Admassu, Yonathan; Shakoor, Abdul
Kinematic analysis is used to analyze the potential for the various modes of structurally controlled rock slope failures (plane, wedge, and toppling failures) due to the presence of unfavorably oriented discontinuities. Traditionally kinematic analysis is performed after plotting discontinuity orientations, slope angle, slope azimuth and representative friction angle value on a stereonet. Due to large number of discontinuities, only representative orientation values (dip/dip direction) for identified cluster sets are considered. This stereonet-based analysis is qualitative in nature and requires the presence of tight data clusters for which a reasonable representative orientation value can be assigned. However, there are cases when a tight circular clustering of discontinuity orientations does not exist, making stereonet-based analysis unreliable. Also, variability of discontinuity data in cluster sets is not easy to consider using the stereonet-based method. To overcome these problems, an application software, DIPANALYST, has been developed by the first author to perform quantitative kinematic analysis based on not just representative discontinuity values, but all discontinuities and their possible intersections. The software calculates ratios of discontinuities or their possible intersections that can potentially cause failures (plane, wedge or toppling) to the total number of discontinuities or their possible intersections. The calculated ratios are known as failure indices, and the method is termed as the quantitative approach for kinematic analysis. DIPANALYST is also capable of performing the traditional stereonet-based method.
Riley, William T; Keberlein, Pamela; Sorenson, Gigi; Mohler, Sailor; Tye, Blake; Ramirez, A Susana; Carroll, Mark
Remote monitoring for heart failure (HF) has had mixed and heterogeneous effects across studies, necessitating further evaluation of remote monitoring systems within specific healthcare systems and their patient populations. "Care Beyond Walls and Wires," a wireless remote monitoring program to facilitate patient and care team co-management of HF patients, served by a rural regional medical center, provided the opportunity to evaluate the effects of this program on healthcare utilization. Fifty HF patients admitted to Flagstaff Medical Center (Flagstaff, AZ) participated in the project. Many of these patients lived in underserved and rural communities, including Native American reservations. Enrolled patients received mobile, broadband-enabled remote monitoring devices. A matched cohort was identified for comparison. HF patients enrolled in this program showed substantial and statistically significant reductions in healthcare utilization during the 6 months following enrollment, and these reductions were significantly greater compared with those who declined to participate but not when compared with a matched cohort. The findings from this project indicate that a remote HF monitoring program can be successfully implemented in a rural, underserved area. Reductions in healthcare utilization were observed among program participants, but reductions were also observed among a matched cohort, illustrating the need for rigorous assessment of the effects of HF remote monitoring programs in healthcare systems.
Teixeira, Flavia C., E-mail: email@example.com [CNEN—Comissao Nacional de Energia Nuclear, Rio de Janeiro, RJ 22290-901, Brazil and LCR/UERJ—Laboratorio de Ciencias Radiologicas/Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ 20550-013 (Brazil); Almeida, Carlos E. de [LCR/UERJ—Laboratorio de Ciencias Radiologicas/Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ 20550-013 (Brazil); Saiful Huq, M. [Department of Radiation Oncology, University of Pittsburgh Cancer Institute and UPMC Cancer Center, Pittsburgh, Pennsylvania 15232 (United States)
Purpose: The goal of this study was to evaluate the safety and quality management program for stereotactic radiosurgery (SRS) treatment processes at three radiotherapy centers in Brazil by using three industrial engineering tools (1) process mapping, (2) failure modes and effects analysis (FMEA), and (3) fault tree analysis. Methods: The recommendations of Task Group 100 of American Association of Physicists in Medicine were followed to apply the three tools described above to create a process tree for SRS procedure for each radiotherapy center and then FMEA was performed. Failure modes were identified for all process steps and values of risk priority number (RPN) were calculated from O, S, and D (RPN = O × S × D) values assigned by a professional team responsible for patient care. Results: The subprocess treatment planning was presented with the highest number of failure modes for all centers. The total number of failure modes were 135, 104, and 131 for centers I, II, and III, respectively. The highest RPN value for each center is as follows: center I (204), center II (372), and center III (370). Failure modes with RPN ≥ 100: center I (22), center II (115), and center III (110). Failure modes characterized by S ≥ 7, represented 68% of the failure modes for center III, 62% for center II, and 45% for center I. Failure modes with RPNs values ≥100 and S ≥ 7, D ≥ 5, and O ≥ 5 were considered as high priority in this study. Conclusions: The results of the present study show that the safety risk profiles for the same stereotactic radiotherapy process are different at three radiotherapy centers in Brazil. Although this is the same treatment process, this present study showed that the risk priority is different and it will lead to implementation of different safety interventions among the centers. Therefore, the current practice of applying universal device-centric QA is not adequate to address all possible failures in clinical processes at different
Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model: A Web-based program designed to evaluate the cost-effectiveness of disease management programs in heart failure.
Reed, Shelby D; Neilson, Matthew P; Gardner, Matthew; Li, Yanhong; Briggs, Andrew H; Polsky, Daniel E; Graham, Felicia L; Bowers, Margaret T; Paul, Sara C; Granger, Bradi B; Schulman, Kevin A; Whellan, David J; Riegel, Barbara; Levy, Wayne C
Heart failure disease management programs can influence medical resource use and quality-adjusted survival. Because projecting long-term costs and survival is challenging, a consistent and valid approach to extrapolating short-term outcomes would be valuable. We developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model, a Web-based simulation tool designed to integrate data on demographic, clinical, and laboratory characteristics; use of evidence-based medications; and costs to generate predicted outcomes. Survival projections are based on a modified Seattle Heart Failure Model. Projections of resource use and quality of life are modeled using relationships with time-varying Seattle Heart Failure Model scores. The model can be used to evaluate parallel-group and single-cohort study designs and hypothetical programs. Simulations consist of 10,000 pairs of virtual cohorts used to generate estimates of resource use, costs, survival, and incremental cost-effectiveness ratios from user inputs. The model demonstrated acceptable internal and external validity in replicating resource use, costs, and survival estimates from 3 clinical trials. Simulations to evaluate the cost-effectiveness of heart failure disease management programs across 3 scenarios demonstrate how the model can be used to design a program in which short-term improvements in functioning and use of evidence-based treatments are sufficient to demonstrate good long-term value to the health care system. The Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model provides researchers and providers with a tool for conducting long-term cost-effectiveness analyses of disease management programs in heart failure. Copyright © 2015 Elsevier Inc. All rights reserved.
Bennedsen, Jens; Caspersen, Michael Edelgaard
It is a common conception that CS1 is a very difficult course and that failure rates are high. However, until now there has only been anecdotal evidence for this claim. This article reports on a survey among institutions around the world regarding failure rates in introductory programming courses....... The article describes the design of the survey and the results. The number of institutions answering the call for data was unfortunately rather low, so it is difficult to make firm conclusions. It is our hope that this article can be the starting point for a systematic collection of data in order to find...
Muhammad Taher Abuelma'atti
Full Text Available The effectiveness of SPICE circuit simulation program in calculating probabilities, reliability, steady-state availability and mean-time to failure of repairable systems described by Markov models is demonstrated. Two examples are presented. The first example is a warm standby system with common-cause failures and human errors. The second example is a non-identical unit parallel system with common-cause failures. In both cases recourse to numerical solution is inevitable to obtain the Laplace transforms of the probabilities. Results obtained using SPICE are compared with previously published results obtained using the Laplace transform method. Full SPICE listings are included.
Howard, Ian; Castle, Nicholas; Al Shaikh, Loua Asad
Rapid sequence intubation (RSI) has become the de facto airway method of choice in the emergency airway management of adult and pediatric patients. There is significant controversy regarding pediatric RSI in the prehospital setting, given not only the complexities inherent in both the procedure and patient population, but in variations in emergency medical service models, prehospital qualifications, scope of practice, and patient exposure too. A Healthcare Failure Mode and Effects Analysis was conducted to identify and mitigate potential hazards in the national implementation of a prehospital pediatric RSI program. A process map and potential failure points were developed and identified. Probabilities, severity, and hazards scores were calculated for each failure point, and actions items developed to address these. One hundred four potential failure points were identified among 44 subprocesses, divided between nine major processes. In terms of severity, most were classified as either major (n = 39 [37.5%]) or catastrophic (n = 35 [33.7%]) with just more than half falling within the uncommon category (n = 56 [53.9%]) in terms of probability. Five strategic actions items were identified to mitigate against the failure points meeting criteria for action. To monitor the success of these, 11 quality and performance indicators were developed for concurrent implementation. The Healthcare Failure Mode and Effects Analysis represents a simple yet comprehensive first step toward risk analysis of complex procedures within the prehospital emergency care setting. Application of the methodology provided guidance for the consensus identification of hazards associated with prehospital pediatric RSI and appropriate actions to mitigate them.
Rempe, J.L.; Chavez, S.A.; Thinnes, G.L. [EG and G Idaho, Inc., Idaho Falls, ID (United States)] [and others
This document presents the results from a US Nuclear Regulatory Commission-sponsored research program to investigate the mode and timing of vessel lower head failure. Major objectives of the analysis were to identify plausible failure mechanisms and to develop a method for determining which failure mode would occur first in different light water reactor designs and accident conditions. Failure mechanisms, such as tube ejection, tube rupture, global vessel failure, and localized vessel creep rupture, were studied. Newly developed models and existing models were applied to predict which failure mechanism would occur first in various severe accident scenarios. So that a broader range of conditions could be considered simultaneously, calculations relied heavily on models with closed-form or simplified numerical solution techniques. Finite element techniques-were employed for analytical model verification and examining more detailed phenomena. High-temperature creep and tensile data were obtained for predicting vessel and penetration structural response.
Hackler, Donald B.; Bui, David T.; Becker, Fred J.
FIRM is software tool for identification of failure and management of risk based on directed-graph ("digraph") approach. Three core algorithms optimized for processing singletons and doubletons and also handle tripletons. FIRM identifies loops in digraphs and displays direct failure paths between any two nodes. Solves for reachability for given node without computing reachability for entire digraph. Represents hybrid between schematic-diagram and fault-tree approaches. Written in C.
Two high-pressure bioassay vessels failed at the Savannah River Site during a microwave heating process for biosample testing. Improper installation of the thermal shield in the first failure caused the vessel to burst during microwave heating. The second vessel failure is attributed to overpressurization during a test run. Vessel failure appeared to initiate in the mold parting line, the thinnest cross-section of the octagonal vessel. No material flaws were found in the vessel that would impair its structural performance. Content weight should be minimized to reduce operating temperature and pressure. Outer vessel life is dependent on actual temperature exposure. Since thermal aging of the vessels can be detrimental to their performance, it was recommended that the vessels be used for a limited number of cycles to be determined by additional testing.
Pack, Ginger L.; Wadsworth, David B.
Understanding risks and avoiding failure are daily concerns for the women and men of NASA. Although NASA's mission propels us to push the limits of technology, and though the risks are considerable, the NASA community has instilled within, the determination to preserve the integrity of the systems upon which our mission and, our employees lives and well-being depend. One of the ways this is being done is by expanding and improving the tools used to perform risk assessment. The Failure Environment Analysis Tool (FEAT) was developed to help engineers and analysts more thoroughly and reliably conduct risk assessment and failure analysis. FEAT accomplishes this by providing answers to questions regarding what might have caused a particular failure; or, conversely, what effect the occurrence of a failure might have on an entire system. Additionally, FEAT can determine what common causes could have resulted in other combinations of failures. FEAT will even help determine the vulnerability of a system to failures, in light of reduced capability. FEAT also is useful in training personnel who must develop an understanding of particular systems. FEAT facilitates training on system behavior, by providing an automated environment in which to conduct 'what-if' evaluation. These types of analyses make FEAT a valuable tool for engineers and operations personnel in the design, analysis, and operation of NASA space systems.
Oyanguren, Juana; Latorre García, Pedro María; Torcal Laguna, Jesús; Lekuona Goya, Iñaki; Rubio Martín, Susana; Maull Lafuente, Elena; Grandes, Gonzalo
Heart failure management programs reduce hospitalizations. Some studies also show reduced mortality. The determinants of program success are unknown. The aim of the present study was to update our understanding of the reductions in mortality and readmissions produced by these programs, elucidate their components, and identify the factors determining program success. Systematic literature review (1990-2014; PubMed, EMBASE, CINAHL, Cochrane Library) and manual search of relevant journals. The studies were selected by 3 independent reviewers. Methodological quality was evaluated in a blinded manner by an external researcher (Jadad scale). These results were pooled using random effects models. Heterogeneity was evaluated with the I 2 statistic, and its explanatory factors were determined using metaregression analysis. Of the 3914 studies identified, 66 randomized controlled clinical trials were selected (18 countries, 13 535 patients). We determined the relative risks to be 0.88 for death (95% confidence interval [95%CI], 0.81-0.96; P < .002; I 2 , 6.1%), 0.92 for all-cause readmissions (95%CI, 0.86-0.98; P < .011; I 2 , 58.7%), and 0.80 for heart failure readmissions (95%CI, 0.71-0.90; P < .0001; I 2 , 52.7%). Factors associated with program success were implementation after 2001, program location outside the United States, greater baseline use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, a higher number of intervention team members and components, specialized heart failure cardiologists and nurses, protocol-driven education and its assessment, self-monitoring of signs and symptoms, detection of deterioration, flexible diuretic regimen, early care-seeking among patients and prompt health care response, psychosocial intervention, professional coordination, and program duration. We confirm the reductions in mortality and readmissions with heart failure management programs. Their success is associated with various structural and
Kibaroglu, D.; Baydogan, M.; Cimenoglu, H.; Bas, B.; Yagsi, C.; Aliyeva, N.
This study deals with the failure analysis of broken fencing blades (one épée and one foil). For the characterization of the broken blades, metallographic examinations, chemical analysis, hardness measurements, fracture surface examinations and tensile tests were performed. Maximum stress occurred at the outer fibres of the blades was estimated as high as 1456 MPa and 1298 MPa for épée and foil, respectively. Results showed that failure of the blades was initiated from a notch, which has been formed as the result of an impact action during training, or from the groove machined along the blade for inserting an electrical wire. In order to increase resistance of the blades against such failures, alternative blade material, modified blade geometry and a surface hardening treatment were proposed.
A failure modes and effects analysis (FMEA) was directed primarily at identifying those critical failure modes that would be hazardous to life or would result in major damage to the system. Each subsystem was approached from the top down, and broken down to successive lower levels where it appeared that the criticality of the failure mode warranted more detail analysis. The results were reviewed by specialists from outside the Mod 1 program, and corrective action taken wherever recommended.
Dyer, M. K.; Little, D. G.; Hoard, E. G.; Taylor, A. C.; Campbell, R.
An approach that might be used for determining the applicability of NASA management techniques to benefit almost any type of down-to-earth enterprise is presented. A study was made to determine the following: (1) the practicality of adopting NASA contractual quality management techniques to the U.S. Geological Survey Outer Continental Shelf lease management function; (2) the applicability of failure mode effects analysis to the drilling, production, and delivery systems in use offshore; (3) the impact on industrial offshore operations and onshore management operations required to apply recommended NASA techniques; and (4) the probable changes required in laws or regulations in order to implement recommendations. Several management activities that have been applied to space programs are identified, and their institution for improved management of offshore and onshore oil and gas operations is recommended.
Failure modes and effects analysis (FMEA) is a bottom-up analytical process that identifies process hazards, which helps managers understand vulnerabilities of systems, as well as assess and mitigate risk. It is one of several engineering tools and techniques available to program and project managers aimed at increasing the likelihood of safe and successful NASA programs and missions. This bibliography references 465 documents in the NASA STI Database that contain the major concepts, failure modes or failure analysis, in either the basic index of the major subject terms.
Henderson, C.L. [Sandia National Labs., Albuquerque, NM (United States); Barnard, R.D. [Schlumberger Technologies, San Jose, CA (United States)
The increasing complexity of integrated circuits demands that software tools, in addition to hardware tools, be used for successful diagnosis of failure. A series of customizable software tools have been developed that organize failure analysis information and provide expert level help to failure analysts to increase their productivity and success.
Ruano Camps, Maria; Brentlinger, Paula E; Augusto, Gerito; Nguimfack, Alexandre; Mudender, Florindo
In accordance with global HIV/AIDS goals, Mozambique is attempting to improve management of antiretroviral treatment failure (TF). We sought to determine whether the utilization of a national HIV/AIDS clinician telephone consultation service increased recognition and reporting of TF. In a retrospective analysis of routinely collected program data from telephone consultation logs and Mozambique's national registry of second-line antiretroviral requests, we used linear mixed methods to describe the association between TF-related telephone consultations and submission of second-line requests, which required documentation of the TF diagnosis. The unit of analysis was the health facility. Available data included 1417 consultations (390 [27.5%] TF related) and 2662 second-line requests from 1011 health units (2015-2016 data). In multivariable analyses, each TF-related consultation was associated with an increase of 0.61 (95% confidence interval 0.15 to 1.06) second-line requests. In this setting, TF-related telephone consultation was positively and significantly associated with diagnosis and reporting of antiretroviral TF.
Reder, M. D.; Gonzalez, E.; Melero, J. J.
The wind industry has been growing significantly over the past decades, resulting in a remarkable increase in installed wind power capacity. Turbine technologies are rapidly evolving in terms of complexity and size, and there is an urgent need for cost effective operation and maintenance (O&M) strategies. Especially unplanned downtime represents one of the main cost drivers of a modern wind farm. Here, reliability and failure prediction models can enable operators to apply preventive O&M strategies rather than corrective actions. In order to develop these models, the failure rates and downtimes of wind turbine (WT) components have to be understood profoundly. This paper is focused on tackling three of the main issues related to WT failure analyses. These are, the non-uniform data treatment, the scarcity of available failure analyses, and the lack of investigation on alternative data sources. For this, a modernised form of an existing WT taxonomy is introduced. Additionally, an extensive analysis of historical failure and downtime data of more than 4300 turbines is presented. Finally, the possibilities to encounter the lack of available failure data by complementing historical databases with Supervisory Control and Data Acquisition (SCADA) alarms are evaluated.
This article examines the concepts of quality management (QM) and quality assurance (QA), as well as the current state of QM and QA practices in radiotherapy. A systematic approach incorporating a series of industrial engineering-based tools is proposed, which can be applied in health care organizations proactively to improve process outcomes, reduce risk and/or improve patient safety, improve through-put, and reduce cost. This tool set includes process mapping and process flowcharting, failure modes and effects analysis (FMEA), value stream mapping, and fault tree analysis (FTA). Many health care organizations do not have experience in applying these tools and therefore do not understand how and when to use them. As a result there are many misconceptions about how to use these tools, and they are often incorrectly applied. This article describes these industrial engineering-based tools and also how to use them, when they should be used (and not used), and the intended purposes for their use. In addition the strengths and weaknesses of each of these tools are described, and examples are given to demonstrate the application of these tools in health care settings.
Newman, John Steven
Space program and space systems failures result in financial losses in the multi-hundred million dollar range every year. In addition to financial loss, space system failures may also represent the loss of opportunity, loss of critical scientific, commercial and/or national defense capabilities, as well as loss of public confidence. The need exists to improve learning and expand the scope of lessons documented and offered to the space industry project team. One of the barriers to incorporating lessons learned include the way in which space system failures are documented. Multiple classes of space system failure information are identified, ranging from "sound bite" summaries in space insurance compendia, to articles in journals, lengthy data-oriented (what happened) reports, and in some rare cases, reports that treat not only the what, but also the why. In addition there are periodically published "corporate crisis" reports, typically issued after multiple or highly visible failures that explore management roles in the failure, often within a politically oriented context. Given the general lack of consistency, it is clear that a good multi-level space system/program failure framework with analytical and predictive capability is needed. This research effort set out to develop such a model. The X-Framework (x-fw) is proposed as an innovative forensic failure analysis approach, providing a multi-level understanding of the space system failure event beginning with the proximate cause, extending to the directly related work or operational processes and upward through successive management layers. The x-fw focus is on capability and control at the process level and examines: (1) management accountability and control, (2) resource and requirement allocation, and (3) planning, analysis, and risk management at each level of management. The x-fw model provides an innovative failure analysis approach for acquiring a multi-level perspective, direct and indirect causation of
Elbaum, Batya; Vaughn, Sharon; Hughes, Marie Tejero; Moody, Sally Watson
Conducts a meta-analysis of supplemental, adult-instructed one-to-one reading interventions for elementary students (N=1,539) at risk for reading failure. Results indicate that interventions using trained volunteers or college students were highly effective. Studies comparing one-to-one with small-group supplemental instruction showed no advantage…
The papers in this volume present basic concepts and new developments in failure and damage analysis with focus on advanced materials such as composites, laminates, sandwiches and foams, and also new metallic materials. Starting from some mathematical foundations (limit surfaces, symmetry considerations, invariants) new experimental results and their analysis are shown. Finally, new concepts for failure prediction and analysis will be introduced and discussed as well as new methods of failure and damage prediction for advanced metallic and non-metallic materials. Based on experimental results the traditional methods will be revised.
Flores, Melissa D.; Malin, Jane T.; Fleming, Land D.
An effort to determine the feasibility of a software tool to assist in Failure Modes and Effects Analysis (FMEA) has been completed. This new and unique approach to FMEA uses model based systems engineering concepts to recommend failure modes, causes, and effects to the user after they have made several selections from pick lists about a component's functions and inputs/outputs. Recommendations are made based on a library using common failure modes identified over the course of several major human spaceflight programs. However, the tool could be adapted for use in a wide range of applications from NASA to the energy industry.
Tekinerdogan, B.; Sözer, Hasan; Aksit, Mehmet
We propose a Software Architecture Reliability Analysis (SARA) approach that benefits from both reliability engineering and scenario-based software architecture analysis to provide an early reliability analysis of the software architecture. SARA makes use of failure scenarios that are prioritized
Full Text Available Gears are very reliable components and normally work 5–6 years without failure. This article is a case study of failure analysis of a gearbox which was failed in three months after its installation. The problem was identified by maintenance engineers through vibration monitoring of gearbox. Hardness measurement of case and core revealed that the core was harder than case and the applied load was sufficiently high for failure of gear. Recommendations were given to improve the fatigue life of gearbox.
Pai, Shantaram S.; Chamis, Christos C.; Murthy, Pappu L. N.; Stefko, George L.; Riha, David S.; Thacker, Ben H.; Nagpal, Vinod K.; Mital, Subodh K.
NASA/NESSUS 6.2c is a general-purpose, probabilistic analysis program that computes probability of failure and probabilistic sensitivity measures of engineered systems. Because NASA/NESSUS uses highly computationally efficient and accurate analysis techniques, probabilistic solutions can be obtained even for extremely large and complex models. Once the probabilistic response is quantified, the results can be used to support risk-informed decisions regarding reliability for safety-critical and one-of-a-kind systems, as well as for maintaining a level of quality while reducing manufacturing costs for larger-quantity products. NASA/NESSUS has been successfully applied to a diverse range of problems in aerospace, gas turbine engines, biomechanics, pipelines, defense, weaponry, and infrastructure. This program combines state-of-the-art probabilistic algorithms with general-purpose structural analysis and lifting methods to compute the probabilistic response and reliability of engineered structures. Uncertainties in load, material properties, geometry, boundary conditions, and initial conditions can be simulated. The structural analysis methods include non-linear finite-element methods, heat-transfer analysis, polymer/ceramic matrix composite analysis, monolithic (conventional metallic) materials life-prediction methodologies, boundary element methods, and user-written subroutines. Several probabilistic algorithms are available such as the advanced mean value method and the adaptive importance sampling method. NASA/NESSUS 6.2c is structured in a modular format with 15 elements.
Ambrose, Paul G
My thesis is a simple one. We have not been doing a good enough job selecting dose regimens for serious infections during the drug development process. If we are to do a better job in the future, we need to revisit some uncomfortable places. That is, some notable program failures. To be clear, we are not revisiting program failures to make anyone uncomfortable or cast aspersions - but rather so that we sow the seeds for a better future. To that end, we will examine program failures and successes through a pharmacometric lens. Through this powerful lens, we will come to understand that many of our failures were not only predictable, but perhaps expected and entirely avoidable. The goal of this communication is to set forth the type of thinking and data that is necessary for rational dose selection. Copyright © 2017 Elsevier Ltd. All rights reserved.
Hanson, John M.; Hill, Ashely D.; Beard, Bernard B.
Launch vehicle ascent is a time of high risk for an on-board crew. There are many types of failures that can kill the crew if the crew is still on-board when the failure becomes catastrophic. For some failure scenarios, there is plenty of time for the crew to be warned and to depart, whereas in some there is insufficient time for the crew to escape. There is a large fraction of possible failures for which time is of the essence and a successful abort is possible if the detection and action happens quickly enough. This paper focuses on abort determination based primarily on data already available from the GN&C system. This work is the result of failure analysis efforts performed during the Ares I launch vehicle development program. Derivation of attitude and attitude rate abort triggers to ensure that abort occurs as quickly as possible when needed, but that false positives are avoided, forms a major portion of the paper. Some of the potential failure modes requiring use of these triggers are described, along with analysis used to determine the success rate of getting the crew off prior to vehicle demise.
Kalbfleisch, John D
Contains additional discussion and examples on left truncation as well as material on more general censoring and truncation patterns.Introduces the martingale and counting process formulation swil lbe in a new chapter.Develops multivariate failure time data in a separate chapter and extends the material on Markov and semi Markov formulations.Presents new examples and applications of data analysis.
Gahlert, M; Burtscher, D; Grunert, I; Kniha, H; Steinhauser, E
The purpose of the present study was the macroscopic and microscopic failure analysis of fractured zirconia dental implants. Thirteen fractured one-piece zirconia implants (Z-Look3) out of 170 inserted implants with an average in situ period of 36.75±5.34 months (range from 20 to 56 months, median 38 months) were prepared for macroscopic and microscopic (scanning electron microscopy [SEM]) failure analysis. These 170 implants were inserted in 79 patients. The patient histories were compared with fracture incidences to identify the reasons for the failure of the implants. Twelve of these fractured implants had a diameter of 3.25 mm and one implant had a diameter of 4 mm. All fractured implants were located in the anterior side of the maxilla and mandibula. The patient with the fracture of the 4 mm diameter implant was adversely affected by strong bruxism. By failure analysis (SEM), it could be demonstrated that in all cases, mechanical overloading caused the fracture of the implants. Inhomogeneities and internal defects of the ceramic material could be excluded, but notches and scratches due to sandblasting of the surface led to local stress concentrations that led to the mentioned mechanical overloading by bending loads. The present study identified a fracture rate of nearly 10% within a follow-up period of 36.75 months after prosthetic loading. Ninety-two per cent of the fractured implants were so-called diameter reduced implants (diameter 3.25 mm). These diameter reduced implants cannot be recommended for further clinical use. Improvement of the ceramic material and modification of the implant geometry has to be carried out to reduce the failure rate of small-sized ceramic implants. Nevertheless, due to the lack of appropriate laboratory testing, only clinical studies will demonstrate clearly whether and how far the failure rate can be reduced. © 2011 John Wiley & Sons A/S.
Full Text Available It is an important subject to research the functional mechanism of cancer-related genes make in formation and development of cancers. The modern methodology of data analysis plays a very important role for deducing the relationship between cancers and cancer-related genes and analyzing functional mechanism of genome. In this research, we construct mutual information networks using gene expression profiles of glioblast and renal in normal condition and cancer conditions. We investigate the relationship between structure and robustness in gene networks of the two tissues using a cascading failure model based on betweenness centrality. Define some important parameters such as the percentage of failure nodes of the network, the average size-ratio of cascading failure and the cumulative probability of size-ratio of cascading failure to measure the robustness of the networks. By comparing control group and experiment groups, we find that the networks of experiment groups are more robust than that of control group. The gene that can cause large scale failure is called structural key gene (SKG. Some of them have been confirmed to be closely related to the formation and development of glioma and renal cancer respectively. Most of them are predicted to play important roles during the formation of glioma and renal cancer, maybe the oncogenes, suppressor genes, and other cancer candidate genes in the glioma and renal cancer cells. However, these studies provide little information about the detailed roles of identified cancer genes.
Frunzaverde, D; Campian, V [Research Center in Hydraulics, Automation and Heat Transfer, ' Eftimie Murgu' University of Resita P-ta Traian Vuia 1-4, RO-320085, Resita (Romania); Muntean, S [Centre of Advanced Research in Engineering Sciences, Romanian Academy - Timisoara Branch Bv. Mihai Viteazu 24, RO-300223, Timisoara (Romania); Marginean, G [University of Applied Sciences Gelsenkirchen, Neidenburger Str. 10, 45877 Gelsenkirchen (Germany); Marsavina, L [Department of Strength, ' Politehnica' University of Timisoara, Bv. Mihai Viteazu 1, RO-300222, Timisoara (Romania); Terzi, R; Serban, V, E-mail: firstname.lastname@example.org, E-mail: email@example.com [Ramnicu Valcea Subsidiary, S.C. Hidroelectrica S.A., Str. Decebal 11, RO-240255, Ramnicu Valcea (Romania)
The variable demand on the energy market requires great flexibility in operating hydraulic turbines. Therefore, turbines are frequently operated over an extended range of regimes. Francis turbines operating at partial load present pressure fluctuations due to the vortex rope in the draft tube cone. This phenomenon generates strong vibrations and noise that may produce failures on the mechanical elements of the machine. This paper presents the failure analysis of a broken Francis turbine runner blade. The failure appeared some months after the welding repair work realized in situ on fatigue cracks initiated near to the trailing edge at the junction with the crown, where stress concentration occurs. In order to determine the causes that led to the fracture of the runner blade, the metallographic investigations on a sample obtained from the blade is carried out. The metallographic investigations included macroscopic and microscopic examinations, both performed with light and scanning electron microscopy, as well as EDX - analyses. These investigations led to the conclusion, that the cracking of the blade was caused by fatigue, initiated by the surface unevenness of the welding seam. The failure was accelerated by the hydrogen embrittlement of the filling material, which appeared as a consequence of improper welding conditions. In addition to the metallographic investigations, numerical computations with finite element analysis are performed in order to evaluate the deformation and stress distribution on blade.
Xu, Andy Yuanguang; Bhatnagar, Jagdish; Bednarz, Greg; Flickinger, John; Arai, Yoshio; Vacsulka, Jonet; Feng, Wenzheng; Monaco, Edward; Niranjan, Ajay; Lunsford, L Dade; Huq, M Saiful
Gamma Knife radiosurgery is a highly precise and accurate treatment technique for treating brain diseases with low risk of serious error that nevertheless could potentially be reduced. We applied the AAPM Task Group 100 recommended failure modes and effects analysis (FMEA) tool to develop a risk-based quality management program for Gamma Knife radiosurgery. A team consisting of medical physicists, radiation oncologists, neurosurgeons, radiation safety officers, nurses, operating room technologists, and schedulers at our institution and an external physicist expert on Gamma Knife was formed for the FMEA study. A process tree and a failure mode table were created for the Gamma Knife radiosurgery procedures using the Leksell Gamma Knife Perfexion and 4C units. Three scores for the probability of occurrence (O), the severity (S), and the probability of no detection for failure mode (D) were assigned to each failure mode by 8 professionals on a scale from 1 to 10. An overall risk priority number (RPN) for each failure mode was then calculated from the averaged O, S, and D scores. The coefficient of variation for each O, S, or D score was also calculated. The failure modes identified were prioritized in terms of both the RPN scores and the severity scores. The established process tree for Gamma Knife radiosurgery consists of 10 subprocesses and 53 steps, including a subprocess for frame placement and 11 steps that are directly related to the frame-based nature of the Gamma Knife radiosurgery. Out of the 86 failure modes identified, 40 Gamma Knife specific failure modes were caused by the potential for inappropriate use of the radiosurgery head frame, the imaging fiducial boxes, the Gamma Knife helmets and plugs, the skull definition tools as well as other features of the GammaPlan treatment planning system. The other 46 failure modes are associated with the registration, imaging, image transfer, contouring processes that are common for all external beam radiation therapy
Logsdon, J M
The 5 January 1972 announcement by President Richard Nixon that the United States would develop during the 1970's a new space transportation system-the space shuttle-has had fundamental impacts on the character of U.S. space activities. In retrospect, it can be argued that the shuttle design chosen was destined to fail to meet many of the policy objectives established for the system; the shuttle's problems in serving as the primary launch vehicle for the United States and in providing routine and cost-effective space transportation are in large part a result of the ways in which compromises were made in the 1971-72 period in order to gain White House and congressional approval to proceed with the program. The decision to develop a space shuttle is an example of a poor quality national commitment to a major technological undertaking.
... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Probability of failure analysis. 417.224..., DEPARTMENT OF TRANSPORTATION LICENSING LAUNCH SAFETY Flight Safety Analysis § 417.224 Probability of failure..., must account for launch vehicle failure probability in a consistent manner. A launch vehicle failure...
Corrosion has a vast impact on the global and domestic economy, and currently incurs losses of nearly $300 billion annually to the U.S. economy alone. Because of the huge impact of corrosion, it is imperative to have a systematic approach to recognizing and mitigating corrosion problems as soon as possible after they become apparent. A proper failure analysis includes collection of pertinent background data and service history, followed by visual inspection, photographic documentation, materi...
Full Text Available Corrosion has a vast impact on the global and domestic economy, and currently incurs losses of nearly $300 billion annually to the U.S. economy alone. Because of the huge impact of corrosion, it is imperative to have a systematic approach to recognizing and mitigating corrosion problems as soon as possible after they become apparent. A proper failure analysis includes collection of pertinent background data and service history, followed by visual inspection, photographic documentation, material evaluation, data review and conclusion procurement. In analyzing corrosion failures, one must recognize the wide range of common corrosion mechanisms. The features of any corrosion failure give strong clues as to the most likely cause of the corrosion. This article details a proven approach to properly determining the root cause of a failure, and includes pictographic illustrations of the most common corrosion mechanisms, including general corrosion, pitting, galvanic corrosion, dealloying, crevice corrosion, microbiologically-influenced corrosion (MIC, corrosion fatigue, stress corrosion cracking (SCC, intergranular corrosion, fretting, erosion corrosion and hydrogen damage.
Full Text Available In the present research work Failure Mode and Effect Analysis (FMEA of an Active Magnetic Bearing (AMB has been presented. Various possible failures modes of AMBs and the corresponding effects of those failures on performance of AMBs have been identified. The identified failure modes of AMBs will facilitate designer to incorporate necessary design features that would prevent the occurrence of the failure. The severity, occurrence and detection of the failures modes are determined based on a rating scale of 1 to 5 to quantify the Risk Priority Number (RPN of the failure modes. The methods to eliminate or reduce the high-risk-failure modes are proposed.
Jones, K.R.; Wade, N.L.; Katsma, K.R.; Siefken, L.J. (EG and G Idaho, Inc., Idaho Falls, ID (United States)); Straka, M. (Halliburton NUS, Idaho Falls, ID (United States))
Research has been conducted to develop and demonstrate a methodology for calculation of the time interval between receipt of the containment isolation signals and the first fuel pin failure for loss-of-coolant accidents (LOCAs). Demonstration calculations were performed for a Babcock and Wilcox (B W) design (Oconee) and a Westinghouse (W) four-loop design (Seabrook). Sensitivity studies were performed to assess the impacts of fuel pin bumup, axial peaking factor, break size, emergency core cooling system availability, and main coolant pump trip on these times. The analysis was performed using the following codes: FRAPCON-2, for the calculation of steady-state fuel behavior; SCDAP/RELAP5/MOD3 and TRACPF1/MOD1, for the calculation of the transient thermal-hydraulic conditions in the reactor system; and FRAP-T6, for the calculation of transient fuel behavior. In addition to the calculation of fuel pin failure timing, this analysis provides a comparison of the predicted results of SCDAP/RELAP5/MOD3 and TRAC-PFL/MOD1 for large-break LOCA analysis. Using SCDAP/RELAP5/MOD3 thermal-hydraulic data, the shortest time intervals calculated between initiation of containment isolation and fuel pin failure are 10.4 seconds and 19.1 seconds for the B W and W plants, respectively. Using data generated by TRAC-PF1/MOD1, the shortest intervals are 10.3 seconds and 29.1 seconds for the B W and W plants, respectively. These intervals are for a double-ended, offset-shear, cold leg break, using the technical specification maximum peaking factor and applied to fuel with maximum design bumup. Using peaking factors commensurate widi actual bumups would result in longer intervals for both reactor designs. This document also contains appendices A through J of this report.
The Failure Environment Analysis Tool, FEAT, enables people to see and better understand the effects of failures in a system. FEAT uses digraph models to determine what will happen to a system if a set of failure events occurs and to identify the possible causes of a selected set of failures. Failures can be user-selected from either engineering schematic or digraph model graphics, and the effects or potential causes of the failures will be color highlighted on the same schematic or model graphic. As a design tool, FEAT helps design reviewers understand exactly what redundancies have been built into a system and where weaknesses need to be protected or designed out. A properly developed digraph will reflect how a system functionally degrades as failures accumulate. FEAT is also useful in operations, where it can help identify causes of failures after they occur. Finally, FEAT is valuable both in conceptual development and as a training aid, since digraphs can identify weaknesses in scenarios as well as hardware. Digraphs models for use with FEAT are generally built with the Digraph Editor, a Macintosh-based application which is distributed with FEAT. The Digraph Editor was developed specifically with the needs of FEAT users in mind and offers several time-saving features. It includes an icon toolbox of components required in a digraph model and a menu of functions for manipulating these components. It also offers FEAT users a convenient way to attach a formatted textual description to each digraph node. FEAT needs these node descriptions in order to recognize nodes and propagate failures within the digraph. FEAT users store their node descriptions in modelling tables using any word processing or spreadsheet package capable of saving data to an ASCII text file. From within the Digraph Editor they can then interactively attach a properly formatted textual description to each node in a digraph. Once descriptions are attached to them, a selected set of nodes can be
Crespo, Luis G.; Munoz, Cesar A.; Narkawicz, Anthony J.; Kenny, Sean P.; Giesy, Daniel P.
This paper proposes an uncertainty analysis framework based on the characterization of the uncertain parameter space. This characterization enables the identification of worst-case uncertainty combinations and the approximation of the failure and safe domains with a high level of accuracy. Because these approximations are comprised of subsets of readily computable probability, they enable the calculation of arbitrarily tight upper and lower bounds to the failure probability. A Bernstein expansion approach is used to size hyper-rectangular subsets while a sum of squares programming approach is used to size quasi-ellipsoidal subsets. These methods are applicable to requirement functions whose functional dependency on the uncertainty is a known polynomial. Some of the most prominent features of the methodology are the substantial desensitization of the calculations from the uncertainty model assumed (i.e., the probability distribution describing the uncertainty) as well as the accommodation for changes in such a model with a practically insignificant amount of computational effort.
Khaleel, Mohammad A.; Simonen, Fredric A.
The work described in this report applies probabilistic structural mechanics models to predict the reliability of nuclear pressure boundary components. These same models are then applied to evaluate the effectiveness of alternative programs for inservice inspection to reduce these failure probabilities. Results of the calculations support the development and implementation of risk-informed inservice inspection of piping and vessels. Studies have specifically addressed the potential benefits of ultrasonic inspections to reduce failure probabilities associated with fatigue crack growth and stress-corrosion cracking. Parametric calculations were performed with the computer code pc-PRAISE to generate an extensive set of plots to cover a wide range of pipe wall thicknesses, cyclic operating stresses, and inspection strategies. The studies have also addressed critical inputs to fracture mechanics calculations such as the parameters that characterize the number and sizes of fabrication flaws in piping welds. Other calculations quantify uncertainties associated with the inputs calculations, the uncertainties in the fracture mechanics models, and the uncertainties in the resulting calculated failure probabilities. A final set of calculations address the effects of flaw sizing errors on the effectiveness of inservice inspection programs.
Begley, S L
The program to immunize 210 million Americans against swine flu failed. It set back the Federal government's relations with state health agencies, private physicians, pharmaceutical manufacturers, and the insurance industry. It increased mistrust of immunization programs and of government health programs in general.The well-intentioned plan had far-reaching consequences because its scope and the speed with which it was implemented were overreactions to the threat. Its size magnified every one of its faults, legal, medical and political. Organizational and scientific capacity were less than expected. Local health agencies could not administer the program with the inadequate funds from HEW and pharmaceutical companies could not produce a safe, effective children's vaccine.Because of the urgency given the program, Congress neglected the opposition of consumer advocates and state health officials, and did not spend time trying to include immunization against childhood disease in the swine flu program.The failure illustrates the dangers of hasty decisions, of considering only direct medical costs and benefits and not social and political effects on health policy, of launching a public health program whose scientific basis is weak and whose administrative requirements are untested.
Full Text Available In this study, the failure analysis on the single lap bonded joint, which is used for joined two composite plates each other with adhesive, is investigated experimentally and numerically. In the joint, the epoxy resin is used for adhesive and the four layered carbon fiber reinforced epoxy matrix resin composite plates are used for adherent. Numerical study is performed in the ANSYS software which is used finite element method for solution. For obtained numerical failure loads, the progressive failure analysis is used with material property degradation rules. In the failure analysis the Hashin Failure Criterion is used for composite plates and the Maximum Principal Stress failure criterion is used for adhesive. The effects of the adhesive thickness overlap lengths and plate weight on the joint strength is investigated with numerically. As a result it is seen that the failure loads is affected the bond face area. The results are presented with graphs and tables.
Full Text Available Materials failure indicates the fault with materials or components during their performance. To avoid the reoccurrence of similar failures, materials failure analysis is executed to investigate the reasons for the failure and to propose improved strategies. The whole procedure needs sufficient domain knowledge and also produces valuable new knowledge. However, the information about the materials failure analysis is usually retained by the domain expert, and its sharing is technically difficult. This phenomenon may seriously reduce the efficiency and decrease the veracity of the failure analysis. To solve this problem, this paper adopts ontology, a novel technology from the Semantic Web, as a tool for knowledge representation and sharing and describes the construction of the ontology to obtain information concerning the failure analysis, application area, materials, and failure cases. The ontology represented information is machine-understandable and can be easily shared through the Internet. At the same time, failure case intelligent retrieval, advanced statistics, and even automatic reasoning can be accomplished based on ontology represented knowledge. Obviously this can promote the knowledge sharing of materials service safety and improve the efficiency of failure analysis. The case of a nuclear power plant area is presented to show the details and benefits of this method.
Baker, Donald J.
The results of an analytical and experimental investigation of the failure of composite is tiffener panels with extension-shear coupling are presented. This tailored concept, when used in the cover skins of a tiltrotor aircraft wing has the potential for increasing the aeroelastic stability margins and improving the aircraft productivity. The extension-shear coupling is achieved by using unbalanced 45 plies in the skin. The failure analysis of two tailored panel configurations that have the center stringer and adjacent skin severed is presented. Finite element analysis of the damaged panels was conducted using STAGS (STructural Analysis of General Shells) general purpose finite element program that includes a progressive failure capability for laminated composite structures that is based on point-stress analysis, traditional failure criteria, and ply discounting for material degradation. The progressive failure predicted the path of the failure and maximum load capability. There is less than 12 percent difference between the predicted failure load and experimental failure load. There is a good match of the panel stiffness and strength between the progressive failure analysis and the experimental results. The results indicate that the tailored concept would be feasible to use in the wing skin of a tiltrotor aircraft.
Using existing data, the EPA's biodiesel emissions analysis program sought to quantify the air pollution emission effects of biodiesel for diesel engines that have not been specifically modified to operate on biodiesel.
Cacciatore, G; Menichelli, M; Albi, F; De Lio, L; Boccanelli, A
Hospitalization of patients with heart failure is often caused by poor adherence to drug therapy, by suboptimal utilization of ACE inhibitors and beta-blockers, and by the lack of systematic monitoring of patients after discharge. The aim of the study is to verify the impact of an outpatient management program on the hospitalization rate and functional status of patients with chronic heart failure. Over a five-year period, 435 patients entered our outpatient management program, which includes adjustment in medical therapy, patient education and visits timed according to the patient's status. Fifty-six percent of the patients were in New York Heart functional class I-II; 74% were male; mean age was 62 +/- 11 years. Heart failure was due to coronary heart disease in 42%, dilated cardiomyopathy in 35%, hypertensive heart disease in 13%, other etiologies in 10%. The following changes in medical therapy were made compared to the period before referral: ACE inhibitors in 88% of the patients vs 70% (p < 0.05), mean dose of enalapril and captopril respectively 18 +/- 6 mg vs 11 +/- 4 mg (p < 0.05) and 89 +/- 28 mg vs 61 +/- 34 mg (p < 0.05); digoxin in 71 vs 70% (NS); furosemide in 90 vs 87%; beta-blockers in 16 vs 6% (p < 0.05); amiodarone in 24 vs 16% (p < 0.05); oral anticoagulants in 22 vs 12% (p < 0.05); calcium channel blockers in 10 vs 16% (p < 0.05). During the follow-up period (35 +/- 11 months), there were 111 hospital admissions compared to 518 during the year before recruitment (p < 0.05). Seventy-two patients died (65 for cardiac causes) and four patients underwent cardiac transplantation. Functional status improved (301 patients in I-II functional class and 56 in III-IV after referral compared to 225 and 132 before referral, respectively). Our results were obtained through adjustment in pharmacological therapy, intensive patient education and therapeutic continuity made possible by our outpatient heart-failure clinic organization. It is likely that the
Tekinerdogan, B.; Sözer, Hasan; Aksit, Mehmet
With the increasing size and complexity of software in embedded systems, software has now become a primary threat for the reliability. Several mature conventional reliability engineering techniques exist in literature but traditionally these have primarily addressed failures in hardware components
The three primary failure modes that may be exhibited by polyethylene (PE) gas pipe materials were described in detail. The modes are: ductile rupture, slow crack growth (SCG), and rapid crack propagation (RCP). Short term mechanical tests were evalu...
Spatola, Jennifer S
High performance fibers have a high tensile strength and modulus, good wear resistance, and a low density, making them ideal for applications in ballistic impact resistance, such as body armor. However, the observed ballistic performance of these fibers is much lower than the predicted values. Since the predictions assume only tensile stress failure, it is safe to assume that the stress state is affecting fiber performance. The purpose of this research was to determine if there are failure mo...
Batson, R. G.
NASA regulations specify that formal risk analysis be performed on a program at each of several milestones. Program risk analysis is discussed as a systems analysis approach, an iterative process (identification, assessment, management), and a collection of techniques. These techniques, which range from extremely simple to complex network-based simulation, are described in this handbook in order to provide both analyst and manager with a guide for selection of the most appropriate technique. All program risk assessment techniques are shown to be based on elicitation and encoding of subjective probability estimates from the various area experts on a program. Techniques to encode the five most common distribution types are given. Then, a total of twelve distinct approaches to risk assessment are given. Steps involved, good and bad points, time involved, and degree of computer support needed are listed. Why risk analysis should be used by all NASA program managers is discussed. Tools available at NASA-MSFC are identified, along with commercially available software. Bibliography (150 entries) and a program risk analysis check-list are provided.
Moriarty, Ann T; Crothers, Barbara A; Bentz, Joel S; Souers, Rhona J; Fatheree, Lisa A; Wilbur, David C
Automatic failure in gynecologic cytology proficiency testing occurs when a high-grade lesion or carcinoma (HSIL+, Category D) is misinterpreted as negative for intraepithelial lesion or malignancy (Category B). To document the automatic failure rate in 2006 and 2007 from the College of American Pathologists proficiency testing program (PAP PT) and compare them to projected values from 2004. Identify automatic failures from PAP PT in 2006 and 2007 and compare the rates of failure regarding participant and preparation type to validated slides in the College of American Pathologists Interlaboratory Comparison Program in 2004. There were 65 264 participant responses for HSIL+ slides included in this analysis from 2006 and 2007. Overall, 1% (666 of 65 264) of the HSIL+ responses were classified as negative, resulting in automatic failure for the participant. There were significantly fewer automatic failures in 2007 as compared with either 2006 or projected from 2004 data (P < .001). Conventional preparations had a lower automatic failure rate than liquid-based preparations but only for 2006. Both pathologists and cytotechnologists interpreting liquid-based preparations faired better than projected from 2004 data. The automatic failure rate in PAP PT is lower than expected based on 2004 data from the College of American Pathologists Interlaboratory Comparison Program. Automatic failures are a relatively small component (1% or less) of proficiency testing failures. The rate of automatic failure decreased from 2006 to 2007 and may be due to loss of poor performers in the testing pool, the test-taking environment, or removal of less robust slides from the program.
Mirzai, M; A Gholami; F. Aminifar
Failures of transformers in sub-transmission systems not only reduce reliability of power system but also have significant effects on power quality since one of the important components of any system quality is reliability of that system. To enhance utility reliability, failure analysis and its rates, failure origin and physical damage causes must be studied. This paper describes a case study of the reliability of sub-transmission transformers (63/20 KV) installed in Mazandaran province, oper...
Full Text Available The mechanical response and the failure mode of thin metal foils under tensile load has been analyzed supplementing the usual test records with full-field measurements performed by three-dimensional digital image correlation (3D DIC techniques. The experiments have been simulated by finite element models formulated within a non-linear continuum framework. The study presented in this contribution concerns symmetrically pre-cracked aluminum samples. The wrinkling of the specimens during the test and the possible and alternative failure mechanisms are evidenced and discussed
Carroll, Allison J; Howrey, Hillary L; Payvar, Susan; Deshida-Such, Kristen; Kansal, Mayank; Brar, Charanjit K
Disease management programs for heart failure (HF) effectively reduce HF-related hospitalization rates and mortality. Shared medical appointments (SMAs) offer a cost-effective delivery method for HF disease management programs. However, few studies have evaluated this cost-effective delivery method of HF disease management among Veterans with acute HF. We hypothesized that Veterans who attended a multidisciplinary HF-SMA clinic promoting HF self-management, compared those who only received individual treatment through the HF specialty clinic, would have better 12-month hospitalization outcomes. We completed a retrospective review of the VA electronic health record for HF-SMA clinic appointments (1/1/2012 to 12/31/2013). The multidisciplinary HF-SMA program comprised 4 weekly sessions covering topics including HF disease, HF medications, diet adherence, physical activity, psychological well-being, and stress management. Patients who attended the HF-SMA clinic (n=54) were compared to patients who were scheduled for an HF-SMA appointment but never attended and were followed only in the HF clinic (n=37). Outcomes were 12-month HF-related and all-cause hospitalization rates, days in the hospital, and time to first hospitalization. Of 141 patients scheduled for an HF-SMA clinic appointment, 54 met criteria for the HF-SMA clinic group and 37 were included in the HF clinic group. The groups did not significantly differ on any sociodemographic variables. Furthermore, no significant differences were observed between the HF-SMA group and the HF clinic group on demographics or hospitalization outcomes, p>.05 for all comparisons. Our results did not support our hypothesis that offering multidisciplinary, HF-SMAs promoting HF self-management skills, above and beyond the individual disease management care provided in an HF specialty clinic, would improve hospitalization outcomes among Veterans with acute HF. Limitations of the present study and recommendations for HF self
Full Text Available This paper shows the conclusions about the corrosion mechanics in storage data magnetic systems (hard disk. It was done from the inspection of 198 units that were in service in nine different climatic regions characteristic for Mexico. The results allow to define trends about the failure forms and the factors that affect them. In turn, this study has analyzed the causes that led to mechanical failure and those due to deterioration by atmospheric corrosion. On the basis of the results obtained from the field sampling, demonstrates that the hard disk failure is fundamentally by mechanical effects. The deterioration by environmental effects were found in read-write heads, integrated circuits, printed circuit boards and in some of the electronic components of the controller card of the device, but not in magnetic storage surfaces. There fore, you can discard corrosion on the surface of the disk as the main kind of failure due to environmental deterioration. To avoid any inconvenience in the magnetic data storage system it is necessary to ensure sealing of the system.
Filardo, Giuseppe; Andriolo, Luca; Balboni, Federica; Marcacci, Maurilio; Kon, Elizaveta
While midterm results of matrix-assisted autologous chondrocyte transplantation (MACT) are now available, less attention has been paid to the evaluation of failures of this surgical approach. Aim of this study was to analyse how "failures" are generally defined in cartilage surgery, in order to understand how the survival rate may change according to different definitions of failure. A systematic review on MACT in the knee was conducted to report failure rates as well as different failure definitions in the available literature. Afterwards, we analysed the survival curve at 8.5-year follow-up of a survey of 193 patients treated with MACT. Using different definitions to identify failures, we compared how the survival rate changed according to the different definitions of failure. The systematic review on 93 papers showed that the average failure rate reported on 3,289 patients was 5.2 % at a mean 34 months of follow-up. However, 41 studies (44.1 %) did not even consider this aspect, and failures were variously defined, thus generating confusing data that make a meta-analysis or a study comparison meaningless. The failure analysis of the MACT survey showed that the survival curve changed significantly depending on the definition applied; in fact, the failure rate ranged from 3.6 to 33.7 %. According to a critical literature and survey analysis, we proposed a combined surgical- and improvement-based definition which led to a failure rate of 25.9 % at midterm/long-term follow-up. Nowadays, failure definitions of cartilage treatments differ in scientific articles, thus generating confusion and heterogeneous data even when applied to the same cohort of patients. While the literature analysis shows a low number of failures, this study demonstrated that if properly addressed with a comprehensive definition, the real failure rate of cartilage surgical procedures in the knee is higher than previously reported. Recognizing failures would give a better understanding and a more
Braaksma, Anne Johannes Jan; Meesters, A.J.; Klingenberg, W.; Hicks, C.
Failure Mode and Effects Analysis (FMEA) is commonly used for designing maintenance routines by analysing potential failures, predicting their effect and facilitating preventive action. It is used to make decisions on operational and capital expenditure. The literature has reported that despite its
Daqing, Li; Yinan, Jiang; Rui, Kang; Havlin, Shlomo
Cascading failures have become major threats to network robustness due to their potential catastrophic consequences, where local perturbations can induce global propagation of failures. Unlike failures spreading via direct contacts due to structural interdependencies, overload failures usually propagate through collective interactions among system components. Despite the critical need in developing protection or mitigation strategies in networks such as power grids and transportation, the propagation behavior of cascading failures is essentially unknown. Here we find by analyzing our collected data that jams in city traffic and faults in power grid are spatially long-range correlated with correlations decaying slowly with distance. Moreover, we find in the daily traffic, that the correlation length increases dramatically and reaches maximum, when morning or evening rush hour is approaching. Our study can impact all efforts towards improving actively system resilience ranging from evaluation of design schemes, development of protection strategies to implementation of mitigation programs.
Yan Li Jian Shua Zhong-Li Jin Ya-Tong Zhao Kui Xu
... combined with internal pressure. Finite element analysis was built according to previous data to study local buckling behavior of pressurized and unpressurized pipes under bending conditions and their differences in local buckling failure modes...
Manzano, M.; Marzo, J. L.; Calle, E.
on topological characteristics. Recently approaches also consider the services supported by such networks. In this paper we carry out a robustness analysis of five real backbone telecommunication networks under defined multiple failure scenarios, taking into account the consequences of the loss of established......Nowadays the ubiquity of telecommunication networks, which underpin and fulfill key aspects of modern day living, is taken for granted. Significant large-scale failures have occurred in the last years affecting telecommunication networks. Traditionally, network robustness analysis has been focused...... connections. Results show which networks are more robust in response to a specific type of failure....
Rudland, D.L.; /Fermilab
The Central Calorimeter and its support cradle are to be supported by either hydraulic or mechanical jacks. If hydraulics are used, each support will use two hydraulically coupled jacks with two out of the four supports hydraulically coupled giving the effect of a three point support system. If mechanical jacks are used, all four points are used for support. Figure 2 shows two examples of jack placement on a 3.5 inch support plate. These two support scenarios lead to five jack failure cases to be studied. This report deals with the way in which a 0.25 inch drop (failed jack) at one support affects the stresses in the cradle. The stresses from each failure case were analyzed in two ways. First, stress factors, defined as quotients of stress intensities of the failed case with respect to the static case, were generated and then, hand calculations similar to those in Engineering Note 3740.215-EN-14 were done using the reaction forces from the failed case.
As part of its EMS, Sandia performs an annual environmental aspects/impacts analysis. The purpose of this analysis is to identify the environmental aspects associated with Sandia's activities, products, and services and the potential environmental impacts associated with those aspects. Division and environmental programs established objectives and targets based on the environmental aspects associated with their operations. In 2007 the most significant aspect identified was Hazardous Materials (Use and Storage). The objective for Hazardous Materials (Use and Storage) was to improve chemical handling, storage, and on-site movement of hazardous materials. One of the targets supporting this objective was to develop an effective chemical exchange program, making a business case for it in FY07, and fully implementing a comprehensive chemical exchange program in FY08. A Chemical Exchange Program (CEP) team was formed to implement this target. The team consists of representatives from the Chemical Information System (CIS), Pollution Prevention (P2), the HWMF, Procurement and the Environmental Management System (EMS). The CEP Team performed benchmarking and conducted a life-cycle analysis of the current management of chemicals at SNL/NM and compared it to Chemical Exchange alternatives. Those alternatives are as follows: (1) Revive the 'Virtual' Chemical Exchange Program; (2) Re-implement a 'Physical' Chemical Exchange Program using a Chemical Information System; and (3) Transition to a Chemical Management Services System. The analysis and benchmarking study shows that the present management of chemicals at SNL/NM is significantly disjointed and a life-cycle or 'Cradle-to-Grave' approach to chemical management is needed. This approach must consider the purchasing and maintenance costs as well as the cost of ultimate disposal of the chemicals and materials. A chemical exchange is needed as a mechanism to re-apply chemicals on site. This
Scott, John H.
NASA's successful conduct of the Apollo Program greatly enhanced the prestige of the United States and remains broadly accepted as America's gift to all Mankind. NASA's accomplishments continue to amaze the world. With the Vision for Space Exploration (VSE) Americans once again tasked NASA to carry out a project that is expected to provide inspiration and economic stimulus to the United States and to the world. In preparation NASA has thoroughly examined space program precedents. There is, however, another precedent which has not been examined in this context but whose scope and environment in many ways parallel the VSE. This project was initiated by a team that had, ten years before, successfully completed an effort that, at a cost of $173 billion (in 2008 dollars), had pushed the envelope of technology, brought economic growth, established their country as the world leader in engineering, and been broadly accepted as that country's gift to all Mankind. The new project was again inspired by popular desire to enhance national prestige and make yet another major contribution to Humanity. This effort was predicted to require eight years and $156 billion (2008 dollars). However, after nine years and expenditures of 96% beyond the baseline, the project collapsed amid bankruptcy, political scandal, and criminal prosecution. This paper applies current project management metrics, such as earned value analysis, to review the strategic decisions in this historic failure and describe its ultimate collapse. Key mistakes are identified, and lessons are drawn which may prove useful in guiding the VSE.
Xie, Zhongdong; Cai, Weiguo; Li, Zhenxing; Guan, YiMing; Zhang, Baocheng; Yang, XiaoTong
One tube was cracked used in the primary reformer furnace in a fertilizer plant for two and half years. In order to find out the causes of cracking, the methods for chemical composition analysis, macro- and microstructure analysis, penetrant testing, weld analysis, crack and surface damage analysis, mechanics property analysis, high temperature endurance performance analysis, stress and wall thickness calculation were adopted. The integrated assessment results showed that the carbon content of the tube was in the lower limit of the standard range; the tube effective wall thickness was too small; local overheating leads to tube cracking in use process.
Butler, Ricky W.; White, Allan L.
The SURE program is a new reliability analysis tool for ultrareliable computer system architectures. The computational methods on which the program is based provide an efficient means for computing accurate upper and lower bounds for the death state probabilities of a large class of semi-Markov models. Once a semi-Markov model is described using a simple input language, the SURE program automatically computes the upper and lower bounds on the probability of system failure. A parameter of the model can be specified as a variable over a range of values directing the SURE program to perform a sensitivity analysis automatically. This feature, along with the speed of the program, makes it especially useful as a design tool.
