Independent Orbiter Assessment (IOA): Analysis of the guidance, navigation, and control subsystem

NASA Technical Reports Server (NTRS)

Trahan, W. H.; Odonnell, R. A.; Pietz, K. C.; Hiott, J. M.

1986-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) is presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The independent analysis results corresponding to the Orbiter Guidance, Navigation, and Control (GNC) Subsystem hardware are documented. The function of the GNC hardware is to respond to guidance, navigation, and control software commands to effect vehicle control and to provide sensor and controller data to GNC software. Some of the GNC hardware for which failure modes analysis was performed includes: hand controllers; Rudder Pedal Transducer Assembly (RPTA); Speed Brake Thrust Controller (SBTC); Inertial Measurement Unit (IMU); Star Tracker (ST); Crew Optical Alignment Site (COAS); Air Data Transducer Assembly (ADTA); Rate Gyro Assemblies; Accelerometer Assembly (AA); Aerosurface Servo Amplifier (ASA); and Ascent Thrust Vector Control (ATVC). The IOA analysis process utilized available GNC hardware drawings, workbooks, specifications, schematics, and systems briefs for defining hardware assemblies, components, and circuits. Each hardware item was evaluated and analyzed for possible failure modes and effects. Criticality was assigned based upon the severity of the effect for each failure mode.

Complexity in Indexing Systems--Abandonment and Failure: Implications for Organizing the Internet.

ERIC Educational Resources Information Center

Weinberg, Bella Hass

1996-01-01

Discusses detailed classification systems, sophisticated alphabetical indexing systems and reasons for the abandonment of complex indexing systems. The suggested structure for indexing the Internet or other large electronic collections of documents is based on that of book indexes: specific headings with coined modifications. (Author/AEF)

Implementation and Qualifications Lessons Learned for Space Flight Photonic Components

NASA Technical Reports Server (NTRS)

Ott, Melanie N.

2010-01-01

This slide presentation reviews the process for implementation and qualification of space flight photonic components. It discusses the causes for most common anomalies for the space flight components, design compatibility, a specific failure analysis of optical fiber that occurred in a cable in 1999-2000, and another ExPCA connector anomaly involving pins that broke off. It reviews issues around material selection, quality processes and documentation, and current projects that the Photonics group is involved in. The importance of good documentation is stressed.

Biomarkers in Cardiology – Part 1 – In Heart Failure and Specific Cardiomyopathies

PubMed Central

2014-01-01

Cardiovascular diseases are the leading causes of mortality and morbidity in Brazil. The primary and secondary preventions of those diseases are a priority for the health system and require multiple approaches to increase their effectiveness. Biomarkers are tools used to more accurately identify high-risk individuals, to speed the diagnosis, and to aid in treatment and prognosis determination. This review aims to highlight the importance of biomarkers in clinical cardiology practice, and to raise relevant points of their use and the promises for the coming years. This document was divided into two parts, and this first one discusses the use of biomarkers in specific cardiomyopathies and heart failure. PMID:25590924

Analysis of warning letters issued by the US Food and Drug Administration to clinical investigators, institutional review boards and sponsors: a retrospective study.

PubMed

Shetty, Yashashri C; Saiyed, Aafreen A

2015-05-01

The US Food and Drug Administration (FDA) issues warning letters to all research stakeholders if unacceptable deficiencies are found during site visits. Warning letters issued by the FDA between January 2011 and December 2012 to clinical investigators and institutional review boards (IRBs) were reviewed for various violation themes and compared to similar studies in the past. Warning letters issued to sponsors between January 2005 and December 2012 were analysed for the first time for a specific set of violations using descriptive statistics. Failure to protect subject safety and to report adverse events to IRBs was found to be significant compared to prior studies for clinical investigators, while failure to follow standard operating procedures and maintain documentation was noted as significant in warning letters to IRBs. Failure to maintain minutes of meeting and to follow written procedures for continuing review were new substantial violations in warning letters issued to IRBs. Forty-six warning letters were issued to sponsors, the most common violations being failure to follow a monitoring schedule (58.69%), failure to obtain investigator agreement (34.78%), failure to secure investigators' compliance (30.43%), and failure to maintain data records and ship documents to investigators (30.43%). Appropriate methods for handling clinical trial procedural violations should be developed and implemented worldwide. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Independent Orbiter Assessment (IOA): Analysis of the electrical power distribution and control/electrical power generation subsystem

NASA Technical Reports Server (NTRS)

Patton, Jeff A.

1986-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. This report documents the independent analysis results corresponding to the Orbiter Electrical Power Distribution and Control (EPD and C)/Electrical Power Generation (EPG) hardware. The EPD and C/EPG hardware is required for performing critical functions of cryogenic reactant storage, electrical power generation and product water distribution in the Orbiter. Specifically, the EPD and C/EPG hardware consists of the following components: Power Section Assembly (PSA); Reactant Control Subsystem (RCS); Thermal Control Subsystem (TCS); Water Removal Subsystem (WRS); and Power Reactant Storage and Distribution System (PRSDS). The IOA analysis process utilized available EPD and C/EPG hardware drawings and schematics for defining hardware assemblies, components, and hardware items. Each level of hardware was evaluated and analyzed for possible failure modes and effects. Criticality was assigned based upon the severity of the effect for each failure mode.

Failures in communication through documents and documentation across the perioperative pathway.

PubMed

Braaf, Sandra; Riley, Robin; Manias, Elizabeth

2015-07-01

To explore how communication failures occur in documents and documentations across the perioperative pathway in nurses' interactions with other nurses, surgeons and anaesthetists. Documents and documentation are used to communicate vital patient and procedural information among nurses, and in nurses' interactions with surgeons and anaesthetists, across the perioperative pathway. Previous research indicates that communication failure regularly occurs in the perioperative setting. A qualitative study was undertaken. The study was conducted over three hospitals in Melbourne, Australia. One hundred and twenty-five healthcare professionals from the disciplines of surgery, anaesthesia and nursing participated in the study. Data collection commenced in January 2010 and concluded in October 2010. Data were generated through 350 hours of observation, two focus groups and 20 semi-structured interviews. A detailed thematic analysis was undertaken. Communication failure occurred owing to a reliance on documents and documentation to transfer information at patient transition points, poor quality documents and documentation, and problematic access to information. Institutional ruling practices of professional practice, efficiency and productivity, and fiscal constraint dominated the coordination of nurses', surgeons' and anaesthetists' communication through documents and documentation. These governing practices configured communication to be incongruous with reliably meeting safety and quality objectives. Communication failure occurred because important information was sometimes buried in documents, insufficient, inaccurate, out-of-date or not verbally reinforced. Furthermore, busy nurses were not always able to access information they required in a timely manner. Patient safety was affected, which led to delays in treatment and at times inadequate care. Organisational support needs to be provided to nurses, surgeons and anaesthetists so they have sufficient time to complete, locate, and read documents and documentation. Infrastructure supporting communication technologies should be implemented to enable the rapid retrieval, entry, and dispersion of information. © 2015 John Wiley & Sons Ltd.

Facilitating access to information in large documents with an intelligent hypertext system

NASA Technical Reports Server (NTRS)

Mathe, Nathalie

1993-01-01

Retrieving specific information from large amounts of documentation is not an easy task. It could be facilitated if information relevant in the current problem solving context could be automatically supplied to the user. As a first step towards this goal, we have developed an intelligent hypertext system called CID (Computer Integrated Documentation) and tested it on the Space Station Freedom requirement documents. The CID system enables integration of various technical documents in a hypertext framework and includes an intelligent context-sensitive indexing and retrieval mechanism. This mechanism utilizes on-line user information requirements and relevance feedback either to reinforce current indexing in case of success or to generate new knowledge in case of failure. This allows the CID system to provide helpful responses, based on previous usage of the documentation, and to improve its performance over time.

45 CFR 1303.7 - Effect of failure to file or serve documents in a timely manner.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Effect of failure to file or serve documents in a... PROSPECTIVE DELEGATE AGENCIES General § 1303.7 Effect of failure to file or serve documents in a timely manner... requisite deadlines or time frames if it exceeds them by any amount. (d) The time to file an appeal...

Severe acute haemorrhagic liver failure in a neonate with a favourable spontaneous outcome.

PubMed

Cavet, Madeleine; Balu, Marie; Garel, Catherine; Mitanchez, Delphine; Renolleau, Sylvain; Alexandre, Marie; Pariente, Danièle; Ducou le Pointe, Hubert

2008-10-01

Acute liver failure in neonates is rare and is frequently associated with an unfavourable outcome. There is no curative treatment other than liver transplantation. Screening for viral, metabolic, toxic or vascular disease is essential to assess the prognosis and to guide specific treatment. Hepatic haemorrhage in neonates is often associated with bacterial infection, trauma and coagulopathies. We present a unique case of neonatal acute liver failure and multifocal massive haemorrhagic intrahepatic lesions of traumatic origin, documented by US and MRI. The patient made a spontaneous recovery. Clinical, biological and imaging outcome was excellent despite the apparent severity of the initial features. The only possible aetiology was a difficult caesarean delivery for mild fetal macrosomia.

Needs of Rural Schools Regarding HIV Education.

ERIC Educational Resources Information Center

Helge, Doris

This document reviews problems related to sexual activity among rural U.S. teenagers, successes and failures of teen sex education programs, and problems and needs specific to rural areas. In a recent poll, 89% of adults favored sex education in the schools and 73% supported making birth control information and contraceptives available in school…

Denuclearization for a Just World: The Failure of Non Proliferation.

ERIC Educational Resources Information Center

Institute for World Order, New York, NY.

The document discusses the non proliferation policies of nuclear power nations. It specifically focuses on the credibility gap which exists between the actual statements of peaceful intentions made by these nations which express the need for non proliferation of nuclear weapons and their actual conduct with regards to nuclear-related issues in…

2013 update on congenital heart disease, clinical cardiology, heart failure, and heart transplant.

PubMed

Subirana, M Teresa; Barón-Esquivias, Gonzalo; Manito, Nicolás; Oliver, José M; Ripoll, Tomás; Lambert, Jose Luis; Zunzunegui, José L; Bover, Ramon; García-Pinilla, José Manuel

2014-03-01

This article presents the most relevant developments in 2013 in 3 key areas of cardiology: congenital heart disease, clinical cardiology, and heart failure and transplant. Within the area of congenital heart disease, we reviewed contributions related to sudden death in adult congenital heart disease, the importance of specific echocardiographic parameters in assessing the systemic right ventricle, problems in patients with repaired tetralogy of Fallot and indication for pulmonary valve replacement, and confirmation of the role of specific factors in the selection of candidates for Fontan surgery. The most recent publications in clinical cardiology include a study by a European working group on correct diagnostic work-up in cardiomyopathies, studies on the cost-effectiveness of percutaneous aortic valve implantation, a consensus document on the management of type B aortic dissection, and guidelines on aortic valve and ascending aortic disease. The most noteworthy developments in heart failure and transplantation include new American guidelines on heart failure, therapeutic advances in acute heart failure (serelaxin), the management of comorbidities such as iron deficiency, risk assessment using new biomarkers, and advances in ventricular assist devices. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

NASA Space Mechanisms Handbook: Lessons Learned Documented

NASA Technical Reports Server (NTRS)

Fusaro, Robert L.

1999-01-01

The need to improve space mechanism reliability is underscored by a long history of flight failures and anomalies caused by malfunctioning mechanisms on spacecraft and launch vehicles. Some examples of these failures are listed in a table. Because much experience has been gained over the years, many specialized design practices have evolved and many unsatisfactory design approaches have been identified.NASA and the NASA Lewis Research Center conducted a Lessons Learned Study (refs. 1 and 2) and wrote a handbook to document what has been learned in the past. The primary goals of the handbook were to identify desirable and undesirable design practices for space mechanisms and to reduce the number of failures caused by the repetition of past design errors. Another goal was to identify a variety of design approaches for specific applications and to provide the associated considerations and caveats for each approach in an effort to help designers choose the approach most suitable for each application. This technical summary outlines the goals and objectives of the handbook and study as well as the contents of the handbook.

Independent Orbiter Assessment (IOA): Analysis of the body flap subsystem

NASA Technical Reports Server (NTRS)

Wilson, R. E.; Riccio, J. R.

1986-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items (PCIs). To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The independent analysis results for the Orbiter Body Flap (BF) subsystem hardware are documented. The BF is a large aerosurface located at the trailing edge of the lower aft fuselage of the Orbiter. The proper function of the BF is essential during the dynamic flight phases of ascent and entry. During the ascent phase of flight, the BF trails in a fixed position. For entry, the BF provides elevon load relief, trim control, and acts as a heat shield for the main engines. Specifically, the BF hardware comprises the following components: Power Drive Unit (PDU), rotary actuators, and torque tubes. The IOA analysis process utilized available BF hardware drawings and schematics for defining hardware assemblies, components, and hardware items. Each level of hardware was evaluated and analyzed for possible failure modes and effects. Criticality was assigned based upon the severity of the effect for each failure mode. Of the 35 failure modes analyzed, 19 were determined to be PCIs.

PV Degradation Curves: Non-Linearities and Failure Modes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jordan, Dirk C.; Silverman, Timothy J.; Sekulic, Bill

Photovoltaic (PV) reliability and durability have seen increased interest in recent years. Historically, and as a preliminarily reasonable approximation, linear degradation rates have been used to quantify long-term module and system performance. The underlying assumption of linearity can be violated at the beginning of the life, as has been well documented, especially for thin-film technology. Additionally, non-linearities in the wear-out phase can have significant economic impact and appear to be linked to different failure modes. In addition, associating specific degradation and failure modes with specific time series behavior will aid in duplicating these degradation modes in accelerated tests and, eventually,more » in service life prediction. In this paper, we discuss different degradation modes and how some of these may cause approximately linear degradation within the measurement uncertainty (e.g., modules that were mainly affected by encapsulant discoloration) while other degradation modes lead to distinctly non-linear degradation (e.g., hot spots caused by cracked cells or solder bond failures and corrosion). The various behaviors are summarized with the goal of aiding in predictions of what may be seen in other systems.« less

Failure detection and recovery in the assembly/contingency subsystem

NASA Technical Reports Server (NTRS)

Gantenbein, Rex E.

1993-01-01

The Assembly/Contingency Subsystem (ACS) is the primary communications link on board the Space Station. Any failure in a component of this system or in the external devices through which it communicates with ground-based systems will isolate the Station. The ACS software design includes a failure management capability (ACFM) that provides protocols for failure detection, isolation, and recovery (FDIR). The the ACFM design requirements as outlined in the current ACS software requirements specification document are reviewed. The activities carried out in this review include: (1) an informal, but thorough, end-to-end failure mode and effects analysis of the proposed software architecture for the ACFM; and (2) a prototype of the ACFM software, implemented as a C program under the UNIX operating system. The purpose of this review is to evaluate the FDIR protocols specified in the ACS design and the specifications themselves in light of their use in implementing the ACFM. The basis of failure detection in the ACFM is the loss of signal between the ground and the Station, which (under the appropriate circumstances) will initiate recovery to restore communications. This recovery involves the reconfiguration of the ACS to either a backup set of components or to a degraded communications mode. The initiation of recovery depends largely on the criticality of the failure mode, which is defined by tables in the ACFM and can be modified to provide a measure of flexibility in recovery procedures.

32 CFR 701.121 - Processing “routine use” disclosures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... DEPARTMENT OF THE NAVY DOCUMENTS AFFECTING THE PUBLIC DON Privacy Program § 701.121 Processing “routine use... be in writing and state that it is being made under a “routine use” established by a specific PA... and maintain a disclosure accounting of the information released. (See § 701.111.) (b) Failure to cite...

Independent Orbiter Assessment (IOA): Analysis of the landing/deceleration subsystem

NASA Technical Reports Server (NTRS)

Compton, J. M.; Beaird, H. G.; Weissinger, W. D.

1987-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. This report documents the independent analysis results corresponding to the Orbiter Landing/Deceleration Subsystem hardware. The Landing/Deceleration Subsystem is utilized to allow the Orbiter to perform a safe landing, allowing for landing-gear deploy activities, steering and braking control throughout the landing rollout to wheel-stop, and to allow for ground-handling capability during the ground-processing phase of the flight cycle. Specifically, the Landing/Deceleration hardware consists of the following components: Nose Landing Gear (NLG); Main Landing Gear (MLG); Brake and Antiskid (B and AS) Electrical Power Distribution and Controls (EPD and C); Nose Wheel Steering (NWS); and Hydraulics Actuators. Each level of hardware was evaluated and analyzed for possible failure modes and effects. Criticality was assigned based upon the severity of the effect for each failure mode. Due to the lack of redundancy in the Landing/Deceleration Subsystems there is a high number of critical items.

Vocabulary of aerospace safety terms pertaining to cryogenic safety, fires, explosions, and structure failure

NASA Technical Reports Server (NTRS)

Pelouch, J. J., Jr.; Mandel, G.; Ordin, P. M.

1976-01-01

This vocabulary listing characterizes the contents of over 10,000 documents of the NASA Aerospace Safety Research and Data Institute's (ASRDI) safety engineering collection. The ASRDI collection is now one of the series accessible on the NASA RECON data base. There are approximately 6,300 postable terms that describe literature in the areas of cryogenic fluid safety, specifically hydrogen, oxygen, liquified natural gas; fire and explosion technology; and the mechanics of structural failure. To facilitate the proper selection of information nonpostable, related and array terms have been included in this listing.

An improved approach for flight readiness certification: Methodology for failure risk assessment and application examples, volume 1

NASA Technical Reports Server (NTRS)

Moore, N. R.; Ebbeler, D. H.; Newlin, L. E.; Sutharshana, S.; Creager, M.

1992-01-01

An improved methodology for quantitatively evaluating failure risk of spaceflight systems to assess flight readiness and identify risk control measures is presented. This methodology, called Probabilistic Failure Assessment (PFA), combines operating experience from tests and flights with engineering analysis to estimate failure risk. The PFA methodology is of particular value when information on which to base an assessment of failure risk, including test experience and knowledge of parameters used in engineering analyses of failure phenomena, is expensive or difficult to acquire. The PFA methodology is a prescribed statistical structure in which engineering analysis models that characterize failure phenomena are used conjointly with uncertainties about analysis parameters and/or modeling accuracy to estimate failure probability distributions for specific failure modes. These distributions can then be modified, by means of statistical procedures of the PFA methodology, to reflect any test or flight experience. Conventional engineering analysis models currently employed for design of failure prediction are used in this methodology. The PFA methodology is described and examples of its application are presented. Conventional approaches to failure risk evaluation for spaceflight systems are discussed, and the rationale for the approach taken in the PFA methodology is presented. The statistical methods, engineering models, and computer software used in fatigue failure mode applications are thoroughly documented.

Multisensor and Multispectral Approach in Documenting and Analyzing Liquefaction Hazard using Remote Sensing

NASA Astrophysics Data System (ADS)

Oommen, T.; Baise, L. G.; Gens, R.; Prakash, A.; Gupta, R. P.

2008-12-01

Seismic liquefaction is the loss of strength of soil due to shaking that leads to various ground failures such as lateral spreading, settlements, tilting, and sand boils. It is important to document these failures after earthquakes to advance our study of when and where liquefaction occurs. The current approach of mapping these failures by field investigation teams suffers due to the inaccessibility to some of the sites immediately after the event, short life of some of these failures, difficulties in mapping the aerial extent of the failure, incomplete coverage etc. After the 2001 Bhuj earthquake (India), researchers, using the Indian remote sensing satellite, illustrated that satellite remote sensing can provide a synoptic view of the terrain and offer unbiased estimates of liquefaction failures. However, a multisensor (data from different sensors onboard of the same or different satellites) and multispectral (data collected in different spectral regions) approach is needed to efficiently document liquefaction incidences and/or its potential of occurrence due to the possibility of a particular satellite being located inappropriately to image an area shortly after an earthquake. The use of SAR satellite imagery ensures the acquisition of data in all weather conditions at day and night as well as information complimentary to the optical data sets. In this study, we analyze the applicability of the various satellites (Landsat, RADARSAT, Terra-MISR, IRS-1C, IRS-1D) in mapping liquefaction failures after the 2001 Bhuj earthquake using Support Vector Data Description (SVDD). The SVDD is a kernel based nonparametric outlier detection algorithm inspired by the Support Vector Machines (SVMs), which is a new generation learning algorithm based on the statistical learning theory. We present the applicability of SVDD for unsupervised change-detection studies (i.e. to identify post-earthquake liquefaction failures). The liquefaction occurrences identified from the different satellites using SVDD have been compared to the ground truth in terms of documented liquefaction failures by other researchers. We present the applicability and appropriateness of the various satellites and spectral regions for documenting liquefaction related failures. Results illustrate that the SVDD is a promising unsupervised change-detection algorithm, which can help in automating the documentation of earthquake induced liquefaction failures.

An improved approach for flight readiness certification: Probabilistic models for flaw propagation and turbine blade failure. Volume 1: Methodology and applications

NASA Technical Reports Server (NTRS)

Moore, N. R.; Ebbeler, D. H.; Newlin, L. E.; Sutharshana, S.; Creager, M.

1992-01-01

An improved methodology for quantitatively evaluating failure risk of spaceflight systems to assess flight readiness and identify risk control measures is presented. This methodology, called Probabilistic Failure Assessment (PFA), combines operating experience from tests and flights with analytical modeling of failure phenomena to estimate failure risk. The PFA methodology is of particular value when information on which to base an assessment of failure risk, including test experience and knowledge of parameters used in analytical modeling, is expensive or difficult to acquire. The PFA methodology is a prescribed statistical structure in which analytical models that characterize failure phenomena are used conjointly with uncertainties about analysis parameters and/or modeling accuracy to estimate failure probability distributions for specific failure modes. These distributions can then be modified, by means of statistical procedures of the PFA methodology, to reflect any test or flight experience. State-of-the-art analytical models currently employed for designs failure prediction, or performance analysis are used in this methodology. The rationale for the statistical approach taken in the PFA methodology is discussed, the PFA methodology is described, and examples of its application to structural failure modes are presented. The engineering models and computer software used in fatigue crack growth and fatigue crack initiation applications are thoroughly documented.

Independent Orbiter Assessment (IOA): Analysis of the Orbiter Experiment (OEX) subsystem

NASA Technical Reports Server (NTRS)

Compton, J. M.

1987-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. This report documents the independent analysis results corresponding to the Orbiter Experiments hardware. Each level of hardware was evaluated and analyzed for possible failure modes and effects. Criticality was assigned based upon the severity of the effect for each failure mode. The Orbiter Experiments (OEX) Program consists of a multiple set of experiments for the purpose of gathering environmental and aerodynamic data to develop more accurate ground models for Shuttle performance and to facilitate the design of future spacecraft. This assessment only addresses currently manifested experiments and their support systems. Specifically this list consists of: Shuttle Entry Air Data System (SEADS); Shuttle Upper Atmosphere Mass Spectrometer (SUMS); Forward Fuselage Support System for OEX (FFSSO); Shuttle Infrared Laced Temperature Sensor (SILTS); Aerodynamic Coefficient Identification Package (ACIP); and Support System for OEX (SSO). There are only two potential critical items for the OEX, since the experiments only gather data for analysis post mission and are totally independent systems except for power. Failure of any experiment component usually only causes a loss of experiment data and in no way jeopardizes the crew or mission.

Guidelines for VCCT-Based Interlaminar Fatigue and Progressive Failure Finite Element Analysis

NASA Technical Reports Server (NTRS)

Deobald, Lyle R.; Mabson, Gerald E.; Engelstad, Steve; Prabhakar, M.; Gurvich, Mark; Seneviratne, Waruna; Perera, Shenal; O'Brien, T. Kevin; Murri, Gretchen; Ratcliffe, James;

Potential surrogate endpoints for prostate cancer survival: analysis of a phase III randomized trial.

PubMed

Ray, Michael E; Bae, Kyounghwa; Hussain, Maha H A; Hanks, Gerald E; Shipley, William U; Sandler, Howard M

2009-02-18

The identification of surrogate endpoints for prostate cancer-specific survival may shorten the length of clinical trials for prostate cancer. We evaluated distant metastasis and general clinical treatment failure as potential surrogates for prostate cancer-specific survival by use of data from the Radiation Therapy and Oncology Group 92-02 randomized trial. Patients (n = 1554 randomly assigned and 1521 evaluable for this analysis) with locally advanced prostate cancer had been treated with 4 months of neoadjuvant and concurrent androgen deprivation therapy with external beam radiation therapy and then randomly assigned to no additional therapy (control arm) or 24 additional months of androgen deprivation therapy (experimental arm). Data from landmark analyses at 3 and 5 years for general clinical treatment failure (defined as documented local disease progression, regional or distant metastasis, initiation of androgen deprivation therapy, or a prostate-specific antigen level of 25 ng/mL or higher after radiation therapy) and/or distant metastasis were tested as surrogate endpoints for prostate cancer-specific survival at 10 years by use of Prentice's four criteria. All statistical tests were two-sided. At 3 years, 1364 patients were alive and contributed data for analysis. Both distant metastasis and general clinical treatment failure at 3 years were consistent with all four of Prentice's criteria for being surrogate endpoints for prostate cancer-specific survival at 10 years. At 5 years, 1178 patients were alive and contributed data for analysis. Although prostate cancer-specific survival was not statistically significantly different between treatment arms at 5 years (P = .08), both endpoints were consistent with Prentice's remaining criteria. Distant metastasis and general clinical treatment failure at 3 years may be candidate surrogate endpoints for prostate cancer-specific survival at 10 years. These endpoints, however, must be validated in other datasets.

19 CFR 10.424 - Effect of noncompliance; failure to provide documentation regarding transshipment of non...

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 1 2014-04-01 2014-04-01 false Effect of noncompliance; failure to provide documentation regarding transshipment of non-originating cotton or man-made fiber fabric or apparel goods. 10... documentation regarding transshipment of non-originating cotton or man-made fiber fabric or apparel goods. (a...

19 CFR 10.424 - Effect of noncompliance; failure to provide documentation regarding transshipment of non...

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 1 2012-04-01 2012-04-01 false Effect of noncompliance; failure to provide documentation regarding transshipment of non-originating cotton or man-made fiber fabric or apparel goods. 10... documentation regarding transshipment of non-originating cotton or man-made fiber fabric or apparel goods. (a...

19 CFR 10.424 - Effect of noncompliance; failure to provide documentation regarding transshipment of non...

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 1 2013-04-01 2013-04-01 false Effect of noncompliance; failure to provide documentation regarding transshipment of non-originating cotton or man-made fiber fabric or apparel goods. 10... documentation regarding transshipment of non-originating cotton or man-made fiber fabric or apparel goods. (a...

19 CFR 10.424 - Effect of noncompliance; failure to provide documentation regarding transshipment of non...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Effect of noncompliance; failure to provide documentation regarding transshipment of non-originating cotton or man-made fiber fabric or apparel goods. 10... documentation regarding transshipment of non-originating cotton or man-made fiber fabric or apparel goods. (a...

19 CFR 10.424 - Effect of noncompliance; failure to provide documentation regarding transshipment of non...

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 1 2011-04-01 2011-04-01 false Effect of noncompliance; failure to provide documentation regarding transshipment of non-originating cotton or man-made fiber fabric or apparel goods. 10... documentation regarding transshipment of non-originating cotton or man-made fiber fabric or apparel goods. (a...

Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure

PubMed Central

Brochard, Laurent; Elliott, Mark W.; Hess, Dean; Hill, Nicholas S.; Navalesi, Paolo; Antonelli, Massimo; Brozek, Jan; Conti, Giorgio; Ferrer, Miquel; Guntupalli, Kalpalatha; Jaber, Samir; Keenan, Sean; Mancebo, Jordi; Mehta, Sangeeta; Raoof, Suhail

2017-01-01

Noninvasive mechanical ventilation (NIV) is widely used in the acute care setting for acute respiratory failure (ARF) across a variety of aetiologies. This document provides European Respiratory Society/American Thoracic Society recommendations for the clinical application of NIV based on the most current literature. The guideline committee was composed of clinicians, methodologists and experts in the field of NIV. The committee developed recommendations based on the GRADE (Grading, Recommendation, Assessment, Development and Evaluation) methodology for each actionable question. The GRADE Evidence to Decision framework in the guideline development tool was used to generate recommendations. A number of topics were addressed using technical summaries without recommendations and these are discussed in the supplementary material. This guideline committee developed recommendations for 11 actionable questions in a PICO (population–intervention–comparison–outcome) format, all addressing the use of NIV for various aetiologies of ARF. The specific conditions where recommendations were made include exacerbation of chronic obstructive pulmonary disease, cardiogenic pulmonary oedema, de novo hypoxaemic respiratory failure, immunocompromised patients, chest trauma, palliation, post-operative care, weaning and post-extubation. This document summarises the current state of knowledge regarding the role of NIV in ARF. Evidence-based recommendations provide guidance to relevant stakeholders. PMID:28860265

Independent Orbiter Assessment (IOA): Assessment of the mechanical actuation subsystem, volume 1

NASA Technical Reports Server (NTRS)

Bradway, M. W.; Slaughter, W. T.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine draft failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the proposed Post 51-L NASA FMEA/CIL baseline that was available. A resolution of each discrepancy from the comparison was provided through additional analysis as required. These discrepancies were flagged as issues, and recommendations were made based on the FMEA data available at the time. This report documents the results of that comparison for the Orbiter Mechanical Actuation System (MAS) hardware. Specifically, the MAS hardware consists of the following components: Air Data Probe (ADP); Elevon Seal Panel (ESP); External Tank Umbilical (ETU); Ku-Band Deploy (KBD); Payload Bay Doors (PBD); Payload Bay Radiators (PBR); Personnel Hatches (PH); Vent Door Mechanism (VDM); and Startracker Door Mechanism (SDM). Criticality was assigned based upon the severity of the effect for each failure mode.

An improved approach for flight readiness certification: Methodology for failure risk assessment and application examples. Volume 3: Structure and listing of programs

NASA Technical Reports Server (NTRS)

Moore, N. R.; Ebbeler, D. H.; Newlin, L. E.; Sutharshana, S.; Creager, M.

1992-01-01

An improved methodology for quantitatively evaluating failure risk of spaceflight systems to assess flight readiness and identify risk control measures is presented. This methodology, called Probabilistic Failure Assessment (PFA), combines operating experience from tests and flights with engineering analysis to estimate failure risk. The PFA methodology is of particular value when information on which to base an assessment of failure risk, including test experience and knowledge of parameters used in engineering analyses of failure phenomena, is expensive or difficult to acquire. The PFA methodology is a prescribed statistical structure in which engineering analysis models that characterize failure phenomena are used conjointly with uncertainties about analysis parameters and/or modeling accuracy to estimate failure probability distributions for specific failure modes. These distributions can then be modified, by means of statistical procedures of the PFA methodology, to reflect any test or flight experience. Conventional engineering analysis models currently employed for design of failure prediction are used in this methodology. The PFA methodology is described and examples of its application are presented. Conventional approaches to failure risk evaluation for spaceflight systems are discussed, and the rationale for the approach taken in the PFA methodology is presented. The statistical methods, engineering models, and computer software used in fatigue failure mode applications are thoroughly documented.

Tin Whiskers: A History of Documented Electrical System Failures

NASA Technical Reports Server (NTRS)

Leidecker, Henning; Brusse, Jay

2006-01-01

This viewgraph presentation reviews the history of tin and other metal whiskers, and the damage they have caused equipment. There are pictures of whiskers on various pieces of electronic equipment, and microscopic views of whiskers. There is also a chart with information on the documented failures associated with metal whiskers. There are also examples of on-orbit failures believed to be caused by whiskers.

Organization of heart failure management in European Society of Cardiology member countries: survey of the Heart Failure Association of the European Society of Cardiology in collaboration with the Heart Failure National Societies/Working Groups.

PubMed

Seferovic, Petar M; Stoerk, Stefan; Filippatos, Gerasimos; Mareev, Viacheslav; Kavoliuniene, Ausra; Ristic, Arsen D; Ponikowski, Piotr; McMurray, John; Maggioni, Aldo; Ruschitzka, Frank; van Veldhuisen, Dirk J; Coats, Andrew; Piepoli, Massimo; McDonagh, Theresa; Riley, Jillian; Hoes, Arno; Pieske, Burkert; Dobric, Milan; Papp, Zoltan; Mebazaa, Alexandre; Parissis, John; Ben Gal, Tuvia; Vinereanu, Dragos; Brito, Dulce; Altenberger, Johann; Gatzov, Plamen; Milinkovic, Ivan; Hradec, Jaromír; Trochu, Jean-Noel; Amir, Offer; Moura, Brenda; Lainscak, Mitja; Comin, Josep; Wikström, Gerhard; Anker, Stefan

2013-09-01

The aim of this document was to obtain a real-life contemporary analysis of the demographics and heart failure (HF) statistics, as well as the organization and major activities of the Heart Failure National Societies (HFNS) in European Society of Cardiology (ESC) member countries. Data from 33 countries were collected from HFNS presidents/representatives during the first Heart Failure Association HFNS Summit (Belgrade, Serbia, 29 October 2011). Data on incidence and/or prevalence of HF were available for 22 countries, and the prevalence of HF ranged between 1% and 3%. In five European and one non-European ESC country, heart transplantation was reported as not available. Natriuretic peptides and echocardiography are routinely applied in the management of acute HF in the median of 80% and 90% of centres, respectively. Eastern European and Mediterranean countries have lower availability of natriuretic peptide testing for acute HF patients, compared with other European countries. Almost all countries have organizations dealing specifically with HF. HFNS societies for HF patients exist in only 12, while in 16 countries HF patient education programmes are active. Most HFNS reported that no national HF registry exists in their country. Fifteen HFNS produced national HF guidelines, while 19 have translated the ESC HF guidelines. Most HFNS (n = 23) participated in the organization of the European HF Awareness Day. This document demonstrated significant heterogeneity in the organization of HF management, and activities of the national HF working groups/associations. High availability of natriuretic peptide and echocardiographic measurements was revealed, with differences between developed countries and countries in transition.

Independent Orbiter Assessment (IOA): Analysis of the electrical power generation/power reactant storage and distribution subsystem

NASA Technical Reports Server (NTRS)

Gotch, S. M.

1986-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NAA FMEA/CIL documentation. The independent analysis results corresponding to the Orbiter Electrical Power Generation (EPG)/Power Reactants Storage and Distribution (PRSD) System Hardware is documented. The EPG/PRSD hardware is required for performing critical functions of cryogenic hydrogen and oxygen storage and distribution to the Fuel Cell Powerplants (FCP) and Atmospheric Revitalization Pressure Control Subsystem (ARPCS). Specifically, the EPG/PRSD hardware consists of the following: Hydryogen (H2) tanks; Oxygen (O2) tanks; H2 Relief Valve/Filter Packages (HRVFP); O2 Relief Valve/Filter Packages (ORVFP); H2 Valve Modules (HVM); O2 Valve Modules (OVM); and O2 and H2 lines, components, and fittings.

"Understanding" medical school curriculum content using KnowledgeMap.

PubMed

Denny, Joshua C; Smithers, Jeffrey D; Miller, Randolph A; Spickard, Anderson

2003-01-01

To describe the development and evaluation of computational tools to identify concepts within medical curricular documents, using information derived from the National Library of Medicine's Unified Medical Language System (UMLS). The long-term goal of the KnowledgeMap (KM) project is to provide faculty and students with an improved ability to develop, review, and integrate components of the medical school curriculum. The KM concept identifier uses lexical resources partially derived from the UMLS (SPECIALIST lexicon and Metathesaurus), heuristic language processing techniques, and an empirical scoring algorithm. KM differentiates among potentially matching Metathesaurus concepts within a source document. The authors manually identified important "gold standard" biomedical concepts within selected medical school full-content lecture documents and used these documents to compare KM concept recognition with that of a known state-of-the-art "standard"-the National Library of Medicine's MetaMap program. The number of "gold standard" concepts in each lecture document identified by either KM or MetaMap, and the cause of each failure or relative success in a random subset of documents. For 4,281 "gold standard" concepts, MetaMap matched 78% and KM 82%. Precision for "gold standard" concepts was 85% for MetaMap and 89% for KM. The heuristics of KM accurately matched acronyms, concepts underspecified in the document, and ambiguous matches. The most frequent cause of matching failures was absence of target concepts from the UMLS Metathesaurus. The prototypic KM system provided an encouraging rate of concept extraction for representative medical curricular texts. Future versions of KM should be evaluated for their ability to allow administrators, lecturers, and students to navigate through the medical curriculum to locate redundancies, find interrelated information, and identify omissions. In addition, the ability of KM to meet specific, personal information needs should be assessed.

The concerns of patients under palliative care and a heart failure clinic are not being met.

PubMed

Anderson, H; Ward, C; Eardley, A; Gomm, S A; Connolly, M; Coppinger, T; Corgie, D; Williams, J L; Makin, W P

2001-07-01

Patients with a terminal illness, identified by palliative care teams working in Manchester, and patients attending a heart failure clinic, were asked to participate in a prospective survey to determine their main concerns. Data were collected from 213 palliative care (PC) patients (mostly with cancer) and 66 patients with heart failure (HF). The median ages of the two patient groups were similar, but the HF patients were more likely to be male and living with a partner; 13% of PC and 7% of HF patients reported that they had no carer. The PC patients had more district nurse, hospice, social work and physiotherapy input. The most frequently reported troublesome problems for PC patients were pain (49%), loss of independence (30%) and difficulty walking (27%). HF patients reported dyspnoea (55%), angina (32%) and tiredness (27%) as the most troublesome problems. From a checklist of symptoms, the frequency of tiredness (PC = 77%, HF = 82%) and difficulty getting about (PC = 71%, HF = 65%) were high in each group. Psychological problems were reported by 61% of PC and 41% of HF patients. Cardiac patients reported more breathlessness and cough than PC patients (83% vs 49% and 44% vs 26%, respectively). Reduced libido was more common in cardiac patients (42% vs 21%). Patient disclosure of troublesome problems to professional carers was high (>87% in both PC and HF patients). Documented action was greater for physical than social or psychological problems. For PC patients, documented action was recorded for 83% physical, 43% social/functional and 52% psychological problems. For HF patients documented action was recorded for 74% cardiac, 60% physical - non-cardiac, 30% social/functional and 28% psychological problems. Clearly many patients' troublesome problems were not being addressed. As a result of this study, specific action by health care professionals was taken in 50% of PC patients and 71% of HF patients. We plan to target specific educational events on the treatment of physical problems, psychological assessment and social service provision.

Security Analysis of Selected AMI Failure Scenarios Using Agent Based Game Theoretic Simulation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Abercrombie, Robert K; Schlicher, Bob G; Sheldon, Frederick T

Information security analysis can be performed using game theory implemented in dynamic Agent Based Game Theoretic (ABGT) simulations. Such simulations can be verified with the results from game theory analysis and further used to explore larger scale, real world scenarios involving multiple attackers, defenders, and information assets. We concentrated our analysis on the Advanced Metering Infrastructure (AMI) functional domain which the National Electric Sector Cyber security Organization Resource (NESCOR) working group has currently documented 29 failure scenarios. The strategy for the game was developed by analyzing five electric sector representative failure scenarios contained in the AMI functional domain. From thesemore » five selected scenarios, we characterize them into three specific threat categories affecting confidentiality, integrity and availability (CIA). The analysis using our ABGT simulation demonstrates how to model the AMI functional domain using a set of rationalized game theoretic rules decomposed from the failure scenarios in terms of how those scenarios might impact the AMI network with respect to CIA.« less

Acute Liver Failure During Deferasirox Chelation: A Toxicity Worth Considering.

PubMed

Menaker, Nathan; Halligan, Katharine; Shur, Natasha; Paige, John; Hickling, Matthew; Nepo, Anne; Weintraub, Lauren

2017-04-01

This case report details a unique case of acute, reversible liver failure in a 12-year-old male with sickle cell anemia on chronic transfusion protocol and deferasirox chelation. There is substantial literature documenting deferasirox-induced renal injury, including Fanconi syndrome, but less documentation of hepatic toxicity and few reports of hepatic failure. The case highlights the importance of close monitoring of ferritin, bilirubin, and transaminases for patients on deferasirox.

A SOA-Based Solution to Monitor Vaccination Coverage Among HIV-Infected Patients in Liguria.

PubMed

Giannini, Barbara; Gazzarata, Roberta; Sticchi, Laura; Giacomini, Mauro

2016-01-01

Vaccination in HIV-infected patients constitutes an essential tool in the prevention of the most common infectious diseases. The Ligurian Vaccination in HIV Program is a proposed vaccination schedule specifically dedicated to this risk group. Selective strategies are proposed within this program, employing ICT (Information and Communication) tools to identify this susceptible target group, to monitor immunization coverage over time and to manage failures and defaulting. The proposal is to connect an immunization registry system to an existing regional platform that allows clinical data re-use among several medical structures, to completely manage the vaccination process. This architecture will adopt a Service Oriented Architecture (SOA) approach and standard HSSP (Health Services Specification Program) interfaces to support interoperability. According to the presented solution, vaccination administration information retrieved from the immunization registry will be structured according to the specifications within the immunization section of the HL7 (Health Level 7) CCD (Continuity of Care Document) document. Immunization coverage will be evaluated through the continuous monitoring of serology and antibody titers gathered from the hospital LIS (Laboratory Information System) structured into a HL7 Version 3 (v3) Clinical Document Architecture Release 2 (CDA R2).

Identification of Modeling Approaches To Support Common-Cause Failure Analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Korsah, Kofi; Wood, Richard Thomas

2015-06-01

Experience with applying current guidance and practices for common-cause failure (CCF) mitigation to digital instrumentation and control (I&C) systems has proven problematic, and the regulatory environment has been unpredictable. The impact of CCF vulnerability is to inhibit I&C modernization and, thereby, challenge the long-term sustainability of existing plants. For new plants and advanced reactor concepts, the issue of CCF vulnerability for highly integrated digital I&C systems imposes a design burden resulting in higher costs and increased complexity. The regulatory uncertainty regarding which mitigation strategies are acceptable (e.g., what diversity is needed and how much is sufficient) drives designers to adoptmore » complicated, costly solutions devised for existing plants. The conditions that constrain the transition to digital I&C technology by the U.S. nuclear industry require crosscutting research to resolve uncertainty, demonstrate necessary characteristics, and establish an objective basis for qualification of digital technology for usage in Nuclear Power Plant (NPP) I&C applications. To fulfill this research need, Oak Ridge National Laboratory is conducting an investigation into mitigation of CCF vulnerability for nuclear-qualified applications. The outcome of this research is expected to contribute to a fundamentally sound, comprehensive technical basis for establishing the qualification of digital technology for nuclear power applications. This report documents the investigation of modeling approaches for representing failure of I&C systems. Failure models are used when there is a need to analyze how the probability of success (or failure) of a system depends on the success (or failure) of individual elements. If these failure models are extensible to represent CCF, then they can be employed to support analysis of CCF vulnerabilities and mitigation strategies. Specifically, the research findings documented in this report identify modeling approaches that can be adapted to contribute to the basis for developing systematic methods, quantifiable measures, and objective criteria for evaluating CCF vulnerabilities and mitigation strategies.« less

Investigation of premature strip seal joint failures and recommendations for assuring proper strip seal joint installation: Bridge 5/104W.

DOT National Transportation Integrated Search

2015-08-01

This document summarizes an investigation that was performed to identify the cause(s) of premature failures of : strip seal expansion joints that were installed on WSDOT Bridge No. 5/104W. The document also includes recommendations : for assuring pro...

19 CFR 10.588 - Effect of noncompliance; failure to provide documentation regarding transshipment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... RATE, ETC. Dominican Republic-Central America-United States Free Trade Agreement Import Requirements... 19 Customs Duties 1 2010-04-01 2010-04-01 false Effect of noncompliance; failure to provide documentation regarding transshipment. 10.588 Section 10.588 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION...

30 CFR 218.41 - Assessments for failure to submit payment of same amount as Form MMS-2014 or bill document or to...

Code of Federal Regulations, 2010 CFR

2010-07-01

... same amount as Form MMS-2014 or bill document or to provide adequate information. 218.41 Section 218.41... Assessments for failure to submit payment of same amount as Form MMS-2014 or bill document or to provide... equivalent in amount to the total of individual line items on the associated Form MMS-2014, Form MMS-4430, or...

Evaluation of clinical pharmacy interventions in a Veterans Affairs medical center primary care clinic.

PubMed

Hough, Augustus; Vartan, Christine M; Groppi, Julie A; Reyes, Sonia; Beckey, Nick P

2013-07-01

The development of an electronic tool to quantify and characterize the interventions made by clinical pharmacy specialists (CPSs) in a primary care setting is described. An electronic clinical tool was developed to document the clinical pharmacy interventions made by CPSs at the Veterans Affairs Medical Center in West Palm Beach, Florida. The tool, embedded into the electronic medical record, utilizes a novel reminder dialogue to complete pharmacotherapy visit encounters and allows CPSs to document interventions made during patient care visits. Interventions are documented using specific electronic health factors so that the type and number of interventions made for both disease-specific and other pharmacotherapy interventions can be tracked. These interventions were assessed and analyzed to evaluate the impact of CPSs in the primary care setting. From February 2011 through January 2012, a total of 16,494 pharmacotherapy interventions (therapeutic changes and goals attained) were recorded. The average numbers of interventions documented per patient encounter were 0.96 for the management of diabetes mellitus, hypertension, dyslipidemia, and heart failure and 1.36 for non-disease-specific interventions, independent of those interventions being made by the primary physician or other members of the primary care team. A clinical reminder tool developed to quantify and characterize the interventions provided by CPSs found that for every visit with a CPS, approximately one disease-specific intervention and one additional pharmacotherapy intervention were made, independent of those interventions being made by the primary physician or other members of the primary care team.

Precise Documentation: The Key to Better Software

NASA Astrophysics Data System (ADS)

Parnas, David Lorge

The prime cause of the sorry “state of the art” in software development is our failure to produce good design documentation. Poor documentation is the cause of many errors and reduces efficiency in every phase of a software product's development and use. Most software developers believe that “documentation” refers to a collection of wordy, unstructured, introductory descriptions, thousands of pages that nobody wanted to write and nobody trusts. In contrast, Engineers in more traditional disciplines think of precise blueprints, circuit diagrams, and mathematical specifications of component properties. Software developers do not know how to produce precise documents for software. Software developments also think that documentation is something written after the software has been developed. In other fields of Engineering much of the documentation is written before and during the development. It represents forethought not afterthought. Among the benefits of better documentation would be: easier reuse of old designs, better communication about requirements, more useful design reviews, easier integration of separately written modules, more effective code inspection, more effective testing, and more efficient corrections and improvements. This paper explains how to produce and use precise software documentation and illustrate the methods with several examples.

A hypertext system that learns from user feedback

NASA Technical Reports Server (NTRS)

Mathe, Nathalie

1994-01-01

Retrieving specific information from large amounts of documentation is not an easy task. It could be facilitated if information relevant in the current problem solving context could be automatically supplied to the user. As a first step towards this goal, we have developed an intelligent hypertext system called CID (Computer Integrated Documentation). Besides providing an hypertext interface for browsing large documents, the CID system automatically acquires and reuses the context in which previous searches were appropriate. This mechanism utilizes on-line user information requirements and relevance feedback either to reinforce current indexing in case of success or to generate new knowledge in case of failure. Thus, the user continually augments and refines the intelligence of the retrieval system. This allows the CID system to provide helpful responses, based on previous usage of the documentation, and to improve its performance over time. We successfully tested the CID system with users of the Space Station Freedom requirements documents. We are currently extending CID to other application domains (Space Shuttle operations documents, airplane maintenance manuals, and on-line training). We are also exploring the potential commercialization of this technique.

Acute respiratory failure secondary to mesalamine-induced interstitial pneumonitis

PubMed Central

Abraham, Albin; Karakurum, Ali

2013-01-01

Interstitial pneumonitis as an adverse effect of mesalamine therapy is a rare but potentially serious complication. Patients typically have a mild disease course with no documented cases of respiratory failure in published literature. Given its variable latent period and non-specific signs and symptoms, it may be difficult to diagnose. We present the case of a 65-year-old man who presented with symptoms of fever, shortness of breath and a non-productive cough, 2 weeks after initiation of therapy with mesalamine. His hospital course was complicated by acute respiratory failure requiring intubation and mechanical ventilation. Radiographic studies revealed bilateral lower lobe infiltrates and bronchosopy with bronchoalveolar lavage and transbronchial biopsy were consistent with a diagnosis of drug-induced interstitial pneumonitis. The aim of this paper is to highlight the importance of considering a diagnosis of mesalamine-induced lung injury in patients presenting with respiratory symptoms while on mesalamine therapy and to review relevant literature. PMID:23964037

Acute respiratory failure secondary to mesalamine-induced interstitial pneumonitis.

PubMed

Abraham, Albin; Karakurum, Ali

2013-08-20

Interstitial pneumonitis as an adverse effect of mesalamine therapy is a rare but potentially serious complication. Patients typically have a mild disease course with no documented cases of respiratory failure in published literature. Given its variable latent period and non-specific signs and symptoms, it may be difficult to diagnose. We present the case of a 65-year-old man who presented with symptoms of fever, shortness of breath and a non-productive cough, 2 weeks after initiation of therapy with mesalamine. His hospital course was complicated by acute respiratory failure requiring intubation and mechanical ventilation. Radiographic studies revealed bilateral lower lobe infiltrates and bronchosopy with bronchoalveolar lavage and transbronchial biopsy were consistent with a diagnosis of drug-induced interstitial pneumonitis. The aim of this paper is to highlight the importance of considering a diagnosis of mesalamine-induced lung injury in patients presenting with respiratory symptoms while on mesalamine therapy and to review relevant literature.

Understanding and Targeting Epigenetic Alterations in Acquired Bone Marrow Failure

DTIC Science & Technology

2016-07-01

should not be construed as an official Department of the Army position, policy or decision unless so designated by other documentation. REPORT...modifiers may specifically impact DNA methylation and/or histone post -translational modifications in a manner that is therapeutically targetable, and (c) if...2016 Tisch Cancer Institute Seminar Series, Icahn School of Medicine at Mount Sinai, New York, NY 2016 11th CML & MPN Post -ASH Workshop, La Jolla

Triggers of State Failure

DTIC Science & Technology

2010-03-01

à 1990) à l’aide de données collatérales additionnelles. Les auteurs du document n’ont pas essayé de suivre les événements qui étaient en cours...défaillance étatique, et les auteurs du document ont reconnu qu’il ne serait pas très utile de reproduire toutes ces informations. Le document s’appuie le...30 Carment, David. Assessing state failure: implications for theory and policy. in Third World Quarterly. Vol 24, no 3. pp 407-427. 30 DRDC

Completion of hand-written surgical consent forms is frequently suboptimal and could be improved by using electronically generated, procedure-specific forms.

PubMed

St John, E R; Scott, A J; Irvine, T E; Pakzad, F; Leff, D R; Layer, G T

2017-08-01

Completion of hand-written consent forms for surgical procedures may suffer from missing or inaccurate information, poor legibility and high variability. We audited the completion of hand-written consent forms and trialled a web-based application to generate modifiable, procedure-specific consent forms. The investigation comprised two phases at separate UK hospitals. In phase one, the completion of individual responses in hand-written consent forms for a variety of procedures were prospectively audited. Responses were categorised into three domains (patient details, procedure details and patient sign-off) that were considered "failed" if a contained element was not correct and legible. Phase two was confined to a breast surgical unit where hand-written consent forms were assessed as for phase one and interrogated for missing complications by two independent experts. An electronic consent platform was introduced and electronically-produced consent forms assessed. In phase one, 99 hand-written consent forms were assessed and the domain failure rates were: patient details 10%; procedure details 30%; and patient sign-off 27%. Laparoscopic cholecystectomy was the most common procedure (7/99) but there was significant variability in the documentation of complications: 12 in total, a median of 6 and a range of 2-9. In phase two, 44% (27/61) of hand-written forms were missing essential complications. There were no domain failures amongst 29 electronically-produced consent forms and no variability in the documentation of potential complications. Completion of hand-written consent forms suffers from wide variation and is frequently suboptimal. Electronically-produced, procedure-specific consent forms can improve the quality and consistency of consent documentation. Copyright © 2015 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

SU-E-T-420: Failure Effects Mode Analysis for Trigeminal Neuralgia Frameless Radiosurgery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Howe, J

2015-06-15

Purpose: Functional radiosurgery has been used successfully in the treatment of trigeminal neuralgia but presents significant challenges to ensuring the high prescription dose is delivered accurately. A review of existing practice should help direct the focus of quality improvement for this treatment regime. Method: Failure modes and effects analysis was used to identify the processes in preparing radiosurgery treatment for TN. The map was developed by a multidisciplinary team including: neurosurgeon, radiation oncology, physicist and therapist. Potential failure modes were identified for each step in the process map as well as potential causes and end effect. A risk priority numbermore » was assigned to each cause. Results: The process map identified 66 individual steps (see attached supporting document). Corrective actions were developed for areas of high risk priority number. Wrong site treatment is at higher risk for trigeminal neuralgia treatment due to the lack of site specific pathologic imaging on MR and CT – additional site specific checks were implemented to minimize the risk of wrong site treatment. Failed collision checks resulted from an insufficient collision model in the treatment planning system and a plan template was developed to address this problem. Conclusion: Failure modes and effects analysis is an effective tool for developing quality improvement in high risk radiotherapy procedures such as functional radiosurgery.« less

Realtime Knowledge Management (RKM): From an International Space Station (ISS) Point of View

NASA Technical Reports Server (NTRS)

Robinson, Peter I.; McDermott, William; Alena, Richard L.

2004-01-01

We are developing automated methods to provide realtime access to spacecraft domain knowledge relevant a spacecraft's current operational state. The method is based upon analyzing state-transition signatures in the telemetry stream. A key insight is that documentation relevant to a specific failure mode or operational state is related to the structure and function of spacecraft systems. This means that diagnostic dependency and state models can provide a roadmap for effective documentation navigation and presentation. Diagnostic models consume the telemetry and derive a high-level state description of the spacecraft. Each potential spacecraft state description is matched against the predictions of models that were developed from information found in the pages and sections in the relevant International Space Station (ISS) documentation and reference materials. By annotating each model fragment with the domain knowledge sources from which it was derived we can develop a system that automatically selects those documents representing the domain knowledge encapsulated by the models that compute the current spacecraft state. In this manner, when the spacecraft state changes, the relevant documentation context and presentation will also change.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sarrack, A.G.

The purpose of this report is to document fault tree analyses which have been completed for the Defense Waste Processing Facility (DWPF) safety analysis. Logic models for equipment failures and human error combinations that could lead to flammable gas explosions in various process tanks, or failure of critical support systems were developed for internal initiating events and for earthquakes. These fault trees provide frequency estimates for support systems failures and accidents that could lead to radioactive and hazardous chemical releases both on-site and off-site. Top event frequency results from these fault trees will be used in further APET analyses tomore » calculate accident risk associated with DWPF facility operations. This report lists and explains important underlying assumptions, provides references for failure data sources, and briefly describes the fault tree method used. Specific commitments from DWPF to provide new procedural/administrative controls or system design changes are listed in the ''Facility Commitments'' section. The purpose of the ''Assumptions'' section is to clarify the basis for fault tree modeling, and is not necessarily a list of items required to be protected by Technical Safety Requirements (TSRs).« less

Independent Orbiter Assessment (IOA): Assessment of the mechanical actuation subsystem, volume 2

NASA Technical Reports Server (NTRS)

Bradway, M. W.; Slaughter, W. T.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine draft failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the proposed Post 51-L NASA FMEA/CIL baseline that was available. A resolution of each discrepancy from the comparison was provided through additional analysis as required. These discrepancies were flagged as issues, and recommendations were made based on the FMEA data available at the time. This report documents the results of that comparison for the Orbiter Mechanical Actuation System (MAS) hardware. Specifically, the MAS hardware consists of the following components: Air Data Probe (ADP); Elevon Seal Panel (ESP); External Tank Umbilical (ETU); Ku-Band Deploy (KBD); Payload Bay Doors (PBD); Payload Bay Radiators (PBR); Personnel Hatches (PH); Vent Door Mechanism (VDM); and Startracker Door Mechanism (SDM). Criticality was assigned based upon the severity of the effect for each failure mode. Volume 2 continues the presentation of IOA analysis worksheets and contains the potential critical items list, detailed analysis, and NASA FMEA/CIL to IOA worksheet cross reference and recommendations.

Investigation of Composite Structures

NASA Technical Reports Server (NTRS)

Hyer, Michael W.

2000-01-01

This final report consists of a compilation of four separate written documents, three dealing with the response and failure of elliptical composite cylinders to an internal pressure load, and the fourth dealing with the influence of manufacturing imperfections in curved composite panels. The three focused on elliptical cylinders consist of the following: 1 - A paper entitled "Progressive Failure Analysis of Internally Pressurized Elliptical Composite Cylinders," 2 - A paper entitled "Influence of Geometric Nonlinearities on the Response and Failure of Internally Pressurized Elliptical Composite Cylinders," and 3 - A report entitled "Response and Failure of Internally Pressurized Elliptical Composite Cyclinders." The document which deals with the influence of manufacturing imperfections is a paper entitled "Manufacturing Distortions of Curved Composite Panels."

Nursing philosophy: A review of current pre registration curricula in the UK.

