Science.gov

Sample records for congestion management rules

  1. Congestion Management Requirements, Methods and Performance Indices

    SciTech Connect

    Kirby, B.J.

    2002-08-28

    Transmission congestion occurs when there is insufficient transmission capacity to simultaneously accommodate all requests for transmission service within a region. Historically, vertically integrated utilities managed this condition by constraining the economic dispatch of generators with the objective of ensuring security and reliability of their own and/or neighboring systems. Electric power industry restructuring has moved generation investment and operations decisions into the competitive market but has left transmission as a communal resource in the regulated environment. This mixing of competitive generation and regulated transmission makes congestion management difficult. The difficulty is compounded by increases in the amount of congestion resulting from increased commercial transactions and the relative decline in the amount of transmission. Transmission capacity, relative to peak load, has been declining in all regions of the U.S. for over a decade. This decline is expected to continue. Congestion management schemes used today have negative impacts on energy markets, such as disruptions and monetary penalties, under some conditions. To mitigate these concerns various congestion management methods have been proposed, including redispatch and curtailment of scheduled energy transmission. In the restructured electric energy industry environment, new congestion management approaches are being developed that strive to achieve the desired degree of reliability while supporting competition in the bulk power market. This report first presents an overview and background on key issues and emerging approaches to congestion management. It goes on to identify and describe policies affecting congestion management that are favored and/or are now being considered by FERC, NERC, and one of the regional reliability councils (WSCC). It reviews the operational procedures in use or proposed by three of the leading independent system operators (ISOs) including ERCOT

  2. Hemodynamic management of congestive heart failure by means of a multiple mode rule-based control system using fuzzy logic.

    PubMed

    Held, C M; Roy, R J

    2000-01-01

    A rule-based system was designed to control the mean arterial pressure (MAP) and the cardiac output (CO) of a patient with congestive heart failure (CHF), using two vasoactive drugs: sodium nitroprusside (SNP) and dopamine (DPM). The controller has three different modes, that engage according to the hemodynamic state. The critical conditions control mode (CCC) determines the initial infusion rates, and continues active if the MAP or the CO fall outside of the defined criticality thresholds: an upper and a lower boundary for the MAP and a lower boundary for the CO. Inside the boundaries the control is performed by noncritical conditions control modes (NCC's), which are fuzzy logic controllers. If the CO is within normal range and the MAP is close to the goal range, then the MAP is driven using only SNP, in a single-input-single-output mode (NCC-SISO). Otherwise the NCC multiple-input-multiple-output is active (NCC-MIMO). The goal values for the controlled variables are defined as a band of 5 mmHg for the MAP and 5 mL/kg/min for the CO, but there is little concern for this application if the CO is too high (i.e., in practical terms the CO only needs to achieve a necessary minimum rate). The NCC-MIMO includes a gain adaptation algorithm to cope with the wide variety in sensitivities to SNP. Supervisory capabilities to ensure adequate drug delivery complete the controller scheme. After extensive testing and tuning on a CHF-hemodynamics nonlinear model, the control system was applied in dog experiments, which led to further enhancements. The results show an adequate control, presenting a fast response to setpoint changes with an acceptable overshoot.

  3. Airport Characterization for the Adaptation of Surface Congestion Management Approaches

    DTIC Science & Technology

    2013-02-01

    1 of 2 Airport Characterization for the Adaptation of Surface Congestion Management Approaches Melanie Sandberg, Tom Reynolds...TYPE 3. DATES COVERED 00-00-2013 to 00-00-2013 4. TITLE AND SUBTITLE Airport Characterization for the Adaptation of Surface Congestion Management...1 Airport Characterization for the Adaptation of Surface Congestion Management Approaches* Melanie

  4. Auctionable fixed transmission rights for congestion management

    NASA Astrophysics Data System (ADS)

    Alomoush, Muwaffaq Irsheid

    Electric power deregulation has proposed a major change to the regulated utility monopoly. The change manifests the main part of engineers' efforts to reshape three components of today's regulated monopoly: generation, distribution and transmission. In this open access deregulated power market, transmission network plays a major role, and transmission congestion is a major problem that requires further consideration especially when inter-zonal/intra-zonal scheme is implemented. Declaring that engineering studies and experience are the criteria to define zonal boundaries or defining a zone based on the fact that a zone is a densely interconnected area (lake) and paths connecting these densely interconnected areas are inter-zonal lines will render insufficient and fuzzy definitions. Moreover, a congestion problem formulation should take into consideration interactions between intra-zonal and inter-zonal flows and their effects on power systems. In this thesis, we introduce a procedure for minimizing the number of adjustments of preferred schedules to alleviate congestion and apply control schemes to minimize interactions between zones. In addition, we give the zone definition a certain criterion based on the Locational Marginal Price (LMP). This concept will be used to define congestion zonal boundaries and to decide whether any zone should be merged with another zone or split into new zones. The thesis presents a unified scheme that combines zonal and FTR schemes to manage congestion. This combined scheme is utilized with LMPs to define zonal boundaries more appropriately. The presented scheme gains the best features of the FTR scheme, which are providing financial certainty, maximizing the efficient use of the system and making users pay for the actual use of congested paths. LMPs may give an indication of the impact of wheeling transactions, and calculations of and comparisons of LMPs with and without wheeling transactions should be adequate criteria to approve

  5. 23 CFR 450.320 - Congestion management process in transportation management areas.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Congestion management process in transportation... Programming § 450.320 Congestion management process in transportation management areas. (a) The transportation planning process in a TMA shall address congestion management through a process that provides for safe...

  6. Managing congestive heart failure using home telehealth.

    PubMed

    Schneider, Nina M

    2004-10-01

    Congestive heart failure (CHF) is the leading cause of rehospitalization and loss of revenue for home care agencies and hospitals. This article outlines how an agency used telehealth to provide CHF patients quality care and improved outcomes while decreasing the number of skilled home nursing visits and reducing rehospitalization rates to 1.2%.

  7. A Hybrid Differential Invasive Weed Algorithm for Congestion Management

    NASA Astrophysics Data System (ADS)

    Basak, Aniruddha; Pal, Siddharth; Pandi, V. Ravikumar; Panigrahi, B. K.; Das, Swagatam

    This work is dedicated to solve the problem of congestion management in restructured power systems. Nowadays we have open access market which pushes the power system operation to their limits for maximum economic benefits but at the same time making the system more susceptible to congestion. In this regard congestion management is absolutely vital. In this paper we try to remove congestion by generation rescheduling where the cost involved in the rescheduling process is minimized. The proposed algorithm is a hybrid of Invasive Weed Optimization (IWO) and Differential Evolution (DE). The resultant hybrid algorithm was applied on standard IEEE 30 bus system and observed to beat existing algorithms like Simple Bacterial foraging (SBF), Genetic Algorithm (GA), Invasive Weed Optimization (IWO), Differential Evolution (DE) and hybrid algorithms like Hybrid Bacterial Foraging and Differential Evolution (HBFDE) and Adaptive Bacterial Foraging with Nelder Mead (ABFNM).

  8. 23 CFR 450.320 - Congestion management process in transportation management areas.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... evaluation of the effectiveness of congestion reduction and mobility enhancement strategies for the movement... cooperatively developed and implemented metropolitan-wide strategy, of new and existing transportation... travel demand reduction and operational management strategies. (b) The development of a congestion...

  9. 23 CFR 450.320 - Congestion management process in transportation management areas.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... evaluation of the effectiveness of congestion reduction and mobility enhancement strategies for the movement... cooperatively developed and implemented metropolitan-wide strategy, of new and existing transportation... travel demand reduction and operational management strategies. (b) The development of a congestion...

  10. 23 CFR 450.320 - Congestion management process in transportation management areas.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... evaluation of the effectiveness of congestion reduction and mobility enhancement strategies for the movement... cooperatively developed and implemented metropolitan-wide strategy, of new and existing transportation... travel demand reduction and operational management strategies. (b) The development of a congestion...

  11. 23 CFR 450.320 - Congestion management process in transportation management areas.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... evaluation of the effectiveness of congestion reduction and mobility enhancement strategies for the movement... cooperatively developed and implemented metropolitan-wide strategy, of new and existing transportation... travel demand reduction and operational management strategies. (b) The development of a congestion...

  12. Current Management of Congestive Heart Failure

    PubMed Central

    Lopez, J.F.

    1989-01-01

    Congestive heart failure is still one of the most common causes of death in our society. Treatment should be approached systematically with a set of well-defined objectives, which include rest, a low-sodium diet, inotropic agents, diuretics, and peripheral vasodilators. Patients receiving treatment for congestive heart failure should be examined daily for symptomatic improvement, cardiac signs, and accurate recording of total fluid intake and output. Serum electrolyte levels and chest X-ray films should also be checked intermittently. When using powerful diuretics or vasodilators, the physician should be aware of the risk-benefit ratio because many of these drugs, alone or in combination, may produce undesirable or even fatal side-effects. PMID:20469506

  13. Prehospital management of congestive heart failure.

    PubMed

    Mattu, Amal; Lawner, Benjamin

    2009-01-01

    The evolution of prehospital treatment of decompensated congestive heart failure has in some ways come full circle: rather than emphasizing a battery of new pharmacotherapies, out-of-hospital providers have a renewed focus on aggressive use of nitrates, optimization of airway support, and rapid transport. The use of furosemide and morphine has become de-emphasized, and a flurry of research activity and excitement revolves around the use of noninvasive positive-pressure ventilation. Further research will clarify the role of bronchodilators and angiotensin-converting enzyme inhibitors in the prehospital setting.

  14. 23 CFR 972.214 - Federal lands congestion management system (CMS).

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 23 Highways 1 2013-04-01 2013-04-01 false Federal lands congestion management system (CMS). 972... § 972.214 Federal lands congestion management system (CMS). (a) For purposes of this section, congestion... interference. For those FWS transportation systems that require a CMS, in both metropolitan and...

  15. 23 CFR 972.214 - Federal lands congestion management system (CMS).

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 23 Highways 1 2014-04-01 2014-04-01 false Federal lands congestion management system (CMS). 972... § 972.214 Federal lands congestion management system (CMS). (a) For purposes of this section, congestion... interference. For those FWS transportation systems that require a CMS, in both metropolitan and...

  16. Transmission dispatch and congestion management in open market systems

    NASA Astrophysics Data System (ADS)

    Fang, Risheng

    This thesis is located in the domain of electricity supply industry restructuring. It deals with emerging issues, whose understanding is essential to advancing knowledge of open access transmission theory and proceeds to develop approaches for solving the transmission dispatch and congestion management problem. An overview of current trends and experiences in utility restructuring and the main models for restructuring, as well as the classifications of system operators, is first presented. A fully unbundled competitive electricity market model, called the bilateral/multilateral trades model, is then developed. A survey of current research in transmission dispatch and congestion management is included with discussion of transmission capacity and ancillary services. A methodology for the power dispatch problem in a structure dominated by bilateral and multilateral transmission contracts is presented. Group structures are mathematically formulated and explored and three basic types of curtailment strategies proposed for use by market participants. A more complex model is then developed, which takes into account the co-existence of bilateral and multilateral contracts with pool type dynamic supplies and demands based on bids and market clearing prices. An integrated dispatch strategy to reconcile all three types of transactions (bilateral, multilateral and pool) is then developed. Prioritization of electricity transactions and related curtailment strategies are explored and a mechanism for coordination between market participants to achieve additional economic advantages is described. A theory of security based rescheduling is presented in order to investigate the security-related aspects of operation in an unbundled and deregulated system. The impact of post-contingency corrective capability on optimal rescheduling results has been identified and the advantage of incorporating post-contingency corrective rescheduling into the objective function demonstrated. Finally

  17. Germany's Disease Management Program: Improving Outcomes in Congestive Heart Failure

    PubMed Central

    Kottmair, Stefan; Frye, Christian; Ziegenhagen, Dieter J.

    2005-01-01

    Hospital admissions among patients with congestive heart failure (CHF) are a major contributor to health care costs. A comprehensive disease management program for CHF was developed for private and statutory health insurance companies in order to improve health outcomes and reduce rehospitalization rates and costs. The program comprises care calls, written training material, telemetric monitoring, and health reports. Currently, 909 members from six insurance companies are enrolled. Routine evaluation, based on medical data warehouse software, demonstrates benefits in terms of improved health outcomes and processes of care. Economical evaluation of claims data indicates significant cost savings in a pre/post study design. PMID:17288080

  18. Germany's disease management program: improving outcomes in congestive heart failure.

    PubMed

    Kottmair, Stefan; Frye, Christian; Ziegenhagen, Dieter J

    2005-01-01

    Hospital admissions among patients with congestive heart failure (CHF) are a major contributor to health care costs. A comprehensive disease management program for CHF was developed for private and statutory health insurance companies in order to improve health outcomes and reduce rehospitalization rates and costs. The program comprises care calls, written training material, telemetric monitoring, and health reports. Currently, 909 members from six insurance companies are enrolled. Routine evaluation, based on medical data warehouse software, demonstrates benefits in terms of improved health outcomes and processes of care. Economical evaluation of claims data indicates significant cost savings in a pre/post study design.

  19. Management of anemia in patients with congestive heart failure.

    PubMed

    Tim Goodnough, Lawrence; Comin-Colet, Josep; Leal-Noval, Santiago; Ozawa, Sherri; Takere, Jacqueline; Henry, David; Javidroozi, Mazyar; Hohmuth, Benjamin; Bisbe, Elvira; Gross, Irwin; Shander, Aryeh

    2017-01-01

    Anemia is an independent risk factor for adverse patient outcomes. There are no guidelines for management of anemia in patients with congestive heart failure (CHF), despite its high incidence. Four objectives were defined by the International Anemia Management and Clinical Outcomes Expert Panel (AMCO), a multinational group of interdisciplinary experts identified by the Society for the Advancement of Blood Management (SABM) to: determine the prevalence of anemia in outpatients; to determine the prevalence of hospital-acquired anemia; to assess the impact of anemia management on clinical outcomes such as quality of life and functional status; and to provide recommendations for primary care physicians and specialists for the diagnosis, evaluation, and management of anemia in patients with CHF. Anemia and iron deficiency were confirmed to be highly prevalent in patients with CHF. Intravenous iron therapy improves anemia, cardiac function and exercise tolerance, leading to improvement in quality of life. Anemia management has been demonstrated to be cost-effective. Clinical care pathways to manage anemia in patients with CHF are recommended as best practices in order to improve patient outcomes. Am. J. Hematol. 92:88-93, 2017. © 2016 Wiley Periodicals, Inc.

  20. Ultrafiltration in the management of refractory congestive heart failure.

    PubMed Central

    Simpson, I A; Rae, A P; Simpson, K; Gribben, J; Boulton Jones, J M; Allison, M E; Hutton, I

    1986-01-01

    Ultrafiltration was performed in nine patients with congestive cardiac failure that was refractory to conventional medical treatment. A mean of 12 X 7 litres of fluid was removed, and there was a sustained symptomatic improvement in all patients. Weight loss continued after ultrafiltration and a sustained increase in serum sodium concentration was also noted. A transient fall in right atrial pressure was seen only at four hours after ultrafiltration. No adverse haemodynamic effects were seen four and eighteen hours after fluid removal. Intracardiac dimensions measured by echocardiography remained unchanged. Ultrafiltration can be used to relieve symptoms in patients with refractory congestive heart failure and gross oedema. PMID:3964500

  1. Risk Management Plan Rule

    EPA Pesticide Factsheets

    RMP implements Section 112(r) of the 1990 Clean Air Act amendments, and requires facilities that use extremely hazardous substances to develop a Risk Management Plan and revise/resubmit every five years. Find guidance, factsheets, training, and assistance.

  2. The congestion control algorithm based on queue management of each node in mobile ad hoc networks

    NASA Astrophysics Data System (ADS)

    Wei, Yifei; Chang, Lin; Wang, Yali; Wang, Gaoping

    2016-12-01

    This paper proposes an active queue management mechanism, considering the node's own ability and its importance in the network to set the queue threshold. As the network load increases, local congestion of mobile ad hoc network may lead to network performance degradation, hot node's energy consumption increase even failure. If small energy nodes congested because of forwarding data packets, then when it is used as the source node will cause a lot of packet loss. This paper proposes an active queue management mechanism, considering the node's own ability and its importance in the network to set the queue threshold. Controlling nodes buffer queue in different levels of congestion area probability by adjusting the upper limits and lower limits, thus nodes can adjust responsibility of forwarding data packets according to their own situation. The proposed algorithm will slow down the send rate hop by hop along the data package transmission direction from congestion node to source node so that to prevent further congestion from the source node. The simulation results show that, the algorithm can better play the data forwarding ability of strong nodes, protect the weak nodes, can effectively alleviate the network congestion situation.

  3. Anesthesia and congestive heart failure: pathology, medical, and surgical management.

    PubMed

    Armstrong, Christopher S; Hoover, Jason M; Fox, Charles J; Field, Aaron M; Richards, Todd A; Islam, Sameer R; Kaye, Alan D

    2006-06-01

    Congestive heart failure (CHF) is increasingly being recognized as a health problem in the United States. It is estimated that the lifetime risk for CHF is 1 in 5. The clinical anesthesiologist can expect to see several cases involving patients suffering from CHF. Because of the danger associated with surgery in a patient with CHF, a thorough knowledge of the disorder and the potential effects on the delivery of anesthetics must be considered. In addition, knowledge of the disease process and its manifestations is required for smooth guidance of the patient through the perioperative period. The understanding of current pharmacotherapies, surgical procedures and their implications related to interactions with anesthetics are all discussed.

  4. A perspective on the surgical management of congestive heart failure.

    PubMed

    Massad, Malek G; Prasad, Sunil M; Chedrawy, Edgar G; Lele, Himalaya

    2008-03-01

    Surgical treatment of patients with congestive heart failure (CHF) has steadily advanced from rescue procedures such as aneurysmectomy, rupture repair, ventricular assist devices (VADs), and transplantation to procedures that can prevent or delay the progression of cardiac dysfunction and failure. The latter include operations such as coronary artery bypass grafting (CABG) and mitral valve repair for patients with ischemic cardiomyopathy (ICMP) and mitral annular dilatation, ventricular restoration and remodeling, and cardiac resynchronization therapy. As the number of heart transplants reported worldwide continues to decline over the past decade (by over 30%), newer surgical therapies have emerged. A need arises for clinical registries such as the NIH-sponsored LVAD registry and registries for biventricular pacing and AICD implantation, for total artificial heart implants, and for mitral valve repair in patients with ICMP. Prospective trials comparing sole ventricular restoration therapy (SVR) to SVR with concomitant CABG/MVR, coronary sinus versus epicardial LV pacing for ventricular resynchronization therapy, trials comparing LVAD as destination therapy to AICD implants, mitral valve repair versus chordal-sparing valve replacement for ischemic and valvular cardiomyopathy, and off-pump versus on-pump CABG for patients with ICMP are urgently needed. Future research should also be directed toward drugs targeting "B-cell mediated" humeral vascular rejection--the Achilles heel of cardiac transplantation, xenotransplantation, permanently implantable VADs, gene therapy, and myocardial cell regeneration therapy.

  5. Role of biological and non biological factors in congestive heart failure mortality: PREDICE-SCORE: a clinical prediction rule.

    PubMed

    de la Cámara, Agustín Gómez; Guerravales, Juan Manuel; Tapia, Purificación Magán; Esteban, Eva Andrés; del Pozo, Silvia Vázquez Fernández; Sandubete, Enrique Calderón; Ortega, Francisco J Medrano; Puerto, Asunción Navarro; Marín-León, Ignacio

    2012-01-01

    Congestive heart failure (HF) is a chronic, frequent and disabling condition but with a modifiable course and a large potential for improving. The aim of this project was to develop a clinical prediction model of biological and non biological factors in patients with first diagnosis of HF that facilitates the risk-stratification and decision-making process at the point of care. Historical cohort analysis of 600 patients attended at three tertiary hospitals and diagnosed of a first episode of HF according Framingham criteria. There were followed 1 year. We analyzed sociodemographic, clinical and laboratory data with potential prognostic value. The modelling process concluded into a logistic regression multivariable analysis and a predictive rule: PREDICE SCORE. Age, dependency for daily basic activities, creatinine clearance, sodium levels at admission and systolic dysfunction diagnosis (HF with left ventricular ejection fraction 〈 40%) were the selected variables. The model showed a c-statistic of 0.763. PREDICE Score, has range of 22 points to stratifications of 1-year mortality. The follow-up of 600 patients hospitalized by a first episode of congestive HF, allowed us to obtain a predictive 1 year mortality model from the combination of demographic data, routine biochemistry and easy handling social and functional variables at the point of care. The variables included were non-invasive, undemanding to collect, and widely available. It allows for risk stratification and therapeutical targeting and may help in the clinical decisions process in a sustainable way.

  6. Case studies in disease management for congestive heart failure.

    PubMed

    Quilty, M; Lewis, A

    1997-03-01

    Today, case management is neither science nor art. Successful programs have little in common except corporate commitment, the right people for the right job, and an understanding of the playing field. The author provides three case studies of HMOs who tried to jump into the field, with varying levels of success.

  7. Streamling the Change Management with Business Rules

    NASA Technical Reports Server (NTRS)

    Savela, Christopher

    2015-01-01

    Will discuss how their organization is trying to streamline workflows and the change management process with business rules. In looking for ways to make things more efficient and save money one way is to reduce the work the workflow task approvers have to do when reviewing affected items. Will share the technical details of the business rules, how to implement them, how to speed up the development process by using the API to demonstrate the rules in action.

  8. Never Been KIST: Tor’s Congestion Management Blossoms with Kernel-Informed Socket Transport

    DTIC Science & Technology

    2014-08-01

    CUBIC congestion control algorithm. Shadow Topology Enhancements: To ensure that we are causing the most realistic performance and con- gestion effects...selection [13, 59, 60], client throttling [14, 38, 45], circuit scheduling [57], and flow/congestion control [15]. While some of this work has or will be...congestion local to relays running in the public Tor network, and use them to measure congestion from three live relays under our control . Second, we

  9. Impact of telemonitoring at home on the management of elderly patients with congestive heart failure.

    PubMed

    Antonicelli, Roberto; Testarmata, Paolo; Spazzafumo, Liana; Gagliardi, Cristina; Bilo, Grzegorz; Valentini, Mariaconsuelo; Olivieri, Fabiola; Parati, Gianfranco

    2008-01-01

    We studied the effects of home telemonitoring in elderly patients with congestive heart failure (CHF) on mortality and rate of hospitalization, compliance with treatment, quality of life and costs of CHF management, by comparison with a group receiving usual care. Fifty-seven elderly CHF patients were randomized to standard care or to home telemonitoring-based care and followed for 12 months. In the subjects who were monitored, weekly reports on their clinical status were obtained and their management was modified accordingly. Home telemonitoring was associated with improvements in the composite endpoint of mortality and rate of hospitalizations (P = 0.006), a better compliance with therapy, more frequent use of beta-blockers and statins, lower total cholesterol level and a better reported health perception score. The improved results with home telemonitoring in CHF were probably due to better compliance and to closer monitoring of the patients.

  10. Congestive heart failure self-management among US veterans: The role of personal and professional advocates.

    PubMed

    Skaperdas, Eleni; Tuepker, Anaïs; Nicolaidis, Christina; Robb, Jessica K; Kansagara, Devan; Hickam, David H

    2014-06-01

    Understand patients' experiences with primary care services for congestive heart failure (CHF) and explore the relationship between health services and self-management. We conducted semi-structured interviews with thirty-nine patients with CHF receiving care at one Veterans Affairs Medical Center (VA). We analyzed data using thematic content analysis. Participants acknowledged the importance of ongoing engagement in the plan of care for CHF. They attributed success in this effort to be greatly influenced by personal advocates. The advocates included both members of the healthcare team with whom they had a continuity relationship and friends or family members who assisted on a daily basis. Participants also identified psychological symptoms as a major barrier to carrying out self-care. Patients identify relationships with health care workers, help from family and friends, and mental health problems as major influences on the ability to manage their CHF. Efforts to optimize CHF self-management should attend to health system and psychosocial barriers to care. Published by Elsevier Ireland Ltd.

  11. FACTS Devices Cost Recovery During Congestion Management in Deregulated Electricity Markets

    NASA Astrophysics Data System (ADS)

    Sharma, Ashwani Kumar; Mittapalli, Ram Kumar; Pal, Yash

    2016-09-01

    In future electricity markets, flexible alternating current transmission system (FACTS) devices will play key role for providing ancillary services. Since huge cost is involved for the FACTS devices placement in the power system, the cost invested has to be recovered in their life time for the replacement of these devices. The FACTS devices in future electricity markets can act as an ancillary services provider and have to be remunerated. The main contributions of the paper are: (1) investment recovery of FACTS devices during congestion management such as static VAR compensator and unified power flow controller along with thyristor controlled series compensator using non-linear bid curves, (2) the impact of ZIP load model on the FACTS cost recovery of the devices, (3) the comparison of results obtained without ZIP load model for both pool and hybrid market model, (4) secure bilateral transactions incorporation in hybrid market model. An optimal power flow based approach has been developed for maximizing social welfare including FACTS devices cost. The optimal placement of the FACTS devices have been obtained based on maximum social welfare. The results have been obtained for both pool and hybrid electricity market for IEEE 24-bus RTS.

  12. Predictive functional control for active queue management in congested TCP/IP networks.

    PubMed

    Bigdeli, N; Haeri, M

    2009-01-01

    Predictive functional control (PFC) as a new active queue management (AQM) method in dynamic TCP networks supporting explicit congestion notification (ECN) is proposed. The ability of the controller in handling system delay along with its simplicity and low computational load makes PFC a privileged AQM method in the high speed networks. Besides, considering the disturbance term (which represents model/process mismatches, external disturbances, and existing noise) in the control formulation adds some level of robustness into the PFC-AQM controller. This is an important and desired property in the control of dynamically-varying computer networks. In this paper, the controller is designed based on a small signal linearized fluid-flow model of the TCP/AQM networks. Then, closed-loop transfer function representation of the system is derived to analyze the robustness with respect to the network and controller parameters. The analytical as well as the packet-level ns-2 simulation results show the out-performance of the developed controller for both queue regulation and resource utilization. Fast response, low queue fluctuations (and consequently low delay jitter), high link utilization, good disturbance rejection, scalability, and low packet marking probability are other features of the developed method with respect to other well-known AQM methods such as RED, PI, and REM which are also simulated for comparison.

  13. Economic evaluation of Manitoba Health Lines in the management of congestive heart failure.

    PubMed

    Cui, Yang; Doupe, Malcolm; Katz, Alan; Nyhof, Paul; Forget, Evelyn L

    2013-11-01

    This one-year study investigated whether the Manitoba Provincial Health Contact program for congestive heart failure (CHF) is a cost-effective intervention relative to the standard treatment. Individual patient-level, randomized clinical trial of cost-effective model using data from the Health Research Data Repository at the Manitoba Centre for Health Policy, University of Manitoba. A total of 179 patients aged 40 and over with a diagnosis of CHF levels II to IV were recruited from Winnipeg and Central Manitoba and randomized into three treatment groups: one receiving standard care, a second receiving Health Lines (HL) intervention and a third receiving Health Lines intervention plus in-house monitoring (HLM). A cost-effectiveness study was conducted in which outcomes were measured in terms of QALYs derived from the SF-36 and costs using 2005 Canadian dollars. Costs included intervention and healthcare utilization. Bootstrap-resampled incremental cost-effectiveness ratios were computed to take into account the uncertainty related to small sample size. The total per-patient mean costs (including intervention cost) were not significantly different between study groups. Both interventions (HL and HLM) cost less and are more effective than standard care, with HL able to produce an additional QALY relative to HLM for $2,975. The sensitivity analysis revealed that there is an 85.8% probability that HL is cost-effective if decision-makers are willing to pay $50,000. Findings demonstrate that the HL intervention from the Manitoba Provincial Health Contact program for CHF is an optimal intervention strategy for CHF management compared to standard care and HLM. Copyright © 2013 Longwoods Publishing.

  14. Economic Evaluation of Manitoba Health Lines in the Management of Congestive Heart Failure

    PubMed Central

    Cui, Yang; Doupe, Malcolm; Katz, Alan; Nyhof, Paul; Forget, Evelyn L.

    2013-01-01

    Objective: This one-year study investigated whether the Manitoba Provincial Health Contact program for congestive heart failure (CHF) is a cost-effective intervention relative to the standard treatment. Design: Individual patient-level, randomized clinical trial of cost-effective model using data from the Health Research Data Repository at the Manitoba Centre for Health Policy, University of Manitoba. Methods: A total of 179 patients aged 40 and over with a diagnosis of CHF levels II to IV were recruited from Winnipeg and Central Manitoba and randomized into three treatment groups: one receiving standard care, a second receiving Health Lines (HL) intervention and a third receiving Health Lines intervention plus in-house monitoring (HLM). A cost-effectiveness study was conducted in which outcomes were measured in terms of QALYs derived from the SF-36 and costs using 2005 Canadian dollars. Costs included intervention and healthcare utilization. Bootstrap-resampled incremental cost-effectiveness ratios were computed to take into account the uncertainty related to small sample size. Results: The total per-patient mean costs (including intervention cost) were not significantly different between study groups. Both interventions (HL and HLM) cost less and are more effective than standard care, with HL able to produce an additional QALY relative to HLM for $2,975. The sensitivity analysis revealed that there is an 85.8% probability that HL is cost-effective if decision-makers are willing to pay $50,000. Conclusion: Findings demonstrate that the HL intervention from the Manitoba Provincial Health Contact program for CHF is an optimal intervention strategy for CHF management compared to standard care and HLM. PMID:24359716

  15. A multi-layer monitoring system for clinical management of Congestive Heart Failure.

    PubMed

    Guidi, Gabriele; Pollonini, Luca; Dacso, Clifford C; Iadanza, Ernesto

    2015-01-01

    Congestive Heart Failure (CHF) is a serious cardiac condition that brings high risks of urgent hospitalization and death. Remote monitoring systems are well-suited to managing patients suffering from CHF, and can reduce deaths and re-hospitalizations, as shown by the literature, including multiple systematic reviews. The monitoring system proposed in this paper aims at helping CHF stakeholders make appropriate decisions in managing the disease and preventing cardiac events, such as decompensation, which can lead to hospitalization or death. Monitoring activities are stratified into three layers: scheduled visits to a hospital following up on a cardiac event, home monitoring visits by nurses, and patient's self-monitoring performed at home using specialized equipment. Appropriate hardware, desktop and mobile software applications were developed to enable a patient's monitoring by all stakeholders. For the first two layers, we designed and implemented a Decision Support System (DSS) using machine learning (Random Forest algorithm) to predict the number of decompensations per year and to assess the heart failure severity based on a variety of clinical data. For the third layer, custom-designed sensors (the Blue Scale system) for electrocardiogram (EKG), pulse transit times, bio-impedance and weight allowed frequent collection of CHF-related data in the comfort of the patient's home. We also performed a short-term Heart Rate Variability (HRV) analysis on electrocardiograms self-acquired by 15 healthy volunteers and compared the obtained parameters with those of 15 CHF patients from PhysioNet's PhysioBank archives. We report numerical performances of the DSS, calculated as multiclass accuracy, sensitivity and specificity in a 10-fold cross-validation. The obtained average accuracies are: 71.9% in predicting the number of decompensations and 81.3% in severity assessment. The most serious class in severity assessment is detected with good sensitivity and specificity (0

  16. CCS_WHMS: A Congestion Control Scheme for Wearable Health Management System.

    PubMed

    Kafi, Mohamed Amine; Ben Othman, Jalel; Bagaa, Miloud; Badache, Nadjib

    2015-12-01

    Wearable computing is becoming a more and more attracting field in the last years thanks to the miniaturisation of electronic devices. Wearable healthcare monitoring systems (WHMS) as an important client of wearable computing technology has gained a lot. Indeed, the wearable sensors and their surrounding healthcare applications bring a lot of benefits to patients, elderly people and medical staff, so facilitating their daily life quality. But from a research point of view, there is still work to accomplish in order to overcome the gap between hardware and software parts. In this paper, we target the problem of congestion control when all these healthcare sensed data have to reach the destination in a reliable manner that avoids repetitive transmission which wastes precious energy or leads to loss of important information in emergency cases, too. We propose a congestion control scheme CCS_WHMS that ensures efficient and fair data delivery while used in the body wearable system part or in the multi-hop inter bodies wearable ones to get the destination. As the congestion detection paradigm is very important in the control process, we do experimental tests to compare between state of the art congestion detection methods, using MICAz motes, in order to choose the appropriate one for our scheme.

  17. 23 CFR 970.214 - Federal lands congestion management system (CMS).

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... selecting congestion mitigation strategies that are the most time efficient and cost effective and that add...-metropolitan areas, consideration shall be given to strategies that promote alternative transportation systems... the use of alternate mode studies and implementation plans as components of the CMS. (4) A CMS will...

  18. 23 CFR 970.214 - Federal lands congestion management system (CMS).

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... selecting congestion mitigation strategies that are the most time efficient and cost effective and that add...-metropolitan areas, consideration shall be given to strategies that promote alternative transportation systems... the use of alternate mode studies and implementation plans as components of the CMS. (4) A CMS will...

  19. 23 CFR 970.214 - Federal lands congestion management system (CMS).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... selecting congestion mitigation strategies that are the most time efficient and cost effective and that add...-metropolitan areas, consideration shall be given to strategies that promote alternative transportation systems... the use of alternate mode studies and implementation plans as components of the CMS. (4) A CMS will...

  20. 23 CFR 973.214 - Indian lands congestion management system (CMS).

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... the IRR transportation plan and the IRRTIP, when selecting strategies for implementation that provide... congestion and enhance mobility. (b) In addition to the requirements provided in § 973.204, the CMS must meet..., consideration shall be given to strategies that reduce private automobile travel and improve existing...

  1. 23 CFR 973.214 - Indian lands congestion management system (CMS).

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... the IRR transportation plan and the IRRTIP, when selecting strategies for implementation that provide... congestion and enhance mobility. (b) In addition to the requirements provided in § 973.204, the CMS must meet..., consideration shall be given to strategies that reduce private automobile travel and improve existing...

  2. Disease management 360 degrees: a scorecard approach to evaluating TRICARE's programs for asthma, congestive heart failure, and diabetes.

    PubMed

    Yang, Wenya; Dall, Timothy M; Zhang, Yiduo; Hogan, Paul F; Arday, David R; Gantt, Cynthia J

    2010-08-01

    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.

  3. Optimal Rescheduling of Generators for Congestion Management and Benefit Maximization in a Decentralized Bilateral Multi-transactions Power Network

    NASA Astrophysics Data System (ADS)

    Singh, Brijesh; Mahanty, Ranjit; Singh, S. P.

    2013-05-01

    This paper presents a framework to achieve an optimal power flow solution in a decentralized bilateral multitransaction-based market. An independent optimal dispatch solution has been used for each market. The interior point (IP)-based optimization technique has been used for finding a global economic optimal solution of the whole system. In this method, all the participants try to maximize their own profits with the help of system information announced by the operator. In the present work, a parallel algorithm has been used to find out a global optimum solution in decentralized market model. The study has been carried out on a modified IEEE-30 bus system. The results show that the suggested decentralized approach can provide a better optimal solution. The obtained results show the effectiveness of IP optimization-based optimal generator schedule and congestion management in the decentralized market.

  4. Risk Management Plan (RMP) Rule Overview

    EPA Pesticide Factsheets

    As required by Section 112(r) of the Clean Air Act Amendments, this rule contains regulations and guidance for chemical accident prevention at facilities that use extremely hazardous substances, and aids in emergency preparedness and response.

  5. 75 FR 4451 - Financial Management Service; Proposed Collection of Information: Final Rule-Management of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-27

    ... Fiscal Service Financial Management Service; Proposed Collection of Information: Final Rule--Management of Federal Agency Disbursements. AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and Request for comments. SUMMARY: The Financial Management Service, as part of...

  6. When weight management lasts. Lower perceived rule complexity increases adherence.

    PubMed

    Mata, Jutta; Todd, Peter M; Lippke, Sonia

    2010-02-01

    Maintaining behavior change is one of the major challenges in weight management and long-term weight loss. We investigated the impact of the cognitive complexity of eating rules on adherence to weight management programs. We studied whether popular weight management programs can fail if participants find the rules too complicated from a cognitive perspective, meaning that individuals are not able to recall or process all required information for deciding what to eat. The impact on program adherence of participants' perceptions of eating rule complexity and other behavioral factors known to influence adherence (including previous weight management, self-efficacy, and planning) was assessed via a longitudinal online questionnaire given to 390 participants on two different popular weight management regimens. As we show, the regimens, Weight Watchers and a popular German recipe diet (Brigitte), strongly differ in objective rule complexity and thus their cognitive demands on the dieter. Perceived rule complexity was the strongest factor associated with increased risk of quitting the cognitively demanding weight management program (Weight Watchers); it was not related to adherence length for the low cognitive demand program (Brigitte). Higher self-efficacy generally helped in maintaining a program. The results emphasize the importance of considering rule complexity to promote long-term weight management. 2009 Elsevier Ltd. All rights reserved.

  7. Knowledge-Centric Management of Business Rules in a Pharmacy

    NASA Astrophysics Data System (ADS)

    Puustjärvi, Juha; Puustjärvi, Leena

    A business rule defines or constraints some aspect of the business. In healthcare sector many of the business rules are dictated by law or medical regulations, which are constantly changing. This is a challenge for the healthcare organizations. Although there is available several commercial business rule management systems the problem from pharmacies point of view is that these systems are overly geared towards the automation and manipulation of business rules, while the main need in pharmacies lies in easy retrieving of business rules within daily routines. Another problem is that business rule management systems are isolated in the sense that they have their own data stores that cannot be accessed by other information systems used in pharmacies. As a result, a pharmacist is burdened by accessing many systems inside a user task. In order to avoid this problem we have modeled business rules as well as their relationships to other relevant information by OWL (Web Ontology Language) such that the ontology is shared among the pharmacy's applications. In this way we can avoid the problems of isolated applications and replicated data. The ontology also encourages pharmacies business agility, i.e., the ability to react more rapidly to the changes required by the new business rules. The deployment of the ontology requires that stored business rules are annotated by appropriate metadata descriptions, which are presented by RDF/XML serialization format. However, neither the designer nor the pharmacists are burdened by RDF/XML format as there are sophisticated graphical editors that can be used.

  8. Use of the short form 36 in a primary care based disease management program for patients with congestive heart failure.

    PubMed

    Sidorov, Jaan; Shull, Robert D; Girolami, Sabrina; Mensch, Debra

    2003-01-01

    While disease management has been described as an important strategy for the care of patients with congestive heart failure (CHF) in the managed care setting, little is known about the impact of this approach on overall health-related quality of life. In this study the Short Form 36 (SF-36) was administered to all patients entering CHF disease management at the time of program entry and at 1 year following entry. Scores on the eight subscales and the two composite scales were calculated and compared before and after. Patients were enrolled from a mixed-model health maintenance organization (HMO) with 34,740 Medicare + Choice enrollees residing in 38 counties in central and northeastern Pennsylvania. Two hundred sixty-eight continuously enrolled patients in an HMO-sponsored CHF disease state management program with completed baseline and follow-up SF-36 surveys were sampled. All patients entered into disease management received primary care based, nurse-directed education about CHF self-management including instruction on etiology of CHF, the importance of medication compliance, home care services if indicated, monitoring weight gain, increased understanding of the warning signs of worsening CHF, and coaching on strategies to contact a physician in a timely manner when CHF worsens. Nurses also facilitated for CHF guidelines among primary care physicians, including the need to obtain a baseline assessment of cardiac function, prescribe angiotensin I-converting enzyme (ACE) inhibitors and beta blockers when appropriate, and initiated appropriate specialist referral. Compared with enrollees who did not complete a pair of SF-36 surveys, the 268 respondents were younger and had a significantly higher rate of cardiac imaging as well as use of ACE inhibitors and beta blocker medications. Analysis of the SF-36 data revealed that three of the eight (Role Physical, General Health Perceptions, and Role Emotional) subscales increased in a statistically significant manner, as

  9. 10 rules for managing global innovation.

    PubMed

    Wilson, Keeley; Doz, Yves L

    2012-10-01

    More and more companies recognize that their dispersed, global operations are a treasure trove of ideas and capabilities for innovation. But it's proving harder than expected to unearth those ideas or exploit those capabilities. Part of the problem is that companies manage global innovation the same way they manage traditional, single-location projects. Single-location projects draw on a large reservoir of tacit knowledge, shared context, and trust that global projects lack. The management challenge, therefore, is to replicate the positive aspects of colocation while harnessing the opportunities of dispersion. In this article, Insead's Wilson and Doz draw on research into global strategy and innovation to present a set of guidelines for setting up and managing global innovation. They explore in detail the challenges that make global projects inherently different and show how these can be overcome by applying superior project management skills across teams, fostering a strong collaborative culture, and using a robust array of communications tools.

  10. KARMA: Managing business rules for specification to implementation

    SciTech Connect

    Sobieski, J.; Krovvidy, S.; McClintock, C.; Thorpe, M.

    1996-12-31

    Fannie Mae is a congressionally chartered, shareholder-owned company and the nation`s largest source of conventional home mortgage funds. Fannie Mae purchases and securitizes loans and is considered the leader in the secondary mortgage market. Because of its strong leadership role, Fannie Mae`s policies for loan eligibility set the standard in the mortgage industry and applying these policies consistently and effectively is critical to Fannie Mae`s mission and profitability. Fannie Mae`s policies for selling and servicing mortgage loans span the business functions of the secondary mortgage market and therefore are contained in many different software applications. Managing policy across multiple business applications became increasingly complex. To meet these demands, Fannie Mae developed KARMA (Knowledge Acquisition and Rule Management Assistant) and the Business Rule Server to allow policy changes to be implemented quickly throughout its software application environment and to provide business users with direct ownership and management of Fannie Mae`s policies in a way that seamlessly integrates policy into the software applications. KARMA is designed to support the management of these policies independent of the applications in which they are embedded. KARMA generates executable business rules which become part of the Business Rule Server. As a result, policy is managed centrally and no longer embedded in multiple applications. KARMA and the Business Rule Server have been running in production supporting the Cash Delivery application since July, 1995.

  11. Ten Rules for Managing by Objectives.

    ERIC Educational Resources Information Center

    Denny, William A.

    1979-01-01

    Ten suggestions for administrators concerning objectives setting, employee participation, yearly reviews, and other aspects of management by objectives programs. Reprint available from Business Horizons, School of Business, Indiana University, Bloomington, IN 47405. (JM)

  12. Weight Management Belief is the Leading Influential Factor of Weight Monitoring Compliance in Congestive Heart Failure Patients

    PubMed Central

    Lu, Min-Xia; Zhang, Yan-Yun; Jiang, Jun-Fang; Ju, Yang; Wu, Qing; Zhao, Xin; Wang, Xiao-Hua

    2016-01-01

    Background Daily weight monitoring is frequently recommended as a part of heart failure self-management to prevent exacerbations. This study is to identify factors that influence weight monitoring compliance of congestive heart failure patients at baseline and after a 1-year weight management (WM) program. Methods This was a secondary analysis of an investigative study and a randomized controlled study. A general information questionnaire assessed patient demographics and clinical variables such as medicine use and diagnoses, and the weight management scale evaluated their WM abilities. Good and poor compliance based on abnormal weight gain from the European Society of Cardiology (> 2 kg in 3 days) were compared, and hierarchical multiple logistic regression analysis was used to identify factors influencing weight monitoring compliance. Results A total of 316 patients were enrolled at baseline, and 66 patients were enrolled after the 1-year WM program. Of them, 12.66% and 60.61% had good weight monitoring compliance at baseline and after 1 year of WM, respectively. A high WM-related belief score indicated good weight monitoring compliance at both time points [odds ratio (OR), 1.043, 95% confidence interval (CI), 1.023-1.063, p < 0.001; and OR, 2.054, 95% CI, 1.209-3.487, p < 0.001, respectively). Patients with a high WM-related practice score had good weight monitoring compliance at baseline (OR, 1.046, 95% CI, 1.027-1.065, p < 0.001), and patients who had not monitored abnormal weight had poor weight monitoring compliance after the 1-year WM program (OR, 0.244, 95% CI, 0.006-0.991, p = 0.049). Conclusions Data from this study suggested that belief related to WM plays an important role in weight monitoring compliance. PMID:27899858

  13. Diagnosis and Management of Congenital Coronary Arteriovenous Fistula in the Pediatric Patients Presenting Congestive Heart Failure and Myocardial Ischemia

    PubMed Central

    Chen, Ming

    2009-01-01

    Purpose Four pediatric patients with congenital coronary arteriovenous fistula (CAVF) were reported to remind pediatric practitioners and cardiologists of its diagnosis and management. Materials and Methods Four pediatric patients with congenital CAVF from June 1999 to November 2007 were included in this retrospective study. Study modalities included reviews of patients' profiles of clinical features, chest radiograph, Doppler echocardiography, cardiac catheterization with angiography, myocardial perfusion scan, and computed tomography. Results All 4 patients were symptomatic. The clinical symptoms and signs were feeding problem, continuous murmur, tachycardia, tachypnea, cardiomegaly, and exertional chest pain. Myocardial enzyme was elevated in 1 patient. Echocardiography showed dilatation of the coronary artery in all 4 patients, and traced down its origin in 3 and drainage in 4. The fistulas originated from the right coronary artery in 2 patients and left coronary artery in 2, and were drained into the right ventricle in 2, right atrium in 1, and pulmonary artery in 1. Single left coronary artery was found in 1 patient. The pulmonary-to-systemic blood flow ratios ranged from 1.2 to 2.5. Transcatheter coil occlusion was successfully performed in 4 patients through a coaxial delivery system. The symptoms and signs of congestive heart failure and myocardial ischemia disappeared after the procedure. Conclusion Diagnosis of congenital CAVF could be achieved by appreciation of continuous murmur over area unusual for the ductus, and by scrupulous examination of echocardiography as well as angiography of the coronary artery through which coaxial transcatheter coil occlusion could be performed successfully. PMID:19259355

  14. Disease management produces limited quality-of-life improvements in patients with congestive heart failure: evidence from a randomized trial in community-dwelling patients.

    PubMed

    Smith, Brad; Forkner, Emma; Zaslow, Barbara; Krasuski, Richard A; Stajduhar, Karl; Kwan, Michael; Ellis, Robert; Galbreath, Autumn Dawn; Freeman, Gregory L

    2005-11-01

    Disease management programs are reported to improve clinical and quality-of-life outcomes while simultaneously lowering healthcare costs. To examine the effectiveness of disease management in improving health-related quality of life (HRQL) among patients with heart failure beyond 12 months. A total of 1069 community-dwelling patients 18 years and older in South Texas with echocardiographic evidence of congestive heart failure were randomly assigned to disease management, augmented disease management, and control groups. They were followed up 18 months. Patients in the control group received usual care. Patients in the intervention groups were assigned a registered nurse as a disease manager who performed telephonic patient education and medication management. Health-related quality-of-life data (based on the Medical Outcomes Study 36-Item Short-Form Health Survey [SF-36]) were collected 4 times, at 6-month intervals. Disease management has a limited effect on HRQL. Analysis of the SF-36 health transition measure showed a positive effect of the intervention on self-reported improvement in health at 6 months and at 12 months (P = .04 and P = .004, respectively). However, no effect of disease management was observed across any of the SF-36 components. Women and patients with diastolic heart failure had poorer HRQL scores. Participation in disease management has little effect on HRQL outcomes in congestive heart failure. Beneficial effects on the SF-36 scale scores seen at 6 and 12 months were not sustained. Therefore, it is unclear whether disease management can provide long-term improvement in HRQL for patients with congestive heart failure.

  15. An analysis of the new EPA risk management rule

    SciTech Connect

    Loran, B.; Nand, K.; Male, M.

    1997-08-01

    Due to increasing public concern of risks from handling highly hazardous chemicals at various facilities, a number of state and federal regulatory agencies, such as the Occupational Safety and Health Administration (OSHA) and recently the US Environmental Protection Agency (EPA), have enacted regulations requiring these facilities to perform accidental risk analysis and develop process safety and risk management programs. The regulatory requirements to be fulfilled are described; the major components involved are a Process Hazard Analysis, a Consequence Analysis, and a Management Program. The performance of these analyses and the development of a management program for 21 facilities operated by the City of Los Angeles Department of Water and Power, treating drinking water supplies with chlorine, is discussed. The effectiveness of the EPA risk management rule in achieving risk reduction is critically analyzed; it is found that, while the rule increases the worker and public awareness of the inherent risks present, some of the analytical results obtained may have a limited practical application.

  16. Software Engineering Laboratory (SEL) relationships, models, and management rules

    NASA Technical Reports Server (NTRS)

    Decker, William; Hendrick, Robert; Valett, Jon D.

    1991-01-01

    Over 50 individual Software Engineering Laboratory (SEL) research results, extracted from a review of published SEL documentation, that can be applied directly to managing software development projects are captured. Four basic categories of results are defined and discussed - environment profiles, relationships, models, and management rules. In each category, research results are presented as a single page that summarizes the individual result, lists potential uses of the result by managers, and references the original SEL documentation where the result was found. The document serves as a concise reference summary of applicable research for SEL managers.

  17. Congestive heart failure disease management program: 1-Year population experience from a tertiary center heart failure registry in Saudi Arabia.

    PubMed

    Salem, Khal; Fallata, Dania; ElSebaie, Maha; Montasser, Ahmad; ElGedamy, Khaled; ElKhateeb, Osama

    2017-04-01

    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.

  18. Market Mechanism for Line Congestion Clearance

    NASA Astrophysics Data System (ADS)

    Ruiz Monroy, José Joaquín; Kita, Hiroyuki; Tanaka, Eiichi; Hasegawa, Jun

    This paper proposes a mechanism for clearance of line congestion and power flow control in a deregulated market environment. The mechanism applies penalties to the bilateral transactions that cause line congestion by increasing the prices of such transactions. The market regulates itself by redefining the transactions and checking again for violations, applying penalties if necessary and repeating the process until all the demand is satisfied without causing line congestion to the system. A bilateral transaction matrix (BTM) creation algorithm developed by the authors and a DC power flow program are integrated as parts of the market mechanism proposed in this paper. The congestion is cleared by the market participants when they reschedule their transactions. This mechanism is useful to study the effects of bilateral transactions on a power system and helps the Independent System Operator (ISO) to create rules and market mechanisms for line congestion clearance and power flow control.

  19. Use of intranasal corticosteroids in the management of congestion and sleep disturbance in pediatric patients with allergic rhinitis.

    PubMed

    Lanier, Bob Q

    2008-06-01

    Allergic rhinitis affects a large number of children and exerts a considerable socioeconomic impact. It is underdiagnosed and inadequately treated, which predisposes children to potentially serious comorbidities. Allergic rhinitis symptoms may create nighttime breathing problems and sleep disturbances and have a negative effect on a child's ability to learn in the classroom. Although antihistamines have shown efficacy in relieving many symptoms, they have little effect on nasal congestion. This article summarizes the advantages of intranasal corticosteroids, including their effectiveness against congestion and excellent safety profile. Intranasal corticosteroids with minimal systemic bioavailability provide topical drug delivery that minimizes the potential for systemic side-effects.

  20. Assessment and management of human health risk from toxic metals and polycyclic aromatic hydrocarbons in urban stormwater arising from anthropogenic activities and traffic congestion.

    PubMed

    Ma, Yukun; Liu, An; Egodawatta, Prasanna; McGree, James; Goonetilleke, Ashantha

    2017-02-01

    Toxic metals (TMs) and polycyclic aromatic hydrocarbons (PAHs) in urban stormwater pose risk to human health, thereby constraining its reuse potential. Based on the hypothesis that stormwater quality is primarily influenced by anthropogenic activities and traffic congestion, the primary focus of the research study was to analyse the impacts on human health risk from TMs and PAHs in urban stormwater and thereby develop a quantitative risk assessment model. The study found that anthropogenic activities and traffic congestion exert influence on the risk posed by TMs and PAHs in stormwater from commercial and residential areas. Motor vehicle related businesses (FVS) and traffic congestion (TC) were identified as two parameters which need to be included as independent variables to improve the model. Based on the study outcomes, approaches for mitigating the risk associated with TMs and PAHs in urban stormwater are discussed. Additionally, a roadmap is presented for the assessment and management of the risk arising from these pollutants. The study outcomes are expected to contribute to reducing the human health risk associated urban stormwater pollution and thereby enhance its reuse potential.

  1. 75 FR 8645 - Public Meetings on the Development of the Forest Service Land Management Planning Rule

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-25

    ... Forest Service Public Meetings on the Development of the Forest Service Land Management Planning Rule... to developing a new Forest Service Land Management Planning Rule (planning rule) through a... roundtables. Summaries of each session will be produced and posted on the planning rule Web site as part...

  2. 34 CFR 668.161 - Scope and purpose (cash management rules).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false Scope and purpose (cash management rules). 668.161... POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION STUDENT ASSISTANCE GENERAL PROVISIONS Cash Management § 668.161 Scope and purpose (cash management rules). (a) General. (1) This subpart establishes the rules and...

  3. 34 CFR 668.161 - Scope and purpose (cash management rules).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 3 2011-07-01 2011-07-01 false Scope and purpose (cash management rules). 668.161... POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION STUDENT ASSISTANCE GENERAL PROVISIONS Cash Management § 668.161 Scope and purpose (cash management rules). (a) General. (1) This subpart establishes the rules and...

  4. Evaluation of wholesale electric power market rules and financial risk management by agent-based simulations

    NASA Astrophysics Data System (ADS)

    Yu, Nanpeng

    As U.S. regional electricity markets continue to refine their market structures, designs and rules of operation in various ways, two critical issues are emerging. First, although much experience has been gained and costly and valuable lessons have been learned, there is still a lack of a systematic platform for evaluation of the impact of a new market design from both engineering and economic points of view. Second, the transition from a monopoly paradigm characterized by a guaranteed rate of return to a competitive market created various unfamiliar financial risks for various market participants, especially for the Investor Owned Utilities (IOUs) and Independent Power Producers (IPPs). This dissertation uses agent-based simulation methods to tackle the market rules evaluation and financial risk management problems. The California energy crisis in 2000-01 showed what could happen to an electricity market if it did not go through a comprehensive and rigorous testing before its implementation. Due to the complexity of the market structure, strategic interaction between the participants, and the underlying physics, it is difficult to fully evaluate the implications of potential changes to market rules. This dissertation presents a flexible and integrative method to assess market designs through agent-based simulations. Realistic simulation scenarios on a 225-bus system are constructed for evaluation of the proposed PJM-like market power mitigation rules of the California electricity market. Simulation results show that in the absence of market power mitigation, generation company (GenCo) agents facilitated by Q-learning are able to exploit the market flaws and make significantly higher profits relative to the competitive benchmark. The incorporation of PJM-like local market power mitigation rules is shown to be effective in suppressing the exercise of market power. The importance of financial risk management is exemplified by the recent financial crisis. In this

  5. [Vascular "tumors" and the rules of their surgical management].

    PubMed

    Enjolras, O; Deffrennes, D; Borsik, M; Diner, P; Laurian, C

    1998-08-01

    After defining vascular tumors and malformations, formerly called angiomas, the authors adopt the classification of the International Society for the Study of vascular Anomalies. The various groups of malformations, after definition of the subject and the problems raised, are illustrated by a number of clinical cases and the rules of surgical management are discussed. Capillary malformations, formerly called portwine stains, can be treated by dye laser, but sometimes tissue and orthognathic reconstructive surgery in the presence of a skeletal malformation. Lymphatic malformations (lymphangiomas), optimally assessed by CT or MRI, can be treated by a variety of approaches: sclerotherapy, surgery. Venous malformations raise very different problems in the cervicocephalic region and on the limbs and trunk, but always require a multidisciplinary approach with, according to the site, size and repercussions, Ethibloc percutaneous sclerotherapy, embolization, surgery. Arteriovenous malformations require complete surgical treatment, usually preceded by embolization; reconstruction consists of local flaps or skin expansion in simple cases, and revascularized free flaps in difficult cases. If the malformation is cosmetically and functionally acceptable, the authors propose conservative management. The first-line treatment of haemangiomas is pharmacological (corticosteroids, interferon), but surgery may be indicated in two situations: early and late. There is a renewed interest in early surgery, subtended by several factors including cosmetic concerns and the development of new technologies, including the Cavitron. Late surgery retains its classical cosmetic and functional indications. Two key-words dominate the rules of therapeutic management of all types of vascular malformations: a multidisciplinary approach and modesty.

  6. Treatment of congestion in upper respiratory diseases

    PubMed Central

    Meltzer, Eli O; Caballero, Fernan; Fromer, Leonard M; Krouse, John H; Scadding, Glenis

    2010-01-01

    Congestion, as a symptom of upper respiratory tract diseases including seasonal and perennial allergic rhinitis, acute and chronic rhinosinusitis, and nasal polyposis, is principally caused by mucosal inflammation. Though effective pharmacotherapy options exist, no agent is universally efficacious; therapeutic decisions must account for individual patient preferences. Oral H1-antihistamines, though effective for the common symptoms of allergic rhinitis, have modest decongestant action, as do leukotriene receptor antagonists. Intranasal antihistamines appear to improve congestion better than oral forms. Topical decongestants reduce congestion associated with allergic rhinitis, but local adverse effects make them unsuitable for long-term use. Oral decongestants show some efficacy against congestion in allergic rhinitis and the common cold, and can be combined with oral antihistamines. Intranasal corticosteroids have broad anti-inflammatory activities, are the most potent long-term pharmacologic treatment of congestion associated with allergic rhinitis, and show some congestion relief in rhinosinusitis and nasal polyposis. Immunotherapy and surgery may be used in some cases refractory to pharmacotherapy. Steps in congestion management include (1) diagnosis of the cause(s), (2) patient education and monitoring, (3) avoidance of environmental triggers where possible, (4) pharmacotherapy, and (5) immunotherapy (for patients with allergic rhinitis) or surgery for patients whose condition is otherwise uncontrolled. PMID:20463825

  7. Autonomous Congestion Control in Delay-Tolerant Networks

    NASA Technical Reports Server (NTRS)

    Burleigh, Scott; Jennings, Esther; Schoolcraft, Joshua

    2006-01-01

    Congestion control is an important feature that directly affects network performance. Network congestion may cause loss of data or long delays. Although this problem has been studied extensively in the Internet, the solutions for Internet congestion control do not apply readily to challenged network environments such as Delay Tolerant Networks (DTN) where end-to-end connectivity may not exist continuously and latency can be high. In DTN, end-to-end rate control is not feasible. This calls for congestion control mechanisms where the decisions can be made autonomously with local information only. We use an economic pricing model and propose a rule-based congestion control mechanism where each router can autonomously decide on whether to accept a bundle (data) based on local information such as available storage and the value and risk of accepting the bundle (derived from historical statistics). Preliminary experimental results show that this congestion control mechanism can protect routers from resource depletion without loss of data.

  8. Autonomous Congestion Control in Delay-Tolerant Networks

    NASA Technical Reports Server (NTRS)

    Burleigh, Scott; Jennings, Esther; Schoolcraft, Joshua

    2006-01-01

    Congestion control is an important feature that directly affects network performance. Network congestion may cause loss of data or long delays. Although this problem has been studied extensively in the Internet, the solutions for Internet congestion control do not apply readily to challenged network environments such as Delay Tolerant Networks (DTN) where end-to-end connectivity may not exist continuously and latency can be high. In DTN, end-to-end rate control is not feasible. This calls for congestion control mechanisms where the decisions can be made autonomously with local information only. We use an economic pricing model and propose a rule-based congestion control mechanism where each router can autonomously decide on whether to accept a bundle (data) based on local information such as available storage and the value and risk of accepting the bundle (derived from historical statistics). Preliminary experimental results show that this congestion control mechanism can protect routers from resource depletion without loss of data.

  9. Case management insider. The 2-midnight rule--a game-changer for case management.

    PubMed

    Cesta, Toni

    2014-04-01

    As a case manager or case management leader, it is important for you to stay in touch with how CMS continues to roll out the two-midnight rules as well as the manner of auditing on a go-forward basis. It is also important that your department continue to have a close working relationship with the billing department in your hospital to ensure that the hospital remains compliant with this new rule. Finally, it is also critical that your emergency department and its physicians are kept up to date on the rule and its implications for hospital admissions. Having a case management presence in the emergency department will help to ensure a sound review process at this important route of entry to the hospital. A working team should be created to review the cases that fall outside of the rule, and these cases should also be presented to the utilization review committee so that the hospital can continue to learn and move forward. Finally, listen to the CMS National Provider Calls (www.cms. gov/NPC) to gain additional and updated information as it becomes available! For additional information on the two-midnight rule go to www.cms.gov and search for CMS-1599-F.