Cronrath, Pam; Lynch, Timothy W; Gilson, Linda J; Nishida, Carol; Sembar, M Colleen; Spencer, Patricia J; West, Daidre Foote
Hospital systems utilize many varied problem-solving processes to address system improvements and ensure patient safety. The Healthcare Failure Mode Effect Analysis (HFMEA) model is one of these tools and uses a multidisciplinary team to look at processes, diagramming the steps involved to identify potential failure points. The application of the HFMEA model allowed one large health care system to address a complex process by prioritizing proactive change improvements in order to prevent postoperative patient-controlled anesthesia oversedation events. The changes implemented identified 16 failure points with a hazard score of 16 or greater. One year later, the established system HFMEA goal was met: oversedation events were reduced by 50%.
Full Text Available Racheli Magnezi,1 Asaf Hemi,1 Rina Hemi2 1Department of Management, Public Health and Health Systems Management Program, Bar Ilan University, Ramat Gan, 2Endocrine Service Unit, Sheba Medical Center, Tel Aviv, Israel Background: Risk management in health care systems applies to all hospital employees and directors as they deal with human life and emergency routines. There is a constant need to decrease risk and increase patient safety in the hospital environment. The purpose of this article is to review the laboratory testing procedures for parathyroid hormone and adrenocorticotropic hormone (which are characterized by short half-lives and to track failure modes and risks, and offer solutions to prevent them. During a routine quality improvement review at the Endocrine Laboratory in Tel Hashomer Hospital, we discovered these tests are frequently repeated unnecessarily due to multiple failures. The repetition of the tests inconveniences patients and leads to extra work for the laboratory and logistics personnel as well as the nurses and doctors who have to perform many tasks with limited resources.Methods: A team of eight staff members accompanied by the Head of the Endocrine Laboratory formed the team for analysis. The failure mode and effects analysis model (FMEA was used to analyze the laboratory testing procedure and was designed to simplify the process steps and indicate and rank possible failures.Results: A total of 23 failure modes were found within the process, 19 of which were ranked by level of severity. The FMEA model prioritizes failures by their risk priority number (RPN. For example, the most serious failure was the delay after the samples were collected from the department (RPN =226.1.Conclusion: This model helped us to visualize the process in a simple way. After analyzing the information, solutions were proposed to prevent failures, and a method to completely avoid the top four problems was also developed. Keywords: failure mode
Sözer, Hasan; Tekinerdogan, B.; Aksit, Mehmet; de Lemos, Rogerio; Gacek, Cristina
Several reliability engineering approaches have been proposed to identify and recover from failures. A well-known and mature approach is the Failure Mode and Effect Analysis (FMEA) method that is usually utilized together with Fault Tree Analysis (FTA) to analyze and diagnose the causes of failures.
Full Text Available The present paper explores advanced approaches to the FMEA method (Failure Mode and Effect Analysis which take into account the costs associated with occurrence of failures during the manufacture of a product. Different approaches are demonstrated using an example FMEA application to production of drawn wire. Their purpose is to determine risk levels, while taking account of the above-mentioned costs. Finally, the resulting priority levels are compared for developing actions mitigating the risks.
Hastings-Tolsma, Marie; Nolte, Anna G W
to reconceptualise the concept of failure to rescue, distinguishing it from its current scientific usage as a surveillance strategy to recognise physiologic decline. failure to rescue has been consistently defined as a failure to save a patient׳s life after development of complications. The term, however, carries a richer connotation when viewed within a midwifery context. Midwives have historically believed themselves to be the vanguards of normal, physiologic processes, including birth. This philosophy mandates careful consideration of what it means to promote normal birth and the consequences of failure to rescue women from processes which challenge that outcome. the Medline, CINAHL, PsycINFO, PubMED, Web of Science and Google Scholar databases were searched from the period of 1992-2014 using the key terms of concept analysis, failure-to-rescue, childbirth, midwifery outcomes, obstetrical outcomes, suboptimal care, and patient outcomes. English language reports were used exclusively. The search yielded 45 articles which were reviewed in this paper. a critical analysis of the published literature was undertaken as a means of determining the adequacy of the concept for midwifery practice and to detail how it relates to other concepts important in development of a conceptual framework promoting normal birth processes. failure to rescue within the context of the midwifery model of care requires robust attention to a midwifery managed setting and surveillance based on a caring presence, patient protection, and midwifery partnership with patient. clarifying the definition of failure to rescue in childbirth and defining its attributes can help inform midwifery providers throughout the world of the ethical importance of considering failure to rescue in clinical practice. Relevance to midwifery care mandates use of failure to rescue as both a process and outcome measure. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
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Cano Novillo, I; Benavent Gordo, M I; Portela Casalod, E; Delgado Muñoz, M D; Aguado Roncero, P; Vilariño Mosquera, A; Berchi García, F J
Recurrent gastroesophageal reflux following fundoplication is a challenging problem, because it is usually refractory to medical treatment and a second, technically difficult, antireflux operation is required. Different factors that may contribute to surgery failure have been identified in children. We present 8 cases who underwent redofundoplication after failed procedures, from a total number of 96 patients operated on due to gastroesophageal reflux. Four patient's had their initial fundoplication performed at our institution. Six patients were neurologically impaired, six had chronic pulmonary disease, and two had esophageal atresia. The main presenting symptoms were recurrent vomiting (n = 8) and aspiration (n = 4). Gastroesophageal reflux was confirmed by barium swallow and endoscopy. Operative findings showed wrap breakdown in two cases, warp breakdown associated with hiatal hernia in five, wrap breakdown associated with paraesophageal hernia in two cases, and paraesophageal hernia with normal wrap in one. A second Nissen procedure were performed in five cases, whereas a Collis-Nissen gastroplasty was realized in three with a short esophagus. Six patients had a successful outcome remaining symptom free, one has severe disphagia, and one has recurrent vomiting. In our experience, patients with recurrent gastroesophageal reflux disease should undergo an antireflux procedure tailored to specific anatomic or functional abnormalities.
Sheena Xin Liu
Full Text Available Telehealth programs for congestive heart failure have been shown to be clinically effective. This study assesses clinical and economic consequences of providing telehealth programs for CHF patients. A Markov model was developed and presented in the context of a home-based telehealth program on CHF. Incremental life expectancy, hospital admissions, and total healthcare costs were examined at periods ranging up to five years. One-way and two-way sensitivity analyses were also conducted on clinical performance parameters. The base case analysis yielded cost savings ranging from $2832 to $5499 and 0.03 to 0.04 life year gain per patient over a 1-year period. Applying telehealth solution to a low-risk cohort with no prior admission history would result in $2502 cost increase per person over the 1-year time frame with 0.01 life year gain. Sensitivity analyses demonstrated that the cost savings were most sensitive to patient risk, baseline cost of hospital admission, and the length-of-stay reduction ratio affected by the telehealth programs. In sum, telehealth programs can be cost saving for intermediate and high risk patients over a 1- to 5-year window. The results suggested the economic viability of telehealth programs for managing CHF patients and illustrated the importance of risk stratification in such programs.
Schuller, Bradley W; Burns, Angi; Ceilley, Elizabeth A; King, Alan; LeTourneau, Joan; Markovic, Alexander; Sterkel, Lynda; Taplin, Brigid; Wanner, Jennifer; Albert, Jeffrey M
To report our early experiences with failure mode and effects analysis (FMEA) in a community practice setting. The FMEA facilitator received extensive training at the AAPM Summer School. Early efforts focused on department education and emphasized the need for process evaluation in the context of high profile radiation therapy accidents. A multidisciplinary team was assembled with representation from each of the major department disciplines. Stereotactic radiosurgery (SRS) was identified as the most appropriate treatment technique for the first FMEA evaluation, as it is largely self-contained and has the potential to produce high impact failure modes. Process mapping was completed using breakout sessions, and then compiled into a simple electronic format. Weekly sessions were used to complete the FMEA evaluation. Risk priority number (RPN) values > 100 or severity scores of 9 or 10 were considered high risk. The overall time commitment was also tracked. The final SRS process map contained 15 major process steps and 183 subprocess steps. Splitting the process map into individual assignments was a successful strategy for our group. The process map was designed to contain enough detail such that another radiation oncology team would be able to perform our procedures. Continuous facilitator involvement helped maintain consistent scoring during FMEA. Practice changes were made responding to the highest RPN scores, and new resulting RPN scores were below our high-risk threshold. The estimated person-hour equivalent for project completion was 258 hr. This report provides important details on the initial steps we took to complete our first FMEA, providing guidance for community practices seeking to incorporate this process into their quality assurance (QA) program. Determining the feasibility of implementing complex QA processes into different practice settings will take on increasing significance as the field of radiation oncology transitions into the new TG-100 QA
Zhu, Zhaosheng; Yegneswaran, Vinod; Chen, Yan
We propose failure information analysis as a novel strategy for uncovering malware activity and other anomalies in enterprise network traffic. A focus of our study is detecting self-propagating malware such as worms and botnets. We begin by conducting an empirical study of transport- and application-layer failure activity using a collection of long-lived malware traces. We dissect the failure activity observed in this traffic in several dimensions, finding that their failure patterns differ significantly from those of real-world applications. Based on these observations, we describe the design of a prototype system called Netfuse to automatically detect and isolate malware-like failure patterns. The system uses an SVM-based classification engine to identify suspicious systems and clustering to aggregate failure activity of related enterprise hosts. Our evaluation using several malware traces demonstrates that the Netfuse system provides an effective means to discover suspicious application failures and infected enterprise hosts. We believe it would be a useful complement to existing defenses.
Zakimi, Ken; Watanabe, Hiroyuki; Ishida, Hideki; Take, Toshio; Kato, Mitsuyoshi; Iwai, Tsugunori; Nitta, Masaru; Kato, Kyouichi; Nakazawa, Yasuo
We analyzed a number of cases about the Linac troubles in our hospital and have examined the effect of preventive maintenance with Weibull analysis and exponential distribution from April 2001 to March 2012. The total failure by irradiation disabled was 1, 192. (1) Medical linear accelerator (MLC) system was 24.0%, (2) radiation dosimetry system 13.1%, and the (3) cooling-water system was 26.5%. It accounts for 63.6% of the total number of failures. Each parameter value m, which means the shape parameter, and the failure period expectancy of parts μ were (1) 1.21, 1.46/3.9, 3.8 years. 3.7, 3.6 years. (2) 2.84, 1.59/6.6, 4.3 years. 6.7, 5.9 years. (3) 5.12, 4.16/6.1, 8.5 years. 6.1, 8.5 years. Each shape parameter was m>1. It is believed that they are in the worn-out failure period. To prevent failure, MLC performance should be overhauled once every 3 years and a cooling unit should be overhauled once every 7 years. Preventive maintenance is useful in assessing the failure of radiation therapy equipment. In a radiation dosimetry part, you can make a preemptive move before the failure by changing the monitor's dosimeter board with a new part from the repairs stockpiled every 6 months for maintenance.
Full Text Available The paper deals with a program SNAP for symbolic analysis of linear circuits in frequency domain. The program is suitable for analysis of circuits with ideal network elements to explore basic principles of their operation. Besides graphical presentation the analysis results can be exported to popular mathematical programs for further processing. Currently, an algorithm for exact symbolic analysis is implemented. Therefore the program is suitable for relatively small circuits.
Home; Journals; Bulletin of Materials Science; Volume 24; Issue 2. Failure analysis of multiple delaminated ... Conventional first order shear deformation is assumed using eight-noded isoparametric quadratic elements to develop the finite element analysis procedure. Composite plates are assumed to contain both single ...
Jamshidi, Ali; Faghih-Roohi, Shahrzad; Hajizadeh, Siamak; Núñez, Alfredo; Babuska, Robert; Dollevoet, Rolf; Li, Zili; De Schutter, Bart
Railway infrastructure monitoring is a vital task to ensure rail transportation safety. A rail failure could result in not only a considerable impact on train delays and maintenance costs, but also on safety of passengers. In this article, the aim is to assess the risk of a rail failure by analyzing a type of rail surface defect called squats that are detected automatically among the huge number of records from video cameras. We propose an image processing approach for automatic detection of squats, especially severe types that are prone to rail breaks. We measure the visual length of the squats and use them to model the failure risk. For the assessment of the rail failure risk, we estimate the probability of rail failure based on the growth of squats. Moreover, we perform severity and crack growth analyses to consider the impact of rail traffic loads on defects in three different growth scenarios. The failure risk estimations are provided for several samples of squats with different crack growth lengths on a busy rail track of the Dutch railway network. The results illustrate the practicality and efficiency of the proposed approach. © 2017 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.
J. Nasl Seraji
Full Text Available Background and aims Prevention of potential accidents and safety promotion in chemical processes requires systematic safety management in them. The main objective of this study was analysis of important process equipment components failure modes and effects in H2S and CO2 isolation from extracted natural gas process. Methods This study was done in sweetening unit of an Iranian gas refinery. Failure Mode and Effect Analysis (FMEA used for identification of process equipments failures. Results Totally 30 failures identified and evaluated using FMEA. P-1 blower's blade breaking and sour gas pressure control valve bearing tight moving had maximum risk Priority number (RPN, P-1 body corrosion and increasing plug lower side angle of reach DEAlevel control valve in tower - 1 were minimum calculated RPN. Conclusion By providing a reliable documentation system for equipment failures and incidents recording, maintaining of basic information for later safety assessments would be possible. Also, the probability of failures and effects could be minimized by conducting preventive maintenance.
Tannure, Patricia Nivoloni; Barcelos, Roberta; Portela, Maristela Barbosa; Gleiser, Rogerio; Primo, Laura Guimarães
The objective of this study was to identify the probable factors associated with pulpectomy failure of primary teeth through qualitative analysis by histopathology (HIST) and scanning electron microscopy (SEM). A longitudinal clinical investigation of the efficacy of pulpectomy in primary teeth with irreversible pulp changes was carried out with 133 teeth (66 children) evaluated up to 48 months. The overall success was 86.1% during follow-up. Of the 18 teeth extracted as a result of treatment failure, 8 presented sufficiently undamaged roots to be randomly selected for HIST (n = 4) and SEM (n = 4) analysis. Necrotic tissue and chronic inflammatory cells were observed in all specimens submitted to HIST as external radicular resorption associated with Howship's lacunae. SEM analysis showed apical and furcation areas heavily infected with microorganisms and Howship's lacunae. These findings suggest that the main factors responsible for pulpectomy failure were technique limitations associated with the morphological irregularities created by external/inflammatory resorption.
This philosophical treatise argues the merits of Human Reliability Analysis (HRA) in the context of the nuclear power industry. Actually, the author attacks historic and current HRA as having failed in informing policy makers who make decisions based on risk that humans contribute to systems performance. He argues for an HRA based on Bayesian (fact-based) inferential statistics, which advocates a systems analysis process that employs cogent heuristics when using opinion, and tempers itself with a rational debate over the weight given subjective and empirical probabilities.
Gudla, Visweswara Chakravarthy; Ambat, Rajan
the susceptibility of these systems to galvanic corrosion. In this study, traditional behind the ear (BTE) hearing aid systems, which failed during service were analysed. Failure analysis was performed on the dome type battery-spring contact systems. The morphology of the contact areas was observed using scanning...... electron microscopy, and the compositional analysis of the corrosion products and contaminants was performed using energy dispersive X-ray spectroscopy. Wear track morphology was observed on the contact points, and the top coating on the dome was worn out exposing the substrate spring material....... The obtained results were correlated to the underlying corrosion mechanism and the failure mode is presented....
Zimmermann, M; Kazimi, M S; Siu, N O; Thome, R J
A failure modes and consequence analysis of fusion magnet system is an important contributor towards enhancing the design by improving the reliability and reducing the risk associated with the operation of magnet systems. In the first part of this study, a failure mode analysis of a superconducting magnet system is performed. Building on the functional breakdown and the fault tree analysis of the Toroidal Field (TF) coils of the Next European Torus (NET), several subsystem levels are added and an overview of potential sources of failures in a magnet system is provided. The failure analysis is extended to the Poloidal Field (PF) magnet system. Furthermore, an extensive analysis of interactions within the fusion device caused by the operation of the PF magnets is presented in the form of an Interaction Matrix. A number of these interactions may have significant consequences for the TF magnet system particularly interactions triggered by electrical failures in the PF magnet system. In the second part of this study, two basic categories of electrical failures in the PF magnet system are examined: short circuits between the terminals of external PF coils, and faults with a constant voltage applied at external PF coil terminals. An electromagnetic model of the Compact Ignition Tokamak (CIT) is used to examine the mechanical load conditions for the PF and the TF coils resulting from these fault scenarios. It is found that shorts do not pose large threats to the PF coils. Also, the type of plasma disruption has little impact on the net forces on the PF and the TF coils. 39 refs., 30 figs., 12 tabs.
Full Text Available Failure analysis of the boiler water-wall tube is presented in this work. In order to examine the causes of failure, various techniques including visual inspection, chemical analysis, optical microscopy, scanning electron microscopy and energy dispersive spectroscopy were carried out. Tube wall thickness measurements were performed on the ruptured tube. The fire-facing side of the tube was observed to have experienced significant wall thinning. The composition of the matrix material of the tube meets the requirements of the relevant standards. Microscopic examinations showed that the spheroidization of pearlite is not very obvious. The failure mechanism is identified as a result of the significant localized wall thinning of the boiler water-wall tube due to oxidation.
Full Text Available Purpose of the article is to present partial results of research solutions in the doctoral thesis Risk Management of customer driven projects. Background is the data from the organization Johnson Controls Inc., s.r.o. – OZ Trencin, presented as a case study. The overall aim is to identify and reduce project risks which are considered as decisive steps in managing successful projects. The principle is based on mapping current literature on risk management as many of problems that currently exist with respect to various projects such as delay, framework changes and even cancellation or revocation of the project may be due to inefficient risk management. The solution is the FMEA method. In order to use this type of risk analysis, the values of severity, occurrence and detection are standard values of FMEA slightly modified according to the guidelines of the organization. The result is presented as a case study in the final section of the article.
Items are shown that have caused 90% of the nuclear unit outages and/or deratings between 1971 and 1980 and the magnitude of the problem indicated by an estimate of power replacement cost when the units are out of service or derated. The funding EPRI has provided on these specific items for R and D and technology transfer in the past and the funding planned in the future (1982 to 1986) are shown. EPRI's R and D may help the utilities on only a small part of their nuclear unit outage problems. For example, refueling is the major cause for nuclear unit outages or deratings and the steam turbine is the second major cause for nuclear unit outages; however, these two items have been ranked fairly low on the EPRI priority list for R and D funding. Other items such as nuclear safety (NRC requirements), reactor general, reactor and safety valves and piping, and reactor fuel appear to be receiving more priority than is necessary as determined by analysis of nuclear unit outage causes.
Salem, Khal; Fallata, Dania; ElSebaie, Maha; Montasser, Ahmad; ElGedamy, Khaled; ElKhateeb, Osama
We aimed to evaluate congestive heart failure (CHF) multidisciplinary disease management program (DMProg) impact on mortality, readmission rates, length of stay (LOS), and gender health characteristics. This was a quasi-observational, pre- and post-trial with a parallel nonequivalent group. We enrolled 174 inpatients having CHF with reduced ejection fraction and New York Heart Association (NYHA) Class II-IV, and a total of 197 hospital admissions. A comparative follow-up was performed from 15 December 2014 to 15 December 2015. Among 197 consecutive hospital admissions, 76 (39%) were included in the preintervention or usual care group and 121 (61%) were assigned to the postintervention group. After 1 year, in comparison with the preintervention group, the postintervention group had shorter average LOS in days (7.6 days vs. 11.1 days, p < 0.002), lower 1-year readmission rate (36% vs. 57%, p < 0.003), and lower in-house mortality (1.6% vs. 7.8%, p = 0.03), but similar baseline mortality scores (38.2 vs. 38.6, p = 0.7), 30-day and 90-day readmission rates (15% vs. 18.3%, p = 0.62 and 27.6% vs. 30%, p = 0.65), and 30-day readmission risk score (24.9% vs. 26.2%, p = 0.09). By regression analysis, the DMProg intervention was an independent factor for 1-year readmission reduction (p = 0.001). Kaplan-Meier survival analysis favored the postintervention group (log-rank, p < 0.001). DMProg significantly decreased 1-year readmission rates, LOS, and in-house mortality.
A new apron pavement for parking aircrafts was constructed in 2014, but major depressions occurred when used by aircrafts soon after the construction. Failure analysis revealed structural design inconsistent with the United States Federal Aviation Administration Design Code AC 150-5320-6E. The methodologies for the ...
Despite Failure Mode and Effect Analysis (FMEA) being a strategic technique for creation of error free service operation, detailed survey study and development of opportunity roadmap for FMEA application in service operation is limited in literature. We presented a preliminary literature survey between 1994 and 2010 that ...
... the crude, but had a rather low fatigue strength (46.10N/mm2) when compared to the standard. It is suggested that welded joints in pipes be heat-treated and coated on clean substrate pipe in order to enhance material integrity in service. Keywords: Failure Analysis, Oil Pipeline, Corrosion, Environment, Photomicrograph ...
Department of Aerospace Engineering, *Department of Civil Engineering, Indian Institute of Technology,. Kharagpur 721 302, India. Abstract. The present work aims at the first ply failure analysis of laminated composite plates with arbitrarily located multiple delaminations subjected to transverse static load as well as impact.
This text provides an excellent bridge between principal theories and concepts and their practical implementation. Topics include convex programming, duality, generalized convexity, analysis of selected nonlinear programs, techniques for numerical solutions, and unconstrained optimization methods.
Leitão Júnior, Plínio de Sá; Universidade Federal de Lavras; Vilela, Plínio Robert Souza; Universidade Metodista de Piracicaba; Jino, Mario; Unicamp
Database applications, including SQL-based applications, have received little attention directed towards improving the knowledge of their possible faults. This paper deals with issues related to software faults and failures aiming at understanding what types of faults occur in SQL manipulation commands, and how they are propagated to the output of command execution. SQL manipulation commands are studied and their structure is organized into structural items, a step towards understanding and g...
Shebl, Nada Atef; Franklin, Bryony Dean; Barber, Nick
Failure Mode and Effects Analysis (FMEA) is a prospective risk assessment tool that has been widely used within the aerospace and automotive industries and has been utilised within healthcare since the early 1990s. The aim of this study was to explore the validity of FMEA outputs within a hospital setting in the United Kingdom. Two multidisciplinary teams each conducted an FMEA for the use of vancomycin and gentamicin. Four different validity tests were conducted: Face validity: by comparing the FMEA participants' mapped processes with observational work. Content validity: by presenting the FMEA findings to other healthcare professionals. Criterion validity: by comparing the FMEA findings with data reported on the trust's incident report database. Construct validity: by exploring the relevant mathematical theories involved in calculating the FMEA risk priority number. Face validity was positive as the researcher documented the same processes of care as mapped by the FMEA participants. However, other healthcare professionals identified potential failures missed by the FMEA teams. Furthermore, the FMEA groups failed to include failures related to omitted doses; yet these were the failures most commonly reported in the trust's incident database. Calculating the RPN by multiplying severity, probability and detectability scores was deemed invalid because it is based on calculations that breach the mathematical properties of the scales used. There are significant methodological challenges in validating FMEA. It is a useful tool to aid multidisciplinary groups in mapping and understanding a process of care; however, the results of our study cast doubt on its validity. FMEA teams are likely to need different sources of information, besides their personal experience and knowledge, to identify potential failures. As for FMEA's methodology for scoring failures, there were discrepancies between the teams' estimates and similar incidents reported on the trust's incident
Gupta, Ankur; Allen, Larry A; Bhatt, Deepak L; Cox, Margueritte; DeVore, Adam D; Heidenreich, Paul A; Hernandez, Adrian F; Peterson, Eric D; Matsouaka, Roland A; Yancy, Clyde W; Fonarow, Gregg C
Public reporting of hospitals' 30-day risk-standardized readmission rates following heart failure hospitalization and the financial penalization of hospitals with higher rates have been associated with a reduction in 30-day readmissions but have raised concerns regarding the potential for unintended consequences. To examine the association of the Hospital Readmissions Reduction Program (HRRP) with readmission and mortality outcomes among patients hospitalized with heart failure within a prospective clinical registry that allows for detailed risk adjustment. Interrupted time-series and survival analyses of index heart failure hospitalizations were conducted from January 1, 2006, to December 31, 2014. This study included 115 245 fee-for-service Medicare beneficiaries across 416 US hospital sites participating in the American Heart Association Get With The Guidelines-Heart Failure registry. Data analysis took place from January 1, 2017, to June 8, 2017. Time intervals related to the HRRP were before the HRRP implementation (January 1, 2006, to March 31, 2010), during the HRRP implementation (April 1, 2010, to September 30, 2012), and after the HRRP penalties went into effect (October 1, 2012, to December 31, 2014). Risk-adjusted 30-day and 1-year all-cause readmission and mortality rates. The mean (SD) age of the study population (n = 115 245) was 80.5 (8.4) years, 62 927 (54.6%) were women, and 91 996 (81.3%) were white and 11 037 (9.7%) were black. The 30-day risk-adjusted readmission rate declined from 20.0% before the HRRP implementation to 18.4% in the HRRP penalties phase (hazard ratio (HR) after vs before the HRRP implementation, 0.91; 95% CI, 0.87-0.95; P service Medicare beneficiaries discharged after heart failure hospitalizations, implementation of the HRRP was temporally associated with a reduction in 30-day and 1-year readmissions but an increase in 30-day and 1-year mortality. If confirmed, this finding may require reconsideration of the HRRP in
McLaughlin, P.V. Jr.; Dasgupta, A.; Chun, Y.W.
The BILAM code which uses constant strain laminate analysis to generate in-plane load/deformation or stress/strain history of composite laminates to the point of laminate failure is described. The program uses bilinear stress-strain curves to model layer stress-strain behavior. Composite laminates are used for flywheels. The use of this computer code will help to develop data on the behavior of fiber composite materials which can be used by flywheel designers. In this program the stress-strain curves are modelled by assuming linear response in axial tension while using bilinear approximations (2 linear segments) for stress-strain response to axial compressive, transverse tensile, transverse compressive and axial shear loadings. It should be noted that the program attempts to empirically simulate the effects of the phenomena which cause nonlinear stress-strain behavior, instead of mathematically modelling the micromechanics involved. This code, therefore, performs a bilinear laminate analysis, and, in conjunction with several user-defined failure interaction criteria, is designed to provide sequential information on all layer failures up to and including the first fiber failure. The modus operandi is described. Code BILAM can be used to: predict the load-deformation/stress-strain behavior of a composite laminate subjected to a given combination of in-plane loads, and make analytical predictions of laminate strength.
Nagarkar, A. P.; Herakovich, C. T.
A quasi-three dimensional, nonlinear elastic finite element stress analysis of finite width composite laminates including curing stresses is presented. Cross-ply, angle-ply, and two quasi-isotropic graphite/epoxy laminates are studied. Curing stresses are calculated using temperature dependent elastic properties that are input as percent retention curves, and stresses due to mechanical loading in the form of an axial strain are calculated using tangent modulii obtained by Ramberg-Osgood parameters. It is shown that curing stresses and stresses due to tensile loading are significant as edge effects in all types of laminate studies. The tensor polynomial failure criterion is used to predict the initiation of failure. The mode of failure is predicted by examining individual stress contributions to the tensor polynomial.
Arabian-Hoseynabadi, H.; Oraee, H.; Tavner, P.J.
The Failure Modes and Effects Analysis (FMEA) method has been used to study the reliability of many different power generation systems. This paper now applies that method to a wind turbine (WT) system using a proprietary software reliability analysis tool. Comparison is made between the quantitative results of an FMEA and reliability field data from real wind turbine systems and their assemblies. These results are discussed to establish relationships which are useful for future wind turbine d...
Hebert, Kathy; Dias, Andre; Franco, Emiliana; Tamariz, Leonardo; Steen, Dylan; Arcement, Lee M
In order to provide efficient utilization of resources in an outpatient setting for acute exacerbation of heart failure (HF), the authors piloted an open-access outpatient intravenous (IV) diuretic program (IVDP) to evaluate utilization in an HF disease management program (HFDMP), patient characteristics for users of the program, and safety. An outpatient HFDMP at Jackson Memorial Hospital in Miami, Florida, enrolling 577 patients 18 years and older with an ejection fraction ≤40% was implemented. For symptoms or weight gain ≥5 pounds, patients were eligible to use an open-access IVDP during clinic hours. A total of 130 HFDM patients (22.5%) used the IVDP. IVDP users were more likely to be diabetic, with lower body mass indices than non-IVDP users. New York Heart Association class IV patients and previously hospitalized patients were more likely to use the IVDP. There were no documented adverse reactions for patients receiving treatment and no difference in mortality between groups. This open-access outpatient IVDP model for patients with HF was readily utilized by the HFDMP participants and appears safe for use in this population. This unique model may provide alternative access for acute HF treatment. Congest Heart Fail. © 2011 Wiley Periodicals, Inc.
Dang, Weixiong; Yi, Anji; Jhamnani, Sunny; Wang, Shi-Yi
Heart failure causes significant health and financial burdens for patients and society. Multidisciplinary management program (MMP) and exercise training program (ETP) have been reported as cost-effective in improving health outcomes, yet no study has compared the 2 programs. We constructed a Markov model to simulate life year (LY) gained and total costs in usual care (UC), MMP, and ETP. The probability of transitions between states and healthcare costs were extracted from previous literature. We calculated the incremental cost-effectiveness ratio (ICER) over a 10-year horizon. Model robustness was assessed through 1-way and probabilistic sensitivity analyses. The expected LY for patients treated with UC, MMP, and ETP was 7.6, 8.2, and 8.4 years, respectively. From a societal perspective, the expected cost of MMP was $20,695, slightly higher than the cost of UC ($20,092). The cost of ETP was much higher ($48,378) because of its high implementation expense and the wage loss it incurred. The ICER of MMP versus UC was $976 per LY gained, and the ICER of ETP versus MMP was $165,702 per LY gained. The results indicated that, under current cost-effectiveness threshold, MMP is cost-effective compared with UC, and ETP is not cost-effective compared with MMP. However, ETP is cost-effective compared with MMP from a healthcare payer's perspective. Copyright © 2017 Elsevier Inc. All rights reserved.
Frady, Greg; Nesman, Thomas; Zoladz, Thomas; Szabo, Roland
For many years, the capabilities to determine the root-cause failure of component failures have been limited to the analytical tools and the state of the art data acquisition systems. With this limited capability, many anomalies have been resolved by adding material to the design to increase robustness without the ability to determine if the design solution was satisfactory until after a series of expensive test programs were complete. The risk of failure and multiple design, test, and redesign cycles were high. During the Space Shuttle Program, many crack investigations in high energy density turbomachines, like the SSME turbopumps and high energy flows in the main propulsion system, have led to the discovery of numerous root-cause failures and anomalies due to the coexistences of acoustic forcing functions, structural natural modes, and a high energy excitation, such as an edge tone or shedding flow, leading the technical community to understand many of the primary contributors to extremely high frequency high cycle fatique fluid-structure interaction anomalies. These contributors have been identified using advanced analysis tools and verified using component and system tests during component ground tests, systems tests, and flight. The structural dynamics and fluid dynamics communities have developed a special sensitivity to the fluid-structure interaction problems and have been able to adjust and solve these problems in a time effective manner to meet budget and schedule deadlines of operational vehicle programs, such as the Space Shuttle Program over the years.
Full Text Available Failures of transformers in sub-transmission systems not only reduce reliability of power system but also have significant effects on power quality since one of the important components of any system quality is reliability of that system. To enhance utility reliability, failure analysis and its rates, failure origin and physical damage causes must be studied. This paper describes a case study of the reliability of sub-transmission transformers (63/20 KV installed in Mazandaran province, operated in sub-transmission system. The information obtained from Meandering Regional Electric Company. The results of study and analysis on 60 substation including more than 110 transformers installed in sub-transmission system show that the failure modes of transformers can be represented by Weibull distribution. Weibull statistics have been widely used and accepted as a successful mathematical method to predict the remaining life time of any equipment. Useful conclusions are presented both for power systems operators and manufactures for improving the reliability of transformers.
Naidu, Sanjiv H.
Small joint replacement arthroplasty of the hand is a well accepted surgical procedure to restore function and cosmesis in an individual with a crippled hand. Silicone elastomers have been used as prosthetic material in various small hand joints for well over three decades. Although the clinical science aspects of silicone elastomer failure are well known, the physical science aspects of prosthetic failure are scant and vague. In the following thesis, using both an animal model, and actual retrieved specimens which have failed in human service, experimental and failure analysis of silicone finger joints are presented. Fractured surfaces of retrieved silicone trapezial implants, and silicone finger joint implants were studied with both FESEM and SEM; the mode of failure for silicone trapezium is by wear polishing, whereas the finger joint implants failed either by fatigue fracture or tearing of the elastomer, or a combination of both. Thermal analysis revealed that the retrieved elastomer implants maintained its viscoelastic properties throughout the service period. In order to provide for a more functional and physiologic arthroplasty a novel finger joint (Rolamite prosthesis) is proposed using more recently developed thermoplastic polymers. The following thesis also addresses the outcome of the experimental studies of the Rolamite prosthesis in a rabbit animal model, in addition to the failure analysis of the thermoplastic polymers while in service in an in vivo synovial environment. Results of retrieved Rolamite specimens suggest that the use for thermoplastic elastomers such as block copolymer based elastomers in a synovial environment such as a mammalian joint may very well be limited.
Bell, Daniel; Cox, Lisa; Jackson, Steve; Schaefer, Phil
The authors have developed a tool that automates the reasoning portion of a failure modes and effects analysis (FMEA). It is built around a flexible causal reasoning module that has been adapted to the FMEA procedure. The approach and software architecture have been proven. A prototype tool has been created and successfully passed a test and evaluation program. The authors are expanding the operational capability and adapting the tool to various CAD/CAE (computer-aided design and engineering) platforms.
Fonseca, J. M.; A. P. Peres
Cleaner production programs (CP) and Failure Modes and Effects Analysis (FMEA) are tools used to improve the sustainability of industries, ensuring greater profitability, quality, reliability and safety of their products and services. The meat industry is among the most polluting industries because of the large amounts of organic waste produced during meat processing. The objective of this study was to combine the CP and FMEA tools and to apply them in a pig slaughterhouse in order to detect ...
This book concentrates on the subject of health monitoring technology of Liquid Rocket Engine (LRE), including its failure analysis, fault diagnosis and fault prediction. Since no similar issue has been published, the failure pattern and mechanism analysis of the LRE from the system stage are of particular interest to the readers. Furthermore, application cases used to validate the efficacy of the fault diagnosis and prediction methods of the LRE are different from the others. The readers can learn the system stage modeling, analyzing and testing methods of the LRE system as well as corresponding fault diagnosis and prediction methods. This book will benefit researchers and students who are pursuing aerospace technology, fault detection, diagnostics and corresponding applications.
Su, Wei; Kong, De-zhi; Liu, Ren-huai; Huang, Shi-qing
This paper discusses staple FRP T-joints on the project based on the classical beam theory of Euler-Bernoulli and a theoretical model of energy release rate is set up to discuss fracture propagation of composite T-joints. The paper is further analysis on fracture failure affected by composite pane depth and joints chamfer dimension parameters and so on. The conclusion benefit for extensive use of projects is also summarized.
Ronald L. Boring; Knut Øien
In this paper, an identification and description of barriers and human failure events (HFEs) for human reliability analysis (HRA) is performed. The barriers, called target systems, are identified from risk significant accident scenarios represented as defined situations of hazard and accident (DSHAs). This report serves as the foundation for further work to develop petroleum HFEs compatible with the SPAR-H method and intended for reuse in future HRAs.
Oluwatoyin Shobowale Kafayat
Full Text Available Finding oil and gas reserves in deep/harsh environment with challenging reservoir and field conditions, subsea multiphase pumping benefits has found its way to provide solutions to these issues. Challenges such as failure issues that are still surging the industry and with the current practice of information hiding, this issues becomes even more difficult to tackle. Although, there are some joint industry projects which are only accessible to its members, still there is a need to have a clear understanding of these equipment groups so as to know which issues to focus attention on. A failure mode and effect analysis (FMEA is a potential first aid in understanding this equipment groups. A survey questionnaire/interview was conducted with the oil and gas operating company and equipment manufacturer based on the literature review. The results indicates that these equipment’s group are similar with its onshore counterpart, but the difference is the robustness built into the equipment internal subsystems for subsea applications. The results from the manufacturer perspectives indicates that Helico-axial multiphase pump have a mean time to failure of more than 10 years, twin-screw and electrical submersible pumps are still struggling with a mean time to failure of less than 5 years.
Reed, Shelby D.; Neilson, Matthew P.; Gardner, Matthew; Li, Yanhong; Briggs, Andrew H.; Polsky, Daniel E.; Graham, Felicia L.; Bowers, Margaret T.; Paul, Sara C.; Granger, Bradi B.; Schulman, Kevin A.; Whellan, David J.; Riegel, Barbara; Levy, Wayne C.
Background Heart failure disease management programs can influence medical resource use and quality-adjusted survival. Because projecting long-term costs and survival is challenging, a consistent and valid approach to extrapolating short-term outcomes would be valuable. Methods We developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure (TEAM-HF) Cost-Effectiveness Model, a Web-based simulation tool designed to integrate data on demographic, clinical, and laboratory characteristics, use of evidence-based medications, and costs to generate predicted outcomes. Survival projections are based on a modified Seattle Heart Failure Model (SHFM). Projections of resource use and quality of life are modeled using relationships with time-varying SHFM scores. The model can be used to evaluate parallel-group and single-cohort designs and hypothetical programs. Simulations consist of 10,000 pairs of virtual cohorts used to generate estimates of resource use, costs, survival, and incremental cost-effectiveness ratios from user inputs. Results The model demonstrated acceptable internal and external validity in replicating resource use, costs, and survival estimates from 3 clinical trials. Simulations to evaluate the cost-effectiveness of heart failure disease management programs across 3 scenarios demonstrate how the model can be used to design a program in which short-term improvements in functioning and use of evidence-based treatments are sufficient to demonstrate good long-term value to the health care system. Conclusion The TEAM-HF Cost-Effectiveness Model provides researchers and providers with a tool for conducting long-term cost-effectiveness analyses of disease management programs in heart failure. PMID:26542504
Full Text Available Abstract Background Failure Mode and Effects Analysis (FMEA is a prospective risk assessment tool that has been widely used within the aerospace and automotive industries and has been utilised within healthcare since the early 1990s. The aim of this study was to explore the validity of FMEA outputs within a hospital setting in the United Kingdom. Methods Two multidisciplinary teams each conducted an FMEA for the use of vancomycin and gentamicin. Four different validity tests were conducted: · Face validity: by comparing the FMEA participants’ mapped processes with observational work. · Content validity: by presenting the FMEA findings to other healthcare professionals. · Criterion validity: by comparing the FMEA findings with data reported on the trust’s incident report database. · Construct validity: by exploring the relevant mathematical theories involved in calculating the FMEA risk priority number. Results Face validity was positive as the researcher documented the same processes of care as mapped by the FMEA participants. However, other healthcare professionals identified potential failures missed by the FMEA teams. Furthermore, the FMEA groups failed to include failures related to omitted doses; yet these were the failures most commonly reported in the trust’s incident database. Calculating the RPN by multiplying severity, probability and detectability scores was deemed invalid because it is based on calculations that breach the mathematical properties of the scales used. Conclusion There are significant methodological challenges in validating FMEA. It is a useful tool to aid multidisciplinary groups in mapping and understanding a process of care; however, the results of our study cast doubt on its validity. FMEA teams are likely to need different sources of information, besides their personal experience and knowledge, to identify potential failures. As for FMEA’s methodology for scoring failures, there were discrepancies
Oh, Heung-Kwon; Ihn, Myong Hun; Son, Il Tae; Park, Jin Taek; Lee, Jaebong; Kim, Duck-Woo; Kang, Sung-Bum
Although enhanced recovery programs (ERPs) have been proven to be beneficial after laparoscopic colon surgery, they may result in adverse clinical outcomes following failure. This study analyzed risk factors associated with ERP failure after laparoscopic colon cancer surgery. We analyzed the outcomes of 208 patients who underwent ERPs following laparoscopic colon cancer surgery between June 2007 and April 2013. The ERP included early oral feeding, early ambulation, and regular laxative administration. ERP failure was defined as postoperative hospital stay of more than 5 days related to postoperative complications, unplanned readmission within 30 days of surgery, or death. Surgical procedures included anterior resection (n = 101), right hemicolectomy (n = 90), and left hemicolectomy (n = 17). The mean postoperative hospital stay was 6.5 ± 2.3 days (range 3-24 days). ERP failure occurred in 36 patients (17.3%), with no mortality; reasons included ileus (n = 14), wound infection (n = 4), chylous drainage (n = 3), anastomotic bleeding (n = 3), pneumonia (n = 1), or readmission (n = 11) owing to delayed complications. Univariable analysis showed that ERP failure was associated with proximal colon cancer, side-to-side anastomosis, longer operation time, increased blood loss, and longer resected specimen length. Multivariable analysis showed that side-to-side anastomosis [odds ratio (OR) 4.534; 95% confidence interval (CI) 1.902-10.811; P = 0.001] and increased blood loss (OR 1.004; 95% CI 1.001-1.008; P = 0.041) were independent risk factors for ERP failure. We showed that increased blood loss and side-to-side anastomosis in comparison with end-to-end anastomosis were independent risk factors associated with ERP failure after laparoscopic colon cancer surgery. This suggests that intraoperative elements may be important determinants to obtain successful postoperative recovery in the era of ERP.
yang, Ma; Chengbing, He; Xinxin, Feng
Recently,with install capacity of wind turbines increases continuously, the wind power consisting of operation,research on reliability,maintenance and rapair will be developed into a key point..Failure analysis can support operation,management of spare components and accessories in wind plants,maintenance and repair of wind turbines.In this paper,with the eye of wind plants'structure and function,statistic and analysis the common fault of each part of the plant,and then find out the faults law, faults cause and fault effect,from which put forward the corresponding measures.
Fleischhauer, Felix; Tiefenauer, Andreas; Graule, Thomas; Danzer, Robert; Mai, Andreas; Kuebler, Jakob
For solid oxide fuel cells (SOFCs) one key aspect is the structural integrity of the cell and hence its thermo mechanical long term behaviour. The present study investigates the failure mechanisms and the actual causes for fracture of electrolyte supported SOFCs which were run using the current μ-CHP system of Hexis AG, Winterthur - Switzerland under lab conditions or at customer sites for up to 40,000 h. In a first step several operated stacks were demounted for post-mortem inspection, followed by a fractographic evaluation of the failed cells. The respective findings are then set into a larger picture including an analysis of the present stresses acting on the cell like thermal and residual stresses and the measurements regarding the temperature dependent electrolyte strength. For all investigated stacks, the mechanical failure of individual cells can be attributed to locally acting bending loads, which rise due to an inhomogeneous and uneven contact between the metallic interconnect and the cell.
Crespo, Luis G.; Kenny, Sean P.; Giesy, Daniel P.
This paper proposes an uncertainty analysis framework based on the characterization of the uncertain parameter space. This characterization enables the identification of worst-case uncertainty combinations and the approximation of the failure and safe domains with a high level of accuracy. Because these approximations are comprised of subsets of readily computable probability, they enable the calculation of arbitrarily tight upper and lower bounds to the failure probability. The methods developed herein, which are based on nonlinear constrained optimization, are applicable to requirement functions whose functional dependency on the uncertainty is arbitrary and whose explicit form may even be unknown. Some of the most prominent features of the methodology are the substantial desensitization of the calculations from the assumed uncertainty model (i.e., the probability distribution describing the uncertainty) as well as the accommodation for changes in such a model with a practically insignificant amount of computational effort.
Machiko R Tomita
Full Text Available Machiko R Tomita1, Bin-Min Tsai2, Nadine M Fisher1, Neeraj A Kumar1, Greg Wilding3, Kathy Stanton1, Bruce J Naughton41Department of Rehabilitation Science, University at Buffalo, Buffalo, New York, USA; 2Department of Occupational Therapy, I-Shou University, Taiwan; 3Department of Biostatistics, University at Buffalo, Buffalo, New York, USA; 4Department of Medicine, University at Buffalo, Buffalo, New York, USAObjectives: To develop and test the effectiveness of an Internet-based self management program by multidisciplinary health care professionals for patients with heart failure (HF.Methods: The comprehensive educational material for HF was created and posted on a website. A computer with Internet connection and computer training were provided first. A secure and simple web-based recording system of vital signs and health behaviors and a mechanism for feedback regarding each participant’s record were developed. A randomized controlled trial with a one-year intervention was conducted using a total of 40 patients who were assessed three times in their homes. An intention-to-treat analysis used multivariate statistics.Results: The treatment group had a high (85% adherence to the intervention. Only the treatment group showed a significant improvement in the knowledge level (p < 0.001, amount of exercise (p = 0.001, and quality of life (p = 0.001, and reduction in HF related symptoms (dyspnea, p = 0.001; fatigue, p = 0.003; functional emotion, p < 0.001, blood pressure (systolic, p = 0.002; diastolic, p < 0.001, frequency of emergency room visit, and length of hospital stay (both p = 0.001.Conclusions: An effective program to change one’s behaviors in managing HF takes a multidisciplinary approach to create and provide feedback regarding a patient’s daily record, which can be accomplished through Internet use.Keywords: e-health, self-management, Internet, heart failure, older adults, exercise
Jaarsma, T.; van der Wal, Martje H.L.; Lesman-Leegte, Ivonne; Luttik, Marie-Louise; Hogenhuis, Jochem; Veeger, Nic J.; Sanderman, Robbert; Hoes, A.W.; van Gilst, Wiek H.; Lok, D.J.; Dunselman, P.H.; Tijssen, J.G.; Hillege, Hans L.; van Veldhuisen, Dirk J.
Background:: Heart failure (HF) disease management programs are widely implemented, but data about their effect on outcome have been inconsistent. Methods: The Coordinating Stud), Evaluating Out-comes of Advising and Counseling in Heart Failure (COACH) was a multicenter, randomized, controlled trial
Full Text Available Developing technology and using equipment in Iranian industries caused that maintenance system would be more important to use. Using proper management techniques not only increase the performance of production system but also reduce the failures and costs. The aim of this study was to determine the quality of maintenance system and the effects of its components on failures of kilns in two gypsum production companies using Failure Modes and Effects Analysis (FMEA. Furthermore the costs of failures were studied. After the study of gypsum production steps in the factories, FMEA was conducted by the determination of analysis insight, information gathering, making list of kilns’ component and filling up the FMEA’s tables. The effects of failures on production, how to fail, failure rate, failure severity, and control measures were studied. The evaluation of maintenance system was studied by a check list including questions related to system components. The costs of failures were determined by refer in accounting notebooks and interview with the head of accounting department. It was found the total qualities of maintenance system in NO.1 was more than NO.2 but because of lower quality of NO.1’s kiln design, number of failures and their costs were more. In addition it was determined that repair costs in NO.2’s kiln were about one third of NO.1’s. The low severity failures caused the most costs in comparison to the moderate and low ones. The technical characteristics of kilns were appeared to be the most important factors in reducing of failures and costs.
Kansas Data Access and Support Center — The Kansas GAP Analysis Land Cover database depicts 43 land cover classes for the state of Kansas. The database was generated using a two-stage hybrid classification...
Peeters, J.F.W.; Basten, R.J.I.; Tinga, Tiedo
When designing a maintenance programme for a capital good, especially a new one, it is of key importance to accurately understand its failure behaviour. Failure mode and effects analysis (FMEA) and fault tree analysis (FTA) are two commonly used methods for failure analysis. FMEA is a bottom-up
U.S. Department of Health & Human Services — This page contains information on Part D program analysis performed by CMS. These reports will also be used to better identify, evaluate and measure the effects of...
Stauffer, Brett D; Fullerton, Cliff; Fleming, Neil; Ogola, Gerald; Herrin, Jeph; Stafford, Pamala Martin; Ballard, David J
Randomized controlled trials have demonstrated the efficacy of nurse-led transitional care programs to reduce readmission rates for patients with heart failure; the effectiveness of these programs in real-world health care systems is less well understood. We performed a prospective study with concurrent controls to test an advanced practice nurse-led transitional care program for patients with heart failure who were 65 years or older and were discharged from Baylor Medical Center Garland (BMCG) from August 24, 2009, through April 30, 2010. We compared the effect of the program on 30-day (from discharge) all-cause readmission rate, length of stay, and 60-day (from admission) direct cost for BMCG with that of other hospitals within the Baylor Health Care System. We also performed a budget impact analysis using costs and reimbursement experience from the intervention. The intervention significantly reduced adjusted 30-day readmission rates to BMCG by 48% during the postintervention period, which was better than the secular reductions seen at all other facilities in the system. The intervention had little effect on length of stay or total 60-day direct costs for BMCG. Under the current payment system, the intervention reduced the hospital financial contribution margin on average $227 for each Medicare patient with heart failure. Preliminary results suggest that transitional care programs reduce 30-day readmission rates for patients with heart failure. This underscores the potential of the intervention to be effective in a real-world setting, but payment reform may be required for the intervention to be financially sustainable by hospitals.
Tabet, Jean-Yves; Meurin, Philippe; Benzidi, Younes; Beauvais, Florence; Ben Driss, Ahmed; Weber, Hélène; Renaud, Nathalie; Dumaine, Raphaelle; Grosdemouge, Anne; Cohen Solal, Alain
Exercise capacity, best reflected by peak exercise oxygen consumption (peak VO(2)), is a powerful prognostic factor in patients with chronic heart failure (CHF). However, the optimal time to assess exercise capacity for prognosis remains unclear and whether an exercise training program (ETP) to improve exercise capacity alters the prognostic value of cardiopulmonary exercise (CPX) testing variables in CHF is unknown. CHF patients who underwent an ETP in two cardiac rehabilitation centers between 2004 and 2009 were prospectively included, and CPX testing was performed before and after ETP completion. We included 285 consecutive patients who underwent an ETP (19.4 ± 8.7 training sessions in 4 to 10 weeks), including segmental gymnastics and cycling sessions. During follow-up (12 months), 14 patients died, 6 underwent cardiac transplantation and 15 were hospitalized for acute heart failure. Univariate analysis and receiver operating characteristic (ROC) curve analysis showed that CPX variables, especially peak oxygen consumption and circulatory power (product of peak VO(2) × peak systolic blood pressure) before and after ETP completion predicted prognosis. However, CPX data obtained after ETP completion had the best prognostic value (area under the ROC curve = 0.79 ± 0.03 for peak VO(2) after ETP completion vs 0.64 ± 0.04 before ETP completion, p < 0.0001). The results did not change even when considering only deaths. In patients with stable CHF who can exercise, the prognostic value of CPX data seems greater after versus before completion of a hospital-based ETP. Therefore, CPX capacity for prognostic purposes should at best be assessed after cardiac rehabilitation. © 2013.
Full Text Available Premature failure of the impeller blade of coke plant has been investigated. The component functioned during the CGC gas intake cycle. The component rotates at 1480 rpm with a volumetric flow of 720 m3/min of flue gas with temperature about 200–300 °C. The failed component reveals exposed surface of a crack that extended slightly beyond the assembly weld. From macro-structural observation under-filled region in welding is observed which is detrimental because it acts as a stress concentration site. The microstructure from the weld zone showed severe intergranular corrosion degradation. Micro cracks and cracks have been observed at several locations, mostly originating from the weld zone. From the EDS analysis of the failed sample it is observed that there is a deposition of Cr along the grain boundary. From the mode of failure it indicates that probable reason for the premature failure is due to sensitization of the component. In this case, the precipitation of chromium carbides may be occurred during welding operation when the heat affected zone (HAZ experiences a particular temperature range (550–850 °C. From the microstructure it is observed that the welding operation was not proper and there is every chance that there is heat generation in around sensitization range leading to precipitation of chromium carbides consumed the alloying element – chromium from a narrow band along the grain boundary and this makes the zone anodic to the unaffected grains. The chromium depleted zone becomes the preferential path for corrosion attack or crack propagation if under tensile stress. Thus it leads to premature failure of the component during service.
Møller, Anders; Schwartzbach, Michael I.
XML graphs have shown to be a simple and effective formalism for representing sets of XML documents in program analysis. It has evolved through a six year period with variants tailored for a range of applications. We present a unified definition, outline the key properties including validation...... of XML graphs against different XML schema languages, and provide a software package that enables others to make use of these ideas. We also survey the use of XML graphs for program analysis with four very different languages: XACT (XML in Java), Java Servlets (Web application programming), XSugar...... (transformations between XML and non-XML data), and XSLT (stylesheets for transforming XML documents)....
Staub-Nielsen, Ditte Emilie; Dieckmann, Peter; Mohr, Marlene
This study explores whether simulation plays a role in health care failure mode and effects analysis (HFMEA); it does this by evaluating whether additional data are found when a traditional HFMEA is augmented with simulation. Two multidisciplinary teams identified vulnerabilities in a process...... by brainstorming, followed by simulation. Two means of adding simulation were investigated as follows: just simulating the process and interrupting the simulation between substeps of the process. By adding simulation to a traditional HFMEA, both multidisciplinary teams identified additional data that were relevant...
Rucisnki, R.A.; /Fermilab
All components related to the nitrogen storage dewar were included. Pipe failures were excluded. Instrument air valves and components were excluded. See the 'What if' analysis for consequences from loss of instrument air.
Full Text Available An axle shaft of fork lift failed at operation within 296 h of service. The shaft transmits torque from discrepancy to wheel through planetary gear arrangement. A section of fractured axle shaft made of induction-hardened steel was analyzed to determine the root cause of the failure. Optical microscopies as well as field emission gun scanning electron microscopy (FEG-SEM along with energy dispersive spectroscopy (EDS were carried out to characterize the microstructure. Hardness profile throughout the cross-section was evaluated by micro-hardness measurements. Chemical analysis indicated that the shaft was made of 42CrMo4 steel grade as per specification. Microstructural analysis and micro-hardness profile revealed that the shaft was improperly heat treated resulting in a brittle case, where crack was found to initiate from the case in a brittle mode in contrast to ductile mode within the core. This behaviour was related to differences in microstructure, which was observed to be martensitic within the case with a micro-hardness equivalent to 735 HV, and a mixture of non-homogeneous structure of pearlite and ferrite within the core with a hardness of 210 HV. The analysis suggests that the fracture initiated from the martensitic case as brittle mode due to improper heat treatment process (high hardness. Moreover the inclusions along the hot working direction i.e. in the longitudinal axis made the component more susceptible to failure.
Arabian-Hoseynabadi, H.; Oraee, H. [Department of Electrical Engineering, Sharif University of Technology, Tehran (Iran); Tavner, P.J. [Energy Group School of Engineering and Computing Sciences, Durham University (United Kingdom)
The Failure Modes and Effects Analysis (FMEA) method has been used to study the reliability of many different power generation systems. This paper now applies that method to a wind turbine (WT) system using a proprietary software reliability analysis tool. Comparison is made between the quantitative results of an FMEA and reliability field data from real wind turbine systems and their assemblies. These results are discussed to establish relationships which are useful for future wind turbine designs. The main system studied is an existing design 2 MW wind turbine with a Doubly Fed Induction Generator (DFIG), which is then compared with a hypothetical wind turbine system using the Brushless Doubly Fed Generator (BDFG) of the same rating. The software reliability analysis tool used for these studies was Relex Reliability Studio 2007 Version 2. (author)
Pulignano, Giovanni; Del Sindaco, Donatella; Di Lenarda, Andrea; Tarantini, Luigi; Cioffi, Giovanni; Gregori, Dario; Tinti, Maria Denitza; Monzo, Luca; Minardi, Giovanni
Disease management programs (DMP) improve outcomes in patients with heart failure. Because older heart failure patients represent a heterogeneous population, the aim of this study was to determine which patients benefit mostly from a DMP, by means of their frailty profile. Heart failure outpatient clinic. Consecutive (n = 173) patients aged more than 70 years were randomized to a multidisciplinary DMP (n = 86) or usual care (n = 87). A modified frailty score (range 1-6) was used as an index of global functional impairment. Mild to moderate frailty (frailty score = 2-3) was associated with significant improvements in outcomes (death and/or heart failure admission, heart failure admissions and all-cause admissions) in DMP patients vs. usual care. Even in more frail patients (frailty score = 4-6) a significant reduction in heart failure admissions was observed. By contrast, nonfrail patients (frailty score = 1) did not derive significant benefit. In the cost-effectiveness analysis, the mean savings per patient, stratified according to their frailty score, were -1003.31 euro for frailty score 1 (95% confidence interval -3717.00-1709.00), 1104.72 euro for frailty score 2 (-280.6-2491.00), 2635.42 euro for frailty score 3 (352.60-4917.00, P = 0.025) and 419.53 euro for frailty score 4-6 (-1909.00-2749.00). Intervention was therefore significantly cost saving in moderately frail, but not in nonfrail or severely frail patients. Thus, DMP was dominant (i.e. both less costly and more effective than usual care) in moderately frail patients. At sensitivity analysis, DMP remained dominant even to changes in cost of intervention and hospitalizations. This suggests that an intensive, hospital-based DMP appears to be more effective in older patients with mild-to-moderate levels of frailty. Thus, a multidimensional assessment of frailty seems to be a useful tool for appropriate selection of model of care.
Ernstmann, N; Karbach, U
German and Turkish-speaking patients were recruited for a chronic heart failure management program. So far little is known about the special needs and characteristics of Turkish-speaking patients with chronic heart failure; therefore, the aim of this study was to examine sociodemographic and illness-related differences between German and Turkish-speaking patients with chronic heart failure. German and Turkish-speaking patients suffering from chronic heart failure and insured with the AOK Rheinland/Hamburg or the BARMER GEK health insurance companies and living in Cologne, Germany, were enrolled. Recruitment took place in hospitals, private practices and at information events. Components of the program were coordination of a guideline-oriented medical care, telemonitoring (e.g., blood pressure, electrocardiogram, and weight), a 24-h information hotline, attendance by German and Turkish-speaking nurses and a patient education program. Data were collected by standardized interviews in German or Turkish language. Data were analyzed with descriptive measures and tested for significance differences using Pearson's χ(2)-test and the t‑test. A total of 465 patients (average age 71 years, 55 % male and 33 % Turkish-speaking) were enrolled in the care program during the study period. Significant differences between German and Turkish-speaking patients were found for age, education, employment status, comorbidities, risk perception, knowledge on heart failure and fear of loss of independence. The response rate could be achieved with the help of specific measures for patient enrollment by Turkish-speaking integration nurses. The differences between German and Turkish-speaking patients should in future be taken into account in the care of people with chronic heart failure.
Choi, Shinhyun; Lee, Jihang; Kim, Sungho; Lu, Wei D.
Resistive switching devices (RRAMs) have been proposed a promising candidate for future memory and neuromorphic applications. Central to the successful application of these emerging devices is the understanding of the resistance switching and failure mechanism, and identification of key physical parameters that will enable continued device optimization. In this study, we report detailed retention analysis of a TaOx based RRAM at high temperatures and the development of a microscopic oxygen diffusion model that fully explains the experimental results and can be used to guide future device developments. The device conductance in low resistance state (LRS) was constantly monitored at several elevated temperatures (above 300 °C), and an initial gradual conductivity drift followed by a sudden conductance drop were observed during retention failure. These observations were explained by a microscopic model based on oxygen vacancy diffusion, which quantitatively explains both the initial gradual conductance drift and the sudden conductance drop. Additionally, a non-monotonic conductance change, with an initial conductance increase followed by the gradual conductance decay over time, was observed experimentally and explained within the same model framework. Specifically, our analysis shows that important microscopic physical parameters such as the activation energy for oxygen vacancy migration can be directly calculated from the failure time versus temperature relationship. Results from the analytical model were further supported by detailed numerical multi-physics simulation, which confirms the filamentary nature of the conduction path in LRS and the importance of oxygen vacancy diffusion in device reliability. Finally, these high-temperature stability measurements also reveal the existence of multiple filaments in the same device.