PubMed

Mackintosh-Franklin, Carolyn

2016-02-01

Nursing in the UK has been subject to criticism for failing to provide care and compassion in practice, with a series of reports highlighting inadequacies in care. This scrutiny provides nursing with an ideal opportunity to evaluate the underpinning philosophy of nursing practice, and for nurse educators to use this philosophy as the basis for programmes which can inculcate neophyte student nurses with a fundamental understanding of the profession, whilst providing other health care professionals and service users with a clear representation of professional nursing practice. The key word philosophy was used in a systematic stepwise descriptive content analysis of the programme specifications of 33 current undergraduate programme documents, leading to an undergraduate award and professional registration as a nurse. The word philosophy featured minimally in programme specification documents, with 12 (36%) documents including it. Its use was superficial in 3 documents and focused on educational philosophy in a further 3 documents. 2 programme specifications identified their philosophy as the NMC (2010) standards for pre-registration nurse education. 2 programme specifications articulated a philosophy specific to that programme and HEI, focusing on caring, and 2 made reference to underpinning philosophies present in nursing literature; the Relationship Centred Care Approach, and The Humanising Care Philosophy. The philosophy of nursing practice is not clearly articulated in pre-registration curricula. This failure to identify the fundamental nature of nursing is detrimental to the development of the profession, and given this lack of direction it is not surprising that some commentators feel nursing has lost its way. Nurse educators must review their current curricula to ensure that there is clear articulation of nursing's professional philosophical stance, and use this as the framework for pre-registration curricula to support the development of neophyte nursing students towards a clear and focused understanding of what nursing practice is. Copyright © 2015 Elsevier Ltd. All rights reserved.

Time-Varying, Serotype-Specific Force of Infection of Dengue Virus

DTIC Science & Technology

2014-05-20

Barraquer I, et al. (2011) From re-emergence to hyperendemicity: The natural history of the dengue epidemic in Brazil . PLoS Negl Trop Dis 5(1):e935. 14...Negl Trop Dis 5(9):e1322. 22. Egger JR, et al. (2008) Reconstructing historical changes in the force of infection of dengue fever in Singapore...documented outbreak of dengue in the Peruvian amazon region . Bull Pan Am Health Organ 26(3):201–207. 26. Watts DM, et al. (1999) Failure of secondary

Independent Orbiter Assessment (IOA): Analysis of the crew equipment subsystem

NASA Technical Reports Server (NTRS)

Sinclair, Susan; Graham, L.; Richard, Bill; Saxon, H.

1987-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical (PCIs) items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The independent analysis results coresponding to the Orbiter crew equipment hardware are documented. The IOA analysis process utilized available crew equipment hardware drawings and schematics for defining hardware assemblies, components, and hardware items. Each level of hardware was evaluated and analyzed for possible failure modes and effects. Criticality was assigned based upon the severity of the effect for each failure mode. Of the 352 failure modes analyzed, 78 were determined to be PCIs.

Documenting Liquefaction Failures Using Satellite Remote Sensing and Artificial Intelligence Algorithms

NASA Astrophysics Data System (ADS)

Oommen, T.; Baise, L. G.; Gens, R.; Prakash, A.; Gupta, R. P.

2009-12-01

Historically, earthquake induced liquefaction is known to have caused extensive damage around the world. Therefore, there is a compelling need to characterize and map liquefaction after a seismic event. Currently, after an earthquake event, field-based mapping of liquefaction is sporadic and limited due to inaccessibility, short life of the failures, difficulties in mapping large aerial extents, and lack of resources. We hypothesize that as liquefaction occurs in saturated granular soils due to an increase in pore pressure, the liquefaction related terrain changes should have an associated increase in soil moisture with respect to the surrounding non-liquefied regions. The increase in soil moisture affects the thermal emittance and, hence, change detection using pre- and post-event thermal infrared (TIR) imagery is suitable for identifying areas that have undergone post-earthquake liquefaction. Though change detection using TIR images gives the first indication of areas of liquefaction, the spatial resolution of TIR images is typically coarser than the resolution of corresponding visible, near-infrared (NIR), and shortwave infrared (SWIR) images. We hypothesize that liquefaction induced changes in the soil and associated surface effects cause textural and spectral changes in images acquired in the visible, NIR, and SWIR. Although these changes can be from various factors, a synergistic approach taking advantage of the thermal signature variation due to changing soil moisture condition, together with the spectral information from high resolution visible, NIR, and SWIR bands can help to narrow down the locations of post-event liquefaction for regional documentation. In this study, we analyze the applicability of combining various spectral bands from different satellites (Landsat, Terra-MISR, IRS-1C, and IRS-1D) for documenting liquefaction failures associated with the magnitude 7.6 earthquake that occurred in Bhuj, India, in 2001. We combine the various spectral bands by neighborhood correlation image analysis using an artificial intelligence algorithm called support vector machine to remotely identify and document liquefaction failures across a region; and assess the reliability and accuracy of the thermal remote sensing approach in documenting regional liquefaction failures. Finally, we present the applicability of the satellite data analyzed and appropriateness of a multisensor and multispectral approach for documenting liquefaction related failures.

Resident-initiated interventions to improve inpatient heart-failure management.

PubMed

Oujiri, James; Hakeem, Abdul; Pack, Quinn; Holland, Robert; Meyers, David; Hildebrand, Christopher; Bridges, Alan; Roach, Mary A; Vogelman, Bennett

2011-02-01

Third-year internal medicine residents participating in a quality improvement rotation identified gaps between the Joint Commission's ORYX quality guidelines and clinical practices for the inpatient management of heart failure (HF) at the William S. Middleton Memorial Veterans Hospital. Residents focused on the performance metrics associated with tobacco-cessation counselling documentation, ejection fraction assessment and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker prescriptions. After analysing data collected by the External Peer Review Program, residents reviewed the institution's admissions and discharge processes with the aim of improving quality and compliance. In redesigning these processes, residents created an admissions template and a discharge face sheet, and compared specific ORYX measure compliance rates before and after institution-wide implementation. Following implementation of the tobacco-cessation admissions template, 100% of HF patients who used tobacco received documented cessation counselling, compared with 59% prior to intervention (p<0.01, n=32). Following implementation of the mandatory discharge face sheet, 97% of HF patients (compared with 92% preintervention, p>0.05) received comprehensive discharge instruction; LV function assessment went from 98% to 100% (p>0.05); and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker prescription for left ventricular systolic dysfunction at discharge (or documentation of a contra-indication) went from 82% to 100% (p<0.01, n=48). By implementing a standardised admissions template and a mandatory discharge face sheet, the hospital improved its processes of documentation and increased adherence to quality-performance measures. By strengthening residents' learning and commitment to quality improvement, the hospital created a foundation for future changes in the systems that affect patient care.

Independent Orbiter Assessment (IOA): Analysis of the hydraulics/water spray boiler subsystem

NASA Technical Reports Server (NTRS)

Duval, J. D.; Davidson, W. R.; Parkman, William E.

1986-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items (PCIs). To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. This report documents the independent analysis results for the Orbiter Hydraulics/Water Spray Boiler Subsystem. The hydraulic system provides hydraulic power to gimbal the main engines, actuate the main engine propellant control valves, move the aerodynamic flight control surfaces, lower the landing gear, apply wheel brakes, steer the nosewheel, and dampen the external tank (ET) separation. Each hydraulic system has an associated water spray boiler which is used to cool the hydraulic fluid and APU lubricating oil. The IOA analysis process utilized available HYD/WSB hardware drawings, schematics and documents for defining hardware assemblies, components, and hardware items. Each level of hardware was evaluated and analyzed for possible failure modes and effects. Criticality was assigned based upon the severity of the effect for each failure mode. Of the 430 failure modes analyzed, 166 were determined to be PCIs.

Independent Orbiter Assessment (IOA): Analysis of the pyrotechnics subsystem

NASA Technical Reports Server (NTRS)

Robinson, W. W.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. This report documents the independent analysis results corresponding to the Orbiter Pyrotechnics hardware. The IOA analysis process utilized available pyrotechnics hardware drawings and schematics for defining hardware assemblies, components, and hardware items. Each level of hardware was evaluated and analyzed for possible failure modes and effects. Criticality was assigned based upon the severity of the effect for each failure mode.

Documenting Employee Conduct

ERIC Educational Resources Information Center

Dalton, Jason

2009-01-01

One of the best ways for a child care program to lose an employment-related lawsuit is failure to document the performance of its employees. Documentation of an employee's performance can provide evidence of an employment-related decision such as discipline, promotion, or discharge. When properly implemented, documentation of employee performance…

The importance of scaling for detecting community patterns: success and failure in assemblages of introduced species

USGS Publications Warehouse

Allen, Craig R.; Angeler, David G.; Moulton, Michael P.; Holling, Crawford S.

2015-01-01

Community saturation can help to explain why biological invasions fail. However, previous research has documented inconsistent relationships between failed invasions (i.e., an invasive species colonizes but goes extinct) and the number of species present in the invaded community. We use data from bird communities of the Hawaiian island of Oahu, which supports a community of 38 successfully established introduced birds and where 37 species were introduced but went extinct (failed invasions). We develop a modified approach to evaluate the effects of community saturation on invasion failure. Our method accounts (1) for the number of species present (NSP) when the species goes extinct rather than during its introduction; and (2) scaling patterns in bird body mass distributions that accounts for the hierarchical organization of ecosystems and the fact that interaction strength amongst species varies with scale. We found that when using NSP at the time of extinction, NSP was higher for failed introductions as compared to successful introductions, supporting the idea that increasing species richness and putative community saturation mediate invasion resistance. Accounting for scale-specific patterns in body size distributions further improved the relationship between NSP and introduction failure. Results show that a better understanding of invasion outcomes can be obtained when scale-specific community structure is accounted for in the analysis.

Baroreflex Activation Therapy in Congestive Heart Failure: Novel Findings and Future Insights.

PubMed

Grassi, Guido; Brambilla, GianMaria; Pizzalla, Daniela Prata; Seravalle, Gino

2016-08-01

Congestive heart failure is characterized by hemodynamic and non-hemodynamic abnormalities, the latter including an activation of the sympathetic influences to the heart and peripheral circulation coupled with an impairment of baroreceptor control of autonomic function. Evidence has been provided that both these alterations are hallmark features of the disease with a specific relevance for the disease progression as well as for the development of life-threatening cardiac arrhythmias. In addition, a number of studies have documented in heart failure the adverse prognostic role of the sympathetic and baroreflex alterations, which both are regarded as major independent determinants of cardiovascular morbidity and mortality. This represents the pathophysiological and clinical background for the use of carotid baroreceptor activation therapy in the treatment of congestive heart failure. Promising data collected in experimental animal models of heart failure have supported the recent performance of pilot small-scale clinical studies, aimed at providing initial information in this area. The results of these studies demonstrated the clinical safety and efficacy of the intervention which has been tested in large-scale clinical studies. The present paper will critically review the background and main results of the published studies designed at defining the clinical impact of baroreflex activation therapy in congestive heart failure patients. Emphasis will be given to the strengths and limitations of such studies, which represent the background for the ongoing clinical trials testing the long-term effects of the device in heart failure patients.

The Room Where It Happens: A Skeptic's Analysis of the New Heart Failure Guidelines.

PubMed

Packer, Milton

2016-09-01

New heart failure guidelines have been issued during the past several months, both in the United States and in Europe, in response to recent advances in and the approval of new drugs for the treatment of heart failure. Although guidelines documents are often viewed as authoritative and purely evidence-based, there are replete with meaningful (and inexplicable) inconsistencies, which derive from a review of the same body of scientific data by different groups. This satirical review highlights several examples of the entertaining foolishness of recent guideline documents in the good-natured hope that physicians will understand what the guidelines are, and more importantly, what they are not. Specifically, this paper describes the emergence of a new nonexistent disease; the strange battle between 2 bradycardic drugs (digoxin and ivabradine); the confusion that reigns over the positioning and dosing of inhibitors of the renin-angiotensin system; and the special recommendations that have been issued for certain special populations. As Otto von Bismarck remarked, guideline deliberations are like sausages; it is better not to see them being made. Yet, even after they are ready for public view, we should be cautious. Practitioners who rely on them for clinical decision-making engage in an unnecessary form of self-deception; those who read them literally and adhere to them strictly do not practice evidence-based medicine; and those who delve into them in a search for the truth are destined to be disappointed. Copyright © 2016 Elsevier Inc. All rights reserved.

Independent Orbiter Assessment (IOA): Analysis of the communication and tracking subsystem

NASA Technical Reports Server (NTRS)

Gardner, J. R.; Robinson, W. M.; Trahan, W. H.; Daley, E. S.; Long, W. C.

1987-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. This report documents the independent analysis results corresponding to the Orbiter Communication and Tracking hardware. The IOA analysis process utilized available Communication and Tracking hardware drawings and schematics for defining hardware assemblies, components, and hardware items. Each level of hardware was evaluated and analyzed for possible failure modes and effects. Criticality was assigned based upon the severity of the effect for each failure mode.

Research and technology goals and objectives for Integrated Vehicle Health Management (IVHM)

NASA Technical Reports Server (NTRS)

1992-01-01

Integrated Vehicle Health Management (IVHM) is defined herein as the capability to efficiently perform checkout, testing, and monitoring of space transportation vehicles, subsystems, and components before, during, and after operational This includes the ability to perform timely status determination, diagnostics, and prognostics. IVHM must support fault-tolerant response including system/subsystem reconfiguration to prevent catastrophic failures; and IVHM must support the planning and scheduling of post-operational maintenance. The purpose of this document is to establish the rationale for IVHM and IVHM research and technology planning, and to develop technical goals and objectives. This document is prepared to provide a broad overview of IVHM for technology and advanced development activities and, more specifically, to provide a planning reference from an avionics viewpoint under the OAST Transportation Technology Program Strategic Plan.

Independent Orbiter Assessment (IOA): Assessment of the active thermal control system

NASA Technical Reports Server (NTRS)

Sinclair, S. K.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Active Thermal Control System (ATCS) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the available NASA FMEA/CIL data. Discrepancies from the comparison were documented, and where enough information was available, recommendations for resolution of the discrepancies were made. This report documents the results of that comparison for the Orbiter ATCS hardware. The IOA product for the ATCS independent analysis consisted of 310 failure mode worksheets that resulted in 101 potential critical items (PCI) being identified. A comparison was made to the available NASA data which consisted of 252 FMEAs and 109 CIL items.

Independent Orbiter Assessment (IOA): Analysis of the DPS subsystem

NASA Technical Reports Server (NTRS)

Lowery, H. J.; Haufler, W. A.; Pietz, K. C.

1986-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis/Critical Items List (FMEA/CIL) is presented. The IOA approach features a top-down analysis of the hardware to independently determine failure modes, criticality, and potential critical items. The independent analysis results corresponding to the Orbiter Data Processing System (DPS) hardware are documented. The DPS hardware is required for performing critical functions of data acquisition, data manipulation, data display, and data transfer throughout the Orbiter. Specifically, the DPS hardware consists of the following components: Multiplexer/Demultiplexer (MDM); General Purpose Computer (GPC); Multifunction CRT Display System (MCDS); Data Buses and Data Bus Couplers (DBC); Data Bus Isolation Amplifiers (DBIA); Mass Memory Unit (MMU); and Engine Interface Unit (EIU). The IOA analysis process utilized available DPS hardware drawings and schematics for defining hardware assemblies, components, and hardware items. Each level of hardware was evaluated and analyzed for possible failure modes and effects. Criticality was assigned based upon the severity of the effect for each failure mode. Due to the extensive redundancy built into the DPS the number of critical items are few. Those identified resulted from premature operation and erroneous output of the GPCs.

Lightning Pin Injection Testing on MOSFETS

NASA Technical Reports Server (NTRS)

Ely, Jay J.; Nguyen, Truong X.; Szatkowski, George N.; Koppen, Sandra V.; Mielnik, John J.; Vaughan, Roger K.; Wysocki, Philip F.; Celaya, Jose R.; Saha, Sankalita

2009-01-01

Lightning transients were pin-injected into metal-oxide-semiconductor field-effect transistors (MOSFETs) to induce fault modes. This report documents the test process and results, and provides a basis for subsequent lightning tests. MOSFETs may be present in DC-DC power supplies and electromechanical actuator circuits that may be used on board aircraft. Results show that unprotected MOSFET Gates are susceptible to failure, even when installed in systems in well-shielded and partial-shielded locations. MOSFET Drains and Sources are significantly less susceptible. Device impedance decreased (current increased) after every failure. Such a failure mode may lead to cascading failures, as the damaged MOSFET may allow excessive current to flow through other circuitry. Preliminary assessments on a MOSFET subjected to 20-stroke pin-injection testing demonstrate that Breakdown Voltage, Leakage Current and Threshold Voltage characteristics show damage, while the device continues to meet manufacturer performance specifications. The purpose of this research is to develop validated tools, technologies, and techniques for automated detection, diagnosis and prognosis that enable mitigation of adverse events during flight, such as from lightning transients; and to understand the interplay between lightning-induced surges and aging (i.e. humidity, vibration thermal stress, etc.) on component degradation.

Effect of discharge instructions on readmission of hospitalised patients with heart failure: do all of the Joint Commission on Accreditation of Healthcare Organizations heart failure core measures reflect better care?

PubMed Central

VanSuch, Monica; Naessens, James M; Stroebel, Robert J; Huddleston, Jeanne M; Williams, Arthur R

2006-01-01

Background Most nationally standardised quality measures use widely accepted evidence‐based processes as their foundation, but the discharge instruction component of the United States standards of Joint Commission on Accreditation of Healthcare Organizations heart failure core measure appears to be based on expert opinion alone. Objective To determine whether documentation of compliance with any or all of the six required discharge instructions is correlated with readmissions to hospital or mortality. Research design A retrospective study at a single tertiary care hospital was conducted on randomly sampled patients hospitalised for heart failure from July 2002 to September 2003. Participants Applying the Joint Commission on Accreditation of Healthcare Organizations criteria, 782 of 1121 patients were found eligible to receive discharge instructions. Eligibility was determined by age, principal diagnosis codes and discharge status codes. Measures The primary outcome measures are time to death and time to readmission for heart failure or readmission for any cause and time to death. Results In all, 68% of patients received all instructions, whereas 6% received no instructions. Patients who received all instructions were significantly less likely to be readmitted for any cause (p = 0.003) and for heart failure (p = 0.035) than those who missed at least one type of instruction. Documentation of discharge instructions is correlated with reduced readmission rates. However, there was no association between documentation of discharge instructions and mortality (p = 0.521). Conclusions Including discharge instructions among other evidence‐based heart failure core measures appears justified. PMID:17142589

Independent Orbiter Assessment (IOA): Analysis of the auxiliary power unit

NASA Technical Reports Server (NTRS)

Barnes, J. E.

1986-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. This report documents the independent analysis results corresponding to the Orbiter Auxiliary Power Unit (APU). The APUs are required to provide power to the Orbiter hydraulics systems during ascent and entry flight phases for aerosurface actuation, main engine gimballing, landing gear extension, and other vital functions. For analysis purposes, the APU system was broken down into ten functional subsystems. Each level of hardware was evaluated and analyzed for possible failure modes and effects. Criticality was assigned based upon the severity of the effect for each failure mode. A preponderance of 1/1 criticality items were related to failures that allowed the hydrazine fuel to escape into the Orbiter aft compartment, creating a severe fire hazard, and failures that caused loss of the gas generator injector cooling system.

Mining Clinicians' Electronic Documentation to Identify Heart Failure Patients with Ineffective Self-Management: A Pilot Text-Mining Study.

PubMed

Topaz, Maxim; Radhakrishnan, Kavita; Lei, Victor; Zhou, Li

2016-01-01

Effective self-management can decrease up to 50% of heart failure hospitalizations. Unfortunately, self-management by patients with heart failure remains poor. This pilot study aimed to explore the use of text-mining to identify heart failure patients with ineffective self-management. We first built a comprehensive self-management vocabulary based on the literature and clinical notes review. We then randomly selected 545 heart failure patients treated within Partners Healthcare hospitals (Boston, MA, USA) and conducted a regular expression search with the compiled vocabulary within 43,107 interdisciplinary clinical notes of these patients. We found that 38.2% (n = 208) patients had documentation of ineffective heart failure self-management in the domains of poor diet adherence (28.4%), missed medical encounters (26.4%) poor medication adherence (20.2%) and non-specified self-management issues (e.g., "compliance issues", 34.6%). We showed the feasibility of using text-mining to identify patients with ineffective self-management. More natural language processing algorithms are needed to help busy clinicians identify these patients.

Potentials and limitations of microorganisms as renal failure biotherapeutics

PubMed Central

Jain, Poonam; Shah, Sapna; Coussa, Razek; Prakash, Satya

2009-01-01

Renal insufficiency leads to uremia, a complicated syndrome. It thus becomes vital to reduce waste metabolites and regulate water and electrolytes in kidney failure. The most common treatment of this disease is either dialysis or transplantation. Although these treatments are very effective, they are extremely costly. Recently artificial cells, microencapsulated live bacterial cells, and other cells have been studied to manage renal failure metabolic wastes. The procedure for microencapsulation of biologically active material is well documented and offers many biomedical applications. Microencapsulated bacteria have been documented to efficiently remove urea and several uremic markers such as ammonia, creatinine, uric acid, phosphate, potassium, magnesium, sodium, and chloride. These bacteria also have further potential as biotherapeutic agents because they can be engineered to remove selected unwanted waste. This application has enormous potential for removal of waste metabolites and electrolytes in renal failure as well as other diseases such as liver failure, phenylketonuria, and Crohn’s disease, to name a few. This paper discusses the various options available to date to manage renal failure metabolites and focuses on the potential of using encapsulated live cells as biotherapeutic agents to control renal failure waste metabolites and electrolytes. PMID:19707412

Design and Documentation: The State of the Art.

ERIC Educational Resources Information Center

Gibbons, Andrew S.

1998-01-01

Although the trend is for less documentation, this article argues that more is needed to help in the analysis of design failure in instructional design. Presents arguments supporting documented design, including error recognition and correction, verification of completeness and soundness, sharing of new design principles, modifiability, error…

Data Linkage from Clinical to Study Databases via an R Data Warehouse User Interface. Experiences from a Large Clinical Follow-up Study.

PubMed

Kaspar, Mathias; Ertl, Maximilian; Fette, Georg; Dietrich, Georg; Toepfer, Martin; Angermann, Christiane; Störk, Stefan; Puppe, Frank

2016-08-05

Data that needs to be documented for clinical studies has often been acquired and documented in clinical routine. Usually this data is manually transferred to Case Report Forms (CRF) and/or directly into an electronic data capture (EDC) system. To enhance the documentation process of a large clinical follow-up study targeting patients admitted for acutely decompensated heart failure by accessing the data created during routine and study visits from a hospital information system (HIS) and by transferring it via a data warehouse (DWH) into the study's EDC system. This project is based on the clinical DWH developed at the University of Würzburg. The DWH was extended by several new data domains including data created by the study team itself. An R user interface was developed for the DWH that allows to access its source data in all its detail, to transform data as comprehensively as possible by R into study-specific variables and to support the creation of data and catalog tables. A data flow was established that starts with labeling patients as study patients within the HIS and proceeds with updating the DWH with this label and further data domains at a daily rate. Several study-specific variables were defined using the implemented R user interface of the DWH. This system was then used to export these variables as data tables ready for import into our EDC system. The data tables were then used to initialize the first 296 patients within the EDC system by pseudonym, visit and data values. Afterwards, these records were filled with clinical data on heart failure, vital parameters and time spent on selected wards. This solution focuses on the comprehensive access and transformation of data for a DWH-EDC system linkage. Using this system in a large clinical study has demonstrated the feasibility of this approach for a study with a complex visit schedule.

St. Vincent's Home telehealth for congestive heart failure patients.

PubMed

Whitten, Pamela; Bergman, Alicia; Meese, Mary Ann; Bridwell, Karin; Jule, Kim

2009-03-01

St. Vincent's Homecare implemented a remote monitoring project in which researchers studied whether the telehome health patients exhibit enhanced clinical outcomes and patient perceptions of telehome healthcare. Fifty congestive heart failure patients (n = 50) participated in this program. Data collection included pre and post Outcome and Assessment Information Set items, 12-Item Short-Form Health Survey and Minnesota Living with Heart Failure Questionnaire, and data from patient charts were used to capture demographic information. In addition, interviews were conducted in order to assess overall perceptions and attitudes. Results indicate significant changes occurring among respondents in three important aspects that impact their quality of life, namely, physical, behavioral, and emotional improvements. Specifically, statistical significance was documented at the 0.05 level regarding improvement for home telehealth patients in shortness of breath, management of oral medications, ability to engage in moderate activities, amount of energy, swelling in legs/ankles, need to sit/lie down during day, fatigue, need for hospitalization, side effects from treatment, and worry. Additionally, patients found the service easy to use and perceived the care they received via telehealth to be as good as regular in-person care.

Critical Review of Commercial Secondary Lithium-Ion Battery Safety Standards

NASA Astrophysics Data System (ADS)

Jones, Harry P.; Chapin, Thomas, J.; Tabaddor, Mahmod

2010-09-01

The development of Li-ion cells with greater energy density has lead to safety concerns that must be carefully assessed as Li-ion cells power a wide range of products from consumer electronics to electric vehicles to space applications. Documented field failures and product recalls for Li-ion cells, mostly for consumer electronic products, highlight the risk of fire, smoke, and even explosion. These failures have been attributed to the occurrence of internal short circuits and the subsequent thermal runaway that can lead to fire and explosion. As packaging for some applications include a large number of cells, the risk of failure is likely to be magnified. To address concerns about the safety of battery powered products, safety standards have been developed. This paper provides a review of various international safety standards specific to lithium-ion cells. This paper shows that though the standards are harmonized on a host of abuse conditions, most lack a test simulating internal short circuits. This paper describes some efforts to introduce internal short circuit tests into safety standards.

Self-care and depression in patients with chronic heart failure.

PubMed

Holzapfel, Nicole; Löwe, Bernd; Wild, Beate; Schellberg, Dieter; Zugck, Christian; Remppis, Andrew; Katus, Hugo A; Haass, Markus; Rauch, Bernhard; Jünger, Jana; Herzog, Wolfgang; Müller-Tasch, Thomas

2009-01-01

Although chronic heart failure (CHF) is often complicated by comorbid depression and poor self-care, little is known about their specific association in patients with CHF. To investigate self-care behavior among patients with CHF with different degrees of depression severity. A total of 287 patients with documented CHF, New York Heart Association functional class II to IV, completed the European Heart Failure Self-Care Behavior Scale. The Structured Clinical Interview for DSM (SCID) IV served as the criterion standard for the presence of a depressive disorder. Analyses of covariance and linear regression analyses revealed that patients with CHF with minor depression reported significantly lower levels of self-care than patients with major depression (P = .003) and nondepressed patients (P = .014). In addition to minor depression, age (P < or = .001), multimorbidity (P = .01), left ventricular ejection fraction (P = .001), and family status (P = .01) were determinants of self-care. Our results demonstrate that patients with CHF with minor depression and not major depression are at higher risk for poor self-care and its resulting consequences, such as symptom deterioration and frequent hospitalization.

The Utility of Failure Modes and Effects Analysis of Consultations in a Tertiary, Academic, Medical Center.

PubMed

Niv, Yaron; Itskoviz, David; Cohen, Michal; Hendel, Hagit; Bar-Giora, Yonit; Berkov, Evgeny; Weisbord, Irit; Leviron, Yifat; Isasschar, Assaf; Ganor, Arian

Failure modes and effects analysis (FMEA) is a tool used to identify potential risks in health care processes. We used the FMEA tool for improving the process of consultation in an academic medical center. A team of 10 staff members-5 physicians, 2 quality experts, 2 organizational consultants, and 1 nurse-was established. The consultation process steps, from ordering to delivering, were computed. Failure modes were assessed for likelihood of occurrence, detection, and severity. A risk priority number (RPN) was calculated. An interventional plan was designed according to the highest RPNs. Thereafter, we compared the percentage of completed computer-based documented consultations before and after the intervention. The team identified 3 main categories of failure modes that reached the highest RPNs: initiation of consultation by a junior staff physician without senior approval, failure to document the consultation in the computerized patient registry, and asking for consultation on the telephone. An interventional plan was designed, including meetings to update knowledge of the consultation request process, stressing the importance of approval by a senior physician, training sessions for closing requests in the patient file, and reporting of telephone requests. The number of electronically documented consultation results and recommendations significantly increased (75%) after intervention. FMEA is an important and efficient tool for improving the consultation process in an academic medical center.

19 CFR 113.45 - Charge for production of a missing document made against a continuous bond.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 1 2013-04-01 2013-04-01 false Charge for production of a missing document made... Charge for production of a missing document made against a continuous bond. When a continuous bond secures the production of a missing document and the bond is breached by the principal's failure to timely...

19 CFR 113.45 - Charge for production of a missing document made against a continuous bond.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Charge for production of a missing document made... Charge for production of a missing document made against a continuous bond. When a continuous bond secures the production of a missing document and the bond is breached by the principal's failure to timely...

19 CFR 113.45 - Charge for production of a missing document made against a continuous bond.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 1 2012-04-01 2012-04-01 false Charge for production of a missing document made... Charge for production of a missing document made against a continuous bond. When a continuous bond secures the production of a missing document and the bond is breached by the principal's failure to timely...

19 CFR 113.45 - Charge for production of a missing document made against a continuous bond.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 1 2011-04-01 2011-04-01 false Charge for production of a missing document made... Charge for production of a missing document made against a continuous bond. When a continuous bond secures the production of a missing document and the bond is breached by the principal's failure to timely...

19 CFR 113.45 - Charge for production of a missing document made against a continuous bond.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 1 2014-04-01 2014-04-01 false Charge for production of a missing document made... Charge for production of a missing document made against a continuous bond. When a continuous bond secures the production of a missing document and the bond is breached by the principal's failure to timely...

8 CFR 211.4 - Waiver of documents for returning residents.

Code of Federal Regulations, 2010 CFR

2010-01-01

... DOCUMENTARY REQUIREMENTS: IMMIGRANTS; WAIVERS § 211.4 Waiver of documents for returning residents. (a... because of failure to have or to present a valid passport, immigrant visa, reentry permit, border crossing...

8 CFR 1211.4 - Waiver of documents for returning residents.

Code of Federal Regulations, 2010 CFR

2010-01-01

... JUSTICE IMMIGRATION REGULATIONS DOCUMENTARY REQUIREMENTS: IMMIGRANTS; WAIVERS § 1211.4 Waiver of documents... temporary absence was inadmissible because of failure to have or to present a valid passport, immigrant visa...

Independent Orbiter Assessment (IOA): Analysis of the life support and airlock support subsystems

NASA Technical Reports Server (NTRS)

Arbet, Jim; Duffy, R.; Barickman, K.; Saiidi, Mo J.

1987-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. This report documents the independent analysis results corresponding to the Orbiter Life Support System (LSS) and Airlock Support System (ALSS). Each level of hardware was evaluated and analyzed for possible failure modes and effects. Criticality was assigned based upon the severity of the effect for each failure mode. The LSS provides for the management of the supply water, collection of metabolic waste, management of waste water, smoke detection, and fire suppression. The ALSS provides water, oxygen, and electricity to support an extravehicular activity in the airlock.

Cause-and-effect analysis of risk management files to assess patient care in the emergency department.

PubMed

White, Andrew A; Wright, Seth W; Blanco, Roberto; Lemonds, Brent; Sisco, Janice; Bledsoe, Sandy; Irwin, Cindy; Isenhour, Jennifer; Pichert, James W

2004-10-01

Identifying the etiologies of adverse outcomes is an important first step in improving patient safety and reducing malpractice risks. However, relatively little is known about the causes of emergency department-related adverse outcomes. The objective was to describe a method for identification of common causes of adverse outcomes in an emergency department. This methodology potentially can suggest ways to improve care and might provide a model for identification of factors associated with adverse outcomes. This was a retrospective analysis of 74 consecutive files opened by a malpractice insurer between 1995 and 2000. Each risk-management file was analyzed to identify potential causes of adverse outcomes. The main outcomes were rater-assigned codes for alleged problems with care (e.g., failures of communication or problems related to diagnosis). About 50% of cases were related to injuries or abdominal complaints. A contributing cause was found in 92% of cases, and most had more than one contributing cause. The most frequent contributing categories included failure to diagnose (45%), supervision problems (31%), communication problems (30%), patient behavior (24%), administrative problems (20%), and documentation (20%). Specific relating factors within these categories, such as lack of timely resident supervision and failure to follow policies and procedures, were identified. This project documented that an aggregate analysis of risk-management files has the potential to identify shared causes related to real or perceived adverse outcomes. Several potentially correctable systems problems were identified using this methodology. These simple, descriptive management tools may be useful in identifying issues for problem solving and can be easily learned by physicians and managers.

Isolated prospective confabulation in Wernicke-Korsakoff syndrome: a case for reality filtering.

PubMed

Schnider, Armin; Nahum, Louis; Pignat, Jean-Michel; Leemann, Béatrice; Lövblad, Karl-Olof; Wissmeyer, Michael; Ptak, Radek

2013-01-01

A 57-year-old man suffered severe amnesia and disorientation, accompanied by content-specific confabulation, due to an alcoholic Wernicke-Korsakoff syndrome. For months, he was deeply concerned about a single obligation that he thought he had to respond to, but which he had already assumed 20 years previously. This monothematic, prospective confabulation was associated with failures of reality filtering as previously documented in behaviorally spontaneous confabulation and disorientation: the patient failed to suppress the interference of currently irrelevant memories and to abandon anticipations that were no longer valid (impaired extinction capacity). Magnetic resonance imaging showed damage to the mamillary bodies and the dorsomedial thalamic nucleus. Positron emission tomography (FDG-PET) showed extended orbitofrontal hypometabolism. We suggest that isolated prospective confabulation shares the core feature (acts and thoughts based on currently irrelevant memory), mechanism (failure of reality filtering), and anatomical basis (orbitofrontal dysfunction) with behaviorally spontaneous confabulations.

Users Guide on Scaled CMOS Reliability: NASA Electronic Parts and Packaging (NEPP) Program Office of Safety and Mission Assurance

NASA Technical Reports Server (NTRS)

White, Mark; Cooper, Mark; Johnston, Allan

2011-01-01

Reliability of advanced CMOS technology is a complex problem that is usually addressed from the standpoint of specific failure mechanisms rather than overall reliability of a finished microcircuit. A detailed treatment of CMOS reliability in scaled devices can be found in Ref. 1; it should be consulted for a more thorough discussion. The present document provides a more concise treatment of the scaled CMOS reliability problem, emphasizing differences in the recommended approach for these advanced devices compared to that of less aggressively scaled devices. It includes specific recommendations that can be used by flight projects that use advanced CMOS. The primary emphasis is on conventional memories, microprocessors, and related devices.

Improved Emergency Egress Lighting System for the ISS

NASA Technical Reports Server (NTRS)

Eaton, Leslie L.; Barr, Don A.

2005-01-01

Emergency lights provide illumination in corridors, stairwells, ramps, escalators, aisles, and exit passageways during power failures. Safety and visibility are critical during a power outage. If emergency lights fail to operate properly, the building occupants can become disoriented. Four documents in a collection discuss different topics relating to a proposed improved emergency egress lighting system (EELS) for the International Space Station (ISS). While the present EELS is designed around rows of green-light-emitting diodes, the proposed system contains strips of electroluminescent tape using different colors for each egress path. The proposed EELS can be powered by the same battery currently used by the present EELS, but would require an inverter because electroluminescent devices require AC. Electroluminescent devices also require significantly less current and, depending on the color, would emit 3 to 8 times the light of the present EELS. In addition, they could operate for up to 75 hours (versus .20 minutes for the present system). The first document contains a one-page summary of the proposal and an evaluation of technical merit. The second document summarizes the motivation for, and the design of, the proposed EELS. The third document addresses relevant aspects of the measurement of spectral sensitivity and the psychophysics of perception of light. The fourth document presents additional background information and technical specifications for the electroluminescent tapes.

Computer system design description for SY-101 hydrogen mitigation test project data acquisition and control system (DACS-1)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ermi, A.M.

1997-05-01

Description of the Proposed Activity/REPORTABLE OCCURRENCE or PIAB: This ECN changes the computer systems design description support document describing the computers system used to control, monitor and archive the processes and outputs associated with the Hydrogen Mitigation Test Pump installed in SY-101. There is no new activity or procedure associated with the updating of this reference document. The updating of this computer system design description maintains an agreed upon documentation program initiated within the test program and carried into operations at time of turnover to maintain configuration control as outlined by design authority practicing guidelines. There are no new crediblemore » failure modes associated with the updating of information in a support description document. The failure analysis of each change was reviewed at the time of implementation of the Systems Change Request for all the processes changed. This document simply provides a history of implementation and current system status.« less

28 CFR 68.10 - Motion to dismiss for failure to state a claim upon which relief can be granted.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Motion to dismiss for failure to state a... JUSTICE (CONTINUED) RULES OF PRACTICE AND PROCEDURE FOR ADMINISTRATIVE HEARINGS BEFORE ADMINISTRATIVE LAW... EMPLOYMENT PRACTICES, AND DOCUMENT FRAUD § 68.10 Motion to dismiss for failure to state a claim upon which...

28 CFR 68.10 - Motion to dismiss for failure to state a claim upon which relief can be granted.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Motion to dismiss for failure to state a... JUSTICE (CONTINUED) RULES OF PRACTICE AND PROCEDURE FOR ADMINISTRATIVE HEARINGS BEFORE ADMINISTRATIVE LAW... EMPLOYMENT PRACTICES, AND DOCUMENT FRAUD § 68.10 Motion to dismiss for failure to state a claim upon which...

Automated extraction of ejection fraction for quality measurement using regular expressions in Unstructured Information Management Architecture (UIMA) for heart failure.

PubMed

Garvin, Jennifer H; DuVall, Scott L; South, Brett R; Bray, Bruce E; Bolton, Daniel; Heavirland, Julia; Pickard, Steve; Heidenreich, Paul; Shen, Shuying; Weir, Charlene; Samore, Matthew; Goldstein, Mary K

2012-01-01

Left ventricular ejection fraction (EF) is a key component of heart failure quality measures used within the Department of Veteran Affairs (VA). Our goals were to build a natural language processing system to extract the EF from free-text echocardiogram reports to automate measurement reporting and to validate the accuracy of the system using a comparison reference standard developed through human review. This project was a Translational Use Case Project within the VA Consortium for Healthcare Informatics. We created a set of regular expressions and rules to capture the EF using a random sample of 765 echocardiograms from seven VA medical centers. The documents were randomly assigned to two sets: a set of 275 used for training and a second set of 490 used for testing and validation. To establish the reference standard, two independent reviewers annotated all documents in both sets; a third reviewer adjudicated disagreements. System test results for document-level classification of EF of <40% had a sensitivity (recall) of 98.41%, a specificity of 100%, a positive predictive value (precision) of 100%, and an F measure of 99.2%. System test results at the concept level had a sensitivity of 88.9% (95% CI 87.7% to 90.0%), a positive predictive value of 95% (95% CI 94.2% to 95.9%), and an F measure of 91.9% (95% CI 91.2% to 92.7%). An EF value of <40% can be accurately identified in VA echocardiogram reports. An automated information extraction system can be used to accurately extract EF for quality measurement.

Chronic renal failure in a patient with bilateral ureterocele

PubMed Central

Dada, Samuel A.; Rafiu, Mojeed O.; Olanrewaju, Timothy O.

2015-01-01

Ureterocele is a congenital anomaly, in which there is mal-development of the caudal segments of the ureter. There is a female preponderance with most cases seen in Caucasians. Among the reported complications of this condition, chronic renal failure occurring in the setting of ureterocele has not been well documented. We report a case of a young girl with bilateral ureterocele presenting with chronic renal failure, whose management presented a diagnostic failure and inadequate treatment. PMID:26108593

76 FR 5494 - Pipeline Safety: Mechanical Fitting Failure Reporting Requirements

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-01

... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration 49 CFR Part... Safety: Mechanical Fitting Failure Reporting Requirements AGENCY: Pipeline and Hazardous Materials Safety... tightening. A widely accepted industry guidance document, Gas Pipeline Technical Committee (GPTC) Guide, does...

Heart failure among Indigenous Australians: a systematic review

PubMed Central

2012-01-01

Background Cardiovascular diseases contribute substantially to the poor health and reduced life expectancy of Indigenous Australians. Heart failure is a common, disabling, progressive and costly complication of these disorders. The epidemiology of heart failure and the adequacy of relevant health service provision in Indigenous Australians are not well delineated. Methods A systematic search of the electronic databases PubMed, Embase, Web of Science, Cinahl Plus, Informit and Google Scholar was undertaken in April 2012 for peer-reviewed journal articles relevant to the topic of heart failure in Indigenous Australians. Additionally, a website search was done to identify other pertinent publications, particularly government reports. Results There was a paucity of relevant peer-reviewed research, and government reports dominated the results. Ten journal articles, 1 published conference abstract and 10 reports were eligible for inclusion. Indigenous Australians reportedly have higher morbidity and mortality from heart failure than their non-Indigenous counterparts (age-standardised prevalence ratio 1.7; age-standardised hospital separation ratio ≥3; crude per capita hospital expenditure ratio 1.58; age-adjusted mortality ratio >2). Despite the evident disproportionate burden of heart failure in Indigenous Australians, the accuracy of estimation from administrative data is limited by poor indigenous identification, inadequate case ascertainment and exclusion of younger subjects from mortality statistics. A recent journal article specifically documented a high prevalence of heart failure in Central Australian Aboriginal adults (5.3%), noting frequent undiagnosed disease. One study examined barriers to health service provision for Indigenous Australians in the context of heart failure. Conclusions Despite the shortcomings of available published data, it is clear that Indigenous Australians have an excess burden of heart failure. Emerging data suggest that undiagnosed cases may be common in this population. In order to optimise management and to inform policy, high quality research on heart failure in Indigenous Australians is required to delineate accurate epidemiological indicators and to appraise health service provision. PMID:23116367

Reproductive Medicine in Amphibians.

PubMed

Chai, Norin

2017-05-01

Reproduction of amphibians includes ovulation, spermiation, fertilization, oviposition, larval stage and development, and metamorphosis. A problem at any stage could lead to reproductive failure. To stimulate reproduction, environmental conditions must be arranged to simulate changes in natural habits. Reproductive life history is well documented in amphibians; a thorough knowledge of this subject will aid the practitioner in diagnosis and treatment. Technologies for artificial reproduction are developing rapidly, and some protocols may be transferable to privately kept or endangered species. Reproductive tract disorders are rarely described; no bacterial or viral diseases are known that specifically target the amphibian reproductive system. Copyright © 2016 Elsevier Inc. All rights reserved.

Facesheet Wrinkling in Sandwich Structures

NASA Technical Reports Server (NTRS)

Ley, Robert P.; Lin, Weichuan; Mbanefo, Uy

1999-01-01

The purpose of this paper is to provide a concise summary of the state-of-the-art for the analysis of the facesheet wrinkling mode of failure in sandwich structures. This document is not an exhaustive review of the published research related to facesheet wrinkling. Instead, a smaller number of key papers are reviewed in order to provide designers and analysts with a working understanding of the state-of-the-art. Designers and analysts should use this survey to guide their judgement when deciding which one of a wide variety of available facesheet wrinkling design formulas is applicable to a specific design problem.

[Early detection, prevention and management of renal failure in liver transplantation].

PubMed

Castells, Lluís; Baliellas, Carme; Bilbao, Itxarone; Cantarell, Carme; Cruzado, Josep Maria; Esforzado, Núria; García-Valdecasas, Juan Carlos; Lladó, Laura; Rimola, Antoni; Serón, Daniel; Oppenheimer, Federico

2014-10-01

Renal failure is a frequent complication in liver transplant recipients and is associated with increased morbidity and mortality. A variety of risk factors for the development of renal failure in the pre- and post-transplantation periods have been described, as well as at the time of surgery. To reduce the negative impact of renal failure in this population, an active approach is required for the identification of those patients with risk factors, the implementation of preventive strategies, and the early detection of progressive deterioration of renal function. Based on published evidence and on clinical experience, this document presents a series of recommendations on monitoring RF in LT recipients, as well as on the prevention and management of acute and chronic renal failure after LT and referral of these patients to the nephrologist. In addition, this document also provides an update of the various immunosuppressive regimens tested in this population for the prevention and control of post-transplantation deterioration of renal function. Copyright © 2013 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

Mod-5A wind turbine generator program design report. Volume 3: Final design and system description, book 2

NASA Technical Reports Server (NTRS)

1984-01-01

The design, development and analysis of the 7.3MW MOD-5A wind turbine generator is documented. The report is divided into four volumes: Volume 1 summarizes the entire MOD-5A program, Volume 2 discusses the conceptual and preliminary design phases, Volume 3 describes the final design of the MOD-5A, and Volume 4 contains the drawings and specifications developed for the final design. Volume 3, book 2 describes the performance and characteristics of the MOD-5A wind turbine generator in its final configuration. The subsystem for power generation, control, and instrumentation subsystems is described in detail. The manufacturing and construction plans, and the preparation of a potential site on Oahu, Hawaii, are documented. The quality assurance and safety plan, and analyses of failure modes and effects, and reliability, availability and maintainability are presented.

GCS plan for software aspects of certification

NASA Technical Reports Server (NTRS)

Shagnea, Anita M.; Lowman, Douglas S.; Withers, B. Edward

1990-01-01

As part of the Guidance and Control Software (GCS) research project being sponsored by NASA to evaluate the failure processes of software, standard industry software development procedures are being employed. To ensure that these procedures are authentic, the guidelines outlined in the Radio Technical Commission for Aeronautics (RTCA/DO-178A document entitled, software considerations in airborne systems and equipment certification, were adopted. A major aspect of these guidelines is proper documentation. As such, this report, the plan for software aspects of certification, was produced in accordance with DO-178A. An overview is given of the GCS research project, including the goals of the project, project organization, and project schedules. It also specifies the plans for all aspects of the project which relate to the certification of the GCS implementations developed under a NASA contract. These plans include decisions made regarding the software specification, accuracy requirements, configuration management, implementation development and verification, and the development of the GCS simulator.

Procedure for Failure Mode, Effects, and Criticality Analysis (FMECA)

NASA Technical Reports Server (NTRS)

1966-01-01

This document provides guidelines for the accomplishment of Failure Mode, Effects, and Criticality Analysis (FMECA) on the Apollo program. It is a procedure for analysis of hardware items to determine those items contributing most to system unreliability and crew safety problems.

Operational excellence (six sigma) philosophy: Application to software quality assurance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lackner, M.

1997-11-01

This report contains viewgraphs on operational excellence philosophy of six sigma applied to software quality assurance. This report outlines the following: goal of six sigma; six sigma tools; manufacturing vs administrative processes; Software quality assurance document inspections; map software quality assurance requirements document; failure mode effects analysis for requirements document; measuring the right response variables; and questions.

Independent Orbiter Assessment (IOA): Assessment of the Orbiter Experiment (OEX) subsystem

NASA Technical Reports Server (NTRS)

Compton, J. M.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Orbiter Experiments (OEX) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the NASA FMEA/CIL baseline with proposed Post 51-L updates included. A resolution of each discrepancy from the comparison is provided through additional analysis as required. The results of that comparison for the Orbiter OEX hardware are documented. The IOA product for the OEX analysis consisted of 82 failure mode worksheets that resulted in two potential critical items being identified.

Report of the NASA Ad Hoc Committee on failure of high strength structural materials

NASA Technical Reports Server (NTRS)

Brown, W. F., Jr. (Editor)

1972-01-01

An analysis of structural failures that have occurred in NASA programs was conducted. Reports of 231 examples of structural failure were reviewed. Attempts were made to identify those factors which contributed to the failures, and recommendations were formulated for actions which would minimize their effects on future NASA programs. Two classes of factors were identified: (1) those associated with deficiencies in existing materials and structures technology and (2) those attributable to inadequate documentation or communication of that technology.

Genesis Failure Investigation Report

NASA Technical Reports Server (NTRS)

Klein, John

2004-01-01

The-Genesis mission to collect solar-wind samples and return them to Earth for detailed analysis proceeded successfully for 3.5 years. During reentry on September 8, 2004, a failure in the entry, descent and landing sequence resulted in a crash landing of the Genesis sample return capsule. This document describes the findings of the avionics sub-team that supported the accident investigation of the JPL Failure Review Board.

28 CFR 68.37 - Waiver of right to appear and failure to participate or to appear.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Waiver of right to appear and failure to... DOCUMENT FRAUD § 68.37 Waiver of right to appear and failure to participate or to appear. (a) Waiver of right to appear. If all parties waive in writing their right to appear before the Administrative Law...

Establishing the need for an engineering standard for agricultural hitch pins.

PubMed

Deboy, G R; Knapp, W M; Field, W E; Krutz, G W; Corum, C L

2012-04-01

Documented incidents have occurred in which failure or unintentional disengagement of agricultural hitch pins has contributed to property damage and personal injury. An examination of current hitch pin use on a convenience sample of farm operations in Indiana revealed a variety of non-standard, worn and damaged, and inappropriately sized hitch pins in use. Informal interviews with the farm operators confirmed that hitch pin misuse, failure, or disengagement is a relatively widespread problem that remains largely unaddressed. On-site observations also suggested a low use of hitch pin retaining devices or safety chains. A review of prior research revealed that little attention has been given to this problem, and currently no documentation allows for an estimate of the frequency or severity of losses associated with hitch pin misuse, failure, or disengagement. No specific engineering standards were found that directly applied to the design, appropriate selection, or loading capacity of agricultural hitch pins. Major suppliers of replacement hitch pins currently provide little or no information on matching hitch pin size to intended applications, and most replacement hitch pins examined were of foreign origin, with the overwhelming majority imported from China or India. These replacement hitch pins provided no specifications other than diameter, length, and, in some cases, labeling that indicated that the pins had been "heat treated. " Testing of a sample of 11 commercially available replacement hitch pins found variation along the length of the pin shaft and between individual pins in surface hardness, a potential predictor of pin failure. Examination of 17 commercially available replacement pins also revealed a variety of identifiers used to describe pin composition and fabrication methods, e.g., "heat treated." None of the pins examined provided any specifications on loading capacity. It was therefore concluded that there is a need to develop an agricultural hitch pin engineering standard that would reflect current agricultural applications and practices and that would be promoted to both original equipment manufacturers and manufacturers and suppliers of replacement hitch pins. The standard should address the design of composite pins, heat treating, surface hardening, loading capacity and labeling of such, incorporation of unintentional disengagement prevention devices, indicators of the need for replacement due to wear, and safety information that should be included in operator instructions. ASABE is the most appropriate organization to develop such a standard. It was also concluded that agricultural safety and health programs and professionals need to raise the awareness of farmers concerning the appropriate selection and use of agricultural hitch pins, including the need to replace non-standard pins with pins less likely to fail or disengage during use, the need to replace hitch pins with indications of potential failure, and the importance of using appropriate safety chains, especially during transport of equipment behind tractors and trucks on public roads.

Space Shuttle Stiffener Ring Foam Failure Analysis, a Non-Conventional Approach

NASA Technical Reports Server (NTRS)

Howard, Philip M.

2015-01-01

The Space Shuttle Program made use of the excellent properties of rigid polyurethane foam for cryogenic tank insulation and as structural protection on the solid rocket boosters. When foam applications de-bond, classical methods of failure analysis did not provide root cause of the failure of the foam. Realizing that foam is the ideal media to document and preserve its own mode of failure, thin sectioning was seen as a logical approach for foam failure analysis to observe the three dimensional morphology of the foam cells. The cell foam morphology provided a much greater understanding of the failure modes than previously achieved.

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

PubMed

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

2017-05-01

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

77 FR 54864 - Federal Acquisition Regulation; Documenting Contractor Performance

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-06

....g., late or nonpayment to subcontractors, trafficking violations, tax delinquency, failure to report... applicable) (e.g.; late or nonpayment to subcontractors, trafficking violations, tax delinquency, failure to... that allowing contractors to ``report to the CPARS system'' would have a negative impact on future...

Independent Orbiter Assessment (IOA): Assessment of the landing/deceleration (LDG/DEC) subsystem FMEA/CIL

NASA Technical Reports Server (NTRS)

Odonnell, R. A.; Weissinger, D.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Landing/Deceleration (LDG/DEC) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the NASA FMEA/CIL baseline with proposed Post 51-L updates included. A resolution of each discrepancy from the comparison is provided through additional analysis as required. This report documents the results of that comparison for the Orbiter LDG/DEC hardware. The IOA product for the LDG/DEC analysis consisted of 259 failure mode worksheets that resulted in 124 potential critical items being identified. Comparison was made to the NASA baseline which consisted of 267 FMEA's and 120 CIL items. This comparison produced agreement on all but 75 FMEA's which caused differences in 51 CIL items.

Independent Orbiter Assessment (IOA): Analysis of the atmospheric revitalization pressure control subsystem

NASA Technical Reports Server (NTRS)

Saiidi, M. J.; Duffy, R. E.; Mclaughlin, T. D.

1986-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis/Critical Items List (FMEA/CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The independent analysis results corresponding to the Orbiter Atmospheric Revitalization and Pressure Control Subsystem (ARPCS) are documented. The ARPCS hardware was categorized into the following subdivisions: (1) Atmospheric Make-up and Control (including the Auxiliary Oxygen Assembly, Oxygen Assembly, and Nitrogen Assembly); and (2) Atmospheric Vent and Control (including the Positive Relief Vent Assembly, Negative Relief Vent Assembly, and Cabin Vent Assembly). The IOA analysis process utilized available ARPCS hardware drawings and schematics for defining hardware assemblies, components, and hardware items. Each level of hardware was evaluated and analyzed for possible failure modes and effects. Criticality was assigned based upon the severity of the effect for each failure mode.

Independent Orbiter Assessment (IOA): FMEA/CIL assessment

NASA Technical Reports Server (NTRS)

Saiidi, Mo J.; Swain, L. J.; Compton, J. M.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. Direction was given by the Orbiter and GFE Projects Office to perform the hardware analysis and assessment using the instructions and ground rules defined in NSTS 22206. The IOA analysis features a top-down approach to determine hardware failure modes, criticality, and potential critical items. To preserve independence, the anlaysis was accomplished without reliance upon the results contained within the NASA and prime contractor FMEA/CIL documentation. The assessment process compares the independently derived failure modes and criticality assignments to the proposed NASA Post 51-L FMEA/CIL documentation. When possible, assessment issues are discussed and resolved with the NASA subsystem managers. The assessment results for each subsystem are summarized. The most important Orbiter assessment finding was the previously unknown stuck autopilot push-button criticality 1/1 failure mode, having a worst case effect of loss of crew/vehicle when a microwave landing system is not active.

Pilot performance in zero-visibility precision approach. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Ephrath, A. R.

1975-01-01

The pilot's short-term decisions regarding performance assessment and failure monitoring is examined. The performance of airline pilots who flew simulated zero-visibility landing approaches is reported. Results indicate that the pilot's mode of participation in the control task has a strong effect on his workload, the induced workload being lowest when the pilot acts as a monitor during a coupled approach and highest when the pilot is an active element in the control loop. A marked increase in workload at altitudes below 500 ft. is documented at all participation modes; this increase is inversely related to distance-to-go. The participation mode is shown to have a dominant effect on failure-detection performance, with a failure in a monitored (coupled) axis being detected faster than a comparable failure in a manually-controlled axis. Touchdown performance is also documented. It is concluded that the conventional instrument panel and its associated displays are inadequate for zero-visibility operations in the final phases of the landing approach.

Consensus Document of the Spanish Society of Cardiology and the Spanish Society of Internal Medicine on the diagnosis and treatment of iron deficiency in heart failure.

PubMed

Manito, N; Cerqueiro, J M; Comín-Colet, J; García-Pinilla, J M; González-Franco, A; Grau-Amorós, J; Peraira, J R; Manzano, L

Iron deficiency in patients with heart failure is a medical problem of recent particular interest. This interest has resulted from the publication of several clinical trials that demonstrated that the administration of intravenous iron to such patients improved their functional capacity and even reduced the number of hospitalisations for heart failure decompensation. However, applying the evidence from these studies in clinical practice is still controversial, both in terms of the diagnostic criteria for iron deficiency (absolute and functional) and the optimal method for iron replenishment. This article is a consensus document that integrates the recommendations of the Spanish Society of Internal Medicine and the Spanish Society of Cardiology. The article reviews the scientific evidence and proposes a diagnostic and therapeutic performance protocol for iron deficiency in heart failure. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Update: Acute Heart Failure (VII): Nonpharmacological Management of Acute Heart Failure.

PubMed

Plácido, Rui; Mebazaa, Alexandre

2015-09-01

Acute heart failure is a major and growing public health problem worldwide with high morbidity, mortality, and cost. Despite recent advances in pharmacological management, the prognosis of patients with acute decompensated heart failure remains poor. Consequently, nonpharmacological approaches are being developed and increasingly used. Such techniques may include several modalities of ventilation, ultrafiltration, mechanical circulatory support, myocardial revascularization, and surgical treatment, among others. This document reviews the nonpharmacological approach in acute heart failure, indications, and prognostic implications. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Payload maintenance cost model for the space telescope

NASA Technical Reports Server (NTRS)

White, W. L.

1980-01-01

An optimum maintenance cost model for the space telescope for a fifteen year mission cycle was developed. Various documents and subsequent updates of failure rates and configurations were made. The reliability of the space telescope for one year, two and one half years, and five years were determined using the failure rates and configurations. The failure rates and configurations were also used in the maintenance simulation computer model which simulate the failure patterns for the fifteen year mission life of the space telescope. Cost algorithms associated with the maintenance options as indicated by the failure patterns were developed and integrated into the model.

