 adverse events included anemia, decreased appetite, and fatigue. The safety profile was similar in patients enrolled in Asia versus ROW. Conclusion Compared with BSC, everolimus did not significantly improve overall survival for advanced gastric cancer that progressed after one or two lines of previous systemic chemotherapy. The safety profile observed for everolimus was consistent with that observed for everolimus in other cancers. PMID:24043745

  8. An extreme ultraviolet wave associated with a failed eruption observed by the Solar Dynamics Observatory

    Science.gov (United States)

    Zheng, R.; Jiang, Y.; Yang, J.; Bi, Y.; Hong, J.; Yang, B.; Yang, D.

    2012-05-01

    Aims: Taking advantage of the high temporal and spatial resolution of the Solar Dynamics Observatory (SDO) observations, we present an extreme ultraviolet (EUV) wave associated with a failed filament eruption that generated no coronal mass ejection (CME) on 2011 March 1. We aim at understanding the nature and origin of this EUV wave. Methods: Combining the high-quality observations in the photosphere, the chromosphere, and the corona, we studied the characteristics of the wave and its relations to the associated eruption. Results: The event occurred at an ephemeral region near a small active region. The continuous magnetic flux cancelation in the ephemeral region produced pre-eruption brightenings and two EUV jets, and excited the filament eruption, accompanying it with a microflare. After the eruption, the filament material appeared far from the eruption center, and the ambient loops seemed to be intact. It was evident that the filament eruption had failed and was not associated with a CME. The wave happened just after the north jet arrived, and apparently emanated ahead of the north jet, far from the eruption center. The wave propagated at nearly constant velocities in the range of 260-350 km s-1, with a slight negative acceleration in the last phase. Remarkably, the wave continued to propagate, and a loop in its passage was intact when wave and loop met. Conclusions: Our analysis confirms that the EUV wave is a true wave, which we interpret as a fast-mode wave. In addition, the close temporal and spatial relationship between the wave and the jet provides evidence that the wave was likely triggered by the jet when the CME failed to happen. Three movies are available in electronic form at http://www.aanda.org

  9. Studying some regimes of the WWER-440 type reactor failed fuel element operation

    International Nuclear Information System (INIS)

    Aksenov, N.A.; Samsonov, B.V.; Sulaberidze, V.Sh.; Frej, A.K.

    1981-01-01

    The results of investigating the serviceability of experimental fuel elements close by type to that of the WWER-440 type reactor in the cans of which untightness in the form of small opening are made. The tests are carried out in the SM-2 reactor high temperature water loop at the temperature of 473 K, pressure of (1-2)x10 4 kPa, coolant flow rate of 3.7-5.5 m 3 /h. The analysis of the obtained results shows that the character of changes in the fission product (FP) activity in the circuit in a considerable extent is determined bt the thermal-optical conditions of the fuel element operation. If water in the gap between fuel and can does not boil, activity changes smoothly and bursts caused by increased FP release are observed only under transient conditions of reactor operation. In the presence of water boiling in the gap the FP release has of impulse character with the frequency determined besides the untightness dimension by free volume inside the fuel element can (with its increase the pulsation frequency increases). FP release from fuel is connected with their direct escape from an open surface. When water in the gap the FP release from the fuel element occurs practically immediately. Without boiling the FP delay in the gap is determined by their diffusion in a layer of water. The conclusion is drawn that the FP release from failed fuel elements may be reduced by eliminating the water boiling in the gap between the fuel and the can by means of the fuel element power or coolant temperature decrease

  10. Hyaluronic acid solution injection for upper and lower gastrointestinal bleeding after failed conventional endoscopic therapy.

    Science.gov (United States)

    Lee, Jin Wook; Kim, Hyung Hun

    2014-03-01

    Hyaluronic acid solution injection can be an additional endoscopic modality for controlling bleeding in difficult cases when other techniques have failed. We evaluated 12 cases in which we used hyaluronic acid solution injection for stopping bleeding. Immediately following hyaluronic acid solution injection, bleeding was controlled in 11 out of 12 cases. There was no clinical evidence of renewed bleeding in 11 cases during follow up.Hyaluronic acid solution injection can be a simple and efficient additional method for controlling upper and lower gastrointestinal bleeding after failed endoscopic therapy. © 2013 The Authors. Digestive Endoscopy © 2013 Japan Gastroenterological Endoscopy Society.