Kietselaer, Bas L J H; Reutelingsperger, Chris P M; Boersma, Hendrikus H; Heidendal, Guido A K; Liem, Ing Han; Crijns, Harry J G M; Narula, Jagat; Hofstra, Leo
UNLABELLED: Apoptosis, or programmed cell death (PCD), contributes to the decline in ventricular function in heart failure. Because apoptosis comprises a programmed cascade of events, it is potentially reversible, and timely intervention should delay the development of cardiomyopathy.
Hendricks, Christopher; Williard, Nick; Mathew, Sony; Pecht, Michael
Lithium-ion batteries are popular energy storage devices for a wide variety of applications. As batteries have transitioned from being used in portable electronics to being used in longer lifetime and more safety-critical applications, such as electric vehicles (EVs) and aircraft, the cost of failure has become more significant both in terms of liability as well as the cost of replacement. Failure modes, mechanisms, and effects analysis (FMMEA) provides a rigorous framework to define the ways in which lithium-ion batteries can fail, how failures can be detected, what processes cause the failures, and how to model failures for failure prediction. This enables a physics-of-failure (PoF) approach to battery life prediction that takes into account life cycle conditions, multiple failure mechanisms, and their effects on battery health and safety. This paper presents an FMMEA of battery failure and describes how this process enables improved battery failure mitigation control strategies.
Olesen, Mads Chr.
Software programs are proliferating throughout modern life, to a point where even the simplest appliances such as lightbulbs contain software, in addition to the software embedded in cars and airplanes. The correct functioning of these programs is therefore of the utmost importance, for the quality...... and sustenance of life. Due to the complexity inherent in the software it can be very difficult for the software developer to guarantee the absence of errors; automated support in the form of automated program analysis is therefore essential. Two methods have traditionally been proposed: model checking...... and abstract interpretation. Model checking views the program as a finite automaton and tries to prove logical properties over the automaton model, or present a counter-example if not possible — with a focus on precision. Abstract interpretation translates the program semantics into abstract semantics...
Mulyana, Cukup; Muhammad, Fajar; Saad, Aswad H.; Mariah, Riveli, Nowo
Storage tank component is the most critical component in LNG regasification terminal. It has the risk of failure and accident which impacts to human health and environment. Risk assessment is conducted to detect and reduce the risk of failure in storage tank. The aim of this research is determining and calculating the probability of failure in regasification unit of LNG. In this case, the failure is caused by Boiling Liquid Expanding Vapor Explosion (BLEVE) and jet fire in LNG storage tank component. The failure probability can be determined by using Fault Tree Analysis (FTA). Besides that, the impact of heat radiation which is generated is calculated. Fault tree for BLEVE and jet fire on storage tank component has been determined and obtained with the value of failure probability for BLEVE of 5.63 × 10-19 and for jet fire of 9.57 × 10-3. The value of failure probability for jet fire is high enough and need to be reduced by customizing PID scheme of regasification LNG unit in pipeline number 1312 and unit 1. The value of failure probability after customization has been obtained of 4.22 × 10-6.
Armstrong, Darrell Jewell; Schwarz, Jens
The LTS Timing Analysis program described in this report uses signals from the Tempest Lasers, Pulse Forming Lines, and Laser Spark Detectors to carry out calculations to quantify and monitor the performance of the the Z-Accelerators laser triggered SF6 switches. The program analyzes Z-shots beginning with Z2457, when Laser Spark Detector data became available for all lines.
Wahbi Izzettin, Omar; Hopper, Ingrid; Ritchie, Edward; Nagalingam, Vathy; Aung, Ar Kar
Heart failure care and education require a multifaceted approach to ensure appropriate transition from inpatient to outpatient care. To explore the feasibility of a multidisciplinary heart failure care model, General Medicine Heart Failure Care Program (GM-HFCP) within a General Medical Unit (GMU). Prospective non-randomised before-and-after observational quality improvement intervention over a 6-month period. All consecutive patients admitted to GMU at Alfred Hospital with diagnosis of acute decompensated heart failure were included. Main outcome measures included changes in rates of pharmacologic prescription, non-pharmacologic ward-based management, patient education and action plan provision after intervention. 108 patients were included [median age 84(IQR 80-89) years, 47(44%) females]. Significant improvements were noted in non-pharmacologic management for patient education regarding fluid restriction (12% to 30%, p = 0.04), weight monitoring (10% to 28%, p = 0.03), heart failure action plan on discharge (4% to 28%, p = 0.002) and salt restriction (6% to 32%, p = 0.002). The rates of prescription of heart failure medications remained similar between the pre- and post-implementation periods, particularly in patients with reduced ejection fraction by 'appropriateness of prescription' criteria. There were no differences in inpatient mortality or 30-day readmission rates in both groups. This prospective observational study demonstrated that it is possible to share the roles of a heart failure nurse amongst members of the multidisciplinary team, with similar rates of delivery of pharmacologic and non-pharmacologic management aspects. However, further innovative improvements are needed to address certain aspects of heart failure care. This article is protected by copyright. All rights reserved.
MATLAB is a high-level language and environment for numerical computation, visualization, and programming. Using MATLAB, you can analyze data, develop algorithms, and create models and applications. The language, tools, and built-in math functions enable you to explore multiple approaches and reach a solution faster than with spreadsheets or traditional programming languages, such as C/C++ or Java. Programming MATLAB for Numerical Analysis introduces you to the MATLAB language with practical hands-on instructions and results, allowing you to quickly achieve your goals. You will first become
Gerbing, David W
This book prepares readers to analyze data and interpret statistical results using R more quickly than other texts. R is a challenging program to learn because code must be created to get started. To alleviate that challenge, Professor Gerbing developed lessR. LessR extensions remove the need to program. By introducing R through less R, readers learn how to organize data for analysis, read the data into R, and produce output without performing numerous functions and programming exercises first. With lessR, readers can select the necessary procedure and change the relevant variables without pro
Bloch, Heinz P
Solve the machinery failure problems costing you time and money with this classic, comprehensive guide to analysis and troubleshooting Provides detailed, complete and accurate information on anticipating risk of component failure and avoiding equipment downtime Includes numerous photographs of failed parts to ensure you are familiar with the visual evidence you need to recognize Covers proven approaches to failure definition and offers failure identification and analysis methods that can be applied to virtually all problem situations Demonstr
Full Text Available This article is devoted to the initial phase of data analysis of failure data from process control systems. Failure data can be used for example to detect weak spots in a production process, but also for failure prediction. To achieve these goals data mining techniques can be used. In this article, we propose a method to prepare and transform failure data from process control systems for application of data mining algorithms, especially cluster analysis.
Németh, Martin; Michaľčonok, German
This article is devoted to the initial phase of data analysis of failure data from process control systems. Failure data can be used for example to detect weak spots in a production process, but also for failure prediction. To achieve these goals data mining techniques can be used. In this article, we propose a method to prepare and transform failure data from process control systems for application of data mining algorithms, especially cluster analysis.
Bonfant, Giovanna; Belfanti, Pietro; Paternoster, Giuseppe; Gabrielli, Danila; Gaiter, Alberto M; Manes, Massimo; Molino, Andrea; Pellu, Valentina; Ponzetti, Clemente; Farina, Massimo; Nebiolo, Pier E
The aim of clinical risk management is to improve the quality of care provided by health care organizations and to assure patients' safety. Failure mode and effect analysis (FMEA) is a tool employed for clinical risk reduction. We applied FMEA to chronic hemodialysis outpatients. FMEA steps: (i) process study: we recorded phases and activities. (ii) Hazard analysis: we listed activity-related failure modes and their effects; described control measures; assigned severity, occurrence and detection scores for each failure mode and calculated the risk priority numbers (RPNs) by multiplying the 3 scores. Total RPN is calculated by adding single failure mode RPN. (iii) Planning: we performed a RPNs prioritization on a priority matrix taking into account the 3 scores, and we analyzed failure modes causes, made recommendations and planned new control measures. (iv) Monitoring: after failure mode elimination or reduction, we compared the resulting RPN with the previous one. Our failure modes with the highest RPN came from communication and organization problems. Two tools have been created to ameliorate information flow: "dialysis agenda" software and nursing datasheets. We scheduled nephrological examinations, and we changed both medical and nursing organization. Total RPN value decreased from 892 to 815 (8.6%) after reorganization. Employing FMEA, we worked on a few critical activities, and we reduced patients' clinical risk. A priority matrix also takes into account the weight of the control measures: we believe this evaluation is quick, because of simple priority selection, and that it decreases action times.
Jaarsma, Tiny; Lesman-Leegte, Ivonne; Hillege, Hans L.; Veeger, Nic J.; Sanderman, Robbert; van Veldhuisen, Dirk J.
Objectives Our aim was to study the possible role of depressive symptoms in the effectiveness of a disease management program (DMP) in heart failure (HF) patients. Background Disease management programs are recommended in current HF guidelines, but certain patient groups, such as those with
Hanson, John M.; Hill, Ashley D.; Beard, Bernard B.
Launch vehicle ascent is a time of high risk for an onboard crew. There is a large fraction of possible failures for which time is of the essence and a successful abort is possible if the detection and action happens quickly enough. This paper focuses on abort determination based on data already available from the Guidance, Navigation, and Control system. This work is the result of failure analysis efforts performed during the Ares I launch vehicle development program. The two primary areas of focus are the derivation of abort triggers to ensure that abort occurs as quickly as possible when needed, but that false aborts are avoided, and evaluation of success in aborting off the failing launch vehicle.
American Society for Testing and Materials. Philadelphia
1.1 This guide covers key issues to be considered when examining metallic failures when corrosion is suspected as either a major or minor causative factor. 1.2 Corrosion-related failures could include one or more of the following: change in surface appearance (for example, tarnish, rust, color change), pin hole leak, catastrophic structural failure (for example, collapse, explosive rupture, implosive rupture, cracking), weld failure, loss of electrical continuity, and loss of functionality (for example, seizure, galling, spalling, swelling). 1.3 Issues covered include overall failure site conditions, operating conditions at the time of failure, history of equipment and its operation, corrosion product sampling, environmental sampling, metallurgical and electrochemical factors, morphology (mode) or failure, and by considering the preceding, deducing the cause(s) of corrosion failure. This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibili...
Full Text Available with specification. This paper presents three historical cases of premature failures on two national trunk roads and one inter regional road in Ghana. These case histories give details on pavement history, pavement structure, premature failure types, pavement...
Clifton Ashley P.
Full Text Available Wind farm collector circuits generally comprise several wind turbine generators (WTG’s. WTG’s are connected in parallel to a substation. This connection acts as the point-of-connection to the national electricity grid. The electrical load in these circuits is close to component (power cables and accessories ratings. The objective of this paper is to identify cable joint failure paths; and, develop an understanding of specific contributing factors. All findings presented were established from literature review involving data analysis and discussion with industry experts working across the wind industry. Application of forces, inadequate workmanship, incorrect thermal resistance or other contributing factors, all contribute to high conductor operating temperatures. High conductor operating temperatures highlight issues including insufficient environmental heat transfer due to the use of inadequate cable trenching materials. This in turn results in the imbalanced application of force, experienced at the cable joint, as a direct result of frequent thermal expansion and contraction. For most cable joint failures, the root cause is insulation breakdown due to sustained deterioration of the cross-linked polyethylene insulation. This is a direct result from excessive operating temperatures.
Gregory, Douglas; Kimmelstiel, Carey; Perry, Kathleen; Parikh, Amay; Konstam, Varda; Konstam, Marvin A
Determine the effect on hospitalization cost of a heart failure disease management (HFDM) program delivered within a diverse provider network as demonstrated in the SPAN-CHF randomized controlled trial. The SPAN-CHF trial was a prospective randomized assessment of the effectiveness of HFDM delivered for 90 days across a diverse provider network in a heterogeneous population of 200 patients. Baseline clinical and demographic data were obtained on each patient, mortality was monitored, and hospitalizations were tracked for 90 days. Cost estimates for each hospitalization were based on a subsample of patients seen at Tufts-New England Medical Center for whom hospitalization costs were calculated. Heart failure disease management program costs were estimated using a programmatic budget model. Hospital utilization and cost data were combined to estimate medical costs for intervention and control groups. Heart failure disease management had a favorable effect on heart failure hospitalization, which was partially offset by noncardiac hospitalizations. The relative odds of at least one all-cause hospitalization during the intervention period trended less for the intervention group compared with the control group (0.76 [95% CI 0.38-1.51]). The point estimate of the differential hospitalization cost between control and intervention groups was a reduction in cost of $375 per patient. The net effect including the costs of the program was an increase of $488 per patient for the intervention group compared with the control group. The program would have been cost saving if HFDM costs had been 24% lower. The HFDM intervention, administered over 90 days to patients hospitalized for heart failure, succeeded in reducing the rate of heart failure hospitalizations, although this effect was partially offset by an increase in non-heart failure hospitalizations. The resulting modest reduction in all-cause hospitalization costs was exceeded by the cost of the intervention. Thus, although
Rincón, Mónica; Rojas, Maria Ximena; Rodriguez Romero, Viviana Alejandra; Tamayo, Diana Carolina; Franco, Camilo; Castro, Hector; Brophy, James; Dennis, Rodolfo
Cardiac rehabilitation (CR) in patients with chronic heart failure (CHF) has met with resistance from third-party payers in low- and middle-income countries because of lack of evidence regarding its cost-effectiveness. We aimed to provide information to help better inform this decision-making process. Costs associated with a 12-week exercise-based rehabilitation program in Colombia for patients with CHF were estimated. We collected data on all medical resources used in ambulatory care and data on hospital costs incurred for treating patients with uncompensated CHF. A literature search to establish the hospitalization rates because of uncompensated CHF, death because of CHF, and potential decreases in these data because of the utilization of CR was conducted. We modeled incremental costs and effectiveness over a period of 5 years from the perspective of the third-party payer. All costs were converted from Colombian pesos to US dollars. For an exercise-based CR program of 12-week duration (36 sessions), costs ranged from US$265 to US$369 per patient. Monthly costs associated with ambulatory care of CHF averaged US$128 ± US$321 per patient, and hospitalization costs were US$3621 ± US$5 444 per event. Yearly hospitalization incidence rates with and without CR were 0.154 and 0.216, respectively. The incremental cost of CR would be US$998 per additional quality-adjusted life-year. Sensitivity analysis did not significantly change these results. Cardiac rehabilitation in patients with CHF in settings such as Colombia can be a cost-effective strategy, with minimal incremental costs and better quality of life, mainly because of decreased rates of hospitalization.
Long, V. S.; Wright, M. C.; McDanels, S. J.; Lubas, D.; Tucker, B.; Marciniak, P. J.
This slide presentation reviews the debris analysis of the Starboard Solar Alpha Rotary Joint (SARJ), a mechanism that is designed to keep the solar arrays facing the sun. The goal of this was to identify the failure mechanism based on surface morphology and to determine the source of debris through elemental and particle analysis.
Zabihpoor, M.; Moslemian, Ramin; Afshin, M.
using 3D FEM in ANSYS commercial code. Tsai-Wu failure criterion is used in the failure analysis. The results indicate that the most important parameter in the proposed joint zone design is the foam -solid laminate interface angle which plays an important role on the value of failure criterion (damage...
Long, Victoria S.; Wright, M. Clara; McDanels, Steve
The United States has had four manned launch programs and three station programs since the era of human space flight began in 1961. The launch programs, Mercury, Gemini, Apollo, and Shuttle, and the station programs, Skylab, Shuttle-Mir, and the International Space Station (ISS), have all been enormously successful, not only in advancing the exploration of space, but also in advancing related technologies. As each subsequent program built upon the successes of previous programs, they similarly learned from their predecessors' failures. While some failures were spectacular and captivated the attention of the world, most only held the attention of the dedicated men and women working to make the missions succeed.
Havelund, Klaus; Goldberg, Allen; Filman, Robert; Rosu, Grigore; Koga, Dennis (Technical Monitor)
Several attempts have been made recently to apply techniques such as model checking and theorem proving to the analysis of programs. This shall be seen as a current trend to analyze real software systems instead of just their designs. This includes our own effort to develop a model checker for Java, the Java PathFinder 1, one of the very first of its kind in 1998. However, model checking cannot handle very large programs without some kind of abstraction of the program. This paper describes a complementary scalable technique to handle such large programs. Our interest is turned on the observation part of the equation: How much information can be extracted about a program from observing a single execution trace? It is our intention to develop a technology that can be applied automatically and to large full-size applications, with minimal modification to the code. We present a tool, Java PathExplorer (JPaX), for exploring execution traces of Java programs. The tool prioritizes scalability for completeness, and is directed towards detecting errors in programs, not to prove correctness. One core element in JPaX is an instrumentation package that allows to instrument Java byte code files to log various events when executed. The instrumentation is driven by a user provided script that specifies what information to log. Examples of instructions that such a script can contain are: 'report name and arguments of all called methods defined in class C, together with a timestamp'; 'report all updates to all variables'; and 'report all acquisitions and releases of locks'. In more complex instructions one can specify that certain expressions should be evaluated and even that certain code should be executed under various conditions. The instrumentation package can hence be seen as implementing Aspect Oriented Programming for Java in the sense that one can add functionality to a Java program without explicitly changing the code of the original program, but one rather writes an
Ren, Ping; Li, Zongquan; Wu, Jiangfei; Guo, Yibin; Li, Wanyou
In diesel generating sets, it will lead to the abominable working condition if the fault couldn’t be recovered when the bolt of intercooler cracks. This paper aims at the fault of the blots of diesel generator intercooler and completes the analysis of the static strength and fatigue strength. Static intensity is checked considering blot preload and thermal stress. In order to obtain the thermal stress of the blot, thermodynamic of intercooler is calculated according to the measured temperature. Based on the measured vibration response and the finite element model, using dynamic load identification technique, equivalent excitation force of unit was solved. In order to obtain the force of bolt, the excitation force is loaded into the finite element model. By considering the thermal stress and preload as the average stress while the mechanical stress as the wave stress, fatigue strength analysis has been accomplished. Procedure of diagnosis is proposed in this paper. Finally, according to the result of intensity verification the fatigue failure is validation. Thereby, further studies are necessary to verification the result of the intensity analysis and put forward some improvement suggestion.
Wanthal, Steven; Schaefer, Joseph; Justusson, Brian; Hyder, Imran; Engelstad, Stephen; Rose, Cheryl
The Advanced Composites Consortium is a US Government/Industry partnership supporting technologies to enable timeline and cost reduction in the development of certified composite aerospace structures. A key component of the consortium's approach is the development and validation of improved progressive damage and failure analysis methods for composite structures. These methods will enable increased use of simulations in design trade studies and detailed design development, and thereby enable more targeted physical test programs to validate designs. To accomplish this goal with confidence, a rigorous verification and validation process was developed. The process was used to evaluate analysis methods and associated implementation requirements to ensure calculation accuracy and to gage predictability for composite failure modes of interest. This paper introduces the verification and validation process developed by the consortium during the Phase I effort of the Advanced Composites Project. Specific structural failure modes of interest are first identified, and a subset of standard composite test articles are proposed to interrogate a progressive damage analysis method's ability to predict each failure mode of interest. Test articles are designed to capture the underlying composite material constitutive response as well as the interaction of failure modes representing typical failure patterns observed in aerospace structures.
Adrian H. Zai
Full Text Available The purpose of this study was to validate a previously developed heart failure readmission predictive algorithm based on psychosocial factors, develop a new model based on patient-reported symptoms from a telemonitoring program, and assess the impact of weight fluctuations and other factors on hospital readmission. Clinical, demographic, and telemonitoring data was collected from 100 patients enrolled in the Partners Connected Cardiac Care Program between July 2008 and November 2011. 38% of study participants were readmitted to the hospital within 30 days. Ten different heart-failure-related symptoms were reported 17,389 times, with the top three contributing approximately 50% of the volume. The psychosocial readmission model yielded an AUC of 0.67, along with sensitivity 0.87, specificity 0.32, positive predictive value 0.44, and negative predictive value 0.8 at a cutoff value of 0.30. In summary, hospital readmission models based on psychosocial characteristics, standardized changes in weight, or patient-reported symptoms can be developed and validated in heart failure patients participating in an institutional telemonitoring program. However, more robust models will need to be developed that use a comprehensive set of factors in order to have a significant impact on population health.
BACKGROUND: Chronic heart failure (HF) is associated with a poor Health Related Quality of Life (HRQoL). HRQoL has been shown to be a predictor of HF outcomes however, variability in the study designs make it difficult to apply these findings to a clinical setting. The aim of this study was to establish if HRQoL is a predictor of long-term mortality and morbidity in HF patients followed-up in a disease management program (DMP) and if a HRQoL instrument could be applied to aid in identifying high-risk patients within a clinical context. METHODS: This is a retrospective analysis of HF patients attending a DMP with 18+\\/-9 months follow-up. Clinical and biochemical parameters were recorded on discharge from index HF admission and HRQoL measures were recorded at 2 weeks post index admission. RESULTS: 225 patients were enrolled into the study (mean age=69+\\/-12 years, male=61%, and 78%=systolic HF). In multivariable analysis, all dimensions of HRQoL (measured by the Minnesota Living with HF Questionnaire) were independent predictors of both mortality and readmissions particularly in patients <80 years. A significant interaction between HRQoL and age (Total((HRQoL))age: p<0.001) indicated that the association of HRQoL with outcomes diminished as age increased. CONCLUSIONS: These data demonstrate that HRQoL is a predictor of outcome in HF patients managed in a DMP. Younger patients (<65 years) with a Total HRQoL score of > or =50 are at high risk of an adverse outcome. In older patients > or =80 years HRQoL is not useful in predicting outcome.
Varzakas, Theodoros H.; Arvanitoyannis, Ioannis S.
Failure Mode and Effect Analysis (FMEA) model has been applied for the risk assessment of poultry slaughtering and manufacturing. In this work comparison of ISO22000 analysis with HACCP is carried out over poultry slaughtering, processing and packaging. Critical Control points and Prerequisite programs (PrPs) have been identified and implemented in the cause and effect diagram (also known as Ishikawa, tree diagram and fishbone diagram).
Shih, Ann T.; Lo, Yunnhon; Ward, Natalie C.
Quantifying the probability of significant launch vehicle failure scenarios for a given design, while still in the design process, is critical to mission success and to the safety of the astronauts. Probabilistic risk assessment (PRA) is chosen from many system safety and reliability tools to verify the loss of mission (LOM) and loss of crew (LOC) requirements set by the NASA Program Office. To support the integrated vehicle PRA, probabilistic design analysis (PDA) models are developed by using vehicle design and operation data to better quantify failure probabilities and to better understand the characteristics of a failure and its outcome. This PDA approach uses a physics-based model to describe the system behavior and response for a given failure scenario. Each driving parameter in the model is treated as a random variable with a distribution function. Monte Carlo simulation is used to perform probabilistic calculations to statistically obtain the failure probability. Sensitivity analyses are performed to show how input parameters affect the predicted failure probability, providing insight for potential design improvements to mitigate the risk. The paper discusses the application of the PDA approach in determining the probability of failure for two scenarios from the NASA Ares I project
Paredes-Atenciano, J A; Roldán-Aviña, J P; González-García, Mercedes; Blanco-Sánchez, M C; Pinto-Melero, M A; Pérez-Ramírez, C; Calvo Rubio-Burgos, Miguel; Osuna-Navarro, F J; Jurado-Carmona, A M
To identify and analyze errors in drug prescriptions of patients treated in a "high resolution" hospital by applying a Failure mode and effects analysis (FMEA).Material and methods A multidisciplinary group of medical specialties and nursing analyzed medical records where drug prescriptions were held in free text format. An FMEA was developed in which the risk priority index (RPI) was obtained from a cross-sectional observational study using an audit of the medical records, carried out in 2 phases: 1) Pre-intervention testing, and (2) evaluation of improvement actions after the first analysis. An audit sample size of 679 medical records from a total of 2,096 patients was calculated using stratified sampling and random selection of clinical events. Prescription errors decreased by 22.2% in the second phase. FMEA showed a greater RPI in "unspecified route of administration" and "dosage unspecified", with no significant decreases observed in the second phase, although it did detect, "incorrect dosing time", "contraindication due to drug allergy", "wrong patient" or "duplicate prescription", which resulted in the improvement of prescriptions. Drug prescription errors have been identified and analyzed by FMEA methodology, improving the clinical safety of these prescriptions. This tool allows updates of electronic prescribing to be monitored. To avoid such errors would require the mandatory completion of all sections of a prescription. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.
Grimes, David A; Peipert, Jeffrey F
Electronic fetal monitoring has failed as a public health screening program. Nevertheless, most of the four million low-risk women giving birth in the United States each year continue to undergo this screening. The failure of this program should have been anticipated and thus avoided had the accepted principles of screening been considered before its introduction. All screening tests have poor positive predictive value when searching for rare conditions such as fetal death in labor or cerebral palsy. This problem is aggravated when the screening test does not have good validity as is the case with electronic fetal monitoring. Because of low-prevalence target conditions and mediocre validity, the positive predictive value of electronic fetal monitoring for fetal death in labor or cerebral palsy is near zero. Stated alternatively, almost every positive test result is wrong. To avoid such costly errors in the future, the prerequisites for any screening program must be fulfilled before the program is begun.
Whellan, David J; Reed, Shelby D; Liao, Lawrence; Gould, Stuart D; O'connor, Christopher M; Schulman, Kevin A
Although heart failure disease management (HFDM) programs improve patient outcomes, the implementation of these programs has been limited because of financial barriers. We undertook the present study to understand the economic incentives and disincentives for adoption of disease management strategies from the perspectives of a physician (group), a hospital, an integrated health system, and a third-party payer. Using the combined results of a group of randomized controlled trials and a set of financial assumptions from a single academic medical center, a financial model was developed to compute the expected costs before and after the implementation of a HFDM program by 3 provider types (physicians, hospitals, and health systems), as well as the costs incurred from a payer perspective. The base-case model showed that implementation of HFDM results in a net financial loss to all potential providers of HFDM. Implementation of HFDM as described in our base-case analysis would create a net loss of US dollars 179,549 in the first year for a physician practice, US dollars 464,132 for an integrated health system, and US dollars 652,643 in the first year for a hospital. Third-party payers would be able to save US dollars 713,661 annually for the care of 350 patients with heart failure in a HFDM program. In conclusion, although HFDM programs may provide patients with improved clinical outcomes and decreased hospitalizations that save third-party payers money, limited financial incentives are currently in place for healthcare providers and hospitals to initiate these programs.
This Failure Modes and Effects Analysis (FMEA) is for the Advanced Microwave Sounding Unit-A (AMSU-A) instruments that are being designed and manufactured for the Meteorological Satellites Project (METSAT) and the Earth Observing System (EOS) integrated programs. The FMEA analyzes the design of the METSAT and EOS instruments as they currently exist. This FMEA is intended to identify METSAT and EOS failure modes and their effect on spacecraft-instrument and instrument-component interfaces. The prime objective of this FMEA is to identify potential catastrophic and critical failures so that susceptibility to the failures and their effects can be eliminated from the METSAT/EOS instruments.
Jamshidi, A.; Faghih Roohi, S.; Hajizadeh, S.; Nunez Vicencio, Alfredo; Babuska, R.; Dollevoet, R.P.B.J.; Li, Z.; De Schutter, B.H.K.
Railway infrastructure monitoring is a vital task to ensure rail transportation safety. A rail failure could result in not only a considerable impact on train delays and maintenance costs, but also on safety of passengers. In this article, the aim is to assess the risk of a rail failure by
Ferrara, A.; Steeneken, P.G.; Boksteen, B.K.; Heringa, A.; Scholten, A.J.; Schmitz, Jurriaan; Hueting, Raymond Josephus Engelbart
In this work, analytical stability equations are derived and combined with a physics-based model of an LDMOS transistor in order to identify the primary cause of failure in different operating and bias conditions. It is found that there is a gradual boundary between an electrical failure region at
One of the main concerns for power electronic engineers regarding capacitors is to predict their remaining lifetime in order to anticipate costly failures or system unavailability. This may be achieved using a Weibull statistical law combined with acceleration factors for the temperature, the voltage, and the humidity. This paper discusses the different capacitor failure modes and their effects and consequences.
Tsacoyeanes, J. C.; Raju, P. P.
The pilot program described has been initiated under the Department of Energy Light Water Reactor Safety Research and Development Program and has the following specific objectives: to identify the principal types and causes of failures in valves, valve operators and their controls and associated hardware, which lead to, or could lead to plant trip; and to suggest possible remedies for the prevention of these failures and recommend future research and development programs which could lead to minimizing these valve failures or mitigating their effect on plant operation. The data surveyed cover incidents reported over the six-year period, beginning 1973 through the end of 1978. Three sources of information on valve failures have been consulted: failure data centers, participating organizations in the nuclear power industry, and technical documents.
Eapen, Zubin J; Reed, Shelby D; Curtis, Lesley H; Hernandez, Adrian F; Peterson, Eric D
Policy makers have proposed bundling payments for all heart failure (HF) care within 30 days of an HF hospitalization in an effort to reduce costs. Disease management (DM) programs can reduce costly HF readmissions but have not been economically attractive for caregivers under existing fee-for-service payment. Whether a bundled payment approach can address the negative financial impact of DM programs is unknown. Our study determined the cost-neutral point for the typical DM program and examined whether published HF DM programs can be cost saving under bundled payment programs. We used a decision analytic model using data from retrospective cohort studies, meta-analyses, 5 randomized trials evaluating DM programs, and inpatient claims for all Medicare beneficiaries discharged with an HF diagnosis from 2001 to 2004. We determined the costs of DM programs and inpatient care over 30 and 180 days. With a baseline readmission rate of 22.9%, the average cost for readmissions over 30 days was $2,272 per patient. Under base-case assumptions, a DM program that reduced readmissions by 21% would need to cost $477 per patient to be cost neutral. Among evaluated published DM programs, 2 of the 5 would increase provider costs (+$15 to $283 per patient), whereas 3 programs would be cost saving (-$241 to $347 per patient). If bundled payments were broadened to include care over 180 days, then program saving estimates would increase, ranging from $419 to $1,706 per patient. Proposed bundled payments for HF admissions provide hospitals with a potential financial incentive to implement DM programs that efficiently reduce readmissions. Copyright © 2011 Mosby, Inc. All rights reserved.
Wong, Frances Kam Yuet; So, Ching; Ng, Alina Yee Man; Lam, Po-Tin; Ng, Jeffrey Sheung Ching; Ng, Nancy Hiu Yim; Chau, June; Sham, Michael Mau Kwong
Studies have shown positive clinical outcomes of specialist palliative care for end-stage heart failure patients, but cost-effectiveness evaluation is lacking. To examine the cost-effectiveness of a transitional home-based palliative care program for patients with end-stage heart failure patients as compared to the customary palliative care service. A cost-effectiveness analysis was conducted alongside a randomized controlled trial (Trial number: NCT02086305). The costs included pre-program training, intervention, and hospital use. Quality of life was measured using SF-6D. The study took place in three hospitals in Hong Kong. The inclusion criteria were meeting clinical indicators for end-stage heart failure patients including clinician-judged last year of life, discharged to home within the service area, and palliative care referral accepted. A total of 84 subjects (study = 43, control = 41) were recruited. When the study group was compared to the control group, the net incremental quality-adjusted life years gain was 0.0012 (28 days)/0.0077 (84 days) and the net incremental costs per case was -HK$7935 (28 days)/-HK$26,084 (84 days). The probability of being cost-effective was 85% (28 days)/100% (84 days) based on the cost-effectiveness thresholds recommended both by National Institute for Health and Clinical Excellence (£20,000/quality-adjusted life years) and World Health Organization (Hong Kong gross domestic product/capita in 2015, HK$328117). Results suggest that a transitional home-based palliative care program is more cost-effective than customary palliative care service. Limitations of the study include small sample size, study confined to one city, clinic consultation costs, and societal costs including patient costs and unpaid care-giving costs were not included.
Ota, Ken S; Beutler, David S; Gerkin, Richard D; Weiss, Jessica L; Loli, Akil I
Despite a variety of national efforts to improve transitions of care for patients at risk for rehospitalization, 30-day rehospitalization rates for patients with heart failure have remained largely unchanged. This is a retrospective review of 73 patients enrolled in our hospital-based, physican-directed Heart Failure Transitional Care Program (HFTCP). This study evaluated the 30- and 90- day readmission rates before and after enrollment in the program. The Transitionalist's services focused on bedside consultation prior to hospital discharge, follow-up home visits within 72 hours of discharge, frequent follow-up phone calls, disease-specific education, outpatient intravenous diuretic therapy, and around-the-clock telephone access to the Transitionalist. The pre-enrollment 30-day readmission rates for acute decompensated heart failure (ADHF) and all-cause readmission was 26.0% and 28.8%, respectively, while the post-enrollment rates for ADHF and all-cause readmission were 4.1% (P < 0.001) and 8.2% (P = 0.002), respectively. The pre-enrollment 90-day all-cause and ADHF readmission rates were 69.8%, and 58.9% respectively, while the post-enrollment rates for all-cause and ADHF were 27.3% (P < 0.001) and 16.4% (P < 0.001) respectively. Our physician-implemented HFTCP reduced rehospitalization risk for patients enrolled in the program. This program may serve as a model to assist other hospital systems to reduce readmission rates of patients with HF.
Kim, Tae Woon; Singh, Brijendra; Sung, Tae Yong; Park, Jin Hee; Lee, Yoon Hwan [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)
Largely, the RCM approach can be divided in three phases; (1) Functional failure analysis (FFA) on the selected system or subsystem, (2) Failure mode, effect and criticality analysis (FMECA) to identify the impact of failure to plant safety or economics, (3) Logical tree analysis (LTA) to select appropriate preventive maintenance and surveillance tasks. This report presents FMECA results for six mechanical subsystems of the diesel generators of nuclear power plants. The six mechanical subsystems are Starting air, Lub oil, Governor, Jacket water cooling, Fuel, and Engine subsystems. Generic and plant-specific failure and maintenance records are reviewed to identify critical components/failure modes. FMECA was performed for these critical component/failure modes. After reviewing current preventive maintenance activities of Wolsung unit 1, draft RCM recommendations are developed. 6 tabs., 16 refs. (Author).
Casey, Megan C.; Lauenstein, Jean-Marie; Wilcox, Edward P.; Topper, Alyson D.; Campola, Michael J.; Label, Kenneth A.
In this work, we use high- and low-magnitude optical microscope images, infrared camera images, and scanning electron microscope images to identify and describe the failure locations in heavy-ion-irradiated Schottky diodes.
Gabrielson, T. B
... and stress in a piezoelectric material. For a transducer operated near resonance, there will be "hot spots" or regions of locally intense stress and electric field that precipitate premature failure...
Prescott, Eva; Hjardem-Hansen, Rasmus; Ørkild, Bodil
Exercise training is known to be beneficial in chronic heart failure (CHF) patients but there is a lack of studies following patient groups for longer duration with maintenance training programs to defer deconditioning.......Exercise training is known to be beneficial in chronic heart failure (CHF) patients but there is a lack of studies following patient groups for longer duration with maintenance training programs to defer deconditioning....
Beaudet, Robert A.
This program is a Microsoft Access program that performed statistical analysis of the colony counts from assays performed on the Mars Science Laboratory (MSL) spacecraft to determine the bioburden density, 3-sigma biodensity, and the total bioburdens required for the MSL prelaunch reports. It also contains numerous tools that report the data in various ways to simplify the reports required. The program performs all the calculations directly in the MS Access program. Prior to this development, the data was exported to large Excel files that had to be cut and pasted to provide the desired results. The program contains a main menu and a number of submenus. Analyses can be performed by using either all the assays, or only the accountable assays that will be used in the final analysis. There are three options on the first menu: either calculate using (1) the old MER (Mars Exploration Rover) statistics, (2) the MSL statistics for all the assays, or This software implements penetration limit equations for common micrometeoroid and orbital debris (MMOD) shield configurations, windows, and thermal protection systems. Allowable MMOD risk is formulated in terms of the probability of penetration (PNP) of the spacecraft pressure hull. For calculating the risk, spacecraft geometry models, mission profiles, debris environment models, and penetration limit equations for installed shielding configurations are required. Risk assessment software such as NASA's BUMPERII is used to calculate mission PNP; however, they are unsuitable for use in shield design and preliminary analysis studies. The software defines a single equation for the design and performance evaluation of common MMOD shielding configurations, windows, and thermal protection systems, along with a description of their validity range and guidelines for their application. Recommendations are based on preliminary reviews of fundamental assumptions, and accuracy in predicting experimental impact test results. The software
A SWOT (strengths, weaknesses, opportunities, and threats) analysis of a teacher education program, or any program, can be the driving force for implementing change. A SWOT analysis is used to assist faculty in initiating meaningful change in a program and to use the data for program improvement. This tool is useful in any undergraduate or degree…
Ahmad, Tariq; Pencina, Michael J; Schulte, Phillip J; O'Brien, Emily; Whellan, David J; Piña, Ileana L; Kitzman, Dalane W; Lee, Kerry L; O'Connor, Christopher M; Felker, G Michael
Classification of chronic heart failure (HF) is on the basis of criteria that may not adequately capture disease heterogeneity. Improved phenotyping may help inform research and therapeutic strategies. This study used cluster analysis to explore clinical phenotypes in chronic HF patients. A cluster analysis was performed on 45 baseline clinical variables from 1,619 participants in the HF-ACTION (Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training) study, which evaluated exercise training versus usual care in chronic systolic HF. An association between identified clusters and clinical outcomes was assessed using Cox proportional hazards modeling. Differential associations between clinical outcomes and exercise testing were examined using interaction testing. Four clusters were identified (ranging from 248 to 773 patients in each), in which patients varied considerably among measures of age, sex, race, symptoms, comorbidities, HF etiology, socioeconomic status, quality of life, cardiopulmonary exercise testing parameters, and biomarker levels. Differential associations were observed for hospitalization and mortality risks between and within clusters. Compared with cluster 1, risk of all-cause mortality and/or all-cause hospitalization ranged from 0.65 (95% confidence interval [95% CI]: 0.54 to 0.78) for cluster 4 to 1.02 (95% CI: 0.87 to 1.19) for cluster 3. However, for all-cause mortality, cluster 3 had a disproportionately lower risk of 0.61 (95% CI: 0.44 to 0.86). Evidence suggested differential effects of exercise treatment on changes in peak oxygen consumption and clinical outcomes between clusters (p for interaction Cluster analysis of clinical variables identified 4 distinct phenotypes of chronic HF. Our findings underscore the high degree of disease heterogeneity that exists within chronic HF patients and the need for improved phenotyping of the syndrome. (Exercise Training Program to Improve Clinical Outcomes in Individuals With
Møller, Anders; Schwartzbach, Michael Ignatieff
XML graphs have shown to be a simple and effective formalism for representing sets of XML documents in program analysis. It has evolved through a six year period with variants tailored for a range of applications. We present a unified definition, outline the key properties including validation...... of XML graphs against different XML schema languages, and provide a software package that enables others to make use of these ideas. We also survey four very different applications: XML in Java, Java Servlets and JSP, transformations between XML and non-XML data, and XSLT....
Patterson, W.N.; Orona, F.
Face haulage equipment used in conjunction with continuous miners (shuttle cars, diesel haulers, battery scoops, and bridge conveyors) was investigated by recording section delay reports for computer analysis to determine the effect of haulage equipment failures and downtime on productivity, pinpoint the causes of machine failures and downtime, and develop the possible design and operational changes required to reduce machine failures and downtime and increase section productivity. For the mobile vehicle type of haulage (shuttle car, diesel hauler, and battery scoop) failure of one unit in multiple unit haulage operations would not normally stop section production. Bridge conveyors as a haulage system provide continuous haulage of section production but when any part of the bridge system fails, the section production is stopped. In the course of this program, it was determined through the use of daily section shift reports on 200 machines that face haulage equipment is responsible for about 40 to 56 minutes of lost section production time per shift. The most prevalent failure for shuttle cars was found to be the trailing cable umbilical. Bridge conveyors had the most trouble with the conveyor subsystem. Discussions of these and other recorded failures are developed with possible solutions outlined for future implementation. This report only covers the face haulage element of the continuous miner system. Companion reports were developed for the continuous miner and roof bolter elements under separate task orders.
Hebert, Kathy A; Horswell, Ronald L; Dy, Sydney; Key, Ira J; Butler, Michael K; Cerise, Frederick P; Arcement, Lee M
Heart failure (HF) produces significant morbidity and mortality. Although HF disease management (HFDM) programs have been shown to decrease this morbidity, there is still a paucity of data on their effect on mortality. The objective of this study was to determine whether participation in an HFDM program would reduce mortality in an indigent population from rural Louisiana. Proportional hazards modeling was used to determine whether patients participating in the HFDM program had improved survival compared with patients receiving traditional outpatient care at the same institution. Inclusion criteria consisted of an index hospitalization with discharge occurring between July 1, 1997, and May 30, 2002, hospital discharge diagnosis of HF, left ventricular systolic dysfunction documented during hospitalization, and at least 1 subsequent outpatient visit. Data from patients having participated in the HFDM program before their index hospitalization were excluded. Compared with patients who were given traditional care (n = 100), HFDM patients (n = 156) were younger (56.7 vs 60 years, P = .031), more likely to be African American (48.7% vs 33.0%, P = .014), more likely to be uninsured (47.4% vs 27%, P = .001), and more likely to have an ejection fraction of HFDM program was associated with a significant reduction in mortality compared with traditional care (adjusted hazard ratio .33, P HFDM program was associated with decreased mortality compared with traditional follow-up care.
Zhong, Yao; Wang, Rui; Yan, Lulu; Lin, Man; Liu, Xingling; You, Tianhui
The aim of this study was to explore the prognostic value of copeptin for predicting all-cause mortality in heart failure (HF). PubMed, Embase and Cochrane databases were systematically searched to identify if a 2×2 contingency table could be constructed based on both the copeptin level and the all-cause mortality in patients diagnosed with HF. The characteristics of test performance were summarized using forest plots and summary receiver operating characteristic curves (SROC). Q-test and I2 index were used to evaluate heterogeneity. Ten prospective cohort studies comprising 4473 patients were eligible in this meta-analysis. An elevated copeptin level was associated with an increased risk of all-cause mortality in HF patients (Relative risk (RR) was 2.64 (95% CI, 2.09-3.32)). The pooled sensitivity (SEN) and specificity (SPE) of copeptin were 0.57 (95% CI, 0.50-0.63) and 0.74 (95% CI, 0.69-0.79), respectively. The positive likelihood ratio was 2.2 (95% CI, 1.90-2.60) and the negative likelihood ratio was 0.58 (95% CI, 0.52-0.66). Furthermore, the summary Diagnostic Odds Ratio (DOR) was 4.00 (95% CI, 3.00-5.00) and the AUC was 0.70 (95% CI, 0.66-0.74) similar to the AUC of NT-proBNP 0.71 (95% CI, 0.67-0.75). Elevated levels of copeptin are associated with all-cause mortality in HF patients. The predictive value of copeptin is comparable with NT-proBNP for all-cause mortality in HF patients. Further studies are warranted to explore the prognostic value of copeptin in conjunction with other biomarkers and to determine an optimal cut-off level. Copyright © 2017 Elsevier B.V. All rights reserved.
DiStefano, Frank, III; Wobick, Craig; Chapman, Kirt; McCloud, Peter
The Personal Computer Transport Analysis Program (PCTAP) is C++ software used for analysis of thermal fluid systems. The program predicts thermal fluid system and component transients. The output consists of temperatures, flow rates, pressures, delta pressures, tank quantities, and gas quantities in the air, along with air scrubbing component performance. PCTAP s solution process assumes that the tubes in the system are well insulated so that only the heat transfer between fluid and tube wall and between adjacent tubes is modeled. The system described in the model file is broken down into its individual components; i.e., tubes, cold plates, heat exchangers, etc. A solution vector is built from the components and a flow is then simulated with fluid being transferred from one component to the next. The solution vector of components in the model file is built at the initiation of the run. This solution vector is simply a list of components in the order of their inlet dependency on other components. The component parameters are updated in the order in which they appear in the list at every time step. Once the solution vectors have been determined, PCTAP cycles through the components in the solution vector, executing their outlet function for each time-step increment.
Hwang, W. C.; Sun, C. T.
A failure analysis of laminated composites is accomplished by using an iterative three-dimensional finite element method. Based on Tsai-Wu failure theory, three different modes of failure are proposed: fiber breakage, matrix cracking, and delamination. The first ply failure load is then evaluated. As the applied load exceeds the first ply failure load, localized structural failure occurs and the global structural stiffness should change. The global stiffness matrix is modified by taking nonlinearity due to partial failures within a laminate into consideration. The first ply failure load is analyzed by using a iterative mixed field method in solving the linear part of the finite element equations. The progressive failure problem is solved numerically by using Newton-Raphson iterative schemes for the solution of nonlinear finite element equations. Numerical examples include angle-ply symmetric Thornel 300 graphite/934 resin epoxy laminates under uniaxial tension. First ply failure loads as well as the final failure loads are evaluated. Good correlation between analytical results and experimental data are observed. Numerical results also include the investigation of composite specimens with a centered hole, under uniaxial tension. Excellent correlation with the experimental data is observed.
Grupp, Thomas M; Weik, Thomas; Bloemer, Wilhelm; Knaebel, Hanns-Peter
Modular neck adapters for hip arthroplasty stems allow the surgeon to modify CCD angle, offset and femoral anteversion intraoperatively. Fretting or crevice corrosion may lead to failure of such a modular device due to high loads or surface contamination inside the modular coupling. Unfortunately we have experienced such a failure of implants and now report our clinical experience with the failures in order to advance orthopaedic material research and joint replacement surgery.The failed neck adapters were implanted between August 2004 and November 2006 a total of about 5000 devices. After this period, the titanium neck adapters were replaced by adapters out of cobalt-chromium. Until the end of 2008 in total 1.4% (n = 68) of the implanted titanium alloy neck adapters failed with an average time of 2.0 years (0.7 to 4.0 years) postoperatively. All, but one, patients were male, their average age being 57.4 years (36 to 75 years) and the average weight 102.3 kg (75 to 130 kg). The failures of neck adapters were divided into 66% with small CCD of 130 degrees and 60% with head lengths of L or larger. Assuming an average time to failure of 2.8 years, the cumulative failure rate was calculated with 2.4%. A series of adapter failures of titanium alloy modular neck adapters in combination with a titanium alloy modular short hip stem was investigated. For patients having received this particular implant combination risk factors were identified which were associated with the occurRence of implant failure. A Kaplan-Meier survival-failure-analysis was conducted. The retrieved implants were analysed using microscopic and chemical methods. Modes of failure were simulated in biomechanical tests. Comparative tests included modular neck adapters made of titanium alloy and cobalt chrome alloy material. Retrieval examinations and biomechanical simulation revealed that primary micromotions initiated fretting within the modular tapered neck connection. A continuous abrasion and
Full Text Available Abstract Background Modular neck adapters for hip arthroplasty stems allow the surgeon to modify CCD angle, offset and femoral anteversion intraoperatively. Fretting or crevice corrosion may lead to failure of such a modular device due to high loads or surface contamination inside the modular coupling. Unfortunately we have experienced such a failure of implants and now report our clinical experience with the failures in order to advance orthopaedic material research and joint replacement surgery. The failed neck adapters were implanted between August 2004 and November 2006 a total of about 5000 devices. After this period, the titanium neck adapters were replaced by adapters out of cobalt-chromium. Until the end of 2008 in total 1.4% (n = 68 of the implanted titanium alloy neck adapters failed with an average time of 2.0 years (0.7 to 4.0 years postoperatively. All, but one, patients were male, their average age being 57.4 years (36 to 75 years and the average weight 102.3 kg (75 to 130 kg. The failures of neck adapters were divided into 66% with small CCD of 130° and 60% with head lengths of L or larger. Assuming an average time to failure of 2.8 years, the cumulative failure rate was calculated with 2.4%. Methods A series of adapter failures of titanium alloy modular neck adapters in combination with a titanium alloy modular short hip stem was investigated. For patients having received this particular implant combination risk factors were identified which were associated with the occurence of implant failure. A Kaplan-Meier survival-failure-analysis was conducted. The retrieved implants were analysed using microscopic and chemical methods. Modes of failure were simulated in biomechanical tests. Comparative tests included modular neck adapters made of titanium alloy and cobalt chrome alloy material. Results Retrieval examinations and biomechanical simulation revealed that primary micromotions initiated fretting within the modular tapered neck
Orlandi, Ester; Tomatis, Stefano; Potepan, Paolo; Bossi, Paolo; Mongioj, Valeria; Carrara, Mauro; Palazzi, Mauro; Franceschini, Marzia; Bergamini, Cristiana; Locati, Laura; Iannacone, Eva; Guzzo, Marco; Ibba, Tullio; Crippa, Flavio; Licitra, Lisa; Pignoli, Emanuele; Fallai, Carlo
To analyze the patterns of locoregional failure following intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC) at our institution, as part of an internal quality assurance program. We aimed to investigate the potential existence of a correlation between any part of the IMRT process and clinical outcome. A total of 106 non-metastatic NPC patients consecutively treated with IMRT (with or without chemotherapy) were analyzed. Radiotherapy was administered using a sequential or simultaneous integrated boost approach at the total prescribed dose of 66-70 Gy (2.00-2.12 Gy per fraction). MRI studies of recurrences were recorded with the planning computed tomography studies to identify volume of failure. Recurrence-related characteristics were analyzed with respect to the original treatment. Failures were classified as 'in-field', 'marginal' or 'out-field' if at least 95, 20-95 or less than 20% of the volume of failure, respectively, was within 95% of the total prescription dose. With a median follow-up of 43.4 months, 5-years local control, regional control, locoregional control and overall survival rates were 87.7, 88.0, 83.5 and 81.3% respectively. A total of 21 failures were registered in 15 patients. In particular, ten failures (47.6%) were classified as 'in-field' (seven local failures and three regional failures [RFs]), nine failures (42.9%) as 'marginal' (five local failures and four RFs) and only two failures (9.5%) as 'out-field' (both RFs). The most relevant causes of failures were suboptimal target definition and target coverage as well as a longer than planned overall treatment time. IMRT determines excellent outcome in NPC patients. However, great attention in all IMRT steps is necessary to reduce potential causes of failure.
Full Text Available The halal food served in restaurants is important for Muslim consumers and it is one of the most susceptible issues for restaurant business. Therefore, restaurant internal efforts to ensure the halal food by examining critical risks including the way to manage them become important to be execute by restaurant management. This research aims to create a model using Failure Mode and Effect Analysis (FMEA method to identify and analyze the existing risks. Moreover, it also explains some improvement programs toward the risk management. The results of the risk identification and analysis will be determined by using Risk Priority Number (RPN. It is categorized that 7% risk event is classified as ‘very high risk’, 50% as ‘high risk’, 25% as ‘moderate risk’, and 18% considered as ‘low risk’. Furthermore, the improvement programs explained in this research are about delivery order system, packaging improvement, and also training, reward and punishment system. These programs are mainly purposed to reduce the risk with ‘high risk’ category.
Lee C. Cadwallader
This report presents the results of a preliminary failure modes and effects analysis (FMEA) of a small tritium-breeding test blanket module design for the International Thermonuclear Experimental Reactor. The FMEA was quantified with “generic” component failure rate data, and the failure events are binned into postulated initiating event families and frequency categories for safety assessment. An appendix to this report contains repair time data to support an occupational radiation exposure assessment for test blanket module maintenance.
Cadwallader, Lee C. [Idaho National Lab. (INL), Idaho Falls, ID (United States)
This report presents the results of a preliminary failure modes and effects analysis (FMEA) of a candidate design for the ITER Disruption Mitigation System. This candidate is the Massive Gas Injection System that provides machine protection in a plasma disruption event. The FMEA was quantified with “generic” component failure rate data as well as some data calculated from operating facilities, and the failure events were ranked for their criticality to system operation.
Panzenboeck, Michael; Freitag, Caroline [Montanuniv. Leoben (Austria). Dept. Metallkunde und Werkstoffpruefung; Borchert, Marlies [Materials Center Leoben (Austria)
In the last fifteen years computer-tomography has proven to be a valuable aid in the fields of medicine, materials technology and forensics. Nowadays it is hard to image non-destructive testing being carried out without its use. This article serves to demonstrate the power of the technique within the field of failure analysis with reference to two chosen case studies. The first case concerns the failure of magnetic valves, the second case focusses on the failure of corrosion resistant screws.
Lee C. Cadwallader
This report presents the results of a preliminary failure modes and effects analysis (FMEA) of a small tritium-breeding test blanket module design for the International Thermonuclear Experimental Reactor. The FMEA was quantified with “generic” component failure rate data, and the failure events are binned into postulated initiating event families and frequency categories for safety assessment. An appendix to this report contains repair time data to support an occupational radiation exposure assessment for test blanket module maintenance.
Full Text Available Single-lap joints made of aluminium and carbon fibre adherends of different thickness are tested to understand better the behaviour of such dissimilar joints. The overlap length and the thickness of the adhesive are kept constant. Local deformation fields are onitored by using the digital image correlation method. Peeling and shearing strains are investigated, emphasizing that peeling is important in the region where failure is initiated, towards an extremity of the overlap region. The use of only carbon fibre adherends is not recommended for a smaller thickness as an additional interface failure is produced and compromises the integrity of the lap joint. However, a dissimilar joint (aluminium-carbon with smaller thickness adherends succeeds to maintain the stiffness of the assembly, but its strength is diminished. The obtained results are suggesting that a complete monitoring of the failure processes in the overlap region can be fully understood only if local deformation measurements are possible.
Zhu, Jun; Xie, Jing; Lipford, Heather Richter; Chu, Bill
Many security incidents are caused by software developers' failure to adhere to secure programming practices. Static analysis tools have been used to detect software vulnerabilities. However, their wide usage by developers is limited by the special training required to write rules customized to application-specific logic. Our approach is interactive static analysis, to integrate static analysis into Integrated Development Environment (IDE) and provide in-situ secure programming support to help developers prevent vulnerabilities during code construction. No additional training is required nor are there any assumptions on ways programs are built. Our work is motivated in part by the observation that many vulnerabilities are introduced due to failure to practice secure programming by knowledgeable developers. We implemented a prototype interactive static analysis tool as a plug-in for Java in Eclipse. Our technical evaluation of our prototype detected multiple zero-day vulnerabilities in a large open source project. Our evaluations also suggest that false positives may be limited to a very small class of use cases.
Full Text Available Many security incidents are caused by software developers’ failure to adhere to secure programming practices. Static analysis tools have been used to detect software vulnerabilities. However, their wide usage by developers is limited by the special training required to write rules customized to application-specific logic. Our approach is interactive static analysis, to integrate static analysis into Integrated Development Environment (IDE and provide in-situ secure programming support to help developers prevent vulnerabilities during code construction. No additional training is required nor are there any assumptions on ways programs are built. Our work is motivated in part by the observation that many vulnerabilities are introduced due to failure to practice secure programming by knowledgeable developers. We implemented a prototype interactive static analysis tool as a plug-in for Java in Eclipse. Our technical evaluation of our prototype detected multiple zero-day vulnerabilities in a large open source project. Our evaluations also suggest that false positives may be limited to a very small class of use cases.
El Hami, Abdelkhalak
In operation, mechatronics embedded systems are stressed by loads of different causes: climate (temperature, humidity), vibration, electrical and electromagnetic. These stresses in components which induce failure mechanisms should be identified and modeled for better control. AUDACE is a collaborative project of the cluster Mov'eo that address issues specific to mechatronic reliability embedded systems. AUDACE means analyzing the causes of failure of components of mechatronic systems onboard. The goal of the project is to optimize the design of mechatronic devices by reliability. The projec
Ota, Ken S; Beutler, David S; Sheikh, Hassam; Weiss, Jessica L; Parkinson, Dallin; Nguyen, Peter; Gerkin, Richard D; Loli, Akil I
This study investigated the trend of phone calls in the Banner Good Samaritan Medical Center (BGSMC) Heart Failure Transitional Care Program (HFTCP). The primary goal of the HFTCP is to reduce 30-Day readmissions for heart failure patients by using a multi-pronged approach. This study included 104 patients in the HFTCP discharged over a 51-week period who had around-the-clock telephone access to the Transitionalist. Cellular phone records were reviewed. This study evaluated the length and timing of calls. A total of 4398 telephone calls were recorded of which 39% were inbound and 61% were outbound. This averaged to 86 calls per week. During the "Weekday Daytime" period, Eighty-five percent of the totals calls were made. There were 229 calls during the "Weekday Nights" period with 1.5 inbound calls per week. The "Total Weekend" calls were 10.2% of the total calls which equated to a weekly average of 8.8. Our experience is that direct, physician-patient telephone contact is feasible with a panel of around 100 HF patients for one provider. If the proper financial reimbursements are provided, physicians may be apt to participate in similar transitional care programs. Likewise, third party payers will benefit from the reduction in unnecessary emergency room visits and hospitalizations.
Aktay, Sevima A; Kowaleski, Michael P
To compare mechanical performance of 2 orientations of the 5 mm Corkscrew® suture anchor with #5 Fiberwire® . In vitro biomechanical study. Suture anchor-suture constructs (n=40). Acute and cyclic tensile loads were applied to suture threaded through eyelets of 40 anchors perpendicular to the long axis of the anchor. Eyelets were positioned so that the suture pull was in line with (anchor rotation angle of 0° [ARA 0]) or 90° (ARA 90) to the eyelet plane. Load at failure, stiffness, and cycles to failure were determined. All constructs failed by suture breakage at the eyelet. Mean load at failure was significantly higher in the ARA 90 group (634 ± 93 N) compared with the ARA 0 group (495 ± 52 N; P=.0015). No significant difference was found between groups for mean number of cycles to failure (270 ± 177 versus 178 ± 109; P=.2166) and stiffness (50 ± 4 versus 48 ± 5 N/mm; P=.3141). The Corkscrew® 5 mm suture anchor with Fiberwire® suture fails via suture breakage at the eyelet under higher acute loads if the suture is loaded at an angle of 90° compared with 0° with respect to the plane of the eyelet. © Copyright 2011 by The American College of Veterinary Surgeons.
The thesis is about the characterization of the microstructure of several aluminium foams and its relation to the failure behavior of these materials under monotonic tension and fatigue. Due to the production processes brittle inclusions are present in the microstructure of the foams investigated.
The results of many researches on the causes of road traffic accidents have always resolved around three main factors, the human, environmental and vehicular factors. In this study, emphasis was placed on the vehicular factor in road traffic accident. It looked into detail on those vehicle components whose failures result in ...
Gravois, Melanie C.
Root Cause Analysis (RCA) identifies the cause of an adverse condition that, if corrected, will preclude recurrence or greatly reduce the probability of recurrence of the same or similar adverse conditions and thereby protect the health and safety of the public, the workers, and the environment. This procedure sets forth the requirements for management determination and the selection of RCA methods and implementation of RCAs that are a result of significant findings from Price-Anderson Amendments Act (PAAA) violations, occurrences/events, Significant Adverse Conditions, and external oversight Corrective Action Requests (CARs) generated by the Office of Enforcement (PAAA headquarters), the U.S. Environmental Protection Agency, and other oversight entities against Lawrence Berkeley National Laboratory (LBNL). Performance of an RCA may result in the identification of issues that should be reported in accordance with the Issues Management Program Manual.