  10. Recommendation System Based On Association Rules For Distributed E-Learning Management Systems

    NASA Astrophysics Data System (ADS)

    Mihai, Gabroveanu

    2015-09-01

    Traditional Learning Management Systems are installed on a single server where learning materials and user data are kept. To increase its performance, the Learning Management System can be installed on multiple servers; learning materials and user data could be distributed across these servers obtaining a Distributed Learning Management System. In this paper is proposed the prototype of a recommendation system based on association rules for Distributed Learning Management System. Information from LMS databases is analyzed using distributed data mining algorithms in order to extract the association rules. Then the extracted rules are used as inference rules to provide personalized recommendations. The quality of provided recommendations is improved because the rules used to make the inferences are more accurate, since these rules aggregate knowledge from all e-Learning systems included in Distributed Learning Management System.

  11. Pathophysiology of nasal congestion

    PubMed Central

    Naclerio, Robert M; Bachert, Claus; Baraniuk, James N

    2010-01-01

    Nasal congestion is a common symptom in rhinitis (both allergic and nonallergic), rhinosinusitis and nasal polyposis. Congestion can also be caused by physical obstruction of nasal passages and/or modulation of sensory perception. Mucosal inflammation underlies many of the specific and interrelated factors that contribute to nasal congestion, as well as other symptoms of both allergic rhinitis and rhinosinusitis. A wide range of biologically active agents (eg, histamine, tumor necrosis factor-α, interleukins, cell adhesion molecules) and cell types contribute to inflammation, which can manifest as venous engorgement, increased nasal secretions and tissue swelling/edema, ultimately leading to impaired airflow and the sensation of nasal congestion. Inflammation-induced changes in the properties of sensory afferents (eg, expression of peptides and receptors) that innervate the nose can also contribute to altered sensory perception, which may result in a subjective feeling of congestion. Increased understanding of the mechanisms underlying inflammation can facilitate improved treatment selection and the development of new therapies for congestion. PMID:20463823

  12. What can a pilot congestive heart failure disease management program tell us about likely return on investment?: A case study from a program offered to federal employees.

    PubMed

    vanVonno, Catherine J; Ozminkowski, Ronald J; Smith, Mark W; Thomas, Eileen G; Kelley, Doniece; Goetzel, Ron; Berg, Gregory D; Jain, Susheel K; Walker, David R

    2005-12-01

    In 1999, the Blue Cross and Blue Shield Federal Employee Program (FEP) implemented a pilot disease management program to manage congestive heart failure (CHF) among members. The purpose of this project was to estimate the financial return on investment in the pilot CHF program, prior to a full program rollout. A cohort of 457 participants from the state of Maryland was matched to a cohort of 803 nonparticipants from a neighboring state where the CHF program was not offered. Each cohort was followed for 12 months before the program began and 12 months afterward. The outcome measures of primary interest were the differences over time in medical care expenditures paid by FEP and by all payers. Independent variables included indicators of program participation, type of heart disease, comorbidity measures, and demographics. From the perspective of the funding organization (FEP), the estimated return on investment for the pilot CHF disease management program was a savings of $1.08 in medical expenditure for every dollar spent on the program. Adding savings to other payers as well, the return on investment was a savings of $1.15 in medical expenditures per dollar spent on the program. The amount of savings depended upon CHF risk levels. The value of a pilot initiative and evaluation is that lessons for larger-scale efforts can be learned prior to full-scale rollout.

  13. 76 FR 33342 - Final Supplementary Rules for Public Lands Managed by the California Desert District

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-08

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE INTERIOR Bureau of Land Management Final Supplementary Rules for Public Lands Managed by the California Desert... offices within the CDD, are issuing Final Supplementary Rules for public lands administered by the BLM...

  14. Risk management. National Aeronautics and Space Administration (NASA). Interim rule adopted as final with changes.

    PubMed

    2000-11-22

    This is a final rule amending the NASA FAR Supplement (NFS) to emphasize considerations of risk management, including safety, security (including information technology security), health, export control, and damage to the environment, within the acquisition process. This final rule addresses risk management within the context of acquisition planning, selecting sources, choosing contract type, structuring award fee incentives, administering contracts, and conducting contractor surveillance.

  15. Focus on renal congestion in heart failure.

    PubMed

    Afsar, Baris; Ortiz, Alberto; Covic, Adrian; Solak, Yalcin; Goldsmith, David; Kanbay, Mehmet

    2016-02-01

    Hospitalizations due to heart failure are increasing steadily despite advances in medicine. Patients hospitalized for worsening heart failure have high mortality in hospital and within the months following discharge. Kidney dysfunction is associated with adverse outcomes in heart failure patients. Recent evidence suggests that both deterioration in kidney function and renal congestion are important prognostic factors in heart failure. Kidney congestion in heart failure results from low cardiac output (forward failure), tubuloglomerular feedback, increased intra-abdominal pressure or increased venous pressure. Regardless of the cause, renal congestion is associated with increased morbidity and mortality in heart failure. The impact on outcomes of renal decongestion strategies that do not compromise renal function should be explored in heart failure. These studies require novel diagnostic markers that identify early renal damage and renal congestion and allow monitoring of treatment responses in order to avoid severe worsening of renal function. In addition, there is an unmet need regarding evidence-based therapeutic management of renal congestion and worsening renal function. In the present review, we summarize the mechanisms, diagnosis, outcomes, prognostic markers and treatment options of renal congestion in heart failure.

  16. Focus on renal congestion in heart failure

    PubMed Central

    Afsar, Baris; Ortiz, Alberto; Covic, Adrian; Solak, Yalcin; Goldsmith, David; Kanbay, Mehmet

    2016-01-01

    Hospitalizations due to heart failure are increasing steadily despite advances in medicine. Patients hospitalized for worsening heart failure have high mortality in hospital and within the months following discharge. Kidney dysfunction is associated with adverse outcomes in heart failure patients. Recent evidence suggests that both deterioration in kidney function and renal congestion are important prognostic factors in heart failure. Kidney congestion in heart failure results from low cardiac output (forward failure), tubuloglomerular feedback, increased intra-abdominal pressure or increased venous pressure. Regardless of the cause, renal congestion is associated with increased morbidity and mortality in heart failure. The impact on outcomes of renal decongestion strategies that do not compromise renal function should be explored in heart failure. These studies require novel diagnostic markers that identify early renal damage and renal congestion and allow monitoring of treatment responses in order to avoid severe worsening of renal function. In addition, there is an unmet need regarding evidence-based therapeutic management of renal congestion and worsening renal function. In the present review, we summarize the mechanisms, diagnosis, outcomes, prognostic markers and treatment options of renal congestion in heart failure. PMID:26798459

  17. Making the Traffic Operations Case for Congestion Pricing: Operational Impacts of Congestion Pricing

    SciTech Connect

    Chin, Shih-Miao; Hu, Patricia S; Davidson, Diane

    2011-02-01

    hours spent in traffic in a year, grew by 22% as the national average of hours spent in delay grew from 36 hours to 44 hours. Peak delay per traveler grew one-third in medium-size urban areas over the 10 year period. The traffic engineering community has developed an arsenal of integrated tools to mitigate the impacts of congestion on freeway throughput and performance, including pricing of capacity to manage demand for travel. Congestion pricing is a strategy which dynamically matches demand with available capacity. A congestion price is a user fee equal to the added cost imposed on other travelers as a result of the last traveler's entry into the highway network. The concept is based on the idea that motorists should pay for the additional congestion they create when entering a congested road. The concept calls for fees to vary according to the level of congestion with the price mechanism applied to make travelers more fully aware of the congestion externality they impose on other travelers and the system itself. The operational rationales for the institution of pricing strategies are to improve the efficiency of operations in a corridor and/or to better manage congestion. To this end, the objectives of this project were to: (1) Better understand and quantify the impacts of congestion pricing strategies on traffic operations through the study of actual projects, and (2) Better understand and quantify the impacts of congestion pricing strategies on traffic operations through the use of modeling and other analytical methods. Specifically, the project was to identify credible analytical procedures that FHWA can use to quantify the impacts of various congestion pricing strategies on traffic flow (throughput) and congestion.

  18. Autonomous Congestion Control in Delay-Tolerant Networks

    NASA Technical Reports Server (NTRS)

    Burleigh, Scott C.; Jennings, Esther H.

    2005-01-01

    Congestion control is an important feature that directly affects network performance. Network congestion may cause loss of data or long delays. Although this problem has been studied extensively in the Internet, the solutions for Internet congestion control do not apply readily to challenged network environments such as Delay Tolerant Networks (DTN) where end-to-end connectivity may not exist continuously and latency can be high. In DTN, end-to-end rate control is not feasible. This calls for congestion control mechanisms where the decisions can be made autonomously with local information only. We use an economic pricing model and propose a rule-based congestion control mechanism where each router can autonomously decide on whether to accept a bundle (data) based on local information such as available storage and the value and risk of accepting the bundle (derived from historical statistics).

  19. 14 CFR 103.15 - Operations over congested areas.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Operations over congested areas. 103.15 Section 103.15 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES ULTRALIGHT VEHICLES Operating Rules § 103.15 Operations...

  20. Evolution of Decision Rules Used for IT Portfolio Management: An Inductive Approach

    NASA Astrophysics Data System (ADS)

    Karhade, Prasanna P.; Shaw, Michael J.; Subramanyam, Ramanath

    IT portfolio management and the related planning decisions for IT-dependent initiatives are critical to organizational performance. Building on the logic of appropriateness theoretical framework, we define an important characteristic of decision rules used during IT portfolio planning; rule appropriateness with regards to the risk-taking criterion. We propose that rule appropriateness will be an important factor explaining the evolution of rules over time. Using an inductive learning methodology, we analyze a unique dataset of actual IT portfolio planning decisions spanning two consecutive years within one organization. We present systematic comparative analysis of the evolution of rules used in planning over two years to validate our research proposition. We find that rules that were inappropriate in the first year are being redefined to design appropriate rules for use in the second year. Our work provides empirical evidence demonstrating organizational learning and improvements in IT portfolio planning capabilities.

  1. Communication Privacy Management and College Instruction: Exploring the Rules and Boundaries that Frame Instructor Private Disclosures

    ERIC Educational Resources Information Center

    Hosek, Angela M.; Thompson, Jason

    2009-01-01

    This study examines the ways in which privacy rules are developed and boundaries are coordinated within the student-teacher relationship using Petronio's Communication Privacy Management theory as a framework. Forty-one college instructors described the specific criteria they use to develop privacy rules and the conditions under which boundaries…

  2. Congestive heart failure and central sleep apnea.

    PubMed

    Sands, Scott A; Owens, Robert L

    2015-07-01

    Congestive heart failure (CHF) is among the most common causes of admission to hospitals in the United States, especially in those over age 65. Few data exist regarding the prevalence CHF of Cheyne-Stokes respiration (CSR) owing to congestive heart failure in the intensive care unit (ICU). Nevertheless, CSR is expected to be highly prevalent among those with CHF. Treatment should focus on the underlying mechanisms by which CHF increases loop gain and promotes unstable breathing. Few data are available to determine prevalence of CSR in the ICU, or how CSR might affect clinical management and weaning from mechanical ventilation.

  3. New accounting rules: asset allocation and portfolio management.

    PubMed

    Andrew, B K

    1997-01-01

    New accounting rules went into effect at the end of 1995 that are now starting to affect how medical practices must report income from equity and fixed income investments. This article explores the new accounting rules and considers the other factors that help practices determine investment strategies, including desired investment return, comfort with level of risk, appropriate time horizons, liquidity needs and legal restrictions. The author also presents an example that examines the different considerations that may affect an asset allocation decision, including endowments and operating reserve funds.

  4. Sequential Decision Rules for Managing Nematodes with Crop Rotations

    PubMed Central

    Burt, O. R.; Ferris, H.

    1996-01-01

    A dynamic model of nematode populations under a crop rotation that includes both host and nonhost crops is developed and used to conceptualize the problem of economic control. The steady state of the dynamic system is used to devise an approximately optimal decision policy, which is then applied to cyst nematode (Heterodera schachtii) control in a rotation of sugarbeet with nonhost crops. Long-run economic returns from this approximately optimal decision rule are compared with results from solution of the exact dynamic optimization model. The simple decision rule based on the steady state provides long-run average returns that are similar to the fully optimal solution. For sugarbeet and H. schachtii, the simplified rule can be calculated by maximizing a relatively simple algebraic expression with respect to the number of years in the sequence of nonhost crops. Maximization is easy because only integers are of interest and the number of years in nonhost crops is typically small. Solution of this problem indirectly yields an approximation to the optimal dynamic economic threshold density of nematodes in the soil. The decision rule requires knowledge of annual nematode population change under host and nonhost crops, and the relationship between crop yield and nematode population density. PMID:19277164

  5. Pharmacotherapy in congestive heart failure: ACE inhibitors and anemia in congestive heart failure.

    PubMed

    Sica, D S

    2000-01-01

    The use of angiotensin-converting enzyme inhibitors can be accompanied by a number of adverse events, including cough, angioedema, and hyperkalemia, as well as a peculiar form of functional renal insufficiency. Other, less obvious side effects accompany ACE inhibitor use, such as a reduction in red blood cell production. This feature of ACE inhibitor use may be employed to good effect, as in the management of post-transplant erythrocytosis. Alternatively, the suppressive effect of ACE inhibitors on red blood cell production may intensify the anemia of chronic renal failure and/or congestive heart failure. The untreated congestive heart failure patient typically has an increased red blood cell mass as a consequence of increased erythropoietin levels, with the latter governed by congestive heart failure-related renal hypoxia. This is not expressed as an increase in hemoglobin concentration because of the increase in plasma volume that marks advanced congestive heart failure. ACE inhibitor therapy can be expected to both reduce plasma volume and decrease red blood cell production. As a result, the hemoglobin concentration changes very little in the ACE inhibitor-treated congestive heart failure patient and usually falls in the low normal range. Recently, erythropoietin has been employed to good effect in congestive heart failure patients with borderline anemia. (c)2000 by CHF, Inc.

  6. Autonomous Congestion Control in Delay-Tolerant Networks

    NASA Technical Reports Server (NTRS)

    Burleigh, Scott; Jennings, Esther; Schoolcraft, Joshua

    2006-01-01

    This presentation highlights communication congestion control in delay-tolerant networks (DTNs). Large-scale future space exploration will offer complex communication challenges that may be best addressed by establishing a network infrastructure. However, current internet techniques for congestion control are not well suited for operation of a network over interplanetary distances. An alternative, delay-tolerant technique for congestion control in a delay-tolerant network is presented. A simple DTN was constructed and an experimental congestion control mechanism was applied. The mechanism appeared to be effective and each router was able to make its bundle acceptance decisions autonomously. Future research will examine more complex topologies and alternative bundle acceptance rules that might enhance performance.

  7. Autonomous Congestion Control in Delay-Tolerant Networks

    NASA Technical Reports Server (NTRS)

    Burleigh, Scott; Jennings, Esther; Schoolcraft, Joshua

    2006-01-01

    This presentation highlights communication congestion control in delay-tolerant networks (DTNs). Large-scale future space exploration will offer complex communication challenges that may be best addressed by establishing a network infrastructure. However, current internet techniques for congestion control are not well suited for operation of a network over interplanetary distances. An alternative, delay-tolerant technique for congestion control in a delay-tolerant network is presented. A simple DTN was constructed and an experimental congestion control mechanism was applied. The mechanism appeared to be effective and each router was able to make its bundle acceptance decisions autonomously. Future research will examine more complex topologies and alternative bundle acceptance rules that might enhance performance.

  8. 75 FR 11002 - Hazardous Waste Management System; Identification and Listing of Hazardous Waste; Final Rule

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-10

    ... AGENCY 40 CFR Part 261 Hazardous Waste Management System; Identification and Listing of Hazardous Waste... released from the waste, plausible and specific types of management of the petitioned waste, the quantities..., Tennessee from the lists of hazardous wastes. This final rule responds to a petition submitted by Valero...

  9. 36 CFR 1202.28 - What rules do NARA employees follow in managing personal information?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Collecting Information § 1202.28 What rules do NARA employees follow in managing personal information? All... follow in managing personal information? 1202.28 Section 1202.28 Parks, Forests, and Public Property... protection of nonpublic information in the Standards of Ethical Conduct for Employees of the Executive...

  10. Congestion control in satellite networks

    NASA Astrophysics Data System (ADS)

    Byun, Do Jun

    Due to exponential increases in internet traffic, Active Queue Management (AQM) has been heavily studied by numerous researchers. However, little is known about AQM in satellite networks. A microscopic examination of queueing behavior in satellite networks is conducted to identify problems with applying existing AQM methods. A new AQM method is proposed to overcome the problems and it is validated using a realistic emulation environment and a mathematical model. Three problems that were discovered during the research are discussed in this dissertation. The first problem is oscillatory queueing, which is caused by high buffering due to Performance Enhancing Proxy (PEP) in satellite networks where congestion control after the PEP buffering does not effectively control traffic senders. Existing AQMs that can solve this problem have tail drop queueing that results in consecutive packet drops (global synchronization). A new AQM method called Adaptive Virtual Queue Random Early Detection (AVQRED) is proposed to solve this problem. The second problem is unfair bandwidth sharing caused by inaccurate measurements of per-flow bandwidth usage. AVQRED is enhanced to accurately measure per-flow bandwidth usage to solve this problem without adding much complexity to the algorithm. The third problem is queueing instability caused by buffer flow control where TCP receive windows are adjusted to flow control traffic senders instead of dropping received packets during congestion. Although buffer flow control is quite attractive to satellite networks, queueing becomes unstable because accepting packets instead of dropping them aggravates the congestion level. Furthermore, buffer flow control has abrupt reductions in the TCP receive window size due to high PEP buffering causing more instability. AVQRED with packet drop is proposed to solve this problem. Networks with scarce bandwidth and high propagation delays can not afford to have an unstable AQM. In this research, three problems

  11. 42 CFR 438.706 - Special rules for temporary management.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Section 438.706 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...) There is continued egregious behavior by the MCO, including but not limited to behavior that is... terminate temporary management until it determines that the MCO can ensure that the sanctioned behavior will...

  12. 42 CFR 438.706 - Special rules for temporary management.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Section 438.706 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...) There is continued egregious behavior by the MCO, including but not limited to behavior that is... terminate temporary management until it determines that the MCO can ensure that the sanctioned behavior will...

  13. 42 CFR 438.706 - Special rules for temporary management.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Section 438.706 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...) There is continued egregious behavior by the MCO, including but not limited to behavior that is... terminate temporary management until it determines that the MCO can ensure that the sanctioned behavior will...

  14. A clinical decision rule for streptococcal pharyngitis management: An update

    PubMed Central

    Nasirian, Hosain; TarvijEslami, Saeedeh; Matini, Esfandiar; Bayesh, Seyedehsara; Omaraee, Yasaman

    2017-01-01

    PURPOSE: Group A streptococcal (GAS) pharyngitis is a common disease worldwide. We aimed to establish a pragmatic program as a clinical decision rule for GAS pharyngitis diagnosis. MATERIALS AND METHODS: This article derived from a research project on children aged 6–15 years. Five hundred and seventy-one children met the enrollment criteria on whom throat culture and validities of clinical findings were assessed in positive and negative throat culture groups. RESULTS: Positive GAS throat culture group included 99 (17.3%) patients with a positive culture. Negative GAS throat culture group included 472 (82.6%) patients. Exudate or enlarged tender nodes each one had 63% and 68% sensitivity and 31.5% and 37.5% specificity with a high percentage of negative predictive value (NPV) 80.54% and 85.09%, respectively. Sequence test revealed validities of exudate plus enlarged nodes at 43.62% sensitivity and 57.19% specificity with 83% NPV. CONCLUSIONS: High NPV of 83% indicated that similar prevalence in the absence of either exudate or enlarged tender lymph nodes. Probability of GAS negative throat cultures among children suspected of GAS pharyngitis was 83% and would correctly not receive inopportune antibiotics. PMID:28367027

  15. Local empathy provides global minimization of congestion in communication networks

    NASA Astrophysics Data System (ADS)

    Meloni, Sandro; Gómez-Gardeñes, Jesús

    2010-11-01

    We present a mechanism to avoid congestion in complex networks based on a local knowledge of traffic conditions and the ability of routers to self-coordinate their dynamical behavior. In particular, routers make use of local information about traffic conditions to either reject or accept information packets from their neighbors. We show that when nodes are only aware of their own congestion state they self-organize into a hierarchical configuration that delays remarkably the onset of congestion although leading to a sharp first-order-like congestion transition. We also consider the case when nodes are aware of the congestion state of their neighbors. In this case, we show that empathy between nodes is strongly beneficial to the overall performance of the system and it is possible to achieve larger values for the critical load together with a smooth, second-order-like, transition. Finally, we show how local empathy minimize the impact of congestion as much as global minimization. Therefore, here we present an outstanding example of how local dynamical rules can optimize the system’s functioning up to the levels reached using global knowledge.

  16. Local empathy provides global minimization of congestion in communication networks.

    PubMed

    Meloni, Sandro; Gómez-Gardeñes, Jesús

    2010-11-01

    We present a mechanism to avoid congestion in complex networks based on a local knowledge of traffic conditions and the ability of routers to self-coordinate their dynamical behavior. In particular, routers make use of local information about traffic conditions to either reject or accept information packets from their neighbors. We show that when nodes are only aware of their own congestion state they self-organize into a hierarchical configuration that delays remarkably the onset of congestion although leading to a sharp first-order-like congestion transition. We also consider the case when nodes are aware of the congestion state of their neighbors. In this case, we show that empathy between nodes is strongly beneficial to the overall performance of the system and it is possible to achieve larger values for the critical load together with a smooth, second-order-like, transition. Finally, we show how local empathy minimize the impact of congestion as much as global minimization. Therefore, here we present an outstanding example of how local dynamical rules can optimize the system's functioning up to the levels reached using global knowledge.

  17. Using a business rule management system to improve disposition of traumatized patients.

    PubMed

    Neuhaus, Philipp; Noack, Oliver; Majchrzak, Tim; Uckert, Frank

    2010-01-01

    We propose a business rule management system that is used to optimize the dispatchment on a mass casualty incident. Using geospatial information from available ambulances and rescue helicopters, a business rule engine calculates an optimized transportation plan for injured persons. It automatically considers special needs like ambulances equipped for baby transportation or special decontamination equipment, e.g. to deal with an accident in a chemical factory. The rules used in the system are not hardcoded; thus, it is possible to redefine them on the fly without changing the program's source code. It is possible to load and save a rule set in case of a catastrophe. Furthermore, it is possible to automatically recalculate an already planned operation if it becomes clear that the rescue vehicles assigned are needed by a person with life-threatening injuries.

  18. Bringing Agility to Business Process Management: Rules Deployment in an SOA

    NASA Astrophysics Data System (ADS)

    El Kharbili, Marwane; Keil, Tobias

    Business process management (BPM) has emerged as paradigm for integrating business strategies and enterprise architecture (EA). In this context, BPM implementation on top of web-service-based service oriented architectures is an accepted approach as shown by great amount of literature. One concern in this regard is how-to make BPs reactive to change. Our approach to the problem is the integration of business rule management (BRM) and BPM by allowing modeling of decisions hard-coded in BPs as separate business rules (BRs). These BRs become EA assets and need to be exploited when executing BPs. We motivate why BPM needs agility and discuss what requirements on BPM this poses. This paper presents prototyping work conducted at a BP modeling and analysis vendor which weeks to showcase how using business rule management (BRM) as a mean for modeling decisions can help achieve a much sought-after agility to BPM. This prototype relies on the integrated modeling of business rules (BRs) and BPs, and rule deployment as web services part of an SOA.

  19. 75 FR 26981 - Notice of Establishment of Interim Final Supplementary Rules for Public Lands Managed by the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-13

    ... rules as interim final supplementary rules. The rules related to hunting and target shooting will help prevent accidental shooting-related injuries and fatalities in areas with high recreational use or in... apply to all lands managed by the Mother Lode Field Office: Target shooting and hunting (in...

  20. Constraint and Flight Rule Management for Space Mission Operations

    NASA Technical Reports Server (NTRS)

    Barreiro, J.; Chachere, J.; Frank, J.; Bertels, C.; Crocker, A.

    2010-01-01

    The exploration of space is one of the most fascinating domains to study from a human factors perspective. Like other complex work domains such as aviation (Pritchett and Kim, 2008), air traffic management (Durso and Manning, 2008), health care (Morrow, North, and Wickens, 2006), homeland security (Cooke and Winner, 2008), and vehicle control (Lee, 2006), space exploration is a large-scale sociotechnical work domain characterized by complexity, dynamism, uncertainty, and risk in real-time operational contexts (Perrow, 1999; Woods et al, 1994). Nearly the entire gamut of human factors issues - for example, human-automation interaction (Sheridan and Parasuraman, 2006), telerobotics, display and control design (Smith, Bennett, and Stone, 2006), usability, anthropometry (Chaffin, 2008), biomechanics (Marras and Radwin, 2006), safety engineering, emergency operations, maintenance human factors, situation awareness (Tenney and Pew, 2006), crew resource management (Salas et al., 2006), methods for cognitive work analysis (Bisantz and Roth, 2008) and the like -- are applicable to astronauts, mission control, operational medicine, Space Shuttle manufacturing and assembly operations, and space suit designers as they are in other work domains (e.g., Bloomberg, 2003; Bos et al, 2006; Brooks and Ince, 1992; Casler and Cook, 1999; Jones, 1994; McCurdy et al, 2006; Neerincx et aI., 2006; Olofinboba and Dorneich, 2005; Patterson, Watts-Perotti and Woods, 1999; Patterson and Woods, 2001; Seagull et ai, 2007; Sierhuis, Clancey and Sims, 2002). The human exploration of space also has unique challenges of particular interest to human factors research and practice. This chapter provides an overview of those issues and reports on some of the latest research results as well as the latest challenges still facing the field.

  1. EPA to Hold Public Hearing in Washington, D.C. on Risk Management Program Proposed Rule

    EPA Pesticide Factsheets

    WASHINGTON - Tomorrow, Tuesday March 29, the U.S. Environmental Protection Agency will hold a public hearing on the proposed Risk Management Program (RMP) rule. The hearing will be held at EPA Headquarters in Washington, D.C., and will provide the o

  2. Congestion Pricing for Aircraft Pushback Slot Allocation.

    PubMed

    Liu, Lihua; Zhang, Yaping; Liu, Lan; Xing, Zhiwei

    2017-01-01

    In order to optimize aircraft pushback management during rush hour, aircraft pushback slot allocation based on congestion pricing is explored while considering monetary compensation based on the quality of the surface operations. First, the concept of the "external cost of surface congestion" is proposed, and a quantitative study on the external cost is performed. Then, an aircraft pushback slot allocation model for minimizing the total surface cost is established. An improved discrete differential evolution algorithm is also designed. Finally, a simulation is performed on Xinzheng International Airport using the proposed model. By comparing the pushback slot control strategy based on congestion pricing with other strategies, the advantages of the proposed model and algorithm are highlighted. In addition to reducing delays and optimizing the delay distribution, the model and algorithm are better suited for use for actual aircraft pushback management during rush hour. Further, it is also observed they do not result in significant increases in the surface cost. These results confirm the effectiveness and suitability of the proposed model and algorithm.

  3. Dynamic congestion control mechanisms for MPLS networks

    NASA Astrophysics Data System (ADS)

    Holness, Felicia; Phillips, Chris I.

    2001-02-01

    Considerable interest has arisen in congestion control through traffic engineering from the knowledge that although sensible provisioning of the network infrastructure is needed, together with sufficient underlying capacity, these are not sufficient to deliver the Quality of Service required for new applications. This is due to dynamic variations in load. In operational Internet Protocol (IP) networks, it has been difficult to incorporate effective traffic engineering due to the limited capabilities of the IP technology. In principle, Multiprotocol Label Switching (MPLS), which is a connection-oriented label swapping technology, offers new possibilities in addressing the limitations by allowing the operator to use sophisticated traffic control mechanisms. This paper presents a novel scheme to dynamically manage traffic flows through the network by re-balancing streams during periods of congestion. It proposes management-based algorithms that will allow label switched routers within the network to utilize mechanisms within MPLS to indicate when flows are starting to experience frame/packet loss and then to react accordingly. Based upon knowledge of the customer's Service Level Agreement, together with instantaneous flow information, the label edge routers can then instigate changes to the LSP route and circumvent congestion that would hitherto violate the customer contacts.

  4. Pelvic Congestion Syndrome

    PubMed Central

    Durham, Janette D.; Machan, Lindsay

    2013-01-01

    Patients with pelvic congestion syndrome present with otherwise unexplained chronic pelvic pain that has been present for greater than 6 months, and anatomic findings that include pelvic venous insufficiency and pelvic varicosities. It remains an underdiagnosed explanation for pelvic pain in young, premenopausal, usually multiparous females. Symptoms include noncyclical, positional lower back, pelvic and upper thigh pain, dyspareunia, and prolonged postcoital discomfort. Symptoms worsen throughout the day and are exacerbated by activity or prolonged standing. Examination may reveal ovarian tenderness and unusual varicosities—vulvoperineal, posterior thigh, and gluteal. Diagnosis is suspected by clinical history and imaging that demonstrates pelvic varicosities. Venography is usually necessary to confirm ovarian vein reflux, although transvaginal ultrasound may be useful in documenting this finding. Endovascular therapy has been validated by several large patient series with long-term follow-up using standardized pain assessment surveys. Embolization has been shown to be significantly more effective than surgical therapy in improving symptoms in patients who fail hormonal therapy. Although there has been variation in approaches between investigators, the goal is elimination of ovarian vein reflux with or without direct sclerosis of enlarged pelvic varicosities. Symptom reduction is seen in 70 to 90% of the treated females despite technical variation. PMID:24436564

  5. Privacy-Sensitive Congestion Charging

    NASA Astrophysics Data System (ADS)

    Beresford, Alastair R.; Davies, Jonathan J.; Harle, Robert K.

    National-scale congestion charging schemes are increasingly viewed as the most viable long-term strategy for controlling congestion and maintaining the viability of the road network. In this paper we challenge the widely held belief that enforceable and economically viable congestion charging schemes require drivers to give up their location privacy to the government. Instead we explore an alternative scheme where privately-owned cars enforce congestion charge payments by using an on-board vehicle unit containing a camera and wireless communications. Our solution prevents centralised tracking of vehicle movements but raises an important issue: should we trust our neighbours with a little personal information in preference to entrusting it all to the government?

  6. Fuzzy rule-based models for decision support in ecosystem management.

    PubMed

    Adriaenssens, Veronique; De Baets, Bernard; Goethals, Peter L M; De Pauw, Niels

    2004-02-05

    To facilitate decision support in the ecosystem management, ecological expertise and site-specific data need to be integrated. Fuzzy logic can deal with highly variable, linguistic, vague and uncertain data or knowledge and, therefore, has the ability to allow for a logical, reliable and transparent information stream from data collection down to data usage in decision-making. Several environmental applications already implicate the use of fuzzy logic. Most of these applications have been set up by trial and error and are mainly limited to the domain of environmental assessment. In this article, applications of fuzzy logic for decision support in ecosystem management are reviewed and assessed, with an emphasis on rule-based models. In particular, the identification, optimisation, validation, the interpretability and uncertainty aspects of fuzzy rule-based models for decision support in ecosystem management are discussed.

  7. Water and Sodium in Heart Failure: A Spotlight on Congestion

    PubMed Central

    Greene, Stephen J.; Torres, Daniele; Alderman, Michael; Bonventre, Joseph Vincent; Di Pasquale, Pietro; Gargani, Luna; Nohria, Anju; Fonarow, Gregg C.; Vaduganathan, Muthiah; Butler, Javed; Paterna, Salvatore; Stevenson, Lynne Warner; Gheorghiade, Mihai

    2015-01-01

    Despite all available therapies, the rates of hospitalization and death from heart failure (HF) remain unacceptably high. The most common reasons for hospital admission are symptoms related to congestion. During hospitalization, most patients respond well to standard therapy and are discharged with significantly improved symptoms. Post-discharge, many patients receive diligent and frequent follow-up. However, rehospitalization rates remain high. One potential explanation is a persistent failure by clinicians to adequately manage congestion in the outpatient setting. The failure to successfully manage these patients post-discharge may represent an unmet need to improve the way congestion is both recognized and treated. A primary aim of future HF management may be to improve clinical surveillance to prevent and manage chronic fluid overload while simultaneously maximizing the use of evidence-based therapies with proven long-term benefit. Improvement in cardiac function is the ultimate goal and maintenance of a “dry” clinical profile is important to prevent hospital admission and improve prognosis. This paper focuses on methods for monitoring congestion, and strategies for water and sodium management in the context of the complex interplay between the cardiac and renal systems. A rationale for improving recognition and treatment of congestion is also proposed. PMID:24942806

  8. Water and sodium in heart failure: a spotlight on congestion.

    PubMed

    Parrinello, Gaspare; Greene, Stephen J; Torres, Daniele; Alderman, Michael; Bonventre, Joseph Vincent; Di Pasquale, Pietro; Gargani, Luna; Nohria, Anju; Fonarow, Gregg C; Vaduganathan, Muthiah; Butler, Javed; Paterna, Salvatore; Stevenson, Lynne Warner; Gheorghiade, Mihai

    2015-01-01

    Despite all available therapies, the rates of hospitalization and death from heart failure (HF) remain unacceptably high. The most common reasons for hospital admission are symptoms related to congestion. During hospitalization, most patients respond well to standard therapy and are discharged with significantly improved symptoms. Post-discharge, many patients receive diligent and frequent follow-up. However, rehospitalization rates remain high. One potential explanation is a persistent failure by clinicians to adequately manage congestion in the outpatient setting. The failure to successfully manage these patients post-discharge may represent an unmet need to improve the way congestion is both recognized and treated. A primary aim of future HF management may be to improve clinical surveillance to prevent and manage chronic fluid overload while simultaneously maximizing the use of evidence-based therapies with proven long-term benefit. Improvement in cardiac function is the ultimate goal and maintenance of a "dry" clinical profile is important to prevent hospital admission and improve prognosis. This paper focuses on methods for monitoring congestion, and strategies for water and sodium management in the context of the complex interplay between the cardiac and renal systems. A rationale for improving recognition and treatment of congestion is also proposed.

  9. Gag rules and trade secrets in managed care contracts. Ethical and legal concerns.

    PubMed

    Brody, H; Bonham, V L

    1997-10-13

    Gag rules-clauses in managed care contracts that prevent physicians from disclosing information that the plan may find disparaging, but that could relate directly to the patient's health-have recently been the subject of ethical condemnation and legislative prohibition. Another serious problem in managed care contracts, trade secrets, or guidelines and quality assurance mechanisms that are imposed on physicians while their origins are shrouded in proprietary secrecy, have by contrast received little attention. Responses to these ethical challenges to the physician's integrity must involve individual physicians, managed care organizations, professional organizations, and public policymakers.

  10. [Analysis of rulings by the Brazilian Ministry of Health and reflections on national health policy management].

    PubMed

    Baptista, Tatiana Wargas de Faria

    2007-03-01

    Ministry of Health rulings and provisions are important policy regulation tools that aim to orient the enforcement of health-related laws passed by the Legislative Branch, under the terms of the 1988 Federal Constitution. Such provisions have played a major role in the health sector, due not only to the number of documents submitted since the late 1990s, but mainly because of this tool's persuasive power in defining health sector policy. The current article aims to foster reflection on both national health policy management in Brazil and the main obstacles to the implementation of health reform operational aspects. The article classified and analyzed Ministry of Health rulings issued from 1990 to 2002. The study highlights the Ministry's centralizing approach and the use of financial and political persuasion tools that subject State and Municipal governments to the system's rules without creating a negotiated and sustained health policy that the country's institutional realities ratify and support.

  11. A comparative study of a new wireless continuous cardiorespiratory monitor for the diagnosis and management of patients with congestive heart failure at home.

    PubMed

    Andrews, D; Gouda, M S; Higgins, S; Johnson, P; Williams, A; Vandenburg, M

    2002-01-01

    Congestive heart failure (CHF) is a major and increasing chronic disease in Western society, with a high mortality, morbidity and cost for unplanned hospital admissions. Continuous cardiorespiratory monitoring is required to detect Cheyne-Stokes respiration (CSR). We have tested a new wireless monitoring system and compared it with polysomnography (PSG) and respiratory inductance plethysmography (RIP) in six CHF patients with CSR in a sleep laboratory. The wireless system compared well with RIP for the detection of CSR but less well with PSG, which had unexpected but significant respiratory sensing errors that led to misclassification of the respiratory disorder present. The wireless system could be used to select CHF patients for better-customized treatment at home as part of a specialist-supported community telemedicine programme.

  12. Congestion control and routing over satellite networks

    NASA Astrophysics Data System (ADS)

    Cao, Jinhua

    Satellite networks and transmissions find their application in fields of computer communications, telephone communications, television broadcasting, transportation, space situational awareness systems and so on. This thesis mainly focuses on two networking issues affecting satellite networking: network congestion control and network routing optimization. Congestion, which leads to long queueing delays, packet losses or both, is a networking problem that has drawn the attention of many researchers. The goal of congestion control mechanisms is to ensure high bandwidth utilization while avoiding network congestion by regulating the rate at which traffic sources inject packets into a network. In this thesis, we propose a stable congestion controller using data-driven, safe switching control theory to improve the dynamic performance of satellite Transmission Control Protocol/Active Queue Management (TCP/AQM) networks. First, the stable region of the Proportional-Integral (PI) parameters for a nominal model is explored. Then, a PI controller, whose parameters are adaptively tuned by switching among members of a given candidate set, using observed plant data, is presented and compared with some classical AQM policy examples, such as Random Early Detection (RED) and fixed PI control. A new cost detectable switching law with an interval cost function switching algorithm, which improves the performance and also saves the computational cost, is developed and compared with a law commonly used in the switching control literature. Finite-gain stability of the system is proved. A fuzzy logic PI controller is incorporated as a special candidate to achieve good performance at all nominal points with the available set of candidate controllers. Simulations are presented to validate the theory. An effocient routing algorithm plays a key role in optimizing network resources. In this thesis, we briefly analyze Low Earth Orbit (LEO) satellite networks, review the Cross Entropy (CE

  13. Probability-based TCP congestion control mechanism

    NASA Astrophysics Data System (ADS)

    Xu, Changbiao; Yang, Shizhong; Xian, Yongju

    2005-11-01

    To mitigate TCP global synchronization and improve network throughput, an improved TCP congestion control mechanism is proposed, namely P-TCP, which adopts the probability-based way to adjust congestion window independently when the network occurs congestion. Therefore, some P-TCP connections may decrease the congestion window greatly while other P-TCP connections may decrease the congestion window lightly. Simulation results show that TCP global synchronization can be effectively mitigated, which leads to efficient utilization of network resources as well as the effective mitigation for network congestion. Simulation results also give some valuable references for determining the related parameters in P-TCP.

  14. Health-Mining: a Disease Management Support Service based on Data Mining and Rule Extraction.

    PubMed

    Bei, Andrea; De Luca, Stefano; Ruscitti, Giancarlo; Salamon, Diego

    2005-01-01

    The disease management is the collection of the processes aimed to control the health care and improving the quality at same time reducing the overall cost of the procedures. Our system, Health-Mining, is a Decision Support System with the objective of controlling the adequacy of hospitalization and therapies, determining the effective use of standard guidelines and eventually identifying better ones emerged from the medical practice (Evidence Based Medicine). In realizing the system, we have the aim of creation of a path to admissions- appropriateness criteria construction, valid at an international level. A main goal of the project is rule extraction and the identification of the rules adequate in term of efficacy, quality and cost reduction, especially in the view of fast changing technologies and medicines. We tested Health-Mining in a real test case for an Italian Region, Regione Veneto, on the installation of pacemaker and ICD.

  15. Rules and management of biomedical waste at Vivekananda Polyclinic: A case study

    SciTech Connect

    Gupta, Saurabh Boojh, Ram Mishra, Ajai Chandra, Hem

    2009-02-15

    Hospitals and other healthcare establishments have a 'duty of care' for the environment and for public health, and have particular responsibilities in relation to the waste they produce (i.e., biomedical waste). Negligence, in terms of biomedical waste management, significantly contributes to polluting the environment, affects the health of human beings, and depletes natural and financial resources. In India, in view of the serious situation of biomedical waste management, the Ministry of Environment and Forests, within the Government of India, ratified the Biomedical Waste (Management and Handling) Rules, in July 1998. The present paper provides a brief description of the biomedical waste (Management and Handling) Rules 1998, and the current biomedical waste management practices in one of the premier healthcare establishments of Lucknow, the Vivekananda Polyclinic. The objective in undertaking this study was to analyse the biomedical waste management system, including policy, practice (i.e., storage, collection, transportation and disposal), and compliance with the standards prescribed under the regulatory framework. The analysis consisted of interviews with medical authorities, doctors, and paramedical staff involved in the management of the biomedical wastes in the Polyclinic. Other important stakeholders that were consulted and interviewed included environmental engineers (looking after the Biomedical Waste Cell) of the State Pollution Control Board, and randomly selected patients and visitors to the Polyclinic. A general survey of the facilities of the Polyclinic was undertaken to ascertain the efficacy of the implemented measures. The waste was quantified based on random samples collected from each ward. It was found that, although the Polyclinic in general abides by the prescribed regulations for the treatment and disposal of biomedical waste, there is a need to further build the capacity of the Polyclinic and its staff in terms of providing state

  16. Medicaid Program; The Use of New or Increased Pass-Through Payments in Medicaid Managed Care Delivery Systems. Final rule.

    PubMed

    2017-01-18

    This rule finalizes changes to the pass-through payment transition periods and the maximum amount of pass-through payments permitted annually during the transition periods under Medicaid managed care contract(s) and rate certification(s). This final rule prevents increases in pass-through payments and the addition of new pass-through payments beyond those in place when the pass-through payment transition periods were established, in the final Medicaid managed care regulations effective July 5, 2016.

  17. Decongestants: OTC Relief for Congestion

    MedlinePlus

    ... individual can purchase each monthRequirement to show photo identification when purchasing the medicineRequirement for retailers to record ... by: familydoctor.org editorial staff Categories: Drugs, Procedures & Devices, Over-the-counter Products, Your Health ResourcesTags: congestion, ...

  18. Rule Driven Multi-Objective Management (RDMOM) - An Alternative Form for Describing and Developing Effective Water Resources Management Strategies

    NASA Astrophysics Data System (ADS)

    Sheer, D. P.

    2011-12-01

    Economics provides a model for describing human behavior applied to the management of water resources, but that model assumes, among other things, that managers have a way of directly relating immediate actions to long-term economic outcomes. This is rarely the case in water resources problems where uncertainty has significant impacts on the effectiveness of management strategies and where the management objectives are very difficult to commensurate. The difficulty in using economics is even greater in multiparty disputes, where each party has a different relative value for each of the management objectives, and many of the management objectives are shared. A three step approach to collaborative decision making can overcome these difficulties. The first step involves creating science based performance measures and evaluation tools to estimate the effect of alternative management strategies on each of the non-commensurate objectives. The second step involves developing short-term surrogate operating objectives that implicitly deal with all of the aspects of the long term uncertainty. Management that continually "optimizes" the short-term objectives subject to physical and other constraints that change through time can be characterized as Rule Driven Multi-Objective Management (RDMOM). RDMOM strategies are then tested in simulation models to provide the basis for evaluating performance measures. Participants in the collaborative process then engage in multiparty discussions that create new alternatives, and "barter" a deal. RDMOM does not assume that managers fully understand the link between current actions and long term goals. Rather, it assumes that managers operate to achieve short-term surrogate objectives which they believe will achieve an appropriate balance of both short and long-term incommensurable benefits. A reservoir rule curve is a simple, but often not particularly effective, example of the real-world implementation of RDMOM. Water managers find they

  19. Congestion Pricing for Aircraft Pushback Slot Allocation

    PubMed Central

    Zhang, Yaping

    2017-01-01

    In order to optimize aircraft pushback management during rush hour, aircraft pushback slot allocation based on congestion pricing is explored while considering monetary compensation based on the quality of the surface operations. First, the concept of the “external cost of surface congestion” is proposed, and a quantitative study on the external cost is performed. Then, an aircraft pushback slot allocation model for minimizing the total surface cost is established. An improved discrete differential evolution algorithm is also designed. Finally, a simulation is performed on Xinzheng International Airport using the proposed model. By comparing the pushback slot control strategy based on congestion pricing with other strategies, the advantages of the proposed model and algorithm are highlighted. In addition to reducing delays and optimizing the delay distribution, the model and algorithm are better suited for use for actual aircraft pushback management during rush hour. Further, it is also observed they do not result in significant increases in the surface cost. These results confirm the effectiveness and suitability of the proposed model and algorithm. PMID:28114429

  20. Congestive Heart Failure.

    PubMed

    Scott, Michael C; Winters, Michael E

    2015-08-01

    Patients with acute decompensated heart failure are usually critically ill and require immediate treatment. However, most are not volume overloaded. Emergency department (ED) management is based on rapid initiation of noninvasive positive-pressure ventilation and aggressive titration of nitrates. Afterload reduction with an angiotensin-converting enzyme inhibitor can be considered. A diuretic should not be administered before optimal preload and afterload reduction has been achieved. Short-term inotropic therapy can be considered in select patients with cardiogenic shock and acute decompensated heart failure (ADHF) who fail to respond to standard therapy.

  1. Successful management of hamstring injuries in Australian Rules footballers: two case reports

    PubMed Central

    Hoskins, Wayne T; Pollard, Henry P

    2005-01-01

    Hamstring injuries are the most prevalent injury in Australian Rules football. There is a lack of evidence based literature on the treatment, prevention and management of hamstring injuries, although it is agreed that the etiology is complicated and multi-factorial. We present two cases of hamstring injury that had full resolution after spinal manipulation and correction of lumbar-pelvic biomechanics. There was no recurrence through preventative treatment over a twelve and sixteen week period. The use of spinal manipulation for treatment or prevention of hamstring injury has not been documented in sports medicine literature and should be further investigated in prospective randomized controlled trials. PMID:15967047

  2. 40 CFR 271.27 - Interim authorization-by-rule for the revised Corrective Action Management Unit rule.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) REQUIREMENTS FOR AUTHORIZATION OF STATE HAZARDOUS WASTE PROGRAMS Requirements for Final Authorization § 271.27 Interim authorization-by-rule for the... State has been granted final authorization pursuant to section 3006(b) of RCRA for the regulation...

  3. Increasing Complexity in Rule-Based Clinical Decision Support: The Symptom Assessment and Management Intervention.

    PubMed

    Lobach, David F; Johns, Ellis B; Halpenny, Barbara; Saunders, Toni-Ann; Brzozowski, Jane; Del Fiol, Guilherme; Berry, Donna L; Braun, Ilana M; Finn, Kathleen; Wolfe, Joanne; Abrahm, Janet L; Cooley, Mary E

    2016-11-08

    Management of uncontrolled symptoms is an important component of quality cancer care. Clinical guidelines are available for optimal symptom management, but are not often integrated into the front lines of care. The use of clinical decision support (CDS) at the point-of-care is an innovative way to incorporate guideline-based symptom management into routine cancer care. The objective of this study was to develop and evaluate a rule-based CDS system to enable management of multiple symptoms in lung cancer patients at the point-of-care. This study was conducted in three phases involving a formative evaluation, a system evaluation, and a contextual evaluation of clinical use. In Phase 1, we conducted iterative usability testing of user interface prototypes with patients and health care providers (HCPs) in two thoracic oncology clinics. In Phase 2, we programmed complex algorithms derived from clinical practice guidelines into a rules engine that used Web services to communicate with the end-user application. Unit testing of algorithms was conducted using a stack-traversal tree-spanning methodology to identify all possible permutations of pathways through each algorithm, to validate accuracy. In Phase 3, we evaluated clinical use of the system among patients and HCPs in the two clinics via observations, structured interviews, and questionnaires. In Phase 1, 13 patients and 5 HCPs engaged in two rounds of formative testing, and suggested improvements leading to revisions until overall usability scores met a priori benchmarks. In Phase 2, symptom management algorithms contained between 29 and 1425 decision nodes, resulting in 19 to 3194 unique pathways per algorithm. Unit testing required 240 person-hours, and integration testing required 40 person-hours. In Phase 3, both patients and HCPs found the system usable and acceptable, and offered suggestions for improvements. A rule-based CDS system for complex symptom management was systematically developed and tested. The

  4. Increasing Complexity in Rule-Based Clinical Decision Support: The Symptom Assessment and Management Intervention

    PubMed Central

    Johns, Ellis B; Halpenny, Barbara; Saunders, Toni-Ann; Brzozowski, Jane; Del Fiol, Guilherme; Berry, Donna L; Braun, Ilana M; Finn, Kathleen; Wolfe, Joanne; Abrahm, Janet L; Cooley, Mary E

    2016-01-01

    Background Management of uncontrolled symptoms is an important component of quality cancer care. Clinical guidelines are available for optimal symptom management, but are not often integrated into the front lines of care. The use of clinical decision support (CDS) at the point-of-care is an innovative way to incorporate guideline-based symptom management into routine cancer care. Objective The objective of this study was to develop and evaluate a rule-based CDS system to enable management of multiple symptoms in lung cancer patients at the point-of-care. Methods This study was conducted in three phases involving a formative evaluation, a system evaluation, and a contextual evaluation of clinical use. In Phase 1, we conducted iterative usability testing of user interface prototypes with patients and health care providers (HCPs) in two thoracic oncology clinics. In Phase 2, we programmed complex algorithms derived from clinical practice guidelines into a rules engine that used Web services to communicate with the end-user application. Unit testing of algorithms was conducted using a stack-traversal tree-spanning methodology to identify all possible permutations of pathways through each algorithm, to validate accuracy. In Phase 3, we evaluated clinical use of the system among patients and HCPs in the two clinics via observations, structured interviews, and questionnaires. Results In Phase 1, 13 patients and 5 HCPs engaged in two rounds of formative testing, and suggested improvements leading to revisions until overall usability scores met a priori benchmarks. In Phase 2, symptom management algorithms contained between 29 and 1425 decision nodes, resulting in 19 to 3194 unique pathways per algorithm. Unit testing required 240 person-hours, and integration testing required 40 person-hours. In Phase 3, both patients and HCPs found the system usable and acceptable, and offered suggestions for improvements. Conclusions A rule-based CDS system for complex symptom management

  5. Simulation of operating rules and discretional decisions using a fuzzy rule-based system integrated into a water resources management model

    NASA Astrophysics Data System (ADS)

    Macian-Sorribes, Hector; Pulido-Velazquez, Manuel

    2013-04-01

    Water resources systems are operated, mostly, using a set of pre-defined rules not regarding, usually, to an optimal allocation in terms of water use or economic benefits, but to historical and institutional reasons. These operating policies are reproduced, commonly, as hedging rules, pack rules or zone-based operations, and simulation models can be used to test their performance under a wide range of hydrological and/or socio-economic hypothesis. Despite the high degree of acceptation and testing that these models have achieved, the actual operation of water resources systems hardly follows all the time the pre-defined rules with the consequent uncertainty on the system performance. Real-world reservoir operation is very complex, affected by input uncertainty (imprecision in forecast inflow, seepage and evaporation losses, etc.), filtered by the reservoir operator's experience and natural risk-aversion, while considering the different physical and legal/institutional constraints in order to meet the different demands and system requirements. The aim of this work is to expose a fuzzy logic approach to derive and assess the historical operation of a system. This framework uses a fuzzy rule-based system to reproduce pre-defined rules and also to match as close as possible the actual decisions made by managers. After built up, the fuzzy rule-based system can be integrated in a water resources management model, making possible to assess the system performance at the basin scale. The case study of the Mijares basin (eastern Spain) is used to illustrate the method. A reservoir operating curve regulates the two main reservoir releases (operated in a conjunctive way) with the purpose of guaranteeing a high realiability of supply to the traditional irrigation districts with higher priority (more senior demands that funded the reservoir construction). A fuzzy rule-based system has been created to reproduce the operating curve's performance, defining the system state (total

  6. Benefit of tolvaptan in the management of hyponatraemia in patients with diuretic‐refractory congestive heart failure: the SEMI‐SEC project

    PubMed Central

    Almenar, Luis; Gavira, Juan José; López‐Granados, Amador; Blasco, Teresa; Delgado, Juan; Aramburu, Oscar; Rodríguez, Avelino; Manzano, Luis; Manito, Nicolás

    2017-01-01

    Abstract Aims Hyponatraemia is an electrolyte disorder that occurs in advanced congestive heart failure (HF) and worsens prognosis. We explored the usefulness of tolvaptan, which has shown promising results in the treatment of this condition. Methods and results This study is based on a retrospective national registry (2011–15) of patients hospitalized with refractory HF and hyponatraemia who agreed to receive tolvaptan when standard treatment was ineffective. The benefit of tolvaptan was analysed according to the following criteria: normalization ([Na+] ≥ 135 mmol/L) or increased sodium levels [Na+] ≥ 4 mEq/L on completion of treatment, and increase in urine output by 300 or 500 mL at 48 h. Factors associated with tolvaptan benefit were explored. A total of 241 patients were included, 53.9% of whom had ejection fraction <40%. All patients received concomitant loop diuretics. Initial tolvaptan dose was 17.2 ± 6.1 mg, and end dose was 26.4 ± 23.2 mg (duration 7.8 ± 8.6 days). Serum sodium concentrations increased significantly at 24–48 h, from 126.5 ± 6.2 mEq/L at baseline to 134.1 ± 6.1 mEq/L at the end of treatment (P < 0.0001). Weight fell by ~5 kg before discharge (P < 0.0001) and urine output increased 1.3‐fold (P < 0.0001). Normal sodium levels and/or increases of 500 mL in urine output were achieved by 90.8% of patients (35.7% achieved both) and 94.8% increased to [Na+] ≥ 4 mEq/L and/or +300 mL in urine output (54.4% both). Conclusions An increase in sodium levels and/or improvement in urine output was observed in patients admitted for HF and refractory hyponatraemia under tolvaptan treatment. Tolvaptan may be useful in this setting, in which no effective proven alternatives are available. PMID:28451449

  7. Self-adapting network topologies in congested scenarios.

    PubMed

    Cholvi, Vicent; Laderas, Víctor; López, Luis; Fernández, Antonio

    2005-03-01

    Most studies in complex networks assume that once a link is created between two nodes it is never deleted. However, there is a recent interest towards systems where links can be rapidly rewired. An important issue in that type of networks is to discover the topology that, given a search algorithm, optimizes the search process. In this paper, we present a system model that, depending on the current network congestion, makes nodes to establish link connections so that the resulting topologies tend to a starlike topology when congestion is small and to randomlike topologies when congestion becomes relevant. Those topologies have been shown to be optimal in the above-mentioned conditions. Such a model can be easily implemented in practice and therefore, may be relevant in areas as the topology management of peer-to-peer networks.

  8. Study on the propagation and dissipation of inland ship congestion under different control strategies

    NASA Astrophysics Data System (ADS)

    Chen, Yanyi; Wu, Hongyu; Wen, Zhe

    2017-05-01

    Inland waterway transportation is an important part of the comprehensive transportation system of sustainable development, and it is also a way of transportation which is restricted by natural conditions greatly. In recent years, the problems of insufficient traffic capacity of The Three Gorges become prominent due to the increasing in the number of ships. And the ship's detention caused by gale, frog, accident and one-way traffic in dry season has occurred, which not only increased the pressure of the navigable waterway but also seriously affected the safety of shipping. Based on the different types of ships, the Arena software was used to simulate the ship traffic flow. The paper analyzed the traffic congestion propagation and dissipation rule of the ship under different navigation control methods, and provided decision reference for the navigation management department to formulate the relevant navigation control strategy.

  9. Medicaid and Children's Health Insurance Program (CHIP) Programs; Medicaid Managed Care, CHIP Delivered in Managed Care, and Revisions Related to Third Party Liability. Final rule.

    PubMed

    2016-05-06

    This final rule modernizes the Medicaid managed care regulations to reflect changes in the usage of managed care delivery systems. The final rule aligns, where feasible, many of the rules governing Medicaid managed care with those of other major sources of coverage, including coverage through Qualified Health Plans and Medicare Advantage plans; implements statutory provisions; strengthens actuarial soundness payment provisions to promote the accountability of Medicaid managed care program rates; and promotes the quality of care and strengthens efforts to reform delivery systems that serve Medicaid and CHIP beneficiaries. It also ensures appropriate beneficiary protections and enhances policies related to program integrity. This final rule also implements provisions of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) and addresses third party liability for trauma codes.

  10. Signalling and obfuscation for congestion control

    NASA Astrophysics Data System (ADS)

    Mareček, Jakub; Shorten, Robert; Yu, Jia Yuan

    2015-10-01

    We aim to reduce the social cost of congestion in many smart city applications. In our model of congestion, agents interact over limited resources after receiving signals from a central agent that observes the state of congestion in real time. Under natural models of agent populations, we develop new signalling schemes and show that by introducing a non-trivial amount of uncertainty in the signals, we reduce the social cost of congestion, i.e., improve social welfare. The signalling schemes are efficient in terms of both communication and computation, and are consistent with past observations of the congestion. Moreover, the resulting population dynamics converge under reasonable assumptions.

  11. Congestion phenomena on complex networks.

    PubMed

    De Martino, Daniele; Dall'asta, Luca; Bianconi, Ginestra; Marsili, Matteo

    2009-01-01

    We define a minimal model of traffic flows in complex networks in order to study the trade-off between topological-based and traffic-based routing strategies. The resulting collective behavior is obtained analytically for an ensemble of uncorrelated networks and summarized in a rich phase diagram presenting second-order as well as first-order phase transitions between a free-flow phase and a congested phase. We find that traffic control improves global performance, enlarging the free-flow region in parameter space only in heterogeneous networks. Traffic control introduces nonlinear effects and, beyond a critical strength, may trigger the appearance of a congested phase in a discontinuous manner. The model also reproduces the crossover in the scaling of traffic fluctuations empirically observed on the Internet.

  12. Avoiding congestion in recommender systems

    NASA Astrophysics Data System (ADS)

    Ren, Xiaolong; Lü, Linyuan; Liu, Runran; Zhang, Jianlin

    2014-06-01

    Recommender systems use the historical activities and personal profiles of users to uncover their preferences and recommend objects. Most of the previous methods are based on objects’ (and/or users’) similarity rather than on their difference. Such approaches are subject to a high risk of increasingly exposing users to a narrowing band of popular objects. As a result, a few objects may be recommended to an enormous number of users, resulting in the problem of recommendation congestion, which is to be avoided, especially when the recommended objects are limited resources. In order to quantitatively measure a recommendation algorithm's ability to avoid congestion, we proposed a new metric inspired by the Gini index, which is used to measure the inequality of the individual wealth distribution in an economy. Besides this, a new recommendation method called directed weighted conduction (DWC) was developed by considering the heat conduction process on a user-object bipartite network with different thermal conductivities. Experimental results obtained for three benchmark data sets showed that the DWC algorithm can effectively avoid system congestion, and greatly improve the novelty and diversity, while retaining relatively high accuracy, in comparison with the state-of-the-art methods.

  13. 77 FR 51939 - Temporary Rule To Establish Management Measures for the Limited Harvest and Possession of South...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-28

    ... Management Measures for the Limited Harvest and Possession of South Atlantic Red Snapper in 2012 AGENCY... management measures to allow for the limited harvest and possession of red snapper in or from the South... recreational fishing seasons for red snapper. The intended effect of this temporary rule is to preserve a...

  14. Management of donated foods in child nutrition programs, the Nutrition Services Incentive Program, and charitable institutions. Final rule.

    PubMed

    2008-08-08

    This final rule revises and clarifies requirements for the management, distribution, and use of donated foods in the National School Lunch Program and other child nutrition programs, in the Nutrition Services Incentive Program, and by charitable institutions. In response to an audit by the USDA Office of Inspector General, the rule establishes specific requirements to ensure that recipient agencies in child nutrition programs receive the benefit and value of all donated foods received and provided to food service management companies to conduct the food service. The rule also incorporates legislative changes affecting the distribution of donated foods in the Nutrition Services Incentive Program, and reduces reporting and administrative requirements for donated foods provided to charitable institutions. Lastly, the rule restructures and revises regulatory provisions in a plain language format to make them easier to read and understand.