Testing and Failure Mechanisms of Ice Phase Change Material Heat Exchangers

NASA Technical Reports Server (NTRS)

Leimkuehler, Thomas O.; Stephan, Ryan A.; Hawkins-Reynolds, Ebony

2011-01-01

Phase change materials (PCM) may be useful for thermal control systems that involve cyclical heat loads or cyclical thermal environments such as specific spacecraft orientations in Low Earth Orbit (LEO) and low beta angle Low Lunar Orbit (LLO). Thermal energy can be stored in the PCM during peak heat loads or in adverse thermal environments. The stored thermal energy can then be released later during minimum heat loads or in more favorable thermal environments. One advantage that PCM s have over evaporators in this scenario is that they do not use a consumable. The use of water as a PCM rather than the more traditional paraffin wax has the potential for significant mass reduction since the latent heat of formation of water is approximately 70% greater than that of wax. One of the potential drawbacks of using ice as a PCM is its potential to rupture its container as water expands upon freezing. In order to develop a space qualified ice PCM heat exchanger, failure mechanisms must first be understood. Therefore, a methodical experimental investigation has been undertaken to demonstrate and document specific failure mechanisms due to ice expansion in the PCM. A number of ice PCM heat exchangers were fabricated and tested. Additionally, methods for controlling void location in order to reduce the risk of damage due to ice expansion were investigated. This paper presents the results of testing that occurred from March through September of 2010 and builds on testing that occurred during the previous year.

Deferred modification of antiretroviral regimen following documented treatment failure in Asia: results from the TREAT Asia HIV Observational Database (TAHOD)

PubMed Central

Zhou, J; Li, PCK; Kumarasamy, N; Boyd, M; Chen, YMA; Sirisanthana, T; Sungkanuparph, S; Oka, S; Tau, G; Phanuphak, P; Saphonn, V; Zhang, FJ; Omar, SFS; Lee, CKC; Ditangco, R; Merati, TP; Lim, PL; Choi, JY; Law, MG; Pujari, S

2010-01-01

Objective The aim of the study was to examine the rates and predictors of treatment modification following combination antiretroviral therapy (cART) failure in Asian patients with HIV enrolled in the TREAT Asia HIV Observational Database (TAHOD). Methods Treatment failure (immunological, virological and clinical) was defined by World Health Organization criteria. Countries were categorized as high or low income by World Bank criteria. Results Among 2446 patients who initiated cART, 447 were documented to have developed treatment failure over 5697 person-years (7.8 per 100 person-years). A total of 253 patients changed at least one drug after failure (51.6 per 100 person-years). There was no difference between patients from high- and low-income countries [adjusted hazard ratio (HR) 1.02; P = 0.891]. Advanced disease stage [Centers for Disease Control and Prevention (CDC) category C vs. A; adjusted HR 1.38, P = 0.040], a lower CD4 count (≥ 51 cells/μL vs. ≤ 50 cells/μL; adjusted HR 0.61, P = 0.022) and a higher HIV viral load (≥ 400 HIV-1 RNA copies/mL vs. < 400 copies/mL; adjusted HR 2.69, P < 0.001) were associated with a higher rate of treatment modification after failure. Compared with patients from low-income countries, patients from high-income countries were more likely to change two or more drugs (67% vs. 49%; P = 0.009) and to change to a protease-inhibitor-containing regimen (48% vs. 16%; P< 0.001). Conclusions In a cohort of Asian patients with HIV infection, nearly half remained on the failing regimen in the first year following documented treatment failure. This deferred modification is likely to have negative implications for accumulation of drug resistance and response to second-line treatment. There is a need to scale up the availability of second-line regimens and virological monitoring in this region. PMID:19601993

Independent Orbiter Assessment (IOA): Analysis of the ascent thrust vector control actuator subsystem

NASA Technical Reports Server (NTRS)

Wilson, R. E.; Riccio, J. R.

1986-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The independent analysis results for the Ascent Thrust Vector Control (ATVC) Actuator hardware are documented. The function of the Ascent Thrust Vector Control Actuators (ATVC) is to gimbal the main engines to provide for attitude and flight path control during ascent. During first stage flight, the SRB nozzles provide nearly all the steering. After SRB separation, the Orbiter is steered by gimbaling of its main engines. There are six electrohydraulic servoactuators, one pitch and one yaw for each of the three main engines. Each servoactuator is composed of four electrohydraulic servovalve assemblies, one second stage power spool valve assembly, one primary piston assembly and a switching valve. Each level of hardware was evaluated and analyzed for possible failure modes and effects. Criticality was assigned based upon the severity of the effect for each failure mode. Critical failures resulting in loss of ATVC were mainly due to loss of hydraulic fluid, fluid contamination and mechanical failures.

26 CFR 301.7502-1 - Timely mailing of documents and payments treated as timely filing and paying.

Code of Federal Regulations, 2010 CFR

2010-04-01

... postmark stamped on the envelope or other appropriate wrapper (envelope) in which the document or payment was mailed. Thus, if the envelope that contains the document or payment has a timely postmark, the... apply in determining whether a failure to file a return or pay a tax has continued for an additional...

Overview of Threats and Failure Models for Safety-Relevant Computer-Based Systems

NASA Technical Reports Server (NTRS)

Torres-Pomales, Wilfredo

2015-01-01

This document presents a high-level overview of the threats to safety-relevant computer-based systems, including (1) a description of the introduction and activation of physical and logical faults; (2) the propagation of their effects; and (3) function-level and component-level error and failure mode models. These models can be used in the definition of fault hypotheses (i.e., assumptions) for threat-risk mitigation strategies. This document is a contribution to a guide currently under development that is intended to provide a general technical foundation for designers and evaluators of safety-relevant systems.

NON-UNIFORM COPPER CORROSION: RESEARCH UPDATE

EPA Science Inventory

Pinhole leaks due to copper pitting corrosion are a major cause of home plumbing failure. This study documents cases of copper pitting corrosion found in homes supplied by Butler County Environmental Services in Ohio. SEM. XRD, and optical microscopy were used to document pit s...

Enhanced methods for determining operational capabilities and support costs of proposed space systems

NASA Technical Reports Server (NTRS)

Ebeling, Charles

1993-01-01

This report documents the work accomplished during the first two years of research to provide support to NASA in predicting operational and support parameters and costs of proposed space systems. The first year's research developed a methodology for deriving reliability and maintainability (R & M) parameters based upon the use of regression analysis to establish empirical relationships between performance and design specifications and corresponding mean times of failure and repair. The second year focused on enhancements to the methodology, increased scope of the model, and software improvements. This follow-on effort expands the prediction of R & M parameters and their effect on the operations and support of space transportation vehicles to include other system components such as booster rockets and external fuel tanks. It also increases the scope of the methodology and the capabilities of the model as implemented by the software. The focus is on the failure and repair of major subsystems and their impact on vehicle reliability, turn times, maintenance manpower, and repairable spares requirements. The report documents the data utilized in this study, outlines the general methodology for estimating and relating R&M parameters, presents the analyses and results of application to the initial data base, and describes the implementation of the methodology through the use of a computer model. The report concludes with a discussion on validation and a summary of the research findings and results.

Long-term side-effects of intermittent androgen suppression therapy in prostate cancer: results of a phase II study.

PubMed

Malone, Shawn; Perry, Gad; Segal, Roanne; Dahrouge, Simone; Crook, Juanita

2005-09-01

To assess the feasibility and tolerability of intermittent androgen suppression therapy (IAS) in prostate cancer. Patients with recurrent or metastic prostate cancer received cyclical periods of treatment with leuprolide acetate and nilutamide for 8 months, and rest periods. Cycles were repeated at progression until the treatment failed to achieve normal prostate-specific antigen (PSA) levels. Patients were followed with PSA level, testosterone level, haemoglobin level, weight and bone mineral density evaluations. The median time to treatment failure, recovery from anaemia, or normalization of testosterone level was estimated by the Kaplan-Meier method. In all, 95 patients received 245 cycles; the median duration of rest periods was 8 months and median time to treatment failure 47 months. Testosterone recovery during rest periods was documented in 117 (61%) of cycles. Anaemia was mild and reported in 33%, 44% and 67% of cycles 1, 2 and 3, respectively. Sexual function recovered during the rest periods in 47% of cycles. There was no significant overall change in body mass index at the end of the treatment period. Osteoporosis was documented in at least one site evaluated in 41 patients (37%). IAS has the potential to reduce side-effects, including recovery of haemoglobin level, return of sexual function and absence of weight gain at the end of the study period.

Independent Orbiter Assessment (IOA): Analysis of the electrical power distribution and control subsystem, volume 1

NASA Technical Reports Server (NTRS)

Schmeckpeper, K. R.

1987-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. This report documents the independent analysis results corresponding to the Orbiter Electrical Power Distribution and Control (EPD and C) hardware. The EPD and C hardware performs the functions of distributing, sensing, and controlling 28 volt DC power and of inverting, distributing, sensing, and controlling 117 volt 400 Hz AC power to all Orbiter subsystems from the three fuel cells in the Electrical Power Generation (EPG) subsystem. Each level of hardware was evaluated and analyzed for possible failure modes and effects. Criticality was assigned based upon the severity of the effect for each failure mode. Of the 1671 failure modes analyzed, 9 single failures were determined to result in loss of crew or vehicle. Three single failures unique to intact abort were determined to result in possible loss of the crew or vehicle. A possible loss of mission could result if any of 136 single failures occurred. Six of the criticality 1/1 failures are in two rotary and two pushbutton switches that control External Tank and Solid Rocket Booster separation. The other 6 criticality 1/1 failures are fuses, one each per Aft Power Control Assembly (APCA) 4, 5, and 6 and one each per Forward Power Control Assembly (FPCA) 1, 2, and 3, that supply power to certain Main Propulsion System (MPS) valves and Forward Reaction Control System (RCS) circuits.

Clavicle anatomical osteosynthesis plate breakage - failure analysis report based on patient morphological parameters.

PubMed

Marinescu, Rodica; Antoniac, Vasile Iulian; Stoia, Dan Ioan; Lăptoiu, Dan Constantin

2017-01-01

Clavicle fracture reported incidence is about 5% of fractures in adult; among them, those located in the middle third of the shaft represent more than 80% from the total of cases. Due to the special morphological and biomechanical constraints of the clavicle, several methods for restoring morphological integrity in these fractures are described, including conservative, non-surgical treatment. The last 10 years of clinical studies in the field have favored the surgical treatment for selected cases; several osteosynthesis implants are in use - mostly anatomical plates with specific advantages and documented complications. A failed anatomical clavicle plate was explanted and analyzed after a protocol using stereomicroscopy, scanning electron microscopy and energy dispersive spectrometry. Based on the computed tomography (CT) scan determination of patient morphological parameters, a finite elements analysis of the failure scenario was completed. The failure analysis has proved that the plate breakage had occurred in the point of maximal elastic stress and minor deformation. The clinical implication is that no hole should remain free of screw during clavicle plate fixation and the implant should be chosen based on patient morphological parameters. In comminuted clavicle fracture, anatomic bridging with locked plate technique may lead to implant failure due to increase of the stress in the midshaft area. Thorough knowledge of anatomy and morphology of complex bones like the clavicle is necessary. Modern osteosynthesis anatomical implants are still to be improved.

Independent Orbiter Assessment (IOA): Analysis of the active thermal control subsystem

NASA Technical Reports Server (NTRS)

Sinclair, S. K.; Parkman, W. E.

1987-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical (PCIs) items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The independent analysis results corresponding to the Orbiter Active Thermal Control Subsystem (ATCS) are documented. The major purpose of the ATCS is to remove the heat, generated during normal Shuttle operations from the Orbiter systems and subsystems. The four major components of the ATCS contributing to the heat removal are: Freon Coolant Loops; Radiator and Flow Control Assembly; Flash Evaporator System; and Ammonia Boiler System. In order to perform the analysis, the IOA process utilized available ATCS hardware drawings and schematics for defining hardware assemblies, components, and hardware items. Each level of hardware was evaluated and analyzed for possible failure modes and effects. Criticality was assigned based upon the severity of the effect for each failure mode. Of the 310 failure modes analyzed, 101 were determined to be PCIs.

Mobile Phone Service Process Hiccups at Cellular Inc.

ERIC Educational Resources Information Center

Edgington, Theresa M.

2010-01-01

This teaching case documents an actual case of process execution and failure. The case is useful in MIS introductory courses seeking to demonstrate the interdependencies within a business process, and the concept of cascading failure at the process level. This case demonstrates benefits and potential problems with information technology systems,…

Sotos syndrome, failure to thrive and parotitis

PubMed Central

Thomas, Megan R

2011-01-01

Sotos syndrome is characterised by excessive pre and postnatal growth, a variable degree of learning difficulties and a recognisable facial appearance. This report highlights the difficulty in making the diagnosis where failure to thrive is the presenting feature and documents a previously undescribed association with recurrent parotitis. PMID:22715272

42 CFR 1001.1201 - Failure to provide payment information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Failure to provide payment information. 1001.1201 Section 1001.1201 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN...) Whether the individual or entity has a documented history of criminal, civil or administrative wrongdoing...

76 FR 70768 - Common-Cause Failure Analysis in Event and Condition Assessment: Guidance and Research, Draft...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-15

... NUCLEAR REGULATORY COMMISSION [NRC-2011-0254] Common-Cause Failure Analysis in Event and Condition Assessment: Guidance and Research, Draft Report for Comment; Correction AGENCY: Nuclear Regulatory Commission. ACTION: Draft NUREG; request for comment; correction. SUMMARY: This document corrects a notice appearing...

Errors in Bibliographic Citations: A Continuing Problem.

ERIC Educational Resources Information Center

Sweetland, James H.

1989-01-01

Summarizes studies examining citation errors and illustrates errors resulting from a lack of standardization, misunderstanding of foreign languages, failure to examine the document cited, and general lack of training in citation norms. It is argued that the failure to detect and correct citation errors is due to diffusion of responsibility in the…

Micromechanics Based Failure Analysis of Heterogeneous Materials

NASA Astrophysics Data System (ADS)

Sertse, Hamsasew M.

In recent decades, heterogeneous materials are extensively used in various industries such as aerospace, defense, automotive and others due to their desirable specific properties and excellent capability of accumulating damage. Despite their wide use, there are numerous challenges associated with the application of these materials. One of the main challenges is lack of accurate tools to predict the initiation, progression and final failure of these materials under various thermomechanical loading conditions. Although failure is usually treated at the macro and meso-scale level, the initiation and growth of failure is a complex phenomena across multiple scales. The objective of this work is to enable the mechanics of structure genome (MSG) and its companion code SwiftComp to analyze the initial failure (also called static failure), progressive failure, and fatigue failure of heterogeneous materials using micromechanics approach. The initial failure is evaluated at each numerical integration point using pointwise and nonlocal approach for each constituent of the heterogeneous materials. The effects of imperfect interfaces among constituents of heterogeneous materials are also investigated using a linear traction-displacement model. Moreover, the progressive and fatigue damage analyses are conducted using continuum damage mechanics (CDM) approach. The various failure criteria are also applied at a material point to analyze progressive damage in each constituent. The constitutive equation of a damaged material is formulated based on a consistent irreversible thermodynamics approach. The overall tangent modulus of uncoupled elastoplastic damage for negligible back stress effect is derived. The initiation of plasticity and damage in each constituent is evaluated at each numerical integration point using a nonlocal approach. The accumulated plastic strain and anisotropic damage evolution variables are iteratively solved using an incremental algorithm. The damage analyses are performed for both brittle failure/high cycle fatigue (HCF) for negligible plastic strain and ductile failure/low cycle fatigue (LCF) for large plastic strain. The proposed approach is incorporated in SwiftComp and used to predict the initial failure envelope, stress-strain curve for various loading conditions, and fatigue life of heterogeneous materials. The combined effects of strain hardening and progressive fatigue damage on the effective properties of heterogeneous materials are also studied. The capability of the current approach is validated using several representative examples of heterogeneous materials including binary composites, continuous fiber-reinforced composites, particle-reinforced composites, discontinuous fiber-reinforced composites, and woven composites. The predictions of MSG are also compared with the predictions obtained using various micromechanics approaches such as Generalized Methods of Cells (GMC), Mori-Tanaka (MT), and Double Inclusions (DI) and Representative Volume Element (RVE) Analysis (called as 3-dimensional finite element analysis (3D FEA) in this document). This study demonstrates that a micromechanics based failure analysis has a great potential to rigorously and more accurately analyze initiation and progression of damage in heterogeneous materials. However, this approach requires material properties specific to damage analysis, which are needed to be independently calibrated for each constituent.

Failure Modes and Effects Analysis (FMEA): A Bibliography

NASA Technical Reports Server (NTRS)

2000-01-01

Failure modes and effects analysis (FMEA) is a bottom-up analytical process that identifies process hazards, which helps managers understand vulnerabilities of systems, as well as assess and mitigate risk. It is one of several engineering tools and techniques available to program and project managers aimed at increasing the likelihood of safe and successful NASA programs and missions. This bibliography references 465 documents in the NASA STI Database that contain the major concepts, failure modes or failure analysis, in either the basic index of the major subject terms.

Hypertension and cardiac arrhythmias: executive summary of a consensus document from the European Heart Rhythm Association (EHRA) and ESC Council on Hypertension, endorsed by the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE).

PubMed

Lip, Gregory Y H; Coca, Antonio; Kahan, Thomas; Boriani, Giuseppe; Manolis, Antonis S; Olsen, Michael Hecht; Oto, Ali; Potpara, Tatjana S; Steffel, Jan; Marín, Francisco; de Oliveira Figueiredo, Márcio Jansen; de Simone, Giovanni; Tzou, Wendy S; En Chiang, Chern; Williams, Bryan

2017-10-01

Hypertension (HTN) is a common cardiovascular risk factor leading to heart failure (HF), coronary artery disease (CAD), stroke, peripheral artery disease and chronic renal failure. Hypertensive heart disease can manifest as many types of cardiac arrhythmias, most commonly being atrial fibrillation (AF). Both supraventricular and ventricular arrhythmias may occur in HTN patients, especially in those with left ventricular hypertrophy (LVH), CAD, or HF. In addition, high doses of thiazide diuretics commonly used to treat HTN, may result in electrolyte abnormalities (e.g. hypokalaemia, hypomagnesaemia), contributing further to arrhythmias, while effective blood pressure control may prevent the development of the arrhythmias such as AF. In recognizing this close relationship between HTN and arrhythmias, the European Heart Rhythm Association (EHRA) and the European Society of Cardiology (ESC) Council on Hypertension convened a Task Force, with representation from the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE), with the remit of comprehensively reviewing the available evidence and publishing a joint consensus document on HTN and cardiac arrhythmias, and providing up-to-date consensus recommendations for use in clinical practice. The ultimate judgment on the care of a specific patient must be made by the healthcare provider and the patient in light of all individual factors presented. This is an executive summary of the full document co-published by EHRA in EP-Europace. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For Permissions, please email: journals.permissions@oup.com.

Automated extraction of ejection fraction for quality measurement using regular expressions in Unstructured Information Management Architecture (UIMA) for heart failure

PubMed Central

DuVall, Scott L; South, Brett R; Bray, Bruce E; Bolton, Daniel; Heavirland, Julia; Pickard, Steve; Heidenreich, Paul; Shen, Shuying; Weir, Charlene; Samore, Matthew; Goldstein, Mary K

2012-01-01

Objectives Left ventricular ejection fraction (EF) is a key component of heart failure quality measures used within the Department of Veteran Affairs (VA). Our goals were to build a natural language processing system to extract the EF from free-text echocardiogram reports to automate measurement reporting and to validate the accuracy of the system using a comparison reference standard developed through human review. This project was a Translational Use Case Project within the VA Consortium for Healthcare Informatics. Materials and methods We created a set of regular expressions and rules to capture the EF using a random sample of 765 echocardiograms from seven VA medical centers. The documents were randomly assigned to two sets: a set of 275 used for training and a second set of 490 used for testing and validation. To establish the reference standard, two independent reviewers annotated all documents in both sets; a third reviewer adjudicated disagreements. Results System test results for document-level classification of EF of <40% had a sensitivity (recall) of 98.41%, a specificity of 100%, a positive predictive value (precision) of 100%, and an F measure of 99.2%. System test results at the concept level had a sensitivity of 88.9% (95% CI 87.7% to 90.0%), a positive predictive value of 95% (95% CI 94.2% to 95.9%), and an F measure of 91.9% (95% CI 91.2% to 92.7%). Discussion An EF value of <40% can be accurately identified in VA echocardiogram reports. Conclusions An automated information extraction system can be used to accurately extract EF for quality measurement. PMID:22437073

19 CFR 10.112 - Filing free entry documents or reduced duty documents after entry.

Code of Federal Regulations, 2010 CFR

2010-04-01

... entry or within the period for which a bond was filed for its production, but failure to file it was not.... [T.D. 74-227, 39 FR 32015, Sept. 4, 1974] Instruments and Apparatus for Educational and Scientific...

Intravenous Milrinone Infusion Improves Congestive Heart Failure Caused by Diastolic Dysfunction

PubMed Central

Albrecht, Carlos A.; Giesler, Gregory M.; Kar, Biswajit; Hariharan, Ramesh; Delgado, Reynolds M.

2005-01-01

Although there have been significant advances in the medical treatment of heart failure patients with impaired systolic function, very little is known about the diagnosis and treatment of diastolic dysfunction. We report the cases of 3 patients in New York Heart Association functional class IV who had echocardiographically documented diastolic dysfunction as the main cause of heart failure. All 3 patients received medical therapy with long-term milrinone infusion. PMID:16107121

Independent Orbiter Assessment (IOA): Analysis of the purge, vent and drain subsystem

NASA Technical Reports Server (NTRS)

Bynum, M. C., III

1987-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. This report documents the independent analysis results corresponding to the Orbiter PV and D (Purge, Vent and Drain) Subsystem hardware. The PV and D Subsystem controls the environment of unpressurized compartments and window cavities, senses hazardous gases, and purges Orbiter/ET Disconnect. The subsystem is divided into six systems: Purge System (controls the environment of unpressurized structural compartments); Vent System (controls the pressure of unpressurized compartments); Drain System (removes water from unpressurized compartments); Hazardous Gas Detection System (HGDS) (monitors hazardous gas concentrations); Window Cavity Conditioning System (WCCS) (maintains clear windows and provides pressure control of the window cavities); and External Tank/Orbiter Disconnect Purge System (prevents cryo-pumping/icing of disconnect hardware). Each level of hardware was evaluated and analyzed for possible failure modes and effects. Criticality was assigned based upon the severity of the effect for each failure mode. Four of the sixty-two failure modes analyzed were determined as single failures which could result in the loss of crew or vehicle. A possible loss of mission could result if any of twelve single failures occurred. Two of the criticality 1/1 failures are in the Window Cavity Conditioning System (WCCS) outer window cavity, where leakage and/or restricted flow will cause failure to depressurize/repressurize the window cavity. Two criticality 1/1 failures represent leakage and/or restricted flow in the Orbiter/ET disconnect purge network which prevent cryopumping/icing of disconnect hardware. Each level of hardware was evaluated and analyzed for possible failure modes and effects. Criticality was assigned based upon the severity of the effect for each failure mode.

Management protocols for chronic heart failure in India.

PubMed

Mishra, S; Mohan, J C; Nair, Tiny; Chopra, V K; Harikrishnan, S; Guha, S; Ramakrishnan, S; Ray, S; Sethi, R; Samal, U C; Sarat Chandra, K; Hiremath, M S; Banerjee, A K; Kumar, S; Das, M K; Deb, P K; Bahl, V K

Heart failure is a common clinical syndrome and a global health priority. The burden of heart failure is increasing at an alarming rate worldwide as well as in India. Heart failure not only increases the risk of mortality, morbidity and worsens the patient's quality of life, but also puts a huge burden on the overall healthcare system. The management of heart failure has evolved over the years with the advent of new drugs and devices. This document has been developed with an objective to provide standard management guidance and simple heart failure algorithms to aid Indian clinicians in their daily practice. It would also inform the clinicians on the latest evidence in heart failure and provide guidance to recognize and diagnose chronic heart failure early and optimize management. Copyright © 2017. Published by Elsevier B.V.

Improved Multi-Axial, Temperature and Time Dependent (MATT) Failure Model

NASA Technical Reports Server (NTRS)

Richardson, D. E.; Anderson, G. L.; Macon, D. J.

2002-01-01

An extensive effort has recently been completed by the Space Shuttle's Reusable Solid Rocket Motor (RSRM) nozzle program to completely characterize the effects of multi-axial loading, temperature and time on the failure characteristics of three filled epoxy adhesives (TIGA 321, EA913NA, EA946). As part of this effort, a single general failure criterion was developed that accounted for these effects simultaneously. This model was named the Multi- Axial, Temperature, and Time Dependent or MATT failure criterion. Due to the intricate nature of the failure criterion, some parameters were required to be calculated using complex equations or numerical methods. This paper documents some simple but accurate modifications to the failure criterion to allow for calculations of failure conditions without complex equations or numerical techniques.

Combining aspirin with angiotensin converting enzyme inhibitors in heart failure: how safe is it?

PubMed

Mehta, H; Mahajan, A; Bansal, N; Vaidya, S; Pathak, L

1998-11-01

The above discussion on the interaction of aspirin and ACE inhibitors seems to suggest that aspirin in high doses may have adverse interaction with ACE inhibitors in patients with heart failure but the data obtained is not sufficient or conclusive to recommended omission of aspirin in patients with heart failure. This raises a query in the mind of the physician whether to use a combination or not? The role of aspirin in the early period after myocardial infarction is well established so is the role of ACE inhibitors. Hence in patients with myocardial infarction and preserved left ventricular function it would not be wrong to administer combination of ACE inhibitors and aspirin. Albeit at a lower dose. In patients with large myocardial infarction or heart failure, warfarin may be an option but still needs to be documented in large trials. As suggested long term use of aspirin after infarction is still ambiguous and may be harmful in patients with heart failure with its anticedent side effects. But long term benefits of ACE inhibitors in heart failure are well documented. Hence if a choice has to be made whether to discontinue either of the two drugs it would be preferable to stop the aspirin. To answer the issue of use of aspirin in patients with heart failure it would be essential to conduct a double blind randomized trial comparing known anti-thrombotic treatment, aspirin and anti-coagulants on mortality in patients with heart failure, especially caused by coronary artery disease. Such a trial is underway at the present and till the results are available it should be left to clinical judgement of the physician whether to administer aspirin in patients with heart failure after weighing the benefits versus risk.

Independent Orbiter Assessment (IOA): Assessment of the crew equipment subsystem

NASA Technical Reports Server (NTRS)

Saxon, H.; Richard, Bill; Sinclair, S. K.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Crew Equipment hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the NASA FMEA/CIL baseline with proposed Post 51-L updates included. A resolution of each discrepancy from the comparison is provided through additional analysis as required. This report documents the results of that comparison for the Orbiter Crew Equipment hardware. The IOA product for the Crew Equipment analysis consisted of 352 failure mode worksheets that resulted in 78 potential critical items being identified. Comparison was made to the NASA baseline which consisted of 351 FMEAs and 82 CIL items.

Acoustic testing of high temperature panels

NASA Technical Reports Server (NTRS)

Leatherwood, Jack D.; Clevenson, Sherman A.; Powell, Clemans A.; Daniels, Edward F.

1990-01-01

Results are presented of a series of thermal-acoustic tests conducted on the NASA Langley Research Center Thermal-Acoustic Test Apparatus to (1) investigate techniques for obtaining strain measurements on metallic and carbon-carbon materials at elevated temperature; (2) document the dynamic strain response characteristics of several superalloy honeycomb thermal protection system panels at elevated temperatures of up to 1200 F; and (3) determine the strain response and sonic fatigue behavior of four carbon-carbon panels at both ambient and elevated temperatures. A second study tested four carbon-carbon panels to document panel dynamic response characteristics at ambient and elevated temperature, determine time to failure and faliure modes, and collect continuous strain data up to panel failure. Strain data are presented from both types of panels, and problems encountered in obtaining reliable strain data on the carbon-carbon panels are described. The failure modes of the carbon-carbon panels are examined.

Independent Orbiter Assessment (IOA): Assessment of the nose wheel steering subsystem

NASA Technical Reports Server (NTRS)

Mediavilla, Anthony Scott

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Nose Wheel Steering (NWS) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the proposed NASA post 51-L FMEA/CIL baseline. A resolution of each discrepancy from the comparison is provided through additional analysis as required. This report documents the results of that comparison for the Orbiter NWS hardware.

Measles Outbreak in a Vaccinated School Population: Epidemiology, Chains of Transmission and the Role of Vaccine Failures.

ERIC Educational Resources Information Center

Nkowane, Benjamin M.; And Others

1987-01-01

An outbreak of measles occurred in a high school with a documented vaccination level of 98 percent. When measles is introduced in a highly vaccinated population, vaccine failures may play some role in transmission but such transmission is not usually sustained. (Author/LHW)

Reading Fluency Instruction for Students at Risk for Reading Failure

ERIC Educational Resources Information Center

Ring, Jeremiah J.; Barefoot, Lexie C.; Avrit, Karen J.; Brown, Sasha A.; Black, Jeffrey L.

2013-01-01

The important role of reading fluency in the comprehension and motivation of readers is well documented. Two reading rate intervention programs were compared in a cluster-randomized clinical trial of students who were considered at-risk for reading failure. One program focused instruction at the word level; the second program focused instruction…

42 CFR 1001.1101 - Failure to disclose certain information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Failure to disclose certain information. 1001.1101 Section 1001.1101 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN... documented history of criminal, civil or administrative wrongdoing (The lack of any prior record is to be...

Moving beyond the Failure of Test-Based Accountability

ERIC Educational Resources Information Center

Koretz, Daniel

2018-01-01

In "The Testing Charade: Pretending to Make Schools Better", the author's new book from which this article is drawn, the failures of test-based accountability are documented and some of the most egregious misuses and outright abuses of testing are described, along with some of the most serious negative effects. Neither good intentions…

Failure mode and effect analysis-based quality assurance for dynamic MLC tracking systems

PubMed Central

Sawant, Amit; Dieterich, Sonja; Svatos, Michelle; Keall, Paul

2010-01-01

Purpose: To develop and implement a failure mode and effect analysis (FMEA)-based commissioning and quality assurance framework for dynamic multileaf collimator (DMLC) tumor tracking systems. Methods: A systematic failure mode and effect analysis was performed for a prototype real-time tumor tracking system that uses implanted electromagnetic transponders for tumor position monitoring and a DMLC for real-time beam adaptation. A detailed process tree of DMLC tracking delivery was created and potential tracking-specific failure modes were identified. For each failure mode, a risk probability number (RPN) was calculated from the product of the probability of occurrence, the severity of effect, and the detectibility of the failure. Based on the insights obtained from the FMEA, commissioning and QA procedures were developed to check (i) the accuracy of coordinate system transformation, (ii) system latency, (iii) spatial and dosimetric delivery accuracy, (iv) delivery efficiency, and (v) accuracy and consistency of system response to error conditions. The frequency of testing for each failure mode was determined from the RPN value. Results: Failures modes with RPN≥125 were recommended to be tested monthly. Failure modes with RPN<125 were assigned to be tested during comprehensive evaluations, e.g., during commissioning, annual quality assurance, and after major software∕hardware upgrades. System latency was determined to be ∼193 ms. The system showed consistent and accurate response to erroneous conditions. Tracking accuracy was within 3%–3 mm gamma (100% pass rate) for sinusoidal as well as a wide variety of patient-derived respiratory motions. The total time taken for monthly QA was ∼35 min, while that taken for comprehensive testing was ∼3.5 h. Conclusions: FMEA proved to be a powerful and flexible tool to develop and implement a quality management (QM) framework for DMLC tracking. The authors conclude that the use of FMEA-based QM ensures efficient allocation of clinical resources because the most critical failure modes receive the most attention. It is expected that the set of guidelines proposed here will serve as a living document that is updated with the accumulation of progressively more intrainstitutional and interinstitutional experience with DMLC tracking. PMID:21302802

Independent Orbiter Assessment (IOA): Analysis of the orbital maneuvering system

NASA Technical Reports Server (NTRS)

Prust, C. D.; Paul, D. J.; Burkemper, V. J.

1987-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The independent analysis results for the Orbital Maneuvering System (OMS) hardware are documented. The OMS provides the thrust to perform orbit insertion, orbit circularization, orbit transfer, rendezvous, and deorbit. The OMS is housed in two independent pods located one on each side of the tail and consists of the following subsystems: Helium Pressurization; Propellant Storage and Distribution; Orbital Maneuvering Engine; and Electrical Power Distribution and Control. The IOA analysis process utilized available OMS hardware drawings and schematics for defining hardware assemblies, components, and hardware items. Each level of hardware was evaluted and analyzed for possible failure modes and effects. Criticality was asigned based upon the severity of the effect for each failure mode.

Risk factors for failed reactivation of a labor epidural for postpartum tubal ligation: a prospective, observational study.

PubMed

Powell, Mark F; Wellons, Douglas D; Tran, Steve F; Zimmerman, John M; Frölich, Michael A

2016-12-01

To determine specific risk factors that increase the failure rate of labor epidurals reactivated for use as a surgical block for postpartum tubal ligation. Prospective, observational study. Labor and delivery suite and operating rooms at the Women and Infants Center. One hundred patients undergoing postpartum tubal ligation with an existing labor epidural that is documented to be within 2 cm of initial placement. Body mass index, patient satisfaction with her epidural during labor and delivery, time from delivery to reactivation for tubal ligation, depth to loss of resistance, and the need for top-ups during labor were recorded preoperatively. Failure to reactivate was recorded and defined as any patient that (1) did not achieve a T 6 level to pinprick, (2) had perceived pain (pain score >3) that required administration of an intravenous opioid or local anesthetic infiltration, or (3) required conversion to general anesthesia. The overall success rate of reactivation was 78%. Significant risk factors for failure to reactivate were (1) poor patient satisfaction (P = .016), (2) increased time from delivery to reactivation (P = .044), and (3) the need for top-ups during labor and delivery (P = .032). Poor satisfaction score of the epidural during labor and delivery, increasing time from delivery to epidural reactivation for tubal ligation, and the need for top-ups during labor and delivery increase the incidence of reactivation failure. No correlation was found with body mass index or loss of resistance and failure to reactivate. Copyright © 2016 Elsevier Inc. All rights reserved.

Microcircuit Device Reliability. Digital Failure Rate Data

DTIC Science & Technology

1981-01-01

Center Staff I IT Research Institute Under Contract to: Rome Air Development Center Griffiss AFB, NY 13441 fortes Ordering No. MDR- 17 biKi frbi...r ■■ ■—■ — SECURITY CLASSIFICATION Or THIS PAGE (Whin Dmlm Enlti»<l) REPORT DOCUMENTATION PAGE «EPO«TNUMBER MDR- 17 4. TITLE (md...MDR- 17 presents com- parisons between actual field experienced failure rates and MIL-HDBK-217C, Notice 1, predicted failure rates. The use of

24 CFR 902.79 - Verification and records.

Code of Federal Regulations, 2011 CFR

2011-04-01

.... All project and PHA certifications, year-end financial information, and supporting documentation are... supporting documents for any certifications and for asset management reviews for at least 3 years. Failure to...), or other methods used to assess performance shall result in a score of zero for the indicator(s) or...

42 CFR 495.324 - Prior approval conditions.

Code of Federal Regulations, 2010 CFR

2010-10-01

...: (1) The HIT advance planning document and the implementation advance planning document. (2) A request... $100,000 or contract time extensions of more than 60 days. (4) The State Medicaid HIT plan. (c) Failure...-competitively from a nongovernmental source HIT equipment or services, with proposed FFP under this subpart if...

The future of telemedicine for the management of heart failure patients: a Consensus Document of the Italian Association of Hospital Cardiologists (A.N.M.C.O), the Italian Society of Cardiology (S.I.C.) and the Italian Society for Telemedicine and eHealth (Digital S.I.T.)

PubMed Central

Casolo, Giancarlo; Gulizia, Michele Massimo; Aspromonte, Nadia; Scalvini, Simonetta; Mortara, Andrea; Alunni, Gianfranco; Ricci, Renato Pietro; Mantovan, Roberto; Russo, Giancarmine; Gensini, Gian Franco; Romeo, Francesco

2017-01-01

Abstract Telemedicine applied to heart failure patients is a tool for recording and providing remote transmission, storage and interpretation of cardiovascular parameters and/or useful diagnostic images to allow for intensive home monitoring of patients with advanced heart failure, or during the vulnerable post-acute phase, to improve patient’s prognosis and quality of life. Recently, several meta-analyses have shown that telemedicine-supported care pathways are not only effective but also economically advantageous. Benefits seem to be substantial, with a 30–35% reduction in mortality and 15–20% decrease in hospitalizations. Patients implanted with cardiac devices can also benefit from an integrated remote clinical management since all modern devices can transmit technical and diagnostic data. However, telemedicine may provide benefits to heart failure patients only as part of a shared and integrated multi-disciplinary and multi-professional ‘chronic care model’. Moreover, the future development of remote telemonitoring programs in Italy will require the primary use of products certified as medical devices, validated organizational solutions as well as legislative and administrative adoption of new care methods and the widespread growth of clinical care competence to remotely manage the complexity of chronicity. Through this consensus document, Italian Cardiology reaffirms its willingness to contribute promoting a new phase of qualitative assessment, standardization of processes and testing of telemedicine-based care models in heart failure. By recognizing the relevance of telemedicine for the care of non-hospitalized patients with heart failure, its strategic importance for the design of innovative models of care, and the many challenges and opportunities it raises, ANMCO and SIC through this document report a consensus on the main directions for its widespread and sustainable clinical implementation PMID:28751839

The future of telemedicine for the management of heart failure patients: a Consensus Document of the Italian Association of Hospital Cardiologists (A.N.M.C.O), the Italian Society of Cardiology (S.I.C.) and the Italian Society for Telemedicine and eHealth (Digital S.I.T.).

PubMed

Di Lenarda, Andrea; Casolo, Giancarlo; Gulizia, Michele Massimo; Aspromonte, Nadia; Scalvini, Simonetta; Mortara, Andrea; Alunni, Gianfranco; Ricci, Renato Pietro; Mantovan, Roberto; Russo, Giancarmine; Gensini, Gian Franco; Romeo, Francesco

2017-05-01

Telemedicine applied to heart failure patients is a tool for recording and providing remote transmission, storage and interpretation of cardiovascular parameters and/or useful diagnostic images to allow for intensive home monitoring of patients with advanced heart failure, or during the vulnerable post-acute phase, to improve patient's prognosis and quality of life. Recently, several meta-analyses have shown that telemedicine-supported care pathways are not only effective but also economically advantageous. Benefits seem to be substantial, with a 30-35% reduction in mortality and 15-20% decrease in hospitalizations. Patients implanted with cardiac devices can also benefit from an integrated remote clinical management since all modern devices can transmit technical and diagnostic data. However, telemedicine may provide benefits to heart failure patients only as part of a shared and integrated multi-disciplinary and multi-professional 'chronic care model'. Moreover, the future development of remote telemonitoring programs in Italy will require the primary use of products certified as medical devices, validated organizational solutions as well as legislative and administrative adoption of new care methods and the widespread growth of clinical care competence to remotely manage the complexity of chronicity. Through this consensus document, Italian Cardiology reaffirms its willingness to contribute promoting a new phase of qualitative assessment, standardization of processes and testing of telemedicine-based care models in heart failure. By recognizing the relevance of telemedicine for the care of non-hospitalized patients with heart failure, its strategic importance for the design of innovative models of care, and the many challenges and opportunities it raises, ANMCO and SIC through this document report a consensus on the main directions for its widespread and sustainable clinical implementation.

Independent Orbiter Assessment (IOA): FMEA/CIL assessment

NASA Technical Reports Server (NTRS)

Hinsdale, L. W.; Swain, L. J.; Barnes, J. E.

1988-01-01

The McDonnell Douglas Astronautics Company (MDAC) was selected to perform an Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL). Direction was given by the Orbiter and GFE Projects Office to perform the hardware analysis and assessment using the instructions and ground rules defined in NSTS 22206. The IOA analysis featured a top-down approach to determine hardware failure modes, criticality, and potential critical items. To preserve independence, the analysis was accomplished without reliance upon the results contained within the NASA and Prime Contractor FMEA/CIL documentation. The assessment process compared the independently derived failure modes and criticality assignments to the proposed NASA post 51-L FMEA/CIL documentation. When possible, assessment issues were discussed and resolved with the NASA subsystem managers. Unresolved issues were elevated to the Orbiter and GFE Projects Office manager, Configuration Control Board (CCB), or Program Requirements Control Board (PRCB) for further resolution. The most important Orbiter assessment finding was the previously unknown stuck autopilot push-button criticality 1/1 failure mode. The worst case effect could cause loss of crew/vehicle when the microwave landing system is not active. It is concluded that NASA and Prime Contractor Post 51-L FMEA/CIL documentation assessed by IOA is believed to be technically accurate and complete. All CIL issues were resolved. No FMEA issues remain that have safety implications. Consideration should be given, however, to upgrading NSTS 22206 with definitive ground rules which more clearly spell out the limits of redundancy.

[The SIAARTI consensus document on the management of patients with end-stage chronic organ failure. From evidence-based medicine to knowledge-based medicine].

PubMed

Bertolini, Guido

2014-01-01

The management of patients with end-stage chronic organ failure is an increasingly important topic, since the extraordinary medical and technological advances have significantly reduced mortality and improved quality of life with prolonged survival of end-stage diseases. What should be the plan of care for these patients? Who should bear the responsibility for care? With what targets? These are crucial questions, to which modern medicine should provide convincing answers. The authors of the document explicitly resisted the temptation to draw up guidelines, showing that it is possible to customize medical intervention on the individual patient, keeping it tightly linked to the available knowledge. This is the most relevant aspect of the document: it goes beyond the classical concept of evidence-based medicine choosing to refer to the most dynamic knowledge-based medicine approach.

Direct Evidence that Myocardial Insulin Resistance following Myocardial Ischemia Contributes to Post-Ischemic Heart Failure

PubMed Central

Fu, Feng; Zhao, Kun; Li, Jia; Xu, Jie; Zhang, Yuan; Liu, Chengfeng; Yang, Weidong; Gao, Chao; Li, Jun; Zhang, Haifeng; Li, Yan; Cui, Qin; Wang, Haichang; Tao, Ling; Wang, Jing; Quon, Michael J; Gao, Feng

2015-01-01

A close link between heart failure (HF) and systemic insulin resistance has been well documented, whereas myocardial insulin resistance and its association with HF are inadequately investigated. This study aims to determine the role of myocardial insulin resistance in ischemic HF and its underlying mechanisms. Male Sprague-Dawley rats subjected to myocardial infarction (MI) developed progressive left ventricular dilation with dysfunction and HF at 4 wk post-MI. Of note, myocardial insulin sensitivity was decreased as early as 1 wk after MI, which was accompanied by increased production of myocardial TNF-α. Overexpression of TNF-α in heart mimicked impaired insulin signaling and cardiac dysfunction leading to HF observed after MI. Treatment of rats with a specific TNF-α inhibitor improved myocardial insulin signaling post-MI. Insulin treatment given immediately following MI suppressed myocardial TNF-α production and improved cardiac insulin sensitivity and opposed cardiac dysfunction/remodeling. Moreover, tamoxifen-induced cardiomyocyte-specific insulin receptor knockout mice exhibited aggravated post-ischemic ventricular remodeling and dysfunction compared with controls. In conclusion, MI induces myocardial insulin resistance (without systemic insulin resistance) mediated partly by ischemia-induced myocardial TNF-α overproduction and promotes the development of HF. Our findings underscore the direct and essential role of myocardial insulin signaling in protection against post-ischemic HF. PMID:26659007

Shuttle/ISS EMU Failure History and the Impact on Advanced EMU Portable Life Support System (PLSS) Design

NASA Technical Reports Server (NTRS)

Campbell, Colin

2015-01-01

As the Shuttle/ISS EMU Program exceeds 35 years in duration and is still supporting the needs of the International Space Station (ISS), a critical benefit of such a long running program with thorough documentation of system and component failures is the ability to study and learn from those failures when considering the design of the next generation space suit. Study of the subject failure history leads to changes in the Advanced EMU Portable Life Support System (PLSS) schematic, selected component technologies, as well as the planned manner of ground testing. This paper reviews the Shuttle/ISS EMU failure history and discusses the implications to the AEMU PLSS.

Space Shuttle Stiffener Ring Foam Failure, a Non-Conventional Approach

NASA Technical Reports Server (NTRS)

Howard, Philip M.

2007-01-01

The Space Shuttle makes use of the excellent properties of rigid polyurethane foam for cryogenic tank insulation and as structural protection on the solid rocket boosters. When foam applications debond, classical methods of analysis do not always provide root cause of the failure of the foam. Realizing that foam is the ideal media to document and preserve its own mode of failure, thin sectioning was seen as a logical approach for foam failure analysis. Thin sectioning in two directions, both horizontal and vertical to the application, was chosen to observe the three dimensional morphology of the foam cells. The cell foam morphology provided a much greater understanding of the failure modes than previously achieved.

Reliability and degradation of oxide VCSELs due to reaction to atmospheric water vapor

NASA Astrophysics Data System (ADS)

Dafinca, Alexandru; Weidberg, Anthony R.; McMahon, Steven J.; Grillo, Alexander A.; Farthouat, Philippe; Ziolkowski, Michael; Herrick, Robert W.

2013-03-01

850nm oxide-aperture VCSELs are susceptible to premature failure if operated while exposed to atmospheric water vapor, and not protected by hermetic packaging. The ATLAS detector in CERN's Large Hadron Collider (LHC) has had approximately 6000 channels of Parallel Optic VCSELs fielded under well-documented ambient conditions. Exact time-to-failure data has been collected on this large sample, providing for the first time actual failure data at use conditions. In addition, the same VCSELs were tested under a variety of accelerated conditions to allow us to construct a more accurate acceleration model. Failure analysis information will also be presented to show what we believe causes corrosion-related failure for such VCSELs.

Shuttle/ISS EMU Failure History and the Impact on Advanced EMU PLSS Design

NASA Technical Reports Server (NTRS)

Campbell, Colin

2011-01-01

As the Shuttle/ISS EMU Program exceeds 30 years in duration and is still successfully supporting the needs of the International Space Station (ISS), a critical benefit of such a long running program with thorough documentation of system and component failures is the ability to study and learn from those failures when considering the design of the next generation space suit. Study of the subject failure history leads to changes in the Advanced EMU Portable Life Support System (PLSS) schematic, selected component technologies, as well as the planned manner of ground testing. This paper reviews the Shuttle/ISS EMU failure history and discusses the implications to the AEMU PLSS.

Shuttle/ISS EMU Failure History and the Impact on Advanced EMU PLSS Design

NASA Technical Reports Server (NTRS)

Campbell, Colin

2015-01-01

As the Shuttle/ISS EMU Program exceeds 30 years in duration and is still supporting the needs of the International Space Station (ISS), a critical benefit of such a long running program with thorough documentation of system and component failures is the ability to study and learn from those failures when considering the design of the next generation space suit. Study of the subject failure history leads to changes in the Advanced EMU Portable Life Support System (PLSS) schematic, selected component technologies, as well as the planned manner of ground testing. This paper reviews the Shuttle/ISS EMU failure history and discusses the implications to the AEMU PLSS.

Independent Orbiter Assessment (IOA): Analysis of the displays and controls subsystem

NASA Technical Reports Server (NTRS)

Trahan, W. H.; Prust, E. E.

1987-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. This report documents the independent analysis results corresponding to the Orbiter Displays and Controls (D and C) subsystem hardware. The function of the D and C hardware is to provide the crew with the monitor, command, and control capabilities required for management of all normal and contingency mission and flight operations. The D and C hardware for which failure modes analysis was performed consists of the following: Acceleration Indicator (G-METER); Head Up Display (HUD); Display Driver Unit (DDU); Alpha/Mach Indicator (AMI); Horizontal Situation Indicator (HSI); Attitude Director Indicator (ADI); Propellant Quantity Indicator (PQI); Surface Position Indicator (SPI); Altitude/Vertical Velocity Indicator (AVVI); Caution and Warning Assembly (CWA); Annunciator Control Assembly (ACA); Event Timer (ET); Mission Timer (MT); Interior Lighting; and Exterior Lighting. Each hardware item was evaluated and analyzed for possible failure modes and effects. Criticality was assigned based upon the severity of the effect for each failure mode.

Independent Orbiter Assessment (IOA): Assessment of the life support and airlock support systems, volume 1

NASA Technical Reports Server (NTRS)

Arbet, J. D.; Duffy, R. E.; Barickman, K.; Saiidi, M. J.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Life Support and Airlock Support Systems (LSS and ALSS) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the NASA FMEA/CIL baseline with proposed Post 51-L updates included. The discrepancies were flagged for potential future resolution. This report documents the results of that comparison for the Orbiter LSS and ALSS hardware. The IOA product for the LSS and ALSS analysis consisted of 511 failure mode worksheets that resulted in 140 potential critical items. Comparison was made to the NASA baseline which consisted of 456 FMEAs and 101 CIL items. The IOA analysis identified 39 failure modes, 6 of which were classified as CIL items, for components not covered by the NASA FMEAs. It was recommended that these failure modes be added to the NASA FMEA baseline. The overall assessment produced agreement on all but 301 FMEAs which caused differences in 111 CIL items.

Independent Orbiter Assessment (IOA): Analysis of the manned maneuvering unit

NASA Technical Reports Server (NTRS)

Bailey, P. S.

1986-01-01

Results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items (PCIs). To preserve indepedence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. This report documents the independent analysis results corresponding to the Manned Maneuvering Unit (MMU) hardware. The MMU is a propulsive backpack, operated through separate hand controllers that input the pilot's translational and rotational maneuvering commands to the control electronics and then to the thrusters. The IOA analysis process utilized available MMU hardware drawings and schematics for defining hardware subsystems, assemblies, components, and hardware items. Final levels of detail were evaluated and analyzed for possible failure modes and effects. Criticality was assigned based upon the worst case severity of the effect for each identified failure mode. The IOA analysis of the MMU found that the majority of the PCIs identified are resultant from the loss of either the propulsion or control functions, or are resultant from inability to perform an immediate or future mission. The five most severe criticalities identified are all resultant from failures imposed on the MMU hand controllers which have no redundancy within the MMU.

Precursor slope distress leading up to the 2010 Mount Meager landslide, British Columbia

NASA Astrophysics Data System (ADS)

Roberti, Gioachino; Ward, Brent; van Wyk de Vries, Benjamin; Friele, Pierre; Clague, John; Perotti, Luigi; Giardino, Marco

2017-04-01

Volcanoes are highly prone to landslides, in part due to erosion of the flanks by glaciers and streams. Mount Meager (British Columbia, Canada) is a glacier-clad volcano that is one of the most landslide-prone areas in Canada, due in part to glacial erosion. In 2010, the south flank of the volcano failed catastrophically, generating one of the largest (˜50 x 106 m 3) landslides in Canadian history. We document the evolution of the edifice up to the time of this failure using an archive of historic aerial photographs spanning the period from 1948 to 2006. Oblique digital photos taken after the landslide yielded information on the geology and internal structure of the volcano. All photos were processed with Structure from Motion (SfM) photogrammetry. We used the SfM products to produce pre-and post-failure geomorphic maps that document glacier and edifice changes. The maps show that a glacier below the 2010 landslide source area re-advanced in the 1980s, then rapidly retreated up to the present. Our photographic reconstruction documents 60 years of progressive development of tension cracks, bulging, and precursor failures (1998, 2009) at the toe of the 2010 failure zone. The final 2010 collapse was conditioned by glacial debuttressing and triggered by hot summer weather accompanied by ice and snow melt. Meltwater increased porewater pressures in fragmented and fractured material at the base of the 2010 failure zone, causing it to mobilize, which in turn triggered several secondary failures controlled by lithology and faults. The landslide retrogressed from the base of the slope to near the peak of Mount Meager and involved basement rock and the overlying volcanic sequence. Elsewhere on the flanks of Mount Meager, large fractures have developed in recently deglaciated areas, conditioning these slopes for collapse and debris avalanches. Potential failures in these areas have larger volumes than the 2010 landslide. Atmospheric warming over the next several decades will cause further loss of snow and glacier ice, and induce additional slope instability. Satellite- and ground-based monitoring of these slopes might provide advanced warning of future landslides and could be used to reduce risk in regions downstream of the volcano.

State-local policy management project. Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1981-08-01

The report describes case studies to explore new approaches for increasing state and local coordination in planning and managing programs in areas with significant scientific and technical components such as energy and environment. Specifically, the case studies reveal efforts of various states in the areas of energy conservation, weatherization, emergency preparedness, and air quality. Successes and failures of Maryland's decentralized approach to energy conservation are documented; success of the thermal and lighting efficiency standards program in Texas is discussed; state aid for local energy conservation programs in Clinton County, Michigan, is reviewed; and the success of the weatherization program inmore » Oregon is examined. Pilot programs in weatherization in Pennsylvania are shown to have led a statewide effort. Two Minnesota projects in emergency preparedness are documented and factors for success are listed. In addition, long-range planning for fuel shortages in New York is examined and the benefits of regional planning in Fairfax County, Virgina, are noted. Efforts are examined to improve air quality in Ohio, California, and New Jersey.« less

ALS rocket engine combustion devices design and demonstration

NASA Technical Reports Server (NTRS)

Arreguin, Steve

1989-01-01

Work performed during Phase one is summarized and the significant technical and programmatic accomplishments occurring during this period are documented. Besides a summary of the results, methodologies, trade studies, design, fabrication, and hardware conditions; the following are included: the evolving Maintainability Plan, Reliability Program Plan, Failure Summary and Analysis Report, and the Failure Mode and Effect Analysis.

Fracture toughness testing data. A bibliography

NASA Technical Reports Server (NTRS)

Carpenter, J. L., Jr.; Moya, N.; Stuhrke, W. F.

1975-01-01

This bibliography is comprised of approximately 800 reference citations related to the mechanics of failure in aerospace structures. Most of the references are for documents that include fracture toughness testing data and its application or documents on the availability and usefulness of fracture mechanics analysis methodology. The bibliography represents a search of the literature published in the period April 1962 through April 1974 and is largely limited to documents published in the United States.

49 CFR Appendix B to Part 604 - Reasons for Removal

Code of Federal Regulations, 2011 CFR

2011-10-01

... service organization represents that its serves the needs of the elderly, persons with disabilities, or... Fourth Edition, West Publishing Company, St. Paul, Minn., 1968. What is a lapse of other documentation? A lapse of other documentation means for example, but is not limited to, failure to have or loss or...

76 FR 61937 - Practice and Procedure: Rules of General Application, Safeguards, Antidumping and Countervailing...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-06

... System Web site at https://edis.usitc.gov . Failure to comply with the requirements of this chapter and... Electronic Document Information System (EDIS) already accepts electronic filing of certain documents, and..., regardless of whether the electronic docketing system is operational. The ITC TLA makes a similar comment...

Obesity and heart failure as a mediator of the cerebrorenal interaction.

PubMed

Jindal, Ankur; Whaley-Connell, Adam; Sowers, James R

2013-01-01

The obesity epidemic is contributing substantially to the burden of cardiovascular disease including heart disease and congestive heart failure, in the United States and the rest of the world. Overnutrition as a driver of obesity, promotes alterations in fatty acid, lipid, and glucose metabolism that influence myocardial function and progression of heart failure from diastolic to systolic failure. The association of progressive heart failure and progressive chronic kidney disease is well documented and often referred to as the cardiorenal syndrome, as well as a prognosticator for cerebrovascular disease (e.g. stroke). Whether the relationship between obesity, heart disease/failure and risk for chronic kidney disease and stroke is direct or a confluence of risk factors is poorly understood. Copyright © 2013 S. Karger AG, Basel.

First incremental buy for Increment 2 of the Space Transportation System (STS)

NASA Technical Reports Server (NTRS)

1989-01-01

Thiokol manufactured and delivered 9 flight motors to KSC on schedule. All test flights were successful. All spent SRMs were recovered. Design, development, manufacture, and delivery of required transportation, handling, and checkout equipment to MSFC and to KSC were completed on schedule. All items of data required by DPD 400 were prepared and delivered as directed. In the system requirements and analysis area, the point of departure from Buy 1 to the operational phase was developed in significant detail with a complete set of transition documentation available. The documentation prepared during the Buy 1 program was maintained and updated where required. The following flight support activities should be continued through other production programs: as-built materials usage tracking on all flight hardware; mass properties reporting for all flight hardware until sample size is large enough to verify that the weight limit requirements were met; ballistic predictions and postflight performance assessments for all production flights; and recovered SRM hardware inspection and anomaly identification. In the safety, reliability, and quality assurance area, activities accomplished were assurance oriented in nature and specifically formulated to prevent problems and hardware failures. The flight program to date has adequately demonstrated the success of this assurance approach. The attention focused on details of design, analysis, manufacture, and inspection to assure the production of high-quality hardware has resulted in the absence of flight failures. The few anomalies which did occur were evaluated, design or manufacturing changes incorporated, and corrective actions taken to preclude recurrence.

Independent Orbiter Assessment (IOA): Assessment of the extravehicular mobility unit, volume 1

NASA Technical Reports Server (NTRS)

Raffaelli, Gary G.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort performed an independent analysis of the Extravehicular Mobility Unit (EMU) hardware and system, generating draft failure modes criticalities and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were than compared to the most recent proposed Post 51-L NASA FMEA/CIL baseline. A resolution of each discrepancy from the comparison was provided through additional analysis as required. This report documents the results of that comparison for the Orbiter EMU hardware.

Independent Orbiter Assessment (IOA): Assessment of the data processing system FMEA/CIL

NASA Technical Reports Server (NTRS)

Lowery, H. J.; Haufler, W. A.