Failure analysis is the preferred method to investigate product or process reliability and to ensure optimum performance of electrical components and systems. The physics-of-failure approach is the only internationally accepted solution for continuously improving the reliability of materials, devices and processes. The models have been developed from the physical and chemical phenomena that are responsible for degradation or failure of electronic components and materials and now replace popular distribution models for failure mechanisms such as Weibull or lognormal. Reliability engineers nee
Zhu, Jiangsheng; Ma, Kuichao; N. Soltani, Mohsen
This paper discusses a cost based Failure Mode and Effect Analysis (FMEA) approch for the Wind Turbine (WT) with condition monitoring system in China. Normally, the traditional FMEA uses the Risk Priority Number (RPN) to rank failure modes. But the RPN can be changed with the Condition Monitoring...
Blanke, M.; Borch, Ole; Bagnoli, F.
implementing an automated technique for Failure Modes and Effects Analysis (FMEA). This technique is based on the matrix formulation of FMEA for the investigation of failure propagation through a system. As main result, this technique will provide the design engineer with decision tables for fault handling...
Blanke, M.; Borch, Ole; Allasia, G.
implementing an automated technique for Failure Modes and Effects Analysis (FMEA). This technique is based on the matrix formulation of FMEA for the investigation of failure propagation through a system. As main result, this technique will provide the design engineer with decision tables for fault handling...
Fabiano Leal; Dagoberto Alves De Almeida; José Arnaldo Barra Montevechi; Fernando Augusto Silva Marins
This work presents a failures interactive effects analysis in a process, by means ofsimulations experiments. The chosen process is a hypothetical system, simulated throughsoftware Promodel®. Two conceptual models are generated, representing the system(mapping process) and the failures considered in system (Fault Tree Analysis). Theseconceptual models are translated in a computerized model, for the analysis of individual andcombined effects on the variable “number of produced pieces”. This exp...
Daimee, Usama A; Vermilye, Katherine; Rosero, Spencer; Schuger, Claudio D; Daubert, James P; Zareba, Wojciech; McNitt, Scott; Polonsky, Bronislava; Moss, Arthur J; Kutyifa, Valentina
The effects of heart failure (HF) severity on risk of inappropriate implantable cardioverter-defibrillator (ICD) therapy have not been thoroughly investigated. We aimed to study the association between HF severity and inappropriate ICD therapy in MADIT-RIT. MADIT-RIT randomized 1,500 patients to three ICD programming arms: conventional (Arm A), high-rate cut-off (Arm B: ≥200 beats/min), and delayed therapy (Arm C: 60-second delay for ≥170 beats/min). We evaluated the association between New York Heart Association (NYHA) class III (n = 256) versus class I-II (n = 251) and inappropriate ICD therapy in Arm A patients with ICD-only and cardiac resynchronization therapy with defibrillator (CRT-D). We additionally assessed benefit of novel ICD programming in Arms B and C versus Arm A by NYHA classification. In Arm A, the risk of inappropriate therapy was significantly higher in those with NYHA III versus NYHA I-II for both ICD (hazard ratio [HR] = 2.55, confidence interval [CI]: 1.51-4.30, P programming significantly reduced inappropriate therapy in patients with both NYHA III (Arm B vs Arm A: HR = 0.08, P programming with high-rate cut-off or delayed detection reduces inappropriate ICD therapies in both mild and moderate HF. © 2017 Wiley Periodicals, Inc.
Zheng, W.; Gao, J. M.; Wang, R. X.; Chen, K.; Jiang, Y.
This paper put forward a new method of technical characteristics deployment based on Reliability Function Deployment (RFD) by analysing the advantages and shortages of related research works on mechanical reliability design. The matrix decomposition structure of RFD was used to describe the correlative relation between failure mechanisms, soft failures and hard failures. By considering the correlation of multiple failure modes, the reliability loss of one failure mode to the whole part was defined, and a calculation and analysis model for reliability loss was presented. According to the reliability loss, the reliability index value of the whole part was allocated to each failure mode. On the basis of the deployment of reliability index value, the inverse reliability method was employed to acquire the values of technology characteristics. The feasibility and validity of proposed method were illustrated by a development case of machining centre’s transmission system.
Zhang, Ying-Zhi; Liu, Jin-Tong; Shen, Gui-Xiang; Long, Zhe; Sun, Shu-Guang
In order to rectify the problems that the component reliability model exhibits deviation, and the evaluation result is low due to the overlook of failure propagation in traditional reliability evaluation of machine center components, a new reliability evaluation method based on cascading failure analysis and the failure influenced degree assessment is proposed. A direct graph model of cascading failure among components is established according to cascading failure mechanism analysis and graph theory. The failure influenced degrees of the system components are assessed by the adjacency matrix and its transposition, combined with the Pagerank algorithm. Based on the comprehensive failure probability function and total probability formula, the inherent failure probability function is determined to realize the reliability evaluation of the system components. Finally, the method is applied to a machine center, it shows the following: 1) The reliability evaluation values of the proposed method are at least 2.5% higher than those of the traditional method; 2) The difference between the comprehensive and inherent reliability of the system component presents a positive correlation with the failure influenced degree of the system component, which provides a theoretical basis for reliability allocation of machine center system.
Torres-Sierra, Heriberto; Gómez-Fragoso, Julieta
The U.S. Geological Survey, in cooperation with the Puerto Rico Electric Power Authority, completed a hydrologic and hydraulic study to assess the potential hazard to human life and property associated with the hypothetical failure of the Lago de Matrullas Dam, located within the headwaters of the Río Grande de Manatí. The hydrologic study yielded outflow hydrographs and peak discharges for Lago de Matrullas and other subbasins in the Río Grande de Manatí hydrographic basin for three extreme rainfall events: (1) a 6-hour probable maximum precipitation (PMP) event, (2) a 24-hour PMP event, and (3) a 100-year-recurrence, 24-hour rainfall event. The hydraulic study simulated the hypothetical dam failure of Lago de Matrullas using hypothetical flood hydrographs generated from the hydrologic study and selected dam breach parameters. The flood wave resulting from the failure was downstream-routed through the lower reaches of the Río Matrullas, the Río Toro Negro, and the Río Grande de Manatí for determination of water-surface profiles developed from the event-based hydrologic scenarios and “sunny day” (no precipitation) conditions. The Hydrologic Modeling System (HEC–HMS) and the River Analysis System (HEC–RAS) computer programs, developed by the Hydrologic Engineering Center (HEC) of the U.S. Army Corps of Engineers, were used for the hydrologic and hydraulic modeling, respectively. The flow routing in the hydraulic analyses was performed using the unsteady-state flow module available in the HEC–RAS model.
Mumaw, Randall J.
The role of an alerting system is to make the system operator (e.g., pilot) aware of an impending hazard or unsafe state so the hazard can be avoided or managed successfully. A review of 46 commercial aviation accidents (between 1998 and 2014) revealed that, in the vast majority of events, either the hazard was not alerted or relevant hazard alerting occurred but failed to aid the flight crew sufficiently. For this set of events, alerting system failures were placed in one of five phases: Detection, Understanding, Action Selection, Prioritization, and Execution. This study also reviewed the evolution of alerting system schemes in commercial aviation, which revealed naive assumptions about pilot reliability in monitoring flight path parameters; specifically, pilot monitoring was assumed to be more effective than it actually is. Examples are provided of the types of alerting system failures that have occurred, and recommendations are provided for alerting system improvements.
Cowgill, M.G.; Czajkowski, C.J.; Franz, E.M.
Brookhaven National Laboratory has for many years conducted examinations related to the failures of nuclear materials and components. These examinations included the confirmation of root cause analyses, the determination of the causes of failure, identification of the species that accelerate corrosion, and comparison of the results of nondestructive examinations with those obtained by destructive examination. The results of those examinations, which had previously appeared in various formats (formal and informal reports, journal articles, etc.), have been collected together and summarized in the present report. The report is divided into sections according to the general subject matter (for example, corrosion, fatigue, etc.). Each section presents summaries of the information contained in specific reports and publications, all of which are fully identified as to title, authors, report number or journal reference, date of publication, and FIN number under which the work was performed.
effects based on how severe they are, how often they might occur, and how easily we can find them. 3. Effects: the consequences of failure. The...Actions ! 0 l!1 .. requirE-ments ~ l=ailure 1-’rP.vP.ntion .., llP.tP.c::tion Completion Dato Action• Taken P. il "’ ; · .. "’ = 0 i;r= ~ ~ " S pnrg
Farhad Asgari Mehrabadi
Full Text Available In the first section of this work, a suitable data reduction scheme is developed to measure the adhesive joints strain energy release rate under pure mode-I loading, and in the second section, three types of adhesive hybrid lap-joints, that is, Aluminum-GFRP (Glass Fiber Reinforced Plastic, GFRP-GFRP, and Steel-GFRP were employed in the determination of adhesive hybrid joints strengths and failures that occur at these assemblies under tension loading. To achieve the aims, Double Cantilever Beam (DCB was used to evaluate the fracture state under the mode-I loading (opening mode and also hybrid lap-joint was employed to investigate the failure load and strength of bonded joints. The finite-element study was carried out to understand the stress intensity factors in DCB test to account fracture toughness using J-integral method as a useful tool for predicting crack failures. In the case of hybrid lap-joint tests, a numerical modeling was also performed to determine the adhesive stress distribution and stress concentrations in the side of lap-joint. Results are discussed in terms of their relationship with adhesively bonded joints and thus can be used to develop appropriate approaches aimed at using adhesive bonding and extending the lives of adhesively bonded repairs for aerospace structures.
Bazant, Z.P.; Bhat, P.D.; Shieh, C.L.
A gradual accumulation of inelastic strain can be most conveniently described in terms of the so-called intrinsic time, whose increment depends on the time increment as well as the strain increments. This approach, which gives a particularly simple description of irreversibility of strain at unloading and cyclic loading, was previously developed for metals and is extended herein to concrete by introducing the hydrostatic pressure sensitivity of inelastic strain, the inelastic dilatancy produced by deviator strains, and the strain-softening tendency at high stress. Failure envelopes are obtained as a collection of the peaks of stress-strain diagrams. By comparison with experimental data from the literature, it is demonstrated that the proposed model predicts quite closely: stress-strain diagrams for concretes of different strength; uniaxial, biaxial and triaxial stress-strain diagrams and failure envelopes; failure envelopes for combined torsion and compression, lateral strains and volume expansion in uniaxial and biaxial tests; the behavior of spirally confined concrete; hysteresis loops or repeated high compression; cyclic creep up to 10/sup 6/ cycles; the strain rate effect; the decrease of long time strength; and the increase of short-time strength due to low stress creep.
Saleh, Joseph Homer; Geng, Fan; Ku, Michelle; Walker, Mitchell L. R.
With a few hundred spacecraft launched to date with electric propulsion (EP), it is possible to conduct an epidemiological study of EP's on orbit reliability. The first objective of the present work was to undertake such a study and analyze EP's track record of on orbit anomalies and failures by different covariates. The second objective was to provide a comparative analysis of EP's failure rates with those of chemical propulsion. Satellite operators, manufacturers, and insurers will make reliability- and risk-informed decisions regarding the adoption and promotion of EP on board spacecraft. This work provides evidence-based support for such decisions. After a thorough data collection, 162 EP-equipped satellites launched between January 1997 and December 2015 were included in our dataset for analysis. Several statistical analyses were conducted, at the aggregate level and then with the data stratified by severity of the anomaly, by orbit type, and by EP technology. Mean Time To Anomaly (MTTA) and the distribution of the time to (minor/major) anomaly were investigated, as well as anomaly rates. The important findings in this work include the following: (1) Post-2005, EP's reliability has outperformed that of chemical propulsion; (2) Hall thrusters have robustly outperformed chemical propulsion, and they maintain a small but shrinking reliability advantage over gridded ion engines. Other results were also provided, for example the differentials in MTTA of minor and major anomalies for gridded ion engines and Hall thrusters. It was shown that: (3) Hall thrusters exhibit minor anomalies very early on orbit, which might be indicative of infant anomalies, and thus would benefit from better ground testing and acceptance procedures; (4) Strong evidence exists that EP anomalies (onset and likelihood) and orbit type are dependent, a dependence likely mediated by either the space environment or differences in thrusters duty cycles; (5) Gridded ion thrusters exhibit both
Bishop, Craig; Johnson, Colin G.
The idea of roles of variables is to provide a vocabulary for describing the way in which variables are used by experienced programmers. This paper presents work on a system that is designed to automatically check students' role assignments in simple procedural programming. This is achieved by applying program analysis techniques, in particular program slicing and data flow analysis, to programs that students have written and annotated with role assignments.
Full Text Available The goal of this paper is to introduce a procedure for risk assessment of insulation failure due to storm surges. The simulations were carried out in ATP / EMTP software, which allowed the use of the Monte Carlo method for the statistical analysis of insulation coordination. The paper gives a detailed account of modelling of all the elements relevant to the analysis. At the same time, the capabilities of the programming language MODELS (allows the creation and implementation of new complex components within the ATP software are discussed.
Zhang, Chao; Santhanagopalan, Shriram; Pesaran, Ahmad
This is a presentation given at the 12th World Congress for Computational Mechanics on coupled mechanical-electrochemical-thermal analysis of failure propagation in lithium-ion batteries for electric vehicles.
Saulino, Michael F; Patel, Teresa; Fisher, Stanley P
This study aimed to utilize failure modes and effects analysis (FMEA) to transform clinical insights into a risk mitigation plan for intrathecal (IT) drug delivery in pain management. The FMEA methodology, which has been used for quality improvement, was adapted to assess risks (i.e., failure modes) associated with IT therapy. Ten experienced pain physicians scored 37 failure modes in the following categories: patient selection for therapy initiation (efficacy and safety concerns), patient safety during IT therapy, and product selection for IT therapy. Participants assigned severity, probability, and detection scores for each failure mode, from which a risk priority number (RPN) was calculated. Failure modes with the highest RPNs (i.e., most problematic) were discussed, and strategies were proposed to mitigate risks. Strategic discussions focused on 17 failure modes with the most severe outcomes, the highest probabilities of occurrence, and the most challenging detection. The topic of the highest-ranked failure mode (RPN = 144) was manufactured monotherapy versus compounded combination products. Addressing failure modes associated with appropriate patient and product selection was predicted to be clinically important for the success of IT therapy. The methodology of FMEA offers a systematic approach to prioritizing risks in a complex environment such as IT therapy. Unmet needs and information gaps are highlighted through the process. Risk mitigation and strategic planning to prevent and manage critical failure modes can contribute to therapeutic success. © 2016 The Authors. Neuromodulation: Technology at the Neural Interface published by Wiley Periodicals, Inc. on behalf of International Neuromodulation Society.
Allinger, J.; Danby, G.; Hsieh, S.Y.; Keane, J.; Powell, J.; Prodell, A.
This report includes the first two quarters study of available information on schemes for protecting superconducting magnets. These schemes can be divided into two different categories. The first category deals with the detection of faulty regions (or normal regions) in the magnet. The second category relates to the protection of the magnet when a fault is detected, and the derived signal which can be used to activate a safety system (or energy removal system). The general detection and protection methods are first described briefly and then followed by a survey of the protection systems used by different laboratories for various magnets. A survey of the cause of the magnet difficulties or failures is also included. A preliminary discussion of these protection schemes and the experimental development of this program is given.
Agboola, Stephen; Jethwani, Kamal; Khateeb, Kholoud; Moore, Stephanie; Kvedar, Joseph
Given the magnitude of increasing heart failure mortality, multidisciplinary approaches, in the form of disease management programs and other integrative models of care, are recommended to optimize treatment outcomes. Remote monitoring, either as structured telephone support or telemonitoring or a combination of both, is fast becoming an integral part of many disease management programs. However, studies reporting on the evaluation of real-world heart failure remote monitoring programs are scarce. This study aims to evaluate the effect of a heart failure telemonitoring program, Connected Cardiac Care Program (CCCP), on hospitalization and mortality in a retrospective database review of medical records of patients with heart failure receiving care at the Massachusetts General Hospital. Patients enrolled in the CCCP heart failure monitoring program at the Massachusetts General Hospital were matched 1:1 with usual care patients. Control patients received care from similar clinical settings as CCCP patients and were identified from a large clinical data registry. The primary endpoint was all-cause mortality and hospitalizations assessed during the 4-month program duration. Secondary outcomes included hospitalization and mortality rates (obtained by following up on patients over an additional 8 months after program completion for a total duration of 1 year), risk for multiple hospitalizations and length of stay. The Cox proportional hazard model, stratified on the matched pairs, was used to assess primary outcomes. A total of 348 patients were included in the time-to-event analyses. The baseline rates of hospitalizations prior to program enrollment did not differ significantly by group. Compared with controls, hospitalization rates decreased within the first 30 days of program enrollment: hazard ratio (HR)=0.52, 95% CI 0.31-0.86, P=.01). The differential effect on hospitalization rates remained consistent until the end of the 4-month program (HR=0.74, 95% CI 0
Sørensen, John Dalsgaard; Burcharth, H. F.
Vertical wall breakwaters are usually designed as concrete caissons placed on the top of a rubble mound foundation or a rubble bedding layer. The purpose of the breakwater is usually to protect the area behind the breakwater from being flooded by large waves. The area protected can for example...... be a harbour of small or large importance, an important industrial area or a heavily populated coast line. This implies that vertical wall breakwaters are used under quite different conditions and therefore the consequences of a complete or partial failure also are very different. This implies...
Tseng, Fu-Min; Chen, Su-Chin; An, Hsiuan-Pei
We constructed a full scale two-dam system in Landao Creek, Huisun forest, Taiwan. From its own alluvium to investigate the dam break morphology and physical properties between two dams with three intervals in 16.2m (case 1), 32.4m (case 2) and 64.8m (case 3). We adjusted the interval by fixed upstream dam and changed downstream dam site to observed and analyzed dam failure processes and hydraulic properties of the dam system. Grain size distribution investigation and 3D Lidar model of the stream bed were executed before and after dams break to discuss the river morphology evolution. In addition, to explore the type of breach varying with time, we used the method of 3D Remodeling from Motion Structure with Multi-View Stereo, which is a 3D spatial modeling process by photoing an object at same time in more than four different angles with over 70% overlap to each other, to construct the 3D model of dams system in this study. Furthermore, the dam break process were analyzed by cameras images and data recorded from water level gauges. The result showed that the shortest intervals in Case 1 result in a stronger torrent impact at upstream side of downstream dam, more significant reduction in dam intensity and wider breach which was 22% more than that in Case 2. On the contrary, the failure duration between two dams in Case 3 was 4.0 and 2.7 times longer than that in Case 1 and Case 2, respectively. Consequently, the decrement of dam interval led to a greater damage and rapid increment of water level which was prompted by outburst flow from the upstream dam failure at downstream dam, and shorter failure duration in two-dam system. In addition, the transport distance of sediment which yielded from upstream dam breach depend on whether downstream was obstructed or not. The 90% sediment of upstream dam breach were deposited on the upstream side of downstream dam with a comparison of entire loss in case of downstream dam.
Full Text Available Introduction: Heart failure is one of the most common cardiovascular diseases which decrease the quality of life. Most of the factors influencing the quality of life can be modified with educational interventions. Therefore, this study examined the impact of a continuous training program on quality of life of patients with heart failure. Methods: This randomized clinical trial study was conducted during May to August 2011. Forty four participants with heart failure referred to Shahid Madani's polyclinics of Tabriz were selected through convenient sampling method and were randomly allocated to two groups. The intervention group (n = 22 received ongoing training including one-to-one teaching, counseling sessions and phone calls over 3 months. The control group (n = 22 received routine care program. Data on quality of life was collected using the Minnesota Living with Heart Failure Questionnaire at baseline as well as three months later. Results: The statistical tests showed significant differences in the physical, emotional dimensions and total quality of life in intervention group. But in control group, no significant differences were obtained. There was not any significant association in demographic characteristics and quality of life. Conclusion: Ongoing training programs can be effective in improving quality of life of patients with heart failure. Hence applying ongoing educational program as a non-pharmacological intervention can help to improve the quality of life of these patients.
Wiser, Ryan; Olson, Scott; Bird, Lori; Swezey, Blair
Development of renewable energy. Such programs have grown in number in recent years. The design features and effectiveness of these programs varies considerably, however, leading a variety of stakeholders to suggest specific marketing and program design features that might improve customer response and renewable energy sales. This report analyzes actual utility green pricing program data to provide further insight into which program features might help maximize both customer participation in green pricing programs and the amount of renewable energy purchased by customers in those programs. Statistical analysis is performed on both the residential and non-residential customer segments. Data comes from information gathered through a questionnaire completed for 66 utility green pricing programs in early 2003. The questionnaire specifically gathered data on residential and non-residential participation, amount of renewable energy sold, program length, the type of renewable supply used, program price/cost premiums, types of consumer research and program evaluation performed, different sign-up options available, program marketing efforts, and ancillary benefits offered to participants.
Ahn, Mu-Young, E-mail: firstname.lastname@example.org [National Fusion Research Institute, Daejeon (Korea, Republic of); Cho, Seungyon [National Fusion Research Institute, Daejeon (Korea, Republic of); Jin, Hyung Gon; Lee, Dong Won [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Park, Yi-Hyun; Lee, Youngmin [National Fusion Research Institute, Daejeon (Korea, Republic of)
Highlights: • Postulated initiating events are identified through failure modes and effects analysis on the current HCCR TBS design. • A set of postulated initiating events are selected for consideration of deterministic analysis. • Accident evolutions on the selected postualted initiating events are qualitatively described for deterministic analysis. - Abstract: Korean Helium cooled ceramic reflector (HCCR) Test blanket system (TBS), which comprises Test blanket module (TBM) and ancillary systems in various locations of ITER building, is operated at high temperature and pressure with decay heat. Therefore, safety is utmost concern in design process and it is required to demonstrate that the HCCR TBS is designed to comply with the safety requirements and guidelines of ITER. Due to complexity of the system with many interfaces with ITER, a systematic approach is necessary for safety analysis. This paper presents preliminary failure modes and effects analysis (FMEA) study performed for the HCCR TBS. FMEA is a systematic methodology in which failure modes for components in the system and their consequences are studied from the bottom-up. Over eighty failure modes have been investigated on the HCCR TBS. The failure modes that have similar consequences are grouped as postulated initiating events (PIEs) and total seven reference accident scenarios are derived from FMEA study for deterministic accident analysis. Failure modes not covered here due to evolving design of the HCCR TBS and uncertainty in maintenance procedures will be studied further in near future.
Taylor, Rocky Scott
The main focus of the study was the analysis of scale effect in local ice pressure resulting from probabilistic (spalling) fracture and the relationship between local and global loads due to the averaging of pressures across the width of a structure. A review of fundamental theory, relevant ice mechanics and a critical analysis of data and theory related to the scale dependent pressure behavior of ice were completed. To study high pressure zones (hpzs), data from small-scale indentation tests carried out at the NRC-IOT were analyzed, including small-scale ice block and ice sheet tests. Finite element analysis was used to model a sample ice block indentation event using a damaging, viscoelastic material model and element removal techniques (for spalling). Medium scale tactile sensor data from the Japan Ocean Industries Association (JOIA) program were analyzed to study details of hpz behavior. The averaging of non-simultaneous hpz loads during an ice-structure interaction was examined using local panel pressure data. Probabilistic averaging methodology for extrapolating full-scale pressures from local panel pressures was studied and an improved correlation model was formulated. Panel correlations for high speed events were observed to be lower than panel correlations for low speed events. Global pressure estimates based on probabilistic averaging were found to give substantially lower average errors in estimation of load compared with methods based on linear extrapolation (no averaging). Panel correlations were analyzed for Molikpaq and compared with JOIA results. From this analysis, it was shown that averaging does result in decreasing pressure for increasing structure width. The relationship between local pressure and ice thickness for a panel of unit width was studied in detail using full-scale data from the STRICE, Molikpaq, Cook Inlet and Japan Ocean Industries Association (JOIA) data sets. A distinct trend of decreasing pressure with increasing ice thickness
Full Text Available The acoustic emission technique is used for monitoring the fatigue failure mechanisms in reinforced concrete beam under three point bending. The analysis was conducted by using the bathtub curve method plotted from acoustic emission data. In this study, the fatigue behavior was divided into three stages. The first stage is involved with the decreasing failure rate, known as early life failure or burn-in phase, the second stage is characterized by constant failure rate and the third stage is called the burn-out phase which is an increase of failure rate. The three parameters used in analyzing is the fatigue behavior for each stage of failure which are severity, signal strength and the cumulative signal strength. From severity analysis, the range of each stage of failure had been determined while from signal strength analysis, the initiation of distribution of crack had been detected through the fluctuation of signal strength. Cumulative signal strength parameter provides a clearer view of the initiation and distribution of crack.
Moss, Marc; Nordon-Craft, Amy; Malone, Dan; Van Pelt, David; Frankel, Stephen K; Warner, Mary Laird; Kriekels, Wendy; McNulty, Monica; Fairclough, Diane L; Schenkman, Margaret
Early physical therapy (PT) interventions may benefit patients with acute respiratory failure by preventing or attenuating neuromuscular weakness. However, the optimal dosage of these interventions is currently unknown. To determine whether an intensive PT program significantly improves long-term physical functional performance compared with a standard-of-care PT program. Patients who required mechanical ventilation for at least 4 days were eligible. Enrolled patients were randomized to receive PT for up to 4 weeks delivered in an intensive or standard-of-care manner. Physical functional performance was assessed at 1, 3, and 6 months in survivors who were not currently in an acute or long-term care facility. The primary outcome was the Continuous Scale Physical Functional Performance Test short form (CS-PFP-10) score at 1 month. A total of 120 patients were enrolled from five hospitals. Patients in the intensive PT group received 12.4 ± 6.5 sessions for a total of 408 ± 261 minutes compared with only 6.1 ± 3.8 sessions for 86 ± 63 minutes in the standard-of-care group (P Physical function assessments were available for 86% of patients at 1 month, for 76% at 3 months, and for 60% at 6 months. In both groups, physical function was reduced yet significantly improved over time between 1, 3, and 6 months. When we compared the two interventions, we found no differences in the total CS-PFP-10 scores at all three time points (P = 0.73, 0.29, and 0.43, respectively) or in the total CS-PFP-10 score trajectory (P = 0.71). An intensive PT program did not improve long-term physical functional performance compared with a standard-of-care program. Clinical trial registered with www.clinicaltrials.gov (NCT01058421).
Zhang, Michael Y; Keel, Siobán B; Walsh, Tom; Lee, Ming K; Gulsuner, Suleyman; Watts, Amanda C; Pritchard, Colin C; Salipante, Stephen J; Jeng, Michael R; Hofmann, Inga; Williams, David A; Fleming, Mark D; Abkowitz, Janis L; King, Mary-Claire; Shimamura, Akiko
Accurate and timely diagnosis of inherited bone marrow failure and inherited myelodysplastic syndromes is essential to guide clinical management. Distinguishing inherited from acquired bone marrow failure/myelodysplastic syndrome poses a significant clinical challenge. At present, diagnostic genetic testing for inherited bone marrow failure/myelodysplastic syndrome is performed gene-by-gene, guided by clinical and laboratory evaluation. We hypothesized that standard clinically-directed genetic testing misses patients with cryptic or atypical presentations of inherited bone marrow failure/myelodysplastic syndrome. In order to screen simultaneously for mutations of all classes in bone marrow failure/myelodysplastic syndrome genes, we developed and validated a panel of 85 genes for targeted capture and multiplexed massively parallel sequencing. In patients with clinical diagnoses of Fanconi anemia, genomic analysis resolved subtype assignment, including those of patients with inconclusive complementation test results. Eight out of 71 patients with idiopathic bone marrow failure or myelodysplastic syndrome were found to harbor damaging germline mutations in GATA2, RUNX1, DKC1, or LIG4. All 8 of these patients lacked classical clinical stigmata or laboratory findings of these syndromes and only 4 had a family history suggestive of inherited disease. These results reflect the extensive genetic heterogeneity and phenotypic complexity of bone marrow failure/myelodysplastic syndrome phenotypes. This study supports the integration of broad unbiased genetic screening into the diagnostic workup of children and young adults with bone marrow failure and myelodysplastic syndromes. Copyright© Ferrata Storti Foundation.
Ibanez-Rosello, B; Bautista, J A; Bonaque, J; Perez-Calatayud, J; Gonzalez-Sanchis, A; Lopez-Torrecilla, J; Brualla-Gonzalez, L; Garcia-Hernandez, T; Vicedo-Gonzalez, A; Granero, D; Serrano, A; Borderia, B; Solera, C; Rosello, J
Total skin electron irradiation (TSEI) is a radiotherapy technique which consists of an homogeneous body surface irradiation by electrons. This treatment requires very strict technical and dosimetric conditions, requiring the implementation of multiple controls. Recently, the Task Group 100 report of the AAPM has recommended adapting the quality assurance program of the facility to the risks of their processes. A multidisciplinary team evaluated the potential failure modes (FMs) of every process step, regardless of the management tools applied in the installation. For every FM, occurrence (O), severity (S) and detectability (D) by consensus was evaluated, which resulted in the risk priority number (RPN), which permitted the ranking of the FMs. Subsequently, all the management tools used, related to the TSEI process, were examined and the FMs were reevaluated, to analyze the effectiveness of these tools and to propose new management tools to cover the greater risk FMs. 361 FMs were identified, 103 of which had RPN ≥80, initially, and 41 had S ≥ 8. Taking this into account the quality management tools FMs were reevaluated and only 30 FMs had RPN ≥80. The study of these 30 FMs emphasized that the FMs that involved greater risk were related to the diffuser screen placement and the patient's position during treatment. The quality assurance program of the facility has been adapted to the risk of this treatment process, following the guidelines proposed by the TG-100. However, clinical experience continually reveals new FMs, so the need for periodic risk analysis is required.
Full Text Available The aim of this work was the experimental research of damascus steel from point of view of the structural analyze, impact strength and failure analyzes. The damascus steel was produced by method of forged welding from STN 41 4260 spring steel and STN 41 9312 tool steel. The damascus steel consisted of both 84 and 168 layers. The impact strength was experimentally determined for original steels and damascus steels after heat treatment in dependence on temperature in the range from -60 to 160 °C. It has been found that the impact strength of experimental steels decreased with decreasing temperature behind with correlated change of damage mode. In the case of experimental tests performed at high temperature ductile fracture was revealed and with decreasing temperature proportion of cleavage facets increased. Only the STN 41 9312 steel did not show considerable difference in values of the impact strength with changing temperature.
Rawls, W E; Rawls, M L; Chernesky, M A
A measles epidemic occurred in the Greensville (Ont.) Unit schools during January and February 1975. There were 47 cases of measles in 403 students: 26 (55%) of the children had a history of being vaccinated and 18 (38%) had not been vaccinated. Among children known to have been vaccinated at less than 1 year of age 7 of 13 contracted measles, while among the 48 children who had not been vaccinated 18 contracted measles. The attack rate among vaccinees increased with increasing time since vaccination. The observations of this study as well as those of similar studies suggest that vaccine failures contributed to the genesis of the epidemic. It is recommended that all children initially vaccinated at less than 1 year of age should be revaccinated with live attenuated measles virus vaccine.
Tianen, Matthew N.
This study investigates the blistering failure of a two part coating consisting of talc-filled polyester resin and polyurethane primer on large gray iron castings. Surface metallography was performed and failed coating was characterized by scanning electron microscopy. Corrosion products were found inside of coating blisters. The proposed blistering mechanism is osmosis as a result of soluble species produced by the corrosion. It was believed that excessively thin primer layers resulted in a poor barrier to permeation of water, leading to blisters, and that a basecoat containing a corrosion inhibitor like zinc phosphate would reduce blistering. These hypotheses were tested with designed experiments using environmental testing in humidity and submersion environments. Thicker primer layers resulted in significant reductions in blistering and prolonged the time required before blister formation. A basecoat containing zinc phosphate was not found to be effective at reducing blistering in this coating system.
Babiker, Amir; Amer, Yasser S; Osman, Mohamed E; Al-Eyadhy, Ayman; Fatani, Solafa; Mohamed, Sarar; Alnemri, Abdulrahman; Titi, Maher A; Shaikh, Farheen; Alswat, Khalid A; Wahabi, Hayfaa A; Al-Ansary, Lubna A
Implementation of clinical practice guidelines (CPGs) has been shown to reduce variation in practice and improve health care quality and patients' safety. There is a limited experience of CPG implementation (CPGI) in the Middle East. The CPG program in our institution was launched in 2009. The Quality Management department conducted a Failure Mode and Effect Analysis (FMEA) for further improvement of CPGI. This is a prospective study of a qualitative/quantitative design. Our FMEA included (1) process review and recording of the steps and activities of CPGI; (2) hazard analysis by recording activity-related failure modes and their effects, identification of actions required, assigned severity, occurrence, and detection scores for each failure mode and calculated the risk priority number (RPN) by using an online interactive FMEA tool; (3) planning: RPNs were prioritized, recommendations, and further planning for new interventions were identified; and (4) monitoring: after reduction or elimination of the failure mode. The calculated RPN will be compared with subsequent analysis in post-implementation phase. The data were scrutinized from a feedback of quality team members using a FMEA framework to enhance the implementation of 29 adapted CPGs. The identified potential common failure modes with the highest RPN (≥ 80) included awareness/training activities, accessibility of CPGs, fewer advocates from clinical champions, and CPGs auditing. Actions included (1) organizing regular awareness activities, (2) making CPGs printed and electronic copies accessible, (3) encouraging senior practitioners to get involved in CPGI, and (4) enhancing CPGs auditing as part of the quality sustainability plan. In our experience, FMEA could be a useful tool to enhance CPGI. It helped us to identify potential barriers and prepare relevant solutions. © 2018 John Wiley & Sons, Ltd.
McGuire, Robin K.
A program for seismic risk analysis is described which combines generality of application, efficiency and accuracy of operation, and the advantage of small storage requirements. The theoretical basis for the program is first reviewed, and the computational algorithms used to apply this theory are described. The information required for running the program is listed. Published attenuation functions describing the variation with earthquake magnitude and distance of expected values for various ground motion parameters are summarized for reference by the program user. Finally, suggestions for use of the program are made, an example problem is described (along with example problem input and output) and the program is listed.
Dorris, William J.; Hairr, John W.; Huang, Jui-Tien; Ingram, J. Edward; Shah, Bharat M.
Non-linear analysis methods were adapted and incorporated in a finite element based DIAL code. These methods are necessary to evaluate the global response of a stiffened structure under combined in-plane and out-of-plane loading. These methods include the Arc Length method and target point analysis procedure. A new interface material model was implemented that can model elastic-plastic behavior of the bond adhesive. Direct application of this method is in skin/stiffener interface failure assessment. Addition of the AML (angle minus longitudinal or load) failure procedure and Hasin's failure criteria provides added capability in the failure predictions. Interactive Stiffened Panel Analysis modules were developed as interactive pre-and post-processors. Each module provides the means of performing self-initiated finite elements based analysis of primary structures such as a flat or curved stiffened panel; a corrugated flat sandwich panel; and a curved geodesic fuselage panel. This module brings finite element analysis into the design of composite structures without the requirement for the user to know much about the techniques and procedures needed to actually perform a finite element analysis from scratch. An interactive finite element code was developed to predict bolted joint strength considering material and geometrical non-linearity. The developed method conducts an ultimate strength failure analysis using a set of material degradation models.
MUHAMMAD AMIRUL BIN YUSOF
Full Text Available Butterfly valves are mostly used in various industries such as oil and gas plant. This valve operates with rotating motion using pneumatic system. Rotating actuator turns the disc either parallel or perpendicular to the flow. When the valve is fully open, the disc is rotated a quarter turn so that it allows free passage of the fluid and when fully closed, the disc rotated a quarter turns to block the fluid. The primary failure modes for valves are the valve leaks to environment through flanges, seals on the valve body, valve stem packing not properly protected, over tightened packing nuts, the valve cracks and leaks over the seat. To identify the failure of valve Failure Mode and Effects Analysis has been chosen. FMEA is the one of technique to perform failure analysis. It involves reviewing as many components to identify failure modes, and their causes and effects. For each component, the failure modes and their resulting effects on the rest of the system are recorded in a specific FMEA form. Risk priority number, severity, detection, occurrence are the factor determined in this studies. Risk priority number helps to find out the highest hazardous activities which need more attention than the other activity. The highest score of risk priority number in this research is seat. Action plan was proposed to reduce the risk priority number and so that potential failures also will be reduced.
Coetzee, Jasper L
The analysis of failure data is an important facet in the development of maintenance strategy for equipment. Only by properly understanding the mechanism of failure, through the modelling of failure data, can a proper maintenance plan be developed. This is normally done by means of probabilistic analysis of the failure data. From this, conclusions can be reached regarding the effectiveness and efficiency of preventive replacement (and overhaul) as well as that of predictive maintenance. The optimal frequency of maintenance can also be established by using well developed optimisation models. These optimise outputs, such as profit, cost and availability. The problem with this approach is that it assumes that all repairable systems are repaired to the 'good-as-new' condition at each repair occasion. Maintenance practice has learnt, however, that in many cases equipment slowly degrades even while being properly maintained (including part replacement and periodic overhaul). The result of this is that failure data sets often display degradation. This renders conventional probabilistic analysis useless. During the last two decades, a few researches applied themselves to the solution of this problem. This paper briefly examines the present state of the theoretical foundation of repairable systems analysis techniques and then develops two formats of the Non-Homogeneous Poisson Process model (NHPP model) for practical use by the maintenance analyst. This includes an identification framework, goodness-of-fit tests and optimisation modelling. The model is tested on two failure data sets from literature and one from industry.
Rosendahl, Mads; Kirkeby, Maja Hanne
The aim of a probabilistic output analysis is to derive a probability distribution of possible output values for a program from a probability distribution of its input. We present a method for performing static output analysis, based on program transformation techniques. It generates a probability...
devices. App stores also provide a tempting vector for an attacker. An attacker can take advantage of bugdoors (software defects that permit...STATIC PROGRAM ANALYSIS FOR RELIABLE, TRUSTED APPS UNIVERSITY OF WASHINGTON FEBRUARY 2017 FINAL TECHNICAL REPORT APPROVED FOR PUBLIC RELEASE...STATIC PROGRAM ANALYSIS FOR RELIABLE, TRUSTED APPS 5a. CONTRACT NUMBER 5b. GRANT NUMBER FA8750-12-2-0107 5c. PROGRAM ELEMENT NUMBER 61101E 6. AUTHOR
Wied, Christian; Foss, Nicolai B; Tengberg, Peter T
Background and purpose - An enhanced treatment program may decrease 30-day mortality below 20% after lower extremity amputations (LEA). The potential and limitations for further reduction are unknown. We analyzed postoperative causes of 30-day mortality, and assessed failure to rescue (FTR) rate ...
Kirby, Sarah; Lauritsen, Janet; Pack, Ginger; Ha, Anhhoang; Jowers, Steven; Mcnenny, Robert; Truong, The; Dell, James
A system which is to provide real-time failure analysis support to controllers at the NASA Johnson Space Center Control Center Complex (CCC) for both Space Station and Space Shuttle on-orbit operations is described. The system employs monitored systems' models of failure behavior and model evaluation algorithms which are domain-independent. These failure models are viewed as a stepping stone to more robust algorithms operating over models of intended function. The described system is designed to meet two sets of requirements. It must provide a useful failure analysis capability enhancement to the mission controller. It must satisfy CCC operational environment constraints such as cost, computer resource requirements, verification, and validation. The underlying technology and how it may be used to support operations is also discussed.
Zdravecká, Eva; Ondáč, Miroslav; Tkáčová, Jana; Vojtko, Marek; Slota, Ján
The present article highlights failure investigation of the pulleys during a press-fit assembling process. Pulleys are used to transmit power between rotational mechanical elements. Failure analysis was performed by metallographic evaluation using light microscopy, SEM and EDX, and chemical analyses. It was found that cooperative influence of higher carbon content with combination of elongated sulphides is reason for pulleys cracking. Steel cleanliness and homogeneous structure is an importan...
The main subject of this thesis is to identify hidden failures in process control systems by developing and using a function-oriented system analysis method. Qualitative failure analysis and the characteristics of the classical failure analysis methods and function-oriented modelling methods are covered. The general limitations of the methods in connection with the identification and representation of hidden failures are discussed. The discussion has led to the justification of developing and using a function-oriented system analysis method to identify and represent the capabilities of the system components, which realize different sets of functions in connection with different sets of goals that the system must achieve. A terminology is introduced to define the basic aspects of technical systems including goals, functions, capabilities and physical structure. A function-oriented system analysis method using this terminology and a tailored combination of the two function-oriented modelling approaches, is also introduced. It is then explained how the method can be applied in the identification and representation of hidden failures. The building blocks of a knowledge-oriented system to perform the diagnosis on the basis of the developed method are equally described. A prototype of the knowledge-based system is developed to demonstrate the applicability of the function-oriented system analysis method and the knowledge-based system. The prototype is implemented within the object-oriented software environment G2. (au) 65 ills., 32 refs.
Full Text Available Petrochemical industries have a high rate of accidents. Failure mode and effect analysis (FMEA is a systematic method and thus is capable of analyzing the risks of systems from concept phase to system disposal, detecting the failures in design stage, and determining the control measures and corrective actions for failures to reduce their impacts. The objectives of this research were to perform FMEA to identify risks in an Iranian petrochemical industry and determine the decrease of the risk priority number (RPN after implementation of intervention programs. This interventional study was performed at one petrochemical plant in Tehran, Iran in 2014. Relevant information about job categories and plant process was gathered using brainstorming techniques, fishbone diagram, and group decision making. The data were collected through interviews, observation, and documents investigations and was recorded in FMEA worksheets. The necessary corrective measures were performed on the basis of the results of initial FMEA. Forty eight failures were identified in welding unit by application of FMEA to assess risks. Welding processes especially working at height got the highest RPN. Obtained RPN for working at height before performing the corrective actions was 120 and the score was reduced to 96 after performing corrective measures. Calculated RPN for all processes was significantly reduced (p≤0.001 by implementing the corrective actions. Scores of RPN in all studied processes effectively decreased after performing corrective actions in a petrochemical industry. FMEA method is a useful tool for identifying risk intervention priorities and effectiveness in a studied petrochemical industry.
Duncan, Kathleen; Pozehl, Bunny; Norman, Joseph F.; Hertzog, Melody
This study measured the impact of the Exercise Adherence Management Program (EAMP) provided to 20 patients with heart failure (HF) who participated in a combined resistance and aerobic exercise training program during two, 12 week phases. The EAMP included strategies designed to support exercise self-efficacy and adherence. Results indicate an improvement in exercise self-efficacy occurred during the study period while exercise adherence declined during the unsupervised phase. The highest rat...
The purpose of this research was to identify the factors that students attending a Midwestern community college perceived contributed to their academic success or failure in an Associate Degree nursing program. A review of student academic records revealed that many students with weak academic records were successful while students with strong…
Full Text Available The objective was to describe the incidence of failure to finish a race in flat-racing Thoroughbreds in New Zealand as these are summary indicators of falls, injuries and poor performance. Retrospective data on six complete flat racing seasons (n = 188,615 race starts of all Thoroughbred flat race starts from 1 August 2005 to 31 July 2011 were obtained. The incidence of failure to finish events and binomial exact 95% confidence intervals were calculated per 1000 horse starts. The association between horse-, rider- and race-level variables with the outcomes failure to finish, pulled-up/fell and lost rider were examined with a mixed effects Poisson regression model. A total of 544 horses failed to finish in 188,615 race starts with an overall incidence of 2.88 per 1000 horse starts (95% CI 2.64–3.12. The incidence of failure to finish horses across each race year showed little variability. In the univariable analysis race distance, larger field size, season, and ratings bands showed association with failing to finish a race. The overall failure to finish outcome was associated with season, race distance and ratings bands (horse experience and success ranking criteria. In the multivariable analysis, race distance and ratings bands were associated with horses that pulled-up/fell; season, apprentice allowances and ratings bands were associated with the outcome lost rider. The failure to finish rate was lower than international figures for race day catastrophic injury. Racing and environmental variables were associated with failure to finish a race highlighting the multifactorial nature of race-day events. Further investigation of risk factors for failure to finish is required to better understand the reasons for a low failure to finish rate in Thoroughbred flat races in New Zealand.
Cannon, Jane A; Moffitt, Peter; Perez-Moreno, Ana Cristina; Walters, Matthew R; Broomfield, Niall M; McMurray, John J V; Quinn, Terence J
Cognitive impairment and dementia are associated with a range of cardiovascular conditions, including hypertension, coronary artery disease, and atrial fibrillation. We aimed to describe the association with heart failure, summarizing published data to give estimates of prevalence, incidence, and relative risk of cognitive impairment/dementia in heart failure. We searched multidisciplinary databases including MEDLINE (OVID), EMBASE (OVID), CINAHL (EBSCO), PsychINFO (EBSCO), Web of Science (Thomson Reuters), and CENTRAL (Cochrane Library) from inception until May 31, 2015. All relevant studies looking at cognitive impairment/dementia in heart failure were included. Studies were selected by 2 independent reviewers using prespecified inclusion/exclusion criteria. Where data allowed, we performed meta-analysis and pooled results using random effects models. From 18,000 titles, 37 studies were eligible (n = 8411 participants). Data from 4 prospective cohorts (n = 2513 participants) suggest greater cognitive decline in heart failure compared with non-heart failure over the longer term. These data were not suitable for meta-analysis. In case control studies describing those with and without heart failure (n = 4 papers, 1414 participants) the odds ratio for cognitive impairment in the heart failure population was 1.67 (95% confidence interval 1.15-2.42). Prevalence of cognitive impairment in heart failure cohorts (n = 26 studies, 4176 participants) was 43% (95% confidence interval 30-55). This review suggests a substantial proportion of patients with heart failure have concomitant cognitive problems. This has implications for planning treatment and services. These data do not allow us to comment on causation, and further work is needed to describe the underlying pathophysiology. Copyright © 2017 Elsevier Inc. All rights reserved.
Wu, Xiaoyu; Gorelov, Dmitry; Grimm, Terry L; Marti, Felix; York, Richard
Previous end-to-end beam dynamics simulation studies* using experimentally-based input beams including alignment and rf errors and variation in charge-stripping foil thickness have indicated that the Rare Isotope Accelerator (RIA) driver linac proposed by MSU has adequate transverse and longitudinal acceptances to accelerate light and heavy ions to final energies of at least 400 MeV/u with beam powers of 100 to 400 kW. During linac operation, equipment loss due to, for example, cavity contamination, availability of cryogens, or failure of rf or power supply systems, will lead to at least a temporary loss of some of the cavities and focusing elements. To achieve high facility availability, each segment of the linac should be capable of adequate performance even with failed elements. Beam dynamics studies were performed to evaluate the linac performance under various scenarios of failed cavities and focusing elements with proper correction schemes, in order to prove the flexibility and robustness of the driver ...
O' Daniel, Jennifer C., E-mail: email@example.com; Yin, Fang-Fang
Purpose: To determine clinic-specific linear accelerator quality assurance (QA) TG-142 test frequencies, to maximize physicist time efficiency and patient treatment quality. Methods and Materials: A novel quantitative approach to failure mode and effect analysis is proposed. Nine linear accelerator-years of QA records provided data on failure occurrence rates. The severity of test failure was modeled by introducing corresponding errors into head and neck intensity modulated radiation therapy treatment plans. The relative risk of daily linear accelerator QA was calculated as a function of frequency of test performance. Results: Although the failure severity was greatest for daily imaging QA (imaging vs treatment isocenter and imaging positioning/repositioning), the failure occurrence rate was greatest for output and laser testing. The composite ranking results suggest that performing output and lasers tests daily, imaging versus treatment isocenter and imaging positioning/repositioning tests weekly, and optical distance indicator and jaws versus light field tests biweekly would be acceptable for non-stereotactic radiosurgery/stereotactic body radiation therapy linear accelerators. Conclusions: Failure mode and effect analysis is a useful tool to determine the relative importance of QA tests from TG-142. Because there are practical time limitations on how many QA tests can be performed, this analysis highlights which tests are the most important and suggests the frequency of testing based on each test's risk priority number.
Chen, X.; Li, Z.; Wang, H.
The application of the s-version finite-element method (SFEM) in the failure analysis of open-hole composite plates is illustrated by using the results of tension tests on a T700/epoxy laminate with a central hole. A modeling methodology for open-hole composite plates based on the SFEM is presented. Proper failure criteria and a material degradation rule are adopted in the progressive analysis. The Patran Comand Language (PCL) is employed for fast modeling and visualization. The FORTRAN scientific programming language and the PARDISO package for solving highly complicated and sparse equations are incorporated into the procedure for a high computational efficiency. Good agreement between experimental data and results of the conventional FEM for the failure and strength of the plates is obtained. Compared with the conventional FEM, the method proposed ensures an easy meshing technique in describing the stress concentration region around an open hole and requires less computer memory. The mesh-dependence and convergence of the approach are demonstrated by a parametric analysis.
Sohn, Stefan; Helms, Thomas M; Pelleter, Jörg T; Müller, Axel; Kröttinger, Annett I; Schöffski, Oliver
A health economic analysis was conducted to evaluate the program "Telemedicine for the Heart," which the German Foundation for the Chronically Ill organizes for the Techniker Krankenkasse, one of the biggest German statutory health insurance funds. The program consists of nurse-calls to motivate patients to perform regular self-measurements (blood pressure, pulse, weight) with either their own or telemedical measuring devices provided by the program. In the case of measured values outside of set limits, calls to treating physicians were placed to allow for the initiation of therapy adjustments where applicable. To evaluate the program, a retrospective matched-pairs analysis was performed. Program participants (n=281) and regularly insured patients (n=843) were matched for demographics and morbidity status and compared according to their use of resources. Significant cost differences in favor of the study group of up to 25% in relation to total costs could be detected, particularly in the group of New York Heart Association (NYHA) classification II patients (persons with mild symptoms and slight limitation according to the NYHA classification for the extent of heart failure). In the more severe NYHA stages III and IV the cost relation differed and showed a slight cost disadvantage for the program group. Mortality was 35.1% lower in the program group than in the control group. Quality of life measures were almost constant over the observation time, compatible with a positive impact of the program on the highly impaired patient group. The findings suggest that, besides a reduction of costs, by participating in "Telemedicine for the Heart" patients with chronic heart failure experienced a reduced number of hospital stays, optimized medical therapy, better quality of life, and reduced mortality.
Dósa, M.; Szegő, K.
The Inclusiveness Program was created with the aim to integrate currently under-represented countries into the mainstream of European planetary research. Main stages of the working plan include setting up a database containing all the research institutes and universities where astronomical or geophysical research is carried out. It is necessary to identify their problems and needs. Challenging part of the project is to find exact means that help their work in a sustainable way. Strengths, weaknesses, opportunities and threats of the program were identified based on feedback from the inclusiveness community. Our conclusions, further suggestions are presented.
Qiu, Zhenzhen; Zheng, Kai; Zhang, Haoxiang; Feng, Ji; Wang, Lizhi; Zhou, Hao
Chronic renal failure is a severe clinical problem which has some significant socioeconomic impact worldwide and hemodialysis is an important way to maintain patients' health state, but it seems difficult to get better in short time. Considering these, the aim in our research is to update and evaluate the effects of exercise on the health of patients with chronic renal failure. The databases were used to search for the relevant studies in English or Chinese. And the association between physical exercise and health state of patients with chronic renal failure has been investigated. Random-effect model was used to compare the physical function and capacity in exercise and control groups. Exercise is helpful in ameliorating the situation of blood pressure in patients with renal failure and significantly reduces VO2 in patients with renal failure. The results of subgroup analyses show that, in the age >50, physical activity can significantly reduce blood pressure in patients with renal failure. The activity program containing warm-up, strength, and aerobic exercises has benefits in blood pressure among sick people and improves their maximal oxygen consumption level. These can help patients in physical function and aerobic capacity and may give them further benefits.
Full Text Available Chronic renal failure is a severe clinical problem which has some significant socioeconomic impact worldwide and hemodialysis is an important way to maintain patients’ health state, but it seems difficult to get better in short time. Considering these, the aim in our research is to update and evaluate the effects of exercise on the health of patients with chronic renal failure. The databases were used to search for the relevant studies in English or Chinese. And the association between physical exercise and health state of patients with chronic renal failure has been investigated. Random-effect model was used to compare the physical function and capacity in exercise and control groups. Exercise is helpful in ameliorating the situation of blood pressure in patients with renal failure and significantly reduces VO2 in patients with renal failure. The results of subgroup analyses show that, in the age >50, physical activity can significantly reduce blood pressure in patients with renal failure. The activity program containing warm-up, strength, and aerobic exercises has benefits in blood pressure among sick people and improves their maximal oxygen consumption level. These can help patients in physical function and aerobic capacity and may give them further benefits.
Harry, T [Oregon State University, Corvallis, OR (United States); University of California, San Diego, La Jolla, CA (United States); Manger, R; Cervino, L; Pawlicki, T [University of California, San Diego, La Jolla, CA (United States)
Purpose: To evaluate the differences between the Veteran Affairs Healthcare Failure Modes and Effect Analysis (HFMEA) and the AAPM Task Group 100 Failure and Effect Analysis (FMEA) risk assessment techniques in the setting of a stereotactic radiosurgery (SRS) procedure were compared respectively. Understanding the differences in the techniques methodologies and outcomes will provide further insight into the applicability and utility of risk assessments exercises in radiation therapy. Methods: HFMEA risk assessment analysis was performed on a stereotactic radiosurgery procedure. A previous study from our institution completed a FMEA of our SRS procedure and the process map generated from this work was used for the HFMEA. The process of performing the HFMEA scoring was analyzed, and the results from both analyses were compared. Results: The key differences between the two risk assessments are the scoring criteria for failure modes and identifying critical failure modes for potential hazards. The general consensus among the team performing the analyses was that scoring for the HFMEA was simpler and more intuitive then the FMEA. The FMEA identified 25 critical failure modes while the HFMEA identified 39. Seven of the FMEA critical failure modes were not identified by the HFMEA and 21 of the HFMEA critical failure modes were not identified by the FMEA. HFMEA as described by the Veteran Affairs provides guidelines on which failure modes to address first. Conclusion: HFMEA is a more efficient model for identifying gross risks in a process than FMEA. Clinics with minimal staff, time and resources can benefit from this type of risk assessment to eliminate or mitigate high risk hazards with nominal effort. FMEA can provide more in depth details but at the cost of elevated effort.
Hei, Yuichiro; Ogishi, Tomohiko; Ano, Shigehiro; Hasegawa, Toru
It is important to monitor routing protocols to ensure IP networks and their operations can maintain sufficient level of stability and reliability because IP routing is an essential part of such networks. In this paper, we focus on Open Shortest Path First (OSPF), a widely deployed intra-domain routing protocol. Routers running OSPF advertise their link states on Link State Advertisements (LSAs) as soon as they detect changes in their link states. In IP network operations, it is important for operators to ascertain the location and type of a failure in order to deal with failures adequately. We therefore studied IP network failure identification based on the monitoring of OSPF LSAs. There are three issues to consider in regard to identifying network failures by monitoring LSAs. The first is that multiple LSAs are flooded by a single failure. The second is the LSA delay, and the third is that multiple failures may occur simultaneously. In this paper, we propose a method of network failure identification based on a detailed analysis of OSPF LSA flooding that takes into account the above three issues.
Belmonte, D.; Vedova, M. D. L. Dalla; Ferro, C.; Maggiore, P.
The proposal of prognostic algorithms able to identify precursors of incipient failures of primary flight command electromechanical actuators (EMA) is beneficial for the anticipation of the incoming failure: an early and correct interpretation of the failure degradation pattern, in fact, can trig an early alert of the maintenance crew, who can properly schedule the servomechanism replacement. An innovative prognostic model-based approach, able to recognize the EMA progressive degradations before his anomalous behaviors become critical, is proposed: the Fault Detection and Identification (FDI) of the considered incipient failures is performed analyzing proper system operational parameters, able to put in evidence the corresponding degradation path, by means of a numerical algorithm based on spectral analysis techniques. Subsequently, these operational parameters will be correlated with the actual EMA health condition by means of failure maps created by a reference monitoring model-based algorithm. In this work, the proposed method has been tested in case of EMA affected by combined progressive failures: in particular, partial stator single phase turn to turn short-circuit and rotor static eccentricity are considered. In order to evaluate the prognostic method, a numerical test-bench has been conceived. Results show that the method exhibit adequate robustness and a high degree of confidence in the ability to early identify an eventual malfunctioning, minimizing the risk of fake alarms or unannounced failures.
Chrcanovic, Bruno Ramos; Kisch, Jenö; Albrektsson, Tomas; Wennerberg, Ann
Some studies indicated that implant failures are commonly concentrated in few patients. To identify and analyze cluster behavior of dental implant failures among subjects of a retrospective study. This retrospective study included patients receiving at least three implants only. Patients presenting at least three implant failures were classified as presenting a cluster behavior. Univariate and multivariate logistic regression models and generalized estimating equations analysis evaluated the effect of explanatory variables on the cluster behavior. There were 1406 patients with three or more implants (8337 implants, 592 failures). Sixty-seven (4.77%) patients presented cluster behavior, with 56.8% of all implant failures. The intake of antidepressants and bruxism were identified as potential negative factors exerting a statistically significant influence on a cluster behavior at the patient-level. The negative factors at the implant-level were turned implants, short implants, poor bone quality, age of the patient, the intake of medicaments to reduce the acid gastric production, smoking, and bruxism. A cluster pattern among patients with implant failure is highly probable. Factors of interest as predictors for implant failures could be a number of systemic and local factors, although a direct causal relationship cannot be ascertained. © 2017 Wiley Periodicals, Inc.
Schwarz, Kathleen B; Dell Olio, Dominic; Lobritto, Steven J; Lopez, M James; Rodriguez-Baez, Norberto; Yazigi, Nada A; Belle, Steven H; Zhang, Song; Squires, Robert H
Viral infections are often suspected to cause pediatric acute liver failure (PALF), but large-scale studies have not been performed. We analyzed the results of viral testing among nonacetaminophen PALF study participants. Participants were enrolled in the PALF registry. Diagnostic evaluation and final diagnosis were determined by the site investigator and methods for viral testing by local standard of care. Viruses were classified as either causative viruses (CVs) or associated viruses (AVs). Supplemental testing for CV was performed if not done clinically and serum was available. Final diagnoses included "viral," "indeterminate," and "other." Of 860 participants, 820 had at least 1 test result for a CV or AV. A positive viral test was found in 166/820 (20.2%) participants and distributed among "viral" (66/80 [82.5%]), "indeterminate" (52/420 [12.4%]), and "other" (48/320 [15.0%]) diagnoses. CVs accounted for 81/166 (48.8%) positive tests. Herpes simplex virus (HSV) was positive in 39/335 (11.6%) who were tested 26/103 (25.2%) and 13/232 (5.6%) among infants 0 to 6 and >6 months, respectively. HSV was not tested in 61.0% and 53% of the overall cohort and those 0 to 6 months, respectively. Supplemental testing yielded 17 positive, including 5 HSV. Viral testing in PALF occurs frequently but is often incomplete. The evidence for acute viral infection was found in 20.2% of those tested for viruses. HSV is an important viral cause for PALF in all age groups. The etiopathogenic role of CV and AV in PALF requires further investigation.