  15. A simple rule based model for scheduling farm management operations in SWAT

    NASA Astrophysics Data System (ADS)

    Schürz, Christoph; Mehdi, Bano; Schulz, Karsten

    2016-04-01

    For many interdisciplinary questions at the watershed scale, the Soil and Water Assessment Tool (SWAT; Arnold et al., 1998) has become an accepted and widely used tool. Despite its flexibility, the model is highly demanding when it comes to input data. At SWAT's core the water balance and the modeled nutrient cycles are plant growth driven (implemented with the EPIC crop growth model). Therefore, land use and crop data with high spatial and thematic resolution, as well as detailed information on cultivation and farm management practices are required. For many applications of the model however, these data are unavailable. In order to meet these requirements, SWAT offers the option to trigger scheduled farm management operations by applying the Potential Heat Unit (PHU) concept. The PHU concept solely takes into account the accumulation of daily mean temperature for management scheduling. Hence, it contradicts several farming strategies that take place in reality; such as: i) Planting and harvesting dates are set much too early or too late, as the PHU concept is strongly sensitivity to inter-annual temperature fluctuations; ii) The timing of fertilizer application, in SWAT this often occurs simultaneously on the same date in in each field; iii) and can also coincide with precipitation events. Particularly, the latter two can lead to strong peaks in modeled nutrient loads. To cope with these shortcomings we propose a simple rule based model (RBM) to schedule management operations according to realistic farmer management practices in SWAT. The RBM involves simple strategies requiring only data that are input into the SWAT model initially, such as temperature and precipitation data. The user provides boundaries of time periods for operation schedules to take place for all crops in the model. These data are readily available from the literature or from crop variety trials. The RBM applies the dates by complying with the following rules: i) Operations scheduled in the

  16. A multicenter randomized controlled evaluation of automated home monitoring and telephonic disease management in patients recently hospitalized for congestive heart failure: the SPAN-CHF II trial.

    PubMed

    Weintraub, Andrew; Gregory, Douglas; Patel, Ayan R; Levine, Daniel; Venesy, David; Perry, Kathleen; Delano, Christine; Konstam, Marvin A

    2010-04-01

    We performed a prospective, randomized investigation assessing the incremental effect of automated health monitoring (AHM) technology over and above that of a previously described nurse directed heart failure (HF) disease management program. The AHM system measured and transmitted body weight, blood pressure, and heart rate data as well as subjective patient self-assessments via a standard telephone line to a central server. A total of 188 consented and eligible patients were randomized between intervention and control groups in 1:1 ratio. Subjects randomized to the control arm received the Specialized Primary and Networked Care in Heart Failure (SPAN-CHF) heart failure disease management program. Subjects randomized to the intervention arm received the SPAN-CHF disease management program in conjunction with the AHM system. The primary end point was prespecified as the relative event rate of HF hospitalization between intervention and control groups at 90 days. The relative event rate of HF hospitalization for the intervention group compared with controls was 0.50 (95%CI [0.25-0.99], P = .05). Short-term reductions in the heart failure hospitalization rate were associated with the use of automated home monitoring equipment. Long-term benefits in this model remain to be studied. (c) 2010 Elsevier Inc. All rights reserved.

  17. A rule-based approach for the correlation of alarms to support Disaster and Emergency Management

    NASA Astrophysics Data System (ADS)

    Gloria, M.; Minei, G.; Lersi, V.; Pasquariello, D.; Monti, C.; Saitto, A.

    2009-04-01

    Key words: Simple Event Correlator, Agent Platform, Ontology, Semantic Web, Distributed Systems, Emergency Management The importance of recognition of emergency's typology to control the critical situation for security of citizens has been always recognized. It follows this aspect is very important for proper management of a hazardous event. In this work we present a solution for the recognition of emergency's typology adopted by an Italian research project, called CI6 (Centro Integrato per Servizi di Emergenza Innovativi). In our approach, CI6 receives alarms by citizen or people involved in the work (for example: police, operator of 112, and so on). CI6 represents any alarm by a set of information, including a text that describes it and obtained when the user points out the danger, and a pair of coordinates for its location. The system realizes an analysis of text and automatically infers information on the type of emergencies by means a set of parsing rules and rules of inference applied by a independent module: a correlator of events based on their log and called Simple Event Correlator (SEC). SEC, integrated in CI6's platform, is an open source and platform independent event correlation tool. SEC accepts input both files and text derived from standard input, making it flexible because it can be matched to any application that is able to write its output to a file stream. The SEC configuration is stored in text files as rules, each rule specifying an event matching condition, an action list, and optionally a Boolean expression whose truth value decides whether the rule can be applied at a given moment. SEC can produce output events by executing user-specified shell scripts or programs, by writing messages to files, and by various other means. SEC has been successfully applied in various domains like network management, system monitoring, data security, intrusion detection, log file monitoring and analysis, etc; it has been used or integrated with many

  18. Congestion and decongestion in a communication network.

    PubMed

    Singh, Brajendra K; Gupte, Neelima

    2005-05-01

    We study network traffic dynamics in a two-dimensional communication network with regular nodes and hubs. If the network experiences heavy message traffic, congestion occurs due to the finite capacity of the nodes. We discuss strategies to manipulate hub capacity and hub connections to relieve congestion and define a coefficient of betweenness centrality (CBC), a direct measure of network traffic, which is useful for identifying hubs that are most likely to cause congestion. The addition of assortative connections to hubs of high CBC relieves congestion very efficiently.

  19. Multipath Binomial Congestion Control Algorithms

    NASA Astrophysics Data System (ADS)

    Le, Tuan Anh; Hong, Choong Seon; Lee, Sungwon

    Nowadays portable devices with multiple wireless interfaces and using multimedia services are becoming more popular on the Internet. This paper describes a family of multipath binomial congestion control algorithms for audio/video streaming, where a low variant of transmission rate is important. We extend the fluid model of binomial algorithms for single-path transmission to support the concurrent transmission of packets across multiple paths. We focus on the extension of two particular algorithms, SQRT and IIAD, for multiple paths, called MPSQRT and MPIIAD, respectively. Additionally, we apply the design technique (using the multipath fluid model) for multipath TCP (MPTCP) into the extension of SQRT and IIAD, called fbMPSQRT and fbMPIIAD, respectively. Both two approaches ensure that multipath binomial congestion control algorithms achieve load-balancing, throughput improvement, and fairness to single-path binomial algorithms at shared bottlenecks. Through the simulations and comparison with the uncoordinated protocols MPSQRT/MPIIAD, fbMPSQRT/fbMPIIAD and MPTCP, we find that our extended multipath transport protocols can preserve lower latency and transmission rate variance than MPTCP, fairly share with single-path SQRT/IIAD, MPTCP and TCP, and also can achieve throughput improvements and load-balancing equivalent to those of MPTCP under various scenarios and network conditions.

  20. Bortezomib-induced Severe Congestive Heart Failure

    PubMed Central

    Jerkins, James H.; Suciu, Anca; Mazimba, Sula; Calvo, Alejandro

    2010-01-01

    The clinical manifestations of anti-cancer drug associated cardiac side effects are diverse and can range from acutely induced cardiac arrhythmias to severe contractile dysfunction, and potentially fatal heart failure. Anthracyclines and trastuzumab cardiac toxicity have been well described and left ventricular ejection fraction (LVEF) evaluation is commonly performed before their use. Bortezomib (Velcade), a potent, specific and reversible proteasome inhibitor is approved for treatment of multiple myeloma (MM). The incidence of cardiac failure associated with bortezomib therapy in clinical trials remains incidental. Acute exacerbation of pre-existing congestive cardiac failure has been associated with this therapy but de novo cardiomyopathy has been reported in only one patient receiving bortezomib for small cell lung cancer. As a result, cardiac evaluation is not normally ordered before its use. We describe a 50-year-old female with newly diagnosed MM and no risk factors for cardiac disease that unexpectedly developed florid heart failure after 2 cycles of bortezomib and low-dose dexamethasone. 2-D echocardiogram showed dilated cardiomyopathy with severely decreased LVEF; no changes consistent with amyloid deposits or myocardial scarring were described. Coronary angiogram ruled out coronary artery disease. The mechanism of bortezomib-induced cardiomyopathy has been postulated to be through fluid retention. Based on literature review we hypothesize that the disruption of the ubiquitin-proteasome system by bortezomib may cause cardiomyopathy and severe cardiac failure. As Bortezomib is a new and promising therapy for MM patients, we recommend routinely monitoring cardiac parameters in patients undergoing this treatment.

  1. Implementation of artificial intelligence rules in a data base management system

    NASA Technical Reports Server (NTRS)

    Feyock, S.

    1986-01-01

    The intelligent front end prototype was transformed into a RIM-integrated system. A RIM-based expert system was written which demonstrated the developed capability. The use of rules to produce extensibility of the intelligent front end, including the concept of demons and rule manipulation rules were investigated. Innovative approaches such as syntax programming were to be considered.

  2. Parents' Management of Adolescents' Romantic Relationships through Dating Rules: Gender Variations and Correlates of Relationship Qualities

    ERIC Educational Resources Information Center

    Madsen, Stephanie D.

    2008-01-01

    This study examined parents' rules concerning their late adolescents' dating activities. Participants were mostly European-American, including 165 mothers or fathers and 103 of their children (ages 17-19; 28 sons and 75 daughters). Parents provided information regarding their use of dating rules; rules were coded by type (i.e., supervision,…

  3. Parents' Management of Adolescents' Romantic Relationships through Dating Rules: Gender Variations and Correlates of Relationship Qualities

    ERIC Educational Resources Information Center

    Madsen, Stephanie D.

    2008-01-01

    This study examined parents' rules concerning their late adolescents' dating activities. Participants were mostly European-American, including 165 mothers or fathers and 103 of their children (ages 17-19; 28 sons and 75 daughters). Parents provided information regarding their use of dating rules; rules were coded by type (i.e., supervision,…

  4. TCP congestion control in input-queued crossbar switch

    NASA Astrophysics Data System (ADS)

    Zheng, Hongyun; Zhao, Yongxiang; Chen, Changjia

    2005-02-01

    In this paper, we consider congestion control in input queued crossbar switch environment where each input port with finite buffer space while TCP protocol is employed for end-to-end congestion control. We find that it is impossible to achieve efficiency and fairness among TCP flows at the same time only by queue management. Then we propose a scheme of hFS&rEDF, which combine heuristic fair switch arbitration (hFS) and queue management policy of early drop front randomly (rEDF). In our proposed scheme, switch arbitration strategy of hFS unevenly allows input ports to transfer packets to output ports while packets at head of any other input ports involved in conflicts have to be dropped by the policy of rEDF with a probability. Simulation results prove that our proposed scheme can achieve better tradeoff between throughput and fairness.

  5. Scientific or rule-of-thumb techniques of ground-water management--Which will prevail?

    USGS Publications Warehouse

    McGuinness, Charles Lee

    1969-01-01

    Emphasis in ground-water development, once directed largely to quantitatively minor (but sociologically vital) service of human and stock needs, is shifting: aquifers are treated as possible regulating reservoirs managed conjunctively with surface water. Too, emphasis on reducing stream pollution is stimulating interest in aquifers as possible waste-storage media. Such management of aquifers requires vast amounts of data plus a much better understanding of aquifer-system behavior than now exists. Implicit in this deficiency of knowledge is a need for much new research, lest aquifers be managed according to ineffective rule-of-thumb standards, or even abandoned as unmanageable. The geohydrologist's task is to define both internal and boundary characteristics of aquifer systems. Stratigraphy is a primary determinant of these characteristics, but stratigraphically minor features may make aquifers transcend stratigraphic boundaries. For example, a structurally insignificant fracture may carry more water than a major fault; a minor stratigraphic discontinuity may be a major hydrologic boundary. Hence, there is a need for ways of defining aquifer boundaries and quantifying aquifer and confining-bed characteristics that are very different from ordinary stratigraphic techniques. Among critical needs are techniques for measuring crossbed permeability; for extrapolating and interpolating point data on direction and magnitude of permeability in defining aquifer geometry; and for accurately measuring geochemical properties of water and aquifer material, and interpreting those measurements in terms of source of water, rate of movement, and waste-sorbing capacities of aquifers and of confining beds--in general, techniques adequate for predicting aquifer response to imposed forces whether static, hydraulic, thermal, or chemical. Only when such predictions can be made routinely can aquifer characteristics be inserted into a master model that incorporates both the hydrologic and

  6. [Anemia in congestive heart failure].

    PubMed

    Abassade, P; Rabenirina, F; Garcon, P; Antakly, Y; Cador, R

    2009-11-01

    Anemia is a common disorder in congestive heart failure and an independant prognostic factor. The aims of this study are to evaluate the prevalence of anemia among a population of in-hospital congestive heart failure patients, to compare anemic patients (A) with non anemic patients (NA) and to study their cares. One hundred and thirty-two patients, 70 men (53%), et 62 women (47%) are enrolled. Mean age is 76.4+/-13.5 years. The prevalence of anemia (WHO criteria) is 49%. Patients A are older than NA: 79.1+/-13.8 years versus 73.8+/-12.9 years (p=0.025), renal function is more altered in A than in NA, creatinine clearance is 56.5 ml/min (A) versus 76.2 ml/min (NA) (p=0.003). Ejection fraction (EF) is lower in A than in NA: 35.1+/-15.3% versus 50.9+/-15.9%, (p<0.0001.) Anemia is less frequent in preserved EF (28%) than in low EF (63%) (p<0.0001). Hospitalization duration is longer in A than in NA: 10.7+/-10.1 days versus 6.9+/-3.7 days (p=0.005). There are more re hospitalized patients among A than NA: 38 versus 10 (p=0.0001). There is a significant difference of survival of NA versus A at day 614 (p=0.03). Anemia is frequent in our population, and is associated with others prognostic factors and comorbidity.

  7. Autonomous Distributed Congestion Control Scheme in WCDMA Network

    NASA Astrophysics Data System (ADS)

    Ahmad, Hafiz Farooq; Suguri, Hiroki; Choudhary, Muhammad Qaisar; Hassan, Ammar; Liaqat, Ali; Khan, Muhammad Umer

    Wireless technology has become widely popular and an important means of communication. A key issue in delivering wireless services is the problem of congestion which has an adverse impact on the Quality of Service (QoS), especially timeliness. Although a lot of work has been done in the context of RRM (Radio Resource Management), the deliverance of quality service to the end user still remains a challenge. Therefore there is need for a system that provides real-time services to the users through high assurance. We propose an intelligent agent-based approach to guarantee a predefined Service Level Agreement (SLA) with heterogeneous user requirements for appropriate bandwidth allocation in QoS sensitive cellular networks. The proposed system architecture exploits Case Based Reasoning (CBR) technique to handle RRM process of congestion management. The system accomplishes predefined SLA through the use of Retrieval and Adaptation Algorithm based on CBR case library. The proposed intelligent agent architecture gives autonomy to Radio Network Controller (RNC) or Base Station (BS) in accepting, rejecting or buffering a connection request to manage system bandwidth. Instead of simply blocking the connection request as congestion hits the system, different buffering durations are allocated to diverse classes of users based on their SLA. This increases the opportunity of connection establishment and reduces the call blocking rate extensively in changing environment. We carry out simulation of the proposed system that verifies efficient performance for congestion handling. The results also show built-in dynamism of our system to cater for variety of SLA requirements.

  8. Binomial congestion control at receivers for multicast

    NASA Astrophysics Data System (ADS)

    Zhang, Bing; Liu, Zengji; Xu, Yayan; Li, Zhen; Zhang, Shi

    2004-09-01

    A single rate multicast congestion control for streaming media applications called Binomial congestion control At Receivers for Multicast (BARM) is proposed. Combining aspects of window-based and rate-based congestion control, the protocol shifts most of the congestion control mechanisms to multicast receivers. The main features of BARM are as follows. (1) The protocol adopts binomial algorithm (k=l=0.5, α=0.28, β=0.2 for our implementation) to adjust congestion window, which not only provides TCP-friendliness but decreases abrupt rate fluctuations, making it suitable for real time streaming media multicast applications. (2) The binomial algorithm is executed at the receivers instead of at the sender; to do this, a congestion window is maintained and updated separately by each receiver. Hence the protocol not only has a better scalability but reduces the burden of the sender significantly and is suitable to Client/Server model. (3) The congestion window is converted to the expected receiving rate which is then fed back to the sender if permitted. Compared to window feedback scheme, rate feedback scheme is simpler and increases the scalability. (4) The representative approach is used to suppress the feedback implosion. Simulations results indicate that BARM shows good fairness, TCP-friendliness, smoothness, scalability, and acceptable responsiveness.

  9. The Rules Grid: Helping Children with Social Communication and Interaction Needs Manage Social Complexity

    ERIC Educational Resources Information Center

    Devlin, Niall

    2009-01-01

    This article introduces a new practical visual approach, the Rules Grid, to support children who have social communication and interaction needs. The Rules Grid involves a system whereby behaviours of concern can be broken down into smaller behavioural manifestations which in turn lead not only to problem identification and specification, but…

  10. Stochastic Congestion Control in Wireless Sensor Networks

    NASA Astrophysics Data System (ADS)

    Kim, Hyung Seok; Lee, Seok; Kim, Namhoon

    In this paper, an effective congestion control algorithm is proposed to increase the end-to-end delivery success ratio of upstream traffic by reduction of buffer drop probabilities and their deviation in wireless sensor networks. According to the queue length of parent and child nodes, each child node chooses one of the parents as the next hop to the sink and controls the delay before transmission begins. It balances traffics among parents and mitigates congestion based on congestion level of a node. Simulation results show that the proposed algorithm reduces buffer drop probabilities and their deviation and increases the end-to-end delivery success ratio in wireless sensor networks.

  11. Congested Aggregation via Newtonian Interaction

    NASA Astrophysics Data System (ADS)

    Craig, Katy; Kim, Inwon; Yao, Yao

    2017-08-01

    We consider a congested aggregation model that describes the evolution of a density through the competing effects of nonlocal Newtonian attraction and a hard height constraint. This provides a counterpoint to existing literature on repulsive-attractive nonlocal interaction models, where the repulsive effects instead arise from an interaction kernel or the addition of diffusion. We formulate our model as the Wasserstein gradient flow of an interaction energy, with a penalization to enforce the constraint on the height of the density. From this perspective, the problem can be seen as a singular limit of the Keller-Segel equation with degenerate diffusion. Two key properties distinguish our problem from previous work on height constrained equations: nonconvexity of the interaction kernel (which places the model outside the scope of classical gradient flow theory) and nonlocal dependence of the velocity field on the density (which causes the problem to lack a comparison principle). To overcome these obstacles, we combine recent results on gradient flows of nonconvex energies with viscosity solution theory. We characterize the dynamics of patch solutions in terms of a Hele-Shaw type free boundary problem and, using this characterization, show that in two dimensions patch solutions converge to a characteristic function of a disk in the long-time limit, with an explicit rate on the decay of the energy. We believe that a key contribution of the present work is our blended approach, combining energy methods with viscosity solution theory.

  12. EPA Proposes Rules to Improve Hazardous Waste Management and Better Protect our Waterways / New Rules Also Reduce Regulatory Burden on Businesses

    EPA Pesticide Factsheets

    WASHINGTON -- The U.S. Environmental Protection Agency (EPA) is proposing two new hazardous waste rules to strengthen environmental protection while reducing regulatory burden on businesses. One of the proposed rules will protect waterways, includin

  13. Route Optimization for Offloading Congested Meter Fixes

    NASA Technical Reports Server (NTRS)

    Xue, Min; Zelinski, Shannon

    2016-01-01

    The Optimized Route Capability (ORC) concept proposed by the FAA facilitates traffic managers to identify and resolve arrival flight delays caused by bottlenecks formed at arrival meter fixes when there exists imbalance between arrival fixes and runways. ORC makes use of the prediction capability of existing automation tools, monitors the traffic delays based on these predictions, and searches the best reroutes upstream of the meter fixes based on the predictions and estimated arrival schedules when delays are over a predefined threshold. Initial implementation and evaluation of the ORC concept considered only reroutes available at the time arrival congestion was first predicted. This work extends previous work by introducing an additional dimension in reroute options such that ORC can find the best time to reroute and overcome the 'firstcome- first-reroute' phenomenon. To deal with the enlarged reroute solution space, a genetic algorithm was developed to solve this problem. Experiments were conducted using the same traffic scenario used in previous work, when an arrival rush was created for one of the four arrival meter fixes at George Bush Intercontinental Houston Airport. Results showed the new approach further improved delay savings. The suggested route changes from the new approach were on average 30 minutes later than those using other approaches, and fewer numbers of reroutes were required. Fewer numbers of reroutes reduce operational complexity and later reroutes help decision makers deal with uncertain situations.

  14. Understanding congested travel in urban areas

    NASA Astrophysics Data System (ADS)

    Çolak, Serdar; Lima, Antonio; González, Marta C.

    2016-03-01

    Rapid urbanization and increasing demand for transportation burdens urban road infrastructures. The interplay of number of vehicles and available road capacity on their routes determines the level of congestion. Although approaches to modify demand and capacity exist, the possible limits of congestion alleviation by only modifying route choices have not been systematically studied. Here we couple the road networks of five diverse cities with the travel demand profiles in the morning peak hour obtained from billions of mobile phone traces to comprehensively analyse urban traffic. We present that a dimensionless ratio of the road supply to the travel demand explains the percentage of time lost in congestion. Finally, we examine congestion relief under a centralized routing scheme with varying levels of awareness of social good and quantify the benefits to show that moderate levels are enough to achieve significant collective travel time savings.

  15. Understanding congested travel in urban areas.

    PubMed

    Çolak, Serdar; Lima, Antonio; González, Marta C

    2016-03-15

    Rapid urbanization and increasing demand for transportation burdens urban road infrastructures. The interplay of number of vehicles and available road capacity on their routes determines the level of congestion. Although approaches to modify demand and capacity exist, the possible limits of congestion alleviation by only modifying route choices have not been systematically studied. Here we couple the road networks of five diverse cities with the travel demand profiles in the morning peak hour obtained from billions of mobile phone traces to comprehensively analyse urban traffic. We present that a dimensionless ratio of the road supply to the travel demand explains the percentage of time lost in congestion. Finally, we examine congestion relief under a centralized routing scheme with varying levels of awareness of social good and quantify the benefits to show that moderate levels are enough to achieve significant collective travel time savings.

  16. Congestion and cascades in payment systems

    NASA Astrophysics Data System (ADS)

    Beyeler, Walter E.; Glass, Robert J.; Bech, Morten L.; Soramäki, Kimmo

    2007-10-01

    We develop a parsimonious model of the interbank payment system. The model incorporates an endogenous instruction arrival process, a scale-free topology of payments between banks, a fixed total liquidity which limits banks’ capacity to process arriving instructions, and a global market that distributes liquidity. We find that at low liquidity the system becomes congested and payment settlement loses correlation with payment instruction arrival, becoming coupled across the network. The onset of congestion is evidently related to the relative values of three characteristic times: the time for banks’ net position to return to 0, the time for a bank to exhaust its liquidity endowment, and the liquidity market relaxation time. In the congested regime settlement takes place in cascades having a characteristic length scale. A global liquidity market substantially attenuates congestion, requiring only a small fraction of the payment-induced liquidity flow to achieve strong beneficial effects.

  17. Traffic congestion in interconnected complex networks

    NASA Astrophysics Data System (ADS)

    Tan, Fei; Wu, Jiajing; Xia, Yongxiang; Tse, Chi K.

    2014-06-01

    Traffic congestion in isolated complex networks has been investigated extensively over the last decade. Coupled network models have recently been developed to facilitate further understanding of real complex systems. Analysis of traffic congestion in coupled complex networks, however, is still relatively unexplored. In this paper, we try to explore the effect of interconnections on traffic congestion in interconnected Barabási-Albert scale-free networks. We find that assortative coupling can alleviate traffic congestion more readily than disassortative and random coupling when the node processing capacity is allocated based on node usage probability. Furthermore, the optimal coupling probability can be found for assortative coupling. However, three types of coupling preferences achieve similar traffic performance if all nodes share the same processing capacity. We analyze interconnected Internet autonomous-system-level graphs of South Korea and Japan and obtain similar results. Some practical suggestions are presented to optimize such real-world interconnected networks accordingly.

  18. Understanding congested travel in urban areas

    PubMed Central

    Çolak, Serdar; Lima, Antonio; González, Marta C.

    2016-01-01

    Rapid urbanization and increasing demand for transportation burdens urban road infrastructures. The interplay of number of vehicles and available road capacity on their routes determines the level of congestion. Although approaches to modify demand and capacity exist, the possible limits of congestion alleviation by only modifying route choices have not been systematically studied. Here we couple the road networks of five diverse cities with the travel demand profiles in the morning peak hour obtained from billions of mobile phone traces to comprehensively analyse urban traffic. We present that a dimensionless ratio of the road supply to the travel demand explains the percentage of time lost in congestion. Finally, we examine congestion relief under a centralized routing scheme with varying levels of awareness of social good and quantify the benefits to show that moderate levels are enough to achieve significant collective travel time savings. PMID:26978719

  19. Traffic congestion in interconnected complex networks.

    PubMed

    Tan, Fei; Wu, Jiajing; Xia, Yongxiang; Tse, Chi K

    2014-06-01

    Traffic congestion in isolated complex networks has been investigated extensively over the last decade. Coupled network models have recently been developed to facilitate further understanding of real complex systems. Analysis of traffic congestion in coupled complex networks, however, is still relatively unexplored. In this paper, we try to explore the effect of interconnections on traffic congestion in interconnected Barabási-Albert scale-free networks. We find that assortative coupling can alleviate traffic congestion more readily than disassortative and random coupling when the node processing capacity is allocated based on node usage probability. Furthermore, the optimal coupling probability can be found for assortative coupling. However, three types of coupling preferences achieve similar traffic performance if all nodes share the same processing capacity. We analyze interconnected Internet autonomous-system-level graphs of South Korea and Japan and obtain similar results. Some practical suggestions are presented to optimize such real-world interconnected networks accordingly.

  20. Rerouting algorithms solving the air traffic congestion

    NASA Astrophysics Data System (ADS)

    Adacher, Ludovica; Flamini, Marta; Romano, Elpidio

    2017-06-01

    Congestion in the air traffic network is a problem with an increasing relevance for airlines costs as well as airspace safety. One of the major issue is the limited operative capacity of the air network. In this work an Autonomous Agent approach is proposed to solve in real time the problem of air traffic congestion. The air traffic infrastructures are modeled with a graph and are considered partitioned in different sectors. Each sector has its own decision agent dealing with the air traffic control involved in it. Each agent sector imposes a real time aircraft scheduling to respect both delay and capacity constrains. When a congestion is predicted, a new aircraft scheduling is computed. Congestion is solved when the capacity constrains are satisfied once again. This can be done by delaying on ground aircraft or/and rerouting aircraft and/or postponing the congestion. We have tested two different algorithms that calculate K feasible paths for each aircraft involved in the congestion. Some results are reported on North Italian air space.

  1. A Monitoring and Advisory System for Diabetes Patient Management Using a Rule-Based Method and KNN

    PubMed Central

    Lee, Malrey; Gatton, Thomas M.; Lee, Keun-Kwang

    2010-01-01

    Diabetes is difficult to control and it is important to manage the diabetic’s blood sugar level and prevent the associated complications by appropriate diabetic treatment. This paper proposes a system that can provide appropriate management for diabetes patients, according to their blood sugar level. The system is designed to send the information about the blood sugar levels, blood pressure, food consumption, exercise, etc., of diabetes patients, and manage the treatment by recommending and monitoring food consumption, physical activity, insulin dosage, etc., so that the patient can better manage their condition. The system is based on rules and the K Nearest Neighbor (KNN) classifier algorithm, to obtain the optimum treatment recommendation. Also, a monitoring system for diabetes patients is implemented using Web Services and Personal Digital Assistant (PDA) programming. PMID:22319334

  2. Heuristic rules embedded genetic algorithm for in-core fuel management optimization

    NASA Astrophysics Data System (ADS)

    Alim, Fatih

    The objective of this study was to develop a unique methodology and a practical tool for designing loading pattern (LP) and burnable poison (BP) pattern for a given Pressurized Water Reactor (PWR) core. Because of the large number of possible combinations for the fuel assembly (FA) loading in the core, the design of the core configuration is a complex optimization problem. It requires finding an optimal FA arrangement and BP placement in order to achieve maximum cycle length while satisfying the safety constraints. Genetic Algorithms (GA) have been already used to solve this problem for LP optimization for both PWR and Boiling Water Reactor (BWR). The GA, which is a stochastic method works with a group of solutions and uses random variables to make decisions. Based on the theories of evaluation, the GA involves natural selection and reproduction of the individuals in the population for the next generation. The GA works by creating an initial population, evaluating it, and then improving the population by using the evaluation operators. To solve this optimization problem, a LP optimization package, GARCO (Genetic Algorithm Reactor Code Optimization) code is developed in the framework of this thesis. This code is applicable for all types of PWR cores having different geometries and structures with an unlimited number of FA types in the inventory. To reach this goal, an innovative GA is developed by modifying the classical representation of the genotype. To obtain the best result in a shorter time, not only the representation is changed but also the algorithm is changed to use in-core fuel management heuristics rules. The improved GA code was tested to demonstrate and verify the advantages of the new enhancements. The developed methodology is explained in this thesis and preliminary results are shown for the VVER-1000 reactor hexagonal geometry core and the TMI-1 PWR. The improved GA code was tested to verify the advantages of new enhancements. The core physics code

  3. 5 CFR 1001.101 - In addition to this part, what other rules of conduct apply to Office of Personnel Management...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... rules of conduct apply to Office of Personnel Management employees? 1001.101 Section 1001.101 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) REGULATIONS GOVERNING EMPLOYEES OF THE OFFICE OF PERSONNEL MANAGEMENT OPM EMPLOYEE RESPONSIBILITIES AND CONDUCT § 1001.101 In addition to this part...

  4. 5 CFR 1001.101 - In addition to this part, what other rules of conduct apply to Office of Personnel Management...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... rules of conduct apply to Office of Personnel Management employees? 1001.101 Section 1001.101 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) REGULATIONS GOVERNING EMPLOYEES OF THE OFFICE OF PERSONNEL MANAGEMENT OPM EMPLOYEE RESPONSIBILITIES AND CONDUCT § 1001.101 In addition to this part...

  5. 5 CFR 1001.101 - In addition to this part, what other rules of conduct apply to Office of Personnel Management...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... rules of conduct apply to Office of Personnel Management employees? 1001.101 Section 1001.101 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) REGULATIONS GOVERNING EMPLOYEES OF THE OFFICE OF PERSONNEL MANAGEMENT OPM EMPLOYEE RESPONSIBILITIES AND CONDUCT § 1001.101 In addition to this part...

  6. 5 CFR 1001.101 - In addition to this part, what other rules of conduct apply to Office of Personnel Management...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... rules of conduct apply to Office of Personnel Management employees? 1001.101 Section 1001.101 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) REGULATIONS GOVERNING EMPLOYEES OF THE OFFICE OF PERSONNEL MANAGEMENT OPM EMPLOYEE RESPONSIBILITIES AND CONDUCT § 1001.101 In addition to this part...

  7. 5 CFR 1001.101 - In addition to this part, what other rules of conduct apply to Office of Personnel Management...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... rules of conduct apply to Office of Personnel Management employees? 1001.101 Section 1001.101 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) REGULATIONS GOVERNING EMPLOYEES OF THE OFFICE OF PERSONNEL MANAGEMENT OPM EMPLOYEE RESPONSIBILITIES AND CONDUCT § 1001.101 In addition to this...

  8. Climate Change Adaptation in the Western U.S.: the Case for Dynamic Rule Curves in Water Resources Management

    NASA Astrophysics Data System (ADS)

    Lee, S.; Hamlet, A. F.; Burges, S. J.

    2008-12-01

    Climate change in the Western U.S. will bring systematic hydrologic changes affecting many water resources systems. Successful adaptation to these changes, which will be ongoing through the 21st century, will require the 'rebalancing' of competing system objectives such as water supply, flood control, hydropower production, and environmental services in response to hydrologic (and other) changes. Although fixed operating policies for the operation of reservoirs has been a traditional approach to water management in the 20th century, the rapid pace of projected climate shifts (~0.5 F per decade), and the prohibitive costs of recursive policy intervention to mitigate impacts, suggest that more sophisticated approaches will be needed to cope with climate change on a long term basis. The use of 'dynamic rule curves' is an approach that maintains some of the key characteristics of current water management practice (reservoir rule curves) while avoiding many of the fundamental drawbacks of traditional water resources management strategies in a non-stationary climate. In this approach, water resources systems are optimized for each operational period using ensemble streamflow and/or water demand forecasts. The ensemble of optimized reservoir storage traces are then analyzed to produce a set of unique reservoir rule curves for each operational period reflecting the current state of the system. The potential advantage of this approach is that hydrologic changes associated with climate change (such as systematically warmer temperatures) can be captured explicitly in operational hydrologic forecasts, which would in turn inform the optimized reservoir management solutions, creating water resources systems that are largely 'self tending' as the climate system evolves. Furthermore, as hydrologic forecasting systems improve (e.g. in response to improved ENSO forecasting or other scientific advances), so does the performance of reservoir operations. An example of the approach is

  9. Research and development of methods/utilities and rules for managing cooperation for performance improvement in government offices

    SciTech Connect

    Kurstedt, H.A.

    1993-03-01

    Purpose is to help managers approach their responsibilities proactively, so that they can anticipate problems and take actions to alleviate or eliminate those problems. Continuous performance improvement, the philosophy behind total quality management, requires working cooperatively to do a little better each day. The most effective tools are working through a closed set of 9 methods: setting expectations, charting, defining indicators and standards, collecting and logging data, converting data to information, organizing and presenting information, reviewing status and progress, self-management, and appraising. In addition, there are 8 rules: focus on what you can do, supply physical evidence of progress, pay attention to detail, inspect (don't expect), review progress routinely and frequently, face ''success/fail'' squarely, communicate crisply, and conduct honest, open appraisals. Scope and plans of the draft research plan (study areas) are described.

  10. The Joint Military Medical Executive Skills initiative: an impressive response to changing human resource management rules of engagement.

    PubMed

    Kerr, Bernard J

    2007-01-01

    Confronted with a sudden and substantial change in the rules regarding who could command a military medical treatment facility (MTF), the Military Health System (MHS) responded to the challenge with an impressive human resource management solution-the Joint Medical Executive Skills Program. The history, emergence, and continuing role of this initiative exemplifies the MHS's capacity to fulfill the spirit and intent of an arduous Congressional mandate while enhancing professional development and sustaining the career opportunities of medical officers. The MHS response to the Congressional requirement that candidates for MTF command demonstrate professional administrative skills was decisive, creative, and consistent with the basic principles of human resource management. The Joint Medical Executive Skills Program is a management success story that demonstrates how strategic planning, well-defined skills requirements, and structured training can assure a ready supply of qualified commanders for the military's MTFs.

  11. 78 FR 26804 - Notice of Proposed Supplementary Rules for Travel Management on Public Lands in Gunnison...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-08

    ... to 5 E. Tps. 41 N., Rs. 5 and 6 W., unsurveyed. Tps. 42 N, Rs. 3 to 6 W., partly unsurveyed. Tps. 43... would provide two exemptions from the restrictions. One exemption would allow big game hunters to use...? (5) Is the description of the proposed supplementary rules in the ``Discussion of...

  12. Congestive Heart Failure home monitoring pilot study in urban Denver.

    PubMed

    Bakhshi, Saba; Li, Xin; Semenov, Nikolay; Apodaca-Madrid, Jesús; Mahoor, Mohammad H; Newman, Kimberly E; Long, Carlin S; Neuman, Christine

    2011-01-01

    With a growing number of low-income patients developing Congestive Heart Failure in urban Denver, accessible and affordable solutions are needed to provide home management options. A multidisciplinary team evaluated currently available options for telemonitoring and developed a solution for an initial pilot study. This system is currently used in the Denver Metro area (Colorado) for 44 CHF patients. Preliminary results show this approach is effective and has reduced the patients' average length of stay at the hospital compared to historical data and control patients who do not use a remote monitoring system.

  13. Congestion Transition in Air Traffic Networks

    PubMed Central

    Monechi, Bernardo; Servedio, Vito D. P.; Loreto, Vittorio

    2015-01-01

    Air Transportation represents a very interesting example of a complex techno-social system whose importance has considerably grown in time and whose management requires a careful understanding of the subtle interplay between technological infrastructure and human behavior. Despite the competition with other transportation systems, a growth of air traffic is still foreseen in Europe for the next years. The increase of traffic load could bring the current Air Traffic Network above its capacity limits so that safety standards and performances might not be guaranteed anymore. Lacking the possibility of a direct investigation of this scenario, we resort to computer simulations in order to quantify the disruptive potential of an increase in traffic load. To this end we model the Air Transportation system as a complex dynamical network of flights controlled by humans who have to solve potentially dangerous conflicts by redirecting aircraft trajectories. The model is driven and validated through historical data of flight schedules in a European national airspace. While correctly reproducing actual statistics of the Air Transportation system, e.g., the distribution of delays, the model allows for theoretical predictions. Upon an increase of the traffic load injected in the system, the model predicts a transition from a phase in which all conflicts can be successfully resolved, to a phase in which many conflicts cannot be resolved anymore. We highlight how the current flight density of the Air Transportation system is well below the transition, provided that controllers make use of a special re-routing procedure. While the congestion transition displays a universal scaling behavior, its threshold depends on the conflict solving strategy adopted. Finally, the generality of the modeling scheme introduced makes it a flexible general tool to simulate and control Air Transportation systems in realistic and synthetic scenarios. PMID:25993476

  14. Congestion transition in air traffic networks.

    PubMed

    Monechi, Bernardo; Servedio, Vito D P; Loreto, Vittorio

    2015-01-01

    Air Transportation represents a very interesting example of a complex techno-social system whose importance has considerably grown in time and whose management requires a careful understanding of the subtle interplay between technological infrastructure and human behavior. Despite the competition with other transportation systems, a growth of air traffic is still foreseen in Europe for the next years. The increase of traffic load could bring the current Air Traffic Network above its capacity limits so that safety standards and performances might not be guaranteed anymore. Lacking the possibility of a direct investigation of this scenario, we resort to computer simulations in order to quantify the disruptive potential of an increase in traffic load. To this end we model the Air Transportation system as a complex dynamical network of flights controlled by humans who have to solve potentially dangerous conflicts by redirecting aircraft trajectories. The model is driven and validated through historical data of flight schedules in a European national airspace. While correctly reproducing actual statistics of the Air Transportation system, e.g., the distribution of delays, the model allows for theoretical predictions. Upon an increase of the traffic load injected in the system, the model predicts a transition from a phase in which all conflicts can be successfully resolved, to a phase in which many conflicts cannot be resolved anymore. We highlight how the current flight density of the Air Transportation system is well below the transition, provided that controllers make use of a special re-routing procedure. While the congestion transition displays a universal scaling behavior, its threshold depends on the conflict solving strategy adopted. Finally, the generality of the modeling scheme introduced makes it a flexible general tool to simulate and control Air Transportation systems in realistic and synthetic scenarios.

  15. Avoiding congestion through dynamic load control

    NASA Astrophysics Data System (ADS)

    Hnatyshin, Vasil; Sethi, Adarshpal S.

    2001-07-01

    The current best effort approach to quality of service in the Internet can no longer satisfy a diverse variety of customer service requirements, and that is why there is a need for alternative strategies. In order to solve this problem a number of service differentiation models have been proposed. Unfortunately, these schemes often fail to provide proper service differentiation during periods of congestion. To deal with the issue of congestion, we introduce a new load control mechanism that eliminates congestion based on the feedback from the network core by dynamically adjusting traffic load at the network boundary. We introduce four methods for calculating load distribution among the ingress routers and among different flows in each ingress router, and we evaluate these proposed methods through simulation.

  16. Fixed-rate layered multicast congestion control

    NASA Astrophysics Data System (ADS)

    Bing, Zhang; Bing, Yuan; Zengji, Liu

    2006-10-01

    A new fixed-rate layered multicast congestion control algorithm called FLMCC is proposed. The sender of a multicast session transmits data packets at a fixed rate on each layer, while receivers each obtain different throughput by cumulatively subscribing to deferent number of layers based on their expected rates. In order to provide TCP-friendliness and estimate the expected rate accurately, a window-based mechanism implemented at receivers is presented. To achieve this, each receiver maintains a congestion window, adjusts it based on the GAIMD algorithm, and from the congestion window an expected rate is calculated. To measure RTT, a new method is presented which combines an accurate measurement with a rough estimation. A feedback suppression based on a random timer mechanism is given to avoid feedback implosion in the accurate measurement. The protocol is simple in its implementation. Simulations indicate that FLMCC shows good TCP-friendliness, responsiveness as well as intra-protocol fairness, and provides high link utilization.

  17. Winning Strategies in Congested Traffic

    NASA Astrophysics Data System (ADS)

    Járai-Szabó, Ferenc; Néda, Zoltán

    2012-09-01

    One-directional traffic on two-lanes is modeled in the framework of a spring-block type model. A fraction q of the cars are allowed to change lanes, following simple dynamical rules, while the other cars keep their initial lane. The advance of cars, starting from equivalent positions and following the two driving strategies is studied and compared. As a function of the parameter q the winning probability and the average gain in the advancement for the lane-changing strategy is computed. An interesting phase-transition like behavior is revealed and conclusions are drawn regarding the conditions when the lane changing strategy is the better option for the drivers.

  18. Adaptive mechanism-based congestion control for networked systems

    NASA Astrophysics Data System (ADS)

    Liu, Zhi; Zhang, Yun; Chen, C. L. Philip

    2013-03-01

    In order to assure the communication quality in network systems with heavy traffic and limited bandwidth, a new ATRED (adaptive thresholds random early detection) congestion control algorithm is proposed for the congestion avoidance and resource management of network systems. Different to the traditional AQM (active queue management) algorithms, the control parameters of ATRED are not configured statically, but dynamically adjusted by the adaptive mechanism. By integrating with the adaptive strategy, ATRED alleviates the tuning difficulty of RED (random early detection) and shows a better control on the queue management, and achieve a more robust performance than RED under varying network conditions. Furthermore, a dynamic transmission control protocol-AQM control system using ATRED controller is introduced for the systematic analysis. It is proved that the stability of the network system can be guaranteed when the adaptive mechanism is finely designed. Simulation studies show the proposed ATRED algorithm achieves a good performance in varying network environments, which is superior to the RED and Gentle-RED algorithm, and providing more reliable service under varying network conditions.

  19. Research and development of methods/utilities and rules for managing cooperation for performance improvement in government offices

    SciTech Connect

    Not Available

    1992-03-01

    On September 1, 1991, Defense Programs (DP) within the US Department of Energy entered into a research grant with Management Systems Laboratories (MSL) of Virginia Polytechnic Institute and State University (Virginia Tech), to study Tools, Methods, and Rules for Managing Cooperation for Performance Improvement. Continuous performance improvement is a gradual, systematic process. The idea is to do a little better each day by knowing where you are, where you want to be, what you have to do to get there, whether or not you have done it, and how to resolve problems doing it. And, although many management decisions are made along direct lines of authority, much of the work of an organization can be achieved only through cooperation (people sharing information and coordinating effort). Therefore, continuous performance improvement requires working cooperatively to do a little better each day. We are researching the most effective configuration of tools working through what we believe is a closed set of nine methods. These methods are: setting expectations, charting, defining indicators and standards, collecting and logging data, converting data to information, organizing and presenting information, reviewing status and progress, self-management, and appraising. We believe that these methods form a closed set because they reflect the management activities of formulation (planning),execution (doing), and verification (evaluating). If these activities are carried out effectively through the methods, the manager can achieve visibility and control.

  20. On the Efficiency of the New York Independent System OperatorMarket for Transmission Congestion Contracts

    SciTech Connect

    Siddiqui, Afzal S.; Bartholomew, Emily S.; Marnay, Chris; Oren,Shmuel S.

    2003-04-01

    The physical nature of electricity generation and deliverycreates special problems for the design of efficient markets, notably theneed to manage delivery in real time and the volatile congestion andassociated costs that result. Proposals for the operation of thederegulated electricity industry tend towards one of two paradigms:centralized and decentralized. Transmission congestion management can beimplemented in the more centralized point-to-point approach, a in NewYork state, where derivative transmission congestion contracts (TCCs) aretraded, or in the more decentralized flowgate-based approach. While it iswidely accepted that theoretically TCCs have attractive properties ashedging instruments against congestion cost uncertainty, whetherefficient markets for them can be established in practice has beenquestioned. Based on an empirical analysis of publicly available datafrom years 2000 and 2001, it appears that New York TCCs providedmarketparticipants with a potentially effective hedge against volatilecongestion rents. However, the prices paid for TCCs systematicallydiverged from the resulting congestion rents for distant locations and athigh prices. The price paid for the hedge not being in line with thecongestion rents, i.e. unreasonably high risk premiums are being paid,suggests an inefficient market. The low liquidity of TCC markets and thedeviation of TCC feasibility requirements from actual energy flows arepossible explanations.

  1. Mean Field Type Control with Congestion

    SciTech Connect

    Achdou, Yves Laurière, Mathieu

    2016-06-15

    We analyze some systems of partial differential equations arising in the theory of mean field type control with congestion effects. We look for weak solutions. Our main result is the existence and uniqueness of suitably defined weak solutions, which are characterized as the optima of two optimal control problems in duality.

  2. Delivering Faster Congestion Feedback with the Mark-Front Strategy

    NASA Technical Reports Server (NTRS)

    Liu, Chunlei; Jain, Raj

    2001-01-01

    Computer networks use congestion feedback from the routers and destinations to control the transmission load. Delivering timely congestion feedback is essential to the performance of networks. Reaction to the congestion can be more effective if faster feedback is provided. Current TCP/IP networks use timeout, duplicate Acknowledgement Packets (ACKs) and explicit congestion notification (ECN) to deliver the congestion feedback, each provides a faster feedback than the previous method. In this paper, we propose a markfront strategy that delivers an even faster congestion feedback. With analytical and simulation results, we show that mark-front strategy reduces buffer size requirement, improves link efficiency and provides better fairness among users. Keywords: Explicit Congestion Notification, mark-front, congestion control, buffer size requirement, fairness.

  3. Analysis of Aircraft Clusters to Measure Sector-Independent Airspace Congestion

    NASA Technical Reports Server (NTRS)

    Bilimoria, Karl D.; Lee, Hilda Q.

    2005-01-01

    The Distributed Air/Ground Traffic Management (DAG-TM) concept of operations* permits appropriately equipped aircraft to conduct Free Maneuvering operations. These independent aircraft have the freedom to optimize their trajectories in real time according to user preferences; however, they also take on the responsibility to separate themselves from other aircraft while conforming to any local Traffic Flow Management (TFM) constraints imposed by the air traffic service provider (ATSP). Examples of local-TFM constraints include temporal constraints such as a required time of arrival (RTA), as well as spatial constraints such as regions of convective weather, special use airspace, and congested airspace. Under current operations, congested airspace typically refers to a sector(s) that cannot accept additional aircraft due to controller workload limitations; hence Dynamic Density (a metric that is indicative of controller workload) can be used to quantify airspace congestion. However, for Free Maneuvering operations under DAG-TM, an additional metric is needed to quantify the airspace congestion problem from the perspective of independent aircraft. Such a metric would enable the ATSP to prevent independent aircraft from entering any local areas of congestion in which the flight deck based systems and procedures may not be able to ensure separation. This new metric, called Gaggle Density, offers the ATSP a mode of control to regulate normal operations and to ensure safety and stability during rare-normal or off-normal situations (e.g., system failures). It may be difficult to certify Free Maneuvering systems for unrestricted operations, but it may be easier to certify systems and procedures for specified levels of Gaggle Density that could be monitored by the ATSP, and maintained through relatively minor flow-rate (RTA type) restrictions. Since flight deck based separation assurance is airspace independent, the challenge is to measure congestion independent of sector

  4. 75 FR 22770 - National Electric Transmission Congestion Study

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-30

    ... National Electric Transmission Congestion Study AGENCY: Office of Electricity Delivery and Energy Reliability (OE), Department of Energy. ACTION: Notice of Availability of 2009 National Electric Transmission... notice that it has issued a National Electric Transmission Congestion Study (2009 Congestion Study) and...

  5. Chronic Pelvic Pain due to Pelvic Congestion Syndrome: The Role of Diagnostic and Interventional Radiology

    SciTech Connect

    Ganeshan, Arul; Upponi, Sara; Hon, Lye-Quen; Uthappa, M. C.; Warakaulle, Dinuke R.; Uberoi, Raman

    2007-11-15

    Chronic pelvic pain (CPP) is a common cause of gynecologic referral. Pelvic congestion syndrome, which is said to occurs due to ovarian vein incompetence, is a recognized cause of CPP. The aim of this paper is to briefly describe the clinical manifestations, and to review the role of diagnostic and interventional radiology in the management of this probably under-diagnosed condition.

  6. Congestive heart failure education study.

    PubMed

    Ribelin, Pam; Neufelder, Louise

    2006-01-01

    Nursing staff providing care to patients on a medical/surgical unit must be generalists rather than specialists in disease management. The diversity of illnesses seen among this population requires the nurse to be expert in many disease processes. The complexity of patients who are admitted to a medical/surgical unit continues to increase and is therefore challenging to nurses. Complex patient populations can be attributed to individuals living longer and the advancement of technology and information in treating serious medical conditions. Nursing expertise for different disease processes can vary according to experience, educational level, and knowledge regarding evidence-based practice. Lack of knowledge regarding current practice guidelines and care may result in poor patient outcomes and high cost. Confidence in performing safe and quality nursing care can also be affected by lack of knowledge. Continuing education for nursing must be made a priority for nurses to provide safe and high quality care. Education provided must be current and based on positive outcomes through research-based nursing practice.

  7. Improving Explicit Congestion Notification with the Mark-Front Strategy

    NASA Technical Reports Server (NTRS)

    Liu, Chunlei; Jain, Raj

    2001-01-01

    Delivering congestion signals is essential to the performance of networks. Current TCP/IP networks use packet losses to signal congestion. Packet losses not only reduces TCP performance, but also adds large delay. Explicit Congestion Notification (ECN) delivers a faster indication of congestion and has better performance. However, current ECN implementations mark the packet from the tail of the queue. In this paper, we propose the mark-front strategy to send an even faster congestion signal. We show that mark-front strategy reduces buffer size requirement, improves link efficiency and provides better fairness among users. Simulation results that verify our analysis are also presented.

  8. Improving UDP/IP Transmission Without Increasing Congestion

    NASA Technical Reports Server (NTRS)

    Burleigh, Scott

    2006-01-01

    Datagram Retransmission (DGR) is a computer program that, within certain limits, ensures the reception of each datagram transmitted under the User Datagram Protocol/Internet Protocol. [User Datagram Protocol (UDP) is considered unreliable because it does not involve a reliability-ensuring connection-initiation dialogue between sender and receiver. UDP is well suited to issuing of many small messages to many different receivers.] Unlike prior software for ensuring reception of UDP datagrams, DGR does not contribute to network congestion by retransmitting data more frequently as an ever-increasing number of messages and acknowledgements is lost. Instead, DGR does just the opposite: DGR includes an adaptive timeout-interval- computing component that provides maximum opportunity for reception of acknowledgements, minimizing retransmission. By monitoring changes in the rate at which message-transmission transactions are completed, DGR detects changes in the level of congestion and responds by imposing varying degrees of delay on the transmission of new messages. In addition, DGR maximizes throughput by not waiting for acknowledgement of a message before sending the next message. All DGR communication is asynchronous, to maximize efficient utilization of network connections. DGR manages multiple concurrent datagram transmission and acknowledgement conversations.

  9. Can complexity decrease in congestive heart failure?

    NASA Astrophysics Data System (ADS)

    Mukherjee, Sayan; Palit, Sanjay Kumar; Banerjee, Santo; Ariffin, M. R. K.; Rondoni, Lamberto; Bhattacharya, D. K.

    2015-12-01

    The complexity of a signal can be measured by the Recurrence period density entropy (RPDE) from the reconstructed phase space. We have chosen a window based RPDE method for the classification of signals, as RPDE is an average entropic measure of the whole phase space. We have observed the changes in the complexity in cardiac signals of normal healthy person (NHP) and congestive heart failure patients (CHFP). The results show that the cardiac dynamics of a healthy subject is more complex and random compare to the same for a heart failure patient, whose dynamics is more deterministic. We have constructed a general threshold to distinguish the border line between a healthy and a congestive heart failure dynamics. The results may be useful for wide range for physiological and biomedical analysis.

  10. Compression treatment of pelvic congestion syndrome.

    PubMed

    Gavrilov, S G; Karalkin, A V; Turischeva, O O

    2017-01-01

    Aim To study the influence of compression treatment on clinical manifestations and venous hemodynamics of the pelvis in patients with pelvic congestion syndrome. Materials and methods A prospective study of the various options and modes of compression treatment was carried out and included 74 patients with pelvic congestion syndrome in 2008-2015. The patients were divided into three groups. The first group consisted of 48 patients with symptoms of pelvic congestion syndrome and chronic pelvic pain. They used Class II compression shorts. In the second group, there were 14 patients with pelvic congestion syndrome, vulvar varicosities without pelvic pain. They used Class II compression shorts and stockings. In the third group, 12 women with pelvic congestion syndrome and chronic pelvic pain used only the Class II compression stockings. The treatment continued for 14 days. A clinical criterion was the change of severity of chronic pelvic pain. The evaluation of the treatments has been performed using radionuclide venography and emission computed tomography with labeled in vivo red blood cells. Results Group 1: The compression shorts had a positive effect on the disease in 81.3% of patients. Chronic pelvic pain decreased from 6.4 ± 1.6 to 1.2 ± 0.7 points. The coefficient of pelvic congestion syndrome (Cpcs) decreased from 1.73 ± 0.32 to 1.12 ± 0.27 (p < 0.05). In 18.8% of patients, no positive effect was observed. Group 2: The results of radionuclide venographyshowed accelerating outflow of blood from the lower limbs and reduction of insufficiency of perforating veins. Mean radionuclide transit time decreased in all patients in the tendon, muscle pump parts, popliteal vein and was respectively: 23.6 ± 2.2 s, 29.6 ± 3.4 s, 32.3 ± 4.2 s and after treatment 16.4 ± 3.1 s, 22.1 ± 2.5 s, 25.7 ± 1.9 s (p < 0.05). Group 3: The use of compression stockings class II on the clinical manifestations of pelvic

  11. [Current echography diagnosis of pelvic congestion syndrome].

    PubMed

    Malinova, M; Shopov, A

    2012-01-01

    Chronic pelvic pain is a common condition. The sources of pelvic pain are multifactorial, and their causes are difficult to determine. Pelvic congestion syndrome (PCS) is associated with varicose ovarian veins and/or varicose veins in the pelvis. The syndrome is associated with constant dull pelvic pain, abnormal menstrual bleeding, tenderness to touch in lower abdomen, pain during intercourse, painful menstrual periods, vaginal discharge, PCOS. The specific diagnosis of Pelvic Congestion Syndrome is made using several tests which include ultrasound, CAT, MIR, MDCT (multidetector) and venogram. The ultrasound is the first test of choice. It can assess the uterus and other organs in the pelvis. Doppler ultrasound can also help visualize the blood flow and asses the presence of varicosities in the pelvis.

  12. Abdominal contributions to cardiorenal dysfunction in congestive heart failure.

    PubMed

    Verbrugge, Frederik H; Dupont, Matthias; Steels, Paul; Grieten, Lars; Malbrain, Manu; Tang, W H Wilson; Mullens, Wilfried

    2013-08-06

    Current pathophysiological models of congestive heart failure unsatisfactorily explain the detrimental link between congestion and cardiorenal function. Abdominal congestion (i.e., splanchnic venous and interstitial congestion) manifests in a substantial number of patients with advanced congestive heart failure, yet is poorly defined. Compromised capacitance function of the splanchnic vasculature and deficient abdominal lymph flow resulting in interstitial edema might both be implied in the occurrence of increased cardiac filling pressures and renal dysfunction. Indeed, increased intra-abdominal pressure, as an extreme marker of abdominal congestion, is correlated with renal dysfunction in advanced congestive heart failure. Intriguing findings provide preliminary evidence that alterations in the liver and spleen contribute to systemic congestion in heart failure. Finally, gut-derived hormones might influence sodium homeostasis, whereas entrance of bowel toxins into the circulatory system, as a result of impaired intestinal barrier function secondary to congestion, might further depress cardiac as well as renal function. Those toxins are mainly produced by micro-organisms in the gut lumen, with presumably important alterations in advanced heart failure, especially when renal function is depressed. Therefore, in this state-of-the-art review, we explore the crosstalk between the abdomen, heart, and kidneys in congestive heart failure. This might offer new diagnostic opportunities as well as treatment strategies to achieve decongestion in heart failure, especially when abdominal congestion is present. Among those currently under investigation are paracentesis, ultrafiltration, peritoneal dialysis, oral sodium binders, vasodilator therapy, renal sympathetic denervation and agents targeting the gut microbiota.

  13. 75 FR 60689 - Hazardous Waste Management System; Identification and Listing of Hazardous Waste; Proposed Rule

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-01

    ... AGENCY 40 CFR Part 261 Hazardous Waste Management System; Identification and Listing of Hazardous Waste... Refinery (Beaumont Refinery) to exclude (or delist) a certain solid waste generated by its Beaumont, Texas, facility from the lists of hazardous wastes. EPA used the Delisting Risk Assessment Software (DRAS) Version...

  14. Revisiting Current Golden Rules in Managing Acute Ischemic Stroke: Evaluation of New Strategies to Further Improve Treatment Selection and Outcome.

    PubMed

    Yuh, William T C; Alexander, Matthew David; Ueda, Toshihiro; Maeda, Masayuki; Taoka, Toshiaki; Yamada, Kei; Beauchamp, Norman J

    2017-01-01

    Advanced stroke imaging has generated much excitement for the early diagnosis of acute ischemic stroke (AIS) and facilitation of intervention. However, its therapeutic impact has not matched its diagnostic utility; most notably, lacking significant contributions to recent major AIS clinical trials. It is time to reexamine the fundamental hypotheses from the enormous body of imaging research on which clinical practices are based and reassess the current standard clinical and imaging strategies, or golden rules, established over decades for AIS. In this article, we will investigate a possible new window of opportunity in managing AIS through a better understanding of the following: first, the potential limitations of the golden rules; second, the significance of imaging-based parenchymal hypoperfusion (i.e., lower-than-normal relative cerebral blood flow [rCBF] may not be indicative of ischemia); third, the other critical factors (e.g., rCBF, collateral circulation, variable therapeutic window, chronicity of occlusion) that reflect more individual ischemic injury for optimal treatment selection; and, fourth, the need for penumbra validation in successfully reperfused patients (not in untreated patients). Individual variations in the therapeutic window, ischemic injury (rCBF), and chronicity of vascular lesion development have not been comprehensively incorporated in the standard algorithms used to manage AIS. The current established imaging parameters have not been consistently validated with successfully reperfused patients and rCBF to quantitatively distinguish between oligemia and ischemia and between penumbra and infarct core within ischemic tissue. A novel paradigm incorporating rCBF values or indirectly incorporating relative rCBF values with higher statistically powered imaging studies to more reliably assess the severity of ischemic injury and differentiate reversibility from viability within the area of imaging-based parenchymal hypoperfusion may provide a

  15. Cardiac CT Angiography in Congestive Heart Failure.

    PubMed

    Levine, Avi; Hecht, Harvey S

    2015-06-01

    Cardiac CT angiography has become an important tool for the diagnosis and treatment of congestive heart failure. Differentiation of ischemic from nonischemic cardiomyopathy; evaluation of myocardial perfusion; characterization of hypertrophic cardiomyopathy, left ventricular noncompaction, and arrhythmogenic right ventricular dysplasia; and delineation of congenital heart defects and valvular abnormalities are the primary diagnostic applications. Therapeutic use includes visualization of the coronary venous anatomy for optimal implementation of cardiac resynchronization therapy and evaluation of left ventricular assist devices and transplant vasculopathy.

  16. Onset of traffic congestion in complex networks.

    PubMed

    Zhao, Liang; Lai, Ying-Cheng; Park, Kwangho; Ye, Nong

    2005-02-01

    Free traffic flow on a complex network is key to its normal and efficient functioning. Recent works indicate that many realistic networks possess connecting topologies with a scale-free feature: the probability distribution of the number of links at nodes, or the degree distribution, contains a power-law component. A natural question is then how the topology influences the dynamics of traffic flow on a complex network. Here we present two models to address this question, taking into account the network topology, the information-generating rate, and the information-processing capacity of individual nodes. For each model, we study four kinds of networks: scale-free, random, and regular networks and Cayley trees. In the first model, the capacity of packet delivery of each node is proportional to its number of links, while in the second model, it is proportional to the number of shortest paths passing through the node. We find, in both models, that there is a critical rate of information generation, below which the network traffic is free but above which traffic congestion occurs. Theoretical estimates are given for the critical point. For the first model, scale-free networks and random networks are found to be more tolerant to congestion. For the second model, the congestion condition is independent of network size and topology, suggesting that this model may be practically useful for designing communication protocols.