1986-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Data Processing System (DPS) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the NASA FMEA/CIL baseline with proposed Post 51-L updates included. A resolution of each discrepancy from the comparison is provided through additional analysis as required. The results of that comparison is documented for the Orbiter DPS hardware.

Severe gastritis decreases success rate of Helicobacter pylori eradication.

PubMed

Kalkan, Ismail Hakki; Sapmaz, Ferdane; Güliter, Sefa; Atasoy, Pınar

2016-05-01

In several studies, different risk factors other than antibiotic resistance have been documented with Helicobacter pylori eradication failure. We aimed in this study to investigate the relationship of gastric density of H. pylori, the occurrence/degree of gastric atrophy, and intestinal metaplasia (IM) with success rate of H. pylori eradication. Two hundred consecutive treatment naive patients who received bismuth containing standart quadruple treatment due to H. pylori infection documented by histopathological examination of two antral or two corpal biopsies entered this retrospective study. The updated Sydney system was used to grade the activity of gastritis, density of H. pylori colonization, atrophy, and IM. Stages III and IV of operative link for gastritis assessment (OLGA) or the operative link on gastric intestinal metaplasia assessment (OLGIM) stages was considered as severe gastritis. H. pylori eradication was determined via stool H. pylori antigen test performed 4 weeks after the end of therapy. The presence of gastric atrophy and IM was significantly higher in patients with eradication failure (p = 0.001 and 0.01, respectively). Severe gastritis (OLGA III-IV and OLGIM III-IV) rates were higher in eradication failure group. A multiple linear regression analysis showed that OLGA and OLGIM stages were to be independent risk factors for eradication failure (p = 0.03 and 0.01, respectively). Our results suggested that histopathologically severe gastritis may cause H. pylori eradication failure. In addition, we found that H. pylori density was not a risk factor for treatment failure in patients who receive quadruple treatment.

Management of acute exacerbations of chronic obstructive pulmonary disease (COPD). Guidelines from the Société de pneumologie de langue française (summary).

PubMed

Jouneau, S; Dres, M; Guerder, A; Bele, N; Bellocq, A; Bernady, A; Berne, G; Bourdin, A; Brinchault, G; Burgel, P R; Carlier, N; Chabot, F; Chavaillon, J M; Cittee, J; Claessens, Y E; Delclaux, B; Deslée, G; Ferré, A; Gacouin, A; Girault, C; Ghasarossian, C; Gouilly, P; Gut-Gobert, C; Gonzalez-Bermejo, J; Jebrak, G; Le Guillou, F; Léveiller, G; Lorenzo, A; Mal, H; Molinari, N; Morel, H; Morel, V; Noel, F; Pégliasco, H; Perotin, J M; Piquet, J; Pontier, S; Rabbat, A; Revest, M; Reychler, G; Stelianides, S; Surpas, P; Tattevin, P; Roche, N

2017-04-01

Chronic obstructive pulmonary disease (COPD) is the chronic respiratory disease with the most important burden on public health in terms of morbidity, mortality and health costs. For patients, COPD is a major source of disability because of dyspnea, restriction in daily activities, exacerbation, risk of chronic respiratory failure and extra-respiratory systemic organ disorders. The previous French Language Respiratory Society (SPLF) guidelines on COPD exacerbations were published in 2003. Using the GRADE methodology, the present document reviews the current knowledge on COPD exacerbation through 4 specific outlines: (1) epidemiology, (2) clinical evaluation, (3) therapeutic management and (4) prevention. Specific aspects of outpatients and inpatients care are discussed, especially regarding assessment of exacerbation severity and pharmacological approach. Copyright © 2017 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Light water reactor lower head failure analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

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

1993-10-01

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

Independent Orbiter Assessment (IOA): Assessment of the electrical power generation/power reactant storage and distribution subsystem FMEA/CIL

NASA Technical Reports Server (NTRS)

Ames, B. E.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) is presented. The IOA effort first completed an analysis of the Electrical Power Generation/Power Reactant Storage and Distribution (EPG/PRSD) subsystem hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the NASA FMEA/CIL baselines with proposed Post 51-L updates included. A resolution of each discrepancy from the comparison is provided through additional analysis as required. The results of that comparison are documented for the Orbiter EPG/PRSD hardware. The comparison produced agreement on all but 27 FMEAs and 9 CIL items. The discrepancy between the number of IOA findings and NASA FMEAs can be partially explained by the different approaches used by IOA and NASA to group failure modes together to form one FMEA. Also, several IOA items represented inner tank components and ground operations failure modes which were not in the NASA baseline.

Independent Orbiter Assessment (IOA): Analysis of the nose wheel steering subsystem

NASA Technical Reports Server (NTRS)

Mediavilla, Anthony Scott

1986-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The independent analysis results for the Orbiter Nose Wheel Steering (NWS) hardware are documented. The NWS hardware provides primary directional control for the Orbiter vehicle during landing rollout. Each level of hardware was evaluated and analyzed for possible failure modes and effects. Criticality was assigned based upon the severity of the effect for each failure mode. The original NWS design was envisioned as a backup system to differential braking for directional control of the Orbiter during landing rollout. No real effort was made to design the NWS system as fail operational. The brakes have much redundancy built into their design but the poor brake/tire performance has forced the NSTS to upgrade NWS to the primary mode of directional control during rollout. As a result, a large percentage of the NWS system components have become Potential Critical Items (PCI).

Characterization of acute-on-chronic liver failure and prediction of mortality in Asian patients with active alcoholism.

PubMed

Kim, Hwi Young; Chang, Young; Park, Jae Yong; Ahn, Hongkeun; Cho, Hyeki; Han, Seung Jun; Oh, Sohee; Kim, Donghee; Jung, Yong Jin; Kim, Byeong Gwan; Lee, Kook Lae; Kim, Won

2016-02-01

Alcoholic liver diseases often evolve to acute-on-chronic liver failure (ACLF), which increases the risk of (multi-)organ failure and death. We investigated the development and characteristics of alcohol-related ACLF and evaluated prognostic scores for prediction of mortality in Asian patients with active alcoholism. A total of 205 patients who were hospitalized with severe alcoholic liver disease were included in this retrospective cohort study, after excluding those with serious cardiovascular diseases, malignancy, or co-existing viral hepatitis. The Chronic Liver Failure (CLIF) Consortium Organ Failure score was used in the diagnosis and grading of ACLF, and the CLIF Consortium ACLF score (CLIF-C ACLFs) was used to predict mortality. Patients with ACLF had higher Maddrey discriminant function, model for end-stage liver disease (MELD), and MELD-sodium scores than those without ACLF. Infections were more frequently documented in patients with ACLF (33.3% vs 53.0%; P = 0.004). Predictive factors for ACLF development were systemic inflammatory response syndrome (odds ratio [OR], 2.239; P < 0.001), serum sodium level (OR, 0.939; P = 0.029), and neutrophil count (OR, 1.000; P = 0.021). For prediction of mortality at predefined time points (28-day and 90-day) in patients with ACLF, areas under the receiver-operating characteristic were significantly greater for the CLIF-C ACLFs than for Child-Pugh, MELD, and MELD-sodium scores. Infection and systemic inflammatory response syndrome play an important role in the development of alcohol-related ACLF in Asian patients with active alcoholism. The CLIF-C ACLFs may be more useful for predicting mortality in ACLF cases than liver-specific scoring systems. © 2015 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

"The Dog Ate It" and Other Reasons Why Students Delay Registration.

ERIC Educational Resources Information Center

Bryant, Debbie; And Others

1996-01-01

Data on the registration patterns of 203 applicants accepted to a regional comprehensive university but registering late found that 15 never made it to the fifth day of class, 22 withdrew officially, 7 were withdrawn administratively for failure to complete documentation, and 1 was suspended for falsifying an official document. Interviews with six…

ANMCO/SIC Consensus Document: cardiology networks for outpatient heart failure care

PubMed Central

Gulizia, Michele Massimo; Di Lenarda, Andrea; Mortara, Andrea; Battistoni, Ilaria; De Maria, Renata; Gabriele, Michele; Iacoviello, Massimo; Navazio, Alessandro; Pini, Daniela; Di Tano, Giuseppe; Marini, Marco; Ricci, Renato Pietro; Alunni, Gianfranco; Radini, Donatella; Metra, Marco; Romeo, Francesco

2017-01-01

Abstract Changing demographics and an increasing burden of multiple chronic comorbidities in Western countries dictate refocusing of heart failure (HF) services from acute in-hospital care to better support the long inter-critical out-of- hospital phases of HF. In Italy, as well as in other countries, needs of the HF population are not adequately addressed by current HF outpatient services, as documented by differences in age, gender, comorbidities and recommended therapies between patients discharged for acute hospitalized HF and those followed-up at HF clinics. The Italian Working Group on Heart Failure has drafted a guidance document for the organisation of a national HF care network. Aims of the document are to describe tasks and requirements of the different health system points of contact for HF patients, and to define how diagnosis, management and care processes should be documented and shared among health-care professionals. The document classifies HF outpatient clinics in three groups: (i) community HF clinics, devoted to management of stable patients in strict liaison with primary care, periodic re-evaluation of emerging clinical needs and prompt treatment of impending destabilizations, (ii) hospital HF clinics, that target both new onset and chronic HF patients for diagnostic assessment, treatment planning and early post-discharge follow-up. They act as main referral for general internal medicine units and community clinics, and (iii) advanced HF clinics, directed at patients with severe disease or persistent clinical instability, candidates to advanced treatment options such as heart transplant or mechanical circulatory support. Those different types of HF clinics are integrated in a dedicated network for management of HF patients on a regional basis, according to geographic features. By sharing predefined protocols and communication systems, these HF networks integrate multi-professional providers to ensure continuity of care and patient empowerment. In conclusion, This guidance document details roles and interactions of cardiology specialists, so as to best exploit the added value of their input in the care of HF patients and is intended to promote a more efficient and effective organization of HF services. PMID:28751837

Independent Orbiter Assessment (IOA): Assessment of the remote manipulator system FMEA/CIL

NASA Technical Reports Server (NTRS)

Tangorra, F.; Grasmeder, R. F.; Montgomery, A. D.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Remote Manipulator System (RMS) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were than compared to the NASA FMEA/CIL baseline with proposed Post 51-L updates included. A resolution of each discrepancy from the comparison is provided through additional analysis as required. The results of that comparison for the Orbiter RMS hardware are documented. The IOA product for the RMS analysis consisted of 604 failure mode worksheets that resulted in 458 potential critical items being identified. Comparison was made to the NASA baseline which consisted of 45 FMEAs and 321 CIL items. This comparison produced agreement on all but 154 FMEAs which caused differences in 137 CIL items.

Independent Orbiter Assessment (IOA): Assessment of the hydraulics/water spray boiler subsystem

NASA Technical Reports Server (NTRS)

Bynum, M. C.; Duval, J. D.; Parkman, W. E.; Davidson, W. R.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Hydraulics/Water Spray Boiler (HYD/WSB) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the NASA FMEA/CIL baseline with proposed Post 51-L updates included. A resolution of each discrepancy from the comparison is provided through additional analysis as required. This report documents the results of that comparison for the Orbiter HYD/WSB hardware. The IOA product for the HYD/WSB analysis consisted of 447 failure mode worksheets that resulted in 183 potential critical items being identified. Comparison was made to the NASA baseline which consisted of 364 FMEAs and 111 CIL items. This comparison produced agreement on all but 68 FMEAs which caused differences in 23 CIL items.

Independent Orbiter Assessment (IOA): Assessment of the Electrical Power Distribution and Control/Electrical Power Generation (EPD and C/EPG) FMEA/CIL

NASA Technical Reports Server (NTRS)

Mccants, C. N.; Bearrow, M.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Electrical Power Distribution and Control/Electrical Power Generation (EPD and C/EPG) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the NASA FMEA/CIL baseline with proposed Post 51-L updates included. A resolution of each discrepancy from the comparison was provided through additional analysis as required. The results of that comparison is documented for the Orbiter EPD and C/EPG hardware. The IOA product for the EPD and C/EPG analysis consisted of 263 failure mode worksheets that resulted in 42 potential critical items being identified. Comparison was made to the NASA baseline which consisted of 211 FMEA and 47 CIL items.

Independent Orbiter Assessment (IOA): Assessment of the auxiliary power unit

NASA Technical Reports Server (NTRS)

Barnes, J. E.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Auxiliary Power Unit (APU) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the NASA FMEA/CIL baseline with proposed Post 51-L updates included. A resolution of each discrepancy from the comparison is provided through additional analysis as required. This report documents the results of that comparison for the Orbiter APU hardware. The IOA product for the APU analysis, covering both APU hardware and APU electrical components, consisted of 344 failure mode worksheets that resulted in 178 potential critical items being identified. A comparison was made of the IOA product to the NASA APU hardware FMEA/CIL baseline which consisted of 184 FMEAs and 57 CIL items. The comparison identified 72 discrepancies.

Independent Orbiter Assessment (IOA): Assessment of the guidance, navigation, and control subsystem FMEA/CIL

NASA Technical Reports Server (NTRS)

Trahan, W. H.; Odonnell, R. A.; Pietz, K. C.; Drapela, L. J.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Guidance, Navigation, and Control System (GNC) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the NASA FMEA/CIL baseline with proposed Post 51-L updates included. A resolution of each discrepancy from the comparison is provided through additional analysis as required. The results of that comparison for the Orbiter GNC hardware is documented. The IOA product for the GNC analysis consisted of 141 failure mode worksheets that resulted in 24 potential critical items being identified. Comparison was made to the NASA baseline which consisted of 148 FMEAs and 36 CIL items. This comparison produced agreement on all but 56 FMEAs which caused differences in zero CIL items.

Independent Orbiter Assessment (IOA): Assessment of the body flap subsystem FMEA/CIL

NASA Technical Reports Server (NTRS)

Wilson, R. E.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Body Flap (BF) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the NASA FMEA/CIL baseline with proposed Post 51-L updates included. A resolution of each discrepancy from the comparison is provided through additional analysis as required. This report documents the results of that comparison for the Orbiter BF hardware. The IOA product for the BF analysis consisted of 43 failure mode worksheets that resulted in 19 potential critical items being identified. Comparison was made to the NASA baseline which consisted of 34 FMEAs and 15 CIL items. This comparison produced agreement on all CIL items. Based on the Pre 51-L baseline, all non-CIL FMEAs were also in agreement.

JPL Test Effectiveness Analysis

NASA Technical Reports Server (NTRS)

Shreck, Stephanie; Sharratt, Stephen; Smith, Joseph F.; Strong, Edward

2008-01-01

1) The pilot study provided meaningful conclusions that are generally consistent with the earlier Test Effectiveness work done between 1992 and 1994: a) Analysis of pre-launch problem/failure reports is consistent with earlier work. b) Analysis of post-launch early mission anomaly reports indicates that there are more software issues in newer missions, and the no-test category for identification of post-launch failures is more significant than in the earlier analysis. 2) Future work includes understanding how differences in Missions effect these analyses: a) There are large variations in the number of problem reports and issues that are documented by the different Projects/Missions. b) Some missions do not have any reported environmental test anomalies, even though environmental tests were performed. 3) Each project/mission has different standards and conventions for filling out the PFR forms, the industry may wish to address this issue: a) Existing problem reporting forms are to document and track problems, failures, and issues (etc.) for the projects, to ensure high quality. b) Existing problem reporting forms are not intended for data mining.

Independent Orbiter Assessment (IOA): Assessment of the elevon actuator subsystem FMEA/CIL

NASA Technical Reports Server (NTRS)

Wilson, R. E.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Elevon Subsystem hardware, generating draft failure modes, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the NASA FMEA/CIL baseline with proposed Post 51-L updates included. A resolution of each discrepancy from the comparison is provided through additional analysis as required. This report documents the results of that comparison for the Orbiter Elevon hardware. The IOA product for the Elevon analysis consisted of 25 failure mode worksheets that resulted in 17 potential critical items being identified. Comparison was made to the NASA FMEA/CIL, which consisted of 23 FMEAs and 13 CIL items. This comparison produced agreement on all CIL items. Based on the Pre 51-L baseline, all non-CIL FMEAs were also in agreement.

Independent Orbiter Assessment (IOA): Assessment of instrumental subsystem FMEA/CIL

NASA Technical Reports Server (NTRS)

Gardner, J. R.; Addis, A. W.

1988-01-01

The McDonnell Douglas Astronautics Company (MDAC) was selected in June 1986 to perform an Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL). The IOA effort first completed an analysis of the Instrumentation hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the NASA FMEA/CIL baseline. A resolution of each discrepancy from the comparison is provided through additional analysis as required. The results of that comparison for the Orbiter Instrumentation hardware are documented. The IOA product for Instrumentation analysis consisted of 107 failure mode worksheets that resulted in 22 critical items being identified. Comparison was made to the Pre 51-L NASA baseline with 14 Post 51-L FMEAs added, which consists of 96 FMEAs and 18 CIL items. This comparison produced agreement on all but 25 FMEAs which caused differences in 5 CIL items.

Engaging staff to improve quality and safety in an austere medical environment: a case-control study in two Sierra Leonean hospitals.

PubMed

Rosen, Michael A; Chima, Adaora M; Sampson, John B; Jackson, Eric V; Koka, Rahul; Marx, Megan K; Kamara, Thaim B; Ogbuagu, Onyebuchi U; Lee, Benjamin H

2015-08-01

Inadequate observance of basic processes in patient care such as patient monitoring and documentation practices are potential impediments to the timely diagnoses and management of patients. These gaps exist in low resource settings such as Sierra Leone and can be attributed to a myriad of factors such as workforce and technology deficiencies. In the study site, only 12.4% of four critical vital signs were documented in the pre-intervention period. Implement a failure mode and effects analysis (FMEA) to improve documentation of four patient vital signs: temperature, blood pressure, pulse rate and respiratory rate. FMEA was implemented among a subpopulation of health workers who are involved in monitoring and documenting patient vital signs. Pre- and post-FMEA monitoring and documentation practice were compared with a control site. Participants identified a four-step process to monitoring and documenting vital signs, three categories of failure modes and four potential solutions. Based on 2100 patient days of documentation compliance data from 147 patients between July and November 2012, staff members at the study site were 1.79 times more likely to document all four patient vital signs in the post-implementation period (95% CI [1.35, 2.38]). FMEA is a feasible and effective strategy for improving quality and safety in an austere medical environment. Documentation compliance improved at the intervention facility. To evaluate the scalability and sustainability of this approach, programs targeting the development of these types of process improvement skills in local staff should be evaluated. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Adequacy of physician documentation and correlation with assessment of transfusion appropriateness: a follow-up study in the setting of prospective audits and patient blood management.

PubMed

Madrigal, Emilio; Prajapati, Shyam; Avadhani, Vaidehi; Annen, Kyle; Friedman, Mark T

2017-02-01

A previous study in our hospitals correlated suboptimal documentation and failure to justify transfusions. In light of implemented blood-conservation strategies, including patient blood management (PBM) and prospective audits (PAs), we performed a follow-up study. We reviewed prospectively audited red blood cell (RBC) transfusions received by adult patients from January to July 2014. Survey forms were used to assess the level of documentation and to classify documentation as adequate, intermediate, or inadequate. Transfusions were deemed justified or not by comparisons with hospital transfusion guidelines. We also analyzed the effect of implemented blood-conservation strategies on our hospital transfusion rates and costs from 2009 to 2015. During the study period, there were 259 prospectively audited transfusion events (TEs) (one or more RBC units transfused to a patient), of which we reviewed 94 TEs (36.3%) in 87 patients. TEs with suboptimal (intermediate and inadequate) documentation accounted for 46.8% of the reviewed TEs, of which 81.8% could not be justified compared with 18.0% of nonjustified, adequately documented TEs. The correlation between suboptimal documentation and failure to justify transfusion was significant (p < 0.001). This correlation remained even in a comparison between the site with a PBM program and the sites without such a program. Overall transfusion rates declined after the introduction of PA, although the decline was only statistically significant at the sites with a PBM program. Suboptimal transfusion documentation remains problematic and is highly correlated with nonjustifiable transfusions. Newly adopted approaches to minimize blood transfusions have not improved transfusion documentation and corresponding out-of-guideline transfusions, although overall transfusions have been reduced by PA, particularly in the setting of a PBM program. © 2016 AABB.

Independent Orbiter Assessment (IOA): Analysis of the orbiter main propulsion system

NASA Technical Reports Server (NTRS)

Mcnicoll, W. J.; Mcneely, M.; Holden, K. A.; Emmons, T. E.; Lowery, H. J.

1987-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items (PCIs). To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The independent analysis results for the Orbiter Main Propulsion System (MPS) hardware are documented. The Orbiter MPS consists of two subsystems: the Propellant Management Subsystem (PMS) and the Helium Subsystem. The PMS is a system of manifolds, distribution lines and valves by which the liquid propellants pass from the External Tank (ET) to the Space Shuttle Main Engines (SSMEs) and gaseous propellants pass from the SSMEs to the ET. The Helium Subsystem consists of a series of helium supply tanks and their associated regulators, check valves, distribution lines, and control valves. The Helium Subsystem supplies helium that is used within the SSMEs for inflight purges and provides pressure for actuation of SSME valves during emergency pneumatic shutdowns. The balance of the helium is used to provide pressure to operate the pneumatically actuated valves within the PMS. Each component was evaluated and analyzed for possible failure modes and effects. Criticalities were assigned based on the worst possible effect of each failure mode. Of the 690 failure modes analyzed, 349 were determined to be PCIs.

A Taxonomy of Fallacies in System Safety Arguments

NASA Technical Reports Server (NTRS)

Greenwell, William S.; Knight, John C.; Holloway, C. Michael; Pease, Jacob J.

2006-01-01

Safety cases are gaining acceptance as assurance vehicles for safety-related systems. A safety case documents the evidence and argument that a system is safe to operate; however, logical fallacies in the underlying argument may undermine a system s safety claims. Removing these fallacies is essential to reduce the risk of safety-related system failure. We present a taxonomy of common fallacies in safety arguments that is intended to assist safety professionals in avoiding and detecting fallacious reasoning in the arguments they develop and review. The taxonomy derives from a survey of general argument fallacies and a separate survey of fallacies in real-world safety arguments. Our taxonomy is specific to safety argumentation, and it is targeted at professionals who work with safety arguments but may lack formal training in logic or argumentation. We discuss the rationale for the selection and categorization of fallacies in the taxonomy. In addition to its applications to the development and review of safety cases, our taxonomy could also support the analysis of system failures and promote the development of more robust safety case patterns.

Studying Associations Between Heart Failure Self-Management and Rehospitalizations Using Natural Language Processing.

PubMed

Topaz, Maxim; Radhakrishnan, Kavita; Blackley, Suzanne; Lei, Victor; Lai, Kenneth; Zhou, Li

2016-09-14

This study developed an innovative natural language processing algorithm to automatically identify heart failure (HF) patients with ineffective self-management status (in the domains of diet, physical activity, medication adherence, and adherence to clinician appointments) from narrative discharge summary notes. We also analyzed the association between self-management status and preventable 30-day hospital readmissions. Our natural language system achieved relatively high accuracy (F-measure = 86.3%; precision = 95%; recall = 79.2%) on a testing sample of 300 notes annotated by two human reviewers. In a sample of 8,901 HF patients admitted to our healthcare system, 14.4% (n = 1,282) had documentation of ineffective HF self-management. Adjusted regression analyses indicated that presence of any skill-related self-management deficit (odds ratio [OR] = 1.3, 95% confidence interval [CI] = [1.1, 1.6]) and non-specific ineffective self-management (OR = 1.5, 95% CI = [1.2, 2]) was significantly associated with readmissions. We have demonstrated the feasibility of identifying ineffective HF self-management from electronic discharge summaries with natural language processing. © The Author(s) 2016.

Current Emergency Locator Transmitter (ELT) deficiencies and potential improvements utilizing TSO-C91a ELTs

NASA Technical Reports Server (NTRS)

Trudell, Bernard J.; Dreibelbis, Ryland R.

1990-01-01

An analysis was conducted of current ELT problems and potential improvements that could be made by employing the TSO-C91a ELTs to replace the current TSO-C91 ELTs. The scope of the study included the following: (1) validate the problems; (2) determine specific failure causes; (3) determine false alarm causes; (4) estimate improvements from TSO-C91a; (5) estimate benefits from replacement of the current ELTs; and (6) determine need and benefits for improved ELT inspection and maintenance. A detailed comparison between the two requirements documents (TSO-C91 and -91a) was made to assess improved performance of the ELT in each category of failure cause and each cause of false alarms. The comparison and analysis resulted in projecting a success of operation rate approximately 3 times the current rate and a reduction in false alarms to 0.25 of those generated by TSO-C91 ELTs. These improvements led to a projection of benefits of approximately 25 additional lives to be saved each year with TSO-C91a ELTs and an improved inspection and maintenance program.

76 FR 53478 - Food Safety Modernization Act Domestic and Foreign Facility Reinspections, Recall, and Importer...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-26

...The Food and Drug Administration (FDA) is correcting a notice that appeared in the Federal Register of August 1, 2011 (76 FR 45820). The document announced the fiscal year 2012 fee rates for certain domestic and foreign facility reinspections, failure to comply with a recall order, and importer reinspections that are mandated in the FDA Food Safety Modernization Act (FSMA). The document was published with two typographical errors. This document corrects those errors.

Progressive failure of sheeted rock slopes: the 2009–2010 Rhombus Wall rock falls in Yosemite Valley, California, USA

USGS Publications Warehouse

Stock, Greg M.; Martel, Stephen J.; Collins, Brian D.; Harp, Edwin L.

2012-01-01

Progressive rock-fall failures in natural rock slopes are common in many environments, but often elude detailed quantitative documentation and analysis. Here we present high-resolution photography, video, and laser scanning data that document spatial and temporal patterns of a 15-month-long sequence of at least 14 rock falls from the Rhombus Wall, a sheeted granitic cliff in Yosemite Valley, California. The rock-fall sequence began on 26 August 2009 with a small failure at the tip of an overhanging rock slab. Several hours later, a series of five rock falls totaling 736 m3progressed upward along a sheeting joint behind the overhanging slab. Over the next 3 weeks, audible cracking occurred on the Rhombus Wall, suggesting crack propagation, while visual monitoring revealed opening of a sheeting joint adjacent to the previous failure surface. On 14 September 2009 a 110 m3 slab detached along this sheeting joint. Additional rock falls between 30 August and 20 November 2010, totaling 187 m3, radiated outward from the initial failure area along cliff (sub)parallel sheeting joints. We suggest that these progressive failures might have been related to stress redistributions accompanying propagation of sheeting joints behind the cliff face. Mechanical analyses indicate that tensile stresses should occur perpendicular to the cliff face and open sheeting joints, and that sheeting joints should propagate parallel to a cliff face from areas of stress concentrations. The analyses also account for how sheeting joints can propagate to lengths many times greater than their depths behind cliff faces. We posit that as a region of failure spreads across a cliff face, stress concentrations along its margin will spread with it, promoting further crack propagation and rock falls.

Single- versus double-row repair for full-thickness rotator cuff tears using suture anchors. A systematic review and meta-analysis of basic biomechanical studies.

PubMed

Hohmann, Erik; König, Anya; Kat, Cor-Jacques; Glatt, Vaida; Tetsworth, Kevin; Keough, Natalie

2018-07-01

The purpose of this study was to perform a systematic review and meta-analysis comparing single- and double-row biomechanical studies to evaluate load to failure, mode of failure and gap formation. A systematic review of MEDLINE, Embase, Scopus and Google Scholar was performed from 1990 through 2016. The inclusion criteria were: documentation of ultimate load to failure, failure modes and documentation of elongation or gap formation. Studies were excluded if the study protocol did not use human specimens. Publication bias was assessed by funnel plot and Egger's test. The risk of bias was established using the Cochrane Collaboration's risk of bias tool. Heterogeneity was assessed using χ 2 and I 2 statistic. Eight studies were included. The funnel plot was asymmetric suggesting publication bias, which was confirmed by Egger's test (p = 0.04). The pooled estimate for load to failure demonstrated significant differences (SMD 1.228, 95% CI: 0.55-5.226, p = 0.006, I 2  = 60.47%), favouring double-row repair. There were no differences for failure modes. The pooled estimate for elongation/gap formation demonstrated significant differences (SMD 0.783, 95% CI: 0.169-1.398, p = 0.012, I 2  = 58.8%), favouring double-row repair. The results of this systematic review and meta-analysis suggest that double-row repair is able to tolerate a significantly greater load to failure. Gap formation was also significantly lower in the double-row repair group, but both of these findings should be interpreted with caution because of the inherent interstudy heterogeneity. Systematic review and meta-analysis.

Media Monopoly in Brazil.

ERIC Educational Resources Information Center

Amaral, Roberto; Guimaraes, Cesar

1994-01-01

Documents the process of broadcasting media development in Brazil, the failure of new technologies to produce democratization, and the barriers to democratization erected by monopolization and "metastasis." (SR)

Independent Orbiter Assessment (IOA): Assessment of the electrical power generation/fuel cell powerplant subsystem FMEA/CIL

NASA Technical Reports Server (NTRS)

Brown, K. L.; Bertsch, P. J.

1987-01-01

Results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Electrical Power Generation/Fuel Cell Powerplant (EPG/FCP) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the proposed Post 51-L NASA FMEA/CIL baseline. A resolution of each discrepancy from the comparison was provided through additional analysis as required. This report documents the results of that comparison for the Orbiter EPG/FCP hardware.

Storage reliability analysis summary report. Volume 2: Electro mechanical devices

NASA Astrophysics Data System (ADS)

Smith, H. B., Jr.; Krulac, I. L.

1982-09-01

This document summarizes storage reliability data collected by the US Army Missile Command on electro-mechanical devices over a period of several years. Sources of data are detailed, major failure modes and mechanisms are listed and discussed. Non-operational failure rate prediction methodology is given, and conclusions and recommendations for enhancing the storage reliability of devices are drawn from the analysis of collected data.

The Age of Confusion. Why So Many Teens Are Getting Pregnant, Turning to Welfare and Ending up Homeless.

ERIC Educational Resources Information Center

Homes for the Homeless, Inc., New York, NY.

This report documents a history of unintended pregnancy, premature motherhood, and failure to plan for the future. Research indicates that most homeless young women are aware of birth control, but few of those who became pregnant were able to translate this knowledge into practice. The failure of homeless mothers to engage in family planning is…

Enhancing Treatment Outcome of Patients at Risk of Treatment Failure: Meta-Analytic and Mega-Analytic Review of a Psychotherapy Quality Assurance System

ERIC Educational Resources Information Center

Shimokawa, Kenichi; Lambert, Michael J.; Smart, David W.

2010-01-01

Objective: Outcome research has documented worsening among a minority of the patient population (5% to 10%). In this study, we conducted a meta-analytic and mega-analytic review of a psychotherapy quality assurance system intended to enhance outcomes in patients at risk of treatment failure. Method: Original data from six major studies conducted…

Stingray Failure Mode, Effects and Criticality Analysis: WEC Risk Registers

DOE Data Explorer

Ken Rhinefrank

2016-07-25

Analysis method to systematically identify all potential failure modes and their effects on the Stingray WEC system. This analysis is incorporated early in the development cycle such that the mitigation of the identified failure modes can be achieved cost effectively and efficiently. The FMECA can begin once there is enough detail to functions and failure modes of a given system, and its interfaces with other systems. The FMECA occurs coincidently with the design process and is an iterative process which allows for design changes to overcome deficiencies in the analysis.Risk Registers for major subsystems completed according to the methodology described in "Failure Mode Effects and Criticality Analysis Risk Reduction Program Plan.pdf" document below, in compliance with the DOE Risk Management Framework developed by NREL.

Ultrasound to Detect Pressure-related Deep Tissue Injuries in Adults Admitted via the Emergency Department: A Prospective, Descriptive, Pilot Study.

PubMed

Scheiner, Jonathan; Farid, Karen; Raden, Mark; Demisse, Seleshi

2017-03-01

Stage 4 pressure ulcers (PUs) start with tissue death at the level of the bone, also known as deep tissue injury (DTI). Studies have shown the appearance of DTI on the skin is delayed for several days after the original pressure-related injury to the deep soft tissues. Studies also suggest DTI can be seen using ultrasound (US) technology. A prospective, descriptive, correlational pilot study was conducted to evaluate the use of US technology to detect DTI in the soft tissues that are not visible on the skin upon hospital admission. Study participants included a convenience sample of 33 persons at risk for PUs (ie, Braden score <18) admitted through the emergency department. Each participant had US scans of 13 common PU body sites. All scans were documented in the radiologist report in the electronic medical record. Creatinine phosphokinase, calcium levels, and urine myoglobin levels also were assessed upon enrollment. Skin failure risk factors (SFRFs), including fever, hypotension, weight loss, coagulopathy, and acidosis/respiratory failure, also were documented. Patients were examined for skin PUs every day for 7 days after US scan. Twenty-three (23) patients completed the study. US scans identified pressure necrosis at 2 levels: bone (54 positive [US+]) and subcutaneous (SC); 79 US+, respectively). US+ bone sites resulted in 5 PUs appearing 6 to 7 days post-admission (sensitivity = 100%, specificity 84.7%, positive predictive value 10%, and negative predictive value 100%), indicating all DTI that later became purple skin DTI were detected by the US. US+ SC sites, located immediately under the skin, yielded 5 PUs appearing on day 2 after admission (sensitivity 100%, specificity 74.8%, positive predictive value 6.3%, and negative predictive value 100%). The participants with PU occurrence in both bone and SC groups had low Braden scores (bone group mean = 13.25, SC group mean = 11.2). Study patients who were positive for PU also had >4 SFRFs. Creatinine phosphokinase, calcium, and myoglobin levels were inconsistent and did not correlate with US+ scans. These observations warrant larger studies to confirm findings and optimize the validity of US screening for DTI in select populations, which may help improve protocols of care and PU admission documentation. The preliminary results suggest inclusion of the Braden Scale score and known PU risk factors may improve the positive predictive value of this test.

Evaluation of the Retrieval of Metallurgical Document References using the Universal Decimal Classification in a Computer-Based System.

ERIC Educational Resources Information Center

Freeman, Robert R.

A set of twenty five questions was processed against a computer-stored file of 9159 document references in the field of ferrous metallurgy, representing the 1965 coverage of the Iron and Steel Institute (London) information service. A basis for evaluation of system performance characteristics and analysis of system failures was provided by using…

Independent Orbiter Assessment (IOA): Analysis of the rudder/speed brake subsystem

NASA Technical Reports Server (NTRS)

Wilson, R. E.; Riccio, J. R.

1986-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The independent analysis results for the Orbiter Rudder/Speedbrake Actuation Mechanism is documented. The function of the Rudder/Speedbrake (RSB) is to provide directional control and to provide a means of energy control during entry. The system consists of two panels on a vertical hinge mounted on the aft part of the vertical stabilizer. These two panels move together to form a rudder but split apart to make a speedbrake. The Rudder/Speedbrake Actuation Mechanism consists of the following elements: (1) Power Drive Unit (PDU) which is composed of hydraulic valve module and a hydraulic motor-powered gearbox which contains differentials and mixer gears to provide PDU torque output; (2) four geared rotary actuators which apply the PDU generated torque to the rudder/speedbrake panels; and (3) ten torque shafts which join the PDU to the rotary actuators and interconnect the four rotary actuators. Each level of hardware was evaluated and analyzed for possible failures and causes. Criticality was assigned based upon the severity of the effect for each failure mode. Critical RSB failures which result in potential loss of vehicle control were mainly due to loss of hydraulic fluid, fluid contaminators, and mechanical failures in gears and shafts.

ISPD Cardiovascular and Metabolic Guidelines in Adult Peritoneal Dialysis Patients Part I - Assessment and Management of Various Cardiovascular Risk Factors.

PubMed

Wang, Angela Yee Moon; Brimble, K Scott; Brunier, Gillian; Holt, Stephen G; Jha, Vivekanand; Johnson, David W; Kang, Shin-Wook; Kooman, Jeroen P; Lambie, Mark; McIntyre, Chris; Mehrotra, Rajnish; Pecoits-Filho, Roberto

2015-01-01

Cardiovascular disease contributes significantly to the adverse clinical outcomes of peritoneal dialysis (PD) patients. Numerous cardiovascular risk factors play important roles in the development of various cardiovascular complications. Of these, loss of residual renal function is regarded as one of the key cardiovascular risk factors and is associated with an increased mortality and cardiovascular death. It is also recognized that PD solutions may incur significant adverse metabolic effects in PD patients. The International Society for Peritoneal Dialysis (ISPD) commissioned a global workgroup in 2012 to formulate a series of recommendations regarding lifestyle modification, assessment and management of various cardiovascular risk factors, as well as management of the various cardiovascular complications including coronary artery disease, heart failure, arrhythmia (specifically atrial fibrillation), cerebrovascular disease, peripheral arterial disease and sudden cardiac death, to be published in 2 guideline documents. This publication forms the first part of the guideline documents and includes recommendations on assessment and management of various cardiovascular risk factors. The documents are intended to serve as a global clinical practice guideline for clinicians who look after PD patients. The ISPD workgroup also identifies areas where evidence is lacking and further research is needed. Copyright © 2015 International Society for Peritoneal Dialysis.

Cognitive failures in late adulthood: The role of age, social context and depressive symptoms.

PubMed

Hitchcott, Paul Kenneth; Fastame, Maria Chiara; Langiu, Dalila; Penna, Maria Pietronilla

2017-01-01

The incidence of self-reported cognitive failures among older adults may be an index of successful cognitive aging. However, self-reported cognitive failures are biased by variation in depressive symptomatology. This study examined age-related and socio-cultural context effects on cognitive failures while controlling for depressive symptoms. Both overall and specific factors of cognitive failures were determined. A further goal was to investigate the relationship between working memory and cognitive efficiency measures and cognitive failures. One hundred and thirty-nine cognitively healthy adults were recruited from two populations known to differ in their dispositions toward cognitive failures and depressive symptoms (Sardinia and northern Italy). The participants were assigned to Young Old (65-74 years old), Old (75-84 years of age) or Oldest Old (≥85 years of age) groups, and individually presented with a test battery including the Cognitive Failures Questionnaire, the Centre for Epidemiological Studies of Depression Scale, and Forward and Backward Digit Span tests. Specific factors of cognitive failures were differentially associated with measures of depression and working memory. While age had no impact on any aspect of cognitive failures, overall and specific dispositions varied between the two populations. The overall liability to cognitive failure was lower in participants from Sardinia, however, this group also had a higher liability to lapses of action (Blunders factor). Overall, these findings highlight that richer information about cognitive failures may be revealed through the investigation of specific factors of cognitive failures. They also confirm that the absence of changes in cognitive failures across old age is independent of variation in depressive symptoms, at least among cognitively healthy elders.

2015 SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care: Endorsed by the American Heart Assocation, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencion; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie d'intervention.

PubMed

Rihal, Charanjit S; Naidu, Srihari S; Givertz, Michael M; Szeto, Wilson Y; Burke, James A; Kapur, Navin K; Kern, Morton; Garratt, Kirk N; Goldstein, James A; Dimas, Vivian; Tu, Thomas

2015-05-19

Although historically the intra-aortic balloon pump has been the only mechanical circulatory support device available to clinicians, a number of new devices have become commercially available and have entered clinical practice. These include axial flow pumps, such as Impella(®); left atrial to femoral artery bypass pumps, specifically the TandemHeart; and new devices for institution of extracorporeal membrane oxygenation. These devices differ significantly in their hemodynamic effects, insertion, monitoring, and clinical applicability. This document reviews the physiologic impact on the circulation of these devices and their use in specific clinical situations. These situations include patients undergoing high-risk percutaneous coronary intervention, those presenting with cardiogenic shock, and acute decompensated heart failure. Specialized uses for right-sided support and in pediatric populations are discussed and the clinical utility of mechanical circulatory support devices is reviewed, as are the American College of Cardiology/American Heart Association clinical practice guidelines. Copyright © 2015 The Society for Cardiovascular Angiography and Interventions, The American College of Cardiology Foundation, The Heart Failure Society of America, and The Society for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

2015 SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care (Endorsed by the American Heart Association, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencion; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie D'intervention).

PubMed

Rihal, Charanjit S; Naidu, Srihari S; Givertz, Michael M; Szeto, Wilson Y; Burke, James A; Kapur, Navin K; Kern, Morton; Garratt, Kirk N; Goldstein, James A; Dimas, Vivian; Tu, Thomas

2015-06-01

Although historically the intra-aortic balloon pump has been the only mechanical circulatory support device available to clinicians, a number of new devices have become commercially available and have entered clinical practice. These include axial flow pumps, such as Impella®; left atrial to femoral artery bypass pumps, specifically the TandemHeart; and new devices for institution of extracorporeal membrane oxygenation. These devices differ significantly in their hemodynamic effects, insertion, monitoring, and clinical applicability. This document reviews the physiologic impact on the circulation of these devices and their use in specific clinical situations. These situations include patients undergoing high-risk percutaneous coronary intervention, those presenting with cardiogenic shock, and acute decompensated heart failure. Specialized uses for right-sided support and in pediatric populations are discussed and the clinical utility of mechanical circulatory support devices is reviewed, as are the American College of Cardiology/American Heart Association clinical practice guidelines. © 2015 by The Society for Cardiovascular Angiography and Interventions, The American College of Cardiology Foundation, The Heart Failure Society of America, and The Society for Thoracic Surgery.

Hypertension Canada's 2018 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hypertension in Adults and Children.

PubMed

Nerenberg, Kara A; Zarnke, Kelly B; Leung, Alexander A; Dasgupta, Kaberi; Butalia, Sonia; McBrien, Kerry; Harris, Kevin C; Nakhla, Meranda; Cloutier, Lyne; Gelfer, Mark; Lamarre-Cliche, Maxime; Milot, Alain; Bolli, Peter; Tremblay, Guy; McLean, Donna; Padwal, Raj S; Tran, Karen C; Grover, Steven; Rabkin, Simon W; Moe, Gordon W; Howlett, Jonathan G; Lindsay, Patrice; Hill, Michael D; Sharma, Mike; Field, Thalia; Wein, Theodore H; Shoamanesh, Ashkan; Dresser, George K; Hamet, Pavel; Herman, Robert J; Burgess, Ellen; Gryn, Steven E; Grégoire, Jean C; Lewanczuk, Richard; Poirier, Luc; Campbell, Tavis S; Feldman, Ross D; Lavoie, Kim L; Tsuyuki, Ross T; Honos, George; Prebtani, Ally P H; Kline, Gregory; Schiffrin, Ernesto L; Don-Wauchope, Andrew; Tobe, Sheldon W; Gilbert, Richard E; Leiter, Lawrence A; Jones, Charlotte; Woo, Vincent; Hegele, Robert A; Selby, Peter; Pipe, Andrew; McFarlane, Philip A; Oh, Paul; Gupta, Milan; Bacon, Simon L; Kaczorowski, Janusz; Trudeau, Luc; Campbell, Norman R C; Hiremath, Swapnil; Roerecke, Michael; Arcand, Joanne; Ruzicka, Marcel; Prasad, G V Ramesh; Vallée, Michel; Edwards, Cedric; Sivapalan, Praveena; Penner, S Brian; Fournier, Anne; Benoit, Geneviève; Feber, Janusz; Dionne, Janis; Magee, Laura A; Logan, Alexander G; Côté, Anne-Marie; Rey, Evelyne; Firoz, Tabassum; Kuyper, Laura M; Gabor, Jonathan Y; Townsend, Raymond R; Rabi, Doreen M; Daskalopoulou, Stella S

2018-05-01

Hypertension Canada provides annually updated, evidence-based guidelines for the diagnosis, assessment, prevention, and treatment of hypertension in adults and children. This year, the adult and pediatric guidelines are combined in one document. The new 2018 pregnancy-specific hypertension guidelines are published separately. For 2018, 5 new guidelines are introduced, and 1 existing guideline on the blood pressure thresholds and targets in the setting of thrombolysis for acute ischemic stroke is revised. The use of validated wrist devices for the estimation of blood pressure in individuals with large arm circumference is now included. Guidance is provided for the follow-up measurements of blood pressure, with the use of standardized methods and electronic (oscillometric) upper arm devices in individuals with hypertension, and either ambulatory blood pressure monitoring or home blood pressure monitoring in individuals with white coat effect. We specify that all individuals with hypertension should have an assessment of global cardiovascular risk to promote health behaviours that lower blood pressure. Finally, an angiotensin receptor-neprilysin inhibitor combination should be used in place of either an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker in individuals with heart failure (with ejection fraction < 40%) who are symptomatic despite appropriate doses of guideline-directed heart failure therapies. The specific evidence and rationale underlying each of these guidelines are discussed. Copyright © 2018 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Independent academic Data Monitoring Committees for clinical trials in cardiovascular and cardiometabolic diseases.

PubMed

Filippatos, Gerasimos S; de Graeff, Pieter; Bax, Jeroen J; Borg, John-Joseph; Cleland, John G F; Dargie, Henry J; Flather, Marcus; Ford, Ian; Friede, Tim; Greenberg, Barry; Henon-Goburdhun, Cécile; Holcomb, Richard; Horst, Bradley; Lekakis, John; Mueller-Velten, Guenther; Papavassiliou, Athanasios G; Prasad, Krishna; Rosano, Giuseppe M C; Severin, Thomas; Sherman, Warren; Stough, Wendy Gattis; Swedberg, Karl; Tavazzi, Luigi; Tousoulis, Dimitris; Vardas, Panagiotis; Ruschitzka, Frank; Anker, Stefan D

2017-04-01

Data Monitoring Committees (DMCs) play a crucial role in the conducting of clinical trials to ensure the safety of study participants and to maintain a trial's scientific integrity. Generally accepted standards exist for DMC composition and operational conduct. However, some relevant issues are not specifically addressed in current guidance documents, resulting in uncertainties regarding optimal approaches for communication between the DMC, steering committee, and sponsors, release of information, and liability protection for DMC members. The Heart Failure Association (HFA) of the European Society of Cardiology (ESC), in collaboration with the Clinical Trials Unit of the European Heart Agency (EHA) of the ESC convened a meeting of international experts in DMCs for cardiovascular and cardiometabolic clinical trials to identify specific issues and develop steps to resolve challenges faced by DMCs.The main recommendations from the meeting relate to methodological consistency, independence, managing conflicts of interest, liability protection, and training of future DMC members. This paper summarizes the key outcomes from this expert meeting, and describes the core set of activities that might be further developed and ultimately implemented by the ESC, HFA, and other interested ESC constituent bodies. The HFA will continue to work with stakeholders in cardiovascular and cardiometabolic clinical research to promote these goals. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

Experiences with Extra-Vehicular Activities in Response to Critical ISS Contingencies

NASA Technical Reports Server (NTRS)

Van Cise, Edward A.; Kelly, Brian J.; Radigan, Jeffery P.; Cranmer, Curtis W.

2016-01-01

Initial "Big 14" work was put to the test for the first time in 2010. Deficiencies were found in some of the planning and approaches to that work; Failure Response Assessment Team created in 2010 to address deficiencies -Identify and perform engineering analysis in operations products prior to failure; incorporate results into operations products -Identify actions for protecting ISS against a Next Worse Failure after the first failure occurs -Better document not only EVA products but also planning products, assumptions, and open actions; Pre-failure investments against critical failures best postures ISS for swift response and recovery -A type of insurance policy -Has proven effective in a number of contingency EVA cases since 2010. Planning for MBSU R&R in 2012, Second PM R&R in 2013, EXT MDM R&R in 2014; Current FRAT schedule projects completion of all analysis in 2018

HEP Outreach, Inreach, and Web 2.0

NASA Astrophysics Data System (ADS)

Goldfarb, Steven

2011-12-01

I report on current usage of multimedia and social networking "Web 2.0" tools for Education and Outreach in high-energy physics, and discuss their potential for internal communication within large worldwide collaborations, such as those of the LHC. Following a brief description of the history of Web 2.0 development, I present a survey of the most popular sites and describe their usage in HEP to disseminate information to students and the general public. I then discuss the potential of certain specific tools, such as document and multimedia sharing sites, for boosting the speed and effectiveness of information exchange within the collaborations. I conclude with a brief discussion of the successes and failures of these tools, and make suggestions for improved usage in the future.

True rate of mineralocorticoid receptor antagonists-related hyperkalemia in placebo-controlled trials: A meta-analysis.

PubMed

Vukadinović, Davor; Lavall, Daniel; Vukadinović, Aleksandra Nikolovska; Pitt, Bertram; Wagenpfeil, Stefan; Böhm, Michael

2017-06-01

Mineralocorticoid receptor antagonists (MRA) improve survival in heart failure with reduced ejection fraction but are often underused, mostly due to concerns of hyperkalemia. Because hyperkalemia occurs also on placebo, we aimed to determine the truly MRA-related rate of hyperkalemia. We performed a meta-analysis including randomized, placebo-controlled trials reporting hyperkalemia on MRAs in patients after myocardial infarction or with chronic heart failure. We evaluated the truly MRA-related rate of hyperkalemia that represents hyperkalemia on MRA, corrected for hyperkalemia on placebo (Pla), according to the equation: True MRA (%)=(MRA (%) - Pla (%))/MRA (%). A total number of 16,065 patients from 7 trials were analyzed. Hyperkalemia was more frequently observed on MRA (9.3%) vs placebo (4.3%) (risk ratio 2.17, 95% CI 1.92-2.45, P<.0001). Truly MRA-related hyperkalemia was 54%, whereas 46% were non-MRA related. In trials using eplerenone, hyperkalemia was documented in 5.0% on eplerenone and in 2.6% on placebo (P<.0001). In spironolactone trials, hyperkalemia was documented in 17.5% and in 7.5% of patients on placebo (P=.0001). Hypokalemia occurred less frequently in patients on MRA (9.3%) compared with placebo (14.8%) (risk ratio 0.58, CI 0.47-0.72, P<.0001). This meta-analysis shows that in clinical trials, 54% of hyperkalemia cases were specifically related to the MRA treatment and 46% to other reasons. Therefore, non-MRA-related rises in potassium levels might be underestimated and should be rigorously explored before cessation of the evidence-based therapy with MRAs. Copyright © 2017 Elsevier Inc. All rights reserved.

Reasons for not prescribing guideline-recommended medications to adults with heart failure

PubMed Central

Steinman, Michael A.; Dimaano, Liezel; Peterson, Carolyn A.; Heidenreich, Paul A.; Knight, Sara J.; Fung, Kathy Z.; Kaboli, Peter J.

2013-01-01

Background Little is known about how often contextual factors such as patient preferences and competing priorities impact prescribing of guideline-recommended medications, or about the extent to which these factors are documented in medical records and available to performance measurement systems. Methods Mixed-methods study of 295 veterans age 50 years and older in 4 VA health care systems who had systolic heart failure and were not prescribed a beta blocker and/or an ACE inhibitor (ACE-I) or angiotensin receptor blocker (ARB). Reasons for non-treatment were identified from clinic notes and from interviews with 62 primary care clinicians caring for these patients. These reasons were classified using a published taxonomy. Results Among 295 patients not receiving guideline-recommended drugs for heart failure, chart review identified biomedical reasons for non-prescribing in 42-58% of patients and contextual reasons in 11-17%. Clinician interviews identified twice as many reasons for non-prescribing as chart review (mean 1.6 vs. 0.8 reasons per patient, P < .001). In these interviews, biomedical reasons for non-prescribing were cited in 50-70% of patients, and contextual reasons in 64-70%. The most common contextual reasons were co-management with other clinicians (32-35% of patients), patient preferences and non-adherence (15-24%), and clinician belief that the medication is not indicated in the patient (12-20%). Conclusions Contextual reasons for not prescribing ACE-I/ARBs and beta blockers are present in two-thirds of patients with heart failure who did not receive these medications, yet are poorly documented in medical records. The structure of medical records should be improved to facilitate documentation of contextual reasons for not providing guideline-recommended care. PMID:23969589

Prevalence and Predictors of Immunological Failure among HIV Patients on HAART in Southern Ethiopia.

PubMed

Yirdaw, Kesetebirhan Delele; Hattingh, Susan

2015-01-01

Immunological monitoring is part of the standard of care for patients on antiretroviral treatment. Yet, little is known about the routine implementation of immunological laboratory monitoring and utilization in clinical care in Ethiopia. This study assessed the pattern of immunological monitoring, immunological response, level of immunological treatment failure and factors related to it among patients on antiretroviral therapy in selected hospitals in southern Ethiopia. A retrospective longitudinal analytic study was conducted using documents of patients started on antiretroviral therapy. Adequacy of timely immunological monitoring was assessed every six months the first year and every one year thereafter. Immunological response was assessed every six months at cohort level. Immunological failure was based on the criteria: fall of follow-up CD4 cell count to baseline (or below), or CD4 levels persisting below 100 cells/mm3, or 50% fall from on-treatment peak value. A total of 1,321 documents of patients reviewed revealed timely immunological monitoring were inadequate. There was adequate immunological response, with pediatric patients, females, those with less advanced illness (baseline WHO Stage I or II) and those with higher baseline CD4 cell count found to have better immunological recovery. Thirty-nine patients (3%) were not evaluated for immunological failure because they had frequent treatment interruption. Despite overall adequate immunological response at group level, the prevalence of those who ever experienced immunological failure was 17.6% (n=226), while after subsequent re-evaluation it dropped to 11.5% (n=147). Having WHO Stage III/IV of the disease or a higher CD4 cell count at baseline was identified as a risk for immunological failure. Few patients with confirmed failure were switched to second line therapy. These findings highlight the magnitude of the problem of immunological failure and the gap in management. Prioritizing care for high risk patients may help in effective utilization of meager resources.

Prevalence and Predictors of Immunological Failure among HIV Patients on HAART in Southern Ethiopia

PubMed Central

2015-01-01

Immunological monitoring is part of the standard of care for patients on antiretroviral treatment. Yet, little is known about the routine implementation of immunological laboratory monitoring and utilization in clinical care in Ethiopia. This study assessed the pattern of immunological monitoring, immunological response, level of immunological treatment failure and factors related to it among patients on antiretroviral therapy in selected hospitals in southern Ethiopia. A retrospective longitudinal analytic study was conducted using documents of patients started on antiretroviral therapy. Adequacy of timely immunological monitoring was assessed every six months the first year and every one year thereafter. Immunological response was assessed every six months at cohort level. Immunological failure was based on the criteria: fall of follow-up CD4 cell count to baseline (or below), or CD4 levels persisting below 100 cells/mm3, or 50% fall from on-treatment peak value. A total of 1,321 documents of patients reviewed revealed timely immunological monitoring were inadequate. There was adequate immunological response, with pediatric patients, females, those with less advanced illness (baseline WHO Stage I or II) and those with higher baseline CD4 cell count found to have better immunological recovery. Thirty-nine patients (3%) were not evaluated for immunological failure because they had frequent treatment interruption. Despite overall adequate immunological response at group level, the prevalence of those who ever experienced immunological failure was 17.6% (n=226), while after subsequent re-evaluation it dropped to 11.5% (n=147). Having WHO Stage III/IV of the disease or a higher CD4 cell count at baseline was identified as a risk for immunological failure. Few patients with confirmed failure were switched to second line therapy. These findings highlight the magnitude of the problem of immunological failure and the gap in management. Prioritizing care for high risk patients may help in effective utilization of meager resources. PMID:25961732

All Systems Failure: An Examination of the Results of Neglecting the Needs of Children with Serious Emotional Disturbance. A Guide for Advocates.

ERIC Educational Resources Information Center

Koyanagi, Chris; Gaines, Sam

This report documents the failure of the educational and mental health systems to meet the needs of children with severe emotional disturbances and provides a guide for advocates at both the state and local levels. Part 1 identifies priorities obtained through a national survey and reports major thrusts, including a wider array of services,…

Periodontitis associated with chronic renal failure: a case report.

PubMed

Khocht, A

1996-11-01

Chronic renal disease is associated with well-documented impairments in polymorphonuclear leucocyte (PMN) function. PMNs are important in defending the periodontium against plaque infections. This report discusses a case of periodontitis in a patient with chronic renal failure. It presents treatment provided and 1-year follow up. It shows that periodontal infections in patients with depressed PMN function could still be managed successfully with standard periodontal treatment emphasizing plaque control.

Independent Orbiter Assessment (IOA): Analysis of the electrical power distribution and control/remote manipulator system subsystem

NASA Technical Reports Server (NTRS)

Robinson, W. W.

1987-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the Electrical Power Distribution and Control (EPD and C)/Remote Manipulator System (RMS) hardware to determine failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained in the NASA FMEA/CIL documentation. This report documents the results of the independent analysis of the EPD and C/RMS (both port and starboard) hardware. The EPD and C/RMS subsystem hardware provides the electrical power and power control circuitry required to safely deploy, operate, control, and stow or guillotine and jettison two (one port and one starboard) RMSs. The EPD and C/RMS subsystem is subdivided into the four following functional divisions: Remote Manipulator Arm; Manipulator Deploy Control; Manipulator Latch Control; Manipulator Arm Shoulder Jettison; and Retention Arm Jettison. The IOA analysis process utilized available EPD and C/RMS hardware drawings and schematics for defining hardware assemblies, components, and hardware items. Each level of hardware was evaluated and analyzed for possible failure modes and effects. Criticality was assigned based on the severity of the effect for each failure mode.

Independent Orbiter Assessment (IOA): Analysis of the extravehicular mobility unit

NASA Technical Reports Server (NTRS)

Raffaelli, Gary G.

