Science.gov

Sample records for failure assessment diagram

  1. Failure Assessment Diagram for Titanium Brazed Joints

    NASA Technical Reports Server (NTRS)

    Flom, Yury; Jones, Justin S.; Powell, Mollie M.; Puckett, David F.

    2011-01-01

    The interaction equation was used to predict failure in Ti-4V-6Al joints brazed with Al 1100 filler metal. The joints used in this study were geometrically similar to the joints in the brazed beryllium metering structure considered for the ATLAS telescope. This study confirmed that the interaction equation R(sub sigma) + R(sub Tau) = 1, where R(sub sigma) and R(sub Tau)are normal and shear stress ratios, can be used as conservative lower bound estimate of the failure criterion in ATLAS brazed joints as well as for construction of the Failure Assessment Diagram (FAD).

  2. Failure Assessment Diagram for Brazed 304 Stainless Steel Joints

    NASA Technical Reports Server (NTRS)

    Flom, Yory

    2011-01-01

    Interaction equations were proposed earlier to predict failure in Albemet 162 brazed joints. Present study demonstrates that the same interaction equations can be used for lower bound estimate of the failure criterion in 304 stainless steel joints brazed with silver-based filler metals as well as for construction of the Failure Assessment Diagrams (FAD).

  3. Evaluation of Brazed Joints Using Failure Assessment Diagram

    NASA Technical Reports Server (NTRS)

    Flom, Yury

    2012-01-01

    Fitness-for service approach was used to perform structural analysis of the brazed joints consisting of several base metal / filler metal combinations. Failure Assessment Diagrams (FADs) based on tensile and shear stress ratios were constructed and experimentally validated. It was shown that such FADs can provide a conservative estimate of safe combinations of stresses in the brazed joints. Based on this approach, Margins of Safety (MS) of the brazed joints subjected to multi-axial loading conditions can be evaluated..

  4. Improved reliability analysis method based on the failure assessment diagram

    NASA Astrophysics Data System (ADS)

    Zhou, Yu; Zhang, Zheng; Zhong, Qunpeng

    2012-07-01

    With the uncertainties related to operating conditions, in-service non-destructive testing (NDT) measurements and material properties considered in the structural integrity assessment, probabilistic analysis based on the failure assessment diagram (FAD) approach has recently become an important concern. However, the point density revealing the probabilistic distribution characteristics of the assessment points is usually ignored. To obtain more detailed and direct knowledge from the reliability analysis, an improved probabilistic fracture mechanics (PFM) assessment method is proposed. By integrating 2D kernel density estimation (KDE) technology into the traditional probabilistic assessment, the probabilistic density of the randomly distributed assessment points is visualized in the assessment diagram. Moreover, a modified interval sensitivity analysis is implemented and compared with probabilistic sensitivity analysis. The improved reliability analysis method is applied to the assessment of a high pressure pipe containing an axial internal semi-elliptical surface crack. The results indicate that these two methods can give consistent sensitivities of input parameters, but the interval sensitivity analysis is computationally more efficient. Meanwhile, the point density distribution and its contour are plotted in the FAD, thereby better revealing the characteristics of PFM assessment. This study provides a powerful tool for the reliability analysis of critical structures.

  5. Application of the failure assessment diagram to the evaluation of pressure-temperature limits for a pressurized water reactor

    SciTech Connect

    Yoon, K.K.; Bloom, J.M.; Pavinich, W.A.; Slager, H.W.

    1984-06-01

    The failure assessment diagram approach, an elastic-plastic fracture mechanics procedure based on the J-integral concept, was used in the evaluation of pressure-temperature (P-T) limits for the beltline region of the vessel of a pressurized water reactor. The main objective of this paper is to illustrate the application of an alternate fracture mechanics method for the evaluation of pressure-temperature limits, as allowed by Title 10, Code of Federal Regulation Part 50 (10 CFR 50), Appendix G. The evaluation of P-T limits for the beltline region of a pressurized water reactor vessel was based on the following assumptions: ASME Pressure Vessel and Piping Code, Section III, Appendix G reference flaw End-of-life fluence level in the beltline region Longitudinal flaw in the beltline weld J-resistance material toughness curves obtained from the U.S. Nuclear Regulatory Commission's Heavy Section Steel Technology (HSST) program Other material properties obtained from the Babcock and Wilcox Integrated Reactor Vessel Material Surveillance Program The maximum allowable pressure levels were calculated at 33 time points along the given bulk coolant temperature history representing the normal operation of a pressurized water reactor. The results of the calculations showed that adequate margins of safety on operating pressure for the critical weld in the beltline of the pressurized water reactor vessel are assured.

  6. Application of ISO22000, failure mode, and effect analysis (FMEA) cause and effect diagrams and pareto in conjunction with HACCP and risk assessment for processing of pastry products.

    PubMed

    Varzakas, Theodoros H

    2011-09-01

    The Failure Mode and Effect Analysis (FMEA) model has been applied for the risk assessment of pastry processing. A tentative approach of FMEA application to the pastry industry was attempted in conjunction with ISO22000. Preliminary Hazard Analysis was used to analyze and predict the occurring failure modes in a food chain system (pastry processing plant), based on the functions, characteristics, and/or interactions of the ingredients or the processes, upon which the system depends. Critical Control points have been identified and implemented in the cause and effect diagram (also known as Ishikawa, tree diagram, and fishbone diagram). In this work a comparison of ISO22000 analysis with HACCP is carried out over pastry processing and packaging. However, the main emphasis was put on the quantification of risk assessment by determining the Risk Priority Number (RPN) per identified processing hazard. Storage of raw materials and storage of final products at -18°C followed by freezing were the processes identified as the ones with the highest RPN (225, 225, and 144 respectively) and corrective actions were undertaken. Following the application of corrective actions, a second calculation of RPN values was carried out leading to considerably lower values (below the upper acceptable limit of 130). It is noteworthy that the application of Ishikawa (Cause and Effect or Tree diagram) led to converging results thus corroborating the validity of conclusions derived from risk assessment and FMEA. Therefore, the incorporation of FMEA analysis within the ISO22000 system of a pastry processing industry is considered imperative.

  7. Failure Diagram for Chemically Assisted Crack Growth

    NASA Astrophysics Data System (ADS)

    Sadananda, K.; Vasudevan, A. K.

    2011-02-01

    A failure diagram that combines the thresholds for failure of a smooth specimen to that of a fracture mechanics specimen, similar to the modified Kitagawa diagram in fatigue, is presented. For a given material/environment system, the diagram defines conditions under which a crack initiated at the threshold stress in a smooth specimen becomes a propagating crack, by satisfying the threshold stress intensity of a long crack. In analogy with fatigue, it is shown that internal stresses or local stress concentrations are required to provide the necessary mechanical crack tip driving forces, on one hand, and reaction/transportation kinetics to provide the chemical potential gradients, on the other. Together, they help in the initiation and propagation of the cracks. The chemical driving forces can be expressed as equivalent mechanical stresses using the failure diagram. Both internal stresses and their gradients, in conjunction with the chemical driving forces, have to meet the minimum magnitude and the minimum gradients to sustain the growth of a microcrack formed. Otherwise, nonpropagating conditions will prevail or a crack formed will remain dormant. It is shown that the processes underlying the crack nucleation in a smooth specimen and the crack growth of a fracture mechanics specimen are essentially the same. Both require building up of internal stresses by local plasticity. The process involves intermittent crack tip blunting and microcrack nucleation until the crack becomes unstable under the applied stress.

  8. Automatically Assessing Graph-Based Diagrams

    ERIC Educational Resources Information Center

    Thomas, Pete; Smith, Neil; Waugh, Kevin

    2008-01-01

    To date there has been very little work on the machine understanding of imprecise diagrams, such as diagrams drawn by students in response to assessment questions. Imprecise diagrams exhibit faults such as missing, extraneous and incorrectly formed elements. The semantics of imprecise diagrams are difficult to determine. While there have been…

  9. Automatically Assessing Graph-Based Diagrams

    ERIC Educational Resources Information Center

    Thomas, Pete; Smith, Neil; Waugh, Kevin

    2008-01-01

    To date there has been very little work on the machine understanding of imprecise diagrams, such as diagrams drawn by students in response to assessment questions. Imprecise diagrams exhibit faults such as missing, extraneous and incorrectly formed elements. The semantics of imprecise diagrams are difficult to determine. While there have been…

  10. A comparative study of wide plate behavior of a range of structural steels using the failure assessment diagram

    SciTech Connect

    Bannister, A.C.; Harrison, P.L.

    1995-12-31

    In the field of structural integrity assessments, attention is currently focused on the ability of such methods to conservatively predict the deformation and fracture behavior of structural steels and their weldments. In the current paper, the results of a series of wide plate tests on a range of structural steels are presented and the results assessed in terms of CTOD-strain relationships, BS PD 6493 Levels 2 and 3, and the crack driving force approach. The behavior of the large scale tests and the results of the various analyses are assessed with regard to the stress-strain characteristics of the individual steels. In a second step, the approach is extended to the assessment of a number of wide plate tests comprising welded joints with mismatched strength levels. Over, under and even-matched welded plates are compared with the behavior of normalized and Quenched and Tempered parent plates. The study demonstrates that the behavior of parent material wide plate tests can vary widely depending on the stress-strain characteristics of the material. The different behavior is a result of the consecutive effects of different steel processing conditions, microstructure, yield to tensile strength ratio and strain hardening exponent. These features are also manifested, to a lesser or greater extent, in the results of wide plate tests on welded plates of mismatched strength. Studies on mismatch effects should therefore include equal attention to the stress-strain characteristics of the parent materials as this may, in some circumstances, dominate any effects of weld strength mismatch.

  11. Using Dynamic Master Logic Diagram for component partial failure analysis

    SciTech Connect

    Ni, T.; Modarres, M.

    1996-12-01

    A methodology using the Dynamic Master Logic Diagram (DMLD) for the evaluation of component partial failure is presented. Since past PRAs have not focused on partial failure effects, the reliability of components are only based on the binary state assumption, i.e. defining a component as fully failed or functioning. This paper is to develop an approach to predict and estimate the component partial failure on the basis of the fuzzy state assumption. One example of the application of this methodology with the reliability function diagram of a centrifugal pump is presented.

  12. Failure Assessment

    NASA Technical Reports Server (NTRS)

    Lutz, Robyn; Nikora, Allen

    2005-01-01

    Three questions to which software developers want accurate, precise answers are "How can the software system fail?", "mat bad things will happen if the software fails?t', and "How many failures will the software experience?". Numerous techniques have been devised to answer these questions; three of the best known are: 1) Software Fault Tree Analysis (SFTA) 2) Software Failure Modes, Effects, and Criticality Analysis (SFMECA 3) Software Fault/Failure Modeling. SFTA and SFMECA have been successfully used to analyze the flight software for a number of robotic planetary exploration missions, including Galileo, Cassini, and Deep Space 1. Given the increasing interest in reusing software components from mission to mission, one of us has developed techniques for reusing the corresponding portions of the SFTA and SFMECA, reducing the effort required to conduct these analyses. SFTA has also been shown to be effective in analyzing the security aspects of software systems; intrusion mechanisms and effects can easily be modeled using these techniques. The Bi- Directional Safety Analysis (BDSA) method combines a forward search (similar to SFMECA) from potential failure modes to their effects, with a backward search (similar to SFTA) from feasible hazards to the contributing causes of each hazard. BDSA offers an efficient way to identify latent failures. Recent work has extended BDSA to product-line applications such as flight-instrumentation displays and developed tool support for the reuse of the failure-analysis artifacts within a product line. BDSA has also been streamlined to support those projects having tight cost and/or schedule constraints for their failure analysis efforts. We discuss lessons learned from practice, describe available tools, and identi@ some future directions for the topic. A substantial amount of research has been devoted to estimating the number of failures that a software system will experience during test and operations, as well as the number of

  13. The Problem of Labels in E-Assessment of Diagrams

    ERIC Educational Resources Information Center

    Jayal, Ambikesh; Shepperd, Martin

    2009-01-01

    In this article we explore a problematic aspect of automated assessment of diagrams. Diagrams have partial and sometimes inconsistent semantics. Typically much of the meaning of a diagram resides in the labels; however, the choice of labeling is largely unrestricted. This means a correct solution may utilize differing yet semantically equivalent…

  14. The Problem of Labels in E-Assessment of Diagrams

    ERIC Educational Resources Information Center

    Jayal, Ambikesh; Shepperd, Martin

    2009-01-01

    In this article we explore a problematic aspect of automated assessment of diagrams. Diagrams have partial and sometimes inconsistent semantics. Typically much of the meaning of a diagram resides in the labels; however, the choice of labeling is largely unrestricted. This means a correct solution may utilize differing yet semantically equivalent…

  15. Using Tree Diagrams as an Assessment Tool in Statistics Education

    ERIC Educational Resources Information Center

    Yin, Yue

    2012-01-01

    This study examines the potential of the tree diagram, a type of graphic organizer, as an assessment tool to measure students' knowledge structures in statistics education. Students' knowledge structures in statistics have not been sufficiently assessed in statistics, despite their importance. This article first presents the rationale and method…

  16. Using Tree Diagrams as an Assessment Tool in Statistics Education

    ERIC Educational Resources Information Center

    Yin, Yue

    2012-01-01

    This study examines the potential of the tree diagram, a type of graphic organizer, as an assessment tool to measure students' knowledge structures in statistics education. Students' knowledge structures in statistics have not been sufficiently assessed in statistics, despite their importance. This article first presents the rationale and method…

  17. The efficiency and effectiveness of utilizing diagrams in interviews: an assessment of participatory diagramming and graphic elicitation.

    PubMed

    Umoquit, Muriah J; Dobrow, Mark J; Lemieux-Charles, Louise; Ritvo, Paul G; Urbach, David R; Wodchis, Walter P

    2008-08-08

    This paper focuses on measuring the efficiency and effectiveness of two diagramming methods employed in key informant interviews with clinicians and health care administrators. The two methods are 'participatory diagramming', where the respondent creates a diagram that assists in their communication of answers, and 'graphic elicitation', where a researcher-prepared diagram is used to stimulate data collection. These two diagramming methods were applied in key informant interviews and their value in efficiently and effectively gathering data was assessed based on quantitative measures and qualitative observations. Assessment of the two diagramming methods suggests that participatory diagramming is an efficient method for collecting data in graphic form, but may not generate the depth of verbal response that many qualitative researchers seek. In contrast, graphic elicitation was more intuitive, better understood and preferred by most respondents, and often provided more contemplative verbal responses, however this was achieved at the expense of more interview time. Diagramming methods are important for eliciting interview data that are often difficult to obtain through traditional verbal exchanges. Subject to the methodological limitations of the study, our findings suggest that while participatory diagramming and graphic elicitation have specific strengths and weaknesses, their combined use can provide complementary information that would not likely occur with the application of only one diagramming method. The methodological insights gained by examining the efficiency and effectiveness of these diagramming methods in our study should be helpful to other researchers considering their incorporation into qualitative research designs.

  18. The efficiency and effectiveness of utilizing diagrams in interviews: an assessment of participatory diagramming and graphic elicitation

    PubMed Central

    Umoquit, Muriah J; Dobrow, Mark J; Lemieux-Charles, Louise; Ritvo, Paul G; Urbach, David R; Wodchis, Walter P

    2008-01-01

    Background This paper focuses on measuring the efficiency and effectiveness of two diagramming methods employed in key informant interviews with clinicians and health care administrators. The two methods are 'participatory diagramming', where the respondent creates a diagram that assists in their communication of answers, and 'graphic elicitation', where a researcher-prepared diagram is used to stimulate data collection. Methods These two diagramming methods were applied in key informant interviews and their value in efficiently and effectively gathering data was assessed based on quantitative measures and qualitative observations. Results Assessment of the two diagramming methods suggests that participatory diagramming is an efficient method for collecting data in graphic form, but may not generate the depth of verbal response that many qualitative researchers seek. In contrast, graphic elicitation was more intuitive, better understood and preferred by most respondents, and often provided more contemplative verbal responses, however this was achieved at the expense of more interview time. Conclusion Diagramming methods are important for eliciting interview data that are often difficult to obtain through traditional verbal exchanges. Subject to the methodological limitations of the study, our findings suggest that while participatory diagramming and graphic elicitation have specific strengths and weaknesses, their combined use can provide complementary information that would not likely occur with the application of only one diagramming method. The methodological insights gained by examining the efficiency and effectiveness of these diagramming methods in our study should be helpful to other researchers considering their incorporation into qualitative research designs. PMID:18691410

  19. Application of Failure Mode and Effect Analysis (FMEA), cause and effect analysis, and Pareto diagram in conjunction with HACCP to a corn curl manufacturing plant.

    PubMed

    Varzakas, Theodoros H; Arvanitoyannis, Ioannis S

    2007-01-01

    The Failure Mode and Effect Analysis (FMEA) model has been applied for the risk assessment of corn curl manufacturing. A tentative approach of FMEA application to the snacks industry was attempted in an effort to exclude the presence of GMOs in the final product. This is of crucial importance both from the ethics and the legislation (Regulations EC 1829/2003; EC 1830/2003; Directive EC 18/2001) point of view. The Preliminary Hazard Analysis and the Fault Tree Analysis were used to analyze and predict the occurring failure modes in a food chain system (corn curls processing plant), based on the functions, characteristics, and/or interactions of the ingredients or the processes, upon which the system depends. Critical Control points have been identified and implemented in the cause and effect diagram (also known as Ishikawa, tree diagram, and the fishbone diagram). Finally, Pareto diagrams were employed towards the optimization of GMOs detection potential of FMEA.

  20. Acute Effects of Vagotomy on Baroreflex Equilibrium Diagram in Rats with Chronic Heart Failure

    PubMed Central

    Kawada, Toru; Li, Meihua; Zheng, Can; Sugimachi, Masaru

    2016-01-01

    The arterial baroreflex system can be divided into the neural arc, from pressure input to efferent sympathetic nerve activity (SNA), and the peripheral arc, from SNA to arterial pressure (AP). Plotting the neural and peripheral arcs on a pressure–SNA plane yields a baroreflex equilibrium diagram. We examined the effects of vagotomy on the open-loop static characteristics of the carotid sinus baroreflex in normal control rats (NC, n = 10) and rats with heart failure after myocardial infarction (MI, n = 10). In the NC group, vagotomy shifted the neural arc toward higher SNA and decreased the slope of the peripheral arc. Consequently, the operating-point SNA increased without a significant change in the operating-point AP on the baroreflex equilibrium diagram. These vagotomy-induced effects were not observed in the MI group, suggesting a loss of vagal modulation of the carotid sinus baroreflex function in heart failure. PMID:27594790

  1. A new model of Ishikawa diagram for quality assessment

    NASA Astrophysics Data System (ADS)

    Liliana, Luca

    2016-11-01

    The paper presents the results of a study concerning the use of the Ishikawa diagram in analyzing the causes that determine errors in the evaluation of theparts precision in the machine construction field. The studied problem was"errors in the evaluation of partsprecision” and this constitutes the head of the Ishikawa diagram skeleton.All the possible, main and secondary causes that could generate the studied problem were identified. The most known Ishikawa models are 4M, 5M, 6M, the initials being in order: materials, methods, man, machines, mother nature, measurement. The paper shows the potential causes of the studied problem, which were firstly grouped in three categories, as follows: causes that lead to errors in assessing the dimensional accuracy, causes that determine errors in the evaluation of shape and position abnormalities and causes for errors in roughness evaluation. We took into account the main components of parts precision in the machine construction field. For each of the three categories of causes there were distributed potential secondary causes on groups of M (man, methods, machines, materials, environment/ medio ambiente-sp.). We opted for a new model of Ishikawa diagram, resulting from the composition of three fish skeletons corresponding to the main categories of parts accuracy.

  2. Students' Understanding of Diagrams for Solving Word Problems: A Framework for Assessing Diagram Proficiency

    ERIC Educational Resources Information Center

    Poch, Apryl L.; van Garderen, Delinda; Scheuermann, Amy M.

    2015-01-01

    A visual representation, such as a diagram, can be a powerful strategy for solving mathematical word problems. However, using a representation to solve mathematical word problems is not as simple as it seems! Many students with learning disabilities struggle to use a diagram effectively and efficiently. This article provides a framework for…

  3. Failure Assessment of Stainless Steel and Titanium Brazed Joints

    NASA Technical Reports Server (NTRS)

    Flom, Yury A.

    2012-01-01

    Following successful application of Coulomb-Mohr and interaction equations for evaluation of safety margins in Albemet 162 brazed joints, two additional base metal/filler metal systems were investigated. Specimens consisting of stainless steel brazed with silver-base filler metal and titanium brazed with 1100 Al alloy were tested to failure under combined action of tensile, shear, bending and torsion loads. Finite Element Analysis (FEA), hand calculations and digital image comparison (DIC) techniques were used to estimate failure stresses and construct Failure Assessment Diagrams (FAD). This study confirms that interaction equation R(sub sigma) + R(sub tau) = 1, where R(sub sigma) and R(sub t u) are normal and shear stress ratios, can be used as conservative lower bound estimate of the failure criterion in stainless steel and titanium brazed joints.

  4. A Triaxial Failure Diagram to predict the forming limit of 3D sheet metal parts subjected to multiaxial stresses

    NASA Astrophysics Data System (ADS)

    Rastellini, F.; Socorro, G.; Forgas, A.; Onate, E.

    2016-08-01

    Accurate prediction of failure and forming limits is essential when modelling sheet metal forming processes. Since traditional Forming Limit Curves (FLCs) are not valid for materials subjected to triaxial loading, a new failure criterion is proposed in this paper based on the stress triaxility and the effective plastic strain accumulated during the history of material loading. Formability zones are identified inside the proposed Triaxial Failure Diagram (TFD). FLCs may be mapped into the TFD defining a new Triaxial Failure Curve, or it can be defined by triaxial failure experiments. Several TFD examples are validated and constrasted showing acceptable accuracy in the numerical prediction of forming failure/limit of 3D thick sheet parts.

  5. Assessment of failure of cemented polyethylene acetabular component due to bone remodeling: A finite element study.

    PubMed

    Ghosh, Rajesh

    2016-09-01

    The aim of the study is to determine failure of the cemented polyethylene acetabular component, which might occur due to excessive bone resorption, cement-bone interface debonding and fatigue failure of the cement mantle. Three-dimensional finite element models of intact and implanted pelvic bone were developed and bone remodeling algorithm was implemented for present analysis. Soderberg fatigue failure diagram was used for fatigue assessment of the cement mantle. Hoffman failure criterion was considered for prediction of cement-bone interface debonding. Results indicate fatigue failure of the cement mantle and implant-bone interface debonding might not occur due to bone remodeling.

  6. Nanoparticles in the environment: assessment using the causal diagram approach

    PubMed Central

    2012-01-01

    Nanoparticles (NPs) cause concern for health and safety as their impact on the environment and humans is not known. Relatively few studies have investigated the toxicological and environmental effects of exposure to naturally occurring NPs (NNPs) and man-made or engineered NPs (ENPs) that are known to have a wide variety of effects once taken up into an organism. A review of recent knowledge (between 2000-2010) on NP sources, and their behaviour, exposure and effects on the environment and humans was performed. An integrated approach was used to comprise available scientific information within an interdisciplinary logical framework, to identify knowledge gaps and to describe environment and health linkages for NNPs and ENPs. The causal diagram has been developed as a method to handle the complexity of issues on NP safety, from their exposure to the effects on the environment and health. It gives an overview of available scientific information starting with common sources of NPs and their interactions with various environmental processes that may pose threats to both human health and the environment. Effects of NNPs on dust cloud formation and decrease in sunlight intensity were found to be important environmental changes with direct and indirect implication in various human health problems. NNPs and ENPs exposure and their accumulation in biological matrices such as microbiota, plants and humans may result in various adverse effects. The impact of some NPs on human health by ROS generation was found to be one of the major causes to develop various diseases. A proposed cause-effects diagram for NPs is designed considering both NNPs and ENPs. It represents a valuable information package and user-friendly tool for various stakeholders including students, researchers and policy makers, to better understand and communicate on issues related to NPs. PMID:22759495

  7. Failure Assessment of Brazed Structures

    NASA Technical Reports Server (NTRS)

    Flom, Yuri

    2012-01-01

    Despite the great advances in analytical methods available to structural engineers, designers of brazed structures have great difficulties in addressing fundamental questions related to the loadcarrying capabilities of brazed assemblies. In this chapter we will review why such common engineering tools as Finite Element Analysis (FEA) as well as many well-established theories (Tresca, von Mises, Highest Principal Stress, etc) don't work well for the brazed joints. This chapter will show how the classic approach of using interaction equations and the less known Coulomb-Mohr failure criterion can be employed to estimate Margins of Safety (MS) in brazed joints.

  8. Do health technology assessments comply with QUOROM diagram guidance? An empirical study.

    PubMed

    Hind, Daniel; Booth, Andrew

    2007-11-20

    The Quality of Reporting of Meta-analyses (QUOROM) statement provides guidance for improving the quality of reporting of systematic reviews and meta-analyses. To make the process of study selection transparent it recommends "a flow diagram providing information about the number of RCTs identified, included, and excluded and the reasons for excluding them". We undertook an empirical study to identify the extent of compliance in the UK Health Technology Assessment (HTA) programme. We searched Medline to retrieve all systematic reviews of therapeutic interventions in the HTA monograph series published from 2001 to 2005. Two researchers recorded whether each study contained a meta-analysis of controlled trials, whether a QUOROM flow diagram was presented and, if so, whether it expressed the relationship between the number of citations and the number of studies. We used Cohen's kappa to test inter-rater reliability. 87 systematic reviews were retrieved. There was good and excellent inter-rater reliability for, respectively, whether a review contained a meta-analysis and whether each diagram contained a citation-to-study relationship. 49% of systematic reviews used a study selection flow diagram. When only systematic reviews containing a meta-analysis were analysed, compliance was only 32%. Only 20 studies (23% of all systematic reviews; 43% of those having a study selection diagram) had a diagram which expressed the relationship between citations and studies. Compliance with the recommendations of the QUOROM statement is not universal in systematic reviews or meta-analyses. Flow diagrams make the conduct of study selection transparent only if the relationship between citations and studies is clearly expressed. Reviewers should understand what they are counting: citations, papers, studies and trials are fundamentally different concepts which should not be confused in a diagram.

  9. Assessment of Nonorganic Failure To Thrive.

    ERIC Educational Resources Information Center

    Wooster, Donna M.

    1999-01-01

    This article describes basic assessment considerations for infants and toddlers exhibiting nonorganic failure to thrive. The evaluation process must examine feeding, maternal-child interactions, child temperament, and environmental risks and behaviors. Early identification and intervention are necessary to minimize the long-term developmental…

  10. Insulation failure assessment under random energization overvoltages

    SciTech Connect

    Mahdy, A.M.; Anis, H.I.; El-Morshedy, A.

    1996-03-01

    This paper offers a new simple approach to the evaluation of the risk of failure of external insulation in view of their known probabilistic nature. This is applied to EHV transmission systems subjected to energization overvoltages. The randomness, both in the applied stresses and insulation`s withstand characteristics are numerically simulated and then integrated to assess the risk of failure. Overvoltage control methods are accounted for, such as the use of pre-insertion breaker resistors, series capacitive compensation, and the installation of shunt reactors.

  11. Renal function assessment in heart failure.

    PubMed

    Pérez Calvo, J I; Josa Laorden, C; Giménez López, I

    Renal function is one of the most consistent prognostic determinants in heart failure. The prognostic information it provides is independent of the ejection fraction and functional status. This article reviews the various renal function assessment measures, with special emphasis on the fact that the patient's clinical situation and response to the heart failure treatment should be considered for the correct interpretation of the results. Finally, we review the literature on the performance of tubular damage biomarkers. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  12. Use of Influence Diagrams and Fuzzy Theory to Develop Assessment Method of Organizational Influences on Component Maintenance

    SciTech Connect

    Yoonik Kim; Kwang-Won Ahn; Chang-Hyun Chung; Kil Yoo Kim; Joon-Eon Yang

    2002-07-01

    Organization can make influences on all the systems. Especially in case of nuclear power plants in which safety is established to be one of the most important operating goals, there have been a lot of research efforts for the hardware advancement. However in recent years, it has been widely recognized that organizational factors in nuclear power plants have an important influence on the safety attitudes and the safe behavior of individuals. Until now, any means to include assessments of organizational structure in probabilistic risk assessments have not been universally accepted. The objective of this work is to develop a method to assess organizational influences on component maintenance. Influence diagrams are introduced in this method as a decision making tool and fuzzy theory is used to reflect the vagueness in considering relevance of human activities in maintenance tasks. Introducing fuzzy theory to assess the organizational factors is deemed to a somewhat new trial, which makes it possible to convert linguistic vague descriptions into mathematical ones. Fuzzy linguistic descriptions offer an alternative and often complementary language to conventional, i.e., analytic approaches to modeling systems. Among the existing methodologies to assess organizational factors, the concept of the {omega}-factor model is utilized and the mechanism that organizational factors have influences on component maintenance is evaluated through composing influence diagrams. These influences go to failure rates and eventually affect component unavailability. Further study will make it possible that the influences of organizational factors on human error probabilities are incorporated into human reliability analysis and furthermore probabilistic safety assessment. (authors)

  13. Development of a diagnostic diagram for rapid field assessment of acidosis severity in diarrheic calves.

    PubMed

    Bellino, Claudio; Arnaudo, Fabrizio; Biolatti, Cristina; Borrelli, Antonio; Gianella, Paola; Maurella, Cristiana; Zabaldano, Giuseppe; Cagnasso, Aurelio; D'Angelo, Antonio

    2012-02-01

    To develop a diagnostic diagram for rapid field assessment of acidosis severity in diarrheic calves. Prospective cross-sectional study. 148 Piedmontese calves (38 calves in preliminary experiments; 83 diarrheic calves and 27 healthy control calves in the primary experiment). Physical examination was performed and a standard data collection form was completed for each calf. Blood samples were obtained and submitted for evaluation of acid-base balance, performance of a CBC, and measurement of electrolyte and total protein concentrations. Severe metabolic acidosis (extracellular base excess more negative than -10 mmol/L) was associated with abnormal mental status, delayed or absent suckle reflex, abnormal posture or gait, enophthalmos, and cold oral mucosal membranes. Clinical signs associated with severe metabolic acidosis were arranged into a grid to create a diagnostic diagram. Sensitivity and specificity of the diagnostic diagram for the prediction of severe metabolic acidosis were 88% and 79%, respectively. Use of the diagnostic diagram may aid differentiation between severe and nonsevere acidosis patterns as determined on the basis of clinical signs.

  14. Failure detection system risk reduction assessment

    NASA Technical Reports Server (NTRS)

    Aguilar, Robert B. (Inventor); Huang, Zhaofeng (Inventor)

    2012-01-01

    A process includes determining a probability of a failure mode of a system being analyzed reaching a failure limit as a function of time to failure limit, determining a probability of a mitigation of the failure mode as a function of a time to failure limit, and quantifying a risk reduction based on the probability of the failure mode reaching the failure limit and the probability of the mitigation.

  15. Derivation of Failure Rates and Probability of Failures for the International Space Station Probabilistic Risk Assessment Study

    NASA Technical Reports Server (NTRS)

    Vitali, Roberto; Lutomski, Michael G.

    2004-01-01

    National Aeronautics and Space Administration s (NASA) International Space Station (ISS) Program uses Probabilistic Risk Assessment (PRA) as part of its Continuous Risk Management Process. It is used as a decision and management support tool to not only quantify risk for specific conditions, but more importantly comparing different operational and management options to determine the lowest risk option and provide rationale for management decisions. This paper presents the derivation of the probability distributions used to quantify the failure rates and the probability of failures of the basic events employed in the PRA model of the ISS. The paper will show how a Bayesian approach was used with different sources of data including the actual ISS on orbit failures to enhance the confidence in results of the PRA. As time progresses and more meaningful data is gathered from on orbit failures, an increasingly accurate failure rate probability distribution for the basic events of the ISS PRA model can be obtained. The ISS PRA has been developed by mapping the ISS critical systems such as propulsion, thermal control, or power generation into event sequences diagrams and fault trees. The lowest level of indenture of the fault trees was the orbital replacement units (ORU). The ORU level was chosen consistently with the level of statistically meaningful data that could be obtained from the aerospace industry and from the experts in the field. For example, data was gathered for the solenoid valves present in the propulsion system of the ISS. However valves themselves are composed of parts and the individual failure of these parts was not accounted for in the PRA model. In other words the failure of a spring within a valve was considered a failure of the valve itself.

  16. European Extremely Large Telescope (E-ELT) availability stochastic model: integrating failure mode and effect analysis (FMEA), influence diagram, and Bayesian network together

    NASA Astrophysics Data System (ADS)

    Verzichelli, Gianluca

    2016-08-01

    An Availability Stochastic Model for the E-ELT has been developed in GeNIE. The latter is a Graphical User Interface (GUI) for the Structural Modeling, Inference, and Learning Engine (SMILE), originally distributed by the Decision Systems Laboratory from the University of Pittsburgh, and now being a product of Bayes Fusion, LLC. The E-ELT will be the largest optical/near-infrared telescope in the world. Its design comprises an Alt-Azimuth mount reflecting telescope with a 39-metre-diameter segmented primary mirror, a 4-metre-diameter secondary mirror, a 3.75-metre-diameter tertiary mirror, adaptive optics and multiple instruments. This paper highlights how a Model has been developed for an earlier on assessment of the Telescope Avail- ability. It also describes the modular structure and the underlying assumptions that have been adopted for developing the model and demonstrates the integration of FMEA, Influence Diagram and Bayesian Network elements. These have been considered for a better characterization of the Model inputs and outputs and for taking into account Degraded-based Reliability (DBR). Lastly, it provides an overview of how the information and knowledge captured in the model may be used for an earlier on definition of the Failure, Detection, Isolation and Recovery (FDIR) Control Strategy and the Telescope Minimum Master Equipment List (T-MMEL).

  17. Assessment of treatment failure in endodontic therapy.

    PubMed

    Bergenholtz, G

    2016-10-01

    There is a paucity of guidelines for the dental profession to assess failure of endodontic therapy. While a successful treatment can be well defined by the absence of apical periodontitis and clinical symptoms after a period of observation, failed treatment has escaped a distinct standing over the years. This article highlights aspects of significance and concludes that research ought to better explore the general health properties of persistent apical periodontitis on root-filled teeth and finally confirm the extent there is an association between apical periodontitis and adverse systemic health effects. Clearing this condition will determine whether clinicians should take a serious or relaxed attitude to persistent apical periodontitis subsequent to endodontic treatment. © 2016 John Wiley & Sons Ltd.

  18. Assessment of Steel Reinforcement Corrosion State by Parameters of Potentiodynamic Diagrams

    NASA Astrophysics Data System (ADS)

    Krajči, Ľudovít; Jerga, Ján

    2015-12-01

    The environment of the steel reinforcement has a significant impact on the durability and service life of a concrete structure. It is not only the presence of aggressive substances from the environment, but also the own composition of concrete mixture. The use of new types of cements, additives and admixtures must be preceded by verification, if they themselves shall not initiate the corrosion. There is a need for closer physical expression of the parameters of the potentiodynamic diagrams allowing reliable assessment of the influence of the surrounding environment on electrochemical behaviour of reinforcement. The analysis of zero retardation limits of potentiodynamic curves is presented.

  19. Assessment of hoist failure rate for Payload Transporter III

    SciTech Connect

    Demmie, P.N.

    1994-02-01

    Assessment of the hoist failure rate for the Payload Transporter Type III (PT-III) hoist was completed as one of the ground transportation tasks for the Minuteman II (MMIII) Weapon System Safety Assessment. The failures of concern are failures that lead to dropping a reentry system (RS) during hoist operations in a silo or the assembly, storage, and inspection building for a MMIII wing. After providing a brief description of the PT-III hoist system, the author summarizes his search for historical data from industry and the military services for failures of electric hoist systems. Since such information was not found, the strategy for assessing a failure rate was to consider failure mechanisms which lead to load-drop accidents, estimate their rates, and sum the rates for the PT-III hoist failure rate. The author discusses failure mechanisms and describes his assessment of a chain failure rate that is based on data from destructive testing of a chain of the type used for the PT-III hoist and projected usage rates for hoist operations involving the RS. The main result provides upper bounds for chain failure rates that are based on these data. No test data were found to estimate failure rates due to mechanisms other than chain failure. The author did not attempt to quantify the effects of human factors on the PT-III hoist failure rate.

  20. Improving FMEA risk assessment through reprioritization of failures

    NASA Astrophysics Data System (ADS)

    Ungureanu, A. L.; Stan, G.

    2016-08-01

    Most of the current methods used to assess the failure and to identify the industrial equipment defects are based on the determination of Risk Priority Number (RPN). Although conventional RPN calculation is easy to understand and use, the methodology presents some limitations, such as the large number of duplicates and the difficulty of assessing the RPN indices. In order to eliminate the afore-mentioned shortcomings, this paper puts forward an easy and efficient computing method, called Failure Developing Mode and Criticality Analysis (FDMCA), which takes into account the failures and the defect evolution in time, from failure appearance to a breakdown.

  1. Common-Cause Failure Analysis in Event Assessment

    SciTech Connect

    Dana L. Kelly; Dale M. Rasmuson

    2008-09-01

    This paper describes the approach taken by the U. S. Nuclear Regulatory Commission to the treatment of common-cause failure in probabilistic risk assessment of operational events. The approach is based upon the Basic Parameter Model for common-cause failure, and examples are illustrated using the alpha-factor parameterization, the approach adopted by the NRC in their Standardized Plant Analysis Risk (SPAR) models. The cases of a failed component (with and without shared common-cause failure potential) and a component being unavailable due to preventive maintenance or testing are addressed. The treatment of two related failure modes (e.g., failure to start and failure to run) is a new feature of this paper. These methods are being applied by the NRC in assessing the risk significance of operational events for the Significance Determination Process (SDP) and the Accident Sequence Precursor (ASP) program.

  2. Thermochemical measurements and assessment of the phase diagrams in the system Y-Ba-Cu-O

    SciTech Connect

    Boudene, A.; Mohammad, A.; Hack, K.

    1996-04-01

    The aim of this project was to provide a self-consistent set of Gibbs energy data for all phases in the system Y-Ba-Cu-O. Experimental thermochemical investigations by differential thermal analysis (DTA), thermogravimetry (TG), electromotive force measurements (EMF), oxygen coulometric titration (OCT), drop and solution calorimetry, and conventional phase analysis (annealing, quenching, and X-ray diffraction [XRD]) as well as ab initio calculations of interaction energies for the 123 phase have been carried out. The experimental information (phase equilibria, heat capacity, enthalpies of formation, oxygen partial pressures, and so forth) has been used in computer-based assessments of the Gibbs energies. These data have been employed to generate phase diagrams by way of equilibrium computations. All binary and ternary subsystems have been fully assessed. For the quaternary system a dataset covering the subsolidus range has been derived. Applications of the data to practical questions, such as the production of 123 superconductors by an MOCVD process, the producibility of metallic precursors, and the oxidation of a copper-enriched stoichiometric oxide precursor, are demonstrated.