  11. Response to health insurance by previously uninsured rural children.

    Science.gov (United States)

    Tilford, J M; Robbins, J M; Shema, S J; Farmer, F L

    1999-08-01

    To examine the healthcare utilization and costs of previously uninsured rural children. Four years of claims data from a school-based health insurance program located in the Mississippi Delta. All children who were not Medicaid-eligible or were uninsured, were eligible for limited benefits under the program. The 1987 National Medical Expenditure Survey (NMES) was used to compare utilization of services. The study represents a natural experiment in the provision of insurance benefits to a previously uninsured population. Premiums for the claims cost were set with little or no information on expected use of services. Claims from the insurer were used to form a panel data set. Mixed model logistic and linear regressions were estimated to determine the response to insurance for several categories of health services. The use of services increased over time and approached the level of utilization in the NMES. Conditional medical expenditures also increased over time. Actuarial estimates of claims cost greatly exceeded actual claims cost. The provision of a limited medical, dental, and optical benefit package cost approximately $20-$24 per member per month in claims paid. An important uncertainty in providing health insurance to previously uninsured populations is whether a pent-up demand exists for health services. Evidence of a pent-up demand for medical services was not supported in this study of rural school-age children. States considering partnerships with private insurers to implement the State Children's Health Insurance Program could lower premium costs by assembling basic data on previously uninsured children.

  12. Why SDI failed: A different perspective

    International Nuclear Information System (INIS)

    Codevilla, A.

    1990-01-01

    Conventional wisdom is wrong. SDI did not fail simply because science could not supply the means to build an anti-missile shield. Rather, it floundered on a combination of unsatisfiable technical requirements and technical boondoggles, charges the author. Rather than building on current technology and doing what could be done with what was at hand, those who shaped SDI policy - both military and civilian - insisted on virtually starting over. He also charges they were either passionately against building anti-missile weapons or lacking in intellectual self-confidence and interest with regard to the subject. Work on using modern optics and computers for anti-missile purposes began in the late 1970s, and the technology already was in use in intelligence satellites - a fact either unknown or ignored by most SDI officials. As a result of the conflicting interests among officials and the organizational structure they put into place, the author says the SDI program could not possibly develop any weapon, even if the people involved wanted to, which they did not

  13. Last bank standing : what do I gain if you fail?

    OpenAIRE

    Perotti, E.C.; Suarez, J.

    2001-01-01

    Banks are highly leveraged institutions, potentially attracted to speculative lending even without deposit insurance. A counterbalancing incentive to lend prudently is the risk of loss of charter value, which depends on future rents. We show in a dynamic model that current concentration does not reduce speculative lending, and may in fact increase it. In contrast, a policy of temporary increases in market concentration after a bank failure, by promoting a takeover of failed banks by a solvent...

  14. Development of the delyed-neutron triangulation technique for locating failed fuel in LMFBR

    International Nuclear Information System (INIS)

    Kryter, R.C.

    1975-01-01

    Two major accomplishments of the ORNL delayed neutron triangulation program are (1) an analysis of anticipated detector counting rates and sensitivities to unclad fuel and erosion types of pin failure, and (2) an experimental assessment of the accuracy with which the position of failed fuel can be determined in the FFTF (this was performed in a quarter-scale water mockup of realistic outlet plenum geometry using electrolyte injections and conductivity cells to simulate delayed-neutron precursor releases and detections, respectively). The major results and conclusions from these studies are presented, along with plans for further DNT development work at ORNL for the FFTF and CRBR. (author)

  15. Feasibility of salvage interstitial microwave thermal therapy for prostate carcinoma following failed brachytherapy: studies in a tissue equivalent phantom

    International Nuclear Information System (INIS)

    McCann, Claire; Kumaradas, J Carl; Gertner, Mark R; Davidson, Sean R H; Dolan, Alfred M; Sherar, Michael D