1986-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items (PCIs). To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. This report documents the independent analysis results corresponding to the Extravehicular Mobility Unit (EMU) hardware. The EMU is an independent anthropomorphic system that provides environmental protection, mobility, life support, and communications for the Shuttle crewmember to perform Extravehicular Activity (EVA) in Earth orbit. Two EMUs are included on each baseline Orbiter mission, and consumables are provided for three two-man EVAs. The EMU consists of the Life Support System (LSS), Caution and Warning System (CWS), and the Space Suit Assembly (SSA). Each level of hardware was evaluated and analyzed for possible failure modes and effects. The majority of these PCIs are resultant from failures which cause loss of one or more primary functions: pressurization, oxygen delivery, environmental maintenance, and thermal maintenance. It should also be noted that the quantity of PCIs would significantly increase if the SOP were to be treated as an emergency system rather than as an unlike redundant element.

Geometric rectification of camera-captured document images.

PubMed

Liang, Jian; DeMenthon, Daniel; Doermann, David

2008-04-01

Compared to typical scanners, handheld cameras offer convenient, flexible, portable, and non-contact image capture, which enables many new applications and breathes new life into existing ones. However, camera-captured documents may suffer from distortions caused by non-planar document shape and perspective projection, which lead to failure of current OCR technologies. We present a geometric rectification framework for restoring the frontal-flat view of a document from a single camera-captured image. Our approach estimates 3D document shape from texture flow information obtained directly from the image without requiring additional 3D/metric data or prior camera calibration. Our framework provides a unified solution for both planar and curved documents and can be applied in many, especially mobile, camera-based document analysis applications. Experiments show that our method produces results that are significantly more OCR compatible than the original images.

[The Spanish AIDS Study Group and Spanish National AIDS Plan (GESIDA/Secretaría del Plan Nacional sobre el Sida) recommendations for the treatment of tuberculosis in HIV-infected individuals (Updated January 2013)].

PubMed

Rivero, Antonio; Pulido, Federico; Caylá, Joan; Iribarren, José A; Miró, José M; Moreno, Santiago; Pérez-Camacho, Inés

2013-12-01

This consensus document was prepared by an expert panel of the Grupo de Estudio de Sida (GESIDA [Spanish AIDS Study Group]) and the Plan Nacional sobre el Sida (PNS [Spanish National AIDS Plan]). The document updates current guidelines on the treatment of tuberculosis (TB) in HIV-infected individuals contained in the guidelines on the treatment of opportunistic infections published by GESIDA and PNS in 2008. The document aims to facilitate the management and treatment of HIV-infected patients with TB in Spain, and includes specific sections and recommendations on the treatment of drug-sensitive TB, multidrug-resistant TB, and extensively drug-resistant TB, in this population. The consensus guidelines also make recommendations on the treatment of HIV-infected patients with TB in special situations, such as chronic liver disease, pregnancy, kidney failure, and transplantation. Recommendations are made on the timing and initial regimens of antiretroviral therapy in patients with TB, and on immune reconstitution syndrome in HIV-infected patients with TB who are receiving antiretroviral therapy. The document does not cover the diagnosis of TB, diagnosis/treatment of latent TB, or treatment of TB in children. The quality of the evidence was evaluated and the recommendations graded using the approach of the Grading of Recommendations Assessment, Development and Evaluation Working Group. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Green Neutrophilic Inclusions and Acute Hepatic Failure: Clinical Significance and Brief Review of the Literature.

PubMed

Haberichter, Kristle L; Crisan, Domnita

2017-01-01

Medical literature has documented an association between acute hepatic failure and coarse, bright-green neutrophilic inclusions. Upon identification of these unique inclusions patients have been reported to have poor outcomes and usually die within 24-72 hours. The exact nature of these inclusions has yet to be determined; it is postulated that they arise from lipofusion-like substance. Here, we describe five cases of acute hepatic failure, with associated bright-green neutrophilic inclusions, where four patients survived beyond the ominous 72-hour window period. © 2017 by the Association of Clinical Scientists, Inc.

Synthetic Biology Open Language (SBOL) Version 2.1.0.

PubMed

Beal, Jacob; Cox, Robert Sidney; Grünberg, Raik; McLaughlin, James; Nguyen, Tramy; Bartley, Bryan; Bissell, Michael; Choi, Kiri; Clancy, Kevin; Macklin, Chris; Madsen, Curtis; Misirli, Goksel; Oberortner, Ernst; Pocock, Matthew; Roehner, Nicholas; Samineni, Meher; Zhang, Michael; Zhang, Zhen; Zundel, Zach; Gennari, John H; Myers, Chris; Sauro, Herbert; Wipat, Anil

2016-09-01

Synthetic biology builds upon the techniques and successes of genetics, molecular biology, and metabolic engineering by applying engineering principles to the design of biological systems. The field still faces substantial challenges, including long development times, high rates of failure, and poor reproducibility. One method to ameliorate these problems would be to improve the exchange of information about designed systems between laboratories. The Synthetic Biology Open Language (SBOL) has been developed as a standard to support the specification and exchange of biological design information in synthetic biology, filling a need not satisfied by other pre-existing standards. This document details version 2.1 of SBOL that builds upon version 2.0 published in last year's JIB special issue. In particular, SBOL 2.1 includes improved rules for what constitutes a valid SBOL document, new role fields to simplify the expression of sequence features and how components are used in context, and new best practices descriptions to improve the exchange of basic sequence topology information and the description of genetic design provenance, as well as miscellaneous other minor improvements.

Synthetic Biology Open Language (SBOL) Version 2.1.0.

PubMed

Beal, Jacob; Cox, Robert Sidney; Grünberg, Raik; McLaughlin, James; Nguyen, Tramy; Bartley, Bryan; Bissell, Michael; Choi, Kiri; Clancy, Kevin; Macklin, Chris; Madsen, Curtis; Misirli, Goksel; Oberortner, Ernst; Pocock, Matthew; Roehner, Nicholas; Samineni, Meher; Zhang, Michael; Zhang, Zhen; Zundel, Zach; Gennari, John; Myers, Chris; Sauro, Herbert; Wipat, Anil

2016-12-18

Synthetic biology builds upon the techniques and successes of genetics, molecular biology, and metabolic engineering by applying engineering principles to the design of biological systems. The field still faces substantial challenges, including long development times, high rates of failure, and poor reproducibility. One method to ameliorate these problems would be to improve the exchange of information about designed systems between laboratories. The Synthetic Biology Open Language (SBOL) has been developed as a standard to support the specification and exchange of biological design information in synthetic biology, filling a need not satisfied by other pre-existing standards. This document details version 2.1 of SBOL that builds upon version 2.0 published in last year’s JIB special issue. In particular, SBOL 2.1 includes improved rules for what constitutes a valid SBOL document, new role fields to simplify the expression of sequence features and how components are used in context, and new best practices descriptions to improve the exchange of basic sequence topology information and the description of genetic design provenance, as well as miscellaneous other minor improvements.

British American Tobacco's failure in Turkey.

PubMed

Lawrence, S

2009-02-01

Transnational tobacco companies (TTCs) considered Turkey an important, potential investment market because of its high consumption rates and domestic commitment to tobacco. This paper outlines how British American Tobacco (BAT) attempted to establish a joint venture with the government monopoly TEKEL, while waiting for privatisation and a private tender. Analysis of tobacco industry documents from the Guildford Depository and online tobacco document sources. BAT failed to establish a market share in Turkey until 2000 despite repeated attempts to form a joint venture with Turkey's tobacco monopoly, TEKEL, once the market liberalised in the mid 1980s. BAT's failure in the Turkish market was due to a misguided investment strategy focused solely on acquiring TEKEL and is contrasted with Philip Morris success in Turkey despite both TTCs working within Turkey's unstable and corrupt investing climate.

In-patient physiotherapy for adults on veno-venous extracorporeal membrane oxygenation – United Kingdom ECMO Physiotherapy Network: A consensus agreement for best practice

PubMed Central

Purkiss, Claire; Cork, Gabriella; Baddeley, Adam; Morris, Kelly; Carey, Leah; Brown, Mike; McGarrigle, Laura; Kennedy, Samantha

2017-01-01

Clinical specialist physiotherapists from the five severe respiratory failure centres in England where respiratory extracorporeal membrane oxygenation (ECMO) is practiced have established this consensus agreement for physiotherapy best practice. The severe respiratory failure centres are Wythenshawe Hospital, Manchester; Glenfield Hospital, Leicester; Papworth Hospital, Cambridge; Guy’s and St Thomas’ Hospital, London and The Royal Brompton Hospital, London. Although research into physiotherapy and ECMO is increasing, there is not a sufficient amount to write evidence-based guidelines; hence the development of a consensus document, using knowledge and experience of the specialist physiotherapists working with patients receiving ECMO. The document outlines safety aspects, practicalities and additional treatment considerations for physiotherapists conducting respiratory care and physical rehabilitation. PMID:29118833

Independent Orbiter Assessment (IOA): Assessment of the Electrical Power Distribution and Control Subsystem, Volume 2

NASA Technical Reports Server (NTRS)

Schmeckpeper, K. R.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA first completed an analysis of the Electrical Power Distribution and Control (EPD and C) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the NASA FMEA/CIL baseline with proposed Post 51-L updates included. A resolution of each discrepancy from the comparison is provided through additional analysis as required. This report documents the results of that comparison for the Orbiter EPD and C hardware. Volume 2 continues the presentation of IOA worksheets.

Data collection and documentation of flooding downstream of a dam failure in Mississippi

USGS Publications Warehouse

Van Wilson, K.; ,

2005-01-01

On March 12, 2004, the Big Bay Lake dam failed, releasing water and affecting lives and property downstream in southern Mississippi. The dam is located near Purvis, Mississippi, on Bay Creek, which flows into Lower Little Creek about 1.9 miles downstream from the dam. Lower Little Creek flows into Pearl River about 16.9 miles downstream from the dam. Knowledge of the hydrology and hydraulics of floods caused by dam breaks is essential to the design of dams. A better understanding of the risks associated with possible dam failures may help limit the loss of life and property that often occurs downstream of a dam failure. The USGS recovered flood marks at the one crossing of Bay Creek and eight crossings of Lower Little Creek. Additional flood marks were also flagged at three other bridges crossing tributaries where backwater occurred. Flood marks were recovered throughout the stream reach of about 3/4 to 15 miles downstream of the dam. Flood marks that were flagged will be surveyed so that a flood profile can be documented downstream of the Big Bay Lake dam failure. Peak discharges are also to be estimated where possible. News reports stated that the peak discharge at the dam was about 67,000 cubic feet per second. Preliminary data suggest the peak discharge from the dam failure attenuated to about 13,000 cubic feet per second at Lower Little Creek at State Highway 43, about 15 miles downstream of the dam.

Evaluation of a Multi-Axial, Temperature, and Time Dependent (MATT) Failure Model

NASA Technical Reports Server (NTRS)

Richardson, D. E.; Anderson, G. L.; Macon, D. J.; Rudolphi, Michael (Technical Monitor)

2002-01-01

To obtain a better understanding the response of the structural adhesives used in the Space Shuttle's Reusable Solid Rocket Motor (RSRM) nozzle, an extensive effort has been conducted to characterize in detail the failure properties of these adhesives. This effort involved the development of a failure model that includes the effects of multi-axial loading, temperature, and time. An understanding of the effects of these parameters on the failure of the adhesive is crucial to the understanding and prediction of the safety of the RSRM nozzle. This paper documents the use of this newly developed multi-axial, temperature, and time (MATT) dependent failure model for modeling failure for the adhesives TIGA 321, EA913NA, and EA946. The development of the mathematical failure model using constant load rate normal and shear test data is presented. Verification of the accuracy of the failure model is shown through comparisons between predictions and measured creep and multi-axial failure data. The verification indicates that the failure model performs well for a wide range of conditions (loading, temperature, and time) for the three adhesives. The failure criterion is shown to be accurate through the glass transition for the adhesive EA946. Though this failure model has been developed and evaluated with adhesives, the concepts are applicable for other isotropic materials.

X-framework: Space system failure analysis framework

NASA Astrophysics Data System (ADS)

Newman, John Steven

Space program and space systems failures result in financial losses in the multi-hundred million dollar range every year. In addition to financial loss, space system failures may also represent the loss of opportunity, loss of critical scientific, commercial and/or national defense capabilities, as well as loss of public confidence. The need exists to improve learning and expand the scope of lessons documented and offered to the space industry project team. One of the barriers to incorporating lessons learned include the way in which space system failures are documented. Multiple classes of space system failure information are identified, ranging from "sound bite" summaries in space insurance compendia, to articles in journals, lengthy data-oriented (what happened) reports, and in some rare cases, reports that treat not only the what, but also the why. In addition there are periodically published "corporate crisis" reports, typically issued after multiple or highly visible failures that explore management roles in the failure, often within a politically oriented context. Given the general lack of consistency, it is clear that a good multi-level space system/program failure framework with analytical and predictive capability is needed. This research effort set out to develop such a model. The X-Framework (x-fw) is proposed as an innovative forensic failure analysis approach, providing a multi-level understanding of the space system failure event beginning with the proximate cause, extending to the directly related work or operational processes and upward through successive management layers. The x-fw focus is on capability and control at the process level and examines: (1) management accountability and control, (2) resource and requirement allocation, and (3) planning, analysis, and risk management at each level of management. The x-fw model provides an innovative failure analysis approach for acquiring a multi-level perspective, direct and indirect causation of failures, and generating better and more consistent reports. Through this approach failures can be more fully understood, existing programs can be evaluated and future failures avoided. The x-fw development involved a review of the historical failure analysis and prevention literature, coupled with examination of numerous failure case studies. Analytical approaches included use of a relational failure "knowledge base" for classification and sorting of x-fw elements and attributes for each case. In addition a novel "management mapping" technique was developed as a means of displaying an integrated snapshot of indirect causes within the management chain. Further research opportunities will extend the depth of knowledge available for many of the component level cases. In addition, the x-fw has the potential to expand the scope of space sector lessons learned, and contribute to knowledge management and organizational learning.

Independent Orbiter Assessment (IOA): Assessment of the rudder/speed brake subsystem FMEA/CIL

NASA Technical Reports Server (NTRS)

Wilson, R. E.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Rudder/Speed Brake (RSB) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the NASA FMEA/CIL baseline along with the proposed Post 51-L CIL updates included. A resolution of each discrepancy from the comparison was provided through additional analysis as required. This report documents the results of that comparison for the Orbiter RSB hardware. The IOA product for the RSB analysis consisted of 38 failure mode worksheets that resulted in 27 potential critical items being identified. Comparison was made to the NASA baseline which consisted of 34 FMEAs and 18 CIL items. This comparison produced agreement on all CIL items. Based on the Pre 51-L baseline, all non-CIL FMEAs were also in agreement.

Independent Orbiter Assessment (IOA): Assessment of the electrical power distribution and control subsystem, volume 1

NASA Technical Reports Server (NTRS)

Schmeckpeper, K. R.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA first completed an analysis of the Electrical Power Distribution and Control (EPD and C) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the NASA FMEA/CIL baseline with proposed Post 51-L updates included. A resolution of each discrepancy from the comparison is provided through additional analysis as required. This report documents the results of that comparison for the Orbiter EPD and C hardware. The IOA product for the EPD and C analysis consisted of 1671 failure mode analysis worksheets that resulted in 468 potential critical items being identified. Comparison was made to the proposed NASA Post 51-L baseline which consisted of FMEAs and 158 CIL items. Volume 1 contains the EPD and C subsystem description, analysis results, ground rules and assumptions, and some of the IOA worksheets.

Independent Orbiter Assessment (IOA): Assessment of the manned maneuvering unit

NASA Technical Reports Server (NTRS)

Huynh, M.; Duffy, R. E.; Saiidi, M. J.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Manned Maneuvering Unit (MMU) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contain within the NASA FMEA/CIL documentation. The IOA results were then compared to the proposed Martin Marietta FMEA/CIL Post 51-L updates. A discussion of each discrepancy from the comparison is provided through additional analysis as required. These discrepancies were flagged as issues, and recommendations were made based on the FMEA data available at the time. The results of this comparison for the Orbiter MMU hardware are documented. The IOA product for the MMU analysis consisted of 204 failure mode worksheets that resulted in 95 potential critical items being identified. Comparison was made to the NASA baseline which consisted of 179 FMEAs and 110 CIL items. This comparison produced agreement on all 121 FMEAs which caused differences in 92 CIL items.

Independent Orbiter Assessment (IOA): Analysis of the reaction control system, volume 1

NASA Technical Reports Server (NTRS)

Burkemper, V. J.; Haufler, W. A.; Odonnell, R. A.; Paul, D. J.

1987-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. This report documents the independent analysis results for the Reaction Control System (RCS). The purpose of the RCS is to provide thrust in and about the X, Y, Z axes for External Tank (ET) separation; orbit insertion maneuvers; orbit translation maneuvers; on-orbit attitude control; rendezvous; proximity operations (payload deploy and capture); deorbit maneuvers; and abort attitude control. The RCS is situated in three independent modules, one forward in the orbiter nose and one in each OMS/RCS pod. Each RCS module consists of the following subsystems: Helium Pressurization Subsystem; Propellant Storage and Distribution Subsystem; Thruster Subsystem; and Electrical Power Distribution and Control Subsystem. Of the failure modes analyzed, 307 could potentially result in a loss of life and/or loss of vehicle.

Independent Orbiter Assessment (IOA): Assessment of the ascent thrust vector control actuator subsystem FMEA/CIL

NASA Technical Reports Server (NTRS)

Wilson, R. E.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Ascent Thrust Vector Control Actuator (ATVD) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the NASA FMEA/CIL baseline with proposed Post 51-L updates included. A resolution of each discrepancy from the comparison is provided through additional analysis as required. This report documents the results of that comparison for the Orbiter ATVC hardware. The IOA product for the ATVC actuator analysis consisted of 25 failure mode worksheets that resulted in 16 potential critical items being identified. Comparison was made to the NASA baseline which consisted of 21 FMEAs and 13 CIL items. This comparison produced agreement on all CIL items. Based on the Pre 51-L baseline, all non-CIL FMEAs were also in agreement.

Soil load above Hanford waste storage tanks (2 volumes)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pianka, E.W.

1995-01-25

This document is a compilation of work performed as part of the Dome Load Control Project in 1994. Section 2 contains the calculations of the weight of the soil over the tank dome for each of the 75-feet-diameter waste-storage tanks located at the Hanford Site. The chosen soil specific weight and soil depth measured at the apex of the dome crown are the same as those used in the primary analysis that qualified the design. Section 3 provides reference dimensions for each of the tank farm sites. The reference dimensions spatially orient the tanks and provide an outer diameter formore » each tank. Section 4 summarizes the available soil surface elevation data. It also provides examples of the calculations performed to establish the present soil elevation estimates. The survey data and other data sources from which the elevation data has been obtained are printed separately in Volume 2 of this Supporting Document. Section 5 contains tables that provide an overall summary of the present status of dome loads. Tables summarizing the load state corresponding to the soil depth and soil specific weight for the original qualification analysis, the gravity load requalification for soil depth and soil specific weight greater than the expected actual values, and a best estimate condition of soil depth and specific weight are presented for the Double-Shell Tanks. For the Single-Shell Tanks, only the original qualification analysis is available; thus, the tabulated results are for this case only. Section 6 provides a brief overview of past analysis and testing results that given an indication of the load capacity of the waste storage tanks that corresponds to a condition approaching ultimate failure of the tank. 31 refs.« less

Instrument Failures for the da Vinci Surgical System: a Food and Drug Administration MAUDE Database Study.

PubMed

Friedman, Diana C W; Lendvay, Thomas S; Hannaford, Blake

2013-05-01

Our goal was to analyze reported instances of the da Vinci robotic surgical system instrument failures using the FDA's MAUDE (Manufacturer and User Facility Device Experience) database. From these data we identified some root causes of failures as well as trends that may assist surgeons and users of the robotic technology. We conducted a survey of the MAUDE database and tallied robotic instrument failures that occurred between January 2009 and December 2010. We categorized failures into five main groups (cautery, shaft, wrist or tool tip, cable, and control housing) based on technical differences in instrument design and function. A total of 565 instrument failures were documented through 528 reports. The majority of failures (285) were of the instrument's wrist or tool tip. Cautery problems comprised 174 failures, 76 were shaft failures, 29 were cable failures, and 7 were control housing failures. Of the reports, 10 had no discernible failure mode and 49 exhibited multiple failures. The data show that a number of robotic instrument failures occurred in a short period of time. In reality, many instrument failures may go unreported, thus a true failure rate cannot be determined from these data. However, education of hospital administrators, operating room staff, surgeons, and patients should be incorporated into discussions regarding the introduction and utilization of robotic technology. We recommend institutions incorporate standard failure reporting policies so that the community of robotic surgery companies and surgeons can improve on existing technologies for optimal patient safety and outcomes.

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

PubMed

Dante, Angelo; Petrucci, Cristina; Lancia, Loreto

2013-01-01

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

Surface-wave potential for triggering tectonic (nonvolcanic) tremor

USGS Publications Warehouse

Hill, D.P.

2010-01-01

Source processes commonly posed to explain instances of remote dynamic triggering of tectonic (nonvolcanic) tremor by surface waves include frictional failure and various modes of fluid activation. The relative potential for Love- and Rayleigh-wave dynamic stresses to trigger tectonic tremor through failure on critically stressed thrust and vertical strike-slip faults under the Coulomb-Griffith failure criteria as a function of incidence angle is anticorrelated over the 15- to 30-km-depth range that hosts tectonic tremor. Love-wave potential is high for strike-parallel incidence on low-angle reverse faults and null for strike-normal incidence; the opposite holds for Rayleigh waves. Love-wave potential is high for both strike-parallel and strike-normal incidence on vertical, strike-slip faults and minimal for ~45?? incidence angles. The opposite holds for Rayleigh waves. This pattern is consistent with documented instances of tremor triggered by Love waves incident on the Cascadia mega-thrust and the San Andreas fault (SAF) in central California resulting from shear failure on weak faults (apparent friction, ????? 0.2). However, documented instances of tremor triggered by surface waves with strike-parallel incidence along the Nankai megathrust beneath Shikoku, Japan, is associated primarily with Rayleigh waves. This is consistent with the tremor bursts resulting from mixed-mode failure (crack opening and shear failure) facilitated by near-lithostatic ambient pore pressure, low differential stress, with a moderate friction coefficient (?? ~ 0.6) on the Nankai subduction interface. Rayleigh-wave dilatational stress is relatively weak at tectonic tremor source depths and seems unlikely to contribute significantly to the triggering process, except perhaps for an indirect role on the SAF in sustaining tremor into the Rayleigh-wave coda that was initially triggered by Love waves.

Surface-wave potential for triggering tectonic (nonvolcanic) tremor-corrected

USGS Publications Warehouse

Hill, David P.

2012-01-01

Source processes commonly posed to explain instances of remote dynamic triggering of tectonic (nonvolcanic) tremor by surface waves include frictional failure and various modes of fluid activation. The relative potential for Love- and Rayleigh-wave dynamic stresses to trigger tectonic tremor through failure on critically stressed thrust and vertical strike-slip faults under the Coulomb-Griffith failure criteria as a function of incidence angle are anticorrelated over the 15- to 30-km-depth range that hosts tectonic tremor. Love-wave potential is high for strike-parallel incidence on low-angle reverse faults and null for strike-normal incidence; the opposite holds for Rayleigh waves. Love-wave potential is high for both strike-parallel and strike-normal incidence on vertical, strike-slip faults and minimal for ~45° incidence angles. The opposite holds for Rayleigh waves. This pattern is consistent with documented instances of tremor triggered by Love waves incident on the Cascadia megathrust and the San Andreas fault (SAF) in central California resulting from shear failure on weak faults (apparent friction is μ* ≤ 0:2). Documented instances of tremor triggered by surface waves with strike-parallel incidence along the Nankai megathrust beneath Shikoku, Japan, however, are associated primarily with Rayleigh waves. This is consistent with the tremor bursts resulting from mixed-mode failure (crack opening and shear failure) facilitated by near-lithostatic ambient pore pressure, low differential stress, with a moderate friction coefficient (μ ~ 0:6) on the Nankai subduction interface. Rayleigh-wave dilatational stress is relatively weak at tectonic tremor source depths and seems unlikely to contribute significantly to the triggering process, except perhaps for an indirect role on the SAF in sustaining tremor into the Rayleigh-wave coda that was initially triggered by Love waves.

Dipeptidyl Peptidase-4 Inhibitors and Heart Failure Exacerbation in the Veteran Population: An Observational Study.

PubMed

Cobretti, Michael R; Bowman, Benjamin; Grabarczyk, Ted; Potter, Emily

2018-03-01

The dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors) are effective modulators of fasting and postprandial hyperglycemia in patients with type 2 diabetes mellitus (T2DM). In 2013 the Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus-Thrombolysis in Myocardial Infarction 53 (SAVOR-TIMI 53) clinical trial found an increased risk of heart failure exacerbation, as a secondary outcome, among patients treated with saxagliptin. This study examines the safety of DPP-4 inhibitors as a class in T2DM in relation to risk of heart failure exacerbations. Retrospective cohort study of two groups of patients using data from the national Department of Veteran's Affairs (VA) Health Care System: patients initially prescribed DPP-4 inhibitors with or without second-generation sulfonylureas and/or metformin (exposed group) compared with patients initially prescribed only second-generation sulfonylureas and/or metformin (unexposed group) between August 1, 2013, and August 30, 2016. The primary aim of this study was to determine the difference in 1-year heart failure exacerbation rate in patients with T2DM between the exposed and unexposed groups. Data were analyzed using the χ 2 Student t test and Kaplan-Meier analysis. Significance was set at p<0.05. The study evaluated 672,265 patients: 33,614 patients in the exposed group and 638,651 patients in the unexposed group. Overall, 130 (0.38%) heart failure exacerbations were documented in the exposed group, and 2222 (0.34%) heart failure exacerbations were documented in the unexposed group; the difference in exacerbation rate was nonsignificant between groups (p=0.24). In a subgroup analysis of patients with a baseline diagnosis of heart failure, the difference in rate of heart failure exacerbations remained nonsignificant (p=0.334). Patients in the veteran population with T2DM treated with DPP-4 inhibitors did not demonstrate a significant increase in risk for heart failure exacerbation, regardless of whether a patient had been previously diagnosed with heart failure. This finding potentially supports safe usage of DPP-4 inhibitors in this patient population regardless of heart failure diagnosis. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

Space Vehicle Reliability Modeling in DIORAMA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tornga, Shawn Robert

When modeling system performance of space based detection systems it is important to consider spacecraft reliability. As space vehicles age the components become prone to failure for a variety of reasons such as radiation damage. Additionally, some vehicles may lose the ability to maneuver once they exhaust fuel supplies. Typically failure is divided into two categories: engineering mistakes and technology surprise. This document will report on a method of simulating space vehicle reliability in the DIORAMA framework.

Probabilistic Risk Assessment: A Bibliography

NASA Technical Reports Server (NTRS)

2000-01-01

Probabilistic risk analysis is an integration of failure modes and effects analysis (FMEA), fault tree analysis and other techniques to assess the potential for failure and to find ways to reduce risk. This bibliography references 160 documents in the NASA STI Database that contain the major concepts, probabilistic risk assessment, risk and probability theory, in the basic index or major subject terms, An abstract is included with most citations, followed by the applicable subject terms.

Common Cause Failure Modeling: Aerospace Versus Nuclear

NASA Technical Reports Server (NTRS)

Stott, James E.; Britton, Paul; Ring, Robert W.; Hark, Frank; Hatfield, G. Spencer

2010-01-01

Aggregate nuclear plant failure data is used to produce generic common-cause factors that are specifically for use in the common-cause failure models of NUREG/CR-5485. Furthermore, the models presented in NUREG/CR-5485 are specifically designed to incorporate two significantly distinct assumptions about the methods of surveillance testing from whence this aggregate failure data came. What are the implications of using these NUREG generic factors to model the common-cause failures of aerospace systems? Herein, the implications of using the NUREG generic factors in the modeling of aerospace systems are investigated in detail and strong recommendations for modeling the common-cause failures of aerospace systems are given.

Evaluation of a Linear Cumulative Damage Failure Model for Epoxy Adhesive

NASA Technical Reports Server (NTRS)

Richardson, David E.; Batista-Rodriquez, Alicia; Macon, David; Totman, Peter; McCool, Alex (Technical Monitor)

2001-01-01

Recently a significant amount of work has been conducted to provide more complex and accurate material models for use in the evaluation of adhesive bondlines. Some of this has been prompted by recent studies into the effects of residual stresses on the integrity of bondlines. Several techniques have been developed for the analysis of bondline residual stresses. Key to these analyses is the criterion that is used for predicting failure. Residual stress loading of an adhesive bondline can occur over the life of the component. For many bonded systems, this can be several years. It is impractical to directly characterize failure of adhesive bondlines under a constant load for several years. Therefore, alternative approaches for predictions of bondline failures are required. In the past, cumulative damage failure models have been developed. These models have ranged from very simple to very complex. This paper documents the generation and evaluation of some of the most simple linear damage accumulation tensile failure models for an epoxy adhesive. This paper shows how several variations on the failure model were generated and presents an evaluation of the accuracy of these failure models in predicting creep failure of the adhesive. The paper shows that a simple failure model can be generated from short-term failure data for accurate predictions of long-term adhesive performance.

Early management of patients with acute heart failure: state of the art and future directions--a consensus document from the SAEM/HFSA acute heart failure working group.

PubMed

Collins, Sean P; Storrow, Alan B; Levy, Phillip D; Albert, Nancy; Butler, Javed; Ezekowitz, Justin A; Felker, G Michael; Fermann, Gregory J; Fonarow, Gregg C; Givertz, Michael M; Hiestand, Brian; Hollander, Judd E; Lanfear, David E; Pang, Peter S; Peacock, W Frank; Sawyer, Douglas B; Teerlink, John R; Lenihan, Daniel J

2015-01-01

Heart failure (HF) afflicts nearly 6 million Americans, resulting in 1 million emergency department (ED) visits and over 1 million annual hospital discharges. The majority of inpatient admissions originate in the ED; thus, it is crucial that emergency physicians and other providers involved in early management understand the latest developments in diagnostic testing, therapeutics, and alternatives to hospitalization. This article discusses contemporary ED management as well as the necessary next steps for ED-based acute HF research. © 2015 by the Society for Academic Emergency Medicine.

75 FR 25121 - Revisions to Energy Efficiency Enforcement Regulations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-07

... disallow a third party with a history of poor performance (e.g., failure to submit certification reports... information be communicated to DOE? Should performance of verification testing be documented on the...

State demonstration project : loop detectors.

DOT National Transportation Integrated Search

1985-01-01

The Virginia Department of Highways and Transportation frequently utilizes induction loops in its vehicle detector systems. Although not documented, there have been many instances of loop failure; therefore, the practices and materials used by the De...

Solder joint aging characteristics from the MC2918 firing set of a B61 accelerated aging unit (AAU)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vianco, P.T.; Rejent, J.A.

1997-10-01

The B61 accelerated aging unit (AAU) provided a unique opportunity to document the effects of a controlled, long-term thermal cycling environment on the aging of materials used in the device. This experiment was of particular interest to solder technologists because thermal cycling environments are a predominant source of solder joint failures in electronic assemblies. Observations of through hole solder joints in the MC2918 Firing Set from the B61 AAU did not reveal signs of catastrophic failure. Quantitative analyses of the microstructural metrics of intermetallic compound layer thickness and Pb-rich phase particle distributions indicated solder joint aging that was commensurate withmore » the accelerated aging environment. The effects of stress-enhanced coarsening of the Pb-rich phase were also documented.« less

Independent Orbiter Assessment (IOA): Analysis of the reaction control system, volume 3

NASA Technical Reports Server (NTRS)

Burkemper, V. J.; Haufler, W. A.; Odonnell, R. A.; Paul, D. J.

1987-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. This report documents the independent analysis results for the Reaction Control System (RCS). The RCS is situated in three independent modules, one forward in the orbiter nose and one in each OMS/RCS pod. Each RCS module consists of the following subsystems: Helium Pressurization Subsystem; Propellant Storage and Distribution Subsystem; Thruster Subsystem; and Electrical Power Distribution and Control Subsystem. Volume 3 continues the presentation of IOA analysis worksheets and the potential critical items list.

Independent Orbiter Assessment (IOA): Assessment of the purge, vent and drain subsystem

NASA Technical Reports Server (NTRS)

Bynum, M. C., III

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Purge, Vent and Drain (PV and D) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the NASA FMEA/CIL baseline with proposed Post 51-L updates included. A resolution of each discrepancy from the comparison is provided through additional analysis as required. This report documents the results of that comparison for the Orbiter PV and D hardware. The PV and D Subsystem controls the environment of unpressurized compartments and window cavities, senses hazardous gases, and purges Orbiter/ET disconnect.

Independent Orbiter Assessment (IOA): Assessment of the orbital maneuvering subsystem, volume 2

NASA Technical Reports Server (NTRS)

Haufler, W. A.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Orbital Maneuvering System (OMS) hardware and electrical power distribution and control (EPD and C), generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the proposed Post 51-L NASA FMEA/CIL baseline. This report documents the results of that comparison for the Orbiter OMS hardware and EPD and C systems. Volume 2 continues the presentation of IOA worksheets and contains the critical items list and the NASA FMEA to IOA worksheet cross reference and recommendations.

Independent Orbiter Assessment (IOA): Assessment of the extravehicular mobility unit, volume 2

NASA Technical Reports Server (NTRS)

Raffaelli, Gary G.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort performed an independent analysis of the Extravehicular Mobility Unit (EMU) hardware and system, generating draft failure modes criticalities and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the most recent proposed Post 51-L NASA FMEA/CIL baseline. A resolution of each discrepancy from the comparison was provided through additional analysis as required. This report documents the results of that comparison for the Orbiter EMU hardware. Volume 2 continues the presentation of IOA analysis worksheets and contains the potential critical items list and NASA FMEA to IOA worksheet cross references and recommendations.

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

PubMed

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

2018-04-01

The aim of the study was to build a model of first failure site- and lesion-specific failure probability after definitive chemoradiotherapy for inoperable NSCLC. We retrospectively analyzed 251 patients receiving definitive chemoradiotherapy for NSCLC at a single institution between 2009 and 2015. All patients were scanned by fludeoxyglucose positron emission tomography/computed tomography for radiotherapy planning. Clinical patient data and fludeoxyglucose positron emission tomography standardized uptake values from primary tumor and nodal lesions were analyzed by using multivariate cause-specific Cox regression. In patients experiencing locoregional failure, multivariable logistic regression was applied to assess risk of each lesion being the first site of failure. The two models were used in combination to predict probability of lesion failure accounting for competing events. Adenocarcinoma had a lower hazard ratio (HR) of locoregional failure than squamous cell carcinoma (HR = 0.45, 95% confidence interval [CI]: 0.26-0.76, p = 0.003). Distant failures were more common in the adenocarcinoma group (HR = 2.21, 95% CI: 1.41-3.48, p < 0.001). Multivariable logistic regression of individual lesions at the time of first failure showed that primary tumors were more likely to fail than lymph nodes (OR = 12.8, 95% CI: 5.10-32.17, p < 0.001). Increasing peak standardized uptake value was significantly associated with lesion failure (OR = 1.26 per unit increase, 95% CI: 1.12-1.40, p < 0.001). The electronic model is available at http://bit.ly/LungModelFDG. We developed a failure site-specific competing risk model based on patient- and lesion-level characteristics. Failure patterns differed between adenocarcinoma and squamous cell carcinoma, illustrating the limitation of aggregating them into NSCLC. Failure site-specific models add complementary information to conventional prognostic models. Copyright © 2018 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

Identifying Differences Between Biochemical Failure and Cure: Incidence Rates and Predictors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vicini, Frank A., E-mail: fvicini@beaumont.edu; Shah, Chirag; Kestin, Larry

2011-11-15

Background: Patients treated with radiation therapy (RT) for prostate cancer were evaluated to estimate the length of time required to document biochemical cure (BC) after treatment and the variables associated with long-term treatment efficacy. Patients and Methods: 2,100 patients received RT alone for localized prostate carcinoma (external-beam RT, n = 1,504; brachytherapy alone, n = 241; or brachytherapy + pelvic radiation, n = 355). The median external-beam dose was 68.4 Gy, and the median follow-up time was 8.6 years. Biochemical failure (BF) was defined according to the Phoenix definition. Results: Biochemical failure was experienced by 685 patients (32.6%). The medianmore » times to BF for low-, intermediate-, and high-risk groups were 6.0, 5.6, and 4.5 years respectively (p < 0.001). The average annual incidence rates of BF for years 1-5, 5-10,11-15, and 16-20 in low-risk patients were 2.0%, 2.0%, 0.3%, and 0.06% (p < 0.001); for intermediate-risk patients, 4%, 3%, 0.3%, and 0% (p < 0.001); and for high-risk patients, 10.0%, 5.0%, 0.3%, and 0.3% (p < 0.001). After 5 years of treatment, 36.9% of all patients experienced BF. The percentage of total failures occurring during years 1-5, 5-10, 11-15, and 16-20 were 48.7%, 43.5%, 6.5%, and 1.3% for low-risk patients; 64.0%, 32.2%, 3.8%, and 0% for intermediate-risk patients; and 71.9%, 25.9%, 1.1%, and 1.1% for high-risk patients, respectively. Increasing time to nadir was associated with increased time to BF. On multivariate analysis, factors significantly associated with 10-year BC included prostate-specific antigen nadir and time to nadir. Conclusions: The incidence rates for BF did not plateau until later than 10 years after treatment, suggesting that extended follow-up time is required to monitor patients after treatment. Prostate-specific antigen nadir and time to nadir have the strongest association with long-term BC.« less

34 CFR 300.311 - Specific documentation for the eligibility determination.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Specific Learning Disabilities § 300.311 Specific documentation for the eligibility determination. (a) For a child suspected of having a specific learning disability, the documentation of the determination... has a specific learning disability; (2) The basis for making the determination, including an assurance...

Mission Success of U.S. Launch Vehicle Flights from a Propulsion Stage-Based Perspective: 1980-2015

NASA Technical Reports Server (NTRS)

Go, Susie; Lawrence, Scott L.; Mathias, Donovan L.; Powell, Ryann

2017-01-01

This report documents a study of the historical safety and reliability trends of U.S. space launch vehicles from 1980 to 2015. The launch data history is examined to determine whether propulsion technology choices drove launch system risk and is used to understand how different propulsion system failures manifested into different failure scenarios. The historical data is processed by launch vehicle stage, where a stage is limited by definition to a single propulsion technology, either liquid or solid. Results are aggregated in terms of failure trends and manifestations as a functions of different propulsion stages. Failure manifestations are analyzed in order to understand the types and frequencies of accident environments in which an abort system for a crewed vehicle would be required to operate.

Challenges in leveraging existing human performance data for quantifying the IDHEAS HRA method

DOE PAGES

Liao, Huafei N.; Groth, Katrina; Stevens-Adams, Susan

2015-07-29

Our article documents an exploratory study for collecting and using human performance data to inform human error probability (HEP) estimates for a new human reliability analysis (HRA) method, the IntegrateD Human Event Analysis System (IDHEAS). The method was based on cognitive models and mechanisms underlying human behaviour and employs a framework of 14 crew failure modes (CFMs) to represent human failures typical for human performance in nuclear power plant (NPP) internal, at-power events [1]. A decision tree (DT) was constructed for each CFM to assess the probability of the CFM occurring in different contexts. Data needs for IDHEAS quantification aremore » discussed. Then, the data collection framework and process is described and how the collected data were used to inform HEP estimation is illustrated with two examples. Next, five major technical challenges are identified for leveraging human performance data for IDHEAS quantification. Furthermore, these challenges reflect the data needs specific to IDHEAS. More importantly, they also represent the general issues with current human performance data and can provide insight for a path forward to support HRA data collection, use, and exchange for HRA method development, implementation, and validation.« less

Joint statement of the European Association for the Study of Obesity and the European Society of Hypertension: obesity and heart failure.

PubMed

Jordan, Jens; Toplak, Hermann; Grassi, Guido; Yumuk, Volkan; Kotsis, Vasilios; Engeli, Stefan; Cuspidi, Cesare; Nilsson, Peter M; Finer, Nick; Doehner, Wolfram

2016-09-01

Obese individuals are more likely to develop heart failure. Yet, once heart failure is established, the impact of overweight and obesity on prognosis and survival is unclear. The purpose of this joint scientific statement of the European Association for the Study of Obesity and the European Society of Hypertension is to provide an overview on the current scientific literature on obesity and heart failure in terms of prognosis, mechanisms, and clinical management implications. Moreover, the document identifies open questions that ought to be addressed. The need for more tailored weight management recommendations in heart failure will be emphasized and, in line with the emerging evidence, aims to distinguish between primary disease and secondary outcome prevention. In the primary prevention of heart failure, it appears prudent advising obese individuals to lose or achieve a healthy body weight, especially in those with risk factors such as hypertension or type 2 diabetes. However, there is no evidence from clinical trials to guide weight management in overweight or obese patients with established heart failure. Prospective clinical trials are strongly encouraged.

Bibliography of information on mechanics of structural failure (hydrogen embrittlement, protective coatings, composite materials, NDE)

NASA Technical Reports Server (NTRS)

Carpenter, J. L., Jr.

1976-01-01

This bibliography is comprised of approximately 1,600 reference citations related to four problem areas in the mechanics of failure in aerospace structures. The bibliography represents a search of the literature published in the period 1962-1976, the effort being largely limited to documents published in the United States. Listings are subdivided into the four problem areas: Hydrogen Embrittlement; Protective Coatings; Composite Materials; and Nondestructive Evaluation. An author index is included.

Perspective: Whither the problem list? Organ-based documentation and deficient synthesis by medical trainees.

PubMed

Kaplan, Daniel M

2010-10-01

The author argues that the well-formulated problem list is essential for both organizing and evaluating diagnostic thinking. He considers evidence of deficiencies in problem lists in the medical record. He observes a trend among medical trainees toward organizing notes in the medical record according to lists of organ systems or medical subspecialties and hypothesizes that system-based documentation may undermine the art of problem formulation and diagnostic synthesis. Citing research linking more sophisticated problem representation with diagnostic success, he suggests that documentation style and clinical reasoning are closely connected and that organ-based documentation may predispose trainees to several varieties of cognitive diagnostic error and deficient synthesis. These include framing error, premature or absent closure, failure to integrate related findings, and failure to recognize the level of diagnostic resolution attained for a given problem. He acknowledges the pitfalls of higher-order diagnostic resolution, including the application of labels unsupported by firm evidence, while maintaining that diagnostic resolution as far as evidence permits is essential to both rational care of patients and rigorous education of learners. He proposes further research, including comparison of diagnostic efficiency between organ- and problem-oriented thinkers. He hypothesizes that the subspecialty-based structure of academic medical services helps perpetuate organ-system-based thinking, and calls on clinical educators to renew their emphasis on the formulation and documentation of complete and precise problem lists and progressively refined diagnoses by trainees.

Rationale, design and conduct of a randomised controlled trial evaluating a primary care-based complex intervention to improve the quality of life of heart failure patients: HICMan (Heidelberg Integrated Case Management)

PubMed Central

Peters-Klimm, Frank; Müller-Tasch, Thomas; Schellberg, Dieter; Gensichen, Jochen; Muth, Christiane; Herzog, Wolfgang; Szecsenyi, Joachim

2007-01-01

Background Chronic congestive heart failure (CHF) is a complex disease with rising prevalence, compromised quality of life (QoL), unplanned hospital admissions, high mortality and therefore high burden of illness. The delivery of care for these patients has been criticized and new strategies addressing crucial domains of care have been shown to be effective on patients' health outcomes, although these trials were conducted in secondary care or in highly organised Health Maintenance Organisations. It remains unclear whether a comprehensive primary care-based case management for the treating general practitioner (GP) can improve patients' QoL. Methods/Design HICMan is a randomised controlled trial with patients as the unit of randomisation. Aim is to evaluate a structured, standardized and comprehensive complex intervention for patients with CHF in a 12-months follow-up trial. Patients from intervention group receive specific patient leaflets and documentation booklets as well as regular monitoring and screening by a prior trained practice nurse, who gives feedback to the GP upon urgency. Monitoring and screening address aspects of disease-specific self-management, (non)pharmacological adherence and psychosomatic and geriatric comorbidity. GPs are invited to provide a tailored structured counselling 4 times during the trial and receive an additional feedback on pharmacotherapy relevant to prognosis (data of baseline documentation). Patients from control group receive usual care by their GPs, who were introduced to guideline-oriented management and a tailored health counselling concept. Main outcome measurement for patients' QoL is the scale physical functioning of the SF-36 health questionnaire in a 12-month follow-up. Secondary outcomes are the disease specific QoL measured by the Kansas City Cardiomyopathy questionnaire (KCCQ), depression and anxiety disorders (PHQ-9, GAD-7), adherence (EHFScBS and SANA), quality of care measured by an adapted version of the Patient Chronic Illness Assessment of Care questionnaire (PACIC) and NT-proBNP. In addition, comprehensive clinical data are collected about health status, comorbidity, medication and health care utilisation. Discussion As the targeted patient group is mostly cared for and treated by GPs, a comprehensive primary care-based guideline implementation including somatic, psychosomatic and organisational aspects of the delivery of care (HICMAn) is a promising intervention applying proven strategies for optimal care. Trial registration Current Controlled Trials ISRCTN30822978. PMID:17716364

Rationale, design and conduct of a randomised controlled trial evaluating a primary care-based complex intervention to improve the quality of life of heart failure patients: HICMan (Heidelberg Integrated Case Management).

PubMed

Peters-Klimm, Frank; Müller-Tasch, Thomas; Schellberg, Dieter; Gensichen, Jochen; Muth, Christiane; Herzog, Wolfgang; Szecsenyi, Joachim

2007-08-23

Chronic congestive heart failure (CHF) is a complex disease with rising prevalence, compromised quality of life (QoL), unplanned hospital admissions, high mortality and therefore high burden of illness. The delivery of care for these patients has been criticized and new strategies addressing crucial domains of care have been shown to be effective on patients' health outcomes, although these trials were conducted in secondary care or in highly organised Health Maintenance Organisations. It remains unclear whether a comprehensive primary care-based case management for the treating general practitioner (GP) can improve patients' QoL. HICMan is a randomised controlled trial with patients as the unit of randomisation. Aim is to evaluate a structured, standardized and comprehensive complex intervention for patients with CHF in a 12-months follow-up trial. Patients from intervention group receive specific patient leaflets and documentation booklets as well as regular monitoring and screening by a prior trained practice nurse, who gives feedback to the GP upon urgency. Monitoring and screening address aspects of disease-specific self-management, (non)pharmacological adherence and psychosomatic and geriatric comorbidity. GPs are invited to provide a tailored structured counselling 4 times during the trial and receive an additional feedback on pharmacotherapy relevant to prognosis (data of baseline documentation). Patients from control group receive usual care by their GPs, who were introduced to guideline-oriented management and a tailored health counselling concept. Main outcome measurement for patients' QoL is the scale physical functioning of the SF-36 health questionnaire in a 12-month follow-up. Secondary outcomes are the disease specific QoL measured by the Kansas City Cardiomyopathy questionnaire (KCCQ), depression and anxiety disorders (PHQ-9, GAD-7), adherence (EHFScBS and SANA), quality of care measured by an adapted version of the Patient Chronic Illness Assessment of Care questionnaire (PACIC) and NT-proBNP. In addition, comprehensive clinical data are collected about health status, comorbidity, medication and health care utilisation. As the targeted patient group is mostly cared for and treated by GPs, a comprehensive primary care-based guideline implementation including somatic, psychosomatic and organisational aspects of the delivery of care (HICMAn) is a promising intervention applying proven strategies for optimal care.

Predicting Quarantine Failure Rates

PubMed Central

2004-01-01

Preemptive quarantine through contact-tracing effectively controls emerging infectious diseases. Occasionally this quarantine fails, however, and infected persons are released. The probability of quarantine failure is typically estimated from disease-specific data. Here a simple, exact estimate of the failure rate is derived that does not depend on disease-specific parameters. This estimate is universally applicable to all infectious diseases. PMID:15109418

When does a strategy intervention overcome a failure of inhibition? Evidence from two left frontal brain tumour cases.

PubMed

Robinson, Gail A; Walker, David G; Biggs, Vivien; Shallice, Tim

2016-06-01

Initiation and inhibition of responses are crucial for appropriate behaviour across different settings. Initiation and inhibition difficulties are well documented following frontal damage, although task differences have limited our understanding. The Hayling Sentence Completion Test was designed to assess verbal initiation and inhibition within the same task. This study investigates the ability of two patients with left frontal tumours (KI: high grade glioma; PM: meningioma) to use a strategy to overcome profound suppression failures on the Hayling Test. KI and PM completed the Hayling Test and two experimental tasks. The Selection Investigation assessed verbal initiation on a sentence completion task that varied selection demands (high/low). The Suppression and Strategy Investigation assessed ability to implement four strategies aimed to override a suppression failure and facilitate production of an unconnected word. On the Hayling Test, KI and PM initiated responses to complete high constraint sentences, in contrast to impaired suppression. KI benefitted minimally from strategies to overcome suppression failure although one strategy (object naming) was partially successful. KI's errors revealed fast suppression errors, in contrast to slow no responses, and selection ability was also impaired for verbal initiation. PM, however, implemented each strategy 100% to overcome a suppression failure and had no difficulty completing sentences meaningfully, regardless of selection demands. This first investigation of strategy implementation to overcome profound suppression impairments provides insights into verbal initiation, inhibition, selection and strategy mechanisms, which has implications for neurorehabilitation. Specifically, both patients had profound inhibition deficits but KI also presented with a selection deficit and was unable to implement a strategy. By contrast, PM's selection ability was intact but she was unable to generate, rather than implement, a strategy. We suggest that KI has both fast, uncontrolled semantic output and response inhibition difficulty, whereas PM's difficulty is underpinned by motivational factors. Copyright © 2016 Elsevier Ltd. All rights reserved.

EPRI/NRC-RES fire human reliability analysis guidelines.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lewis, Stuart R.; Cooper, Susan E.; Najafi, Bijan

2010-03-01

During the 1990s, the Electric Power Research Institute (EPRI) developed methods for fire risk analysis to support its utility members in the preparation of responses to Generic Letter 88-20, Supplement 4, 'Individual Plant Examination - External Events' (IPEEE). This effort produced a Fire Risk Assessment methodology for operations at power that was used by the majority of U.S. nuclear power plants (NPPs) in support of the IPEEE program and several NPPs overseas. Although these methods were acceptable for accomplishing the objectives of the IPEEE, EPRI and the U.S. Nuclear Regulatory Commission (NRC) recognized that they required upgrades to support currentmore » requirements for risk-informed, performance-based (RI/PB) applications. In 2001, EPRI and the USNRC's Office of Nuclear Regulatory Research (RES) embarked on a cooperative project to improve the state-of-the-art in fire risk assessment to support a new risk-informed environment in fire protection. This project produced a consensus document, NUREG/CR-6850 (EPRI 1011989), entitled 'Fire PRA Methodology for Nuclear Power Facilities' which addressed fire risk for at power operations. NUREG/CR-6850 developed high level guidance on the process for identification and inclusion of human failure events (HFEs) into the fire PRA (FPRA), and a methodology for assigning quantitative screening values to these HFEs. It outlined the initial considerations of performance shaping factors (PSFs) and related fire effects that may need to be addressed in developing best-estimate human error probabilities (HEPs). However, NUREG/CR-6850 did not describe a methodology to develop best-estimate HEPs given the PSFs and the fire-related effects. In 2007, EPRI and RES embarked on another cooperative project to develop explicit guidance for estimating HEPs for human failure events under fire generated conditions, building upon existing human reliability analysis (HRA) methods. This document provides a methodology and guidance for conducting a fire HRA. This process includes identification and definition of post-fire human failure events, qualitative analysis, quantification, recovery, dependency, and uncertainty. This document provides three approaches to quantification: screening, scoping, and detailed HRA. Screening is based on the guidance in NUREG/CR-6850, with some additional guidance for scenarios with long time windows. Scoping is a new approach to quantification developed specifically to support the iterative nature of fire PRA quantification. Scoping is intended to provide less conservative HEPs than screening, but requires fewer resources than a detailed HRA analysis. For detailed HRA quantification, guidance has been developed on how to apply existing methods to assess post-fire fire HEPs.« less

CONSIDERATIONS FOR FAILURE PREVENTION IN AEROSPACE ELECTRICAL POWER SYSTEMS UTILIZING HIGHER VOLTAGES

DTIC Science & Technology

2017-07-01

work , the guideline document (1) provides a basis for identifying high voltage design risks, (2) defines areas of concern as a function of environment ... work , the guideline document 1) provides a basis for identifying high voltage design risks, 2) defines areas of concern as a function of environment ...pressures (y-axis - breakdown voltage [volts-peak]) As an example of the impact of the aerospace environment , consider the calculation of the safe

19 CFR 354.5 - Report of violation and investigation.

Code of Federal Regulations, 2011 CFR

2011-04-01

... which the data were obtained by burning or shredding of the documents or by erasing electronic memory, computer disk, or tape memory, as set forth in the administrative protective order. (5) Failure to delete...

Installation report, state demonstration project, loop detectors.

DOT National Transportation Integrated Search

1982-01-01

The Virginia Department of Highways and Transportation frequently utilizes induction loops in its vehicle detector systems. Although not documented, there have been many instances of loop failure; therefore, the practices and materials used by the De...

19 CFR 354.5 - Report of violation and investigation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... which the data were obtained by burning or shredding of the documents or by erasing electronic memory, computer disk, or tape memory, as set forth in the administrative protective order. (5) Failure to delete...

Testing and Failure Mechanisms of Ice Phase Change Material Heat Exchangers

NASA Technical Reports Server (NTRS)

Leimkuehler, Thomas O.; Stephan, Ryan A.; Hawkins-Reynolds, Ebony

2010-01-01

Phase change materials (PCM) may be useful for thermal control systems that involve cyclical heat loads or cyclical thermal environments such as Low Earth Orbit (LEO) and Low Lunar Orbit (LLO). Thermal energy can be stored in the PCM during peak heat loads or in adverse thermal environments. The stored thermal energy can then be released later during minimum heat loads or in more favorable thermal environments. One advantage that PCM s have over evaporators in this scenario is that they do not use a consumable. The use of water as a PCM rather than the more traditional paraffin wax has the potential for significant mass reduction since the latent heat of formation of water is approximately 70% greater than that of wax. One of the potential drawbacks of using ice as a PCM is its potential to rupture its container as water expands upon freezing. In order to develop a space qualified ice PCM heat exchanger, failure mechanisms must first be understood. Therefore, a methodical experimental investigation has been undertaken to demonstrate and document specific failure mechanisms due to ice expansion in the PCM. A number of ice PCM heat exchangers were fabricated and tested. Additionally, methods for controlling void location in order to reduce the risk of damage due to ice expansion were investigated. This paper presents the results of testing that occurred from March through September of 2010 and builds on testing that occurred during the previous year.

Composite Interlaminar Shear Fracture Toughness, G(sub 2c): Shear Measurement of Sheer Myth?

NASA Technical Reports Server (NTRS)

OBrien, T. Kevin

1997-01-01

The concept of G2c as a measure of the interlaminar shear fracture toughness of a composite material is critically examined. In particular, it is argued that the apparent G2c as typically measured is inconsistent with the original definition of shear fracture. It is shown that interlaminar shear failure actually consists of tension failures in the resin rich layers between plies followed by the coalescence of ligaments created by these failures and not the sliding of two planes relative to one another that is assumed in fracture mechanics theory. Several strain energy release rate solutions are reviewed for delamination in composite laminates and structural components where failures have been experimentally documented. Failures typically occur at a location where the mode 1 component accounts for at least one half of the total G at failure. Hence, it is the mode I and mixed-mode interlaminar fracture toughness data that will be most useful in predicting delamination failure in composite components in service. Although apparent G2c measurements may prove useful for completeness of generating mixed-mode criteria, the accuracy of these measurements may have very little influence on the prediction of mixed-mode failures in most structural components.

Evaluation of the Humoral Immune Response to Human Leukocyte Antigens in Brazilian Renal Transplant Candidates

PubMed Central

Saito, Patricia Keiko; Yamakawa, Roger Haruki; Aparecida, Erica Pereira; da Silva Júnior, Waldir Verissimo; Borelli, Sueli Donizete

2014-01-01

Pre-transplant sensitization to human leukocyte antigens (HLA) is a risk factor for graft failure. Studies of the immunological profile related to anti-HLA antibodies in Brazilian renal transplant candidates are few. In this study, we evaluated the humoral immune response to HLA antigens in 269 renal transplant candidates, in Paraná State, Brazil. The HLA typing was performed by the polymerase chain reaction sequence-specific oligonucleotide method (PCR-SSO) combined with Luminex technology, using an SSO-LABType commercial kit (One Lambda, Inc., Canoga Park, CA, USA). The percentages of panel-reactive antibodies (PRA) and the specificity of anti-HLA antibodies were determined using the LS1PRA and LS2PRA commercial kits (One Lambda, Inc.). The PRA-positive group consisted of 182 (67.7%) patients, and the PRA-negative group of 87 (32.3%) patients. The two groups differed significantly only with respect to gender. Females were the most sensitized. Among the 182 patients with PRA- positive, 62 (34.1%) were positive for class I and negative for class II, 39 (21.4%) were negative for class I and positive for class II, and 81 (44.5%) were positive for both classes I and II. The HLA-A*02, A*24, A*01, B*44, B*35, B*15, DRB1*11, DRB1*04 and DRB1*03 allele groups were the most frequent. The specificities of anti-HLA antibodies were more frequent: A34, B57, Cw15, Cw16, DR51, DQ8 and DP14. This study documented the profile of anti-HLA antibodies in patients with chronic renal failure who were on waiting lists for an organ in Paraná, and found high sensitization to HLA antigens in the samples. PMID:24927116

Variability in the quality of overdose advice in Summary of Product Characteristics (SPC) documents: gut decontamination recommendations for CNS drugs.