  3. Development and validation of standard area diagrams to aide assessment of pecan scab symptoms on pecan fruit

    USDA-ARS?s Scientific Manuscript database

    Pecan scab (Fusicladium effusum) causes losses of pecan nutmeat yield and quality in the southeastern U.S. Disease assessment relies on visual rating, which can be inaccurate, imprecise with poor inter-rater reliability. A standard area diagram (SAD) set for pecan scab on fruit valves was develope...

  4. Common-Cause Failure Analysis in Event Assessment

    SciTech Connect

    D. M. Rasmuson; D. L. Kelly

    2008-06-01

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

  5. 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.

  6. Reliability assessment on interfacial failure of thermal barrier coatings

    NASA Astrophysics Data System (ADS)

    Guo, Jin-Wei; Yang, Li; Zhou, Yi-Chun; He, Li-Min; Zhu, Wang; Cai, Can-Ying; Lu, Chun-Sheng

    2016-10-01

    Thermal barrier coatings (TBCs) usually exhibit an uncertain lifetime owing to their scattering mechanical properties and severe service conditions. To consider these uncertainties, a reliability assessment method is proposed based on failure probability analysis. First, a limit state equation is established to demarcate the boundary between failure and safe regions, and then the failure probability is calculated by the integration of a probability density function in the failure area according to the first- or second-order moment. It is shown that the parameters related to interfacial failure follow a Weibull distribution in two types of TBC. The interfacial failure of TBCs is significantly affected by the thermal mismatch of material properties and the temperature drop in service.

  7. Public Notification - RTCR Failure To Perform Level 1 Assessment Template

    EPA Pesticide Factsheets

    When a PWS fails to perform a required Level 1 Assessment, it must issue a public notice to inform the consumers of its water of that failure. You can use this template as a guide to prepare that public notice.

  8. An influence diagram for assessing GVHD prophylaxis after bone marrow transplantation in children.

    PubMed

    Quaglini, S; Bellazzi, R; Locatelli, F; Stefanelli, M; Salvaneschi, C

    1994-01-01

    Graft-versus-host disease (GVHD) represents one of the major complications of allogeneic bone marrow transplantation (BMT). Nevertheless, the occurrence of mild GVHD could be desirable in high-risk leukemic patients, due to a relapse-preventing effect known as the graft-versus-leukemia (GVL) effect. Given that different prophylactic interventions are available to prevent GVHD development, the decision problem consists in assessing both type and dosage of the drugs in order to avoid or induce GVHD, according to the specific patient's condition. The decision problem can be represented and solved by using an influence diagram. The choice of this formalism allows using new available methods for building and updating the model of the decision problem. The qualitative structure of the model and the conditional probabilities were first derived by combining literature results with a medical expert's judgement. More specifically, probabilities were initially assigned as ranges rather than as point values. Then, conditional probabilities were updated, by using a learning algorithm, as new cases became available. The authors analyzed 50 cases of pediatric patients affected by either malignant or nonmalignant diseases, undergoing BMT and receiving GVHD prophylaxis. They used the first 25 cases to adjust the initially assigned conditional probabilities, then checked the model obtained on the remaining patients. The overall performance for GVHD prediction was about 80%.

  9. Assessing disease severity: accuracy and reliability of rater estimates in relation to number of diagrams in a standard area diagram set

    USDA-ARS?s Scientific Manuscript database

    Error in rater estimates of plant disease severity occur, and standard area diagrams (SADs) help improve accuracy and reliability. The effects of diagram number in a SAD set on accuracy and reliability is unknown. The objective of this study was to compare estimates of pecan scab severity made witho...

  10. How many standard area diagram sets are needed for accurate disease severity assessment

    USDA-ARS?s Scientific Manuscript database

    Standard area diagram sets (SADs) are widely used in plant pathology: a rater estimates disease severity by comparing an unknown sample to actual severities in the SADs and interpolates an estimate as accurately as possible (although some SADs have been developed for categorizing disease too). Most ...

  11. A Big Data Analysis Approach for Rail Failure Risk Assessment.

    PubMed

    Jamshidi, Ali; Faghih-Roohi, Shahrzad; Hajizadeh, Siamak; Núñez, Alfredo; Babuska, Robert; Dollevoet, Rolf; Li, Zili; De Schutter, Bart

    2017-08-01

    Railway infrastructure monitoring is a vital task to ensure rail transportation safety. A rail failure could result in not only a considerable impact on train delays and maintenance costs, but also on safety of passengers. In this article, the aim is to assess the risk of a rail failure by analyzing a type of rail surface defect called squats that are detected automatically among the huge number of records from video cameras. We propose an image processing approach for automatic detection of squats, especially severe types that are prone to rail breaks. We measure the visual length of the squats and use them to model the failure risk. For the assessment of the rail failure risk, we estimate the probability of rail failure based on the growth of squats. Moreover, we perform severity and crack growth analyses to consider the impact of rail traffic loads on defects in three different growth scenarios. The failure risk estimations are provided for several samples of squats with different crack growth lengths on a busy rail track of the Dutch railway network. The results illustrate the practicality and efficiency of the proposed approach. © 2017 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

  12. Assessing the Impacts of Multiple Breadbasket Failures

    NASA Astrophysics Data System (ADS)

    Casellas Connors, J. P.; Janetos, A.

    2016-12-01

    A relatively small area of the world accounts for a large proportion of total global cereal production, with most of the area devoted to the production of the world's three major cereal crops, rice, wheat and maize. An extensive literature of the sensitivity of agricultural productivity of these crops, and many others, has arisen over the past 25 years, with a general consensus that continued change in the physical climate system will very likely increase the difficulty of agricultural production in areas of the world that are already marginal with respect to production. But what this research only rarely does is assess the influence of extreme events in shocking agricultural production, and how the rest of the agricultural system reacts, in terms of prices, food insecurity, subsequent land-use change, and terrestrial carbon emissions, among many other possible responses. Because the agricultural system is interlinked with energy systems, food distribution and transportation systems, and economic systems, models that focus only on agricultural productivity can only provide a unidimensional view of the magnitude of potential impacts. We know such impacts can occur as a consequence of extreme climatic events, because they have - the impact of the severe regional drought and heat wave on the Russian and Ukrainian wheat harvests in 2010 had global consequences for food prices, just as one example. In this paper, we use an Integrated Assessment Model, the Global Change Assessment Model (GCAM), to investigate the potential outcomes of both moderate and severe shocks to agricultural productivity in the major breadbaskets of the world - both singly and in combination. The results demonstrate clearly that there are likely to be multidimensional consequences from the kinds of shocks that are possible from a rapidly changing climate system, especially when combined with other demographic and economic trends in the coming decades. These results are only one aspect of

  13. The ultrasound examination in assessment of parotid gland tumours: the novel graphic diagram.

    PubMed

    Luczewski, L; Golusinski, P; Pazdrowski, J; Pienkowski, P; Kordylewska, M; Guntinas-Lichius, O; Golusinski, W

    2013-07-01

    Ultrasound is one of the main diagnostic techniques for parotid gland tumours. It is inexpensive, non-invasive and widely available. However, interpretation of the images is highly subjective and constitutes a major limitation. To overcome this problem, we developed a graphic diagram to provide a standardised template that can be used for more precise identification of the tumour localisation within the parenchyma of the parotid gland. This new diagram may be used to provide surgeons with an improved and more objective localisation of the tumour. The study included 237 patients who underwent surgery for parotid tumours. To obtain the precise spatial location of the tumours, three topographic coordinates of tumour location in the coronal, sagittal and transversal plane were marked preoperatively during sonography within the parenchyma of the parotid gland. The localisation identified ultrasonically was then compared to the postsurgical report: 197 (83 %) tumours were found within the superficial lobe of the parotid gland and 40 (17 %) within the deep lobe of the parotid gland. In 157 (66 %) cases, tumours were found within the lower pole of the parotid gland, and in 64 (27 %) at the level of earlobe and its insertion, 16 (7 %) tumours were located at the level of the tragus and above it. Based on the results obtained, a graphic diagram of parotid gland tumour locations was developed.

  14. Methods for Assessing Honeycomb Sandwich Panel Wrinkling Failures

    NASA Technical Reports Server (NTRS)

    Zalewski, Bart F.; Dial, William B.; Bednarcyk, Brett A.

    2012-01-01

    Efficient closed-form methods for predicting the facesheet wrinkling failure mode in sandwich panels are assessed. Comparisons were made with finite element model predictions for facesheet wrinkling, and a validated closed-form method was implemented in the HyperSizer structure sizing software.

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

    PubMed

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

    2017-06-30

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

  16. Failure of sewage pumps: statistical modelling and impact assessment.

    PubMed

    Korving, H; Geise, M; Clemens, F

    2006-01-01

    Sewage pumping stations are directly responsible for affecting performance, i.e. failing pumps may result in combined sewer overflows or flooding. However, failures of sewage pumps are not yet incorporated in sewer assessments due to lack of knowledge and data. This paper presents the analysis of pump failure data provided by two sewer management authorities in The Netherlands. Pump failures have been studied accounting for the nature of the failures, the operation and maintenance procedures of the management authority, the ageing of the pumps and the changes in the environment of pumps. The analysis shows that sewage pumps fail relatively often due to the composition of sewage and the discontinuous operation of the pumps. The interarrival time and the duration of failures are highly variable and independent of the pump type and the specific function of the pump. The results also indicate that the serviceability of sewer systems is significantly affected by failing pumps. As a consequence, part of the environmental damage due to CSOs (combined sewer overflows) can be avoided by improving maintenance of pumping stations.

  17. Assessment of facial form modifications in orthodontics: proposal of a modified computerized mesh diagram analysis.

    PubMed

    Ferrario, V F; Sforza, C; Dalloca, L L; DeFranco, D J

    1996-03-01

    A modified computerized mesh diagram analysis enables rapid, easy, and independent quantifications of facial size, shape, and head position. A lateral cephalometric radiograph is traced, positioned in natural head position (NHP) according to the NHP registered on a lateral photograph, and superimposed by the standard grid of rectangles determined by the patient's upper face height and face depth. The patient's tracing is compared with a reference tracing of a norm. The two tracings are registered at nasion in NHP, and the size difference of the patient's mesh rectangles from the norm is quantified by a size normalization. The shape discrepancies are evaluated by calculating relevant displacement vectors for each cephalometric landmark, and a global difference factor. This computerized method provides a rapid graphic evaluation of the patient's sagittal and vertical discrepancies and can also be applied to determine the effects of orthodontic therapy and/or growth on the skeletal and dental relationships in a single patient.

  18. Auto-entrainment risk assessment in heart failure.

    PubMed

    Roach, Daniel E; Morck, Margaret L; Sheldon, Robert S; Duff, Henry J

    2013-02-01

    Risk assessment studies use a suite of nominally independent noninvasive heart rate metrics, often brought together in a statistical model to compute a risk score. The ongoing need to noninvasively identify the higher risk patients requiring more invasive investigations/interventions drives the search for better noninvasive predictive metrics, with increased sensitivity. Many varieties of autoregulatory malfunction occur within the cardiovascular system; thus, it seems a daunting challenge to build predictive models that account for all potential modes of failure. Auto-entrainment (AE) methodology was developed to help address this challenge. AE methodology tests intrinsic capacity to maintain a stable and coherent oscillatory dynamic of autoregulatory control via respiratory entrainment of the blood pressure and heart period. Using cardiovascular death (n=18) at follow-up (1.5 years) as the end point, analysis of AE measurements from 148 patients with heart failure revealed 2 parameters significantly predictive of death. Using logistic regression, the magnitude of systolic pulsus alternans measured during AE had predictive sensitivity of 90% (confidence interval, 62%-100% and specificity of 62% (confidence interval, 49%-74%). The capacity to maintain a stable oscillatory dynamic was measured by the fraction of the total RR-interval spectral power contained within the AE-band. This capacity had predictive sensitivity of 73% (confidence interval, 47%-99%) and specificity of 55% (confidence interval, 43%-66%). AE methodology provides a noninvasive platform to assess the integrity of cardiovascular autoregulatory control systems for risk assessment in heart failure patients.

  19. Online assessment of patients' views on hospital performances using Rasch model's KIDMAP diagram

    PubMed Central

    Chien, Tsair-Wei; Wang, Wen-Chung; Wang, Hsien-Yi; Lin, Hung-Jung

    2009-01-01

    Background To overcome the drawback of individual item-by-item box plots of disclosure for patient views on healthcare service quality, we propose to inspect interrelationships among items that measure a common entity. A visual diagram on the Internet is developed to provide thorough information for hospitals. Methods We used the Rasch rating scale model to analyze the 2003 English inpatient questionnaire data regarding patient satisfactory perception, which were collected from 169 hospitals, examined model-data fit, and developed a KIDMAP diagram on the Internet depicting the satisfaction level of each hospital and investigating aberrant responses with Z-scores and MNSQ statistics for individual hospitals. Differential item functioning (DIF) analysis was conducted to verify construct equivalence across types of hospitals. Results 18 of the 45 items fit to the model's expectations, indicating they jointly defined a common construct and an equal-interval logit scale was achieved. The most difficult aspect for hospitals to earn inpatients' satisfaction were item 29 (staff told you about any medication side effects to watch when going home). No DIF in the 18-item questionnaire was found between types of hospitals, indicating the questionnaire measured the same construct across hospitals. Different types of hospitals obtained different levels of satisfaction. The KIDMAP on the Internet provided more interpretable and visualized message than traditional item-by-item box plots of disclosure. Conclusion After removing misfit items, we find that the 18-item questionnaire measures the same construct across types of hospitals. The KIDMAP on the Internet provides an exemplary comparison in quality of healthcare. Rasch analysis allows intra- and inter-hospital performances to be compared easily and reliably with each other on the Internet. PMID:19646267

  20. Online assessment of patients' views on hospital performances using Rasch model's KIDMAP diagram.

    PubMed

    Chien, Tsair-Wei; Wang, Wen-Chung; Wang, Hsien-Yi; Lin, Hung-Jung

    2009-07-31

    To overcome the drawback of individual item-by-item box plots of disclosure for patient views on healthcare service quality, we propose to inspect interrelationships among items that measure a common entity. A visual diagram on the Internet is developed to provide thorough information for hospitals. We used the Rasch rating scale model to analyze the 2003 English inpatient questionnaire data regarding patient satisfactory perception, which were collected from 169 hospitals, examined model-data fit, and developed a KIDMAP diagram on the Internet depicting the satisfaction level of each hospital and investigating aberrant responses with Z-scores and MNSQ statistics for individual hospitals. Differential item functioning (DIF) analysis was conducted to verify construct equivalence across types of hospitals. 18 of the 45 items fit to the model's expectations, indicating they jointly defined a common construct and an equal-interval logit scale was achieved. The most difficult aspect for hospitals to earn inpatients' satisfaction were item 29 (staff told you about any medication side effects to watch when going home). No DIF in the 18-item questionnaire was found between types of hospitals, indicating the questionnaire measured the same construct across hospitals. Different types of hospitals obtained different levels of satisfaction. The KIDMAP on the Internet provided more interpretable and visualized message than traditional item-by-item box plots of disclosure. After removing misfit items, we find that the 18-item questionnaire measures the same construct across types of hospitals. The KIDMAP on the Internet provides an exemplary comparison in quality of healthcare. Rasch analysis allows intra- and inter-hospital performances to be compared easily and reliably with each other on the Internet.

  1. Methods of failure and reliability assessment for mechanical heart pumps.

    PubMed

    Patel, Sonna M; Allaire, Paul E; Wood, Houston G; Throckmorton, Amy L; Tribble, Curt G; Olsen, Don B

    2005-01-01

    Artificial blood pumps are today's most promising bridge-to-recovery (BTR), bridge-to-transplant (BTT), and destination therapy solutions for patients suffering from intractable congestive heart failure (CHF). Due to an increased need for effective, reliable, and safe long-term artificial blood pumps, each new design must undergo failure and reliability testing, an important step prior to approval from the United States Food and Drug Administration (FDA), for clinical testing and commercial use. The FDA has established no specific standards or protocols for these testing procedures and there are only limited recommendations provided by the scientific community when testing an overall blood pump system and individual system components. Product development of any medical device must follow a systematic and logical approach. As the most critical aspects of the design phase, failure and reliability assessments aid in the successful evaluation and preparation of medical devices prior to clinical application. The extent of testing, associated costs, and lengthy time durations to execute these experiments justify the need for an early evaluation of failure and reliability. During the design stages of blood pump development, a failure modes and effects analysis (FMEA) should be completed to provide a concise evaluation of the occurrence and frequency of failures and their effects on the overall support system. Following this analysis, testing of any pump typically involves four sequential processes: performance and reliability testing in simple hydraulic or mock circulatory loops, acute and chronic animal experiments, human error analysis, and ultimately, clinical testing. This article presents recommendations for failure and reliability testing based on the National Institutes of Health (NIH), Society for Thoracic Surgeons (STS) and American Society for Artificial Internal Organs (ASAIO), American National Standards Institute (ANSI), the Association for Advancement of

  2. Validating the strategies analysis diagram: assessing the reliability and validity of a formative method.

    PubMed

    Cornelissen, Miranda; McClure, Roderick; Salmon, Paul M; Stanton, Neville A

    2014-11-01

    The Strategies Analysis Diagram (SAD) is a recently developed method to model the range of possible strategies available for activities in complex sociotechnical systems. Previous applications of the new method have shown that it can effectively identify a comprehensive range of strategies available to humans performing activity within a particular system. A recurring criticism of Ergonomics methods is however, that substantive evidence regarding their performance is lacking. For a method to be widely used by other practitioners such evaluations are necessary. This article presents an evaluation of criterion-referenced validity and test-retest reliability of the SAD method when used by novice analysts. The findings show that individual analyst performance was average. However, pooling the individual analyst outputs into a group model increased the reliability and validity of the method. It is concluded that the SAD method's reliability and validity can be assured through the use of a structured process in which analysts first construct an individual model, followed by either another analyst pooling the individual results or a group process pooling individual models into an agreed group model. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  3. The influence of biaxial stresses on the failure assessment curve

    SciTech Connect

    Wang, W.Q.; Li, A.J.; Ding, P.F.

    1995-11-01

    In this paper, the influence of biaxial stresses on the crack/notch failure assessment curve (FAC) has been explored by means of incremental theory elastic-plastic finite element (EPFE) method. The FACs of different ratio of biaxial stresses have been established based on the J-integral calculation of center cracked and notched specimens. Meanwhile the comparisons have been made between the FACs given by EPFE and CEGB R6 Option 2. It shows that the biaxial stresses at plastic stage have evident influence on FACs, but the safety range of the FACs are close to that of uniaxial stress FAC. With the standpoint of view of engineering, the FAC given by R6 Option 2 under the uniaxial stress condition could roughly be used to the failure assessment of structures containing defects under biaxial stress condition, but for advanced or precise assessment, the biaxial stress effect must be taken into account. The influence of biaxial stresses on J-integral values and path independence has been investigated at the same time.

  4. Thermodynamic Diagrams

    NASA Astrophysics Data System (ADS)

    Chaston, Scot

    1999-02-01

    Thermodynamic data such as equilibrium constants, standard cell potentials, molar enthalpies of formation, and standard entropies of substances can be a very useful basis for an organized presentation of knowledge in diverse areas of applied chemistry. Thermodynamic data can become particularly useful when incorporated into thermodynamic diagrams that are designed to be easy to recall, to serve as a basis for reconstructing previous knowledge, and to determine whether reactions can occur exergonically or only with the help of an external energy source. Few students in our chemistry-based courses would want to acquire the depth of knowledge or rigor of professional thermodynamicists. But they should nevertheless learn how to make good use of thermodynamic data in their professional occupations that span the chemical, biological, environmental, and medical laboratory fields. This article discusses examples of three thermodynamic diagrams that have been developed for this purpose. They are the thermodynamic energy account (TEA), the total entropy scale, and the thermodynamic scale diagrams. These diagrams help in the teaching and learning of thermodynamics by bringing the imagination into the process of developing a better understanding of abstract thermodynamic functions, and by allowing the reader to keep track of specialist thermodynamic discourses in the literature.

  5. Quantitative risk assessment for skin sensitization: Success or failure?

    PubMed

    Kimber, Ian; Gerberick, G Frank; Basketter, David A

    2017-02-01

    Skin sensitization is unique in the world of toxicology. There is a combination of reliable, validated predictive test methods for identification of skin sensitizing chemicals, a clearly documented and transparent approach to risk assessment, and effective feedback from dermatology clinics around the world delivering evidence of the success or failure of the hazard identification/risk assessment/management process. Recent epidemics of contact allergy, particularly to preservatives, have raised questions of whether the safety/risk assessment process is working in an optimal manner (or indeed is working at all!). This review has as its focus skin sensitization quantitative risk assessment (QRA). The core toxicological principles of QRA are reviewed, and evidence of use and misuse examined. What becomes clear is that skin sensitization QRA will only function adequately if two essential criteria are met. The first is that QRA is applied rigourously, and the second is that potential exposure to the sensitizing substance is assessed adequately. This conclusion will come as no surprise to any toxicologist who appreciates the basic premise that "risk = hazard x exposure". Accordingly, use of skin sensitization QRA is encouraged, not least because the essential feedback from dermatology clinics can be used as a tool to refine QRA in situations where this risk assessment tool has not been properly used. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. [Volume assessment in the acute heart and renal failure].

    PubMed

    Vujicić, Bozidar; Ruzić, Alen; Zaputović, Luka; Racki, Sanjin

    2012-10-01

    Acute kidney injury (AKI) is an important clinical issue, especially in the setting of critical care. It has been shown in multiple studies to be a key independent risk factor for mortality, even after adjustment for demographics and severity of illness. There is wide agreement that a generally applicable classification system is required for AKI which helps to standardize estimation of severity of renal disfunction and to predict outcome associated with this condition. That's how RIFLE (Risk-Injury-Failure-Loss-End-stage renal disease), and AKIN (Acute Kidney Injury Network) classifications for AKI were found in 2004 and 2007, respectively. In the clinical setting of heart failure, a positive fluid balance (often expressed in the literature as weight gain) is used by disease management programs as a marker of heart failure decompensation. Oliguria is defined as urine output less than 0,3 ml/kg/h for at least 24 h. Since any delay in treatment can lead to a dangerous progression of the AKI, early recognition of oliguria appears to be crucial. Critically ill patients with oliguric AKI are at increased risk for fluid imbalance due to widespread systemic inflammation, reduced plasma oncotic pressure and increased capillary leak. These patients are particulary at risk of fluid overload and therefore restrictive strategy of fluid administration should be used. Objective, rapid and accurate volume assessment is important in undiagnosed patients presenting with critical illness, as errors may result in interventions with fatal outcomes. The historical tools such as physical exam, and chest radiography suffer from significant limitations. As gold standard, radioisolopic measurement of volume is impractical in the acute care enviroment. Newer technologies offer the promise of both rapid and accurate bedside estimation of volume status with the potential to improve clinical outcomes. Blood assessment with bioimpendance vector analysis, and bedside ultrasound seem to be

  7. The Assessment of the Right Heart Failure Syndrome.

    PubMed

    Kholdani, Cyrus A; Oudiz, Ronald J; Fares, Wassim H

    2015-12-01

    The right heart failure (RHF) syndrome is a pathophysiologically complex state commonly associated with dysfunction of the right ventricle (RV). The normal RV is suited for its purposes of distributing venous blood to the low-resistance pulmonary circulation. Myriad stresses imposed upon it, though, can ultimately result in its failure, with the threat of cardiovascular collapse being the most dreaded outcome. Decreased cardiac output with increased central venous pressures are hemodynamic hallmarks of this highly morbid condition. Proper management of RHF is predicated on the accurate assessment of the key hemodynamic and clinical components signaling the syndrome that is the result of the failing RV. Appropriate use of diagnostic tools is paramount for understanding the key components of RV function: the preload state of the RV, its contractility, and the afterload burden placed on it. In making these assessments, it remains crucial to understand the limitations of these tools when managing RHF in the intensive care unit. An understanding of each of these components allows for the understanding of the physiology and the clinical presentation which can guide the use of therapies appropriately tailored to manage the condition. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  8. Selected component failure rate values from fusion safety assessment tasks

    SciTech Connect

    Cadwallader, L.C.

    1998-09-01

    This report is a compilation of component failure rate and repair rate values that can be used in magnetic fusion safety assessment tasks. Several safety systems are examined, such as gas cleanup systems and plasma shutdown systems. Vacuum system component reliability values, including large vacuum chambers, have been reviewed. Values for water cooling system components have also been reported here. The report concludes with the examination of some equipment important to personnel safety, atmospheres, combustible gases, and airborne releases of radioactivity. These data should be useful to system designers to calculate scoping values for the availability and repair intervals for their systems, and for probabilistic safety or risk analysts to assess fusion systems for safety of the public and the workers.

  9. Selected Component Failure Rate Values from Fusion Safety Assessment Tasks

    SciTech Connect

    Cadwallader, Lee Charles

    1998-09-01

    This report is a compilation of component failure rate and repair rate values that can be used in magnetic fusion safety assessment tasks. Several safety systems are examined, such as gas cleanup systems and plasma shutdown systems. Vacuum system component reliability values, including large vacuum chambers, have been reviewed. Values for water cooling system components have also been reported here. The report concludes with the examination of some equipment important to personnel safety, atmospheres, combustible gases, and airborne releases of radioactivity. These data should be useful to system designers to calculate scoping values for the availability and repair intervals for their systems, and for probabilistic safety or risk analysts to assess fusion systems for safety of the public and the workers.

  10. Cutting Up Text To Make Moveable, Magnetic Diagrams: A Way of Teaching and Assessing Biological Processes.

    ERIC Educational Resources Information Center

    Britton, Lynda A.; Wandersee, James H.

    1997-01-01

    Describes a method of cutting up pages in texts to make moveable, magnetic cards that can be used for instruction and assessment. Uses the diagrammatic illustrations associated with the complicated biotechnology procedures of the polymerase chain reaction and restriction fragment length polymorphism. (JRH)

  11. Hubble Diagram

    NASA Astrophysics Data System (ADS)

    Djorgovski, S.; Murdin, P.

    2000-11-01

    Initially introduced as a way to demonstrate the expansion of the universe, and subsequently to determine the expansion rate (the HUBBLE CONSTANT H0), the Hubble diagram is one of the classical cosmological tests. It is a plot of apparent fluxes (usually expressed as magnitudes) of some types of objects at cosmological distances, against their REDSHIFTS. It is used as a tool to measure the glob...

  12. Assessing Wind Farm Reliability Using Weather Dependent Failure Rates

    NASA Astrophysics Data System (ADS)

    Wilson, G.; McMillan, D.

    2014-06-01

    Using reliability data comprising of two modern, large scale wind farm sites and wind data from two onsite met masts, a model is developed which calculates wind speed dependant failure rates which are used to populate a Markov Chain. Monte Carlo simulation is then exercised to simulate three wind farms which are subjected to controlled wind speed conditions from three separate potential UK sites. The model then calculates and compares wind farm reliability due to corrective maintenance and component failure rates influenced by the wind speed of each of the sites. Results show that the components affected most by changes in average daily wind speed are the control system and the yaw system. A comparison between this model and a more simple estimation of site yield is undertaken. The model takes into account the effects of the wind speed on the cost of operation and maintenance and also includes the impact of longer periods of downtime in the winter months and shorter periods in the summer. By taking these factors into account a more detailed site assessment can be undertaken. There is significant value to this model for operators and manufacturers.

  13. Comparison of postinjury multiple-organ failure scoring systems: Denver versus Sequential Organ Failure Assessment.

    PubMed

    Dewar, David C; White, Amanda; Attia, John; Tarrant, Seth M; King, Kate L; Balogh, Zsolt J

    2014-10-01

    The Denver and Sequential Organ Failure Assessment (SOFA) scores have been used widely to describe the epidemiology of postinjury multiple-organ failure; however, differences in these scores make it difficult to compare incidence, duration, and mortality of multiple-organ failure. The study aim was to compare the performance of the Denver and SOFA scores with respect to the outcomes of mortality, intensive care unit length of stay (ICU LOS), and ventilator days. A 60-month prospective epidemiologic study was undertaken at an Australian Level I trauma center. Data were collected on trauma patients that met inclusion criteria (ICU admission, Injury Severity Score [ISS] > 15, age > 18 years, head Abbreviated Injury Scale [AIS] score < 3, survival for >48 hours). Demographics, ISS, physiologic parameters, SOFA and Denver scores, and outcome data were prospectively collected. Sensitivity/specificity and receiver operating characteristic curve were calculated for both scores. Analysis was also completed for a Day 3 postinjury SOFA and Denver score. A total of 140 patients met the inclusion criteria (mean [SD] age, 47 [21] years; ISS, 30; male, 69%; mortality rate, 6%; mean [SD] ICU LOS, 9 [7] days; mean [SD] ventilation period, 6 [7] days). There was no difference in the score performance predicting mortality. Day 3 SOFA score of 4 or greater outperformed the Denver score of greater than 3 when predicting ICU LOS and ventilator days (area under the curve, 0.83 vs. 0.69, 0.86 vs. 0.73, respectively). The SOFA score was more sensitive and the Denver score was more specific when predicting mortality, ICU LOS, and ventilator days. Both scores had similar performance predicting mortality; however, the Day 3 SOFA score outperforms the Denver score when predicting ICU LOS and ventilator days. Either score could be superior based on whether one is seeking to optimize specificity or sensitivity. It is important to note that these findings are in a non-head-injured population and

  14. Reconciling Streamflow Uncertainty Estimation and River Bed Morphology Dynamics. Insights from a Probabilistic Assessment of Streamflow Uncertainties Using a Reliability Diagram

    NASA Astrophysics Data System (ADS)

    Morlot, T.; Mathevet, T.; Perret, C.; Favre Pugin, A. C.

    2014-12-01

    Streamflow uncertainty estimation has recently received a large attention in the literature. A dynamic rating curve assessment method has been introduced (Morlot et al., 2014). This dynamic method allows to compute a rating curve for each gauging and a continuous streamflow time-series, while calculating streamflow uncertainties. Streamflow uncertainty takes into account many sources of uncertainty (water level, rating curve interpolation and extrapolation, gauging aging, etc.) and produces an estimated distribution of streamflow for each days. In order to caracterise streamflow uncertainty, a probabilistic framework has been applied on a large sample of hydrometric stations of the Division Technique Générale (DTG) of Électricité de France (EDF) hydrometric network (>250 stations) in France. A reliability diagram (Wilks, 1995) has been constructed for some stations, based on the streamflow distribution estimated for a given day and compared to a real streamflow observation estimated via a gauging. To build a reliability diagram, we computed the probability of an observed streamflow (gauging), given the streamflow distribution. Then, the reliability diagram allows to check that the distribution of probabilities of non-exceedance of the gaugings follows a uniform law (i.e., quantiles should be equipropables). Given the shape of the reliability diagram, the probabilistic calibration is caracterised (underdispersion, overdispersion, bias) (Thyer et al., 2009). In this paper, we present case studies where reliability diagrams have different statistical properties for different periods. Compared to our knowledge of river bed morphology dynamic of these hydrometric stations, we show how reliability diagram gives us invaluable information on river bed movements, like a continuous digging or backfilling of the hydraulic control due to erosion or sedimentation processes. Hence, the careful analysis of reliability diagrams allows to reconcile statistics and long

  15. Comparison of Body Composition Assessment Methods in Pediatric Intestinal Failure

    PubMed Central

    Mehta, Nilesh M.; Raphael, Bram; Guteirrez, Ivan; Quinn, Nicolle; Mitchell, Paul D.; Litman, Heather J.; Jaksic, Tom; Duggan, Christopher P.

    2015-01-01

    Objectives To examine the agreement of multifrequency bioelectric impedance analysis (BIA) and anthropometry with reference methods for body composition assessment in children with intestinal failure (IF). Methods We conducted a prospective pilot study in children 14 years of age or younger with IF resulting from either short bowel syndrome (SBS) or motility disorders. Bland Altman analysis was used to examine the agreement between BIA and deuterium dilution in measuring total body water (TBW) and lean body mass (LBM); and between BIA and dual X-ray absorptiometry (DXA) techniques in measuring LBM and FM. Fat mass (FM) and percent body fat (%BF) measurements by BIA and anthropometry, were also compared in relation to those measured by deuterium dilution. Results Fifteen children with IF, median (IQR) age 7.2 (5.0, 10.0) years, 10 (67%) male, were studied. BIA and deuterium dilution were in good agreement with a mean bias (limits of agreement) of 0.9 (-3.2, 5.0) for TBW (L) and 0.1 (-5.4 to 5.6) for LBM (kg) measurements. The mean bias (limits) for FM (kg) and %BF measurements were 0.4 (-3.8, 4.6) kg and 1.7 (-16.9, 20.3)% respectively. The limits of agreement were within 1 SD of the mean bias in 12/14 (86%) subjects for TBW and LBM, and in 11/14 (79%) for FM and %BF measurements. Mean bias (limits) for LBM (kg) and FM (kg) between BIA and DXA were 1.6 (-3.0 to 6.3) kg and -0.1 (-3.2 to 3.1) kg, respectively. Mean bias (limits) for FM (kg) and %BF between anthropometry and deuterium dilution were 0.2 (-4.2, 4.6) and -0.2 (-19.5 to 19.1), respectively. The limits of agreement were within 1 SD of the mean bias in 10/14 (71%) subjects. Conclusions In children with intestinal failure, TBW and LBM measurements by multifrequency BIA method were in agreement with isotope dilution and DXA methods, with small mean bias. In comparison to deuterium dilution, BIA was comparable to anthropometry for FM and %BF assessments with small mean bias. However, the limits of agreement

  16. Phase Diagram

    NASA Astrophysics Data System (ADS)

    Walker, Matthew S.; Fruehan, Richard J.

    2014-08-01

    The thermodynamics of several aspects of the carbothermic reduction of alumina have been examined. In Part I, the results of measuring the evolved CO from the reaction between Al2O3 and C mixtures were used to determine the temperature and carbon contents for carbide formation at alumina saturation and at carbide saturation in the Al2O3-Al4C3 system. In this part of the paper, results are presented for a thermogravimetric study of the reactions of Al2O3 with carbon, as well as those for the determination of the Al2O3 liquidus line and the Al2O3-Al4O4C eutectic in the Al2O3-Al4C3 phase diagram. The critical temperature for Al2O3 and C to react, producing gas at 1 atm., was in agreement with that predicted from thermodynamics and measured in Part I of this paper. However, the Al2O3 liquidus appeared to be steeper and the eutectic temperature lower than the predicted phase diagram.

  17. Clinical nurse specialist assessment of nurses' knowledge of heart failure.

    PubMed

    Mahramus, Tara L; Penoyer, Daleen Aragon; Sole, Mary Lou; Wilson, Debra; Chamberlain, Lyne; Warrington, William

    2013-01-01

    Patients' self-management of heart failure (HF) is associated with improved adherence and reduced readmissions. Nurses' knowledge about self-management of HF may influence their ability to adequately perform discharge education. Inadequate nurse knowledge may lead to insufficient patient education, and insufficient education may decrease patients' ability to perform self-management. Prior to developing interventions to improve patient education, clinical nurse specialists should assess nurses' knowledge of HF. The purpose of this study was to determine nurses' knowledge of HF self-management principles. This was a prospective, exploratory, and descriptive online test. There were 3 patient care settings: tertiary care teaching hospital, community hospital, and home healthcare division. The sample was composed of 90 registered nurses who worked directly with patients with HF. Nurses completed an online test of knowledge using the Nurses' Knowledge of Heart Failure Education Principles instrument. Registered nurses (n = 90) completed the knowledge test instrument; their average score was 71% (SD, 10.8%) (range, 20%-90%). The percentage of correct items on each subscale ranged from 63.9% (SD, 30.0) for medications to 83.3% (SD, 25.0) for exercise. Only 8.9% of respondents achieved a passing score of greater than 85%, and a passing score was not associated with any demographic characteristics. Overall, nursing knowledge of HF self-management principles was low. Scores from our nurses were similar to those found in other studies. There is a need to develop interventions to improve nursing knowledge of HF self-management principles. Clinical nurse specialists can be instrumental in developing knowledge interventions for nurses.

  18. Assessment of Commonly Available Educational Materials in Heart Failure Clinics

    PubMed Central

    Taylor-Clarke, Kimberli; Henry-Okafor, Queen; Murphy, Clare; Keyes, Madeline; Rothman, Russell; Churchwell, Andre; Mensah, George A.; Sawyer, Douglas; Sampson, Uchechukwu K. A.

    2014-01-01

    Background Health literacy (HL) is an established independent predictor of cardiovascular outcomes. Approximately 90 million Americans have limited HL and read at ≤ 5th grade-level. Therefore, we sought to determine the suitability and readability level of common cardiovascular patient education materials (PEM) related to heart failure and heart-healthy lifestyle. Methods and Results The suitability and readability of written PEMs were assessed using the suitability assessment of materials (SAM) and Fry readability formula. The SAM criteria are comprised of the following categories: message content, text appearance, visuals, and layout and design. We obtained a convenience sample of 18 English-written cardiovascular PEMs freely available from major health organizations. Two reviewers independently appraised the PEMs. Final suitability scores ranged from 12 to 87%. Readability levels ranged between 3rd and 15th grade-level; the average readability level was 8th grade. Ninety-four percent of the PEMs were rated either superior or adequate on text appearance, but ≥ 50% of the PEMs were rated inadequate on each of the other categories of the SAM criteria. Only two (11%) PEMs had the optimum suitability score of ≥ 70% and ≤ 5th grade readability level suitable for populations with limited HL. Conclusions Commonly available cardiovascular PEMs used by some major healthcare institutions are not suitable for the average American patient. The true prevalence of suboptimal PEMs needs to be determined as it potentially negatively impacts optimal healthcare delivery and outcomes. PMID:21743339

  19. A failure diagnosis and impact assessment prototype for Space Station Freedom

    NASA Technical Reports Server (NTRS)

    Baker, Carolyn G.; Marsh, Christopher A.

    1991-01-01

    NASA is investigating the use of advanced automation to enhance crew productivity for Space Station Freedom in numerous areas, one being failure management. A prototype is described that diagnoses failure sources and assesses the future impacts of those failures on other Freedom entities.

  20. Proof test diagrams for Zerodur glass-ceramic

    NASA Technical Reports Server (NTRS)

    Tucker, D. S.

    1991-01-01

    Proof test diagrams for Zerodur glass-ceramics are calculated from available fracture mechanics data. It is shown that the environment has a large effect on minimum time-to-failure as predicted by proof test diagrams.