    2003-01-01

    Thermal therapy is an experimental treatment to destroy solid tumours by heating them to temperatures ranging from 55 deg C to 90 deg C, inducing thermal coagulation and necrosis of the tumour. We are investigating the feasibility of interstitial microwave thermal therapy as a salvage treatment for prostate cancer patients with local recurrence following failed brachytherapy. Due to the electrical and thermal conductivity of the brachytherapy seeds, we hypothesized that the seeds could scatter the microwave energy and cause unpredictable heating. To investigate this, a 915 MHz helical antenna was inserted into a muscle-equivalent phantom with and without brachytherapy seeds. Following a 10 W, 5 s input to the antenna, the temperature rise was used to calculate absorbed power, also referred to as specific absorption rate (SAR). Plane wave models based on Maxwell's equations were also used to characterize the electromagnetic scattering effect of the seeds. In addition, the phantom was heated with 8 W for 5 min to quantify the effect of the seeds on the temperature distribution during extended heating. SAR measurements indicated that the seeds had no significant effect on the shape and size of the SAR pattern of the antenna. However, the plane wave simulations indicated that the seeds could scatter the microwave energy resulting in hot spots at the seed edges. Lack of experimental evidence of these hot spots was probably due to the complex polarization of the microwaves emitted by the helical antenna. Extended heating experiments also demonstrated that the seeds had no significant effect on the temperature distributions and rates of temperature rise measured in the phantom. The results indicate that brachytherapy seeds are not a technical impediment to interstitial microwave thermal therapy as a salvage treatment following failed brachytherapy

  16. 30 CFR 77.902-1 - Fail safe ground check circuits; maximum voltage.

    Science.gov (United States)

    2010-07-01

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

  17. 30 CFR 77.803-1 - Fail safe ground check circuits; maximum voltage.

    Science.gov (United States)

    2010-07-01

    ... voltage. 77.803-1 Section 77.803-1 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF... OF UNDERGROUND COAL MINES Surface High-Voltage Distribution § 77.803-1 Fail safe ground check circuits; maximum voltage. The maximum voltage used for ground check circuits under § 77.803 shall not...

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

    Science.gov (United States)

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

    2014-03-01

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

  19. 20 CFR 641.740 - How will the Department determine whether a grantee fails, meets, or exceeds the expected levels...

    Science.gov (United States)

    2010-04-01

    ... determine whether a grantee fails, meets, or exceeds the expected levels of performance for the core indicators and what will be the consequences of failing to meet expected levels of performance? (a) Aggregate... determine if a national grantee has met the expected levels of performance (including any adjustments to...

  20. High soluble CD30 levels and associated anti-HLA antibodies in patients with failed renal allografts.

    Science.gov (United States)

    Karahan, Gonca E; Caliskan, Yasar; Ozdilli, Kursat; Kekik, Cigdem; Bakkaloglu, Huseyin; Caliskan, Bahar; Turkmen, Aydin; Sever, Mehmet S; Oguz, Fatma S

    2017-01-13

    Serum soluble CD30 (sCD30), a 120-kD glycoprotein that belongs to the tumor necrosis factor receptor family, has been suggested as a marker of rejection in kidney transplant patients. The aim of this study was to evaluate the relationship between sCD30 levels and anti-HLA antibodies, and to compare sCD30 levels in patients undergoing hemodialysis (HD) with and without failed renal allografts and transplant recipients with functioning grafts. 100 patients undergoing HD with failed grafts (group 1), 100 patients undergoing HD who had never undergone transplantation (group 2), and 100 kidney transplant recipients (group 3) were included in this study. Associations of serum sCD30 levels and anti-HLA antibody status were analyzed in these groups. The sCD30 levels of group 1 and group 2 (154 ± 71 U/mL and 103 ± 55 U/mL, respectively) were significantly higher than those of the transplant recipients (group 3) (39 ± 21 U/mL) (p<0.001 and p<0.001). The serum sCD30 levels in group 1 (154 ± 71 U/mL) were also significantly higher than group 2 (103 ± 55 U/mL) (p<0.001). Anti-HLA antibodies were detected in 81 (81%) and 5 (5%) of patients in groups 1 and 2, respectively (p<0.001). When multiple regression analysis was performed to predict sCD30 levels, the independent variables in group 1 were the presence of class I anti-HLA antibodies (β = 0.295; p = 0.003) and age (β = -0.272; p = 0.005), and serum creatinine (β = 0.218; p = 0.027) and presence of class II anti-HLA antibodies (standardized β = 0.194; p = 0.046) in group 3. Higher sCD30 levels and anti-HLA antibodies in patients undergoing HD with failed renal allografts may be related to higher inflammatory status in these patients.