Becker, Guenter; Johanson, Gunnar; Lindberg, Sandra; Vaurio, Jussi
The Regulatory Code SSMFS 2008:1 of Swedish Radiation Safety Authority (SSM) includes requirements regarding the performance of probabilistic safety assessments (PSA), as well as PSA activities in general. Therefore, the follow-up of these activities is part of the inspection tasks of SSM. According to the SSMFS 2008:1, the safety analyses shall be based on a systematic identification and evaluation of such events, event sequences and other conditions which may lead to a radiological accident. The research report Nordic/German Working Group on Common cause Failure analysis. Phase 2 project report: Development of Harmonized Approach and Applications for Common Cause Failure Quantification has been developed under a contract with the Nordic PSA Group (NPSAG) and its German counterpart VGB, with the aim to create a common experience base for defence and analysis of dependent failures i.e. Common Cause Failures CCF. Phase 2 in this project if a deepened data analyses of CCF events and a demonstration on how the so called impact vectors can be constructed and on how CCF parameters are estimated. The word Guidance in the report title is used in order to indicate a common methodological guidance accepted by the NPSAG, based on current state of the art concerning the analysis of dependent failures and adapted to conditions relevant for Nordic sites. This will make it possible for the utilities to perform cost effective improvements and analyses. The report presents a common attempt by the authorities and the utilities to create a methodology and experience base for defence and analysis of dependent failures. The performed benchmark application has shown how important the interpretation of base data is to obtain robust CCF data and data analyses results. Good features were found in all benchmark approaches. The obtained experiences and approaches should now be used in harmonised procedures. A next step could be to develop and agree on event and formula driven impact vector
Gámez-López, Antonio L; Bonilla-Palomas, Juan L; Anguita-Sánchez, Manuel; Moreno-Conde, Mirian; López-Ibáñez, Cristina; Alhambra-Expósito, Rosa; Castillo-Domínguez, Juan C; Villar-Ráez, Antonia; Suárez de Lezo, José
Hospitalized patients with heart failure who are malnourished present a worse prognosis than those with an adequate nutritional status. It is unknown whether a nutritional intervention can modify the prognosis of these patients. The aim of this study is to assess the efficacy of a nutritional intervention on morbidity and mortality in hospitalized patients with heart failure who are malnourished. PICNIC is a multicentre, randomized, controlled trial in which hospitalized patients with heart failure and malnutrition, as defined by the Mini Nutritional Assessment, are randomly assigned to conventional management of heart failure or conventional management of heart failure and an individualized nutritional intervention consisting of 3 points: optimization of diet, specific recommendations, and prescription, if deemed necessary, of nutritional supplements. A sample size of 182 patients for a maximum follow-up of 12 months has been estimated. The primary endpoint is time to death from any cause or rehospitalization because of heart failure. Analysis is by intention to treat. PICNIC study will determine the prognostic impact of a nutritional intervention in hospitalized patients with heart failure who are malnourished. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.
multiple layers of object-oriented abstractions. Our hypothesis has been that static analysis techniques have reached the point that sound, precise and...important features of STAMP are: • An interface for reading and interpreting DEX bytecode, allowing analysis of libraries in compiled form, both statically...describe a new bottom-up, subset-based, and context-sensitive pointer analysis for Java. The main novelty of our technique is the constraint-based handling
Intra, Giulia; Alteri, Alessandra; Corti, Laura; Rabellotti, Elisa; Papaleo, Enrico; Restelli, Liliana; Biondo, Stefania; Garancini, Maria Paola; Candiani, Massimo; Viganò, Paola
Assisted reproduction technology laboratories have a very high degree of complexity. Mismatches of gametes or embryos can occur, with catastrophic consequences for patients. To minimize the risk of error, a multi-institutional working group applied failure mode and effects analysis (FMEA) to each critical activity/step as a method of risk assessment. This analysis led to the identification of the potential failure modes, together with their causes and effects, using the risk priority number (RPN) scoring system. In total, 11 individual steps and 68 different potential failure modes were identified. The highest ranked failure modes, with an RPN score of 25, encompassed 17 failures and pertained to "patient mismatch" and "biological sample mismatch". The maximum reduction in risk, with RPN reduced from 25 to 5, was mostly related to the introduction of witnessing. The critical failure modes in sample processing were improved by 50% in the RPN by focusing on staff training. Three indicators of FMEA success, based on technical skill, competence and traceability, have been evaluated after FMEA implementation. Witnessing by a second human operator should be introduced in the laboratory to avoid sample mix-ups. These findings confirm that FMEA can effectively reduce errors in assisted reproduction technology laboratories. Copyright © 2016 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
Bennett, J.P.; Kwong, K.-S.; Powell, C.A.; Thomas, H.; Krabbe, R.A.
High Cr2O3 refractory materials are used to line the hot face of slagging gasifiers. Gasifiers are reaction chambers that convert water, oxygen, and a carbon feedstock into CO, H2, and methane at temperatures as high as 1575oC and pressures up to 1000 psi. Ash in the carbon feedstock liquefies, erodes and corrodes the gasifier’s refractory liner, contributing to liner failure within a few months to two years. The failure of a refractory liner decreases a gasifier’s on-line availability and causes costly system downtime and repairs. Many factors contribute to refractory lining failure, including slag penetration and corrosion, thermal cycling, gasifier environment, and mechanical loads. The results of refractory post-mortem failure analysis and how observations relate to gasifier service life will be discussed.
Bennett, James P.; Kwong, Kyei-Sing; Powell, Cynthia A.; Thomas, Hugh; Krabbe, Rick
High Cr2O3 refractory materials are used to line the hot face of slagging gasifiers. Gasifiers are reaction chambers that convert water, oxygen, and a carbon feedstock into CO, H2, and methane at temperatures as high as 1575DGC and pressures up to 1000 psi. Ash in the carbon feedstock liquefies, erodes and corrodes the gasifier's refractory liner, contributing to liner failure within a few months to two years. The failure of a refractory liner decreases a gasifier's on-line availability and causes costly system downtime and repairs. Many factors contribute to refractory lining failure, including slag penetration and corrosion, thermal cycling, gasifier environment, and mechanical loads. The results of refractory post-mortem failure analysis and how observations relate to gasifier service life will be discussed.
Eva María Guerra-Alia
Full Text Available To carry out a Failure Mode and Effects Analysis (FMEA to the use of oral syringes. Methods: A multidisciplinary team was assembled within the Safety Committee. The stages of oral administration process of liquid medication were analysed, identifying the most critical and establishing the potential modes of failure that can cause errors. The impact associated with each mode of failure was calculated using the Risk Priority Number (RPN. Preventive actions were proposed. Results: Five failure modes were identified, all classified as high risk (RPN> 100. Seven of the eight preventive actions were implemented. Conclusions: The FMEA methodology was a useful tool. It has allowed to know the risks, analyse the causes that cause them, their effects on patient safety and the measures to reduce them
Xu, Y; Bhatnagar, J; Bednarz, G; Flickinger, J; Arai, Y; Huq, M Saiful [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States); Vacsulka, J; Monaco, E; Niranjan, A; Lunsford, L Dade [Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA (United States); Feng, W [Dept of Radiation Oncology, New York Presbyterian Hospital/Columbia Univ Medical Center, New York, NY (United States)
Purpose: To perform a failure modes and effects analysis (FMEA) study for Gamma Knife (GK) radiosurgery processes at our institution based on our experience with the treatment of more than 13,000 patients. Methods: A team consisting of medical physicists, nurses, radiation oncologists, neurosurgeons at the University of Pittsburgh Medical Center and an external physicist expert was formed for the FMEA study. A process tree and a failure mode table were created for the GK procedures using the Leksell GK Perfexion and 4C units. Three scores for the probability of occurrence (O), the severity (S), and the probability of no detection (D) for failure modes were assigned to each failure mode by each professional on a scale from 1 to 10. The risk priority number (RPN) for each failure mode was then calculated (RPN = OxSxD) as the average scores from all data sets collected. Results: The established process tree for GK radiosurgery consists of 10 sub-processes and 53 steps, including a sub-process for frame placement and 11 steps that are directly related to the frame-based nature of the GK radiosurgery. Out of the 86 failure modes identified, 40 failure modes are GK specific, caused by the potential for inappropriate use of the radiosurgery head frame, the imaging fiducial boxes, the GK helmets and plugs, and the GammaPlan treatment planning system. The other 46 failure modes are associated with the registration, imaging, image transfer, contouring processes that are common for all radiation therapy techniques. The failure modes with the highest hazard scores are related to imperfect frame adaptor attachment, bad fiducial box assembly, overlooked target areas, inaccurate previous treatment information and excessive patient movement during MRI scan. Conclusion: The implementation of the FMEA approach for Gamma Knife radiosurgery enabled deeper understanding of the overall process among all professionals involved in the care of the patient and helped identify potential
Wei, Ting; Pearson, Mike N; Armstrong, Karen; Blohm, Dietmar; Liu, Jue
The factors that affect the formation and stability of DNA/DNA duplexes are complicated and still mostly unknown. In this study attempts were made to look for the crucial factor affecting hybridization failure in DNA microarray assays. A comprehensive range of factors were investigated simultaneously using a 25-mer oligonucleotide Potyvirus microarray. These included steric hindrance, direct/indirect labelling types, distance of a probe to the fluorescent labelling end, target (the DNA fragment used to hybridize with microarray probes) strand types either single strand or double strand, probes without mismatch and with different numbers of mismatch nucleotides (up to 36%) and different mismatch locations (5' end, centre and 3' end), probe GC content and T(m), secondary structures of probes and targets, different target lengths (0.277 kb to ~1.3 kb) and concentrations (0.1-30 nM). The results showed that whilst most of these known factors were unlikely to be the main causes of failed hybridization, there was strong evidence suggesting that the viral amplicon target structure is the most crucial factor. However, computing predicted target secondary structures by Mfold showed no correlation with the hybridization results. One explanation is that the predicted target secondary structures are different from the real structures. Here we postulate that the real target structure might be a combination of secondary structures resulting in a three-dimensional structure from exposure to three types of sub-structures: (1) a completely exposed linear structure to allow probes access for the successful hybridization and showing strong fluorescent signals; (2) a partially exposed structure to allow unstable binding and showing weak fluorescent signals; (3) a closed structure resulting in failed hybridization. These results are very important for microarray based studies as they not only provide an explanation for some current controversial results, but also provide potential
Overdevest, Ep; van Hees, Jwh; Lagerburg, V; Kloeze, C; van Straten, Ahm
The introduction of new and more advanced technology in healthcare occurs with an increasing speed. Therefore, more attention is needed for safety evaluation of new devices or techniques from an end-user perspective, especially when (inter-) national perfusion safety standards are lacking. A recently increased awareness of the safety risks as a consequence of technical or human error has provoked interest in optimisation of perfusion methodology and devices. To prevent or reduce the severity or likelihood of failures of new technology, 'failure mode effect analysis' is a proven proactive technique. When it is used as a qualitative analysis for possible hazards in patient treatment associated with the use of medical devices, it's called healthcare failure mode effect analysis (hFMEA). To evaluate the safety of the Extra Corporeal Circulation Optimized (ECCO, Sorin Group, Mirandola, Italy) miniaturized bypass circuit, hFMEA was used. A multi disciplinary team that consisted of two clinical perfusionists, a clinical physicist, a clinical physicist trainee and a technician has performed this analysis. The hFMEA demonstrated that failure of the bubble sensor for the electric remote clamping system on the arterial line (Figure 1), activated by air passing the venous bubble trap, had the highest risk score of all failure modes. This has led to the implementation of an extra low-level sensor in the system to prevent air passing through into the centrifugal pump. The hFMEA has also indicated that extra individual simulation training is needed for handling critical failures during the use of the miniature bypass system. Early identification of possible technology failures in any process or device can avoid adverse patient outcomes. The technique of hFMEA is a valuable tool in evaluating the use of high-risk apparatus, such as an extracorporeal bypass system, in patient treatment in order to increase patient safety. © The Author(s) 2014.
Full Text Available Corrosion is recognized as one of the most important degradation mechanisms that affect the long-term reliability and integrity of metallic structures. Studying the structural reliability with pitting corrosion damage is useful for risk control and safety operation for the corroded structure. This paper proposed a structure corrosion reliability analysis approach based on the physics-based failure model of pitting corrosion, where the states of pitting growth, pit-to-crack, and cracking propagation are included in failure model. Then different probabilistic analysis methods such as Monte-Carlo Simulation (MCS, First-Order Reliability Method (FORM, Second-Order Reliability Method (SORM, and response surface method are employed to calculate the reliability. At last, an example is presented to demonstrate the capability of the proposed structural reliability model and calculating methods for structural corrosion failure analysis.
Nawrocki, Pawel; Szwedo, Ireneusz; Tyc, Joanna; Hawrysz, Anna; Janiak, Kamila; Cichoń, Romuald
Acute renal failure (ARF) is a rare (2-15%), but severe complication of cardiac surgery with overall mortality reaching 40-80%. In order to save patients' lives they are treated with renal replacement therapy (RRT). The aim of our study was to assess the impact of different perioperative factors on mortality among patients treated with RRT because of acute renal failure, which occurred as a complication of a heart surgery. Retrospective analysis included 45 patients, operated in the years 2009-2013, who underwent renal replacement therapy in order to treat postoperative ARF. The perioperative factors were analysed in two groups: group 1 - patients who died before discharge; and group 2 - those who survived until hospital discharge. Forty-five of 3509 cardiac surgical patients (1.25%) required RRT after the surgery. A total of 23 (51.11%) died before discharge (group 1). Patients in group 1 were characterised by older age (70.21 vs. 67 years), higher mean EuroSCORE value (9.28 vs. 7.15) (p < 0.05), higher percentage of concomitant surgery (63.63% vs. 28.57%) (p < 0.05) and of admission of catecholamines in the postoperative period (100% vs. 68.42%) (p < 0.005), and higher mean urea blood level prior to RRT initiation (156.65 vs. 102.54 mg/dl) (p < 0.05). The statistically relevant death predictors proved to be: high EuroSCORE, concomitant surgery, and high urea level at RRT initiation and admission of catecholamines in the postoperative period. After conformation in further studies, those factors may prove useful in stratification of death risk among surgical patients requiring RRT.
..., for failure to complete a program of study. 2 57.314 Section 57.314 Public Health PUBLIC HEALTH... made after November 17, 1971, for failure to complete a program of study. 2 2 Effective November 26... in nursing for which an eligible education loan was made upon certification by a school of nursing...
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The extent of intestinal failure-associated liver disease in patients referred for intestinal rehabilitation is associated with increased mortality: an analysis of the pediatric intestinal failure consortium database.
Javid, Patrick J; Oron, Assaf P; Duggan, Christopher; Squires, Robert H; Horslen, Simon P
The advent of regional multidisciplinary intestinal rehabilitation programs has been associated with improved survival in pediatric intestinal failure. Yet, the optimal timing of referral for intestinal rehabilitation remains unknown. We hypothesized that the degree of intestinal failure-associated liver disease (IFALD) at initiation of intestinal rehabilitation would be associated with overall outcome. The multicenter, retrospective Pediatric Intestinal Failure Consortium (PIFCon) database was used to identify all subjects with baseline bilirubin data. Conjugated bilirubin (CBili) was used as a marker for IFALD, and we stratified baseline bilirubin values as CBili4 mg/dL. The association between baseline CBili and mortality was examined using Cox proportional hazards regression. Of 272 subjects in the database, 191 (70%) children had baseline bilirubin data collected. 38% and 28% of patients had CBili >4 mg/dL and CBili 4 mg/dL, prematurity, race, and small bowel atresia. On regression analysis controlling for age, prematurity, and diagnosis, the risk of mortality was increased by 3-fold for baseline CBili 2-4 mg/dL (HR 3.25 [1.07-9.92], p=0.04) and 4-fold for baseline CBili >4 mg/dL (HR 4.24 [1.51-11.92], p=0.006). On secondary analysis, CBili >4 mg/dL at baseline was associated with a lower chance of attaining enteral autonomy. In children with intestinal failure treated at intestinal rehabilitation programs, more advanced IFALD at referral is associated with increased mortality and decreased prospect of attaining enteral autonomy. Early referral of children with intestinal failure to intestinal rehabilitation programs should be strongly encouraged. Treatment Study, Level III. Copyright © 2017 Elsevier Inc. All rights reserved.
Duncan, Kathleen; Pozehl, Bunny; Norman, Joseph F; Hertzog, Melody
This study measured the impact of the Exercise Adherence Management Program (EAMP) provided to 20 patients with heart failure (HF) who participated in a combined resistance and aerobic exercise training program during two 12-week phases. The EAMP included strategies designed to support exercise self-efficacy and adherence. Results indicate that an improvement in exercise self-efficacy occurred during the study period, whereas exercise adherence declined during the unsupervised phase. The highest rated adherence strategy for helpfulness and self-efficacy was group sessions. The study supports the use of adherence strategies based on self-efficacy in exercise programs for patients with HF. Published by Elsevier Inc.
Modern analytical tools can yield invaluable results during materials characterization and failure analysis. Scanning electron microscopes (SEMs) provide significant analytical capabilities, including angstrom-level resolution. These systems can be equipped with a silicon drift detector (SDD) for very fast yet precise analytical mapping of phases, as well as electron back-scattered diffraction (EBSD) units to map grain orientations, chambers that admit large samples, variable pressure for wet samples, and quantitative analysis software to examine phases. Advanced solid-state electronics have also improved surface and bulk analysis instruments: Secondary ion mass spectroscopy (SIMS) can quantitatively determine and map light elements such as hydrogen, lithium, and boron - with their isotopes. Its high sensitivity detects impurities at parts per billion (ppb) levels. X-ray photo-electron spectroscopy (XPS) can determine oxidation states of elements, as well as identifying polymers and measuring film thicknesses on coated composites. This technique is also known as electron spectroscopy for chemical analysis (ESCA). Scanning Auger electron spectroscopy (SAM) combines surface sensitivity, spatial lateral resolution (10 nm), and depth profiling capabilities to describe elemental compositions of near and below surface regions down to the chemical state of an atom.
Carey, Shawn Allen
Fiber reinforced polymer composite materials, particularly carbon (CFRPs), are being used for primary structural applications, particularly in the aerospace and naval industries. Advantages of CFRP materials, compared to traditional materials such as steel and aluminum, include: light weight, high strength to weight ratio, corrosion resistance, and long life expectancy. A concern with CFRPs is that despite quality control during fabrication, the material can contain many hidden internal flaws. These flaws in combination with unseen damage due to fatigue and low velocity impact have led to catastrophic failure of structures and components. Therefore a large amount of research has been conducted regarding nondestructive testing (NDT) and structural health monitoring (SHM) of CFRP materials. The principal objective of this research program was to develop methods to characterize failure mechanisms in CFRP materials used by the U.S. Army using acoustic emission (AE) and/or acousto-ultrasonic (AU) data. Failure mechanisms addressed include fiber breakage, matrix cracking, and delamination due to shear between layers. CFRP specimens were fabricated and tested in uniaxial tension to obtain AE and AU data. The specimens were designed with carbon fibers in different orientations to produce the different failure mechanisms. Some specimens were impacted with a blunt indenter prior to testing to simulate low-velocity impact. A signature analysis program was developed to characterize the AE data based on data examination using visual pattern recognition techniques. It was determined that it was important to characterize the AE event , using the location of the event as a parameter, rather than just the AE hit (signal recorded by an AE sensor). A back propagation neural network was also trained based on the results of the signature analysis program. Damage observed on the specimens visually with the aid of a scanning electron microscope agreed with the damage type assigned by the
Sander Josemir W
Full Text Available Abstract Background Retention time (time to treatment failure is a commonly used outcome in antiepileptic drug (AED studies. Methods Two datasets are used to demonstrate the issues in a competing risks analysis of AEDs. First, data collection and follow-up considerations are discussed with reference to information from 15 monotherapy trials. Recommendations for improved data collection and cumulative incidence analysis are then illustrated using the SANAD trial dataset. The results are compared to the more common approach using standard survival analysis methods. Results A non-significant difference in overall treatment failure time between gabapentin and topiramate (logrank test statistic = 0.01, 1 degree of freedom, p-value = 0.91 masked highly significant differences in opposite directions with gabapentin resulting in fewer withdrawals due to side effects (Gray's test statistic = 11.60, 1 degree of freedom, p = 0.0007 but more due to poor seizure control (Gray's test statistic = 14.47, 1 degree of freedom, p-value = 0.0001. The significant difference in overall treatment failure time between lamotrigine and carbamazepine (logrank test statistic = 5.6, 1 degree of freedom, p-value = 0.018 was due entirely to a significant benefit of lamotrigine in terms of side effects (Gray's test statistic = 10.27, 1 degree of freedom, p = 0.001. Conclusion Treatment failure time can be measured reliably but care is needed to collect sufficient information on reasons for drug withdrawal to allow a competing risks analysis. Important differences between the profiles of AEDs may be missed unless appropriate statistical methods are used to fully investigate treatment failure time. Cumulative incidence analysis allows comparison of the probability of failure between two AEDs and is likely to be a more powerful approach than logrank analysis for most comparisons of standard and new anti-epileptic drugs.
Gu, Moli; Ma, Yanlan; Zhou, Ti; Xia, Yunfeng
Although the role of primary care for the management of patients with chronic heart failure (CHF) has been highly recommended, structural involvement of primary care in heart failure (HF) management programs is extremely limited. To examine the feasibility and applicability of two most recommended forms of care delivery mode, home visit and telephone support, for CHF management in the setting of community health service center (CHSC). Prospective study. This study was conducted in two CHSCs in Beijing, China. Care delivery was led by trained general practitioners or community nurses via home visits in one CHSC and telephone support in the other. Data regarding the change in mortality and hospitalization rate during 12 months and self-care level at 6 months were prospectively collected and compared across the intervention groups. A total of 329 patients were included, with 142 in the home visit group and 187 in the telephone support group. Patients in both groups had frequent visits to CHSC (8.1±5.9 in the home visit and 7.7±4.1 in the telephone support group, p=0.45) during the follow-up period. Compared to the telephone support group, patients in the home visit group showed a reduction in all-cause mortality (14.1% versus 20.3%, p=0.14), one or more hospitalizations due to any cause (33.8% versus 44.2%, p=0.12) and one or more hospitalizations due to cardiac cause (17.6% versus 24.6%, p=0.13) in the home visit group. The absolute differences were 6.2% (95% CI: 1.9%, 14.3%), 8.4% (95% CI: 2.1%, 18.9%) and 7.3% (95% CI: 1.5%, 16.1%), respectively, although the results were not statistically significant. After 6 months of intervention, patients in both groups achieved marked improvement in self-care with reference to their own baseline values. Although no statistical difference was observed between the two care delivery approaches regarding the clinical outcomes of interest, given the high participation rates, the acceptable rate of adverse events, frequent CHSC
Wise, Marcie A.; Saleh, Joseph H.; Haga, Rachel A.
Choosing the "right" satellite platform for a given market and mission requirements is a major investment decision for a satellite operator. With a variety of platforms available on the market from different manufacturers, and multiple offerings from the same manufacturer, the down-selection process can be quite involved. In addition, because data for on-obit failures and anomalies per platform is unavailable, incomplete, or fragmented, it is difficult to compare options and make an informed choice with respect to the critical attribute of field reliability of different platforms. In this work, we first survey a large number of geosynchronous satellite platforms by the major satellite manufacturers, and we provide a brief overview of their technical characteristics, timeline of introduction, and number of units launched. We then analyze an extensive database of satellite failures and anomalies, and develop for each platform a "health scorecard" that includes all the minor and major anomalies, and complete failures—that is failure events of different severities—observed on-orbit for each platform. We identify the subsystems that drive these failure events and how much each subsystem contributes to these events for each platform. In addition, we provide the percentage of units in each platform which have experienced failure events, and, after calculating the total number of years logged on-orbit by each platform, we compute its corresponding average failure and anomaly rate. We conclude this work with a preliminary comparative analysis of the health scorecards of different platforms. The concept of a "health scorecard" here introduced provides a useful snapshot of the failure and anomaly track record of a spacecraft platform on orbit. As such, it constitutes a useful and transparent benchmark that can be used by satellite operators to inform their acquisition choices ("inform" not "base" as other considerations are factored in when comparing different spacecraft
Barrese, James C.; Rao, Naveen; Paroo, Kaivon; Triebwasser, Corey; Vargas-Irwin, Carlos; Franquemont, Lachlan; Donoghue, John P.
Objective. Brain-computer interfaces (BCIs) using chronically implanted intracortical microelectrode arrays (MEAs) have the potential to restore lost function to people with disabilities if they work reliably for years. Current sensors fail to provide reliably useful signals over extended periods of time for reasons that are not clear. This study reports a comprehensive retrospective analysis from a large set of implants of a single type of intracortical MEA in a single species, with a common set of measures in order to evaluate failure modes. Approach. Since 1996, 78 silicon MEAs were implanted in 27 monkeys (Macaca mulatta). We used two approaches to find reasons for sensor failure. First, we classified the time course leading up to complete recording failure as acute (abrupt) or chronic (progressive). Second, we evaluated the quality of electrode recordings over time based on signal features and electrode impedance. Failure modes were divided into four categories: biological, material, mechanical, and unknown. Main results. Recording duration ranged from 0 to 2104 days (5.75 years), with a mean of 387 days and a median of 182 days (n = 78). Sixty-two arrays failed completely with a mean time to failure of 332 days (median = 133 days) while nine array experiments were electively terminated for experimental reasons (mean = 486 days). Seven remained active at the close of this study (mean = 753 days). Most failures (56%) occurred within a year of implantation, with acute mechanical failures the most common class (48%), largely because of connector issues (83%). Among grossly observable biological failures (24%), a progressive meningeal reaction that separated the array from the parenchyma was most prevalent (14.5%). In the absence of acute interruptions, electrode recordings showed a slow progressive decline in spike amplitude, noise amplitude, and number of viable channels that predicts complete signal loss by about eight years. Impedance measurements showed
Klein, William E.; Lali, Vincent R.
The results failure modes and effects analysis (FMEA) conducted for wind-turbine generators are presented. The FMEA was performed for the functional modes of each system, subsystem, or component. The single-point failures were eliminated for most of the systems. The blade system was the only exception. The qualitative probability of a blade separating was estimated at level D-remote. Many changes were made to the hardware as a result of this analysis. The most significant change was the addition of the safety system. Operational experience and need to improve machine availability have resulted in subsequent changes to the various systems, which are also reflected in this FMEA.
J. M. Fonseca
Full Text Available Cleaner production programs (CP and Failure Modes and Effects Analysis (FMEA are tools used to improve the sustainability of industries, ensuring greater profitability, quality, reliability and safety of their products and services. The meat industry is among the most polluting industries because of the large amounts of organic waste produced during meat processing. The objective of this study was to combine the CP and FMEA tools and to apply them in a pig slaughterhouse in order to detect critical points along the production chain that have a major environmental impact and to establish corrective and preventive actions that could minimize these problems. The results showed that water is the most consumed resource by the industry and also the main producer of waste due to microbiological contamination with animal feces and blood and meat residues. All impacts were found to be real due to their daily occurrence in the industry. Their severity, occurrence, detection and coverage were classified as moderate and high, high, low and moderate, and moderate and high, respectively. The application of the CP and FMEA tools was efficient in identifying and evaluating the environmental impacts caused by the slaughter and processing of pork carcasses. Liquid slaughter effluents and solid wastes (blood and bones are the factors that pose the greatest risks to the environment. The substitution of treatment plant chemicals with decomposing microorganisms, composting, and the production of animal meal and feed from solid waste are appropriate measures the industry could adopt to minimize the contamination of water resources and soil.
Yang, Wenya; Dall, Timothy M; Zhang, Yiduo; Hogan, Paul F; Arday, David R; Gantt, Cynthia J
To assess the effect of TRICARE's asthma, congestive heart failure, and diabetes disease management programs using a scorecard approach. EVALUATION MEASURES: Patient healthcare utilization, financial, clinical, and humanistic outcomes. Absolute measures were translated into effect size and incorporated into a scorecard. Actual outcomes for program participants were compared with outcomes predicted in the absence of disease management. The predictive equations were established from regression models based on historical control groups (n = 39,217). Z scores were calculated for the humanistic measures obtained through a mailed survey. Administrative records containing medical claims, patient demographics and characteristics, and program participation status were linked using an encrypted patient identifier (n = 57,489). The study time frame is 1 year prior to program inception through 2 years afterward (October 2005-September 2008). A historical control group was identified with the baseline year starting October 2003 and a 1-year follow-up period starting October 2004. A survey was administered to a subset of participants 6 months after baseline assessment (39% response rate). Within the observation window--24 months for asthma and congestive heart failure, and 15 months for the diabetes program--we observed modest reductions in hospital days and healthcare cost for all 3 programs and reductions in emergency visits for 2 programs. Most clinical outcomes moved in the direction anticipated. The scorecard provided a useful tool to track performance of 3 regional contractors for each of 3 diseases and over time.
Lee, Howard; Lee, Heechan; Baik, Jungmi; Kim, Hyunjung; Kim, Rachel
Failure mode and effects analysis (FMEA) is a risk management tool to proactively identify and assess the causes and effects of potential failures in a system, thereby preventing them from happening. The objective of this study was to evaluate effectiveness of FMEA applied to an academic clinical trial center in a tertiary care setting. A multidisciplinary FMEA focus group at the Seoul National University Hospital Clinical Trials Center selected 6 core clinical trial processes, for which potential failure modes were identified and their risk priority number (RPN) was assessed. Remedial action plans for high-risk failure modes (RPN >160) were devised and a follow-up RPN scoring was conducted a year later. A total of 114 failure modes were identified with an RPN score ranging 3-378, which was mainly driven by the severity score. Fourteen failure modes were of high risk, 11 of which were addressed by remedial actions. Rescoring showed a dramatic improvement attributed to reduction in the occurrence and detection scores by >3 and >2 points, respectively. FMEA is a powerful tool to improve quality in clinical trials. The Seoul National University Hospital Clinical Trials Center is expanding its FMEA capability to other core clinical trial processes.
Xie, Feng; Nguyen, Hong-Ky; Leblanc, Herve; Hughes, Larry; Wang, Jie; Miller, Dean J.; Lascola, Kevin
Here we present lifetime test results of 4 groups of quantum cascade lasers (QCL) under various aging conditions including an accelerated life test. The total accumulated life time exceeds 1.5 million device·hours, which is the largest QCL reliability study ever reported. The longest single device aging time was 46.5 thousand hours (without failure) in the room temperature test. Four failures were found in a group of 19 devices subjected to the accelerated life test with a heat-sink temperature of 60 °C and a continuous-wave current of 1 A. Visual inspection of the laser facets of failed devices revealed an astonishing phenomenon, which has never been reported before, which manifested as a dark belt of an unknown substance appearing on facets. Although initially assumed to be contamination from the environment, failure analysis revealed that the dark substance is a thermally induced oxide of InP in the buried heterostructure semiinsulating layer. When the oxidized material starts to cover the core and blocks the light emission, it begins to cause the failure of QCLs in the accelerated test. An activation energy of 1.2 eV is derived from the dependence of the failure rate on laser core temperature. With the activation energy, the mean time to failure of the quantum cascade lasers operating at a current density of 5 kA/cm2 and heat-sink temperature of 25°C is expected to be 809 thousand hours.
Littell, Justin D.; Binienda, Wieslaw K.; Goldberg, Robert K.; Roberts, Gary D.
Quasi-static tests have been performed on triaxially braided carbon fiber composite materials with large unit cell sizes. The effects of different fibers and matrix materials on the failure mode were investigated. Simulations of the tests have been performed using the transient dynamic finite element code, LS-DYNA. However, the wide range of failure modes observed for the triaxial braided carbon fiber composites during tests could not be simulated using composite material models currently available within LS-DYNA. A macroscopic approach has been developed that provides better simulation of the material response in these materials. This approach uses full-field optical measurement techniques to measure local failures during quasi-static testing. Information from these experiments is then used along with the current material models available in LS-DYNA to simulate the influence of the braided architecture on the failure process. This method uses two-dimensional shell elements with integration points through the thickness of the elements to represent the different layers of braid along with a new analytical method for the import of material stiffness and failure data directly. The present method is being used to examine the effect of material properties on the failure process. The experimental approaches used to obtain the required data will be described, and preliminary results of the numerical analysis will be presented.
Wan, Lipeng [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Wang, Feiyi [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Oral, H. Sarp [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Vazhkudai, Sudharshan S. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Cao, Qing [Univ. of Tennessee, Knoxville, TN (United States)
High-performance computing (HPC) storage systems provide data availability and reliability using various hardware and software fault tolerance techniques. Usually, reliability and availability are calculated at the subsystem or component level using limited metrics such as, mean time to failure (MTTF) or mean time to data loss (MTTDL). This often means settling on simple and disconnected failure models (such as exponential failure rate) to achieve tractable and close-formed solutions. However, such models have been shown to be insufficient in assessing end-to-end storage system reliability and availability. We propose a generic simulation framework aimed at analyzing the reliability and availability of storage systems at scale, and investigating what-if scenarios. The framework is designed for an end-to-end storage system, accommodating the various components and subsystems, their interconnections, failure patterns and propagation, and performs dependency analysis to capture a wide-range of failure cases. We evaluate the framework against a large-scale storage system that is in production and analyze its failure projections toward and beyond the end of lifecycle. We also examine the potential operational impact by studying how different types of components affect the overall system reliability and availability, and present the preliminary results
pressures in the diamond anvil cell. The DTA procedure showed one glass transition for the neat fluid but two for the mixture (Figures 14 and 15) as the...provides spectra thiat are miore easik intf: -led tItan those of Nlode 2. but reqitires at least twice tGW 411" ack I as mart > experiments for the...thermal analysis ( DTA ). rials, such as those used hv Rounds (3). The assumption of a correspondence of temperature decrease with pressure increase is
Al Jabbari, Youssef S; Fournelle, Raymond; Al Qhatani, Mirae; Zinelis, Spiros
The aim was to determine the fracture mechanism of two clinically failed ParaPost drills. First, the fracture planes were analyzed by scanning electron microscopy (SEM). The drill end of one of the fractured pieces of each drill was then embedded in resin and after being metallographically ground and polished, was chemically etched. The microstructure and elemental composition were then examined by SEM/EDS analysis while hardness was determined with a Vickers testing device. Fractographic analysis revealed that both drills failed in a brittle manner and showed a pattern characteristic of a quasi-cleavage fracture mode. SEM and EDS analysis revealed a random distribution of a second phase enriched in Mo, W, and V, probably appended to (Mo, W, V)×C carbides, while the alloy composition is similar to M3 tool steel, a high-speed molybdenum tool steel. The microhardness of a ParaPost Drill #1 was found to be HV 862±29 and that for a Drill #2 was 846±16, with no significant differences (p>0.05). In both cases, fracture originated from surface points acting as stress concentrators and facilitating brittle fracture in the quasi-cleavage mode indicating that failure rate might be further minimized by a better instrument design.
Youngblood, R. W. [Idaho National Laboratory, Idaho Falls, ID (United States); Duffey, R. B. [Idaho National Laboratory, Idaho Falls, ID (United States)
Models of reliability growth relate current system unreliability to currently accumulated experience. But “experience” comes in different forms. Looking back after a major accident, one is sometimes able to identify previous events or measurable performance trends that were, in some sense, signaling the potential for that major accident: potential that could have been recognized and acted upon, but was not recognized until the accident occurred. This could be a previously unrecognized cause of accidents, or underestimation of the likelihood that a recognized potential cause would actually operate. Despite improvements in the state of practice of modeling of risk and reliability, operational experience still has a great deal to teach us, and work has been going on in several industries to try to do a better job of learning from experience before major accidents occur. It is not enough to say that we should review operating experience; there is too much “experience” for such general advice to be considered practical. The paper discusses the following: 1. The challenge of deciding what to focus on in analysis of operating experience. 2. Comparing what different models of learning and reliability growth imply about trending and precursor analysis.
Farley, T M; Ali, M M; Slaymaker, E
For the analysis of time to event data in contraceptive studies when individuals are subject to competing causes for discontinuation, some authors have recently advocated the use of the cumulative incidence rate as a more appropriate measure to summarize data than the complement of the Kaplan-Meier estimate of discontinuation. The former method estimates the rate of discontinuation in the presence of competing causes, while the latter is a hypothetical rate that would be observed if discontinuations for the other reasons could not occur. The difference between the two methods of analysis is the continuous time equivalent of a debate that took place in the contraceptive literature in the 1960s, when several authors advocated the use of net (adjusted or single decrement life table rates) rates in preference to crude rates (multiple decrement life table rates). A small simulation study illustrates the interpretation of the two types of estimate - the complement of the Kaplan-Meier estimate corresponds to a hypothetical rate where discontinuations for other reasons did not occur, while the cumulative incidence gives systematically lower estimates. The Kaplan-Meier estimates are more appropriate when estimating the effectiveness of a contraceptive method, but the cumulative incidence estimates are more appropriate when making programmatic decisions regarding contraceptive methods. Other areas of application, such as cancer studies, may prefer to use the cumulative incidence estimates, but their use should be determined according to the application. Copyright 2001 John Wiley & Sons, Ltd.
Full Text Available The purpose of the paper was to evaluate the probability of the top event in the fluidity test by Fault Tree Analysis (FTA. One of the important tests used in the foundry practice is the test of the fluidity. Fluidity is the ability of the molten metal to fill the cavity of the molds and create a cast. The AlSi10MgMn (EN 1706 alloy with 5 or 10.54 % of silica was the experimental material. The melted alloy was cast into "horizontal" three-channel mold to test its fluidity. The pouring temperatures were between 605 and 830 °C. In some cases, the experiment was not successful, for a some reasons. This fact led to a waste of time, energy, potential risk of accident, confusion among participants, especially "beginners" founders and became an impulse for the analysis of creation and possible events of fault for the fluidity test using the FTA. It has been found that for the probability of the top event in examined process was disproportionately high (0.29824. The Monte Carlo method was used for the simulation of the effect of decreasing the probability of basic events on the probability of the top event – the fault of the fluidity test.
Full Text Available A peculiar type of edge discoloration defect on the surface of some galvanized fuel tank was observed, causing significant appearance problems. In the present study, the surface defect was characterized by visual inspection, optical microscopy, scanning electron microscopy and energy dispersive spectroscopic analysis to understand the source and mechanism of the defect. In the visual inspection, these peculiar surface appearances were observed in fuel tank at three distinct locations. The SEM examination exhibited two distinct regions on the surface apart from the normal galvanized surface: (1 galvannealed, (2 mixture of galvanized and galvannealed texture. The energy dispersive spectroscopic analysis of galvannealed region indicated enrichment of Zn and Al whereas in the region of galvanized majorly Zn was observed. Surface texture of galvannealed region showed majorly zeta crystals along with skin pass marks; whereas no such zeta crystals were observed in case of galvanized regions. Based on the preliminary results, the following hypothesis was made: Coil processed during galvanizing to galvannealing transition. Thickness and width changed to wider and thicker section, which resulted into lower line speed. Due to the lower Al content, lower speed and thicker section combination resulted in formation of partial GA in the coil owing to the internal heat content of the coil. This paper presents the results of the investigation.
Askari, Roohollah; Shafii, Milad; Rafiei, Sima; Abolhassani, Mohammad Sadegh; Salarikhah, Elaheh
Purpose Failure modes and effects analysis (FMEA) is a practical tool to evaluate risks, discover failures in a proactive manner and propose corrective actions to reduce or eliminate potential risks. The purpose of this paper is to apply FMEA technique to examine the hazards associated with the process of service delivery in intensive care unit (ICU) of a tertiary hospital in Yazd, Iran. Design/methodology/approach This was a before-after study conducted between March 2013 and December 2014. By forming a FMEA team, all potential hazards associated with ICU services - their frequency and severity - were identified. Then risk priority number was calculated for each activity as an indicator representing high priority areas that need special attention and resource allocation. Findings Eight failure modes with highest priority scores including endotracheal tube defect, wrong placement of endotracheal tube, EVD interface, aspiration failure during suctioning, chest tube failure, tissue injury and deep vein thrombosis were selected for improvement. Findings affirmed that improvement strategies were generally satisfying and significantly decreased total failures. Practical implications Application of FMEA in ICUs proved to be effective in proactively decreasing the risk of failures and corrected the control measures up to acceptable levels in all eight areas of function. Originality/value Using a prospective risk assessment approach, such as FMEA, could be beneficial in dealing with potential failures through proposing preventive actions in a proactive manner. The method could be used as a tool for healthcare continuous quality improvement so that the method identifies both systemic and human errors, and offers practical advice to deal effectively with them.
KÖlzer, J.; Otto, J.
Chip verification and failure analysis during the design evaluation of very large scale integrated (VLSI) devices call for highly accurate internal analysis methods. After having characterized the first silicon by automated functional testing, classification and statistical analysis can be carried out : In this way a rough electrical evaluation of the material under investigation can be made. Further clues to a faulty device behavior can only be obtained by internal measurements. Serious malf...
Full Text Available This article proposes an algorithm for prognosis in optimal analysis of manufacturing systems. Uncertain knowledge of such task requires for specific reasoning and adaptive model base of fuzzy logic analyzes. The proposed method performs the interfaces between the results provided by the fuzzy supervision model and the algorithm witch identify the real state of the monitored system. The supervisory system sends failure signals described in a fuzzy approach. These ones represent inputs values in the system of failure optimal analysis which identifies the current degradation states by recurrent identification cycle. The proposed algorithm has also predictive component capable to determine the possible evolution of the system state towards a critical state of failure.
Levine, M.D.; Koomey, J.G.; McMahon, J.E.; Sanstad, A.H. [Lawrence Berkeley Lab., CA (United States). Energy and Environment Div.; Hirst, E. [Oak Ridge National Lab., TN (United States). Energy Div.
This paper presents a framework for evaluating engineering-economic evidence on the diffusion of energy efficiency improvements. Four examples are evaluated within this framework. The analysis provides evidence of market failures related to energy efficiency. Specific market failures that may impede the adoption of cost-effective energy efficiency are discussed. Two programs that have had a major impact in overcoming these market failures, utility DSM programs and appliance standards, are described.
Full Text Available Howard Lee,1,2,* Heechan Lee,1,2,* Jungmi Baik,3 Hyunjung Kim,3 Rachel Kim4 1Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, 2Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, 3Clinical Trials Center, Seoul National University Hospital, Seoul, Republic of Korea, 4Global Clinical Trial Execution, Pfizer Korea, Seoul, Republic of Korea *These authors contributed equally to this work Background: Failure mode and effects analysis (FMEA is a risk management tool to proactively identify and assess the causes and effects of potential failures in a system, thereby preventing them from happening. The objective of this study was to evaluate effectiveness of FMEA applied to an academic clinical trial center in a tertiary care setting.Methods: A multidisciplinary FMEA focus group at the Seoul National University Hospital Clinical Trials Center selected 6 core clinical trial processes, for which potential failure modes were identified and their risk priority number (RPN was assessed. Remedial action plans for high-risk failure modes (RPN >160 were devised and a follow-up RPN scoring was conducted a year later.Results: A total of 114 failure modes were identified with an RPN score ranging 3–378, which was mainly driven by the severity score. Fourteen failure modes were of high risk, 11 of which were addressed by remedial actions. Rescoring showed a dramatic improvement attributed to reduction in the occurrence and detection scores by >3 and >2 points, respectively.Conclusions: FMEA is a powerful tool to improve quality in clinical trials. The Seoul National University Hospital Clinical Trials Center is expanding its FMEA capability to other core clinical trial processes. Keywords: clinical trial, failure modes and effects analysis, quality improvement, quality management, quality risks
The Energy Analysis Program has played an active role in the analysis and discussion of energy and environmental issues at several levels. (1) at the international level, with programs as developing scenarios for long-term energy demand in developing countries and organizing leading an analytic effort, ``Energy Efficiency, Developing Countries, and Eastern Europe,`` part of a major effort to increase support for energy efficiency programs worldwide; (2) at national level, the Program has been responsible for assessing energy forecasts and policies affecting energy use (e.g., appliance standards, National Energy Strategy scenarios); and (3) at the state and utility levels, the Program has been a leader in promoting integrated resource utility planning; the collaborative process has led to agreement on a new generation of utility demand-site programs in California, providing an opportunity to use knowledge and analytic techniques of the Program`s researchers. We continue to place highest on analyzing energy efficiency, with particular attention given to energy use in buildings. The Program continues its active analysis of international energy issues in Asia (including China), the Soviet Union, South America, and Western Europe. Analyzing the costs and benefits of different levels of standards for residential appliances continues to be the largest single area of research within the Program. The group has developed and applied techniques for forecasting energy demand (or constructing scenarios) for the United States. We have built a new model of industrial energy demand, are in the process of making major changes in our tools for forecasting residential energy demand, have built an extensive and documented energy conservation supply curve of residential energy use, and are beginning an analysis of energy-demand forecasting for commercial buildings.
Gharacholou, S Michael; Hellkamp, Anne S; Hernandez, Adrian F; Peterson, Eric D; Bhatt, Deepak L; Yancy, Clyde W; Fonarow, Gregg C
Heart failure disease management (HFDM) may be beneficial in heart failure (HF) patients at risk for readmission or post-discharge mortality. However, characteristics of hospitalized HF patients referred to HFDM are not known. Get With the Guidelines (GWTG) program data was used to analyze 57,969 patients hospitalized with HF from January 2005 through January 2010 from 235 sites. Factors associated with referral to HFDM and rates of HF quality measures by referral status were studied. Mean age of patients was 69.7 ± 14.5 years, 52% were men, and 65% were white. HFDM referral occurred in 11,150 (19.2%) patients. The median rate of HFDM referral among all hospitals was 3.5% (25th-75th percentiles 0%-16.7%) and 8.7% (2.8%-27.7%) among hospitals with at least one previous HFDM referral. Quality and performance measures were higher in patients referred to HFDM. HFDM referral was associated with atrial fibrillation, implanted cardiac device, depression, and treatment at larger hospitals. Patients at higher 90-day mortality risk were paradoxically less likely to receive HFDM referral. HFDM referral occurred in less than one-fifth of hospitalized HF patients and was more frequently recommended to lower-risk patients. Increasing use and optimizing selection of patients for HFDM referral is a potential target for quality improvement. Copyright © 2011 Elsevier Inc. All rights reserved.
Karian, V.E.; Burrows, P.E.; Connor, L. [Dept. of Radiology, Children' s Hospital, Boston, MA (United States); Zurakowski, D. [Dept. of Biostatistics, Children' s Hospital, Boston, MA (United States); Mason, K.P. [Dept. of Anesthesiology, Children' s Hospital, Boston, MA (United States)
Background. Sedation for diagnostic imaging and interventional radiologic procedures in pediatrics has greatly increased over the past decade. With appropriate patient selection and monitoring, serious adverse effects are infrequent, but failure to sedate and paradoxical reactions do occur. Objective. The purpose of this study was to determine, among patients undergoing sedation for radiologic procedures, the incidence of sedation failure and paradoxical reaction to pentobarbital and to identify potentially correctable causes. Materials and methods. Records of 1665 patients who were sedated in the radiology department from 1 November 1997 to 1 July 1998 were reviewed. Patients failing sedation or experiencing paradoxical reaction were compared with respect to sex, age group, diagnosis, scan type, time of day, NPO status, use of IV contrast and type of sedation agent using the Fisher exact test, Pearson chi-square, analysis of variance (ANOVA), the Student t-test, and logistic regression. Results. Data analysis revealed a sedation failure rate of 1 % and paradoxical reaction rate of 1.2 %. Stepwise multiple logistic regression revealed that the only significant independent multivariate predictor of failure was the need for the administration of a combination of pentobarbital, fentanyl, and midazolam IV. Conclusion. The low rate of sedation failure and paradoxical reactions to pentobarbital was near optimal and probably cannot be improved with the currently available sedatives. (orig.)
Full Text Available This study attempts to apply Failure Mode Effects and Criticality Analysis (FMECA to improve the safety of a production system, specifically the production process of an oil company. Since food processing is a worldwide issue and self-management of a food company is more important than relying on government regulations, therefore this study focused on that matter. The initial step of this study is to identify and analyze the criticality of the potential failure modes of the production process. Furthermore, take corrective action to minimize the probability of repeating the same failure mode, followed by a re-analysis of its criticality. The results of corrective actions were compared with those before improvement conditions by testing the significance of the difference using two sample t-test. The final measured result is the Criticality Priority Number (CPN, which refers to the severity category of the failure mode and the probability of occurrence of the same failure mode. The recommended actions proposed by the FMECA significantly reduce the CPN compared with the value before improvement, with increases of 38.46% for the palm olein case study.
Zhou, K; Mao, Y
Palliative care can play an important role in the management of heart failure. We conducted a systematic review and meta-analysis to compare the efficacy and safety of palliative care in patients with heart failure. PubMed, Embase, Web of Science, EBSCO, and the Cochrane Library databases were systematically searched. Randomized controlled trials (RCTs) on the impact of palliative care on heart failure were included. Two investigators independently searched the articles, extracted data, and assessed the quality of included studies. The primary outcome was mortality. Seven RCTs were included in the meta-analysis. Compared with usual care for heart failure, palliative care was associated with a significantly increased quality of life (standardized mean difference = 1.46; 95% confidence interval [CI] = 0.12 to 2.79; p = 0.03) and reduced depression scores (standardized mean difference = -0.62; 95% CI = -0.99 to -0.25; p = 0.03), but demonstrated no impact on mortality (risk ratio [RR] = 1.28; 95% CI = 0.86 to 1.92; p = 0.22) and rehospitalization (RR = 0.84; 95% CI = 0.66 to 1.07; p = 0.16). Palliative care can improve the quality of life and reduce the occurrence of depression in patients with heart failure.
Lu, Yao; Teng, Fang; Zhou, Jie; Wen, Aiqing; Bi, Yutian
The aim of blood transfusion risk management is to improve the quality of blood products and to assure patient safety. We utilize failure mode and effect analysis (FMEA), a tool employed for evaluating risks and identifying preventive measures to reduce the risks in blood transfusion. The failure modes and effects occurring throughout the whole process of blood transfusion were studied. Each failure mode was evaluated using three scores: severity of effect (S), likelihood of occurrence (O), and probability of detection (D). Risk priority numbers (RPNs) were calculated by multiplying the S, O, and D scores. The plan-do-check-act cycle was also used for continuous improvement. Analysis has showed that failure modes with the highest RPNs, and therefore the greatest risk, were insufficient preoperative assessment of the blood product requirement (RPN, 245), preparation time before infusion of more than 30 minutes (RPN, 240), blood transfusion reaction occurring during the transfusion process (RPN, 224), blood plasma abuse (RPN, 180), and insufficient and/or incorrect clinical information on request form (RPN, 126). After implementation of preventative measures and reassessment, a reduction in RPN was detected with each risk. The failure mode with the second highest RPN, namely, preparation time before infusion of more than 30 minutes, was shown in detail to prove the efficiency of this tool. FMEA evaluation model is a useful tool in proactively analyzing and reducing the risks associated with the blood transfusion procedure. © 2013 American Association of Blood Banks.
Full Text Available The problem of large amounts of carbon emissions causes wide concern across the world, and it has become a serious threat to the sustainable development of the manufacturing industry. The intensive research into technologies and methodologies for green product design has significant theoretical meaning and practical value in reducing the emissions of the manufacturing industry. Therefore, a low carbon-oriented product reliability optimal design model is proposed in this paper: (1 The related expert evaluation information was prepared in interval numbers; (2 An improved product failure analysis considering the uncertain carbon emissions of the subsystem was performed to obtain the subsystem weight taking the carbon emissions into consideration. The interval grey correlation analysis was conducted to obtain the subsystem weight taking the uncertain correlations inside the product into consideration. Using the above two kinds of subsystem weights and different caution indicators of the decision maker, a series of product reliability design schemes is available; (3 The interval-valued intuitionistic fuzzy sets (IVIFSs were employed to select the optimal reliability and optimal design scheme based on three attributes, namely, low carbon, correlation and functions, and economic cost. The case study of a vertical CNC lathe proves the superiority and rationality of the proposed method.
Braaksma, Jan; Klingenberg, W.; Veldman, J.
Failure mode and effect analysis (FMEA) is an important method for designing and prioritising preventive maintenance activities and is often used as the basis for preventive maintenance planning. Although FMEA was studied extensively, most of the published work so far covers FMEA concept design.
Braaksma, Anne Johannes Jan; Klingenberg, W.; Veldman, Jasper
Failure mode and effect analysis (FMEA) is an important method for designing and prioritising preventive maintenance activities and is often used as the basis for preventive maintenance planning. Although FMEA was studied extensively, most of the published work so far covers FMEA concept design.
Buijs, L.J.; Eijk, A.; Hooft, L. van
This paper will present the root cause analysis and the solution of fatigue failures of the pump valves of three membrane pump systems installed on a chemical plant of Momentive in Pernis, the Netherlands. The membrane pumps were installed approximately 30 years ago. Each system has encountered
Jeuring, J.T.; Swierstra, S.D.
This paper discusses the derivation of functional programs for grammar analysis problems, such as the Empty problem and the Reachable problem. Grammar analysis problems can be divided into two classes: top-down problems such as Follow and Reachable, which are described in terms of the contexts of
Although the possibilities for the treatment of infertility have been improved tremendously, not every couple will be treated successfully. Crude overall pregnancy rates of 50-65% per patient can be achieved nowadays, irrespective of the type of profertility treatment applied first. IVF only accounts for about 20% of the pregnancies achieved. Dropout is an important reason for not reaching the estimated pregnancy rate. Even after failed IVF, spontaneous pregnancies do occur. Sperm and oocyte donation (OD) offer additional chances to subfertile couples. Severity of the male factor (in sperm donation) and young donor age (in OD) are important determinants of success. Analysis of assisted reproduction technology outcomes would benefit from more universally accepted definitions and deserves better statistical analysis. Long-term cumulative live birth rates of 80% may be expected if dropout can be limited. Milder stimulation, a patient-friendlier approach and better counseling may help to keep more patients in the program.
Gorski, Lisa A; Johnson, Kathy
This article describes a collaborative approach to manage patients with heart failure between a home care agency and a care management agency. The resulting disease management program used a combination of home visits and phone contact. Care management plans emphasized patient education on increasing adherence to medical and diet regimens, and recognizing early symptoms of exacerbation that could lead to rehospitalization. Clinician activities and patient outcomes are described.
Hatfield, Glen S.; Hark, Frank; Stott, James
Launch vehicle reliability analysis is largely dependent upon using predicted failure rates from data sources such as MIL-HDBK-217F. Reliability prediction methodologies based on component data do not take into account system integration risks such as those attributable to manufacturing and assembly. These sources often dominate component level risk. While consequence of failure is often understood, using predicted values in a risk model to estimate the probability of occurrence may underestimate the actual risk. Managers and decision makers use the probability of occurrence to influence the determination whether to accept the risk or require a design modification. The actual risk threshold for acceptance may not be fully understood due to the absence of system level test data or operational data. This paper will establish a method and approach to identify the pitfalls and precautions of accepting risk based solely upon predicted failure data. This approach will provide a set of guidelines that may be useful to arrive at a more realistic quantification of risk prior to acceptance by a program.
The Energy Analysis Program has played an active role in the analysis and discussion of energy and environmental issues at several levels. (1) at the international level, with programs as developing scenarios for long-term energy demand in developing countries and organizing leading an analytic effort, Energy Efficiency, Developing Countries, and Eastern Europe,'' part of a major effort to increase support for energy efficiency programs worldwide; (2) at national level, the Program has been responsible for assessing energy forecasts and policies affecting energy use (e.g., appliance standards, National Energy Strategy scenarios); and (3) at the state and utility levels, the Program has been a leader in promoting integrated resource utility planning; the collaborative process has led to agreement on a new generation of utility demand-site programs in California, providing an opportunity to use knowledge and analytic techniques of the Program's researchers. We continue to place highest on analyzing energy efficiency, with particular attention given to energy use in buildings. The Program continues its active analysis of international energy issues in Asia (including China), the Soviet Union, South America, and Western Europe. Analyzing the costs and benefits of different levels of standards for residential appliances continues to be the largest single area of research within the Program. The group has developed and applied techniques for forecasting energy demand (or constructing scenarios) for the United States. We have built a new model of industrial energy demand, are in the process of making major changes in our tools for forecasting residential energy demand, have built an extensive and documented energy conservation supply curve of residential energy use, and are beginning an analysis of energy-demand forecasting for commercial buildings.
Moss, Marc; Nordon-Craft, Amy; Malone, Dan; Van Pelt, David; Frankel, Stephen K.; Warner, Mary Laird; Kriekels, Wendy; McNulty, Monica; Fairclough, Diane L.; Schenkman, Margaret
Rationale: Early physical therapy (PT) interventions may benefit patients with acute respiratory failure by preventing or attenuating neuromuscular weakness. However, the optimal dosage of these interventions is currently unknown.
Energy analysis attempts to understand the volitional choices of energy use and supply available to human society, and the multi-faceted consequences of choosing any one of them. Topics deal with economic impacts; assessments of regional issues and impacts; air quality evaluation; institutional and political issues in California power plant siting; assessment of environmental standards; water issues; characterization of aquatic systems dissolved oxygen profiles; modeling; computer-generated interactive graphics; energy assessment in Hawaii; solar energy in communities; utilities solar financial data; population impacts of geothermal development; energy conservation in colleges and residential sectors; energy policy; decision making; building energy performance standards; standards for residential appliances; and impact of energy performance standards on demand for peak electrical energy.
Tardiff, G.E.; Snell, E.O.
A metallurgical analysis of a fractured Hastelloy C-276 brine injection pump shaft was carried out to determine the cause of failure. Loss of load carrying cross section due to intergranular corrosion by molten bronze bearing alloy followed by torsional overload of the remaining section was the cause of failure. Lack of evidence for brine induced corrosion or stress corrosion of the Hastelloy C-276 alloy is consistent with prior successful experience with this material in contact with high temperature, high salinity Salton Sea Geothermal Field brines.
Full Text Available The present article highlights failure investigation of the pulleys during a press-fit assembling process. Pulleys are used to transmit power between rotational mechanical elements. Failure analysis was performed by metallographic evaluation using light microscopy, SEM and EDX, and chemical analyses. It was found that cooperative influence of higher carbon content with combination of elongated sulphides is reason for pulleys cracking. Steel cleanliness and homogeneous structure is an important factor for users of steel. The success of production process is connected with the optimal quality of steel.
Ciocca, Mario, E-mail: firstname.lastname@example.org [Unit of Medical Physics, Centro Nazionale di Adroterapia Oncologica (CNAO) Foundation, via Campeggi, 27100 Pavia (Italy); Cantone, Marie-Claire; Veronese, Ivan [Department of Physics, Universita degli Studi di Milano, via Celoria 16, 20133 Milano (Italy); Istituto Nazionale di Fisica Nucleare, INFN Milano, via Celoria 16, 20133 Milano (Italy); Cattani, Federica; Pedroli, Guido [Unit of Medical Physics, European Institute of Oncology, via Ripamonti 435, 20141 Milano (Italy); Molinelli, Silvia [Unit of Medical Physics, Centro Nazionale di Adroterapia Oncologica (CNAO) Foundation, via Campeggi, 27100 Pavia (Italy); Vitolo, Viviana [Unit of Radiotherapy, Centro Nazionale di Adroterapia Oncologica (CNAO) Foundation, via Campeggi, 27100 Pavia (Italy); Orecchia, Roberto [Division of Radiation Oncology, European Institute of Oncology, via Ripamonti 435, 20141 Milano (Italy); Scientific Direction, Centro Nazionale di Adroterapia Oncologica (CNAO) Foundation, via Campeggi, 27100 Pavia (Italy); Faculty of Medicine, Universita degli Studi di Milano, via Ripamonti 435, 20141 Milano (Italy)
Purpose: Failure mode and effects analysis (FMEA) represents a prospective approach for risk assessment. A multidisciplinary working group of the Italian Association for Medical Physics applied FMEA to electron beam intraoperative radiation therapy (IORT) delivered using mobile linear accelerators, aiming at preventing accidental exposures to the patient. Methods and Materials: FMEA was applied to the IORT process, for the stages of the treatment delivery and verification, and consisted of three steps: 1) identification of the involved subprocesses; 2) identification and ranking of the potential failure modes, together with their causes and effects, using the risk probability number (RPN) scoring system, based on the product of three parameters (severity, frequency of occurrence and detectability, each ranging from 1 to 10); 3) identification of additional safety measures to be proposed for process quality and safety improvement. RPN upper threshold for little concern of risk was set at 125. Results: Twenty-four subprocesses were identified. Ten potential failure modes were found and scored, in terms of RPN, in the range of 42-216. The most critical failure modes consisted of internal shield misalignment, wrong Monitor Unit calculation and incorrect data entry at treatment console. Potential causes of failure included shield displacement, human errors, such as underestimation of CTV extension, mainly because of lack of adequate training and time pressures, failure in the communication between operators, and machine malfunctioning. The main effects of failure were represented by CTV underdose, wrong dose distribution and/or delivery, unintended normal tissue irradiation. As additional safety measures, the utilization of a dedicated staff for IORT, double-checking of MU calculation and data entry and finally implementation of in vivo dosimetry were suggested. Conclusions: FMEA appeared as a useful tool for prospective evaluation of patient safety in radiotherapy. The
Chrcanovic, B R; Kisch, J; Albrektsson, T; Wennerberg, A
Recent studies have suggested that the insertion of dental implants in patients being diagnosed with bruxism negatively affected the implant failure rates. The aim of the present study was to investigate the association between the bruxism and the risk of dental implant failure. This retrospective study is based on 2670 patients who received 10 096 implants at one specialist clinic. Implant- and patient-related data were collected. Descriptive statistics were used to describe the patients and implants. Multilevel mixed effects parametric survival analysis was used to test the association between bruxism and risk of implant failure adjusting for several potential confounders. Criteria from a recent international consensus (Lobbezoo et al., J Oral Rehabil, 40, 2013, 2) and from the International Classification of Sleep Disorders (International classification of sleep disorders, revised: diagnostic and coding manual, American Academy of Sleep Medicine, Chicago, 2014) were used to define and diagnose the condition. The number of implants with information available for all variables totalled 3549, placed in 994 patients, with 179 implants reported as failures. The implant failure rates were 13·0% (24/185) for bruxers and 4·6% (155/3364) for non-bruxers (P bruxism was a statistically significantly risk factor to implant failure (HR 3·396; 95% CI 1·314, 8·777; P = 0·012), as well as implant length, implant diameter, implant surface, bone quantity D in relation to quantity A, bone quality 4 in relation to quality 1 (Lekholm and Zarb classification), smoking and the intake of proton pump inhibitors. It is suggested that the bruxism may be associated with an increased risk of dental implant failure. © 2016 John Wiley & Sons Ltd.