  1. Usefulness of the culturally adapted oxygen-cost diagram in the assessment of dyspnea in Puerto Rico.

    PubMed

    De Jesús-Berrios, Yohana; Santos-Rodríguez, Ruth A; Dexter, Donald; Nieves-Plaza, Mariely; Nazario, Cruz M

    2015-03-01

    Breathlessness is a common and disabling symptom of pulmonary disease. Measuring its severity is recommended as such measurements can be helpful in both clinical and research settings. The oxygen-cost diagram (OCD) and the Medical Research Council (MRC) dyspnea scale were developed in English to measure severity of dyspnea. These scales were previously translated to Spanish and adapted for use in a Hispanic population. The objective of this study is to assess the psychometric properties of these scales. We propose the scales correlate well with measures of physiological impairment. Subjects having pulmonary disease rated their perceptions of dyspnea using the scales, performed a spirometry test, and did a 6-min walk. Spearman correlation coefficients (p) were used to correlate dyspnea scores with spirometric parameters and distance walked (6MWD). Sixty-six patients having stable asthma (n = 36), chronic obstructive pulmonary disease (n = 19), or interstitial lung disease (n = 11) participated in the study. OCD scores showed a significant correlation with FEV1 (p = 0.41; p < 0.01), FEV1% (p = 0.36; p < 0.01), FVC (p = 0.44; p < 0.01), and FVC% (p = 0.37; p < 0.01) in the study population. The OCD scores were highly correlated with 6MWD (p = 0.59, p < 0.01). The MRC dyspnea scale showed significant inverse correlation with FEV1 (p = -0.34; p < 0.01) and 6MWD (p = -0.33; p < 0.05), but the correlations were weaker compared to the correlations with the OCD scale. The severity of breathlessness as measured by the adapted Spanish OCD showed a moderate to high correlation with spirometric parameters and 6MWD; therefore, the adapted OCD should prove to be useful in Puerto Rico.

  2. Biomechanical and psychosocial exposures are independent risk factors for carpal tunnel syndrome: assessment of confounding using causal diagrams.

    PubMed

    Harris-Adamson, Carisa; Eisen, Ellen A; Neophytou, Andreas; Kapellusch, Jay; Garg, Arun; Hegmann, Kurt T; Thiese, Matthew S; Dale, Ann Marie; Evanoff, Bradley; Bao, Stephen; Silverstein, Barbara; Gerr, Fred; Burt, Susan; Rempel, David

    2016-11-01

    Between 2001 and 2010, six research groups conducted coordinated prospective studies of carpal tunnel syndrome (CTS) incidence among US workers from various industries to estimate exposure-response relationships. This analysis examined the presence and magnitude of confounding between biomechanical and workplace psychosocial factors and incidence of dominant-hand CTS. 1605 participants, without CTS at enrolment, were followed for up to 3.5 years (2471 person-years). Demographic information, medical history and workplace psychosocial stress measures were collected at baseline. Individual workplace biomechanical exposures were collected for each task and combined across the workweek using time-weighted averaging (TWA). CTS case criteria were based on symptoms and results of electrophysiological testing. HRs were estimated with Cox proportional hazard models. Confounding was assessed using causal diagrams and an empirical criterion of 10% or greater change in effect estimate magnitude. There were 109 incident CTS cases (IR=4.41/100 person-years; 6.7% cumulative incidence). The relationships between CTS and forceful repetition rate, % time forceful hand exertion and the Threshold Limit Value for Hand Activity Level (TLV-HAL) were slightly confounded by decision latitude with effect estimates being attenuated towards the null (10-14% change) after adjustment. The risk of CTS among participants reporting high job strain was attenuated towards the null by 14% after adjusting for the HAL Scale or the % time forceful hand exertions. Although attenuation of the relationships between CTS and some biomechanical and work psychosocial exposures was observed after adjusting for confounding, the magnitudes were small and confirmed biomechanical and work psychosocial exposures as independent risk factors for incident CTS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  3. 29 CFR 2700.27 - Effect of failure to contest proposed penalty assessment.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Effect of failure to contest proposed penalty assessment. 2700.27 Section 2700.27 Labor Regulations Relating to Labor (Continued) FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION PROCEDURAL RULES Contests of Proposed Penalties § 2700.27 Effect of failure to contest proposed penalty assessment. If, within...

  4. Consequence assessment of large rock slope failures in Norway

    NASA Astrophysics Data System (ADS)

    Oppikofer, Thierry; Hermanns, Reginald L.; Horton, Pascal; Sandøy, Gro; Roberts, Nicholas J.; Jaboyedoff, Michel; Böhme, Martina; Yugsi Molina, Freddy X.

    2014-05-01

    Steep glacially carved valleys and fjords in Norway are prone to many landslide types, including large rockslides, rockfalls, and debris flows. Large rockslides and their secondary effects (rockslide-triggered displacement waves, inundation behind landslide dams and outburst floods from failure of landslide dams) pose a significant hazard to the population living in the valleys and along the fjords shoreline. The Geological Survey of Norway performs systematic mapping of unstable rock slopes in Norway and has detected more than 230 unstable slopes with significant postglacial deformation. This large number necessitates prioritisation of follow-up activities, such as more detailed investigations, periodic displacement measurements, continuous monitoring and early-warning systems. Prioritisation is achieved through a hazard and risk classification system, which has been developed by a panel of international and Norwegian experts (www.ngu.no/en-gb/hm/Publications/Reports/2012/2012-029). The risk classification system combines a qualitative hazard assessment with a consequences assessment focusing on potential life losses. The hazard assessment is based on a series of nine geomorphological, engineering geological and structural criteria, as well as displacement rates, past events and other signs of activity. We present a method for consequence assessment comprising four main steps: 1. computation of the volume of the unstable rock slope; 2. run-out assessment based on the volume-dependent angle of reach (Fahrböschung) or detailed numerical run-out modelling; 3. assessment of possible displacement wave propagation and run-up based on empirical relations or modelling in 2D or 3D; and 4. estimation of the number of persons exposed to rock avalanches or displacement waves. Volume computation of an unstable rock slope is based on the sloping local base level technique, which uses a digital elevation model to create a second-order curved surface between the mapped extent of

  5. Using Bayesian influence diagrams to assess organizational performance in 4 California county health departments, April-July 2009.

    PubMed

    Comfort, Louise K; Scheinert, Steve; Yeo, Jungwon; Schuh, Russell; Duran, Luis; Potter, Margaret A

    2013-01-01

    A Bayesian influence diagram is used to analyze interactions among operational units of county health departments. This diagram, developed using Bayesian network analysis, represents a novel method of analyzing the internal performance of county health departments that were operating under the simultaneous constraints of budget cuts and increased demand for services during the H1N1 threat in California, April-July 2009. This analysis reveals the interactions among internal organizational units that degrade performance under stress or, conversely, enable a county health department to manage heavy demands effectively.

  6. [Assessing patients needs in outpatients with advanced heart failure].

    PubMed

    Pianese, Marina; De Astis, Vittoria; Griffo, Raffaele

    2011-06-01

    Because of the progressive ageing of the population and the extensive use of recommended drugs, the number of patients with advanced heart failure (AHF) constantly increases. AHF is the most common cause of acute hospital admission. The outcome and quality of life are generally poor for repeated hospital readmission. To assess a mixed method approach: face-to-face semi-structured qualitative interview incorporating quantitative analysis of demographic data and qualitative exploration of perception of needs in outpatients AHF, plus Barthel score [BS], Short Portable Mental Status Questionnaire [SPMSQ] and Moriski Medication Adherence Scale [MS]). Longitudinal prospective study in 50 elderly (age > 75 years) patients with AHF (stage C and D AHA/ACC plus almost two hospital admission in the last 12 months with main diagnosis of HF). Patients and caregivers were asked what they considered to be their main needs, including social support and the provision of practical care, psychological support; and information and choice. In the same time, BS, SPMSQ and MS were delivered. The main areas of needs identified by patients were knowledge of available social and health services (80%) and disease and lifestyle habits (respectively 66% and 72% of patients), clear identification of the care-manager (70%), awareness of alarm and worsening symptoms (60%). Patients experienced difficulty in communication and information exchange, and fragmented co-ordination between social and care services was identified. The quality of life was generally poor for repeated hospital readmission, mainly for poor adherence to drugs and lifestyle, lacking attention to new onset or worsening symptoms, no planning of hospital discharge and for inadequate social support. The semi-structured interview is a useful tool to identify the patient information and educational needs. The main care needs identified by advanced HF outpatients relate to the everyday social and practical aspects of care. There is a

  7. A density management diagram for Scots pine (Pinus sylvestris L.): A tool for assessing the forest's protective effect

    Treesearch

    Giorgio Vacchiano; Renzo Motta; James N. Long; John D. Shaw

    2008-01-01

    Density management diagrams (DMD) are graphical tools used in the design of silvicultural regimes in even-aged forests. They depict the relationship between stand density, average tree size, stand yield and dominant height, based upon relevant ecological and allometric relationships such as the self-thinning rule, the yield-density effect, and site index curves. DMD...

  8. Assessing mechanical vulnerability in water distribution networks under multiple failures

    NASA Astrophysics Data System (ADS)

    Berardi, Luigi; Ugarelli, Rita; Røstum, Jon; Giustolisi, Orazio

    2014-03-01

    Understanding mechanical vulnerability of water distribution networks (WDN) is of direct relevance for water utilities since it entails two different purposes. On the one hand, it might support the identification of severe failure scenarios due to external causes (e.g., natural or intentional events) which result into the most critical consequences on WDN supply capacity. On the other hand, it aims at figure out the WDN portions which are more prone to be affected by asset disruptions. The complexity of such analysis stems from the number of possible scenarios with single and multiple simultaneous shutdowns of asset elements leading to modifications of network topology and insufficient water supply to customers. In this work, the search for the most disruptive combinations of multiple asset failure events is formulated and solved as a multiobjective optimization problem. The higher vulnerability failure scenarios are detected as those causing the lower supplied demand due to the lower number of simultaneous failures. The automatic detection of WDN topology, subsequent to the detachments of failed elements, is combined with pressure-driven analysis. The methodology is demonstrated on a real water distribution network. Results show that, besides the failures causing the detachment of reservoirs, tanks, or pumps, there are other different topological modifications which may cause severe WDN service disruptions. Such information is of direct relevance to support planning asset enhancement works and improve the preparedness to extreme events.

  9. A Critical Assessment of Ages Derived Using Pre-Main-Sequence Isochrones in Colour-Magnitude Diagrams

    NASA Astrophysics Data System (ADS)

    Bell, Cameron P. M.

    2012-11-01

    In this thesis a critical assessment of the ages derived using theoretical pre-main-sequence (pre-MS) stellar evolutionary models is presented by comparing the predictions to the low-mass pre-MS population of 14 young star-forming regions (SFRs) in colour-magnitude diagrams (CMDs). Deriving pre-MS ages requires precise distances and estimates of the reddening. Therefore, the main-sequence (MS) members of the SFRs have been used to derive a self-consistent set of statistically robust ages, distances and reddenings with associated uncertainties using a maximum-likelihood fitting statistic and MS evolutionary models. A photometric method for de-reddening individual stars - known as the Q-method - in regions where the extinction is spatially variable has been updated and is presented. The effects of both the model dependency and the SFR composition on these derived parameters are also discussed. The problem of calibrating photometric observations of red pre-MS stars is examined and it is shown that using observations of MS stars to transform the data into a standard photometric system can introduce significant errors in the position of the pre-MS locus in CMD space. Hence, it is crucial that precise photometric studies - especially of pre-MS objects - be carried out in the natural photometric system of the observations. This therefore requires a robust model of the system responses for the instrument used, and thus the calculated responses for the Wide-Field Camera on the Isaac Newton Telescope are presented. These system responses have been tested using standard star observations and have been shown to be a good representation of the photometric system. A benchmark test for the pre-MS evolutionary models is performed by comparing them to a set of well-calibrated CMDs of the Pleiades in the wavelength regime 0.4-2.5 μm. The masses predicted by these models are also tested against dynamical masses using a sample of MS binaries by calculating the system magnitude in a

  10. Validity of a Modified Sequential Organ Failure Assessment Score Using the Richmond Agitation-Sedation Scale.

    PubMed

    Vasilevskis, Eduard E; Pandharipande, Pratik P; Graves, Amy J; Shintani, Ayumi; Tsuruta, Ryosuke; Ely, E Wesley; Girard, Timothy D

    2016-01-01

    The Sequential Organ Failure Assessment and other severity of illness scales rely on the Glasgow Coma Scale to measure acute neurologic dysfunction, but the Glasgow Coma Scale is unavailable or inconsistently applied in some institutions. The objective of this study was to assess the validity of a modified Sequential Organ Failure Assessment that uses the Richmond Agitation-Sedation Scale instead of Glasgow Coma Scale. Prospective cohort study. Medical and surgical ICUs within a large, tertiary care hospital. Critically ill medical/surgical ICU patients. We calculated daily Sequential Organ Failure Assessment scores by using electronic medical record-derived data. By using bedside nurse-recorded Glasgow Coma Scale and Richmond Agitation-Sedation Scale measures, we calculated neurologic Sequential Organ Failure Assessment scores using the original Glasgow Coma Scale-based approach and a novel Richmond Agitation-Sedation Scale-based approach, converting the 10-point Richmond Agitation-Sedation Scale to a 4-point neurologic Sequential Organ Failure Assessment score. We assessed construct validity of Richmond Agitation-Sedation Scale-based Sequential Organ Failure Assessment by analyzing correlations with established severity of illness constructs (Acute Physiology and Chronic Health Evaluation II and Glasgow Coma Scale-based Sequential Organ Failure Assessment) and predictive validity by using logistic regression to determine whether Richmond Agitation-Sedation Scale-based Sequential Organ Failure Assessment predicts ICU, hospital, and 1-year mortality. We assessed discriminative performance with c-statistics. Among 513 patients (5,199 patient-days), Richmond Agitation-Sedation Scale-based Sequential Organ Failure Assessment was strongly correlated with Acute Physiology and Chronic Health Evaluation II acute physiology score at enrollment (r = 0.583; 95% CI, 0.518-0.642) and daily Glasgow Coma Scale-based Sequential Organ Failure Assessment scores (r = 0.963; 95% CI

  11. Assessment of Left Ventricular Function in Elderly Medicare Beneficiaries with Newly Diagnosed Heart Failure

    PubMed Central

    Curtis, Lesley H.; Greiner, Melissa A.; Shea, Alisa M.; Whellan, David J.; Hammill, Bradley G.; Schulman, Kevin A.; Douglas, Pamela S.

    2011-01-01

    Background Assessment of left ventricular function is a recommended performance measure for the care of patients with newly diagnosed heart failure. Little is known about the extent to which left ventricular function is assessed in real-world settings. Methods and Results We analyzed a 5% national sample of data from the Centers for Medicare & Medicaid Services from 1991 through 2008. Patients were 65 years or older with incident heart failure in 1995, 1999, 2003, or 2007. We searched for evidence of tests of left ventricular function from 30 days before through 60 days after an incident heart failure diagnosis. We used logistic regression to identify patient characteristics associated with assessment of left ventricular function. There were 45 005 patients with incident heart failure in 1995, 38 425 in 1999, 39 529 in 2003, and 32 629 in 2007. Assessment of left ventricular function increased from 46% to 60%, with rest echocardiography being the predominant mode. Patients diagnosed with heart failure during a hospitalization had the highest assessment rates (58% in 1995, 64% in 1999, 69% in 2003, 73% in 2007). After adjustment for other patient characteristics, odds of assessment were 4 times higher among patients diagnosed in inpatient settings. Conclusions Nearly 40% of Medicare beneficiaries do not undergo assessment of left ventricular function when newly diagnosed with heart failure. Quality-improvement strategies are needed to optimize the care of these patients, especially in outpatient settings. PMID:21098783

  12. Common-Cause Failure Treatment in Event Assessment: Basis for a Proposed New Model

    SciTech Connect

    Dana Kelly; Song-Hua Shen; Gary DeMoss; Kevin Coyne; Don Marksberry

    2010-06-01

    Event assessment is an application of probabilistic risk assessment in which observed equipment failures and outages are mapped into the risk model to obtain a numerical estimate of the event’s risk significance. In this paper, we focus on retrospective assessments to estimate the risk significance of degraded conditions such as equipment failure accompanied by a deficiency in a process such as maintenance practices. In modeling such events, the basic events in the risk model that are associated with observed failures and other off-normal situations are typically configured to be failed, while those associated with observed successes and unchallenged components are assumed capable of failing, typically with their baseline probabilities. This is referred to as the failure memory approach to event assessment. The conditioning of common-cause failure probabilities for the common cause component group associated with the observed component failure is particularly important, as it is insufficient to simply leave these probabilities at their baseline values, and doing so may result in a significant underestimate of risk significance for the event. Past work in this area has focused on the mathematics of the adjustment. In this paper, we review the Basic Parameter Model for common-cause failure, which underlies most current risk modelling, discuss the limitations of this model with respect to event assessment, and introduce a proposed new framework for common-cause failure, which uses a Bayesian network to model underlying causes of failure, and which has the potential to overcome the limitations of the Basic Parameter Model with respect to event assessment.

  13. Defining multiple organ failure after major trauma: A comparison of the Denver, Sequential Organ Failure Assessment and Marshall scoring systems

    PubMed Central

    Hutchings, Lynn; Watkinson, Peter; Young, J Duncan; Willett, Keith

    2017-01-01

    Background Postinjury multiple organ failure (MOF) remains a significant cause of morbidity and mortality. A large number of scoring systems have been proposed to define MOF, with no gold-standard. The purpose of this study was to compare three commonly used scores – the Denver PostInjury Multiple Organ Failure Score, the Sequential Organ Failure Assessment (SOFA) and the Marshall Multiple Organ Dysfunction Score – by descriptive analysis of the populations described by each score, and their predictive ability for mortality. Methods An observational cohort study was performed at a UK trauma center on major trauma patients requiring ICU admission from 2003-2011. A novel trauma database was created, merging national audit data with local electronic monitoring systems. Data were collected on demographics, laboratory results, pharmacy, interventions, and hourly physiological monitoring. The primary outcome measure was mortality within 100 days from injury. Sensitivity analyses and receiver operating characteristic (ROC) curves were used to assess the predictive ability of MOF scores for mortality. Results In total, 491 patients were included in the trauma database. MOF incidence ranged from 22.8% (Denver) to 40.5% (Marshall) to 58.5% (SOFA). MOF definition did not affect timing of onset, but did alter duration and organ failure patterns. Overall mortality was 10.6%, with Denver MOF associated with the greatest increased risk of death (Hazard Ratio 3.87, 95% CI 2.24-6.66). No significant difference was observed in area under the ROC curve values between scores. Marked differences were seen in relative predictors, with Denver showing highest specificity (81%) and SOFA highest sensitivity (73%) for mortality. Conclusions The choice of MOF scoring system affects incidence, duration, organ dysfunction patterns and mortality prediction. We would recommend use of the Denver score since it is simplest to calculate, identifies a high-risk group of patients and has the

  14. Defining multiple organ failure after major trauma: A comparison of the Denver, Sequential Organ Failure Assessment, and Marshall scoring systems.

    PubMed

    Hutchings, Lynn; Watkinson, Peter; Young, J Duncan; Willett, Keith

    2017-03-01

    Postinjury multiple organ failure (MOF) remains a significant cause of morbidity and mortality. A large number of scoring systems have been proposed to define MOF, with no criterion standard. The purpose of this study was to compare three commonly used scores: the Denver Postinjury Multiple Organ Failure Score, the Sequential Organ Failure Assessment (SOFA), and the Marshall Multiple Organ Dysfunction Score, by descriptive analysis of the populations described by each score, and their predictive ability for mortality. An observational cohort study was performed at a UK trauma center on major trauma patients requiring intensive care unit admission from 2003 to 2011. A novel trauma database was created, merging national audit data with local electronic monitoring systems. Data were collected on demographics, laboratory results, pharmacy, interventions, and hourly physiological monitoring. The primary outcome measure was mortality within 100 days from injury. Sensitivity analyses and receiver operating characteristic curves were used to assess the predictive ability of MOF scores for mortality. In total, 491 patients were included in the trauma database. MOF incidence ranged from 22.8% (Denver) to 40.5% (Marshall) to 58.5% (SOFA). MOF definition did not affect timing of onset, but did alter duration and organ failure patterns. Overall mortality was 10.6%, with Denver MOF associated with the greatest increased risk of death (hazard ratio 3.87, 95% confidence interval, 2.24-6.66). No significant difference was observed in area under the receiver operating characteristic curve values between scores. Marked differences were seen in relative predictors, with Denver showing highest specificity (81%) and SOFA highest sensitivity (73%) for mortality. The choice of MOF scoring system affects incidence, duration, organ dysfunction patterns, and mortality prediction. We would recommend use of the Denver score since it is simplest to calculate, identifies a high-risk group of

  15. Patient-centered needs assessment: rationale for a psychometric measure for assessing needs in heart failure.

    PubMed

    Davidson, Patricia; Cockburn, Jill; Daly, John; Sanson Fisher, Rob

    2004-01-01

    Determining an individual's unique perspective of an illness experience remains a challenge for clinicians, administrators, and researchers. A range of concepts and psychometric measures have been developed and evaluated to capture this information. These include patient satisfaction, quality of life, and utility measures. Needs assessment as a tool for evaluating perceptions of health status and determining patient satisfaction and treatment plans has been explored in oncology. Studies have demonstrated that a high proportion of patients have unmet needs in relation to activities of daily living, information sources, and comfort. Heart failure (HF), a condition with significant individual and societal burden, mirrors the illness of experience of cancer, as individuals process issues related to prognosis, treatment regimens, and decreased functional status. A needs-based assessment of health status, expectations, and perceptions is patient-centered and has the capacity to not only evaluate current health status but also plan and project care plans. Needs assessment is a dynamic construct rather than a point in time consistent with other assessment modalities, such as quality of life. Multidimensional needs assessment allows for planning and projection of needs, not only on an individual but also a population basis. Implicit in the exploration of needs is an expectation of level of care to be provided, from both the provider and recipient of care. In many instances a misalignment may exist between services and resources available to the individual. This article seeks to provide a theoretical justification for the development of a needs assessment instrument for patients with HF and to discuss the rationale of this method of assessment to create better alignment and resources with patients needs and expectations.

  16. Failure assessment techniques to ensure shipping container integrity

    SciTech Connect

    McConnell, P.

    1986-02-01

    This report discusses several methodologies which may be used to ensure the structural integrity of containment systems to be used for the transport and storage of high-level radioactive substances. For economic reasons, shipping containers constructed of ferritic materials are being considered for manufacture by vendors in the US and Europe. Ferritic show an inherent transition from a ductile, high energy failure mode to a brittle, low energy fracture mode with decreasing temperature. Therefore, formal consideration of means by which to avoid unstable brittle fracture is necessary prior to the licensing of ferritic casks. It is suggested that failure of a shipping container wall be defined as occurring when a flaw extends through the outer wall of the containment system. Crack initiation which may lead to unstable brittle crack growth should therefore be prevented. It is suggested that a fundamental linear elastic fracture mechanics (lefm) approach be adopted on a case-by-case basis, applied perhaps by means of appropriate modifications to ASMA Section III or Section XI. A lefm analysis requires information concerning service temperatures, loading rates, flaw sizes, and applied stresses. Tentative judgments regarding these parameters for typical shipping containers have been made.

  17. Acute Heart Failure Registry: Risk Assessment Model in Decompensated Heart Failure

    PubMed Central

    Delgado, Anne; Rodrigues, Bruno; Nunes, Sara; Baptista, Rui; Marmelo, Bruno; Moreira, Davide; Gama, Pedro; Nunes, Luís; Santos, Oliveira; Cabral, Costa

    2016-01-01

    Background Heart failure (HF) is a highly prevalent syndrome. Although the long-term prognostic factors have been identified in chronic HF, this information is scarcer with respect to patients with acute HF. despite available data in the literature on long-term prognostic factors in chronic HF, data on acute HF patients are more scarce. Objectives To develop a predictor of unfavorable prognostic events in patients hospitalized for acute HF syndromes, and to characterize a group at higher risk regarding their clinical characteristics, treatment and outcomes. Methods cohort study of 600 patients admitted for acute HF, defined according to the European Society of Cardiology criteria. Primary endpoint for score derivation was defined as all-cause mortality and / or rehospitalization for HF at 12 months. For score validation, the following endpoints were used: all-cause mortality and / or readmission for HF at 6, 12 and 24 months. The exclusion criteria were: high output HF; patients with acute myocardial infraction, acute myocarditis, infectious endocarditis, pulmonary infection, pulmonary artery hypertension and severe mitral stenosis. Results 505 patients were included, and prognostic predicting factors at 12 months were identified. One or two points were assigned according to the odds ratio (OR) obtained (p < 0.05). After the total score value was determined, a 4-point cut-off was determined for each ROC curve at 12 months. Two groups were formed according to the number of points, group A < 4 points, and group B = 4 points. Group B was composed of older patients, with higher number of comorbidities and predictors of the combined endpoint at 6, 12 and 24 months, as linearly represented in the survival curves (Log rank). Conclusions This risk score enabled the identification of a group with worse prognosis at 12 months.

  18. 45 CFR 150.461 - Failure to pay assessment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... entered final judgment in favor of CMS, CMS refers the matter to the Attorney General, who brings an action against the entity in the appropriate United States district court to recover the amount assessed. ...

  19. Expert consensus document: Echocardiography and lung ultrasonography for the assessment and management of acute heart failure.

    PubMed

    Price, Susanna; Platz, Elke; Cullen, Louise; Tavazzi, Guido; Christ, Michael; Cowie, Martin R; Maisel, Alan S; Masip, Josep; Miro, Oscar; McMurray, John J; Peacock, W Frank; Martin-Sanchez, F Javier; Di Somma, Salvatore; Bueno, Hector; Zeymer, Uwe; Mueller, Christian

    2017-07-01

    Echocardiography is increasingly recommended for the diagnosis and assessment of patients with severe cardiac disease, including acute heart failure. Although previously considered to be within the realm of cardiologists, the development of ultrasonography technology has led to the adoption of echocardiography by acute care clinicians across a range of specialties. Data from echocardiography and lung ultrasonography can be used to improve diagnostic accuracy, guide and monitor the response to interventions, and communicate important prognostic information in patients with acute heart failure. However, without the appropriate skills and a good understanding of ultrasonography, its wider application to the most acutely unwell patients can have substantial pitfalls. This Consensus Statement, prepared by the Acute Heart Failure Study Group of the ESC Acute Cardiovascular Care Association, reviews the existing and potential roles of echocardiography and lung ultrasonography in the assessment and management of patients with acute heart failure, highlighting the differences from established practice where relevant.

  20. Omnibus risk assessment via accelerated failure time kernel machine modeling.

    PubMed

    Sinnott, Jennifer A; Cai, Tianxi

    2013-12-01

    Integrating genomic information with traditional clinical risk factors to improve the prediction of disease outcomes could profoundly change the practice of medicine. However, the large number of potential markers and possible complexity of the relationship between markers and disease make it difficult to construct accurate risk prediction models. Standard approaches for identifying important markers often rely on marginal associations or linearity assumptions and may not capture non-linear or interactive effects. In recent years, much work has been done to group genes into pathways and networks. Integrating such biological knowledge into statistical learning could potentially improve model interpretability and reliability. One effective approach is to employ a kernel machine (KM) framework, which can capture nonlinear effects if nonlinear kernels are used (Scholkopf and Smola, 2002; Liu et al., 2007, 2008). For survival outcomes, KM regression modeling and testing procedures have been derived under a proportional hazards (PH) assumption (Li and Luan, 2003; Cai, Tonini, and Lin, 2011). In this article, we derive testing and prediction methods for KM regression under the accelerated failure time (AFT) model, a useful alternative to the PH model. We approximate the null distribution of our test statistic using resampling procedures. When multiple kernels are of potential interest, it may be unclear in advance which kernel to use for testing and estimation. We propose a robust Omnibus Test that combines information across kernels, and an approach for selecting the best kernel for estimation. The methods are illustrated with an application in breast cancer. © 2013, The International Biometric Society.

  1. Development and Validation of a Questionnaire to Assess Fear of Kidney Failure Following Living Donation

    PubMed Central

    Rodrigue, James R.; Fleishman, Aaron; Vishnevsky, Tanya; Whiting, James; Vella, John P.; Garrison, Krista; Moore, Deonna; Kayler, Liise; Baliga, Prabhakar; Chavin, Kenneth D.; Karp, Seth; Mandelbrot, Didier A.

    2014-01-01

    Living kidney donors (LKDs) may feel more anxious about kidney failure now that they have only one kidney and the security of a second kidney is gone. The aim of this cross-sectional study was to develop and empirically validate a self-report scale for assessing fear of kidney failure in former LKDs. Participants were 364 former LKDs within the past 10 years at five U.S. transplant centers and 219 healthy non-donor controls recruited through Mechanical Turk who completed several questionnaires. Analyses revealed a unidimensional factor structure, excellent internal consistency (α = 0.88), and good convergent validity for the Fear of Kidney Failure questionnaire. Only 13% of former donors reported moderate to high fear of kidney failure. Non-white race (OR=2.9, P=0.01), genetic relationship with the recipient (OR=2.46, P=0.04), and low satisfaction with the donation experience (OR=0.49, P=0.002) were significant predictors of higher fear of kidney failure. We conclude that while mild anxiety about kidney failure is common, high anxiety about future renal failure among former LKDs is uncommon. The Fear of Kidney Failure questionnaire is reliable, valid, and easy to use in the clinical setting. PMID:24606048

  2. Development and validation of a questionnaire to assess fear of kidney failure following living donation.

    PubMed

    Rodrigue, James R; Fleishman, Aaron; Vishnevsky, Tanya; Whiting, James; Vella, John P; Garrison, Krista; Moore, Deonna; Kayler, Liise; Baliga, Prabhakar; Chavin, Kenneth D; Karp, Seth; Mandelbrot, Didier A

    2014-06-01

    Living kidney donors (LKDs) may feel more anxious about kidney failure now that they have only one kidney and the security of a second kidney is gone. The aim of this cross-sectional study was to develop and empirically validate a self-report scale for assessing fear of kidney failure in former LKDs. Participants were 364 former LKDs within the past 10 years at five US transplant centers and 219 healthy nondonor controls recruited through Mechanical Turk who completed several questionnaires. Analyses revealed a unidimensional factor structure, excellent internal consistency (α = 0.88), and good convergent validity for the Fear of Kidney Failure questionnaire. Only 13% of former donors reported moderate to high fear of kidney failure. Nonwhite race (OR = 2.9, P = 0.01), genetic relationship with the recipient (OR = 2.46, P = 0.04), and low satisfaction with the donation experience (OR = 0.49, P = 0.002) were significant predictors of higher fear of kidney failure. We conclude that while mild anxiety about kidney failure is common, high anxiety about future renal failure among former LKDs is uncommon. The Fear of Kidney Failure questionnaire is reliable, valid, and easy to use in the clinical setting. © 2014 Steunstichting ESOT.

  3. A novel risk assessment method for landfill slope failure: Case study application for Bhalswa Dumpsite, India.

    PubMed

    Jahanfar, Ali; Amirmojahedi, Mohsen; Gharabaghi, Bahram; Dubey, Brajesh; McBean, Edward; Kumar, Dinesh

    2017-03-01

    Rapid population growth of major urban centres in many developing countries has created massive landfills with extraordinary heights and steep side-slopes, which are frequently surrounded by illegal low-income residential settlements developed too close to landfills. These extraordinary landfills are facing high risks of catastrophic failure with potentially large numbers of fatalities. This study presents a novel method for risk assessment of landfill slope failure, using probabilistic analysis of potential failure scenarios and associated fatalities. The conceptual framework of the method includes selecting appropriate statistical distributions for the municipal solid waste (MSW) material shear strength and rheological properties for potential failure scenario analysis. The MSW material properties for a given scenario is then used to analyse the probability of slope failure and the resulting run-out length to calculate the potential risk of fatalities. In comparison with existing methods, which are solely based on the probability of slope failure, this method provides a more accurate estimate of the risk of fatalities associated with a given landfill slope failure. The application of the new risk assessment method is demonstrated with a case study for a landfill located within a heavily populated area of New Delhi, India.

  4. Caution: Venn Diagrams Ahead!

    ERIC Educational Resources Information Center

    Kimmins, Dovie L.; Winters, J. Jeremy

    2015-01-01

    Two perspectives of the term "Venn diagram" reflect the typical differences in the uses of Venn diagrams in the subject areas of mathematics and language arts. These differences are subtle; nevertheless, they can potentially be confusing. In language arts, the circles in a Venn diagram typically represent things that can be compared and…

  5. Caution: Venn Diagrams Ahead!

    ERIC Educational Resources Information Center

    Kimmins, Dovie L.; Winters, J. Jeremy

    2015-01-01

    Two perspectives of the term "Venn diagram" reflect the typical differences in the uses of Venn diagrams in the subject areas of mathematics and language arts. These differences are subtle; nevertheless, they can potentially be confusing. In language arts, the circles in a Venn diagram typically represent things that can be compared and…

  6. Lumbar Transpedicular Implant Failure: A Clinical and Surgical Challenge and Its Radiological Assessment

    PubMed Central

    Ali, Abdel Mohsen Arafa

    2014-01-01

    Study Design It is a multicenter, controlled case study review of a big scale of pedicle-screw procedures from January 2000 to June 2010. The outcomes were compared to those with no implant failure. Purpose The purpose of this study was to review retrospectively the outcome of 100 patients with implant failure in comparison to 100 control-patients, and to study the causes of failure and its prevention. Overview of Literature Transpedicular fixation is associated with risks of hardware failure, such as screw/rod breakage and/or loosening at the screw-rod interface and difficulties in the system assembly, which remain a significant clinical problem. Removal or revision of the spinal hardware is often required. Methods Two hundred patients (88 women, 112 men) were divided into 2 major groups, with 100 patients in group I (implant failure group G1) and 100 patients in group II (successful fusion, control group G2). We subdivided the study groups into two subgroups: subgroup a (single-level instrumented group) and subgroup b (multilevel instrumented group). The implant status was assessed based on intraoperative and follow-up radiographs. Results Implant failure in general was present in 36% in G1a, and in 64% in G1b, and types of implant failure included screw fracture (34%), rod fracture (24%), rod loosening (22%), screw loosening (16%), and failure of both rod and screw (4%). Most of the failures (90%) occurred within 6 months after surgery, with no reported cases 1 year postoperatively. Conclusions We tried to address the problem and study the causes of failure, and proposed solutions for its prevention. PMID:24967042

  7. Application of ISO22000 and Failure Mode and Effect Analysis (fmea) for Industrial Processing of Poultry Products

    NASA Astrophysics Data System (ADS)

    Varzakas, Theodoros H.; Arvanitoyannis, Ioannis S.

    Failure Mode and Effect Analysis (FMEA) model has been applied for the risk assessment of poultry slaughtering and manufacturing. In this work comparison of ISO22000 analysis with HACCP is carried out over poultry slaughtering, processing and packaging. Critical Control points and Prerequisite programs (PrPs) have been identified and implemented in the cause and effect diagram (also known as Ishikawa, tree diagram and fishbone diagram).

  8. Phase Equilibria Diagrams Database

    National Institute of Standards and Technology Data Gateway

    SRD 31 NIST/ACerS Phase Equilibria Diagrams Database (PC database for purchase)   The Phase Equilibria Diagrams Database contains commentaries and more than 21,000 diagrams for non-organic systems, including those published in all 21 hard-copy volumes produced as part of the ACerS-NIST Phase Equilibria Diagrams Program (formerly titled Phase Diagrams for Ceramists): Volumes I through XIV (blue books); Annuals 91, 92, 93; High Tc Superconductors I & II; Zirconium & Zirconia Systems; and Electronic Ceramics I. Materials covered include oxides as well as non-oxide systems such as chalcogenides and pnictides, phosphates, salt systems, and mixed systems of these classes.

  9. Preliminary Master Logic Diagram for ITER operation

    SciTech Connect

    Cadwallader, L.C.; Taylor, N.P.; Poucet, A.E.

    1998-04-01

    This paper describes the work performed to develop a Master Logic Diagram (MLD) for the operations phase of the International Thermonuclear Experimental Reactor (ITER). The MLD is a probabilistic risk assessment tool used to identify the broad set of potential initiating events that could lead to an offsite radioactive or toxic chemical release from the facility under study. The MLD described here is complementary to the failure modes and effects analyses (FMEAs) that have been performed for ITER`s major plant systems in the engineering evaluation of the facility design. While the FMEAs are a bottom-up or component level approach, the MLD is a top-down or facility level approach to identifying the broad spectrum of potential events. Strengths of the MLD are that it analyzes the entire plant, depicts completeness in the accident initiator process, provides an independent method for identification, and can also identify potential system interactions. MLDs have been used successfully as a hazard analysis tool. This paper describes the process used for the ITER MLD to treat the variety of radiological and toxicological source terms present in the ITER design. One subtree of the nineteen page MLD is shown to illustrate the levels of the diagram.

  10. System Reliability Assessment for a Rock Tunnel with Multiple Failure Modes

    NASA Astrophysics Data System (ADS)

    Lü, Qing; Chan, Chin Loong; Low, Bak Kong

    2013-07-01

    This paper presents a practical procedure for assessing the system reliability of a rock tunnel. Three failure modes, namely, inadequate support capacity, excessive tunnel convergence, and insufficient rockbolt length, are considered and investigated using a deterministic model of ground-support interaction analysis based on the convergence-confinement method (CCM). The failure probability of each failure mode is evaluated from the first-order reliability method (FORM) and the response surface method (RSM) via an iterative procedure. The system failure probability bounds are estimated using the bimodal bounds approach suggested by Ditlevsen (1979), based on the reliability index and design point inferred from the FORM. The proposed approach is illustrated with an example of a circular rock tunnel. The computed system failure probability bounds compare favorably with those generated from Monte Carlo simulations. The results show that the relative importance of different failure modes to the system reliability of the tunnel mainly depends on the timing of support installation relative to the advancing tunnel face. It is also shown that reliability indices based on the second-order reliability method (SORM) can be used to achieve more accurate bounds on the system failure probability for nonlinear limit state surfaces. The system reliability-based design for shotcrete thickness is also demonstrated.

  11. ANALYSIS OF SEQUENTIAL FAILURES FOR ASSESSMENT OF RELIABILITY AND SAFETY OF MANUFACTURING SYSTEMS. (R828541)

    EPA Science Inventory

    Assessment of reliability and safety of a manufacturing system with sequential failures is an important issue in industry, since the reliability and safety of the system depend not only on all failed states of system components, but also on the sequence of occurrences of those...

  12. When Summative Computer-Aided Assessments Go Wrong: Disaster Recovery after a Major Failure

    ERIC Educational Resources Information Center

    Harwood, Ian

    2005-01-01

    This case study outlines the events of a recent summative computer-aided assessment (CAA) failure involving 280 first-year undergraduate students. Post-test analysis found that the central server had become unexpectedly overloaded, thereby causing the CAA to be abandoned. Practical advice on just what to do in the event of a summative CAA failure…

  13. ANALYSIS OF SEQUENTIAL FAILURES FOR ASSESSMENT OF RELIABILITY AND SAFETY OF MANUFACTURING SYSTEMS. (R828541)

    EPA Science Inventory

    Assessment of reliability and safety of a manufacturing system with sequential failures is an important issue in industry, since the reliability and safety of the system depend not only on all failed states of system components, but also on the sequence of occurrences of those...