PubMed

Wall, Andrew J B; Bateman, D N; Waring, W S

2009-01-01

Deliberate self-poisoning is a major cause of morbidity and mortality. The Summary of Product Characteristics (SPC) document is a legal requirement for all drugs, and Section 4.9 addresses the features of toxicity and clinical advice on management of overdose. The quality and appropriateness of this advice have received comparatively little attention. Section 4.9 of the SPC was examined for all drugs in the central nervous system (CNS) category of the British National Formulary. Advice concerning gut decontamination was examined with respect to specific interventions: induced vomiting, oral activated charcoal, gastric lavage, and other interventions. Data were compared with standard reference sources for clinical management advice in poisoning. These were graded 'A' if no important differences existed, 'B' if differences were noted but not thought clinically important, and 'C' if differences were thought to be clinically significant. SPC documents were examined for 258 medications from 67 manufacturers. The overall agreement was 'A' in 23 (8.9%), 'B' in 28 (10.9%) and 'C' in 207 (80.2%). Discrepancies were due to inappropriate recommendation of induced emesis in 21.7% (95% confidence interval 17.1, 27.1), gastric lavage in 38.4% (32.7, 44.4), other gut decontamination in 5.8% (3.6, 9.4) and failure to recommend oral activated charcoal in 57.4% (51.1, 63.4). Gut decontamination advice in SPC documents with respect to CNS drugs was inadequate. Possible reasons for the observed discrepancies and ways of improving the consistency of advice are proposed.

A new casemix adjustment index for hospital mortality among patients with congestive heart failure.

PubMed

Polanczyk, C A; Rohde, L E; Philbin, E A; Di Salvo, T G

1998-10-01

Comparative analysis of hospital outcomes requires reliable adjustment for casemix. Although congestive heart failure is one of the most common indications for hospitalization, congestive heart failure casemix adjustment has not been widely studied. The purposes of this study were (1) to describe and validate a new congestive heart failure-specific casemix adjustment index to predict in-hospital mortality and (2) to compare its performance to the Charlson comorbidity index. Data from all 4,608 admissions to the Massachusetts General Hospital from January 1990 to July 1996 with a principal ICD-9-CM discharge diagnosis of congestive heart failure were evaluated. Massachusetts General Hospital patients were randomly divided in a derivation and a validation set. By logistic regression, odds ratios for in-hospital death were computed and weights were assigned to construct a new predictive index in the derivation set. The performance of the index was tested in an internal Massachusetts General Hospital validation set and in a non-Massachusetts General Hospital external validation set incorporating data from all 1995 New York state hospital discharges with a primary discharge diagnosis of congestive heart failure. Overall in-hospital mortality was 6.4%. Based on the new index, patients were assigned to six categories with incrementally increasing hospital mortality rates ranging from 0.5% to 31%. By logistic regression, "c" statistics of the congestive heart failure-specific index (0.83 and 0.78, derivation and validation set) were significantly superior to the Charlson index (0.66). Similar incrementally increasing hospital mortality rates were observed in the New York database with the congestive heart failure-specific index ("c" statistics 0.75). In an administrative database, this congestive heart failure-specific index may be a more adequate casemix adjustment tool to predict hospital mortality in patients hospitalized for congestive heart failure.

Experimental investigation of fluvial dike breaching due to flow overtopping

NASA Astrophysics Data System (ADS)

El Kadi Abderrezzak, K.; Rifai, I.; Erpicum, S.; Archambeau, P.; Violeau, D.; Pirotton, M.; Dewals, B.

2017-12-01

The failure of fluvial dikes (levees) often leads to devastating floods that cause loss of life and damages to public infrastructure. Overtopping flows have been recognized as one of the most frequent cause of dike erosion and breaching. Fluvial dike breaching is different from frontal dike (embankments) breaching, because of specific geometry and boundary conditions. The current knowledge on the physical processes underpinning fluvial dike failure due to overtopping remains limited. In addition, there is a lack of a continuous monitoring of the 3D breach formation, limiting the analysis of the key mechanisms governing the breach development and the validation of conceptual or physically-based models. Laboratory tests on breach growth in homogeneous, non-cohesive sandy fluvial dikes due to flow overtopping have been performed. Two experimental setups have been constructed, permitting the investigation of various hydraulic and geometric parameters. Each experimental setup includes a main channel, separated from a floodplain by a dike. A rectangular initial notch is cut in the crest to initiate dike breaching. The breach development is monitored continuously using a specific developed laser profilometry technique. The observations have shown that the breach develops in two stages: first the breach deepens and widens with the breach centerline being gradually shifted toward the downstream side of the main channel. This behavior underlines the influence of the flow momentum component parallel to the dike crest. Second, the dike geometry upstream of the breach stops evolving and the breach widening continues only toward the downstream side of the main channel. The breach evolution has been found strongly affected by the flow conditions (i.e. inflow discharge in the main channel, downstream boundary condition) and floodplain confinement. The findings of this work shed light on key mechanisms of fluvial dike breaching, which differ substantially from those of dam breaching. These specific features need to be incorporated in flood risk analyses involving fluvial dike breach and failure. In addition, a well-documented, reliable data set, with a continuous high resolution monitoring of the 3D breach evolution under various flow conditions, has been gathered, which can be used for validating numerical models.

Intelligent Document Gateway: A Service System Case Study and Analysis

NASA Astrophysics Data System (ADS)

Krishna, Vikas; Lelescu, Ana

In today's fast paced world, it is necessary to process business ­documents expediently, accurately, and diligently. In other words, processing has to be fast, errors must be prevented (or caught and corrected quickly), and documents cannot be lost or misplaced. The failure to meet these criteria, depending on the type and purpose of the documents, can have serious business, legal, or safety consequences. In this paper, we evaluated a B2B order placement service system that allows clients to place orders for products and services over a network. We describe the order placement service before and after deploying the Intelligent Document Gateway (IDG), a document-centric business process automation technology from IBM Research. Using service science perspective and service systems frameworks, we provide an analysis of how IDG improved the value proposition for both the service providers and service clients.

Development of An Intelligent Flight Propulsion Control System

NASA Technical Reports Server (NTRS)

Calise, A. J.; Rysdyk, R. T.; Leonhardt, B. K.

1999-01-01

The initial design and demonstration of an Intelligent Flight Propulsion and Control System (IFPCS) is documented. The design is based on the implementation of a nonlinear adaptive flight control architecture. This initial design of the IFPCS enhances flight safety by using propulsion sources to provide redundancy in flight control. The IFPCS enhances the conventional gain scheduled approach in significant ways: (1) The IFPCS provides a back up flight control system that results in consistent responses over a wide range of unanticipated failures. (2) The IFPCS is applicable to a variety of aircraft models without redesign and,(3) significantly reduces the laborious research and design necessary in a gain scheduled approach. The control augmentation is detailed within an approximate Input-Output Linearization setting. The availability of propulsion only provides two control inputs, symmetric and differential thrust. Earlier Propulsion Control Augmentation (PCA) work performed by NASA provided for a trajectory controller with pilot command input of glidepath and heading. This work is aimed at demonstrating the flexibility of the IFPCS in providing consistency in flying qualities under a variety of failure scenarios. This report documents the initial design phase where propulsion only is used. Results confirm that the engine dynamics and associated hard nonlineaaities result in poor handling qualities at best. However, as demonstrated in simulation, the IFPCS is capable of results similar to the gain scheduled designs of the NASA PCA work. The IFPCS design uses crude estimates of aircraft behaviour. The adaptive control architecture demonstrates robust stability and provides robust performance. In this work, robust stability means that all states, errors, and adaptive parameters remain bounded under a wide class of uncertainties and input and output disturbances. Robust performance is measured in the quality of the tracking. The results demonstrate the flexibility of the IFPCS architecture and the ability to provide robust performance under a broad range of uncertainty. Robust stability is proved using Lyapunov like analysis. Future development of the IFPCS will include integration of conventional control surfaces with the use of propulsion augmentation, and utilization of available lift and drag devices, to demonstrate adaptive control capability under a greater variety of failure scenarios. Further work will specifically address the effects of actuator saturation.

MO-E-9A-01: Risk Based Quality Management: TG100 In Action

DOE Office of Scientific and Technical Information (OSTI.GOV)

Huq, M; Palta, J; Dunscombe, P

2014-06-15

One of the goals of quality management in radiation therapy is to gain high confidence that patients will receive the prescribed treatment correctly. To accomplish these goals professional societies such as the American Association of Physicists in Medicine (AAPM) has published many quality assurance (QA), quality control (QC), and quality management (QM) guidance documents. In general, the recommendations provided in these documents have emphasized on performing device-specific QA at the expense of process flow and protection of the patient against catastrophic errors. Analyses of radiation therapy incidents find that they are most often caused by flaws in the overall therapymore » process, from initial consult through final treatment, than by isolated hardware or computer failures detectable by traditional physics QA. This challenge is shared by many intrinsically hazardous industries. Risk assessment tools and analysis techniques have been developed to define, identify, and eliminate known and/or potential failures, problems, or errors, from a system, process and/or service before they reach the customer. These include, but are not limited to, process mapping, failure modes and effects analysis (FMEA), fault tree analysis (FTA), and establishment of a quality management program that best avoids the faults and risks that have been identified in the overall process. These tools can be easily adapted to radiation therapy practices because of their simplicity and effectiveness to provide efficient ways to enhance the safety and quality of treatment processes. Task group 100 (TG100) of AAPM has developed a risk-based quality management program that uses these tools. This session will be devoted to a discussion of these tools and how these tools can be used in a given radiotherapy clinic to develop a risk based QM program. Learning Objectives: Learn how to design a process map for a radiotherapy process. Learn how to perform a FMEA analysis for a given process. Learn what Fault tree analysis is all about. Learn how to design a quality management program based upon the information obtained from process mapping, FMEA and FTA.« less

Mediational and Deviance Theories of Late High School Failure: Process Roles of Structural Strains, Academic Competence, and General versus Specific Problem Behavior

ERIC Educational Resources Information Center

Newcomb, Michael D.; Abbott, Robert D.; Catalano, Richard F.; Hawkins, J. David; Battin-Pearson, Sara; Hill, Karl

2002-01-01

Understanding and preventing high school failure is a national priority. Structural strain and general deviance theories attempt to explain late high school failure. The authors tested the hypotheses that general (vs. specific) deviance and academic competence mediate the relationships between structural strain factors (gender, ethnicity, and…

Independent Orbiter Assessment (IOA): Assessment of the communication and tracking subsystem, volume 1

NASA Technical Reports Server (NTRS)

Long, W. C.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed and analysis of the Communication and Tracking hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the NASA FMEA/CIL baseline. A resolution of each discrepancy from the comparison is provided through additional analysis as required. This report documents the results of that comparison for the Orbiter Communication and Tracking hardware. The IOA product for the Communication and Tracking consisted of 1,108 failure mode worksheets that resulted in 298 critical items being identified. Comparison was made to the NASA baseline which consists of 697 FMEAs and 239 CIL items. The comparison determined if there were any results which had been found by IOA but were not in the NASA baseline. This comparison produced agreement on all but 407 FMEAs which caused differences in 294 CIL items. Volume 1 contains the subsystem description, assessment results, ground rules and assumptions, and some of the IOA worksheets.

Independent Orbiter Assessment (IOA): Assessment of the orbital maneuvering system FMEA/CIL, volume 1

NASA Technical Reports Server (NTRS)

Prust, Chet D.; Haufler, W. A.; Marino, A. J.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Orbital Maneuvering System (OMS) hardware and Electrical Power Distribution and Control (EPD and C), generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the proposed Post 51-L NASA FMEA/CIL baseline. This report documents the results of that comparison for the Orbiter OMS hardware. The IOA analysis defined the OMS as being comprised of the following subsystems: helium pressurization, propellant storage and distribution, Orbital Maneuvering Engine, and EPD and C. The IOA product for the OMS analysis consisted of 284 hardware and 667 EPD and C failure mode worksheets that resulted in 160 hardware and 216 EPD and C potential critical items (PCIs) being identified. A comparison was made of the IOA product to the NASA FMEA/CIL baseline which consisted of 101 hardware and 142 EPD and C CIL items.

Investigation of Spiral Bevel Gear Condition Indicator Validation Via AC-29-2C Using Damage Progression Tests

NASA Technical Reports Server (NTRS)

Dempsey, Paula J.

2014-01-01

This report documents the results of spiral bevel gear rig tests performed under a NASA Space Act Agreement with the Federal Aviation Administration (FAA) to support validation and demonstration of rotorcraft Health and Usage Monitoring Systems (HUMS) for maintenance credits via FAA Advisory Circular (AC) 29-2C, Section MG-15, Airworthiness Approval of Rotorcraft (HUMS) (Ref. 1). The overarching goal of this work was to determine a method to validate condition indicators in the lab that better represent their response to faults in the field. Using existing in-service helicopter HUMS flight data from faulted spiral bevel gears as a "Case Study," to better understand the differences between both systems, and the availability of the NASA Glenn Spiral Bevel Gear Fatigue Rig, a plan was put in place to design, fabricate and test comparable gear sets with comparable failure modes within the constraints of the test rig. The research objectives of the rig tests were to evaluate the capability of detecting gear surface pitting fatigue and other generated failure modes on spiral bevel gear teeth using gear condition indicators currently used in fielded HUMS. Nineteen final design gear sets were tested. Tables were generated for each test, summarizing the failure modes observed on the gear teeth for each test during each inspection interval and color coded based on damage mode per inspection photos. Gear condition indicators (CI) Figure of Merit 4 (FM4), Root Mean Square (RMS), +/- 1 Sideband Index (SI1) and +/- 3 Sideband Index (SI3) were plotted along with rig operational parameters. Statistical tables of the means and standard deviations were calculated within inspection intervals for each CI. As testing progressed, it became clear that certain condition indicators were more sensitive to a specific component and failure mode. These tests were clustered together for further analysis. Maintenance actions during testing were also documented. Correlation coefficients were calculated between each CI, component, damage state and torque. Results found test rig and gear design, type of fault and data acquisition can affect CI performance. Results found FM4, SI1 and SI3 can be used to detect macro pitting on two more gear or pinion teeth as long as it is detected prior to progressing to other components or transitioning to another failure mode. The sensitivity of RMS to system and operational conditions limit its reliability for systems that are not maintained at steady state. Failure modes that occurred due to scuffing or fretting were challenging to detect with current gear diagnostic tools, since the damage is distributed across all the gear and pinion teeth, smearing the impacting signatures typically used to differentiate between a healthy and damaged tooth contact. This is one of three final reports published on the results of this project. In the second report, damage modes experienced in the field will be mapped to the failure modes created in the test rig. The helicopter CI data will then be re-processed with the same analysis techniques applied to spiral bevel rig test data. In the third report, results from the rig and helicopter data analysis will be correlated. Observations, findings and lessons learned using sub-scale rig failure progression tests to validate helicopter gear condition indicators will be presented.

Rare Cardiopulmonary Complications of Chronically Decompensated Myasthenia Gravis

PubMed Central

Chisholm, Joseph C.; Gilson, Alan

1980-01-01

Although myasthenia gravis (MG) is frequently mentioned in standard textbooks and journal articles as a rare cause for pulmonary hypertension and right heart failure, no case can actually be found in the literature. The case described in this report is the first documented case of chronically decompensated MG manifesting itself as pulmonary hypertension, severe right heart failure, and functional prolapse of both the mitral and tricuspid valves. Interestingly, no hepatic biochemical abnormalities were present in spite of significant congestive hepatomegaly. PMID:7420443

Bibliography of information on mechanics of structural failure

NASA Technical Reports Server (NTRS)

Carpenter, J. L., Jr.; Moya, N.; Shaffer, R. A.; Smith, D. M.

1973-01-01

A bibliography of approximately 1500 reference citations related to six problem areas in the mechanics of failure in aerospace structures is presented. The bibliography represents a search of the literature published in the ten year period 1962-1972 and is largely limited to documents published in the United States. Listings are subdivided into the six problem areas: (1) life prediction of structural materials; (2) fracture toughness data; (3) fracture mechanics analysis; (4) hydrogen embrittlement; (5) protective coatings; and (6) composite materials. An author index is included.

User-defined Material Model for Thermo-mechanical Progressive Failure Analysis

NASA Technical Reports Server (NTRS)

Knight, Norman F., Jr.

2008-01-01

Previously a user-defined material model for orthotropic bimodulus materials was developed for linear and nonlinear stress analysis of composite structures using either shell or solid finite elements within a nonlinear finite element analysis tool. Extensions of this user-defined material model to thermo-mechanical progressive failure analysis are described, and the required input data are documented. The extensions include providing for temperature-dependent material properties, archival of the elastic strains, and a thermal strain calculation for materials exhibiting a stress-free temperature.

Timing of antibiotic prophylaxis in surgery for adult hip fracture.

PubMed Central

Thonse, Raghuram; Sreenivas, Muthyala; Sherman, Kevin P.

2004-01-01

BACKGROUND: Antibiotic prophylaxis is widely used in surgery for hip fractures. METHODS AND RESULTS: In a retrospective study of case notes of 100 patients, frequent inaccuracies in dose administration were observed. This was applicable to both the pre-operative and the postoperative doses. Longer time intervals between the doses, failure to administer the prescribed doses, and failure of proper documentation were observed. CONCLUSIONS: Improvement in the awareness of staff and timely administration of prophylactic antibiotic has resulted from this study. PMID:15239868

75 FR 29588 - Notice of Availability of the Models for Plant-Specific Adoption of Technical Specifications Task...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-26

... Documents Access and Management System (ADAMS) under Accession Number ML090510686. The proposed changes... Documents Access and Management System (ADAMS): Publicly available documents created or received at the NRC... expedited approval of plant-specific adoption of TSTF- 501, Revision 1. Documents: You can access publicly...

75 FR 26294 - Notice of Availability of the Models for Plant-Specific Adoption of Technical Specifications Task...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-11

... an errata sheet are available in the Agencywide Documents Access and Management System (ADAMS) under... Agencywide Documents Access and Management System (ADAMS): Publicly available documents created or received... facilitate expedited approval of plant-specific adoption of TSTF-493, Revision 4. Documents: You can access...

Cognitive influences on self-care decision making in persons with heart failure.

PubMed

Dickson, Victoria V; Tkacs, Nancy; Riegel, Barbara

2007-09-01

Despite advances in management, heart failure is associated with high rates of hospitalization, poor quality of life, and early death. Education intended to improve patients' abilities to care for themselves is an integral component of disease management programs. True self-care requires that patients make decisions about symptoms, but the cognitive deficits documented in 30% to 50% of the heart failure population may make daily decision making challenging. After describing heart failure self-care as a naturalistic decision making process, we explore cognitive deficits known to exist in persons with heart failure. Problems in heart failure self-care are analyzed in relation to neural alterations associated with heart failure. As a neural process, decision making has been traced to regions of the prefrontal cortex, the same areas that are affected by ischemia, infarction, and hypoxemia in heart failure. Resulting deficits in memory, attention, and executive function may impair the perception and interpretation of early symptoms and reasoning and, thereby, delay early treatment implementation. There is compelling evidence that the neural processes critical to decision making are located in the same structures that are affected by heart failure. Because self-care requires the cognitive ability to learn, perceive, interpret, and respond, research is needed to discern how neural deficits affects these abilities, decision-making, and self-care behaviors.

Slope Stabilization Using Recycled Plastic Pins, Phase III.

DOT National Transportation Integrated Search

2007-01-01

A new technique for stabilizing surficial slope failures using recycled plastic reinforcing members has been developed. The : objective of the project described in this report has been to develop, evaluate, and document a technique for stabilization ...

INDUCTION OF ALBENDAZOLE RESISTANCE IN GIARDIA LAMBLIA

EPA Science Inventory

Previous studies have shown that Giardia lamblia resistance to metronidazole can be induced in the laboratory, and treatment failures with this drug have also been documented. As replacement theraples, anthelmintic benzimidazoles have antigiardial activity with few clinical side ...

Probabilistic failure assessment with application to solid rocket motors

NASA Technical Reports Server (NTRS)

Jan, Darrell L.; Davidson, Barry D.; Moore, Nicholas R.

1990-01-01

A quantitative methodology is being developed for assessment of risk of failure of solid rocket motors. This probabilistic methodology employs best available engineering models and available information in a stochastic framework. The framework accounts for incomplete knowledge of governing parameters, intrinsic variability, and failure model specification error. Earlier case studies have been conducted on several failure modes of the Space Shuttle Main Engine. Work in progress on application of this probabilistic approach to large solid rocket boosters such as the Advanced Solid Rocket Motor for the Space Shuttle is described. Failure due to debonding has been selected as the first case study for large solid rocket motors (SRMs) since it accounts for a significant number of historical SRM failures. Impact of incomplete knowledge of governing parameters and failure model specification errors is expected to be important.

Independent Orbiter Assessment (IOA): Assessment of the life support and airlock support systems, volume 2

NASA Technical Reports Server (NTRS)

Barickman, K.

1988-01-01

The McDonnell Douglas Astronautics Company (MDAC) was selected in June 1986 to perform an Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL). The IOA effort first completed an analysis of the Life Support and Airlock Support Systems (LSS and ALSS) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the NASA FMEA/CIL baseline with proposed Post 51-L updates included. The discrepancies were flagged for potential future resolution. This report documents the results of that comparison for the Orbiter LSS and ALSS hardware. Volume 2 continues the presentation of IOA worksheets and contains the critical items list and NASA FMEA to IOA worksheet cross reference and recommendations.

Independent Orbiter Assessment (IOA): Analysis of the Electrical Power Distribution and Control Subsystem, Volume 2

NASA Technical Reports Server (NTRS)

Schmeckpeper, K. R.

1987-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. This report documents the independent analysis results corresponding to the Orbiter Electrical Power Distribution and Control (EPD and C) hardware. The EPD and C hardware performs the functions of distributing, sensing, and controlling 28 volt DC power and of inverting, distributing, sensing, and controlling 117 volt 400 Hz AC power to all Orbiter subsystems from the three fuel cells in the Electrical Power Generation (EPG) subsystem. Volume 2 continues the presentation of IOA analysis worksheets and contains the potential critical items list.

Independent Orbiter Assessment (IOA): Assessment of the electrical power distribution and control subsystem, volume 3

NASA Technical Reports Server (NTRS)

Schmeckpeper, K. R.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA first completed an analysis of the Electrical Power Distribution and Control (EPD and C) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the NASA FMEA/CIL baseline with proposed Post 51-L updates included. A resolution of each discrepancy from the comparison is provided through additional analysis as required. This report documents the results of that comparison for the Orbiter EPD and C hardware. Volume 3 continues the presentation of IOA worksheets and contains the potential critical items list and the NASA FMEA to IOA worksheet cross reference and recommendations.

British American Tobacco’s failure in Turkey

PubMed Central

Lawrence, S

2009-01-01

Background and objectives Transnational tobacco companies (TTCs) considered Turkey an important, potential investment market because of its high consumption rates and domestic commitment to tobacco. This paper outlines how British American Tobacco (BAT) attempted to establish a joint venture with the government monopoly TEKEL, while waiting for privatisation and a private tender. Methods Analysis of tobacco industry documents from the Guildford Depository and online tobacco document sources. Results BAT failed to establish a market share in Turkey until 2000 despite repeated attempts to form a joint venture with Turkey’s tobacco monopoly, TEKEL, once the market liberalised in the mid 1980s. Conclusions BAT’s failure in the Turkish market was due to a misguided investment strategy focused solely on acquiring TEKEL and is contrasted with Philip Morris success in Turkey despite both TTCs working within Turkey’s unstable and corrupt investing climate. PMID:18845622

Independent Orbiter Assessment (IOA): Assessment of the atmospheric revitalization pressure control subsystem FMEA/CIL

NASA Technical Reports Server (NTRS)

Saiidi, M. J.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the atmospheric Revitalization Pressure Control Subsystem (ARPCS) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the NASA FMEA/CIL proposed Post 51-L updates based upon the CCB/PRCB presentations and an informal criticality summary listing. A discussion of each discrepancy from the comparison is provided through additional analysis as required. These discrepancies were flagged as issues, and recommendations were made based on the FMEA data available at the time. This report documents the results of that comparison for the Orbiter ARPCS hardware.

Firefighter safety: rampant unsafe practices as documented in mainstream media.

PubMed

Kahn, Steven A; Woods, Jason; Sipes, Jan C; Toscano, Nicole; Bell, Derek E

2014-01-01

More than 30,000 firefighters are injured on the fireground each year. Literature suggests that injury often occurs when protective gear is not used properly. According to firefighters, failure to correctly wear protective equipment occurs for several reasons: (1) gear not used because of haste, (2) cumbersome gear can sometimes interfere with performance, and (3) cultural factors. The purpose of this study is to quantify improper gear and tactic use in a publicly available, online video repository in order to better understand unsafe firefighting. This was an Institutional Review Board-exempt study of public video records. A search for "fire fighting videos" was conducted at YouTube (www.youtube.com). The first 50 videos that contained volunteer or career firefighters at work fighting fires were selected evaluated for appropriate use of personal protective equipment and for safe behavior. The videos were evaluated by two highly experienced professional firefighters. Of the 50 videos reviewed, 25 (50%) demonstrated violations of firefighting safety principles. Of the unsafe videos, 21 (42%) displayed firefighters improperly using gear, while the other 4 (8%) were related to unsound tactics. The most common problem was failure to wear or properly secure a self-contained breathing apparatus when appropriate (14 videos or 28%). The second most common failure was lack of helmet, hood, or approved gloves (11 videos or 22%). In conclusion, firefighting as documented on YouTube is often unsafe because of failure to properly use personal protective equipment. Half of the videos reviewed contained unsafe practices. With such a shockingly high rate of unsafe firefighting, the profession is in need of additional education and reform. In response to this epidemic, a multidisciplinary educational program has been developed to improve firefighter awareness of gear limitations and burn injury risk. Effectiveness of educational programs should be documented in additional prospective studies.

[Problems encountered during the installation of an automated anesthesia documentation system (AIMS)].

PubMed

Müller, H; Naujoks, F; Dietz, S

2002-08-01

Problems encountered during the installation and introduction of an automated anaesthesia documentation system are discussed. Difficulties have to be expected in the area of staff training because of heterogeneous experience in computer usage and in the field of online documentation of vital signs. Moreover the areas of net administration and hardware configuration as well as general administrative issues also represent possible sources of drawbacks. System administration and reliable support provided by personnel of the department of anaesthesiology assuring staff motivation and reducing time of system failures require adequately staffed departments. Based on our own experiences, we recommend that anaesthesiology departments considering the future installation and use of an automated anaesthesia documentation system should verify sufficient personnel capacities prior to their decision.

Gary-Chicago-Milwaukee corridor : corridor transportation information center : system glossary

DOT National Transportation Integrated Search

1995-10-30

The following definitions, abbreviations and acronyms are generated from the : System Definition Document (Document #9931.GCM), the Interface Control : Specification (Document #9932.GCM), and the Requirements Specification (Document : #9933.GCM). The...

Progressive liver failure post acute hepatitis A, over a three-month period, resulting in hepatorenal syndrome and death

PubMed Central

Al Saadi, Tareq; Sawaf, Bisher; Alkhatib, Mahmoud; Zakaria, Mhd Ismael; Daaboul, Bisher

2017-01-01

Abstract Hepatitis A is a common viral illness worldwide. It usually results in an acute, self-limiting disease and only rarely leads to fulminant hepatic failure or any other complications. During the period of conflict in Syria, and due to the damages to water infrastructure and poor sanitation, a dramatic increase in hepatitis A virus infection has been documented. Here we report a rare case of a 14-year-old male whose hepatitis A was complicated with hepatorenal syndrome and subacute liver failure. The war condition in Syria impeded transportation of the patient to a nearby country for liver transplantation, contributing to his unfortunate death. PMID:27247182

Application of Weibull analysis to SSME hardware

NASA Technical Reports Server (NTRS)

Gray, L. A. B.

1986-01-01

Generally, it has been documented that the wearing of engine parts forms a failure distribution which can be approximated by a function developed by Weibull. The purpose here is to examine to what extent the Weibull distribution approximates failure data for designated engine parts of the Space Shuttle Main Engine (SSME). The current testing certification requirements will be examined in order to establish confidence levels. An examination of the failure history of SSME parts/assemblies (turbine blades, main combustion chamber, or high pressure fuel pump first stage impellers) which are limited in usage by time or starts will be done by using updated Weibull techniques. Efforts will be made by the investigator to predict failure trends by using Weibull techniques for SSME parts (turbine temperature sensors, chamber pressure transducers, actuators, and controllers) which are not severely limited by time or starts.

Formal Specification and Validation of a Hybrid Connectivity Restoration Algorithm for Wireless Sensor and Actor Networks †

PubMed Central

Imran, Muhammad; Zafar, Nazir Ahmad

2012-01-01

Maintaining inter-actor connectivity is extremely crucial in mission-critical applications of Wireless Sensor and Actor Networks (WSANs), as actors have to quickly plan optimal coordinated responses to detected events. Failure of a critical actor partitions the inter-actor network into disjoint segments besides leaving a coverage hole, and thus hinders the network operation. This paper presents a Partitioning detection and Connectivity Restoration (PCR) algorithm to tolerate critical actor failure. As part of pre-failure planning, PCR determines critical/non-critical actors based on localized information and designates each critical node with an appropriate backup (preferably non-critical). The pre-designated backup detects the failure of its primary actor and initiates a post-failure recovery process that may involve coordinated multi-actor relocation. To prove the correctness, we construct a formal specification of PCR using Z notation. We model WSAN topology as a dynamic graph and transform PCR to corresponding formal specification using Z notation. Formal specification is analyzed and validated using the Z Eves tool. Moreover, we simulate the specification to quantitatively analyze the efficiency of PCR. Simulation results confirm the effectiveness of PCR and the results shown that it outperforms contemporary schemes found in the literature.

Prevalence of Heart Failure Signs and Symptoms in a Large Primary Care Population Identified Through the Use of Text and Data Mining of the Electronic Health Record

PubMed Central

Vijayakrishnan, Rajakrishnan; Steinhubl, Steven R.; Ng, Kenney; Sun, Jimeng; Byrd, Roy J.; Daar, Zahra; Williams, Brent A.; deFilippi, Christopher; Ebadollahi, Shahram; Stewart, Walter F.

2014-01-01

Background The electronic health record contains a tremendous amount of data that if appropriately detected can lead to earlier identification of disease states such as heart failure (HF). Using a novel text and data analytic tool we explored the longitudinal EHR of over 50,000 primary care patients to identify the documentation of the signs and symptoms of HF in the years preceding its diagnosis. Methods and Results Retrospective analysis consisting of 4,644 incident HF cases and 45,981 group-matched controls. Documentation of Framingham HF signs and symptoms within encounter notes were carried out using a previously validated natural language processing procedure. A total of 892,805 affirmed criteria were documented over an average observation period of 3.4 years. Among eventual HF cases, 85% had at least one criterion within a year prior to their HF diagnosis (as did 55% of controls). Substantial variability in the prevalence of individual signs and symptoms were found in both cases and controls. Conclusions HF signs and symptoms are frequently documented in a primary care population as identified through automated text and data mining of EHRs. Their frequent identification demonstrates the rich data available within EHRs that will allow for future work on automated criterion identification to help develop predictive models for HF. PMID:24709663

Evaluation of near-miss and adverse events in radiation oncology using a comprehensive causal factor taxonomy.

PubMed

Spraker, Matthew B; Fain, Robert; Gopan, Olga; Zeng, Jing; Nyflot, Matthew; Jordan, Loucille; Kane, Gabrielle; Ford, Eric

Incident learning systems (ILSs) are a popular strategy for improving safety in radiation oncology (RO) clinics, but few reports focus on the causes of errors in RO. The goal of this study was to test a causal factor taxonomy developed in 2012 by the American Association of Physicists in Medicine and adopted for use in the RO: Incident Learning System (RO-ILS). Three hundred event reports were randomly selected from an institutional ILS database and Safety in Radiation Oncology (SAFRON), an international ILS. The reports were split into 3 groups of 100 events each: low-risk institutional, high-risk institutional, and SAFRON. Three raters retrospectively analyzed each event for contributing factors using the American Association of Physicists in Medicine taxonomy. No events were described by a single causal factor (median, 7). The causal factor taxonomy was found to be applicable for all events, but 4 causal factors were not described in the taxonomy: linear accelerator failure (n = 3), hardware/equipment failure (n = 2), failure to follow through with a quality improvement intervention (n = 1), and workflow documentation was misleading (n = 1). The most common causal factor categories contributing to events were similar in all event types. The most common specific causal factor to contribute to events was a "slip causing physical error." Poor human factors engineering was the only causal factor found to contribute more frequently to high-risk institutional versus low-risk institutional events. The taxonomy in the study was found to be applicable for all events and may be useful in root cause analyses and future studies. Communication and human behaviors were the most common errors affecting all types of events. Poor human factors engineering was found to specifically contribute to high-risk more than low-risk institutional events, and may represent a strategy for reducing errors in all types of events. Copyright © 2017 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Preparation guide for class B software specification documents

NASA Technical Reports Server (NTRS)

Tausworthe, R. C.

1979-01-01

General conceptual requirements and specific application rules and procedures are provided for the production of software specification documents in conformance with deep space network software standards and class B standards. Class B documentation is identified as the appropriate level applicable to implementation, sustaining engineering, and operational uses by qualified personnel. Special characteristics of class B documents are defined.

Risk Factors of Clinical and Immunological Failure in South Indian Cohort on Generic Antiretroviral Therapy.

PubMed

Sadashiv, Mucheli Shravan; Rupali, Priscilla; Manesh, Abi; Kannangai, Rajesh; Abraham, Ooriapadickal Cherian; Pulimood, Susanne A; Karthik, Rajiv; Rajkumar, S; Thomas, Kurien

2017-12-01

Since the time of NACO Antiretroviral (ART) roll-out, generic ART has been the mainstay of therapy. There are many studies documenting the efficacy of generic ART but with the passage of time, failure of therapy is on the rise. As institution of second line ART has significant financial implications both for a program and for an individual it is imperative that we determine factors which contribute towards treatment failure in a cohort of patients on generic antiretroviral therapy. This was a nested matched case-control study assessing the predictors for treatment failure in our cohort who had been on Anti-retroviral therapy for at least a year. We identified 42 patients (Cases) with documented treatment failure out of our cohort of 823 patients and 42 sex, age and duration of therapy-matched controls. Using a structured proforma, we collected information from the out-patient and in-patient charts of the Infectious Diseases clinic Cohort in CMC, Vellore. A set of predetermined variables were studied as potential risk factors for treatment failure on ART. Univariate analysis showed significant association with 1) Self-reported nonadherence<95% [OR 12.81 (95%CI 1.54-281.45)]. 2) Treatment interruptions in adherent cases (OR 9.56 (95% CI 1.11-213.35)]. 3) Past inappropriate therapies [OR 9.65 (95% CI 1.12-215.94)]. 4) Diarrhoea [OR 16.40 (95% CI 2.02-3.55.960]. 5) GI opportunistic infections (OR 11.06 (95% CI 1.31 -244.27)] and 6) Drug Toxicity [OR 3.69 (95% CI 1.15-12.35).In multiple logistic regression analysis, we found independent risk factors of treatment failure to be: Self-reported non-adherence (<95%) with OR 15.46(95%CI 1.55 - 154.08), drug toxicity - OR 4.13(95%CI 1.095 - 15.534) and history of diarrhoea - OR 23.446(95%CI 2.572 - 213.70). This study reveals that besides adherence to therapy, presence of diarrhoea and occurrence of drug toxicity are significant risk factors associated with failure of anti-retroviral therapy. There is a need for further prospective studies to assess their role in development of treatment failure on ART and thus help development of targeted interventions.

MANAGEMENT OF FAILED MITRAL VALVE REPLACEMENT. THE DURBAN EXPERIENCE.

PubMed

Kistan, D; Booysen, M; Alexander, G; Madiba, T E

2017-06-01

Mitral valve replacement is the procedure of choice in patients with severe mitral valve disease. However, these patients are surviving longer and are thus at an increased risk of prosthesis failure or valve-related complications. Study setting: Inkosi Albert Luthuli Central Hospital, a tertiary referral Hospital in Durban. Study population: All patients undergoing redo mechanical mitral valve replacement surgery between January 2005 and December 2014. Study design: Retrospective analysis of patients undergoing redo mitral valve replacement. Patients were identified from theatre record books, their files were electronically accessed and pertinent information extracted onto a data capture sheet. Information documented included demographics, duration to failure, INR, Albumin, HIV status, clinical findings and outcome. The data was stored on an Excel datasheet. Fifty-eight patients were documented (mean age 32 ± 15.81 years; M:F 1:3). Ten patients (17%) were HIV positive (median CD4 count 478). Mean duration between first surgery and redo was 8.8 years. Thirty-five patients (60%) had no co-morbidities. Presenting features at redo surgery were congestive cardiac failure (27), chest pain (11) and palpitations (17). Mean preoperative Ejection Fraction was 51.65 %. Twenty-nine patients (55%) had emergency redo surgery. Twenty-two patients (75%) had acute prosthetic valve thrombosis. Thirty-two patients had tricuspid regurgitation. Original pathology was documented in 23 patients (40%) as Rheumatic valve disease. Prosthetic valve thrombosis was documented in 31 patients (54%). The most commonly used valve was the On-X. Mean presenting INR was 1.96 + 1.2 and mean presenting serum albumin was 36.7 + 7.8 g/l. Forty-one patients (71%) were found to be compliant to Warfarin therapy prior to redo surgery. Mean ICU stay was 6 +9 days. Two patients died postoperatively. Mean followup was 32 + 26.6 months. Twelve patients (20.7%) developed postoperative complications. Patients were younger than world literature suggests. Rheumatic heart disease was the common underlying pathology. Prosthetic valve thrombosis was common. More than half had emergency surgery. Mortality rate was negligible.

Design of Critical Components

NASA Technical Reports Server (NTRS)

Hendricks, Robert C.; Zaretsky, Erwin V.

2001-01-01

Critical component design is based on minimizing product failures that results in loss of life. Potential catastrophic failures are reduced to secondary failures where components removed for cause or operating time in the system. Issues of liability and cost of component removal become of paramount importance. Deterministic design with factors of safety and probabilistic design address but lack the essential characteristics for the design of critical components. In deterministic design and fabrication there are heuristic rules and safety factors developed over time for large sets of structural/material components. These factors did not come without cost. Many designs failed and many rules (codes) have standing committees to oversee their proper usage and enforcement. In probabilistic design, not only are failures a given, the failures are calculated; an element of risk is assumed based on empirical failure data for large classes of component operations. Failure of a class of components can be predicted, yet one can not predict when a specific component will fail. The analogy is to the life insurance industry where very careful statistics are book-kept on classes of individuals. For a specific class, life span can be predicted within statistical limits, yet life-span of a specific element of that class can not be predicted.

13 CFR 120.1720 - SBA's right to review Pool Loan documents.

Code of Federal Regulations, 2010 CFR

2010-01-01

... may constitute a material failure to comply with the Program Rules and Regulations and may lead to an... Program and may restrict further sales under the Program until SBA determines that the Seller has provided...

DCDS: A Real-time Data Capture and Personalized Decision Support System for Heart Failure Patients in Skilled Nursing Facilities.

PubMed

Zhu, Wei; Luo, Lingyun; Jain, Tarun; Boxer, Rebecca S; Cui, Licong; Zhang, Guo-Qiang

2016-01-01

Heart disease is the leading cause of death in the United States. Heart failure disease management can improve health outcomes for elderly community dwelling patients with heart failure. This paper describes DCDS, a real-time data capture and personalized decision support system for a Randomized Controlled Trial Investigating the Effect of a Heart Failure Disease Management Program (HF-DMP) in Skilled Nursing Facilities (SNF). SNF is a study funded by the NIH National Heart, Lung, and Blood Institute (NHLBI). The HF-DMP involves proactive weekly monitoring, evaluation, and management, following National HF Guidelines. DCDS collects a wide variety of data including 7 elements considered standard of care for patients with heart failure: documentation of left ventricular function, tracking of weight and symptoms, medication titration, discharge instructions, 7 day follow up appointment post SNF discharge and patient education. We present the design and implementation of DCDS and describe our preliminary testing results.

[Actuarial analysis of time-failure data and its rrelevance for interpretation of results. Audit of the journal "Strahlentherapie und Onkologie" (Radiotherapy and Oncology)].

PubMed

Dubben, H H; Beck-Bornholdt, H P

2000-12-01

The statistical quality of the contributions to "Strahlentherapie und Onkologie" is assessed, aiming for improvement of the journal and consequently its impact factor. All 181 articles published during 1998 and 1999 in the categories "review", "original contribution", and "short communication" were analyzed concerning actuarial analysis of time-failure data. One hundred and twenty-three publications without time-failure data were excluded from analysis. Forty-five of the remaining 58 publications with time-failure data were evaluated actuarially. This corresponds to 78% (95% confidence interval: 64 to 88%) of papers, in which data were adequately analyzed. Complications were reported in 16 of 58 papers, but in only 3 cases actuarially. The number of patients at risk during the course of follow-up was documented adequately in 22 of the 45 publications with actuarial analysis. Authors, peer reviewers, and editors could contribute to improve the quality of the journal by setting value on acturial analysis of time-failure data.

Forecasting slope failures from space-based synthetic aperture radar (SAR) measurements

NASA Astrophysics Data System (ADS)

Wasowski, J.; Bovenga, F.; Nutricato, R.; Nitti, D. O.; Chiaradia, M. T.; Tijani, K.; Morea, A.

2017-12-01

New space-borne radar sensors enable multi-scale monitoring of potentially unstable slopes thanks to wide-area coverage (tens of thousands km2), regular long-term image acquisition schedule with increasing re-visit frequency (weekly to daily), and high measurement precision (mm). In particular, the recent radar satellite missions e.g., COSMO-SkyMed (CSK), Sentinel-1 (S-1) and improved multi-temporal interferometry (MTI) processing techniques allow timely delivery of information on slow ground surface displacements. Here we use two case study examples to show that it is possible to capture pre-failure slope strains through long-term MTI-based monitoring. The first case is a retrospective investigation of a huge 500ML m3 landslide, which occurred in Sept. 2016 in a large, active open-cast coal mine in central Europe. We processed over 100 S-1 images acquired since Fall 2014. The MTI results showed that the slope that failed had been unstable at least since 2014. Importantly, we detected consistent displacement trends and trend changes, which can be used for slope failure forecasting. Specifically, we documented significant acceleration in slope surface displacement in the two months preceding the catastrophic failure. The second case of retrospectively captured pre-failure slope strains regards our earlier study of a small 50 m long landslide, which occurred on Jan. 2014 and caused the derailment of a train on the railway line connecting NW Italy to France. We processed 56 CSK images acquired from Fall 2008 to Spring 2014. The MTI results revealed pre-failure displacements of the engineering structures on the slope subsequently affected by the 2014 slide. The analysis of the MTI time series further showed that the displacements had been occurring since 2009. This information could have been used to forewarn the railway authority about the slope instability hazard. The above examples indicate that more frequent and consistent image acquisitions by the new radar satellites represent the key improvement for MTI-based slope monitoring. The forecasting of potential slope failures from space is now more feasible. ACKNOWLEDGEMENTS We thank European (ESA) and Italian (ASI) space agencies for S-1 and CSK® Products. We also acknowledge the IT resources made available by ReCaS, a project financed by the MIUR.

Independent Orbiter Assessment (IOA): Assessment of the backup flight system FMEA/CIL

NASA Technical Reports Server (NTRS)

Prust, E. E.; Ewell, J. J., Jr.; Hinsdale, L. W.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Backup Flight System (BFS) hardware, generating draft failure modes and Potential Critical Items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the proposed NASA Post 51-L FMEA/CIL baseline. A resolution of each discrepancy from the comparison is provided through additional analysis as required. This report documents the results of that comparison for the Orbiter BFS hardware. The IOA product for the BFS analysis consisted of 29 failure mode worksheets that resulted in 21 Potential Critical Items (PCI) being identified. This product was originally compared with the proposed NASA BFS baseline and subsequently compared with the applicable Data Processing System (DPS), Electrical Power Distribution and Control (EPD and C), and Displays and Controls NASA CIL items. The comparisons determined if there were any results which had been found by the IOA but were not in the NASA baseline. The original assessment determined there were numerous failure modes and potential critical items in the IOA analysis that were not contained in the NASA BFS baseline. Conversely, the NASA baseline contained three FMEAs (IMU, ADTA, and Air Data Probe) for CIL items that were not identified in the IOA product.

A Statistical Perspective on Highly Accelerated Testing

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thomas, Edward V.

Highly accelerated life testing has been heavily promoted at Sandia (and elsewhere) as a means to rapidly identify product weaknesses caused by flaws in the product's design or manufacturing process. During product development, a small number of units are forced to fail at high stress. The failed units are then examined to determine the root causes of failure. The identification of the root causes of product failures exposed by highly accelerated life testing can instigate changes to the product's design and/or manufacturing process that result in a product with increased reliability. It is widely viewed that this qualitative use ofmore » highly accelerated life testing (often associated with the acronym HALT) can be useful. However, highly accelerated life testing has also been proposed as a quantitative means for "demonstrating" the reliability of a product where unreliability is associated with loss of margin via an identified and dominating failure mechanism. It is assumed that the dominant failure mechanism can be accelerated by changing the level of a stress factor that is assumed to be related to the dominant failure mode. In extreme cases, a minimal number of units (often from a pre-production lot) are subjected to a single highly accelerated stress relative to normal use. If no (or, sufficiently few) units fail at this high stress level, some might claim that a certain level of reliability has been demonstrated (relative to normal use conditions). Underlying this claim are assumptions regarding the level of knowledge associated with the relationship between the stress level and the probability of failure. The primary purpose of this document is to discuss (from a statistical perspective) the efficacy of using accelerated life testing protocols (and, in particular, "highly accelerated" protocols) to make quantitative inferences concerning the performance of a product (e.g., reliability) when in fact there is lack-of-knowledge and uncertainty concerning the assumed relationship between the stress level and performance. In addition, this document contains recommendations for conducting more informative accelerated tests.« less

Cord blood clinical processing, cryopreservation, and storage.

PubMed

Elmoazzen, Heidi; Holovati, Jelena L

2015-01-01

Allogeneic umbilical cord blood (UCB) hematopoietic stem cell transplantation has become a crucial advancement in the treatment for a variety of diseases including hematopoietic and non-hematopoietic malignancies, BM failure syndromes, hemoglobinopathies, and metabolic and immunodeficiency disorders. It has been well documented that the success of UCB engraftment is tied to UCB banking processes, and now there are established guidelines for standardization of collection, banking, processing, and cryopreservation for unrelated UCB units with purpose of achieving consistent production of high quality placental and UCB units for administration. In 2011, Canada's Ministry of Health has announced Canada's first national, publicly funded umbilical cord blood bank, which aims to provide altruistic donations for unrelated allogeneic hematopoietic stem cell transplant. In this chapter, we describe specific protocols for clinical processing, cryopreservation, and storage of UCB used by the Canadian Blood Services National Public Umbilical Cord Blood Bank.

[Large benign prostatic hiperplasia].

PubMed

Soria-Fernández, Guillermo René; Jungfermann-Guzman, José René; Lomelín-Ramos, José Pedro; Jaspersen-Gastelum, Jorge; Rosas-Nava, Jesús Emmanuel

2012-01-01

the term prostatic hyperplasia is most frequently used to describe the benign prostatic growth, this being a widely prevalent disorder associated with age that affects most men as they age. The association between prostate growth and urinary obstruction in older adults is well documented. large benign prostatic hyperplasia is rare and few cases have been published and should be taken into account during the study of tumors of the pelvic cavity. we report the case of an 81-year-old who had significant symptoms relating to storage and bladder emptying, with no significant elevation of prostate specific antigen. this is a rare condition but it is still important to diagnose and treat as it may be related to severe obstructive uropathy and chronic renal failure. In our institution, cases of large prostatic hyperplasia that are solved by suprapubic adenomectomy are less than 3%.

Two strikes: race and the disciplining of young students.

PubMed

Okonofua, Jason A; Eberhardt, Jennifer L

2015-05-01

There are large racial disparities in school discipline in the United States, which, for Black students, not only contribute to school failure but also can lay a path toward incarceration. Although the disparities have been well documented, the psychological mechanisms underlying them are unclear. In two experiments, we tested the hypothesis that such disparities are, in part, driven by racial stereotypes that can lead teachers to escalate their negative responses to Black students over the course of multiple interpersonal (e.g., teacher-to-student) encounters. More generally, we argue that race not only can influence how perceivers interpret a specific behavior, but also can enhance perceivers' detection of behavioral patterns across time. Finally, we discuss the theoretical and practical benefits of employing this novel approach to stereotyping across a range of real-world settings. © The Author(s) 2015.

Lox/Gox related failures during Space Shuttle Main Engine development

NASA Technical Reports Server (NTRS)

Cataldo, C. E.

1981-01-01

Specific rocket engine hardware and test facility system failures are described which were caused by high pressure liquid and/or gaseous oxygen reactions. The failures were encountered during the development and testing of the space shuttle main engine. Failure mechanisms are discussed as well as corrective actions taken to prevent or reduce the potential of future failures.

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

PubMed Central

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

2007-01-01

Heart failure is common, yet it is difficult to treat. It presents in many different guises and circumstances in which therapy needs to be individualized. The Canadian Cardiovascular Society published a comprehensive set of recommendations in January 2006 on the diagnosis and management of heart failure, and the present update builds on those core recommendations. Based on feedback obtained through a national program of heart failure workshops during 2006, several topics were identified as priorities because of the challenges they pose to health care professionals. New evidence-based recommendations were developed using the structured approach for the review and assessment of evidence adopted and previously described by the Society. Specific recommendations and practical tips were written for the prevention of heart failure, the management of heart failure during intercurrent illness, the treatment of acute heart failure, and the current and future roles of biomarkers in heart failure care. Specific clinical questions that are addressed include: which patients should be identified as being at high risk of developing heart failure and which interventions should be used? What complications can occur in heart failure patients during an intercurrent illness, how should these patients be monitored and which medications may require a dose adjustment or discontinuation? What are the best therapeutic, both drug and nondrug, strategies for patients with acute heart failure? How can new biomarkers help in the treatment of heart failure, and when and how should BNP be measured in heart failure patients? The goals of the present update are to translate best evidence into practice, to apply clinical wisdom where evidence for specific strategies is weaker, and to aid physicians and other health care providers to optimally treat heart failure patients to result in a measurable impact on patient health and clinical outcomes in Canada. PMID:17245481

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

PubMed

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

2007-01-01

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

Editorial Commentary: Size Does Matter-Anterior Cruciate Ligament Graft Diameter Affects Biomechanical and Clinical Outcomes.

PubMed

Steiner, Mark

2017-05-01

Anterior cruciate ligament (ACL) graft strength is related to graft diameter and how ACL grafts heal. All grafts appear to lose strength during healing. Clinical studies have documented that hamstring grafts less than 8 mm wide are more vulnerable to failure. Tripling the semitendinosus allows to increase the graft diameter and strength. A recent study documents a semitendinosus tripling technique with excellent clinical results. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

48 CFR 11.201 - Identification and availability of specifications.

Code of Federal Regulations, 2011 CFR

2011-10-01

... standard, or from an authorized document reseller. The National Institute of Standards and Technology can... Documents 11.201 Identification and availability of specifications. (a) Solicitations citing requirements documents listed in the General Services Administration (GSA) Index of Federal Specifications, Standards and...

Is addiction a failure of rationality?

PubMed

Ferguson, Brian

2012-01-01

This note argues that addiction itself can be seen as a form of double failure, specifically the failure to stick to a predetermined optimal lifetime consumption path for an addictive commodity, which failure might be the result of bad luck, and the failure to adjust the level of consumption of the addictive commodity once the consumer is off their optimal path, which might be seen as a failure of judgment.

Forensic investigation of brick paver crosswalks at Court Square in Charlottesville, Virginia.

DOT National Transportation Integrated Search

2007-01-01

This report documents the findings of a forensic investigation to determine the causes of premature failures noted in brick paver crosswalks in the Court Square area in Charlottesville, Virginia. Brick paver crosswalks were installed in late November...

Explosive eruption, flank collapse and megatsunami at Tenerife ca. 170 ka.

PubMed

Paris, Raphaël; Bravo, Juan J Coello; González, María E Martín; Kelfoun, Karim; Nauret, François

2017-05-15

Giant mass failures of oceanic shield volcanoes that generate tsunamis potentially represent a high-magnitude but low-frequency hazard, and it is actually difficult to infer the mechanisms and dynamics controlling them. Here we document tsunami deposits at high elevation (up to 132 m) on the north-western slopes of Tenerife, Canary Islands, as a new evidence of megatsunami generated by volcano flank failure. Analyses of the tsunami deposits demonstrate that two main tsunamis impacted the coasts of Tenerife 170 kyr ago. The first tsunami was generated during the submarine stage of a retrogressive failure of the northern flank of the island, whereas the second one followed the debris avalanche of the subaerial edifice and incorporated pumices from an on-going ignimbrite-forming eruption. Coupling between a massive retrogressive flank failure and a large explosive eruption represents a new type of volcano-tectonic event on oceanic shield volcanoes and a new hazard scenario.

[Combined heart-kidney transplantation in Mexic].

PubMed

Careaga-Reyna, Guillermo; Zetina-Tun, Hugo Jesús; Lezama-Urtecho, Carlos Alberto; Hernández-Domínguez, José Mariano; Santos-Caballero, Marlene

In our country, heart and kidney transplantation is a novel option for treatment of combined terminal heart and kidney failure. This program began in 2012 for selected patients with documented terminal heart failure and structural kidney damage with renal failure. Description of cases: Between January 1, 2012 and April 30, 2016, we made 92 orthotopic heart transplantations. In five of these cases the heart transplantation was combined with kidney transplantation. There were three male and two female patients with a mean age 25.6 ± 5.2 years (range, 17-29). The patients improved their renal function and the heart transplantation was successful with an improved quality of life. One patient died from abdominal sepsis. The other patients are doing well. The combined heart-kidney transplantation is a safe and efficient procedure for patients with structural kidney and heart damage as a cause of terminal failure.

Chronic sublethal stress causes bee colony failure.

PubMed

Bryden, John; Gill, Richard J; Mitton, Robert A A; Raine, Nigel E; Jansen, Vincent A A

2013-12-01

Current bee population declines and colony failures are well documented yet poorly understood and no single factor has been identified as a leading cause. The evidence is equivocal and puzzling: for instance, many pathogens and parasites can be found in both failing and surviving colonies and field pesticide exposure is typically sublethal. Here, we investigate how these results can be due to sublethal stress impairing colony function. We mathematically modelled stress on individual bees which impairs colony function and found how positive density dependence can cause multiple dynamic outcomes: some colonies fail while others thrive. We then exposed bumblebee colonies to sublethal levels of a neonicotinoid pesticide. The dynamics of colony failure, which we observed, were most accurately described by our model. We argue that our model can explain the enigmatic aspects of bee colony failures, highlighting an important role for sublethal stress in colony declines. © 2013 The Authors. Ecology Letters published by John Wiley & Sons Ltd and CNRS.

Determination of UAV pre-flight Checklist for flight test purpose using qualitative failure analysis

NASA Astrophysics Data System (ADS)

Hendarko; Indriyanto, T.; Syardianto; Maulana, F. A.

2018-05-01

Safety aspects are of paramount importance in flight, especially in flight test phase. Before performing any flight tests of either manned or unmanned aircraft, one should include pre-flight checklists as a required safety document in the flight test plan. This paper reports on the development of a new approach for determination of pre-flight checklists for UAV flight test based on aircraft’s failure analysis. The Lapan’s LSA (Light Surveillance Aircraft) is used as a study case, assuming this aircraft has been transformed into the unmanned version. Failure analysis is performed on LSA using fault tree analysis (FTA) method. Analysis is focused on propulsion system and flight control system, which fail of these systems will lead to catastrophic events. Pre-flight checklist of the UAV is then constructed based on the basic causes obtained from failure analysis.

Chronic sublethal stress causes bee colony failure

PubMed Central

Bryden, John; Gill, Richard J; Mitton, Robert A A; Raine, Nigel E; Jansen, Vincent A A; Hodgson, David

2013-01-01

Current bee population declines and colony failures are well documented yet poorly understood and no single factor has been identified as a leading cause. The evidence is equivocal and puzzling: for instance, many pathogens and parasites can be found in both failing and surviving colonies and field pesticide exposure is typically sublethal. Here, we investigate how these results can be due to sublethal stress impairing colony function. We mathematically modelled stress on individual bees which impairs colony function and found how positive density dependence can cause multiple dynamic outcomes: some colonies fail while others thrive. We then exposed bumblebee colonies to sublethal levels of a neonicotinoid pesticide. The dynamics of colony failure, which we observed, were most accurately described by our model. We argue that our model can explain the enigmatic aspects of bee colony failures, highlighting an important role for sublethal stress in colony declines. PMID:24112478

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tiradani, Tiradani,Anthony; Altunay, Mine; Dagenhart, David

The Decision Engine is a critical component of the HEP Cloud Facility. It provides the functionality of resource scheduling for disparate resource providers, including those which may have a cost or a restricted allocation of cycles. Along with the architecture, design, and requirements for the Decision Engine, this document will provide the rationale and explanations for various design decisions. In some cases, requirements and interfaces for a limited subset of external services will be included in this document. This document is intended to be a high level design. The design represented in this document is not complete and does notmore » break everything down in detail. The class structures and pseudo-code exist for example purposes to illustrate desired behaviors, and as such, should not be taken literally. The protocols and behaviors are the important items to take from this document. This project is still in prototyping mode so flaws and inconsistencies may exist and should be noted and treated as failures.« less

Evaluation of echocardiography in the management of elderly patients with heart failure.