  17. Process safety management in the pipeline industry: parallels and differences between the pipeline integrity management (IMP) rule of the Office of Pipeline Safety and the PSM/RMP approach for process facilities.

    PubMed

    DeWolf, Glenn B

    2003-11-14

    In 2001, the Federal Office of Pipeline Safety promulgated its pipeline integrity management rule for hazardous liquid pipelines. A notice of proposed rule making for a similar rule for gas pipelines was issued in January 2003. A final rule must be in place by the end of 2003. These rules derive from formal risk management initiatives of both the pipeline industry and the regulators beginning in the early to mid-1990s. The initiatives and resulting rules built on many of the process safety and risk management concepts and frameworks of the process industries, as modified for pipelines. Looking closely at the parallels and the differences is an interesting study of how the technical, public and industry-specific requirements affect the types of regulations, supporting management system frameworks and the technical activities for improving hazardous materials process safety. This paper is based on the experience of the author in project work with federal and state regulators and with industry groups and companies, in both the process and pipeline industries over the last 17 years. It provides insights into various alternative pathways for communicating process safety concepts and improving process safety as the concepts are translated into specific company and even individual employee actions. It specifically highlights how the commonalities and differences in the types and configurations of physical assets and operating practices of the pipeline companies and process facilities affect respective cultures, language and actions for process safety management.

  18. Cerebral Venous Congestion as Indication for Thrombolytic Treatment

    SciTech Connect

    Tsai, Fong Y. Kostanian, Varoujan; Rivera, Monica; Lee, Kwo-Whie; Chen, Clayton C.; Nguyen, Thong H.

    2007-07-15

    Purpose. To carry out a retrospective analysis of patients with acute dural sinus thrombosis, and the role of cerebral venous congestion in patient management. Methods. Twenty-five patients were identified with the clinical and imaging diagnosis of acute dural sinus thrombosis. The imaging diagnosis was by magnetic resonance (MR) and/or computed tomography (CT) venography. There was a female predominance with a female to male ratio of 1.5 to 1 (16 women, 9 men). The age range was from 19 to 64 years old with an average age of 37 years. The first 10 patients, who ranged in age from 21 to 64 years old (average 37 years), received only anticoagulation therapy with heparin and warfarin for periods ranging from 5 days to 2 months. The remaining 15 patients ranged in age from 19 to 57 years old (average 38 years). They either underwent subsequent thrombectomy after a trial of anticoagulation therapy, or went straight to thrombectomy. These latter 15 patients had initial evidence of cerebral venous congestion, either clinically by severe or worsening symptoms despite anticoagulation therapy, or on initial or subsequent CT or MR imaging. In our experience, the cerebral venous congestion imaging findings included intracranial hemorrhage, a hematoma, or edema. The thrombolytic treatment technique consisted of the advancement of a 6 Fr guiding catheter to the jugular bulb or sigmoid sinus from a transfemoral approach. A microcatheter was then advanced to the proximal portion of the thrombus and then either tissue plasminogen activator (tPA) or urokinase was injected to prevent clot propagation. A balloon catheter was used to perform thrombectomy since the thrombolytic agents can be injected via the inner lumen with an inflated balloon. The inflated balloon helped to keep the venous flow from washing out the thrombolytic agent, thus facilitating the agent's effect. Results. The first 10 patients received only anticoagulation therapy with heparin and warfarin for periods

  19. Report: Efficiency of EPA’s Rule Development Process Can Be Better Measured Through Improved Management and Information

    EPA Pesticide Factsheets

    Report #13-P-0167, February 28, 2013. Rule development is one of the Agency’s principal tasks. EPA develops rules to carry out the environmental and public health protection laws passed by Congress.

  20. A new rule generation method to develop a decision support system for integrated management at river basin scale.

    PubMed

    Benedetti, Lorenzo; Prat, Pau; Nopens, Ingmar; Poch, Manel; Poch, Manel; Turon, Clàudia; De Baets, Bernard; Comas, Joaquim

    2009-01-01

    The Besòs River Basin authority is working towards the implementation of integrated river basin management, as required by the Water Framework Directive (WFD), to achieve a good ecological and chemical status of all water bodies by 2015. The studied system is constituted by two communities (La Garriga and Granollers), their corresponding draining catchments, sewer systems and two WWTPs, which discharge treated water at different locations of the same river. Within this context, the realisation of an integrated model of the river stretch and of the two WWTPs with their sewer systems and draining catchments was necessary. Such a model allows to efficiently simulate and analyse the behaviour of the integrated system and to optimize its performance holistically. In this article, a method is presented to generate rules to be implemented in a supervisory system for automatic management of the Integrated Urban Wastewater System (IUWS) in dry and storm weather. This is achieved by identifying, with the help of Monte Carlo simulations, the most performing operational parameters-according to environmental and economic criteria-for the two weather conditions.

  1. CSLAA and FAA'S Rules: Incorporating a 'Risk Management Framework' to Minimise Human Space Flight Risks

    NASA Astrophysics Data System (ADS)

    Chaddha, S.

    2012-01-01

    th This year marks the 50 anniversary of a landmark victory for humankind in its endeavour of entering and exploring the final frontier. During these years of space activity, we have witnessed a number of cumulative successes. One of which is the emergence of the commercial human space flight, or "space tourism", market. Commercial companies have the aim of travelling people into space safely and affordably. This paper shall consider the U.S. regulatory framework governing the space tourism market. It scrutinises the adequacy of the Commercial Space Launch and Amendment Act of 2004 (CSLAA), as bolstered by the FAA's requirements, to protect launching passengers to an acceptable standard of safety from the inherent risks associated with human space flights. It is argued that the legislative regime embeds a three-limb "risk management framework" as an appropriate response to address the concern over the safety of public space travel.

  2. Status of the IAA study group on traffic management rules for space operations

    NASA Astrophysics Data System (ADS)

    Contant, Corinne; Lala, Petr; Schrogl, Kai-Uwe

    2007-10-01

    The investigation of space traffic and its management has only recently become a point of wider discussion. In particular, the series of workshops organized by the American Institute of Aeronautics and Astronautics (AIAA) and other international organizations on international cooperation highlighted the issue. It was discussed thoroughly at the workshops, which took place in 1999 and 2001, respectively. It was at the 2001 workshop, when the suggestion was made that an International Academy of Astronautics (IAA) Study on the subject of space traffic management should be prepared. This suggestion was taken up and a proposal was presented to the Board of Trustees of IAA, which, in late 2001, accepted this proposal. Following this, an interdisciplinary study group of around 20 persons was composed. One early milestone in the process of work was the conduct of an International Institute of Space Law (IISL)/European Center of Space Law (ECSL) Symposium alongside the 2002 session of the United Nations Committee on the Peaceful Uses of Outer Space (UNCOPUOS) Legal Subcommittee. This symposium consisted of presentations of members of the IAA study group. Also, close coordination with other study projects of IAA, in particular with the one on space debris, is sought. This paper presents the status of work of the study group, in particular, the approach and the scope of the study as well as its preliminary findings. The study group intends to finalize its work in early 2004, in order to be able to put the study before IAA and launch its review process before the 2004 International Astronautical Congress. Following this review, the study will be published and may be expected to make an impact in fora like the UNCOPUOS. The authors of this paper act as the coordinators/the rapporteur to this study. The paper will be presented in the IAA—as well as the IISL—session dealing with space traffic, by that bridging the two areas and seeking input from various sources.

  3. Managing in the Virtual World: How Second Life is Rewriting the Rules of "Real Life" Business

    NASA Astrophysics Data System (ADS)

    Wyld, David C.

    In this paper, we will explore the growth of virtual worlds - one of the most exciting and fast-growing concepts in the Web 2.0 era. We will see that while there has been significant growth across all demographic groups, online gaming in MMOGs (Massively Multiplayer Online Games) are finding particular appeal in today's youth - the so-called "digital native" generation. We then overview the today's virtual world marketplace, both in the youth and adult-oriented markets. Second Life is emerging as the most important virtual world today, due to the intense interest amongst both large organizations and individual entrepreneurs to conduct real business in the virtual environment. Due to its prominence today and its forecasted growth over the next decade, we take a look at the unscripted world of Second Life, examining the corporate presence in-world, as well as the economic, technical, legal, ethical and security issues involved for companies doing business in the virtual world. In conclusion, we present an analysis of where we stand in terms of virtual world development today and a projection of where we will be heading in the near future. Finally, we present advice to management practitioners and academicians on how to learn about virtual worlds and explore the world of opportunities in them.

  4. The "Rules" Still Rule: The Failure of School-Based Management/Shared Decision-Making (SBM/SDM) in the New York City Public School System.

    ERIC Educational Resources Information Center

    Fager, John C.

    This study finds that the New York City version of school-based decision making, School-Based Management/Shared Decision Making (SBM/SDM), fails to bring school-based management or shared decision making to the schools. This report begins by describing the seriously dysfunctional structure of the New York City public schools and explains the…

  5. Congestion Measures for Organized Markets in the U.S.

    SciTech Connect

    Fisher, Emily; Eto, Joseph H.

    2013-12-16

    Transmission lines deliver electricity that is generated at power plants to loads. When there is not sufficient transmission capacity to schedule or transport all desired electricity transfers, the transmission system is constrained, and the particular line, flowgate or interface is congested. While it is useful to measure congestion for several reasons—to identify where and how much congestion exists and how this changes over time, to determine whether or what to do about it, and to assess the effectiveness of actions taken—it is challenging to measure congestion in a meaningful and consistent way across markets or over time in the same market. This paper examines current public reporting of congestion measures for organized markets in the U.S., and what these measures can and cannot tell us about congestion across regions or over time in the same region.

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

    PubMed

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

    2015-01-01

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

  7. Traffic Congestion Model: Challenges and Opportunities

    NASA Astrophysics Data System (ADS)

    Enjat Munajat, M. D.; Munir, Rinaldi; Widyantoro, Dwi H.

    2017-01-01

    This paper discusses models to detect traffic congestion using two approaches: road detection and moving object detection. There are two methods proposed to detect roads and moving objects. The methods involve the detection of both moving and non-moving objects. The system presented in this paper is able to detect roads as well as moving objects. However, further development is needed to detect extreme road curves. The system presented in this paper is relatively inexpensive since it only uses one camera and capable of capturing satisfactorily detailed images.

  8. Modeling congestion on urban roads and assessing level of service

    SciTech Connect

    Maitra, B.; Sikdar, P.K.; Dhingra, S.L.

    1999-12-01

    A unified methodology has been proposed for the quantification of congestion, incorporating the volume and operational characteristics of traffic movement. The level of congestion has been modeled to relate to the causal influences of traffic movement. Modeling congestion has provided a quantitative basis for understanding the contribution of different vehicle types in overall congestion, and it is useful for evolving the policy for congestion mitigation. Quantified congestion level has been used as a logical and improved measure of effectiveness to account for the conceptual definition of level of service in a quantitative manner. Based on the congestion level, 10 levels of service have been proposed, with 9 in stable flow zone (presently designated as A-E), and 1 representing an unstable operation (presently designated as F). The philosophy has been demonstrated by developing congestion models and assessing the effect of roadway width on congestion levels and service volumes. While it is possible to assess the realized benefits from an increase in roadway width, the required number of traffic lanes for a desired level of service can also be estimated.

  9. Adapting End Host Congestion Control for Mobility

    NASA Technical Reports Server (NTRS)

    Eddy, Wesley M.; Swami, Yogesh P.

    2005-01-01

    Network layer mobility allows transport protocols to maintain connection state, despite changes in a node's physical location and point of network connectivity. However, some congestion-controlled transport protocols are not designed to deal with these rapid and potentially significant path changes. In this paper we demonstrate several distinct problems that mobility-induced path changes can create for TCP performance. Our premise is that mobility events indicate path changes that require re-initialization of congestion control state at both connection end points. We present the application of this idea to TCP in the form of a simple solution (the Lightweight Mobility Detection and Response algorithm, that has been proposed in the IETF), and examine its effectiveness. In general, we find that the deficiencies presented are both relatively easily and painlessly fixed using this solution. We also find that this solution has the counter-intuitive property of being both more friendly to competing traffic, and simultaneously more aggressive in utilizing newly available capacity than unmodified TCP.

  10. Green supply chain: Simulating road traffic congestion

    NASA Astrophysics Data System (ADS)

    Jalal, Muhammad Zulqarnain Hakim Abd; Nawawi, Mohd Kamal Mohd; Laailatul Hanim Mat Desa, Wan; Khalid, Ruzelan; Khalid Abduljabbar, Waleed; Ramli, Razamin

    2017-09-01

    With the increasing awareness of the consumers about environmental issues, businesses, households and governments increasingly want use green products and services which lead to green supply chain. This paper discusses a simulation study of a selected road traffic system that will contribute to the air pollution if in the congestion state. Road traffic congestion (RTC) can be caused by a temporary obstruction, a permanent capacity bottleneck in the network itself, and stochastic fluctuation in demand within a particular sector of the network, leading to spillback and queue propagation. A discrete-event simulation model is developed to represent the real traffic light control (TLC) system condition during peak hours. Certain performance measures such as average waiting time and queue length were measured using the simulation model. Existing system uses pre-set cycle time to control the light changes which is fixed time cycle. In this research, we test several other combination of pre-set cycle time with the objective to find the best system. In addition, we plan to use a combination of the pre-set cycle time and a proximity sensor which have the authority to manipulate the cycle time of the lights. The sensors work in such situation when the street seems to have less occupied vehicles, obviously it may not need a normal cycle for green light, and automatically change the cycle to street where vehicle is present.

  11. Development & optimization of a rule-based energy management strategy for fuel economy improvement in hybrid electric vehicles

    NASA Astrophysics Data System (ADS)

    Asfoor, Mostafa

    The gradual decline of oil reserves and the increasing demand for energy over the past decades has resulted in automotive manufacturers seeking alternative solutions to reduce the dependency on fossil-based fuels for transportation. A viable technology that enables significant improvements in the overall energy conversion efficiencies is the hybridization of conventional vehicle drive systems. This dissertation builds on prior hybrid powertrain development at the University of Idaho. Advanced vehicle models of a passenger car with a conventional powertrain and three different hybrid powertrain layouts were created using GT-Suite. These different powertrain models were validated against a variety of standard driving cycles. The overall fuel economy, energy consumption, and losses were monitored, and a comprehensive energy analysis was performed to compare energy sources and sinks. The GT-Suite model was then used to predict the formula hybrid SAE vehicle performance. Inputs to this model were a numerically predicted engine performance map, an electric motor torque curve, vehicle geometry, and road load parameters derived from a roll-down test. In this case study, the vehicle had a supervisory controller that followed a rule-based energy management strategy to insure a proper power split during hybrid mode operation. The supervisory controller parameters were optimized using discrete grid optimization method that minimized the total amount of fuel consumed during a specific urban driving cycle with an average speed of approximately 30 [mph]. More than a 15% increase in fuel economy was achieved by adding supervisory control and managing power split. The vehicle configuration without the supervisory controller displayed a fuel economy of 25 [mpg]. With the supervisory controller this rose to 29 [mpg]. Wider applications of this research include hybrid vehicle controller designs that can extend the range and survivability of military combat platforms. Furthermore, the

  12. Containing air pollution and traffic congestion: Transport policy and the environment in Singapore

    NASA Astrophysics Data System (ADS)

    Chin, Anthony T. H.

    Land transportation remains one of the main contributors of noise and air pollution in urban areas. This is in addition to traffic congestion and accidents which result in the loss of productive activity. While there is a close relationship between traffic volumes and levels of noise and air pollution, transport authorities often assume that solving traffic congestion would reduce noise and air pollutant levels. Tight control over automobile ownership and use in Singapore has contributed in improving traffic flows, travel speeds and air quality. The adoption of internationally accepted standards on automobile emissions and gasoline have been effective in reducing air pollution from motor vehicles. Demand management measures have largely focused on controlling the source of traffic congestion, i.e. private automobile ownership and its use especially within the Central Business District during the day. This paper reviews and analyzes the effectiveness of two measures which are instrumental in controlling congestion and automobile ownership, i.e. road pricing and the vehicle quota scheme (VQS). While these measures have been successful in achieving desired objectives, it has also led to the spreading of traffic externalities to other roads in the network, loss in consumer welfare and rent seeking by automobile traders.

  13. Rules and regulations as potential moderator on the relationship between organizational internal and external factors with effective construction risk management in Nigerian construction companies: A proposed framework

    NASA Astrophysics Data System (ADS)

    Adeleke, A. Q.; Bahaudin, A. Y.; Kamaruddeen, A. M.

    2016-08-01

    Certain organizational internal and external factors have been found to influence effective construction risk management within the construction company which has contributed to massive risk occurrence on the projects. Yet, the influence of the organizational factors such as effective communication, team competency with skills, active leadership, political factor, organizational culture, technology factor and economic factor on effective construction risk management among the construction companies operating in Abuja and Lagos state Nigeria have not received considerable attention. More so, a moderating variable is proposed. This paper proposes rules and regulations as the potential moderator on the relationship between organisational internal factors, external factors and effective construction risk management.

  14. 77 FR 75649 - Establishment of Interim Final Supplementary Rules for Public Lands Managed by the Carrizo Plain...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-21

    ... immediately and remain in effect until modified or rescinded by the publication of final supplementary rules... Monument, signed April 10, 2010, provides for those supplementary rules to remain in effect. The... replica weapons (such as paintball, airsoft, or war game apparatus) is prohibited on the Monument. The...

  15. Strategy as simple rules.

    PubMed

    Eisenhardt, K M; Sull, D N

    2001-01-01

    The success of Yahoo!, eBay, Enron, and other companies that have become adept at morphing to meet the demands of changing markets can't be explained using traditional thinking about competitive strategy. These companies have succeeded by pursuing constantly evolving strategies in market spaces that were considered unattractive according to traditional measures. In this article--the third in an HBR series by Kathleen Eisenhardt and Donald Sull on strategy in the new economy--the authors ask, what are the sources of competitive advantage in high-velocity markets? The secret, they say, is strategy as simple rules. The companies know that the greatest opportunities for competitive advantage lie in market confusion, but they recognize the need for a few crucial strategic processes and a few simple rules. In traditional strategy, advantage comes from exploiting resources or stable market positions. In strategy as simple rules, advantage comes from successfully seizing fleeting opportunities. Key strategic processes, such as product innovation, partnering, or spinout creation, place the company where the flow of opportunities is greatest. Simple rules then provide the guidelines within which managers can pursue such opportunities. Simple rules, which grow out of experience, fall into five broad categories: how- to rules, boundary conditions, priority rules, timing rules, and exit rules. Companies with simple-rules strategies must follow the rules religiously and avoid the temptation to change them too frequently. A consistent strategy helps managers sort through opportunities and gain short-term advantage by exploiting the attractive ones. In stable markets, managers rely on complicated strategies built on detailed predictions of the future. But when business is complicated, strategy should be simple.

  16. An international study of emergency physicians' practice for acute headache management and the need for a clinical decision rule.

    PubMed

    Perry, Jeffrey J; Eagles, Debra; Clement, Catherine M; Brehaut, Jamie; Kelly, Anne-Maree; Mason, Suzanne; Stiell, Ian G

    2009-11-01

    Patients with acute headache often undergo computed tomography (CT) followed by a lumbar puncture to rule out subarachnoid hemorrhage. Our international study examined current practice, the perceived need for a clinical decision rule for acute headache and the required sensitivity for such a rule. We approached 2100 emergency physicians from 4 countries (Australia, Canada, the United Kingdom and the United States) to participate in our survey by sampling the membership of their emergency associations. We used a modified Dillman technique with 3-5 notifications and a prenotification letter employing a combination of electronic mail and postal mail. Physicians were questioned about neurologically intact patients who presented with headache. Analysis included both descriptive statistics for the entire sample and stratification by country. The total response rate was 54.7% (1149/2100). Respondents were primarily male (75.5%), with a mean age of 42.5 years and a mean 12.3 years of emergency department (ED) experience. Of the physicians who responded, 49.5% thought all acute headache patients should be investigated with CT and 57.4% felt CT should always be followed by lumbar puncture. Of the respondents, 95.7% reported they would consider using a clinical decision rule for patients with acute headache to rule out subarachnoid hemorrhage. Respondents deemed the median sensitivity required by such a rule to be 99% (interquartile range 98%-99%). Approximately 1 in 5 physicians suggested that 100% sensitivity was required. Emergency physicians report that they would welcome a clinical decision rule for headache that would determine which patients require costly or invasive tests to rule out subarachnoid hemorrhage. The required sensitivity of such a rule was realistic. These results will inform and inspire the development of clinical decision rules for acute headache in the ED.

  17. Pulmonary Congestion Predicts Cardiac Events and Mortality in ESRD

    PubMed Central

    Torino, Claudia; Tripepi, Rocco; Tripepi, Giovanni; D’Arrigo, Graziella; Postorino, Maurizio; Gargani, Luna; Sicari, Rosa; Picano, Eugenio; Mallamaci, Francesca

    2013-01-01

    Pulmonary congestion is highly prevalent and often asymptomatic among patients with ESRD treated with hemodialysis, but whether its presence predicts clinical outcomes is unknown. Here, we tested the prognostic value of extravascular lung water measured by a simple, well validated ultrasound B-lines score (BL-US) in a multicenter study that enrolled 392 hemodialysis patients. We detected moderate-to-severe lung congestion in 45% and very severe congestion in 14% of the patients. Among those patients with moderate-to-severe lung congestion, 71% were asymptomatic or presented slight symptoms of heart failure. Compared with those patients having mild or no congestion, patients with very severe congestion had a 4.2-fold risk of death (HR=4.20, 95% CI=2.45–7.23) and a 3.2-fold risk of cardiac events (HR=3.20, 95% CI=1.75–5.88) adjusted for NYHA class and other risk factors. Including the degree of pulmonary congestion in the model significantly improved the risk reclassification for cardiac events by 10% (P<0.015). In summary, lung ultrasound can detect asymptomatic pulmonary congestion in hemodialysis patients, and the resulting BL-US score is a strong, independent predictor of death and cardiac events in this population. PMID:23449536

  18. Driving with a Congestion Assistant; mental workload and acceptance.

    PubMed

    Brookhuis, Karel A; van Driel, Cornelie J G; Hof, Tineke; van Arem, Bart; Hoedemaeker, Marika

    2009-11-01

    New driver support systems are developed and introduced to the market at increasing speed. In conditions of traffic congestion drivers may be supported by a "Congestion Assistant", a system that combines the features of a Congestion Warning System (acoustic warning and gas pedal counterforce) and a Stop & Go system (automatic gas and brake pedal during congestion). To gain understanding of the effects of driving with a Congestion Assistant on drivers, mental workload of drivers was registered under different conditions as well as acceptance of the system. Mental workload was measured by means of physiological registrations, i.e. heart rate, a secondary task and with the aid of subjective scaling techniques. Acceptance was measured with an acceptance scale. The study was carried out in an advanced driving simulator. Driving with the Congestion Assistant while in congestion potentially leads to decreased driver mental workload, whereas just before congestion starts, i.e. developing just noticeable, the system may add to the workload of the driver. Acceptance is generally high after experiencing the system, though not in all respects.

  19. 14 CFR 105.21 - Parachute operations over or into a congested area or an open-air assembly of persons.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false Parachute operations over or into a... PARACHUTE OPERATIONS Operating Rules § 105.21 Parachute operations over or into a congested area or an open-air assembly of persons. (a) No person may conduct a parachute operation, and no pilot in command of...

  20. 14 CFR 105.21 - Parachute operations over or into a congested area or an open-air assembly of persons.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Parachute operations over or into a... PARACHUTE OPERATIONS Operating Rules § 105.21 Parachute operations over or into a congested area or an open-air assembly of persons. (a) No person may conduct a parachute operation, and no pilot in command of...

  1. 14 CFR 105.21 - Parachute operations over or into a congested area or an open-air assembly of persons.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Parachute operations over or into a... PARACHUTE OPERATIONS Operating Rules § 105.21 Parachute operations over or into a congested area or an open-air assembly of persons. (a) No person may conduct a parachute operation, and no pilot in command of...

  2. 14 CFR 105.21 - Parachute operations over or into a congested area or an open-air assembly of persons.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false Parachute operations over or into a... PARACHUTE OPERATIONS Operating Rules § 105.21 Parachute operations over or into a congested area or an open-air assembly of persons. (a) No person may conduct a parachute operation, and no pilot in command of...

  3. 14 CFR 105.21 - Parachute operations over or into a congested area or an open-air assembly of persons.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false Parachute operations over or into a... PARACHUTE OPERATIONS Operating Rules § 105.21 Parachute operations over or into a congested area or an open-air assembly of persons. (a) No person may conduct a parachute operation, and no pilot in command of...

  4. Stochastic Stability in Internet Router Congestion Games

    NASA Astrophysics Data System (ADS)

    Chung, Christine; Pyrga, Evangelia

    Congestion control at bottleneck routers on the internet is a long standing problem. Many policies have been proposed for effective ways to drop packets from the queues of these routers so that network endpoints will be inclined to share router capacity fairly and minimize the overflow of packets trying to enter the queues. We study just how effective some of these queuing policies are when each network endpoint is a self-interested player with no information about the other players’ actions or preferences. By employing the adaptive learning model of evolutionary game theory, we study policies such as Droptail, RED, and the greedy-flow-punishing policy proposed by Gao et al. [10] to find the stochastically stable states: the states of the system that will be reached in the long run.

  5. Congestive heart failure in women in Iraq

    PubMed Central

    Damluji, Salem F.; Al-Saffar, Ghanim; Thamer, Mahmoud A.; Mary, Adil S.

    1964-01-01

    Stimulated by the world-wide interest in cardiovascular diseases, the authors made a study of 1001 consecutive admissions to a female medical ward in Baghdad, Iraq, and found that 146 patients were in congestive failure on admission, and an additional 197 patients were suffering from primary cardiovascular disease without failure. Of the group in failure, 47.9% had rheumatic heart disease; none of these patients had been on chemoprophylaxis. Bilharziasis was associated with a considerable number of cases of hypertension and with a small percentage of cases of cor pulmonale. The authors feel that prevention of rheumatic fever and bilharziasis should constitute the corner-stone of any effective control programme of cardiovascular disease at this stage of medical development in Iraq. PMID:14267742

  6. Treatment of Congestive Heart Failure with Triamterene

    PubMed Central

    Wener, J.; Schucher, R.; Friedman, R.

    1965-01-01

    Triamterene, a newer oral diuretic, was administered to nine hospitalized patients with congestive heart failure for an average of 15 days, and to 22 ambulatory patients for a period of three to 11 months. The daily dosage of triamterene ranged from 50 to 250 mg., but usually 100-200 mg. was administered daily in two divided doses, with or without the addition of 50 mg. of hydrochlorothiazide daily. Triamterene is a safe and effective diuretic at doses of 100-200 mg. daily and no drug tolerance develops with long-term therapy. However, when used alone, it is not as effective as hydrochlorothiazide, but in combination with the latter drug the resultant diuresis is unsurpassed by any other oral diuretic therapy that we have used to date. Triamterene itself does not produce kaliuresis and it blocks thiazide-induced kaliuresis. Serum uric acid levels may rise slightly, but no clinical gout was seen in this study. PMID:14259336

  7. Demand and Congestion in Multiplex Transportation Networks.

    PubMed

    Chodrow, Philip S; Al-Awwad, Zeyad; Jiang, Shan; González, Marta C

    Urban transportation systems are multimodal, sociotechnical systems; however, while their multimodal aspect has received extensive attention in recent literature on multiplex networks, their sociotechnical aspect has been largely neglected. We present the first study of an urban transportation system using multiplex network analysis and validated Origin-Destination travel demand, with Riyadh's planned metro as a case study. We develop methods for analyzing the impact of additional transportation layers on existing dynamics, and show that demand structure plays key quantitative and qualitative roles. There exist fundamental geometrical limits to the metro's impact on traffic dynamics, and the bulk of environmental accrue at metro speeds only slightly faster than those planned. We develop a simple model for informing the use of additional, "feeder" layers to maximize reductions in global congestion. Our techniques are computationally practical, easily extensible to arbitrary transportation layers with complex transfer logic, and implementable in open-source software.

  8. Demand and Congestion in Multiplex Transportation Networks

    PubMed Central

    al-Awwad, Zeyad; Jiang, Shan; González, Marta C.

    2016-01-01

    Urban transportation systems are multimodal, sociotechnical systems; however, while their multimodal aspect has received extensive attention in recent literature on multiplex networks, their sociotechnical aspect has been largely neglected. We present the first study of an urban transportation system using multiplex network analysis and validated Origin-Destination travel demand, with Riyadh’s planned metro as a case study. We develop methods for analyzing the impact of additional transportation layers on existing dynamics, and show that demand structure plays key quantitative and qualitative roles. There exist fundamental geometrical limits to the metro’s impact on traffic dynamics, and the bulk of environmental accrue at metro speeds only slightly faster than those planned. We develop a simple model for informing the use of additional, “feeder” layers to maximize reductions in global congestion. Our techniques are computationally practical, easily extensible to arbitrary transportation layers with complex transfer logic, and implementable in open-source software. PMID:27657738

  9. Pelvic congestion syndrome and pelvic varicosities.

    PubMed

    Koo, Sonya; Fan, Chieh-Min

    2014-06-01

    Pelvic venous insufficiency (PVI), defined as retrograde flow in the gonadal and internal iliac veins, is the underlying cause of pelvic congestion syndrome (PCS), a common cause of disabling chronic pelvic pain in women of child-bearing age. PCS is a chronic pain syndrome characterized by positional pelvic pain that is worse in the upright position and is associated with pelvic and vulvar varicosities as well as symptoms of dyspareunia and postcoital pain. Through collaterals to the lower extremity venous system, PVI may also contribute to varicose vein formation and recurrence in the lower extremities. Endovascular embolization of the ovarian and internal iliac veins has become the treatment of choice for PVI and PCS. This article reviews the pelvic retroperitoneal venous anatomy, pathophysiology of PCS, treatment options and techniques, and clinical outcomes of embolotherapy for PCS.

  10. Transformation of Arden Syntax's medical logic modules into ArdenML for a business rules management system.

    PubMed

    Jung, Chai Young; Choi, Jong-Ye; Jeong, Seong Jik; Cho, Kyunghee; Koo, Yong Duk; Bae, Jin Hee; Kim, Sukil

    2016-05-16

    Arden Syntax is a Health Level Seven International (HL7) standard language that is used for representing medical knowledge as logic statements. Arden Syntax Markup Language (ArdenML) is a new representation of Arden Syntax based on XML. Compilers are required to execute medical logic modules (MLMs) in the hospital environment. However, ArdenML may also replace the compiler. The purpose of this study is to demonstrate that MLMs, encoded in ArdenML, can be transformed into a commercial rule engine format through an XSLT stylesheet and made executable in a target system. The target rule engine selected was Blaze Advisor. We developed an XSLT stylesheet to transform MLMs in ArdenML into Structured Rules Language (SRL) in Blaze Advisor, through a comparison of syntax between the two languages. The stylesheet was then refined recursively, by building and applying rules collected from the billing and coding guidelines of the Korean health insurance service. Two nurse coders collected and verified the rules and two information technology (IT) specialists encoded the MLMs and built the XSLT stylesheet. Finally, the stylesheet was validated by importing the MLMs into Blaze Advisor and applying them to claims data. The language comparison revealed that Blaze Advisor requires the declaration of variables with explicit types. We used both integer and real numbers for numeric types in ArdenML. "IF∼THEN" statements and assignment statements in ArdenML become rules in Blaze Advisor. We designed an XSLT stylesheet to solve this issue. In addition, we maintained the order of rule execution in the transformed rules, and added two small programs to support variable declarations and action statements. A total of 1489 rules were reviewed during this study, of which 324 rules were collected. We removed duplicate rules and encoded 241 unique MLMs in ArdenML, which were successfully transformed into SRL and imported to Blaze Advisor via the XSLT stylesheet. When applied to 73

  11. Local debris congestion in the geosynchronous environment with population augmentation

    NASA Astrophysics Data System (ADS)

    Anderson, Paul V.; Schaub, Hanspeter

    2014-02-01

    Forecasting of localized debris congestion in the geostationary (GEO) regime is performed to investigate how frequently near-miss events occur for each of the longitude slots in the GEO ring. The present-day resident space object (RSO) population at GEO is propagated forward in time to determine current debris congestion conditions, and new probability density functions that describe where GEO satellites are inserted into operational orbits are harnessed to assess longitude-dependent congestion in "business-as-usual" launch traffic, with and without re-orbiting at end-of-life. Congestion forecasting for a 50-year period is presented to illustrate the need for appropriately executed mitigation measures in the GEO ring. Results indicate that localized debris congestion will double within 50 years under current 80% re-orbiting success rates.

  12. Crystal structures of three sterically congested disilanes

    PubMed Central

    Pichaandi, Kothanda Rama

    2017-01-01

    In the three sterically congested silanes, C24H38Si2 (1) (1,1,2,2-tetra­isopropyl-1,2-di­phenyl­disilane), C24H34Br4Si2 (2) [1,1,2,2-tetra­kis­(2-bromo­propan-2-yl)-1,2-di­phenyl­disilane] and C32H38Si2 (3) (1,2-di-tert-butyl-1,1,2,2-tetra­phenyl­disilane), the Si—Si bond length is shortest in (1) and longest in (2), with (3) having an inter­mediate value, which parallels the increasing steric congestion. A comparison of the two isopropyl derivatives, (1 and 2), shows a significant increase in the Si—C(ipso) distance with the introduction of bromine. Also, in the brominated compound 2, attractive inter­molecular Br⋯Br inter­actions exist with Br⋯Br separations ca 0.52 Å shorter than the sum of the van der Waals radii. In compound 2, one of the bromo­isopropyl groups is rotationally disordered in an 0.8812 (9):0.1188 (9) ratio. Compound 3 exhibits ‘whole mol­ecule’ disorder in a 0.9645 (7):0.0355 (7) ratio with the Si—Si bonds in the two components making an angle of ca 66°. PMID:28316829

  13. Agent Reward Shaping for Alleviating Traffic Congestion

    NASA Technical Reports Server (NTRS)

    Tumer, Kagan; Agogino, Adrian

    2006-01-01

    Traffic congestion problems provide a unique environment to study how multi-agent systems promote desired system level behavior. What is particularly interesting in this class of problems is that no individual action is intrinsically "bad" for the system but that combinations of actions among agents lead to undesirable outcomes, As a consequence, agents need to learn how to coordinate their actions with those of other agents, rather than learn a particular set of "good" actions. This problem is ubiquitous in various traffic problems, including selecting departure times for commuters, routes for airlines, and paths for data routers. In this paper we present a multi-agent approach to two traffic problems, where far each driver, an agent selects the most suitable action using reinforcement learning. The agent rewards are based on concepts from collectives and aim to provide the agents with rewards that are both easy to learn and that if learned, lead to good system level behavior. In the first problem, we study how agents learn the best departure times of drivers in a daily commuting environment and how following those departure times alleviates congestion. In the second problem, we study how agents learn to select desirable routes to improve traffic flow and minimize delays for. all drivers.. In both sets of experiments,. agents using collective-based rewards produced near optimal performance (93-96% of optimal) whereas agents using system rewards (63-68%) barely outperformed random action selection (62-64%) and agents using local rewards (48-72%) performed worse than random in some instances.

  14. Agent Reward Shaping for Alleviating Traffic Congestion

    NASA Technical Reports Server (NTRS)

    Tumer, Kagan; Agogino, Adrian

    2006-01-01

    Traffic congestion problems provide a unique environment to study how multi-agent systems promote desired system level behavior. What is particularly interesting in this class of problems is that no individual action is intrinsically "bad" for the system but that combinations of actions among agents lead to undesirable outcomes, As a consequence, agents need to learn how to coordinate their actions with those of other agents, rather than learn a particular set of "good" actions. This problem is ubiquitous in various traffic problems, including selecting departure times for commuters, routes for airlines, and paths for data routers. In this paper we present a multi-agent approach to two traffic problems, where far each driver, an agent selects the most suitable action using reinforcement learning. The agent rewards are based on concepts from collectives and aim to provide the agents with rewards that are both easy to learn and that if learned, lead to good system level behavior. In the first problem, we study how agents learn the best departure times of drivers in a daily commuting environment and how following those departure times alleviates congestion. In the second problem, we study how agents learn to select desirable routes to improve traffic flow and minimize delays for. all drivers.. In both sets of experiments,. agents using collective-based rewards produced near optimal performance (93-96% of optimal) whereas agents using system rewards (63-68%) barely outperformed random action selection (62-64%) and agents using local rewards (48-72%) performed worse than random in some instances.

  15. Validating the HERDOO2 rule to guide treatment duration for women with unprovoked venous thrombosis: multinational prospective cohort management study.

    PubMed

    Rodger, Marc A; Le Gal, Gregoire; Anderson, David R; Schmidt, Jeannot; Pernod, Gilles; Kahn, Susan R; Righini, Marc; Mismetti, Patrick; Kearon, Clive; Meyer, Guy; Elias, Antoine; Ramsay, Tim; Ortel, Thomas L; Huisman, Menno V; Kovacs, Michael J

    2017-03-17

    Objective To prospectively validate the HERDOO2 rule (Hyperpigmentation, Edema, or Redness in either leg; D-dimer level ≥250 μg/L; Obesity with body mass index ≥30; or Older age, ≥65 years), which states that women with none or one of the criteria can safely discontinue anticoagulants after short term treatment.Design Prospective cohort management study.Setting 44 secondary or tertiary care centres in seven countries.Participants Of 3155 consecutive eligible participants with a first unprovoked venous thromboembolism (VTE, proximal leg deep vein thrombosis or pulmonary embolism) who completed 5-12 months of short term anticoagulant treatment, 370 declined to participate, leaving 2785 enrolled participants. 2.3% were lost to follow-up.Interventions Women with none or one of the HERDOO2 criteria were classified as at low risk of recurrent VTE and discontinued anticoagulants (intervention arm), whereas anticoagulant management for high risk women (≥2 HERDOO2 criteria) and men was left to the discretion of the clinicians and patients (observation arm).Main outcome measure Recurrent symptomatic VTE (independently and blindly adjudicated) over one year of follow-up.Results Of 1213 women, 631 (51.3%) were classified as low risk and 591 discontinued oral anticoagulant treatment. In the primary analysis, 17 low risk women who discontinued anticoagulants developed recurrent VTE during 564 patient years of follow-up (3.0% per patient year, 95% confidence interval 1.8% to 4.8%). In 323 high risk women and men who discontinued anticoagulants, 25 had VTE during 309 patient years of follow-up (8.1%, 5.2% to 11.9%), whereas in 1802 high risk women and men who continued anticoagulants 28 had recurrent VTE during 1758 patient years of follow-up (1.6%, 1.1% to 2.3%).Conclusions Women with a first unprovoked VTE event and none or one of the HERDOO2 criteria have a low risk of recurrent VTE and can safely discontinue anticoagulants after completing short term treatment

  16. Enrollment and Stopping Rules for Managing Toxicity Requiring Long Follow-Up in Phase II Oncology Trials.

    PubMed

    Song, Guochen; Ivanova, Anastasia

    2015-01-01

    Monitoring of toxicity is often conducted in Phase II trials in oncology to avoid an excessive number of toxicities if the wrong dose is chosen for Phase II. Existing stopping rules for toxicity use information from patients who have already completed follow-up. We describe a stopping rule that uses all available data to determine whether to stop for toxicity or not when follow-up for toxicity is long. We propose an enrollment rule that prescribes the maximum number of patients that may be enrolled at any given point in the trial.

  17. Using OSHA`s requirement for the revalidation of PHA`s to comply with EPA`s proposed risk management rule

    SciTech Connect

    Him, M.S.; Mannan, M.

    1996-11-01

    OSHA`s Process Safety Management rule not only requires the performance of process hazards analyses (PHA`s) of covered areas, but the revalidation of these PHA`s every 5 years. With the May 26, 1997 deadline for the completion of initial PHA`s nearing and the pending approval on or before March 1996 of EPA`s Risk Management Programs (RMP) for Chemical Accidental Release Prevention ({section}40 CFR 68), PSM-covered facilities must start developing plans for compliance with one or more of the requirements of these regulations. This paper discusses some of the strategies that companies falling under Tier 3 of EPA`s RMP rule may use to comply with OSHA`s revalidation of PHA`s and the upcoming EPA rule. The paper also provides details on the use of other PSM elements for PHA revalidation (such as compliance audits and management of change), the development of schedules for PHA revalidation, preparation time, the revalidation process, and the documentation/identification of RMP hazard scenarios.

  18. Using OSHA`s requirement for the revalidation of PHA`STo comply with EPA`s proposed risk management rule

    SciTech Connect

    Him, M.S.; Mannan, M.

    1996-08-01

    OSHA`s Process Safety Management rule not only requires the performance of process hazards analyses (PHA`s) of covered areas, but the revalidation of these PHA`s every 5 years. With the May 26, 1997 deadline for the completion of initial PHA`s nearing and the pending approval on or before March 1996 of EPA`s Risk Management Programs (RMP) for Chemical Accidental Release Prevention ({section}40 CFR 68), PSM-covered facilities must start developing plans for compliance with one or more of the requirements of these regulations. This paper discusses some of the strategies that companies falling under Tier 3 of EPA`s RMP rule may use to comply with OSHA`s revalidation of PHA`s and the upcoming EPA rule. The paper also provides details on the use of other PSM elements for PHA revalidation (such as compliance audits and management of change), the development of schedules for PHA revalidation, preparation time, the revalidation process, and the documentation/identification of RMP hazard scenarios.

  19. Hazardous Waste Management System - Definition of Hazardous Waste - Mixture and Derived- From Rules - Federal Register Notice, October 30, 1992

    EPA Pesticide Factsheets

    This action responds to public comment on two proposals (57 FR 7636, March 3, 1992, and 57 FR 21450, May 20, 1992) to modify EPA's hazardous waste identification rules under the Resource Conservation and Recovery Act (RCRA).

  20. Assessment of the Municipal Solid Waste & Status of Implementation of Municipal Solid Waste (Management & Handling), Rules, 2000 in the State of Madhya Pradesh, 2008 - a case study.

    PubMed

    Lal Patel, Munna; Jain, Rajnikant; Saxena, Alok

    2011-05-01

    The municipal solid waste (MSW), generated from different activities in the township and city areas is a subject of deep concern for its proper management. The improper management of the MSW is a major cause for water, air and soil pollution. The population explosion and sustained drive for economic progress and development have resulted in a remarkable increase/ change in quantity and characteristics of MSW generation over the last 20 years. The local bodies are responsible for the management of the MSW in the State. The Municipal Solid Waste (Management & Handling), Rules, 2000 came into force from the date of its publication in the official Gazette of India and are applicable to every local body responsible for the proper management of the MSW in the State. The status report of the implementation of the Municipal Solid Waste (Management & Handling), Rules, 2000 in the State of Madhya Pradesh, is prepared as per the MOU signed by the State Pollution Control Board with the Central Pollution Control Board, New Delhi. The necessary data for the preparation of the report, collected from the respective local bodies through the regional offices of the Board during the period February to December 2008. There are 342 local bodies (municipal corporations, 14; municipal committees or municipalities, 86; Nagar Panchyats, 237; and cantonment boards, 5) responsible for the implementation of the MSW, in the State. It is estimated that around 4500 Mt day(-1) MSW is generated from all the 342 local bodies. The local bodies of the State are not well equipped for the proper management of the MSW. A total of 323 local bodies has identified land for the development of the landfill sites as per the provisions of the Rules but only 90 local bodies acquired the same. As an outcome of this assessment, the local bodies are not financially and technically capable for the proper implementation of the Rules. The collection of the waste is around 60-70%. This status report will serve as an

  1. Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE Reserve Select for certain members of the selected reserve; Transitional Assistance Management Program; early eligibility for TRICARE for certain reserve component members. Interim final rule with comment period.

    PubMed

    2005-03-16

    This interim final rule establishes requirements and procedures for implementation of TRICARE Reserve Select. It also revises requirements and procedures for the Transitional Assistance Management Program. In addition, it establishes requirements and procedures for implementation of the earlier TRICARE eligibility for certain reserve component members. The rule is being published as an interim final rule with comment period in order to comply with statutory effective dates.

  2. Challenges for Rule Systems on the Web

    NASA Astrophysics Data System (ADS)

    Hu, Yuh-Jong; Yeh, Ching-Long; Laun, Wolfgang

    The RuleML Challenge started in 2007 with the objective of inspiring the issues of implementation for management, integration, interoperation and interchange of rules in an open distributed environment, such as the Web. Rules are usually classified as three types: deductive rules, normative rules, and reactive rules. The reactive rules are further classified as ECA rules and production rules. The study of combination rule and ontology is traced back to an earlier active rule system for relational and object-oriented (OO) databases. Recently, this issue has become one of the most important research problems in the Semantic Web. Once we consider a computer executable policy as a declarative set of rules and ontologies that guides the behavior of entities within a system, we have a flexible way to implement real world policies without rewriting the computer code, as we did before. Fortunately, we have de facto rule markup languages, such as RuleML or RIF to achieve the portability and interchange of rules for different rule systems. Otherwise, executing real-life rule-based applications on the Web is almost impossible. Several commercial or open source rule engines are available for the rule-based applications. However, we still need a standard rule language and benchmark for not only to compare the rule systems but also to measure the progress in the field. Finally, a number of real-life rule-based use cases will be investigated to demonstrate the applicability of current rule systems on the Web.

  3. Improving Area Control Error Diversity Interchange (ADI) Program by Incorporating Congestion Constraints

    SciTech Connect

    Zhou, Ning; Etingov, Pavel V.; Makarov, Yuri V.; Guttromson, Ross T.; McManus, Bart

    2010-04-30

    The area control error (ACE) determines how much a balancing authority (BA) needs to move its regulating units to meet mandatory control performance standard requirements. Regulation is an expensive resource that could cost several hundred million dollars a year for a BA. The amount of regulation needed in a system is increasing with more intermittent generation resources added to the system. The ACE diversity interchange (ADI) program provides a tool for reducing the regulation requirement by combining ACEs from several participating BAs followed by sharing the total ACE among all participating balancing areas. The effect is achieved as a result of the low statistical correlation between the original ACEs of participating BAs. A rule-based ADI approach has already been put into practice in the US Western Interconnection. The degree of actual ACE sharing is artificially limited because of the unknown redistribution of power flows and possible system congestion (these factors are not monitored in the existing ADI). This paper proposes a two-step linear programming (LP) ADI approach that incorporates congestion constraints. In the first step of the proposed LP ADI, the line transmission limits are enforced by setting up corresponding constraints. In the second step, the business fairness is pursued. Simulation is performed to compare the properties of the proposed LP ADI and the existing rule-based ADI. Favorable features, such as avoiding line limit violations and increasing the degree of possible ACE sharing, are observed for the proposed LP ADI.

  4. Cardiomyopathy and right-sided congestive heart failure in a red-tailed hawk (Buteo jamaicensis).

    PubMed

    Knafo, S Emmanuelle; Rapoport, Gregg; Williams, Jamie; Brainard, Benjamin; Driskell, Elizabeth; Uhl, Elizabeth; Crochik, Sonia; Divers, Stephen J

    2011-03-01

    A 15-year-old female red-tailed hawk (Buteo jamaicensis) was evaluated because of dyspnea, anorexia, and coelomic distension. Diagnostic imaging results confirmed severe coelomic effusion and revealed a markedly dilated right ventricle. The diagnosis was right-sided congestive heart failure. Results of measurements of vitamin E, selenium, lead, zinc, and cardiac troponin levels were normal or nondiagnostic. The hawk was treated with furosemide, antifungal and antimicrobial agents, and supplemental fluids and oxygen, but euthanasia was elected because of the poor prognosis and the practical difficulties associated with intensive case management. To our knowledge, this is the first described case of cardiomyopathy and congestive heart failure in a captive red-tailed hawk.

  5. Local Debris Congestion in the Geosynchronous Environment with Population Augmentation

    NASA Astrophysics Data System (ADS)

    Anderson, P.; Schaub, H.

    2013-08-01

    Forecasting of localized debris congestion in the geostationary (GEO) ring is performed to investigate how frequently near-miss events occur for every longitude slot at GEO. A parallelized propagation routine is used to propagate the current resident space object (RSO) population at GEO forward in time, and representative augmentation of this population is implemented to simulate congestion in "business-as-usual" launch traffic, with and without mitigation at end-of-life. Congestion forecasting for a 50- year time frame is presented to illustrate the need for both appropriately-executed mitigation and active remediation measures at GEO.

  6. Combining remote sensing with an inverse Bruun Rule for the analysis and management of almost equilibrium beaches

    NASA Astrophysics Data System (ADS)

    Eelsalu, Maris; Soomere, Tarmo; Männikus, Rain

    2016-04-01

    The management of beaches that suffer from sediment deficit and construction of nearshore infrastructure in locations with intense sediment transit require adequate predictions of the future of the relevant sedimentary systems. To a large extent, this task can be accomplished by using jointly the information about sediment texture and long-term changes in the dry beach volume and the location of the waterline. It is straightforward to evaluate relative changes in the dry beach volume from a succession of airborne laser scanning (ALS) surveys. We use in addition terrestrial laser scanning (TLS) technique to reduce ALS surveys performed with different devices and from different height to the same absolute height. This is accomplished using a TLS survey of a large horizontal surface of constant elevation within ALS snapshots. The most complicated, time-consuming and expensive task in beach management and planning of nearshore infrastructure is to get an adequate picture of the intensity and direction of underwater sediment transport processes. We demonstrate how a simple application of so-called inverse Bruun Rule makes it possible to evaluate the underwater volumetric changes for almost equilibrium beaches. The approach requires three data sets: wave statistics, sediment texture and changes in the average position of the waterline. The main properties of the wave climate, closure depths, magnitude and direction of wave-driven alongshore transport near the test areas are established using a triple nested high-resolution version of the wave model WAM that is forced for 34 years by high-quality marine winds. The relocation of the waterline is extracted from the ALS scanning of elevation isolines of 0.4-0.7 m on the subaerial beach. The technique has been applied to two basically different sections of Tallinn Bay, the Baltic Sea. Pirita Beach is gradually losing sand and requires beach refill while a moderate reclamation action is planned in the vicinity of gradually

  7. An Application of the Phosphorus Consistent Rule for Environmentally Acceptable Cost-Efficient Management of Broiler Litter in Crop Production

    NASA Technical Reports Server (NTRS)

    Paudel, Krishna P.; Limaye, Ashutosh; Adhikari, Murali; Martin, Neil R., Jr.

    2004-01-01

    We calculated the profitability of using broiler litter as a source of plant nutrients using the phosphorus consistent litter application rule. The cost saving by using litter is 37% over the use of chemical fertilizer-only option to meet the nutrient needs of major crops grown in Alabama. In the optimal solution, only a few routes of all the possible routes developed were used for inter- and intra- county litter hauling. If litter is not adopted as the sole source of crop nutrients, the best environmental policy may be to pair the phosphorus consistent rule with taxes, marketable permits, and subsidies.flaws

  8. Products containing microorganisms as a tool in integrated pest management and the rules of their market placement in the European Union.

    PubMed

    Matyjaszczyk, Ewa

    2015-09-01

    Products containing microorganisms (bacteria, fungi and viruses) can be used in plant production as an intervention as well as a prevention method for pest control. Their utilisation is strictly in line with the principles of integrated pest management, provided that they are effective and safe. The rules of registration of microorganisms for crop production in the European Union differ, depending on whether they are placed on the market as plant protection products or not. For over 20 years, uniform rules for registration of plant protection products have been in force. Currently, 36 microorganisms marked up to the strain are approved for use in pest control in the Community. The decision concerning market placement of plant protection products containing approved microorganisms is issued for each member state separately. The approaches to market placement of other products with microorganisms differ within the EU, ranging from a complete lack of requirements to long and costly registration procedures. © 2015 Society of Chemical Industry.

  9. Scheduled Controller Design of Congestion Control Considering Network Resource Constraints

    NASA Astrophysics Data System (ADS)

    Naito, Hiroyuki; Azuma, Takehito; Fujita, Masayuki

    In this paper, we consider a dynamical model of computer networks and derive a synthesis method for congestion control. First, we show a model of TCP/AQM (Transmission Control Protocol/Active Queue Management) as a dynamical model of computer networks. The dynamical model of TCP/AQM networks consists of models of TCP window size, queue length and AQM mechanisms. Second, we propose to describe the dynamical model of TCP/AQM networks as linear systems with self-scheduling parameters, which also depend on information delay. Here we focus on the constraints on the maximum queue length and TCP window-size, which are the network resources in TCP/AQM networks. We derive TCP/AQM networks as the LPV system (linear parameter varying system) with information delay and self-scheduling parameter. We design a memoryless state feedback controller of the LPV system based on a gain-scheduling method. Finally, the effectiveness of the proposed method is evaluated by using MATLAB and the well-known ns-2 (Network Simulator Ver.2) simulator.

  10. Decrease of cardiac chaos in congestive heart failure

    NASA Astrophysics Data System (ADS)

    Poon, Chi-Sang; Merrill, Christopher K.

    1997-10-01

    The electrical properties of the mammalian heart undergo many complex transitions in normal and diseased states. It has been proposed that the normal heartbeat may display complex nonlinear dynamics, including deterministic chaos,, and that such cardiac chaos may be a useful physiological marker for the diagnosis and management, of certain heart trouble. However, it is not clear whether the heartbeat series of healthy and diseased hearts are chaotic or stochastic, or whether cardiac chaos represents normal or abnormal behaviour. Here we have used a highly sensitive technique, which is robust to random noise, to detect chaos. We analysed the electrocardiograms from a group of healthy subjects and those with severe congestive heart failure (CHF), a clinical condition associated with a high risk of sudden death. The short-term variations of beat-to-beat interval exhibited strongly and consistently chaotic behaviour in all healthy subjects, but were frequently interrupted by periods of seemingly non-chaotic fluctuations in patients with CHF. Chaotic dynamics in the CHF data, even when discernible, exhibited a high degree of random variability over time, suggesting a weaker form of chaos. These findings suggest that cardiac chaos is prevalent in healthy heart, and a decrease in such chaos may be indicative of CHF.

  11. Congestion Induced by the Structure of Multiplex Networks

    NASA Astrophysics Data System (ADS)

    Solé-Ribalta, Albert; Gómez, Sergio; Arenas, Alex

    2016-03-01

    Multiplex networks are representations of multilayer interconnected complex networks where the nodes are the same at every layer. They turn out to be good abstractions of the intricate connectivity of multimodal transportation networks, among other types of complex systems. One of the most important critical phenomena arising in such networks is the emergence of congestion in transportation flows. Here, we prove analytically that the structure of multiplex networks can induce congestion for flows that otherwise would be decongested if the individual layers were not interconnected. We provide explicit equations for the onset of congestion and approximations that allow us to compute this onset from individual descriptors of the individual layers. The observed cooperative phenomenon is reminiscent of Braess' paradox in which adding extra capacity to a network when the moving entities selfishly choose their route can in some cases reduce overall performance. Similarly, in the multiplex structure, the efficiency in transportation can unbalance the transportation loads resulting in unexpected congestion.

  12. Traffic congestion and the lifetime of networks with moving nodes

    NASA Astrophysics Data System (ADS)

    Yang, Xianxia; Li, Jie; Pu, Cunlai; Yan, Meichen; Sharafat, Rajput Ramiz; Yang, Jian; Gakis, Konstantinos; Pardalos, Panos M.

    2017-01-01

    For many power-limited networks, such as wireless sensor networks and mobile ad hoc networks, maximizing the network lifetime is the first concern in the related designing and maintaining activities. We study the network lifetime from the perspective of network science. In our model, nodes are initially assigned a fixed amount of energy moving in a square area and consume the energy when delivering packets. We obtain four different traffic regimes: no, slow, fast, and absolute congestion regimes, which are basically dependent on the packet generation rate. We derive the network lifetime by considering the specific regime of the traffic flow. We find that traffic congestion inversely affects network lifetime in the sense that high traffic congestion results in short network lifetime. We also discuss the impacts of factors such as communication radius, node moving speed, routing strategy, etc., on network lifetime and traffic congestion.

  13. Efficiency and profit in the NYISO transmission congestion contract market

    SciTech Connect

    Hadsell, Lester; Shawky, Hany A.

    2009-11-15

    Evidence of speculator profit and TCC price less than congestion charges suggests that additional competition in the TCC auction should be encouraged as a way to increase efficiency and lower the price of this ''insurance'' for hedgers. (author)

  14. Modeling general AIMD congestion control throughput with slow start

    NASA Astrophysics Data System (ADS)

    Yu, Shengsheng; Zha, Hui; Zhou, Jingli

    2005-05-01

    General Additive Increase and Multiplicative Decrease (General AIMD or GAIMD) congestion control generalizes the standard TCP congestion control mechanism. In this paper, we present GAIMD-SS, an enhanced model for predicting the long-term steady-state mean throughput of the GAIMD congestion control, towards more accurate results than previous GAIMD model. We develop a three-state Markov chain for analyzing the behaviors of the GAIMD, and enhance previous works by taking into account the slow start phase and receiver's maximum window limitation. Our experiment and simulation results show that the GAIMD-SS model predicts the sending rate of GAIMD congestion control more accurately than the previous works in a wider range of packet loss rate.

  15. Properties of volume-capacity ratio in congested complex networks

    NASA Astrophysics Data System (ADS)

    Zhu, Zhi-Hong; Zheng, Jian-Feng; Gao, Zi-You; Du, Hao-Ming

    2014-04-01

    The volume-capacity ratio (v/c) is one of the most important indexes to measure the congestion of a traffic network. If v/c is very small, the traffic demand is deficient and/or the transportation supply or capacity is surplus, leading to a waste of capacity; on the contrary, a large value of v/c means that the traffic network is seriously congested. This paper investigates the properties of v/c in complex small-world and scale-free networks by introducing the congestion effects, described by link cost functions. The relationship between v/c and the degree of the node is mainly discussed. Finally, a simple strategy is presented to balance the tradeoff between traffic congestion and a waste of capacity.

  16. Influence of periodic traffic congestion on epidemic spreading

    NASA Astrophysics Data System (ADS)

    Zheng, Muhua; Ruan, Zhongyuan; Tang, Ming; Do, Younghae; Liu, Zonghua

    2016-11-01

    In the metropolis, traffic congestion has become a very serious problem, especially in rush hours. This congestion causes people to have more chance to contact each other and thus will accelerate epidemic spreading. To explain this observation, we present a reaction-diffusion (RD) model with a periodic varying diffusion rate to represent the daily traveling behaviors of human beings and its influence to epidemic spreading. By extensive numerical simulations, we find that the epidemic spreading can be significantly influenced by traffic congestion where the amplitude, period and duration of diffusion rate are the three key parameters. Furthermore, a brief theory is presented to explain the effects of the three key parameters. These findings suggest that except the normal ways of controlling contagion in working places and long-distance traveling, controlling the contagion in daily traffic congestion may be another effective way to reduce epidemic spreading.

  17. On-board congestion control for satellite packet switching networks

    NASA Technical Reports Server (NTRS)

    Chu, Pong P.

    1991-01-01

    It is desirable to incorporate packet switching capability on-board for future communication satellites. Because of the statistical nature of packet communication, incoming traffic fluctuates and may cause congestion. Thus, it is necessary to incorporate a congestion control mechanism as part of the on-board processing to smooth and regulate the bursty traffic. Although there are extensive studies on congestion control for both baseband and broadband terrestrial networks, these schemes are not feasible for space based switching networks because of the unique characteristics of satellite link. Here, we propose a new congestion control method for on-board satellite packet switching. This scheme takes into consideration the long propagation delay in satellite link and takes advantage of the the satellite's broadcasting capability. It divides the control between the ground terminals and satellite, but distributes the primary responsibility to ground terminals and only requires minimal hardware resource on-board satellite.