  14. Assessing performance and validating finite element simulations using probabilistic knowledge

    SciTech Connect

    Dolin, Ronald M.; Rodriguez, E. A.

    2002-01-01

    Two probabilistic approaches for assessing performance are presented. The first approach assesses probability of failure by simultaneously modeling all likely events. The probability each event causes failure along with the event's likelihood of occurrence contribute to the overall probability of failure. The second assessment method is based on stochastic sampling using an influence diagram. Latin-hypercube sampling is used to stochastically assess events. The overall probability of failure is taken as the maximum probability of failure of all the events. The Likelihood of Occurrence simulation suggests failure does not occur while the Stochastic Sampling approach predicts failure. The Likelihood of Occurrence results are used to validate finite element predictions.

  15. Coronary flow reserve assessed by myocardial contrast echocardiography predicts mortality in patients with heart failure.

    PubMed

    Anantharam, Brijesh; Janardhanan, Raj; Hayat, Sajad; Hickman, Michael; Chahal, Navtej; Bassett, Paul; Senior, Roxy

    2011-01-01

    the aim of the study was to assess whether myocardial contrast echocardiography (MCE) can predict mortality in patients with heart failure. Myocardial viability, ischaemia, and coronary flow reserve (CFR) are predictors of mortality in patients with heart failure. MCE can assess myocardial viability, ischaemia, and CFR at the bedside. However, its prognostic value is unknown in patients with heart failure. eighty-seven patients (age: 68 ± 10 years, 62% male) with heart failure [left ventricular ejection fraction (LVEF): 35% ± 13] underwent low-power intermittent MCE at rest and 2 min after dipyridamole infusion. Resting and stress perfusion score index were derived qualitatively. CFR (MBF at stress/MBF at rest) was calculated by a quantitative method. All patients underwent coronary arteriography. Patients were followed up for mortality. Of the 87 patients, 43 (49%) patients had coronary artery disease. There were 28 (32%) deaths during a mean follow-up of 4.1 ± 1.7 years. Type 2 diabetes [P = 0.02, hazard ratios (HR) 2.43, confidence interval (CI) 1.13-5.22] and CFR (P = 0.001, HR 0.15, CI 0.05-0.45) were independent predictors of mortality. A CFR ≤ 1.5 had a significantly (P < 0.0001) higher mortality of 49 vs. 10% in patients with CFR > 1.5 over the 4 year follow-up period. CFR determined by MCE is a powerful predictor of mortality in patients with heart failure.

  16. An improved approach for flight readiness certification: Methodology for failure risk assessment and application examples. Volume 2: Software documentation

    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.

  17. 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.

  18. 76 FR 67764 - Common-Cause Failure Analysis in Event and Condition Assessment: Guidance and Research, Draft...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-02

    ... COMMISSION Common-Cause Failure Analysis in Event and Condition Assessment: Guidance and Research, Draft...-xxxx, Revision 0, ``Common-Cause Failure Analysis in Event and Condition Assessment: Guidance and... at (301) 492-3446. FOR FURTHER INFORMATION CONTACT: Song-Hua Shen, Division of Risk Analysis,...

  19. Assessment of current structural design methodology for high-temperature reactors based on failure tests

    SciTech Connect

    Corum, J.M.; Sartory, W.K.

    1985-01-01

    A mature design methodology, consisting of inelastic analysis methods, provided in Department of Energy guidelines, and failure criteria, contained in ASME Code Case N-47, exists in the United States for high-temperature reactor components. The objective of this paper is to assess the adequacy of this overall methodology by comparing predicted inelastic deformations and lifetimes with observed results from structural failure tests and from an actual service failure. Comparisons are presented for three types of structural situations: (1) nozzle-to-spherical shell specimens, where stresses at structural discontinuities lead to cracking, (2) welded structures, where metallurgical discontinuities play a key role in failures, and (3) thermal shock loadings of cylinders and pipes, where thermal discontinuities can lead to failure. The comparison between predicted and measured inelastic responses are generally reasonalbly good; quantities are sometimes overpredicted somewhat, and, sometimes underpredicted. However, even seemingly small discrepancies can have a significant effect on structural life, and lifetimes are not always as closely predicted. For a few cases, the lifetimes are substantially overpredicted, which raises questions regarding the adequacy of existing design margins.

  20. Performance improvement through proactive risk assessment: Using failure modes and effects analysis

    PubMed Central

    Yarmohammadian, Mohammad Hossein; Abadi, Tahereh Naseri Boori; Tofighi, Shahram; Esfahani, Sekine Saghaeiannejad

    2014-01-01

    Introduction: Cognizance of any error-prone professional activities has a great impact on the continuity of professional organizations in the competitive atmosphere, particularly in health care industry where every second has critical value in patients’ life saving. Considering invaluable functions of medical record department — as legal document and continuity of health care — “failure mode and effects analysis (FMEA)” utilized to identify the ways a process can fail, and how it can be made safer. Materials and Methods: The structured approach involved assembling a team of experts, employing a trained facilitator, introducing the rating scales and process during team orientation and collectively scoring failure modes. The probability of the failure-effect combination was related to the frequency of occurrence, potential severity, and likelihood of detection before causing any harm to the staff or patients. Frequency, severity and detectability were each given a score from 1 to 10. Risk priority numbers were calculated. Results: In total 56 failure modes were identified and in subsets of Medical Record Department including admission unit dividing emergency, outpatient and inpatient classes, statististic, health data organizing and data processing and Medical Coding units. Although most failure modes were classified as a high risk group, limited resources were, as an impediment to implement recommended actions at the same time. Conclusion: Proactive risk assessment methods, such as FMEA enable health care administrators to identify where and what safeguards are needed to protect against a bad outcome even when an error does occur. PMID:25013821

  1. Hertzsprung-Russell Diagram

    NASA Astrophysics Data System (ADS)

    Chiosi, C.; Murdin, P.

    2000-11-01

    The Hertzsprung-Russell diagram (HR-diagram), pioneered independently by EJNAR HERTZSPRUNG and HENRY NORRIS RUSSELL, is a plot of the star luminosity versus the surface temperature. It stems from the basic relation for an object emitting thermal radiation as a black body: ...

  2. Early detection of nonneurologic organ failure in patients with severe traumatic brain injury: Multiple organ dysfunction score or sequential organ failure assessment?

    PubMed Central

    Ramtinfar, Sara; Chabok, Shahrokh Yousefzadeh; Chari, Aliakbar Jafari; Reihanian, Zoheir; Leili, Ehsan Kazemnezhad; Alizadeh, Arsalan

    2016-01-01

    Objective: The aim of this study is to compare the discriminant function of multiple organ dysfunction score (MODS) and sequential organ failure assessment (SOFA) components in predicting the Intensive Care Unit (ICU) mortality and neurologic outcome. Materials and Methods: A descriptive–analytic study was conducted at a level I trauma center. Data were collected from patients with severe traumatic brain injury admitted to the neurosurgical ICU. Basic demographic data, SOFA and MOD scores were recorded daily for all patients. Odd's ratios (ORs) were calculated to determine the relationship of each component score to mortality, and area under receiver operating characteristic (AUROC) curve was used to compare the discriminative ability of two tools with respect to ICU mortality. Results: The most common organ failure observed was respiratory detected by SOFA of 26% and MODS of 13%, and the second common was cardiovascular detected by SOFA of 18% and MODS of 13%. No hepatic or renal failure occurred, and coagulation failure reported as 2.5% by SOFA and MODS. Cardiovascular failure defined by both tools had a correlation to ICU mortality and it was more significant for SOFA (OR = 6.9, CI = 3.6–13.3, P < 0.05 for SOFA; OR = 5, CI = 3–8.3, P < 0.05 for MODS; AUROC = 0.82 for SOFA; AUROC = 0.73 for MODS). The relationship of cardiovascular failure to dichotomized neurologic outcome was not significant statistically. ICU mortality was not associated with respiratory or coagulation failure. Conclusion: Cardiovascular failure defined by either tool significantly related to ICU mortality. Compared to MODS, SOFA-defined cardiovascular failure was a stronger predictor of death. ICU mortality was not affected by respiratory or coagulation failures. PMID:27829712

  3. Airway Management & Assessment of Dyspnea in Emergency Department Patients with Acute Heart Failure

    PubMed Central

    Pang, Peter S.; Zaman, Masood

    2013-01-01

    Shortness of breath is the most common symptom in patients with acute heart failure (AHF). Ensuring adequate oxygenation and ventilation as well as symptomatic relief are key goals of early emergency department management. In this focused review, we describe how to assess dyspnea in clinical practice and how to treat AHF patients to relieve dyspnea, with initial discussion on Airway and Breathing management for patients who present in extremis. PMID:23795334

  4. Inductively generating Euler diagrams.

    PubMed

    Stapleton, Gem; Rodgers, Peter; Howse, John; Zhang, Leishi

    2011-01-01

    Euler diagrams have a wide variety of uses, from information visualization to logical reasoning. In all of their application areas, the ability to automatically layout Euler diagrams brings considerable benefits. In this paper, we present a novel approach to Euler diagram generation. We develop certain graphs associated with Euler diagrams in order to allow curves to be added by finding cycles in these graphs. This permits us to build Euler diagrams inductively, adding one curve at a time. Our technique is adaptable, allowing the easy specification, and enforcement, of sets of well-formedness conditions; we present a series of results that identify properties of cycles that correspond to the well-formedness conditions. This improves upon other contributions toward the automated generation of Euler diagrams which implicitly assume some fixed set of well-formedness conditions must hold. In addition, unlike most of these other generation methods, our technique allows any abstract description to be drawn as an Euler diagram. To establish the utility of the approach, a prototype implementation has been developed.

  5. New medicinal products for chronic heart failure: advances in clinical trial design and efficacy assessment.

    PubMed

    Cowie, Martin R; Filippatos, Gerasimos S; Alonso Garcia, Maria de Los Angeles; Anker, Stefan D; Baczynska, Anna; Bloomfield, Daniel M; Borentain, Maria; Bruins Slot, Karsten; Cronin, Maureen; Doevendans, Pieter A; El-Gazayerly, Amany; Gimpelewicz, Claudio; Honarpour, Narimon; Janmohamed, Salim; Janssen, Heidi; Kim, Albert M; Lautsch, Dominik; Laws, Ian; Lefkowitz, Martin; Lopez-Sendon, Jose; Lyon, Alexander R; Malik, Fady I; McMurray, John J V; Metra, Marco; Figueroa Perez, Santiago; Pfeffer, Marc A; Pocock, Stuart J; Ponikowski, Piotr; Prasad, Krishna; Richard-Lordereau, Isabelle; Roessig, Lothar; Rosano, Giuseppe M C; Sherman, Warren; Stough, Wendy Gattis; Swedberg, Karl; Tyl, Benoit; Zannad, Faiez; Boulton, Caroline; De Graeff, Pieter

    2017-03-27

    Despite the availability of a number of different classes of therapeutic agents with proven efficacy in heart failure, the clinical course of heart failure patients is characterized by a reduction in life expectancy, a progressive decline in health-related quality of life and functional status, as well as a high risk of hospitalization. New approaches are needed to address the unmet medical needs of this patient population. The European Medicines Agency (EMA) is undertaking a revision of its Guideline on Clinical Investigation of Medicinal Products for the Treatment of Chronic Heart Failure. The draft version of the Guideline was released for public consultation in January 2016. The Cardiovascular Round Table of the European Society of Cardiology (ESC), in partnership with the Heart Failure Association of the ESC, convened a dedicated two-day workshop to discuss three main topic areas of major interest in the field and addressed in this draft EMA guideline: (i) assessment of efficacy (i.e. endpoint selection and statistical analysis); (ii) clinical trial design (i.e. issues pertaining to patient population, optimal medical therapy, run-in period); and (iii) research approaches for testing novel therapeutic principles (i.e. cell therapy). This paper summarizes the key outputs from the workshop, reviews areas of expert consensus, and identifies gaps that require further research or discussion. Collaboration between regulators, industry, clinical trialists, cardiologists, health technology assessment bodies, payers, and patient organizations is critical to address the ongoing challenge of heart failure and to ensure the development and market access of new therapeutics in a scientifically robust, practical and safe way.

  6. Assessment of compressive failure process of cortical bone materials using damage-based model.

    PubMed

    Ng, Theng Pin; R Koloor, S S; Djuansjah, J R P; Abdul Kadir, M R

    2017-02-01

    The main failure factors of cortical bone are aging or osteoporosis, accident and high energy trauma or physiological activities. However, the mechanism of damage evolution coupled with yield criterion is considered as one of the unclear subjects in failure analysis of cortical bone materials. Therefore, this study attempts to assess the structural response and progressive failure process of cortical bone using a brittle damaged plasticity model. For this reason, several compressive tests are performed on cortical bone specimens made of bovine femur, in order to obtain the structural response and mechanical properties of the material. Complementary finite element (FE) model of the sample and test is prepared to simulate the elastic-to-damage behavior of the cortical bone using the brittle damaged plasticity model. The FE model is validated in a comparative method using the predicted and measured structural response as load-compressive displacement through simulation and experiment. FE results indicated that the compressive damage initiated and propagated at central region where maximum equivalent plastic strain is computed, which coincided with the degradation of structural compressive stiffness followed by a vast amount of strain energy dissipation. The parameter of compressive damage rate, which is a function dependent on damage parameter and the plastic strain is examined for different rates. Results show that considering a similar rate to the initial slope of the damage parameter in the experiment would give a better sense for prediction of compressive failure.

  7. The importance of assessing nutritional status in elderly patients with heart failure.

    PubMed

    Sargento, Luis; Longo, Susana; Lousada, Nuno; dos Reis, Roberto Palma

    2014-06-01

    Heart failure (HF) is a syndrome characterized by high morbidity and mortality, despite advances in medical and device therapy that have significantly improved survival. The outcome of HF in elderly patients results from a combination of biological, functional, psychological, and environmental factors, one of which is nutritional status. Malnutrition, as well as HF, is frequently present with aging. Early detection might lead to earlier intervention. It is our goal to review the importance of nutritional status in elderly patients with HF, as well as tools for assessing it. We also propose a simple decision algorithm for the nutritional assessment of elderly patients with HF.

  8. Square Source Type Diagram

    NASA Astrophysics Data System (ADS)

    Aso, N.; Ohta, K.; Ide, S.

    2014-12-01

    Deformation in a small volume of earth interior is expressed by a symmetric moment tensor located on a point source. The tensor contains information of characteristic directions, source amplitude, and source types such as isotropic, double-couple, or compensated-linear-vector-dipole (CLVD). Although we often assume a double couple as the source type of an earthquake, significant non-double-couple component including isotropic component is often reported for induced earthquakes and volcanic earthquakes. For discussions on source types including double-couple and non-double-couple components, it is helpful to display them using some visual diagrams. Since the information of source type has two degrees of freedom, it can be displayed onto a two-dimensional flat plane. Although the diagram developed by Hudson et al. [1989] is popular, the trace corresponding to the mechanism combined by two mechanisms is not always a smooth line. To overcome this problem, Chapman and Leaney [2012] developed a new diagram. This diagram has an advantage that a straight line passing through the center corresponds to the mechanism obtained by a combination of an arbitrary mechanism and a double-couple [Tape and Tape, 2012], but this diagram has some difficulties in use. First, it is slightly difficult to produce the diagram because of its curved shape. Second, it is also difficult to read out the ratios among isotropic, double-couple, and CLVD components, which we want to obtain from the estimated moment tensors, because they do not appear directly on the horizontal or vertical axes. In the present study, we developed another new square diagram that overcomes the difficulties of previous diagrams. This diagram is an orthogonal system of isotropic and deviatoric axes, so it is easy to get the ratios among isotropic, double-couple, and CLVD components. Our diagram has another advantage that the probability density is obtained simply from the area within the diagram if the probability density

  9. Assessment of acid-base status of cats with naturally occurring chronic renal failure.

    PubMed

    Elliott, J; Syme, H M; Reubens, E; Markwell, P J

    2003-02-01

    Metabolic acidosis is reported to be a common complication of feline chronic renal failure (CRF) but acid-base status of feline patients with this disease is rarely assessed by general practitioners. A cross-sectional study involving 59 cases of naturally occurring feline CRF was conducted to determine the prevalence of acid-base disturbances. Cases were categorised on the basis of their plasma creatinine concentrations as mild, moderate or severe. A group of 27 clinically healthy, age-matched cats was assessed for comparison. A low venous blood pH (<7.270) was found in 10 of the 19 severe cases (52.6 per cent), three of the 20 moderate cases (15 per cent) and none of the 20 mild cases. Acidaemia was associated with an increased anion gap contributed to by both low plasma bicarbonate and low chloride ion concentrations. Biochemical analysis of urine samples showed urine pH to decrease with increasing severity of renal failure. Urinary loss of bicarbonate was not associated with the occurrence of acidaemia and there was a tendency for urinary ammonium ion excretion to decrease as the severity of renal failure increased. Cats with naturally occurring CRF do not show plasma biochemical evidence of acid-base disturbances until the disease is advanced.

  10. Assessment of dune failure along the Dutch coast using a fully probabilistic approach

    NASA Astrophysics Data System (ADS)

    den Heijer, C.(Kees); Baart, Fedor; van Koningsveld, Mark

    2012-03-01

    This paper describes an investigation into the added value of a fully probabilistic approach to dune resilience assessment over the currently applied deterministic and semi-probabilistic approaches. The method is applied to the Dutch coast but is generically applicable, provided of course the sufficient availability of data. The DUROS+ model in its most basic form was used to quantitatively assess dune resilience. The Monte Carlo method was used for the probabilistic investigation. Important research questions were (1) where can the DUROS+ model in combination with the fully probabilistic approach be applied along the Dutch coast? and (2) what is the alongshore variability of failure probability using this probabilistic approach? The main conclusion of the work presented in this paper is that the fully probabilistic approach provides valuable added insight with respect to the actual failure probability of transects. At the same time it is noted that the current dune erosion model in its most basic form is not able to cover all of the Dutch coast. Reasons lie in the availability of sufficient quality boundary conditions, applicability limits associated with model assumptions and insufficient quality coastal profile information. To extend the coverage of the analysis of failure probabilities along the Dutch coast it is recommended (1) to involve more process-based model concepts that can cope with the situations DUROS+ cannot, and (2) to expand currently available data on boundary conditions.

  11. Use of Minimal Residual Disease Assessment to Redefine Induction Failure in Pediatric Acute Lymphoblastic Leukemia.

    PubMed

    O'Connor, David; Moorman, Anthony V; Wade, Rachel; Hancock, Jeremy; Tan, Ronald M R; Bartram, Jack; Moppett, John; Schwab, Claire; Patrick, Katharine; Harrison, Christine J; Hough, Rachael; Goulden, Nick; Vora, Ajay; Samarasinghe, Sujith

    2017-02-20

    Purpose Our aim was to determine the role of end-of-induction (EOI) minimal residual disease (MRD) assessment in the identification and stratification of induction failure in patients with pediatric acute lymphoblastic leukemia (ALL) and to identify genetic abnormalities that drive disease in these patients. Patients and Methods Analysis included 3,113 patients who were treated in the Medical Research Council UKALL2003 multicenter randomized trial (NCT00222612) between 2003 and 2011. MRD was measured by using standardized real-time quantitative PCR. Median follow-up was 5 years 9 months. Results Fifty-nine patients (1.9%) had morphologic induction failure with 5-year event-free survival (EFS) of 50.7% (95% CI, 37.4 to 64.0) and 5-year overall survival of 57.7% (95% CI, 44.2 to 71.2). Of these, a small proportion of patients with M2 marrow (6 of 44) and a low EOI MRD level (< 0.01%) had 5-year EFS of 100%. Conversely, among patients with morphologic remission 2.3% (61 of 2,633) had high MRD (≥ 5%) and 5-year EFS of 47.0% (95% CI, 32.9 to 61.1), which was similar to those with morphologic induction failure. Redefining induction failure to include morphologic induction failure and/or MRD ≥ 5% identified 3.9% (120 of 3,133 patients) of the trial cohort with 5-year EFS of 48.0% (95% CI, 39.3 to 58.6). Induction failure (morphologic or MRD ≥ 5%) occurred most frequently in T-ALL (10.1%; 39 of 386 T-ALL cases) and B-other ALL, that is, lacking established chromosomal abnormalities (5.6%; 43 of 772 B-other cases). Genetic testing within the B-other group revealed the presence of PDGFRB gene fusions, particularly EBF1-PDGFRB, in almost one third of B-other ALL cases. Conclusion Integration of EOI MRD level with morphology identifies induction failure more precisely than morphology alone. Prevalence of EBF1-PDGFRB fusions in this group highlights the importance of genetic screening to identify abnormalities that may be targets for novel agents.

  12. Poster - Thur Eve - 19: Risk assessment of clinical radiation processes using failure modes and effect analysis.

    PubMed

    Angers, C; Studinski, R; La Russa, D; Bahm, J; Renaud, J; Clark, B G

    2012-07-01

    The aim of this work was to apply failure modes and effect analysis (FMEA) to assess risk in two radiation planning and treatment processes; our on-call (out-of-clinical hours) process and our tomotherapy process. The motivation was provided by analysis of 2506 adverse incidents reported over a 5 year period, the on-call process for giving rise to a higher than expected number of incidents and our tomotherapy process for the reverse. For the on-call scenario, three separate processes were analysed: our current process, our current process incorporating a software upgrade eliminating several planning steps and a fully integrated process in which the patient is imaged, planned and treated on a single platform (TomoTherapy Hi Art, Accuray Incorporated, Sunnyvale, CA). After construction of a detailed process map for each case, a multidisciplinary group identified potential failure modes for each process step, the effects of each failure and existing controls. Risk probability numbers were determined from severity, frequency of occurrence and detectability scores assigned to each failure mode according to a standard scale. The results were analysed to identify and prioritise feasible and effective process improvements. For the on-call process, our current workflow was identified as incurring the highest risk of the three processes analysed, demonstrating quantitatively the value of the software upgrade and providing a clear rationale for the associated expense. In summary, we have found FMEA to be a feasible tool for assessing relative risk in a clinical process. However, operational and resource issues must be considered separately. © 2012 American Association of Physicists in Medicine.

  13. 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

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION 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...

  14. A Retrospective Analysis of the Effectiveness of the Longevity Protocol for Assessing the Risk of Implant Failure.

    PubMed

    Testori, Tiziano; Clauser, Carlo; Deflorian, Matteo; Capelli, Matteo; Zuffetti, Francesco; Fabbro, Massimo Del

    2016-12-01

    A new, computerized diagnostic tool, called the Longevity Protocol, was recently developed to predict implant failure. The present retrospective analysis was undertaken to assess the prognostic validity of this protocol. A selected group of patients who had been treated with implants over the past 10 years at six dental clinics and experienced implant failure were included in the analysis. Another group of patients with similar characteristics, not experiencing implant failure, was used as control. In April of 2015, data about each of the patients was entered into the Longevity Protocol database. For each patient, the risk assessment produced by the protocol was compared to whether the implants eventually failed. The implant failure predictions and actual implant failures were compared. The Longevity Protocol analyzed the possible failure of 595 implants placed in 221 patients (323 implants placed in 138 patients classified as low risk, 180 implants placed in 55 patients classified as moderate risk, and 92 implants placed in 28 patients classified as high risk). The actual percentage of implant failure in the three groups was 10%, 15%, and 22%, respectively. The differences between the groups were statistically significant. The sensitivity and specificity of the Longevity Protocol was 84.9% and 11.90% in the high/moderate risk group and 47.17% and 32.74% in the low risk group, respectively. Statistically significant results were obtained. The Longevity Protocol reliably identified patients who risked implant failure. The protocol appears to be an important tool for prognosis assessment. © 2016 Wiley Periodicals, Inc.

  15. Weyl card diagrams

    SciTech Connect

    Jones, Gregory; Wang, John E.

    2005-06-15

    To capture important physical properties of a spacetime we construct a new diagram, the card diagram, which accurately draws generalized Weyl spacetimes in arbitrary dimensions by encoding their global spacetime structure, singularities, horizons, and some aspects of causal structure including null infinity. Card diagrams draw only nontrivial directions providing a clearer picture of the geometric features of spacetimes as compared to Penrose diagrams, and can change continuously as a function of the geometric parameters. One of our main results is to describe how Weyl rods are traversable horizons and the entirety of the spacetime can be mapped out. We review Weyl techniques and as examples we systematically discuss properties of a variety of solutions including Kerr-Newman black holes, black rings, expanding bubbles, and recent spacelike-brane solutions. Families of solutions will share qualitatively similar cards. In addition we show how card diagrams not only capture information about a geometry but also its analytic continuations by providing a geometric picture of analytic continuation. Weyl techniques are generalized to higher dimensional charged solutions and applied to generate perturbations of bubble and S-brane solutions by Israel-Khan rods.

  16. Hemodynamic assessment in heart failure: role of physical examination and noninvasive methods.

    PubMed

    Almeida Junior, Gustavo Luiz; Xavier, Sérgio Salles; Garcia, Marcelo Iorio; Clausell, Nadine

    2012-01-01

    Among the cardiovascular diseases, heart failure (HF) has a high rate of hospitalization, morbidity and mortality, consuming vast resources of the public health system in Brazil and other countries. The correct determination of the filling pressures of the left ventricle by noninvasive or invasive assessment is critical to the proper treatment of patients with decompensated chronic HF, considering that congestion is the main determinant of symptoms and hospitalization. Physical examination has shown to be inadequate to predict the hemodynamic pattern. Several studies have suggested that agreement on physical findings by different physicians is small and that, ultimately, adaptive physiological alterations in chronic HF mask important aspects of the physical examination. As the clinical assessment fails to predict hemodynamic aspects and because the use of Swan-Ganz catheter is not routinely recommended for this purpose in patients with HF, noninvasive hemodynamic assessment methods, such as BNP, echocardiography and cardiographic bioimpedance, are being increasingly used. The present study intends to carry out, for the clinician, a review of the role of each of these tools when defining the hemodynamic status of patients with decompensated heart failure, aiming at a more rational and individualized treatment.

  17. Assessment of Three Finite Element Approaches for Modeling the Ballistic Impact Failure of Metal Plates

    NASA Astrophysics Data System (ADS)

    Mansur, Ali; Nganbe, Michel

    2015-03-01

    The ballistic impact was numerically modeled for AISI 450 steel struck by a 17.3 g ogive nose WC-Co projectile using Abaqus/Explicit. The model was validated using experimental results and data for different projectiles and metal targets. The Abaqus ductile-shear, local principal strain to fracture, and absorbed strain energy at failure criteria were investigated. Due to the highly dynamic nature of ballistic impacts, the absorbed strain energy approach posed serious challenges in estimating the effective deformation volume and yielded the largest critical plate thicknesses for through-thickness penetration (failure). In contrast, the principal strain criterion yielded the lowest critical thicknesses and provided the best agreement with experimental ballistic test data with errors between 0 and 30%. This better accuracy was due to early failure definition when the very first mesh at the target back side reached the strain to fracture, which compensated for the overall model overestimation. The ductile-shear criterion yielded intermediate results between those of the two comparative approaches. In contrast to the ductile-shear criterion, the principal strain criterion requires only basic data readily available for practically all materials. Therefore, it is a viable alternative for an initial assessment of the ballistic performance and pre-screening of a large number of new candidate materials as well as for supporting the development of novel armor systems.

  18. Risk assessment for Industrial Control Systems quantifying availability using mean failure cost (MFC)

    SciTech Connect

    Chen, Qian; Abercrombie, Robert K; Sheldon, Frederick T.

    2015-09-23

    Industrial Control Systems (ICS) are commonly used in industries such as oil and natural gas, transportation, electric, water and wastewater, chemical, pharmaceutical, pulp and paper, food and beverage, as well as discrete manufacturing (e.g., automotive, aerospace, and durable goods.) SCADA systems are generally used to control dispersed assets using centralized data acquisition and supervisory control.Originally, ICS implementations were susceptible primarily to local threats because most of their components were located in physically secure areas (i.e., ICS components were not connected to IT networks or systems). The trend toward integrating ICS systems with IT networks (e.g., efficiency and the Internet of Things) provides significantly less isolation for ICS from the outside world thus creating greater risk due to external threats. Albeit, the availability of ICS/SCADA systems is critical to assuring safety, security and profitability. Such systems form the backbone of our national cyber-physical infrastructure.Herein, we extend the concept of mean failure cost (MFC) to address quantifying availability to harmonize well with ICS security risk assessment. This new measure is based on the classic formulation of Availability combined with Mean Failure Cost (MFC). Finally, the metric offers a computational basis to estimate the availability of a system in terms of the loss that each stakeholder stands to sustain as a result of security violations or breakdowns (e.g., deliberate malicious failures).

  19. Risk assessment for Industrial Control Systems quantifying availability using mean failure cost (MFC)

    DOE PAGES

    Chen, Qian; Abercrombie, Robert K; Sheldon, Frederick T.

    2015-09-23

    Industrial Control Systems (ICS) are commonly used in industries such as oil and natural gas, transportation, electric, water and wastewater, chemical, pharmaceutical, pulp and paper, food and beverage, as well as discrete manufacturing (e.g., automotive, aerospace, and durable goods.) SCADA systems are generally used to control dispersed assets using centralized data acquisition and supervisory control.Originally, ICS implementations were susceptible primarily to local threats because most of their components were located in physically secure areas (i.e., ICS components were not connected to IT networks or systems). The trend toward integrating ICS systems with IT networks (e.g., efficiency and the Internet ofmore » Things) provides significantly less isolation for ICS from the outside world thus creating greater risk due to external threats. Albeit, the availability of ICS/SCADA systems is critical to assuring safety, security and profitability. Such systems form the backbone of our national cyber-physical infrastructure.Herein, we extend the concept of mean failure cost (MFC) to address quantifying availability to harmonize well with ICS security risk assessment. This new measure is based on the classic formulation of Availability combined with Mean Failure Cost (MFC). Finally, the metric offers a computational basis to estimate the availability of a system in terms of the loss that each stakeholder stands to sustain as a result of security violations or breakdowns (e.g., deliberate malicious failures).« less

  20. Assessing Hospital Readmission Risk Factors in Heart Failure Patients Enrolled in a Telemonitoring Program

    PubMed Central

    Zai, Adrian H.; Ronquillo, Jeremiah G.; Nieves, Regina; Chueh, Henry C.; Kvedar, Joseph C.; Jethwani, Kamal

    2013-01-01

    The purpose of this study was to validate a previously developed heart failure readmission predictive algorithm based on psychosocial factors, develop a new model based on patient-reported symptoms from a telemonitoring program, and assess the impact of weight fluctuations and other factors on hospital readmission. Clinical, demographic, and telemonitoring data was collected from 100 patients enrolled in the Partners Connected Cardiac Care Program between July 2008 and November 2011. 38% of study participants were readmitted to the hospital within 30 days. Ten different heart-failure-related symptoms were reported 17,389 times, with the top three contributing approximately 50% of the volume. The psychosocial readmission model yielded an AUC of 0.67, along with sensitivity 0.87, specificity 0.32, positive predictive value 0.44, and negative predictive value 0.8 at a cutoff value of 0.30. In summary, hospital readmission models based on psychosocial characteristics, standardized changes in weight, or patient-reported symptoms can be developed and validated in heart failure patients participating in an institutional telemonitoring program. However, more robust models will need to be developed that use a comprehensive set of factors in order to have a significant impact on population health. PMID:23710170

  1. Assessing hospital readmission risk factors in heart failure patients enrolled in a telemonitoring program.

    PubMed

    Zai, Adrian H; Ronquillo, Jeremiah G; Nieves, Regina; Chueh, Henry C; Kvedar, Joseph C; Jethwani, Kamal

    2013-01-01

    The purpose of this study was to validate a previously developed heart failure readmission predictive algorithm based on psychosocial factors, develop a new model based on patient-reported symptoms from a telemonitoring program, and assess the impact of weight fluctuations and other factors on hospital readmission. Clinical, demographic, and telemonitoring data was collected from 100 patients enrolled in the Partners Connected Cardiac Care Program between July 2008 and November 2011. 38% of study participants were readmitted to the hospital within 30 days. Ten different heart-failure-related symptoms were reported 17,389 times, with the top three contributing approximately 50% of the volume. The psychosocial readmission model yielded an AUC of 0.67, along with sensitivity 0.87, specificity 0.32, positive predictive value 0.44, and negative predictive value 0.8 at a cutoff value of 0.30. In summary, hospital readmission models based on psychosocial characteristics, standardized changes in weight, or patient-reported symptoms can be developed and validated in heart failure patients participating in an institutional telemonitoring program. However, more robust models will need to be developed that use a comprehensive set of factors in order to have a significant impact on population health.

  2. A theoretical approach to assess microbial risks due to failures in drinking water systems.

    PubMed

    Westrell, T; Bergstedt, O; Stenström, T A; Ashbolt, N J

    2003-06-01

    A failure in treatment or in the distribution network of a surface water-works could have serious consequences due to the variable raw water quality in combination with an extended distribution. The aim of this study was to examine the theoretical impact of incidents in the drinking water system on the annual risk of infection in a population served by a large water treatment plant in Sweden. Reported incidents in the system were examined and a microbial risk assessment that included three pathogens, Cryptosporidium parvum, rotavirus and Campylobacter jejuni, was performed. The main risk incidents in water treatment were associated with sub-optimal particle removal or disinfection malfunction. Incidents in the distribution network included cross-connections and microbial pollution of reservoirs and local networks. The majority of the annual infections were likely to be due to pathogens passing treatment during normal operation and not due to failures, thus adding to the endemic rate. Among the model organisms, rotavirus caused the largest number of infections. Decentralised water treatment with membranes was also considered in which failures upstream fine-pored membranes would have little impact as long as the membranes were kept intact.

  3. Sample handler for x-ray tomographic microscopy and image-guided failure assessment

    SciTech Connect

    Wyss, Peter; Thurner, Philipp; Broennimann, Rolf; Sennhauser, Urs; Stampanoni, Marco; Abela, Rafael; Mueller, Ralph

    2005-07-15

    X-ray tomographic microscopy (XTM) yields a three-dimensional data model of an investigated specimen. XTM providing micrometer resolution requires synchrotron light, high resolution area detectors, and a precise sample handler. The sample handler has a height of 270 mm only, is usable for 1 {mu}m resolution, and is able to carry loading machines with a weight of up to 20 kg. This allows exposing samples to load between scans for image-guided failure assessment. This system has been used in the XTM end station of the materials science beamline of the Swiss Light Source at the Paul Scherrer Institut.

  4. The assessment of low probability containment failure modes using dynamic PRA

    NASA Astrophysics Data System (ADS)

    Brunett, Acacia Joann

    Although low probability containment failure modes in nuclear power plants may lead to large releases of radioactive material, these modes are typically crudely modeled in system level codes and have large associated uncertainties. Conventional risk assessment techniques (i.e. the fault-tree/event-tree methodology) are capable of accounting for these failure modes to some degree, however, they require the analyst to pre-specify the ordering of events, which can vary within the range of uncertainty of the phenomena. More recently, dynamic probabilistic risk assessment (DPRA) techniques have been developed which remove the dependency on the analyst. Through DPRA, it is now possible to perform a mechanistic and consistent analysis of low probability phenomena, with the timing of the possible events determined by the computational model simulating the reactor behavior. The purpose of this work is to utilize DPRA tools to assess low probability containment failure modes and the driving mechanisms. Particular focus is given to the risk-dominant containment failure modes considered in NUREG-1150, which has long been the standard for PRA techniques. More specifically, this work focuses on the low probability phenomena occurring during a station blackout (SBO) with late power recovery in the Zion Nuclear Power Plant, a Westinghouse pressurized water reactor (PWR). Subsequent to the major risk study performed in NUREG-1150, significant experimentation and modeling regarding the mechanisms driving containment failure modes have been performed. In light of this improved understanding, NUREG-1150 containment failure modes are reviewed in this work using the current state of knowledge. For some unresolved mechanisms, such as containment loading from high pressure melt ejection and combustion events, additional analyses are performed using the accident simulation tool MELCOR to explore the bounding containment loads for realistic scenarios. A dynamic treatment in the

  5. Impulse-Momentum Diagrams

    ERIC Educational Resources Information Center

    Rosengrant, David

    2011-01-01

    Multiple representations are a valuable tool to help students learn and understand physics concepts. Furthermore, representations help students learn how to think and act like real scientists. These representations include: pictures, free-body diagrams, energy bar charts, electrical circuits, and, more recently, computer simulations and…

  6. Understanding Network Diagrams.

    ERIC Educational Resources Information Center

    Waller, Robert

    A survey of a range of introductory university level textbooks in the social sciences found little use of network diagrams (NDs), i.e., graphic representations of processes, organizations, systems, and mechanisms. NDs can be viewed as a text/picture hybrid medium with titles and captions serving to qualify and identify the meaning and status of…

  7. Impulse-Momentum Diagrams

    ERIC Educational Resources Information Center

    Rosengrant, David

    2011-01-01

    Multiple representations are a valuable tool to help students learn and understand physics concepts. Furthermore, representations help students learn how to think and act like real scientists. These representations include: pictures, free-body diagrams, energy bar charts, electrical circuits, and, more recently, computer simulations and…

  8. The efficacy of loop diuretics in acute renal failure: assessment using Bayesian evidence synthesis techniques.

    PubMed

    Sampath, Sriram; Moran, John L; Graham, Petra L; Rockliff, Sue; Bersten, Andrew D; Abrams, Keith R

    2007-11-01

    To quantify the therapeutic efficacy of loop diuretics in acute renal failure using Bayesian evidence synthesis, because despite widespread use, the role of diuretics is controversial. Randomized controlled trials or nonrandomized studies, 1966 to January 2007, identified from MEDLINE and EMBASE databases and manual bibliographic search. Studies with assessable predefined end points, exclusive of those pertaining to acute renal failure prophylaxis or chronic renal failure. Data extraction was performed jointly by the first two authors; independent study assessment was via standard checklist, unblinded. The primary outcome was mortality; secondary outcomes were time to renal function normalization and total number of dialyses. Bayesian hierarchical random effects estimates of treatment effects were determined as risk ratio for mortality, incidence rate ratio for dialysis number, and mean difference for continuous measures. Bayesian outcome probabilities were calculated as probability (P) that risk ratio or incidence rate ratio of loop diuretics >1 and probability that mean difference >0. Five randomized controlled trials and eight nonrandomized studies were identified. Loop diuretics were not associated with decreased mortality in either randomized controlled trials or nonrandomized studies: overall risk ratio 1.10; 95% credible interval 0.85, 1.42; P(risk ratio >1) > 83.8%. The oliguric period was decreased by loop diuretics: overall mean difference -7.70 days; 95% credible interval -12.51, -2.08; P (mean difference >0) = 0.7%. Although the dialysis rate credible interval, loop diuretics vs. control, spanned unity (incidence rate ratio 0.71; 95% credible interval 0.47, 1.06), the probability that the incidence rate ratio exceeded unity indicated a substantial benefit: P (incidence rate ratio >1 = 4.1%. Uremic duration was not substantially different, loop diuretics vs. control: overall mean difference -1.54 days; 95% credible interval -5.62, 2.46; P [mean

  9. Assessing elderly patients with congestive heart failure via in-home interactive telecommunication.

    PubMed

    Jenkins, R L; McSweeney, M

    2001-01-01

    The efficacy of telemedicine technology was tested for equivalence of nursing assessment with chronic congestive heart failure (CHF) home care patients (N = 28). The equivalence of nurses' physical assessment findings was estimated using an innovative two-way, telemedicine audiovisual system. Nurses were randomly assigned to a method of client assessment: on-site (real time) or telemedicine (monitor time). Each assessment was performed within 10 minutes of each other. Assessment variables compared were auscultation of lung sounds, heart sounds, rate and rhythm, blood pressure, weight, edema, respiratory effort, and client's face, lip, and nail color. Eighteen physiological parameters were analyzed, using either the Wilcoxon signed ranks test or the McNemar test. Results indicate few significant differences between the assessments of the real time and monitor time nurses. The monitor nurse was more likely to claim abnormality than the real nurse was when assessing the color of nails (p = .048). The real nurse picked up ankle edema (p = .024), pedal edema (p = .099), and inspiratory wheeze (p = .01) more frequently than did the monitor nurse. Kappa coefficients to determine the extent of agreement between nurse's assessments were significant. Nurses' comments were favorable, but they recommended altering the interview to elicit symptoms not easily observed by the monitor nurse such as diaphoresis. Exit interviews of the elderly patients revealed a favorable reaction to using the telemedicine monitor, citing a quick connection to a nurse and response to their concerns and questions. Both nurses and patients reported the need to have real nurse home visits along with telemedicine visits.