Tahir Mehmood Khan
Full Text Available Objective: To estimate the incidence of dengue-induced organ failure form 2010–2015 in Malaysia. Methods: Data were extracted from the Malaysian Registry of Intensive Care published in June 2016. Analysis of proportions was carried out using StatsDirect software. Binary data for the outcomes available from the included studies were analyzed using StatsDirect software, using random effect model. Results: It is noteworthy that there was a drop in all complications among dengue patients at 2011. Except in year 2011, 52% [0.52 (CI 95% 0.49–0.56] of the patients with dengue developed hematological failure. Conclusions: The statistics indicate that dengue has increasingly led to cardiovascular, neurological, renal and hematological failure, as indicated from an increasing trend from year 2011–2015.
Zuo, Ye; Sun, Guangjun; Li, Hongjing
Under the action of near-fault ground motions, curved bridges are prone to pounding, local damage of bridge components and even unseating. A multi-scale fine finite element model of a typical three-span curved bridge is established by considering the elastic-plastic behavior of piers and pounding effect of adjacent girders. The nonlinear time-history method is used to study the seismic response of the curved bridge equipped with unseating failure control system under the action of near-fault ground motion. An in-depth analysis is carried to evaluate the control effect of the proposed unseating failure control system. The research results indicate that under the near-fault ground motion, the seismic response of the curved bridge is strong. The unseating failure control system perform effectively to reduce the pounding force of the adjacent girders and the probability of deck unseating.
Xu, J. B.; Cheng, K. F.; Tu, S. L.; He, X. M.; Ma, C.; Jin, Y. Z.; Kang, X. N.; Sun, T.; Zhang, Y.
The aim of the present study was to discuss a new and effective method for testing artificial muscles based on micro-failure behaviors analysis. Thermo-mechanical actuators based on fishing line and sewing thread, also, the capability of responding to ambient temperature variations producing a large amount of shrinkage ratio of a resulting variation in longitudinal length. The minimum micro-failure value is 0.02μm and the maximum value is 1.72μm with nylon twist pattern. The discovery of an innovative effective testing of artificial muscles based on polymeric fibers specimens on micro-failure, rupture, slippage, etc. This research finds out a micro-failure behavior analysis of thermo-mechanical actuators based on fishing line and sewing thread. The specimens show large deformations when heated together with warping performance in terms of shrinkage of energy and densities. With the purpose of providing useful analysis data for the further technology applications, we attempt micrometre-sized artificial muscles which were also tested was readily accessible and also can be applied to other polymeric fibers. Effective use of this technique achievement relies on rotate speed, temperature and tensile direction. The results of the tensile testing experiments were outstanding with respect to some important issues related to the response of micro-structure, twisted polymeric fibers and shrinkage ratio.
Song, Kyonchan; Li, Yingyong; Rose, Cheryl A.
The performance of a state-of-the-art continuum damage mechanics model for interlaminar damage, coupled with a cohesive zone model for delamination is examined for failure prediction of quasi-isotropic open-hole tension laminates. Limitations of continuum representations of intra-ply damage and the effect of mesh orientation on the analysis predictions are discussed. It is shown that accurate prediction of matrix crack paths and stress redistribution after cracking requires a mesh aligned with the fiber orientation. Based on these results, an aligned mesh is proposed for analysis of the open-hole tension specimens consisting of different meshes within the individual plies, such that the element edges are aligned with the ply fiber direction. The modeling approach is assessed by comparison of analysis predictions to experimental data for specimen configurations in which failure is dominated by complex interactions between matrix cracks and delaminations. It is shown that the different failure mechanisms observed in the tests are well predicted. In addition, the modeling approach is demonstrated to predict proper trends in the effect of scaling on strength and failure mechanisms of quasi-isotropic open-hole tension laminates.
Chen, Ying-Chu; Tsai, Pei-Yi
The potential problems and risks of biomedical waste generation have become increasingly apparent in recent years. This study applied a failure mode and effects analysis to evaluate the operational problems and risks of biomedical waste. The microbiological contamination of biomedical waste seldom receives the attention of researchers. In this study, the biomedical waste lifecycle was divided into seven processes: Production, classification, packaging, sterilisation, weighing, storage, and transportation. Twenty main failure modes were identified in these phases and risks were assessed based on their risk priority numbers. The failure modes in the production phase accounted for the highest proportion of the risk priority number score (27.7%). In the packaging phase, the failure mode 'sharp articles not placed in solid containers' had the highest risk priority number score, mainly owing to its high severity rating. The sterilisation process is the main difference in the treatment of infectious and non-infectious biomedical waste. The failure modes in the sterilisation phase were mainly owing to human factors (mostly related to operators). This study increases the understanding of the potential problems and risks associated with biomedical waste, thereby increasing awareness of how to improve the management of biomedical waste to better protect workers, the public, and the environment.
Limited numbers of large effectiveness studies on routine dental implant treatment are available in the literature. To report retro-prospective data on prevalence of early implant failures in a large number of routine patients/operations at 1 referral clinic. A total of 2848 patients were consecutively provided with 9582 implants with an anodized surface (Nobel Biocare AB) during 3448 implant operations between 2003 and 2011. All patients were invited to a follow-up program and early implant failures up to first annual examination were consecutively identified. A logistic multivariate data analysis was performed to identify possible factors with an association to early implant failures. A total of 43, 73, and 81 implant operations were denoted as early failures depending on when cut-off time was defined, using: abutment connection, prosthesis placement, or at first year of follow-up, respectively. Five factors showed significant association to "early implant failures," where the highest risk for a failure was associated to "surgeon" (hazard ratio [HR] 5.13), followed by "not prosthetic treatment at the referral clinic" (HR 2.71). When all 5 significant factors were present, the risk for an early failure after an operation was 7.0%, and the risk decreased to 0.1% when none/lowest risk factors were present. The role of the surgeons/dentists involved in the rehabilitation of the implant patients and numbers of placed implants (degree of tooth loss) showed the strongest associations to early implant failures in the present clinic. Also increased bone resorption was associated to increased risk for implant failure. © 2017 Wiley Periodicals, Inc.
Full Text Available Background and Aims: This study was hold in purpose of recognizing and controlling workplacehazards in production units of a drag ManufactureMethod:So for recognition and assessment of hazards, FMEA Method was used. FMEASystematically investigates the effects of equipment and system failures leading often toequipment design improvements. At first the level of the study defined as system. Then accordingto observations, accident statistic, and interview with managers, supervisory, and workers highrisk system were determiner. So the boundaries of the system established and informationregarding the relevant Components, their function and interactions gathered. To preventConfusion between Similar pieces of equipment, a unique system identifier developed. After thatall failure modes and their causes for each equipment or system listed, the immediate effects ofeach failure mode and interactive effect on other equipment or system was described too. Riskpriority number was determined according to global and local criteriaResults: After all some actions and solution proposed to reduce the likelihood and severity offailures and raise their delectability.Conclusion :This study illustrated that although of the first step drug manufacture may seem safe,but there are still many hazardous condition that could cause serious accidents, The result proposedit is necessary: (1 to develop comprehensive manual for periodical and regular inspection ofinstruments of workplaces in purpose of recognize unknown failures and their causes, (2 developa comprehensive program for systems maintenance and repair, and (3 conduct worker training.
Yan, Rundong; Sarah J. Dunnett; Lisa M. Jackson
Automated Guided Vehicles (AGVs) are being increasingly used for intelligent transportation and distribution of materials in warehouses and auto-production lines. In this paper, a preliminary hazard analysis of an AGV's critical components is conducted by the approach of Failure Modes Effects and Criticality Analysis (FMECA). To implement this research, a particular AGV transport system is modelled as a phased mission. Then, Fault Tree Analysis (FTA) is adopted to model the causes of phase fa...
Zhou, Yi; Gao, Jinxia; Luo, Le; Wang, Yining
Bruxism was usually considered as a contraindication for oral implanting. The causal relationship between bruxism and dental implant failure was remained controversial in existing literatures. This meta-analysis was performed to investigate the relationship between them. This review conducted an electronic systematic literature search in MEDLINE (PubMed) and EmBase in November 2013 without time and language restrictions. Meanwhile, a hand searching for all the relevant references of included studies was also conducted. Study information extraction and methodological quality assessments were accomplished by two reviewers independently. A discussion ensued if any disagreement occurred, and unresolved issues were solved by consulting a third reviewer. Methodological quality was assessed by using the Newcastle-Ottawa Scale tool. Odds ratio (OR) with 95% confidence interval (CI) was pooled to estimate the relative effect of bruxism on dental implant failures. Fixed effects model was used initially; if the heterogeneity was high, random effects model was chosen for meta-analysis. Statistical analyses were carried out by using Review Manager 5.1. In this meta-analysis review, extracted data were classified into two groups based on different units. Units were based on the number of prostheses (group A) and the number of patients (group B). In group A, the total pooled OR of bruxers versus nonbruxers for all subgroups was 4.72 (95% CI: 2.66-8.36, p = .07). In group B, the total pooled OR of bruxers versus nonbruxers for all subgroups was 3.83 (95% CI: 2.12-6.94, p = .22). This meta-analysis was performed to evaluate the relationship between bruxism and dental implant failure. In contrast to nonbruxers, prostheses in bruxers had a higher failure rate. It suggests that bruxism is a contributing factor of causing the occurrence of dental implant technical/biological complications and plays a role in dental implant failure. © 2015 Wiley Periodicals, Inc.
Jermyn, Rita; Alam, Amit; Kvasic, Jessica; Saeed, Omar; Jorde, Ulrich
The real-world impact of remote pulmonary artery pressure (PAP) monitoring on New York Heart Association (NYHA) class improvement and heart failure (HF) hospitalization rate is presented here from a single center. METHODS: Seventy-seven previously hospitalized outpatients with NYHA class III HF were offered PAP monitoring via device implantation in a multidisciplinary HF-management program. Prospective effectiveness analyses compared outcomes in 34 hemodynamically monitored patients to a group of similar patients (n = 32) who did not undergo device implantation but received usual care. NYHA class and 6-minute walk testing were assessed at baseline and 90 days. All hospitalizations were collected after 6 months of the implantation date (average follow-up, 15 months) and compared with the number of hospitalizations experienced prior to hemodynamic monitoring. Patients in both groups had similar distributions of age, sex, and ejection fraction. After 90 days, 61.8% of the monitored patients had NYHA class improvement of ≥1, compared with 12.5% in the controls (P management leads to significant improvements in NYHA class and HF hospitalization rate in a real-world setting compared with usual care delivered in a comprehensive disease-management program. © 2016 Wiley Periodicals, Inc.
Jiang, Yuanyuan; Jiang, Hongmin; Ding, Siyi; Liu, Qin
Timely delivery of correct results has long been considered as the goal of quality management in clinical laboratory. With increasing workload as well as complexities of laboratory testing and patient care, the traditional technical adopted like internal quality control (IQC) and external quality assessment (EQA) may not enough to cope with quality management problems for clinical laboratories. We applied failure mode and effects analysis (FMEA), a proactive tool, to reduce errors associated with the process beginning with sample collection and ending with a test report in a clinical chemistry laboratory. Our main objection was to investigate the feasibility of FMEA in a real-world situation, namely the working environment of hospital. A team of 8 people (3 laboratory workers, 2 couriers, 2 nurses, and 1 physician) from different departments who were involved in the testing process were recruited and trained. Their main responsibility was to analyze and score all possible clinical chemistry laboratory failures based on three aspects: the severity of the outcome (S), the likeliness of occurrence (O), and the probability of being detected (D). These three parameters were multiplied to calculate risk priority numbers (RPNs), which were used to prioritize remedial measures. Failure modes with RPN≥200 were deemed as high risk, meaning that they needed immediate corrective action. After modifications that were put, we compared the resulting RPN with the previous one. A total of 33 failure modes were identified. Many of the failure modes, including the one with the highest RPN (specimen hemolysis) appeared in the pre-analytic phase, whereas no high-risk failure modes (RPN≥200) were found during the analytic phase. High-priority risks were "sample hemolysis" (RPN, 336), "sample delivery delay" (RPN, 225), "sample volume error" (RPN, 210), "failure to release results in a timely manner" (RPN, 210), and "failure to identify or report critical results" (RPN, 200). The
Kavadi, Niranjan; Tallarico, Richard A; Lavelle, William F
Correction of fixed spinal imbalance in a sagittal and/or coronal plane frequently needs a tricolumnar wedge resection when the deformity is rigid. Complications associated with deformity correction surgery are pseudoarthrosis and implant failure located along the construct. The purposes of this study were to assess comparative rates of pseudoarthrosis (implant failure) at weaker points along lumbosacral junction and level of osteotomy, estimate overall incidence of implant failure, and comparatively analyze failures at different points along the construct. This was an IRB approved, single center study retrospective analysis. Twenty-six patients who underwent three column osteotomies were grouped according to procedure: pedicle subtraction osteotomy (PSO, (n = 18)); vertebral column resection (VCR, (n = 4)); hemivertebra excision (HE, (n = 2)); and extracavitary corpectomy (EC, (n = 2)). Follow-up data is presented on all of the study patients. Number of levels of fusion, anchors, percent saturation of fixation levels, type of bone graft and graft substitutes, and rod material and diameter were recorded. Radiographical data was reviewed preoperatively and postoperatively at 2 weeks and 3, 6, and 12 months and annually to determine sagittal and coronal balance, lumbopelvic parameters, presence or absence of interbody structural support, laterality or rod failure, and time to implant failure. Twenty-seven percent (7/26) patients demonstrated rod breakage either unilaterally (N = 2) or bilaterally (N = 5) during follow-up. Seventy-one percent had increasing back pain or worsening sagittal balance, while remaining failures found incidentally. No failures in children were seen. Tricolumnar osteotomy by posterior approach is a valuable tool. Rod failures found approximately 1 year from surgery, with 86% located at level of osteotomy and 14% at lumbosacral junction. Possible reasons are increased stress in the rod at this point and relatively
Rafique Asim M
Full Text Available Abstract Background Echocardiography plays an integral role in the diagnosis of congestive heart failure including measurement of left heart pressure as well as mechanical dyssynchrony. Methods In this report we describe novel therapeutic uses of echo pulsed wave Doppler in atrioventricular pacemaker optimization in patients who had either not derived significant symptomatic benefit post biventricular pacemaker implantation or deteriorated after deriving initial benefit. In these patients atrioventricular optimization showed novel findings and improved cardiac output and symptoms. Results In 3 patients with Cheyne Stokes pattern of respiration echo Doppler showed worsening of mitral regurgitation during hyperpneac phase in one patient, marked E and A fusion in another patient and exaggerated ventricular interdependence in a third patient thus highlighting mechanisms of adverse effects of Cheyne Stokes respiration in patients with heart failure. All 3 patients required a very short atrioventricular delay programming for best cardiac output. In one patient with recurrent congestive heart failure post cardiac resynchronization, mitral inflow pulse wave Doppler showed no A wave until a sensed atrioventricular delay of 190 ms was reached and showed progressive improvement in mitral inflow pattern until an atrioventricular delay of 290 ms. In 2 patients atrioventricular delay as short as 50 ms was required to allow E and A separation and prevent diastolic mitral regurgitation. All patients developed marked improvement in congestive heart failure symptoms post echo-guided biv pacemaker optimization. Conclusion These findings highlight the value of echo-guided pacemaker optimization in symptomatic patients post cardiac resynchronization treatment.
Full Text Available The rotors of steam turbines belong to the extremely loaded parts of turbo generators due to various mechanical and thermal influences during their operation. The following paper presents the results of the analysis of failure causes of the rotor shaft of a steam turbine with the power of 6,43 MW, which occurred after approximately one year of operation. The analysis was performed on the basis of the analysis of the chemical composition and microstructure of the material, the mechanical properties of the material under static and fatigue loading, as well as operational loading of the critical location of the shaft, using numerical and analytical methods. The conclusions about the possible causes of the shaft failure were drawn on the basis of the results obtained.
Kim, Junhwan; Shin, Kwangbok [Hanbat National University, Daejeon (Korea, Republic of); Hwang, Taekyung [Agency for Defence Development, Daejeon (Korea, Republic of)
This study performed the progressive failure analysis of adhesive joints of a composite pressure vessel with a separated dome by using a cohesive zone model. In order to determine the input parameters of a cohesive element for numerical analysis, the interlaminar fracture toughness values in modes I and II and in the mixed mode for the adhesive joints of the composite pressure vessel were obtained by a material test. All specimens were manufactured by the filament winding method. A mechanical test was performed on adhesively bonded double-lap joints to determine the shear strength of the adhesive joints and verify the reliability of the cohesive zone model for progressive failure analysis. The test results showed that the shear strength of the adhesive joints was 32MPa; the experiment and analysis results had an error of about 4.4%, indicating their relatively good agreement. The progressive failure analysis of a composite pressure vessel with an adhesively bonded dome performed using the cohesive zone model showed that only 5.8% of the total adhesive length was debonded and this debonded length did not affect the structural integrity of the vessel.
Bednarcyk, Brett A.; Arnold, Steven M.
A framework is presented that enables coupled multiscale analysis of composite structures. The recently developed, free, Finite Element Analysis-Micromechanics Analysis Code (FEAMAC) software couples the Micromechanics Analysis Code with Generalized Method of Cells (MAC/GMC) with ABAQUS to perform micromechanics based FEA such that the nonlinear composite material response at each integration point is modeled at each increment by MAC/GMC. As a result, the stochastic nature of fiber breakage in composites can be simulated through incorporation of an appropriate damage and failure model that operates within MAC/GMC on the level of the fiber. Results are presented for the progressive failure analysis of a titanium matrix composite tensile specimen that illustrate the power and utility of the framework and address the techniques needed to model the statistical nature of the problem properly. In particular, it is shown that incorporating fiber strength randomness on multiple scales improves the quality of the simulation by enabling failure at locations other than those associated with structural level stress risers.
Kato, Kyoichi; Sato, Hisaya; Abe, Yoshihisa; Ishimori, Yoshiyuki; Hirano, Hiroshi; Higashimura, Kyoji; Amauchi, Hiroshi; Yanakita, Takashi; Kikuchi, Kei; Nakazawa, Yasuo
How the maintenance checks of the medical treatment system, including start of work check and the ending check, was effective for preventive maintenance and the safety improvement was verified. In this research, date on the failure of devices in multiple facilities was collected, and the data of the trouble repair record was analyzed by the technique of reliability engineering. An analysis of data on the system (8 general systems, 6 Angio systems, 11 CT systems, 8 MRI systems, 8 RI systems, and the radiation therapy system 9) used in eight hospitals was performed. The data collection period assumed nine months from April to December 2008. Seven items were analyzed. (1) Mean time between failures (MTBF) (2) Mean time to repair (MTTR) (3) Mean down time (MDT) (4) Number found by check in morning (5) Failure generation time according to modality. The classification of the breakdowns per device, the incidence, and the tendency could be understood by introducing reliability engineering. Analysis, evaluation, and feedback on the failure generation history are useful to keep downtime to a minimum and to ensure safety.
Hu, Xiaolin; Dolansky, Mary A; Su, Yonglin; Hu, Xiuying; Qu, Moying; Zhou, Lingjuan
Caregivers of patients with heart failure experience burden and negative health outcomes. Adequate support for family caregivers improves their well-being and the quality of care provided to the patients. However, little is known about the benefits of interventions for caregivers of patients with heart failure in China. To test the effects of a multidisciplinary supportive program for family caregivers on caregiver burden, quality of life, and depression. A randomized controlled design with repeated measures was used in this study. A total of 118 participants were randomized into experimental (n=59) and control groups (n=59) from May to December 2014 in one hospital in Chengdu, People's Republic of China. Participants in the experimental group received a 3-month multidisciplinary supportive program, consisting of three 60-min sessions of group classes, three 30-min peer support groups, and regular telephone follow-ups and consultations, while participants in the control group received usual care only. Outcomes were caregiver burden, quality of life, and depression. Data were collected at baseline, post-test (3 months after discharge), and 3 months after post-test (6 months after discharge). The repeated measures analysis of variance was used to examine the effects of groups, changes over time, and time-group interaction on outcome variables. There were significant improvements in caregiver burden, mental health, and depression after post-test and 3 months after post-test in the experimental group. However, there was no significant improvement in caregivers' physical health at either 3 or 6 months following discharge. A multidisciplinary supportive program for caregivers of heart failure patients had positive effects and provides a unique perspective of an intervention considering Chinese culture and customs. Copyright © 2016 Elsevier Ltd. All rights reserved.
Wells, J.E.; Lappa, D.A.; Bernreuter, D.L.; Chen, J.C.; Chuang, T.Y. [Lawrence Livermore National Lab., CA (United States); Johnson, J.J.; Campbell, R.D.; Hashimoto, P.S.; Maslenikov, O.R.; Tiong, L.W.; Ravindra, M.K.; Kincaid, R.H. [EQE, International, Irvine, CA (United States); Sues, R.H.; Putcha, C.S. [NTS Engineering, Long Beach, CA (United States)
This report describes the methodology used and the results obtained from the application of a simplified seismic risk methodology to the LaSalle County Nuclear Generating Station Unit 2. This study is part of the Level I analysis being performed by the Risk Methods Integration and Evaluation Program (RMIEP). Using the RMIEP developed event and fault trees, the analysis resulted in a seismically induced core damage frequency point estimate of 6.OE-7/yr. This result, combined with the component importance analysis, indicated that system failures were dominated by random events. The dominant components included diesel generator failures (failure to swing, failure to start, failure to run after started), and condensate storage tank.
Tan, Vivian S; Nash, Danielle M; McArthur, Eric; Jain, Arsh K; Garg, Amit X; Juurlink, David N; Weir, Matthew A
Beginning in February 2012, there was a shortage of injectable furosemide in the province of Ontario, Canada. The objective of this study was to assess the effects of the furosemide shortage on heart failure outcomes in Ontario, Canada. We determined which hospitals experienced a shortage of injectable furosemide using an online survey. We then used health administrative data to identify all patients who presented to those hospitals with congestive heart failure. Using 40 months of data from before the shortage, we determined the proportion of patients with heart failure expected to die each month. We then used time series analysis to forecast the 30-day mortality rate during the shortage period and compared it with the observed rate. Secondary outcomes included length of hospital stay, transfer to an intensive care unit, mechanical ventilation during the hospital stay, and risk of 30-day readmission for heart failure. Survey results were obtained for 82% of hospitals, 28 of which experienced a severe shortage of injectable furosemide in the year 2012. The 30-day mortality among patients presenting to these hospitals with congestive heart failure before the shortage period was 11.2%. We forecasted a mortality rate of 11.3% (95% confidence interval, 8.2-14.4) for the shortage period, which was not significantly different from the observed rate of 10.9%. Similarly, we found no significant effect of the shortage on secondary outcomes. A severe shortage of injectable furosemide did not increase the risk of adverse outcomes among patients who presented to the hospital with congestive heart failure. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
Korsah, Kofi [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Wood, Richard Thomas [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)
Experience with applying current guidance and practices for common-cause failure (CCF) mitigation to digital instrumentation and control (I&C) systems has proven problematic, and the regulatory environment has been unpredictable. The impact of CCF vulnerability is to inhibit I&C modernization and, thereby, challenge the long-term sustainability of existing plants. For new plants and advanced reactor concepts, the issue of CCF vulnerability for highly integrated digital I&C systems imposes a design burden resulting in higher costs and increased complexity. The regulatory uncertainty regarding which mitigation strategies are acceptable (e.g., what diversity is needed and how much is sufficient) drives designers to adopt complicated, costly solutions devised for existing plants. The conditions that constrain the transition to digital I&C technology by the U.S. nuclear industry require crosscutting research to resolve uncertainty, demonstrate necessary characteristics, and establish an objective basis for qualification of digital technology for usage in Nuclear Power Plant (NPP) I&C applications. To fulfill this research need, Oak Ridge National Laboratory is conducting an investigation into mitigation of CCF vulnerability for nuclear-qualified applications. The outcome of this research is expected to contribute to a fundamentally sound, comprehensive technical basis for establishing the qualification of digital technology for nuclear power applications. This report documents the investigation of modeling approaches for representing failure of I&C systems. Failure models are used when there is a need to analyze how the probability of success (or failure) of a system depends on the success (or failure) of individual elements. If these failure models are extensible to represent CCF, then they can be employed to support analysis of CCF vulnerabilities and mitigation strategies. Specifically, the research findings documented in this report identify modeling approaches that
Wiser, R.; Olson, S.; Bird, L.; Swezey, B.
This report analyzes actual utility green pricing program data to provide further insight into which program features might help maximize both customer participation in green pricing programs and the amount of renewable energy purchased by customers in those programs.
input impedance of ideal, lossless dipole antennas . Both the biconical and cylindri- cal dipoles, illustrated in Figure 2-2, were studied. a a h h ’I...on reverse ardde it neessary and 1~11’fff by block ambetf) Systems EMC Anaysis, Intrasystem Analysis Code, Frequency Le.- Antenna Models, Nonlinear...Receptor Models, Waveform Sensitive Rezept.;t, Spectral Models, Intrasystem EMC Analysis Program, Antenna Matching Factor, Trans- mission Line Loss
Press, Craig A; Morgan, Lindsey; Mills, Michele; Stack, Cynthia V; Goldstein, Joshua L; Alonso, Estella M; Wainwright, Mark S
Spectral electroencephalogram analysis is a method for automated analysis of electroencephalogram patterns, which can be performed at the bedside. We sought to determine the utility of spectral electroencephalogram for grading hepatic encephalopathy in children with acute liver failure. Retrospective cohort study. Tertiary care pediatric hospital. Patients between 0 and 18 years old who presented with acute liver failure and were admitted to the PICU. None. Electroencephalograms were analyzed by spectral analysis including total power, relative δ, relative θ, relative α, relative β, θ-to-Δ ratio, and α-to-Δ ratio. Normal values and ranges were first derived using normal electroencephalograms from 70 children of 0-18 years old. Age had a significant effect on each variable measured (p spectral analysis. The median age was 4.3 years, 14 of 33 were male, and the majority had an indeterminate etiology of acute liver failure. Neuroimaging was performed in 26 cases and was normal in 20 cases (77%). The majority (64%) survived, and 82% had a good outcome with a score of 1-3 on the Pediatric Glasgow Outcome Scale-Extended at the time of discharge. Hepatic encephalopathy grade correlated with the qualitative visual electroencephalogram scores assigned by blinded neurophysiologists (rs = 0.493; p Spectral electroencephalogram characteristics varied significantly with the qualitative electroencephalogram classification (p Spectral electroencephalogram variables including relative Δ, relative θ, relative α, θ-to-Δ ratio, and α-to-Δ ratio all significantly varied with the qualitative electroencephalogram (p 0.05). Spectral electroencephalogram classification correlated with outcome (p Spectral electroencephalogram analysis can be used to evaluate even young patients for hepatic encephalopathy and correlates with outcome. Spectral electroencephalogram may allow improved quantitative and reproducible assessment of hepatic encephalopathy grade in children with acute
Valente, Thomas W; Palinkas, Lawrence A; Czaja, Sara; Chu, Kar-Hai; Brown, C Hendricks
This paper introduces the use of social network analysis theory and tools for implementation research. The social network perspective is useful for understanding, monitoring, influencing, or evaluating the implementation process when programs, policies, practices, or principles are designed and scaled up or adapted to different settings. We briefly describe common barriers to implementation success and relate them to the social networks of implementation stakeholders. We introduce a few simple measures commonly used in social network analysis and discuss how these measures can be used in program implementation. Using the four stage model of program implementation (exploration, adoption, implementation, and sustainment) proposed by Aarons and colleagues  and our experience in developing multi-sector partnerships involving community leaders, organizations, practitioners, and researchers, we show how network measures can be used at each stage to monitor, intervene, and improve the implementation process. Examples are provided to illustrate these concepts. We conclude with expected benefits and challenges associated with this approach.
Hoskin, HLD; Furie, E.; Collins, W.; Ganey, TM; Schlatterer, DR
Since Sir John Charnley began his monumental hip arthroplasty work in 1958, clinical researchers have been incrementally improving longevity and functionality of total joint systems, although implant failure occurs on occasion. The purpose of this study is to report the fracture of the humeral tray Morse taper of a reverse total shoulder system (RTSS), which to date has not been reported with metallurgic analysis for any RTSS. There was no reported antecedent fall, motor vehicle collision, or other traumatic event prior to implant fracture in this case. Analysis was performed on the retrieved failed implant by Scanning Electron Microscopy (SEM) and Electron Dispersion Spectroscopy (EDS) in an attempt to determine the failure method, as well as to offer improvements for future implants. At the time of revision surgery all explants were retained from the left shoulder of a 61-year old male who underwent a non-complicated RTSS 4 years prior. The explants, particularly the cracked humeral tray, were processed as required for SEM and EDS. Analysis was performed on the failure sites in order to determine the chemical composition of the different parts of the implant, discover the chemical composition of the filler metal used during the electron beam welding process, and to detect any foreign elements that could suggest corrosion or other evidence of failure etiology. Gross visual inspection of all explants revealed that implant failure was a result of dissociation of the taper from the humeral tray at the weld, leaving the Morse taper embedded in the humeral stem while the tray floated freely in the patient’s shoulder. SEM further confirmed the jagged edges noted grossly at the weld fracture site, both suggesting failure due to torsional forces. EDS detected elevated levels of carbon and oxygen at the fracture site on the taper only and not on the humeral tray. In order to determine the origin of the high levels of C and O, it was considered that in titanium alloys, C
Peterson, Dennis C. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)
This document will detail the training curriculum for the Counter-Trafficking System Development (CTSD) Analysis Modules and Lesson Plans are derived from the United States Military, Department of Energy doctrine and Lawrence Livermore National Laboratory (LLNL), Global Security (GS) S Program.
Lambert, E. Beverley; Clancy, Susan
This study describes the use of content analysis to develop a framework for analysing children's animated television programs (in this case, "Bob the Builder") and as such represents the initial stage of a larger project. Results indicate this popular TV series for preschoolers presents contradictory social messages about the roles of…
Ronald E. McRoberts
The Agricultural Research, Extension, and Education Reform Act of 1998 (Public Law 105â185), also known as the 1998 Farm Bill, prescribed conceptual changes in approaches to forest inventories conducted by the Forest Inventory and Analysis (FIA) Program of the U.S. Department of Agriculture (USDA) Forest Service. Realization of these conceptual changes required...
Von der Heidt, Andreas; Ammenwerth, Elske; Bauer, Karl; Fetz, Bettina; Fluckinger, Thomas; Gassner, Andrea; Grander, Willhelm; Gritsch, Walter; Haffner, Immaculata; Henle-Talirz, Gudrun; Hoschek, Stefan; Huter, Stephan; Kastner, Peter; Krestan, Susanne; Kufner, Peter; Modre-Osprian, Robert; Noebl, Josef; Radi, Momen; Raffeiner, Clemens; Welte, Stefan; Wiseman, Andreas; Poelzl, Gerhard
Heart failure (HF) is approaching epidemic proportions worldwide and is the leading cause of hospitalization in the elderly population. High rates of readmission contribute substantially to excessive health care costs and highlight the fragmented nature of care available to HF patients. Disease management programs (DMPs) have been implemented to improve health outcomes, patient satisfaction, and quality of life, and to reduce health care costs. Telemonitoring systems appear to be effective in the vulnerable phase after discharge from hospital to prevent early readmissions. DMPs that emphasize comprehensive patient education and guideline-adjusted therapy have shown great promise to result in beneficial long-term effects. It can be speculated that combining core elements of the aforementioned programs may substantially improve long-term cost-effectiveness of patient management.We introduce a collaborative post-discharge HF disease management program (HerzMobil Tirol network) that incorporates physician-controlled telemonitoring and nurse-led care in a multidisciplinary network approach.
Full Text Available Introduction: Successful performance of emergency department(ED is one of the important indications of increasing the satisfaction among referees. The insurance of such successful performance is fiscal discipline and avoiding from non-beneficial activities in this department. Therefore, the increasing revenue of emergency department is one of the interested goals of hospital management system. According to above-mentioned, the researchers assessed problems lead to loss the revenue of ED and eliminate them by using failure mode and effects analysis (FMEA.Methods: This was the prospective cohort study performed during 18 months, set in 6 phases. In the first phase, the failures were determined and some solutions suggested to eliminate them. During 2-5 phases, based on the prioritizing the problems, solutions were performed. In the sixth phase, final assessment of the study was done. Finally, the feedback of system’s revenue was evaluated and data analyzed using repeated measure ANOVA.Results: Lack of recording the consuming instrument and attribution of separate codes for emergency services of hospitalized patients were the most important failures that lead to decrease the revenue of ED. Such elimination caused to 75.9% increase in revenue within a month (df = 1.6; F = 84.0; p<0.0001. Totally, 18 months following the eliminating of failures caused to 328.2% increase in the revenue of ED (df = 15.9; F = 215; p<0.0001.Conclusion: The findings of the present study shows that failure mode and effect analysis, can be used as a safe and effected method to reduce the expenses of ED and increase its revenue.
Full Text Available The reasons for the failure of a buried pipeline perforated during construction were investigated by a chemical composition analysis; a metallographic test; macromorphology observation; characterization of the corrosion products by scanning electron microscopy, energy-dispersive X-ray spectroscopy, and X-ray diffraction; field medium characterization; and an analysis of the working conditions. The results revealed that the material composition and organization of the steel pipe conformed to API Specification 5CT. However, the reason for the perforation of the L415 steel pipe was an ultrahigh growth rate of pitting corrosion, as high as 14 mm per year. We confirmed that the synergistic effect of a high partial pressure of oxygen introduced by an improper packing process and concentrated Cl− in the corrosion product layer, which originated from groundwater with a high salt concentration that was used for the water pressure test, were responsible for the failure process.
van Deursen, Vincent M.; Urso, Renato; Laroche, Cecile; Damman, Kevin; Dahlstrom, Ulf; Tavazzi, Luigi; Maggioni, Aldo P.; Voors, Adriaan A.
Aims Co-morbidities frequently accompany heart failure (HF), contributing to increased morbidity and mortality, and an impairment of quality of life. We assessed the prevalence, determinants, regional variation, and prognostic implications of co-morbidities in patients with chronic HF in Europe.
Despite the fact that by 1980 Brazil's external debt approached US$100 billion and the effects of economic crisis were strongly felt, the government attempted to continue with previously launched integrated regional development projects including the "Polonoroeste" program. 3 phases were foreseen for the project, in Rondonia, Mato Grosso, and in new colonization zones. The goals of the Rondonia and Mato Grosso phases were to establish agriculture in the Amazon basin zone covered by the Polonoroeste, where the soils were reported to be of good or average quality although extremely heterogeneous over small areas. To avoid danger of rapid and complete deforestation, each colonist was to receive 100 hectares, 5 of which would be cleared and planted each year, allowing the forest to regenerate over 20 years. Colonists were expected to preserve 50 hectares of forest in their 100 hectare lots, but with increasing numbers of colonists the tendency has been to cut back the forest. Colonists were to receive credits and low interest loans repayable beginning 5 years after settlement over a period of 15 years. Since loans were not indexed, the amounts due would be a very small proportion of their initial worth in Brazil's inflationary economy. Boundary disputes sometimes resulting in armed conflict or murder have occurred in both Rondonia and especially in Mato Grosso between legal settlers and squatters, and between different categories of settlers. More serious has been the settlers' resentment and contesting of the large reserves set aside for the indigenous population, which has declined precipitously in recent years, probably as the result of massacres. In Mato Grosso, inequality in land holdings is demonstrated by the control over 55% of the land exercised by 1% of landholders. The demographic response to the colonization schemes was overwhelming. The populations of Rondonia and Mato Grosso respectively were estimated at 36,935 and 522,044 in 1950, 69,792 and 889,539 in
Tangri, Navdeep; Grams, Morgan E; Levey, Andrew S; Coresh, Josef; Appel, Lawrence J; Astor, Brad C; Chodick, Gabriel; Collins, Allan J; Djurdjev, Ognjenka; Elley, C Raina; Evans, Marie; Garg, Amit X; Hallan, Stein I; Inker, Lesley A; Ito, Sadayoshi; Jee, Sun Ha; Kovesdy, Csaba P; Kronenberg, Florian; Heerspink, Hiddo J Lambers; Marks, Angharad; Nadkarni, Girish N; Navaneethan, Sankar D; Nelson, Robert G; Titze, Stephanie; Sarnak, Mark J; Stengel, Benedicte; Woodward, Mark; Iseki, Kunitoshi
Identifying patients at risk of chronic kidney disease (CKD) progression may facilitate more optimal nephrology care. Kidney failure risk equations, including such factors as age, sex, estimated glomerular filtration rate, and calcium and phosphate concentrations, were previously developed and validated in 2 Canadian cohorts. Validation in other regions and in CKD populations not under the care of a nephrologist is needed. To evaluate the accuracy of the risk equations across different geographic regions and patient populations through individual participant data meta-analysis. Thirty-one cohorts, including 721,357 participants with CKD stages 3 to 5 in more than 30 countries spanning 4 continents, were studied. These cohorts collected data from 1982 through 2014. Cohorts participating in the CKD Prognosis Consortium with data on end-stage renal disease. Data were obtained and statistical analyses were performed between July 2012 and June 2015. Using the risk factors from the original risk equations, cohort-specific hazard ratios were estimated and combined using random-effects meta-analysis to form new pooled kidney failure risk equations. Original and pooled kidney failure risk equation performance was compared, and the need for regional calibration factors was assessed. Kidney failure (treatment by dialysis or kidney transplant). During a median follow-up of 4 years of 721,357 participants with CKD, 23,829 cases kidney failure were observed. The original risk equations achieved excellent discrimination (ability to differentiate those who developed kidney failure from those who did not) across all cohorts (overall C statistic, 0.90; 95% CI, 0.89-0.92 at 2 years; C statistic at 5 years, 0.88; 95% CI, 0.86-0.90); discrimination in subgroups by age, race, and diabetes status was similar. There was no improvement with the pooled equations. Calibration (the difference between observed and predicted risk) was adequate in North American cohorts, but the original risk
The aim of this study is to evaluate how far the detrended fluctuation analysis (DFA) approach helps to characterize the short-term and intermediate-term fractal correlations in the raw electrocardiogram (ECG) signals and thereby discriminate between normal and congestive heart failure (CHF) subjects. The DFA-1 calculations were performed on normal and CHF short-term ECG segments, of the order of 20 seconds duration. Differences were found in shortterm and intermediate-term correlation pro...
Chaoyang Xie; Hong-Zhong Huang
Corrosion is recognized as one of the most important degradation mechanisms that affect the long-term reliability and integrity of metallic structures. Studying the structural reliability with pitting corrosion damage is useful for risk control and safety operation for the corroded structure. This paper proposed a structure corrosion reliability analysis approach based on the physics-based failure model of pitting corrosion, where the states of pitting growth, pit-to-crack, and cracking propa...
A. P. Puvanasvaran; N. Jamibollah; N.Norazlin
The Failure Mode and Effect Analysis (FMEA) is a one of the requirements which was required by the Automotive Industries Action Group (AIAG) to all the automotive suppliers and manufacturers worldwide through the TS16949 Quality System. There were a lot of dicrepencies detected on implementing the FMEA which directly related to the user experinces and knowledge. The descrepencies cause the FMEA not meeting the objectives of it. Conceptually, Poka Yoke is able to fit into the Process FMEA. Fai...
Full Text Available Magnetic tunnel junction nanopillar with interfacial perpendicular magnetic anisotropy (PMA-MTJ becomes a promising candidate to build up spin transfer torque magnetic random access memory (STT-MRAM for the next generation of non-volatile memory as it features low spin transfer switching current, fast speed, high scalability, and easy integration into conventional complementary metal oxide semiconductor (CMOS circuits. However, this device suffers from a number of failure issues, such as large process variation and tunneling barrier breakdown. The large process variation is an intrinsic issue for PMA-MTJ as it is based on the interfacial effects between ultra-thin films with few layers of atoms; the tunneling barrier breakdown is due to the requirement of an ultra-thin tunneling barrier (e.g., <1 nm to reduce the resistance area for the spin transfer torque switching in the nanopillar. These failure issues limit the research and development of STT-MRAM to widely achieve commercial products. In this paper, we give a full analysis of failure mechanisms for PMA-MTJ and present some eventual solutions from device fabrication to system level integration to optimize the failure issues.
Full Text Available The dynamic behavior of cable-stayed bridges subjected to moving loads and affected by an accidental failure in the cable suspension system is investigated. The main aim of the paper is to quantify, numerically, the dynamic amplification factors of typical kinematic and stress design variables, by means of a parametric study developed in terms of the structural characteristics of the bridge components. The bridge formulation is developed by using a geometric nonlinear formulation, in which the effects of local vibrations of the stays and of large displacements in the girder and the pylons are taken into account. Explicit time dependent damage laws, reproducing the failure mechanism in the cable system, are considered to investigate the influence of the failure mode characteristics on the dynamic bridge behavior. The analysis focuses attention on the influence of the inertial characteristics of the moving loads, by accounting coupling effects arising from the interaction between girder and moving system. Sensitivity analyses of typical design bridge variables are proposed. In particular, the effects produced by the moving system characteristics, the tower typologies, and the failure mode characteristics involved in the cable system are investigated by means of comparisons between damaged and undamaged bridge configurations.
Pommer, Bernhard; Frantal, Sophie; Willer, Jürgen; Posch, Martin; Watzek, Georg; Tepper, Gabor
To test the null hypothesis of no difference in failure rates of short (minimum length: 7 mm) and longer dental implants (≥ 10 mm), a meta-analysis was performed on prospective observational trials. A systematic electronic and hand search was performed to identify eligible studies. Having additional data supplied by the authors, 54 publications were included (19,083 implants). In case of mandibular implants, the null hypothesis of no impact of reduced implant length on failure within the first year of prosthetic loading could not be rejected. A significant impact of implant length could be substantiated for short machined implants in the anterior [odds ratio (OR) 5.4] and posterior maxilla (OR 3.4), while short rough-surfaced implants demonstrated increased failure rates in the anterior maxillary sites. No influence of implant diameter and denture type on the failure rate of short implants could be revealed. In areas of reduced alveolar bone height the use of short dental implants may reduce the need for invasive bone augmentation procedures. © 2011 John Wiley & Sons A/S.
Mao, J. Z.; Sun, X. S.; Ridha, M.; Tan, V. B. C.; Tay, T. E.
This paper presents a multiscale modeling approach for the progressive failure analysis of carbon-fiber-reinforced woven composite materials. Hierarchical models of woven composites at three different length scales (micro, meso, and macro) were developed according to their unique geometrical and material characteristics. A novel strategy of two-way information transfer is developed for the multiscale analysis of woven composites. In this strategy, the macroscopic effective material properties are obtained from property homogenizations at micro and meso scales and the stresses at three length scales are computed with stress amplification method from macroscale to microscale. By means of the two-way information transfer, the micro, meso and macro structural characterizations of composites are carried out so that the micromechanisms of damage and their interactions are successfully investigated in a single macro model. In addition, both the nucleation and growth of damages are tracked during the progressive failure analysis. A continuum damage mechanics (CDM) method is used for post-failure modeling. The material stiffness, tensile strength and damage patterns of an open-hole woven composite laminate are predicted with the proposed multiscale method. The predictions are in good agreement with the experimental results.
Boring, Ronald Laurids [Idaho National Lab. (INL), Idaho Falls, ID (United States)
In the probabilistic risk assessments (PRAs) used in the nuclear industry, human failure events (HFEs) are determined as a subset of hardware failures, namely those hardware failures that could be triggered by human action or inaction. This approach is top-down, starting with hardware faults and deducing human contributions to those faults. Elsewhere, more traditionally human factors driven approaches would tend to look at opportunities for human errors first in a task analysis and then identify which of those errors is risk significant. The intersection of top-down and bottom-up approaches to defining HFEs has not been carefully studied. Ideally, both approaches should arrive at the same set of HFEs. This question is crucial, however, as human reliability analysis (HRA) methods are generalized to new domains like oil and gas. The HFEs used in nuclear PRAs tend to be top-down—defined as a subset of the PRA—whereas the HFEs used in petroleum quantitative risk assessments (QRAs) often tend to be bottom-up—derived from a task analysis conducted by human factors experts. The marriage of these approaches is necessary in order to ensure that HRA methods developed for top-down HFEs are also sufficient for bottom-up applications.
Kirkeby, Maja Hanne; Rosendahl, Mads
The aim of a probabilistic resource analysis is to derive a probability distribution of possible resource usage for a program from a probability distribution of its input. We present an automated multi-phase rewriting based method to analyze programs written in a subset of C. It generates...... a probability distribution of the resource usage as a possibly uncomputable expression and then transforms it into a closed form expression using over-approximations. We present the technique, outline the implementation and show results from experiments with the system....
Full Text Available Concurrently accessing shared data without locking is usually a subject to race conditions resulting in inconsistent or corrupted data. However, there are programs operating correctly without locking by exploiting the atomicity of certain operations on a speciﬁc hardware. In this paper, we describe how to precisely analyze lockless microcontroller C programs with interrupts by taking the hardware architecture into account. We evaluate this technique in an octagon-based value range analysis using access-based localization to increase efﬁciency.
Cuomo, Sabatino; Castorino, Giuseppe Claudio; Iervolino, Aniello
In the last decades, the analysis of slope stability conditions over large areas has become popular among scientists and practitioners (Cascini et al., 2011; Cuomo and Della Sala, 2013). This is due to the availability of new computational tools (Baum et al., 2002; Godt et al., 2008; Baum and Godt, 2012; Salciarini et al., 2012) - implemented in GIS (Geographic Information System) platforms - which allow taking into account the major hydraulic and mechanical issues related to slope failure, even for unsaturated soils, as well as the spatial variability of both topography and soil properties. However, the effectiveness (Sorbino et al., 2010) of the above methods it is still controversial for landslides forecasting especially depending on the accuracy of DTM (Digital Terrain Model) and for the chance that distinct triggering mechanisms may occur over large area. Among the major uncertainties, layering of soil deposits is of primary importance due to soil layer conductivity contrast and differences in shear strength. This work deals with the hazard analysis of shallow landslides over large areas, considering two distinct schematizations of soil stratigraphy, i.e. homogeneous or layered. To this purpose, the physically-based model TRIGRS (Baum et al., 2002) is firstly used, then extended to the case of layered deposit: specifically, a unique set of hydraulic properties is assumed while distinct soil unit weight and shear strength are considered for each soil layer. Both models are applied to a significant study area of Southern Italy, about 4 km2 large, where shallow deposits of air-fall volcanic (pyroclastic) soils have been affected by several landslides, causing victims, damages and economic losses. The achieved results highlight that soil volume globally mobilized over the study area highly depends on local stratigraphy of shallow deposits. This relates to the depth of critical slip surface which rarely corresponds to the bedrock contact where cohesionless coarse
Gallagher, John Patrick
programs presented here is based on a transformation of the input program, which makes explicit the dependencies of the given program points on the initial goals. The transformation is derived from the resultants semantics of logic programs. The transformed program is then analysed using a standard...... framework and no special properties of the abstract domain....
Blanco, Vanessa; Rohde, Paul; Vázquez, Fernando L; Otero, Patricia
The purpose of this study was to identify subgroups of university students with the highest likelihood of remaining at elevated levels of depressive symptoms six months following the receipt of a depressive prevention intervention on the basis of known risk factors and participation in one of two depression prevention programs. Data from a randomized controlled trial evaluating depression prevention among 133 college students with elevated depressive symptoms were analyzed. Participants were randomized to a cognitive-behavioral or relaxation training group preventive intervention. Classification tree analysis showed that older age was the strongest risk factor for persistently elevated depression. Additional risk factors were: (1) for younger students, fewer daily pleasant activities; (2) for those with higher level of pleasant activities, higher level of stressful events; and (3) for those with higher level of stressful events, lower assertiveness. Results offer directions for prevention foci, identify specific subgroups of college students to target for depression prevention efforts, and suggest that research aim to help older, non-traditional students or graduating students manage the transition from college to the work force.
Blanco, Vanessa; Rohde, Paul; Vázquez, Fernando L.; Otero, Patricia
The purpose of this study was to identify subgroups of university students with the highest likelihood of remaining at elevated levels of depressive symptoms six months following the receipt of a depressive prevention intervention on the basis of known risk factors and participation in one of two depression prevention programs. Data from a randomized controlled trial evaluating depression prevention among 133 college students with elevated depressive symptoms were analyzed. Participants were randomized to a cognitive-behavioral or relaxation training group preventive intervention. Classification tree analysis showed that older age was the strongest risk factor for persistently elevated depression. Additional risk factors were: (1) for younger students, fewer daily pleasant activities; (2) for those with higher level of pleasant activities, higher level of stressful events; and (3) for those with higher level of stressful events, lower assertiveness. Results offer directions for prevention foci, identify specific subgroups of college students to target for depression prevention efforts, and suggest that research aim to help older, non-traditional students or graduating students manage the transition from college to the work force. PMID:24714056
Rodriguez-Gonzalez, Carmen Guadalupe; Martin-Barbero, Maria Luisa; Herranz-Alonso, Ana; Durango-Limarquez, Maria Isabel; Hernandez-Sampelayo, Paloma; Sanjurjo-Saez, Maria
To critically evaluate the causes of preventable adverse drug events during the nurse medication administration process in inpatient units with computerized prescription order entry and profiled automated dispensing cabinets in order to prioritize interventions that need to be implemented and to evaluate the impact of specific interventions on the criticality index. This is a failure mode, effects and criticality analysis (FMECA) study. A multidisciplinary consensus committee composed of pharmacists, nurses and doctors evaluated the process of administering medications in a hospital setting in Spain. By analysing the process, all failure modes were identified and criticality was determined by rating severity, frequency and likelihood of failure detection on a scale of 1 to 10, using adapted versions of already published scales. Safety strategies were identified and prioritized. Through consensus, the committee identified eight processes and 40 failure modes, of which 20 were classified as high risk. The sum of the criticality indices was 5254. For the potential high-risk failure modes, 21 different potential causes were found resulting in 24 recommendations. Thirteen recommendations were prioritized and developed over a 24-month period, reducing total criticality from 5254 to 3572 (a 32.0% reduction). The recommendations with a greater impact on criticality were the development of an electronic medication administration record (-582) and the standardization of intravenous drug compounding in the unit (-168). Other improvements, such as barcode medication administration technology (-1033), were scheduled for a longer period of time because of lower feasibility. FMECA is a useful approach that can improve the medication administration process. © 2015 John Wiley & Sons, Ltd.
Ciapponi, Agustín; Alcaraz, Andrea; Calderón, María; Matta, María Gabriela; Chaparro, Martin; Soto, Natalie; Bardach, Ariel
Heart failure is a major public health concern. The aim of this review was to estimate the burden of heart failure in Latin America. Systematic review and meta-analysis following a search in MEDLINE, EMBASE, LILACS, and CENTRAL for articles published between January 1994 and June 2014, with no language restrictions. We included experimental and observational studies with at least 50 participants aged ≥ 18 years. In total, 143 of the 4792 references retrieved were included in the study. Most studies had been conducted in South America (92%), and mainly in Brazil (64%). The mean age of the patients was 60 ± 9 years, and mean ejection fraction was 36% ± 9%. The incidence of heart failure in the single population study providing this information was 199 cases per 100000 person-years. The prevalence of heart failure was 1% (95% confidence interval [95%CI], 0.1%-2.7%); hospital readmission rates were 33%, 28%, 31%, and 35% at 3, 6, 12, and 24 to 60 months of follow-up, respectively; and the median duration of hospitalization was 7.0 days. The 1-year mortality rate was 24.5% (95%CI, 19.4%-30.0%). In-hospital mortality was 11.7% (95%CI, 10.4%-13.0%), and the rate was higher in patients with a reduced ejection fraction, ischemic heart disease, or Chagas disease. Few studies have evaluated the incidence and prevalence of heart failure in Latin America. High mortality and hospitalization rates were found, and the main limitation was heterogeneity between studies. The results presented provide useful epidemiologic information for decision-making related to this disease. Further studies with standardized methods and representative populations are needed in this line. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.
Zheng, Bin; Ma, Qin; Zheng, Li-Hong; Yong, Qiang; He, Yi-Hua; Liu, Jing-Hua
Previous data are controversial about the association of renal artery stenosis (RAS) with clinical outcome in patients with heart failure. Definition of RAS in previous studies might not be appropriate. By definition of RAS with renal duplex sonography, we investigated the association of RAS with clinical outcome in patients with heart failure. In this retrospective study, we identified 164 patients with heart failure (New York Heart Association classification ≥II; left ventricular ejection fraction renal duplex sonography during hospital stay. RAS was defined as renal-aortic ratio ≥3.5 or a peak systolic velocity ≥200 cm/s (or both), or occlusion of the renal artery. Categorical data of patients were compared using the Chi-square test or Fisher's exact test. Cox proportional hazards regression modeling technique was used to investigate the prognostic significance of possible predictors. Finally, 143 patients were enrolled. Median follow-up time was 32 months (1-53 months). Twenty-two patients were diagnosed as RAS by renal duplex sonography, including 13 unilateral RAS (3 left RAS, 10 right RAS) and 9 bilateral RAS. There were more all-cause mortality and cardiovascular death in patients with RAS than patients without RAS. By multivariate analysis, RAS was a significant predictor for all-cause death and cardiovascular death (hazard ratio [HR] = 4.155, 95% confidence interval [CI]: 1.546-11.164, P = 0.005; and HR = 3.483, 95% CI: 1.200-10.104, P = 0.022, respectively). As for composite endpoint events, including death, nonfatal myocardial infarction, ischemic stroke or intracranial hemorrhage, rehospitalization for cardiac failure, and renal replacement therapy, only angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker was significant predictor. RAS was not a significant predictor for composite endpoint events. Our data suggested that RAS is associated with a poorer clinical outcome in patients with heart failure.
Broggi, Sara; Cantone, Marie Claire; Chiara, Anna; Di Muzio, Nadia; Longobardi, Barbara; Mangili, Paola; Veronese, Ivan
The aim of this paper was the application of the failure mode and effects analysis (FMEA) approach to assess the risks for patients undergoing radiotherapy treatments performed by means of a helical tomotherapy unit. FMEA was applied to the preplanning imaging, volume determination, and treatment planning stages of the tomotherapy process and consisted of three steps: 1) identification of the involved subprocesses; 2) identification and ranking of the potential failure modes, together with their causes and effects, using the risk probability number (RPN) scoring system; and 3) identification of additional safety measures to be proposed for process quality and safety improvement. RPN upper threshold for little concern of risk was set at 125. A total of 74 failure modes were identified: 38 in the stage of preplanning imaging and volume determination, and 36 in the stage of planning. The threshold of 125 for RPN was exceeded in four cases: one case only in the phase of preplanning imaging and volume determination, and three cases in the stage of planning. The most critical failures appeared related to (i) the wrong or missing definition and contouring of the overlapping regions, (ii) the wrong assignment of the overlap priority to each anatomical structure, (iii) the wrong choice of the computed tomography calibration curve for dose calculation, and (iv) the wrong (or not performed) choice of the number of fractions in the planning station. On the basis of these findings, in addition to the safety strategies already adopted in the clinical practice, novel solutions have been proposed for mitigating the risk of these failures and to increase patient safety.
Kotecha, Dipak; Manzano, Luis; Altman, Douglas G; Krum, Henry; Erdem, Guliz; Williams, Nicola; Flather, Marcus D
The Beta-Blockers in Heart Failure Collaborative Group (BB-HF) was formed to obtain and analyze individual patient data from the major randomized controlled trials of beta-blockers in heart failure. Even though beta-blockers are an established treatment for heart failure, uptake is still sub-optimal. Further, the balance of efficacy and safety remains uncertain for common groups including older persons, women, those with impaired renal function and diabetes. Our aim is to provide clinicians with a thorough and definitive evidence-based assessment of these agents. We have identified 11 large randomized trials of beta-blockers versus placebo in heart failure and plan to meta-analyze the data on an individual patient level. In total, these trials have enrolled 18,630 patients. Uniquely, the BB-HF group has secured access to the individual data for all of these trials, with the participation of key investigators and pharmaceutical companies.Our principal objectives include deriving an overall estimate of efficacy for all-cause mortality and cardiovascular hospitalization. Importantly, we propose a statistically-robust sub-group assessment according to age, gender, diabetes and other key factors; analyses which are only achievable using an individual patient data meta-analysis. Further, we aim to provide an assessment of economic benefit and develop a risk model for the prognosis of patients with chronic heart failure.This paper outlines inclusion criteria, search strategies, outcome measures and planned statistical analyses. http://clinicaltrials.gov/ct2/show/NCT00832442.