  18. Traffic congestion and the lifetime of networks with moving nodes.

    PubMed

    Yang, Xianxia; Li, Jie; Pu, Cunlai; Yan, Meichen; Sharafat, Rajput Ramiz; Yang, Jian; Gakis, Konstantinos; Pardalos, Panos M

    2017-01-01

    For many power-limited networks, such as wireless sensor networks and mobile ad hoc networks, maximizing the network lifetime is the first concern in the related designing and maintaining activities. We study the network lifetime from the perspective of network science. In our model, nodes are initially assigned a fixed amount of energy moving in a square area and consume the energy when delivering packets. We obtain four different traffic regimes: no, slow, fast, and absolute congestion regimes, which are basically dependent on the packet generation rate. We derive the network lifetime by considering the specific regime of the traffic flow. We find that traffic congestion inversely affects network lifetime in the sense that high traffic congestion results in short network lifetime. We also discuss the impacts of factors such as communication radius, node moving speed, routing strategy, etc., on network lifetime and traffic congestion.

  19. Prognostic value of residual pulmonary congestion at discharge assessed by lung ultrasound imaging in heart failure.

    PubMed

    Coiro, Stefano; Rossignol, Patrick; Ambrosio, Giuseppe; Carluccio, Erberto; Alunni, Gianfranco; Murrone, Adriano; Tritto, Isabella; Zannad, Faiez; Girerd, Nicolas

    2015-11-01

    Residual pulmonary congestion at discharge is associated with poor prognosis in heart failure (HF), but its quantification through physical examination is challenging. Ultrasound imaging of lung comets (B-lines) could improve congestion evaluation. The aim of this study was to assess the short-term prognostic value of B-lines after discharge from HF hospitalisation compared with other indices of haemodynamic congestion (BNP, E/e', and inferior vena cava diameter) or clinical status (NYHA class). Sixty consecutive HF inpatients underwent clinical examination, echocardiography, and lung ultrasound at discharge, independently of, and in addition to routine management by the attending physicians. The median B-line count was 8.5 (5-34). Three-month event-free survival for the primary endpoint (all-cause death or HF hospitalisation) was 27 ± 10% in patients with ≥30 B-lines and 88 ± 5% in those with <30 B-lines (P < 0.0001). In a multivariable model, ≥30 B-lines significantly predicted the combined endpoint (hazard ratio 5.66, 95% confidence interval 1.74-18.39, P = 0.04), along with NYHA ≥III and inferior vena cava diameter, while other indirect measures of congestion (BNP and E/e' ≥15) were not retained in the model; furthermore ≥30 B-lines independently also predicted the secondary outcomes (HF hospitalisation and death). Importantly, B-line addition to NYHA class and BNP was associated with improved risk classification (integrated discrimination improvement 15%, P = 0.02; continuous net reclassification improvement 65%, P = 0.03). Residual pulmonary congestion at discharge, as assessed by a B-line count ≥30, is a strong predictor of outcome. Lung ultrasonography may represent a useful tool to identify and monitor congestion and optimize therapy during and/or after hospitalisation for HF, which should be further validated in multicentre studies. © 2015 The Authors European Journal of Heart Failure © 2015 European Society of Cardiology.

  20. Association Rules

    NASA Astrophysics Data System (ADS)

    Höppner, Frank

    Association rules are rules of the kind "70% of the customers who buy vine and cheese also buy grapes". While the traditional field of application is market basket analysis, association rule mining has been applied to various fields since then, which has led to a number of important modifications and extensions. We discuss the most frequently applied approach that is central to many extensions, the Apriori algorithm, and briefly review some applications to other data types, well-known problems of rule evaluation via support and confidence, and extensions of or alternatives to the standard framework.

  1. Magnetic resonance imaging in the evaluation of congestive cardiac failure.

    PubMed

    Rajiah, Prabhakar

    2012-07-01

    Congestive cardiac failure is the end-result of various cardiac disorders, and is a major contributor to morbidity, mortality, and financial burden throughout the world. Due to advances in the knowledge of the disease and scanner technology, magnetic resonance imaging (MRI) is playing an increasingly important role in the evaluation of cardiac failure, including in establishing diagnosis, problem solving, risk stratification, and monitoring of therapy. This review discusses and illustrates the role of MRI in the assessment of congestive cardiac failure.

  2. Reducing congestion on complex networks by dynamic relaxation processes

    NASA Astrophysics Data System (ADS)

    Macri, Pablo A.; Pastore y Piontti, Ana L.; Braunstein, Lidia A.

    2007-12-01

    We study the effects of relaxational dynamics on the congestion pressure in general transport networks. We show that the congestion pressure is reduced in scale-free networks if a relaxation mechanism is utilized, while this is in general not the case for non-scale-free graphs such as random graphs. We also present evidence supporting the idea that the emergence of scale-free networks arise from optimization mechanisms to balance the load of the networks nodes.

  3. Research and development of methods/utilities and rules for managing cooperation for performance improvement in government offices. Second Technical progress report, September 1, 1992--January 31, 1993

    SciTech Connect

    Kurstedt, H.A.

    1993-03-01

    Purpose is to help managers approach their responsibilities proactively, so that they can anticipate problems and take actions to alleviate or eliminate those problems. Continuous performance improvement, the philosophy behind total quality management, requires working cooperatively to do a little better each day. The most effective tools are working through a closed set of 9 methods: setting expectations, charting, defining indicators and standards, collecting and logging data, converting data to information, organizing and presenting information, reviewing status and progress, self-management, and appraising. In addition, there are 8 rules: focus on what you can do, supply physical evidence of progress, pay attention to detail, inspect (don`t expect), review progress routinely and frequently, face ``success/fail`` squarely, communicate crisply, and conduct honest, open appraisals. Scope and plans of the draft research plan (study areas) are described.

  4. 75 FR 32968 - Final Supplementary Rules for Public Land Administered by the Bureau of Land Management in...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-10

    ... extend the time the public must remain absent from a site once the current 14-day camping stay limit is reached. They also require that once campers have camped for 14 days, they must move away from that particular location for 30 days, rather than seven days, before returning. These rules are needed to...

  5. Congestion, air pollution, and road fatalities in urban areas.

    PubMed

    Shefer, D

    1994-08-01

    The continuous rapid growth in vehicle miles travelled coupled with the rapid increase in traffic congestion on highways of virtually every large urban area, explain a major portion of the observed deterioration of urban air quality. To halt this deterioration and to secure safe and healthy environments and improve the quality of life in our cities, it is useful to initiate and implement programs that treat jointly traffic congestion, air quality, and road safety. Market-based strategies, driven by price mechanisms, have been proposed as the best and most efficient way to decrease traffic congestion and to reduce vehicle emission. Congestion pricing, emission fees, reducing emissions of high-polluting vehicles, and introducing more efficient vehicle and/or fuel technologies are not mutually exclusive strategies and therefore they can be employed jointly within an overall strategy. In view of the conflicting objectives that may exist between improving urban air quality and reducing road fatalities and traffic congestion, it is of great importance to investigate thoroughly these functional relationships. The results of such studies will help decision makers identify the "socially optimal level of congestion" that will yield the highest net social benefit.

  6. A theory of traffic congestion at moving bottlenecks

    NASA Astrophysics Data System (ADS)

    Kerner, Boris S.; Klenov, Sergey L.

    2010-10-01

    The physics of traffic congestion occurring at a moving bottleneck on a multi-lane road is revealed based on the numerical analyses of vehicular traffic with a discrete stochastic traffic flow model in the framework of three-phase traffic theory. We find that there is a critical speed of a moving bottleneck at which traffic breakdown, i.e. a first-order phase transition from free flow to synchronized flow, occurs spontaneously at the moving bottleneck, if the flow rate upstream of the bottleneck is great enough. The greater the flow rate, the higher the critical speed of the moving bottleneck. A diagram of congested traffic patterns at the moving bottleneck is found, which shows regions in the flow-rate-moving-bottleneck-speed plane in which congested patterns emerge spontaneously or can be induced through large enough disturbances in an initial free flow. A comparison of features of traffic breakdown and resulting congested patterns at the moving bottleneck with known ones at an on-ramp (and other motionless) bottleneck is made. Nonlinear features of complex interactions and transformations of congested traffic patterns occurring at on- and off-ramp bottlenecks due to the existence of the moving bottleneck are found. The physics of the phenomenon of traffic congestion due to 'elephant racing' on a multi-lane road is revealed.

  7. Optimal structure of complex networks for minimizing traffic congestion.

    PubMed

    Zhao, Liang; Cupertino, Thiago Henrique; Park, Kwangho; Lai, Ying-Cheng; Jin, Xiaogang

    2007-12-01

    To design complex networks to minimize traffic congestion, it is necessary to understand how traffic flow depends on network structure. We study data packet flow on complex networks, where the packet delivery capacity of each node is not fixed. The optimal configuration of capacities to minimize traffic congestion is derived and the critical packet generating rate is determined, below which the network is at a free flow state but above which congestion occurs. Our analysis reveals a direct relation between network topology and traffic flow. Optimal network structure, free of traffic congestion, should have two features: uniform distribution of load over all nodes and small network diameter. This finding is confirmed by numerical simulations. Our analysis also makes it possible to theoretically compare the congestion conditions for different types of complex networks. In particular, we find that network with low critical generating rate is more susceptible to congestion. The comparison has been made on the following complex-network topologies: random, scale-free, and regular.

  8. Abrupt transition to complete congestion on complex networks and control.

    PubMed

    Wang, Wen-Xu; Wu, Zhi-Xi; Jiang, Rui; Chen, Guanrong; Lai, Ying-Cheng

    2009-09-01

    Previous works on traffic-flow dynamics on complex networks have mostly focused on continuous phase transition from a free-flow state to a locally congested state as a parameter, such as the packet-generating rate, is increased through a critical value. Above the transition point congestion occurs on a small subset of nodes. Utilizing a conventional traffic-flow model based on the packet birth-death process and more importantly, taking into account the fact that in realistic networks nodes have only finite buffers, we find an abrupt transition from free flow to complete congestion. Slightly below the transition point, the network can support the maximum amount of traffic for some optimal value of the routing parameter. We develop a mean-field theory to explain the surprising transition phenomenon and provide numerical support. Furthermore, we propose a control strategy based on the idea of random packet dropping to prevent/break complete congestion. Our finding provides insights into realistic communication networks where complete congestion can occur directly from a free-flow state without any apparent precursor, and our control strategy can be effective to restore traffic flow once complete congestion has occurred.

  9. Radiographic and echocardiographic assessment of left atrial size in 100 cats with acute left-sided congestive heart failure.

    PubMed

    Schober, Karsten E; Wetli, Ellen; Drost, Wm Tod

    2014-01-01

    The aims of this study were to evaluate left atrial size in cats with acute left-sided congestive heart failure. We hypothesized that left atrial size as determined by thoracic radiography can be normal in cats with acute left-sided congestive heart failure. One hundred cats with acute left-sided congestive heart failure in which thoracic radiography and echocardiography were performed within 12 h were identified. Left atrial size was evaluated using right lateral and ventrodorsal radiographs. Measurements were compared to two-dimensional echocardiographic variables of left atrial size and left ventricular size. On echocardiography, left atrial enlargement was observed in 96% cats (subjective assessment) whereas maximum left atrial dimension was increased (>15.7 mm) in 93% cats. On radiographs left atrial enlargement (subjective assessment) was found in 48% (lateral view), 53% (ventrodorsal view), and 64% (any view) of cats whereas left atrial enlargement was absent in 36% of cats in both views. Agreement between both methods of left atrial size estimation was poor (Cohen's kappa 0.17). Receiver operating characteristic curve analysis identified a maximum echocardiographic left atrial dimension of approximately 20 mm as the best compromise (Youden index) between sensitivity and specificity in the prediction of radiographic left atrial enlargement. Left atrial enlargement as assessed by thoracic radiography may be absent in a clinically relevant number of cats with congestive heart failure. Therefore, normal left atrial size on thoracic radiographs does not rule out presence of left-sided congestive heart failure in cats with clinical signs of respiratory distress.

  10. Comprehensive Child Welfare Information System. Final rule.

    PubMed

    2016-06-02

    This final rule replaces the Statewide and Tribal Automated Child Welfare Information Systems (S/TACWIS) rule with the Comprehensive Child Welfare Information System (CCWIS) rule. The rule also makes conforming amendments in rules in related requirements. This rule will assist title IV-E agencies in developing information management systems that leverage new innovations and technology in order to better serve children and families. More specifically, this final rule supports the use of cost-effective, innovative technologies to automate the collection of high-quality case management data and to promote its analysis, distribution, and use by workers, supervisors, administrators, researchers, and policy makers.

  11. Highly Dynamic and Adaptive Traffic Congestion Avoidance in Real-Time Inspired by Honey Bee Behavior

    NASA Astrophysics Data System (ADS)

    Wedde, Horst F.; Lehnhoff, Sebastian; van Bonn, Bernhard; Bay, Z.; Becker, S.; Böttcher, S.; Brunner, C.; Büscher, A.; Fürst, T.; Lazarescu, A. M.; Rotaru, E.; Senge, S.; Steinbach, B.; Yilmaz, F.; Zimmermann, T.

    Traffic congestions have become a major problem in metropolitan areas world-wide, within and between cities, to an extent where they make driving and transportation times largely unpredictable. Due to the highly dynamic character of congestion building and dissolving this phenomenon appears even to resist a formal treatment. Static approaches, and even more their global management, have proven counterproductive in practice. Given the latest progress in VANET technology and the remarkable commercially driven efforts like in the European C2C consortium, or the VSC Project in the US, allow meanwhile to tackle various aspects of traffic regulation through VANET communication. In this paper we introduce a novel, completely decentralized multi-agent routing algorithm (termed BeeJamA) which we have derived from the foraging behavior of honey bees. It is highly dynamic, adaptive, robust, and scalable, and it allows for both avoiding congestions, and minimizing traveling times to individual destinations. Vehicle guidance is provided well ahead of every intersection, depending on the individual speeds. Thus strict deadlines are imposed on, and respected by, the BeeJamA algorithm. We report on extensive simulation experiments which show the superior performance of BeeJamA over conventional approaches.

  12. [Intraoperative fluid therapy in infants with congestive heart failure due to intracranial pial arteriovenous fistula].

    PubMed

    Arroyo-Fernández, F J; Calderón-Seoane, E; Rodríguez-Peña, F; Torres-Morera, L M

    2016-05-01

    Pial arteriovenous fistula is a rare intracranial congenital malformation (0.1-1: 100,000). It has a high blood flow between one or more pial arteries and drains into the venous circulation. It is usually diagnosed during the childhood by triggering an intracranial hypertension and/or congestive heart failure due to left-right systemic shunt. It is a rare malformation with a complex pathophysiology. The perioperative anaesthetic management is not well established. We present a 6-month-old infant diagnosed with pial arteriovenous fistula with hypertension and congestive heart failure due to left-right shunt. He required a craniotomy and clipping of vascular malformation. Anaesthetic considerations in patients with this condition are a great challenge. It must be performed by multidisciplinary teams with experience in paediatrics. The maintenance of blood volume during the intraoperative course is very important. Excessive fluid therapy can precipitate a congestive heart failure or intracranial hypertension, and a lower fluid therapy may cause a tissue hypoxia due to the bleeding. Copyright © 2015 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Anaemia and congestive heart failure early post-renal transplantation.

    PubMed

    Borrows, Richard; Loucaidou, Marina; Chusney, Gary; Borrows, Sarah; Tromp, Jen Van; Cairns, Tom; Griffith, Megan; Hakim, Nadey; McLean, Adam; Palmer, Andrew; Papalois, Vassilios; Taube, David

    2008-05-01

    Anaemia is common following renal transplantation and is associated with the development of congestive heart failure (CHF). However the prevalence of anaemia in the first year following transplantation and the association between anaemia occurring early and the development of CHF have been understudied. In this study, 132 incident patients undergoing tacrolimus and mycophenolate mofetil-based renal transplantation were studied for the prevalence of, and risk factors for, anaemia and CHF in the early period post transplantation. Anaemia occurred in 94.5% and 53.1% of patients at 1 week and 12 months, respectively, and was associated with allograft dysfunction, hypoalbuminaemia, higher mycophenolic acid (MPA) levels, bacterial infection and hypoalbuminaemia. The association with hypoalbuminaemia may reflect the presence of chronic inflammation post-transplantation. Of patients displaying haemoglobin <11 g/dl, 41.1% and 29.4% were treated with erythropoiesis stimulating agents (ESAs) at 1 and 12 months respectively. CHF developed in 26 patients beyond 1 month post-transplantation, with echocardiographic left ventricular systolic function preserved in all but one. CHF was associated with anaemia and lower haemoglobin, allograft dysfunction, duration of dialysis and left ventricular hypertrophy on echocardiography prior to transplantation, suggesting the aetiology of CHF may involve the interplay of diastolic cardiac dysfunction, pre-load mismatch and after-load mismatch. Modification of risk factors may improve anaemia management post transplantation. Reducing the prevalence of anaemia may in turn reduce the incidence of CHF-these observations support the need for clinical trials to determine how anaemia management may impact CHF incidence.

  14. Mechanism of reduction of newborn metabolic acidemia following application of a rule-based 5-category color-coded fetal heart rate management framework.

    PubMed

    Katsuragi, Shinji; Parer, Julian T; Noda, Shunichi; Onishi, Junji; Kikuchi, Hitomi; Ikeda, Tomoaki

    2015-09-01

    Abstracts Objective: We have reported a 7-fold reduction in newborn umbilical arterial (UA) metabolic acidemia after adoption of a rule-based 5-category color-coded fetal heart rate (FHR) management framework. We sought evidence for the relationship being causal by detailed analysis of FHR characteristics and acid-base status before and after training. Rates of UA pH and base excess (BE) were determined over a 5-year period in a single Japanese hospital, serving mainly low-risk patients, with 3907 deliveries. We compared results in the 2 years before and after a 6-month training period in the FHR management system. We used a previously published classification schema, which was linked to management guidelines. After the training period, there was an increase in the percentage of normal patterns (23%), and a decrease in variable decelerations (14%), late decelerations (8%) and prolonged decelerations (12%) in the last 60 min of labor compared to the pre-training period. There was also a significant reduction in mean UA pH and BE in the groups with decelerations after introduction of the FHR management framework. The adoption of this FHR management system was associated with a reduction of decelerations and metabolic acidemia, without a change in cesarean or vacuum delivery rates. These results suggest that the obstetrical providers were able to better select for intervention those patients destined to develop more severe acidemia, demonstrating a possible causal relationship between the management system and reduced decelerations and metabolic acidemia.

  15. Research and development of methods/utilities and rules for managing cooperation for performance improvement in government offices. First technical progress report, September 1, 1991--August 31, 1992

    SciTech Connect

    Not Available

    1992-03-01

    On September 1, 1991, Defense Programs (DP) within the US Department of Energy entered into a research grant with Management Systems Laboratories (MSL) of Virginia Polytechnic Institute and State University (Virginia Tech), to study Tools, Methods, and Rules for Managing Cooperation for Performance Improvement. Continuous performance improvement is a gradual, systematic process. The idea is to do a little better each day by knowing where you are, where you want to be, what you have to do to get there, whether or not you have done it, and how to resolve problems doing it. And, although many management decisions are made along direct lines of authority, much of the work of an organization can be achieved only through cooperation (people sharing information and coordinating effort). Therefore, continuous performance improvement requires working cooperatively to do a little better each day. We are researching the most effective configuration of tools working through what we believe is a closed set of nine methods. These methods are: setting expectations, charting, defining indicators and standards, collecting and logging data, converting data to information, organizing and presenting information, reviewing status and progress, self-management, and appraising. We believe that these methods form a closed set because they reflect the management activities of formulation (planning),execution (doing), and verification (evaluating). If these activities are carried out effectively through the methods, the manager can achieve visibility and control.

  16. Exploration of SWRL Rule Bases through Visualization, Paraphrasing, and Categorization of Rules

    NASA Astrophysics Data System (ADS)

    Hassanpour, Saeed; O'Connor, Martin J.; Das, Amar K.

    Rule bases are increasingly being used as repositories of knowledge content on the Semantic Web. As the size and complexity of these rule bases increases, developers and end users need methods of rule abstraction to facilitate rule management. In this paper, we describe a rule abstraction method for Semantic Web Rule Language (SWRL) rules that is based on lexical analysis and a set of heuristics. Our method results in a tree data structure that we exploit in creating techniques to visualize, paraphrase, and categorize SWRL rules. We evaluate our approach by applying it to several biomedical ontologies that contain SWRL rules, and show how the results reveal rule patterns within the rule base. We have implemented our method as a plug-in tool for Protégé-OWL, the most widely used ontology modeling software for the Semantic Web. Our tool can allow users to rapidly explore content and patterns in SWRL rule bases, enabling their acquisition and management.

  17. Congestion Control for a Fair Packet Delivery in WSN: From a Complex System Perspective

    PubMed Central

    2014-01-01

    In this work, we propose that packets travelling across a wireless sensor network (WSN) can be seen as the active agents that make up a complex system, just like a bird flock or a fish school, for instance. From this perspective, the tools and models that have been developed to study this kind of systems have been applied. This is in order to create a distributed congestion control based on a set of simple rules programmed at the nodes of the WSN. Our results show that it is possible to adapt the carried traffic to the network capacity, even under stressing conditions. Also, the network performance shows a smooth degradation when the traffic goes beyond a threshold which is settled by the proposed self-organized control. In contrast, without any control, the network collapses before this threshold. The use of the proposed solution provides an effective strategy to address some of the common problems found in WSN deployment by providing a fair packet delivery. In addition, the network congestion is mitigated using adaptive traffic mechanisms based on a satisfaction parameter assessed by each packet which has impact on the global satisfaction of the traffic carried by the WSN. PMID:25177722

  18. Congestion control for a fair packet delivery in WSN: from a complex system perspective.

    PubMed

    Aguirre-Guerrero, Daniela; Marcelín-Jiménez, Ricardo; Rodriguez-Colina, Enrique; Pascoe-Chalke, Michael

    2014-01-01

    In this work, we propose that packets travelling across a wireless sensor network (WSN) can be seen as the active agents that make up a complex system, just like a bird flock or a fish school, for instance. From this perspective, the tools and models that have been developed to study this kind of systems have been applied. This is in order to create a distributed congestion control based on a set of simple rules programmed at the nodes of the WSN. Our results show that it is possible to adapt the carried traffic to the network capacity, even under stressing conditions. Also, the network performance shows a smooth degradation when the traffic goes beyond a threshold which is settled by the proposed self-organized control. In contrast, without any control, the network collapses before this threshold. The use of the proposed solution provides an effective strategy to address some of the common problems found in WSN deployment by providing a fair packet delivery. In addition, the network congestion is mitigated using adaptive traffic mechanisms based on a satisfaction parameter assessed by each packet which has impact on the global satisfaction of the traffic carried by the WSN.

  19. CONGESTIVE HEART FAILURE ASSOCIATED WITH PREGNANCY IN OKAPI (OKAPIA JOHNSTONI).

    PubMed

    Warren, Joshua D; Aitken-Palmer, Copper; Weldon, Alan D; Flanagan, Joseph P; Howard, Lauren L; Garner, Michael M; Citino, Scott B

    2017-03-01

    Acute signs associated with cardiovascular disease occurred in three pregnant okapi ( Okapia johnstoni ) during early to midgestation and progressed to congestive heart failure. Congestive heart failure was diagnosed antemortem using echocardiography and plasma cardiac troponin levels. Clinical signs included decreased activity, hyporexia, tachypnea, dyspnea, flared nostrils, and productive coughing with copious amounts of foamy nasal discharge. Parenteral and oral treatment with furosemide, enalapril, and spironolactone controlled clinical signs in the three okapi allowing each to carry out one pregnancy to term. Two okapi carried the first pregnancy to term after showing signs, while one okapi aborted the first calf and gave birth to a healthy calf in a subsequent pregnancy. Subsequent pregnancy in one okapi ended with abortion and associated dystocia and endometritis. Following parturition, clinical signs associated with heart failure resolved in all three individuals; serial echocardiography in two individuals showed improvement in fractional shortening and left atrial size and all three okapi showed markedly decreased pleural effusion and resolution of pulmonary edema. However, subsequent pregnancies in all three okapi induced respiratory distress and recurrence of congestive heart failure; one okapi died from congestive heart failure associated with subsequent pregnancy. This case series describes the clinical presentation and pathologic findings of congestive heart failure during pregnancy in adult okapi.

  20. Ventricular arrhythmias in congestive heart failure: clinical significance and management.

    PubMed Central

    Khoshnevis, G R; Massumi, A

    1999-01-01

    The benefit of defibrillator therapy has been well established for patients with LV dysfunction (ejection fraction less than 35%), coronary artery disease, NSVT, and inducible and nonsuppressible ventricular tachycardia. Implantable cardioverter-defibrillator therapy is also indicated for all CHF patients in NYHA functional classes I, II, and III who present with aborted sudden cardiac death, or ventricular fibrillation, or hemodynamically unstable ventricular tachycardia--and also in patients with syncope with no documented ventricular tachycardia but with inducible ventricular tachycardia at electrophysiology study. The ongoing MADIT II trial was designed to evaluate the benefit of prophylactic ICD implantation in these patients (ejection fraction less than 30%, coronary artery disease, and NSVT) without prior risk stratification by PES. The CABG Patch trial concluded that prophylactic placement of an ICD during coronary artery bypass grafting in patients with low ejection fraction and abnormal SAECG is not justifiable. Except for the indications described above, ICD implantation has not been proved to be beneficial as primary or secondary therapy. Until more data are available, patients should be encouraged to enroll in the ongoing clinical trials. PMID:10217470

  1. Continuity of care prism process applied to the congestive heart failure population.

    PubMed

    Smoot, S M

    1998-01-01

    Emphasis in healthcare during the 1990s has been both to provide optimal wellness and function with quality in a cost-effective manner. The Continuity of Care Prism Process was developed to meet the need to guide clients along the continuum of care and to achieve continuity of care. Advanced practice nurses are the "expert" clinicians in a position to care manage clients and meet the financial and quality constraints currently being placed on healthcare agencies. In this article, the vehicle used to demonstrate the Continuity of Care Prism Process is a congestive heart failure clinical pathway.

  2. A perspective on sympathetic renal denervation in chronic congestive heart failure.

    PubMed

    Madanieh, Raef; El-Hunjul, Mohammed; Alkhawam, Hassan; Kosmas, Constantine E; Madanieh, Abed; Vittorio, Timothy J

    2016-01-01

    Medical therapy has indisputably been the mainstay of management for chronic congestive heart failure. However, a significant percentage of patients continue to experience worsening heart failure (HF) symptoms despite treatment with multiple therapeutic agents. Recently, catheter-based interventional strategies that interrupt the renal sympathetic nervous system have shown promising results in providing better symptom control in patients with HF. In this article, we will review the pathophysiology of HF for better understanding of the interplay between the cardiovascular system and the kidney. Subsequently, we will briefly discuss pivotal renal denervation (RDN) therapy trials in patients with resistant hypertension and then present the available evidence on the role of RDN in HF therapy.

  3. Cooperative vehicles for robust traffic congestion reduction: An analysis based on algorithmic, environmental and agent behavioral factors.

    PubMed

    Desai, Prajakta; Loke, Seng W; Desai, Aniruddha

    2017-01-01

    Traffic congestion continues to be a persistent problem throughout the world. As vehicle-to-vehicle communication develops, there is an opportunity of using cooperation among close proximity vehicles to tackle the congestion problem. The intuition is that if vehicles could cooperate opportunistically when they come close enough to each other, they could, in effect, spread themselves out among alternative routes so that vehicles do not all jam up on the same roads. Our previous work proposed a decentralized multiagent based vehicular congestion management algorithm entitled Congestion Avoidance and Route Allocation using Virtual Agent Negotiation (CARAVAN), wherein the vehicles acting as intelligent agents perform cooperative route allocation using inter-vehicular communication. This paper focuses on evaluating the practical applicability of this approach by testing its robustness and performance (in terms of travel time reduction), across variations in: (a) environmental parameters such as road network topology and configuration; (b) algorithmic parameters such as vehicle agent preferences and route cost/preference multipliers; and (c) agent-related parameters such as equipped/non-equipped vehicles and compliant/non-compliant agents. Overall, the results demonstrate the adaptability and robustness of the decentralized cooperative vehicles approach to providing global travel time reduction using simple local coordination strategies.

  4. Increasing Intelligence in Inter-Vehicle Communications to Reduce Traffic Congestions: Experiments in Urban and Highway Environments

    PubMed Central

    Filho, Geraldo P. R.; Guidoni, Daniel L.; Pessin, Gustavo; Villas, Leandro A.; Ueyama, Jó

    2016-01-01

    Intelligent Transportation Systems (ITS) rely on Inter-Vehicle Communication (IVC) to streamline the operation of vehicles by managing vehicle traffic, assisting drivers with safety and sharing information, as well as providing appropriate services for passengers. Traffic congestion is an urban mobility problem, which causes stress to drivers and economic losses. In this context, this work proposes a solution for the detection, dissemination and control of congested roads based on inter-vehicle communication, called INCIDEnT. The main goal of the proposed solution is to reduce the average trip time, CO emissions and fuel consumption by allowing motorists to avoid congested roads. The simulation results show that our proposed solution leads to short delays and a low overhead. Moreover, it is efficient with regard to the coverage of the event and the distance to which the information can be propagated. The findings of the investigation show that the proposed solution leads to (i) high hit rate in the classification of the level of congestion, (ii) a reduction in average trip time, (iii) a reduction in fuel consumption, and (iv) reduced CO emissions PMID:27526048

  5. Cooperative vehicles for robust traffic congestion reduction: An analysis based on algorithmic, environmental and agent behavioral factors

    PubMed Central

    Desai, Prajakta; Desai, Aniruddha

    2017-01-01

    Traffic congestion continues to be a persistent problem throughout the world. As vehicle-to-vehicle communication develops, there is an opportunity of using cooperation among close proximity vehicles to tackle the congestion problem. The intuition is that if vehicles could cooperate opportunistically when they come close enough to each other, they could, in effect, spread themselves out among alternative routes so that vehicles do not all jam up on the same roads. Our previous work proposed a decentralized multiagent based vehicular congestion management algorithm entitled Congestion Avoidance and Route Allocation using Virtual Agent Negotiation (CARAVAN), wherein the vehicles acting as intelligent agents perform cooperative route allocation using inter-vehicular communication. This paper focuses on evaluating the practical applicability of this approach by testing its robustness and performance (in terms of travel time reduction), across variations in: (a) environmental parameters such as road network topology and configuration; (b) algorithmic parameters such as vehicle agent preferences and route cost/preference multipliers; and (c) agent-related parameters such as equipped/non-equipped vehicles and compliant/non-compliant agents. Overall, the results demonstrate the adaptability and robustness of the decentralized cooperative vehicles approach to providing global travel time reduction using simple local coordination strategies. PMID:28792513

  6. Increasing Intelligence in Inter-Vehicle Communications to Reduce Traffic Congestions: Experiments in Urban and Highway Environments.

    PubMed

    Meneguette, Rodolfo I; Filho, Geraldo P R; Guidoni, Daniel L; Pessin, Gustavo; Villas, Leandro A; Ueyama, Jó

    2016-01-01

    Intelligent Transportation Systems (ITS) rely on Inter-Vehicle Communication (IVC) to streamline the operation of vehicles by managing vehicle traffic, assisting drivers with safety and sharing information, as well as providing appropriate services for passengers. Traffic congestion is an urban mobility problem, which causes stress to drivers and economic losses. In this context, this work proposes a solution for the detection, dissemination and control of congested roads based on inter-vehicle communication, called INCIDEnT. The main goal of the proposed solution is to reduce the average trip time, CO emissions and fuel consumption by allowing motorists to avoid congested roads. The simulation results show that our proposed solution leads to short delays and a low overhead. Moreover, it is efficient with regard to the coverage of the event and the distance to which the information can be propagated. The findings of the investigation show that the proposed solution leads to (i) high hit rate in the classification of the level of congestion, (ii) a reduction in average trip time, (iii) a reduction in fuel consumption, and (iv) reduced CO emissions.

  7. Reliability and Congestion Effects on Embedded Cost of Transmission Services

    NASA Astrophysics Data System (ADS)

    Shooshtari, Alireza Tavakoli; Joorabian, Mahmood; Milani, Armin Ebrahimi

    2011-06-01

    The aim of this paper is to make a novel method for calculating the investment cost of Transmission services. It should be noted that some considerations such as used capacity, profits of reliability and profits of decreasing congestion-the money allocated to transmission services- are also taken into account. The proposed method is tested on an 8 bus test system. All simulations are done in MATLAB environment, and MATPOWER is used for Power Flow Analysis. In order to verify the proposed method, the optimal results are compared with the pervious techniques. Therefore, the proposed technique in the paper has important effects on investment on transmission network by improving the profits of reliability and decreasing congestion. Furthermore, simulations show that increasing maximum acceptable level of current will decrease the profit of decreasing congestion.

  8. A Circuit Simulation Technique for Congested Network Traffic Assignment Problem

    NASA Astrophysics Data System (ADS)

    Cho, Hsun-Jung; Huang, Heng

    2007-12-01

    The relation between electrical circuit and traffic network has been proposed by Sasaki and Inouye, but they proposed link cost function is a linear function which cannot present the congestion situation. Cho and Huang extended the link cost function to a nonlinear function which can explain the congested network. In this paper, we proposed a foremost and novel approach to solve the traffic assignment problem (TAP) by simulating the electrical circuit network which consists of nonlinear link cost function models. Comparing with the solutions of Frank-Wolfe algorithm, the simulation results are nearly identical. Thus, the simulation of a network circuit model can be applied to solve network traffic assignment problems. Finally, two examples are proposed, and the results confirmed that electrical circuit simulation is workable in solving congested network traffic assignment problems.

  9. Traffic Congestion Detection System through Connected Vehicles and Big Data.

    PubMed

    Cárdenas-Benítez, Néstor; Aquino-Santos, Raúl; Magaña-Espinoza, Pedro; Aguilar-Velazco, José; Edwards-Block, Arthur; Medina Cass, Aldo

    2016-04-28

    This article discusses the simulation and evaluation of a traffic congestion detection system which combines inter-vehicular communications, fixed roadside infrastructure and infrastructure-to-infrastructure connectivity and big data. The system discussed in this article permits drivers to identify traffic congestion and change their routes accordingly, thus reducing the total emissions of CO₂ and decreasing travel time. This system monitors, processes and stores large amounts of data, which can detect traffic congestion in a precise way by means of a series of algorithms that reduces localized vehicular emission by rerouting vehicles. To simulate and evaluate the proposed system, a big data cluster was developed based on Cassandra, which was used in tandem with the OMNeT++ discreet event network simulator, coupled with the SUMO (Simulation of Urban MObility) traffic simulator and the Veins vehicular network framework. The results validate the efficiency of the traffic detection system and its positive impact in detecting, reporting and rerouting traffic when traffic events occur.

  10. Involvement of systemic venous congestion in heart failure.

    PubMed

    Rubio Gracia, J; Sánchez Marteles, M; Pérez Calvo, J I

    2017-04-01

    Systemic venous congestion has gained significant importance in the interpretation of the pathophysiology of acute heart failure, especially in the development of renal function impairment during exacerbations. In this study, we review the concept, clinical characterisation and identification of venous congestion. We update current knowledge on its importance in the pathophysiology of acute heart failure and its involvement in the prognosis. We pay special attention to the relationship between abdominal congestion, the pulmonary interstitium as filtering membrane, inflammatory phenomena and renal function impairment in acute heart failure. Lastly, we review decongestion as a new therapeutic objective and the measures available for its assessment. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  11. Universal waste rule: Final rule issued. Environmental Guidance Regulatory Bulletin

    SciTech Connect

    1995-08-14

    On February 11, 1993, EPA proposed to streamline the management requirements for certain hazardous wastes that were generated in large quantities by a variety of generators (i.e., residential, small businesses, industries, etc.). EPA`s intention was to facilitate the environmentally sound collection and disposal of these types of wastes. In this proposed rule, EPA termed these types of hazardous wastes ``universal wastes`` and developed a management system which was less stringent than the existing Subtitle C regulations. EPA proposed that the following three types of hazardous wastes be managed as universal wastes: batteries, certain pesticides, and thermostats. Because EPA believed that the authority to propose the promulgation of the universal waste rule was not significantly linked to HSWA provisions, the Agency proposed the promulgation of the universal waste rule under pre-HSWA authority. On May 11, 1995, at FR 25492, EPA promulgated a pre-HSWA rule that streamlined hazardous waste management regulations for universal wastes.

  12. [Erythropoiesis-stimulating agents in congestive heart failure patients].

    PubMed

    Robles Perez-Monteoliva, Nicolás Roberto; Macías Núñez, Juan Francisco; Herrera Pérez de Villar, Julio

    2014-03-04

    Congestive heart failure is a disease of high incidence and prevalence in the elderly. Anemia is associated with an increased mortality in these patients. This article reviews the cumulated evidence about the use of erythropoiesis-stimulating agents in congestive heart failure patients. Although some improvement in quality of life has been shown, it has not been found any decrement on mortality and, as a result, together with the high drug cost, it is not recommended the use of this kind of drugs in heart failure patients.

  13. Congestive heart failure and other medical facts about ferrets.

    PubMed

    Williams, Lavonn A

    2009-01-01

    Congestive heart failure, the most common form of heart disease in aged ferrets, is only one of the diseases to which ferrets are susceptible. Congestive heart failure is an insidious, progressive disease for which there is no cure. Once the diagnosis is made and the proper medication is determined, the ferret must remain on the medication. The case report included with this article, which was submitted by a pet owner, and the accompanying formula is an example of how a compounding pharmacist can work with the veterinarian to aid in the treatment of a small veterinary patient by preparing specific medications.

  14. Traffic congestion classification using motion vector statistical features

    NASA Astrophysics Data System (ADS)

    Riaz, Amina; Khan, Shoab A.

    2013-12-01

    Due to the rapid increase in population, one of the major problems faced by the urban areas is traffic congestion. In this paper we propose a method for classifying highway traffic congestion using motion vector statistical properties. Motion vectors are estimated using pyramidal Kanada-Lucas-Tomasi (KLT) tracker algorithm. Then motion vector features are extracted and are used to classify the traffic patterns into three categories: light, medium and heavy. Classification using neural network, on publicly available dataset, shows an accuracy of 95.28%, with robustness to environmental conditions such as variable luminance. Our system provides a more accurate solution to the problem as compared to the systems previously proposed.

  15. Hamilton's rule.

    PubMed

    van Veelen, Matthijs; Allen, Benjamin; Hoffman, Moshe; Simon, Burton; Veller, Carl

    2017-02-07

    This paper reviews and addresses a variety of issues relating to inclusive fitness. The main question is: are there limits to the generality of inclusive fitness, and if so, what are the perimeters of the domain within which inclusive fitness works? This question is addressed using two well-known tools from evolutionary theory: the replicator dynamics, and adaptive dynamics. Both are combined with population structure. How generally Hamilton's rule applies depends on how costs and benefits are defined. We therefore consider costs and benefits following from Karlin and Matessi's (1983) "counterfactual method", and costs and benefits as defined by the "regression method" (Gardner et al., 2011). With the latter definition of costs and benefits, Hamilton's rule always indicates the direction of selection correctly, and with the former it does not. How these two definitions can meaningfully be interpreted is also discussed. We also consider cases where the qualitative claim that relatedness fosters cooperation holds, even if Hamilton's rule as a quantitative prediction does not. We furthermore find out what the relation is between Hamilton's rule and Fisher's Fundamental Theorem of Natural Selection. We also consider cancellation effects - which is the most important deepening of our understanding of when altruism is selected for. Finally we also explore the remarkable (im)possibilities for empirical testing with either definition of costs and benefits in Hamilton's rule.

  16. Analysis of traffic congestion induced by the work zone

    NASA Astrophysics Data System (ADS)

    Fei, L.; Zhu, H. B.; Han, X. L.

    2016-05-01

    Based on the cellular automata model, a meticulous two-lane cellular automata model is proposed, in which the driving behavior difference and the difference of vehicles' accelerations between the moving state and the starting state are taken into account. Furthermore the vehicles' motion is refined by using the small cell of one meter long. Then accompanied by coming up with a traffic management measure, a two-lane highway traffic model containing a work zone is presented, in which the road is divided into normal area, merging area and work zone. The vehicles in different areas move forward according to different lane changing rules and position updating rules. After simulation it is found that when the density is small the cluster length in front of the work zone increases with the decrease of the merging probability. Then the suitable merging length and the appropriate speed limit value are recommended. The simulation result in the form of the speed-flow diagram is in good agreement with the empirical data. It indicates that the presented model is efficient and can partially reflect the real traffic. The results may be meaningful for traffic optimization and road construction management.

  17. 14 CFR 137.51 - Operation over congested areas: General.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Operation over congested areas: General. 137.51 Section 137.51 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR CARRIERS AND OPERATORS FOR COMPENSATION OR HIRE: CERTIFICATION AND OPERATIONS...

  18. Nuclear angiography in a dog with congestive cardiomyopathy

    SciTech Connect

    Lippert, A.C.; Twardock, A.R.; Gelberg, H.B.

    1986-03-01

    Nuclear angiography was used as a diagnostic aid and in monitoring the clinical course of a case of congestive cardiomyopathy in a dog. Serial examinations revealed progressively deteriorating values for left ventricular ejection fraction before the dog's death. This noninvasive technique can be an alternative to echocardiography for the evaluation of cardiac performance.

  19. Controlling congestion on complex networks: fairness, efficiency and network structure.

    PubMed

    Buzna, Ľuboš; Carvalho, Rui

    2017-08-22

    We consider two elementary (max-flow and uniform-flow) and two realistic (max-min fairness and proportional fairness) congestion control schemes, and analyse how the algorithms and network structure affect throughput, the fairness of flow allocation, and the location of bottleneck edges. The more realistic proportional fairness and max-min fairness algorithms have similar throughput, but path flow allocations are more unequal in scale-free than in random regular networks. Scale-free networks have lower throughput than their random regular counterparts in the uniform-flow algorithm, which is favoured in the complex networks literature. We show, however, that this relation is reversed on all other congestion control algorithms for a region of the parameter space given by the degree exponent γ and average degree 〈k〉. Moreover, the uniform-flow algorithm severely underestimates the network throughput of congested networks, and a rich phenomenology of path flow allocations is only present in the more realistic α-fair family of algorithms. Finally, we show that the number of paths passing through an edge characterises the location of a wide range of bottleneck edges in these algorithms. Such identification of bottlenecks could provide a bridge between the two fields of complex networks and congestion control.

  20. Understanding congestion in China's medical market: an incentive structure perspective.

    PubMed

    Sun, Zesheng; Wang, Shuhong; Barnes, Stephen R

    2016-04-01

    Congestion has become one of the most important factors leading to patient dissatisfaction and doctor-patient conflicts in the medical market of China. In this study, we explore the causes and effects of structural congestion in the Chinese medical market from an incentive structure perspective. Our analysis reveals that prior medical system reforms with price regulation in China have induced hospitals to establish incentives for capital-intensive investments, while ignoring human capital, and have driven medical staff and patients to higher-level hospitals, reinforcing an incentive structure in which congestion in higher-level hospitals and idle resources in lower-level hospitals coexist. The existing incentive structure has led to cost increases and degradation of human capital and specific factor effects. Recent reforms to reduce congestion in the Chinese medical market were not effective. Most of them had no impact on and did not involve the existing distorted incentive structure. Future reforms should consider rebalancing expectations for medical quality, free flow of human capital and price regulation reforms to rebuild a new incentive structure. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  1. Cooperative multiagent congestion control for high-speed networks.

    PubMed

    Hwang, Kao-Shing; Tan, Shun-Wen; Hsiao, Ming-Chang; Wu, Cheng-Shong

    2005-04-01

    An adaptive multiagent reinforcement learning method for solving congestion control problems on dynamic high-speed networks is presented. Traditional reactive congestion control selects a source rate in terms of the queue length restricted to a predefined threshold. However, the determination of congestion threshold and sending rate is difficult and inaccurate due to the propagation delay and the dynamic nature of the networks. A simple and robust cooperative multiagent congestion controller (CMCC), which consists of two subsystems: a long-term policy evaluator, expectation-return predictor and a short-term rate selector composed of action-value evaluator and stochastic action selector elements has been proposed to solve the problem. After receiving cooperative reinforcement signals generated by a cooperative fuzzy reward evaluator using game theory, CMCC takes the best action to regulate source flow with the features of high throughput and low packet loss rate. By means of learning procedures, CMCC can learn to take correct actions adaptively under time-varying environments. Simulation results showed that the proposed approach can promote the system utilization and decrease packet losses simultaneously.

  2. Teaching Congestive Heart Failure to Doctor of Pharmacy Students.

    ERIC Educational Resources Information Center

    Parker, Robert B.

    1992-01-01

    This paper summarizes a lecture given to pharmacy students that emphasizes the pathophysiologic mechanisms causing congestive heart failure and the effects of drugs on these mechanisms. The approach shows the importance of drug therapy in this disorder and how this knowledge can improve patient care. An appendix provides a case study. (GLR)

  3. Continuous ultrafiltration for congestive heart failure: the CUORE trial.

    PubMed

    Marenzi, Giancarlo; Muratori, Manuela; Cosentino, Eugenio R; Rinaldi, Elisa R; Donghi, Valeria; Milazzo, Valentina; Ferramosca, Emiliana; Borghi, Claudio; Santoro, Antonio; Agostoni, Piergiuseppe

    2014-05-01

    Background: There are limited data comparing ultrafiltration with standard medical therapy as first-line treatment in patients with severe congestive heart failure (HF). We compared ultrafiltration and conventional therapy in patients hospitalized for HF and overt fluid overload.Methods and Results: Fifty-six patients with congestive HF were randomized to receive standard medical therapy (control group; n = 29) or ultrafiltration (ultrafiltration group; = 27). The primary endpoint of the study was rehospitalizations for congestive HF during a 1-year follow-up. Despite similar body weight reduction at hospital discharge in the 2 groups (7.5 ± 4.5 and 7.9 ± 5.0 kg, respectively;P = .75), a lower incidence of rehospitalizations for HF was observed in the ultrafiltration-treated patients during the following year (hazard ratio 0.14, 95% confidence interval 0.04-0.48; P = .002).Ultrafiltration-induced benefit was associated with a more stable renal function, unchanged furosemide dose, and lower B-type natriuretic peptide levels. At 1 year, 7 deaths (30%) occurred in the ultrafiltration group and 11 (44%) in the control group (P = .33).Conclusions: In HF patients with severe fluid overload, first-line treatment with ultrafiltration is associated with a prolonged clinical stabilization and a greater freedom from rehospitalization for congestive HF.

  4. Intramembrane congestion effects on lysenin channel voltage-induced gating.

    PubMed

    Krueger, Eric; Bryant, Sheenah; Shrestha, Nisha; Clark, Tyler; Hanna, Charles; Pink, David; Fologea, Daniel

    2016-03-01

    All cell membranes are packed with proteins. The ability to investigate the regulatory mechanisms of protein channels in experimental conditions mimicking their congested native environment is crucial for understanding the environmental physicochemical cues that may fundamentally contribute to their functionality in natural membranes. Here we report on investigations of the voltage-induced gating of lysenin channels in congested conditions experimentally achieved by increasing the number of channels inserted into planar lipid membranes. Typical electrophysiology measurements reveal congestion-induced changes to the voltage-induced gating, manifested as a significant reduction of the response to external voltage stimuli. Furthermore, we demonstrate a similar diminished voltage sensitivity for smaller populations of channels by reducing the amount of sphingomyelin in the membrane. Given lysenin's preference for targeting lipid rafts, this result indicates the potential role of the heterogeneous organization of the membrane in modulating channel functionality. Our work indicates that local congestion within membranes may alter the energy landscape and the kinetics of conformational changes of lysenin channels in response to voltage stimuli. This level of understanding may be extended to better characterize the role of the specific membrane environment in modulating the biological functionality of protein channels in health and disease.

  5. Intramembrane congestion effects on lysenin channel voltage-induced gating

    PubMed Central

    Krueger, Eric; Bryant, Sheenah; Shrestha, Nisha; Clark, Tyler; Hanna, Charles; Pink, David; Fologea, Daniel

    2016-01-01

    All cell membranes are packed with proteins. The ability to investigate the regulatory mechanisms of protein channels in experimental conditions mimicking their congested native environment is crucial for understanding the environmental physicochemical cues that may fundamentally contribute to their functionality in natural membranes. Here we report on investigations of the voltage-induced gating of lysenin channels in congested conditions experimentally achieved by increasing the number of channels inserted into planar lipid membranes. Typical electrophysiology measurements reveal congestion-induced changes to the voltage-induced gating, manifested as a significant reduction of the response to external voltage stimuli. Furthermore, we demonstrate a similar diminished voltage sensitivity for smaller populations of channels by reducing the amount of sphingomyelin in the membrane. Given lysenin’s preference for targeting lipid rafts, this result indicates the potential role of the heterogeneous organization of the membrane in modulating channel functionality. Our work indicates that local congestion within membranes may alter the energy landscape and the kinetics of conformational changes of lysenin channels in response to voltage stimuli. This level of understanding may be extended to better characterize the role of the specific membrane environment in modulating the biological functionality of protein channels in health and disease. PMID:26695013

  6. Congestion Control in TCP/AQM Networks Using a Disturbance Observer

    NASA Astrophysics Data System (ADS)

    Kubo, Ryogo; Kani, Junichi; Fujimoto, Yukihiro

    This paper presents a novel congestion controller for transmission control protocol/active queue management (TCP/AQM) networks. In order to maintain the queue length to a value less than the buffer size at the aggregation nodes, the queue management mechanism drops some packets depending on the probability calculated by a congestion controller. However, conventional controllers such as random early detection (RED) algorithms and proportional-integral-derivative (PID)-based controllers are not compatible with parameter variation in TCP/AQM networks. Parameter variation in TCP/AQM networks includes the change of the number of TCP connections, the inflow of user datagram protocol (UDP) flows and so on. In the proposed method, the effect of parameter variation is estimated as drop probability disturbance by using a disturbance observer (DOB). By using the DOB, disturbance suppression characteristics of the controlled system can be drastically improved. In addition, the TCP/AQM network system is analyzed on the basis of an acceleration control scheme. The proposed method is validated by simulation studies performed using a nonlinear model of a TCP/AQM network and verifications made using the network simulator ns-2.

  7. Health practitioners’ perceptions of adopting clinical prediction rules in the management of musculoskeletal pain: a qualitative study in Australia

    PubMed Central

    Kelly, Joan; Sterling, Michele; Rebbeck, Trudy; Bandong, Aila Nica; Leaver, Andrew; Mackey, Martin; Ritchie, Carrie

    2017-01-01

    Objectives To investigate health practitioners’ understanding and practice behaviours with regards to clinical prediction rules (CPRs) and explore their perceptions of adopting a new whiplash CPR. Design Qualitative study using six semistructured focus groups. Setting Primary and secondary care in New South Wales and Queensland, Australia. Participants Physiotherapists (n=19), chiropractors (n=6) and osteopaths (n=3) were purposively sampled to include health practitioners who provide routine treatment to people with whiplash-associated disorders. Methods Focus group discussions (n=6) were audio-recorded, transcribed verbatim and analysed using an inductive thematic approach. Results Health practitioners’ understanding and use of CPRs were mixed. Clinicians considered components relating to acceptability (‘whether I agree with it’) and implementation (‘how I'll use it’) when deciding on whether to adopt a new CPR. Acceptability was informed by four themes: knowledge and understanding, CPR type, congruence and weighted value. Consideration of matters that promote implementation occurred once a CPR was deemed to be acceptable. Three themes were identified as potentially enhancing whiplash CPR implementation: the presence of an external driver of adoption, flexibility in how the CPR could be administered and guidance regarding communication of CPR output to patients. Conclusions Education on CPR purpose and fit with practice is needed to enhance the perceived acceptability of CPRs. Strategies that facilitate practitioner motivation, enable administrative flexibility and assist clinicians in communicating the results of the whiplash CPR could promote adoption of the whiplash CPR. PMID:28801412

  8. Increased walking variability in elderly persons with congestive heart failure

    NASA Technical Reports Server (NTRS)

    Hausdorff, J. M.; Forman, D. E.; Ladin, Z.; Goldberger, A. L.; Rigney, D. R.; Wei, J. Y.

    1994-01-01

    OBJECTIVES: To determine the effects of congestive heart failure on a person's ability to walk at a steady pace while ambulating at a self-determined rate. SETTING: Beth Israel Hospital, Boston, a primary and tertiary teaching hospital, and a social activity center for elderly adults living in the community. PARTICIPANTS: Eleven elderly subjects (aged 70-93 years) with well compensated congestive heart failure (NY Heart Association class I or II), seven elderly subjects (aged 70-79 years) without congestive heart failure, and 10 healthy young adult subjects (aged 20-30 years). MEASUREMENTS: Subjects walked for 8 minutes on level ground at their own selected walking rate. Footswitches were used to measure the time between steps. Step rate (steps/minute) and step rate variability were calculated for the entire walking period, for 30 seconds during the first minute of the walk, for 30 seconds during the last minute of the walk, and for the 30-second period when each subject's step rate variability was minimal. Group means and 5% and 95% confidence intervals were computed. MAIN RESULTS: All measures of walking variability were significantly increased in the elderly subjects with congestive heart failure, intermediate in the elderly controls, and lowest in the young subjects. There was no overlap between the three groups using the minimal 30-second variability (elderly CHF vs elderly controls: P < 0.001, elderly controls vs young: P < 0.001), and no overlap between elderly subjects with and without congestive heart failure when using the overall variability. For all four measures, there was no overlap in any of the confidence intervals, and all group means were significantly different (P < 0.05).

  9. Increased walking variability in elderly persons with congestive heart failure

    NASA Technical Reports Server (NTRS)

    Hausdorff, J. M.; Forman, D. E.; Ladin, Z.; Goldberger, A. L.; Rigney, D. R.; Wei, J. Y.

    1994-01-01

    OBJECTIVES: To determine the effects of congestive heart failure on a person's ability to walk at a steady pace while ambulating at a self-determined rate. SETTING: Beth Israel Hospital, Boston, a primary and tertiary teaching hospital, and a social activity center for elderly adults living in the community. PARTICIPANTS: Eleven elderly subjects (aged 70-93 years) with well compensated congestive heart failure (NY Heart Association class I or II), seven elderly subjects (aged 70-79 years) without congestive heart failure, and 10 healthy young adult subjects (aged 20-30 years). MEASUREMENTS: Subjects walked for 8 minutes on level ground at their own selected walking rate. Footswitches were used to measure the time between steps. Step rate (steps/minute) and step rate variability were calculated for the entire walking period, for 30 seconds during the first minute of the walk, for 30 seconds during the last minute of the walk, and for the 30-second period when each subject's step rate variability was minimal. Group means and 5% and 95% confidence intervals were computed. MAIN RESULTS: All measures of walking variability were significantly increased in the elderly subjects with congestive heart failure, intermediate in the elderly controls, and lowest in the young subjects. There was no overlap between the three groups using the minimal 30-second variability (elderly CHF vs elderly controls: P < 0.001, elderly controls vs young: P < 0.001), and no overlap between elderly subjects with and without congestive heart failure when using the overall variability. For all four measures, there was no overlap in any of the confidence intervals, and all group means were significantly different (P < 0.05).

  10. A theoretical model for the development of a diagnosis-based clinical decision rule for the management of patients with spinal pain

    PubMed Central

    Murphy, Donald R; Hurwitz, Eric L

    2007-01-01

    Background Spinal pain is a common problem, and disability related to spinal pain has great consequence in terms of human suffering, medical costs and costs to society. The traditional approach to the non-surgical management of patients with spinal pain, as well as to research in spinal pain, has been such that the type of treatment any given patient receives is determined more by what type of practitioner he or she sees, rather than by diagnosis. Furthermore, determination of treatment depends more on the type of practitioner than by the needs of the patient. Much needed is an approach to clinical management and research that allows clinicians to base treatment decisions on a reliable and valid diagnostic strategy leading to treatment choices that result in demonstrable outcomes in terms of pain relief and functional improvement. The challenges of diagnosis in patients with spinal pain, however, are that spinal pain is often multifactorial, the factors involved are wide ranging, and for most of these factors there exist no definitive objective tests. Discussion The theoretical model of a diagnosis-based clinical decision rule has been developed that may provide clinicians with an approach to non-surgical spine pain patients that allows for specific treatment decisions based on a specific diagnosis. This is not a classification scheme, but a thought process that attempts to identify most important features present in each individual patient. Presented here is a description of the proposed approach, in which reliable and valid assessment procedures are used to arrive at a working diagnosis which considers the disparate factors contributing to spinal pain. Treatment decisions are based on the diagnosis and the outcome of treatment can be measured. Summary In this paper, the theoretical model of a proposed diagnosis-based clinical decision rule is presented. In a subsequent manuscript, the current evidence for the approach will be systematically reviewed, and we will

  11. Technology-assisted congestive heart failure care.

    PubMed

    Iyngkaran, P; Toukhsati, S R; Biddagardi, N; Zimmet, H; J Atherton, J; Hare, D L

    2015-04-01

    The interface between eHealth technologies and disease management in chronic conditions such as chronic heart failure (CHF) has advanced beyond the research domain. The substantial morbidity, mortality, health resource utilization and costs imposed by chronic disease, accompanied by increasing prevalence, complex comorbidities and changing client and health staff demographics, have pushed the boundaries of eHealth to alleviate costs whilst maintaining services. Whilst the intentions are laudable and the technology is appealing, this nonetheless requires careful scrutiny. This review aims to describe this technology and explore the current evidence and measures to enhance its implementation.

  12. Federal employees health benefits program: limitation on physician charges and FEHB Program payments--Office of Personnel Management. Final rule.

    PubMed

    1996-09-27

    The Office of Personnel Management (OPM) is making final its interim regulation that amends current Federal Employees Health Benefits (FEHB) Program regulations. The final regulation requires that the charges and FEHB fee-for-service plans' benefit payments for certain physician services furnished to retired enrolled individuals do not exceed the limits on charges and payments established under the Medicare fee schedule for physician services.

  13. This final rule establishes consolidated permit program ...

    EPA Pesticide Factsheets

    This final rule establishes consolidated permit program requirements governing the Hazardous Waste Management program under the Resource Conservation and Recovery Act (RCRA) and other related programs.

  14. Transport growth in Bangkok: Energy, environment, and traffic congestion. Workshop proceedings

    SciTech Connect

    Philpott, J.

    1995-07-01

    Bangkok, the capital of Thailand, is a physically and economically complexcity with a complicated transport system. With daily traffic congestion averaging 16 hours, the air quality is such that to breathe street level pollution for 8 eight hours is roughly equivalent to smoking nine cigarettes per day. Estimates suggest idling traffic costs up to $1.6 billion annually. Energy use within the transport sector is on a steady rise with an estimated increase in 11 years of two and one half times. Severe health impacts have begun to effect many residents - young children and the elderly being particularly vulnerable. Bangkok`s air quality and congestion problems are far from hopeless. Great potential exists for Bangkok to remedy its transport-related problems. The city has many necessary characteristics that allow an efficient, economical system of transport. For example, its high density level makes the city a prime candidate for an efficient system of mass transit and the multitude and close proximity of shops, street vendors, restaurants, and residential areas is highly conducive to walking and cycling. Technical knowledge and capacity to devise and implement innovative policies and projects to address air quality and congestion problems is plentiful. There is also consensus among Bangkokians that something needs to be done immediately to clear the air and the roads. However, little has been done. This report proposes a new approach to transport planning for Bangkok that integrates consideration of ecological, social, and financial viability in the process of making decisions regarding managing existing infrastructure and investments in new infrastructure. Selected papers have been indexed separately for inclusion in the Energy Science and Technology Database.

  15. Health practitioners' perceptions of adopting clinical prediction rules in the management of musculoskeletal pain: a qualitative study in Australia.

    PubMed

    Kelly, Joan; Sterling, Michele; Rebbeck, Trudy; Bandong, Aila Nica; Leaver, Andrew; Mackey, Martin; Ritchie, Carrie

    2017-08-11

    To investigate health practitioners' understanding and practice behaviours with regards to clinical prediction rules (CPRs) and explore their perceptions of adopting a new whiplash CPR. Qualitative study using six semistructured focus groups. Primary and secondary care in New South Wales and Queensland, Australia. Physiotherapists (n=19), chiropractors (n=6) and osteopaths (n=3) were purposively sampled to include health practitioners who provide routine treatment to people with whiplash-associated disorders. Focus group discussions (n=6) were audio-recorded, transcribed verbatim and analysed using an inductive thematic approach. Health practitioners' understanding and use of CPRs were mixed. Clinicians considered components relating to acceptability ('whether I agree with it') and implementation ('how I'll use it') when deciding on whether to adopt a new CPR. Acceptability was informed by four themes: knowledge and understanding, CPR type, congruence and weighted value. Consideration of matters that promote implementation occurred once a CPR was deemed to be acceptable. Three themes were identified as potentially enhancing whiplash CPR implementation: the presence of an external driver of adoption, flexibility in how the CPR could be administered and guidance regarding communication of CPR output to patients. Education on CPR purpose and fit with practice is needed to enhance the perceived acceptability of CPRs. Strategies that facilitate practitioner motivation, enable administrative flexibility and assist clinicians in communicating the results of the whiplash CPR could promote adoption of the whiplash CPR. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. Modelling the management rules and risk of failure of the Jura lakes system to study the influence of the climatic change

    NASA Astrophysics Data System (ADS)

    Mouhous, N.; Bogner, K.; Schaefli, B.; Hingray, B.; Musy, A.