  10. Assessment selection in human-automation interaction studies: The Failure-GAM(2)E and review of assessment methods for highly automated driving.

    PubMed

    Grane, Camilla

    2017-08-30

    Highly automated driving will change driver's behavioural patterns. Traditional methods used for assessing manual driving will only be applicable for the parts of human-automation interaction where the driver intervenes such as in hand-over and take-over situations. Therefore, driver behaviour assessment will need to adapt to the new driving scenarios. This paper aims at simplifying the process of selecting appropriate assessment methods. Thirty-five papers were reviewed to examine potential and relevant methods. The review showed that many studies still relies on traditional driving assessment methods. A new method, the Failure-GAM(2)E model, with purpose to aid assessment selection when planning a study, is proposed and exemplified in the paper. Failure-GAM(2)E includes a systematic step-by-step procedure defining the situation, failures (Failure), goals (G), actions (A), subjective methods (M), objective methods (M) and equipment (E). The use of Failure-GAM(2)E in a study example resulted in a well-reasoned assessment plan, a new way of measuring trust through feet movements and a proposed Optimal Risk Management Model. Failure-GAM(2)E and the Optimal Risk Management Model are believed to support the planning process for research studies in the field of human-automation interaction. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Assessment and prevalence of pulmonary oedema in contemporary acute heart failure trials: a systematic review.

    PubMed

    Platz, Elke; Jhund, Pardeep S; Campbell, Ross T; McMurray, John J

    2015-09-01

    Pulmonary oedema is a common and important finding in acute heart failure (AHF). We conducted a systematic review to describe the methods used to assess pulmonary oedema in recent randomized AHF trials and report its prevalence in these trials. Of 23 AHF trials published between 2002 and 2013, six were excluded because they were very small or not randomized, or missing full-length publications. Of the remaining 17 (n = 200-7141) trials, six enrolled patients with HF and reduced ejection fraction (HF-REF) and 11, patients with both HF-REF and HF with preserved ejection fraction (HF-PEF). Pulmonary oedema was an essential inclusion criterion, in most trials, based upon findings on physical examination ('rales'), radiographic criteria ('signs of congestion'), or both. The prevalence of pulmonary oedema in HF-REF trials ranged from 75% to 83% and in combined HF-REF and HF-PEF trials from 51% to 100%. Five trials did not report the prevalence or extent of pulmonary oedema assessed by either clinical examination or chest x-ray. Improvement of pulmonary congestion with treatment was inconsistently reported and commonly grouped with other signs of congestion into a score. One trial suggested that patients with rales over >2/3 of the lung fields on admission were at higher risk of adverse outcomes than those without. Although pulmonary oedema is a common finding in AHF, represents a therapeutic target, and may be of prognostic importance, recent trials used inconsistent criteria to define it, and did not consistently report its severity at baseline or its response to treatment. Consistent and ideally quantitative, methods for the assessment of pulmonary oedema in AHF trials are needed. © 2015 The Authors European Journal of Heart Failure © 2015 European Society of Cardiology.

  12. Readability Assessment of Online Patient Education Material on Congestive Heart Failure

    PubMed Central

    2017-01-01

    Background Online health information is being used more ubiquitously by the general population. However, this information typically favors only a small percentage of readers, which can result in suboptimal medical outcomes for patients. Objective The readability of online patient education materials regarding the topic of congestive heart failure was assessed through six readability assessment tools. Methods The search phrase “congestive heart failure” was employed into the search engine Google. Out of the first 100 websites, only 70 were included attending to compliance with selection and exclusion criteria. These were then assessed through six readability assessment tools. Results Only 5 out of 70 websites were within the limits of the recommended sixth-grade readability level. The mean readability scores were as follows: the Flesch-Kincaid Grade Level (9.79), Gunning-Fog Score (11.95), Coleman-Liau Index (15.17), Simple Measure of Gobbledygook (SMOG) index (11.39), and the Flesch Reading Ease (48.87). Conclusion Most of the analyzed websites were found to be above the sixth-grade readability level recommendations. Efforts need to be made to better tailor online patient education materials to the general population. PMID:28656111

  13. Tectonic discrimination diagrams revisited

    NASA Astrophysics Data System (ADS)

    Vermeesch, Pieter

    2006-06-01

    The decision boundaries of most tectonic discrimination diagrams are drawn by eye. Discriminant analysis is a statistically more rigorous way to determine the tectonic affinity of oceanic basalts based on their bulk-rock chemistry. This method was applied to a database of 756 oceanic basalts of known tectonic affinity (ocean island, mid-ocean ridge, or island arc). For each of these training data, up to 45 major, minor, and trace elements were measured. Discriminant analysis assumes multivariate normality. If the same covariance structure is shared by all the classes (i.e., tectonic affinities), the decision boundaries are linear, hence the term linear discriminant analysis (LDA). In contrast with this, quadratic discriminant analysis (QDA) allows the classes to have different covariance structures. To solve the statistical problems associated with the constant-sum constraint of geochemical data, the training data must be transformed to log-ratio space before performing a discriminant analysis. The results can be mapped back to the compositional data space using the inverse log-ratio transformation. An exhaustive exploration of 14,190 possible ternary discrimination diagrams yields the Ti-Si-Sr system as the best linear discrimination diagram and the Na-Nb-Sr system as the best quadratic discrimination diagram. The best linear and quadratic discrimination diagrams using only immobile elements are Ti-V-Sc and Ti-V-Sm, respectively. As little as 5% of the training data are misclassified by these discrimination diagrams. Testing them on a second database of 182 samples that were not part of the training data yields a more reliable estimate of future performance. Although QDA misclassifies fewer training data than LDA, the opposite is generally true for the test data. Therefore LDA is a cruder but more robust classifier than QDA. Another advantage of LDA is that it provides a powerful way to reduce the dimensionality of the multivariate geochemical data in a similar

  14. Neurocognitive assessments in advanced heart failure patients receiving continuous-flow left ventricular assist devices.

    PubMed

    Petrucci, Ralph J; Wright, Susan; Naka, Yoshifuma; Idrissi, Kathy A; Russell, Stuart D; Dordunoo, Dzifa; Jaski, Brian; Chillcott, Suzanne; Feldman, David; Yanssens, Tammy; Heatley, Gerald; Koundakjian, Lalig; Farrar, David J; Aaronson, Keith D

    2009-06-01

    Neurocognitive (NC) changes in heart failure patients receiving left ventricular assist devices (LVADs) are not well understood. The purpose of this study was to document changes in the cognitive performance of patients with the continuous-flow HeartMate II LVAD as a bridge to transplant (BTT). A NC protocol was used to evaluate patient performance at 1, 3 and 6 months after LVAD implantation at 11 centers. A total of 239 test sessions were completed in 93 patients including paired evaluations in 51 to 57 patients from 1 to 3 months, and in 20 to 28 patients with results from 1, 3 and 6 months. Five NC domains were assessed, including visual spatial perception, auditory and visual memory, executive functions, language and processing speed. There were statistically significant (p < 0.05), but limited improvements between 1, 3 and 6 months in NC domain performances as seen in visual memory, executive functions, visual spatial perception and processing speed. There were no significant declines in any neurocognitive test in any domain over these time periods. The cognitive performance of advanced heart failure patients remained stable or showed slight improvements from Month 1 to Month 6 of continuous-blood-flow support with the HeartMate II LVAD.

  15. Multinational assessment of accuracy of equations for predicting risk of kidney failure: a meta-analysis

    PubMed Central

    Tangri, Navdeep; Grams, Morgan E.; Levey, Andrew S.; Coresh, Josef; Appel, Lawrence; Astor, Brad C.; Chodick, Gabriel; Collins, Allan J.; Djurdjev, Ognjenka; Elley, C. Raina; Evans, Marie; Garg, Amit X.; Hallan, Stein I.; Inker, Lesley; Ito, Sadayoshi; Jee, Sun Ha; Kovesdy, Csaba P.; Kronenberg, Florian; Lambers Heerspink, Hiddo J.; Marks, Angharad; Nadkarni, Girish N.; Navaneethan, Sankar D.; Nelson, Robert G.; Titze, Stephanie; Sarnak, Mark J.; Stengel, Benedicte; Woodward, Mark; Iseki, Kunitoshi

    2016-01-01

    Importance Identifying patients at risk of chronic kidney disease (CKD) progression may facilitate more optimal nephrology care. Kidney failure risk equations (KFREs) were previously developed and validated in two Canadian cohorts. Validation in other regions and in CKD populations not under the care of a nephrologist is needed. Objective To evaluate the accuracy of the KFREs across different geographic regions and patient populations through individual-participant data meta-analysis. Data Sources Thirty-one cohorts, including 721,357 participants with CKD Stages 3–5 in over 30 countries spanning 4 continents, were studied. These cohorts collected data from 1982 through 2014. Study Selection Cohorts participating in the CKD Prognosis Consortium with data on end-stage renal disease. Data Extraction and Synthesis Data were obtained and statistical analyses were performed between July 2012 and June 2015. Using the risk factors from the original KFREs, cohort-specific hazard ratios were estimated, and combined in meta-analysis to form new “pooled” KFREs. Original and pooled equation performance was compared, and the need for regional calibration factors was assessed. Main Outcome and Measure Kidney failure (treatment by dialysis or kidney transplantation). Results During a median follow-up of 4 years, 23,829 cases of kidney failure were observed. The original KFREs achieved excellent discrimination (ability to differentiate those who developed kidney failure from those who did not) across all cohorts (overall C statistic, 0.90 (95% CI 0.89–0.92) at 2 years and 0.88 (95% CI 0.86–0.90) at 5 years); discrimination in subgroups by age, race, and diabetes status was similar. There was no improvement with the pooled equations. Calibration (the difference between observed and predicted risk) was adequate in North American cohorts, but the original KFREs overestimated risk in some non-North American cohorts. Addition of a calibration factor that lowered the baseline

  16. Modeling of Electrical Cable Failure in a Dynamic Assessment of Fire Risk

    NASA Astrophysics Data System (ADS)

    Bucknor, Matthew D.

    complexity to existing cable failure techniques and tuned to empirical data can better approximate the temperature response of a cables located in tightly packed cable bundles. The new models also provide a way to determine the conditions insides a cable bundle which allows for separate treatment of cables on the interior of the bundle from cables on the exterior of the bundle. The results from the DET analysis show that the overall assessed probability of cable failure can be significantly reduced by more realistically accounting for the influence that the fire brigade has on a fire progression scenario. The shielding analysis results demonstrate a significant reduction in the temperature response of a shielded versus a non-shielded cable bundle; however the computational cost of using a fire progression model that can capture these effects may be prohibitive for performing DET analyses with currently available computational fluid dynamics models and computational resources.

  17. Noninvasive assessment of right and left ventricular function in acute and chronic respiratory failure

    SciTech Connect

    Matthay, R.A.; Berger, H.J.

    1983-05-01

    This review evaluates noninvasive techniques for assessing cardiovascular performance in acute and chronic respiratory failure. Radiographic, radionuclide, and echocardiographic methods for determining ventricular volumes, right (RV) and left ventricular (LV) ejection fractions, and pulmonary artery pressure (PAP) are emphasized. These methods include plain chest radiography, radionuclide angiocardiography, thallium-201 myocardial imaging, and M mode and 2-dimensional echocardiography, which have recently been applied in patients to detect pulmonary artery hypertension (PAH), right ventricular enlargement, and occult ventricular performance abnormalities at rest or exercise. Moreover, radionuclide angiocardiography has proven useful in combination with hemodynamic measurements, for evaluating the short-and long-term cardiovascular effects of therapeutic agents, such as oxygen, digitalis, theophylline, beta-adrenergic agents, and vasodilators.

  18. Aerobic exercise training intensity in patients with chronic heart failure: principles of assessment and prescription.

    PubMed

    Carvalho, Vitor Oliveira; Mezzani, Alessandro

    2011-02-01

    Chronic heart failure (CHF) is a significant cause of worldwide mortality and morbidity, whose clinical picture is characterized by exercise intolerance and impaired quality of life. Aerobic exercise training is a well-established nonpharmacological tool improving the CHF’s pathophysiological, clinical, and prognostic picture, and prescription of an adequate training intensity is crucial to obtain both exercise-induced benefits and a reasonable control of exercise-related risk. However, clarity is still lacking regarding the definition of exercise intensity domains and the lower and upper intensity limits of prescriptible aerobic exercise in CHF patients. The purpose of this review is to provide an update of the methods for the exercise intensity assessment and continuous aerobic training intensity prescription in the CHF population, furnishing indications useful for implementation of physical rehabilitation programs in these patients.

  19. Risk assessment of turbine rotor failure using probabilistic ultrasonic non-destructive evaluations

    NASA Astrophysics Data System (ADS)

    Guan, Xuefei; Zhang, Jingdan; Zhou, S. Kevin; Rasselkorde, El Mahjoub; Abbasi, Waheed A.

    2014-02-01

    The study presents a method and application of risk assessment methodology for turbine rotor fatigue failure using probabilistic ultrasonic nondestructive evaluations. A rigorous probabilistic modeling for ultrasonic flaw sizing is developed by incorporating the model-assisted probability of detection, and the probability density function (PDF) of the actual flaw size is derived. Two general scenarios, namely the ultrasonic inspection with an identified flaw indication and the ultrasonic inspection without flaw indication, are considered in the derivation. To perform estimations for fatigue reliability and remaining useful life, uncertainties from ultrasonic flaw sizing and fatigue model parameters are systematically included and quantified. The model parameter PDF is estimated using Bayesian parameter estimation and actual fatigue testing data. The overall method is demonstrated using a realistic application of steam turbine rotor, and the risk analysis under given safety criteria is provided to support maintenance planning.

  20. Radionuclide noninvasive evaluation of heart failure beyond left ventricular function assessment.

    PubMed

    Flotats, Albert; Carrió, Ignasi

    2009-01-01

    The management of patients with heart failure (HF) is challenging and requires the integration of clinical skills and accurate ancillary tests for the correct diagnosis and estimation of individual prognosis. Although the basic characterization of patients with HF is supported primarily by echocardiographic assessment of the left ventricular function, other noninvasive imaging procedures are being developed, including those involved in the processes of myocardial perfusion, metabolism, cellular injury, intersticial dysregulation, and neurohormonal receptor function. Nuclear techniques for molecular imaging of the myocardium may provide valuable insights into the pathophysiology, severity, management (medical/mechanical/surgical), response to treatment, and prognosis of HF patients. This will permit individualized management decisions and hopefully facilitate better clinical outcomes for patients with HF.

  1. Risk assessment of turbine rotor failure using probabilistic ultrasonic non-destructive evaluations

    SciTech Connect

    Guan, Xuefei; Zhang, Jingdan; Zhou, S. Kevin; Rasselkorde, El Mahjoub; Abbasi, Waheed A.

    2014-02-18

    The study presents a method and application of risk assessment methodology for turbine rotor fatigue failure using probabilistic ultrasonic nondestructive evaluations. A rigorous probabilistic modeling for ultrasonic flaw sizing is developed by incorporating the model-assisted probability of detection, and the probability density function (PDF) of the actual flaw size is derived. Two general scenarios, namely the ultrasonic inspection with an identified flaw indication and the ultrasonic inspection without flaw indication, are considered in the derivation. To perform estimations for fatigue reliability and remaining useful life, uncertainties from ultrasonic flaw sizing and fatigue model parameters are systematically included and quantified. The model parameter PDF is estimated using Bayesian parameter estimation and actual fatigue testing data. The overall method is demonstrated using a realistic application of steam turbine rotor, and the risk analysis under given safety criteria is provided to support maintenance planning.

  2. TEP process flow diagram

    SciTech Connect

    Wilms, R Scott; Carlson, Bryan; Coons, James; Kubic, William

    2008-01-01

    This presentation describes the development of the proposed Process Flow Diagram (PFD) for the Tokamak Exhaust Processing System (TEP) of ITER. A brief review of design efforts leading up to the PFD is followed by a description of the hydrogen-like, air-like, and waterlike processes. Two new design values are described; the mostcommon and most-demanding design values. The proposed PFD is shown to meet specifications under the most-common and mostdemanding design values.

  3. Spinning Witten diagrams

    NASA Astrophysics Data System (ADS)

    Sleight, Charlotte; Taronna, Massimo

    2017-06-01

    We develop a systematic framework to compute the conformal partial wave expansions (CPWEs) of tree-level four-point Witten diagrams with totally symmetric external fields of arbitrary mass and integer spin in AdS d+1. As an intermediate step, we identify convenient bases of three-point bulk and boundary structures to invert linear map between spinning three-point conformal structures and spinning cubic couplings in AdS. Given a CFT d , this provides the complete holographic reconstruction of all cubic couplings involving totally symmetric fields in the putative dual theory on AdS d+1. Employing this framework, we determine the CPWE of a generic four-point exchange Witten diagram with spinning exchanged field. As a concrete application, we compute all four-point exchange Witten diagrams in the type A higher-spin gauge theory on AdS d+1, which is conjectured to be dual to the free scalar O ( N ) model.

  4. Workshop on Applications of Phase Diagrams in Metallurgy and Ceramics

    NASA Technical Reports Server (NTRS)

    Bennett, L. H.; Carter, G. C.

    1977-01-01

    A workshop was held to assess the current national and international status of phase diagram determinations and evaluations for alloys, ceramics, and semiconductors; to determine the needs and priorities, especially technological, for phase diagram determinations and evaluations; and to estimate the resources being used and potentially available for phase diagram evaluation. Highlights of the workshop, description of a new poster board design used in the poster sessions, lists of attendees and demonstrations, the program, and descriptions of the presentations are included.

  5. Investigating pain in heart failure patients: the pain assessment, incidence, and nature in heart failure (PAIN-HF) study.

    PubMed

    Goodlin, Sarah J; Wingate, Sue; Albert, Nancy M; Pressler, Susan J; Houser, Janet; Kwon, Jennifer; Chiong, Jun; Storey, C Porter; Quill, Timothy; Teerlink, John R

    2012-10-01

    Patients with advanced heart failure (HF) have high rates of pain and other symptoms that diminish quality of life. We know little about the characteristics and correlates of pain in patients with advanced HF. We identified pain prevalence, location, character, severity, frequency, and correlates in 347 outpatients with advanced HF enrolled from hospices and clinics. We evaluated the correlation of pain with HF-related quality of life, mortality, symptoms and health problems, and current treatments for pain. Pain at any site was reported by 293 patients (84.4%), and 138 (39.5%) reported pain at more than one site. The most common site of pain was the legs below the knees (32.3% of subjects). Pain interfered with activity for 70% of patients. Pain was "severe" or "very severe" for 28.6% of subjects with chest pain, and for 38.9% of those with other sites of pain. The only medication reported to provide pain relief was opioids, prescribed for 34.1% of subjects (P = .001). The strongest predictors of pain were degenerative joint disease (DJD) (odds ratio [OR] 14.95, 95% confidence interval [CI] 3.9-56.0; P < .001), other arthritis (OR 2.8, 95% CI 1.20-6.62; P = .017), shortness of breath (OR 3.27, 95% CI 1.47-7.28; P = .004), and angina pectoris (OR 3.38, 95% CI 1.30-8.81; P = .013). Pain occurred at multiple sites in patients with advanced HF. Pain correlated with DJD or other arthritis, shortness of breath, and angina. Only opioid analgesics provided relief of pain. Future research should evaluate the etiology of and interventions to manage pain in patients with HF. Published by Elsevier Inc.

  6. A Model for Assessment of Failure of LWR Fuel during an RIA

    SciTech Connect

    Liu, Wenfeng; Kazimi, Mujid S.

    2007-07-01

    This paper presents a model for Pellet-Cladding Mechanical Interaction (PCMI) failure of LWR fuel during an RIA. The model uses the J-integral as a driving parameter to characterize the failure potential during PCMI. The model is implemented in the FRAPTRAN code and is validated by CABRI and NSRR simulated RIA test data. Simulation of PWR and BWR conditions are conducted by FRAPTRAN to evaluate the fuel failure potential using this model. Model validation and simulation results are compared with the strain-based failure model of PNNL and the SED/CSED model of EPRI. Our fracture mechanics model has good capability to differentiate failure from non-failure cases. The results reveal significant effects of power pulse width: a wider pulse width generally increases the threshold for fuel failure. However, this effect is less obvious for highly corroded cladding. (authors)

  7. Relationship between Sequential Organ Failure Assessment (SOFA) and intra-abdominal pressure in intensive care unit

    PubMed Central

    de FREITAS, Gustavo Rocha Costa; da FONSECA-NETO, Olival Cirilo Lucena; PINHEIRO, Carla Larissa Fernandes; ARAÚJO, Luiz Clêiner; BARBOSA, Roberto Esmeraldo Nogueira; ALVES, Pedro

    2014-01-01

    Background Patients in the intensive care unit are at risk of developing intra-abdominal hypertension and abdominal compartment syndrome. Aim To describe the relation between Sequential Organ Failure Assessment (SOFA) vs. intra-abdominal pressure and the relation between SOFA and risk factors for intra-abdominal hypertension. Method In accordance with the recommendations of the World Society of the Abdominal Compartment Syndrome, the present study measured the intra-abdominal pressure of patients 24 h and 48 h after admission to the unit and calculated the SOFA after 24 h and 48 h. Data was collected over two-month period. Results No correlation was found between SOFA and intra-abdominal pressure. Seventy percent of the patients were men and the mean age was 44 years, 10% had been referred from general surgery (with a mean intra-abdominal pressure of 11) and 65% from neurosurgery (with a mean intra-abdominal of 6.7). Only three (7.5%) presented with intra-abdominal hypertension. The highest SOFA was 15 and the most frequent kind of organ failure was neurological, with a frequency of 77%. There was a strong correlation between the SOFA after 24 h and 48 h and peak respiratory pressure (ρ=0.43/p=0.01; ρ=0.39/p=0.02). Conclusion No correlation was found between SOFA and intra-abdominal pressure in the patients covered by the present study. However, it is possible in patients undergoing abdominal surgery or those with abdominal sepsis. Não houve correlação entre o SOFA e a pressão intra-abdominal nos pacientes aqui estudados; contudo, sinalizou ser possível em pacientes com operação abdominal ou naqueles com sepse abdominal. PMID:25626934

  8. Relationship between Sequential Organ Failure Assessment (SOFA) and intra-abdominal pressure in intensive care unit.

    PubMed

    de Freitas, Gustavo Rocha Costa; da Fonseca-Neto, Olival Cirilo Lucena; Pinheiro, Carla Larissa Fernandes; Araújo, Luiz Clêiner; Barbosa, Roberto Esmeraldo Nogueira; Alves, Pedro

    2014-01-01

    Patients in the intensive care unit are at risk of developing intra-abdominal hypertension and abdominal compartment syndrome. To describe the relation between Sequential Organ Failure Assessment (SOFA) vs. intra-abdominal pressure and the relation between SOFA and risk factors for intra-abdominal hypertension. In accordance with the recommendations of the World Society of the Abdominal Compartment Syndrome, the present study measured the intra-abdominal pressure of patients 24 h and 48 h after admission to the unit and calculated the SOFA after 24 h and 48 h. Data was collected over two-month period. No correlation was found between SOFA and intra-abdominal pressure. Seventy percent of the patients were men and the mean age was 44 years, 10% had been referred from general surgery (with a mean intra-abdominal pressure of 11) and 65% from neurosurgery (with a mean intra-abdominal of 6.7). Only three (7.5%) presented with intra-abdominal hypertension. The highest SOFA was 15 and the most frequent kind of organ failure was neurological, with a frequency of 77%. There was a strong correlation between the SOFA after 24 h and 48 h and peak respiratory pressure (ρ=0.43/p=0.01; ρ=0.39/p=0.02). No correlation was found between SOFA and intra-abdominal pressure in the patients covered by the present study. However, it is possible in patients undergoing abdominal surgery or those with abdominal sepsis. Não houve correlação entre o SOFA e a pressão intra-abdominal nos pacientes aqui estudados; contudo, sinalizou ser possível em pacientes com operação abdominal ou naqueles com sepse abdominal.

  9. Wilson Loop Diagrams and Positroids

    NASA Astrophysics Data System (ADS)

    Agarwala, Susama; Marin-Amat, Eloi

    2017-03-01

    In this paper, we study a new application of the positive Grassmannian to Wilson loop diagrams (or MHV diagrams) for scattering amplitudes in N= 4 Super Yang-Mill theory ( N = 4 SYM). There has been much interest in studying this theory via the positive Grassmannians using BCFW recursion. This is the first attempt to study MHV diagrams for planar Wilson loop calculations (or planar amplitudes) in terms of positive Grassmannians. We codify Wilson loop diagrams completely in terms of matroids. This allows us to apply the combinatorial tools in matroid theory used to identify positroids (non-negative Grassmannians) to Wilson loop diagrams. In doing so, we find that certain non-planar Wilson loop diagrams define positive Grassmannians. While non-planar diagrams do not have physical meaning, this finding suggests that they may have value as an algebraic tool, and deserve further investigation.

  10. Petersen diagram revolution

    NASA Astrophysics Data System (ADS)

    Smolec, Radoslaw; Dziembowski, Wojciech; Moskalik, Pawel; Netzel, Henryka; Prudil, Zdenek; Skarka, Marek; Soszynski, Igor

    2017-09-01

    Over the recent years, the Petersen diagram for classical pulsators, Cepheids and RR Lyr stars, populated with a few hundreds of new multiperiodic variables. We review our analyses of the OGLE data, which resulted in a significant extension of the known, and in the discovery of a few new and distinct forms of multiperiodic pulsation. The showcase includes not only radial mode pulsators, but also radial-non-radial pulsators and stars with significant modulation observed on top of the beat pulsation. First theoretical models explaining the new forms of stellar variability are briefly discussed.

  11. What can we learn by comparing students' diagram-construction processes with the mathematical conceptions inferred from their explanations with completed diagrams?

    NASA Astrophysics Data System (ADS)

    Lobato, Joanne; Hohensee, Charles; Diamond, Jaime Marie

    2014-09-01

    Despite recent research interest in student-created diagrams, little research has systematically investigated students' diagram- construction processes, meaning the order and manner in which students create markings as they physically generate diagrams. In this study, we characterize the various processes students use to create diagrams that represent a quadratic motion situation involving increasing speed, and we explore how these diagram-construction processes are related to students' conceptions of speed as inferred from their explanations with their completed diagrams. Previous literature suggests contrasting predictions regarding whether or not students' diagram-construction processes are closely related (from our perspective as researchers) to students' inferred conceptions. We see the study as having value for research and practice by raising new questions related to diagram-construction processes, pointing to the potential formative assessment value of attending to diagram-construction processes, and demonstrating the need for the development of theory to explain the relationships identified by this study.

  12. Assessment and prevalence of pulmonary oedema in contemporary acute heart failure trials: a systematic review

    PubMed Central

    Platz, Elke; Jhund, Pardeep S.; Campbell, Ross T.; McMurray, John J.

    2015-01-01

    Aims Pulmonary oedema is a common and important finding in acute heart failure (AHF). We conducted a systematic review to describe the methods used to assess pulmonary oedema in recent randomized AHF trials and report its prevalence in these trials. Methods and results Of 23 AHF trials published between 2002 and 2013, six were excluded because they were very small or not randomized, or missing full-length publications. Of the remaining 17 (n = 200–7141) trials, six enrolled patients with HF and reduced ejection fraction (HF-REF) and 11, patients with both HF-REF and HF with preserved ejection fraction (HF-PEF). Pulmonary oedema was an essential inclusion criterion, in most trials, based upon findings on physical examination (‘rales’), radiographic criteria (‘signs of congestion’), or both. The prevalence of pulmonary oedema in HF-REF trials ranged from 75% to 83% and in combined HF-REF and HF-PEF trials from 51% to 100%. Five trials did not report the prevalence or extent of pulmonary oedema assessed by either clinical examination or chest x-ray. Improvement of pulmonary congestion with treatment was inconsistently reported and commonly grouped with other signs of congestion into a score. One trial suggested that patients with rales over >2/3 of the lung fields on admission were at higher risk of adverse outcomes than those without. Conclusion Although pulmonary oedema is a common finding in AHF, represents a therapeutic target, and may be of prognostic importance, recent trials used inconsistent criteria to define it, and did not consistently report its severity at baseline or its response to treatment. Consistent and ideally quantitative, methods for the assessment of pulmonary oedema in AHF trials are needed. PMID:26230356

  13. Methods for the development and assessment of atrial fibrillation and heart failure dog models

    PubMed Central

    Urban, Jon F; Gerhart, Renee L; Krzeszak, Jason R; Leet, Corey R; Lentz, Linnea R; McClay, Carolyn B

    2011-01-01

    Objective To report Medtronic experiences with the development of animal models for atrial fibrillation (AF) and chronic heart failure (CHF) using high-rate pacing for AF and microemboli for CHF. Methods For the AF model, an atrial lead was attached to a Medtronic Synergy™ neurostimulator, which was programmed to stimulate at 50 Hz in an on-off duty cycle. Atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP) and N-terminal pro brain natriuretic peptide (NT-proBNP) were assayed at select time points. For CHF model, a serial injection of 90 µm polystyrene microspheres at 62,400 beads/mL (Polybead, Polysciences, Inc.) was performed to induce global ischemia, either with weekly monitoring and embolization schedule (group 1, n = 25) or with biweekly monitoring and emboliation schedule (group 2, n = 36 ). Echocardiograms were used along with ventriculograms and magnetic resonance imaging scans weekly to assess cardiac function and ANP, BNP and NT-proBNP were monitored. Results For the AF model, the days to sustained AF for four animals following surgery were 7, 25, 21 and 19, respectively; For the CHF model, the days to meet CHF endpoints were 116 in group 1 and 89 in group 2. For both AF and CHF models, NT-proBNP correlated well with the development of disease states. Conclusion Our experience for the development and assessment of AF and CHF dog models may help researchers who are in search for animal model for assessing the safety and efficacy of a device-based therapy. PMID:22783299

  14. Evaluation of the Response Bias Scale and Improbable Failure Scale in assessing feigned cognitive impairment.

    PubMed

    Grossi, Laura M; Green, Debbie; Einzig, Shanah; Belfi, Brian

    2017-05-01

    The present study evaluated the Response Bias scale (RBS), a symptom validity test embedded within the Minnesota Multiphasic Personality Inventory (MMPI)-2 Restructured Form (MMPI-2-RF) that assesses for feigned neurocognitive complaints, in a sample of pretrial incompetent to stand trial (IST) criminal defendants. Additionally, we examined the Improbable Failure (IF) scale, a performance validity test embedded within the Structured Interview of Reported Symptoms, Second Edition (SIRS-2), which similarly assesses for feigned cognitive impairment (FCI). Results indicated that both the RBS (area under the curve [AUC] = .76) and IF scale (AUC = .72) achieved moderate classification accuracy using the Test of Memory Malingering (TOMM) as the criterion. Further, the RBS and IF scale appeared to be most useful for screening out those defendants who presented as genuine (specificity = 99% and 88%, respectively), and less effective at classifying those defendants suspected of feigning according to the TOMM (sensitivity = 29% and 46%, respectively). In order to identify a significant proportion of IST defendants who may be feigning impairment, considerably lower cutoff scores than those recommended in each measure's manual were evaluated. An RBS T score of 63 (sensitivity = 86%; specificity = 37%), and IF scale raw score of 2 (sensitivity = 80%; specificity = 43%), was required to achieve ≥80% sensitivity; these alternate cutoff scores may therefore be useful when screening inpatient forensic psychiatric IST defendants. Further, the 2 scales effectively predicted TOMM classification in combination, although only the RBS significantly contributed to the model. Implications for the assessment of FCI in forensic psychiatric settings are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  15. Moraine-dammed lake failures in Patagonia and assessment of outburst susceptibility in the Baker Basin

    NASA Astrophysics Data System (ADS)

    Iribarren Anacona, P.; Norton, K. P.; Mackintosh, A.

    2014-12-01

    Glacier retreat since the Little Ice Age has resulted in the development or expansion of hundreds of glacial lakes in Patagonia. Some of these lakes have produced large (≥ 106 m3) Glacial Lake Outburst Floods (GLOFs) damaging inhabited areas. GLOF hazard studies in Patagonia have been mainly based on the analysis of short-term series (≤ 50 years) of flood data and until now no attempt has been made to identify the relative susceptibility of lakes to failure. Power schemes and associated infrastructure are planned for Patagonian basins that have historically been affected by GLOFs, and we now require a thorough understanding of the characteristics of dangerous lakes in order to assist with hazard assessment and planning. In this paper, the conditioning factors of 16 outbursts from moraine-dammed lakes in Patagonia were analysed. These data were used to develop a classification scheme designed to assess outburst susceptibility, based on image classification techniques, flow routine algorithms and the Analytical Hierarchy Process. This scheme was applied to the Baker Basin, Chile, where at least seven moraine-dammed lakes have failed in historic time. We identified 386 moraine-dammed lakes in the Baker Basin of which 28 were classified with high or very high outburst susceptibility. Commonly, lakes with high outburst susceptibility are in contact with glaciers and have moderate (> 8°) to steep (> 15°) dam outlet slopes, akin to failed lakes in Patagonia. The proposed classification scheme is suitable for first-order GLOF hazard assessments in this region. However, rapidly changing glaciers in Patagonia make detailed analysis and monitoring of hazardous lakes and glaciated areas upstream from inhabited areas or critical infrastructure necessary, in order to better prepare for hazards emerging from an evolving cryosphere.

  16. Moraine-dammed lake failures in Patagonia and assessment of outburst susceptibility in the Baker Basin

    NASA Astrophysics Data System (ADS)

    Iribarren Anacona, P.; Norton, K. P.; Mackintosh, A.

    2014-07-01

    Glacier retreat since the Little Ice Age has resulted in the development or expansion of hundreds of glacial lakes in Patagonia. Some of these lakes have produced large (≥106 m3) Glacial Lake Outburst Floods (GLOFs) damaging inhabited areas. GLOF hazard studies in Patagonia have been mainly based on the analysis of short-term series (≤50 years) of flood data and until now no attempt has been made to identify the relative susceptibility of lakes to failure. Power schemes and associated infrastructure are planned for Patagonian basins that have historically been affected by GLOFs, and we now require a thorough understanding of the characteristics of dangerous lakes in order to assist with hazard assessment and planning. In this paper, the conditioning factors of 16 outbursts from moraine dammed lakes in Patagonia were analysed. These data were used to develop a classification scheme designed to assess outburst susceptibility, based on image classification techniques, flow routine algorithms and the Analytical Hierarchy Process. This scheme was applied to the Baker Basin, Chile, where at least 7 moraine-dammed lakes have failed in historic time. We identified 386 moraine-dammed lakes in the Baker Basin of which 28 were classified with high or very high outburst susceptibility. Commonly, lakes with high outburst susceptibility are in contact with glaciers and have moderate (>8°) to steep (>15°) dam outlet slopes, akin to failed lakes in Patagonia. The proposed classification scheme is suitable for first-order GLOF hazard assessments in this region. However, rapidly changing glaciers in Patagonia make detailed analysis and monitoring of hazardous lakes and glaciated areas upstream from inhabited areas or critical infrastructure necessary, in order to better prepare for hazards emerging from an evolving cryosphere.

  17. Software Tools for Lifetime Assessment of Thermal Barrier Coatings Part I — Thermal Ageing Failure and Thermal Fatigue Failure

    NASA Astrophysics Data System (ADS)

    Renusch, Daniel; Rudolphi, Mario; Schütze, Michael

    Thermal barrier coatings (TBCs) increase the service lifetime of specific components in, for example, gas turbines or airplane engines and allow higher operating temperatures to increase efficiency. Lifetime prediction models are therefore of both academic and applied interest; either to test new coatings or to determine operational conditions that can ensure a certain lifetime, for example 25,000 hr for gas turbines. Driven by these demands, the equations used in lifetime prediction have become more and more sophisticated and consequently are complicated to apply. A collection of software tools for lifetime assessment was therefore developed to provide an easy to use graphical user interface whilst incorporating the recent improvements in modeling equations. The Windows based software is compatible with other Windows applications, such as, Power Point, Excel, or Origin. Laboratory lifetime data from isothermal, thermal cyclic and/or burner rig testing can be loaded into the software for analysis and the program provides confidence limits and an accuracy assessment of the analysis model. The main purpose of the software tool is to predict TBC spallation for a given bond coat temperature, temperature gradient across the coating, and thermal cycle frequency.

  18. Warped penguin diagrams

    SciTech Connect

    Csaki, Csaba; Grossman, Yuval; Tanedo, Philip; Tsai, Yuhsin

    2011-04-01

    We present an analysis of the loop-induced magnetic dipole operator in the Randall-Sundrum model of a warped extra dimension with anarchic bulk fermions and an IR brane-localized Higgs. These operators are finite at one-loop order and we explicitly calculate the branching ratio for {mu}{yields}e{gamma} using the mixed position/momentum space formalism. The particular bound on the anarchic Yukawa and Kaluza-Klein (KK) scales can depend on the flavor structure of the anarchic matrices. It is possible for a generic model to either be ruled out or unaffected by these bounds without any fine-tuning. We quantify how these models realize this surprising behavior. We also review tree-level lepton flavor bounds in these models and show that these are on the verge of tension with the {mu}{yields}e{gamma} bounds from typical models with a 3 TeV Kaluza-Klein scale. Further, we illuminate the nature of the one-loop finiteness of these diagrams and show how to accurately determine the degree of divergence of a five-dimensional loop diagram using both the five-dimensional and KK formalism. This power counting can be obfuscated in the four-dimensional Kaluza-Klein formalism and we explicitly point out subtleties that ensure that the two formalisms agree. Finally, we remark on the existence of a perturbative regime in which these one-loop results give the dominant contribution.