Full Text Available Abstract The Beta-Blockers in Heart Failure Collaborative Group (BB-HF was formed to obtain and analyze individual patient data from the major randomized controlled trials of beta-blockers in heart failure. Even though beta-blockers are an established treatment for heart failure, uptake is still sub-optimal. Further, the balance of efficacy and safety remains uncertain for common groups including older persons, women, those with impaired renal function and diabetes. Our aim is to provide clinicians with a thorough and definitive evidence-based assessment of these agents. We have identified 11 large randomized trials of beta-blockers versus placebo in heart failure and plan to meta-analyze the data on an individual patient level. In total, these trials have enrolled 18,630 patients. Uniquely, the BB-HF group has secured access to the individual data for all of these trials, with the participation of key investigators and pharmaceutical companies. Our principal objectives include deriving an overall estimate of efficacy for all-cause mortality and cardiovascular hospitalization. Importantly, we propose a statistically-robust sub-group assessment according to age, gender, diabetes and other key factors; analyses which are only achievable using an individual patient data meta-analysis. Further, we aim to provide an assessment of economic benefit and develop a risk model for the prognosis of patients with chronic heart failure. This paper outlines inclusion criteria, search strategies, outcome measures and planned statistical analyses. Trial registration Clinical trial registration information: http://clinicaltrials.gov/ct2/show/NCT00832442
Stut, Wim; Deighan, Carolyn; Armitage, Wendy; Clark, Michelle; Cleland, John G; Jaarsma, Tiny
Heart failure (HF) is common, and it is associated with high rates of hospital readmission and mortality. It is generally assumed that appropriate self-care can improve outcomes in patients with HF, but patient adherence to many self-care behaviors is poor. The objective of our study was to develop and test an intervention to increase self-care in patients with HF using a novel, online, automated education and coaching program. The online automated program was developed using a well-established, face-to-face, home-based cardiac rehabilitation approach. Education is tailored to the behaviors and knowledge of the individual patient, and the system supports patients in adopting self-care behaviors. Patients are guided through a goal-setting process that they conduct at their own pace through the support of the system, and they record their progress in an electronic diary such that the system can provide appropriate feedback. Only in challenging situations do HF nurses intervene to offer help. The program was evaluated in the HeartCycle study, a multicenter, observational trial with randomized components in which researchers investigated the ability of a third-generation telehealth system to enhance the management of patients with HF who had a recent (Heart Association (NYHA) functional class III/IV symptoms despite treatment with diuretic agents. The patients were enrolled from January 2012 through February 2013 at 3 hospital sites within the United Kingdom, Germany, and Spain. Of 123 patients enrolled (mean age 66 years (SD 12), 66% NYHA III, 79% men), 50 patients (41%) reported that they were not physically active, 56 patients (46%) did not follow a low-salt diet, 6 patients (5%) did not restrict their fluid intake, and 6 patients (5%) did not take their medication as prescribed. About 80% of the patients who started the coaching program for physical activity and low-salt diet became adherent by achieving their personal goals for 2 consecutive weeks. After becoming
Wilde, Paul D.; Morse, Elisabeth L.; Rosati, Paul; Cather, Corey
Recognizing the central importance of probability of failure estimates to ensuring public safety for launches, the Federal Aviation Administration (FAA), Office of Commercial Space Transportation (AST), the National Aeronautics and Space Administration (NASA), and U.S. Air Force (USAF), through the Common Standards Working Group (CSWG), developed a guide for conducting valid probability of failure (POF) analyses for expendable launch vehicles (ELV), with an emphasis on POF analysis for new ELVs. A probability of failure analysis for an ELV produces estimates of the likelihood of occurrence of potentially hazardous events, which are critical inputs to launch risk analysis of debris, toxic, or explosive hazards. This guide is intended to document a framework for POF analyses commonly accepted in the US, and should be useful to anyone who performs or evaluates launch risk analyses for new ELVs. The CSWG guidelines provide performance standards and definitions of key terms, and are being revised to address allocation to flight times and vehicle response modes. The POF performance standard allows a launch operator to employ alternative, potentially innovative methodologies so long as the results satisfy the performance standard. Current POF analysis practice at US ranges includes multiple methodologies described in the guidelines as accepted methods, but not necessarily the only methods available to demonstrate compliance with the performance standard. The guidelines include illustrative examples for each POF analysis method, which are intended to illustrate an acceptable level of fidelity for ELV POF analyses used to ensure public safety. The focus is on providing guiding principles rather than "recipe lists." Independent reviews of these guidelines were performed to assess their logic, completeness, accuracy, self- consistency, consistency with risk analysis practices, use of available information, and ease of applicability. The independent reviews confirmed the
Giannuzzi, Viviana; Landi, Annalisa; Bosone, Enrico; Giannuzzi, Floriana; Nicotri, Stefano; Torrent-Farnell, Josep; Bonifazi, Fedele; Felisi, Mariagrazia; Bonifazi, Donato; Ceci, Adriana
The research and development process in the field of rare diseases is characterised by many well-known difficulties, and a large percentage of orphan medicinal products do not reach the marketing approval.This work aims at identifying orphan medicinal products that failed the developmental process and investigating reasons for and possible factors influencing failures. Drugs designated in Europe under Regulation (European Commission) 141/2000 in the period 2000-2012 were investigated in terms of the following failures: (1) marketing authorisation failures (refused or withdrawn) and (2) drugs abandoned by sponsors during development.Possible risk factors for failure were analysed using statistically validated methods. This study points out that 437 out of 788 designations are still under development, while 219 failed the developmental process. Among the latter, 34 failed the marketing authorisation process and 185 were abandoned during the developmental process. In the first group of drugs (marketing authorisation failures), 50% reached phase II, 47% reached phase III and 3% reached phase I, while in the second group (abandoned drugs), the majority of orphan medicinal products apparently never started the development process, since no data on 48.1% of them were published and the 3.2% did not progress beyond the non-clinical stage.The reasons for failures of marketing authorisation were: efficacy/safety issues (26), insufficient data (12), quality issues (7), regulatory issues on trials (4) and commercial reasons (1). The main causes for abandoned drugs were efficacy/safety issues (reported in 54 cases), inactive companies (25.4%), change of company strategy (8.1%) and drug competition (10.8%). No information concerning reasons for failure was available for 23.2% of the analysed products. This analysis shows that failures occurred in 27.8% of all designations granted in Europe, the main reasons being safety and efficacy issues. Moreover, the stage of development
Drake, R. L.; Duvoisin, P. F.; Asthana, A.; Mather, T. W.
High speed automated identification and design of dynamic systems, both linear and nonlinear, are discussed. Special emphasis is placed on developing hardware and techniques which are applicable to practical problems. The basic modeling experiment and new results are described. Using the improvements developed successful identification of several systems, including a physical example as well as simulated systems, was obtained. The advantages of parameter signature analysis over signal signature analysis in go-no go testing of operational systems were demonstrated. The feasibility of using these ideas in failure mode prediction in operating systems was also investigated. An improved digital controlled nonlinear function generator was developed, de-bugged, and completely documented.
Full Text Available Farm management needs creative methods to success. FMEA (Failure Modes and Effects Analysis is a new method to analyze potential reliability problems in the development cycle of the project, making it easier to take actions to overcome such issues, thus enhancing the reliability through design or process. Anticipating these failure modes, being the central step in the analysis, needs to be carried on extensively, in order to prepare a list of maximum potential failure modes. Risk is measured in terms of Risk Priority Number (RPN that is a product of occurrence, severity, and detection difficulty. This study attempted to improve clod mean weight diameter and soil inversion as indicators of tillage quality by FMEA methodology. The results showed that low soil moisture, slow speed of ploughing and great depth of ploughing is the most important factors that increase clod MWD with 900, 630 and 560 RPN, respectively. Also for soil inversion the slow speed of ploughing, not using coulter, low soil moisture and great depth of ploughing are important factors with 720, 648, 490 and 420 RPN. Using a split - split factorial experiment with 16 treatments and three replications also acknowledged the results of this method. After reforming the conditions and re-testing the experiment, results showed that clod MWD was reduced 20% and soil inversion increased 2% approximately. This study proposes the use of this technique in agricultural management.
Full Text Available To satisfy the requirement for diverse risk preferences, we propose a generic risk priority number (GRPN function that assigns a risk weight to each parameter such that they represent individual organization/department/process preferences for the parameters. This research applies GRPN function-based model to differentiate the types of risk, and primary data are generated through simulation. We also conduct sensitivity analysis on correlation and regression to compare it with the traditional RPN (TRPN. The proposed model outperforms the TRPN model and provides a practical, effective, and adaptive method for risk evaluation. In particular, the defined GRPN function offers a new method to prioritize failure modes in failure mode and effect analysis (FMEA. The different risk preferences considered in the healthcare example show that the modified FMEA model can take into account the various risk factors and prioritize failure modes more accurately. In addition, the model also can apply to a generic e-healthcare service environment with a hierarchical architecture.
Full Text Available Recently, a number of wind power structures in tropical cyclone zones are damaged by typhoon. In order to study the failure mechanics and failure modes of wind power structure subjected to typhoon, the typhoon wind field in Dongtai wind farm is simulated based on the classical autoregressive (AR model and a regional power-spectrum-density (PSD model, and the simulated spectrum is verified to be in good agreement with the target spectrum. An integrated finite element (FE model of wind power structure, composed of rotor, nacelle, tower, pile cap, and PHC piles, is established. Modal analysis reveals that pile stiffness decreases the structure’s natural frequencies, especially for high order frequencies. Structural responses under the simulated typhoon are calculated by dynamic analysis. Results show that tower buckling is the most prone failure mode of the structure. The horizontal displacement of the hub and the axial force of the most unfavorable piles are both under the limit. This study provides a way to the antityphoon design of large-scale wind power structures.
Mohapatra, J. N.; Patil, Sujay; Sah, Rameshwar; Krishna, P. C.; Eswarappa, B.
Failure analysis was carried out on a prematurely failed tertiary superheater tube used in gas-fired boiler. The analysis includes a comparative study of visual examination, chemical composition, hardness and microstructure at failed region, adjacent and far to failure as well as on fresh tube. The chemistry was found matching to the standard specification, whereas the hardness was low in failed tube compared to the fish mouth opening region and the fresh tube. Microscopic examination of failed sample revealed the presence of spheroidal carbides of Cr and Mo predominantly along the grain boundaries. The primary cause of failure is found to be localized heating. Magnetic hysteresis loop (MHL) measurements were carried out to correlate the magnetic parameters with microstructure and mechanical properties to establish a possible non-destructive evaluation (NDE) for health monitoring of the tubes. The coercivity of the MHL showed a very good correlation with microstructure and mechanical properties deterioration enabling a possible NDE technique for the health monitoring of the tubes.
Bhaduri, Anirban; Bhaduri, Susmita; Ghosh, Dipak
Study of RR interval time series for Congestive Heart Failure had been an area of study with different methods including non-linear methods. In this article the cardiac dynamics of heart beat are explored in the light of complex network analysis, viz. visibility graph method. Heart beat (RR Interval) time series data taken from Physionet database [46, 47] belonging to two groups of subjects, diseased (congestive heart failure) (29 in number) and normal (54 in number) are analyzed with the technique. The overall results show that a quantitative parameter can significantly differentiate between the diseased subjects and the normal subjects as well as different stages of the disease. Further, the data when split into periods of around 1 hour each and analyzed separately, also shows the same consistent differences. This quantitative parameter obtained using the visibility graph analysis thereby can be used as a potential bio-marker as well as a subsequent alarm generation mechanism for predicting the onset of Congestive Heart Failure.
Errichello, R.; Muller, J.
Unintended gearbox failures have a significant impact on the cost of wind farm operations. In 2007, NREL initiated the Gearbox Reliability Collaborative (GRC). The project combines analysis, field testing, dynamometer testing, condition monitoring, and the development and population of a gearbox failure database in a multi-pronged approach to determine why wind turbine gearboxes do not achieve their expected design life. The collaborative of manufacturers, owners, researchers, and consultants focuses on gearbox testing and modeling and the development of a gearbox failure database. Collaborative members also investigate gearbox condition monitoring techniques. Data gained from the GRC will enable designers, developers, and manufacturers to improve gearbox designs and testing standards and create more robust modeling tools. GRC project essentials include the development of two identical, heavily instrumented representative gearbox designs. Knowledge gained from the field and dynamometer tests conducted on these gearboxes builds an understanding of how the selected loads and events translate into bearing and gear response. This report contains the analysis of the first gearbox design.
Full Text Available Clutch is device which is used to transmit power one component to another. It is a device used to connect the driving shaft to a driven shaft, so that the driven shaft may be started or stopped at will, without stopping the driving shaft. A clutch thus provides an interruptible connection between two rotating shafts Clutches allow a high inertia load to be stated with a small power. The engine power transmitted to the system through the clutch. The failure of such a critical component during service can stall the whole application. The objective of present project is to do analysis on driven plate of a clutch which is often fails during the operation. In this present research work analysis is conducted on driven plate of a clutch used in TATA Vehicle. There are so many complaints are noted against the failure of clutch during heavy loads. The driven main plate failed normally during its operation due to cyclic loading. For this reason we designed the driven plate and modeled in Pro-E and analyzed using FEA package in the process of designing and analyzing the actual design is changed to lower down the failure values. And the design may suggest to the company.
Full Text Available This paper presents a failure analysis on a modern high performance diesel engine cylinder head made of gray cast iron. Cracks appeared intensively at the intersection of two exhaust passages in the cylinder head. The metallurgical examination was conducted in the crack origin zone and other zones. Meanwhile, the load state of the failure part of the cylinder head was determined through the Finite Element Analysis. The results showed that both the point of the maximum temperature and the point of the maximum thermal-mechanical coupling stress were not in the crack position. The excessive load was not the main cause of the failure. The large cooling rate in the casting process created an abnormal graphite zone that existed below the surface of the exhaust passage (about 1.1 mm depth, which led to the fracture of the cylinder head. In the fractured area, there were a large number of casting defects (dip sand, voids, etc. and inferior graphite structure (type D, type E which caused stress concentration. Moreover, high temperature gas entered the cracks, which caused material corrosion, material oxidization, and crack propagation. Finally, premature fracture of the cylinder head took place.
Adsett, Julie A; Mudge, Alison M; Morris, Norman; Kuys, Suzanne; Paratz, Jennifer D
A meta-analysis and review of the evidence was conducted to determine the efficacy of aquatic exercise training for individuals with heart failure compared to traditional land-based programmes. A systematic search was conducted for studies published prior to March 2014, using MEDLINE, PUBMED, Cochrane Library, CINAHL and PEDro databases. Key words and synonyms relating to aquatic exercise and heart failure comprised the search strategy. Interventions included aquatic exercise or a combination of aquatic plus land-based training, whilst comparator protocols included usual care, no exercise or land-based training alone. The primary outcome of interest was exercise performance. Studies reporting on muscle strength, quality of life and a range of haemodynamic and physiological parameters were also reviewed. Eight studies met criteria, accounting for 156 participants. Meta-analysis identified studies including aquatic exercise to be superior to comparator protocols for 6 minute walk test (p aquatic exercise training provided similar benefits for VO(2peak), muscle strength and quality of life, though was not superior. Cardiac dimensions, left ventricular ejection fraction, cardiac output and BNP were not influenced by aquatic exercise training. For those with stable heart failure, aquatic exercise training can improve exercise capacity, muscle strength and quality of life similar to land-based training programmes. This form of exercise may provide a safe and effective alternative for those unable to participate in traditional exercise programmes. Crown Copyright © 2015. Published by Elsevier Ireland Ltd. All rights reserved.
Liu Hong Liang
Full Text Available One 530mm X80 pipeline weld failed infrequently in service process. This paper gives a systematic analysis in consideration of both material quality and loading condition. Inspection was performed on chemical composition, mechanical performance, metallograghy and micro-morphology. The result shows that weld joint’s leakage failure accident is fatigue failure. Under the effect of tensile- tensile stress fatigue stress, fatigue crack originated from weld fusion line near the pipe body and developed along the weld. Porosity defect in the weld reduced its bearing capacity, and promoted the formation and development of the fatigue crack. Fatigue strength and fatigue life of the weld has great relationship with the size and distribution of porosity. The greater the porosity, the more close to surface, the decrease of fatigue life is more obvious.
Buchanan, Randy K.; Bryan, Coleman; Ludwig, Larry
The Laboratory Virtual Instrumentation Engineering Workstation (LabVIEW) software is designed such that equipment and processes related to control systems can be operationally lined and controlled by the use of a computer. Various processes within the failure analysis laboratories of NASA's Kennedy Space Center (KSC) demonstrate the need for modernization and, in some cases, automation, using LabVIEW. An examination of procedures and practices with the Failure Analaysis Laboratory resulted in the conclusion that some device was necessary to elevate the potential users of LabVIEW to an operational level in minimum time. This paper outlines the process involved in creating a tutorial application to enable personnel to apply LabVIEW to their specific projects. Suggestions for furthering the extent to which LabVIEW is used are provided in the areas of data acquisition and process control.
Given enough time and use, all designs will fail. There are no fail-free designs. This is especially true when it comes to automotive seating comfort where the characteristics and preferences of individual customers are many and varied. To address this problem, individuals charged with automotive seating comfort development have, traditionally, relied on iterative and, as a result, expensive build-test cycles. Cost pressures being placed on today's vehicle manufacturers have necessitated the search for more efficient alternatives. This contribution aims to fill this need by proposing the application of an analytical technique common to engineering circles (but new to seating comfort development), namely Design Failure Mode and Effects Analysis (DFMEA). An example is offered to describe how development teams can use this systematic and disciplined approach to highlight potential seating comfort failure modes, reduce their risk, and bring capable designs to life. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.
Negishi, Jun; Kawanami, Masamitsu; Ogami, Eriko
The risk of failure of root canal therapy was assessed in teeth with inaccessible apical constriction and factors influencing treatment outcome in these teeth were analyzed. From the same 57 patients, one tooth with inaccessible apical constriction (n=57) and one tooth with adequate accessibility (n=57) were included in this retrospective investigation. Cox regression analysis was used to analyze factors that may have influenced the outcome one or more years after obturation. These factors included inaccessibility, systemic disease, canal curvature, preoperative periradicular lesion, widening of periodontal ligament space, patient gender and age, size of master apical file, preoperative pulp vitality, years of operator experience and obturation length. Inaccessible apical constriction was a significant factor related to outcome (odds ratio, 5.301). Preoperative presence of periradicular lesion significantly influenced the outcome in cases with inaccessibility (odds ratio, 4.448). Inaccessibility increases the risk of root canal therapy failure particularly in teeth with preoperative periradicular lesion.
Tobi, A. L. Mohd; Kamdi, Z.; Ismail, M. I.; Nagentrau, M.; Roslan, L. N. H.; Mohamad, Z.; Omar, A. S.; Latif, N. Abdul
This study investigate the abrasive wear failure of tungsten carbide hardfacing on continuous digester (CD) blade (carbon steel) in an environment of sulphuric acid and ilmenite ore mixture. Comparison being made on the hardness, thickness and microstructural of the hardfacing between unworn and 3 months old worn blade on few locations around the blade. The cross sections of the blade revealed non-uniform coverage of the hardfacing on the blade for both worn and unworn blade. The edge of the blade has the least amount of hardfacing thickness which with time acts as the point of failure during the wear process. The hardness obtained from both the unworn and worn samples are around 25% lower from the hardfacing electrode manufacturer’s hardness specification. Microstructural micrograph analysis of the hardfacing revealed non uniform size carbide with non-uniform distributed of carbide in the hardfacing layer.
Full Text Available Columnar jointed basalt is a type of joint rock mass formed by the combined cutting effect of original joints and aphanitic microcracks. After excavation unloading, such rock mass manifested distinct mechanical properties including discontinuity, anisotropy, and proneness of cracking. On the basis of former research findings, this paper establishes a D-CRDM method applicable to the analysis of columnar jointed basalt, which not only integrates discrete element and equivalent finite-element methods, but also takes into account the coupling effect of original joints and aphanitic microcracks. From the comparative study of field monitoring data and strain softening constitutive model calculated results, it can be found that this method may well be used for the simulation of mechanical properties of columnar jointed basalts and the determination of rock failure mechanism and failure modes, thus providing references for the selection of supporting measures for this type of rock mass.
Full Text Available A failure incident of heat-exchange tubes in ammonia evaporators, which suffered from unexpected wall thinning after only one-year service with respect to their original design lifetime of fifteen years, was reported and carefully analyzed. After overall inspection, many tube walls in the evaporators were found to experience severe degradations at both sides with distinct corroded defects and general cracking of corrosion layers. Thus, comprehensive investigations including external appearance, microscopic morphology and chemical composition were carried out by using a series of characterization methods. The analysis results demonstrated that the unexpected wall thinning of tubes was primarily ascribed to multiple corrosion factors including uniform corrosion, pitting and interaction behavior between them. Relative failure mechanisms were discussed in detail and prevention measures were also proposed for ammonia evaporators under similar operating condition.
Simonotto, Jennifer; Furman, Michael; Beaver, Thomas; Spano, Mark; Kavanagh, Katherine; Iden, Jason; Hu, Gang; Ditto, William
Explanted Porcine hearts were Langendorff-perfused, administered a voltage-sensitive fluorescent dye (Di-4-ANEPPS) and illuminated with a ND:Yag laser (532 nm); the change in fluorescence resulting from electrical activity on the heart surface was recorded with an 80 x 80 pixel CCD camera at 1000 frames per second. The heart was put into fibrillation with rapid ventricular pacing and shocks were administered close to the defibrillation threshold. Defibrillation failure data was analyzed using synchronization, space-time volume plots and recurrence quantification. Preliminary spatiotemporal synchronization results reveal a short window of time ( 1 second) after defibrillation failure in which the disordered electrical activity becomes ordered; this ordered period occurs 4-5 seconds after the defibrillation shock. Recurrence analysis of a single time series confirmed these results, thus opening the avenue for dynamic defibrillators that can detect an optimal window for cardioversion.
with static program analysis techniques. The former technique can separate security concerns out of the main logic, and thus improves system modularity. The latter can analyze the system behavior, and thus helps detect software bugs or potential malicious code. We present AspectKE, an aspect......-oriented extensions based on KLAIM, followed by a discussion of open joinpoints that commonly exist in coordination languages such as KLAIM. Based on the idea of AspectKE, we design and implement a proof-of-concept programming language AspectKE*, which enables programmers to easily specify analysis-based security......Enforcing security policies to IT systems, especially for a mobile distributed system, is challenging. As society becomes more IT-savvy, our expectations about security and privacy evolve. This is usually followed by changes in regulation in the form of standards and legislation. In many cases...
Santos, Azenildo M
The current Brazilian situation is such that it is difficult to obtain a worldwide evaluation of failure in education, intervention, or prevention programs. How fragile Brazil's anti-doping system is, its appropriateness as well as its relevance, with needed policy infrastructures for achieving the selected goals, and how wide the gap is between education and prevention program effectiveness between high-performance athletes and recreational practitioners who just want to look good. An additional concern, and ever present flaw regarding Brazil's "common sportsman" in day-to-day society is their not receiving known and necessary "sports education," enabling the development of an "at-risk" population for self-harm. Reflections on public health policy are noted.
Foo, Jonathan; Rivers, George; Ilic, Dragan; Evans, Darrell J R; Walsh, Kieran; Haines, Terrence; Paynter, Sophie; Morgan, Prue; Lincke, Karl; Lambrou, Haria; Nethercote, Anna; Maloney, Stephen
Failure by students in health professional clinical education intertwines the health and education sectors, with actions in one having potential downstream effects on the other. It is unknown what economic costs are associated with failure, how these costs are distributed, and the impacts these have on students, clinicians and workplace productivity. An understanding of cost drivers and cost boundaries will enable evidence-based targeting of strategic investments into clinical education, including where they should be made and by whom. This study was designed to determine the additional economic costs associated with failure by students in health professional clinical education. A cost analysis study involving cost identification, measurement, valuation and the calculation of total cost was conducted. Costs were considered from the perspective of the student, the education institution, the clinical educator, the health service placement provider organisation and the government. Data were based on a 5-week clinical education programme at Monash University, Australia. Data were collected using quantitative surveys and interviews conducted with health professional students, clinical educators and education institute staff. Reference group representation was also sought at various education institution and health service organisation levels. A transferable model with sensitivity analysis was developed. There is a total additional cost of US$9371 per student failing in clinical education from the perspective of all stakeholders considered. Students bear the majority of this burden, incurring 49% of costs, followed by the government (22%), the education institution (18%), the health service organisation (10%) and the clinical educator (1%). Strong economic links for multiple stakeholders as a result of failure by students in clinical education have been identified. The cost burden is skewed in the direction of students. Any generalisation of these results should be made
Khaykin, Pavel; Postel, N; Reeb, I; Staszewski, S
The aim of this database analysis was to investigate the efficacy and safety of efavirenz (EFV)-based highly active antiretroviral therapy (HAART) after switching from failed protease inhibitor (PI)- and boosted PI (PI/r)-based regimens. Data were analyzed from 17 adult patients previously treated with a PI-based HAART with substitution of PI with EFV because of virologic failure and from 14 patients previously treated with a PI-based HAART, with substitution of PI due to tolerability issues. Of 17 patients who switched therapy because of virologic failure, 5 patients maintained EFV-therapy for more than 1 year. In 11/17 patients, EFV-based HAART was discontinued during follow-up and one patient was lost to follow-up. Reasons for discontinuation were: virologic failure in 4, adverse events in 6 (5 CNS-adverse events and 1 rash) and non-compliance in 1 of 17 patients. Of 14 patients who stopped PI-therapy and switched to EFV due to tolerability issues, 6 patients maintained EFV-therapy for more than 1 year. In 8/14 patients EFV-based HAART was discontinued during follow-up. Reasons for discontinuation were: virologic failure in 3, adverse events in 3 (2 CNS-adverse events and 1 patient had rash) and non-compliance in 2 of 14 patients. Instable switch to an EFV-based regimen due to virologic failure or toxicity reasons with a boosted or unboosted PI does not show significant differences but outcome was worse than had been described previously for stable switch settings, likely due to multiple prior virologic failures in many patients.
Park, Jin Joo; Choi, Dong-Ju; Yoon, Chang-Hwan; Oh, Il-Young; Lee, Ju Hyun; Ahn, Soyeon; Yoo, Byung-Su; Kang, Seok-Min; Kim, Jae-Joong; Baek, Sang-Hong; Cho, Myeong-Chan; Jeon, Eun-Seok; Chae, Shung Chull; Ryu, Kyu-Hyung; Oh, Byung-Hee
In acute heart failure (AHF) patients, pulmonary oedema and low tissue perfusion may lead to changes in the acid-base balance, which may be associated with worse outcomes. In this prospective nationwide cohort study from 24 academic hospitals, arterial blood gas (ABG) was measured in 1982 AHF patients at hospital admission. Acidosis was defined as pH 7.44. Mortality was stratified according to ABG results. Overall, 19% had acidosis, 37% had normal pH, and 44% had alkalosis. The most common type of acidosis was the mixed type (42%) followed by metabolic acidosis (40%), and the most common type of alkalosis was respiratory alkalosis (58%). At 12 months' follow-up 304 patients (15%) died. Patients with acidosis had higher mortality (acidosis 19.5%, neutral pH 13.7%, alkalosis 14.9%; P = 0.007). In the Cox proportional-hazards regression model, acidosis was a significant predictor of mortality (hazard ratio 1.93; 95% confidence intervals 1.27-2.93) along with N-terminal pro-brain type natriuretic peptide (NT-proBNP), among others. In contrast, alkalosis was not associated with increased mortality. pH had an incremental prognostic value over NT-proBNP (net reclassification improvement 30%; P analysis identified extra patients at increased risk for mortality among patients with an NT-proBNP level less than the median (12-month mortality 17.5% vs. 9.9%; P = 0.009). In high-risk AHF patients, the most common acid-base imbalance is respiratory alkalosis. Acidosis is observed in every fifth patient and is a significant predictor of mortality. pH provides an additional prognostic value and may be used to optimize risk stratification in high-risk AHF patients. © 2015 The Authors. European Journal of Heart Failure © 2015 European Society of Cardiology.
Martelli, S; Taddei, F; Cristofolini, L; Gill, H S; Viceconti, M
There has been recent renewed interest in proximal femur epiphyseal replacement as an alternative to conventional total hip replacement. In many branches of engineering, risk analysis has proved to be an efficient tool for avoiding premature failures of innovative devices. An extensive risk analysis procedure has been developed for epiphyseal hip prostheses and the predictions of this method have been compared to the known clinical outcomes of a well-established contemporary design, namely hip resurfacing devices. Clinical scenarios leading to revision (i.e. loosening, neck fracture and failure of the prosthetic component) were associated with potential failure modes (i.e. overload, fatigue, wear, fibrotic tissue differentiation and bone remodelling). Driving parameters of the corresponding failure mode were identified together with their safe thresholds. For each failure mode, a failure criterion was identified and studied under the most relevant physiological loading conditions. All failure modes were investigated with the most suitable investigation tool, either numerical or experimental. Results showed a low risk for each failure scenario either in the immediate postoperative period or in the long term. These findings are in agreement with those reported by the majority of clinical studies for correctly implanted devices. Although further work is needed to confirm the predictions of this method, it was concluded that the proposed risk analysis procedure has the potential to increase the efficacy of preclinical validation protocols for new epiphyseal replacement devices.
Luo, Y; Chen, Q
Aliskiren might be beneficial for heart failure. However, the results of various studies are controversial. We conducted a systematic review and meta-analysis to explore the efficacy of aliskiren supplementation for heart failure. PubMed, Embase, Web of Science, EBSCO, and the Cochrane Library databases were systematically searched. Randomized controlled trials (RCTs) assessing the efficacy of aliskiren for heart failure were included. Two investigators independently searched for articles, extracted data, and assessed the quality of included studies. The meta-analysis was performed using the random-effect model. Five RCTs comprising 1973 patients were included in the meta-analysis. Compared with control interventions in heart failure, aliskiren supplementation was found to significantly reduce NT-proBNP levels (standardized mean difference [SMD] = -0.12; 95% CI = -0.21 to -0.03 pg/ml; p = 0.008) and plasma renin activity (SMD = -0.66; 95% CI = -0.89 to -0.44 ng/ml.h; p < 0.00001) while increasing plasma renin concentration (SMD = 0.52; 95% CI = 0.30-0.75 ng/l; p < 0.00001); however, it demonstrated no significant influence on BNP levels (SMD = -0.08; 95% CI = -0.31-0.15 pg/ml; p = 0.49), mortality (RR = 0.97; 95% CI = 0.79-1.20; p = 0.79), aldosterone levels (SMD = -0.09; 95% CI = -0.32-0.14 pmol/l; p = 0.44), adverse events (RR = 3.03; 95% CI = 0.18-49.51; p = 0.44), and serious adverse events (RR = 1.34; 95% CI = 0.54-3.33; p = 0.53). Aliskiren supplementation was found to significantly decrease NT-proBNP levels and plasma renin activity and to improve plasma renin concentration in the setting of heart failure.
Ronald Laurids Boring, PhD
In the probabilistic safety assessments (PSAs) used in the nuclear industry, human failure events (HFEs) are determined as a subset of hardware failures, namely those hardware failures that could be triggered or exacerbated by human action or inaction. This approach is top-down, starting with hardware faults and deducing human contributions to those faults. Elsewhere, more traditionally human factors driven approaches would tend to look at opportunities for human errors first in a task analysis and then identify which of those errors is risk significant. The intersection of top-down and bottom-up approaches to defining HFEs has not been carefully studied. Ideally, both approaches should arrive at the same set of HFEs. This question remains central as human reliability analysis (HRA) methods are generalized to new domains like oil and gas. The HFEs used in nuclear PSAs tend to be top-down—defined as a subset of the PSA—whereas the HFEs used in petroleum quantitative risk assessments (QRAs) are more likely to be bottom-up—derived from a task analysis conducted by human factors experts. The marriage of these approaches is necessary in order to ensure that HRA methods developed for top-down HFEs are also sufficient for bottom-up applications. In this paper, I first review top-down and bottom-up approaches for defining HFEs and then present a seven-step guideline to ensure a task analysis completed as part of human error identification decomposes to a level suitable for use as HFEs. This guideline illustrates an effective way to bridge the bottom-up approach with top-down requirements.
Russell, D. L.; Blacklock, K.; Langhenry, M. T.
The recertification of the Space Shuttle Solid Rocket Booster (SRB) and Solid Rocket Motor (SRM) has included an extensive rewriting of the Failure Mode and Effects Analysis (FMEA) and Critical Items List (CIL). The evolution of the groundrules and methodology used in the analysis is discussed and compared to standard FMEA techniques. Especially highlighted are aspects of the FMEA/CIL which are unique to the analysis of an SRM. The criticality category definitions are presented and the rationale for assigning criticality is presented. The various data required by the CIL and contribution of this data to the retention rationale is also presented. As an example, the FMEA and CIL for the SRM nozzle assembly is discussed in detail. This highlights some of the difficulties associated with the analysis of a system with the unique mission requirements of the Space Shuttle.
Steele, John; Metselaar, Carol; Peyton, Barbara; Rector, Tony; Rossato, Robert; Macias, Brian; Weigel, Dana; Holder, Don
During EVA (Extravehicular Activity) No. 23 aboard the ISS (International Space Station) on 07/16/2013 water entered the EMU (Extravehicular Mobility Unit) helmet resulting in the termination of the EVA (Extravehicular Activity) approximately 1-hour after it began. It was estimated that 1.5-L of water had migrated up the ventilation loop into the helmet, adversely impacting the astronauts hearing, vision and verbal communication. Subsequent on-board testing and ground-based TT and E (Test, Tear-down and Evaluation) of the affected EMU hardware components led to the determination that the proximate cause of the mishap was blockage of all water separator drum holes with a mixture of silica and silicates. The blockages caused a failure of the water separator function which resulted in EMU cooling water spilling into the ventilation loop, around the circulating fan, and ultimately pushing into the helmet. The root cause of the failure was determined to be ground-processing short-comings of the ALCLR (Airlock Cooling Loop Recovery) Ion Filter Beds which led to various levels of contaminants being introduced into the Filters before they left the ground. Those contaminants were thereafter introduced into the EMU hardware on-orbit during ALCLR scrubbing operations. This paper summarizes the failure analysis results along with identified process, hardware and operational corrective actions that were implemented as a result of findings from this investigation.
Castillo, Enrique; Conejo, Antonio J.; Minguez, Roberto; Castillo, Carmen
The paper introduces a method for solving the failure probability-safety factor problem for designing engineering works proposed by Castillo et al. that optimizes an objective function subject to the standard geometric and code constraints, and two more sets of constraints that simultaneously guarantee given safety factors and failure probability bounds associated with a given set of failure modes. The method uses the dual variables and is especially convenient to perform a sensitivity analysis, because sensitivities of the objective function and the reliability indices can be obtained with respect to all data values. To this end, the optimization problems are transformed into other equivalent ones, in which the data parameters are converted into artificial variables, and locked to their actual values. In this way, some variables of the associated dual problems become the desired sensitivities. In addition, using the proposed methodology, calibration of codes based on partial safety factors can be done. The method is illustrated by its application to the design of a simple rubble mound breakwater and a bridge crane.
Bobba, Sujith; Leman, Z.; Zainuddin, E. S.; Sapuan, S. M.
A comprehensive review is conducted on the failures in the field of manufacturing and installation of E-glass fiber reinforced pipes (GFRP). Some of the failures which are mainly encountered after the installation of E-Glass fiber reinforced pipes are the for nation of air bubbles in between the polyester resin layer and the surface film, dispersion of moisture in between the tubing outer and inner layers after installation, heat released in between the layers of E-glass fiber reinforced pipes due to exothermic reaction which in turn results in the formation of cracks on the surface of the pipe. The recent findings and challenges performed in conducting research regarding the deterioration caused in glass fiber reinforced pipes are highlighted and each type of failure that was identified was illustrated with an appropriate high resolution photograph. Performing creep resistance and fatigue analysis are new aspects which are still requited to be analyzed which ave not been stated in the literature which are nominated.
Full Text Available Abstract Background Transcriptional responses often consist of regulatory modules – sets of genes with a shared expression pattern that are controlled by the same regulatory mechanisms. Previous methods allow dissecting regulatory modules from genomics data, such as expression profiles, protein-DNA binding, and promoter sequences. In cases where physical protein-DNA data are lacking, such methods are essential for the analysis of the underlying regulatory program. Results Here, we present a novel approach for the analysis of modular regulatory programs. Our method – Biochemical Regulatory Network Inference (BRNI – is based on an algorithm that learns from expression data a biochemically-motivated regulatory program. It describes the expression profiles of gene modules consisting of hundreds of genes using a small number of regulators and affinity parameters. We developed an ensemble learning algorithm that ensures the robustness of the learned model. We then use the topology of the learned regulatory program to guide the discovery of a library of cis-regulatory motifs, and determined the motif compositions associated with each module. We test our method on the cell cycle regulatory program of the fission yeast. We discovered 16 coherent modules, covering diverse processes from cell division to metabolism and associated them with 18 learned regulatory elements, including both known cell-cycle regulatory elements (MCB, Ace2, PCB, ACCCT box and novel ones, some of which are associated with G2 modules. We integrate the regulatory relations from the expression- and motif-based models into a single network, highlighting specific topologies that result in distinct dynamics of gene expression in the fission yeast cell cycle. Conclusion Our approach provides a biologically-driven, principled way for deconstructing a set of genes into meaningful transcriptional modules and identifying their associated cis-regulatory programs. Our analysis sheds
Rowe, Emily; Hutchinson, D. Jean; Kromer, Ryan A.; Edwards, Tom
Many natural geological hazards are present along the Thompson River corridor in British Columbia, Canada, including one particularly hazardous rocky slope known as the White Canyon. Railway tracks used by Canadian National (CN) and Canadian Pacific (CP) Railway companies pass through this area at the base of the Canyon slope. The geologically complex and weathered rock face exposed at White Canyon is prone to rockfalls. With a limited ditch capacity, these falling rocks have the potential to land on the tracks and therefore increase the risk of train derailment. Since 2012, terrestrial laser scanning (TLS) data has been collected at this site on a regular basis to enable researchers at Queen's University to study these rockfalls in greater detail. In this paper, the authors present a summary of an analysis of these TLS datasets including an examination of the pre-failure deformation patterns exhibited by failed rock blocks as well as an investigation into the influence of structural constraints on the pre-failure behavior of these blocks. Aligning rockfall source zones in an early point cloud dataset to a later dataset generates a transformation matrix describing the movement of the block from one scan to the next. This process was repeated such that the motion of the block over the entire TLS data coverage period was measured. A 3D roto-translation algorithm was then used to resolve the motion into translation and rotation components (Oppikofer et al. 2009; Kromer et al. 2015). Structural information was plotted on a stereonet for further analysis. A total of 111 rockfall events exceeding a volume of 1 m3 were analyzed using this approach. The study reveals that although some rockfall source blocks blocks do not exhibit detectable levels of deformation prior to failure, others do experience cm-level translation and rotation on the order of 1 to 6 degrees before detaching from the slope. Moreover, these movements may, in some cases, be related to the discontinuity
Smith, Christina R.; Marchand-Martella, Nancy E.; Martella, Ronald C.
This study assessed the effects of the "Rocket Math" program on the math fluency skills of a first grade student at risk for school failure. The student received instruction in the "Rocket Math" program over 6 months. He was assessed using a pre- and posttest curriculum-based measurement (CBM) and individualized fluency checkouts within the…
The Program became deeply involved in establishing 4 Washington, D.C., project office diving the last few months of fiscal year 1942. This project office, which reports to the Energy & Environment Division, will receive the majority of its support from the Energy Analysis Program. We anticipate having two staff scientists and support personnel in offices within a few blocks of DOE. Our expectation is that this office will carry out a series of projects that are better managed closer to DOE. We also anticipate that our representation in Washington will improve and we hope to expand the Program, its activities, and impact, in police-relevant analyses. In spite of the growth that we have achieved, the Program continues to emphasize (1) energy efficiency of buildings, (2) appliance energy efficiency standards, (3) energy demand forecasting, (4) utility policy studies, especially integrated resource planning issues, and (5) international energy studies, with considerate emphasis on developing countries and economies in transition. These continuing interests are reflected in the articles that appear in this report.
Eichenfield, Lawrence F; Krakowski, Andrew C
The iPLEDGE protocol for isotretinoin treatment requires multiple steps to be completed within strict timing windows, resulting in many interruptions or discontinuations of treatment. The US Food and Drug Administration has indicated that approximately 40% of isotretinoin prescriptions written over the course of one year of the iPLEDGE program were denied due to failure to comply with iPLEDGE. Insurance restrictions add to the likelihood of prescriptions not being filled. Here, we describe a novel program implemented specifically to assist patients and providers with improving isotretinoin therapy adherence. This innovative isotretinoin support program provides assistance with insurance questions and hurdles, an uninterrupted treatment supply, educational support, reminder communications, and an indigent patient assistance program. Proof-of-concept analysis shows that 17 months after implementation of the program, 93% of prescriptions received have been filled. Utilization of the program appears to improve adherence to an isotretinoin treatment regimen, with fewer interruptions due directly to unfilled prescriptions.
Tehrani, Faramarz; Dhesi, Pavittarpaul; Daneshvar, Daniel; Phan, Anita; Rafique, Asim; Siegel, Robert J; Cercek, Bojan
Anemia is prevalent in patients with heart failure and an independent prognostic sign of poor outcome. The current report is a meta-analysis of published clinical trials assessing the use of erythropoeisis stimulating agents (ESA) in heart failure (HF) patients with anemia. Literature and Medline search was performed to identify studies with control groups (case-control, cohort or randomized controlled trials) that examined the effect of ESA therapy in patients with HF and anemia. Seven prospective controlled trials met inclusion criteria (n = 663 subjects). The ESA studied was darbepoetin in 4 trials and erythropoietin in 3 trials. Mean follow up period ranged from 12 to 27 weeks. Compared to placebo ESA therapy was associated with improvement in six cardiovascular parameters assessed by at least three of the analyzed trials, including increase in hemoglobin levels 2.35(95% confidence interval [Cl], 1.76-2.93, P < 0.00001), increase in exercise duration 0.91(95% Cl, 0.08-1.73, P = 0.03), improvement in New York Heart Association functional class -1.46(95% Cl, -2.32 to -0.60, P = 0.0009), improvement in 6-minute walk test 1.42(95% Cl, 0.31-2.54, P = 0.01), decrease in B-type natriuretic peptide -0.54(95% Cl, -1.03 to -0.06, P = 0.03), and improvement in peak oxygen consumption 0.93(95% Cl, 0.52-1.34, P < 0.00001). In patients with heart failure and anemia, erythropoiesis stimulating agent therapy appears to have a positive effect on several important cardiovascular parameters, compared to control therapy. Large prospective randomized controlled trials are warranted to comprehensively evaluate the potential effects of erythropoiesis stimulating agents on clinical outcomes in heart failure patients with anemia.
Rienzi, L; Bariani, F; Dalla Zorza, M; Albani, E; Benini, F; Chamayou, S; Minasi, M G; Parmegiani, L; Restelli, L; Vizziello, G; Costa, A Nanni
Can traceability of gametes and embryos be ensured during IVF? The use of a simple and comprehensive traceability system that includes the most susceptible phases during the IVF process minimizes the risk of mismatches. Mismatches in IVF are very rare but unfortunately possible with dramatic consequences for both patients and health care professionals. Traceability is thus a fundamental aspect of the treatment. A clear process of patient and cell identification involving witnessing protocols has to be in place in every unit. To identify potential failures in the traceability process and to develop strategies to mitigate the risk of mismatches, previously failure mode and effects analysis (FMEA) has been used effectively. The FMEA approach is however a subjective analysis, strictly related to specific protocols and thus the results are not always widely applicable. To reduce subjectivity and to obtain a widespread comprehensive protocol of traceability, a multicentre centrally coordinated FMEA was performed. Seven representative Italian centres (three public and four private) were selected. The study had a duration of 21 months (from April 2015 to December 2016) and was centrally coordinated by a team of experts: a risk analysis specialist, an expert embryologist and a specialist in human factor. Principal investigators of each centre were first instructed about proactive risk assessment and FMEA methodology. A multidisciplinary team to perform the FMEA analysis was then formed in each centre. After mapping the traceability process, each team identified the possible causes of mistakes in their protocol. A risk priority number (RPN) for each identified potential failure mode was calculated. The results of the FMEA analyses were centrally investigated and consistent corrective measures suggested. The teams performed new FMEA analyses after the recommended implementations. In each centre, this study involved: the laboratory director, the Quality Control & Quality
IBM-PC usable versions of several computer models useful in particulate control are provided. The models were originally written for the TRS-80 Model I-III series of microcomputers and have been translated to run on the IBM-PC. The documentation for the TRS-80 versions applies to the IBM-PC versions. The programs are written in FORTRAN and are provided in both source (FORTRAN) and executable form. Some small machine language routines are used to format the screen for data entry. These routines limit the programs to IBM-PC and close clones. The minimum hardware requirements are 256K IBM-PC or close clone, a monochrome monitor, and a disk drive. A printer is useful but not required. The following computer programs are provided in the four-disk package: (1) ESP section failure model, (2) GCA/EPA baghouse model, (3) Plume opacity prediction model, and (4) In-stack opacity calculator. All the models are documented in EPA report Microcomputer Programs for Particulate Control, EPA-600/8-85-025a (PB86-146529). The models provide useful tools for those involved in particulate control.
Full Text Available This paper presents an algorithm designed for the analysis of a sedimentary sample of unconsolidated material and seeks to identify very quickly the main features that occur in a sediment and thus classify them fast and efficiently. For this purpose, it requires that the weight of each particle size to be entered in the program and using the method of Moments, which is based on four equations representing the mean, standard deviation, skewness and kurtosis, is found the attributes of the sample in few seconds. With the program these calculations are performed in an effective and more accurately way, obtaining also the explanations of the results of the features such as grain size, sorting, symmetry and origin, which helps to improve the study of sediments and in general the study of sedimentary rocks.
Zalevsky, Zeev; Gur, Eran
New Approaches to Image Processing Based Failure Analysis of Nano-Scale ULSI Devices introduces the reader to transmission and scanning microscope image processing for metal and non-metallic microstructures. Engineers and scientists face the pressing problem in ULSI development and quality assurance: microscopy methods can't keep pace with the continuous shrinking of feature size in microelectronics. Nanometer scale sizes are below the resolution of light, and imaging these features is nearly impossible even with electron microscopes, due to image noise. This book presents novel ""smart"
Bonded structure, can be either considered a multilayer material system, where its sublayers are held together through media that provide adhesion, or an adhesive joint designated for the assembly of different parts involved in a structure. For the assessment of the adhesion strength...... that characterizes a given bondline, both its cohesive strength and fracture toughness material parameters must be experimentally defined. Based on these properties, failure analysis of the bondline can be done either through stress- or energy-based criteria. The aim of this work is to investigate the effectiveness...
West, Ole H.E.; Dahl, Kristian Vinter; Christiansen, Thomas Lundin
the influence of different alloying concepts, prior heat treatments and nitriding parameters on the case properties. With optimum nitriding conditions a maximum nitriding depth of 800 μm was achieved, without formation of a thick porous compound layer. The build-up of near surface compressive stresses...... was confirmed by synchrotron X–ray diffraction stress analysis. The performance of surface engineered rollers was evaluated by RCF testing under conditions that are known to provoke failure in rollers made from a standard bearing steel. One of the nitrided materials showed promising results....
Necas, Libor; Hrubina, Maros; Cibula, Zoltan; Behounek, Jiri; Krivanek, Stanislav; Horak, Zdenek
The study was aimed at the clinical and biomechanical analyses of the sliding hip screw breakage with the use of finite element method. We have identified two patients with the sliding screw breakage. In the first patient, the biomechanical analysis revealed the reduced stress values σHMH not exceeding the yield limit or strength limit of the implant. The yield limit was exceeded in second one. Clinical and biomechanical analyses have demonstrated that adherence to technical requirements of the appropriate osteosynthesis implementation is the principal condition of timely healing since it prevents the material failure.
Stecki, J. S.; Conrad, Finn; Oh, B.
Offshore, marine,aircraft and other complex engineering systems operate in harsh environmental and operational conditions and must meet stringent requirements of reliability, safety and maintability. To reduce the hight costs of development of new systems in these fields improved the design...... management techniques and a vast array of computer aided techniques are applied during design and testing stages. The paper present and discusses the research and development of a software tool for automated failure mode and effects analysis - FMEA - of hydraulic systems. The paper explains the underlying...
Krebs, Frederik C; Norrman, Kion
elucidated by the time-of-flight secondary ion mass spectrometry (TOF-SIMS) analysis in conjunction with isotopic labelling using O-18(2) after a total testing time of 13 000 h. This experiment allowed us to understand the chemistry that takes place in three dimensions during degradation and failure...... of the device under accelerated testing conditions. The cell was subjected to continuous illumination with an incident light intensity of 1000 W m(-2) (AM1.5) at 72 +/- 2 degrees C under a vacuum of...
Ceccarelli, L.; Reigosa, P. D.; Iannuzzo, F.
The aim of this paper is to provide an extensive overview about the state-of-art commercially available SiC power MOSFET, focusing on their short-circuit ruggedness. A detailed literature investigation has been carried out, in order to collect and understand the latest research contribution within...... this topic and create a survey of the present scenario of SiC MOSFETs reliability evaluation and failure mode analysis, pointing out the evolution and improvements as well as the future challenges in this promising device technology....
Li, Bo; Hu, Weiye
Failure analysis on a fractured radome framework component was carried out through visual observations, metallographic examination using optical microscope, fractog-raphy inspections using scanning electron microscope and chemical composition analysis. The failed frame was made of casting Al-Si7-Mg0.4 aluminum alloy. It had suffered a former vi-bration performance tests. It was indicated that the fractures were attributed to fatigue cracks which were induced by casting porosities at the outer surfaces of frame. Failure analysis was carefully conducted for the semi-penetrating crack appearing on the framework. According to the fractography inspected by scanning electron microscope, it was indicated that numerous casting porosities at the outer surface of the framework played the role of multiple fracture sources due to some applied stresses. Optical microstructure observations suggested that the dendrite-shaped casting porosities largely contributed to the crack-initiation. The groove-shaped structure at roots of spatial convex-bodies on the edge of casting porosities supplied the preferred paths of the crack-propagation. Besides, the brittle silicon eutectic particles distrib-uting along grain boundaries induced the intergranular fracture mode in the region of the over-load final fracture surface.
Giménez, Ana; Gagliardi, Andrés; Ares, Gastón
For most food products, shelf life is determined by changes in their sensory characteristics. A predetermined increase or decrease in the intensity of a sensory characteristic has frequently been used to signal that a product has reached the end of its shelf life. Considering all attributes change simultaneously, the concept of multivariate shelf life allows a single measurement of deterioration that takes into account all these sensory changes at a certain storage time. The aim of the present work was to apply survival analysis to estimate failure criteria in multivariate sensory shelf life testing using two case studies, hamburger buns and orange juice, by modelling the relationship between consumers' rejection of the product and the deterioration index estimated using PCA. In both studies, a panel of 13 trained assessors evaluated the samples using descriptive analysis whereas a panel of 100 consumers answered a "yes" or "no" question regarding intention to buy or consume the product. PC1 explained the great majority of the variance, indicating all sensory characteristics evolved similarly with storage time. Thus, PC1 could be regarded as index of sensory deterioration and a single failure criterion could be estimated through survival analysis for 25 and 50% consumers' rejection. The proposed approach based on multivariate shelf life testing may increase the accuracy of shelf life estimations. Copyright © 2017 Elsevier Ltd. All rights reserved.
Meng, Karin; Musekamp, Gunda; Seekatz, Bettina; Glatz, Johannes; Karger, Gabriele; Kiwus, Ulrich; Knoglinger, Ernst; Schubmann, Rainer; Westphal, Ronja; Faller, Hermann
Chronic heart failure requires a complex treatment regimen on a life-long basis. Therefore, self-care/self-management is an essential part of successful treatment and comprehensive patient education is warranted. However, specific information on program features and educational strategies enhancing treatment success is lacking. This trial aims to evaluate a patient-oriented and theory-based self-management educational group program as compared to usual care education during inpatient cardiac rehabilitation in Germany. The study is a multicenter cluster randomized controlled trial in four cardiac rehabilitation clinics. Clusters are patient education groups that comprise HF patients recruited within 2 weeks after commencement of inpatient cardiac rehabilitation. Cluster randomization was chosen for pragmatic reasons, i.e. to ensure a sufficient number of eligible patients to build large-enough educational groups and to prevent contamination by interaction of patients from different treatment allocations during rehabilitation. Rehabilitants with chronic systolic heart failure (n = 540) will be consecutively recruited for the study at the beginning of inpatient rehabilitation. Data will be assessed at admission, at discharge and after 6 and 12 months using patient questionnaires. In the intervention condition, patients receive the new patient-oriented self-management educational program, whereas in the control condition, patients receive a short lecture-based educational program (usual care). The primary outcome is patients' self-reported self-management competence. Secondary outcomes include behavioral determinants and self-management health behavior (symptom monitoring, physical activity, medication adherence), health-related quality of life, and treatment satisfaction. Treatment effects will be evaluated separately for each follow-up time point using multilevel regression analysis, and adjusting for baseline values. This study evaluates the effectiveness of a
Ko, William L.
The operational life analysis of any airborne failure-critical structural component requires the stress-load equation, which relates the applied load to the maximum tangential tensile stress at the critical stress point. The failure-critical structural components identified are the B-52B Pegasus pylon adapter shackles, B-52B Pegasus pylon hooks, B-52H airplane pylon hooks, B-52H airplane front fittings, B-52H airplane rear pylon fitting, and the B-52H airplane pylon lower sway brace. Finite-element stress analysis was performed on the said structural components, and the critical stress point was located and the stress-load equation was established for each failure-critical structural component. The ultimate load, yield load, and proof load needed for operational life analysis were established for each failure-critical structural component.
Nouri Gharahasanlou, Ali; Mokhtarei, Ashkan; Khodayarei, Aliasqar; Ataei, Mohammad
Evaluating and analyzing the risk in the mining industry is a new approach for improving the machinery performance. Reliability, safety, and maintenance management based on the risk analysis can enhance the overall availability and utilization of the mining technological systems. This study investigates the failure occurrence probability of the crushing and mixing bed hall department at Azarabadegan Khoy cement plant by using fault tree analysis (FTA) method. The results of the analysis in 200 h operating interval show that the probability of failure occurrence for crushing, conveyor systems, crushing and mixing bed hall department is 73, 64, and 95 percent respectively and the conveyor belt subsystem found as the most probable system for failure. Finally, maintenance as a method of control and prevent the occurrence of failure is proposed.
... 34 Education 3 2010-07-01 2010-07-01 false What is the State Program Analysis Assistance and Policy Studies Program? 477.1 Section 477.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION STATE PROGRAM ANALYSIS ASSISTANCE AND POLICY STUDIES PROGRAM...
Marcia, S. Marx; Alicia, R. Pannell; Parpura-Gill, Aleksandra; Cohen-Mansfield, Jiska
Ten elementary school students in need of a positive self-image and/or a sense of appropriate social conduct took part in a monthly intergenerational visiting program at an assisted living facility. In comparison to systematic observations obtained in their classrooms, the children were observed to be significantly less anxious, more interested,…
Full Text Available By combining incident learning and process failure-mode-and-effects-analysis in a structure-process-outcome framework we have created a risk profile for our radiation medicine practice and implemented evidence-based risk mitigation initiatives focused on patient safety. Based on reactive reviews of incidents reported in our departmental incident-reporting system and proactive failure-mode-and-effects-analysis, high safety-risk procedures in our paperless radiation medicine process and latent risk factors were identified. Six initiatives aimed at the mitigation of associated severity, likelihood of occurrence and detectability risks were implemented. These were the standardization of care pathways and toxicity grading, pre-treatment-planning peer review, a policy to thwart delay-rushed processes, an electronic whiteboard to enhance coordination and the use of six-sigma metrics to monitor operational efficiencies. The effectiveness of these initiatives over a three year period was assessed using process and outcome specific metrics within the framework of the department structure. There has been a 47% increase in incident reporting, with no increase in adverse events. Care pathways have been used with greater than 97% clinical compliance rate. The implementation of peer review prior to treatment planning and use of the whiteboard have provided opportunities for proactive detection and correction of errors. There has been a twofold drop in the occurrence of high-risk procedural delays. Patient treatment start delays are routinely enforced on cases that would have historically been rushed. Z-scores for high risk procedures have steadily improved from 1.78 to 2.35. The initiatives resulted in sustained reductions of failure-mode risks as measured by a set of evidence-based metrics over a three year period. These augment or incorporate many of the published recommendations for patient safety in radiation medicine by translating them to clinical
Full Text Available Purpose: Esteya® (Nucletron, an Elekta company, Elekta AB, Stockholm, Sweden is an electronic brachytherapy device used for skin cancer lesion treatment. In order to establish an adequate level of quality of treatment, a risk analysis of the Esteya treatment process has been done, following the methodology proposed by the TG-100 guidelines of the American Association of Physicists in Medicine (AAPM. Material and methods: A multidisciplinary team familiar with the treatment process was formed. This team developed a process map (PM outlining the stages, through which a patient passed when subjected to the Esteya treatment. They identified potential failure modes (FM and each individual FM was assessed for the severity (S, frequency of occurrence (O, and lack of detection (D. A list of existing quality management tools was developed and the FMs were consensually reevaluated. Finally, the FMs were ranked according to their risk priority number (RPN and their S. Results : 146 FMs were identified, 106 of which had RPN ≥ 50 and 30 had S ≥ 7. After introducing the quality management tools, only 21 FMs had RPN ≥ 50. The importance of ensuring contact between the applicator and the surface of the patient’s skin was emphasized, so the setup was reviewed by a second individual before each treatment session with periodic quality control to ensure stability of the applicator pressure. Some of the essential quality management tools are already being implemented in the installation are the simple templates for reproducible positioning of skin applicators, that help marking the treatment area and positioning of X-ray tube. Conclusions : New quality management tools have been established as a result of the application of the failure modes and effects analysis (FMEA treatment. However, periodic update of the FMEA process is necessary, since clinical experience has suggested occurring of further new possible potential failure modes.
Purpose Medication management is a complex process, at high risk of error with life threatening consequences. The focus should be on devising strategies to avoid errors and make the process self-reliable by ensuring prevention of errors and/or error detection at subsequent stages. The purpose of this paper is to use failure mode effect analysis (FMEA), a systematic proactive tool, to identify the likelihood and the causes for the process to fail at various steps and prioritise them to devise risk reduction strategies to improve patient safety. Design/methodology/approach The study was designed as an observational analytical study of medication management process in the inpatient area of a multi-speciality hospital in Gurgaon, Haryana, India. A team was made to study the complex process of medication management in the hospital. FMEA tool was used. Corrective actions were developed based on the prioritised failure modes which were implemented and monitored. Findings The percentage distribution of medication errors as per the observation made by the team was found to be maximum of transcription errors (37 per cent) followed by administration errors (29 per cent) indicating the need to identify the causes and effects of their occurrence. In all, 11 failure modes were identified out of which major five were prioritised based on the risk priority number (RPN). The process was repeated after corrective actions were taken which resulted in about 40 per cent (average) and around 60 per cent reduction in the RPN of prioritised failure modes. Research limitations/implications FMEA is a time consuming process and requires a multidisciplinary team which has good understanding of the process being analysed. FMEA only helps in identifying the possibilities of a process to fail, it does not eliminate them, additional efforts are required to develop action plans and implement them. Frank discussion and agreement among the team members is required not only for successfully conducing
Safiyari-Hafizi, Hedieh; Taunton, Jack; Ignaszewski, Andrew; Warburton, Darren E R
Recently, high-intensity interval training has been advocated for the rehabilitation of persons living with heart failure (HF). Home-based training is more convenient for many patients and could augment compliance. However, the safety and efficacy of home-based interval training remains unclear. We evaluated the safety and efficacy of a supervised home-based exercise program involving a combination of interval and resistance training. Measures of aerobic power, endurance capacity, ventilatory threshold, and quality of life in 40 patients with HF, were taken at baseline and after 12 weeks. Patients were matched and randomized to either control (CTL; n = 20) or experimental (EXP; n = 20) conditions. The EXP group underwent a 12-week high-intensity interval and resistance training program while the CTL group maintained their usual activities of daily living. In the EXP group, we found a significant improvement in aerobic power, endurance capacity, ventilatory threshold, and quality of life. There were no significant changes in the CTL group. We have shown that a home-based cardiac rehabilitation program involving interval and resistance training is associated with improved aerobic capacity and quality of life in patients with HF. This research has important implications for the treatment of HF. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
Ana González Rodríguez
Full Text Available Los programas de continuidad de cuidados surgen a finales de los años 70 en EEUU, en respuesta a los problemas detectados durante del proceso de desintitucionalización de los hospitales psiquiátricos. Desde entonces, se han extendido por todo el mundo, con variaciones y peculiaridades según las regiones, convirtiéndose en piedra angular de la atención a las personas con enfermedad mental grave y persistente. En este artículo se revisa el origen de estos programas, su desarrollo a lo largo de más de treinta años, la filosofía que los ha guiado en su devenir, así como los éxitos y fracasos en su desarrollo.The case management programs arise in the late 70's in the U.S., in response to problems identified during the process of deinstitutionalization of psychiatric hospitals. Since then, the case management and the assertive community treatment programs have spread throughout the world, with variations and particularities in different regions, becoming the cornerstone of the community care for people with severe and persistent mental illness. This article reviews the origins of these programs in U.S., their development for over thirty years around the world, the philosophy and objectives that have guided its evolution, as well as successes and failures in their development.