PubMed

Hendry, A; Hacking, L; Langhorne, P; Vallance, R; MacDonald, J

1999-09-01

To determine the validity of a clinical diagnosis of systolic dysfunction in elderly patients with heart failure and assess the contribution of echocardiography to their management. 61 elderly patients with a diagnosis of heart failure in a geriatric assessment unit setting. Prospective study determining sensitivity, specificity and predictive values of a clinical and radiological diagnosis compared with echocardiographic standard. Proposed management was compared before and after echocardiography. Clinical assessment was highly sensitive (93%) but lacked specificity (32%). Combining radiological and clinical diagnoses increased specificity to 58%. Echocardiography revised the lead cardiac diagnosis for 28% of patients and influenced patient management plans for 41%. For elderly patients with heart failure, echocardiography improves diagnostic accuracy and identifies those patients with potential to benefit from angiotensin-converting enzyme inhibitors.

34 CFR 300.311 - Specific documentation for the eligibility determination.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Learning Disabilities § 300.311 Specific documentation for the eligibility determination. (a) For a child suspected of having a specific learning disability, the documentation of the determination of eligibility... learning disability; (2) The basis for making the determination, including an assurance that the...

Metallurgical failure analysis of MH-1A reactor core hold-down bolts. Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hawthorne, J.R.; Watson, H.E.

1976-11-01

The Naval Research Laboratory has performed a failure analysis on two MH-1A reactor core hold-down bolts that broke in service. Adherence to fabrication specifications, post-service properties and possible causes of bolt failure were investigated. The bolt material was verified as 17-4PH precipitation hardening stainless steel. Measured bolt dimensions also were in accordance with fabrication drawing specifications. Bolt failure occurred in the region of a locking pin hole which reduced the bolt net section by 47 percent. The failure analysis indicates that the probable cause of failure was net section overloading resulting from a lateral bending force on the bolt. Themore » analysis indicates that net section overloading could also have resulted from combined tensile stresses (bolt preloading plus differential thermal expansion). Recommendations are made for improved bolting.« less

Fault Injection Techniques and Tools

NASA Technical Reports Server (NTRS)

Hsueh, Mei-Chen; Tsai, Timothy K.; Iyer, Ravishankar K.

1997-01-01

Dependability evaluation involves the study of failures and errors. The destructive nature of a crash and long error latency make it difficult to identify the causes of failures in the operational environment. It is particularly hard to recreate a failure scenario for a large, complex system. To identify and understand potential failures, we use an experiment-based approach for studying the dependability of a system. Such an approach is applied not only during the conception and design phases, but also during the prototype and operational phases. To take an experiment-based approach, we must first understand a system's architecture, structure, and behavior. Specifically, we need to know its tolerance for faults and failures, including its built-in detection and recovery mechanisms, and we need specific instruments and tools to inject faults, create failures or errors, and monitor their effects.

Failing by design.

PubMed

McGrath, Rita Gunther

2011-04-01

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

Independent Orbiter Assessment (IOA): Assessment of the EPD and C/remote manipulator system FMEA/CIL

NASA Technical Reports Server (NTRS)

Robinson, W. W.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Electrical Power Distribution and Control (EPD and C)/Remote Manipulator System (RMS) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA analysis of the EPD and C/RMS hardware initially generated 345 failure mode worksheets and identified 117 Potential Critical Items (PCIs) before starting the assessment process. These analysis results were compared to the proposed NASA Post 51-L baseline of 132 FMEAs and 66 CIL items.

Ovarian Failure and the Menopause

PubMed Central

McEwen, Donald C.

1965-01-01

Long-term replacement therapy for ovarian deficiency or failure, including the menopause, has been widely debated. In the past, treatment, if indicated, was reassurance, sedation, and occasionally short-term estrogen therapy. Today, because of recent advances in steroid synthesis, the consequences of ovarian deficiency may be preventable. Ovarian function and failure are discussed, the apparent physiological renaissance of nine patients documented, and the methods of treatment detailed. Thirty-three patients, who took part in this program during the past two years, have continued treatment with enthusiasm, without major problems in management, and have shown evidence of improved physical and emotional well-being. Further unbiased long-term research, possibly using modern computer technique, is needed to decide between traditional and replacement therapy for the menopause. ImagesFig. 1 PMID:14289145

Analysis of the STS-126 Flow Control Valve Structural-Acoustic Coupling Failure

NASA Technical Reports Server (NTRS)

Jones, Trevor M.; Larko, Jeffrey M.; McNelis, Mark E.

2010-01-01

During the Space Transportation System mission STS-126, one of the main engine's flow control valves incurred an unexpected failure. A section of the valve broke off during liftoff. It is theorized that an acoustic mode of the flowing fuel, coupled with a structural mode of the valve, causing a high cycle fatigue failure. This report documents the analysis efforts conducted in an attempt to verify this theory. Hand calculations, computational fluid dynamics, and finite element methods are all implemented and analyses are performed using steady-state methods in addition to transient analysis methods. The conclusion of the analyses is that there is a critical acoustic mode that aligns with a structural mode of the valve

Explanation and elaboration of the SQUIRE (Standards for Quality Improvement Reporting Excellence) Guidelines, V.2.0: examples of SQUIRE elements in the healthcare improvement literature

PubMed Central

Goodman, Daisy; Ogrinc, Greg; Davies, Louise; Baker, G Ross; Barnsteiner, Jane; Foster, Tina C; Gali, Kari; Hilden, Joanne; Horwitz, Leora; Kaplan, Heather C; Leis, Jerome; Matulis, John C; Michie, Susan; Miltner, Rebecca; Neily, Julia; Nelson, William A; Niedner, Matthew; Oliver, Brant; Rutman, Lori; Thomson, Richard

2016-01-01

Since its publication in 2008, SQUIRE (Standards for Quality Improvement Reporting Excellence) has contributed to the completeness and transparency of reporting of quality improvement work, providing guidance to authors and reviewers of reports on healthcare improvement work. In the interim, enormous growth has occurred in understanding factors that influence the success, and failure, of healthcare improvement efforts. Progress has been particularly strong in three areas: the understanding of the theoretical basis for improvement work; the impact of contextual factors on outcomes; and the development of methodologies for studying improvement work. Consequently, there is now a need to revise the original publication guidelines. To reflect the breadth of knowledge and experience in the field, we solicited input from a wide variety of authors, editors and improvement professionals during the guideline revision process. This Explanation and Elaboration document (E&E) is a companion to the revised SQUIRE guidelines, SQUIRE 2.0. The product of collaboration by an international and interprofessional group of authors, this document provides examples from the published literature, and an explanation of how each reflects the intent of a specific item in SQUIRE. The purpose of the guidelines is to assist authors in writing clearly, precisely and completely about systematic efforts to improve the quality, safety and value of healthcare services. Authors can explore the SQUIRE statement, this E&E and related documents in detail at http://www.squire-statement.org. PMID:27076505

Concept Development for Software Health Management

NASA Technical Reports Server (NTRS)

Riecks, Jung; Storm, Walter; Hollingsworth, Mark

2011-01-01

This report documents the work performed by Lockheed Martin Aeronautics (LM Aero) under NASA contract NNL06AA08B, delivery order NNL07AB06T. The Concept Development for Software Health Management (CDSHM) program was a NASA funded effort sponsored by the Integrated Vehicle Health Management Project, one of the four pillars of the NASA Aviation Safety Program. The CD-SHM program focused on defining a structured approach to software health management (SHM) through the development of a comprehensive failure taxonomy that is used to characterize the fundamental failure modes of safety-critical software.

Manned space flight nuclear system safety. Volume 3: Reactor system preliminary nuclear safety analysis. Part 2A: Accident model document, appendix

NASA Technical Reports Server (NTRS)

1972-01-01

The detailed abort sequence trees for the reference zirconium hydride (ZrH) reactor power module that have been generated for each phase of the reference Space Base program mission are presented. The trees are graphical representations of causal sequences. Each tree begins with the phase identification and the dichotomy between success and failure. The success branch shows the mission phase objective as being achieved. The failure branch is subdivided, as conditions require, into various primary initiating abort conditions.

How and why of orthodontic bond failures: An in vivo study

PubMed Central

Vijayakumar, R. K.; Jagadeep, Raju; Ahamed, Fayyaz; Kanna, Aprose; Suresh, K.

2014-01-01

Introduction: The bonding of orthodontic brackets and their failure rates by both direct and in-direct procedures are well-documented in orthodontic literature. Over the years different adhesive materials and various indirect bonding transfer procedures have been compared and evaluated for bond failure rates. The aim of our study is to highlight the use of a simple, inexpensive and ease of manipulation of a single thermo-plastic transfer tray and the use the of a single light cure adhesive to evaluate the bond failure rates in clinical situations. Materials and Methods: A total of 30 patients were randomly divided into two groups (Group A and Group B). A split-mouth study design was used, for, both the groups so that they were distributed equally with-out bias. After initial prophylaxis, both the procedures were done as per manufactures instructions. All patients were initially motivated and reviewed for bond failures rates for 6 months. Results: Bond failure rates were assessed for over-all direct and indirect procedures, anterior and posterior arches, and for individual tooth. Z-test was used for statistically analyzing, the normal distribution of the sample in a spilt mouth study. The results of the two groups were compared and P value was calculated using Z-proportion test to assess the significance of the bond failure. Conclusion: Over-all bond failure was more for direct bonding. Anterior bracket failure was more in-direct bonding than indirect procedure, which showed more posterior bracket failures. In individual tooth bond failure, mandibular incisor, and premolar brackets showed more failure, followed by maxillary premolars and canines. PMID:25210392

Standardization Documents

DTIC Science & Technology

2011-08-01

Specifications and Standards; Guide Specifications; CIDs; and NGSs . Learn. Perform. Succeed. STANDARDIZATION DOCUMENTS Federal Specifications Commercial...national or international standardization document developed by a private sector association, organization, or technical society that plans ...Maintain lessons learned • Examples: Guidance for application of a technology; Lists of options Learn. Perform. Succeed. DEFENSE HANDBOOK

Heart Failure with Preserved Ejection Fraction: Molecular Pathways of the Aging Myocardium

PubMed Central

Loffredo, Francesco S.; Nikolova, Andriana P.; Pancoast, James R.; Lee, Richard T.

2014-01-01

Age-related diastolic dysfunction is a major factor in the epidemic of heart failure. In patients hospitalized with heart failure, diastolic heart failure is now as common as systolic heart failure. We now have many successful treatments for HFrEF, while specific treatment options for HFpEF patients remain elusive. The lack of treatments for HFpEF reflects our very incomplete understanding of this constellation of diseases. There are many pathophysiological factors in HFpEF, but aging appears to play an important role. Here we propose that aging of the myocardium is itself a specific pathophysiological process. New insights into the aging heart, including hormonal controls and specific molecular pathways such as microRNAs, are pointing to myocardial aging as a potentially reversible process. While the overall process of aging remains mysterious, understanding the molecular pathways of myocardial aging has never been more important. Unraveling these pathways could lead to new therapies for the enormous and growing problem of HFpEF. PMID:24951760

Development, Testing, and Failure Mechanisms of a Replicative Ice Phase Change Material Heat Exchanger

NASA Technical Reports Server (NTRS)

Leimkuehler, Thomas O.; Hansen, Scott; Stephan, Ryan A.

2009-01-01

Phase change materials (PCM) may be useful for thermal control systems that involve cyclical heat loads or cyclical thermal environments such as Low Earth Orbit (LEO) and Low Lunar Orbit (LLO). Thermal energy can be stored in the PCM during peak heat loads or in adverse thermal environments. The stored thermal energy can then be released later during minimum heat loads or in more favorable thermal environments. One advantage that PCM s have over evaporators in this scenario is that they do not use a consumable. Wax PCM units have been baselined for the Orion thermal control system and also provide risk mitigation for the Altair Lander. However, the use of water as a PCM has the potential for significant mass reduction since the latent heat of formation of water is approximately 70% greater than that of wax. One of the potential drawbacks of using ice as a PCM is its potential to rupture its container as water expands upon freezing. In order to develop a space qualified ice PCM heat exchanger, failure mechanisms must first be understood. Therefore, a methodical experimental investigation has been undertaken to demonstrate and document specific failure mechanisms due to ice expansion in the PCM. An ice PCM heat exchanger that replicates the thermal energy storage capacity of an existing wax PCM unit was fabricated and tested. Additionally, methods for controlling void location in order to reduce the risk of damage due to ice expansion are investigated. This paper presents the results to date of this investigation.

Development, Testing, and Failure Mechanisms of a Replicative Ice Phase Change Material Heat Exchanger

NASA Technical Reports Server (NTRS)

Leimkuehler, Thomas O.; Hansen, Scott; Stephan, Ryan A.

2010-01-01

Phase change materials (PCM) may be useful for thermal control systems that involve cyclical heat loads or cyclical thermal environments such as Low Earth Orbit (LEO) and Low Lunar Orbit (LLO). Thermal energy can be stored in the PCM during peak heat loads or in adverse thermal environments. The stored thermal energy can then be released later during minimum heat loads or in more favorable thermal environments. One advantage that PCM's have over evaporators in this scenario is that they do not use a consumable. Wax PCM units have been baselined for the Orion thermal control system and also provide risk mitigation for the Altair Lander. However, the use of water as a PCM has the potential for significant mass reduction since the latent heat of formation of water is approximately 70% greater than that of wax. One of the potential drawbacks of using ice as a PCM is its potential to rupture its container as water expands upon freezing. In order to develop a space qualified ice PCM heat exchanger, failure mechanisms must first be understood. Therefore, a methodical experimental investigation has been undertaken to demonstrate and document specific failure mechanisms due to ice expansion in the PCM. An ice PCM heat exchanger that replicates the thermal energy storage capacity of an existing wax PCM unit was fabricated and tested. Additionally, methods for controlling void location in order to reduce the risk of damage due to ice expansion are investigated. This paper presents the results to date of this investigation. Nomenclature

Positive and negative volume-outcome relationships in the geriatric trauma population.

PubMed

Matsushima, Kazuhide; Schaefer, Eric W; Won, Eugene J; Armen, Scott B; Indeck, Matthew C; Soybel, David I

2014-04-01

In trauma populations, improvements in outcome are documented in institutions with higher case volumes. However, it is not known whether improved outcomes are attributable to the case volume within specific higher-risk groups, such as the elderly, or to the case volume among all trauma patients treated by an institution. To test the hypothesis that outcomes of trauma care for geriatric patients are affected differently by the volume of geriatric cases and nongeriatric cases of an institution. This retrospective cohort study using a statewide trauma registry was set in state-designated levels 1 and 2 trauma centers in Pennsylvania. It included 39 431 eligible geriatric trauma patients (aged >65 years) in the Pennsylvania Trauma Outcomes Study. In-hospital mortality, major complications, and mortality after major complications (failure to rescue). Between 2001 and 2010, 39 431 geriatric trauma patients and 105 046 nongeriatric patients were captured in a review of outcomes in 20 state-designated levels 1 and 2 trauma centers. Larger volumes of geriatric trauma patients were significantly associated with lower odds of in-hospital mortality, major complications, and failure to rescue. In contrast, larger nongeriatric trauma volumes were significantly associated with higher odds of major complications in geriatric patients. Higher rates of in-hospital mortality, major complications, and failure to rescue were associated with lower volumes of geriatric trauma care and paradoxically with higher volumes of trauma care for younger patients. These findings offer the possibility that outcomes might be improved with differentiated pathways of care for geriatric trauma patients.

Losing the beat: deficits in temporal coordination.

PubMed

Palmer, Caroline; Lidji, Pascale; Peretz, Isabelle

2014-12-19

Tapping or clapping to an auditory beat, an easy task for most individuals, reveals precise temporal synchronization with auditory patterns such as music, even in the presence of temporal fluctuations. Most models of beat-tracking rely on the theoretical concept of pulse: a perceived regular beat generated by an internal oscillation that forms the foundation of entrainment abilities. Although tapping to the beat is a natural sensorimotor activity for most individuals, not everyone can track an auditory beat. Recently, the case of Mathieu was documented (Phillips-Silver et al. 2011 Neuropsychologia 49, 961-969. (doi:10.1016/j.neuropsychologia.2011.02.002)). Mathieu presented himself as having difficulty following a beat and exhibited synchronization failures. We examined beat-tracking in normal control participants, Mathieu, and a second beat-deaf individual, who tapped with an auditory metronome in which unpredictable perturbations were introduced to disrupt entrainment. Both beat-deaf cases exhibited failures in error correction in response to the perturbation task while exhibiting normal spontaneous motor tempi (in the absence of an auditory stimulus), supporting a deficit specific to perception-action coupling. A damped harmonic oscillator model was applied to the temporal adaptation responses; the model's parameters of relaxation time and endogenous frequency accounted for differences between the beat-deaf cases as well as the control group individuals.

Losing the beat: deficits in temporal coordination

PubMed Central

Palmer, Caroline; Lidji, Pascale; Peretz, Isabelle

2014-01-01

Tapping or clapping to an auditory beat, an easy task for most individuals, reveals precise temporal synchronization with auditory patterns such as music, even in the presence of temporal fluctuations. Most models of beat-tracking rely on the theoretical concept of pulse: a perceived regular beat generated by an internal oscillation that forms the foundation of entrainment abilities. Although tapping to the beat is a natural sensorimotor activity for most individuals, not everyone can track an auditory beat. Recently, the case of Mathieu was documented (Phillips-Silver et al. 2011 Neuropsychologia 49, 961–969. (doi:10.1016/j.neuropsychologia.2011.02.002)). Mathieu presented himself as having difficulty following a beat and exhibited synchronization failures. We examined beat-tracking in normal control participants, Mathieu, and a second beat-deaf individual, who tapped with an auditory metronome in which unpredictable perturbations were introduced to disrupt entrainment. Both beat-deaf cases exhibited failures in error correction in response to the perturbation task while exhibiting normal spontaneous motor tempi (in the absence of an auditory stimulus), supporting a deficit specific to perception–action coupling. A damped harmonic oscillator model was applied to the temporal adaptation responses; the model's parameters of relaxation time and endogenous frequency accounted for differences between the beat-deaf cases as well as the control group individuals. PMID:25385783

ANMCO/ELAS/SIBioC Consensus Document: biomarkers in heart failure

PubMed Central

Gulizia, Michele Massimo; Clerico, Aldo; Di Tano, Giuseppe; Emdin, Michele; Feola, Mauro; Iacoviello, Massimo; Latini, Roberto; Mortara, Andrea; Valle, Roberto; Misuraca, Gianfranco; Passino, Claudio; Masson, Serge; Aimo, Alberto; Ciaccio, Marcello; Migliardi, Marco

2017-01-01

Abstract Biomarkers have dramatically impacted the way heart failure (HF) patients are evaluated and managed. A biomarker is a characteristic that is objectively measured and evaluated as an indicator of normal biological or pathogenic processes, or pharmacological responses to a therapeutic intervention. Natriuretic peptides [B-type natriuretic peptide (BNP) and N-terminal proBNP] are the gold standard biomarkers in determining the diagnosis and prognosis of HF, and a natriuretic peptide-guided HF management looks promising. In the last few years, an array of additional biomarkers has emerged, each reflecting different pathophysiological processes in the development and progression of HF: myocardial insult, inflammation, fibrosis, and remodelling, but their role in the clinical care of the patient is still partially defined and more studies are needed before to be well validated. Moreover, several new biomarkers have the potential to identify patients with early renal dysfunction and appear to have promise to help the management cardio-renal syndrome. With different biomarkers reflecting HF presence, the various pathways involved in its progression, as well as identifying unique treatment options for HF management, a closer cardiologist-laboratory link, with a multi-biomarker approach to the HF patient, is not far ahead, allowing the unique opportunity for specifically tailoring care to the individual pathological phenotype. PMID:28751838

Arthroscopic anterior cruciate ligament distal graft rupture: a method of salvage.

PubMed

Larrain, Mario V; Mauas, David M; Collazo, Cristian C; Rivarola, Horacio F

2004-09-01

We describe a rare case of anterior cruciate ligament (ACL) distal graft rupture in a high-demand rugby player. Fifteen months before this episode, he underwent an ACL reconstruction (autologous patellar tendon graft surgery) plus posterolateral reconstruction with direct suture and fascia lata augmentation. Radiographs revealed correct positioning of tunnels and fixation screws. Magnetic resonance imaging showed that the graft rupture was close to the tibial bone block and presented a signal compatible to the optimal graft incorporation. Surgery recording and clinical records were reviewed. No failures were found. After careful evaluation we concluded that the primary cause of failure was trauma. Based on these findings a salvage surgery technique was performed. Return to sport activities was allowed after four months when sufficient strength and range of motion had returned. Recent follow up (2 years 8 months postoperative) has shown an excellent result with a Lysholm score of 100, International Knee Documentation Committee (IKDC) score of 100, and a KT-1000 arthrometer reading of between 0 and 5 mm. The athlete has returned to his previous professional level. We believe this simple, specific, nonaggressive, and anatomic reconstructive technique may be used in the case of avulsion or distal detachment caused only by trauma and with a graft that is likely to heal.

Experimental Investigation of Ice Phase Change Material Heat Exchangers

NASA Technical Reports Server (NTRS)

Leimkuehler, Thomas O.; Stephan, Ryan A.

2011-01-01

Phase change materials (PCM) may be useful for spacecraft thermal control systems that involve cyclical heat loads or cyclical thermal environments. Thermal energy can be stored in the PCM during peak heat loads or in adverse thermal environments. The stored thermal energy can then be released later during minimum heat loads or in more favorable thermal environments. This can result in a decreased turndown ratio for the radiator and a reduced system mass. The use of water as a PCM rather than the more traditional paraffin wax has the potential for significant mass reduction since the latent heat of formation of water is approximately 70% greater than that of wax. One of the potential drawbacks of using ice as a PCM is its potential to rupture its container as water expands upon freezing. In order to develop a space qualified ice PCM heat exchanger, failure mechanisms must first be understood. Therefore, a methodical experimental investigation has been undertaken to demonstrate and document specific failure mechanisms due to ice expansion in the PCM. A number of ice PCM heat exchangers were fabricated and tested. Additionally, methods for controlling void location in order to reduce the risk of damage due to ice expansion were investigated. This paper presents an overview of the results of this investigation from the past three years.

Experimental Investigation of Ice Phase Change Material Heat Exchangers

NASA Technical Reports Server (NTRS)

Leimkuehler, Thomas O.; Stephan, Ryan A.

2012-01-01

Phase change materials (PCM) may be useful for spacecraft thermal control systems that involve cyclical heat loads or cyclical thermal environments. Thermal energy can be stored in the PCM during peak heat loads or in adverse thermal environments. The stored thermal energy can then be released later during minimum heat loads or in more favorable thermal environments. This can result in a decreased turndown ratio for the radiator and a reduced system mass. The use of water as a PCM rather than the more traditional paraffin wax has the potential for significant mass reduction since the latent heat of formation of water is approximately 70% greater than that of wax. One of the potential drawbacks of using ice as a PCM is its potential to rupture its container as water expands upon freezing. In order to develop a space qualified ice PCM heat exchanger, failure mechanisms must first be understood. Therefore, a methodical experimental investigation has been undertaken to demonstrate and document specific failure mechanisms due to ice expansion in the PCM. A number of ice PCM heat exchangers were fabricated and tested. Additionally, methods for controlling void location in order to reduce the risk of damage due to ice expansion were investigated. This paper presents an overview of the results of this investigation from the past three years.

Undertreatment of hyperlipidemia in patients with coronary artery disease and heart failure.

PubMed

Sueta, Carla A; Massing, Mark W; Chowdhury, Mridul; Biggs, David P; Simpson, Ross J

2003-02-01

Coronary artery disease patients with heart failure (CAD+HF) are at high risk for cardiovascular events. We examined the frequency of lipid assessment and prescription of lipid-lowering agents in outpatients with combined CAD+HF compared with patients with CAD alone. We analyzed an administrative data set from the Quality Assurance Program II, a Merck & Co., Inc., sponsored national retrospective chart audit of 41,487 CAD patients seen at 296 ambulatory medical practices. About 34% of these patients had CAD+HF. Documentation of low-density lipoprotein (LDL) cholesterol was significantly lower in patients with CAD+HF (53%) compared with those with CAD alone (69%). Lipid-lowering drugs were prescribed in only 36% of patients with CAD+HF, compared with 52% of patients with CAD alone. Lipid levels alone did not justify this disparity. Patients with documented LDL cholesterol values were 4 times more likely to receive a prescription for a lipid-lowering medication than those without recorded values. Other predictors of lipid-lowering prescription included: younger age, history of myocardial infarction, revascularization, care by a cardiologist, and geographic region. Patients with CAD, HF, and advanced age simultaneously experience among the highest risk and the lowest lipid-lowering treatment rates. Strategies to increase LDL testing and aggressively treat patients with heart failure and CAD are warranted.

46 CFR 502.210 - Refusal to comply with orders to answer or produce documents; sanctions; enforcement.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., inferences will be drawn adverse to the person or party refusing to obey such order; (3) An order striking... failure to comply. A private party shall advise the Commission five (5) days (excluding Saturdays, Sundays...

46 CFR 502.210 - Refusal to comply with orders to answer or produce documents; sanctions; enforcement.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., inferences will be drawn adverse to the person or party refusing to obey such order; (3) An order striking... or failure to comply. A private party shall advise the Commission five (5) days (excluding Saturdays...

Evaluation of design methods to determine scour depths for bridge structures.

DOT National Transportation Integrated Search

2013-03-01

Scour of bridge foundations is the most common cause of bridge failures. The overall goal of this project was to evaluate the applicability of the existing Hydraulic Engineering Circular (HEC-18) documents method to Louisiana bridges that are mostly ...

19 CFR 10.515 - Effect of noncompliance; failure to provide documentation regarding third country transportation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... FREE, SUBJECT TO A REDUCED RATE, ETC. United States-Singapore Free Trade Agreement Import Requirements... Singapore or the United States, and the importer of the good does not provide, at the request of the port...

Brain micro-inflammation at specific vessels dysregulates organ-homeostasis via the activation of a new neural circuit

PubMed Central

Arima, Yasunobu; Ohki, Takuto; Nishikawa, Naoki; Higuchi, Kotaro; Ota, Mitsutoshi; Tanaka, Yuki; Nio-Kobayashi, Junko; Elfeky, Mohamed; Sakai, Ryota; Mori, Yuki; Kawamoto, Tadafumi; Stofkova, Andrea; Sakashita, Yukihiro; Morimoto, Yuji; Kuwatani, Masaki; Iwanaga, Toshihiko; Yoshioka, Yoshichika; Sakamoto, Naoya; Yoshimura, Akihiko; Takiguchi, Mitsuyoshi; Sakoda, Saburo; Prinz, Marco; Kamimura, Daisuke; Murakami, Masaaki

2017-01-01

Impact of stress on diseases including gastrointestinal failure is well-known, but molecular mechanism is not understood. Here we show underlying molecular mechanism using EAE mice. Under stress conditions, EAE caused severe gastrointestinal failure with high-mortality. Mechanistically, autoreactive-pathogenic CD4+ T cells accumulated at specific vessels of boundary area of third-ventricle, thalamus, and dentate-gyrus to establish brain micro-inflammation via stress-gateway reflex. Importantly, induction of brain micro-inflammation at specific vessels by cytokine injection was sufficient to establish fatal gastrointestinal failure. Resulting micro-inflammation activated new neural pathway including neurons in paraventricular-nucleus, dorsomedial-nucleus-of-hypothalamus, and also vagal neurons to cause fatal gastrointestinal failure. Suppression of the brain micro-inflammation or blockage of these neural pathways inhibited the gastrointestinal failure. These results demonstrate direct link between brain micro-inflammation and fatal gastrointestinal disease via establishment of a new neural pathway under stress. They further suggest that brain micro-inflammation around specific vessels could be switch to activate new neural pathway(s) to regulate organ homeostasis. DOI: http://dx.doi.org/10.7554/eLife.25517.001 PMID:28809157

Quality Evaluation of Nursing Observation Based on a Survey of Nursing Documents Using NursingNAVI.

PubMed

Tsuru, Satoko; Omori, Miho; Inoue, Manami; Wako, Fumiko

2016-01-01

We have identified three foci of the nursing observation and nursing action respectively. Using these frameworks, we have developed the structured knowledge model for a number of diseases and medical interventions. We developed this structure based NursingNAVI^® contents collaborated with some quality centred hospitals. Authors analysed the nursing care documentations of post-gastrectomy patients in light of the standardized nursing care plan in the "NursingNAVI^®" developed by ourselves and revealed the "failure to observe" and "failure to document", which leaded to the volatility of the patients' data, conditions and some situation. This phenomenon should have been avoided if nurses had employed a standardized nursing care plan. So, we developed thinking process support system for planning, delivering, recording and evaluating in daily nursing using NursingNAVI^® contents. It is important to identify the problem of the volatility of the patients' data, conditions and some situation. We developed a survey tool of nursing documents using NursingNAVI^® Content for quality evaluation of nursing observation. We recommended some hospitals to use this survey tool. Fifteen hospitals participated the survey using this tool. It is estimated that the volatilizing situation. A hospital which don't participate this survey, knew the result. So the hospital decided to use NursingNAVI^® contents in HIS. It was suggested that the system has availability for nursing OJT and time reduction of planning and recording without volatilizing situation.

Bone Marrow Failure Secondary to Cytokinesis Failure

DTIC Science & Technology

2015-12-01

SUPPLEMENTARY NOTES 14. ABSTRACT Fanconi anemia (FA) is a human genetic disease characterized by a progressive bone marrow failure and heightened...Fanconi anemia (FA) is the most commonly inherited bone marrow failure syndrome. FA patients develop bone marrow failure during the first decade of...experiments proposed in specific aims 1- 3 (Tasks 1-3). Task 1: To determine whether HSCs from Fanconi anemia mouse models have increased cytokinesis

Capturing a failure of an ASIC in-situ, using infrared radiometry and image processing software

NASA Technical Reports Server (NTRS)

Ruiz, Ronald P.

2003-01-01

Failures in electronic devices can sometimes be tricky to locate-especially if they are buried inside radiation-shielded containers designed to work in outer space. Such was the case with a malfunctioning ASIC (Application Specific Integrated Circuit) that was drawing excessive power at a specific temperature during temperature cycle testing. To analyze the failure, infrared radiometry (thermography) was used in combination with image processing software to locate precisely where the power was being dissipated at the moment the failure took place. The IR imaging software was used to make the image of the target and background, appear as unity. As testing proceeded and the failure mode was reached, temperature changes revealed the precise location of the fault. The results gave the design engineers the information they needed to fix the problem. This paper describes the techniques and equipment used to accomplish this failure analysis.

Attributional processes in the learned helplessness paradigm: behavioral effects of global attributions.

PubMed

Mikulincer, M

1986-12-01

Following the learned helplessness paradigm, I assessed in this study the effects of global and specific attributions for failure on the generalization of performance deficits in a dissimilar situation. Helplessness training consisted of experience with noncontingent failures on four cognitive discrimination problems attributed to either global or specific causes. Experiment 1 found that performance in a dissimilar situation was impaired following exposure to globally attributed failure. Experiment 2 examined the behavioral effects of the interaction between stable and global attributions of failure. Exposure to unsolvable problems resulted in reduced performance in a dissimilar situation only when failure was attributed to global and stable causes. Finally, Experiment 3 found that learned helplessness deficits were a product of the interaction of global and internal attribution. Performance deficits following unsolvable problems were recorded when failure was attributed to global and internal causes. Results were discussed in terms of the reformulated learned helplessness model.

Geological hazards associated with intense rain and flooding in Natal

NASA Astrophysics Data System (ADS)

Thomas, M. A.; van Schalkwyk, A.

1993-02-01

The combination of rugged topography and climate predisposes the province of Natal to severe floods. Information available since 1856 shows that bridge and slope failures have been recorded in twenty out of twenty-five flood episodes. Bridge failures are caused mostly by geological factors. The mechanism of failure can be classified broadly into foundation failures and changes of river course. Scour and debris build-up have led to failures of foundations located in rock and alluvial sediments. In preparing and replacing bridges the aims have been to increase the area of waterway, increase foundation depths to reach more competent strata and lay protection along banks and abutments to counteract scour. Historically, slope failures have not been well documented but following the 1987/88 storms 223 slope failures were recorded. The classification of the failures allowed the mechanisms of failure to be ascertained, and general design considerations to be reviewed. In areas adjacent to the Drakensberg Mountains slope failures are part of a natural erosion cycle which may be accelerated in periods of heavy rain. Throughout Natal, hummocky ground adjacent to dolerite intrusions reveals the on-going history of failure caused by water ingress and the generation of high pore water pressures on the slip planes. Classic flows occurred throughout the Greater Durban area where residual sandy soils of the Natal Group sandstone became supersaturated. Slumping was common on steep terrain underlain by granite-gneiss in the Kwa-Zulu area. Shales of the Pietermaritzburg Formation are notoriously unstable, yet few failures occurred during the summer storms of 1987/88. Inadequate drainage was responsible for many failures, this was particularly so along the railways.

Software Assists in Responding to Anomalous Conditions

NASA Technical Reports Server (NTRS)

James, Mark; Kronbert, F.; Weiner, A.; Morgan, T.; Stroozas, B.; Girouard, F.; Hopkins, A.; Wong, L.; Kneubuhl, J.; Malina, R.

2004-01-01

Fault Induced Document Retrieval Officer (FIDO) is a computer program that reduces the need for a large and costly team of engineers and/or technicians to monitor the state of a spacecraft and associated ground systems and respond to anomalies. FIDO includes artificial-intelligence components that imitate the reasoning of human experts with reference to a knowledge base of rules that represent failure modes and to a database of engineering documentation. These components act together to give an unskilled operator instantaneous expert assistance and access to information that can enable resolution of most anomalies, without the need for highly paid experts. FIDO provides a system state summary (a configurable engineering summary) and documentation for diagnosis of a potentially failing component that might have caused a given error message or anomaly. FIDO also enables high-level browsing of documentation by use of an interface indexed to the particular error message. The collection of available documents includes information on operations and associated procedures, engineering problem reports, documentation of components, and engineering drawings. FIDO also affords a capability for combining information on the state of ground systems with detailed, hierarchically-organized, hypertext- enabled documentation.

Probability of Accurate Heart Failure Diagnosis and the Implications for Hospital Readmissions.

PubMed

Carey, Sandra A; Bass, Kyle; Saracino, Giovanna; East, Cara A; Felius, Joost; Grayburn, Paul A; Vallabhan, Ravi C; Hall, Shelley A

2017-04-01

Heart failure (HF) is a complex syndrome with inherent diagnostic challenges. We studied the scope of possibly inaccurately documented HF in a large health care system among patients assigned a primary diagnosis of HF at discharge. Through a retrospective record review and a classification schema developed from published guidelines, we assessed the probability of the documented HF diagnosis being accurate and determined factors associated with HF-related and non-HF-related hospital readmissions. An arbitration committee of 3 experts reviewed a subset of records to corroborate the results. We assigned a low probability of accurate diagnosis to 133 (19%) of the 712 patients. A subset of patients were also reviewed by an expert panel, which concluded that 13% to 35% of patients probably did not have HF (inter-rater agreement, kappa = 0.35). Low-probability HF was predictive of being readmitted more frequently for non-HF causes (p = 0.018), as well as documented arrhythmias (p = 0.023), and age >60 years (p = 0.006). Documented sleep apnea (p = 0.035), percutaneous coronary intervention (p = 0.006), non-white race (p = 0.047), and B-type natriuretic peptide >400 pg/ml (p = 0.007) were determined to be predictive of HF readmissions in this cohort. In conclusion, approximately 1 in 5 patients documented to have HF were found to have a low probability of actually having it. Moreover, the determination of low-probability HF was twice as likely to result in readmission for non-HF causes and, thus, should be considered a determinant for all-cause readmissions in this population. Copyright © 2017 Elsevier Inc. All rights reserved.

Implementation of a scalable, web-based, automated clinical decision support risk-prediction tool for chronic kidney disease using C-CDA and application programming interfaces.

PubMed

Samal, Lipika; D'Amore, John D; Bates, David W; Wright, Adam

2017-11-01

Clinical decision support tools for risk prediction are readily available, but typically require workflow interruptions and manual data entry so are rarely used. Due to new data interoperability standards for electronic health records (EHRs), other options are available. As a clinical case study, we sought to build a scalable, web-based system that would automate calculation of kidney failure risk and display clinical decision support to users in primary care practices. We developed a single-page application, web server, database, and application programming interface to calculate and display kidney failure risk. Data were extracted from the EHR using the Consolidated Clinical Document Architecture interoperability standard for Continuity of Care Documents (CCDs). EHR users were presented with a noninterruptive alert on the patient's summary screen and a hyperlink to details and recommendations provided through a web application. Clinic schedules and CCDs were retrieved using existing application programming interfaces to the EHR, and we provided a clinical decision support hyperlink to the EHR as a service. We debugged a series of terminology and technical issues. The application was validated with data from 255 patients and subsequently deployed to 10 primary care clinics where, over the course of 1 year, 569 533 CCD documents were processed. We validated the use of interoperable documents and open-source components to develop a low-cost tool for automated clinical decision support. Since Consolidated Clinical Document Architecture-based data extraction extends to any certified EHR, this demonstrates a successful modular approach to clinical decision support. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association.

Data expansion: the potential of grey literature for understanding floods

NASA Astrophysics Data System (ADS)

Uhlemann, S.; Bertelmann, R.; Merz, B.

2012-09-01

Sophisticated methods have been developed and become standard in analysing floods as well as for assessing the flood risk. However, increasingly critique of the current standards and scientific practice can be found both in the flood hydrology community as well as in the risk community who argue that the considerable amount of information already available on natural disasters has not been adequately deployed and brought to effective use. We describe this phenomenon as a failure to synthesize knowledge that results from barriers and ignorance in awareness, use and management of the entire spectrum of relevant content, that is, data, information and knowledge. In this paper we argue that the scientific community in flood risk research ignores event specific analysis and documentations as another source of data. We present results from a systematic search that includes an intensive study on sources and ways of information dissemination of flood relevant publications. We obtain 183 documents that contain information on the sources, pathways, receptors and/or consequences for any of the 40 strongest trans-basin floods in Germany in the period 1952-2002. This study therefore provides the most comprehensive meta-data collection of flood documentations for the considered geographical space and period. 87.5% of all events have been documented and especially the most severe floods have received extensive coverage. Only 30% of the material has been produced in the scientific/academic environment and the majority of all documents (about 80%) can be considered grey literature. Therefore, ignoring grey sources in flood research also means ignoring the largest part of knowledge available on single flood events (in Germany). Further, the results of this study underpin the rapid changes in information dissemination of flood event literature over the last decade. We discuss the options and obstacles of incorporating this data in the knowledge building process in the light of the current technological developments and international, interdisciplinary debates for data curation.

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

PubMed

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

2006-02-01

Implantable cardioverter-defibrillator (ICD) lead failures often present as inappropriate shock therapy. An algorithm that can reliably discriminate between ventricular tachyarrhythmias and noise due to lead failure may prevent patient discomfort and anxiety and avoid device-induced proarrhythmia by preventing inappropriate ICD shocks. The goal of this analysis was to test an ICD tachycardia detection algorithm that differentiates noise due to lead failure from ventricular tachyarrhythmias. We tested an algorithm that uses a measure of the ventricular intracardiac electrogram baseline to discriminate the sinus rhythm isoelectric line from the right ventricular coil-can (i.e., far-field) electrogram during oversensing of noise caused by a lead failure. The baseline measure was defined as the product of the sum (mV) and standard deviation (mV) of the voltage samples for a 188-ms window centered on each sensed electrogram. If the minimum baseline measure of the last 12 beats was <0.35 mV-mV, then the detected rhythm was considered noise due to a lead failure. The first ICD-detected episode of lead failure and inappropriate detection from 24 ICD patients with a pace/sense lead failure and all ventricular arrhythmias from 56 ICD patients without a lead failure were selected. The stored data were analyzed to determine the sensitivity and specificity of the algorithm to detect lead failures. The minimum baseline measure for the 24 lead failure episodes (0.28 +/- 0.34 mV-mV) was smaller than the 135 ventricular tachycardia (40.8 +/- 43.0 mV-mV, P <.0001) and 55 ventricular fibrillation episodes (19.1 +/- 22.8 mV-mV, P <.05). A minimum baseline <0.35 mV-mV threshold had a sensitivity of 83% (20/24) with a 100% (190/190) specificity. A baseline measure of the far-field electrogram had a high sensitivity and specificity to detect lead failure noise compared with ventricular tachycardia or fibrillation.

75 FR 75705 - Notice of Availability of the Models for Plant-Specific Adoption of Technical Specifications Task...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-06

..., Rockville, Maryland. NRC's Agencywide Documents Access and Management System (ADAMS): Publicly available documents created or received at the NRC are available electronically at the NRC's Electronic Reading Room... Specifications End States (BAW- 2441).'' TSTF-431, Revision 3, is available in the Agencywide Documents Access...

Resource Document for the Design of Electronic Instrument Approach Procedure Displays

DOT National Transportation Integrated Search

1995-03-01

Instrument approach procedure (IAP) charts play a large role in contributing to the success or failure of approaches and : landings. Paper IAP charts have been criticized for excessive clutter, for text sizes that are too small to read, and : for ina...

20 CFR 633.315 - Replacement, corrective action, termination.

Code of Federal Regulations, 2010 CFR

2010-04-01

...; documented information from the Inspector General or gained through incident reports of poor performance... whose performance has been found deficient, but not sufficient to warrant termination for cause or... successive periods within 30 days after they are due; (ii) Failure to submit required quarterly performance...

45 CFR 95.610 - Submission of advance planning documents.

Code of Federal Regulations, 2011 CFR

2011-10-01

... system failure and disaster recovery/business continuity procedures available or to be implemented; and... generally applies to large statewide system developments and/or major hardware acquisitions. States with large, independent counties requesting funding at the regular match rate for county systems are strongly...

13 CFR 315.10 - Loss of certification benefits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Loss of certification benefits. 315.10 Section 315.10 Business Credit and Assistance ECONOMIC DEVELOPMENT ADMINISTRATION, DEPARTMENT... expiration; (b) Failure to submit documentation necessary to start implementation or modify its request for...

Questions and Answers Regarding the 1997 State Plan Requirements for Hospital, Medical, and Infectious Waste Incinerators (HMIWI)

EPA Pesticide Factsheets

This November 1997 document contains questions and answers on the state plan requirements for HMIWI regulations. The questions cover topics such as re-opening existing sources, timelines for submission, consequences for failure to submit, and more.

The Rights of Homeless Students.

ERIC Educational Resources Information Center

Strong, Penny

This booklet presents information concerning homelessness and the education of homeless children nationwide and in Illinois. Estimates of the number of homeless children vary widely. Reasons for homeless children's failure to attend school include school residency requirements, delays in transfer of documents, and lack of transportation. The…

22 CFR 42.83 - Termination of registration.

Code of Federal Regulations, 2012 CFR

2012-04-01

....83 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF IMMIGRANTS UNDER THE... Termination of registration. (a) Termination following failure of applicant to apply for visa. In accordance with INA 203(g), an alien's registration for an immigrant visa shall be terminated if, within one year...

22 CFR 42.83 - Termination of registration.

Code of Federal Regulations, 2011 CFR

2011-04-01

....83 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF IMMIGRANTS UNDER THE... Termination of registration. (a) Termination following failure of applicant to apply for visa. In accordance with INA 203(g), an alien's registration for an immigrant visa shall be terminated if, within one year...

22 CFR 42.83 - Termination of registration.

Code of Federal Regulations, 2010 CFR

2010-04-01

....83 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF IMMIGRANTS UNDER THE... Termination of registration. (a) Termination following failure of applicant to apply for visa. In accordance with INA 203(g), an alien's registration for an immigrant visa shall be terminated if, within one year...

22 CFR 42.83 - Termination of registration.

Code of Federal Regulations, 2014 CFR

2014-04-01

....83 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF IMMIGRANTS UNDER THE... Termination of registration. (a) Termination following failure of applicant to apply for visa. In accordance with INA 203(g), an alien's registration for an immigrant visa shall be terminated if, within one year...

22 CFR 42.83 - Termination of registration.

Code of Federal Regulations, 2013 CFR

2013-04-01

....83 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF IMMIGRANTS UNDER THE... Termination of registration. (a) Termination following failure of applicant to apply for visa. In accordance with INA 203(g), an alien's registration for an immigrant visa shall be terminated if, within one year...

15 CFR 700.71 - Audits and investigations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... interviews and a systems evaluation to detect problems or failures in the implementation of this regulation... Commerce to interview the person's employees or agents, to inspect books, records, documents, other... them, and to inspect a person's property when such interviews and inspections are necessary or...

Common Problems of Documentary Information Transfer, Storage and Retrieval in Industrial Organizations.

ERIC Educational Resources Information Center

Vickers, P. H.

1983-01-01

Examination of management information systems of three manufacturing firms highlights principal characteristics, document types and functions, main information flows, storage and retrieval systems, and common problems (corporate memory failure, records management, management information systems, general management). A literature review and…

Problem Solving for Volatilizing Situation in Nursing: Developing Thinking Process Supporting System using NursingNAVI® Contents.

PubMed

Tsuru, Satoko; Wako, Fumiko; Omori, Miho; Sudo, Kumiko

2015-01-01

We have identified three foci of the nursing observation and nursing action respectively. Using these frameworks, we have developed the structured knowledge model for a number of diseases and medical interventions. We developed this structure based NursingNAVI® contents collaborated with some quality centered hospitals. Authors analysed the nursing care documentations of post-gastrectomy patients in light of the standardized nursing care plan in the "NursingNAVI®" developed by ourselves and revealed the "failure to observe" and "failure to document", which leaded to the volatility of the patients' data, conditions and some situation. This phenomenon should have been avoided if nurses had employed a standardized nursing care plan. So, we developed thinking process support system for planning, delivering, recording and evaluating in daily nursing using NursingNAVI® contents. A hospital decided to use NursingNAVI® contents in HIS. It was suggested that the system has availability for nursing OJT and time reduction of planning and recording without volatilizing situation.

Critical laboratory value notification: a failure mode effects and criticality analysis.

PubMed

Saxena, Sunita; Kempf, Raymond; Wilcox, Susan; Shulman, Ira A; Wong, Louise; Cunningham, Glenn; Vega, Elaine; Hall, Stephanie

2005-09-01

The Failure Mode Effects and Criticality Analysis (FMECA) was applied to improve the timeliness of reporting and the timeliness of receipt by the responsible licensed caregiver of critical laboratory values (CLVs) for outpatients and non-critical care inpatients. Through a risk prioritization process, the most important areas for improvement, including contacting the provider, assisting the provider in contacting the patient, and educating the provider in follow-up options available during off hours, were identified. A variety of systemic improvements were made; for example, the CLV notification process was centralized in the customer service center, with databases to help providers select options and make arrangements for follow-up care and an electronic abstract form to document the CLV notification process. Review of documentation and appropriateness of CLV follow-up care was integrated into the quality monitoring process to detect any variations or problems. The average CLV notification time for the month steadily declined during an eight-month period. Compliance was 100% for the "read-back" requirement and documentation in patient's health record. This proactive risk assessment project successfully modified the CLV notification program from a high- to a low-risk process, identified activities to further improve the process, and helped ensure compliance with a variety of requirements.

Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions: Endorsed by the Chinese Society of Cardiology.

PubMed

Räber, Lorenz; Mintz, Gary S; Koskinas, Konstantinos C; Johnson, Thomas W; Holm, Niels R; Onuma, Yoshinubo; Radu, Maria D; Joner, Michael; Yu, Bo; Jia, Haibo; Menevau, Nicolas; de la Torre Hernandez, Jose M; Escaned, Javier; Hill, Jonathan; Prati, Francesco; Colombo, Antonio; di Mario, Carlo; Regar, Evelyn; Capodanno, Davide; Wijns, William; Byrne, Robert A; Guagliumi, Giulio

2018-05-22

This Consensus Document is the first of two reports summarizing the views of an expert panel organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) on the clinical use of intracoronary imaging including intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The first document appraises the role of intracoronary imaging to guide percutaneous coronary interventions (PCIs) in clinical practice. Current evidence regarding the impact of intracoronary imaging guidance on cardiovascular outcomes is summarized, and patients or lesions most likely to derive clinical benefit from an imaging-guided intervention are identified. The relevance of the use of IVUS or OCT prior to PCI for optimizing stent sizing (stent length and diameter) and planning the procedural strategy is discussed. Regarding post-implantation imaging, the consensus group recommends key parameters that characterize an optimal PCI result and provides cut-offs to guide corrective measures and optimize the stenting result. Moreover, routine performance of intracoronary imaging in patients with stent failure (restenosis or stent thrombosis) is recommended. Finally, strengths and limitations of IVUS and OCT for guiding PCI and assessing stent failures and areas that warrant further research are critically discussed.

11C choline PET guided salvage radiotherapy with volumetric modulation arc therapy and hypofractionation for recurrent prostate cancer after HIFU failure: preliminary results of tolerability and acute toxicity.

PubMed

Alongi, Filippo; Liardo, Rocco L E; Iftode, Cristina; Lopci, Egesta; Villa, Elisa; Comito, Tiziana; Tozzi, Angelo; Navarria, Pierina; Ascolese, Anna M; Mancosu, Pietro; Tomatis, Stefano; Bellorofonte, Carlo; Arturo, Chiti; Scorsetti, Marta

2014-10-01

The purpose of this work was to evaluate tolerance, feasibility and acute toxicity in patients undergoing salvage radiotherapy after high-intensity focused ultrasound (HIFU) failure. From 2005 to 2011 a total of 15 patients were treated with HIFU as primary radical treatment. Between July 2011 and February 2013, all 15 patients presented biochemical relapse after HIFU and 11C choline PET documenting intrapostatic-only failure. Salvage EBRT was performed with moderate hypofractionation schedule in 28 fractions with volumetric modulation arc therapy (VMAT). Genito-urinary (GU) and rectal and bowel toxicity were scored by common terminology criteria for adverse events version 4 (CTCAE V.4) scale. Biochemical response was assessed by ASTRO Phoenix criteria. Median age of patients was 67 years (range: 53-85). The median Gleason score was 7 (range: 6-9). The median prostate specific antigen (PSA) at the time of biochemical relapse after HIFU was 5.2 ng/mL (range: 2-64.2). Seven of the 15 patients received androgen deprivation therapy (ADT) started after HIFU failure, interrupted before 11C choline PET and radiotherapy. Median prescribed dose was 71.4 Gy (range: 71.4-74.2 Gy) in 28 fractions. No radiation related major upper gastrointestinal (GI), rectal and GU toxicity were experienced. GU, acute grade 1 and grade 2 toxicities were recorded in 7/15 and 4/15 respectively; bowel acute grade 1 and grade 2 toxicities in 4/15 and 1/15; rectal acute grade 1 and grade 2 toxicities in 3/15 and 2/15 respectively. No grade 3 or greater acute or late toxicities occurred. Biochemical control was assessed in 12/15 (80%) patients. With a median follow up of 12 months, three out of 15 patients, with biochemical relapse, showed lymph-nodal recurrence. Our early clinical results and biochemical data confirm the feasibility and show a good tolerance of the 11C choline PET guided salvage radiation therapy after HIFU failure. The findings of low acute toxicity is encouraging, but longer follow-up is needed to assess late toxicity and definitive outcomes.

Prognostic significance of 5-year PSA value for predicting prostate cancer recurrence after brachytherapy alone and combined with hormonal therapy and/or external beam radiotherapy.

PubMed

Stock, Richard G; Klein, Thomas J; Cesaretti, Jamie A; Stone, Nelson N

2009-07-01

To analyze the prognosis and outcomes of patients who remain free of biochemical failure during the first 5 years after treatment. Between 1991 and 2002, 742 patients with prostate cancer were treated with brachytherapy alone (n = 306), brachytherapy and hormonal therapy (n = 212), or combined implantation and external beam radiotherapy (with or without hormonal therapy; n = 224). These patients were free of biochemical failure (American Society for Therapeutic Radiology and Oncology [ASTRO] definition) during the first 5 post-treatment years and had a documented 5-year prostate-specific antigen (PSA) value. The median follow-up was 6.93 years. The actuarial 10-year freedom from PSA failure rate was 97% using the ASTRO definition and 95% using the Phoenix definition. The median 5-year PSA level was 0.03 ng/mL (range, 0-3.6). The 5-year PSA value was 0.01-0.10 in 31.1%, >0.10-0.2 in 10.2%, >0.2-0.5 in 7.82%, and >0.5 in 3.10%. The 5-year PSA value had prognostic significance, with a PSA value of or=0.2 ng/mL (n = 81; p < .0001). The treatment regimen had no effect on biochemical failure. None of the 742 patients in this study developed metastatic disease or died of prostate cancer. The results of this study have shown that the prognosis for patients treated with brachytherapy and who remain biochemically free of disease for >or=5 years is excellent and none developed metastatic disease during the first 10 years after treatment. The 5-year PSA value is prognostic, and patients with a PSA value <0.2 ng/mL are unlikely to develop subsequent biochemical relapse.

The first permanent molar: spontaneous eruption after a five-year failure.

PubMed

Mistry, Vinay N; Barker, Christopher S; James Spencer, R

2017-09-01

It is rare for a first permanent molar (FPM) to temporarily exhibit clinical features of failure of eruption, followed by regeneration of full eruptive capacity 5 years later. Indeterminate failure of eruption (IFE) is a diagnosis of exclusion where the distinction between primary failure of eruption (PFE) and mechanical failure of eruption (MFE) is unclear, including patients too young to specify. An 11-year-old girl attended the orthodontic clinic at Mid Yorkshire Hospitals NHS Trust regarding an unerupted lower right FPM. Her medical and dental trauma history was unremarkable. She presented with a Class II division 2 malocclusion in the mixed dentition, with all other FPMs fully erupted. This report documents that an unerupted FPM in an 11-year-old patient may still have the eruptive potential to become functional within the dentition. The period spent monitoring the FPM's outcome prior to surgical intervention has avoided an operation under general anaesthetic and potentially unnecessary orthodontic treatment, as the tooth subsequently erupted without treatment. © 2017 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Hypervelocity impact testing of the Space Station utility distribution system carrier

NASA Technical Reports Server (NTRS)

Lazaroff, Scott

1993-01-01

A two-phase, joint JSC and McDonnell Douglas Aerospace-Huntington Beach hypervelocity impact (HVI) test program was initiated to develop an improved understanding of how meteoroid and orbital debris (M/OD) impacts affect the Space Station Freedom (SSF) avionic and fluid lines routed in the Utility Distribution System (UDS) carrier. This report documents the first phase of the test program which covers nonpowered avionic line segment and pressurized fluid line segment HVI testing. From these tests, a better estimation of avionic line failures is approximately 15 failures per year and could very well drop to around 1 or 2 avionic line failures per year (depending upon the results of the second phase testing of the powered avionic line at White Sands). For the fluid lines, the initial McDonnell Douglas analysis calculated 1 to 2 line failures over a 30 year period. The data obtained from these tests indicate the number of predicted fluid line failures increased slightly to as many as 3 in the first 10 years and up to 15 for the entire 30 year life of SSF.

Transient neonatal renal failure and massive polyuria in MEGDEL syndrome.

PubMed

Harbulot, Carole; Paquay, Stéphanie; Dorboz, Imen; Pichard, Samia; Bourillon, Agnès; Benoist, Jean-François; Jardel, Claude; Ogier de Baulny, Hélène; Boespflug-Tanguy, Odile; Schiff, Manuel

2016-06-01

MEGDEL (3-methylglutaconic aciduria with deafness, encephalopathy, and Leigh-like syndrome) syndrome is a mitochondrial disorder associated with recessive mutations in SERAC1. To report transient neonatal renal findings in MEGDEL syndrome. This 7 year-old girl was the first child of consanguineous Turkish parents. She exhibited an acute neonatal deterioration with severe lactic acidosis and liver failure. Initial evaluation revealed massive polyuria and renal failure with 3-methylglutaconic aciduria. Symptoms and biological findings progressively improved with symptomatic treatment but lactic acidosis and high lactate to pyruvate ratio along with 3-methylglutaconic aciduria persisted. At 8 months of age, a subacute neurological degradation occurred with severe hypotonia, dystonia with extrapyramidal movements and failure to thrive. Brain MRI revealed basal ganglia lesions suggestive of Leigh syndrome. At 3 years of age, sensorineural deafness was documented. MEGDEL syndrome was further confirmed by the identification of an already reported homozygous mutation in SERAC1. Transient neonatal polyuria and renal failure have not been reported to date in SERAC1 defective patients. Such neonatal kidney findings expand the clinical spectrum of MEGDEL syndrome.