    2003-04-01

    The Jura lakes system is a complex hydrological system located in the western part of Swiss plain. It appears that the critical hydrological variable that influences the satisfaction of the agricultural, ecological, flood protection and hydropower interests is the lakes water level. The Swiss institution in charge of water resources management has thus identified an optimal water level depending on the calendar day. To assess the “performance” of the management system for a given climatic situation, deviations of simulated water level from the daily optimum are analysed. To study the effect of the climate change on the Jura lakes system, the hydrological behaviour of the three interconnected lakes (Neuchatel, Bienne and Morat) was first analysed for the present times to identify the dominant hydrological processes and the management rules that have to be counted for further simulations. Two models were then developed. The first model describes the rainfall-runoff process. The snowmelt and accumulation on the upstream catchment are dominant. A snow pack behaviour model based on an adapted snowmelt degree-day method was thus developed to simulate series of equivalent rainfall. The rainfall-runoff model consists then in a linear regression between the discharge of the present day and the equivalent rainfall averaged over the m previous days. The second model simulates the time evolution of the water level in the 3 lakes given the input discharge series obtained from the rainfall-runoff model. The aim of this presentation is to study the “performance” of the management system elaborated to optimise the satisfaction of the different interests previously quoted .

  17. School Children's Reasoning about School Rules

    ERIC Educational Resources Information Center

    Thornberg, Robert

    2008-01-01

    School rules are usually associated with classroom management and school discipline. However, rules also define ways of thinking about oneself and the world. Rules are guidelines for actions and for the evaluation of actions in terms of good and bad, or right and wrong, and therefore a part of moral or values education in school. This study is a…

  18. Site selection for managed aquifer recharge using fuzzy rules: integrating geographical information system (GIS) tools and multi-criteria decision making

    NASA Astrophysics Data System (ADS)

    Malekmohammadi, Bahram; Ramezani Mehrian, Majid; Jafari, Hamid Reza

    2012-11-01

    One of the most important water-resources management strategies for arid lands is managed aquifer recharge (MAR). In establishing a MAR scheme, site selection is the prime prerequisite that can be assisted by geographic information system (GIS) tools. One of the most important uncertainties in the site-selection process using GIS is finite ranges or intervals resulting from data classification. In order to reduce these uncertainties, a novel method has been developed involving the integration of multi-criteria decision making (MCDM), GIS, and a fuzzy inference system (FIS). The Shemil-Ashkara plain in the Hormozgan Province of Iran was selected as the case study; slope, geology, groundwater depth, potential for runoff, land use, and groundwater electrical conductivity have been considered as site-selection factors. By defining fuzzy membership functions for the input layers and the output layer, and by constructing fuzzy rules, a FIS has been developed. Comparison of the results produced by the proposed method and the traditional simple additive weighted (SAW) method shows that the proposed method yields more precise results. In conclusion, fuzzy-set theory can be an effective method to overcome associated uncertainties in classification of geographic information data.

  19. Fluid Volume Overload and Congestion in Heart Failure: Time to Reconsider Pathophysiology and How Volume Is Assessed.

    PubMed

    Miller, Wayne L

    2016-08-01

    Volume regulation, assessment, and management remain basic issues in patients with heart failure. The discussion presented here is directed at opening a reassessment of the pathophysiology of congestion in congestive heart failure and the methods by which we determine volume overload status. Peer-reviewed historical and contemporary literatures are reviewed. Volume overload and fluid congestion remain primary issues for patients with chronic heart failure. The pathophysiology is complex, and the simple concept of intravascular fluid accumulation is not adequate. The dynamics of interstitial and intravascular fluid compartment interactions and fluid redistribution from venous splanchnic beds to central pulmonary circulation need to be taken into account in strategies of volume management. Clinical bedside evaluations and right heart hemodynamic assessments can alert clinicians of changes in volume status, but only the quantitative measurement of total blood volume can help identify the heterogeneity in plasma volume and red blood cell mass that are features of volume overload in patients with chronic heart failure and help guide individualized, appropriate therapy-not all volume overload is the same. © 2016 American Heart Association, Inc.

  20. Hyponatremia in refractory congestive heart failure patients treated with icodextrin-based peritoneal dialysis: A case series.

    PubMed

    Kunin, Margarita; Ganon, Liat; Holtzman, Eli J; Dinour, Dganit

    2017-07-28

    Severe congestive heart failure (CHF) patients are prone to hyponatremia. Peritoneal dialysis (PD) is increasingly used for long-term management of refractory CHF patients. The glucose polymer icodextrin was proposed to be a good option for fluid removal in such patients. A small, although statistically significant reduction in serum sodium (∼2mmol/l) consistently observed in multiple trials, is considered as not clinically relevant. Here we reported five refractory CHF patients who demonstrated sodium drop by median of 8meq/l (range 5.4-8.3meq/l) after icodextrin was added to their program. It seems that icodextrin may contribute to clinically relevant hyponatremia if the hyponatremia is compounded by other factors. Patients with extremely severe congestive heart failure are susceptible to this complication. Copyright © 2017 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  1. Can conservation biologists rely on established community structure rules to manage novel systems? ... Not in salt marshes.

    PubMed

    Fariña, José M; Silliman, Brian R; Bertness, Mark D

    2009-03-01

    We experimentally examined plant zonation in a previously unstudied Chilean salt marsh system to test the generality of mechanisms generating zonation of plants across intertidal stress gradients. Vertical zonation in this system is striking. The low-lying clonal succulent, Sarcocornia fruticosa, dominates the daily flooded low marsh, while intermediate elevations are dominated by the much taller Spartina densiflora. Irregularly flooded higher elevations are dominated by Schoenoplectus californicus, with the small forb, Selliera radicans, found associated with Schoenoplectus at its base. Transplant studies of all four species into each zone both with and without competition revealed the mechanisms driving these striking patterns in plant segregation. In the regularly flooded low marsh, Sarcocornia and Spartina grow in the zone that they normally dominate and are displaced when reciprocally transplanted between zones with neighbors, but without neighbors they grow well in each other's zone. Thus, interspecific competition alone generates low marsh zonation as in some mediterranean marshes, but differently than most of the Californian marshes where physical stress is the dominant factor. In contrast, mechanisms generating high marsh patterns are similar to New England marshes. Schoenoplectus dies when transplanted to lower elevations with or without neighbors and thus is limited from the low marsh by physical stress, while Selliera grows best associated with Schoenoplectus, which shades and ameliorates potentially limiting desiccation stress. These results reveal that mechanisms driving community organization across environmental stress gradients, while generally similar among systems, cannot be directly extrapolated to unstudied systems. This finding has important implications for ecosystem conservation because it suggests that the mechanistic understanding of pattern generation necessary to manage and restore specific communities in novel habitats cannot rely

  2. Congestion Avoidance Control through Non-cooperative Games between Customers and Service Providers

    NASA Astrophysics Data System (ADS)

    Charilas, Dimitris E.; Panagopoulos, Athanasios D.; Vlacheas, Panagiotis; Markaki, Ourania I.; Constantinou, Philip

    Congestion avoidance control refers to controlling the load of the network by restricting the admission of new user’s sessions and resolving the unwanted overload situations. Admission control and Load control constitute key mechanisms regarding Radio Resource Management. As the wireless world is moving towards heterogeneous wireless networks, these types of control are facing more challenges, since efficiency and fairness are required. Game theory provides an appropriate framework for formulating fair and efficient congestion avoidance control problems. In this paper we formulate a non-cooperative game between service providers and customers. On the one hand, the service providers wish to maximize their revenue, but on the other hand, the users wish to maximize the quality of service received, keeping at the same time the expenses as low as possible. Therefore a balance has to be established among these contradictory demands. Our effort also concentrates in the proper modeling of the user’s level of satisfaction, so as to provide a logical decision-taking framework. The proposed scheme is then tested using the ns2 simulator. Results show that both parties can benefit from this mechanism.

  3. Renal replacement therapy in congestive heart failure requiring left ventricular assist device augmentation.

    PubMed

    Thomas, Bernadette A; Logar, Christine M; Anderson, Arthur E

    2012-01-01

    "Cardiorenal syndrome" is a term used to describe a dys-regulation of the heart affecting the kidneys, or vice versa, in an acute or chronic manner (1,2). Renal impairment can range from reversible ischemic damage to renal failure requiring short- or long-term renal replacement therapy (2). Patients who require mechanical circulatory support, such as a left ventricular assist device (LVAD), as definitive treatment for congestive heart failure or as a bridge to cardiac transplantation pose a unique challenge with respect to receiving dialysis, because they experience higher rates of morbidity and mortality from infection in the post-LVAD period (3-7). Acute dialysis access can pose an increased infection risk. In this article, we present a patient who required renal replacement therapy and a LVAD for management of acute-on-chronic cardiorenal syndrome while awaiting heart transplantation. A literature review to determine whether peritoneal dialysis or hemodialysis is superior for patients with profound hemodynamic dysfunction and the need to minimize risk of infection did not offer clear guidance about which modality is superior in patients with advanced congestive heart failure. However, there is clear evidence of the superiority of peritoneal dialysis in reducing the risk of systemic infection secondary to acute dialysis access. Given the high risk of LVAD infection, we therefore conclude that, to decrease mortality secondary to systemic infection, peritoneal dialysis should strongly be considered in patients who require renal replacement therapy before or after LVAD placement.

  4. How congestion shapes cities: from mobility patterns to scaling

    PubMed Central

    Louf, Rémi; Barthelemy, Marc

    2014-01-01

    The recent availability of data for cities has allowed scientists to exhibit scalings which present themselves in the form of a power-law dependence on population of various socio-economical and structural indicators. We propose here a stochastic theory of urban growth which accounts for some of the observed scalings and we confirm these predictions on US and OECD empirical data. In particular, we show that the dependence on population size of the total number of miles driven daily, the total length of the road network, the total traffic delay, the total consumption of gasoline, the quantity of CO2 emitted and the relation between area and population of cities, are all governed by a single parameter which characterizes the sensitivity to congestion. Our results suggest that diseconomies associated with congestion scale superlinearly with population size, implying that –despite polycentrism– cities whose transportation infrastructure rely heavily on traffic sensitive modes are unsustainable. PMID:24990624

  5. How congestion shapes cities: from mobility patterns to scaling

    NASA Astrophysics Data System (ADS)

    Louf, Rémi; Barthelemy, Marc

    2014-07-01

    The recent availability of data for cities has allowed scientists to exhibit scalings which present themselves in the form of a power-law dependence on population of various socio-economical and structural indicators. We propose here a stochastic theory of urban growth which accounts for some of the observed scalings and we confirm these predictions on US and OECD empirical data. In particular, we show that the dependence on population size of the total number of miles driven daily, the total length of the road network, the total traffic delay, the total consumption of gasoline, the quantity of CO2 emitted and the relation between area and population of cities, are all governed by a single parameter which characterizes the sensitivity to congestion. Our results suggest that diseconomies associated with congestion scale superlinearly with population size, implying that -despite polycentrism- cities whose transportation infrastructure rely heavily on traffic sensitive modes are unsustainable.

  6. How congestion shapes cities: from mobility patterns to scaling.

    PubMed

    Louf, Rémi; Barthelemy, Marc

    2014-07-03

    The recent availability of data for cities has allowed scientists to exhibit scalings which present themselves in the form of a power-law dependence on population of various socio-economical and structural indicators. We propose here a stochastic theory of urban growth which accounts for some of the observed scalings and we confirm these predictions on US and OECD empirical data. In particular, we show that the dependence on population size of the total number of miles driven daily, the total length of the road network, the total traffic delay, the total consumption of gasoline, the quantity of CO2 emitted and the relation between area and population of cities, are all governed by a single parameter which characterizes the sensitivity to congestion. Our results suggest that diseconomies associated with congestion scale superlinearly with population size, implying that -despite polycentrism- cities whose transportation infrastructure rely heavily on traffic sensitive modes are unsustainable.

  7. Left ventricular filling after long-term angiotensin converting enzyme inhibition in congestive heart failure.

    PubMed

    Baur, L H; Schipperheyn, J J; Cats, V M; van der Wall, E E; Baan, J; van Dijk, A D; Bruschke, A V

    1992-11-01

    As a rule, left ventricular relaxation is impaired in patients with coronary artery disease and congestive heart failure. In addition, the passive elastic properties in early and late diastole change when the ventricle dilates. Diastolic properties of the left ventricle were studied in 11 patients with congestive heart failure class II-IV (NYHA) before and 3 months after 10-20 mg enalapril was added to their regimen of salt restriction, a diuretic and occasionally digitalis. Haemodynamic studies were performed using radionuclide angiography and simultaneous pressure-volume measurements. Systemic vascular resistance decreased from 1479 to 1182 dynes.s.-1 cm-5 (P < 0.05) and left ventricular end-diastolic pressure from 19.2 to 15.9 mmHg (P < 0.05). Left ventricular end-diastolic volume index decreased from 130 +/- 22 to 81 +/- 22 ml (P < 0.01). Indices of early diastolic relaxation, such as peak filling rate (1.43 +/- 0.46 to 1.49 +/- 0.84 EDV/s), time to peak filling rate (460 +/- 70 to 490 +/- 70 ms), peak negative dP/dt (-903 +/- 190 to -891 +/- 190 mmHg/s) and tau, the time constant of isovolumic pressure decay (58.7 +/- 14.4 to 48.4 +/- 15.2 ms) did not change significantly. In nine patients pressure-volume loops shifted to the left in all patients but one due to reduction in end-systolic and end-diastolic volume. The steepness of the diastolic part of the pressure-volume relationship increased, indicating an increase in chamber stiffness. The stiffness constant increased about 25% towards a more normal value. The alteration in stiffness seemed to be mainly due to the change of the geometry of the ventricle and not to a major change in the visco-elastic properties of the ventricular wall. In conclusion, regression of remodelling induced by enalapril does not change diastolic function parameters in patients with chronic congestive heart failure beyond the changes caused by regression of ventricular dilation.

  8. Collaboration rules.

    PubMed

    Evans, Philip; Wolf, Bob

    2005-01-01

    Corporate leaders seeking to boost growth, learning, and innovation may find the answer in a surprising place: the Linux open-source software community. Linux is developed by an essentially volunteer, self-organizing community of thousands of programmers. Most leaders would sell their grandmothers for workforces that collaborate as efficiently, frictionlessly, and creatively as the self-styled Linux hackers. But Linux is software, and software is hardly a model for mainstream business. The authors have, nonetheless, found surprising parallels between the anarchistic, caffeinated, hirsute world of Linux hackers and the disciplined, tea-sipping, clean-cut world of Toyota engineering. Specifically, Toyota and Linux operate by rules that blend the self-organizing advantages of markets with the low transaction costs of hierarchies. In place of markets' cash and contracts and hierarchies' authority are rules about how individuals and groups work together (with rigorous discipline); how they communicate (widely and with granularity); and how leaders guide them toward a common goal (through example). Those rules, augmented by simple communication technologies and a lack of legal barriers to sharing information, create rich common knowledge, the ability to organize teams modularly, extraordinary motivation, and high levels of trust, which radically lowers transaction costs. Low transaction costs, in turn, make it profitable for organizations to perform more and smaller transactions--and so increase the pace and flexibility typical of high-performance organizations. Once the system achieves critical mass, it feeds on itself. The larger the system, the more broadly shared the knowledge, language, and work style. The greater individuals' reputational capital, the louder the applause and the stronger the motivation. The success of Linux is evidence of the power of that virtuous circle. Toyota's success is evidence that it is also powerful in conventional companies.

  9. Understanding the topological characteristics and flow complexity of urban traffic congestion

    NASA Astrophysics Data System (ADS)

    Wen, Tzai-Hung; Chin, Wei-Chien-Benny; Lai, Pei-Chun

    2017-05-01

    For a growing number of developing cities, the capacities of streets cannot meet the rapidly growing demand of cars, causing traffic congestion. Understanding the spatial-temporal process of traffic flow and detecting traffic congestion are important issues associated with developing sustainable urban policies to resolve congestion. Therefore, the objective of this study is to propose a flow-based ranking algorithm for investigating traffic demands in terms of the attractiveness of street segments and flow complexity of the street network based on turning probability. Our results show that, by analyzing the topological characteristics of streets and volume data for a small fraction of street segments in Taipei City, the most congested segments of the city were identified successfully. The identified congested segments are significantly close to the potential congestion zones, including the officially announced most congested streets, the segments with slow moving speeds at rush hours, and the areas near significant landmarks. The identified congested segments also captured congestion-prone areas concentrated in the business districts and industrial areas of the city. Identifying the topological characteristics and flow complexity of traffic congestion provides network topological insights for sustainable urban planning, and these characteristics can be used to further understand congestion propagation.

  10. Application of Epidemiology Model on Complex Networks in Propagation Dynamics of Airspace Congestion.

    PubMed

    Dai, Xiaoxu; Hu, Minghua; Tian, Wen; Xie, Daoyi; Hu, Bin

    2016-01-01

    This paper presents a propagation dynamics model for congestion propagation in complex networks of airspace. It investigates the application of an epidemiology model to complex networks by comparing the similarities and differences between congestion propagation and epidemic transmission. The model developed satisfies the constraints of actual motion in airspace, based on the epidemiology model. Exploiting the constraint that the evolution of congestion cluster in the airspace is always dynamic and heterogeneous, the SIR epidemiology model (one of the classical models in epidemic spreading) with logistic increase is applied to congestion propagation and shown to be more accurate in predicting the evolution of congestion peak than the model based on probability, which is common to predict the congestion propagation. Results from sample data show that the model not only predicts accurately the value and time of congestion peak, but also describes accurately the characteristics of congestion propagation. Then, a numerical study is performed in which it is demonstrated that the structure of the networks have different effects on congestion propagation in airspace. It is shown that in regions with severe congestion, the adjustment of dissipation rate is more significant than propagation rate in controlling the propagation of congestion.

  11. Self-Tuned Congestion Control for Multiprocessor Networks

    DTIC Science & Technology

    2005-01-01

    multiprocessor networks, including virtual cut-through [15] networks and wormhole networks [6, 5]. However, in this paper we evaluate the technique in the...context of wormhole switched, k-ary,n-cube networks. Simulation results for a 16-ary,2-cube (256 node net- work) show that our congestion control...through the net- work. Each packet is composed of flits (flow control units) that are transferred between network nodes.1 Both wormhole routing and cut

  12. Optimal Use of Beta-Blockers for Congestive Heart Failure.

    PubMed

    Lee, Hae-Young; Baek, Sang Hong

    2016-01-01

    Beta-blockers are the cornerstone treatment for congestive heart failure (HF). Current HF guidelines commonly recommend β-blockers for the treatment of HF with reduced left ventricular ejection fraction (LVEF). The effect of β-blockers, however, is less clear for HF patients with preserved LVEF, unstable severe acute HF, or right ventricular failure. This review summarizes the effect of β-blockers in various clinical situations and suggests a strategy for optimal use. (Circ J 2016; 80: 565-571).

  13. Congestion Control and Fairness in Wireless Sensor Networks

    DTIC Science & Technology

    2010-04-01

    RCRT uses end-to-end explicit loss recovery by implementing a NACK based scheme. Furthermore, RCRT places all congestion detection and rate...gateway nodes, we make use of the broadcast nature of the wireless medium, which enables a child node to overhear transmissions of its parent. When...the broadcast nature of the wireless medium, enabling a child node to overhear transmission of its parent. Thus, when the minimum bandwidth

  14. Management of rare, low anal anterior fistula exception to Goodsall's rule with Kṣārasūtra

    PubMed Central

    Shindhe, Pradeep S.

    2014-01-01

    Anal fistula (bhagandara) is a chronic inflammatory condition, a tubular structure opening in the ano-rectal canal at one end and surface of perineum/peri-anal skin on the other end. Typically, fistula has two openings, one internal and other external associated with chronic on/off pus discharge on/off pain, pruritis and sometimes passing of stool from external opening. This affects predominantly male patients due to various etiologies viz., repeated peri-anal infections, Crohn's disease, HIV infection, etc., Complex and atypical variety is encountered in very few patients, which require special treatment for cure. The condition poses difficulty for a surgeon in treating due to issues like patient hesitation, trouble in preparing kṣārasūtra, natural and routine infection with urine, stool etc., and dearth of surgical experts and technique. We would like to report a complex and atypical, single case of anterior, low anal fistula with tract reaching to median raphe of scrotum, which was managed successfully by limited application of kṣārasūtra. PMID:25538355

  15. Predictability of Road Traffic and Congestion in Urban Areas

    PubMed Central

    Wang, Jingyuan; Mao, Yu; Li, Jing; Xiong, Zhang; Wang, Wen-Xu

    2015-01-01

    Mitigating traffic congestion on urban roads, with paramount importance in urban development and reduction of energy consumption and air pollution, depends on our ability to foresee road usage and traffic conditions pertaining to the collective behavior of drivers, raising a significant question: to what degree is road traffic predictable in urban areas? Here we rely on the precise records of daily vehicle mobility based on GPS positioning device installed in taxis to uncover the potential daily predictability of urban traffic patterns. Using the mapping from the degree of congestion on roads into a time series of symbols and measuring its entropy, we find a relatively high daily predictability of traffic conditions despite the absence of any priori knowledge of drivers' origins and destinations and quite different travel patterns between weekdays and weekends. Moreover, we find a counterintuitive dependence of the predictability on travel speed: the road segment associated with intermediate average travel speed is most difficult to be predicted. We also explore the possibility of recovering the traffic condition of an inaccessible segment from its adjacent segments with respect to limited observability. The highly predictable traffic patterns in spite of the heterogeneity of drivers' behaviors and the variability of their origins and destinations enables development of accurate predictive models for eventually devising practical strategies to mitigate urban road congestion. PMID:25849534

  16. Traffic Congestion Detection System through Connected Vehicles and Big Data

    PubMed Central

    Cárdenas-Benítez, Néstor; Aquino-Santos, Raúl; Magaña-Espinoza, Pedro; Aguilar-Velazco, José; Edwards-Block, Arthur; Medina Cass, Aldo

    2016-01-01

    This article discusses the simulation and evaluation of a traffic congestion detection system which combines inter-vehicular communications, fixed roadside infrastructure and infrastructure-to-infrastructure connectivity and big data. The system discussed in this article permits drivers to identify traffic congestion and change their routes accordingly, thus reducing the total emissions of CO2 and decreasing travel time. This system monitors, processes and stores large amounts of data, which can detect traffic congestion in a precise way by means of a series of algorithms that reduces localized vehicular emission by rerouting vehicles. To simulate and evaluate the proposed system, a big data cluster was developed based on Cassandra, which was used in tandem with the OMNeT++ discreet event network simulator, coupled with the SUMO (Simulation of Urban MObility) traffic simulator and the Veins vehicular network framework. The results validate the efficiency of the traffic detection system and its positive impact in detecting, reporting and rerouting traffic when traffic events occur. PMID:27136548

  17. RATE-ADJUSTMENT ALGORITHM FOR AGGREGATE TCP CONGESTION CONTROL

    SciTech Connect

    P. TINNAKORNSRISUPHAP, ET AL

    2000-09-01

    The TCP congestion-control mechanism is an algorithm designed to probe the available bandwidth of the network path that TCP packets traverse. However, it is well-known that the TCP congestion-control mechanism does not perform well on networks with a large bandwidth-delay product due to the slow dynamics in adapting its congestion window, especially for short-lived flows. One promising solution to the problem is to aggregate and share the path information among TCP connections that traverse the same bottleneck path, i.e., Aggregate TCP. However, this paper shows via a queueing analysis of a generalized processor-sharing (GPS) queue with regularly-varying service time that a simple aggregation of local TCP connections together into a single aggregate TCP connection can result in a severe performance degradation. To prevent such a degradation, we introduce a rate-adjustment algorithm. Our simulation confirms that by utilizing our rate-adjustment algorithm on aggregate TCP, connections which would normally receive poor service achieve significant performance improvements without penalizing connections which already receive good service.

  18. Congestive heart failure detection using random forest classifier.

    PubMed

    Masetic, Zerina; Subasi, Abdulhamit

    2016-07-01

    Automatic electrocardiogram (ECG) heartbeat classification is substantial for diagnosing heart failure. The aim of this paper is to evaluate the effect of machine learning methods in creating the model which classifies normal and congestive heart failure (CHF) on the long-term ECG time series. The study was performed in two phases: feature extraction and classification phase. In feature extraction phase, autoregressive (AR) Burg method is applied for extracting features. In classification phase, five different classifiers are examined namely, C4.5 decision tree, k-nearest neighbor, support vector machine, artificial neural networks and random forest classifier. The ECG signals were acquired from BIDMC Congestive Heart Failure and PTB Diagnostic ECG databases and classified by applying various experiments. The experimental results are evaluated in several statistical measures (sensitivity, specificity, accuracy, F-measure and ROC curve) and showed that the random forest method gives 100% classification accuracy. Impressive performance of random forest method proves that it plays significant role in detecting congestive heart failure (CHF) and can be valuable in expressing knowledge useful in medicine. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Congestion control for low-priority filler traffic

    NASA Astrophysics Data System (ADS)

    Ott, Brian A.; Warnky, Timothy; Liberatore, Vincenzo

    2003-08-01

    As the cost of Internet access rises and the amount of deployed bandwidth increases, a way to make efficient use of the oft-unused bandwidth is desired. Simply providing a lower priority for traffic than best effort allows this bandwidth to be used without noticeable interference with regular traffic. Because bursts of normal traffic are given priority over this background, or filler, traffic, a more aggressive congestion control protocol is called for in the filler traffic. In our paper, we compare numerous versions of TCP-like congestion control of our own design, over which to implement low-priority traffic, by using the unused bandwidth at any given time. These protocols are divided into six "classes," which differ by the core congestion control algorithm and use different constants. Using the ns-2 network simulator, we collected network traces using each of our protocols in different network configurations, with multiple parameters for each configuration. These configurations simulated high- and low-bandwidth and latency networks. We compared the resulting throughput and sharing - the cumulative variation of throughput over each stream, normalized by the total throughput over the link - to our chosen baseline, TCP Sack. Most of the basic algorithms performed as well as or better than Sack in a background traffic environment, especially in terms of throughput. Using features from multiple classes, we also designed a more complex protocol that performed better than Sack in almost every environment, and performed better than the other algorithms in general.

  20. Predictability of road traffic and congestion in urban areas.

    PubMed

    Wang, Jingyuan; Mao, Yu; Li, Jing; Xiong, Zhang; Wang, Wen-Xu

    2015-01-01

    Mitigating traffic congestion on urban roads, with paramount importance in urban development and reduction of energy consumption and air pollution, depends on our ability to foresee road usage and traffic conditions pertaining to the collective behavior of drivers, raising a significant question: to what degree is road traffic predictable in urban areas? Here we rely on the precise records of daily vehicle mobility based on GPS positioning device installed in taxis to uncover the potential daily predictability of urban traffic patterns. Using the mapping from the degree of congestion on roads into a time series of symbols and measuring its entropy, we find a relatively high daily predictability of traffic conditions despite the absence of any priori knowledge of drivers' origins and destinations and quite different travel patterns between weekdays and weekends. Moreover, we find a counterintuitive dependence of the predictability on travel speed: the road segment associated with intermediate average travel speed is most difficult to be predicted. We also explore the possibility of recovering the traffic condition of an inaccessible segment from its adjacent segments with respect to limited observability. The highly predictable traffic patterns in spite of the heterogeneity of drivers' behaviors and the variability of their origins and destinations enables development of accurate predictive models for eventually devising practical strategies to mitigate urban road congestion.

  1. Load Distribution in Congested Scale-Free Networks

    NASA Astrophysics Data System (ADS)

    Zheng, Jian-Feng; Gao, Zi-You; Fu, Bai-Bai

    In this work, we study the effects of scale-free topology and congestion on load distribution. Congestion effect can be described by link cost functions, which map link flows into travel times. Two different kinds of link's practical capacity (it is similar to link's capacity for transport) which is a parameter in link cost functions, i.e., uniform case and nonuniform case, are investigated. After introducing the effect of congestion, load distribution is typically discussed in Barábasi-Albert and Goh scale-free networks. In the uniform case, for Barábasi-Albert scale-free networks, we recover a power-law behavior for load distribution with a larger exponent, as compared with the distribution of betweenness centrality; for Goh scale-free networks, we also recover a power-law behavior and its exponent approaches to the exponent of degree distribution. While in the nonuniform case, the power-law behavior for load distribution may not always be conserved in both Barábasi-Albert and Goh scale-free networks. That is to say, different kinds of load distributions are obtained under different conditions. It may shed some light to study traffic dynamics on scale-free networks.

  2. Arteriosclerotic changes in the myocardium, lung, and kidney in dogs with chronic congestive heart failure and myxomatous mitral valve disease.

    PubMed

    Falk, Torkel; Jönsson, Lennart; Olsen, Lisbeth H; Pedersen, Henrik D

    2006-01-01

    The occurrence of small vessel arteriosclerosis in the myocardium, kidney, and lung in dogs with naturally occurring myxomatous mitral valve disease has not been previously investigated systematically. Twenty-one dogs with naturally occurring congestive heart failure and 21 age-matched, sex-matched, and weight-matched control dogs underwent extensive pathological and histopathological examination. Morphometry and scoring of tissue sections were used to measure arterial narrowing and fibrosis in the myocardium, kidney, and lung; and intimal thickness and plaque formation in the aorta and pulmonary artery. Dogs with congestive heart failure had significantly more arterial narrowing in the left ventricle (P < .003), lung (P < .0001), and kidney (P < .02); intimal-medial thickening in the pulmonary artery (P = .04); and fibrosis in the left ventricle (P < .0001) than control dogs. However, they did not have more plaque formation or intimal-medial thickening in the aorta than controls. There was significantly more arterial narrowing in papillary muscles than in all other locations in dogs with congestive heart failure (P < .002). In control dogs, arterial changes were less pronounced and did not differ in different locations. Dogs with naturally occurring myxomatous mitral valve disease have significantly more arterial changes in the myocardium, lung, and kidney, and significantly more fibrosis in the myocardium than control dogs. This could have important implications in the management of myxomatous mitral valve disease and raises interesting questions about the occurrence and importance of intramural small vessel disease in humans with primary mitral valve prolapse.

  3. Reasoning the Causality of City Sprawl, Traffic Congestion, and Green Land Disappearance in Taiwan Using the CLD Model

    PubMed Central

    Chen, Mei-Chih; Chang, Kaowen

    2014-01-01

    Many city governments choose to supply more developable land and transportation infrastructure with the hope of attracting people and businesses to their cities. However, like those in Taiwan, major cities worldwide suffer from traffic congestion. This study applies the system thinking logic of the causal loops diagram (CLD) model in the System Dynamics (SD) approach to analyze the issue of traffic congestion and other issues related to roads and land development in Taiwan’s cities. Comparing the characteristics of development trends with yearbook data for 2002 to 2013 for all of Taiwan’s cities, this study explores the developing phenomenon of unlimited city sprawl and identifies the cause and effect relationships in the characteristics of development trends in traffic congestion, high-density population aggregation in cities, land development, and green land disappearance resulting from city sprawl. This study provides conclusions for Taiwan’s cities’ sustainability and development (S&D). When developing S&D policies, during decision making processes concerning city planning and land use management, governments should think with a holistic view of carrying capacity with the assistance of system thinking to clarify the prejudices in favor of the unlimited developing phenomena resulting from city sprawl. PMID:25383609

  4. Reasoning the causality of city sprawl, traffic congestion, and green land disappearance in Taiwan using the CLD model.

    PubMed

    Chen, Mei-Chih; Chang, Kaowen

    2014-11-06

    Many city governments choose to supply more developable land and transportation infrastructure with the hope of attracting people and businesses to their cities. However, like those in Taiwan, major cities worldwide suffer from traffic congestion. This study applies the system thinking logic of the causal loops diagram (CLD) model in the System Dynamics (SD) approach to analyze the issue of traffic congestion and other issues related to roads and land development in Taiwan's cities. Comparing the characteristics of development trends with yearbook data for 2002 to 2013 for all of Taiwan's cities, this study explores the developing phenomenon of unlimited city sprawl and identifies the cause and effect relationships in the characteristics of development trends in traffic congestion, high-density population aggregation in cities, land development, and green land disappearance resulting from city sprawl. This study provides conclusions for Taiwan's cities' sustainability and development (S&D). When developing S&D policies, during decision making processes concerning city planning and land use management, governments should think with a holistic view of carrying capacity with the assistance of system thinking to clarify the prejudices in favor of the unlimited developing phenomena resulting from city sprawl.

  5. Analysis of safety factors for urban expressways considering the effect of congestion in Shanghai, China.

    PubMed

    Sun, Jian; Li, Tienan; Li, Feng; Chen, Feng

    2016-10-01

    Urban expressways are the key components of the urban traffic network. The traffic safety situation on expressways directly influences the efficiency of the whole network. A total of 48,325 crashes were recorded by Shanghai Expressway Surveillance System in a three-year period. Considering the different crash mechanisms under different congestion levels, models for the total crashes, non-congested-flow crashes and congested-flow crashes were respectively formulated based on the real-time traffic condition corresponding to each crash. Moreover, considering the potential spatial correlation among segments, the adjacent-correlated spatial and distance-correlated spatial models were formulated and compared to the traditional non-spatial-correlated model. A Bayesian approach was employed to estimate the parameters. The results showed that the congestion index, merging ratio, ramp density, and average daily traffic significantly affect the crash frequency. The safety factors in non-congested flow and congested flow are different; diverging behavior is more risky in non-congested flow, more lanes tend to increase the risk of crashes in congested flow, and horizontal curves tend to decrease the crash risk in congested flow but cause high risk in non-congested flow. In addition, the distance-correlated spatial model is found to be the best-fitting model. The results of this study suggested that dedicated safety countermeasures can be designed for different traffic situations on urban expressways.

  6. Tunneled Pleural Catheter Placement with and without Talc Poudrage for Treatment of Pleural Effusions Due to Congestive Heart Failure.

    PubMed

    Majid, Adnan; Kheir, Fayez; Fashjian, Meghan; Chatterji, Sumit; Fernandez-Bussy, Sebastian; Ochoa, Sebastian; Cheng, George; Folch, Erik

    2016-02-01

    There is a paucity of evidence regarding the role of tunneled pleural catheters in pleural effusions caused by congestive heart failure that is refractory to medical management. The aim of this study was to assess the feasibility of tunneled pleural catheter drainage for treatment of refractory pleural effusions associated with congestive heart failure, either when used alone or with concomitant talc pleurodesis performed during thoracoscopy. This was a retrospective cohort study. We identified patients with congestive heart failure and recurrent symptomatic pleural effusions who were treated between 2005 and 2015 by placement of a tunneled pleural catheter. Patients underwent either thoracoscopy followed by talc poudrage and pleural catheter placement (group 1) or catheter insertion alone (group 2). Forthy-three catheters were inserted in 36 patients, with 15 placed in group 1 and 28 in group 2. Successful pleurodesis was seen in 80% in group 1 and 25% in group 2. The median time of catheter placement was 11.5 days in group 1 and 66 days in group 2. There was a significant decrease in hospital admissions and pleural interventions after catheter placement compared with before insertion (P < 0.05). This single-center, retrospective study demonstrated the feasibility of catheter placement used alone or with talc poudrage for the treatment of refractory pleural effusions associated with congestive heart failure. The addition of talc poudrage might increase the pleurodesis rate and reduce the days to catheter removal in highly selected patients. Prospective studies on a larger number of patients are warranted to verify the safety and efficacy of this intervention.

  7. A "Sweet 16" of Rules About Teamwork

    NASA Technical Reports Server (NTRS)

    Laufer, Alexander (Editor)

    2002-01-01

    The following "Sweet 16" rules included in this paper derive from a longer paper by APPL Director Dr. Edward Hoffman and myself entitled " 99 Rules for Managing Faster, Better, Cheaper Projects." Our sources consisted mainly of "war stories" told by master project managers in my book Simultaneous Management: Managing Projects in a Dynamic Environment (AMACOM, The American Management Association, 1996). The Simultaneous Management model was a result of 10 years of intensive research and testing conducted with the active participation of master project managers from leading private organizations such as AT&T, DuPont, Exxon, General Motors, IBM, Motorola and Procter & Gamble. In a more recent study, led by Dr. Hoffman, we learned that master project managers in leading public organizations employ most of these rules as well. Both studies, in private and public organizations, found that a dynamic environment calls for dynamic management, and that is especially clear in how successful project managers think about their teams.

  8. Infinite horizon optimal impulsive control with applications to Internet congestion control

    NASA Astrophysics Data System (ADS)

    Avrachenkov, Konstantin; Habachi, Oussama; Piunovskiy, Alexey; Zhang, Yi

    2015-04-01

    We investigate infinite-horizon deterministic optimal control problems with both gradual and impulsive controls, where any finitely many impulses are allowed simultaneously. Both discounted and long-run time-average criteria are considered. We establish very general and at the same time natural conditions, under which the dynamic programming approach results in an optimal feedback policy. The established theoretical results are applied to the Internet congestion control, and by solving analytically and nontrivially the underlying optimal control problems, we obtain a simple threshold-based active queue management scheme, which takes into account the main parameters of the transmission control protocols, and improves the fairness among the connections in a given network.

  9. Congestive heart failure: a review and case report from a chiropractic teaching clinic.

    PubMed

    Osterhouse, Melanie D; Kettner, Norman W; Boesch, Ron

    2005-06-01

    To discuss the case of a 62-year-old woman with congestive heart failure (CHF), precipitated by a previous arteriovenous malformation, and to review the clinical presentation, pathophysiology, and treatment options for patients with CHF. The patient complained of pain, rapid weight gain, and shortness of breath. The index event for this patient was known to be an arteriovenous malformation. Biventricular cardiomegaly with pulmonary venous hypertension was evident on chest radiographs. The patient received both medical care (drug therapy) and chiropractic care (manipulation and soft tissue techniques to alleviate symptoms and discomfort). Patients with known and undiagnosed CHF may visit the chiropractic physician; thus, knowledge of comprehensive care, differential diagnosis, and continuity of care are important. Chiropractic management may be helpful in alleviating patient discomfort. Further clinical investigations may help to clarify the role of complementary and alternative care in the diagnosis and treatment of CHF.

  10. Feasibility of congestive heart failure telemanagement using a wii-based telecare platform.

    PubMed

    Finkelstein, Joseph; Wood, Jeffrey; Cha, Eunme; Orlov, Alexander; Dennison, Cheryl

    2010-01-01

    A gaming platform has been used to implement a Home Automated Telemanagement (HAT) system for chronic disease management in the patient's home. The system questions patients with congestive heart failure (CHF) to monitor symptoms, weight changes, and quality of life while educating the patient on their disease. The system is designed to run on the Nintendo Wii videogame console using an active internet connection and the console's built in internet browser. It questions the patient daily on their condition, monitors their weight, and provides the patient with instant feedback on their condition in the form of a 3 zone CHF action plan. The system is designed to be as simple as possible, making it usable by patients with no prior computer or videogame experience. This telemanagement system has been successfully designed and implemented to optimize the care of patients with CHF.

  11. Hearing the Veteran's Voice in Congestive Heart Failure Readmissions.

    PubMed

    Stevenson, Carl W; Pori, Daria; Payne, Kattie; Black, Mary; Taylor, Victoria E

    2015-01-01

    Our purpose was to examine congestive heart failure (CHF) readmissions from the veterans' perspective. The use of health care provider interventions, such as standardized education materials, home telehealth, and a CHF clinic, was able to reduce readmissions rates from 35% to 23%. Our objective was to use input from the veterans to fine-tune our efforts and achieve readmission rates for patients with CHF below the national average of 21%. We wanted to identify factors that result in CHF readmissions, including disease education, self-care management, and barriers to self-care. This study was directed toward answering two questions: 1. What is the veteran’s explanation for readmission? 2. According to the veteran, what are the barriers to following their treatment regimen? It was a rural 84-bed Veterans Health Administration hospital in the Western United States. Before this study, our efforts to reduce CHF readmissions were one-sided, all from the health care professionals' viewpoint. We wanted to hear what the veteran had to say; so, we interviewed 25 veterans. Four veterans were excluded due to issues with their consents. Ninety percent (n = 19/21) responded that they knew their CHF was worse by a change in their breathing (shortness of breath). They identified 48 signs/symptoms that indicated worsening CHF. Weight gain was noted as an indication of worsening CHF symptoms (n = 6/48) in 12.5% of the responses. Twenty-five percent (n = 12/48) of the veterans stated they recognized the early symptoms of worsening CHF. Thirty-eight percent (n = 8/21) of the veterans stated they had early symptoms of worsening CHF, but only two of them contacted their doctor. It is interesting to note that only 29% (n = 6/21) of the veterans recognized weight gain as a sign of worsening CHF and all of these veterans listed other symptoms (such as shortness of breath) along with weight gain. Weighing on a daily basis was practiced by only 30% of the group (n = 7/21); all but two of

  12. Office of the Secretary; Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); transitional assistance management program; early eligibility for TRICARE for certain reserve component members. Final rule.

    PubMed

    2006-06-02

    This final rule revises requirements and procedures for the Transitional Assistance Management Program, which was temporarily revised by section 704 of the National Defense Authorization Act for Fiscal Year 2004 (NDAA-04) (Pub. L. 108-136) and section 1117 of the Emergency Supplemental Appropriations Act for the Reconstruction of Iraq and Afghanistan, 2004 (Emergency Supplemental) (Pub. L. 108-106), which revisions were made permanent by section 706(a) of the Ronald W. Reagan National Defense Authorization Act for Fiscal Year 2005 (NDAA-05) (Pub. L. 108-375). In addition, it establishes requirements and procedures for implementation of the earlier TRICARE eligibility for certain reserve component members authorized by section 703 of NDAA-04 and section 1116 of the Emergency Supplemental, which provisions were made permanent by section 703 of NDAA-05. The rule adopts the interim rule published in the Federal Register on March 16, 2005 (70 FR 12798).

  13. Pulmonary Congestion and Physical Functioning in Peritoneal Dialysis Patients

    PubMed Central

    Enia, Giuseppe; Tripepi, Rocco; Panuccio, Vincenzo; Torino, Claudia; Garozzo, Maurizio; Battaglia, Giovanni Giorgio; Zoccali, Carmine

    2012-01-01

    ♦ Purpose: Decline in physical function is commonly observed in patients with kidney failure on dialysis. Whether lung congestion, a predictable consequence of cardiomyopathy and fluid overload, may contribute to the low physical functioning of these patients has not been investigated. ♦ Methods: In 51 peritoneal dialysis (PD) patients, we investigated the cross-sectional association between the physical functioning scale of the Kidney Disease Quality of Life Short Form (KDQOL-SF: Rand Corporation, Santa Monica, CA, USA) and an ultrasonographic measure of lung water recently validated in dialysis patients. The relationship between physical functioning and lung water was also analyzed taking into account the severity of dyspnea measured using the New York Heart Association (NYHA) classification currently used to grade the severity of heart failure. ♦ Results: Evidence of moderate-to-severe lung congestion was evident in 20 patients, and this alteration was asymptomatic (that is, NHYHA class I) in 11 patients (55%). On univariate analysis, physical functioning was inversely associated with lung water (r = -0.48, p < 0.001), age (r = -0.44, p = 0.001), previous cardiovascular events (r = -0.46, p = 0.001), and fibrinogen (r = -0.34, p = 0.02). Physical functioning was directly associated with blood pressure, the strongest association being with diastolic blood pressure (r = 0.38, p = 0.006). The NYHA class correlated inversely with physical functioning (r = -0.51, p < 0.001). In multiple regression analysis, only lung water and fibrinogen remained independent correlates of physical functioning. The NYHA class failed to maintain its independent association. ♦ Conclusions: This cross-sectional study supports the hypothesis that symptomatic and asymptomatic lung congestion is a relevant factor in the poor physical functioning of patients on PD. PMID:22942271

  14. Nitrendipine binding in congestive heart failure due to myocardial infarction

    SciTech Connect

    Dixon, I.M.; Lee, S.L.; Dhalla, N.S. )

    1990-03-01

    Depressed cardiac pump function is the hallmark of congestive heart failure, and it is suspected that decreased influx of Ca2+ into the cardiac cell is responsible for depressed contractile function. Since Ca2+ channels in the sarcolemmal membrane are considered to be an important route for the entry of Ca2+, we examined the status of Ca2+ receptors/channels in failing rat hearts after myocardial infarction of the left ventricular free wall. For this purpose, the left coronary artery was ligated and hearts were examined 4, 8, and 16 weeks later; sham-operated animals served as controls. Hemodynamic assessment revealed decreased total mechanical energy (left ventricular systolic pressure x heart rate), increased left ventricular diastolic pressure, and decreased positive and negative dP/dt in experimental animals at 4, 8, and 16 weeks. Although accumulation of ascites in the abdominal cavity was evident at 4 weeks, other clinical signs of congestive heart failure in experimental rats were evident from the presence of lung congestion and cardiac dilatation at 8 and 16 weeks after induction of myocardial infarction. The density of Ca2+ receptors/channels in crude membranes, as assessed by (3H)nitrendipine binding assay, was found to be decreased in the uninfarcted experimental left ventricle at 8 and 16 weeks; however, no change in the affinity of nitrendipine was evident. A similar depression in the specific binding of another dihydropyridine compound, (3H)PN200-110, was also evident in failing hearts. Brain and skeletal muscle crude membrane preparations, unlike those of the right ventricle and liver, revealed a decrease in Ca2+ receptors/channels density in experimental animals at 16 weeks.

  15. Effect of Congestion Costs on Shortest Paths Through Complex Networks

    NASA Astrophysics Data System (ADS)

    Ashton, Douglas J.; Jarrett, Timothy C.; Johnson, Neil F.

    2005-02-01

    We analyze analytically the effect of congestion costs within a physically relevant, yet exactly solvable, network model featuring central hubs. These costs lead to a competition between centralized and decentralized transport pathways. In stark contrast to conventional no-cost networks, there now exists an optimal number of connections to the central hub in order to minimize the shortest path. Our results shed light on an open problem in biology, informatics, and sociology, concerning the extent to which decentralized versus centralized design benefits real-world complex networks.

  16. Effect of congestion costs on shortest paths through complex networks.

    PubMed

    Ashton, Douglas J; Jarrett, Timothy C; Johnson, Neil F

    2005-02-11

    We analyze analytically the effect of congestion costs within a physically relevant, yet exactly solvable, network model featuring central hubs. These costs lead to a competition between centralized and decentralized transport pathways. In stark contrast to conventional no-cost networks, there now exists an optimal number of connections to the central hub in order to minimize the shortest path. Our results shed light on an open problem in biology, informatics, and sociology, concerning the extent to which decentralized versus centralized design benefits real-world complex networks.

  17. Service dogs. Final rule.

    PubMed

    2012-09-05

    The Department of Veterans Affairs (VA) amends its regulations concerning veterans in need of service dogs. Under this final rule, VA will provide to veterans with visual, hearing, or mobility impairments benefits to support the use of a service dog as part of the management of such impairments. The benefits include assistance with veterinary care, travel benefits associated with obtaining and training a dog, and the provision, maintenance, and replacement of hardware required for the dog to perform the tasks necessary to assist such veterans.

  18. Coronary computed tomography and triple rule out CT in patients with acute chest pain and an intermediate cardiac risk profile. Part 1: impact on patient management.

    PubMed

    Gruettner, Joachim; Fink, Christian; Walter, Thomas; Meyer, Mathias; Apfaltrer, Paul; Schoepf, U Joseph; Saur, Joachim; Sueselbeck, Tim; Traunwieser, Dominik; Takx, Richard; Kralev, Stefan; Borggrefe, Martin; Schoenberg, Stefan O; Henzler, Thomas

    2013-01-01

    To evaluate the impact of coronary CT angiography (coronary CTA) or "triple-rule-out" CT angiography (TRO-CTA) on patient management in the work-up of patients with acute chest pain and an intermediate cardiac risk profile. 100 patients with acute chest pain and an intermediate cardiac risk for acute coronary syndrome (ACS) underwent coronary CTA or TRO-CTA for the evaluation of chest pain. Patients with a high and low cardiac risk profile were not included in this study. All patients with significant coronary stenosis >50% on coronary CTA underwent invasive coronary catheterization (ICC). Important other pathological findings were recorded. All patients had a 90-day follow-up period for major adverse cardiac events (MACE). Based on a negative coronary CTA 60 of 100 patients were discharged on the same day. None of the discharged patients showed MACE during the 90-day follow-up. Coronary CTA revealed a coronary stenosis >50% in 19 of 100 patients. ICC confirmed significant coronary stenosis in 17/19 patients. Among the 17 true positive patients, 9 underwent percutaneous coronary intervention with stent implantation, 7 were received intensified medical therapy, and 1 patient underwent coronary artery bypass surgery. A TRO-CTA protocol was performed in 36/100 patients due to elevated d-dimer levels. Pulmonary embolism was present in 5 patients, pleural effusion of unknown etiology in 3 patients, severe right ventricular dysfunction with pericardial effusion in 1 patient, and an incidental bronchial carcinoma was diagnosed in 1 patient. Coronary CTA and TRO-CTA allow a rapid and safe discharge in the majority of patients presenting with acute chest pain and an intermediate risk for ACS while at the same time identifies those with significant coronary artery stenosis. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  19. Experimental Verification of H∞ Congestion Controllers for TCP/AQM Networks

    NASA Astrophysics Data System (ADS)

    Naito, Hiroyuki; Azuma, Takehito; Nishimura, Akihiko; Fujita, Masayuki

    The purpose of this paper is to design a congestion controller for TCP/AQM networks based on the H∞ control theory, and validate the effectiveness of the designed H∞ congestion controller via a testbed which is the small-scale network for verification of the designed H∞ congestion controller. Firstly, a nonlinear and the linearized model of TCP/AQM networks are introduced, and control objectives are described. The H∞ congestion controller is designed by solving the mixed sensitivity problem for the linearized model. In order to verify the designed H∞ congestion controller, we show simulation results using SIMULINK and ns-2 simulator, and compare the congestion controller via PI control with the designed H∞ congestion controller. Finally, we develop a testbed for verification of the effectiveness of the designed H∞ congestion controller which is implemented to the testbed by improving Linux kernel and carry out an experiment. As experimental results using the developed testbed, we show the queue size in the router, where the designed H∞ congestion controller is implemented, and confirm that the control objectives are achieved.

  20. Congestion phenomena caused by matching pennies in evolutionary games

    NASA Astrophysics Data System (ADS)

    Szabó, György; Szolnoki, Attila

    2015-03-01

    Evolutionary social dilemma games are extended by an additional matching-pennies game that modifies the collected payoffs. In a spatial version players are distributed on a square lattice and interact with their neighbors. First, we show that the matching-pennies game can be considered as the microscopic force of the Red Queen effect that breaks the detailed balance and induces eddies in the microscopic probability currents if the strategy update is analogous to the Glauber dynamics for the kinetic Ising models. The resulting loops in probability current breaks symmetry between the chessboardlike arrangements of strategies via a bottleneck effect occurring along the four-edge loops in the microscopic states. The impact of this congestion is analogous to the application of a staggered magnetic field in the Ising model; that is, the order-disorder critical transition is wiped out by noise. It is illustrated that the congestion induced symmetry breaking can be beneficial for the whole community within a certain region of parameters.

  1. Nonlinear dynamics of congestive heart failure (Invited Paper)

    NASA Astrophysics Data System (ADS)

    Bernjak, Alan; Clarkson, Peter B. M.; McClintock, Peter V. E.; Stefanovska, Aneta

    2005-05-01

    Preliminary results are reported from a research project analysing congestive heart failure in terms a stochastic coupled-oscillator model of the cardiovascular system. Measurements of blood flow by laser Doppler flowmetry (LDF) have been processed by use of the wavelet transform to separate its oscillatory components, which number at least five. Particular attention was concentrated on the frequency content near 0.01 Hz, which is known to be associated with endothelial function. The LDF was carried out in conjunction with iontophoretically administered acetylcholine (ACh) and sodium nitroprusside (SNP) in order to evaluate endothelial reactivity. Measurements were made on 17 congestive heart failure (CHF) patients (a) on first diagnosis, and (b) again several weeks later after their treatment with a β-blocker had been stabilised. The results of these two sets of measurements are being compared with each other, and with data from an age and sex-matched group of healthy controls. It is confirmed that endothelial reactivity is reduced in CHF patients, as compared to healthy controls, and it is found that one effect of the Beta-blocker is to ameliorate the loss of endothelial function in CHF. The implications of these results are discussed.

  2. [Juvenile haemochromatosis presenting as intractable congestive heart failure].

    PubMed

    Vas, Katalin; Hubay, Marta; Tordai, Attila; Andrikovics, Hajnalka; Zoltán, Sápi; Jánosi, András

    2005-12-18

    Juvenile haemochromatosis is an autosomal, recessive inherited iron metabolism disorder. The rapid deterioration and malignant prognosis differentiate juvenile haemochromatosis from hereditary haemochromatosis. The authors summarize the history of a 25 year old man, who worked in Hungary as a guest worker living in Romania. No significant illness has occurred in his previous history. The abdominal pain was his first symptom and he was treated in different institutions, where cholecystitis, alcoholic hepatic disease, hepatic cirrhosis were considered as a cause of his symptoms. Some weeks later atrial tachycardia, and congestive heart failure were observed and he was sent to our Cardiology Department. The echocardiography revealed diffuse hypokinesis, serious systolic dysfunction (ejection fraction: 21%), grade II mitral and tricuspid insufficiency with pulmonary hypertension. Considering the rapid deterioration of his cardiac function, myocarditis was suspected. Myocardial biopsy and coronary arteriography were performed. Coronary arteries were normal. Ventricular fibrillation occurred during coronary arteriography. Myocardial biopsy revealed juvenile haemochromatosis. Special laboratory examinations (transferrin saturation) were made after biopsy, that also confirmed the diagnosis of juvenile haemochromatosis. Cardiac transplantation was planned. Some days after the diagnosis was made the patient died of cardiogenic shock and intractable heart failure. Autopsy revealed hypogonadism and serious haemochromatosis in different parenchymal organs. Juvenile haemochromatosis should be considered in every young patient with congestive heart failure of unknown etiology.

  3. The impact of congestion charging on social capital.

    PubMed

    Munford, Luke A

    2017-03-01

    We analyse a new data set to examine how congestion charging policies affect an individual's investment social capital. We exploit a (quasi-) natural experiment - the implementation of the Western Extension Zone (WEZ) to the London Congestion Charging zone in 2007. We measure investment in social capital by using the frequency of visits to friends and family before and after the implementation of the WEZ. Using longitudinal data collected in January and November 2007 made available by Transport for London, we perform difference-in-difference analysis, using both OLS and interval regression, with the treatment group defined as those who used a car to make visits pre-WEZ. We observe large and statistically significant reductions in visits as a result of the WEZ, with, for example, a reduction of around 20 visits a year to friends. The effect of the WEZ on the number of visits to act as an informal carer is much larger, with reductions of around 100 visits a year. Given that the changes occurred in such a small time frame (10 months), we conclude that the WEZ is likely to be the main driver of these reductions.

  4. A minimal model for congestion phenomena on complex networks

    NASA Astrophysics Data System (ADS)

    DeMartino, Daniele; Dall'Asta, Luca; Bianconi, Ginestra; Marsili, Matteo

    2009-08-01

    We study a minimal model of traffic flows in complex networks, simple enough for getting analytical results, but with a very rich phenomenology, presenting continuous, discontinuous as well as hybrid phase transitions between a free-flow phase and a congested phase, critical points and different behaviors of scaling with the system size. It consists of random walkers on a queuing network with one-range repulsion, where particles can be destroyed only if they can move. We focus on the dependence on the topology as well as on the level of traffic control. We are able to obtain transition curves and phase diagrams at an analytical level for the ensemble of uncorrelated networks and numerically for single instances. We find that traffic control improves global performance, enlarging the free-flow region in parameter space only in heterogeneous networks. Traffic control introduces non-linear effects and, beyond a critical strength, may trigger the appearance of a congested phase in a discontinuous manner. The model also reproduces the crossover in the scaling of traffic fluctuations empirically observed in the Internet, and moreover, a conserved version can reproduce qualitatively some stylized facts of traffic in transportation networks.

  5. Cascading Failures in Congested Scale-Free Networks

    NASA Astrophysics Data System (ADS)

    Zheng, Jian-Feng; Yang, Ling-Xiao; Gao, Zi-You; Fu, Bai-Bai

    In this work, we study the effect of congestion on the behavior of cascading failures in scale-free networks, where a capacity is assigned on each node (controlled by a tolerance parameter α), and traffic flows are governed by user equilibrium instead of going along the shortest paths. The effect of congestion can be described by link cost function, which denotes the time needed to travel along the link. Here we focus on studying the effect of link's practical capacity, which is a parameter in link cost function. Two different kinds of link's practical capacity are investigated, i.e. uniform case and nonuniform case. In the uniform case, each link has the same value of practical capacity. While in the nonuniform case, we assume that link's practical capacity and degrees of the link's endpoints are correlated (controlled by parameter θ, which governs the heterogeneity of link's practical capacity). Simulation results show that, in the uniform case, scale-free networks are more prone to cascading failures when increasing the value of link's practical capacity. In the nonuniform case, cascading failures in scale-free networks are very sensitive to α when θ > 0; while θ < 0, scale-free networks may suffer from serious cascading failures, regardless of α.

  6. Modeling and simulating for congestion pedestrian evacuation with panic

    NASA Astrophysics Data System (ADS)

    Wang, Jinhuan; Zhang, Lei; Shi, Qiongyu; Yang, Peng; Hu, Xiaoming

    2015-06-01

    A new multi-agent based congestion evacuation model incorporating panic behavior is proposed in this paper for simulating pedestrian evacuation in public places such as a stadium. Different from the existing results, pedestrians in this model are divided into four classes and each pedestrian's status can be either normal, being overtaken, or casualty. The direction of action for each individual is affected by competitive ability, distance to the exits as well as number and density of occupants within the view field of the agent. Our simulations exhibit that during the evacuation process: (1) The agents gather in front of the exits spontaneously and present arched shapes close to the exits. (2) Under the panic state the agents cohere closely and almost do not change the target exit. So other alternative exits are ignored. (3) For the case without obstacle, the casualties under panic increase greatly. But if there are obstacles (chairs), the congestion can be alleviated. Thus the casualties are reduced. (4) If certain exit is partly clogged, the evacuation becomes more efficient when adding a virtual leader. The overall simulation results show that the proposed model can reproduce the real evacuation process in a stadium quite well.

  7. Interpretation and Use of Natriuretic Peptides in Non-Congestive Heart Failure Settings

    PubMed Central

    Lin, Yen-Yue; Chu, Shi-Jye; Hsu, Ching-Wang; Cheng, Shu-Meng

    2010-01-01

    Natriuretic peptides (NPs) have been found to be useful markers in differentiating acute dyspneic patients presenting to the emergency department (ED) and emerged as potent prognostic markers for patients with congestive heart failure (CHF). The best-established and widely used clinical application of BNP and NT-proBNP testing is for the emergent diagnosis of CHF in patients presenting with acute dyspnea. Nevertheless, elevated NPs levels can be found in many circumstances involving left ventricular (LV) dysfunction or hypertrophy; right ventricular (RV) dysfunction secondary to pulmonary diseases; cardiac inflammatory or infectious diseases; endocrinology diseases and high output status without decreased LV ejection fraction. Even in the absence of significant clinical evidence of volume overload or LV dysfunction, markedly elevated NP levels can be found in patients with multiple comorbidities with a certain degree of prognostic value. Potential clinical applications of NPs are expanded accompanied by emerging reports regarding screening the presence of secondary cardiac dysfunction; monitoring the therapeutic responses, risk stratifications and providing prognostic values in many settings. Clinicians need to have expanded knowledge regarding the interpretation of elevated NPs levels and potential clinical applications of NPs. Clinicians should recognize that currently the only reasonable application for routine practice is limited to differentiation of acute dyspnea, rule-out-diagnostic-tests, monitoring of therapeutic responses and prognosis of acute or decompensated CHF. The rationales as well the potential applications of NPs in these settings are discussed in this review article. PMID:20191004

  8. 43 CFR 3483.6 - Special logical mining unit rules.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Special logical mining unit rules. 3483.6... MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) COAL EXPLORATION AND MINING OPERATIONS RULES Diligence Requirements § 3483.6 Special logical mining unit rules. (a) Production anywhere...