  19. Markov Influence Diagrams.

    PubMed

    Díez, Francisco J; Yebra, Mar; Bermejo, Iñigo; Palacios-Alonso, Miguel A; Calleja, Manuel Arias; Luque, Manuel; Pérez-Martín, Jorge

    2017-02-01

    Markov influence diagrams (MIDs) are a new type of probabilistic graphical model that extends influence diagrams in the same way that Markov decision trees extend decision trees. They have been designed to build state-transition models, mainly in medicine, and perform cost-effectiveness analyses. Using a causal graph that may contain several variables per cycle, MIDs can model various patient characteristics without multiplying the number of states; in particular, they can represent the history of the patient without using tunnel states. OpenMarkov, an open-source tool, allows the decision analyst to build and evaluate MIDs-including cost-effectiveness analysis and several types of deterministic and probabilistic sensitivity analysis-with a graphical user interface, without writing any code. This way, MIDs can be used to easily build and evaluate complex models whose implementation as spreadsheets or decision trees would be cumbersome or unfeasible in practice. Furthermore, many problems that previously required discrete event simulation can be solved with MIDs; i.e., within the paradigm of state-transition models, in which many health economists feel more comfortable.

  20. Probabilistic exposure assessment model to estimate aseptic-UHT product failure rate.

    PubMed

    Pujol, Laure; Albert, Isabelle; Magras, Catherine; Johnson, Nicholas Brian; Membré, Jeanne-Marie

    2015-01-02

    Aseptic-Ultra-High-Temperature (UHT) products are manufactured to be free of microorganisms capable of growing in the food at normal non-refrigerated conditions at which the food is likely to be held during manufacture, distribution and storage. Two important phases within the process are widely recognised as critical in controlling microbial contamination: the sterilisation steps and the following aseptic steps. Of the microbial hazards, the pathogen spore formers Clostridium botulinum and Bacillus cereus are deemed the most pertinent to be controlled. In addition, due to a relatively high thermal resistance, Geobacillus stearothermophilus spores are considered a concern for spoilage of low acid aseptic-UHT products. A probabilistic exposure assessment model has been developed in order to assess the aseptic-UHT product failure rate associated with these three bacteria. It was a Modular Process Risk Model, based on nine modules. They described: i) the microbial contamination introduced by the raw materials, either from the product (i.e. milk, cocoa and dextrose powders and water) or the packaging (i.e. bottle and sealing component), ii) the sterilisation processes, of either the product or the packaging material, iii) the possible recontamination during subsequent processing of both product and packaging. The Sterility Failure Rate (SFR) was defined as the sum of bottles contaminated for each batch, divided by the total number of bottles produced per process line run (10(6) batches simulated per process line). The SFR associated with the three bacteria was estimated at the last step of the process (i.e. after Module 9) but also after each module, allowing for the identification of modules, and responsible contamination pathways, with higher or lower intermediate SFR. The model contained 42 controlled settings associated with factory environment, process line or product formulation, and more than 55 probabilistic inputs corresponding to inputs with variability

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

    PubMed

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

    2015-11-01

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

  2. Materials Degradation & Failure: Assessment of Structure and Properties. Resources in Technology.

    ERIC Educational Resources Information Center

    Technology Teacher, 1991

    1991-01-01

    This module provides information on materials destruction (through corrosion, oxidation, and degradation) and failure. A design brief includes objective, student challenge, resources, student outcomes, and quiz. (SK)

  3. Materials Degradation & Failure: Assessment of Structure and Properties. Resources in Technology.

    ERIC Educational Resources Information Center

    Technology Teacher, 1991

    1991-01-01

    This module provides information on materials destruction (through corrosion, oxidation, and degradation) and failure. A design brief includes objective, student challenge, resources, student outcomes, and quiz. (SK)

  4. Assessing the Value-Added by the Environmental Testing Process with the Aide of Physics/Engineering of Failure Evaluations

    NASA Technical Reports Server (NTRS)

    Cornford, S.; Gibbel, M.

    1997-01-01

    NASA's Code QT Test Effectiveness Program is funding a series of applied research activities focused on utilizing the principles of physics and engineering of failure and those of engineering economics to assess and improve the value-added by the various validation and verification activities to organizations.

  5. Curricular Change Agenda for Failure-Experienced Mathematics Students: Can Success-Promoting Assessment Make a Difference?

    ERIC Educational Resources Information Center

    Tzur, Ron; Movshovitz-Hadar, Nitsa

    1998-01-01

    Whether a success-promoting assessment schema (SPAS) can be designed to have a positive impact on the mathematics learning of failure-experienced students was studied with 200 noncollege-bound students in Israel. Results suggest that the SPAS in conjunction with suitable curricular materials could support student learning by changing student…

  6. Assessing the Value-Added by the Environmental Testing Process with the Aide of Physics/Engineering of Failure Evaluations

    NASA Technical Reports Server (NTRS)

    Cornford, S.; Gibbel, M.

    1997-01-01

    NASA's Code QT Test Effectiveness Program is funding a series of applied research activities focused on utilizing the principles of physics and engineering of failure and those of engineering economics to assess and improve the value-added by the various validation and verification activities to organizations.

  7. Symptom burden in heart failure: assessment, impact on outcomes, and management.

    PubMed

    Alpert, Craig M; Smith, Michael A; Hummel, Scott L; Hummel, Ellen K

    2017-01-01

    Evidence-based management has improved long-term survival in patients with heart failure (HF). However, an unintended consequence of increased longevity is that patients with HF are exposed to a greater symptom burden over time. In addition to classic symptoms such as dyspnea and edema, patients with HF frequently suffer additional symptoms such as pain, depression, gastrointestinal distress, and fatigue. In addition to obvious effects on quality of life, untreated symptoms increase clinical events including emergency department visits, hospitalizations, and long-term mortality in a dose-dependent fashion. Symptom management in patients with HF consists of two key components: comprehensive symptom assessment and sufficient knowledge of available approaches to alleviate the symptoms. Successful treatment addresses not just the physical but also the emotional, social, and spiritual aspects of suffering. Despite a lack of formal experience during cardiovascular training, symptom management in HF can be learned and implemented effectively by cardiology providers. Co-management with palliative medicine specialists can add significant value across the spectrum and throughout the course of HF.

  8. Optimal Allocation of Gold Standard Testing under Constrained Availability: Application to Assessment of HIV Treatment Failure

    PubMed Central

    Liu, Tao; Hogan, Joseph W.; Wang, Lisa; Zhang, Shangxuan; Kantor, Rami

    2013-01-01

    The World Health Organization (WHO) guidelines for monitoring the effectiveness of HIV treatment in resource-limited settings (RLS) are mostly based on clinical and immunological markers (e.g., CD4 cell counts). Recent research indicates that the guidelines are inadequate and can result in high error rates. Viral load (VL) is considered the “gold standard”, yet its widespread use is limited by cost and infrastructure. In this paper, we propose a diagnostic algorithm that uses information from routinely-collected clinical and immunological markers to guide a selective use of VL testing for diagnosing HIV treatment failure, under the assumption that VL testing is available only at a certain portion of patient visits. Our algorithm identifies the patient sub-population, such that the use of limited VL testing on them minimizes a pre-defined risk (e.g., misdiagnosis error rate). Diagnostic properties of our proposal algorithm are assessed by simulations. For illustration, data from the Miriam Hospital Immunology Clinic (RI, USA) are analyzed. PMID:24672142

  9. Quantitative Assessment of Fluid Accumulation Using Bioelectrical Impedance Analysis in Patients With Acute Decompensated Heart Failure.

    PubMed

    Sakaguchi, Taiki; Yasumura, Kaori; Nishida, Hiroki; Inoue, Hiroyuki; Furukawa, Tetsuo; Shinouchi, Kazuya; Miura, Hiroyuki; Miyazaki, Koichi; Hamano, Gou; Koide, Masao; Abe, Haruhiko; Date, Motoo; Hirooka, Keiji; Koretsune, Yukihiro; Kusuoka, Hideo; Yasumura, Yoshio

    2015-01-01

    Acute decompensated heart failure (ADHF) is generally considered to be a problem of fluid volume overload, therefore accurately quantifying the degree of fluid accumulation is of critical importance in assessing whether adequate decongestion has been achieved. The aim of this study was to develop and validate a method to quantify the degree of fluid accumulation in patients with ADHF. Using multi-frequency bioelectrical impedance analysis (BIA), we measured extracellular water (ECW) volume in 130 ADHF patients on admission and at discharge. We also predicted optimal ECW volume using original equations based on data from 60 control subjects without the signs of HF. Measured/predicted (M/P) ratio of ECW in ADHF patients was observed to decrease from 1.26±0.25 to 1.04±0.17 during hospitalization (P<0.001). The amount of ECW volume reduction was significantly correlated with reduction in body weight (r=0.766, P<0.001). On multivariate analysis, higher M/P ratio of ECW at discharge was associated with increased risk of ADHF readmission or cardiac death within 6 months after discharge. Multi-frequency BIA-measured ECW was found to offer valuable information for analyzing the pathophysiology of ADHF, and may be a useful guide in the management of this disease.

  10. Direct and indirect assessment of skeletal muscle blood flow in chronic congestive heart failure

    SciTech Connect

    LeJemtel, T.H.; Scortichini, D.; Katz, S.

    1988-09-09

    In patients with chronic congestive heart failure (CHF), skeletal muscle blood flow can be measured directly by the continuous thermodilution technique and by the xenon-133 clearance method. The continuous thermodilution technique requires retrograde catheterization of the femoral vein and, thus, cannot be repeated conveniently in patients during evaluation of pharmacologic interventions. The xenon-133 clearance, which requires only an intramuscular injection, allows repeated determination of skeletal muscle blood flow. In patients with severe CHF, a fixed capacity of the skeletal muscle vasculature to dilate appears to limit maximal exercise performance. Moreover, the changes in peak skeletal muscle blood flow noted during long-term administration of captopril, an angiotensin-converting enzyme inhibitor, appears to correlate with the changes in aerobic capacity. In patients with CHF, resting supine deep femoral vein oxygen content can be used as an indirect measurement of resting skeletal muscle blood flow. The absence of a steady state complicates the determination of peak skeletal muscle blood flow reached during graded bicycle or treadmill exercise in patients with chronic CHF. Indirect assessments of skeletal muscle blood flow and metabolism during exercise performed at submaximal work loads are currently developed in patients with chronic CHF.

  11. A non-stationary earthquake probability assessment with the Mohr-Coulomb failure criterion

    NASA Astrophysics Data System (ADS)

    Wang, J. P.; Xu, Y.

    2015-10-01

    From theory to experience, earthquake probability associated with an active fault should be gradually increasing with time since the last event. In this paper, a new non-stationary earthquake assessment motivated/derived from the Mohr-Coulomb failure criterion is introduced. Different from other non-stationary earthquake analyses, the new model can more clearly define and calculate the stress states between two characteristic earthquakes. In addition to the model development and the algorithms, this paper also presents an example calculation to help explain and validate the new model. On the condition of best-estimate model parameters, the example calculation shows a 7.6 % probability for the Meishan fault in central Taiwan to induce a major earthquake in years 2015-2025, and if the earthquake does not occur by 2025, the earthquake probability will increase to 8 % in 2025-2035, which validates the new model that can calculate non-stationary earthquake probability as it should vary with time.

  12. Assessment of respiratory flow cycle morphology in patients with chronic heart failure.

    PubMed

    Garde, Ainara; Sörnmo, Leif; Laguna, Pablo; Jané, Raimon; Benito, Salvador; Bayés-Genís, Antoni; Giraldo, Beatriz F

    2017-02-01

    Breathing pattern as periodic breathing (PB) in chronic heart failure (CHF) is associated with poor prognosis and high mortality risk. This work investigates the significance of a number of time domain parameters for characterizing respiratory flow cycle morphology in patients with CHF. Thus, our primary goal is to detect PB pattern and identify patients at higher risk. In addition, differences in respiratory flow cycle morphology between CHF patients (with and without PB) and healthy subjects are studied. Differences between these parameters are assessed by investigating the following three classification issues: CHF patients with PB versus with non-periodic breathing (nPB), CHF patients (both PB and nPB) versus healthy subjects, and nPB patients versus healthy subjects. Twenty-six CHF patients (8/18 with PB/nPB) and 35 healthy subjects are studied. The results show that the maximal expiratory flow interval is shorter and with lower dispersion in CHF patients than in healthy subjects. The flow slopes are much steeper in CHF patients, especially for PB. Both inspiration and expiration durations are reduced in CHF patients, mostly for PB. Using the classification and regression tree technique, the most discriminant parameters are selected. For signals shorter than 1 min, the time domain parameters produce better results than the spectral parameters, with accuracies for each classification of 82/78, 89/85, and 91/89 %, respectively. It is concluded that morphologic analysis in the time domain is useful, especially when short signals are analyzed.

  13. Validation of Computerized Automatic Calculation of the Sequential Organ Failure Assessment Score

    PubMed Central

    Harrison, Andrew M.; Pickering, Brian W.; Herasevich, Vitaly

    2013-01-01

    Purpose. To validate the use of a computer program for the automatic calculation of the sequential organ failure assessment (SOFA) score, as compared to the gold standard of manual chart review. Materials and Methods. Adult admissions (age > 18 years) to the medical ICU with a length of stay greater than 24 hours were studied in the setting of an academic tertiary referral center. A retrospective cross-sectional analysis was performed using a derivation cohort to compare automatic calculation of the SOFA score to the gold standard of manual chart review. After critical appraisal of sources of disagreement, another analysis was performed using an independent validation cohort. Then, a prospective observational analysis was performed using an implementation of this computer program in AWARE Dashboard, which is an existing real-time patient EMR system for use in the ICU. Results. Good agreement between the manual and automatic SOFA calculations was observed for both the derivation (N=94) and validation (N=268) cohorts: 0.02 ± 2.33 and 0.29 ± 1.75 points, respectively. These results were validated in AWARE (N=60). Conclusion. This EMR-based automatic tool accurately calculates SOFA scores and can facilitate ICU decisions without the need for manual data collection. This tool can also be employed in a real-time electronic environment. PMID:23936639

  14. Using Eye Tracking to Investigate Semantic and Spatial Representations of Scientific Diagrams during Text-Diagram Integration

    ERIC Educational Resources Information Center

    Jian, Yu-Cin; Wu, Chao-Jung

    2015-01-01

    We investigated strategies used by readers when reading a science article with a diagram and assessed whether semantic and spatial representations were constructed while reading the diagram. Seventy-one undergraduate participants read a scientific article while tracking their eye movements and then completed a reading comprehension test. Our…

  15. Using Eye Tracking to Investigate Semantic and Spatial Representations of Scientific Diagrams during Text-Diagram Integration

    ERIC Educational Resources Information Center

    Jian, Yu-Cin; Wu, Chao-Jung

    2015-01-01

    We investigated strategies used by readers when reading a science article with a diagram and assessed whether semantic and spatial representations were constructed while reading the diagram. Seventy-one undergraduate participants read a scientific article while tracking their eye movements and then completed a reading comprehension test. Our…

  16. Use of risk assessment analysis by failure mode, effects, and criticality to reduce door-to-balloon time.

    PubMed

    Khare, Rahul K; Nannicelli, Anna P; Powell, Emilie S; Seivert, Nicholas P; Adams, James G; Holl, Jane L

    2013-10-01

    The Centers for Medicare & Medicaid Services currently endorses a door-to-balloon time of 90 minutes or less for patients presenting to the emergency department (ED) with ST-segment elevation myocardial infarction. Recent evidence shows that a door-to-balloon time of 60 minutes significantly decreases inhospital mortality. We seek to use a proactive risk assessment method of failure mode, effects, and criticality analysis (FMECA) to evaluate door-to-balloon time process, to investigate how each component failure may affect the performance of a system, and to evaluate the frequency and the potential severity of harm of each failure. We conducted a 2-part study: FMECA of the door-to-balloon time system and process of care, and evaluation of a single institution's door-to-balloon time operational data using a retrospective observational cohort design. A multidisciplinary group of FMECA participants described the door-to-balloon time process to then create a comprehensive map and table listing all process steps and identified process failures, including their frequency, consequence, and causes. Door-to-balloon time operational data were assessed by "on" versus "off" hours. Fifty-one failure points were identified across 4 door-to-balloon time phases. Of the 12 high-risk failures, 58% occurred between ECG and catheterization laboratory activation. Total door-to-balloon time during on hours had a median time of 55 minutes (95% confidence interval 46 to 60 minutes) compared with 77 minutes (95% confidence interval 68 to 83 minutes) during off hours. The FMECA revealed clear areas of potential delay and vulnerability that can be addressed to decrease door-to-balloon time from 90 to 60 minutes. FMECAs can provide a robust assessment of potential risks and can serve as the platform for significant process improvement and system redesign for door-to-balloon time. Copyright © 2013 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  17. Acute Kidney Injury Enhances Outcome Prediction Ability of Sequential Organ Failure Assessment Score in Critically Ill Patients

    PubMed Central

    Chang, Chih-Hsiang; Fan, Pei-Chun; Chang, Ming-Yang; Tian, Ya-Chung; Hung, Cheng-Chieh; Fang, Ji-Tseng; Yang, Chih-Wei; Chen, Yung-Chang

    2014-01-01

    Introduction Acute kidney injury (AKI) is a common and serious complication in intensive care unit (ICU) patients and also often part of a multiple organ failure syndrome. The sequential organ failure assessment (SOFA) score is an excellent tool for assessing the extent of organ dysfunction in critically ill patients. This study aimed to evaluate the outcome prediction ability of SOFA and Acute Physiology and Chronic Health Evaluation (APACHE) III score in ICU patients with AKI. Methods A total of 543 critically ill patients were admitted to the medical ICU of a tertiary-care hospital from July 2007 to June 2008. Demographic, clinical and laboratory variables were prospectively recorded for post hoc analysis as predictors of survival on the first day of ICU admission. Results One hundred and eighty-seven (34.4%) patients presented with AKI on the first day of ICU admission based on the risk of renal failure, injury to kidney, failure of kidney function, loss of kidney function, and end-stage renal failure (RIFLE) classification. Major causes of the ICU admissions involved respiratory failure (58%). Overall in-ICU mortality was 37.9% and the hospital mortality was 44.7%. The predictive accuracy for ICU mortality of SOFA (areas under the receiver operating characteristic curves: 0.815±0.032) was as good as APACHE III in the AKI group. However, cumulative survival rates at 6-month follow-up following hospital discharge differed significantly (p<0.001) for SOFA score ≤10 vs. ≥11 in these ICU patients with AKI. Conclusions For patients coexisting with AKI admitted to ICU, this work recommends application of SOFA by physicians to assess ICU mortality because of its practicality and low cost. A SOFA score of ≥ “11” on ICU day 1 should be considered an indicator of negative short-term outcome. PMID:25279844

  18. Application of a modified sequential organ failure assessment score to critically ill patients.

    PubMed

    Namendys-Silva, S A; Silva-Medina, M A; Vásquez-Barahona, G M; Baltazar-Torres, J A; Rivero-Sigarroa, E; Fonseca-Lazcano, J A; Domínguez-Cherit, G

    2013-02-01

    The purpose of the present study was to explore the usefulness of the Mexican sequential organ failure assessment (MEXSOFA) score for assessing the risk of mortality for critically ill patients in the ICU. A total of 232 consecutive patients admitted to an ICU were included in the study. The MEXSOFA was calculated using the original SOFA scoring system with two modifications: the PaO2/FiO2 ratio was replaced with the SpO2/FiO2 ratio, and the evaluation of neurologic dysfunction was excluded. The ICU mortality rate was 20.2%. Patients with an initial MEXSOFA score of 9 points or less calculated during the first 24 h after admission to the ICU had a mortality rate of 14.8%, while those with an initial MEXSOFA score of 10 points or more had a mortality rate of 40%. The MEXSOFA score at 48 h was also associated with mortality: patients with a score of 9 points or less had a mortality rate of 14.1%, while those with a score of 10 points or more had a mortality rate of 50%. In a multivariate analysis, only the MEXSOFA score at 48 h was an independent predictor for in-ICU death with an OR = 1.35 (95%CI = 1.14-1.59, P < 0.001). The SOFA and MEXSOFA scores calculated 24 h after admission to the ICU demonstrated a good level of discrimination for predicting the in-ICU mortality risk in critically ill patients. The MEXSOFA score at 48 h was an independent predictor of death; with each 1-point increase, the odds of death increased by 35%.

  19. Application of a modified sequential organ failure assessment score to critically ill patients

    PubMed Central

    Ñamendys-Silva, S.A.; Silva-Medina, M.A.; Vásquez-Barahona, G.M.; Baltazar-Torres, J.A.; Rivero-Sigarroa, E.; Fonseca-Lazcano, J.A.; Domínguez-Cherit, G.

    2013-01-01

    The purpose of the present study was to explore the usefulness of the Mexican sequential organ failure assessment (MEXSOFA) score for assessing the risk of mortality for critically ill patients in the ICU. A total of 232 consecutive patients admitted to an ICU were included in the study. The MEXSOFA was calculated using the original SOFA scoring system with two modifications: the PaO2/FiO2 ratio was replaced with the SpO2/FiO2 ratio, and the evaluation of neurologic dysfunction was excluded. The ICU mortality rate was 20.2%. Patients with an initial MEXSOFA score of 9 points or less calculated during the first 24 h after admission to the ICU had a mortality rate of 14.8%, while those with an initial MEXSOFA score of 10 points or more had a mortality rate of 40%. The MEXSOFA score at 48 h was also associated with mortality: patients with a score of 9 points or less had a mortality rate of 14.1%, while those with a score of 10 points or more had a mortality rate of 50%. In a multivariate analysis, only the MEXSOFA score at 48 h was an independent predictor for in-ICU death with an OR = 1.35 (95%CI = 1.14-1.59, P < 0.001). The SOFA and MEXSOFA scores calculated 24 h after admission to the ICU demonstrated a good level of discrimination for predicting the in-ICU mortality risk in critically ill patients. The MEXSOFA score at 48 h was an independent predictor of death; with each 1-point increase, the odds of death increased by 35%. PMID:23369978

  20. Assessing functional exercise capacity using telehealth: Is it valid and reliable in patients with chronic heart failure?

    PubMed

    Hwang, Rita; Mandrusiak, Allison; Morris, Norman R; Peters, Robyn; Korczyk, Dariusz; Russell, Trevor

    2017-02-01

    Introduction This study aimed to determine the validity and reliability of video-based telerehabilitation assessments in patients with heart failure. Methods Seventeen consecutive participants (mean age 69 years, SD 12 years and 88% males) undertook assessments of three functional tests via both telerehabilitation and face-to-face approaches, on the same day. The assessment order was randomised and conducted by independent assessors. Outcome measures included functional tests: timed up and go (time), six-minute walk (distance), grip strength (kilograms); system usability scale to rate participant experience with telerehabilitation assessment; and number of technical issues encountered. Validity and inter- and intra-rater reliability of telerehabilitation assessments were examined using limits of agreement, intra-class correlation coefficients (ICC), and paired t-tests. Results The limits of agreement for telerehabilitation assessments were within the clinically acceptable limits for timed up and go and grip strength. Telerehabilitation assessments for all functional tests were strongly associated with face-to-face assessments, with ICCs of between 0.85 and 0.96. Inter- and intra-rater reliability of telerehabilitation assessments for all functional tests were excellent (all ICC > 0.95). The mean (SD) system usability scale score was 85 (15)/100. Some incidences of Internet drop-outs, video freezing and auditory fading occurred. Discussion The use of telehealth for the assessment of functional exercise capacity appears to be valid and reliable in patients with heart failure.

  1. Program Synthesizes UML Sequence Diagrams

    NASA Technical Reports Server (NTRS)

    Barry, Matthew R.; Osborne, Richard N.

    2006-01-01

    A computer program called "Rational Sequence" generates Universal Modeling Language (UML) sequence diagrams of a target Java program running on a Java virtual machine (JVM). Rational Sequence thereby performs a reverse engineering function that aids in the design documentation of the target Java program. Whereas previously, the construction of sequence diagrams was a tedious manual process, Rational Sequence generates UML sequence diagrams automatically from the running Java code.

  2. Assessing Strategies for Heart Failure with Preserved Ejection Fraction at the Outpatient Clinic

    PubMed Central

    Jorge, Antonio José Lagoeiro; Rosa, Maria Luiza Garcia; Ribeiro, Mario Luiz; Fernandes, Luiz Claudio Maluhy; Freire, Monica Di Calafiori; Correia, Dayse Silva; Teixeira, Patrick Duarte; Mesquita, Evandro Tinoco

    2014-01-01

    Background: Heart failure with preserved ejection fraction (HFPEF) is the most common form of heart failure (HF), its diagnosis being a challenge to the outpatient clinic practice. Objective: To describe and compare two strategies derived from algorithms of the European Society of Cardiology Diastology Guidelines for the diagnosis of HFPEF. Methods: Cross-sectional study with 166 consecutive ambulatory patients (67.9±11.7 years; 72% of women). The strategies to confirm HFPEF were established according to the European Society of Cardiology Diastology Guidelines criteria. In strategy 1 (S1), tissue Doppler echocardiography (TDE) and electrocardiography (ECG) were used; in strategy 2 (S2), B-type natriuretic peptide (BNP) measurement was included. Results: In S1, patients were divided into groups based on the E/E'ratio as follows: GI, E/E'> 15 (n = 16; 9%); GII, E/E'8 to 15 (n = 79; 48%); and GIII, E/E'< 8 (n = 71; 43%). HFPEF was confirmed in GI and excluded in GIII. In GII, TDE [left atrial volume index (LAVI) ≥ 40 mL/m2; left ventricular mass index LVMI) > 122 for women and > 149 g/m2 for men] and ECG (atrial fibrillation) parameters were assessed, confirming HFPEF in 33 more patients, adding up to 49 (29%). In S2, patients were divided into three groups based on BNP levels. GI (BNP > 200 pg/mL) consisted of 12 patients, HFPEF being confirmed in all of them. GII (BNP ranging from 100 to 200 pg/mL) consisted of 20 patients with LAVI > 29 mL/m2, or LVMI ≥ 96 g/m2 for women or ≥ 116 g/m2 for men, or E/E'≥ 8 or atrial fibrillation on ECG, and the diagnosis of HFPEF was confirmed in 15. GIII (BNP < 100 pg/mL) consisted of 134 patients, 26 of whom had the diagnosis of HFPEF confirmed when GII parameters were used. Measuring BNP levels in S2 identified 4 more patients (8%) with HFPEF as compared with those identified in S1. Conclusion: The association of BNP measurement and TDE data is better than the isolated use of those parameters. BNP can be useful in

  3. 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.

  4. Fuzzy-logic assessment of failure hazard in pipelines due to mining activity

    NASA Astrophysics Data System (ADS)

    Malinowska, A. A.; Hejmanowski, R.

    2015-11-01

    The present research is aimed at a critical analysis of a method presently used for evaluating failure hazard in linear objects in mining areas. A fuzzy model of failure hazard of a linear object was created on the basis of the experience gathered so far. The rules of Mamdani fuzzy model have been used in the analyses. Finally the scaled model was integrated with a Geographic Information System (GIS), which was used to evaluate failure hazard in a water pipeline in a mining area.

  5. Diagonal Slices of 3D Young Diagrams in the Approach of Maya Diagrams

    NASA Astrophysics Data System (ADS)

    Cai, Li-Qiang; Wang, Li-Fang; Wu, Ke; Yang, Jie

    2014-09-01

    According to the correspondence between 2D Young diagrams and Maya diagrams and the relation between 2D and 3D Young diagrams, we construct 3D Young diagrams in the approach of Maya diagrams. Moreover, we formulate the generating function of 3D Young diagrams, which is the MacMahon function in terms of Maya diagrams.

  6. Evaluation of two methods for continuous cardiac output assessment during exercise in chronic heart failure patients.

    PubMed

    Kemps, Hareld M C; Thijssen, Eric J M; Schep, Goof; Sleutjes, Boudewijn T H M; De Vries, Wouter R; Hoogeveen, Adwin R; Wijn, Pieter F F; Doevendans, Pieter A F M

    2008-12-01

    The purpose of this study was to evaluate the accuracy of two techniques for the continuous assessment of cardiac output in patients with chronic heart failure (CHF): a radial artery pulse contour analysis method that uses an indicator dilution method for calibration (LiDCO) and an impedance cardiography technique (Physioflow), using the Fick method as a reference. Ten male CHF patients (New York Heart Association class II-III) were included. At rest, cardiac output values obtained by LiDCO and Physioflow were compared with those of the direct Fick method. During exercise, the continuous Fick method was used as a reference. Exercise, performed on a cycle ergometer in upright position, consisted of two constant-load tests at 30% and 80% of the ventilatory threshold and a symptom-limited maximal test. Both at rest and during exercise LiDCO showed good agreement with reference values [bias +/- limits of agreement (LOA), -1% +/- 28% and 2% +/- 28%, respectively]. In contrast, Physioflow overestimated reference values both at rest and during exercise (bias +/- LOA, 48% +/- 60% and 48% +/- 52%, respectively). Exercise-related within-patient changes of cardiac output, expressed as a percent change, showed for both techniques clinically acceptable agreement with reference values (bias +/- LOA: 2% +/- 26% for LiDCO, and -2% +/- 36% for Physioflow, respectively). In conclusion, although the limits of agreement with the Fick method are pretty broad, LiDCO provides accurate measurements of cardiac output during rest and exercise in CHF patients. Although Physioflow overestimates cardiac output, this method may still be useful to estimate relative changes during exercise.

  7. RIFLE criteria and hepatic function in the assessment of acute renal failure in liver transplantation.

    PubMed

    Tinti, F; Umbro, I; Meçule, A; Rossi, M; Merli, M; Nofroni, I; Corradini, S Ginanni; Poli, L; Pugliese, F; Ruberto, F; Berloco, P B; Mitterhofer, A P

    2010-05-01

    Renal dysfunction in cirrhotic patients is primary related to disturbances of circulatory function, triggered by portal hypertension with chronic intrarenal vasoconstriction and hypoperfusion. Pretransplant renal function is an important factor implicated in the development of acute renal failure (ARF) after liver transplantation (OLT), but other factors mostly related to liver function seem to influence the development of ARF. The Acute Dialysis Quality Initiative workgroup developed the RIFLE classification to define ARF. We sought to evaluate the incidence of ARF among patients undergoing OLT, to evaluate the association of ARF with pre-OLT renal and hepatic functions, and to evaluate the influence of ARF on chronic kidney disease (CKD) at 1 month post-OLT. Clinical, renal, hepatic function, and donor risk index data of 24 patients who underwent deceased donor OLT were collected before transplantation, in the perioperative period and in the first month post-OLT. ARF occurred in 37.5% of patients with 56% developing the R grade and 44% the I grade; no patient showed the F grade. An association was observed between ARF and a higher Model for End-Stage Liver Disease (MELD) score and between ARF and a reduced pre-OLT serum albumin. No association was noted between ARF and other pre-OLT parameters. In cirrhotic patients serum creatinine is a bias for renal function assessment and the Modification of Diet in Renal Disease formula overestimates GFR. Post-OLT CKD was present in 6.7% of patients without ARF and in 44.4% of patients with ARF. The R grade developed more frequently among patients with viral cirrhosis. The association of ARF with MELD and hypoalbuminemia may be the result of a close relationship between renal and hepatic functions among cirrhotic patients. Post-OLT CKD may be the result of unrecognized, preexisting CKD and/or the effects of not fully resolved acute damage to an injured kidney. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  8. Echocardiographic Assessment of Pulmonary Artery Systolic Pressure and Outcomes in Ambulatory Heart Failure Patients

    PubMed Central

    Kalogeropoulos, Andreas P.; Siwamogsatham, Sarawut; Hayek, Salim; Li, Song; Deka, Anjan; Marti, Catherine N.; Georgiopoulou, Vasiliki V.; Butler, Javed

    2014-01-01

    Background Pulmonary hypertension (PH) in patients with heart failure (HF) is associated with worse outcomes and is rapidly being recognized as a therapeutic target. To facilitate pragmatic research efforts, data regarding the prognostic importance of noninvasively assessed pulmonary artery systolic pressure (PASP) in stable ambulatory patients with HF are needed. Methods and Results We examined the association between echocardiographic PASP and outcomes in 417 outpatients with HF (age, 54±13 years; 60.7% men; 50.4% whites; 24.9% with preserved ejection fraction). Median PASP was 36 mm Hg (interquartile range [IQR]: 29, 46). After a median follow‐up of 2.6 years (IQR: 1.7, 3.9) there were 72 major events (57 deaths; 9 urgent heart transplants; and 6 ventricular assist device implantations) and 431 hospitalizations for HF. In models adjusting for clinical risk factors and therapy, a 10‐mm Hg higher PASP was associated with 37% higher risk (95% CI: 18, 59; P<0.001) for major events, and 11% higher risk (95% CI: 1, 23; P=0.039) for major events or HF hospitalization. The threshold that maximized the likelihood ratio for both endpoints was 48 mm Hg; those with PASP ≥48 mm Hg (N=84; 20.1%) had an adjusted hazard ratio of 3.33 (95% CI: 1.96, 5.65; P<0.001) for major events and 1.47 (95% CI: 1.02, 2.11; P=0.037) for major events or HF hospitalization. Reduced right ventricular systolic function had independent prognostic utility over PASP for adverse outcomes. Right atrial pressure and transtricuspid gradient both contributed to risk. Conclusions Elevated PASP, determined by echocardiography, identifies ambulatory patients with HF at increased risk for adverse events. PMID:24492947

  9. Using the Human Activity Profile to Assess Functional Performance in Heart Failure.

    PubMed

    Ribeiro-Samora, Giane Amorim; Pereira, Danielle Aparecida Gomes; Vieira, Otávia Alves; de Alencar, Maria Clara Noman; Rodrigues, Roseane Santo; Carvalho, Maria Luiza Vieira; Montemezzo, Dayane; Britto, Raquel Rodrigues

    2016-01-01

    To investigate (1) the validity of using the Human Activity Profile (HAP) in patients with heart failure (HF) to estimate functional capacity; (2) the association between the HAP and 6-Minute Walk Test (6MWT) distance; and (3) the ability of the HAP to differentiate between New York Heart Association (NYHA) functional classes. In a cross-sectional study, we evaluated 62 clinically stable patients with HF (mean age, 47.98 years; NYHA class I-III). Variables included maximal functional capacity as measured by peak oxygen uptake ((Equation is included in full-text article.)O2) using a cardiopulmonary exercise test (CPET), peak (Equation is included in full-text article.)O2 as estimated by the HAP, and exercise capacity as measured by the 6MWT. The difference between the measured (CPET) and estimated (HAP) peak (Equation is included in full-text article.)O2 against the average values showed a bias of 2.18 mL/kg/min (P = .007). No agreement was seen between these measures when applying the Bland-Altman method. Peak (Equation is included in full-text article.)O2 in the HAP showed a moderate association with the 6MWT distance (r = 0.62; P < .0001). Peak (Equation is included in full-text article.)O2 in the HAP was able to statistically differentiate NYHA functional classes I, II, and III (P < .05). The estimated peak (Equation is included in full-text article.)O2 using the HAP was not concordant with the gold standard CPET measure. On the contrary, the HAP was able to differentiate NYHA functional class associated with the 6MWT distance; therefore, the HAP is a useful tool for assessing functional performance in patients with HF.

  10. Iterative User Interface Design for Automated Sequential Organ Failure Assessment Score Calculator in Sepsis Detection.

    PubMed

    Aakre, Christopher Ansel; Kitson, Jaben E; Li, Man; Herasevich, Vitaly

    2017-05-18

    The new sepsis definition has increased the need for frequent sequential organ failure assessment (SOFA) score recalculation and the clerical burden of information retrieval makes this score ideal for automated calculation. The aim of this study was to (1) estimate the clerical workload of manual SOFA score calculation through a time-motion analysis and (2) describe a user-centered design process for an electronic medical record (EMR) integrated, automated SOFA score calculator with subsequent usability evaluation study. First, we performed a time-motion analysis by recording time-to-task-completion for the manual calculation of 35 baseline and 35 current SOFA scores by 14 internal medicine residents over a 2-month period. Next, we used an agile development process to create a user interface for a previously developed automated SOFA score calculator. The final user interface usability was evaluated by clinician end users with the Computer Systems Usability Questionnaire. The overall mean (standard deviation, SD) time-to-complete manual SOFA score calculation time was 61.6 s (33). Among the 24% (12/50) usability survey respondents, our user-centered user interface design process resulted in >75% favorability of survey items in the domains of system usability, information quality, and interface quality. Early stakeholder engagement in our agile design process resulted in a user interface for an automated SOFA score calculator that reduced clinician workload and met clinicians' needs at the point of care. Emerging interoperable platforms may facilitate dissemination of similarly useful clinical score calculators and decision support algorithms as "apps." A user-centered design process and usability evaluation should be considered during creation of these tools.

  11. Validation of the Chinese version of the CogState computerised cognitive assessment battery in Taiwanese patients with heart failure.

    PubMed

    Chou, Cheng-Chen; Pressler, Susan J; Giordani, Bruno; Fetzer, Susan Jane

    2015-11-01

    To evaluate the validity of the Chinese version of the CogState battery, a computerised cognitive testing among patients with heart failure in Taiwan. Cognitive deficits are common in patients with heart failure and a validated Chinese measurement is required for assessing cognitive change for this population. The CogState computerised battery is a measurement of cognitive function and has been validated in many languages, but not Chinese. A cross-sectional study. A convenience sample consisted of 76 women with heart failure and 64 healthy women in northern Taiwan. Women completed the Chinese version of the CogState battery and the Montreal Cognitive Assessment. Construct validity of the Chinese version of the battery was evaluated by exploratory factor analysis and known-group comparisons. Convergent validity of the CogState tasks was examined by Pearson correlation coefficients. Principal components factor analysis with promax rotation showed two factors reflecting the speed and memory dimensions of the tests. Scores for CogState battery tasks showed significant differences between the heart failure and healthy control group. Examination of convergent validity of the CogState found a significant association with the Montreal Cognitive Assessment. The Chinese CogState Battery has satisfactory construct and convergent validity to measure cognitive deficits in patients with heart failure in Taiwan. The Chinese CogState battery is a valid instrument for detecting cognitive deficits that may be subtle in the early stages, and identifying changes that provide insights into patients' abilities to implement treatment accurately and consistently. Better interventions tailored to the needs of the cognitive impaired population can be developed. © 2015 John Wiley & Sons Ltd.