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

    Directory of Open Access Journals (Sweden)

    Douglas M. Richardson

    2016-05-01

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

  2. κ-Casein-deficient mice fail to lactate

    Science.gov (United States)

    Shekar, P. Chandra; Goel, Sandeep; Rani, S. Deepa Selvi; Sarathi, D. Partha; Alex, Jomini Liza; Singh, Shashi; Kumar, Satish

    2006-01-01

    Acquisition of milk production capabilities by an ancestor of mammals is at the root of mammalian evolution. Milk casein micelles are a primary source of amino acids and calcium phosphate to neonates. To understand the role of κ-casein in lactation, we have created and characterized a null mouse strain (Csnk−/−) lacking this gene. The mutant κ-casein allele did not affect the expression of other milk proteins in Csnk−/− females. However, these females did not suckle their pups and failed to lactate because of destabilization of the micelles in the lumina of the mammary gland. Thus, κ-casein is essential for lactation and, consequently, for the successful completion of the process of reproduction in mammals. In view of the extreme structural conservation of the casein locus, as well as the phenotype of Csnk−/− females, we propose that the organization of a functional κ-casein gene would have been one of the critical events in the evolution of mammals. Further, κ-casein variants are known to affect the industrial properties of milk in dairy animals. Given the expenses and the time scale of such experiments in livestock species, it is desirable to model the intended genetic modifications in mice first. The mouse strain that we have created would be a useful model to study the effect of κ-casein variants on the properties of milk and/or milk products. PMID:16698927

  3. Water hydraulic manipulator for fail safe and fault tolerant remote handling operations at ITER

    International Nuclear Information System (INIS)

    Nieminen, Peetu; Esque, Salvador; Muhammad, Ali; Mattila, Jouni; Vaeyrynen, Jukka; Siuko, Mikko; Vilenius, Matti

    2009-01-01

    Department of Intelligent Hydraulics and Automation (IHA) of Tampere University of Technology has been involved in the European Fusion program since 1994 within the ITER reactor maintenance activities. In this paper we discuss the design and development of a six degrees of freedom water hydraulic manipulator with a force feedback for teleoperation tasks. The manipulator is planned to be delivered to Divertor Test Platform 2 (DTP2) during year 2008. The paper also discusses the possibility to improve the fail safe and redundant operation of the manipulator. During the design of the water hydraulic manipulator, special provisions have been made in order to meet the safety requirements such as servo valve block for redundant operation and safety vane brakes for fail safe operation.

  4. The Influence of a Failed Irrigation and Debridement on the Outcomes of a Subsequent 2-Stage Revision Knee Arthroplasty.

    Science.gov (United States)

    Nodzo, Scott R; Boyle, Keely K; Nocon, Allina A; Henry, Michael W; Mayman, David J; Westrich, Geoffrey H

    2017-08-01

    Previous work has suggested a failed irrigation and debridement (I&D) before a 2-stage exchange negatively impacts the outcome of the subsequent 2-stage revision. This was a retrospective review of 132 patients who underwent a 2-stage exchange without prior I&D (2-Stage), and 45 patients had a failed I&D before their 2-stage exchange (I&D+2Stage) between April 2009 and April 2015. Charts were reviewed for patient demographics, presenting inflammatory laboratory values, type of antibiotic spacer used, surgical details, microbiology data, length of postoperative antibiotic treatment, and reoperation. A logistic regression was used to assess the association between I&D and reoperation. The I&D+2Stage group had an 82.2% success rate, and the 2-Stage group had an 82.5% success rate (P = .95). The odds of reoperation for infection with the use of greater than 2 grams of vancomycin was 0.33 (P = .01, 95% confidence interval 0.14-0.79) as compared with having less than 2 grams of vancomycin in the construct. Spacer type, having a prior I&D to the 2-stage procedure, being infected with an antibiotic resistant organism, total grams of aminoglycoside were not associated with a risk of failure. Success rates between the I&D+2Stage group and the 2-Stage group were similar. The use of greater than 2 grams of vancomycin in the spacer construct decreased the odds of reoperation. I&D before a 2-stage exchange may not negatively influence the outcomes of a subsequent 2-stage revision procedure and requires further investigation. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Method and device for detecting failed fuels

    International Nuclear Information System (INIS)

    Saito, Shozo; Suzumura, Takeshi.