  9. 43 CFR 3483.6 - Special logical mining unit rules.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Special logical mining unit rules. 3483.6... MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) COAL EXPLORATION AND MINING OPERATIONS RULES Diligence Requirements § 3483.6 Special logical mining unit rules. (a) Production anywhere...

  10. 43 CFR 3483.6 - Special logical mining unit rules.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Special logical mining unit rules. 3483.6... MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) COAL EXPLORATION AND MINING OPERATIONS RULES Diligence Requirements § 3483.6 Special logical mining unit rules. (a) Production anywhere...

  11. 43 CFR 3483.6 - Special logical mining unit rules.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Special logical mining unit rules. 3483.6... MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) COAL EXPLORATION AND MINING OPERATIONS RULES Diligence Requirements § 3483.6 Special logical mining unit rules. (a) Production anywhere...

  12. Congestive Heart Failure and Noncardiac Operations: Risk of Serious Morbidity, Readmission, Reoperation, and Mortality.

    PubMed

    Turrentine, Florence E; Sohn, Min-Woong; Jones, Rayford Scott

    2016-06-01

    Congestive heart failure (CHF) predicts surgical morbidity and mortality. However, few studies evaluate CHF's impact on noncardiac operations. Because of CHFs serious threat to health and survival, surgeons must understand risks CHF poses to patients undergoing a diverse array of operations. We used 2009 to 2013 American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Participant Use Files to estimate the risk of serious morbidity, reoperation, readmission, mortality, and other postoperative complications associated with preoperative diagnosis of CHF. Multivariable logistic regression analysis provided odds ratios (OR) and 95% confidence intervals (CI) for outcomes in 34 ACS NSQIP procedure groups, controlling for age, sex, race, emergency surgery status, American Society of Anesthesiologists Classification, body mass index, and selected laboratory values. Unadjusted ORs indicate adverse effects of CHF on surgical outcomes for most procedures considered. When adjusted for age and other confounders, CHF persists with adverse effects on most outcomes, including serious morbidity (OR 1.52, 95% CI, 1.44 to 1.61; p < 0.001); reoperation (OR 1.29, 95% CI, 1.17 to 1.42; p < 0.001); readmission (OR 1.39, 95% CI, 1.29 to 1.50; p < 0.001); and 30-day mortality (OR 1.96, 95% CI 1.80 to 2.13; p < 0.001). The impact of CHF on morbidity and mortality substantially affected those undergoing carotid endarterectomy and lower extremity endovascular repair. Cardiac arrest, mortality, unplanned intubation, and ventilator > 48 hours were complications most affected by CHF. Congestive heart failure strongly predicts serious morbidity, unplanned reoperation, readmission, and surgical mortality for noncardiac operations. Surgeons must pay particular attention to recognizing CHF and optimizing perioperative management when considering surgery. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  13. A Bayesian ridge regression analysis of congestion's impact on urban expressway safety.

    PubMed

    Shi, Qi; Abdel-Aty, Mohamed; Lee, Jaeyoung

    2016-03-01

    With the rapid growth of traffic in urban areas, concerns about congestion and traffic safety have been heightened. This study leveraged both Automatic Vehicle Identification (AVI) system and Microwave Vehicle Detection System (MVDS) installed on an expressway in Central Florida to explore how congestion impacts the crash occurrence in urban areas. Multiple congestion measures from the two systems were developed. To ensure more precise estimates of the congestion's effects, the traffic data were aggregated into peak and non-peak hours. Multicollinearity among traffic parameters was examined. The results showed the presence of multicollinearity especially during peak hours. As a response, ridge regression was introduced to cope with this issue. Poisson models with uncorrelated random effects, correlated random effects, and both correlated random effects and random parameters were constructed within the Bayesian framework. It was proven that correlated random effects could significantly enhance model performance. The random parameters model has similar goodness-of-fit compared with the model with only correlated random effects. However, by accounting for the unobserved heterogeneity, more variables were found to be significantly related to crash frequency. The models indicated that congestion increased crash frequency during peak hours while during non-peak hours it was not a major crash contributing factor. Using the random parameter model, the three congestion measures were compared. It was found that all congestion indicators had similar effects while Congestion Index (CI) derived from MVDS data was a better congestion indicator for safety analysis. Also, analyses showed that the segments with higher congestion intensity could not only increase property damage only (PDO) crashes, but also more severe crashes. In addition, the issues regarding the necessity to incorporate specific congestion indicator for congestion's effects on safety and to take care of the

  14. Analysis of random drop for gateway congestion control. M.S. Thesis

    NASA Technical Reports Server (NTRS)

    Hashem, Emam Salaheddin

    1989-01-01

    Lately, the growing demand on the Internet has prompted the need for more effective congestion control policies. Currently No Gateway Policy is used to relieve and signal congestion, which leads to unfair service to the individual users and a degradation of overall network performance. Network simulation was used to illustrate the character of Internet congestion and its causes. A newly proposed gateway congestion control policy, called Random Drop, was considered as a promising solution to the pressing problem. Random Drop relieves resource congestion upon buffer overflow by choosing a random packet from the service queue to be dropped. The random choice should result in a drop distribution proportional to the bandwidth distribution among all contending TCP connections, thus applying the necessary fairness. Nonetheless, the simulation experiments demonstrate several shortcomings with this policy. Because Random Drop is a congestion control policy, which is not applied until congestion has already occurred, it usually results in a high drop rate that hurts too many connections including well-behaved ones. Even though the number of packets dropped is different from one connection to another depending on the buffer utilization upon overflow, the TCP recovery overhead is high enough to neutralize these differences, causing unfair congestion penalties. Besides, the drop distribution itself is an inaccurate representation of the average bandwidth distribution, missing much important information about the bandwidth utilization between buffer overflow events. A modification of Random Drop to do congestion avoidance by applying the policy early was also proposed. Early Random Drop has the advantage of avoiding the high drop rate of buffer overflow. The early application of the policy removes the pressure of congestion relief and allows more accurate signaling of congestion. To be used effectively, algorithms for the dynamic adjustment of the parameters of Early Random Drop

  15. Hidden Rules of the Superintendency.

    ERIC Educational Resources Information Center

    Caloss, Ronald

    1999-01-01

    Effective superintendents recognize three key management precepts and their hidden rules. Administrators should avoid mixing emotion and logic, attending to detractors' emotional needs before presenting a differing viewpoint. They should be graceful under pressure, expect the unexpected, and build coalitions gradually, mindful of all community…

  16. Direct Open Venous Drainage: An Alternative Choice for Flap Congestion Salvage.

    PubMed

    Park, Su Han; Choi, Woo Young; Son, Kyung Min; Cheon, Ji Seon; Yang, Jeong Yeol

    2015-12-01

    In this report, we present a scalp defect reconstruction with lateral arm free flap. We highlight the difficulty in obtaining a recipient vein and the venous drainage managed through an open end of the donor vein. A 52-year-old woman presented with a pressure sore on the left scalp. A lateral arm free flap was transferred to cover this 8×6 cm defect. The arterial anastomosis was successful, but no recipient vein could be identified within the wound bed. Instead, we used a donor venous end for the direct open venous drainage. In order to keep this exposed venous end patent, we applied heparin-soaked gauze dressing to the wound. Also, the vein end was mechanically dilated and irrigated with heparin solution at two hour intervals. Along with fluid management and blood transfusion, this management was continued for the five days after the operation. The flap survived well without any complication. Through this case, we were able to demonstrate that venous congestion can be avoided by drainage of the venous blood through an open vessel without the use of leeches.

  17. Integrative Medical Care Plus Mindfulness Training for Patients With Congestive Heart Failure: Proof of Concept.

    PubMed

    Kemper, Kathi J; Carmin, Cheryl; Mehta, Bella; Binkley, Phillip

    2016-10-01

    Congestive heart failure (CHF) has a high rate of morbidity and mortality. It is often accompanied by other medical and psychosocial comorbidities that complicate treatment and adherence. We conducted a proof of concept pilot project to determine the feasibility of providing integrative group medical visits plus mindfulness training for patients recently discharged with CHF. Patients were eligible if they had been discharged from an inpatient stay for CHF within the 12 months prior to the new program. The Compassionate Approach to Lifestyle and Mind-Body (CALM) Skills for Patients with CHF consisted of 8 weekly visits focusing on patient education about medications, diet, exercise, sleep, and stress management; group support; and training in mind-body skills such as mindfulness, self-compassion, and loving-kindness. Over two 8-week sessions, 8/11 (73%) patients completed at least 4 visits. The patients had an average age of 57 years. The most common comorbidities were weight gain, sleep problems, and fatigue. After the sessions, 100% of patients planned to make changes to their diet, exercise, and stress management practices. Over half of the patients who met with a pharmacist had a medication-related problem. Improvements were observed in depression, fatigue, and satisfaction with life. Integrative group visits focusing on healthy lifestyle, support, and skill-building are feasible even among CHF patients and should be evaluated in controlled trials as a patient-centered approach to improving outcomes related to improving medication management, depression, fatigue, and quality of life.

  18. Congestive heart failure as a determinant of postoperative delirium.

    PubMed

    Parente, Daniela; Luís, Clara; Veiga, Dalila; Silva, Hugo; Abelha, Fernando

    2013-09-01

    Postoperative delirium (POD) is a frequent post-surgical complication that is associated with increased mortality and poor patient outcomes. POD is a complex disorder with multiple risk factors such as pre-existing patient comorbidities and perioperative complications. The aim of this study was to evaluate the incidence of POD and to identify risk factors for the development of POD in a post-anesthesia care unit (PACU). We enrolled 97 adult patients admitted to a PACU over a five-day period (start date September 6, 2010). Patient demographics and intraoperative and postoperative data were collected. Patients were followed for the development of delirium using the Intensive Care Delirium Screening Checklist. Descriptive analyses of variables were used to summarize data, and the Mann-Whitney U test was used to compare continuous variables; the chi-square or Fisher's exact test was used for comparisons. Univariate analysis was performed using simple binary logistic regression with odds ratios (OR) and 95% confidence intervals (95% CI). The significance level for multiple comparisons was controlled by applying the Bonferroni correction for multiple comparisons and variables were deemed significant if p≤0.0025. Six percent of patients developed POD. These patients were older and more likely to have higher American Society of Anesthesiologists (ASA) physical status (83 vs. 22% with ASA III/IV, p=0.004) as well as a higher frequency of congestive heart failure (50 vs. 3%, p=0.003) and a higher Revised Cardiac Risk Index (RCRI) score (33 vs. 6% with RCRI ≥2, p=0.039). The duration of anesthesia for patients with POD was also longer and they received a greater volume of crystalloids, colloids, and erythrocytes during surgery. Congestive heart disease was an independent risk factor for POD (OR 29.3, 95% CI 4.1-210.6; p<0.001). In addition, patients who developed POD had higher in-hospital mortality and longer PACU and hospital stays. Patients who developed POD had longer

  19. Congestion at Card and Book Catalogs--A Queuing-Theory Approach

    ERIC Educational Resources Information Center

    Bookstein, Abraham

    1972-01-01

    This paper attempts to analyze the problem of congestion, using a mathematical model shown to be of value in other similar applications. Three criteria of congestion are considered, and it is found that the conclusion one can draw is sensitive to which of these criteria is paramount. (8 references) (Author/NH)

  20. Liver congestion in heart failure contributes to inappropriately increased serum hepcidin despite anemia.

    PubMed

    Ohno, Yukako; Hanawa, Haruo; Jiao, Shuang; Hayashi, Yuka; Yoshida, Kaori; Suzuki, Tomoyasu; Kashimura, Takeshi; Obata, Hiroaki; Tanaka, Komei; Watanabe, Tohru; Minamino, Tohru

    2015-01-01

    Hepcidin is a key regulator of mammalian iron metabolism and mainly produced by the liver. Hepcidin excess causes iron deficiency and anemia by inhibiting iron absorption from the intestine and iron release from macrophage stores. Anemia is frequently complicated with heart failure. In heart failure patients, the most frequent histologic appearance of liver is congestion. However, it remains unclear whether liver congestion associated with heart failure influences hepcidin production, thereby contributing to anemia and functional iron deficiency. In this study, we investigated this relationship in clinical and basic studies. In clinical studies of consecutive heart failure patients (n = 320), anemia was a common comorbidity (41%). In heart failure patients without active infection and ongoing cancer (n = 30), log-serum hepcidin concentration of patients with liver congestion was higher than those without liver congestion (p = 0.0316). Moreover, in heart failure patients with liver congestion (n = 19), the anemia was associated with the higher serum hepcidin concentrations, which is a type of anemia characterized by induction of hepcidin. Subsequently, we produced a rat model of heart failure with liver congestion by injecting monocrotaline that causes pulmonary hypertension. The monocrotaline-treated rats displayed liver congestion with increase of hepcidin expression at 4 weeks after monocrotaline injection, followed by anemia and functional iron deficiency observed at 5 weeks. We conclude that liver congestion induces hepcidin production, which may result in anemia and functional iron deficiency in some patients with heart failure.

  1. 76 FR 75875 - Plan for Conduct of 2012 Electric Transmission Congestion Study

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-05

    ... for Conduct of 2012 Electric Transmission Congestion Study AGENCY: Office of Electricity Delivery and... regional workshops and request for written comments in connection with the preparation of a study of...://energy.gov/oe/congestion-study-2012 . ] Issued in Washington, DC on November 29, 2011. Patricia A...

  2. Traffic Congestion on a University Campus: A Consideration of Unconventional Remedies to Nontraditional Transportation Patterns

    ERIC Educational Resources Information Center

    Kaplan, Dave; Clapper, Thomas

    2007-01-01

    U.S. transportation data suggest that the number of vehicle miles traveled has far surpassed new capacity, resulting in increased traffic congestion in many communities throughout the country. This article reports on traffic congestion around a university campus located within a small town. The mix of trip purposes varies considerably in this…

  3. Traffic Congestion on a University Campus: A Consideration of Unconventional Remedies to Nontraditional Transportation Patterns

    ERIC Educational Resources Information Center

    Kaplan, Dave; Clapper, Thomas

    2007-01-01

    U.S. transportation data suggest that the number of vehicle miles traveled has far surpassed new capacity, resulting in increased traffic congestion in many communities throughout the country. This article reports on traffic congestion around a university campus located within a small town. The mix of trip purposes varies considerably in this…

  4. Congestion at Card and Book Catalogs--A Queuing-Theory Approach

    ERIC Educational Resources Information Center

    Bookstein, Abraham

    1972-01-01

    This paper attempts to analyze the problem of congestion, using a mathematical model shown to be of value in other similar applications. Three criteria of congestion are considered, and it is found that the conclusion one can draw is sensitive to which of these criteria is paramount. (8 references) (Author/NH)

  5. Evaluation of performance characteristics of the medicinal leech (Hirudo medicinalis) for the treatment of venous congestion.

    PubMed

    Conforti, Michael L; Connor, Nadine P; Heisey, Dennis M; Hartig, Gregory K

    2002-01-01

    Medicinal leeches (Hirudo medicinalis) are a standard treatment for venous congestion, a complication that can occur after reconstructive surgery. If the cause of venous congestion cannot be surgically corrected, then medicinal leeches are used to temporarily increase perfusion levels and maintain physiologic requirements within the congested tissue. Leeches increase perfusion within congested tissue by actively drawing off blood as a bloodmeal. Furthermore, the leech bite continues to bleed and relieve congestion after detachment because of the anticoagulation effects of leech saliva left behind in the bite. In a porcine model, a 10 x 10 cm cutaneous flank flap was congested by clamping the venae comitantes. Four medicinal leeches were allowed to attach to the congested flap, and parameters of active feeding and passive bleeding after detachment were recorded. The average bloodmeal volume for the medicinal leeches was 2.45 ml. Average passive bleeding for the first 2 and 4 hours after leech detachment totaled 2.21 and 2.50 ml, respectively, with 90 percent of passive bleeding occurring within 5 hours after detachment. Laser Doppler imaging indicated that the spatial arrangement of surface perfusion increases were localized to a 1.6-cm-diameter circle around the leech head (bite) and corresponded well with the visual return of normal skin tones to the same area. This study provides a realistic and quantitative estimate of the spatial and volumetric characteristics of leech feeding and passive bleeding using a clinically relevant model of acute, severe congestion.

  6. Problems of rapid digitalization in severe congestive heart failure.

    PubMed

    Haustein, K O; Assmann, I; Fiehring, H

    1980-02-01

    The pharmacodynamic effects (changes of systolic time intervals, STI, reaction of pulmonary arterial pressure) of digitoxin were studied in 7 patients with severe congestive heart failure in comparison with the corresponding plasma level. STI indicated glycoside-dependent changes, i.e. shortening of LVETc and QS2c and normalization of prolonged PEPc, while ICT shortening was less observed. In 2 patients with cor pulmonale a pulmonary oedema occurred accompanied with prolonged LVETc. During the early period of glycoside-dependent recompensation no significant correlation between STI shortening and glycoside plasma level was observed. Because of the retarded normalization of the haemodynamics of the pulmonary circulation and because of possible side-effects, rapid digitalization has to be reconsidered.

  7. Complexity in congestive heart failure: A time-frequency approach

    NASA Astrophysics Data System (ADS)

    Banerjee, Santo; Palit, Sanjay K.; Mukherjee, Sayan; Ariffin, MRK; Rondoni, Lamberto

    2016-03-01

    Reconstruction of phase space is an effective method to quantify the dynamics of a signal or a time series. Various phase space reconstruction techniques have been investigated. However, there are some issues on the optimal reconstructions and the best possible choice of the reconstruction parameters. This research introduces the idea of gradient cross recurrence (GCR) and mean gradient cross recurrence density which shows that reconstructions in time frequency domain preserve more information about the dynamics than the optimal reconstructions in time domain. This analysis is further extended to ECG signals of normal and congestive heart failure patients. By using another newly introduced measure—gradient cross recurrence period density entropy, two classes of aforesaid ECG signals can be classified with a proper threshold. This analysis can be applied to quantifying and distinguishing biomedical and other nonlinear signals.

  8. Respiratory sleep disorders in patients with congestive heart failure.

    PubMed

    Naughton, Matthew T

    2015-08-01

    Respiratory sleep disorders (RSD) occur in about 40-50% of patients with symptomatic congestive heart failure (CHF). Obstructive sleep apnea (OSA) is considered a cause of CHF, whereas central sleep apnea (CSA) is considered a response to heart failure, perhaps even compensatory. In the setting of heart failure, continuous positive airway pressure (CPAP) has a definite role in treating OSA with improvements in cardiac parameters expected. However in CSA, CPAP is an adjunctive therapy to other standard therapies directed towards the heart failure (pharmacological, device and surgical options). Whether adaptive servo controlled ventilatory support, a variant of CPAP, is beneficial is yet to be proven. Supplemental oxygen therapy should be used with caution in heart failure, in particular, by avoiding hyperoxia as indicated by SpO2 values >95%.

  9. Weighted congestion coefficient feedback in intelligent transportation systems

    NASA Astrophysics Data System (ADS)

    Dong, Chuan-Fei; Ma, Xu; Wang, Bing-Hong

    2010-03-01

    In traffic systems, a reasonable information feedback can improve road capacity. In this Letter, we study dynamics of traffic flow with real-time information. And the influence of a feedback strategy named Weighted Congestion Coefficient Feedback Strategy (WCCFS) is introduced, based on a two-route scenario in which dynamic information can be generated and displayed on the board to guide road users to make a choice. Our model incorporates the effects of adaptability into the cellular automaton models of traffic flow and simulation results adopting this optimal information feedback strategy have demonstrated high efficiency in controlling spatial distribution of traffic patterns compared with the other three information feedback strategies, i.e., vehicle number and flux.

  10. Psychobiology of depression/distress in congestive heart failure

    PubMed Central

    Hassan, Mustafa; Sheps, David S.

    2011-01-01

    Heart failure affects millions of Americans and new diagnosis rates are expected to almost triple over the next 30 years as our population ages. Affective disorders including clinical depression and anxiety are common in patients with congestive heart failure. Furthermore, the presence of these disorders significantly impacts quality of life, medical outcomes, and healthcare service utilization. In recent years, the literature has attempted to describe potential pathophysiologic mechanisms relating affective disorders and psychosocial stress to heart failure. Several potential mechanisms have been proposed including autonomic nervous system dysfunction, inflammation, cardiac arrhythmias, and altered platelet function. These mechanisms are reviewed in this article. Additional novel mechanisms such as mental stress-induced myocardial ischemia are also discussed. PMID:18368481

  11. Congestive heart failure from suspected ductal closure in utero.

    PubMed

    Arcilla, R A; Thilenius, O G; Ranniger, K

    1969-07-01

    This is the 1st case report of a ductal closure occurring during fetal growth. The case was a spontaneous delivery in cephalic presentation from a 31-year-old gravida 3, para 3 Black woman who had been treated with isoniazid and spreptomycin up to 2 months before her delivery. Gestational age was 37 weeks when the fetus was delivered weighing 3.15 kgm. The cord had been wrapped around the fetus's neck, and breathing was delayed 2 minutes. In the nursery, the baby's general condition was poor, and congestive heart failure was diagnosed. The newborn had trieuspid insufficiency, severe heart failure, and acidosis at birth. These disappeared the next day. Hemodynamic studies when the baby was 4 hours old showed a large cone-shaped ductus arteriousus extending from the pulmonary artery but ending blindly at the aortic end.

  12. 30 CFR 250.1607 - Field rules.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Field rules. 250.1607 Section 250.1607 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Sulphur Operations § 250.1607 Field rules. When geological and...

  13. 30 CFR 250.1607 - Field rules.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 2 2011-07-01 2011-07-01 false Field rules. 250.1607 Section 250.1607 Mineral... OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Sulphur Operations § 250.1607 Field rules. When geological and engineering information in a field enables a District Manager to...

  14. 17 CFR 200.29 - Rules.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 17 Commodity and Securities Exchanges 2 2011-04-01 2011-04-01 false Rules. 200.29 Section 200.29 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION ORGANIZATION; CONDUCT AND ETHICS; AND INFORMATION AND REQUESTS Organization and Program Management General Organization § 200.29 Rules....

  15. 17 CFR 200.29 - Rules.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 17 Commodity and Securities Exchanges 2 2013-04-01 2013-04-01 false Rules. 200.29 Section 200.29 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION ORGANIZATION; CONDUCT AND ETHICS; AND INFORMATION AND REQUESTS Organization and Program Management General Organization § 200.29 Rules....

  16. Venous Congestion, Endothelial and Neurohormonal Activation in Acute Decompensated Heart Failure: Cause or Effect?

    PubMed Central

    Colombo, Paolo C.; Doran, Amanda C.; Onat, Duygu; Wong, Ka Yuk; Ahmad, Myra; Sabbah, Hani N.; Demmer, Ryan T.

    2015-01-01

    Venous congestion and endothelial and neurohormonal activation are known to occur in acute decompensated heart failure (ADHF), yet the temporal role of these processes in the pathophysiology of decompensation is not fully understood. Conventional wisdom presumes congestion to be a consequence of worsening cardiovascular function; however, the biomechanically driven effects of venous congestion are biologically plausible contributors to ADHF that remain largely unexplored in vivo. Recent experimental evidence from human models suggests that fluid accumulation and venous congestion are not simply consequences of poor cardiovascular function, but rather are fundamental pro-oxidant, pro-inflammatory, and hemodynamic stimuli that contribute to acute decompensation. The latest advances in the monitoring of volume status using implantable devices allow for the detection of venous congestion before symptoms arise. This may ultimately lead to improved treatment strategies including not only diuretics, but also specific, adjuvant interventions to counteract endothelial and neurohormonal activation during early preclinical decompensation. PMID:25740404

  17. Enhanced TCP Congestion Control with Higher Utilization in Under-Buffered Links

    NASA Astrophysics Data System (ADS)

    Hyun, Dowon; Jang, Ju Wook

    TCP Reno is not fully utilized in under-buffered links. We propose a new TCP congestion control algorithm that can utilize the link almost up to 100% except the first congestion avoidance cycle. Our scheme estimates the minimum congestion window size for full link utilization in every congestion avoidance cycle and sends extra packets without touching TCP Reno congestion control. It has the same RTT fairness and the same saw-tooth wave as TCP Reno does. Our scheme does not affect competing TCP Reno flows since it uses only unused link capacity. We provide a simple mathematical modeling as well as ns-2 simulation results which show that the link utilization is improved by up to 19.88% for k=1/8 against TCP Reno when the buffer is k times the optimal buffer size. We claim that our scheme is useful for transmitting large amount of data in under-buffered links.

  18. Estimation of congestion in free disposal hull models using data envelopment analysis.

    PubMed

    Abbasi, M; Jahanshahloo, G R; Rostamy-Malkhlifeh, M; Hosseinzadeh Lotfi, F

    2014-01-01

    This paper deals with evaluating congestion in free disposal hull (FDH) models. There are several approaches in data envelopment analysis (DEA) literatures which discuss the theory and application of congestion. However, almost all of these approaches considered convex DEA technologies. So, in the case of nonconvex technologies, including FDH technology, this field is almost nil. This paper makes an attempt to fill in this void. To do so, this study provides a pairwise comparisons-based algorithm to evaluate congestion in FDH model. This algorithm identifies the sources of congestion and estimates its amounts. It is also capable of detecting the losses amounts of output due to congestion. The validity of the proposed model is demonstrated using some numerical and empirical examples.

  19. Clustering and congestion effects on cascading failures of scale-free networks

    NASA Astrophysics Data System (ADS)

    Zheng, J.-F.; Gao, Z.-Y.; Zhao, X.-M.

    2007-09-01

    In this work, we study cascading failures of scale-free networks by considering congestion effects, which should be very common in the transportation or communication systems. In terms of User Equilibrium condition, congestion effects can be described by cost functions or link performance functions, which map link flows to travel times. The cost on the link represents the travel time when passing through the link. Betweenness centrality of the link is introduced to define the "practical capacity" of the link in the cost function. Different from betweeness centrality, by considering congestion effects, load dynamics can be determined in a more meaningful way. Simulation results indicate that, due to congestion effects, load distribution may become sensitive to the initial node removals for the scale-free networks. Moreover, based on congestion effects, scale-free networks with larger clustering coefficients are more sensitive to cascading failures.

  20. Development of a mechanical device to replace medicinal leech (Hirudo medicinalis) for treatment of venous congestion.

    PubMed

    Conforti, Michael L; Connor, Nadine P; Heisey, Dennis M; Vanderby, Ray; Kunz, David; Hartig, Gregory K

    2002-01-01

    Medicinal leeches are used to treat venous congestion, a complication of reconstructive surgery. Despite substantial drawbacks of leeching, little progress has been made to develop a device that would replace the leech for this purpose. The goal of this study was to develop and test mechanical prototypes for the treatment of venous congestion. We tested four prototypes (1, 2, 3a, and 3b) using congested fasciocutaneous flaps in swine. Blood removed by each prototype was measured for up to 4 hours. On average, the four prototypes removed 609%, 644%, 853%, and 811% more blood, respectively, from congested flaps versus a leech. Prototypes 3a and 3b, which allowed for innovative subcutaneous chemical (3a and 3b) and mechanical (3b) anticoagulation at the bleeding wound, sustained high levels of blood removal for up to 4 hours. Thus, a mechanical device can potentially replace the use of leeches for treating venous congestion.

  1. Relationship Between Carbon Dioxide Levels and Reported Congestion and Headaches on the International Space Station

    NASA Technical Reports Server (NTRS)

    Cole, Robert; Wear, Mary; Young, Millennia; Cobel, Christopher; Mason, Sara

    2017-01-01

    Congestion is commonly reported during spaceflight, and most crewmembers have reported using medications for congestion during International Space Station (ISS) missions. Although congestion has been attributed to fluid shifts during spaceflight, fluid status reaches equilibrium during the first week after launch while congestion continues to be reported throughout long duration missions. Congestion complaints have anecdotally been reported in relation to ISS CO2 levels; this evaluation was undertaken to determine whether or not an association exists. METHODS: Reported headaches, congestion symptoms, and CO2 levels were obtained for ISS expeditions 2-31, and time-weighted means and single-point maxima were determined for 24-hour (24hr) and 7-day (7d) periods prior to each weekly private medical conference. Multiple imputation addressed missing data, and logistic regression modeled the relationship between probability of reported event of congestion or headache and CO2 levels, adjusted for possible confounding covariates. The first seven days of spaceflight were not included to control for fluid shifts. Data were evaluated to determine the concentration of CO2 required to maintain the risk of congestion below 1% to allow for direct comparison with a previously published evaluation of CO2 concentrations and headache. RESULTS: This study confirmed a previously identified significant association between CO2 and headache and also found a significant association between CO2 and congestion. For each 1-mm Hg increase in CO2, the odds of a crew member reporting congestion doubled. The average 7-day CO2 would need to be maintained below 1.5 mmHg to keep the risk of congestion below 1%. The predicted probability curves of ISS headache and congestion curves appear parallel when plotted against ppCO2 levels with congestion occurring at approximately 1mmHg lower than a headache would be reported. DISCUSSION: While the cause of congestion is multifactorial, this study showed

  2. The biosphere rules.

    PubMed

    Unruh, Gregory C

    2008-02-01

    Sustainability, defined by natural scientists as the capacity of healthy ecosystems to function indefinitely, has become a clarion call for business. Leading companies have taken high-profile steps toward achieving it: Wal-Mart, for example, with its efforts to reduce packaging waste, and Nike, which has removed toxic chemicals from its shoes. But, says Unruh, the director of Thunderbird's Lincoln Center for Ethics in Global Management, sustainability is more than an endless journey of incremental steps. It is a destination, for which the biosphere of planet Earth--refined through billions of years of trial and error--is a perfect model. Unruh distills some lessons from the biosphere into three rules: Use a parsimonious palette. Managers can rethink their sourcing strategies and dramatically simplify the number and types of materials their companies use in production, making recycling cost-effective. After the furniture manufacturer Herman Miller discovered that its leading desk chair had 200 components made from more than 800 chemical compounds, it designed an award-winning successor whose far more limited materials palette is 96% recyclable. Cycle up, virtuously. Manufacturers should design recovery value into their products at the outset. Shaw Industries, for example, recycles the nylon fiber from its worn-out carpet into brand-new carpet tile. Exploit the power of platforms. Platform design in industry tends to occur at the component level--but the materials in those components constitute a more fundamental platform. Patagonia, by recycling Capilene brand performance underwear, has achieved energy costs 76% below those for virgin sourcing. Biosphere rules can teach companies how to build ecologically friendly products that both reduce manufacturing costs and prove highly attractive to consumers. And managers need not wait for a green technological revolution to implement them.

  3. The 5-Second Rule

    MedlinePlus

    ... to Know About Puberty Train Your Temper The 5-Second Rule KidsHealth > For Kids > The 5-Second Rule Print A A A en español La regla ... drop it, he or she might have yelled, "5-second rule!" This so-called rule says food is OK ...

  4. A novel approach to monitoring pulmonary congestion in heart failure: initial animal and clinical experiences using remote dielectric sensing technology.

    PubMed

    Amir, Offer; Rappaport, Dan; Zafrir, Barak; Abraham, William T

    2013-01-01

    Despite current therapies and disease management approaches, rates of heart failure (HF) rehospitalization remain high. New tools are needed to assess preclinical (asymptomatic) pulmonary congestion to enable outpatient management. Hence, a novel monitoring system based on noninvasive remote dielectric sensing (ReDS) technology was developed. Validation of the ReDS technology was conducted in preclinical and clinical studies. In a porcine HF model, acute fluid overload followed by administration of diuretics were performed. Changes in ReDS values were correlated to serial computed tomographic (CT) assessments of lung fluid concentrations. In hospitalized decompensated HF patients, changes in ReDS values were correlated to net fluid balance changes. A nearly linear pattern between the changes in ReDS and CT fluid concentration values was observed in 6 discrete experiments (Intraclass correlation=0.95). Results from 24 patients demonstrated a reduction in ReDS values of 17.53%±11% throughout hospitalization, consistent with a reduction in pulmonary congestion. This finding strongly correlated with changes in net fluid balance (Pearson correlation=0.86; 95% confidence interval, 0.68-0.94; R(2) =0.74). These findings suggest that ReDS technology accurately quantifies lung fluid concentration and has potential for monitoring HF patients through hospitalization and possibly at home. © 2013 Wiley Periodicals, Inc.

  5. Medical Qualification Determinations. Final rule.

    PubMed

    2017-01-18

    The U.S. Office of Personnel Management (OPM) is issuing a final rule to revise its regulations for medical qualification determinations. The revised regulations update references and language; add and modify definitions; clarify coverage and applicability; address the need for medical documentation and medical examination and/or testing for an applicant or employee whose position may or may not have medical standards and/or physical requirements; and recommend the establishment of agency medical review boards. The final rule provides agencies guidance regarding medical evaluation procedures.

  6. Flight Rules Critical Readiness Review

    NASA Technical Reports Server (NTRS)

    Kim, E.; Knudsen, F.; Rice, S.

    2010-01-01

    The increment 23/24 Critical Readiness Review (CRR) flight rules are presented. The topics include: 1) B13-152 Acoustic Constraints; 2) B13-113 IFM/Corrective Action Prioritization Due to Loss of Exercise Capability; 3) B13-116 Constraints on Treadmill VIS Failure; 4) B13-201 Medical Management of ISS Fire/Smoke Response; 5) ARED and T2 Exercise constraints Flight rules (flight and stage specific); 6) FYI: B14 FR to be updated with requirement to sample crew sleep locations prior to receiving a "recommendation" from SRAG on where to sleep.

  7. 17 CFR 200.29 - Rules.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... INFORMATION AND REQUESTS Organization and Program Management General Organization § 200.29 Rules. The.... Where any such proposals presents a legal problem or is a matter of first impression, or involves a...

  8. Accounting principles, reporting rules, and payment practices.

    PubMed

    Kovener, R R

    1979-12-01

    Misconceptions concerning the distinction between accounting principles, reporting rules, and payment practices and how they interrelate can lessen the effectiveness of hospital financial managers in these areas/clarification and recommendations are offered.

  9. 43 CFR 4120.4 - Special rules.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR RANGE MANAGEMENT (4000) GRAZING ADMINISTRATION-EXCLUSIVE OF ALASKA Grazing Management § 4120.4 Special rules. (a) When a State Director determines that local conditions require a...

  10. 43 CFR 4120.4 - Special rules.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR RANGE MANAGEMENT (4000) GRAZING ADMINISTRATION-EXCLUSIVE OF ALASKA Grazing Management § 4120.4 Special rules. (a) When a State Director determines that local conditions require a...

  11. 43 CFR 4120.4 - Special rules.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR RANGE MANAGEMENT (4000) GRAZING ADMINISTRATION-EXCLUSIVE OF ALASKA Grazing Management § 4120.4 Special rules. (a) When a State Director determines that local conditions require a...

  12. Exploring feasibility of home telemanagement in African Americans with congestive heart failure.

    PubMed

    Finkelstein, Joseph; Cha, Eunme; Dennison, Cheryl R

    2010-01-01

    Existing telemonitoring systems provide limited support in implementing personalized treatment plans. We developed a Home Automated Telemanagement (HAT) system for patients with congestive heart failure (CHF) to provide support in following individualized treatment plans as well as to monitor symptoms, weight changes, and quality of life, while educating the patient on their disease. The system is designed to be placed in the patient's home and to communicate all patient data to a central server implementing real-time clinical decision support. The system questions the patient daily on their condition, monitors their weight, and provides the patient with instant feedback on their condition in the form of a 3-zone CHF action plan. Their medication regimen and suggested actions are determined by their care management team and integrated into the system, keeping a personalized approach to disease management while taking advantage of the technology available. The system is designed to be as simple as possible, making it usable by patients with no prior computer experience. A feasibility assessment in African American patients with CHF and without prior computer experience demonstrated high level of acceptance of the CHF HAT system.

  13. Rules to acquire by.

    PubMed

    Nolop, Bruce

    2007-09-01

    When Bruce Nolop was an investment banker, he saw only the glamorous side of acquisitions. Since becoming executive vice president and chief financial officer of Pitney Bowes, however, he's learned how hard it is to pull them off. In this article, he shares the lessons his organization has learned throughout its successful six-year acquisition campaign, which comprised more than 70 deals: Stick to adjacent spaces, take a portfolio approach, have a business sponsor, know how to judge an acquisition, and don't shop when you're hungry. Pitney Bowes's management and board of directors now use these five basic rules to chart the company's growth course. For example, when evaluating a potential acquisition, Pitney Bowes distinguishes between "platform" and "bolt-on" acquisitions to set expectations and guide integration efforts; the company applies different criteria, depending on the type. According to Nolop, any company can improve its acquisition track record if it is able to learn from experience, and he suspects that Pitney Bowes's rules apply just as well to other organizations. Buying a company should be treated like any other business process, he maintains. It should be approached deliberately and reviewed and improved constantly. That means mapping a complex chain of actions; paying attention to what can go right or wrong at different stages; and using standard, constantly honed, approaches and tools.

  14. 75 FR 57813 - Proposed Supplementary Rules on Public Land, Idaho

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-22

    ... Bureau of Land Management Proposed Supplementary Rules on Public Land, Idaho AGENCY: Bureau of Land Management, Interior. ACTION: Proposed supplementary rules. SUMMARY: The Bureau of Land Management (BLM... public lands in Idaho. The BLM is also proposing to prohibit the possession of an open alcoholic...

  15. 44 CFR 1.16 - Adoption of a final rule.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Adoption of a final rule. 1.16 Section 1.16 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT... Adoption of a final rule. (a) All timely comments will be considered in taking final action on a proposed...

  16. 44 CFR 1.16 - Adoption of a final rule.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Adoption of a final rule. 1.16 Section 1.16 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT... Adoption of a final rule. (a) All timely comments will be considered in taking final action on a proposed...

  17. 44 CFR 1.16 - Adoption of a final rule.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Adoption of a final rule. 1.16 Section 1.16 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT... Adoption of a final rule. (a) All timely comments will be considered in taking final action on a proposed...

  18. 44 CFR 1.16 - Adoption of a final rule.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Adoption of a final rule. 1.16 Section 1.16 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT... Adoption of a final rule. (a) All timely comments will be considered in taking final action on a proposed...

  19. Federal coal leasing proposed rules published

    SciTech Connect

    Not Available

    1981-12-30

    Proposed rules by the Bureau of Land Management (BLM) and the US Geological Survey (USGS) are designed to streamline the existing federal coal leasing rules and ultimately accelerate the offering of publicly-owned coal lands, according to an announcement by Interior Secretary James Watt. The rules were published in the December 16, 1981 federal Register. The BLM and the USGS proposed rules (which appear in the Code of Federal Regulations, Group 3400 of Title 43 and Part 211 of Title 30, respectively) are coordinated and cross-referenced to serve as a total revision of the Federal coal leasing program. The proposed rules maintain the existing structure of the Federal coal management program, but make several important modifications that strengthen the program and add needed flexibility.

  20. Congestive hepatic fibrosis score: a novel histologic assessment of clinical severity.

    PubMed

    Dai, Dao-Fu; Swanson, Paul E; Krieger, Eric V; Liou, Iris W; Carithers, Robert L; Yeh, Matthew M

    2014-12-01

    Chronic right heart failure predisposes to hepatic passive congestion and centrizonal necrosis that may lead to hepatic fibrosis (cardiac sclerosis). Although there have been several studies on the histologic features of congestive hepatopathy, there is no available grading system. In this study we developed a novel grading system for congestive hepatic fibrosis. Liver biopsies were examined in patients with chronic heart failure of various etiologies including congenital heart disease, idiopathic cardiomyopathy, ischemic heart disease, and valvular heart disease. The cases with available echocardiography and/or right heart catheterization were included. Cases with other types of underlying chronic liver diseases, alcoholic liver disease, significant steatosis (>20%), malignant neoplasm, and acute heart failure or shock were excluded. After exclusion, 42 cases were included in the study. We herein proposed a novel congestive hepatic fibrosis score and correlated it with the right heart structure and function obtained by echocardiography and/or right heart catheterization. Our results showed that congestive hepatic fibrosis score is well correlated with the right atrial pressure (P for trend <0.001). The presence of portal fibrosis (congestive hepatic fibrosis scores 2 and 3) is associated with significantly higher right atrial pressure than those with no fibrosis (P<0.001) or with centrizonal fibrosis only (P=0.02). Congestive hepatic fibrosis score is also significantly associated with increasing severity of right atrial dilatation (P=0.03) and right ventricular dilatation (P=0.02), indicators for chronic volume and/or pressure overload. Other histopathologic features include sinusoidal dilatation and centrizonal hepatocyte atrophy. In summary, although sinusoidal dilatation and centrizonal fibrosis are the hallmarks of hepatic passive congestion, the presence of portal fibrosis is suggestive of more advanced disease, as it correlates with more severe impairment

  1. The effects of congestions tax on air quality and health

    NASA Astrophysics Data System (ADS)

    Johansson, Christer; Burman, Lars; Forsberg, Bertil

    The "Stockholm Trial" involved a road pricing system to improve the air quality and reduce traffic congestion. The test period of the trial was January 3-July 31, 2006. Vehicles travelling into and out of the charge cordon were charged for every passage during weekdays. The amount due varied during the day and was highest during rush hours (20 SEK = 2.2 EUR, maximum 60 SEK per day). Based on measured and modelled changes in road traffic it was estimated that this system resulted in a 15% reduction in total road use within the charged cordon. Total traffic emissions in this area of NO x and PM10 fell by 8.5% and 13%, respectively. Air quality dispersion modelling was applied to assess the effect of the emission reductions on ambient concentrations and population exposure. For the situations with and without the trial, meteorological conditions and other emissions than from road traffic were kept the same. The calculations show that, with a permanent congestion tax system like the Stockholm Trial, the annual average NO x concentrations would be lower by up to 12% along the most densely trafficked streets. PM10 concentrations would be up to 7% lower. The limit values for both PM10 and NO 2 would still be exceeded along the most densely trafficked streets. The total population exposure of NO x in Greater Stockholm (35 × 35 km with 1.44 million people) is estimated to decrease with a rather modest 0.23 μg m -3. However, based on a long-term epidemiological study, that found an increased mortality risk of 8% per 10 μg m -3 NO x, it is estimated that 27 premature deaths would be avoided every year. According to life-table analysis this would correspond to 206 years of life gained over 10 years per 100 000 people following the trial if the effects on exposures would persist. The effect on mortality is attributed to road traffic emissions (likely vehicle exhaust particles); NO x is merely regarded as an indicator of traffic exposure. This is only the tip of the ice

  2. Diagnosis and Treatment of Depression in Patients With Congestive Heart Failure: A Review of the Literature

    PubMed Central

    Stern, Theodore A.; Hebert, Kathy A.; Musselman, Dominique L.

    2013-01-01

    Context: Major depressive disorder (MDD) can be challenging to diagnose in patients with congestive heart failure, who often suffer from fatigue, insomnia, weight changes, and other neurovegetative symptoms that overlap with those of depression. Pathophysiologic mechanisms (eg, inflammation, autonomic nervous system dysfunction, cardiac arrhythmias, and altered platelet function) connect depression and congestive heart failure. Objective: We sought to review the prevalence, diagnosis, neurobiology, and treatment of depression associated with congestive heart failure. Data Sources: A search of all English-language articles between January 2003 and January 2013 was conducted using the search terms congestive heart failure and depression. Study Selection: We found 1,498 article abstracts and 19 articles (meta-analyses, systematic reviews, and original research articles) that were selected for inclusion, as they contained information about our focus on diagnosis, treatment, and pathophysiology of depression associated with congestive heart failure. The search was augmented with manual review of reference lists of articles from the initial search. Articles selected for review were determined by author consensus. Data Extraction: The prevalence, diagnosis, neurobiology, and treatment of depression associated with congestive heart failure were reviewed. Particular attention was paid to the safety, efficacy, and tolerability of antidepressant medications commonly used to treat depression and how their side-effect profiles impact the pathophysiology of congestive heart failure. Drug-drug interactions between antidepressant medications and medications used to treat congestive heart failure were examined. Results: MDD is highly prevalent in patients with congestive heart failure. Moreover, the prevalence and severity of depression correlate with the degree of cardiac dysfunction and development of congestive heart failure. Depression increases the risk of congestive heart

  3. Quantum random walks on congested lattices and the effect of dephasing

    PubMed Central

    Motes, Keith R.; Gilchrist, Alexei; Rohde, Peter P.

    2016-01-01

    We consider quantum random walks on congested lattices and contrast them to classical random walks. Congestion is modelled on lattices that contain static defects which reverse the walker’s direction. We implement a dephasing process after each step which allows us to smoothly interpolate between classical and quantum random walks as well as study the effect of dephasing on the quantum walk. Our key results show that a quantum walker escapes a finite boundary dramatically faster than a classical walker and that this advantage remains in the presence of heavily congested lattices. PMID:26812924

  4. Reliable on-demand multicast routing with congestion control in wireless ad hoc networks

    NASA Astrophysics Data System (ADS)

    Tang, Ken; Gerla, Mario

    2001-07-01

    In this paper, we address the congestion control multicast routing problem in wireless ad hoc networks through the medium access control (MAC) layer. We first introduce the Broadcast Medium Window (BMW) MAC protocol, which provides reliable delivery to broadcast packets at the MAC layer. We then extend the wireless On-Demand Multicast Routing Protocol (ODMRP) to facilitate congestion control in ad hoc networks using BMW. Through simulation, we show that ODMRP with congestion control adapts well to multicast sources that are aggressive in data transmissions.

  5. Ability of physicians to diagnose congestive heart failure based on chest X-ray.

    PubMed

    Kennedy, Sarah; Simon, Barry; Alter, Harrison J; Cheung, Paul

    2011-01-01

    Chest X-ray interpretation is an important skill in the diagnosis of congestive heart failure (CHF) by emergency physicians. This study evaluated the ability of emergency physicians to recognize CHF on chest X-ray and the effect of level of training and confidence upon accuracy of interpretation. This was a prospective, blinded study in which 24 patients with an elevated brain natriuretic peptide, low ejection fraction, and diagnosis of CHF were retrospectively identified. In addition, 31 patients without CHF were identified and used as controls. These 55 chest X-rays were presented to emergency attending and housestaff and a radiologist. We calculated the accuracy of the raters' diagnoses, and measured their confidence in that diagnosis and their level of training. Physicians correctly identified the CHF chest X-rays 79% of the time (sensitivity 59%, specificity 96%; positive likelihood ratio 14.6, negative likelihood ratio 0.43). Accuracy ranged from a low of 78% among first-year residents to a high of 85% among attending, and from 73% (confidence rating of 3/5) to 91% (confidence rating of 5/5). Increasing confidence was significantly correlated with accuracy across the spectrum (p = 0.001). An accuracy of 95% among radiologists suggests that a negative X-ray does not rule out CHF. High specificity (96%) and low sensitivity (59%) suggest that emergency physicians are excellent at identifying CHF on X-ray when present, but under-call it frequently. Sensitivity may be much higher in real life given clinical correlation. Both increased level of training and higher confidence significantly improved accuracy. Copyright © 2011 Elsevier Inc. All rights reserved.

  6. 33 CFR 161.5 - Deviations from the rules.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) PORTS AND WATERWAYS SAFETY VESSEL TRAFFIC MANAGEMENT Vessel Traffic Services General Rules § 161.5... handling characteristics, traffic density, radar contacts, environmental conditions and other relevant...

  7. 33 CFR 161.5 - Deviations from the rules.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) PORTS AND WATERWAYS SAFETY VESSEL TRAFFIC MANAGEMENT Vessel Traffic Services General Rules § 161.5... handling characteristics, traffic density, radar contacts, environmental conditions and other relevant...

  8. Chronic vagal stimulation in patients with congestive heart failure.

    PubMed

    De Ferrari, Gaetano M; Sanzo, Antonio; Schwartz, Peter J

    2009-01-01

    Increased sympathetic and reduced vagal activity predict increased mortality in patients with congestive heart failure (CHF). Experimentally, vagal stimulation (VS) is protective both during acute myocardial ischemia and in chronic heart failure. In man, VS is used in refractory epilepsy but has never been used in cardiovascular diseases. Thus, there is a strong rationale to investigate the effects of chronic VS in patients with CHF. We assesses the feasibility and safety of chronic VS with CardioFit (BioControl Medical), a VS implantable system delivering pulses synchronous with heart beats to the right cervical vagus nerve in a preliminary pilot study in eight advanced CHF patients with favorable results, and subsequently in a larger multicenter study. Overall, 32 patients have been successfully implanted (mostly in NYHA Class III; mean age 56 years, ischemic etiology in 69%; prior implantable cardioverter-defibrillator (ICD) in 63%; concomitant beta blocker and angiotensin converting enzyme inhibitor (ACE-I) or angiotensin receptor blocker (ARB) in 100%). Preliminary results confirm feasibility of the study, an acceptable side effect profile and promising preliminary efficacy data. Several mechanisms may contribute to the beneficial effect observed in patients with heart failure. Should these results be confirmed in larger controlled studies, chronic vagal stimulation could be a further treatment option for CHF patients, possibly integrated with defibrillator and resynchronization therapies.

  9. Prognosis and possible presymptomatic manifestations of congestive cardiomyopathy (COCM).

    PubMed Central

    Kuhn, H.; Breithardt, G.; Knieriem, H. J.; Köhler, E.; Lösse, B.; Seipel, L.; Loogen, F.

    1978-01-01

    In order to find evidence of prognosis and of presymptomatic manifestation of congestive cardiomyopathy (COCM) in fifty-eight patients, the extent of morphological changes of endomyocardial catheter biopsy (EMCB), clinical and haemodynamic data were correlated to the clinical course. In addition, clinical, haemodynamic, angiographic, morphological and His-bundle electrographic studies were performed in patients with left bundle branch block (LBBB), normal left ventricular end-diastolic volume, and normal coronary arteries (n = 43). Related to a 10-year mortality rate of 70% from the onset of symptoms, COCM is one of the most severe heart diseases. Endomyocardial catheter biopsy (EMCB) allowed clear prognostic separation in patients with COCM and seems to be of diagnostic value in patients with only slightly enlarged hearts and in patients with a short history of symptoms. The studies also revealed much evidence that at least some patients with LBBB, normal left ventricular end-diastolic volume (LVEDV) and normal coronary arteries exhibit an early stage of COCM. In these patients especially EMCB with severe changes of heart muscle cells and/or impaired left ventricular function may indicate subsequent COCM. So that there is now a new indication for performing EMCB. PMID:704515

  10. Body fluid distribution in elderly subjects with congestive heart failure.

    PubMed

    Sergi, Giuseppe; Lupoli, Lucia; Volpato, Stefania; Bertani, Roberta; Coin, Alessandra; Perissinotto, Egle; Calliari, Irene; Inelmen, Emine Meral; Busetto, Luca; Enzi, Giuliano

    2004-01-01

    The aims of this study were to investigate body fluid changes in elderly patients suffering from congestive heart failure (CHF) and to identify the fluid measurement that best characterizes fluid overload states in CHF patients by comparison with normal hydration in the elderly. In a case-controlled experimental design, 72 elderly subjects (65-98 yr), 38 healthy and 34 with CHF, were studied. Total body water (TBW) and extracellular water (ECW) were determined by dilution methods; fat-free mass (FFM) and fat mass (FM) were determined by dual-energy X-ray absorptiometry (DEXA). In healthy subjects, the FFM hydration expressed as TBW% FFM (males 72.0 +/- 4.3 vs females 72.4 +/- 5.0%) and ECW% TBW (males 47.3 +/- 3.4 vs females 47.8 +/- 5.1) were similar in both genders. ECW in liters for FFM and for TBW (ECW% TBW), corrected for body weight, was greater in the group with CHF than in the control group, in both sexes. Among the relative fluid measures, only ECW% TBW [odds ratio (OR) 1.5] independently predicted fluid retention. Having an ECW% TBW greater than 50% corresponded to an OR of about 10. In conclusion, elderly patients suffering from CHF have a characteristic increase in body fluid levels, mainly affecting the extracellular compartment, and ECW% TBW is a useful indicator of fluid retention.

  11. Atrial natriuretic factor binding sites in experimental congestive heart failure

    SciTech Connect

    Bianchi, C.; Thibault, G.; Wrobel-Konrad, E.; De Lean, A.; Genest, J.; Cantin, M. )

    1989-10-01

    A quantitative in vitro autoradiographic study was performed on the aorta, renal glomeruli, and adrenal cortex of cardiomyopathic hamsters in various stages of heart failure and correlated, in some instances, with in vivo autoradiography. The results indicate virtually no correlation between the degree of congestive heart failure and the density of 125I-labeled atrial natriuretic factor ((Ser99, Tyr126)ANF) binding sites (Bmax) in the tissues examined. Whereas the Bmax was increased in the thoracic aorta in moderate and severe heart failure, there were no significant changes in the zona glomerulosa. The renal glomeruli Bmax was lower in mild and moderate heart failure compared with control and severe heart failure. The proportion of ANF B- and C-receptors was also evaluated in sections of the aorta, adrenal, and kidney of control and cardiomyopathic hamsters with severe heart failure. (Arg102, Cys121)ANF (des-(Gln113, Ser114, Gly115, Leu116, Gly117) NH2) (C-ANF) at 10(-6) M displaced approximately 505 of (Ser99, Tyr126)125I-ANF bound in the aorta and renal glomeruli and approximately 20% in the adrenal zona glomerulosa in both series of animals. These results suggest that ANF may exert a buffering effect on the vasoconstriction of heart failure and to a certain extent may inhibit aldosterone secretion. The impairment of renal sodium excretion does not appear to be related to glomerular ANF binding sites at any stage of the disease.

  12. Practical Rate-Based Congestion Control for Wireless Mesh Networks

    NASA Astrophysics Data System (ADS)

    Elrakabawy, Sherif M.; Lindemann, Christoph

    We introduce an adaptive pacing scheme to overcome the drawbacks of TCP in wireless mesh networks with Internet connectivity. The pacing scheme is implemented at the wireless TCP sender as well as at the mesh gateway, and reacts according to the direction of TCP flows running across the wireless network and the Internet. TCP packets are transmitted rate-based within the TCP congestion window according to the current out-of-interference delay and the coefficient of variation of recently measured round-trip times. Opposed to the majority of previous work which builds on simulations, we implement a Linux prototype of our approach and evaluate its feasibility in a real 20-node mesh testbed. In an experimental performance study, we compare the goodput and fairness of our approach against the widely deployed TCP NewReno. Experiments show that our approach, which we denote as Mesh Adaptive Pacing (MAP), can achieve up to 150% more goodput than TCP NewReno and significantly improves fairness between competing flows. MAP is incrementally deployable since it is TCP-compatible, does not require cross-layer information from intermediate nodes along the path, and requires no modifications in the wired domain.

  13. Optimal information transmission in organizations: search and congestion

    SciTech Connect

    Arenas, A.; Cabrales, A.; Danon, L.; Diaz-Guilera, A.; Guimera, R.; Vega-Redondo, F.

    2008-01-01

    We propose a stylized model of a problem-solving organization whose internal communication structure is given by a fixed network. Problems arrive randomly anywhere in this network and must find their way to their respective specialized solvers by relying on local information alone. The organization handles multiple problems simultaneously. For this reason, the process may be subject to congestion. We provide a characterization of the threshold of collapse of the network and of the stock of floating problems (or average delay) that prevails below that threshold. We build upon this characterization to address a design problem: the determination of what kind of network architecture optimizes performance for any given problem arrival rate. We conclude that, for low arrival rates, the optimal network is very polarized (i.e. star-like or centralized), whereas it is largely homogeneous (or decentralized) for high arrival rates. These observations are in line with a common transformation experienced by information-intensive organizations as their work flow has risen in recent years.

  14. Pelvic congestion syndrome masquerading as osteoarthritis of the hip

    PubMed Central

    Dos Santos, Scott J; Whiteley, Mark S

    2016-01-01

    Objectives: Pelvic congestion syndrome (PCS) is associated with pelvic vein reflux (PVR), occasionally secondary to venous compression. Its symptoms, usually intra-pelvic, are alleviated following the abolition of this reflux by pelvic vein embolisation (PVE). The objective of this report is to present two cases of left hip pain, erroneously diagnosed as osteoarthritis, which disappeared after successful PVE and abolition of PVR. Methods: Two females presented with lower limb varicose veins, and also had a history of left-sided hip pain. Both had previously been investigated for the hip pain and diagnosed as osteoarthritis despite minimal arthritic changes on pelvic X-rays. During investigation for lower limb varicose veins, both showed a pelvic origin for their leg veins and hence underwent transvaginal duplex ultrasound. This revealed PVR, and PVE was planned in both patients. Results: Both patients underwent PVE and reported ‘miraculous’ resolution of left hip pain and also PCS symptoms including pelvic pain, irritable bowel issues and the disappearance of pelvic dragging, with almost immediate disappearance of vulval and vaginal varicosities. One patient also noted reduced clitoral sensitivity. Conclusion: Manifestations of PCS may vary in terms of intra- or extra-pelvic signs. PCS and PVR should be considered in the differential diagnosis of patients with arthritic symptoms in the hip without evident radiographic evidence. PMID:27994874

  15. Cheyne-Stokes respiration in patients with congestive heart failure.

    PubMed

    Brack, Thomas

    2003-12-13

    Cheyne-Stokes Respiration (CSR) is a breathing pattern characterised by rhythmic oscillation of tidal volume with regularly recurring periods of hyperpnoea, hypopnoea and apnoea. CSR is no longer solely regarded as a symptom of severe congestive heart failure (CHF), but has been recognised as an independent risk factor for worsening heart failure and reduced survival in patients with CHF. CSR is associated with frequent awakening that fragment sleep and with concomitant sympathetic activation both of which may worsen CHF. Cheyne-Stokes Respiration is very common in patients with severe CHF and its prevalence may have been underestimated in the past due to technical limitations that precluded respiratory monitoring outside sleep laboratories. Since treatment of CSR appears to be beneficial and safe, patients at risk should be promptly diagnosed and treated. Treatment of CSR has been demonstrated to improve left ventricular ejection fraction and potentially prolongs survival in patients with severe CHF. This article briefly summarises the current knowledge of the patho-physiology, prevalence and therapy of Cheyne-Stokes respiration.

  16. A Remote Patient Monitoring System for Congestive Heart Failure

    PubMed Central

    Suh, Myung-kyung; Chen, Chien-An; Woodbridge, Jonathan; Tu, Michael Kai; Kim, Jung In; Nahapetian, Ani; Evangelista, Lorraine S.; Sarrafzadeh, Majid

    2011-01-01

    Congestive heart failure (CHF) is a leading cause of death in the United States affecting approximately 670,000 individuals. Due to the prevalence of CHF related issues, it is prudent to seek out methodologies that would facilitate the prevention, monitoring, and treatment of heart disease on a daily basis. This paper describes WANDA (Weight and Activity with Blood Pressure Monitoring System); a study that leverages sensor technologies and wireless communications to monitor the health related measurements of patients with CHF. The WANDA system is a three-tier architecture consisting of sensors, web servers, and back-end databases. The system was developed in conjunction with the UCLA School of Nursing and the UCLA Wireless Health Institute to enable early detection of key clinical symptoms indicative of CHF-related decompensation. This study shows that CHF patients monitored by WANDA are less likely to have readings fall outside a healthy range. In addition, WANDA provides a useful feedback system for regulating readings of CHF patients. PMID:21611788

  17. [Congestive heart failure in patients with chronic kidney disease].

    PubMed

    Poskurica, Mileta; Petrović, Dejan

    2014-01-01

    Cardiovascular disorders are the most frequent cause of death (46-60%) among patients with advanced chronic renal failure (CRF), and on dialysis treatment. Uremic cardiomyopathy is the basic pathophysiologic substrate, whereas ischemic heart disease (IHD) and anemia are the most important contributing factors. Associated with well-know risk factors and specific disorders for terminal kidney failure and dialysis, the aforementioned factors instigate congestive heart failure (CHF). Suspected CHF is based on the anamnesis, clinical examination and ECG, while it is confirmed and defined more precisely on the basis of echocardiography and radiology examination. Biohumoral data (BNP, NT-proBNP) are not sufficiently reliable because of specific volemic fluctuation and reduced natural clearance. Therapy approach is similar to the one for the general population: ACEI, ARBs, β-blockers, inotropic drugs and diuretics. Hypervolemia and most of the related symptoms can be kept under control effectively by the isolated or ultrafiltation, in conjunction with dialysis, during the standard bicarbonate hemodialysis or hemodiafiltration. In the same respect peritoneal dialysis is efficient for the control of hypervolemia symptoms, mainly during the first years of its application and in case of the lower NYHA class (II°/III°). In general, heart support therapy, surgical interventions of the myocardium and valve replacement are rarely used in patients on dialysis, whereas revascularization procedures are beneficial for associated IHD. In selected cases the application of cardiac resynchronization and/or implantation of a cardioverter defibrillator are advisable.