  12. Assessing the interaction of respiration and heart rate in heart failure and controls using ambulatory Holter recordings.

    PubMed

    Haigney, Mark; Zareba, Wojceich; La Rovere, Maria Teresa; Grasso, Ian; Mortara, David

    2014-01-01

    Breathing is a critical component of cardiopulmonary function, but few tools exist to evaluate respiration in ambulatory patients. Holter monitoring allows accurate diagnosis of a host of cardiac issues, and several investigators have demonstrated the ability to detect respiratory effort on the electrocardiogram. In this study we introduce a myogram signal derived from 12-lead, high frequency Holter as a means of detecting respiratory effort. Using the combined myogram and ECG signal, four novel variables were created: total number of Cheyne-Stokes episodes; the BWRatio, the ratio of power (above baseline) measured one second after peak-to-peak respiratory power, an assessment of the "shape" of the respiratory effort; DRR, the change in RR interval centering around peak inspiration; and minutes of synchronized breathing, a fixed ratio of heart beats to respiratory cycles. These variables were assessed in 24-hour recordings from three cohorts: healthy volunteers (n=33), heart failure subjects from the GISSI HF trial (n=383), and subjects receiving implantable defibrillators with severely depressed left ventricular function enrolled in the M2Risk trial (n=470). We observed a statistically significant 6-fold increase in the number of Cheyne-Stokes episodes (p=0.01 by ANOVA), decreases in BWRatio (p<0.001), as well as decrease in DRR in heart failure subjects; only minutes of synchronized breathing was not significantly decreased in heart failure. This study provides "proof of concept" that novel variables incorporating Holter-derived respiration can distinguish healthy subjects from heart failure. The utility of these variables for predicting heart failure, arrhythmia, and death risk in prospective studies needs to be assessed. Published by Elsevier Inc.

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

    PubMed

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

    2014-01-01

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

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

    PubMed

    Miller, Wayne L

    2016-08-01

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

  15. Potential-pH Diagrams.

    ERIC Educational Resources Information Center

    Barnum, Dennis W.

    1982-01-01

    Potential-pH diagrams show the domains of redoxpotential and pH in which major species are most stable. Constructing such diagrams provides students with opportunities to decide what species must be considered, search literature for equilibrium constants and free energies of formation, and practice in using the Nernst equation. (Author/JN)

  16. Potential-pH Diagrams.

    ERIC Educational Resources Information Center

    Barnum, Dennis W.

    1982-01-01

    Potential-pH diagrams show the domains of redoxpotential and pH in which major species are most stable. Constructing such diagrams provides students with opportunities to decide what species must be considered, search literature for equilibrium constants and free energies of formation, and practice in using the Nernst equation. (Author/JN)

  17. Using Workflow Diagrams to Address Hand Hygiene in Pediatric Long-Term Care Facilities.

    PubMed

    Carter, Eileen J; Cohen, Bevin; Murray, Meghan T; Saiman, Lisa; Larson, Elaine L

    2015-01-01

    Hand hygiene (HH) in pediatric long-term care settings has been found to be sub-optimal. Multidisciplinary teams at three pediatric long-term care facilities developed step-by-step workflow diagrams of commonly performed tasks highlighting HH opportunities. Diagrams were validated through observation of tasks and concurrent diagram assessment. Facility teams developed six workflow diagrams that underwent 22 validation observations. Four main themes emerged: 1) diagram specificity, 2) wording and layout, 3) timing of HH indications, and 4) environmental hygiene. The development of workflow diagrams is an opportunity to identify and address the complexity of HH in pediatric long-term care facilities.

  18. Genus Ranges of Chord Diagrams

    PubMed Central

    Burns, Jonathan; Jonoska, Nataša; Saito, Masahico

    2015-01-01

    A chord diagram consists of a circle, called the backbone, with line segments, called chords, whose endpoints are attached to distinct points on the circle. The genus of a chord diagram is the genus of the orientable surface obtained by thickening the backbone to an annulus and attaching bands to the inner boundary circle at the ends of each chord. Variations of this construction are considered here, where bands are possibly attached to the outer boundary circle of the annulus. The genus range of a chord diagram is the genus values over all such variations of surfaces thus obtained from a given chord diagram. Genus ranges of chord diagrams for a fixed number of chords are studied. Integer intervals that can be, and those that cannot be, realized as genus ranges are investigated. Computer calculations are presented, and play a key role in discovering and proving the properties of genus ranges. PMID:26478650

  19. Genus Ranges of Chord Diagrams.

    PubMed

    Burns, Jonathan; Jonoska, Nataša; Saito, Masahico

    2015-04-01

    A chord diagram consists of a circle, called the backbone, with line segments, called chords, whose endpoints are attached to distinct points on the circle. The genus of a chord diagram is the genus of the orientable surface obtained by thickening the backbone to an annulus and attaching bands to the inner boundary circle at the ends of each chord. Variations of this construction are considered here, where bands are possibly attached to the outer boundary circle of the annulus. The genus range of a chord diagram is the genus values over all such variations of surfaces thus obtained from a given chord diagram. Genus ranges of chord diagrams for a fixed number of chords are studied. Integer intervals that can be, and those that cannot be, realized as genus ranges are investigated. Computer calculations are presented, and play a key role in discovering and proving the properties of genus ranges.

  20. Porcine model characterizing various parameters assessing the outcome after acetaminophen intoxication induced acute liver failure

    PubMed Central

    Thiel, Karolin; Klingert, Wilfried; Klingert, Kathrin; Morgalla, Matthias H; Schuhmann, Martin U; Leckie, Pamela; Sharifi, Yalda; Davies, Nathan A; Jalan, Rajiv; Peter, Andreas; Grasshoff, Christian; Königsrainer, Alfred; Schenk, Martin; Thiel, Christian

    2017-01-01

    AIM To investigate the changes of hemodynamic and laboratory parameters during the course of acute liver failure following acetaminophen overdose. METHODS Eight pigs underwent a midline laparotomy following jejunal catheter placement for further acetaminophen intoxication and positioning of a portal vein Doppler flow-probe. Acute liver failure was realized by intrajejunal acetaminophen administration in six animals, two animals were sham operated. All animals were invasively monitored and received standardized intensive care support throughout the study. Portal blood flow, hemodynamic and ventilation parameters were continuously recorded. Laboratory parameters were analysed every eight hours. Liver biopsies were sampled every 24 h following intoxication and upon autopsy. RESULTS Acute liver failure (ALF) occurred after 28 ± 5 h resulted in multiple organ failure and death despite maximal support after further 21 ± 1 h (study end). Portal blood flow (baseline 1100 ± 156 mL/min) increased to a maximum flow of 1873 ± 175 mL/min at manifestation of ALF, which was significantly elevated (P < 0.01). Immediately after peaking, portal flow declined rapidly to 283 ± 135 mL/min at study end. Thrombocyte values (baseline 307 × 103/µL ± 34 × 103/µL) of intoxicated animals declined slowly to values of 145 × 103/µL ± 46 × 103/µL when liver failure occurred. Subsequent appearance of severe thrombocytopenia in liver failure resulted in values of 11 × 103/µL ± 3 × 103/µL preceding fatality within few hours which was significant (P > 0.01). CONCLUSION Declining portal blood flow and subsequent severe thrombocytopenia after acetaminophen intoxication precede fatality in a porcine acute liver failure model. PMID:28321158

  1. Assessment and management of cerebral edema and intracranial hypertension in acute liver failure.

    PubMed

    Mohsenin, Vahid

    2013-10-01

    Acute liver failure is uncommon but not a rare complication of liver injury. It can happen after ingestion of acetaminophen and exposure to toxins and hepatitis viruses. The defining clinical symptoms are coagulopathy and encephalopathy occurring within days or weeks of the primary insult in patients without preexisting liver injury. Acute liver failure is often complicated by multiorgan failure and sepsis. The most life-threatening complications are sepsis, multiorgan failure, and brain edema. The clinical signs of increased intracranial pressure (ICP) are nonspecific except for neurologic deficits in impending brain stem herniation. Computed tomography of the brain is not sensitive enough in gauging intracranial hypertension or ruling out brain edema. Intracranial pressure monitoring, transcranial Doppler, and jugular venous oximetry provide valuable information for monitoring ICP and guiding therapeutic measures in patients with encephalopathy grade III or IV. Osmotic therapy using hypertonic saline and mannitol, therapeutic hypothermia, and propofol sedation are shown to improve ICPs and stabilize the patient for liver transplantation. In this article, diagnosis and management of hepatic encephalopathy and cerebral edema in patients with acute liver failure are reviewed.

  2. Acute Right Ventricle Failure in the Intensive Care Unit: Assessment and Management.

    PubMed

    Hrymak, Carmen; Strumpher, Johann; Jacobsohn, Eric

    2017-01-01

    Caring for the critically ill patient with acute right ventricle (RV) failure is a diagnostic and management challenge. A thorough understanding of normal RV anatomy and physiology is essential to manage RV failure. Despite the fact that the RV is essentially a volume chamber that ejects into a low-pressure system, the left ventricle contributes significantly to RV function through maintenance of the transseptal gradient (TSG). Preserving systemic mean arterial pressure maintains the TSG and RV perfusion. Various pathological states cause acute RV failure by decreasing the TSG and RV perfusion and/or increasing pulmonary vascular resistance. Early diagnosis prevents rapid progression of RV failure due to the "double hit phenomenon," which is acute intra-abdominal multiple organ system failure as a result of a reduced blood pressure and elevated central venous pressure. Management includes hemodynamic support and reversal of the precipitating cause through optimizing RV rate and rhythm, determining ideal RV filling pressure, reducing RV afterload through nonpharmacologic and pharmacological means, and selecting the appropriate RV inotrope or mechanical support. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  3. Proactive Risk Assessment of Blood Transfusion Process, in Pediatric Emergency, Using the Health Care Failure Mode and Effects Analysis (HFMEA)

    PubMed Central

    Dehnavieh, Reza; Ebrahimipour, Hossein; Molavi-Taleghani, Yasamin; Vafaee-Najar, Ali; Hekmat, Somayeh Noori; Esmailzdeh, Hamid

    2015-01-01

    Introduction: Pediatric emergency has been considered as a high risk area, and blood transfusion is known as a unique clinical measure, therefore this study was conducted with the purpose of assessing the proactive risk assessment of blood transfusion process in Pediatric Emergency of Qaem education- treatment center in Mashhad, by the Healthcare Failure Mode and Effects Analysis (HFMEA) methodology. Methodology: This cross-sectional study analyzed the failure mode and effects of blood transfusion process by a mixture of quantitative-qualitative method. The proactive HFMEA was used to identify and analyze the potential failures of the process. The information of the items in HFMEA forms was collected after obtaining a consensus of experts’ panel views via the interview and focus group discussion sessions. Results: The Number of 77 failure modes were identified for 24 sub-processes enlisted in 8 processes of blood transfusion. Totally 13 failure modes were identified as non-acceptable risk (a hazard score above 8) in the blood transfusion process and were transferred to the decision tree. Root causes of high risk modes were discussed in cause-effect meetings and were classified based on the UK national health system (NHS) approved classifications model. Action types were classified in the form of acceptance (11.6%), control (74.2%) and elimination (14.2%). Recommendations were placed in 7 categories using TRIZ (“Theory of Inventive Problem Solving.”) Conclusion: The re-engineering process for the required changes, standardizing and updating the blood transfusion procedure, root cause analysis of blood transfusion catastrophic events, patient identification bracelet, training classes and educational pamphlets for raising awareness of personnel, and monthly gathering of transfusion medicine committee have all been considered as executive strategies in work agenda in pediatric emergency. PMID:25560332

  4. Proactive risk assessment of blood transfusion process, in pediatric emergency, using the Health Care Failure Mode and Effects Analysis (HFMEA).

    PubMed

    Dehnavieh, Reza; Ebrahimipour, Hossein; Molavi-Taleghani, Yasamin; Vafaee-Najar, Ali; Noori Hekmat, Somayeh; Esmailzdeh, Hamid

    2014-12-25

    Pediatric emergency has been considered as a high risk area, and blood transfusion is known as a unique clinical measure, therefore this study was conducted with the purpose of assessing the proactive risk assessment of blood transfusion process in Pediatric Emergency of Qaem education- treatment center in Mashhad, by the Healthcare Failure Mode and Effects Analysis (HFMEA) methodology. This cross-sectional study analyzed the failure mode and effects of blood transfusion process by a mixture of quantitative-qualitative method. The proactive HFMEA was used to identify and analyze the potential failures of the process. The information of the items in HFMEA forms was collected after obtaining a consensus of experts' panel views via the interview and focus group discussion sessions. The Number of 77 failure modes were identified for 24 sub-processes enlisted in 8 processes of blood transfusion. Totally 13 failure modes were identified as non-acceptable risk (a hazard score above 8) in the blood transfusion process and were transferred to the decision tree. Root causes of high risk modes were discussed in cause-effect meetings and were classified based on the UK national health system (NHS) approved classifications model. Action types were classified in the form of acceptance (11.6%), control (74.2%) and elimination (14.2%). Recommendations were placed in 7 categories using TRIZ ("Theory of Inventive Problem Solving.") The re-engineering process for the required changes, standardizing and updating the blood transfusion procedure, root cause analysis of blood transfusion catastrophic events, patient identification bracelet, training classes and educational pamphlets for raising awareness of personnel, and monthly gathering of transfusion medicine committee have all been considered as executive strategies in work agenda in pediatric emergency.

  5. Brown Dwarf Microlensing Diagram

    NASA Image and Video Library

    2016-11-10

    For the first time, two space-based telescopes have teamed up with ground-based observatories to observe a microlensing event, a magnification of the light of a distant star due to the gravitational effects of an unseen object in the foreground. In this case, the cause of the microlensing event was a brown dwarf, dubbed OGLE-2015-BLG-1319, orbiting a star. In terms of mass, brown dwarfs fall somewhere between the size of the largest planets and the smallest stars. Curiously, scientists have found that, for stars roughly the mass of our sun, less than 1 percent have a brown dwarf orbiting within 3 AU (1 AU is the distance between Earth and the sun). This newly discovered brown dwarf may fall in that distance range. This microlensing event was observed by ground-based telescopes looking for these uncommon events, and subsequently seen by NASA's Spitzer and Swift space telescopes. As the diagram shows, Spitzer and Swift offer additional vantage points for viewing this chance alignment. While Swift orbits close to Earth, and saw (blue diamonds) essentially the same change in light that the ground-based telescopes measured (grey markers), Spitzer's location much farther away from Earth gave it a very different perspective on the event (red circles). In particular, Spitzer's vantage point resulted in a time lag in the microlensing event it observed, compared to what was seen by Swift and the ground-based telescope. This offset allowed astronomers to determine the distance to OGLE-2015-BLG-1319 as well as its mass: around 30-65 times that of Jupiter. http://photojournal.jpl.nasa.gov/catalog/PIA21077

  6. Rectangular diagrams of surfaces: representability

    NASA Astrophysics Data System (ADS)

    Dynnikov, I. A.; Prasolov, M. V.

    2017-06-01

    Introduced here is a simple combinatorial way, which is called a rectangular diagram of a surface, to represent a surface in the three-sphere. It has a particularly nice relation to the standard contact structure on S^3 and to rectangular diagrams of links. By using rectangular diagrams of surfaces it is intended, in particular, to develop a method to distinguish Legendrian knots. This requires a lot of technical work of which the present paper addresses only the first basic question: which isotopy classes of surfaces can be represented by a rectangular diagram? Roughly speaking, the answer is this: there is no restriction on the isotopy class of the surface, but there is a restriction on the rectangular diagram of the boundary link arising from the presentation of the surface. The result extends to Giroux's convex surfaces for which this restriction on the boundary has a natural meaning. In a subsequent paper, transformations of rectangular diagrams of surfaces will be considered and their properties will be studied. By using the formalism of rectangular diagrams of surfaces an annulus in S^3 is produced here that is expected to be a counterexample to the following conjecture: if two Legendrian knots cobound an annulus and have zero Thurston-Bennequin numbers relative to this annulus, then they are Legendrian isotopic. Bibliography: 30 titles.

  7. Pregnancy in women with heart disease: risk assessment and management of heart failure.

    PubMed

    Grewal, Jasmine; Silversides, Candice K; Colman, Jack M

    2014-01-01

    Heart disease, present in 0.5% to 3% of pregnant women, is an important cause of morbidity and the leading cause of death among pregnant women in the developed world. Certain heart conditions are associated with an increased risk of heart failure during pregnancy or the postpartum period; for these conditions, management during pregnancy benefits from multidisciplinary care at a center with expertise in pregnancy and heart disease. This article focuses on cardiac risks and management strategies for women with acquired and congenital heart disease who are at increased risk of heart failure during pregnancy.

  8. Students' different understandings of class diagrams

    NASA Astrophysics Data System (ADS)

    Boustedt, Jonas

    2012-03-01

    The software industry needs well-trained software designers and one important aspect of software design is the ability to model software designs visually and understand what visual models represent. However, previous research indicates that software design is a difficult task to many students. This article reports empirical findings from a phenomenographic investigation on how students understand class diagrams, Unified Modeling Language (UML) symbols, and relations to object-oriented (OO) concepts. The informants were 20 Computer Science students from four different universities in Sweden. The results show qualitatively different ways to understand and describe UML class diagrams and the "diamond symbols" representing aggregation and composition. The purpose of class diagrams was understood in a varied way, from describing it as a documentation to a more advanced view related to communication. The descriptions of class diagrams varied from seeing them as a specification of classes to a more advanced view, where they were described to show hierarchic structures of classes and relations. The diamond symbols were seen as "relations" and a more advanced way was seeing the white and the black diamonds as different symbols for aggregation and composition. As a consequence of the results, it is recommended that UML should be adopted in courses. It is briefly indicated how the phenomenographic results in combination with variation theory can be used by teachers to enhance students' possibilities to reach advanced understanding of phenomena related to UML class diagrams. Moreover, it is recommended that teachers should put more effort in assessing skills in proper usage of the basic symbols and models and students should be provided with opportunities to practise collaborative design, e.g. using whiteboards.

  9. Particles, Feynman Diagrams and All That

    ERIC Educational Resources Information Center

    Daniel, Michael

    2006-01-01

    Quantum fields are introduced in order to give students an accurate qualitative understanding of the origin of Feynman diagrams as representations of particle interactions. Elementary diagrams are combined to produce diagrams representing the main features of the Standard Model.

  10. Particles, Feynman Diagrams and All That

    ERIC Educational Resources Information Center

    Daniel, Michael

    2006-01-01

    Quantum fields are introduced in order to give students an accurate qualitative understanding of the origin of Feynman diagrams as representations of particle interactions. Elementary diagrams are combined to produce diagrams representing the main features of the Standard Model.

  11. Risk assessment of the emergency processes: Healthcare failure mode and effect analysis

    PubMed Central

    Taleghani, Yasamin Molavi; Rezaei, Fatemeh; Sheikhbardsiri, Hojat

    2016-01-01

    BACKGROUND: Ensuring about the patient’s safety is the first vital step in improving the quality of care and the emergency ward is known as a high-risk area in treatment health care. The present study was conducted to evaluate the selected risk processes of emergency surgery department of a treatment-educational Qaem center in Mashhad by using analysis method of the conditions and failure effects in health care. METHODS: In this study, in combination (qualitative action research and quantitative cross-sectional), failure modes and effects of 5 high-risk procedures of the emergency surgery department were identified and analyzed according to Healthcare Failure Mode and Effects Analysis (HFMEA). To classify the failure modes from the “nursing errors in clinical management model (NECM)”, the classification of the effective causes of error from “Eindhoven model” and determination of the strategies to improve from the “theory of solving problem by an inventive method” were used. To analyze the quantitative data of descriptive statistics (total points) and to analyze the qualitative data, content analysis and agreement of comments of the members were used. RESULTS: In 5 selected processes by “voting method using rating”, 23 steps, 61 sub-processes and 217 potential failure modes were identified by HFMEA. 25 (11.5%) failure modes as the high risk errors were detected and transferred to the decision tree. The most and the least failure modes were placed in the categories of care errors (54.7%) and knowledge and skill (9.5%), respectively. Also, 29.4% of preventive measures were in the category of human resource management strategy. CONCLUSION: “Revision and re-engineering of processes”, “continuous monitoring of the works”, “preparation and revision of operating procedures and policies”, “developing the criteria for evaluating the performance of the personnel”, “designing a suitable educational content for needs of employee”,

  12. Heart Failure

    MedlinePlus

    ... version of this page please turn Javascript on. Heart Failure What is Heart Failure? In heart failure, the heart cannot pump enough ... failure often experience tiredness and shortness of breath. Heart Failure is Serious Heart failure is a serious and ...

  13. Incorporation of a community pharmacy-based heart failure assessment tool by advanced pharmacy practice experience students.

    PubMed

    Kelling, Sarah E; Walker, Paul C; Mason, James G; Zara, Nadir; Bleske, Barry E

    To incorporate a published clinical tool related to heart failure (HF) assessment into advanced pharmacy practice experiences in the community pharmacy setting to provide a meaningful and innovative learning experience for students. Sixteen independent and chain community pharmacies that served as advanced pharmacy practice experience locations. Sixteen community pharmacy locations served as rotation sites and participated in data collection (8 chain and 8 independent). This was the first study in which pharmacy students used The One-Minute Clinic for Heart Failure (TOM-C HF) tool to assess HF within the community pharmacy setting. Trained student pharmacists identified patients who may have heart failure by evaluating medication dispensing records, interviewed the patient using the TOM-C HF tool, and made interventions as clinically appropriate. The number of students using the TOM-C HF tool, the number and types of interventions made, and student perceptions about the educational and professional value of the patient interaction. Thirty-three of 83 (40%) students completed 63 patient assessments. Thirty-five percent of patients (22/63) were candidates for an intervention. Interventions were performed in 9 of 22 patients (41%). More than 65% of students found the patient interaction to have educational and professional value. Students were able to assess HF patients and make interventions in a community pharmacy setting. The majority of students also perceived some value in these assessments. The incorporation of a clinical tool in the community setting driven by fourth-year pharmacy students has been shown to be feasible and to provide both a novel advanced practice experience. In addition, it may be expandable to the services offered at community pharmacies. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  14. The use of sequential organ failure assessment parameters in an awake porcine model of severe Staphylococcus aureus sepsis.

    PubMed

    Soerensen, Karen E; Nielsen, Ole L; Birck, Malene M; Soerensen, Dorte B; Leifsson, Páll S; Jensen, Henrik E; Aalbaek, Bent; Kristensen, Annemarie T; Wiinberg, Bo; Kjelgaard-Hansen, Mads; Heegaard, Peter M H; Iburg, Tine M

    2012-11-01

    The human sequential organ failure assessment (SOFA) scoring system is used worldwide in intensive care units for assessing the extent of organ dysfunction/failure in patients with severe sepsis. An increasing number of septic cases are caused by Gram-positive bacteria as Staphylococcus aureus. The aim of the current study was to apply the human SOFA parameters in an awake, porcine model of severe S. aureus sepsis. Five pigs were inoculated intravenously with S. aureus and two control animals were sham-inoculated. Extensive clinical monitoring and sequential blood sampling was obtained and analysed for SOFA parameters. Dysfunction/failure was observed in the respiratory, haemostatic and hepatic system of all infected animals, together with initial cardiovascular dysfunction. The pulmonary system was the first to fail clinically, which corresponds with similar human findings, whereas the liver was affected earlier in pigs compared to humans. The use of human SOFA parameters was valuable in identifying dysfunctional/failing organs and showed consistency between this porcine model and human severe sepsis. Applying SOFA parameters in this model increased the relevance for comparison to clinical methods of evaluating human severe sepsis. Changes in SOFA parameters may in future porcine studies serve as a target for monitoring the effect of therapeutic intervention. © 2012 The Authors APMIS © 2012 APMIS.

  15. The Hertzsprung-Russell Diagram.

    ERIC Educational Resources Information Center

    Woodrow, Janice

    1991-01-01

    Describes a classroom use of the Hertzsprung-Russell diagram to infer not only the properties of a star but also the star's probable stage in evolution, life span, and age of the cluster in which it is located. (ZWH)

  16. Atemporal diagrams for quantum circuits

    SciTech Connect

    Griffiths, Robert B.; Wu Shengjun; Yu Li; Cohen, Scott M.

    2006-05-15

    A system of diagrams is introduced that allows the representation of various elements of a quantum circuit, including measurements, in a form which makes no reference to time (hence 'atemporal'). It can be used to relate quantum dynamical properties to those of entangled states (map-state duality), and suggests useful analogies, such as the inverse of an entangled ket. Diagrams clarify the role of channel kets, transition operators, dynamical operators (matrices), and Kraus rank for noisy quantum channels. Positive (semidefinite) operators are represented by diagrams with a symmetry that aids in understanding their connection with completely positive maps. The diagrams are used to analyze standard teleportation and dense coding, and for a careful study of unambiguous (conclusive) teleportation. A simple diagrammatic argument shows that a Kraus rank of 3 is impossible for a one-qubit channel modeled using a one-qubit environment in a mixed state.

  17. The Hertzsprung-Russell Diagram.

    ERIC Educational Resources Information Center

    Woodrow, Janice

    1991-01-01

    Describes a classroom use of the Hertzsprung-Russell diagram to infer not only the properties of a star but also the star's probable stage in evolution, life span, and age of the cluster in which it is located. (ZWH)

  18. Ion mixing and phase diagrams

    NASA Astrophysics Data System (ADS)

    Lau, S. S.; Liu, B. X.; Nicolet, M.-A.

    1983-05-01

    Interactions induced by ion irradiation are generally considered to be non-equilibrium processes, whereas phase diagrams are determined by phase equilibria. These two entities are seemingly unrelated. However, if one assumes that quasi-equilibrium conditions prevail after the prompt events, subsequent reactions are driven toward equilibrium by thermodynamical forces. Under this assumption, ion-induced reactions are related to equilibrium and therefore to phase diagrams. This relationship can be seen in the similarity that exists in thin films between reactions induced by ion irradiation and reactions induced by thermal annealing. In the latter case, phase diagrams have been used to predict the phase sequence of stable compound formation, notably so in cases of silicide formation. Ion-induced mixing not only can lead to stable compound formation, but also to metastable alloy formation. In some metal-metal systems, terminal solubilities can be greatly extended by ion mixing. In other cases, where the two constituents of the system have different crystal structures, extension of terminal solubility from both sides of the phase diagram eventually becomes structurally incompatible and a glassy (amorphous) mixture can form. The composition range where this bifurcation is likely to occur is in the two-phase regions of the phase diagram. These concepts are potentially useful guides in selecting metal pairs that from metallic glasses by ion mixing. In this report, phenomenological correlation between stable (and metastable) phase formation and phase diagram is discussed in terms of recent experimental data.

  19. Pulse contour cardiac output monitoring in acute heart failure patients : Assessment of hemodynamic measurements.

    PubMed

    Wernly, Bernhard; Lichtenauer, Michael; Franz, Marcus; Fritzenwanger, Michael; Kabisch, Bjoern; Figulla, Hans-Reiner; Jung, Christian

    2016-12-01

    Heart failure is known to be a major public health problem. Fluid redistribution contributes to acute heart failure; therefore, knowledge of hemodynamic parameters could be important for optimizing outcomes. The pulse contour cardiac output monitor PiCCO uses the single thermal indicator technique and pulse contour analysis to calculate hemodynamic parameters of preload, afterload, cardiac output, systemic vascular resistance and extravascular lung water. We primarily aimed to describe values and parameters seen in acute heart failure patients admitted to the intensive care unit (ICU) and secondly to investigate associations between hemodynamic measurements and survival data. In this study 420 consecutive patients admitted to a tertiary medical university hospital ICU between January 2004 and December 2009 were retrospectively investigated. The study sample was divided into two subgroups: patients monitored by PiCCO (n = 47) and those not monitored by thermodilution measurements (n = 373). No predetermined treatment algorithm based on knowledge obtained by the PiCCO monitor was used and measurements were individually interpreted by the treating physician. The PiCCO monitor measurements were carried out according to manufacturer's directions. Patients with PiCCO monitoring were clinically in poorer health with a mean simplified acute physiology score II (SAPS2) of 45 ± 17 vs. 56 ± 20 (p < 0.01). The ICU mortality (22 % vs. 38 %, p = 0.02) and, at least as a tendency, long-term-mortality were increased in patients monitored by PiCCO (RR 1.49, 95 % CI 0.96-2.31, p = 0.08). We provide hemodynamic measurements in acute heart failure patients: cardiac index (2.7 ± 1.2 l/min/m²) was reduced, preload and extravascular lung water index (EVLWI, 11.5 ± 5.1 ml/kg body weight), representing lung edema, were increased. We provide real world values for PiCCO parameters in acutely decompensated heart failure. In our study patients who were clinically in

  20. Can cardiorespiratory polygraphy replace portable polysomnography in the assessment of sleep-disordered breathing in heart failure patients?

    PubMed

    Pinna, Gian Domenico; Robbi, Elena; Pizza, Fabio; Taurino, Anna Eugenia; Pronzato, Caterina; La Rovere, Maria Teresa; Maestri, Roberto

    2014-09-01

    Portable polysomnography (PSG) and cardiorespiratory polygraphy are increasingly being used in the assessment of sleep-disordered breathing (SDB) in heart failure patients. Scoring of SDB from cardiorespiratory polygraphy recordings is based only on respiratory signals, while electroencephalographic, electrooculographic and electromyographic channels are taken into account when using PSG recordings. The aim of this study was to assess the agreement between these two scoring methods. An overnight sleep study was performed in 67 heart failure patients using a standard portable polysomnograph. Each recording was scored twice, once using all acquired signals (PSG mode) and, after a median of 64 days, using only respiratory signals (cardiorespiratory mode). Agreement was assessed by Bland-Altman analysis and Cohen's kappa. We found that (1) more respiratory events were detected using cardiorespiratory analysis [median (25th percentile, 75th percentile), 75 (39, 200) events] compared to analysis of portable PSG [69 (29, 173) events, p < 0.0001], the extra events being, for the vast majority, central in origin; (2) the apnea/hypopnea index (AHI) estimated by cardiorespiratory polygraphy [11.9 (5.7, 30.8)/h] showed a negligible negative bias relative to portable PSG [15.1 (5.7, 33.6)/h; bias, -0.8 (-2.9, 0.4)/h, p = 0.0002]; (3) limits of agreement between the two systems (-6.2/h, 1.7/h) were much smaller than those previously observed between two nights using the same scoring modality; and (4) the kappa coefficient using categorised AHI was 0.89 (95% confidence interval (CI) 0.82, 0.96). We found a high degree of agreement between the AHIs obtained from the two scoring methods, thus suggesting that cardiorespiratory polygraphy may be used as an alternative to portable PSG in the assessment of SDB in heart failure patients.

  1. Theoretical assessment of burst failure of internally pressurized defect-free pipelines with plastic anisotropy

    NASA Astrophysics Data System (ADS)

    Zhang, Yong-qiang; Wang, Li-zhong; Jin, Wei-liang

    2013-08-01

    In the framework of finite deformation theory, the burst failure analysis of end-opened defect-free pipes with plastic anisotropy under internal pressure is carried out. The analytical solutions of burst pressure and the corresponding equivalent stress and strain are obtained for thin-walled pipes, which can take into account the effects of material plastic anisotropy and strain hardening exponent. The influences of plastic anisotropy on the burst pressure and the corresponding equivalent stress and strain are discussed. It is shown that the burst pressure and the corresponding equivalent stress and strain are dependent upon the plastic anisotropy of material, and the degree of dependence is related to the strain hardening exponent of material. In addition, the effects of the strain hardening exponent on burst failure are investigated.

  2. Risk Assessment Planning for Airborne Systems: An Information Assurance Failure Mode, Effects and Criticality Analysis Methodology

    DTIC Science & Technology

    2012-06-01

    that all those cards were used fraudulently, but that credit card information on the cardholders was exposed. Sony Says PlayStation Hacker Got...Personal Data April 26, 2011 Last week, Sony’s online network for the PlayStation suffered a catastrophic failure through a hacking attack. And since...Internet or to download demos of new games. Then, on Tuesday, after several days of near silence, Sony said that as a result of the attack, an

  3. Micro-compression: a novel technique for the nondestructive assessment of local bone failure.

    PubMed

    Müller, R; Gerber, S C; Hayes, W C

    1998-12-01

    Many bones within the axial and appendicular skeleton are subjected to repetitive, cyclic loading during the course of ordinary daily activities. If this repetitive loading is of sufficient magnitude or duration, fatigue failure of the bone tissue may result. In clinical orthopedics, trabecular fatigue fractures are observed as compressive stress fractures in the proximal femur, vertebrae, calcaneus and tibia, and are often preceded by buckling and bending of microstructural elements. However, the relative importance of bone density and architecture in the etiology of these fractures is poorly understood. The aim of the study was to investigate failure mechanisms of 3D trabecular bone using micro-computed tomography (microCT). Because of its nondestructive nature, microCT represents an ideal approach for performing not only static measurements of bone architecture but also dynamic measurements of failure initiation and propagation as well as damage accumulation. For the purpose of the study, a novel micro-compression device was devised to measure loaded trabecular bone specimens directly in a micro-tomographic system. The measurement window in the device was made of a radiolucent, highly stiff plastic to enable X-rays to penetrate the material. The micro-compressor has an outer diameter of 19 mm and a total length of 65 mm. The internal load chamber fits wet or dry bone specimens with maximal diameters of 9 mm and maximal lengths of 22 mm. For the actual measurement, first, the unloaded bone is measured in the microCT. Second, a load-displacement curve is recorded where the load is measured with an integrated mini-button load cell and the displacement is computed directly from the microCT scout-view. For each load case, a 3D snap-shot of the structure under load is taken providing 34 microm nominal resolution. Initial measurements included specimens from bovine tibiae and whale spine to investigate the influence of the structure type on the failure mechanism. In a

  4. Reliability block diagrams to model disease management.

    PubMed

    Sonnenberg, A; Inadomi, J M; Bauerfeind, P

    1999-01-01

    Studies of diagnostic or therapeutic procedures in the management of any given disease tend to focus on one particular aspect of the disease and ignore the interaction between the multitude of factors that determine its final outcome. The present article introduces a mathematical model that accounts for the joint contribution of various medical and non-medical components to the overall disease outcome. A reliability block diagram is used to model patient compliance, endoscopic screening, and surgical therapy for dysplasia in Barrett's esophagus. The overall probability of a patient with a Barrett's esophagus to comply with a screening program, be correctly diagnosed with dysplasia, and undergo successful therapy is 37%. The reduction in the overall success rate, despite the fact that the majority of components are assumed to function with reliability rates of 80% or more, is a reflection of the multitude of serial subsystems involved in disease management. Each serial component influences the overall success rate in a linear fashion. Building multiple parallel pathways into the screening program raises its overall success rate to 91%. Parallel arrangements render systems less sensitive to diagnostic or therapeutic failures. A reliability block diagram provides the means to model the contributions of many heterogeneous factors to disease outcome. Since no medical system functions perfectly, redundancy provided by parallel subsystems assures a greater overall reliability.

  5. Risk Assessment of Using Entonox for the Relief of Labor Pain: A Healthcare Failure Modes and Effects Analysis Approach

    PubMed Central

    Najafi, Tahereh Fathi; Bahri, Narjes; Ebrahimipour, Hosein; Najar, Ali Vafaee; Taleghani, Yasamin Molavi

    2016-01-01

    Introduction In order to prevent medical errors, it is important to know why they occur and to identify their causes. Healthcare failure modes and effects analysis (HFMEA) is a type of qualitative descriptive that is used to evaluate the risk. The aim of this study was to assess the risks of using Entonox for labor pain by HFMEA. Methods A mixed-methods design (qualitative action research and quantitative cross-sectional research) was used. The modes and effects of failures in the process of using Entonox were detected and analyzed during 2013–2014 at Hefdahe Shahrivar Hospital, Mashhad, Iran. Overall, 52 failure modes were identified, with 25 being recognized as high-risk modes. Results The results revealed that 48.5% of these errors fall into the care process type, 22.05% belong to the communicative type, 19.1% fall into the administrative type, and 10.2% are of the knowledge and skills type. Strategies were presented in the forms of acceptance (3.2%), control (90.3%), and elimination (6.4%). Conclusion The following actions are suggested for improving the process of using Entonox: Close supervision by the midwife, precise recording of all the stages of the process in the woman’s medical record, the necessity of the presence of the anesthesiologist at the woman’s bedside during labor, confirming the indications for use of Entonox, and close monitoring to ensure the safety of the gas cylinder guards. PMID:27123224

  6. Analysis of Japanese banks’ historical tree diagram

    NASA Astrophysics Data System (ADS)

    Ueno, Hiromichi; Mizuno, Takayuki; Takayasu, Misako

    2007-09-01

    By using the historical data from the Japanese banks’ database at “The Bankers Library” of Japanese Banker Association, we analyze the historical network of banks from 1868 to 2006. Firstly, we define a bank every year by a particle and draw a space-time evolution process of merger, division, establishment, and failure by a tree diagram structure. We found that the distribution of the tree basin size of real data and simulation result are mostly fitting well. Secondly, we analyze the raw data of financial statements of banks collected by the National Diet library. We confirm that the distributions of the amount of deposits have fat-tail every year, however, small deviations are observed relating to governmental policy.

  7. Assessment of WHO criteria for identifying ART treatment failure in Vietnam from 2007 to 2011.

    PubMed

    Le, Nicole K; Riggi, Emilia; Marrone, Gaetano; Vu, Tam Van; Izurieta, Ricardo O; Nguyen, Chuc Kim Thi; Larsson, Mattias; Do, Cuong Duy

    2017-01-01

    We evaluated the sensitivity and specificity of the WHO immunological criteria for detecting antiretroviral therapy (ART) treatment failure in a cohort of Vietnamese patients. We conducted a stratified analysis to determine the effects of BMI, peer support, adherence to antiretroviral (ARV) drugs, age, and gender on the sensitivity and specificity of the WHO criteria. We conducted a retrospective cohort study of 605 HIV-infected patients using data previously collected from a cluster randomized control trial study. We compared the sensitivity and specificity of CD4+ counts to the gold standard of virologic testing as a diagnostic test for ART failure at different time points of 12, 18, and 24 months. The sensitivity [95% confidence interval (CI)] of the WHO immunological criteria based on a viral load ≥ 1000 copies/mL was 12% (5%-23%), 14% (2%-43%), and 12.5% (2%-38%) at 12, 18, and 24 months, respectively. In the same order, the specificity was 93% (90%-96%), 98% (96%-99%), and 98% (96%-100%). The positive predictive values (PPV) at 12, 18, and 24 months were 22% (9%-40%), 20% (3%-56%), and 29% (4%-71%); the negative predictive values (NPV) at the same time points were 87% (84%-90%), 97% (95%-98%), and 96% (93%-98%). The stratified analysis revealed similar sensitivities and specificities. The sensitivity of the WHO immunological criteria is poor, but the specificity is high. Although testing costs may increase, we recommend that Vietnam and other similar settings adopt viral load testing as the principal method for determining ART failure.