    1981-01-01

    Purpose: To shorten the time required for inspecting a failed fuel by providing a first outlet for exhausting cleaning liquid to a sampling pipe and a second outlet for exhausting sampled coolant, thereby safely setting a collecting means to the first outlet. Constitution: A sampling pipe is inserted into a fuel assembly loaded within a reactor core, and coolant flow is thus prevented from passing through the fuel assembly interior. Then, with the coolant flow stopped, it is allowed to stand for a predetermined time. Subsequently, cleaning liquid is supplied into the sampling tube and the interior of the sampling pipe is cleaned. Thereafter, the sampling liquid that was in the sampling pipe is exhausted from the first outlet of the sampling pipe. Then, the coolant in the fuel assembly is supplied from the second outlet of the sampling pipe to a collecting means. (Aizawa, K.)

  6. Trending a New Normal: Is Nigeria becoming a failed Nation?

    OpenAIRE

    Emmanuel Olusegun Stober

    2017-01-01

    Judging from every economic parameter, Nigeria will suggest being a failed nation. Not so long ago international investors identified Nigeria as one of the world’s most promising investment opportunities, but things have changed drastically in the meantime. The slump in the price of crude oil has hit Nigerian economy hard, the twin curses of insecurity and corruption have not gone away either. The Nigerian currency - naira has also lost its value by 170% from its value in 2015. The question m...

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

    Science.gov (United States)

    Berg, Melanie; LaBel, Kenneth; Pellish, Jonathan

    2016-01-01

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

  8. Predictive factors for the development of diabetes in women with previous gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Damm, P.; Kühl, C.; Bertelsen, Aksel

    1992-01-01

    OBJECTIVES: The purpose of this study was to determine the incidence of diabetes in women with previous dietary-treated gestational diabetes mellitus and to identify predictive factors for development of diabetes. STUDY DESIGN: Two to 11 years post partum, glucose tolerance was investigated in 241...... women with previous dietary-treated gestational diabetes mellitus and 57 women without previous gestational diabetes mellitus (control group). RESULTS: Diabetes developed in 42 (17.4%) women with previous gestational diabetes mellitus (3.7% insulin-dependent diabetes mellitus and 13.7% non...... of previous patients with gestational diabetes mellitus in whom plasma insulin was measured during an oral glucose tolerance test in late pregnancy a low insulin response at diagnosis was found to be an independent predictive factor for diabetes development. CONCLUSIONS: Women with previous dietary...

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

    Science.gov (United States)

    Wiseman, Hadas

    2008-07-01

    Intergenerational consequences of extensive trauma experienced by parents for the loneliness experienced by their children were explored in 52 adults (26 men and 26 women) who grew up in Holocaust survivor families. These adults, children of mothers who had survived Nazi concentration camps, were recruited from a random nonclinical Israeli sample. A narrative analysis of their recollected accounts of loneliness in childhood and adolescence yielded 4 major categories of loneliness experiences in the context of growing up in Holocaust survivor families: (a) echoes of parental intrusive traumatic memories; (b) echoes of parental numbing and detachment; (c) perceived parents' caregiving style; and (d) social comparison with other families, in particular the lack of grandparents. The echoes of the parental trauma in the recollected loneliness accounts are conceptualized as representing a sense of failed intersubjectivity in these interpersonal processes. The experiences of not being understood by others, not understanding others, and the lack of shared understanding involved in failed intersubjectivity are discussed and related to the importance of opening lines of communication between survivors and their descendents. (c) 2009 APA, all rights reserved

  10. Severe male infertility after failed ICSI treatment-a phenomenological study of men's experiences

    Directory of Open Access Journals (Sweden)

    Hellström Anna-Lena

    2011-02-01

    Full Text Available Abstract Background Male-factor infertility underlies approximately 30% of infertility in couples seeking treatment; of which 10% is due to azoospermia. The development of assisted reproductive technology (ART, enabling the use of epididymal or testicular sperm for fertilization of the partner's oocytes, has made biological fatherhood possible for men with obstructive azoospermia. There is limited knowledge of men's experience of their own infertility. The aim of this study was to describe men's experiences of obstructive azoospermia infertility. Methods Eight men with obstructive azoospermia, who had terminated Swedish public health system ART treatment two years previously without subsequent childbirth, were interviewed using a descriptive phenomenological method. Results The essence of the phenomenon is expressed with a metaphor: climbing a mountain step by step with the aim of reaching the top, i.e. having a child and thus a family with a child. Four constituents are included (1 inadequacy followed by a feeling of redress (2 marginalisation, (3 chivalry (4 extension of life and starting a family as driving forces. Conclusions Knowledge of men's experiences of their own infertility is important as a supporting measure to increase the quality of care of infertile couples. By adopting this facet of gender perspective in fertility treatment guidelines, care can hopefully be optimized.