French College Students’ Sports Practice and Its Relations with Stress, Coping Strategies and Academic Success

PubMed Central

Décamps, Greg; Boujut, Emilie; Brisset, Camille

2012-01-01

College students at university have to face several stress factors. Although sports practice has been considered as having beneficial effects upon stress and general health, few studies have documented its influence on this specific population. The aim of this comparative study was to determine whether the intensity of the college students’ sports practice (categorized into three groups: rare, regular, or intensive) would influence their levels of stress and self-efficacy, their coping strategies, and their academic success/failure. Three self-completion questionnaires were administered to 1071 French freshmen during their compulsory medical visit at the preventive medicine service of the university. Results indicated that students with intensive sport practice reported lower scores of general stress, academic stress, and emotion-focused coping strategies, and higher scores of self-efficacy than those with rare practice. However, the proportion of successful students did not differ significantly between the three groups of sports practice. PMID:22514544

Directory of aerospace safety specialized information sources

NASA Technical Reports Server (NTRS)

Fullerton, E. A.; Rubens, L. S.

1973-01-01

A directory is presented to make available to the aerospace safety community a handbook of organizations and experts in specific, well-defined areas of safety technology. It is designed for the safety specialist as an aid for locating both information sources and individual points of contact (experts) in engineering related fields. The file covers sources of data in aerospace design, tests, as well as information in hazard and failure cause identification, accident analysis, materials characteristics, and other related subject areas. These 171 organizations and their staff members, hopefully, should provide technical information in the form of documentation, data and consulting expertise. These will be sources that have assembled and collated their information, so that it will be useful in the solution of engineering problems. One of the goals of the project in the United States that have and are willing to share data of value to the aerospace safety community.

Software for Quantifying and Simulating Microsatellite Genotyping Error

PubMed Central

Johnson, Paul C.D.; Haydon, Daniel T.

2007-01-01

Microsatellite genetic marker data are exploited in a variety of fields, including forensics, gene mapping, kinship inference and population genetics. In all of these fields, inference can be thwarted by failure to quantify and account for data errors, and kinship inference in particular can benefit from separating errors into two distinct classes: allelic dropout and false alleles. Pedant is MS Windows software for estimating locus-specific maximum likelihood rates of these two classes of error. Estimation is based on comparison of duplicate error-prone genotypes: neither reference genotypes nor pedigree data are required. Other functions include: plotting of error rate estimates and confidence intervals; simulations for performing power analysis and for testing the robustness of error rate estimates to violation of the underlying assumptions; and estimation of expected heterozygosity, which is a required input. The program, documentation and source code are available from http://www.stats.gla.ac.uk/~paulj/pedant.html. PMID:20066126

Can paracetamol (acetaminophen) be administered to patients with liver impairment?

PubMed Central

Hayward, Kelly L.; Powell, Elizabeth E.; Irvine, Katharine M.

2015-01-01

Although 60 years have passed since it became widely available on the therapeutic market, paracetamol dosage in patients with liver disease remains a controversial subject. Fulminant hepatic failure has been a well documented consequence of paracetamol overdose since its introduction, while short and long term use have both been associated with elevation of liver transaminases, a surrogate marker for acute liver injury. From these reports it has been assumed that paracetamol use should be restricted or the dosage reduced in patients with chronic liver disease. We review the factors that have been purported to increase risk of hepatocellular injury from paracetamol and the pharmacokinetic alterations in different pathologies of chronic liver disease which may affect this risk. We postulate that inadvertent under‐dosing may result in concentrations too low to enable efficacy. Specific research to improve the evidence base for prescribing paracetamol in patients with different aetiologies of chronic liver disease is needed. PMID:26460177

Advanced composites structural concepts and materials technologies for primary aircraft structures. Structural response and failure analysis: ISPAN modules users manual

NASA Technical Reports Server (NTRS)

Hairr, John W.; Huang, Jui-Ten; Ingram, J. Edward; Shah, Bharat M.

1992-01-01

The ISPAN Program (Interactive Stiffened Panel Analysis) is an interactive design tool that is intended to provide a means of performing simple and self contained preliminary analysis of aircraft primary structures made of composite materials. The program combines a series of modules with the finite element code DIAL as its backbone. Four ISPAN Modules were developed and are documented. These include: (1) flat stiffened panel; (2) curved stiffened panel; (3) flat tubular panel; and (4) curved geodesic panel. Users are instructed to input geometric and material properties, load information and types of analysis (linear, bifurcation buckling, or post-buckling) interactively. The program utilizing this information will generate finite element mesh and perform analysis. The output in the form of summary tables of stress or margins of safety, contour plots of loads or stress, and deflected shape plots may be generalized and used to evaluate specific design.

A Methodological Review of Meditation Research

PubMed Central

Thomas, John W.; Cohen, Marc

2014-01-01

Despite over 50 years of research into the states of consciousness induced by various meditation practices, no clear neurophysiological signatures of these states have been found. Much of this failure can be attributed to the narrow range of variables examined in most meditation studies, with the focus being restricted to a search for correlations between neurophysiological measures and particular practices, without documenting the content and context of these practices. We contend that more meaningful results can be obtained by expanding the methodological paradigm to include multiple domains including: the cultural setting (“the place”), the life situation of the meditator (“the person”), details of the particular meditation practice (‘the practice’), and the state of consciousness of the meditator (“the phenomenology”). Inclusion of variables from all these domains will improve the ability to predict the psychophysiological variables (“the psychophysiology”) associated with specific meditation states and thus explore the mysteries of human consciousness. PMID:25071607

Reproducibility in Natural Language Processing: A Case Study of Two R Libraries for Mining PubMed/MEDLINE.

PubMed

Cohen, K Bretonnel; Xia, Jingbo; Roeder, Christophe; Hunter, Lawrence E

2016-05-01

There is currently a crisis in science related to highly publicized failures to reproduce large numbers of published studies. The current work proposes, by way of case studies, a methodology for moving the study of reproducibility in computational work to a full stage beyond that of earlier work. Specifically, it presents a case study in attempting to reproduce the reports of two R libraries for doing text mining of the PubMed/MEDLINE repository of scientific publications. The main findings are that a rational paradigm for reproduction of natural language processing papers can be established; the advertised functionality was difficult, but not impossible, to reproduce; and reproducibility studies can produce additional insights into the functioning of the published system. Additionally, the work on reproducibility lead to the production of novel user-centered documentation that has been accessed 260 times since its publication-an average of once a day per library.

Commons ignorance: the failure of environmental law to produce needed information on health and the environment.

PubMed

Wagner, Wendy E

2004-04-01

One of the most significant problems facing environmental law is the dearth of scientific information available to assess the impact of industrial activities on public health and the environment. After documenting the significant gaps in existing information, this Article argues that existing laws both exacerbate and perpetuate this problem. By failing to require actors to assess the potential harm from their activities, and by penalizing them with additional regulation when they do, existing laws fail to counteract actors' natural inclination to remain silent about the harms that they might be causing. Both theory and practice confirm that when the stakes are high, actors not only will resist producing potentially incriminating information but will invest in discrediting public research that suggests their activities are harmful. The Article concludes with specific recommendations about how these perverse incentives for ignorance can be reversed.

Wire and Cable Cold Bending Test

NASA Technical Reports Server (NTRS)

Colozza, Anthony

2010-01-01

One of the factors in assessing the applicability of wire or cable on the lunar surface is its flexibility under extreme cold conditions. Existing wire specifications did not address their mechanical behavior under cold, cryogenic temperature conditions. Therefore tests were performed to provide this information. To assess this characteristic 35 different insulated wire and cable pieces were cold soaked in liquid nitrogen. The segments were then subjected to bending and the force was recorded. Any failure of the insulation or jacketing was also documented for each sample tested. The bending force tests were performed at room temperature to provide a comparison to the change in force needed to bend the samples due to the low temperature conditions. The results from the bending tests were plotted and showed how various types of insulated wire and cable responded to bending under cold conditions. These results were then used to estimate the torque needed to unroll the wire under these low temperature conditions.

Irreproducibility in Preclinical Biomedical Research: Perceptions, Uncertainties, and Knowledge Gaps.

PubMed

Jarvis, Michael F; Williams, Michael

2016-04-01

Concerns regarding the reliability of biomedical research outcomes were precipitated by two independent reports from the pharmaceutical industry that documented a lack of reproducibility in preclinical research in the areas of oncology, endocrinology, and hematology. Given their potential impact on public health, these concerns have been extensively covered in the media. Assessing the magnitude and scope of irreproducibility is limited by the anecdotal nature of the initial reports and a lack of quantitative data on specific failures to reproduce published research. Nevertheless, remediation activities have focused on needed enhancements in transparency and consistency in the reporting of experimental methodologies and results. While such initiatives can effectively bridge knowledge gaps and facilitate best practices across established and emerging research disciplines and therapeutic areas, concerns remain on how these improve on the historical process of independent replication in validating research findings and their potential to inhibit scientific innovation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Newcastle Disease Virus in Madagascar: Identification of an Original Genotype Possibly Deriving from a Died Out Ancestor of Genotype IV

PubMed Central

Maminiaina, Olivier F.; Gil, Patricia; Briand, François-Xavier; Albina, Emmanuel; Keita, Djénéba; Andriamanivo, Harentsoaniaina Rasamoelina; Chevalier, Véronique; Lancelot, Renaud; Martinez, Dominique; Rakotondravao, R.; Rajaonarison, Jean-Joseph; Koko, M.; Andriantsimahavandy, Abel A.; Jestin, Véronique; Servan de Almeida, Renata

2010-01-01

In Madagascar, Newcastle disease (ND) has become enzootic after the first documented epizootics in 1946, with recurrent annual outbreaks causing mortality up to 40%. Four ND viruses recently isolated in Madagascar were genotypically and pathotypically characterised. By phylogenetic inference based on the F and HN genes, and also full-genome sequence analyses, the NDV Malagasy isolates form a cluster distant enough to constitute a new genotype hereby proposed as genotype XI. This new genotype is presumably deriving from an ancestor close to genotype IV introduced in the island probably more than 50 years ago. Our data show also that all the previously described neutralising epitopes are conserved between Malagasy and vaccine strains. However, the potential implication in vaccination failures of specific amino acid substitutions predominantly found on surface-exposed epitopes of F and HN proteins is discussed. PMID:21085573

Newcastle disease virus in Madagascar: identification of an original genotype possibly deriving from a died out ancestor of genotype IV.

PubMed

Maminiaina, Olivier F; Gil, Patricia; Briand, François-Xavier; Albina, Emmanuel; Keita, Djénéba; Andriamanivo, Harentsoaniaina Rasamoelina; Chevalier, Véronique; Lancelot, Renaud; Martinez, Dominique; Rakotondravao, R; Rajaonarison, Jean-Joseph; Koko, M; Andriantsimahavandy, Abel A; Jestin, Véronique; Servan de Almeida, Renata

2010-11-15

In Madagascar, Newcastle disease (ND) has become enzootic after the first documented epizootics in 1946, with recurrent annual outbreaks causing mortality up to 40%. Four ND viruses recently isolated in Madagascar were genotypically and pathotypically characterised. By phylogenetic inference based on the F and HN genes, and also full-genome sequence analyses, the NDV Malagasy isolates form a cluster distant enough to constitute a new genotype hereby proposed as genotype XI. This new genotype is presumably deriving from an ancestor close to genotype IV introduced in the island probably more than 50 years ago. Our data show also that all the previously described neutralising epitopes are conserved between Malagasy and vaccine strains. However, the potential implication in vaccination failures of specific amino acid substitutions predominantly found on surface-exposed epitopes of F and HN proteins is discussed.

No post-no core approach to restore severely damaged posterior teeth: An up to 10-year retrospective study of documented endocrown cases.

PubMed

Belleflamme, Marcia M; Geerts, Sabine O; Louwette, Marie M; Grenade, Charlotte F; Vanheusden, Alain J; Mainjot, Amélie K

2017-08-01

The objectives of the present study were to (1) retrospectively evaluate documented cases of ceramic and composite endocrowns performed using immediate dentin sealing (IDS); (2) correlate failures with clinical parameters such as tooth preparation characteristics and occlusal parameters. 99 documented cases of endocrowns were evaluated after a mean observation period of 44.7±34.6months. A classification of restorations was established in function of the level of damage of residual tooth tissues after preparation, from 1 to 3. Evaluation was performed according to FDI criteria and endodontic outcomes were analyzed. Occlusal risk factors were examined and fractographic analysis was performed in case of fracture. 48.4% of patients were shown to present occlusal risk factors. 75.8% of restorations were Class 3 endocrowns. 56.6% were performed on molars, 41.4% on premolars and 2.0% on canines. 84.8% were performed in lithium-disilicate glass-ceramic and 12.1% in Polymer-Infiltrated Ceramic Network (PICN) material. The survival and success rates of endocrowns were 99.0% and 89.9% respectively, while the 10-year Kaplan-Meier estimated survival and success rates were 98.8% and 54.9% respectively. Ten failures were detected: periodontal disease (n=3), endocrown debonding (n=2), minor chipping (n=2), caries recurrence (n=2) and major fractures (n=1). Due to the reduced amount of failures, no statistical correlation could be established with clinical parameters. Endocrowns were shown to constitute a reliable approach to restore severely damaged molars and premolars, even in the presence of extensive coronal tissue loss or occlusal risk factors, such as bruxism or unfavorable occlusal relationships. Practitioners should consider the endocrown instead of the post and core approach to restore severely damaged non-vital posterior teeth. This minimally invasive solution reduces the risk of catastrophic failures and is easily performed. The use of IDS procedure and lithium-disilicate glass-ceramic as prosthesis material gave very good results. Copyright © 2017 Elsevier Ltd. All rights reserved.

Map Showing Seacliff Response to Climatic and Seismic Events, Seabright Beach, Santa Cruz County, California

USGS Publications Warehouse

Hapke, Cheryl J.; Richmond, Bruce M.; D'Iorio, Mimi M.

2002-01-01

Introduction The coastal cliffs along much of the central California coast are actively retreating. Large storms and periodic earthquakes are responsible for most of the documented sea cliff slope failures. Long-term average erosion rates calculated for this section of coast do not provide the spatial or temporal data resolution necessary to identify the processes responsible for retreat of the sea cliffs where episodic retreat threatens homes and community infrastructure. Research suggests that more erosion occurs along the California coast over a short time scale, during periods of severe storms or seismic activity, than occurs during decades of normal weather or seismic quiescence. This is the third map in a series of maps prepared to document the processes of short-term sea cliff retreat through the identification of slope failure styles, spatial variability of failures, and temporal variation in retreat amounts in an area that has been identified as an erosion hotspot. This map presents sea cliff failure and retreat data from the Seabright Beach section, California, which is located on the east side of Santa Cruz along the northern Monterey Bay coast. The data presented in this map series provide high-resolution spatial and temporal information on the location, amount, and processes of sea cliff retreat in Santa Cruz, California. These data show the response of the sea cliffs to both large magnitude earthquakes and severe climatic events such as El Ni?os; this information may prove useful in predicting the future response of the cliffs to events of similar magnitude. The map data can also be incorporated into Global Information System (GIS) for use by researchers and community planners. During this study we developed a method for investigating short-term processes of sea cliff evolution using rectified photographic stereo models. This method allows us to document the linear extent of cliff failures, the spatial and temporal relationship between failures, and the type or style of slope failure. Seabright Beach extends 0.9 km from San Lorenzo Point on the west to the Santa Cruz Yacht Harbor on the east. The cliffs at Seabright Beach are completely protected from wave attack by a wide beach. The protective beach is a relatively recent feature that formed after the emplacement of the Santa Cruz Yacht Harbor jetty in 1963-1964. Prior to the completion of the jetty, the cliffs at Seabright Beach were subject to daily wave attack. The data in this study are post-jetty construction; therefore, the sea cliff failures and cliff retreat are the result of nonmarine processes (rainfall, groundwater and seismic shaking). The 8 to 15 m high cliffs at Seabright Beach are composed of the Miocene to Pliocene Purisima Formation, which is overlain by unconsolidated Pleistocene terrace deposits. The relative thickness of these units varies along the length of the cliff. At the west end of Seabright Beach, including San Lorenzo Point, nearly the entire cliff section is composed of Purisima Formation and is capped by less than 2 m of terrace deposits. In this exposure, the Purisima Formation is a moderately weathered, moderately indurated massive sandstone. The height of the cliffs and the thickness of the Purisima Formation decrease to the east. In the cliffs immediately adjacent to the harbor, the entire exposure is composed of terrace deposits. Toe-slope debris and wind-blown sand form a nearly continuous fan along the cliff base that obscure the lower portion of the cliff. This study documents the impacts of earthquakes and large storms to the sea cliffs in the Seabright Beach section. The first event is the 1989 Loma Prieta earthquake, a M7.1 earthquake that caused widespread damage to the area stretching from Santa Cruz to the San Francisco Bay. The epicenter of the earthquake was located in the Santa Cruz Mountains, approximately 9 km inland from the coast. Extensive block and debris falls, induced by the seismic shaking, occ

GSC configuration management plan

NASA Technical Reports Server (NTRS)

Withers, B. Edward

1990-01-01

The tools and methods used for the configuration management of the artifacts (including software and documentation) associated with the Guidance and Control Software (GCS) project are described. The GCS project is part of a software error studies research program. Three implementations of GCS are being produced in order to study the fundamental characteristics of the software failure process. The Code Management System (CMS) is used to track and retrieve versions of the documentation and software. Application of the CMS for this project is described and the numbering scheme is delineated for the versions of the project artifacts.

A new criterion needed to evaluate reliability of digital protective relays

NASA Astrophysics Data System (ADS)

Gurevich, Vladimir

2012-11-01

There is a wide range of criteria and features for evaluating reliability in engineering; but as many as there are, only one of them has been chosen to evaluate reliability of Digital Protective Relays (DPR) in the technical documentation: Mean (operating) Time Between Failures (MTBF), which has gained universal currency and has been specified in technical manuals, information sheets, tender documentation as the key indicator of DPR reliability. But is the choice of this criterion indeed wise? The answer to this question is being sought by the author of this article.

Diagnosis of coccidioidomycosis by culture: safety considerations, traditional methods, and susceptibility testing.

PubMed

Sutton, Deanna A

2007-09-01

The recovery of Coccidioides spp. by culture and confirmation utilizing the AccuProbe nucleic acid hybridization method by GenProbe remain the definitive diagnostic method. Biosafety considerations from specimen collection through culture confirmation in the mycology laboratory are critical, as acquisition of coccidioidomycosis by laboratory workers is well documented. The designation of Coccidioides spp. as select agents of potential bioterrorism has mandated strict regulation of their transport and inventory. The genus appears generally susceptible, in vitro, although no defined breakpoints exist. Susceptibility testing may assist in documenting treatment failures.

Predictive power of individual factors and clinical learning experience on academic success: findings from a longitudinal study.

PubMed

Dante, Angelo; Fabris, Stefano; Palese, Alvisa

2015-01-01

Academic failure is the inability of a nursing student to graduate or to complete the nursing degree on time. This longitudinal cohort study, involving 2 Italian universities, documents the effects of selected individual variables and the quality of the clinical learning experience as perceived by students on academic success. Factors related to the clinical learning experience were the quality of the supervisory relationship, pedagogical atmosphere, and commitment of the ward related to the level of personalized nursing care delivered and clarity of nursing documentation.

International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics.

PubMed

Goldstein, Brahm; Giroir, Brett; Randolph, Adrienne

2005-01-01

Although general definitions of the sepsis continuum have been published for adults, no such work has been done for the pediatric population. Physiologic and laboratory variables used to define the systemic inflammatory response syndrome (SIRS) and organ dysfunction require modification for the developmental stages of children. An international panel of 20 experts in sepsis and clinical research from five countries (Canada, France, Netherlands, United Kingdom, and United States) was convened to modify the published adult consensus definitions of infection, sepsis, severe sepsis, septic shock, and organ dysfunction for children. Consensus conference. This document describes the issues surrounding consensus on four major questions addressed at the meeting: a) How should the pediatric age groups affected by sepsis be delineated? b) What are the specific definitions of pediatric SIRS, infection, sepsis, severe sepsis, and septic shock? c) What are the specific definitions of pediatric organ failure and the validity of pediatric organ failure scores? d) What are the appropriate study populations and study end points required to successfully conduct clinical trials in pediatric sepsis? Five subgroups first met separately and then together to evaluate the following areas: signs and symptoms of sepsis, cell markers, cytokines, microbiological data, and coagulation variables. All conference participants approved the final draft of the proceedings of the meeting. Conference attendees modified the current criteria used to define SIRS and sepsis in adults to incorporate pediatric physiologic variables appropriate for the following subcategories of children: newborn, neonate, infant, child, and adolescent. In addition, the SIRS definition was modified so that either criteria for fever or white blood count had to be met. We also defined various organ dysfunction categories, severe sepsis, and septic shock specifically for children. Although no firm conclusion was made regarding a single appropriate study end point, a novel nonmortality end point, organ failure-free days, was considered optimal for pediatric clinical trials given the relatively low incidence of mortality in pediatric sepsis compared with adult populations. We modified the adult SIRS criteria for children. In addition, we revised definitions of severe sepsis and septic shock for the pediatric population. Our goal is for these first-generation pediatric definitions and criteria to facilitate the performance of successful clinical studies in children with sepsis.

Education Reform in Mathematics: A History Ignored?

ERIC Educational Resources Information Center

Hofmeister, Alan M.

2004-01-01

Nationally, public education prepares to meet increasing federal and state accountability requirements. This article examines the history of math education reform and concludes that many present national trends do not provide substantive, valid alternatives to past failed practices. The evidence documents a failure to apply fundamental research…

Organizing for Excellence.

ERIC Educational Resources Information Center

Duttweiler, Patricia Cloud

Factors that contribute to excellence in education, as well as those that have contributed to the failure of change efforts, are the subject of this document. It provides a summary of the literature on reform efforts; effective schools; new organizational perspectives derived from the business sector; organizational restructuring being tested in…

49 CFR Appendix D to Part 236 - Independent Review of Verification and Validation

Code of Federal Regulations, 2010 CFR

2010-10-01

... standards. (f) The reviewer shall analyze all Fault Tree Analyses (FTA), Failure Mode and Effects... for each product vulnerability cited by the reviewer; (4) Identification of any documentation or... not properly followed; (6) Identification of the software verification and validation procedures, as...

30 CFR 250.1402 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Definitions. Terms used in this subpart have the following meaning: Case file means an MMS document file... fine. It is an MMS regulatory enforcement tool used in addition to Notices of Incidents of... employee assigned to review case files and assess civil penalties. Violation means failure to comply with...

The Role of Affect in Rational (Attributional) Approaches to Human Motivation.

ERIC Educational Resources Information Center

Weiner, Bernard

1980-01-01

Documents characteristics of emotions in relation to action and self-perception. Argues that taking affect into account yields a different interpretation of successful achievement-change programs. Also clarifies the differences between ability and effort as perceived causes of success and failure. (Author/GC)

7 CFR 765.202 - Borrower responsibilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... or other security instruments; and (2) The cost of lien search reports; (d) Pay taxes on property...) Non-compliance with the provisions of loan agreements and documents, other than failure to meet... FLP loans by the borrower; (2) Borrower non-compliance will be considered by the Agency when making...

Preschool Contracting: A Technical Assistance Guide. Revision.

ERIC Educational Resources Information Center

Kentucky State Dept. of Education, Frankfort.

This document presents information needed for development of contractual or cooperative arrangements between local school districts and other agencies and programs in Kentucky in order to better serve preschool children who are at risk of educational failure or who have identified disabilities. After an introductory section, the Preschool…

Student Involvement in the Community College Setting. ERIC Digest.

ERIC Educational Resources Information Center

Chaves, Christopher A.

This document discusses the challenges community colleges, particularly urban ones, face in delivering education to their first-generation, immigrant, economically disadvantaged, non-white, limited-English-ability, and other non-traditional students. These challenges can be exacerbated by students' failure to connect and become involved in college…

NASA geometry data exchange specification for computational fluid dynamics (NASA IGES)

NASA Technical Reports Server (NTRS)

Blake, Matthew W.; Kerr, Patricia A.; Thorp, Scott A.; Jou, Jin J.

1994-01-01

This document specifies a subset of an existing product data exchange specification that is widely used in industry and government. The existing document is called the Initial Graphics Exchange Specification. This document, a subset of IGES, is intended for engineers analyzing product performance using tools such as computational fluid dynamics (CFD) software. This document specifies how to define mathematically and exchange the geometric model of an object. The geometry is represented utilizing nonuniform rational B-splines (NURBS) curves and surfaces. Only surface models are represented; no solid model representation is included. This specification does not include most of the other types of product information available in IGES (e.g., no material properties or surface finish properties) and does not provide all the specific file format details of IGES. The data exchange protocol specified in this document is fully conforming to the American National Standard (ANSI) IGES 5.2.

An error taxonomy system for analysis of haemodialysis incidents.

PubMed

Gu, Xiuzhu; Itoh, Kenji; Suzuki, Satoshi

2014-12-01

This paper describes the development of a haemodialysis error taxonomy system for analysing incidents and predicting the safety status of a dialysis organisation. The error taxonomy system was developed by adapting an error taxonomy system which assumed no specific specialty to haemodialysis situations. Its application was conducted with 1,909 incident reports collected from two dialysis facilities in Japan. Over 70% of haemodialysis incidents were reported as problems or complications related to dialyser, circuit, medication and setting of dialysis condition. Approximately 70% of errors took place immediately before and after the four hours of haemodialysis therapy. Error types most frequently made in the dialysis unit were omission and qualitative errors. Failures or complications classified to staff human factors, communication, task and organisational factors were found in most dialysis incidents. Device/equipment/materials, medicine and clinical documents were most likely to be involved in errors. Haemodialysis nurses were involved in more incidents related to medicine and documents, whereas dialysis technologists made more errors with device/equipment/materials. This error taxonomy system is able to investigate incidents and adverse events occurring in the dialysis setting but is also able to estimate safety-related status of an organisation, such as reporting culture. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

HyRAM V1.0 User Guide

DOE Office of Scientific and Technical Information (OSTI.GOV)

Groth, Katrina M.; Zumwalt, Hannah Ruth; Clark, Andrew Jordan

2016-03-01

Hydrogen Risk Assessment Models (HyRAM) is a prototype software toolkit that integrates data and methods relevant to assessing the safety of hydrogen fueling and storage infrastructure. The HyRAM toolkit integrates deterministic and probabilistic models for quantifying accident scenarios, predicting physical effects, and characterizing the impact of hydrogen hazards, including thermal effects from jet fires and thermal pressure effects from deflagration. HyRAM version 1.0 incorporates generic probabilities for equipment failures for nine types of components, and probabilistic models for the impact of heat flux on humans and structures, with computationally and experimentally validated models of various aspects of gaseous hydrogen releasemore » and flame physics. This document provides an example of how to use HyRAM to conduct analysis of a fueling facility. This document will guide users through the software and how to enter and edit certain inputs that are specific to the user-defined facility. Description of the methodology and models contained in HyRAM is provided in [1]. This User’s Guide is intended to capture the main features of HyRAM version 1.0 (any HyRAM version numbered as 1.0.X.XXX). This user guide was created with HyRAM 1.0.1.798. Due to ongoing software development activities, newer versions of HyRAM may have differences from this guide.« less

Geography Assessment and Exercise Specifications for the 1994 National Assessment of Educational Progress.

ERIC Educational Resources Information Center

American Inst. for Research, Washington, DC. Washington Research Center.

This document lists and outlines the specific educational objectives of the content of the 1994 National Assessment of Educational Progress's Geography Assessment. The document is divided into two sections: "Assessment Specifications" and "Exercise Specifications." The "Assessment Specifications" provide an overall…

Multidisciplinary approach for in-deep assessment of joint prosthesis failure.

PubMed

Tessarolo, F; Caola, I; Piccoli, F; Dorigotti, P; Demattè, E; Molinari, M; Malavolta, M; Barbareschi, M; Caciagli, P; Nollo, G

2009-01-01

In spite of advancement in biomaterials and biomechanics, in development of new osteo-integrative materials and coatings, and in macro- micro- component design, a non negligible fraction of the implanted prosthesis fails before the expected lifetime. A prospective observational clinical study has been conducted to define and apply a set of experimental techniques to in-deep assess the failure of joint prosthesis. Microbiological, histological and micro-structural techniques were implemented to specifically address phenomena occurring at the tissue-implant interface. Results obtained from 27 cases of prosthetic joint failure are discussed in terms of sensitivity and specificity. A procedural flow-chart is finally proposed for the assessment of joint prosthesis failure.

Independent Orbiter Assessment (IOA): Assessment of the main propulsion subsystem FMEA/CIL, volume 3

NASA Technical Reports Server (NTRS)

Holden, K. A.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Main Propulsion System (MPS) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to available data from the Rockwell Downey/NASA JSC FMEA/CIL review. Volume 3 continues the presentation of IOA worksheets and includes the potential critical items list.

Hypothyroidism is a predisposing factor for fenofibrate-induced rhabdomyolysis--patient report and literature review.

PubMed

Satarasinghe, R L; Ramesh, R; Riyaaz, A A A; Gunarathne, P A K G; de Silva, A P

2007-01-01

A literature survey reveals that both lipid lowering drugs - statins and fibrates--and hypothyroidism are documented causes of muscle disorders including rhabdomyolysis leading to acute renal failure. We describe a case of fenofibrate monotherapy (Lipicard) induced dialysis dependent acute renal failure in an undiagnosed hypothyroid patient which is the first case to be reported from Sri Lanka. We strongly recommend that all patients who are receiving statins and/or fibrates should be screened for occult hypothyroidism which seems to aggravate the muscle damage due to the above drugs, with or without other risk factors.

Failure of BACTEC™ MGIT 960™ to detect Mycobacterium tuberculosis complex within a 42-day incubation period.

PubMed

Mahomed, Sharana; Dlamini-Mvelase, Nomonde R; Dlamini, Moses; Mlisana, Koleka

2017-01-01

For the optimal recovery of Mycobacterium tuberculosis from the BACTEC™ Mycobacterium Growth Indicator Tube 960™ system, an incubation period of 42-56 days is recommended by the manufacturer. Due to logistical reasons, it is common practice to follow an incubation period of 42 days. We undertook a retrospective study to document positive Mycobacterium Growth Indicator Tube cultures beyond the 42-day incubation period. In total, 98/110 (89%) were positive for M. tuberculosis complex. This alerted us to M. tuberculosis growth detection failure at 42 days.

Independent Orbiter Assessment (IOA): Assessment of the main propulsion subsystem FMEA/CIL, volume 2

NASA Technical Reports Server (NTRS)

Holden, K. A.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Main Propulsion System (MPS) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were than compared to available data from the Rockwell Downey/NASA JSC FMEA/CIL review. Volume 2 continues the presentation of IOA worksheets for MPS hardware items.

Independent Orbiter Assessment (IOA): Assessment of the communication and tracking subsystem, volume 2

NASA Technical Reports Server (NTRS)

Long, W. C.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed and analysis of the Communication and Tracking hardware, generating draft failure modes and potential critical items. The IOA results were then compared to the NASA FMEA/CIL baseline. A resolution of each discrepancy from the comparison is provided through additional analysis as required. This report documents the results of that comparison for the Orbiter Communication and Tracking hardware. Volume 2 continues the presentation of IOA worksheets.

Independent Orbiter Assessment (IOA): Assessment of the reaction control system, volume 3

NASA Technical Reports Server (NTRS)

Prust, Chet D.; Hartman, Dan W.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the aft and forward Reaction Control System (RCS) hardware and Electrical Power Distribution and Control (EPD and C), generating draft failure modes and potential critical items. The IOA results were then compared to the proposed Post 51-L NASA FMEA/CIL baseline. This report documents the results of that comparison for the Orbiter RCS hardware and EPD and C systems. Volume 3 continues the presentation of IOA worksheets.

Independent Orbiter Assessment (IOA): Assessment of the reaction control system, volume 2

NASA Technical Reports Server (NTRS)

Prust, Chet D.; Hartman, Dan W.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the aft and forward Reaction Control System (RCS) hardware and Electrical Power Distribution and Control (EPD and C), generating draft failure modes and potential critical items. The IOA results were then compared to the proposed Post 51-L NASA FMEA/CIL baseline. This report documents the results of that comparison for the Orbiter RCS hardware and EPD and C systems. Volume 2 continues the presentation of IOA worksheets.

Cardiomyocyte-Specific Telomere Shortening is a Distinct Signature of Heart Failure in Humans.

PubMed

Sharifi-Sanjani, Maryam; Oyster, Nicholas M; Tichy, Elisia D; Bedi, Kenneth C; Harel, Ofer; Margulies, Kenneth B; Mourkioti, Foteini

2017-09-07

Telomere defects are thought to play a role in cardiomyopathies, but the specific cell type affected by the disease in human hearts is not yet identified. The aim of this study was to systematically evaluate the cell type specificity of telomere shortening in patients with heart failure in relation to their cardiac disease, age, and sex. We studied cardiac tissues from patients with heart failure by utilizing telomere quantitative fluorescence in situ hybridization, a highly sensitive method with single-cell resolution. In this study, total of 63 human left ventricular samples, including 37 diseased and 26 nonfailing donor hearts, were stained for telomeres in combination with cardiomyocyte- or α-smooth muscle cell-specific markers, cardiac troponin T, and smooth muscle actin, respectively, and assessed for telomere length. Patients with heart failure demonstrate shorter cardiomyocyte telomeres compared with nonfailing donors, which is specific only to cardiomyocytes within diseased human hearts and is associated with cardiomyocyte DNA damage. Our data further reveal that hypertrophic hearts with reduced ejection fraction exhibit the shortest telomeres. In contrast to other reported cell types, no difference in cardiomyocyte telomere length is evident with age. However, under the disease state, telomere attrition manifests in both young and older patients with cardiac hypertrophy. Finally, we demonstrate that cardiomyocyte-telomere length is better sustained in women than men under diseased conditions. This study provides the first evidence of cardiomyocyte-specific telomere shortening in heart failure. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Implicit and Explicit Processing in Deep Dyslexia: Semantic Blocking as a Test for Failure of Inhibition in the Phonological Output Lexicon

ERIC Educational Resources Information Center

Colangelo, Annette; Buchanan, Lori

2006-01-01

The failure of inhibition hypothesis posits a theoretical distinction between implicit and explicit access in deep dyslexia. Specifically, the effects of failure of inhibition are assumed only in conditions that have an explicit selection requirement in the context of production (i.e., aloud reading). In contrast, the failure of inhibition…

[Sleep apnea and heart failure: pathophysiology, diagnosis and therapy].

PubMed

Monda, Cinzia; Scala, Oriana; Paolillo, Stefania; Savarese, Gianluigi; Cecere, Milena; D'Amore, Carmen; Parente, Antonio; Musella, Francesca; Mosca, Susanna; Filardi, Pasquale Perrone

2010-11-01

Sleep apnea, defined as a pathologic pause in breathing during sleep >10 s, promotes the progression of chronic heart failure and may be a predictor of poor prognosis. It causes, in fact, several mechanical, hemodynamic, chemical and inflammatory changes that negatively compromise cardiovascular homeostasis of heart failure patients. Sleep apnea is recognized as sleep apnea syndrome when specific symptoms, such as sleepiness and headache during the daytime and snoring, are present and is diagnosed with an overnight test called polysomnography. There are two different forms of sleep apnea, central and obstructive. Breathing is interrupted by the loss of respiratory drive and the lack of respiratory effort in the central form, which affects about 40-60% of heart failure patients. In obstructive sleep apnea, breathing stops when throat muscles relax, despite respiratory effort. This form affects about 3% of the general population, while it is present in at least 30% of heart failure patients. The diagnosis of sleep disorders in heart failure becomes very important to help patients adopting lifestyle changes and starting specific therapies to improve quality of life and retard the progression of chronic heart failure.

Seismic characteristics of tensile fracture growth induced by hydraulic fracturing

NASA Astrophysics Data System (ADS)

Eaton, D. W. S.; Van der Baan, M.; Boroumand, N.

2014-12-01

Hydraulic fracturing is a process of injecting high-pressure slurry into a rockmass to enhance its permeability. Variants of this process are used for unconventional oil and gas development, engineered geothermal systems and block-cave mining; similar processes occur within volcanic systems. Opening of hydraulic fractures is well documented by mineback trials and tiltmeter monitoring and is a physical requirement to accommodate the volume of injected fluid. Numerous microseismic monitoring investigations acquired in the audio-frequency band are interpreted to show a prevalence of shear-dominated failure mechanisms surrounding the tensile fracture. Moreover, the radiated seismic energy in the audio-frequency band appears to be a miniscule fraction (<< 1%) of the net injected energy, i.e., the integral of the product of fluid pressure and injection rate. We use a simple penny-shaped crack model as a predictive framework to describe seismic characteristics of tensile opening during hydraulic fracturing. This model provides a useful scaling relation that links seismic moment to effective fluid pressure within the crack. Based on downhole recordings corrected for attenuation, a significant fraction of observed microseismic events are characterized by S/P amplitude ratio < 5. Despite the relatively small aperture of the monitoring arrays, which precludes both full moment-tensor analysis and definitive identification of nodal planes or axes, this ratio provides a strong indication that observed microseismic source mechanisms have a component of tensile failure. In addition, we find some instances of periodic spectral notches that can be explained by an opening/closing failure mechanism, in which fracture propagation outpaces fluid velocity within the crack. Finally, aseismic growth of tensile fractures may be indicative of a scenario in which injected energy is consumed to create new fracture surfaces. Taken together, our observations and modeling provide evidence that failure mechanisms documented by passive monitoring of hydraulic fractures may contain a significant component of tensile failure, including fracture opening and closing, although creation of extensive new fracture surfaces may be a seismically inefficient process that radiates at sub-audio frequencies.

Failure of pre-natal ultrasonography to prevent urinary infection associated with underlying urological abnormalities.

PubMed

Lakhoo, K; Thomas, D F; Fuenfer, M; D'Cruz, A J

1996-06-01

To analyse the reasons underlying the failure of routine pre-natal ultrasonography to prevent the subsequent development of urinary tract infection (UTI) in children with predisposing urological abnormalities. This retrospective study comprised 39 children (22 females and 17 males) who had at least one documented UTI, the presence of an anatomical anomaly of the urinary tract recognized as predisposing to UTI and had undergone ultrasonography of the urinary tract undertaken in fetal life as part of routine maternal ante-natal ultrasonography. Four categories of patients were defined: Group A, those with normal findings on pre-natal ultrasonography and no urological abnormality detected; Group B, those with a urological abnormality detected but where there was a subsequent failure of communication among clinicians; Group C, those with a urological abnormality but who received inappropriate or sub-optimal post-natal management and; Group D, those with a urological abnormality but who had a UTI despite appropriate post-natal management. In each case, the most severe documented episode of UTI was categorized as: Grade I, asymptomatic bacteriuria; Grade II, mild/moderate symptomatic UTI and; Grade III, severe symptomatic UTI necessitating hospital admission. Group A comprised 22 (56%), Group B three (9%), Group C two (5%) and Group D 12 children (31%). Of the 22 children in Group A, nine experienced a UTI of sufficient severity to necessitate hospital admission. Of the 12 children in Group D only one required hospital admission. The failure of pre-natal ultrasonography to identify the underlying predisposing urological abnormality was the most important factor contributing to subsequent UTI in post-natal life. Failure of communication and inappropriate post-natal management were numerically unimportant. In some children, UTI occurred despite pre-natal detection of their underlying anomaly and appropriate post-natal management. However, in this group the UTI was less severe than in those children whose urological anomalies had not been detected by pre-natal ultrasonography.

Combined Endometrial Ablation and Levonorgestrel Intrauterine System Use in Women With Dysmenorrhea and Heavy Menstrual Bleeding: Novel Approach for Challenging Cases.

PubMed

Papadakis, Efstathios P; El-Nashar, Sherif A; Laughlin-Tommaso, Shannon K; Shazly, Sherif A M; Hopkins, Matthew R; Breitkopf, Daniel M; Famuyide, Abimbola O

2015-01-01

To evaluate the feasibility and impact of levonorgestrel intrauterine system (LNG-IUS) on treatment failure after endometrial ablation (EA) in women with heavy menstrual bleeding (HMB) and dysmenorrhea at 4 years. Cohort study (Canadian Task Force II-2). An academic institution in the upper Midwest. All women with HMB and dysmenorrhea who underwent EA with combined placement of LNG-IUS (EA/LNG-IUS cohort, 23 women) after 2005 and an historic reference group from women who had EA alone (EA cohort, 65 women) from 1998 through the end of 2005. Radiofrequency EA, thermal balloon ablation, and LNG-IUS. The primary outcome was treatment failure defined as persistent pain, bleeding, and hysterectomy after EA at 4 years. The combined treatment failure outcome was documented in 2 patients (8.7%) in the EA/LNG-IUS group and 19 patients (29.2%) in the EA group with an unadjusted OR of .23 (95% CI, .05-1.08). After adjusting for known risk factors of failure, the adjusted OR was .19 (95% CI, .26-.88). None of the women who underwent EA/LNG-IUS had hysterectomy for treatment failure compared with 16 (24%) in the EA group (p = .009); postablation pelvic pain was documented in 1 woman (4.3%) in the EA/LNG-IUS group compared with 8 women (12.3%) in the EA group (p = .24). One woman in the EA/LNG-IUS group (4.3%) presented with persistent bleeding compared with 15 (23.1%) in the EA group (p = .059). Office removal of the intrauterine device was performed in 4 women with no complications. LNG-IUS insertion at the time of EA is feasible and can provide added benefit after EA in women with dysmenorrhea and HMB. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

Early Adoption of Sacubitril/Valsartan for Patients With Heart Failure With Reduced Ejection Fraction: Insights From Get With the Guidelines-Heart Failure (GWTG-HF).

PubMed

Luo, Nancy; Fonarow, Gregg C; Lippmann, Steven J; Mi, Xiaojuan; Heidenreich, Paul A; Yancy, Clyde W; Greiner, Melissa A; Hammill, Bradley G; Hardy, N Chantelle; Turner, Stuart J; Laskey, Warren K; Curtis, Lesley H; Hernandez, Adrian F; Mentz, Robert J; O'Brien, Emily C

2017-04-01

The aim of this study was to assess the prevalence and variation in angiotensin receptor/neprilysin inhibitor (ARNI) prescription among a real-world population with heart failure with reduced ejection fraction (HFrEF). The U.S. Food and Drug Administration approved sacubitril/valsartan for patients with HFrEF in July 2015. Little is known about the early patterns of use of this novel therapy. The study included patients discharged alive from hospitals in Get With the Guidelines-Heart Failure (GWTG-HF), a registry of hospitalized patients with heart failure, between July 2015 and June 2016 who had documentation of whether ARNIs were prescribed at discharge. Patient and hospital characteristics were compared among patients with HFrEF (ejection fraction ≤40%) with and without ARNI prescription at discharge, excluding those with documented contraindications to ARNIs. To evaluate hospital variation, hospitals with at least 10 eligible hospitalizations during the study period were assessed. Of 21,078 patients hospitalized with HFrEF during the study period, 495 (2.3%) were prescribed ARNIs at discharge. Patients prescribed ARNIs were younger (median age 65 years vs. 70 years; p < 0.001), had lower ejection fractions (median 23% vs. 25%; p < 0.001), and had higher use of aldosterone antagonists (45% vs. 31%; p < 0.001) at discharge. At the 241 participating hospitals with 10 or more eligible admissions, 125 (52%) reported no discharge prescriptions of ARNIs. Approximately 2.3% of patients hospitalized for HFrEF in a national registry were prescribed ARNI therapy in the first 12 months following Food and Drug Administration approval. Further study is needed to identify and overcome barriers to implementing new evidence into practice, such as ARNI use among eligible patients with HFrEF. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Explosive eruption, flank collapse and megatsunami at Tenerife ca. 170 ka

PubMed Central

Paris, Raphaël; Bravo, Juan J. Coello; González, María E. Martín; Kelfoun, Karim; Nauret, François

2017-01-01

Giant mass failures of oceanic shield volcanoes that generate tsunamis potentially represent a high-magnitude but low-frequency hazard, and it is actually difficult to infer the mechanisms and dynamics controlling them. Here we document tsunami deposits at high elevation (up to 132 m) on the north-western slopes of Tenerife, Canary Islands, as a new evidence of megatsunami generated by volcano flank failure. Analyses of the tsunami deposits demonstrate that two main tsunamis impacted the coasts of Tenerife 170 kyr ago. The first tsunami was generated during the submarine stage of a retrogressive failure of the northern flank of the island, whereas the second one followed the debris avalanche of the subaerial edifice and incorporated pumices from an on-going ignimbrite-forming eruption. Coupling between a massive retrogressive flank failure and a large explosive eruption represents a new type of volcano-tectonic event on oceanic shield volcanoes and a new hazard scenario. PMID:28504256

First documented case of successful kidney transplantation from a donor with acute renal failure treated with dialysis.

PubMed

Bacak-Kocman, Iva; Peric, Mladen; Kastelan, Zeljko; Kes, Petar; Mesar, Ines; Basic-Jukic, Nikolina

2013-10-01

There is a widening gap between the needs and possibilities of kidney transplantation. In order to solve the problem of organ shortage, the selection criteria for kidney donors have been less stringent over the last years. Favorable outcome of renal transplantation from deceased donors with acute renal failure requiring dialysis may have an important role in expanding the pool of donors. We present the case of two renal transplantations from a polytraumatized 20-years old donor with acute renal failure requiring dialysis. One recipient established good diuresis from the first post-transplant day and did not require hemodialysis. The second recipient had delayed graft function and was treated with 8 hemodialysis sessions. The patient was discharged with good diuresis and normal serum creatinine. After two years of follow-up, both recipients have normal graft function. According to our experience, kidneys from deceased young donors with acute renal failure requiring dialysis may be transplanted, in order to decrease the number of patients on transplantation waiting lists.

Reassessing Phase II Heart Failure Clinical Trials: Consensus Recommendations

PubMed Central

Butler, Javed; Hamo, Carine E.; Udelson, James E.; O’Connor, Christopher; Sabbah, Hani N.; Metra, Marco; Shah, Sanjiv J.; Kitzman, Dalane W.; Teerlink, John; Bernstein, Harold S.; Brooks, Gabriel; Depre, Christophe; DeSouza, Mary M.; Dinh, Wilfried; Donovan, Mark; Frische-Danielson, Regina; Frost, Robert J.; Garza, Dahlia; Gohring, Udo-Michael; Hellawell, Jennifer; Hsia, Judith; Ishihara, Shiro; Kay-Mugford, Patricia; Koglin, Joerg; Kozinn, Marc; Larson, Christopher J.; Mayo, Martha; Gan, Li-Ming; Mugnier, Pierrre; Mushonga, Sekayi; Roessig, Lothar; Russo, Cesare; Salsali, Afshin; Satler, Carol; Shi, Victor; Ticho, Barry; van der Laan, Michael; Yancy, Clyde; Stockbridge, Norman; Gheorghiade, Mihai

2017-01-01

The increasing burden and the continued suboptimal outcomes for patients with heart failure underlines the importance of continued research to develop novel therapeutics for this disorder. This can only be accomplished with successful translation of basic science discoveries into direct human application through effective clinical trial design and execution that results in a substantially improved clinical course and outcomes. In this respect, phase II clinical trials play a pivotal role in determining which of the multitude of potential basic science discoveries should move to the large and expansive registration trials in humans. A critical examination of the phase II trials in heart failure reveals multiple shortcomings in their concept, design, execution, and interpretation. To further a dialogue regarding the challenges and potential for improvement and the role of phase II trials in patients with heart failure, the Food and Drug Administration facilitated a meeting on October 17th 2016 represented by clinicians, researchers, industry members, and regulators. This document summarizes the discussion from this meeting and provides key recommendations for future directions. PMID:28356300

21 CFR 111.560 - What requirements apply to the review and investigation of a product complaint?

Code of Federal Regulations, 2012 CFR

2012-04-01

... PRACTICE IN MANUFACTURING, PACKAGING, LABELING, OR HOLDING OPERATIONS FOR DIETARY SUPPLEMENTS Product... a possible failure of a dietary supplement to meet any of its specifications, or any other... failure of a dietary supplement to meet any of its specifications, or any other requirements of this part...

21 CFR 111.560 - What requirements apply to the review and investigation of a product complaint?

Code of Federal Regulations, 2014 CFR

2014-04-01

... PRACTICE IN MANUFACTURING, PACKAGING, LABELING, OR HOLDING OPERATIONS FOR DIETARY SUPPLEMENTS Product... a possible failure of a dietary supplement to meet any of its specifications, or any other... failure of a dietary supplement to meet any of its specifications, or any other requirements of this part...

21 CFR 111.560 - What requirements apply to the review and investigation of a product complaint?

Code of Federal Regulations, 2010 CFR

2010-04-01

... PRACTICE IN MANUFACTURING, PACKAGING, LABELING, OR HOLDING OPERATIONS FOR DIETARY SUPPLEMENTS Product... a possible failure of a dietary supplement to meet any of its specifications, or any other... failure of a dietary supplement to meet any of its specifications, or any other requirements of this part...

Different acute cardiovascular stress in response to resistance exercise leading to failure versus not to failure in elderly women with and without hypertension--a pilot study.

PubMed

Tajra, Vitor; Vieira, Denis C L; Tibana, Ramires A; Teixeira, Tatiane G; Silva, Alessandro O; Farias, Darlan L; Nascimento, Dahan da C; de Sousa, Nuno M F; Willardson, Jeffrey; Prestes, Jonato

2015-03-01

The purpose of the present study was to compare the effects of resistance exercise (RE) leading to failure versus not to failure on 24-h blood pressure (BP) and rate-pressure product (RPP) responses in normotensive and hypertensive trained elderly women. Seven normotensive women and seven women with medically documented hypertension randomly performed three experimental sessions: (i) a non-exercise control session that involved 30 min of seated rest, (ii) whole body RE leading to failure that involved three sets with an eight repetitions maximum (8RM) load and (iii) whole body RE not to failure that involved three sets with 70% of an 8RM load. Systolic BP (SBP), diastolic BP (DBP) and mean BP (MBP) responses during each hour of sleep and awake states were measured. Results of all subjects revealed that the RPP was higher (P ≤ 0.05) during afternoon and night hours after the RE session leading to failure versus not to failure and the non-exercise control session. For the hypertensive group during the night hours, SBP remained higher after the RE session not to failure (P = 0.047) versus non-exercise control session. For the normotensive group, DBP remained higher after the RE session leading to failure over the 24-h period (approximately 8 mmHg h(-1), P = 0.044) and the period upon awaking (approximately 5 mmHg h(-1), P = 0.044) versus the hypertensive group. The normotensive elderly women of this pilot study presented a greater cardiovascular response to RE leading to failure, as a consequence of the higher training intensity. © 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Subject specific finite element modeling of periprosthetic femoral fracture using element deactivation to simulate bone failure.

PubMed

Miles, Brad; Kolos, Elizabeth; Walter, William L; Appleyard, Richard; Shi, Angela; Li, Qing; Ruys, Andrew J

2015-06-01

Subject-specific finite element (FE) modeling methodology could predict peri-prosthetic femoral fracture (PFF) for cementless hip arthoplasty in the early postoperative period. This study develops methodology for subject-specific finite element modeling by using the element deactivation technique to simulate bone failure and validate with experimental testing, thereby predicting peri-prosthetic femoral fracture in the early postoperative period. Material assignments for biphasic and triphasic models were undertaken. Failure modeling with the element deactivation feature available in ABAQUS 6.9 was used to simulate a crack initiation and propagation in the bony tissue based upon a threshold of fracture strain. The crack mode for the biphasic models was very similar to the experimental testing crack mode, with a similar shape and path of the crack. The fracture load is sensitive to the friction coefficient at the implant-bony interface. The development of a novel technique to simulate bone failure by element deactivation of subject-specific finite element models could aid prediction of fracture load in addition to fracture risk characterization for PFF. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

Novel prognostic tissue markers in congestive heart failure.

PubMed

Stone, James R

2015-01-01

Heart failure is a relatively common disorder associated with high morbidity, mortality, and economic burden. Better tools to predict outcomes for patients with heart failure could allow for better decision making concerning patient treatment and management and better utilization of health care resources. Endomyocardial biopsy offers a mechanism to pathologically diagnose specific diseases in patients with heart failure, but such biopsies can often be negative, with no specific diagnostic information. Novel tissue markers in endomyocardial biopsies have been identified that may be useful in assessing prognosis in heart failure patients. Such tissue markers include ubiquitin, Gremlin-1, cyclophilin A, and heterogeneous nuclear ribonucleoprotein C. In some cases, tissue markers have been found to be independent of and even superior to clinical indices and serum markers in predicting prognosis for heart failure patients. In some cases, these novel tissue markers appear to offer prognostic information even in the setting of an otherwise negative endomyocardial biopsy. Copyright © 2014 Elsevier Inc. All rights reserved.

Application Agreement and Integration Services

NASA Technical Reports Server (NTRS)

Driscoll, Kevin R.; Hall, Brendan; Schweiker, Kevin

2013-01-01

Application agreement and integration services are required by distributed, fault-tolerant, safety critical systems to assure required performance. An analysis of distributed and hierarchical agreement strategies are developed against the backdrop of observed agreement failures in fielded systems. The documented work was performed under NASA Task Order NNL10AB32T, Validation And Verification of Safety-Critical Integrated Distributed Systems Area 2. This document is intended to satisfy the requirements for deliverable 5.2.11 under Task 4.2.2.3. This report discusses the challenges of maintaining application agreement and integration services. A literature search is presented that documents previous work in the area of replica determinism. Sources of non-deterministic behavior are identified and examples are presented where system level agreement failed to be achieved. We then explore how TTEthernet services can be extended to supply some interesting application agreement frameworks. This document assumes that the reader is familiar with the TTEthernet protocol. The reader is advised to read the TTEthernet protocol standard [1] before reading this document. This document does not re-iterate the content of the standard.

Direct seeding for forestation

Treesearch

Walter H. Davidson

1980-01-01

Direct seeding, an attractive alternative to planting, is not a simple method of forestation. Past experiences show far more failures than successes. Well documented procedures must be followed to insure any degree of success. In general, conifers have given the best results. Black walnut and black locust are notable exceptions. Current research suggests that other...

Fighting Back in Appalachia: Traditions of Resistance and Change.

ERIC Educational Resources Information Center

Fisher, Stephen L., Ed.

Sixteen essays document the extent and variety of community resistance and struggle in Appalachia since 1960, and the origins and factors contributing to success or failure of particular efforts. They also relate the study of Appalachian dissent to issues informing scholarly discussions of dissent nationally. Of particular educational relevance…

Report: EPA Has Not Reported to Congress on BEACH Act Progress as Statutorily Required or Fully Documented Budget Decisions

EPA Pesticide Factsheets

Report #18-P-0071, January 18, 2018. Failure to submit required reports and keep required records limits congressional, public and EPA knowledge about the impact of the agency's BEACH Act program and decisions regarding the use of taxpayer dollars.

12 CFR 1780.29 - Deposition of witness unavailable for hearing.

Code of Federal Regulations, 2010 CFR

2010-01-01

... HOUSING AND URBAN DEVELOPMENT RULES OF PRACTICE AND PROCEDURE RULES OF PRACTICE AND PROCEDURE Prehearing... not be available for the hearing, a party desiring to preserve that witness' testimony for the record... the grounds for the objection. Failure to object to questions or documents is not deemed a waiver...

36 CFR 800.7 - Failure to resolve adverse effects.

Code of Federal Regulations, 2010 CFR

2010-07-01

... into account the Council's comments in reaching a final decision on the undertaking. Section 110(l) of the act directs that the head of the agency shall document this decision and may not delegate his or... comments. Upon request of the Council, the agency official shall provide additional existing information...

Who Teaches Mathematics at Second Level in Ireland?

ERIC Educational Resources Information Center

Ni Riordain, Maire; Hannigan, Ailish

2011-01-01

Ireland's "mathematics problem" is well-documented and extensively reported in the media and elsewhere (Expert Group on Future Skills Needs (EGFSN) 2008; Task Force on the Physical Sciences 2002). Concern primarily lies with post-primary students' underperformance in mathematics coupled with a failure to make a successful transition to…

Creating Effective Video to Promote Student-Centered Teaching

ERIC Educational Resources Information Center

Gainsburg, Julie

2009-01-01

Training and investing teachers at all career levels in student-centered practices is widely recognized as a significant challenge. Various studies document the failure of student-centered teaching practices to take hold in K-12 mathematics classrooms in significant ways, including collaborative work; problems that are cognitively demanding or…

Final report and recommendations for research on human-automation interaction in the Next Generation Air Transportation System

DOT National Transportation Integrated Search

2006-11-01

This is the final report of an 18-month project to: (1) review Next Generation Air Transportation System (NGATS) Joint Planning and Development Office (JPDO) documents as they pertain to human-automation interaction; (2) review past system failures i...

45 CFR 150.455 - Sanctions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... of a regulation, for abandonment of a case, or for other actions that interfere with the speedy... severity and nature of the failure or action. (b) A sanction may include any of the following actions: (1... case. (6) Entering a decision by default. (7) Refusing to consider any motion or other document that is...

Genetic variation in California oaks

Treesearch

Constance I. Millar; Diane L. Delany; Lawrence A. Riggs

1990-01-01

In forestry the importance of genetic variation for successful reproduction, survival and growth has been widely documented for commercial conifers; until recently, little genetic work has been done on the California oaks. Even before the nature of genetic variation was scientifically investigated, its importance was suspected in operational forestry. Many failures of...

78 FR 30385 - Approval of Noise Compatibility Program for Tweed-New Haven Regional Airport

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-22

... use of flight procedures can be implemented within the period covered by the program without... maps, descriptions, and other documentation produced during the noise compatibility planning study... 180 days (other than the use of new flight procedures for noise control). Failure to approve or...