  18. Congestive heart failure in children with pneumonia and respiratory failure.

    PubMed

    Nimdet, Kachaporn; Techakehakij, Win

    2017-03-01

    Congestive heart failure (CHF) is one of the most common cardiac complications of pneumonia in adulthood leading to increased risk of morbidity and mortality. Little is known, however, of CHF and pneumonia in children. The aim of this study was therefore to investigate the characteristics and factors associated with CHF in under-5 children with pneumonia and respiratory failure. A retrospective cohort was conducted in hospitalized patients aged 2-59 months with community-acquired pneumonia and respiratory failure from June 2011 to June 2014 at Suratthani Hospital, Thailand. The characteristics, therapeutic strategy, and clinical outcomes of CHF were reviewed. Baseline characteristics and basic laboratory investigations on admission were compared between the CHF and non-CHF groups. Of 135 patients, 14 (10%) had CHF. Compared with patients without CHF, the CHF group had prolonged intubation and hospital stay and high rates of associated complications such as ventilator-associated pneumonia, sepsis, shock, and 30 day mortality. CHF was significantly associated with certain characteristics, including male sex and bacterial pneumonia. Pneumonia with respiratory failure is associated with CHF even in healthy children without cardiac risks. The awareness and early recognition of CHF, particularly in male, and bacterial pneumonia, is important in order to provide immediate treatment to reduce complications. © 2016 Japan Pediatric Society.

  19. A case of severe hypoalbuminemia associated with chronic congestive heart failure: the role of the tricuspid regurgitation.

    PubMed

    Alexa, Ioana Dana; Ilie, Adina Carmen; Moroşanu, Anca; Crăcană, Irina; Onuţu, Ramona; Voica, Ana

    2014-01-01

    Hypoalbuminemia is considered an independent predictor of mortality, especially in elderly patients. It is common in patients with congestive heart failure, when is due to several mechanisms: increased volume of distribution, significant stasis in the mesenteric circulation and altered protein metabolism in the liver. These alterations are even more pregnant when tricuspid regurgitation is associated or aggravated by different risk factors (recent infections, anemia, hyperthyroidism). We present the case of an elderly patient with severe hypoproteinemia and important hypoalbuminemia associated with congestive heart failure and aggravation of tricuspid regurgitation. The differential diagnosis concluded that hypoalbuminemia was influenced by tricuspid regurgitation as it enhanced liver dysfunction and enteral protein absorption due to increased stasis in mesenteric system. On the other hand, hypoalbuminemia contributed to the progression of heart failure by favoring myocardial edema, volume overload, and diuretic resistance. This is why correct management of this situation should include removal of subclinical excess of fluid and renutrition. A multidisciplinary approach is needed in order to achieve a good control of the symptoms and a significant improvement of quality of life.

  20. 44 CFR 7.920 - Rules against discrimination.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Rules against discrimination... Standards for Determining Age Discrimination § 7.920 Rules against discrimination. The rules stated in this... denied the benefits of, or be subjected to discrimination under, any program or activity receiving...

  1. 42 CFR 35.1 - Hospital and station rules.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Hospital and station rules. 35.1 Section 35.1... EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.1 Hospital and station rules. The officer in charge of a station or hospital of the Service is authorized to adopt such rules and issue such instructions...

  2. 42 CFR 35.2 - Compliance with hospital rules.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Compliance with hospital rules. 35.2 Section 35.2... EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.2 Compliance with hospital rules. All patients and visitors in stations and hospitals of the Service are expected to comply with the rules and instructions...

  3. 41 CFR 101-8.704 - Rules against age discrimination.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 2 2013-07-01 2012-07-01 true Rules against age... FEDERAL FINANCIAL ASSISTANCE 8.7-Discrimination Prohibited on the Basis of Age § 101-8.704 Rules against age discrimination. The rules stated in this section are limited by the exceptions contained in §...

  4. 41 CFR 101-8.704 - Rules against age discrimination.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true Rules against age... FEDERAL FINANCIAL ASSISTANCE 8.7-Discrimination Prohibited on the Basis of Age § 101-8.704 Rules against age discrimination. The rules stated in this section are limited by the exceptions contained in §...

  5. 41 CFR 101-8.704 - Rules against age discrimination.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 41 Public Contracts and Property Management 2 2014-07-01 2012-07-01 true Rules against age... FEDERAL FINANCIAL ASSISTANCE 8.7-Discrimination Prohibited on the Basis of Age § 101-8.704 Rules against age discrimination. The rules stated in this section are limited by the exceptions contained in §...

  6. 41 CFR 101-8.704 - Rules against age discrimination.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 41 Public Contracts and Property Management 2 2012-07-01 2012-07-01 false Rules against age... FEDERAL FINANCIAL ASSISTANCE 8.7-Discrimination Prohibited on the Basis of Age § 101-8.704 Rules against age discrimination. The rules stated in this section are limited by the exceptions contained in §...

  7. 41 CFR 101-8.704 - Rules against age discrimination.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Rules against age... FEDERAL FINANCIAL ASSISTANCE 8.7-Discrimination Prohibited on the Basis of Age § 101-8.704 Rules against age discrimination. The rules stated in this section are limited by the exceptions contained in §...

  8. Phonological reduplication in sign language: Rules rule.

    PubMed

    Berent, Iris; Dupuis, Amanda; Brentari, Diane

    2014-01-01

    Productivity-the hallmark of linguistic competence-is typically attributed to algebraic rules that support broad generalizations. Past research on spoken language has documented such generalizations in both adults and infants. But whether algebraic rules form part of the linguistic competence of signers remains unknown. To address this question, here we gauge the generalization afforded by American Sign Language (ASL). As a case study, we examine reduplication (X→XX)-a rule that, inter alia, generates ASL nouns from verbs. If signers encode this rule, then they should freely extend it to novel syllables, including ones with features that are unattested in ASL. And since reduplicated disyllables are preferred in ASL, such a rule should favor novel reduplicated signs. Novel reduplicated signs should thus be preferred to nonreduplicative controls (in rating), and consequently, such stimuli should also be harder to classify as nonsigns (in the lexical decision task). The results of four experiments support this prediction. These findings suggest that the phonological knowledge of signers includes powerful algebraic rules. The convergence between these conclusions and previous evidence for phonological rules in spoken language suggests that the architecture of the phonological mind is partly amodal.

  9. Processes and Outcomes of Congestive Heart Failure Care by Different Types of Primary Care Models.

    PubMed

    Kuo, Yong-Fang; Adhikari, Deepak; Eke, Chiemeziem G; Goodwin, James S; Raji, Mukaila A

    2017-09-01

    Having nurse practitioners (NPs) as primary care providers for patients with congestive heart failure (CHF) is one way to address the growing shortage of primary care physicians (PCPs). We used inverse probability of treatment weighted with propensity score to examine the processes and outcomes of care for patients under three care models. Approximately 72.9%, 0.8%, and 26.3% of CHF patients received care under the PCP model, the NP model, and the shared care model, respectively. Patients under the NP or shared care models were more likely than those under the PCP model to be referred to cardiologists (OR=1.35, 95%CI:1.32-1.37 and OR=1.32, 95%CI:1.30-1.35) and to get guideline-recommended medications. NPs and PCPs had similar rates of ER visits and Medicare spending after adjusting for processes of care. Patients under the shared care model had a higher burden of comorbidity and experienced a higher rate of ER visits and hospitalizations than those under the PCP model. The delivery of CHF care mirrors the severity of comorbidity in these patients. The high rate of hospitalization and ER visits in the shared care model underscores the need to design and implement more effective chronic disease management and integrated care programs. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Two Rules for Communication

    ERIC Educational Resources Information Center

    Hamilton, Mark R.

    2005-01-01

    One of the most important and most difficult skills of academic leadership is communication. In this column, the author defines what he considers to be the two most important rules for communication. The first rule, which he terms the "Great American Rule," involves trusting that the person on the other end of the line or the fax or the e-mail is…

  11. A Better Budget Rule

    ERIC Educational Resources Information Center

    Dothan, Michael; Thompson, Fred

    2009-01-01

    Debt limits, interest coverage ratios, one-off balanced budget requirements, pay-as-you-go rules, and tax and expenditure limits are among the most important fiscal rules for constraining intertemporal transfers. There is considerable evidence that the least costly and most effective of such rules are those that focus directly on the rate of…

  12. Modifying Intramural Rules.

    ERIC Educational Resources Information Center

    Rokosz, Francis M.

    1981-01-01

    Standard sports rules can be altered to improve the game for intramural participants. These changes may improve players' attitudes, simplify rules for officials, and add safety features to a game. Specific rule modifications are given for volleyball, football, softball, floor hockey, basketball, and soccer. (JN)

  13. A Better Budget Rule

    ERIC Educational Resources Information Center

    Dothan, Michael; Thompson, Fred

    2009-01-01

    Debt limits, interest coverage ratios, one-off balanced budget requirements, pay-as-you-go rules, and tax and expenditure limits are among the most important fiscal rules for constraining intertemporal transfers. There is considerable evidence that the least costly and most effective of such rules are those that focus directly on the rate of…

  14. 5-Second Rule

    MedlinePlus

    ... I Help Someone Who's Being Bullied? Volunteering The 5-Second Rule KidsHealth > For Teens > The 5-Second Rule Print A A A Almost everyone ... wanted to eat it. Some people apply the "5-second rule" — that random saying about how food ...

  15. Chance Constrained Input Relaxation to Congestion in Stochastic DEA. An Application to Iranian Hospitals.

    PubMed

    Kheirollahi, Hooshang; Matin, Behzad Karami; Mahboubi, Mohammad; Alavijeh, Mehdi Mirzaei

    2015-01-01

    This article developed an approached model of congestion, based on relaxed combination of inputs, in stochastic data envelopment analysis (SDEA) with chance constrained programming approaches. Classic data envelopment analysis models with deterministic data have been used by many authors to identify congestion and estimate its levels; however, data envelopment analysis with stochastic data were rarely used to identify congestion. This article used chance constrained programming approaches to replace stochastic models with "deterministic equivalents". This substitution leads us to non-linear problems that should be solved. Finally, the proposed method based on relaxed combination of inputs was used to identify congestion input in six Iranian hospital with one input and two outputs in the period of 2009 to 2012.

  16. Hyponatraemia and congestive heart failure refractory to diuretic treatment. Utility of tolvaptan.

    PubMed

    Pose, A; Almenar, L; Manzano, L; Gavira, J J; López Granados, A; Delgado, J; Aramburu, O; Arévalo, J C; Méndez, M; Comín, J; Manito, N

    2017-10-01

    Heart failure (HF) is currently one of the most significant healthcare problems in Spain and has a continuously increasing prevalence. Advances in our understanding of the various biological responses that promote cardiac remodelling and pulmonary venous congestion constitute the basis of current treatment. This article, prepared by members of the HF groups of the Spanish Society of Cardiology and the Spanish Society of Internal Medicine, discusses the current therapeutic strategies for patients with congestion refractory to diuretic treatment. The article includes our clinical experience with the use of tolvaptan as an additional treatment for congestion associated with hyponatraemia. To this end, we propose an algorithm for the use of tolvaptan in patients with congestive HF, natraemia <130mEq/l and poor response to conventional diuretic treatment. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  17. 78 FR 67442 - Congestion Mitigation and Air Quality Improvement Program Interim Guidance

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-12

    ... Federal Highway Administration Congestion Mitigation and Air Quality Improvement Program Interim Guidance... Mitigation and Air Quality Improvement (CMAQ) Program (Interim Guidance). The Interim Guidance revises CMAQ....gov/environment/air_quality/cmaq/policy_and_guidance/2008_guidance/ guidance/. DATES: This...

  18. Effects of tolvaptan on congestive heart failure complicated with chylothorax in a neonate.

    PubMed

    Sato, Nikiko; Sugiura, Tokio; Nagasaki, Rika; Suzuki, Kazutaka; Ito, Koichi; Kato, Takenori; Inukai, Sachiko; Saitoh, Shinji

    2015-10-01

    Tolvaptan is an oral vasopressin type 2 receptor antagonist that can be used for heart failure patients with hyponatremia or symptomatic congestion. Although the effects of tolvaptan in adults have been well documented, only limited information is available in children. The case of a neonate with congestive heart failure complicated with chylothorax after palliative surgery for transposition of the great arteries treated with tolvaptan is reported. Slow up-titration to 0.1 mg/kg successfully increased urine output and improved refractory congestive heart failure without hypernatremia. Subsequently, bodyweight and chylothorax decreased gradually. Moreover, the use of tolvaptan reduced the dosage of furosemide. Tolvaptan could be an alternative drug for neonates with congestive heart failure. Further large studies are needed to confirm the efficacy and identify the appropriate dose of tolvaptan in neonates.

  19. Acute and long-term renal and metabolic effects of piretanide in congestive cardiac failure.

    PubMed Central

    McNabb, W R; Noormohamed, F H; Lant, A F

    1988-01-01

    ). Piretanide was well tolerated, and effective in the management of congestive cardiac failure without any other recognized metabolic or electrolyte changes. PMID:3207551

  20. A Study of Congestion in the Kansas City Southern Railway System

    DTIC Science & Technology

    2007-11-02

    used to test power’s relation to congestion. Friedman’s Rank Test , a nonparametric statistical model, tests the significance of power against eight...other factors in their relation to train delays. The second model tests the correlation between train time delays and number of ൬-hour cars." This...Pacific are summarized. Two quantitative models are used to test power’s relation to congestion. Friedman’s Rank Test , a nonparametric statistical model

  1. The prevalence, aetiology and treatment of congestive cardiac failure in Antigua and Barbuda.

    PubMed

    McSwain, M; Martin, T C; Amaraswamy, R

    1999-09-01

    A retrospective review of the cases of congestive heart failure admitted to Holberton Hospital in Antigua in 1995 and 1996 was undertaken. Two hundred and ninety-three (293) patients were identified by International Statistical Classification of Diseases, 10th revision (ICD-10) coding as having congestive cardiac failure in the period but only 138 charts were either available or fitted the definition of congestive cardiac failure and these provided the basis for this analysis. The average age of patients admitted for congestive cardiac failure was 69 years (range: 5 months to 99 years), and 63% were female. the aetiology of congestive cardiac failure was hypertension (41%), ischaemia (33%), valvular (12%), alcohol related (2%), idiopathic (5%) and mixed (7%). Treatment included diuretics (95%), angiotensin converting enzyme inhibitors (78%), digoxin (75%), nitrates (34%), calcium channel blockers (25%), other vasodilators (7%) and antiarrhythmics (5%). Of those with congestive heart failure, diabetes was present in 38%, atrial fibrillation in 19%, renal insufficiency in 17%, elevated cholesterol in 11%, obesity in 9% and tobacco use in 7%. The in-hospital mortality in the 2-year period was 17.4% (females 15%, males 22%, 11% < 65 years, 20% > 65 years, 14% for those with 1 to 3 admissions and 83% for those with > 3 admissions, 19% for those with atrial fibrillation and 16% for those without). The prevalence of congestive cardiac failure utilizing the data analysed in this study (138 patients) was 0.21% of the population of the island state but based on the discharge diagnosis using ICD-10 coding it was 0.5%; it was 1% in the 40 to 65-year-age group and 4% in those > 65 years of age. The patients in this study represented only those with New York Heart Association (NYHA) classes III and IV, hence the true prevalence would be higher than recorded here. Congestive cardiac failure is emerging as a significant health problem in Antigua and Barbuda.

  2. A source-based congestion control strategy for real-time video transport on IP network

    NASA Astrophysics Data System (ADS)

    Chen, Xia; Cai, Canhui

    2005-07-01

    The goal of this paper is to design a TCP friendly real-time video transport protocol that will not only utilize network resource efficiently, but also prevent network congestion from the real-time video transmitting effectively. To this end, we proposed a source based congestion control scheme to adapt video coding rate to the channel capacity of the IP network, including three stages: rate control, rate-adaptive video encoding, and rate shaping.

  3. Congestive cardiomyopathy and endobronchial granulomas as manifestations of Churg-Strauss syndrome.

    PubMed Central

    Alvarez-Sala, R.; Prados, C.; Armada, E.; Del Arco, A.; Villamor, J.

    1995-01-01

    Churg-Strauss syndrome is a systemic vasculitis. Its most frequent complications are heart diseases and asthma. Usually, cardiological manifestations are pericarditis, cardiac failure and myocardial infarction. Endobronchial granulomas identified by bronchoscopy are unusual. We present the case of a man with congestive cardiomyopathy and endobronchial granulomas macroscopically visible at bronchoscopy. After a review of medical literature, we found one case of congestive cardiomyopathy and no cases of endobronchial granulomas observed by bronchoscopy associated with Churg-Strauss syndrome. Images Figure PMID:7644400

  4. Algorithm and data support of traffic congestion forecasting in the controlled transport

    NASA Astrophysics Data System (ADS)

    Dmitriev, S. V.

    2015-06-01

    The topicality of problem of the traffic congestion forecasting in the logistic systems of product movement highways is considered. The concepts: the controlled territory, the highway occupancy by vehicles, the parking and the controlled territory are introduced. Technical realizabilityof organizing the necessary flow of information on the state of the transport system for its regulation has been marked. Sequence of practical implementation of the solution is given. An algorithm for predicting traffic congestion in the controlled transport system is suggested.

  5. Rules on determining hearing appearances. Final rule.

    PubMed

    2013-05-21

    This final rule is another step in our continual efforts to handle workloads more effectively and efficiently. We are publishing final rules for portions of the rules we proposed in October 2007 that relate to persons, other than the claimant or any other party to the hearing, appearing by telephone. We are also clarifying that the administrative law judge (ALJ) will allow the claimant or any other party to a hearing to appear by telephone under certain circumstances when the claimant or other party requests to make his or her appearance in that manner. We expect that these final rules will make the hearings process more efficient and help us continue to reduce the hearings backlog. In addition, we made some minor editorial changes to our regulations that do not have any effect on the rights of claimants or any other parties.

  6. Conformance Testing: Measurement Decision Rules

    NASA Technical Reports Server (NTRS)

    Mimbs, Scott M.

    2010-01-01

    The goal of a Quality Management System (QMS) as specified in ISO 9001 and AS9100 is to provide assurance to the customer that end products meet specifications. Measuring devices, often called measuring and test equipment (MTE), are used to provide the evidence of product conformity to specified requirements. Unfortunately, processes that employ MTE can become a weak link to the overall QMS if proper attention is not given to the measurement process design, capability, and implementation. Documented "decision rules" establish the requirements to ensure measurement processes provide the measurement data that supports the needs of the QMS. Measurement data are used to make the decisions that impact all areas of technology. Whether measurements support research, design, production, or maintenance, ensuring the data supports the decision is crucial. Measurement data quality can be critical to the resulting consequences of measurement-based decisions. Historically, most industries required simplistic, one-size-fits-all decision rules for measurements. One-size-fits-all rules in some cases are not rigorous enough to provide adequate measurement results, while in other cases are overly conservative and too costly to implement. Ideally, decision rules should be rigorous enough to match the criticality of the parameter being measured, while being flexible enough to be cost effective. The goal of a decision rule is to ensure that measurement processes provide data with a sufficient level of quality to support the decisions being made - no more, no less. This paper discusses the basic concepts of providing measurement-based evidence that end products meet specifications. Although relevant to all measurement-based conformance tests, the target audience is the MTE end-user, which is anyone using MTE other than calibration service providers. Topics include measurement fundamentals, the associated decision risks, verifying conformance to specifications, and basic measurement

  7. Large-Scale Transportation Network Congestion Evolution Prediction Using Deep Learning Theory

    PubMed Central

    Ma, Xiaolei; Yu, Haiyang; Wang, Yunpeng; Wang, Yinhai

    2015-01-01

    Understanding how congestion at one location can cause ripples throughout large-scale transportation network is vital for transportation researchers and practitioners to pinpoint traffic bottlenecks for congestion mitigation. Traditional studies rely on either mathematical equations or simulation techniques to model traffic congestion dynamics. However, most of the approaches have limitations, largely due to unrealistic assumptions and cumbersome parameter calibration process. With the development of Intelligent Transportation Systems (ITS) and Internet of Things (IoT), transportation data become more and more ubiquitous. This triggers a series of data-driven research to investigate transportation phenomena. Among them, deep learning theory is considered one of the most promising techniques to tackle tremendous high-dimensional data. This study attempts to extend deep learning theory into large-scale transportation network analysis. A deep Restricted Boltzmann Machine and Recurrent Neural Network architecture is utilized to model and predict traffic congestion evolution based on Global Positioning System (GPS) data from taxi. A numerical study in Ningbo, China is conducted to validate the effectiveness and efficiency of the proposed method. Results show that the prediction accuracy can achieve as high as 88% within less than 6 minutes when the model is implemented in a Graphic Processing Unit (GPU)-based parallel computing environment. The predicted congestion evolution patterns can be visualized temporally and spatially through a map-based platform to identify the vulnerable links for proactive congestion mitigation. PMID:25780910

  8. Large-scale transportation network congestion evolution prediction using deep learning theory.

    PubMed

    Ma, Xiaolei; Yu, Haiyang; Wang, Yunpeng; Wang, Yinhai

    2015-01-01

    Understanding how congestion at one location can cause ripples throughout large-scale transportation network is vital for transportation researchers and practitioners to pinpoint traffic bottlenecks for congestion mitigation. Traditional studies rely on either mathematical equations or simulation techniques to model traffic congestion dynamics. However, most of the approaches have limitations, largely due to unrealistic assumptions and cumbersome parameter calibration process. With the development of Intelligent Transportation Systems (ITS) and Internet of Things (IoT), transportation data become more and more ubiquitous. This triggers a series of data-driven research to investigate transportation phenomena. Among them, deep learning theory is considered one of the most promising techniques to tackle tremendous high-dimensional data. This study attempts to extend deep learning theory into large-scale transportation network analysis. A deep Restricted Boltzmann Machine and Recurrent Neural Network architecture is utilized to model and predict traffic congestion evolution based on Global Positioning System (GPS) data from taxi. A numerical study in Ningbo, China is conducted to validate the effectiveness and efficiency of the proposed method. Results show that the prediction accuracy can achieve as high as 88% within less than 6 minutes when the model is implemented in a Graphic Processing Unit (GPU)-based parallel computing environment. The predicted congestion evolution patterns can be visualized temporally and spatially through a map-based platform to identify the vulnerable links for proactive congestion mitigation.

  9. Frame Transmission Efficiency-Based Cross-Layer Congestion Notification Scheme in Wireless Ad Hoc Networks

    PubMed Central

    He, Huaguang; Li, Taoshen; Feng, Luting; Ye, Jin

    2017-01-01

    Different from the traditional wired network, the fundamental cause of transmission congestion in wireless ad hoc networks is medium contention. How to utilize the congestion state from the MAC (Media Access Control) layer to adjust the transmission rate is core work for transport protocol design. However, recent works have shown that the existing cross-layer congestion detection solutions are too complex to be deployed or not able to characterize the congestion accurately. We first propose a new congestion metric called frame transmission efficiency (i.e., the ratio of successful transmission delay to the frame service delay), which describes the medium contention in a fast and accurate manner. We further present the design and implementation of RECN (ECN and the ratio of successful transmission delay to the frame service delay in the MAC layer, namely, the frame transmission efficiency), a general supporting scheme that adjusts the transport sending rate through a standard ECN (Explicit Congestion Notification) signaling method. Our method can be deployed on commodity switches with small firmware updates, while making no modification on end hosts. We integrate RECN transparently (i.e., without modification) with TCP on NS2 simulation. The experimental results show that RECN remarkably improves network goodput across multiple concurrent TCP flows. PMID:28714898

  10. Frame Transmission Efficiency-Based Cross-Layer Congestion Notification Scheme in Wireless Ad Hoc Networks.

    PubMed

    He, Huaguang; Li, Taoshen; Feng, Luting; Ye, Jin

    2017-07-15

    Different from the traditional wired network, the fundamental cause of transmission congestion in wireless ad hoc networks is medium contention. How to utilize the congestion state from the MAC (Media Access Control) layer to adjust the transmission rate is core work for transport protocol design. However, recent works have shown that the existing cross-layer congestion detection solutions are too complex to be deployed or not able to characterize the congestion accurately. We first propose a new congestion metric called frame transmission efficiency (i.e., the ratio of successful transmission delay to the frame service delay), which describes the medium contention in a fast and accurate manner. We further present the design and implementation of RECN (ECN and the ratio of successful transmission delay to the frame service delay in the MAC layer, namely, the frame transmission efficiency), a general supporting scheme that adjusts the transport sending rate through a standard ECN (Explicit Congestion Notification) signaling method. Our method can be deployed on commodity switches with small firmware updates, while making no modification on end hosts. We integrate RECN transparently (i.e., without modification) with TCP on NS2 simulation. The experimental results show that RECN remarkably improves network goodput across multiple concurrent TCP flows.

  11. Limb congestion enhances the synchronization of sympathetic outflow with muscle contraction

    NASA Technical Reports Server (NTRS)

    Mostoufi-Moab, S.; Herr, M. D.; Silber, D. H.; Gray, K. S.; Leuenberger, U. A.; Sinoway, L. I.

    2000-01-01

    In this report, we examined if the synchronization of muscle sympathetic nerve activity (MSNA) with muscle contraction is enhanced by limb congestion. To explore this relationship, we applied signal-averaging techniques to the MSNA signal obtained during short bouts of forearm contraction (2-s contraction/3-s rest cycle) at 40% maximal voluntary contraction for 5 min. We performed this analysis before and after forearm venous congestion; an intervention that augments the autonomic response to sustained static muscle contractions via a local effect on muscle afferents. There was an increased percentage of the MSNA noted during second 2 of the 5-s contraction/rest cycles. The percentage of total MSNA seen during this particular second increased from minute 1 to 5 of contraction and was increased further by limb congestion (control minute 1 = 25.6 +/- 2.0%, minute 5 = 32.8 +/- 2.2%; limb congestion minute 1 = 29.3 +/- 2.1%, minute 5 = 37.8 +/- 3.9%; exercise main effect <0.005; limb congestion main effect P = 0.054). These changes in the distribution of signal-averaged MSNA were seen despite the fact that the mean number of sympathetic discharges did not increase over baseline. We conclude that synchronization of contraction and MSNA is seen during short repetitive bouts of handgrip. The sensitizing effect of contraction time and limb congestion are apparently due to feedback from muscle afferents within the exercising muscle.

  12. How Travel Demand Affects Detection of Non-Recurrent Traffic Congestion on Urban Road Networks

    NASA Astrophysics Data System (ADS)

    Anbaroglu, B.; Heydecker, B.; Cheng, T.

    2016-06-01

    Occurrence of non-recurrent traffic congestion hinders the economic activity of a city, as travellers could miss appointments or be late for work or important meetings. Similarly, for shippers, unexpected delays may disrupt just-in-time delivery and manufacturing processes, which could lose them payment. Consequently, research on non-recurrent congestion detection on urban road networks has recently gained attention. By analysing large amounts of traffic data collected on a daily basis, traffic operation centres can improve their methods to detect non-recurrent congestion rapidly and then revise their existing plans to mitigate its effects. Space-time clusters of high link journey time estimates correspond to non-recurrent congestion events. Existing research, however, has not considered the effect of travel demand on the effectiveness of non-recurrent congestion detection methods. Therefore, this paper investigates how travel demand affects detection of non-recurrent traffic congestion detection on urban road networks. Travel demand has been classified into three categories as low, normal and high. The experiments are carried out on London's urban road network, and the results demonstrate the necessity to adjust the relative importance of the component evaluation criteria depending on the travel demand level.

  13. Spatial-Temporal Congestion Identification Based on Time Series Similarity Considering Missing Data.

    PubMed

    Qi, Hongsheng; Liu, Meiqi; Wang, Dianhai; Chen, Mengwei

    2016-01-01

    Traffic congestion varies spatially and temporally. The observation of the formation, propagation and dispersion of network traffic congestion can lead to insights about the network performance, the bottleneck dynamics etc. While many researchers use the traffic flow data to reconstruct the congestion profile, the data missing problem is bypassed. Current methods either omit the missing data or supplement the missing part by average etc. Great error may be introduced during these processes. Rather than simply discarding the missing data, this research regards the data missing event as a result of either the severe congestion which prevent the floating vehicle from entering the congested area, or a type of feature of the resulting traffic flow time series. Hence a new traffic flow operational index time series similarity measurement is expected to be established as a basis of identifying the dynamic network bottleneck. The method first measures the traffic flow operational similarity between pairs of neighboring links, and then the similarity results are used to cluster the spatial-temporal congestion. In order to get the similarity under missing data condition, the measurement is implemented in a two-stage manner: firstly the so called first order similarity is calculated given that the traffic flow variables are bounded both upside and downside; then the first order similarity is aggregated to generate the second order similarity as the output. We implement the method on part of the real-world road network; the results generated are not only consistent with empirical observation, but also provide useful insights.

  14. Does rush hour see a rush of emotions? Driver mood in conditions likely to exhibit congestion.

    PubMed

    Morris, Eric A; Hirsch, Jana A

    2016-09-01

    Polls show that a large portion of the public considers traffic congestion to be a problem and believes a number of policy interventions would ameliorate it. However, most of the public rejects new taxes and fees to fund these improvements. This may be because of a disconnect between the public's stated antipathy towards congestion and the recalled emotional costs congestion imposes. To explore this, we use a large and representative sample drawn from the American Time Use Survey to examine how drivers experience four emotions (happiness, sadness, stress, and fatigue), plus a constructed composite mood variable, when they travel in peak periods, in large cities, in city centers, and in combinations of these. We also explore the interactions between these indicators and trip duration. We find evidence that drivers in the largest cities at the very peak of rush hour (5:00pm-6:00pm) are in a less positive mood, presumably because of congestion. However, this effect, though significant, is small, and we find no significant results using broader definitions of the peak period. In all, our findings suggest that congestion's impact on drivers as a group is quite limited. This may help explain why the public's attitude toward painful financial trade-offs to address congestion is lukewarm.

  15. Limb congestion enhances the synchronization of sympathetic outflow with muscle contraction

    NASA Technical Reports Server (NTRS)

    Mostoufi-Moab, S.; Herr, M. D.; Silber, D. H.; Gray, K. S.; Leuenberger, U. A.; Sinoway, L. I.

    2000-01-01

    In this report, we examined if the synchronization of muscle sympathetic nerve activity (MSNA) with muscle contraction is enhanced by limb congestion. To explore this relationship, we applied signal-averaging techniques to the MSNA signal obtained during short bouts of forearm contraction (2-s contraction/3-s rest cycle) at 40% maximal voluntary contraction for 5 min. We performed this analysis before and after forearm venous congestion; an intervention that augments the autonomic response to sustained static muscle contractions via a local effect on muscle afferents. There was an increased percentage of the MSNA noted during second 2 of the 5-s contraction/rest cycles. The percentage of total MSNA seen during this particular second increased from minute 1 to 5 of contraction and was increased further by limb congestion (control minute 1 = 25.6 +/- 2.0%, minute 5 = 32.8 +/- 2.2%; limb congestion minute 1 = 29.3 +/- 2.1%, minute 5 = 37.8 +/- 3.9%; exercise main effect <0.005; limb congestion main effect P = 0.054). These changes in the distribution of signal-averaged MSNA were seen despite the fact that the mean number of sympathetic discharges did not increase over baseline. We conclude that synchronization of contraction and MSNA is seen during short repetitive bouts of handgrip. The sensitizing effect of contraction time and limb congestion are apparently due to feedback from muscle afferents within the exercising muscle.

  16. [Management of patients with arrhythmias undergoing thoracic surgery].

    PubMed

    Ishibashi, H; Okubo, K

    2012-07-01

    Recentry, surgical candidates have become older and have more surgical risk factors, perioperative patient management become more important than before. In the patients with significant arrhythmia observed in the preoperative period, examination of the baseline heart disease, i.e. myocardial ischemia or congestive heart failure, is mandatory and, if necessary, adequate treatment such as defibrillator, the implantation of a pacemaker, anticoagulation therapy, or other medical therapy should be performed. In the patients with atrial fibrillation, clinical prediction rules such as the congestive heart failure, hypertension, age>75, diabetes, previous stroke or transient ischemic attack (TIA) [CHADS 2] score have been developed to identify those patients at highest risk for thrombo-embolism and can be used when assessing the need for bridging anticoagulation by heparin prior to surgery. The electrical stimulus from electrocautery may inhibit demand pacemakers or may reprogram the pacemaker. An asynchronous or non-sensing pacemaker mode is recommended in patients who are pacemaker dependent and whose underlying rhythm is unreliable. The device has to be checked to ensure appropriate programming and sensing pacing thresholds after surgery. The implantable cardioverter defibrillator should be turned off during surgery and switched on in the recovery phase before discharge to the ward.

  17. Dynamically reconfigurable router for NoC congestion reduction

    NASA Astrophysics Data System (ADS)

    Rosales, Juan E.; Tobajas, Félix; de Armas, Valentín; Mori, José A.; Sarmiento, Roberto

    2011-05-01

    Multiprocessor System-on-Chip (MPSoCs) are emerging as one of the technologies providing a way to support the growing design complexity of embedded systems including several types of cores. The interconnection among cores of a MPSoC is proposed to be provided by Networks-on-Chip (NoC). In real applications it is usual to find different interconnection needs amongst cores, so distinct bandwidth is needed in each node of a NoC. Since larger FIFOs in NoC routers provide larger throughputs and smaller latencies, depths are usually sized for the worst case, compromising not only the routing area, but power consumption. In this paper, a reconfigurable router with a dynamic sharing mechanism of buffers at the input channels is proposed to reduce congestion in the network. In this situation, a channel may dynamically lend or borrow some non-used buffer units to or from neighboring channels, in accordance to the connection rates. The proposed reconfigurable router architecture was embedded in the Hermes NoC. The main advantages of the Hermes are its small size and modular design. This, as well as the open source approach, have lead to the selection of this NoC. The basic element of Hermes is a router with five bi-directional ports employing an XY routing algorithm. FIFO buffering is present only at the input channel, with all channels having the same buffer depth defined at design time. The proposed reconfigurable router has been coded in VHDL at RTL level from the adaptation of the Hermes router to fit into the proposed scheme. Results obtained from the simulation of the router under scenarios with different traffic characteristics and percentage of shared buffer, show that mean latency can be reduced up to a 30% in comparison to the original router.

  18. Does Thiazolidinedione therapy exacerbate fluid retention in congestive heart failure?

    PubMed

    Goltsman, Ilia; Khoury, Emad E; Winaver, Joseph; Abassi, Zaid

    2016-12-01

    The ever-growing global burden of congestive heart failure (CHF) and type 2 diabetes mellitus (T2DM) as well as their co-existence necessitate that anti-diabetic pharmacotherapy will modulate the cardiovascular risk inherent to T2DM while complying with the accompanying restrictions imposed by CHF. The thiazolidinedione (TZD) family of peroxisome proliferator-activated receptor γ (PPARγ) agonists initially provided a promising therapeutic option in T2DM owing to anti-diabetic efficacy combined with pleiotropic beneficial cardiovascular effects. However, the utility of TZDs in T2DM has declined in the past decade, largely due to concomitant adverse effects of fluid retention and edema formation attributed to salt-retaining effects of PPARγ activation on the nephron. Presumably, the latter effects are potentially deleterious in the context of pre-existing fluid retention in CHF. However, despite a considerable body of evidence on mechanisms responsible for TZD-induced fluid retention suggesting that this class of drugs is rightfully prohibited from use in CHF patients, there is a paucity of experimental and clinical studies that investigate the effects of TZDs on salt and water homeostasis in the CHF setting. In an attempt to elucidate whether TZDs actually exacerbate the pre-existing fluid retention in CHF, our review summarizes the pathophysiology of fluid retention in CHF. Moreover, we thoroughly review the available data on TZD-induced fluid retention and proposed mechanisms in animals and patients. Finally, we will present recent studies challenging the common notion that TZDs worsen renal salt and water retention in CHF. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. A New TCP Congestion Control Supporting RTT-Fairness

    NASA Astrophysics Data System (ADS)

    Ogura, Kazumine; Nemoto, Yohei; Su, Zhou; Katto, Jiro

    This paper focuses on RTT-fairness of multiple TCP flows over the Internet, and proposes a new TCP congestion control named “HRF (Hybrid RTT-Fair)-TCP”. Today, it is a serious problem that the flows having smaller RTT utilize more bandwidth than others when multiple flows having different RTT values compete in the same network. This means that a user with longer RTT may not be able to obtain sufficient bandwidth by the current methods. This RTT fairness issue has been discussed in many TCP papers. An example is CR (Constant Rate) algorithm, which achieves RTT-fairness by multiplying the square of RTT value in its window increment phase against TCP-Reno. However, the method halves its windows size same as TCP-Reno when a packet loss is detected. This makes worse its efficiency in certain network cases. On the other hand, recent proposed TCP versions essentially require throughput efficiency and TCP-friendliness with TCP-Reno. Therefore, we try to keep these advantages in our TCP design in addition to RTT-fairness. In this paper, we make intuitive analytical models in which we separate resource utilization processes into two cases: utilization of bottleneck link capacity and that of buffer space at the bottleneck link router. These models take into account three characteristic algorithms (Reno, Constant Rate, Constant Increase) in window increment phase where a sender receives an acknowledgement successfully. Their validity is proved by both simulations and implementations. From these analyses, we propose HRF-TCP which switches two modes according to observed RTT values and achieves RTT fairness. Experiments are carried out to validate the proposed method. Finally, HRF-TCP outperforms conventional methods in RTT-fairness, efficiency and friendliness with TCP-Reno.

  20. Effects of bucindolol on neurohormonal activation in congestive heart failure

    SciTech Connect

    Eichhorn, E.J.; McGhie, A.L.; Bedotto, J.B.; Corbett, J.R.; Malloy, C.R.; Hatfield, B.A.; Deitchman, D.; Willard, J.E.; Grayburn, P.A. )

    1991-01-01

    To examine the effects of beta-adrenergic blockade on neurohormonal activation in patients with congestive heart failure, 15 men had assessments of hemodynamics and supine peripheral renin and norepinephrine levels before and after 3 months of oral therapy with bucindolol, a nonselective beta antagonist. At baseline, plasma renin activity did not correlate with any hemodynamic parameter. However, norepinephrine levels had a weak correlation with left ventricular end-diastolic pressure (r = 0.74, p less than 0.01), stroke volume index (r = 0.61, p less than 0.02) and pulmonary vascular resistance (r = 0.54, p less than 0.05). Plasma renin decreased with bucindolol therapy, from 11.6 +/- 13.4 to 4.3 +/- 4.1 ng/ml/hour (mean +/- standard deviation; p less than 0.05), whereas plasma norepinephrine was unchanged, from 403 +/- 231 to 408 +/- 217 pg/ml. A wide diversity of the norepinephrine response to bucindolol was observed with reduction of levels in some patients and elevation in others. Although plasma norepinephrine did not decrease, heart rate tended to decrease (from 82 +/- 20 vs 73 +/- 11 min-1, p = 0.059) with beta-adrenergic blockade, suggesting neurohormonal antagonism at the receptor level. No changes in I-123 metaiodobenzylguanidine uptake occurred after bucindolol therapy, suggesting unchanged adrenergic uptake of norepinephrine with beta-blocker therapy. Despite reductions in plasma renin activity and the presence of beta blockade, the response of renin or norepinephrine levels to long-term bucindolol therapy did not predict which patients had improved in hemodynamic status (chi-square = 0.37 for renin, 0.82 for norepinephrine).

  1. Pneumoconiosis increases the risk of congestive heart failure

    PubMed Central

    Yen, Chia-Ming; Lin, Cheng-Li; Lin, Ming-Chia; Chen, Huei-Yong; Lu, Nan-Han; Kao, Chia-Hung

    2016-01-01

    Abstract The purpose of the study was to determine the relationship between pneumoconiosis and congestive heart failure (CHF). We collected data from the National Health Insurance Research Database in Taiwan. The study sample comprised 8923 patients with pneumoconiosis and 35,692 nonpneumoconiosis controls enrolled from 2000 to 2011. Patients were followed up until the end of 2011 to evaluate the incidence of CHF. The risk of CHF was analyzed using Cox proportional hazard regression models, and the analysis accounted for factors such as sex, age, comorbidities, and air pollutants (μg/m3). The overall incidence of CHF was higher in the pneumoconiosis cohort (15.7 per 1000 person-y) than in the nonpneumoconiosis cohort (11.2 per 1000 person-y), with a crude hazard ratio (HR) of 1.40 (P < 0.001). The HR for CHF was 1.38-fold greater in the pneumoconiosis cohort than in the nonpneumoconiosis cohort (P < 0.001) after the model was adjusted for age, sex, various comorbidities, and air pollutants (μg/m3). The relative risk for CHF in the sex-specific pneumoconiosis cohort compared with the nonpneumoconiosis cohort was significant for men (adjusted HR = 1.40, 95% confidence interval = 1.21–1.62, P < 0.001). The incidence density rates of CHF increased with age; pneumoconiosis patients had a higher relative risk of CHF for all age group. Patients with pneumoconiosis were at higher risk for developing CHF than patients in the nonpneumoconiosis cohort, particularly in cases with coexisting coronary artery disease, hypertension, and chronic obstructive pulmonary disease. PMID:27336897

  2. Decreasing body temperature predicts early rehospitalization in congestive heart failure.

    PubMed

    Ahmed, Amany; Aboshady, Ibrahim; Munir, Shahzeb M; Gondi, Sreedevi; Brewer, Alan; Gertz, S David; Lai, Dejian; Shaik, Naushad A; Shankar, K J; Deswal, Anita; Casscells, S Ward

    2008-08-01

    In congestive heart failure (CHF), a low body temperature at hospital admission predicts in-hospital mortality. We hypothesized that a postdischarge reduction in body temperature predicts early CHF rehospitalization and death. We reviewed the records of 198 patients discharged after CHF hospitalization. We categorized the patients as hypothermic or normothermic (cutoff point, 36.3 degrees C/97.4 degrees F) according to body temperature at discharge. We classified the 2 groups according to the direction of temperature change between discharge and the first follow-up visit: normothermic/non-decreasing temperature (N+), normothermic/decreasing temperature (N-), hypothermic/non-decreasing temperature (H+), and hypothermic/decreasing temperature (H-). Ninety-three patients (47%) had decreasing temperatures, and 105 patients (53%) had non-decreasing temperatures. Kaplan-Meier analysis revealed a significant intergroup difference in survival (P = .01) and rehospitalization time (P = .005). On logistic regression, a decreasing temperature was significantly associated with rehospitalization within 180 days (odds ratio, 4.01; 95% confidence interval, 1.63-10.02; P = .003). On Cox regression, the hazard ratios for death were 3.19 (P = .07), 6.49 (P = .004), and 5.17 (P = .07), for the N-, H+, and H- groups, respectively, versus the N+ group. For rehospitalization time, the hazard ratios were 7.02 (P = .01), 4.24 (P = .08), and 13.43 (P = .005) for the N-, H+, and H- groups, respectively, versus the N+ group. Decreasing body temperatures can predict readmission, decreased time to rehospitalization, and (in combination with hypothermia) decreased survival.

  3. Sodium and water balance in chronic congestive heart failure.

    PubMed Central

    Cody, R J; Covit, A B; Schaer, G L; Laragh, J H; Sealey, J E; Feldschuh, J

    1986-01-01

    As the characteristics of sodium and water balance in heart failure remain undefined, we evaluated the hemodynamic, metabolic, and hormonal effects of balanced sodium intake in 10 patients with chronic congestive heart failure. We discontinued diuretics to avoid their confounding influence, and all patients received 1 wk of 10 meq and 100 meq balanced sodium intake and controlled free water. Comparing sodium intake of 10 with 100 meq, the following observations were made. There was weight gain (2.0 kg) and increased sodium excretion (11 +/- 3 to 63 +/- 15 meq/24 h), unaccompanied by increase of blood volume. Both renin-angiotensin system and sympathetic nervous system activity were greater during the 10 meq diet, and suppressed with the 100 meq sodium diet. For both diets, plasma renin and urinary aldosterone excretion were correlated with urinary sodium excretion (r = -0.768, r = -0.726, respectively; P less than 0.005). Systemic hemodynamics were minimally changed with increased sodium intake. However, reversal of vasoconstriction by captopril during the 10 meq diet, and its ineffectiveness during the 100 meq diet, indicated a renin-dependent mechanism in the former, and a renin-independent mechanism in the latter diet. There were two subgroups of response to the 100 meq diet: one group (n = 5) achieved neutral balance, while the second (n = 5) avidly retained sodium and water. Renin-angiotensin system activity was significantly higher in the latter group, and the mechanism for differences in sodium excretion for the subgroups could not be identified by blood volume or hemodynamic parameters. Orthostatic hypotension during tilt was greater during the 10 meq sodium diet, and in all cases, related to ineffective hemodynamic and hormonal compensatory responses. PMID:3517066

  4. An intervention for VA patients with congestive heart failure.

    PubMed

    Copeland, Laurel A; Berg, Gregory D; Johnson, Donna M; Bauer, Richard L

    2010-03-01

    To assess the effect of a telephone intervention to improve quality of life among patients with congestive heart failure (CHF). Prospective randomized study. Single-site recruitment of 458 patients using Veterans Health Administration care into a randomized controlled trial with a 1-year preintervention data collection period and a 1-year intervention and follow-up period. To compensate for imbalanced study groups, propensity scores were included in adjusted models of quality of life, satisfaction with care, inpatient utilization, survival, and costs of care. Patients aged 45 to 95 years participated in the study; 22% were of Hispanic race/ethnicity, and 7% were African American. All but 5 were male, consistent with the older population among veterans. At baseline, 40% were in Goldman Specific Activity Scale class I, 42% were in class III, 6% were in class II or IV, and 12% were unclassified. Patients scored a mean (SD) of 14 (1.5) points below the norm on the physical component score. After the yearlong intervention, no differences in clinical outcomes were noted between the intervention group and the control group. The CHF-related costs were higher for the intervention group, as were overall costs that included the cost of the intervention. Intervention group patients reported better compliance with weight monitoring and exercise recommendations. A risk-stratified intervention for patients with CHF resulted in potential behavioral improvements but no survival benefit. A high-cost high-intensity intervention may be required to improve survival for patients with CHF. Inclusion of the costs of interventions is recommended for future researchers.

  5. Outcomes for older men and women with congestive heart failure.

    PubMed

    Burns, R B; McCarthy, E P; Moskowitz, M A; Ash, A; Kane, R L; Finch, M

    1997-03-01

    To describe and compare outcomes for men and women discharged alive following a hospitalization for congestive heart failure (CHF). Prospective cohort study. A total of 519 patients, aged > or = 65, who were discharged alive after a hospitalization for CHF (DRG = 127). Outcomes (Activities of Daily Living (ADLs), shortness of breath when walking, perceived health, living situation, rehospitalization, and mortality) were measured at 3 times (6 weeks, 6 months, and 1 year) post-discharge. The 205 men were, on average, younger (77 +/- 7 vs 80 +/- 8, P < .001), wealthier (46% vs 21% earned > or = $10,000, P < .001), and more often married (50% vs 19%, P < .001). Men were more likely than women to have a previous history of CHF (71% vs 63%, P = .052). Men also had higher 1-year mortality than women (48% vs 35%, P = .009), even after adjusting for age, comorbidity, physiological severity (APACHE II APS and RAND discharge instability), radiological evidence of CHF, prior ADLs, walking ability, living situation, and perceived health. Men and women survivors at 1-year had similar and substantial impairment for all non-fatal outcomes considered (all P values > or = .489). Their adjusted mean ADL scores were consistent with complete dependence on one essential activity (range 0-6 dependencies); 35% were short of breath walking less than 1 block; 62% had fair or poor perceived health; 32% received some formal care; and 46% were rehospitalized within 1 year of discharge. Men with CHF have a higher mortality than women with CHF. Men and women who survive have similar and substantial impairment for all non-fatal outcomes (ADLs, shortness of breath upon walking, perceived health, living situation, and rehospitalization).

  6. Effects of desipramine on norepinephrine clearance in congestive heart failure

    SciTech Connect

    Clemson, B.; Baily, R.G.; Davis, D.; Zelis, R. )

    1990-08-01

    Elevated plasma norepinephrine (NE) in congestive heart failure (CHF) is caused by increased NE spillover and decreased NE clearance. To evaluate the effects of neuronal uptake blockade on NE clearance, we studied NE kinetics during steady-state infusions of (3H)NE, before and after oral desipramine (DMI, 50 mg) in 11 patients with CHF and 8 normal volunteers. Baseline plasma NE was greater in the CHF group (637 +/- 56 vs. 271 +/- 32 pg/ml; P less than 0.001), NE clearance was lower in CHF (1.31 +/- 0.21 vs. 1.94 +/- 0.17 l.min-1.m-2; P = 0.026), and NE spillover was greater in CHF (4.71 +/- 0.78 vs. 3.04 +/- 0.35 nmol.min-1.m-2, P = 0.054). After DMI, plasma NE rose significantly in CHF (778 +/- 67; P = 0.008), and NE clearance decreased further in CHF (0.97 +/- 0.16; P = 0.024), but neither changed in normal subjects. NE spillover did not change in either group. There appears to be an enhanced effect of DMI on NE clearance in CHF patients. Two general mechanisms may be responsible for this finding, an increased concentration of drug, possibly caused by a decreased volume of distribution, and an increased sensitivity of neuronal amine pumps to DMI. Both mechanisms may reflect a more general abnormality of clearance of drugs and hormones related to abnormalities of tissue perfusion in CHF.

  7. Managerial Innovation: Rules for Successful Implementation.

    ERIC Educational Resources Information Center

    Baldridge, J. Victor

    1980-01-01

    The Higher Education Research Institute studied the impact of Exxon Foundation grants from the Resource Allocation and Management Program (RAMP) at 49 private colleges to determine if and how college planning and financial stability were affected by changes in management techniques. Rules for supporting innovations at various phases of a project's…

  8. Managerial Innovation: Rules for Successful Implementation.

    ERIC Educational Resources Information Center

    Baldridge, J. Victor

    1980-01-01

    The Higher Education Research Institute studied the impact of Exxon Foundation grants from the Resource Allocation and Management Program (RAMP) at 49 private colleges to determine if and how college planning and financial stability were affected by changes in management techniques. Rules for supporting innovations at various phases of a project's…

  9. 42 CFR 438.602 - Basic rule.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Certifications and Program Integrity § 438.602 Basic rule. As a condition for receiving payment under the Medicaid managed care program, an MCO, PCCM, PIHP, or PAHP must comply...

  10. 44 CFR 5.26 - Rules for public inspection and copying.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Rules for public inspection and copying. 5.26 Section 5.26 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY... Availability of General Agency Information, Rules, Orders, Policies, and Similar Material § 5.26 Rules for...

  11. 18 CFR 385.104 - Rule of construction (Rule 104).

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... (Rule 104). 385.104 Section 385.104 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY PROCEDURAL RULES RULES OF PRACTICE AND PROCEDURE Applicability and Definitions § 385.104 Rule of construction (Rule 104). To the extent that the text of a rule is inconsistent...

  12. 18 CFR 385.104 - Rule of construction (Rule 104).

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... (Rule 104). 385.104 Section 385.104 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY PROCEDURAL RULES RULES OF PRACTICE AND PROCEDURE Applicability and Definitions § 385.104 Rule of construction (Rule 104). To the extent that the text of a rule is inconsistent...

  13. 18 CFR 385.104 - Rule of construction (Rule 104).

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... (Rule 104). 385.104 Section 385.104 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY PROCEDURAL RULES RULES OF PRACTICE AND PROCEDURE Applicability and Definitions § 385.104 Rule of construction (Rule 104). To the extent that the text of a rule is inconsistent...

  14. Evaluation of the public health impacts of traffic congestion: a health risk assessment

    PubMed Central

    2010-01-01

    Background Traffic congestion is a significant issue in urban areas in the United States and around the world. Previous analyses have estimated the economic costs of congestion, related to fuel and time wasted, but few have quantified the public health impacts or determined how these impacts compare in magnitude to the economic costs. Moreover, the relative magnitudes of economic and public health impacts of congestion would be expected to vary significantly across urban areas, as a function of road infrastructure, population density, and atmospheric conditions influencing pollutant formation, but this variability has not been explored. Methods In this study, we evaluate the public health impacts of ambient exposures to fine particulate matter (PM2.5) concentrations associated with a business-as-usual scenario of predicted traffic congestion. We evaluate 83 individual urban areas using traffic demand models to estimate the degree of congestion in each area from 2000 to 2030. We link traffic volume and speed data with the MOBILE6 model to characterize emissions of PM2.5 and particle precursors attributable to congestion, and we use a source-receptor matrix to evaluate the impact of these emissions on ambient PM2.5 concentrations. Marginal concentration changes are related to a concentration-response function for mortality, with a value of statistical life approach used to monetize the impacts. Results We estimate that the monetized value of PM2.5-related mortality attributable to congestion in these 83 cities in 2000 was approximately $31 billion (2007 dollars), as compared with a value of time and fuel wasted of $60 billion. In future years, the economic impacts grow (to over $100 billion in 2030) while the public health impacts decrease to $13 billion in 2020 before increasing to $17 billion in 2030, given increasing population and congestion but lower emissions per vehicle. Across cities and years, the public health impacts range from more than an order of

  15. Microscopic theory of spatial-temporal congested traffic patterns at highway bottlenecks

    NASA Astrophysics Data System (ADS)

    Kerner, Boris S.; Klenov, Sergey L.

    2003-09-01

    A microscopic theory of spatial-temporal congested traffic patterns at highway bottlenecks due to on-ramps, merge bottlenecks (a reduction of highway lanes), and off-ramps is presented. The basic postulate of three-phase traffic theory is used, which claims that homogeneous (in space and time) model solutions (steady states) of synchronized flow cover a two dimensional region in the flow-density plane [B. S. Kerner, Phys. Rev. Lett. 81, 3797 (1998); Trans. Res. Rec. 1678, 160 (1999)]. Phase transitions leading to diverse congested patterns, pattern evolution, and pattern nonlinear features have been found. Diagrams of congested patterns, i.e., regions of the pattern emergence dependent on traffic demand, have been derived. Diverse effects of metastability with respect to the pattern formation have been found. The microscopic theory allows us to explain the main empirical pattern features at on-ramps and off-ramps which have recently been found [B. S. Kerner, Phys. Rev. E 65, 046138 (2002)]. (i) Rather than moving jams, synchronized flow first occurs at bottlenecks if the flow rate is slowly increasing. Wide moving jams can spontaneously occur only in synchronized flow. (ii) General patterns (GP) and synchronized flow patterns (SP) can spontaneously emerge at the bottlenecks. There can be the widening SP (WSP), the moving SP (MSP), and the localized SP. (iii) At on-ramps cases of “weak” and “strong” congestion should be distinguished. In contrast to weak congestion, under strong congestion the flow rate in synchronized flow in GP reaches a limit flow rate, the frequency of the moving jam emergence reaches a maximum, i.e., the GP characteristics under strong congestion do not depend on traffic demand. (iv) At the off-ramp GP with weak congestion occur. (v) A study of the pattern formation on a highway with two bottlenecks shows that diverse expanded patterns can occur, which cover both bottlenecks. SP first emerged at the downstream bottleneck can be caught

  16. Microscopic theory of spatial-temporal congested traffic patterns at highway bottlenecks.

    PubMed

    Kerner, Boris S; Klenov, Sergey L

    2003-09-01

    A microscopic theory of spatial-temporal congested traffic patterns at highway bottlenecks due to on-ramps, merge bottlenecks (a reduction of highway lanes), and off-ramps is presented. The basic postulate of three-phase traffic theory is used, which claims that homogeneous (in space and time) model solutions (steady states) of synchronized flow cover a two dimensional region in the flow-density plane [B. S. Kerner, Phys. Rev. Lett. 81, 3797 (1998); Trans. Res. Rec. 1678, 160 (1999)]. Phase transitions leading to diverse congested patterns, pattern evolution, and pattern nonlinear features have been found. Diagrams of congested patterns, i.e., regions of the pattern emergence dependent on traffic demand, have been derived. Diverse effects of metastability with respect to the pattern formation have been found. The microscopic theory allows us to explain the main empirical pattern features at on-ramps and off-ramps which have recently been found [B. S. Kerner, Phys. Rev. E 65, 046138 (2002)]. (i) Rather than moving jams, synchronized flow first occurs at bottlenecks if the flow rate is slowly increasing. Wide moving jams can spontaneously occur only in synchronized flow. (ii) General patterns (GP) and synchronized flow patterns (SP) can spontaneously emerge at the bottlenecks. There can be the widening SP (WSP), the moving SP (MSP), and the localized SP. (iii) At on-ramps cases of "weak" and "strong" congestion should be distinguished. In contrast to weak congestion, under strong congestion the flow rate in synchronized flow in GP reaches a limit flow rate, the frequency of the moving jam emergence reaches a maximum, i.e., the GP characteristics under strong congestion do not depend on traffic demand. (iv) At the off-ramp GP with weak congestion occur. (v) A study of the pattern formation on a highway with two bottlenecks shows that diverse expanded patterns can occur, which cover both bottlenecks. SP first emerged at the downstream bottleneck can be caught at the

  17. Implementing home telemanagement of congestive heart failure using Xbox gaming platform.

    PubMed

    Finkelstein, Joseph; Wood, Jeffrey

    2011-01-01

    Gaming platforms have been recognized for user-friendly interface which does not require previous computer-related experience. Easy to use and wide availability of these platforms at patient households make them an attractive means to facilitate consumer health. The potential of such widely used platforms as Xbox for self-management of chronic health conditions has not yet been fully uncovered. We developed a Home Automated Telemanagement (HAT) system which utilizes Xbox to access personal health record, receive self-care support and exchange information with health care providers. The system questions patients with congestive heart failure (CHF) to monitor symptoms, weight changes, medication adherence and quality of life while educating the patient on their disease. The patients receive an instant feedback on their condition in the form of a 3-zone CHF action plan. The patient self-management information can be reviewed by a provider on a designated web site. The system is programmed to run on the Microsoft Xbox videogame console using an active internet connection and a connection to a computer running Windows Media Center. The system is designed to be as simple as possible making it usable by patients with no prior computer or videogame experience. The feasibility of this approach was tested in ten adults with no previous Xbox experience who completed attitudinal surveys and semi-structured qualitative interviews after using the system. All participants claimed that they did not have any problems in using the system and that they would use the system in the future if necessary. An Xbox-based telemanagement system has potential to optimize the care of patients with CHF and other chronic conditions.

  18. Designing a robust PID congestion controller supporting TCP flows based on H optimal control theory

    NASA Astrophysics Data System (ADS)

    Yu, Li; Shi, Zibo; Chen, Kun; Shu, Yantai

    2007-09-01

    A robust PID controller for active queue management (AQM) based on modern H∞ optimal control theory is presented in this paper. Taken both robustness and closed loop performance into consideration, most desirable parameters value can be gotten through some straightforward analytical formulas. Our robust PID controller is determined only by one parameter, other than traditional PID controller is by three or more. Additionally, this new parameters determining method can not only be extended to other AQM controller based on classical control theory or optimal control theory, but also be easily understood and implementation. We evaluate the performances of the controller extensively. The results show that the robust PID congestion controller outperform the existing controller, such as PI, RED, on keeping the router queue size at the target value. The most obvious property of the controller is that it takes on robustness such that it can adapt the network dynamic.

  19. 41 CFR 51-9.101-4 - Rules of conduct.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 41 Public Contracts and Property Management 1 2014-07-01 2014-07-01 false Rules of conduct. 51-9.101-4 Section 51-9.101-4 Public Contracts and Property Management Other Provisions Relating to Public...-General Policy § 51-9.101-4 Rules of conduct. Any employee of the Committee involved in the...

  20. 41 CFR 51-9.101-4 - Rules of conduct.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 41 Public Contracts and Property Management 1 2012-07-01 2009-07-01 true Rules of conduct. 51-9.101-4 Section 51-9.101-4 Public Contracts and Property Management Other Provisions Relating to Public...-General Policy § 51-9.101-4 Rules of conduct. Any employee of the Committee involved in the...