  11. Book Review: Why Nations fail – the origins of power, prosperity and poverty

    OpenAIRE

    Deniz Kellecioglu

    2013-01-01

    Why nations fail is a compelling contribution to the classic question of why some countries are poor and some rich, but it is also marred from several shortcomings and under-representations, which cast doubts on the positive messages of creating better institutions and reducing poverty.

  12. Development of a Simple Tool for Identifying Alcohol Use Disorder in Female Korean Drinkers from Previous Questionnaires.

    Science.gov (United States)

    Seo, Yu Ri; Kim, Jong Sung; Kim, Sung Soo; Yoon, Seok Joon; Suh, Won Yoon; Youn, Kwangmi

    2016-01-01

    This study aimed to develop a simple tool for identifying alcohol use disorders in female Korean drinkers from previous questionnaires. This research was conducted on 400 women who consumed at least one alcoholic drink during the past month and visited the health promotion center at Chungnam National University Hospital between June 2013 to May 2014. Drinking habits and alcohol use disorders were assessed by structured interviews using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition diagnostic criteria. The subjects were also asked to answer the Alcohol Use Disorders Identification Test (AUDIT), AUDIT-Consumption, CAGE (Cut down, Annoyed, Guilty, Eye-opener), TWEAK (Tolerance, Worried, Eye-opener, Amnesia, Kut down), TACE (Tolerance, Annoyed, Cut down, Eye-opener), and NET (Normal drinker, Eye-opener, Tolerance) questionnaires. The area under receiver operating characteristic (AUROC) of each question of the questionnaires on alcohol use disorders was assessed. After combining two questions with the largest AUROC, it was compared to other previous questionnaires. Among the 400 subjects, 58 (14.5%) were identified as having an alcohol use disorder. Two questions with the largest AUROC were question no. 7 in AUDIT, "How often during the last year have you had a feeling of guilt or remorse after drinking?" and question no. 5 in AUDIT, "How often during the past year have you failed to do what was normally expected from you because of drinking?" with an AUROC (95% confidence interval [CI]) of 0.886 (0.850-0.915) and 0.862 (0.824-0.894), respectively. The AUROC (95% CI) of the combination of the two questions was 0.958 (0.934-0.976) with no significant difference as compared to the existing AUDIT with the largest AUROC. The above results suggest that the simple tool consisting of questions no. 5 and no. 7 in AUDIT is useful in identifying alcohol use disorders in Korean female drinkers.

  13. Analysis of failed ramps during the RHIC FY09 run

    Energy Technology Data Exchange (ETDEWEB)

    Minty, M. [Brookhaven National Lab. (BNL), Upton, NY (United States). Collider-Accelerator Dept.

    2014-08-15

    The Relativistic Heavy Ion Collider (RHIC) is a versatile accelerator that supports operation with polarized protons of up to 250 GeV and ions with up to 100 GeV/nucleon. During any running period, various operating scenarios with different particle species, beam energies or accelerator optics are commissioned. In this report the beam commissioning periods for establishing full energy beams (ramp development periods) from the FY09 run are summarized and, for the purpose of motivating further developments, we analyze the reasons for all failed ramps.

  14. Analysis of failed ramps during the RHIC FY09 run

    International Nuclear Information System (INIS)

    Minty, M.

    2014-01-01

    The Relativistic Heavy Ion Collider (RHIC) is a versatile accelerator that supports operation with polarized protons of up to 250 GeV and ions with up to 100 GeV/nucleon. During any running period, various operating scenarios with different particle species, beam energies or accelerator optics are commissioned. In this report the beam commissioning periods for establishing full energy beams (ramp development periods) from the FY09 run are summarized and, for the purpose of motivating further developments, we analyze the reasons for all failed ramps.

  15. The cost of failing states and the limits to sovereignty

    OpenAIRE

    Chauvet, Lisa; Collier, Paul; Hoeffler, Anke

    2007-01-01

    In this paper, we estimate the costs of state failure, both for the failing state itself and for its neighbours. In our analysis, the cost of failure arises from two distinct sources: organized violence due to the incapacity of the state to ensure its own citizens’ security and low quality of regulation and public goods due to poor governance. To estimate the cost of failure, we proceed in two steps. First we estimate the annual loss of growth induced by state failure. Then we cumulate this l...