Mohammadzadeh, Niloofar; Safdari, Reza; Baraani, Alireza; Mohammadzadeh, Farshid
Intelligent data analysis has ability to prepare and present complex relations between symptoms and diseases, medical and treatment consequences and definitely has significant role in improving follow-up management of chronic heart failure (CHF) patients, increasing speed and accuracy in diagnosis and treatments; reducing costs, designing and implementation of clinical guidelines. The aim of this article is to describe intelligent data analysis methods in order to improve patient monitoring in follow and treatment of chronic heart failure patients as the best approach for CHF follow up management. Minimum data set (MDS) requirements for monitoring and follow up of CHF patient designed in checklist with six main parts. All CHF patients that discharged in 2013 from Tehran heart center have been selected. The MDS for monitoring CHF patient status were collected during 5 months in three different times of follow up. Gathered data was imported in RAPIDMINER 5 software. Modeling was based on decision trees methods such as C4.5, CHAID, ID3 and k-Nearest Neighbors algorithm (K-NN) with k=1. Final analysis was based on voting method. Decision trees and K-NN evaluate according to Cross-Validation. Creating and using standard terminologies and databases consistent with these terminologies help to meet the challenges related to data collection from various places and data application in intelligent data analysis. It should be noted that intelligent analysis of health data and intelligent system can never replace cardiologists. It can only act as a helpful tool for the cardiologist's decisions making.
The occurrence of poor patient care is emerging as one of the most significant, challenging, and critical issues confronting contemporary nursing and those responsible for the provision of health care more generally. Indeed, as a consequence of the increased recognition of the manner in which nurses can be implicated in the occurrence of poor patient care, there has been sustained critical debate that seeks to understand how such healthcare failings can occur and, in particular, why nurses seemingly fail to intervene, raise concerns, and effectively respond to prevent the occurrence and continuation of such poor patient care. In seeking to contribute to this critical discussion, and in contrast to those "situational explanations" that maintain that the failure to raise concerns is a consequence of the contextual factors and challenging conditions to which nurses can be subject in the clinical setting, this paper will provide a resolutely philosophical analysis of that failure. In particular, it will draw upon the work of Jean-Paul Sartre-the French philosopher generally regarded as one of the most influential thinkers of the twentieth century-in order to propose that his work can be productively recontextualized to provide a detailed, challenging, and provocative critical analysis of the occurrence and continuation of poor patient care and the role of individual nurse practitioners in such healthcare failings. © 2016 John Wiley & Sons Ltd.
Muñoz-Diosdado, A.; del Río Correa, J. L.
Many physical and biological systems exhibit complex behavior characterized by long-range power-law correlations. Detrended fluctuation analysis (DFA) is a scaling analysis method that provides a scaling parameter to represent the correlation properties of a signal. The study of interbeat sequences with the DFA method has revealed the presence of crossovers associated with physiological aging and heart with failure; the hinges present in the crossover region from both the elderly healthy individuals and the patients with congestive heart failure (CHF) are in opposite directions. The interbeat sequences of healthy young persons do not show crossovers. In this paper we study interbeat time series of healthy young and elderly persons and patients with CHF. We use the DFA-m method, where m refers to the order of the polynomial function used for the fitting. For instance, DFA-2 filters linear trends and DFA-3 filters quadratic trends. We found that the presence of the crossovers and the direction of the hinges are conserved when we apply the DFA method for different values of m. Therefore we conclude that the DFA-m method is a reliable method to accurately quantify correlations in interbeat time series even if there are polynomial trends. We can characterize the crossovers and we can conclude that the crossovers are not a result of the trends; they are part of the system dynamics.
Liao, Ching-Jong; Ho, Chao Chung, E-mail: email@example.com
Highlights: • This study is based on a real case in hospital in Taiwan. • We use Failure Mode and Effects Analysis (FMEA) as the evaluation method. • We successfully identify the evaluation factors of bio-medical waste disposal risk. - Abstract: Using the failure mode and effects analysis, this study examined biomedical waste companies through risk assessment. Moreover, it evaluated the supervisors of biomedical waste units in hospitals, and factors relating to the outsourcing risk assessment of biomedical waste in hospitals by referring to waste disposal acts. An expert questionnaire survey was conducted on the personnel involved in waste disposal units in hospitals, in order to identify important factors relating to the outsourcing risk of biomedical waste in hospitals. This study calculated the risk priority number (RPN) and selected items with an RPN value higher than 80 for improvement. These items included “availability of freezing devices”, “availability of containers for sharp items”, “disposal frequency”, “disposal volume”, “disposal method”, “vehicles meeting the regulations”, and “declaration of three lists”. This study also aimed to identify important selection factors of biomedical waste disposal companies by hospitals in terms of risk. These findings can serve as references for hospitals in the selection of outsourcing companies for biomedical waste disposal.
Fu Ronghua; Yao Baokui; Sun Yuke
Bai Huichang landslide is a large scale landslide which is of the character of leveled pushing slide and collapse. To study the failure mechanism of the landslide, to analyse the reasons for failure of the landslide, to evaluate and to predict the stability of the slope, systematic tests of physico-mechanical properties of the clay rock on the sliding surface and analysis of the constituents of the substances are made. Tests on slope models made of photo-elastic material and of blocks are made. The results show that the landslide is a typical one with leveled pushing slide and collapse character, and the main reason for the landslide is the poor physico-mechanical properties and the poor water-stable properties of the clay rock which contain a vast amount of the montmorillonite. The deformation of the slope model is very similar to that of the actual slope. Regression analysis of the observed deformation of the slope indicates that the deformation decays at a rate about 70% each year. It means that the landslide will tend to be stable and no serious landslide will occur which will endanger the safety of Changhangou Colliery. 3 references.
Gu, Ja-Uk; Choi, Nak-Sam
In this study, a nondestructive method based on acoustic emission (AE) analysis was developed to evaluate the marginal failure states of dental composite restorations. Three types of ring-shaped substrates, which were modeled after a Class I cavity, were prepared from polymethyl methacrylate, stainless steel, and human molar teeth. A bonding agent and a composite resin were applied to the ring-shaped substrates and cured by light exposure. At each time-interval measurement, the tooth substrate presented a higher number of AE hits than polymethyl methacrylate and steel substrates. Marginal disintegration estimations derived from cumulative AE hits and cumulative AE energy parameters showed that a signification portion of marginal gap formation was already realized within 1 min at the initial light-curing stage. Estimation based on cumulative AE energy gave a higher level of marginal failure than that based on AE hits. It was concluded that the AE analysis method developed in this study was a viable approach in predicting the clinical survival of dental composite restorations efficiently within a short test period.
Vanessa Blanco; Paul Rohde; Fernando L. Vázquez; Patricia Otero
The purpose of this study was to identify subgroups of university students with the highest likelihood of remaining at elevated levels of depressive symptoms six months following the receipt of a depressive prevention intervention on the basis of known risk factors and participation in one of two depression prevention programs. Data from a randomized controlled trial evaluating depression prevention among 133 college students with elevated depressive symptoms were analyzed. Participants were ...
Full Text Available Introduction: The burden of cardiovascular disease is increasing in India. It is a chronic condition, and poor management can increase the risk and frequency of acute episodes resulting in poor quality of life (QOL, frequent hospital admissions, and mortality. Disease management programs can improve medication adherence and patient's QOL. Objective: The aim of this study is to assess the effectiveness of nurse-led home-based heart failure management program (HOME-N. Materials and Methods: This randomized controlled trial was conducted among fifty outpatient heart failure (HF patients visiting a tertiary care hospital. The control group received usual routine care, whereas the experimental group received HOME-N, which included formal health teaching, a HF checklist (Hriday card, telemonitoring of vital parameters (blood pressure, heart rate, and weight weekly through a mobile application named as “Dhadkan” and telephonic follow-up for 3 months. Kansas City Cardiomyopathy Questionnaire (KCCQ and adherence to refills and medications scale were used to assess QOL and drug adherence, respectively, in the study patients. The outcome measures were the QOL, drug compliance, hospitalization, and mortality rate. Results: At baseline, the demographic and morbidity profile, and QOL and drug compliance scores of both groups were comparable. After intervention, the QOL domain score of KCCQ as well as drug compliance improved significantly both within the experimental group (P = 0.001, P = 0.001 and as compared to control group (P = 0.001, P = 0.004, respectively. Conclusion: The HOME-N was significantly effective in improving QOL and drug compliance in HF patients.
Sarabia Jose Manuel
Full Text Available This study examined the effects of a 6-week non-failure strength training program in youth tennis players. Twenty tennis players (age: 15.0 ± 1 years, body height: 170.9 ± 5.1 cm, body mass: 63.3 ± 9.1 kg were divided into experimental and control groups. Pre and post-tests included half squats, bench press, squat jumps, countermovementjumps and side-ball throws. Salivary cortisol samples were collected, and the Profile of Mood States questionnaire was used weekly during an anatomical adaptation period, a main training period and after a tapering week. The results showed that, after the main training period, the experimental group significantly improved (p<0.05 in mean and peak power output and in the total number of repetitions during the half-squat endurance test; mean force, power and velocity in the half-squat power output test; Profile of Mood States (in total mood disturbance between the last week of the mean training period and the tapering week; and in squat-jump and countermovement-jump height. Moreover, significant differences were found between the groups at the post-tests in the total number of repetitions, mean and peak power during the half-squat endurance test, mean velocity in the half-squat power output test, salivary cortisol concentration (baselines, first and third week of the mean training period and in the Profile of Mood States (in fatigue subscale: first and third week of the mean training period. In conclusion, a non-failure strength training protocol improved lower-limb performance levels and produced a moderate psychophysiological impact in youth elite tennis players, suggesting that it is a suitable program to improve strength. Such training protocols do not increase the total training load of tennis players and may be recommended to improve strength.
Courter, Joshua D; Baker, William L; Nowak, Katherine S; Smogowicz, Lori A; Desjardins, Lindsey L; Coleman, Craig I; Girotto, Jennifer E
Macrolide antibiotics are often used to treat children with acute otitis media (AOM); however, the 2004 American Academy of Pediatrics (AAP) and American Academy of Family Physicians guidelines recommend against their use in patients without history of a type I allergic reaction to penicillins. To evaluate via meta-analysis the comparative efficacy of amoxicillin or amoxicillin/clavulanate to that of macrolide antibiotics in the treatment of children with AOM. A systematic literature search of MEDLINE, EMBASE, and International Pharmaceutical Abstracts was conducted from the earliest available date through September 2008. We used the following MeSH and key words: amoxicillin, amoxicillin/clavulanate, Augmentin, azithromycin, ceftriaxone, clarithromycin, macrolides, AND media, otitis media, and effusion. Included studies were randomized, blinded, and controlled trials evaluating guideline-recommended antibiotics (amoxicillin or amoxicillin/clavulanate) compared to macrolide antibiotics (azithromycin or clarithromycin) in AOM in children. The primary outcome assessed was clinical failure measured between days 10 and 16 after starting antibiotic therapy. Results are reported as relative risks (RRs) with 95% confidence intervals and were calculated using a random-effects model. A total of 10 trials (N = 2766) evaluating children 6 months-15 years old were included in the meta-analysis. Upon meta-analysis, the use of macrolide antibiotics was associated with an increased risk of clinical failure (RR 1.31 [95% CI 1.07 to 1.60]; p = 0.008) corresponding to a number needed to harm of 32. Upon safety analysis, rates of any adverse reaction (RR 0.74 [95% CI 0.60 to 0.90]; p = 0.003) and diarrhea (RR 0.41 [95% CI 0.32 to 0.52]; p macrolide group. The meta-analysis suggests that patients treated with macrolides for AOM may be more likely to have clinical failures. As such, it supports the current AAP AOM recommendation that macrolides be reserved for patients who can not
Lee, Heesun; Park, Jun-Bean; Choi, Sae Won; Yoon, Yeonyee E; Park, Hyo Eun; Lee, Sang Eun; Lee, Seung-Pyo; Kim, Hyung-Kwan; Cho, Hyun-Jai; Choi, Su-Yeon; Lee, Hae-Young; Choi, Jonghyuk; Lee, Young-Joon; Kim, Yong-Jin; Cho, Goo-Yeong; Choi, Jinwook; Sohn, Dae-Won
Despite the advances in the diagnosis and treatment of heart failure (HF), the current hospital-oriented framework for HF management does not appear to be sufficient to maintain the stability of HF patients in the long term. The importance of self-care management is increasingly being emphasized as a promising long-term treatment strategy for patients with chronic HF. The objective of this study was to evaluate whether a new information communication technology (ICT)-based telehealth program with voice recognition technology could improve clinical or laboratory outcomes in HF patients. In this prospective single-arm pilot study, we recruited 31 consecutive patients with chronic HF who were referred to our institute. An ICT-based telehealth program with voice recognition technology was developed and used by patients with HF for 12 weeks. Patients were educated on the use of this program via mobile phone, landline, or the Internet for the purpose of improving communication and data collection. Using these systems, we collected comprehensive data elements related to the risk of HF self-care management such as weight, diet, exercise, medication adherence, overall symptom change, and home blood pressure. The study endpoints were the changes observed in urine sodium concentration (uNa), Minnesota Living with Heart Failure (MLHFQ) scores, 6-min walk test, and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) as surrogate markers for appropriate HF management. Among the 31 enrolled patients, 27 (87%) patients completed the study, and 10 (10/27, 37%) showed good adherence to ICT-based telehealth program with voice recognition technology, which was defined as the use of the program for 100 times or more during the study period. Nearly three-fourths of the patients had been hospitalized at least once because of HF before the enrollment (20/27, 74%); 14 patients had 1, 2 patients had 2, and 4 patients had 3 or more previous HF hospitalizations. In the total study
Full Text Available The aim of this study is to evaluate how far the detrended fluctuation analysis (DFA approach helps to characterize the short-term and intermediate-term fractal correlations in the raw electrocardiogram (ECG signals and thereby discriminate between normal and congestive heart failure (CHF subjects. The DFA-1 calculations were performed on normal and CHF short-term ECG segments, of the order of 20 seconds duration. Differences were found in shortterm and intermediate-term correlation properties and the corresponding scaling exponents of the two groups (normal and CHF. The statistical analyses show that short-term fractal scaling exponent alone is sufficient to distinguish between normal and CHF subjects. The receiver operating characteristic curve (ROC analysis confirms the robustness of this new approach and exhibits an average accuracy that exceeds 98.2%, average sensitivity of about 98.4%, positive predictivity of 98.00%, and average specificity of 98.00%.
Murphy, Michael M; Ellenberger, John L; Esterhuizen, Gabriel S; Miller, Tim
A limestone mine in Ohio has had instability problems that have led to massive roof falls extending to the surface. This study focuses on the role that weak, moisture-sensitive floor has in the instability issues. Previous NIOSH research related to this subject did not include analysis for weak floor or weak bands and recommended that when such issues arise they should be investigated further using a more advanced analysis. Therefore, to further investigate the observed instability occurring on a large scale at the Ohio mine, FLAC3D numerical models were employed to demonstrate the effect that a weak floor has on roof and pillar stability. This case study will provide important information to limestone mine operators regarding the impact of weak floor causing the potential for roof collapse, pillar failure, and subsequent subsidence of the ground surface.
Shi, Quan; Xu, Juan; Huo, Na; Cai, Chuan; Liu, Hongchen
Owing to limited evidence, it is unclear whether diabetes that is not well controlled would lead to a higher rate of dental implant failure. The authors of this meta-analysis evaluated whether the failure rate for patients with diabetes that was not well controlled was higher than the failure rate for patients with well-controlled diabetes. The authors searched PubMed, the Cochrane Library, and ClinicalTrials.gov without limitations for studies whose investigators compared the dental implant failure rates between patients with well-controlled diabetes and diabetes that was not well controlled. The authors pooled the relative risk (RR) and 95% confidence interval (CI) values to estimate the relative effect of the glycemic level on dental implant failures. The authors used a subgroup analysis to identify the association between the implant failure rate and the stage at which the failure occurred. The authors included 7 studies in this meta-analysis, including a total of 252 patients and 587 dental implants. The results of the pooled analysis did not indicate a direct association between the glycemic level in patients with diabetes and the dental implant failure rate (RR, 0.620; 95% CI, 0.225-1.705). The pooled RR in the subgroup of patients who experienced early implant failure was 0.817 (95% CI, 0.096-6.927), whereas in the subgroup of patients who experienced late implant failure, the pooled RR was 0.572 (95% CI, 0.206-1.586). On the basis of the evidence, the results of this meta-analysis failed to show a difference in the failure rates for dental implants between patients with well-controlled diabetes and patients with diabetes that was not well controlled. However, considering the limitations associated with this meta-analysis, the authors determined that future studies that are well designed and provide adequate controls for confounding factors are required. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.
Kim, Hyunwoo; Seo, Hye Mi; Kim, Ji Young; Kim, Miyeon
Segmental bioimpedance analysis (BIA) can identify fluid volume changes in the arms of patients on hemodialysis (HD) after vascular access surgery. We investigated whether the difference in fluid volumes between the arms of the patients using segmental BIA is associated with vascular access outcome. Body composition measurements were taken for 127 patients on HD with segmental, multi-frequency BIA equipment (InBody 1.0, Biospace Co. Ltd, Seoul, Korea). The difference in fluid volume between the arms of the patients was calculated from the fluid volume of the arm with the vascular access minus that of the other. The primary outcome was the loss of vascular access patency within 3 months of BIA measurement. The median absolute and relative inter-arm fluid volume differences were 150 ml [interquartile range (IQR) 90-250 ml] and 9.6% (IQR 4.9-14.4%), respectively. Within 3 months of BIA measurement, 38 patients (30.0%) experienced vascular access failure. When the patients were divided into three groups based on the tertiles of relative inter-arm fluid volume differences (lowest tertile: 12.7%), greater difference in relative inter-arm fluid volume differences was associated with higher vascular access failure rates (14 vs. 28 vs. 48%, p value for trend across tertiles = 0.003). We conclude that segmental BIA may be used as a tool that can predict vascular access failure in patients on HD by calculating the relative difference in fluid volume between the arms of the patients with and without vascular access.
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Shah, Nikhil; Reintjes, Frances; Courtney, Mark; Klarenbach, Scott W; Ye, Feng; Schick-Makaroff, Kara; Jindal, Kailash; Pauly, Robert P
Little is known about patients exiting home hemodialysis. We sought to characterize the reasons, clinical characteristics, and pre-exit health care team interactions of patients on home hemodialysis who died or underwent modality conversion (negative disposition) compared with prevalent patients and those who were transplanted (positive disposition). We conducted an audit of all consecutive patients incident to home hemodialysis from January of 2010 to December of 2014 as part of ongoing quality assurance. Records were reviewed for the 6 months before exit, and vital statistics were assessed up to 90 days postexit. Ninety-four patients completed training; 25 (27%) received a transplant, 11 (12%) died, and 23 (25%) were transferred to in-center hemodialysis. Compared with the positive disposition group, patients in the negative disposition group had a longer mean dialysis vintage (3.15 [SD=4.98] versus 1.06 [SD=1.16] years; P=0.003) and were performing conventional versus a more intensive hemodialysis prescription (23 of 34 versus 23 of 60; Pday mortality among patients undergoing modality conversion was 26%. Over a 6-year period, approximately one third of patients exited the program due to death or modality conversion. Patients who die or transfer to another modality have significantly higher health care resource utilization (e.g., hospitalization, respite treatments, nursing time, etc.). Copyright © 2017 by the American Society of Nephrology.
Cadwallader, L.C. (EG and G Idaho, Inc., Idaho Falls, ID (USA)); Stolpe Gavett, M.A. (Los Alamos National Lab., NM (USA))
This document gives the failure rates for the major tritium-bearing components in the Tritium Waste Treatment System at the Tritium Systems Test Assembly, which is a fusion research and technology facility at the Los Alamos National Laboratory. The failure reports, component populations, and operating demands/hours are given in this report, and sample calculations for binomial demand failure rates and poisson hourly failure rates are given in the appendices. The failure rates for tritium-bearing components were on the order of the screening failure rate values suggested for fusion reliability and risk analyses. More effort should be directed toward collecting and analyzing fusion component failure data, since accurate failure rates are necessary to refine reliability and risk analyses. 15 refs., 4 figs., 4 tabs.
Khanmohammadi, Mohammdreza; Ghasemi, Keyvan; Garmarudi, Amir Bagheri; Ramin, Mehdi
A new diagnostic approach based on Attenuated Total Reflectance-Fourier Transform Infrared (ATR-FTIR) spectrometry and classification algorithm has been introduced which provides a rapid, reliable, and easy way to perform blood test for the diagnosis of renal failure. Blood serum samples from 35 renal failure patients and 40 healthy persons were analyzed by ATR-FTIR spectrometry. The resulting data was processed by Quadratic Discriminant Analysis (QDA) and QDA combined with simple filtered method. Spectroscopic studies were performed in 900-2000 cm-1 spectral region with 3.85 cm-1 data space. Results showed 93.33% and 100% of accuracy for QDA and filter-QDA models, respectively. In the first step, 30 samples were applied to construct the model. In order to modify the capability of QDA in prediction of test samples, filter-based feature selection methods were applied. It was found that the filtered spectra coupled with QDA could correctly predict the test samples in most of the cases.
Kohler, Laura E; Silverstein, JoAnn; Rajagopalan, Balaji
Owner resistance to increasing regulation of on-site wastewater treatment systems (OWTS), including obligatory inspections and upgrades, moratoriums and cease-and-desist orders in communities around the U.S. demonstrate the challenges associated with managing risks of inadequate performance of owner-operated wastewater treatment systems. As a result, determining appropriate and enforceable performance measures in an industry with little history of these requirements is challenging. To better support such measures, we develop a statistical method to predict lifetime failure risks, expressed as costs, in order to identify operational factors associated with costly repairs and replacement. A binomial logistic regression is used to fit data from public records of reported OWTS failures, in Boulder County, Colorado, which has 14 300 OWTS to determine the probability that an OWTS will be in a low- or high-risk category for lifetime repair and replacement costs. High-performing or low risk OWTS with repairs and replacements below the threshold of $9000 over a 40-year life are associated with more frequent inspections and upgrades following home additions. OWTS with a high risk of exceeding the repair cost threshold of $18 000 are further analyzed in a variation of extreme value analysis (EVA), Points Over Threshold (POT) where the distribution of risk-cost exceedance values are represented by a generalized Pareto distribution. The resulting threshold cost exceedance estimates for OWTS in the high-risk category over a 40-year expected life ranged from $18 000 to $44 000.
Chandonnet, Celeste J; Kahlon, Prerna S; Rachh, Pratik; Degrazia, Michele; Dewitt, Eileen C; Flaherty, Kathleen A; Spigel, Nadine; Packard, Stephanie; Casey, Denise; Rachwal, Christine; Agrawal, Pankaj B
Central line-associated bloodstream infections (CLABSIs) in NICU result in increased mortality, morbidity, and length of stay. Our NICU experienced an increase in the number of CLABSIs over a 2-year period. We sought to reduce risks for CLABSIs using health care failure mode and effect analysis (HFMEA) by analyzing central line insertion, maintenance, and removal practices. A multidisciplinary team was assembled that included clinicians from nursing, neonatology, surgery, infection prevention, pharmacy, and quality management. Between March and October 2011, the team completed the HFMEA process and implemented action plans that included reeducation, practice changes, auditing, and outcome measures. The HFMEA identified 5 common failure modes that contribute to the development of CLABSIs. These included contamination, suboptimal environment of care, improper documentation and evaluation of central venous catheter dressing integrity, issues with equipment and suppliers, and lack of knowledge. Since implementing the appropriate action plans, the NICU has experienced a significant decrease in CLABSIs from 2.6 to 0.8 CLABSIs per 1000 line days. The process of HFMEA helped reduce the CLABSI rate and reinforce the culture of continuous quality improvement and safety in the NICU.
Jacobo Armendariz, V.H.; Cerrud Sanchez, S.M.; Ramirez Rodriguez, M.A.; Ortiz Prado, A. [Facultad de Ingenieria, UNAM, Mexico, D.F. (Mexico)
An expert system for the failure analysis in metallic mechanical devices is being Developer at the Mechanical Engineering departments of the Faculty of Engineering of the Universidad Nacional Autonoma de Mexico (UNAM) to provide a solution for the failure analysis in cases where considerable experience in needed. The system pretends to resolve the scarceness of experts in the field of failure analysis and is oriented toward the metal-mechanics industry and will also have didactic applications. The main complication in the development of the system is the broad range of applications envisioned, like gears, shafts, bolts and springs between others. Therefore, it was decided to develop the system in a modular way, using the experience obtained in a first module to proceed faster in the others. The present paper presents the elaboration of the module that analyses shafts. This will serve as the base to expand the system toward other components. It uses the general structure of the global system, including an auxiliary software for the determination of maximum stresses in the corresponding parts. [Spanish] Con el fin de contar con un medio eficaz para la solucion de problemas relacionados con el analisis de falla, en donde la experiencia juega un papel fundamental, el Departamento de Ingenieria Mecanica de la Facultad de ingenieria de la Universidad Nacional Autonoma de Mexico (UNAM) , esta desarrollando el proyecto Sistema experto para analisis de falla de elementos mecanicos, dicho sistema busca resolver el inconveniente de la escasez de expertos y se orienta, tanto a la necesidad de la industria metalmecanica como a la de la docencia. Presenta tambien complicaciones en su desarrollo, ya que se pretende la posibilidad de realizar analisis de falla de elementos como ejes, engranes, pernos, bielas, resortes, tornillos etc. Por lo anterior, se establecio como estrategia el desarrollo del sistema por modulos, ya que teniendo la experiencia de elaboracion de un primer
Rafsanjani, Hesam Mirzaei; Sørensen, John Dalsgaard
Fatigue failure is one of the main failure modes for wind turbine drivetrain components made of cast iron. The wind turbine drivetrain consists of a variety of heavily loaded components, like the main shaft, the main bearings, the gearbox and the generator. The failure of each component will lead...
Full Text Available The introduction of the paper gives the basic concepts, historical development of methods of Fault Tree Analysis - FTA and Failure Modes, Effects and Criticality Analysis - FMECA for analysis of the reliability and safety of technical systems and importance of applying this method is highlighted. Failure analysis is particularly important for systems whose failures lead to the endangerment of people safety, such as, for example, the braking system of motor vehicles. For the failure analysis of the considered device, it is necessary to know the structure, functioning, working conditions and all factors that have a greater or less influence on its reliability. By formation of the fault tree of drum brakes in braking systems of commercial vehicles, it was established a causal relation between the different events that lead to a reduction in performance or complete failure of the braking system. Based on data from exploitation, using FMECA methods, determination of the criticality degree of drum brake’s elements on the reliable and safe operation of the braking system is performed.
Jan 1, 2016 ... airframe aerodynamics. This paper focuses on UAV flight control system. Chen et al studied the Probabilistic Safety Analysis of a. Flight Control System based on Bayesian Network . Their results revealed that the Bayesian Network provide a simple and intuitive measure to deal with the safety analysis of ...
Daiana C. Bündchen
Full Text Available Background: Patients with heart failure (HF usually develop exercise intolerance. In this context, noninvasive ventilation (NIV can help to increase physical performance. Objective: To undertake a systematic review and meta-analysis of randomized controlled trials that evaluated the effects of NIV on exercise tolerance in patients with HF. Method: Search Strategy: Articles were searched in the following databases: Physiotherapy Evidence Database (PEDro, Scientific Electronic Library Online (SciELO, and MEDLINE. Selection Criteria: This review included only randomized controlled trials involving patients with HF undergoing NIV, with or without other therapies, that used exercise tolerance as an outcome, verified by the distance travelled in the six-minute walk test (6MWT, VO2peak in the cardiopulmonary test, time spent in testing, and dyspnea. Data Collection and Analysis: The methodological quality of the studies was rated according to the PEDro scale. Data were pooled in fixed-effect meta-analysis whenever possible. Results: Four studies were selected. A meta-analysis including 18 participants showed that the use of NIV prior to the 6MWT promoted increased distance, [mean difference 65.29 m (95% CI 38.80 to 91.78]. Conclusions: The use of NIV prior to the 6MWT in patients with HF may promote increased distance. However, the limited number of studies may have compromised a more definitive conclusion on the subject.
Hyder, Imran; Schaefer, Joseph; Justusson, Brian; Wanthal, Steve; Leone, Frank; Rose, Cheryl
Reducing the timeline for development and certification for composite structures has been a long standing objective of the aerospace industry. This timeline can be further exacerbated when attempting to integrate new fiber-reinforced composite materials due to the large number of testing required at every level of design. computational progressive damage and failure analysis (PDFA) attempts to mitigate this effect; however, new PDFA methods have been slow to be adopted in industry since material model evaluation techniques have not been fully defined. This study presents an efficient evaluation framework which uses a piecewise verification and validation (V&V) approach for PDFA methods. Specifically, the framework is applied to evaluate PDFA research codes within the context of intralaminar damage. Methods are incrementally taken through various V&V exercises specifically tailored to study PDFA intralaminar damage modeling capability. Finally, methods are evaluated against a defined set of success criteria to highlight successes and limitations.
Chandler, Faith T. (Inventor); Valentino, William D. (Inventor); Philippart, Monica F. (Inventor); Relvini, Kristine M. (Inventor); Bessette, Colette I. (Inventor); Shedd, Nathaneal P. (Inventor)
Methods, computer-readable media, and systems for automatically performing Human Factors Process Failure Modes and Effects Analysis for a process are provided. At least one task involved in a process is identified, where the task includes at least one human activity. The human activity is described using at least one verb. A human error potentially resulting from the human activity is automatically identified, the human error is related to the verb used in describing the task. A likelihood of occurrence, detection, and correction of the human error is identified. The severity of the effect of the human error is identified. The likelihood of occurrence, and the severity of the risk of potential harm is identified. The risk of potential harm is compared with a risk threshold to identify the appropriateness of corrective measures.
Zhao, Yu-liang; Zhang, Ling; Yang, Ying-ying; Tang, Yi; Liu, Fang; Fu, Ping
To explore whether ultrafiltration is superior to intravenous diuretics in ameliorating fluid overload and preserving renal functions in decompensated heart failure patients. By searching in Pubmed, Cochrane Library, Embase, Springer, WanFang, CQVIP, CNKI and CBM database as well as related Chinese journals, qualified randomized controlled trials (RCTs) were included for meta-analysis by Revman 5.0 and STATA 10.0. Six RCTs were included with 241 patients in ultrafiltration group and 240 patients in intravenous diuretics group. Pooled analyses demonstrated ultrafiltration was superior to intravenous diuretics in the aspects of weight loss (WMD = 1.44 kg, 95%CI:0.33-2.55 kg, P = 0.01) and fluid removal (WMD = 1.23 kg, 95%CI:0.63-1.82 kg, P diuretics in mitigating fluid overload. No intergroup difference was observed in renal function preservation, mortality or rehospitalization.
Guidi, G; Pettenati, M C; Miniati, R; Iadanza, E
In this paper we describe an Heart Failure analysis Dashboard that, combined with a handy device for the automatic acquisition of a set of patient's clinical parameters, allows to support telemonitoring functions. The Dashboard's intelligent core is a Computer Decision Support System designed to assist the clinical decision of non-specialist caring personnel, and it is based on three functional parts: Diagnosis, Prognosis, and Follow-up management. Four Artificial Intelligence-based techniques are compared for providing diagnosis function: a Neural Network, a Support Vector Machine, a Classification Tree and a Fuzzy Expert System whose rules are produced by a Genetic Algorithm. State of the art algorithms are used to support a score-based prognosis function. The patient's Follow-up is used to refine the diagnosis.
Full Text Available Disconnected piled raft (DPR foundations are characterized by having no structural connection to a raft. The raft-pile gap is filled with a granular cushion, which creates a more uniform pressure distribution on the raft and reduces the differential settlement. A series of tests has been performed to investigate the load transfer mechanisms of a DPR. The effects of the thickness and stiffness of the cushion and the pile diameter are presented and discussed. A simple failure mode of the cushion is also put forward according to the cushion slip plane obtained by using the digital image correlation technique that tracks the pixels in the images and generates a displacement field. Then a new theoretical analysis has been presented for rigid pile composite foundation. Through comparative studies, it is found that the present method is validated as reasonable by laboratory tests and is in agreement with several current design methods.
Full Text Available An analytical approach with the help of numerical simulations based on the equivalent constraint model (ECM was proposed to investigate the progressive failure behavior of symmetric fiber-reinforced composite laminates damaged by transverse ply cracking. A fracture criterion was developed to describe the initiation and propagation of the transverse ply cracking. This work was also concerned with a statistical distributions of the critical fracture toughness values with due consideration given to the scale size effect. The Monte Carlo simulation technique coupled with statistical analysis was applied to study the progressive cracking behaviors of composite structures, by considering the effects of lamina properties and lay-up configurations. The results deduced from the numerical procedure were in good agreement with the experimental results obtained for laminated composites formed by unidirectional fiber reinforced laminae with different orientations.
Banciu Felicia Veronica
Full Text Available The design of a fixture device is very laborious, requiring consideration of many issues from series production, information on the raw part material, required precision surfaces, ensuring an appropriate orientation scheme, continue with requirements related device itself as number of parts, parts type, complexity, manageability, easy operation and maintenance. That is why realising a proper analyse regarding the possible failures associated to these issues is overwhelming. This paper’s aim is to propose an approach for collection of items necessary for starting a Design FMEA, using Functional Analysis, TRIZ functional modelling and axiomatic design approaches. The proposed approach – to extract items for a FMEA analyse – is applied to an example of an expanding mandrel regarding its internal components and theirs relations in order to accomplish the main requirement: the accurate locating and clamping of a part.
Tang, L. W.; Ong, N. R.; Mohamad, I. S. B.; Alcain, J. B.; Retnasamy, V.
A study has been conducted to investigate failure analysis on probe pins of test modules for microprocessor. The `health condition' of the probe pin is determined by the resistance value. A test module of 5V power supplied from Arduino UNO with "Four-wire Ohm measurement" method is implemented in this study to measure the resistance of the probe pins of a microprocessor. The probe pins from a scrapped computer motherboard is used as the test sample in this study. The functionality of the test module was validated with the pre-measurement experiment via VEE Pro software. Lastly, the experimental work have demonstrated that the implemented test module have the capability to identify the probe pin's `health condition' based on the measured resistance value.
Sanstad, A.H.; Koomey, J.G.; Levine, M.D.
In his recent paper in The Energy Journal, Ronald Sutherland argues that several so-called market barriers'' to energy efficiency frequently cited in the literature are not market failures in the conventional sense and are thus irrelevant for energy policy. We argue that Sutherland has inadequately analyzed the idea of market barrier and misrepresented the policy implications of microeconomics. We find that economic theory, correctly interpreted, does not provide for the categorical dismissal of market barriers. We explore important methodological issues underlying the debate over market barriers, and discuss the importance of reconciling the findings of non-economic social sciences with the economic analysis of energy demand and consumer decision-making. We also scrutinize Sutherland's attempt to apply finance theory to rationalize high implicit discount rates observed in energy-related choices, and find this use of finance theory to be inappropriate.
Sanstad, A.H.; Koomey, J.G.; Levine, M.D.
In his recent paper in The Energy Journal, Ronald Sutherland argues that several so-called ``market barriers`` to energy efficiency frequently cited in the literature are not market failures in the conventional sense and are thus irrelevant for energy policy. We argue that Sutherland has inadequately analyzed the idea of market barrier and misrepresented the policy implications of microeconomics. We find that economic theory, correctly interpreted, does not provide for the categorical dismissal of market barriers. We explore important methodological issues underlying the debate over market barriers, and discuss the importance of reconciling the findings of non-economic social sciences with the economic analysis of energy demand and consumer decision-making. We also scrutinize Sutherland`s attempt to apply finance theory to rationalize high implicit discount rates observed in energy-related choices, and find this use of finance theory to be inappropriate.
Stacey M. L. Hendrickson; April M. Whaley; Ronald L. Boring; James Y. H. Chang; Song-Hua Shen; Ali Mosleh; Johanna H. Oxstrand; John A. Forester; Dana L. Kelly; Erasmia L. Lois
The Office of Nuclear Regulatory Research (RES) is sponsoring work in response to a Staff Requirements Memorandum (SRM) directing an effort to establish a single human reliability analysis (HRA) method for the agency or guidance for the use of multiple methods. As part of this effort an attempt to develop a comprehensive HRA qualitative approach is being pursued. This paper presents a draft of the method’s middle layer, a part of the qualitative analysis phase that links failure mechanisms to performance shaping factors. Starting with a Crew Response Tree (CRT) that has identified human failure events, analysts identify potential failure mechanisms using the mid-layer model. The mid-layer model presented in this paper traces the identification of the failure mechanisms using the Information-Diagnosis/Decision-Action (IDA) model and cognitive models from the psychological literature. Each failure mechanism is grouped according to a phase of IDA. Under each phase of IDA, the cognitive models help identify the relevant performance shaping factors for the failure mechanism. The use of IDA and cognitive models can be traced through fault trees, which provide a detailed complement to the CRT.
Kim, Jae Whan; Jung, Won Dea; Park, Jin Yun; Kang, Dae Il
The study deals with a method for systematically identifying and assessing the EOC events that might be caused from a diagnosis failure or misdiagnosis of the expected events in accident scenarios of nuclear power plants. The method for EOC identification and assessment consists of three steps: analysis of the potential for a diagnosis failure (or misdiagnosis), identification of the EOC events from the diagnosis failure, quantitative assessment of the identified EOC events. As a tool for analysing a diagnosis failure, the MisDiagnosis Tree Analysis (MDTA) technique is proposed with the taxonomy of misdiagnosis causes. Also, the guidance on the identification of EOC events and the classification system and data are given for quantitiative assessment. As an applicaton of the proposed method, the EOCs identification and assessment for Younggwang 3 and 4 plants and their impact on the plant risk were performed. As the result, six events or event sequences were considered for diagnosis failures and about 20 new Human Failure Events (HFEs) involving EOCs were identified. According to the assessment of the risk impact of the identified HFEs, they increase the CDF by 11.4 % of the current CDF value, which corresponds to 10.2 % of the new CDF. The small loss of coolant accident (SLOCA) turned out to be a major contributor to the increase of CDF resulting in 9.2 % increaseof the current CDF.
Berruyer, M; Atkinson, S; Lebel, D; Bussières, J-F
Insulin is a high-alert drug. The main objective of this descriptive cross-sectional study was to evaluate the risks associated with insulin use in healthcare centers. The secondary objective was to propose corrective measures to reduce the main risks associated with the most critical failure modes in the analysis. We conducted a failure mode and effects analysis (FMEA) in obstetrics-gynecology, neonatology and pediatrics. Five multidisciplinary meetings occurred in August 2013. A total of 44 out of 49 failure modes were analyzed. Nine out of 44 (20%) failure modes were deemed critical, with a criticality score ranging from 540 to 720. Following the multidisciplinary meetings, everybody agreed that an FMEA was a useful tool to identify failure modes and their relative importance. This approach identified many corrective measures. This shared experience increased awareness of safety issues with insulin in our mother-child center. This study identified the main failure modes and associated corrective measures. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Nishii, Nobuhiro; Miyoshi, Akihito; Kubo, Motoki; Miyamoto, Masakazu; Morimoto, Yoshimasa; Kawada, Satoshi; Nakagawa, Koji; Watanabe, Atsuyuki; Nakamura, Kazufumi; Morita, Hiroshi; Ito, Hiroshi
Remote monitoring (RM) has been advocated as the new standard of care for patients with cardiovascular implantable electronic devices (CIEDs). RM has allowed the early detection of adverse clinical events, such as arrhythmia, lead failure, and battery depletion. However, lead failure was often identified only by arrhythmic events, but not impedance abnormalities. To compare the usefulness of arrhythmic events with conventional impedance abnormalities for identifying lead failure in CIED patients followed by RM. CIED patients in 12 hospitals have been followed by the RM center in Okayama University Hospital. All transmitted data have been analyzed and summarized. From April 2009 to March 2016, 1,873 patients have been followed by the RM center. During the mean follow-up period of 775 days, 42 lead failure events (atrial lead 22, right ventricular pacemaker lead 5, implantable cardioverter defibrillator [ICD] lead 15) were detected. The proportion of lead failures detected only by arrhythmic events, which were not detected by conventional impedance abnormalities, was significantly higher than that detected by impedance abnormalities (arrhythmic event 76.2%, 95% CI: 60.5-87.9%; impedance abnormalities 23.8%, 95% CI: 12.1-39.5%). Twenty-seven events (64.7%) were detected without any alert. Of 15 patients with ICD lead failure, none has experienced inappropriate therapy. RM can detect lead failure earlier, before clinical adverse events. However, CIEDs often diagnose lead failure as just arrhythmic events without any warning. Thus, to detect lead failure earlier, careful human analysis of arrhythmic events is useful. © 2017 Wiley Periodicals, Inc.
Full Text Available Introduction: Heart failure (HF is always complicated with anemia and is associated with bad prognosis in this patient population. Several studies have assessed the potential role of erythropoietin-stimulating agent (ESA in improving cardiac function and reducing the number of hospitalizations in anemic patients with HF. Aim : We performed a meta-analysis to assess the potential role of ESA in the treatment of anemic patients with HF. Material and methods : A literature and Medline search was performed to identify studies with control groups that examined the efficacy of ESA therapy in patients with HF and anemia. Results: A total of 11 studies were included (n = 3044 subjects in the final analysis. Compared to placebo, ESA therapy was associated with increased hemoglobin levels (1.89 g/dl; 95% CI: 1.64–2.14, p < 0.00001, increased left ventricular ejection fraction (LVEF to 6.88 (95% CI: 0.49–13.28, p = 0.03, decreased B-type natriuretic protein (–272.20; 95% CI: (–444.52–(–99.89, p = 0.002, improvement in New York Heart Association functional class to –0.33 mean difference (95% CI: (–0.44–(–0.23, p < 0.00001, and decreased hospitalization (OR = 0.61, 95% CI: 0.39–0.94, p = 0.02. There was no significant between-group difference in all-cause mortality (OR = 0.78, 95% CI: 0.51–1.21, p = 0.27. Conclusions : The treatment of anemia with ESA therapy did not reduce the rate of all-cause mortality among patients with heart failure, but ESA therapy made a potential important contribution to patients’ symptomatic improvement.
Mathew, D; Alaei, P [University Minnesota, Minneapolis, MN (United States)
Purpose: A small-scale implementation of Failure Modes and Effects Analysis (FMEA) for treatment planning system QA by utilizing methodology of AAPM TG-100 report. Methods: FMEA requires numerical values for severity (S), occurrence (O) and detectability (D) of each mode of failure. The product of these three values gives a risk priority number (RPN). We have implemented FMEA for the treatment planning system (TPS) QA for two clinics which use Pinnacle and Eclipse TPS. Quantitative monthly QA data dating back to 4 years for Pinnacle and 1 year for Eclipse have been used to determine values for severity (deviations from predetermined doses at points or volumes), and occurrence of such deviations. The TPS QA protocol includes a phantom containing solid water and lung- and bone-equivalent heterogeneities. Photon and electron plans have been evaluated in both systems. The dose values at multiple distinct points of interest (POI) within the solid water, lung, and bone-equivalent slabs, as well as mean doses to several volumes of interest (VOI), have been re-calculated monthly using the available algorithms. Results: The computed doses vary slightly month-over-month. There have been more significant deviations following software upgrades, especially if the upgrade involved re-modeling of the beams. TG-100 guidance and the data presented here suggest an occurrence (O) of 2 depending on the frequency of re-commissioning the beams, severity (S) of 3, and detectability (D) of 2, giving an RPN of 12. Conclusion: Computerized treatment planning systems could pose a risk due to dosimetric errors and suboptimal treatment plans. The FMEA analysis presented here suggests that TPS QA should immediately follow software upgrades, but does not need to be performed every month.
Diop, Michelle S; Rudolph, James L; Zimmerman, Kristin M; Richter, Mary A; Skarf, L Michal
To systematically characterize interventions and effectiveness of palliative care for advanced heart failure (HF) patients. Patients with advanced heart failure experience a high burden of distressing symptoms and diminished quality of life. Palliative care expertise with symptom management and healthcare decision-making benefits HF patients. A systematic PubMed search was conducted from inception to June 2016 for studies of palliative care interventions for HF patients. Studies of humans with a HF diagnosis who underwent a palliative care intervention were included. Data were extracted on study design, participant characteristics, intervention components, and in three groups of outcomes: patient-centered outcomes, quality-of-death outcomes, and resource utilization. Study characteristics were examined to determine if meta-analysis was possible. The fifteen identified studies varied in design (prospective, n = 10; retrospective, n = 5). Studies enrolled older patients, but greater variability was found for race, sex, and marital status. A majority of studies measuring patient-centered outcomes demonstrated improvements including quality of life and satisfaction. Quality-of-death outcomes were mixed with a majority of studies reporting clarification of care preferences, but less improvement in death at home and hospice enrollment. A meta-analysis in three studies found that home-based palliative care consults in HF patients lower the risk of rehospitalization by 42% (RR = 0.58; 95% Confidence Interval 0.44, 0.77). Available evidence suggests that home and team-based palliative interventions for HF patients improve patient-centered outcomes, documentation of preferences, and utilization. Increased high quality studies will aid the determination of the most effective palliative care approaches for the HF population.
DeLuca, Lawrence A; Simpson, Allan; Beskind, Dan; Grall, Kristi; Stoneking, Lisa; Stolz, Uwe; Spaite, Daniel W; Panchal, Ashish R; Denninghoff, Kurt R
Automated external defibrillators are essential for treatment of cardiac arrest by lay rescuers and must determine when to shock and if they are functioning correctly. We seek to characterize automated external defibrillator failures reported to the Food and Drug Administration (FDA) and whether battery failures are properly detected by automated external defibrillators. FDA adverse event reports are catalogued in the Manufacturer and User Device Experience (MAUDE) database. We developed and internally validated an instrument for analyzing MAUDE data, reviewing all reports in which a fatality occurred. Two trained reviewers independently analyzed each report, and a third resolved discrepancies or passed them to a committee for resolution. One thousand two hundred eighty-four adverse events were reported between June 1993 and October 2008, of which 1,150 were failed defibrillation attempts. Thirty-seven automated external defibrillators never powered on, 252 failed to complete rhythm analysis, and 524 failed to deliver a recommended shock. In 149 cases, the operator disagreed with the device's rhythm analysis. In 54 cases, the defibrillator stated the batteries were low and in 110 other instances powered off unexpectedly. Interrater agreement between reviewers 1 and 2 ranged by question from 69.0% to 98.6% and for most likely cause was 55.9%. Agreement was obtained for 93.7% to 99.6% of questions by the third reviewer. Remaining discrepancies were resolved by the arbitration committee. MAUDE information is often incomplete and frequently no corroborating data are available. Some conditions not detected by automated external defibrillators during self-test cause units to power off unexpectedly, causing defibrillation delays. Backup units frequently provide shocks to patients. Copyright © 2011 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.
Julie H Levison
Full Text Available We investigated the prevalence of wild-type virus (no major drug resistance and drug resistance mutations at second-line antiretroviral treatment (ART failure in a large HIV treatment program in South Africa.HIV-infected patients ≥ 15 years of age who had failed protease inhibitor (PI-based second-line ART (2 consecutive HIV RNA tests >1000 copies/ml on lopinavir/ritonavir, didanosine, and zidovudine were identified retrospectively. Patients with virologic failure were continued on second-line ART. Genotypic testing for drug resistance was performed on frozen plasma samples obtained closest to and after the date of laboratory confirmed second-line ART failure. Of 322 HIV-infected patients on second-line ART, 43 were adults with confirmed virologic failure, and 33 had available plasma for viral sequencing. HIV-1 RNA subtype C predominated (n = 32, 97%. Mean duration on ART (SD prior to initiation of second-line ART was 23 (17 months, and time from second-line ART initiation to failure was 10 (9 months. Plasma samples were obtained 7(9 months from confirmed failure. At second-line failure, 22 patients (67% had wild-type virus. There was no major resistance to PIs found. Eleven of 33 patients had a second plasma sample taken 8 (5.5 months after the first. Median HIV-1 RNA and the genotypic resistance profile were unchanged.Most patients who failed second-line ART had wild-type virus. We did not observe evolution of resistance despite continuation of PI-based ART after failure. Interventions that successfully improve adherence could allow patients to continue to benefit from second-line ART therapy even after initial failure.
Full Text Available A Light Utility Helicopter (LUH, in the course of a training flight, leaving the ground during the taxi to take off, went into an uncontrolled rolling to the right; consequently the helicopter gradually laid down on the right side. The impact with the runway destroyed the rotating blades up to the hubs rotor. The accident investigation focused on main rotor oscillatory plate servo actuators . These components, directly linked to the cloche movements, regulate main rotor blades plane tilt and pitch. Following the preliminary examination, only front servo actuator attachment was found to be broken in two parts. In detail, the present paper deals with the fracture analysis results. The servo actuator attachment material is a 2014 Aluminum alloy extrudate, undergone to T651 heat treatment. Fracture surfaces were examined by optical and electronic microscopy in order to determine the main morphological features and consequently to trace the origin of failure mechanism and causes. The accordance with the specification requirements about alloy composition was verified by quantitative elementary analysis through inductive coupled plasma spectroscopy (ICP; furthermore, semi-quantitative elementary analysis was locally verified by Energy dispersion spectroscopy X ray (EDS_RX. Finally, the hydrogen content of the material was evaluated by the total hydrogen analysis. Microstructural and technological alloy characteristics were verified as well by using metallographic microscopy and hardness testing of the material.Macroscopic fracture surfaces evidences were characterized by the lack of any significant plastic deformations and by the presence of symmetry compared to the servo actuator axis. Microscopic fracture features of both the investigated surfaces were not coherent to the hypothesis of an impact of the main rotor to the soil. Further achieved evidences, such as grain boundary fracture propagation, the presence of corrosion products, were all in
Forister, J Glenn; Stilp, Curt
The Accreditation Review Commission on Education for the Physician Assistant projects a total of 273 accredited programs by the summer of 2020. Over the past 10 years, the number of Central Application Service for Physician Assistants (CASPA) applicants per seat has increased by 53%. However, no studies have addressed the current geographic relationship of applicants to programs and program growth. The purpose of this study was to describe the geospatial patterns and relationships of physician assistant (PA) programs and CASPA applicants. Program directory information for established (n = 159), satellite (n = 18), and new PA programs (n = 95) was mapped using ArcGIS software. Permanent US ZIP codes for PA applicants (n = 22,603) from the 2014 to 2015 CASPA admissions cycle were also mapped. Point data were used to calculate the nearest neighbor by program type. Correlation was used to measure the association between PA applicants, program class size, and state population metrics. Most of the 95 new PA programs were geographically close to established programs. The median distance of new programs to the nearest neighboring established program was 25.6 miles (mean 39, standard deviation 38). Both established and new PA programs were found to be highly clustered (Moran's I z score < 2.58, p = .01). The geographic distribution of the CASPA applicant pool was related to distribution of the US population, certified PAs, and practicing physicians. PA program growth has exceeded projections. The close proximity of new programs to established programs will likely result in continued competition for quality applicants, PA faculty members, and clinical training sites.
Kitazawa, Sin-iti, E-mail: firstname.lastname@example.org; Ogawa, Hiroaki
Highlights: • Divertor impurity influx monitor for ITER (DIM) is procured by JADA. • DIM is designed to observe light from nuclear fusion plasma directly. • DIM is under preliminary design phase. • Failure mode of DIM was prepared for RAMI analysis. • RAMI analysis on DIM was performed to reduce technical risks. - Abstract: The objective of the divertor impurity influx monitor (DIM) for ITER is to measure the parameters of impurities and hydrogen isotopes (tritium, deuterium, and hydrogen) in divertor plasma using visible and UV spectroscopic techniques in the 200–1000 nm wavelength range. In ITER, special provisions are required to ensure accuracy and full functionality of the diagnostic components under harsh conditions (high temperature, high magnetic field, high vacuum condition, and high radiation field). Japan Domestic Agency is preparing the preliminary design of the ITER DIM system, which will be installed in the upper, equatorial and lower ports. The optical and mechanical designs of the DIM are conducted to fit ITER’s requirements. The optical and mechanical designs meet the requirements of spatial resolution. Some auxiliary systems were examined via prototyping. The preliminary design of the ITER DIM system was evaluated by RAMI analysis. The availability of the designed system is adequately high to satisfy the project requirements. However, some equipment does not have certain designs, and this may cause potential technical risks. The preliminary design should be modified to reduce technical risks and to prepare the final design.
Pijls, Bart G; Nieuwenhuijse, Marc J; Schoones, Jan W; Middeldorp, Saskia; Valstar, Edward R; Nelissen, Rob G H H
In a previous radiostereometric (RSA) trial the uncoated, uncemented, Interax tibial components showed excessive migration within 2 years compared to HA-coated and cemented tibial components. It was predicted that this type of fixation would have a high failure rate. The purpose of this systematic review and meta-analysis was to investigate whether this RSA prediction was correct. We performed a systematic review and meta-analysis to determine the revision rate for aseptic loosening of the uncoated and cemented Interax tibial components. 3 studies were included, involving 349 Interax total knee arthroplasties (TKAs) for the comparison of uncoated and cemented fixation. There were 30 revisions: 27 uncoated and 3 cemented components. There was a 3-times higher revision rate for the uncoated Interax components than that for cemented Interax components (OR = 3; 95% CI: 1.4-7.2). This meta-analysis confirms the prediction of a previous RSA trial. The uncoated Interax components showed the highest migration and turned out to have the highest revision rate for aseptic loosening. RSA appears to enable efficient detection of an inferior design as early as 2 years postoperatively in a small group of patients.
Full Text Available The objective of green logistics has thus far failed. For example, the share of greenhouse gas emissions by the transportation and logistics sector in Europe rose from 16.6% in 1990 to 24.3% in 2012. This article analyzes the reasons behind this failure by drawing on political, economic and business as well as social motivations and examples. At the core of this analysis are the established theorems of the Jevons paradox and the median voter (Black, Downs in combination with time-distorted preferences of voters and consumers. Adding to the hurdles of green logistics are the problems of short-term political programs and decisions versus long-term business investments in transportation and logistics. Two cases from Germany are outlined regarding this political “meddling through” with a recent 2015 truck toll decision and the support for electric trucks and vehicles. Finally, the article proposes two ways forward: public control and restriction of carbon raw materials (coal, oil, as well as public investment in low-emission transport infrastructure or biofuels as the more feasible and likely alternative.
Veronese, Ivan; De Martin, Elena; Martinotti, Anna Stefania; Fumagalli, Maria Luisa; Vite, Cristina; Redaelli, Irene; Malatesta, Tiziana; Mancosu, Pietro; Beltramo, Giancarlo; Fariselli, Laura; Cantone, Marie Claire
A multidisciplinary and multi-institutional working group applied the Failure Mode and Effects Analysis (FMEA) approach to assess the risks for patients undergoing Stereotactic Body Radiation Therapy (SBRT) treatments for lesions located in spine and liver in two CyberKnife® Centres. The various sub-processes characterizing the SBRT treatment were identified to generate the process trees of both the treatment planning and delivery phases. This analysis drove to the identification and subsequent scoring of the potential failure modes, together with their causes and effects, using the risk probability number (RPN) scoring system. Novel solutions aimed to increase patient safety were accordingly considered. The process-tree characterising the SBRT treatment planning stage was composed with a total of 48 sub-processes. Similarly, 42 sub-processes were identified in the stage of delivery to liver tumours and 30 in the stage of delivery to spine lesions. All the sub-processes were judged to be potentially prone to one or more failure modes. Nineteen failures (i.e. 5 in treatment planning stage, 5 in the delivery to liver lesions and 9 in the delivery to spine lesions) were considered of high concern in view of the high RPN and/or severity index value. The analysis of the potential failures, their causes and effects allowed to improve the safety strategies already adopted in the clinical practice with additional measures for optimizing quality management workflow and increasing patient safety.
Muhson, Ali; Lestari, Barkah; Supriyanto; Baroroh, Kiromim
Item analysis has essential roles in the learning assessment. The item analysis program is designed to measure student achievement and instructional effectiveness. This study was aimed to develop item-analysis program and verify its feasibility. This study uses a Research and Development (R & D) model. The procedure includes designing and…
Cadwallader, L.C. [EG and G Idaho, Inc., Idaho Falls, ID (United States); Sanchez, D.P. [Los Alamos National Lab., NM (United States)
This report gives the failure rates for the major tritium containing glovebox systems that comprise the Secondary Containment System at the Tritium systems Test Assembly, which is a fusion research and technology facility at the Los Alamos National Laboratory. The component failure reports, the numbers of components, and operating times or demands are all given in this report, and sample calculations of the binomial demand failure rates and poisson hourly failure rates are given in the appendices. The failure rates for these components form a solid data point based on actual operating experience, where there is very little published information. The eight years of nearly continuous Secondary Containment System operations should result in steady state failure rate values. These data should be useful for future fusion reactor design work and safety assessment tasks.
Álvarez-Bermejo, José A; Belmonte-Ureña, Luis J; Martos-Martínez, África; Barragán-Martín, Ana B; Simón-Márquez, María M
As first year students come from diverse backgrounds, basic skills should be accessible to everyone as soon as possible. Transferring such skills to these students is challenging, especially in highly technical courses. Ensuring that essential knowledge is acquired quickly promotes the student's self-esteem and may positively influence failure rates. Metaphors can help do this. Metaphors are used to understand the unknown. This paper shows how we made a turn in student learning at the University of Almeria. Our hypothesis assumed that metaphors accelerate the acquisition of basic knowledge so that other skills built on that foundation are easily learned. With these goals in mind, we changed the way we teach by using metaphors and abstract concepts in a computer organization course, a technical course in the first year of an information technology engineering degree. Cluster analysis of the data on collective student performance after this methodological change clearly identified two distinct groups. These two groups perfectly matched the "before and after" scenarios of the use of metaphors. The study was conducted during 11 academic years (2002/2003 to 2012/2013). The 475 observations made during this period illustrate the usefulness of this change in teaching and learning, shifting from a propositional teaching/learning model to a more dynamic model based on metaphors and abstractions. Data covering the whole period showed favorable evolution of student achievement and reduced failure rates, not only in this course, but also in many of the following more advanced courses. The paper is structured in five sections. The first gives an introduction, the second describes the methodology. The third section describes the sample and the study carried out. The fourth section presents the results and, finally, the fifth section discusses the main conclusions.
Jose Antonio Alvarez Bermejo
Full Text Available As first-year students come from diverse backgrounds, basic skills should be accessible to everyone as soon as possible. Transferring such skills to these students is challenging, especially in highly technical courses. Ensuring that essential knowledge is acquired quickly promotes the student’s self-esteem and may positively influence failure rates. Metaphors can help do this. Metaphors are used to understand the unknown. This paper shows how we made a turn in student learning at the University of Almeria. Our hypothesis assumed that metaphors accelerate the acquisition of basic knowledge so that other skills built on that foundation are easily learned. With these goals in mind, we changed the way we teach by using metap