  16. GnRH agonist ovulation trigger and hCG-based, progesterone-free luteal support: a proof of concept study

    DEFF Research Database (Denmark)

    Kol, Shahar; Humaidan, Peter; Itskovitz-Eldor, Joseph

    2011-01-01

    in normal responder IVF patients. We here present a novel approach for luteal support after a GnRHa trigger. METHODS Normal responder patients who failed at least one previous IVF attempt, during which a conventional hCG trigger was used, were consecutively enrolled in the study. A GnRH antagonist...

  17. 49 CFR 173.23 - Previously authorized packaging.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Previously authorized packaging. 173.23 Section... REQUIREMENTS FOR SHIPMENTS AND PACKAGINGS Preparation of Hazardous Materials for Transportation § 173.23 Previously authorized packaging. (a) When the regulations specify a packaging with a specification marking...

  18. Icotinib versus docetaxel used in lung adenocarcinoma patients who failed platinum-based chemotherapy: a retrospective study.

    Science.gov (United States)

    He, Wei; Zhang, Yan; Xiong, Yu; Dai, Feng-Juan; Fan, Qing-Xia

    2016-01-01

    The efficacy and safety of epidermal growth factor receptor tyrosine kinase inhibitors have been studied worldwide. However, there are few reports directly comparing the efficacy and safety between icotinib and docetaxel as second-line treatment in lung adenocarcinoma patients who have failed platinum-based chemotherapy. This article offers insight into this field. A total of 137 patients with stage III or IV lung adenocarcinoma who had progressed on first-line platinum-based therapies and received icotinib or docetaxel therapy between October 2011 and February 2013 were retrospectively reviewed. Patients in the icotinib group received oral icotinib at a dose of 125 mg tid, while patients in the docetaxel group received infusion docetaxel at a dose of 75 mg/m(2) on day 1 of every 21 days (four to six cycles) until disease progression or unacceptable toxicity occurred after which best supportive care was given. There was no statistically significant difference in the objective response rate (23.3% vs 12.5%, P=0.103), progression-free survival (121 days vs 106 days, P=0.083), and overall survival (307 days vs 254 days, P=0.070) between the two groups. As compared to the docetaxel group, the disease control rate (75.3% vs 54.7%, P=0.011) was significantly better in the icotinib group. In the icotinib group, the most common adverse events were rash (35.62%) and diarrhea (24.66%), whereas in the docetaxel group, elevation of transaminase (37.50%), leukopenia (50.00%), and anemia (54.69%) were the most common. Icotinib had similar efficacy and a lower adverse events rate in epidermal growth factor receptor-unselected patients as compared to docetaxel, thereby making it an effective second-line therapy option for lung adenocarcinoma.

  19. Remembering past exchanges: Apes fail to use social cues

    Directory of Open Access Journals (Sweden)

    Amy Lewis

    2018-02-01

    Full Text Available Nonhuman primates can remember events from their distant past. Furthermore, they can distinguish between very similar events by the process of binding. So far, research into long-term memory and binding has focused on the binding of contextual information, such as spatial surroundings. As such, we aimed to investigate if apes can bind and retrieve other types of information, specifically, social information. We presented great apes with three different object types; they learnt to exchange (via reinforcement one of the object types with one experimenter and another type with a second, different, experimenter. The remaining object type was not reinforced by either of the experimenters. After a delay of two or ten weeks, we assessed the apes’ memory of which object type was exchanged with which experimenter. Additionally, we introduced a new experimenter to see if the apes could infer by exclusion that the remaining object type should be exchanged with the new experimenter. The apes successfully remembered which object types were exchanged, but failed to distinguish which object type was exchanged with whom. This failure to bind an object type to a specific person may have resulted from the apes learning to use a rule based on recency, as opposed to learning a conditional rule involving social information. However, results from a second experiment suggested they fail to incorporate social information even when no other information could guide successful performance. Our findings are consistent with research showing long-term memory in primates, but suggest that social information may not be bound in memory as readily as spatial or contextual information.

  20. The job satisfaction of principals of previously disadvantaged schools

    African Journals Online (AJOL)

    The aim of this study was to identify influences on the job satisfaction of previously disadvantaged ..... I am still riding the cloud … I hope it lasts. .... as a way of creating a climate and culture in schools where individuals are willing to explore.