  8. [Assessment of body composition and prognosis in chronic heart failure. Beyond the "obesity paradox"].

    PubMed

    Gámez-López, Antonio Luis; Bonilla-Palomas, Juan Luis; López-Ibáñez, María Cristina; Moreno-Conde, Mirian; Anguita-Sánchez, Manuel; Villar-Ráez, Antonia

    It is unknown the influence of body composition in the inverse relationship of mortality with overweight and obesity in heart failure patients. 234 patients with chronic heart failure were evaluated. Body mass index, tricipital skinfold thickness, brachial muscle circumference and body fat percentage determined by bioelectrical impedance analysis were measured. The influence of previous anthropometric variables on total mortality was analyzed. Mean follow-up was 21±10.7 months. We observed an inverse relationship of total mortality with body mass index (hazard ratio=0.91, 95% confidence interval, 0.87-0.96; P<.001), with body fat estimated by the tricipital skinfold thickness (hazard ratio=0.95, 95% confidence interval, 0.92-0.99; P=.013) and the fat percentage obtained by bioelectrical impedance analysis (hazard ratio=0.96; 95% confidence interval, 0.93-0.99; P=.007) and with muscle mass estimated by the brachial muscle circumference (hazard ratio=0.87; 95% confidence interval,0.81-0.94; P=.001). Only brachial muscle circumference maintained its prognostic significance in multivariate analysis that included different anthropometric measurements (hazard ratio=0.88, 95% confidence interval 0.77-0.99; P=.035). Finally we found a positive linear correlation between the values of body mass index with tricipital skinfold thickness, fat percentage and brachial muscle circumference. The muscle mass of patients with heart failure, estimated by the brachial muscle circumference, is associated inversely with overall mortality. The correlation between values of brachial muscle circumference with the body mass index would explain the "obesity paradox" observed. Copyright © 2016 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  9. Failure assessment of aluminum liner based filament-wound hybrid riser subjected to internal hydrostatic pressure

    NASA Astrophysics Data System (ADS)

    Dikshit, Vishwesh; Seng, Ong Lin; Maheshwari, Muneesh; Asundi, A.

    2015-03-01

    The present study describes the burst behavior of aluminum liner based prototype filament-wound hybrid riser under internal hydrostatic pressure. The main objective of present study is to developed an internal pressure test rig set-up for filament-wound hybrid riser and investigate the failure modes of filament-wound hybrid riser under internal hydrostatic burst pressure loading. The prototype filament-wound hybrid riser used for burst test consists of an internal aluminum liner and outer composite layer. The carbon-epoxy composites as part of the filament-wound hybrid risers were manufactured with [±55o] lay-up pattern with total composite layer thickness of 1.6 mm using a CNC filament-winding machine. The burst test was monitored by video camera which helps to analyze the failure mechanism of the fractured filament-wound hybrid riser. The Fiber Bragg Grating (FBG) sensor was used to monitor and record the strain changes during burst test of prototype filament-wound hybrid riser. This study shows good improvements in burst strength of filament-wound hybrid riser compared to the monolithic metallic riser. Since, strain measurement using FBG sensors has been testified as a reliable method, we aim to further understand in detail using this technique.

  10. Development of Methodology to Assess the Failure Behaviour of Bamboo Single Fibre by Acoustic Emission Technique

    NASA Astrophysics Data System (ADS)

    Alam, Md. Saiful; Gulshan, Fahmida; Ahsan, Qumrul; Wevers, Martine; Pfeiffer, Helge; van Vuure, Aart-Willem; Osorio, Lina; Verpoest, Ignaas

    2016-06-01

    Acoustic emission (AE) was used as a tool for detecting, evaluating and for better understanding of the damage mechanism and failure behavior in composites during mechanical loading. Methodology was developed for tensile test of natural fibres (bamboo single fibre). A series of experiments were performed and load drops (one or two) were observed in the load versus time graphs. From the observed AE parameters such as amplitude, energy, duration etc. significant information corresponding to the load drops were found. These AE signals from the load drop occurred from such failure as debonding between two elementary fibre or from join of elementary fibre at edge. The various sources of load at first load drop was not consistent for the different samples (for a particular sample the value is 8 N, stress: 517.51 MPa). Final breaking of fibre corresponded to saturated level AE amplitude of preamplifier (99.9 dB) for all samples. Therefore, it was not possible to determine the exact AE energy value for final breaking. Same methodology was used for tensile test of three single fibres, which gave clear indication of load drop before the final breaking of first and second fibre.

  11. Development of Methodology to Assess the Failure Behaviour of Bamboo Single Fibre by Acoustic Emission Technique

    NASA Astrophysics Data System (ADS)

    Alam, Md. Saiful; Gulshan, Fahmida; Ahsan, Qumrul; Wevers, Martine; Pfeiffer, Helge; van Vuure, Aart-Willem; Osorio, Lina; Verpoest, Ignaas

    2017-04-01

    Acoustic emission (AE) was used as a tool for detecting, evaluating and for better understanding of the damage mechanism and failure behavior in composites during mechanical loading. Methodology was developed for tensile test of natural fibres (bamboo single fibre). A series of experiments were performed and load drops (one or two) were observed in the load versus time graphs. From the observed AE parameters such as amplitude, energy, duration etc. significant information corresponding to the load drops were found. These AE signals from the load drop occurred from such failure as debonding between two elementary fibre or from join of elementary fibre at edge. The various sources of load at first load drop was not consistent for the different samples (for a particular sample the value is 8 N, stress: 517.51 MPa). Final breaking of fibre corresponded to saturated level AE amplitude of preamplifier (99.9 dB) for all samples. Therefore, it was not possible to determine the exact AE energy value for final breaking. Same methodology was used for tensile test of three single fibres, which gave clear indication of load drop before the final breaking of first and second fibre.

  12. Matched designs and causal diagrams

    PubMed Central

    Mansournia, Mohammad A; Hernán, Miguel A; Greenland, Sander

    2013-01-01

    We use causal diagrams to illustrate the consequences of matching and the appropriate handling of matched variables in cohort and case-control studies. The matching process generally forces certain variables to be independent despite their being connected in the causal diagram, a phenomenon known as unfaithfulness. We show how causal diagrams can be used to visualize many previous results about matched studies. Cohort matching can prevent confounding by the matched variables, but censoring or other missing data and further adjustment may necessitate control of matching variables. Case-control matching generally does not prevent confounding by the matched variables, and control of matching variables may be necessary even if those were not confounders initially. Matching on variables that are affected by the exposure and the outcome, or intermediates between the exposure and the outcome, will ordinarily produce irremediable bias. PMID:23918854

  13. Electrochemical Phase Diagrams for Aqueous Redox Systems

    DTIC Science & Technology

    1989-12-22

    theoretical analysis permits a classification of potential-pH diagrams into two basic types: 1) Pourbaix diagrams , in which 1 the stability field of solid...property" diagrams will contain conventional Pourbaix and Ellingham diagrams as subsets. 3. Improve the data-base supporting the computations by...research grant DAAL03-86-K-0062 and the preceding grant DAAG29-84-K-0074. 1. John C. Angus and Charles T. Angus, "Computation of Pourbaix Diagrams Using

  14. An assessment of BWR (boiling water reactor) Mark-II containment challenges, failure modes, and potential improvements in performance

    SciTech Connect

    Kelly, D.L.; Jones, K.R.; Dallman, R.J. ); Wagner, K.C. )

    1990-07-01

    This report assesses challenges to BWR Mark II containment integrity that could potentially arise from severe accidents. Also assessed are some potential improvements that could prevent core damage or containment failure, or could mitigate the consequences of such failure by reducing the release of fission products to the environment. These challenges and improvements are analyzed via a limited quantitative risk/benefit analysis of a generic BWR/4 reactor with Mark II containment. Point estimate frequencies of the dominant core damage sequences are obtained and simple containment event trees are constructed to evaluate the response of the containment to these severe accident sequences. The resulting containment release modes are then binned into source term release categories, which provide inputs to the consequence analysis. The output of the consequences analysis is used to construct an overall base case risk profile. Potential improvements and sensitivities are evaluated by modifying the event tree spilt fractions, thus generating a revised risk profile. Several important sensitivity cases are examined to evaluate the impact of phenomenological uncertainties on the final results. 75 refs., 25 figs., 65 tabs.

  15. Doppler assessment of brachial artery flow as a measure of endothelial dysfunction in pediatric chronic renal failure.

    PubMed

    Hussein, Gehan; Bughdady, Yasser; Kandil, Manal E; Bazaraa, Hafez M; Taher, Heba

    2008-11-01

    Cardiovascular morbidity and mortality are highly prevalent among patients with chronic renal failure (CRF). Endothelial dysfunction is regarded as the initial reversible step in the development of atherosclerosis and has been demonstrated in all stages of renal failure. Non-invasive techniques to assess endothelial function have been recently developed and have been proven to predict future mortality in adults. We aimed to assess endothelial function in children with stage 4 chronic kidney disease (CKD 4) on conservative treatment, using a-non invasive, high-resolution, ultrasound Doppler study of the brachial artery flow, correlating it with other clinical and laboratory parameters. This study included 34 children with CKD 4 on conservative treatment who were compared with 30 healthy controls. Flow-mediated dilatation (FMD), nitroglycerin-mediated dilatation (NTG-MD) and FMD/NTG-MD ratio were estimated. FMD was abnormal (< 5%) in 24 patients (71%). FMD and FMD/NTG-MD ratio were significantly lower in patients than in controls (P = 0.001 and P = 0.01, respectively). FMD correlated positively with serum calcium and negatively with alkaline phosphatase. We concluded that endothelial dysfunction is present in children with CKD 4 on conservative treatment and may reflect increased atherogenic and thrombogenic properties of the endothelium, contributing to subsequent adverse cardiovascular outcome.

  16. Assessing validity by comparing transition and static measures of dyspnea in patients with acute decompensated heart failure.

    PubMed

    Smithline, Howard A; Caglar, Selin; Blank, Fidela S J

    2010-01-01

    This study assessed the convergent validity of 2 dyspnea measures, the transition measure and the change measure, by comparing them with each other in patients admitted to the hospital with acute decompensated heart failure. Static measures of dyspnea were obtained at baseline (pre-static measure) and at time 1 hour and 4 hour (post-static measures). The change measure was calculated as the difference between the pre-static and post-static measures. Transition measures were obtained at time 1 hour and 4 hour. Visual analog scales and Likert scales were used. Both physicians and patients measured the dyspnea independently. A total of 112 patients had complete data sets at time 0 and 1 hour and 86 patients had complete data sets at all 3 time points. Correlations were calculated between the transition measures and static measures (pre-static, post-static, and change measure). Bland-Altman plots were generated and the mean difference and limits of agreement between the transition measures and the change measures were calculated. In general, short-term dyspnea assessment using transition measures and serial static measures can not be used to validate each other in this population of patients being admitted with acute decompensated heart failure.

  17. Assessing cell fusion and cytokinesis failure as mechanisms of clone 9 hepatocyte multinucleation in vitro.

    PubMed

    Simic, Damir; Euler, Catherine; Thurby, Christina; Peden, Mike; Tannehill-Gregg, Sarah; Bunch, Todd; Sanderson, Thomas; Van Vleet, Terry

    2012-08-01

    In this in vitro model of hepatocyte multinucleation, separate cultures of rat Clone 9 cells are labeled with either red or green cell tracker dyes (Red Cell Tracker CMPTX or Vybrant CFDA SE Cell Tracer), plated together in mixed-color colonies, and treated with positive or negative control agents for 4 days. The fluorescent dyes become cell-impermeant after entering cells and are not transferred to adjacent cells in a population, but are inherited by daughter cells after fusion. The mixed-color cultures are then evaluated microscopically for multinucleation and analysis of the underlying mechanism (cell fusion/cytokinesis). Multinucleated cells containing only one dye have undergone cytokinesis failure, whereas dual-labeled multinucleated cells have resulted from fusion. © 2012 by John Wiley & Sons, Inc.

  18. Assessing Risk and Preventing 30-Day Readmissions in Decompensated Heart Failure: Opportunity to Intervene?

    PubMed

    Dunbar-Yaffe, Richard; Stitt, Audra; Lee, Joseph J; Mohamed, Shanas; Lee, Douglas S

    2015-10-01

    Heart failure (HF) patients are at high risk of hospital readmission, which contributes to substantial health care costs. There is great interest in strategies to reduce rehospitalization for HF. However, many readmissions occur within 30 days of initial hospital discharge, presenting a challenge for interventions to be instituted in a short time frame. Potential strategies to reduce readmissions for HF can be classified into three different forms. First, patients who are at high risk of readmission can be identified even before their initial index hospital discharge. Second, ambulatory remote monitoring strategies may be instituted to identify early warning signs before acute decompensation of HF occurs. Finally, strategies may be employed in the emergency department to identify low-risk patients who may not need hospital readmission. If symptoms improve with initial therapy, low-risk patients could be referred to specialized, rapid outpatient follow-up care where investigations and therapy can occur in an outpatient setting.

  19. [Assessment of natriuretic peptide indices and oxidative stress in patients with chronic heart failure].

    PubMed

    Abezov, D K; Kamilova, U K; Shukurdzhanova, S M; Rakhmonov, R R; Alieva, T A

    2010-01-01

    The authors have studied indices of natriuretic peptide and oxidative stress in patients with chronic heart failure (CHF). 52 male patients with postinfarction cardiosclerosis (PICS) who have developed CHF have been observed. The age of the patients varied from 38 till 60. It was established that CHF patients with progression of the disease had worsening of their clinical condition together with an increase of oxidative stress which was characterized through decrease of NO metabolites, NADPH--diaphorase (eNOS), increase of nitrite reductase (iNOS) and peroxinitrite (ONOO), correlative increase the level of brain natriuretic peptide in blood plazma. Reliable connection between considerable increase of oxidative stress and the level of NT-pro BNP was noted in CHF patients, which demands necessity of correction of observed disorders.

  20. 30 CFR 1218.40 - Assessments for incorrect or late reports and failure to report.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... geothermal, solid minerals, and Indian oil and gas leases. (b) An assessment of an amount not to exceed $10... Indian oil and gas leases. (c) For purpose of assessments discussed in this section, a report is defined... Remittance, as appropriate. (2) For Indian oil and gas and all geothermal leases, a report is each line on...

  1. Organ dysfunction as estimated by the sequential organ failure assessment score is related to outcome in critically ill burn patients.

    PubMed

    Lorente, José A; Vallejo, Alfonso; Galeiras, Rita; Tómicic, Vinko; Zamora, Javier; Cerdá, Enrique; de la Cal, Miguel A; Esteban, Andrés

    2009-02-01

    The objectives of the study were to assess organ dysfunction in burn patients by using the Sequential Organ Failure Assessment (SOFA) score, to determine the relationship between early (day 1) and late (day 4) organ dysfunction, as well as the change in organ dysfunction from admission to day 4, and mortality. The design was a prospective observational cohort study. Patients were admitted to our intensive care burn unit with severe thermal burns (> or =20% total body surface area [BSA] burned) or inhalation injury with a delay from injury to admission less than 12 h and a length of stay less than 3 days (n = 439; age, 46.0 +/- 20.3 yrs; total BSA burned, 31.6% +/- 20.2% [mean +/- SD]; inhalation injury, 44.4%; crude mortality, 18.5%). Sequential Organ Failure Assessment scores were measured on admission (SOFA 0) and on subsequent days (SOFA 1, SOFA 2, SOFA 3, and SOFA 4). The difference between SOFA 0 and SOFA 4 (DeltaSOFA 0-4) was calculated. Multivariate logistic regression analyses, including other variables associated with mortality in the models, were performed to calculate adjusted odds ratios (ORs) of organ dysfunction measurements for mortality. After adjusting for age, BSA burned, diagnosis of inhalation injury, and sex, SOFA 1 (OR, 1.89; 95% confidence interval [CI], 1.55-2.32), SOFA 4 (OR, 1.33; 95% CI, 1.19-1.47), and DeltaSOFA 0-4 (OR, 1.40; 95% CI, 1.28-1.55) were independently associated with mortality. The SOFA score is useful to assess organ dysfunction in burn patients. Burn-induced organ dysfunction (early and late), as well as the change in organ dysfunction, is independently associated with mortality.

  2. Temporal Causal Diagrams for Diagnosing Failures in Cyber Physical Systems

    DTIC Science & Technology

    2014-10-02

    that are designed to detect abnormal changes in physical proper- ties (current, voltage , impedance) and actuation devices such as breakers that can... detects the absence of the discrepancy D3 (transition: D3 ↓)), it issues a command C2 (event) and transitions back to the state S1 (and restores the system ... intelligent process control for cogenerator plants. Journal of Parallel and Distributed Systems , 15, 90–103. Lee, S., Choi, M., Kang, S., Jin, B., Lee, D

  3. Voronoi Diagrams and Spring Rain

    ERIC Educational Resources Information Center

    Perham, Arnold E.; Perham, Faustine L.

    2011-01-01

    The goal of this geometry project is to use Voronoi diagrams, a powerful modeling tool across disciplines, and the integration of technology to analyze spring rainfall from rain gauge data over a region. In their investigation, students use familiar equipment from their mathematical toolbox: triangles and other polygons, circumcenters and…

  4. Voronoi Diagrams and Spring Rain

    ERIC Educational Resources Information Center

    Perham, Arnold E.; Perham, Faustine L.

    2011-01-01

    The goal of this geometry project is to use Voronoi diagrams, a powerful modeling tool across disciplines, and the integration of technology to analyze spring rainfall from rain gauge data over a region. In their investigation, students use familiar equipment from their mathematical toolbox: triangles and other polygons, circumcenters and…

  5. Risk assessment of drain valve failure in the K-West basin south loadout pit

    SciTech Connect

    MORGAN, R.G.

    1999-06-23

    The drain valve located in the bottom of the K-West Basin South Loadout Pit (SLOP) could provide an additional leak path from the K Basins if the drain valve were damaged during construction, installation, or operation of the cask loading system. For the K-West Basin SLOP the immersion pail support structure (IPSS) has already been installed, but the immersion pail has not been installed in the IPSS. The objective of this analysis is to evaluate the risk of damaging the drain valve during the remaining installation activities or operation of the cask loading system. Valve damage, as used in this analysis, does not necessarily imply large amounts of the water will be released quickly from the basin, rather valve damage implies that the valve's integrity has been compromised. The analysis process is a risk-based uncertainty analysis where best engineering judgement is used to represent each variable in the analysis. The uncertainty associated with each variable is represented by a probability distribution. The uncertainty is propagated through the analysis by Monte Carlo convolution techniques. The corresponding results are developed as a probability distribution and the risk is expressed in terms of the corresponding complementary cumulative distribution function (''risk curve''). The total risk is the area under the ''risk curve''. The risk of potentially dropping a cask into or on the IPSS and damaging the drain valve is approximately 1 x 10{sup -4} to 2 x 10{sup -5} per year. The risk of objects falling behind the IPSS and damaging the valve is 3 x 10{sup -2} to 6 x 10{sup -3} per year. Both risks are expressed as drain value failure frequencies. The risk of objects falling behind the IPSS and damaging the valve can be significantly reduced by an impact limiter and/or installing a gating or plate over the area bounded by the back of the IPSS and the wall of the SLOP. With either of these actions there is a 90 percent confidence that the frequency of drain valve

  6. The prevalence of sarcopenia in patients with respiratory failure classified as normally nourished using computed tomography and subjective global assessment.

    PubMed

    Sheean, Patricia M; Peterson, Sarah J; Gomez Perez, Sandra; Troy, Karen L; Patel, Ankur; Sclamberg, Joy S; Ajanaku, Folabomi C; Braunschweig, Carol A

    2014-09-01

    Declines in nutrition status and adverse body composition changes frequently occur in the critically ill. The objective of this cross-sectional study was to examine the prevalence of sarcopenia and its occurrence in patients classified as normal nourished using subjective global assessment (SGA). Exploiting diagnostic CT images, skeletal muscle mass at the L3 region was quantified and used to determine sarcopenia and its association with normal nutrition status in 56 patients with respiratory failure. Sarcopenia was defined as an L3 skeletal muscle index of ≤38.5 cm(2)/m(2) for women and ≤52.4 cm(2)/m(2) for men. CT imaging and SGA classifications completed within 14, 10 and 7 days of each other were analyzed to assess sarcopenia and the influence of time between scans on misclassification (ie, normal nourished and sarcopenic). Descriptive statistics were conducted. The average patient was 59.2 (± 15.6) years old, admitted with sepsis/infection, an APACHE II score of 26 (± 8.0), and BMI of 28.3 (± 5.8). Sarcopenia and sarcopenic obesity were prevalent in a minimum of 56% and 24% of patients, respectively, depending on the number of days between CT imaging and SGA assessment. Misclassified individuals were predominantly male, minority and overweight or obese. Controlling for age, no significant differences were noted for patients classified as normal nourished vs malnourished by SGA for lumbar muscle cross-sectional, whole-body lean mass, or skeletal muscle index. Sarcopenia is highly prevalent among patients with respiratory failure requiring mechanical ventilation (MV) and not readily detected in patients classified as normal nourished using SGA. © 2013 American Society for Parenteral and Enteral Nutrition.

  7. Assessment of composite failure and ultimate strength without experiment on composite

    NASA Astrophysics Data System (ADS)

    Huang, Zheng-Ming; Liu, Ling

    2014-08-01

    This paper attempts to estimate the ultimate strength of a laminated composite only based on its constituent properties measured independently. Three important issues involved have been systematically addressed, i.e., stress calculation for the constituent fiber and matrix materials, failure detection for the lamina and laminate upon the internal stresses in their constituents, and input data determination of the constituents from monolithic measurements. There are three important factors to influence the accuracy of the strength prediction. One is the stress concentration factor (SCF) in the matrix. Another is matrix plasticity. The third is thermal residual stresses in the constituents. It is these three factors, however, that have not been sufficiently well realized in the composite community. One can easily find out the elastic and strength parameters of a great many laminae and laminates in the current literature. Unfortunately, necessary information to determine the SCF, the matrix plasticity, and the thermal residual stresses of the composites is rare or incomplete. A useful design methodology is demonstrated in the paper.

  8. The Assessing of the Failure Behavior of Glass/Polyester Composites Subject to Quasi Static Stresses

    NASA Astrophysics Data System (ADS)

    Stanciu, M. D.; Savin, A.; Teodorescu-Drăghicescu, H.

    2017-06-01

    Using glass fabric reinforced composites for structure of wind turbine blades requires high mechanical strengths especially to cyclic stresses. Studies have shown that approximately 50% of composite material failure occurs because of fatigue. Composites behavior to cyclic stresses involves three stages regarding to stiffness variation: the first stage is characterized by the accelerated decline of stiffness with micro-cracks, the second stage - a slight decrease of stiffness characterized by the occurrence of delamination and third stage characterized by higher decreases of resistance and occurrence of fracture thereof. The aim of the paper is to analyzed the behavior of composites reinforced with glass fibers fabric type RT500 and polyester resin subjected to tensile cyclic loading with pulsating quasi-static regime with asymmetry coefficient R = 0. The samples were tested with the universal tensile machine LS100 Lloyd Instruments Plus, with a load capacity of 100 kN. The load was applied with different speeds of 1 mm/min, 10 mm/min and 20 mm/min. After tests, it was observed that the greatest permanent strains were recorded in the first load cycles when the total energy storage by material was lost due to internal friction. With increasing number of cycles, the glass/polyester composites ability to store energy of deformation decreases, the flow phenomenon characterized by large displacements to smaller loading forces appearing.

  9. Failure Impact Analysis of Key Management in AMI Using Cybernomic Situational Assessment (CSA)

    SciTech Connect

    Abercrombie, Robert K; Sheldon, Frederick T; Hauser, Katie R; Lantz, Margaret W; Mili, Ali

    2013-01-01

    In earlier work, we presented a computational framework for quantifying the security of a system in terms of the average loss a stakeholder stands to sustain as a result of threats to the system. We named this system, the Cyberspace Security Econometrics System (CSES). In this paper, we refine the framework and apply it to cryptographic key management within the Advanced Metering Infrastructure (AMI) as an example. The stakeholders, requirements, components, and threats are determined. We then populate the matrices with justified values by addressing the AMI at a higher level, rather than trying to consider every piece of hardware and software involved. We accomplish this task by leveraging the recently established NISTR 7628 guideline for smart grid security. This allowed us to choose the stakeholders, requirements, components, and threats realistically. We reviewed the literature and selected an industry technical working group to select three representative threats from a collection of 29 threats. From this subset, we populate the stakes, dependency, and impact matrices, and the threat vector with realistic numbers. Each Stakeholder s Mean Failure Cost is then computed.

  10. Etiology-specific assessment of predictors of long-term survival in chronic systolic heart failure.

    PubMed

    Franke, Jennifer; Zugck, Christian; Hochadel, Matthias; Hack, Anna; Frankenstein, Lutz; Zhao, Jingting Désirée; Ehlermann, Philipp; Nelles, Manfred; Zeymer, Uwe; Winkler, Ralph; Zahn, Ralf; Katus, Hugo A; Senges, Jochen

    2015-06-01

    We sought to identify prognostic factors of long-term mortality, specific for the underlying etiology of chronic systolic heart failure (CHF). Between 1995 and 2009 baseline characteristics, treatment and follow-up data from 2318 CHF-patients due to ischemic (ICM; 1100 patients) or dilated cardiomyopathy (DCM; 1218 patients) were prospectively compared. To calculate hazard ratios with 95%-confidence intervals cox regression was used. We respectively established etiology-specific multivariable models of independent prognostic factors. During the follow-up period of up to 14.8 years (mean = 53.1 ± 43.5 months; 10,264 patient-years) 991 deaths (42.8%) occurred. In the ICM-cohort, 5-year-survival was 53.4% (95% CI: 49.9-56.7%), whereas in DCM-patients it was higher (68.1% (95% CI: 65.1-71.0%)). Age, ejection fraction, or hyponatremia were independent predictors for mortality in both cohorts, whereas diabetes, COPD, atrial fibrillation and a heart rate of ≥ 80/min carried independent predictive power only in ICM-patients. This study demonstrates the disparity of prognostic value of clinically derived risk factors between the two main causes of CHF. The effects of covariables in DCM-patients were lower, suggesting a less modifiable disease through risk factors considering mortality risk. An etiology-specific prognostic model may improve accuracy of survival estimations in CHF.

  11. Assessment of Cost and Health Resource Utilization for Elderly Patients With Heart Failure and Diabetes Mellitus

    PubMed Central

    BOGNER, HILLARY R.; MILLER, STEVEN D.; DE VRIES, HEATHER F.; CHHATRE, SUMEDHA; JAYADEVAPPA, RAVISHANKAR

    2010-01-01

    Background Our aim was to examine the health resource utilization and cost of care associated with heart failure (HF) and diabetes mellitus (DM) for elderly Medicare enrollees. Methods and Results A retrospective case-control design was used to identify 4 groups of elderly patients with HF and DM (n = 498), HF only (n = 1089), DM only (n = 971), and no-HF and no-DM (n = 5438) using an administrative database of a large urban academic health care system. Demographic, diagnostic, health resource utilization, and cost (reimbursement) data were obtained from the Medicare claims database for the years 2000 and 2001. Disease states were identified by ICD-9 codes. Costs and health resource utilization were compared across the groups. The mean total costs were highest for the group with HF and DM ($32,676), and second highest for the HF only group ($22,230). In multivariable models that adjusted for potentially influential covariates, the group with HF and DM had a 3-fold increase in total cost compared with the group without DM and HF (relative total cost = 4.51, 95% confidence interval 3.82–5.31). Conclusions The presence of DM has a substantial influence on the costs for managing older patients with HF. An integrated approach to management may be needed. PMID:20610226

  12. A harvest failure approach to assess the threat from an invasive species.

    PubMed

    Yemshanov, Denys; McKenney, Daniel W; de Groot, Peter; Haugen, Dennis; Pedlar, John; Sidders, Derek; Joss, Brent

    2011-01-01

    We present the idea of using potential infringements on annual allowable harvest targets as an approach to estimate threats from invasive species to the forest products sector. The approach uses present-day harvest levels as a reference level to estimate when and where the impact of a nonnative forest pest could become economically damaging. We use a generic model that simulates spread and damage by nonnative invasive species, basic harvest and forest growth through time. The concept is illustrated with a case study of a new nonnative invasive pest, Sirex noctilio Fabricius on pine resources in eastern Canada. Impacts of invasion on wood supply, in particular, the point at which present-day harvest levels are not attainable, were identified for 77 non-overlapping geographical regions that delimit the primary wood supply areas around large mills and wood processing facilities in eastern Canada. The results identify the minimum area of a pest outbreak that could trigger harvest shortages (approximately 12.5-14 M ha of pine forests in Ontario and Quebec). Beyond this level, the amount of host resource available for harvesting in any given year declines rapidly. The failure to sustain broad-scale harvest targets may be an attractive and intuitive indicator for policy makers and regulators interested in developing control and "slow-the-spread" programs for non-native forest pests.

  13. Efficacy of fluid assessment based on intrathoracic impedance monitoring in patients with systolic heart failure.

    PubMed

    Soga, Yoshimitsu; Ando, Kenji; Arita, Takeshi; Hyodo, Makoto; Goya, Masahiko; Iwabuchi, Masashi; Nobuyoshi, Masakiyo

    2011-01-01

    Previous studies have demonstrated that intrathoracic impedance monitoring (IIM) is associated with fluid overload. However, it remains unclear whether this new technology can predict heart failure (HF) before deterioration. Whether fluid status based on IIM predicts HF in patients with left ventricular (LV) systolic dysfunction was investigated. A prospective clinical observational study of 123 patients implanted with IIM-capable cardiac devices was carried out. The primary endpoint was the positive predictive value (PPV) at 12 months. Secondary endpoints were a correlation between onset of HF and IIM, optimal threshold of fluid index and duration between the alert and HF. Complete follow-up clinical data were obtained from 111 patients. During the observational period, 168 alerts were confirmed from 68 patients. In patient-based analysis (alert-based analysis), PPV was 33.8% (33.9%). Sensitivity, specificity and false positive was 67.6% (83.8%), 49.4% (28.4%) and 50.6% (71.6%), respectively. Mean duration between the alert and HF event was 21.4 ± 6.1 days. On multivariate logistic analysis, maximum fluid index, LV ejection fraction and atrial fibrillation were independent predictors of HF events. The optimal cut-off value determined by receiver operating characteristic curve was 114-ohm·day with sensitivity and specificity of 89.5% and 73.0%, respectively. IIM-based fluid index in patients with HF due to LV systolic dysfunction was effective in predicting worsening HF.

  14. Risk assessment of failure modes of gas diffuser liner of V94.2 siemens gas turbine by FMEA method

    NASA Astrophysics Data System (ADS)

    Mirzaei Rafsanjani, H.; Rezaei Nasab, A.

    2012-05-01

    Failure of welding connection of gas diffuser liner and exhaust casing is one of the failure modes of V94.2 gas turbines which are happened in some power plants. This defect is one of the uncertainties of customers when they want to accept the final commissioning of this product. According to this, the risk priority of this failure evaluated by failure modes and effect analysis (FMEA) method to find out whether this failure is catastrophic for turbine performance and is harmful for humans. By using history of 110 gas turbines of this model which are used in some power plants, the severity number, occurrence number and detection number of failure determined and consequently the Risk Priority Number (RPN) of failure determined. Finally, critically matrix of potential failures is created and illustrated that failure modes are located in safe zone.

  15. Assessing the Effects of the "Rocket Math" Program with a Primary Elementary School Student at Risk for School Failure: A Case Study

    ERIC Educational Resources Information Center

    Smith, Christina R.; Marchand-Martella, Nancy E.; Martella, Ronald C.

    2011-01-01

    This study assessed the effects of the "Rocket Math" program on the math fluency skills of a first grade student at risk for school failure. The student received instruction in the "Rocket Math" program over 6 months. He was assessed using a pre- and posttest curriculum-based measurement (CBM) and individualized fluency checkouts within the…

  16. Assessing the Effects of the "Rocket Math" Program with a Primary Elementary School Student at Risk for School Failure: A Case Study

    ERIC Educational Resources Information Center

    Smith, Christina R.; Marchand-Martella, Nancy E.; Martella, Ronald C.

    2011-01-01

    This study assessed the effects of the "Rocket Math" program on the math fluency skills of a first grade student at risk for school failure. The student received instruction in the "Rocket Math" program over 6 months. He was assessed using a pre- and posttest curriculum-based measurement (CBM) and individualized fluency checkouts within the…

  17. Evaluation of site-site bridge diagrams for molecular fluids

    NASA Astrophysics Data System (ADS)

    Vatamanu, J.; Cann, N. M.

    2004-10-01

    The presence of bridge functions in formally exact integral equation theories is the primary obstacle preventing the extraction of exact fluid structure from these theories. The bridge functions are typically neglected but in many fluids their impact may be significant. Each bridge function can be subdivided into bridge diagrams, which are well defined but difficult to evaluate. The calculation of bridge diagrams for the Chandler-Silbey-Ladanyi (CSL) integral equation theory [D. Chandler, R. Silbey, and B. Ladanyi, Mol. Phys. 46, 1335 (1982)] is the subject of this paper. In particular, we evaluate the diagrams required to yield an exact theory up to the first power in density [O(ρ1)] and provide algorithms that remain feasible for any molecule. Further, the bridge diagrams are evaluated and compared with the f-bond and h-bond formulations. Exact bridge diagrams are numerically evaluated for several chiral molecules, for two polar dimers, and for SPC/E water [W. L. Jorgensen, J. Chandrasekhar, J. D. Madura, R. W. Impey, and M. L. Klein, J. Chem. Phys. 79, 926 (1983)]. The quality of the diagrams is assessed in two ways: First, the predicted interatomic distributions are compared with those obtained from Monte Carlo simulations. Second, the connectivity constraints are evaluated and the errors in satisfying these exact relationships are compared for the f-bond and h-bond formulations. For apolar fluids, a clear improvement in CSL theory is evident with the inclusion of O(ρ0) and O(ρ1) diagrams. In contrast, for polar fluids, the inclusion of bridge diagrams does not lead to improvement in the structural predictions.

  18. 30 CFR 1218.40 - Assessments for incorrect or late reports and failure to report.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., solid minerals, and Indian oil and gas leases. (b) An assessment of an amount not to exceed $10 per day may be charged for each incorrectly completed report for geothermal, solid minerals, and Indian oil... appropriate. (2) For Indian oil and gas and all geothermal leases, a report is each line on Form MMS-2014. (d...

  19. Small Data, Online Learning and Assessment Practices in Higher Education: A Case Study of Failure?

    ERIC Educational Resources Information Center

    Watson, Cate; Wilson, Anna; Drew, Valerie; Thompson, Terrie Lynn

    2017-01-01

    In this paper, we present an in-depth case study of a single student who failed an online module which formed part of a master's programme in Professional Education and Leadership. We use this case study to examine assessment practices in higher education in the online environment. In taking this approach, we go against the current predilection…

  20. Using Curriculum-Based Measurement To Prevent Failure and Assess Learning in the Content Areas.

    ERIC Educational Resources Information Center

    Busch, Todd W.; Espin, Christine A.

    2003-01-01

    This article describes a curriculum-based measure, vocabulary matching, that can be used to assess the performance of students with reading difficulties in the content areas. Data showing the validity and reliability of vocabulary matching as a measure of performance in the content areas are included. A case study illustrates the use of vocabulary…

  1. 30 CFR 218.40 - Assessments for incorrect or late reports and failure to report.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... MMS by the designated due date for geothermal, solid minerals, and Indian oil and gas leases. (b) An... geothermal, solid minerals, and Indian oil and gas leases. (c) For purpose of assessments discussed in this... line on Form MMS-4430, Solid Minerals Production and Royalty Report; or on Form MMS-2014, Report of...

  2. A micromechanical model for the failure and damage assessment of woven composites

    NASA Astrophysics Data System (ADS)

    Abdelrahman, Wael Gamal Eldin

    A micromechanical model is advanced in order to study the stress transfer and associated damage and failure in classes of conventional and textile type fibrous composites. Unidirectionally reinforced matrix with straight and undulated fibers define the repeating constructing cell for conventional and textile composites, respectively. Starting with the case of straight reinforcement, we approximate and model the actual discrete composite as a concentric cylindrical system. For axisymmetric loading, and upon adopting some appropriate restrictions on the radial behavior of some field quantities, an elasticity-based procedure reduces the two-dimensional field equations, which hold in both fiber and matrix components together with the appropriate interface, symmetry and boundary conditions, to a quasi-one-dimensional system. This analysis is further extended to cases involving undulated fibers. Based upon local directions (slopes) of the undulated fibers, the linear transformation is used to obtain local stress distributions along the undulated fibers. The total stress field is found to be combinations of these local stresses and the inherent contributions obtained from the transformations of the normal loads along the undulated directions in the absence of reinforcement. This simple system retains total account of the system's physics and presents itself in the form of coupled partial differential equations in the longitudinal displacements and stresses of both the fiber and matrix components. According to this model, damage is simulated in the form of stress free boundary conditions. Perpetuation of damage is based upon the maximum normal stress criterion. The adverse effect of such damage on the stiffness properties of the composite is predicted. Results show the favorable effect of undulation in decreasing the rate of property degradation with increasing damage. The model is quite general and has been applied to several situations. These include response to static

  3. Wall shear stress assessment in the common carotid artery of end-stage renal failure patients.

    PubMed

    Samijo, S K; Barkhuysen, R; Willigers, J M; Leunissen, K M L; Ledoux, L A F; Kitslaar, P J E H M; Hoeks, A P G

    2002-01-01

    Under physiological circumstances in the common carotid artery (CCA), mean wall shear stress (WSS), defined as mean wall shear rate (WSR) times local whole blood viscosity (WBV), is maintained at approximately 1.5 Pa. In patients with end-stage renal failure (ESRF) whole blood viscosity is low and it is not unlikely that mean WSS is lower in these patients than in control subjects. Moreover, hemodialysis causes an acute increase in blood viscosity with possible effects on WSS. In this study WSS in the CCA was determined with the Shear Rate Estimating System, an apparatus based on ultrasound, in ESRF patients (n = 13) and in presumed healthy age- and sex-matched control subjects (n = 13). Prior to hemodialysis, mean WSS (0.67 +/- 0.23 Pa) was significantly lower (p < 0.05) in patients with ESRF, due to both a lower WBV (2.80 +/- 0.52 mPa.s) and mean WSR (271 +/- 109 s(-1)), than in the control subjects (mean WSS: 1.24 +/- 0.20 Pa; WBV: 3.20 +/- 0.29 mPa.s; WSR: 387 +/- 51 s(-1)). Hemodialysis induced an increase in WBV (up to 3.71 +/- 1.54 mPa.s, p < 0.01), but mean WSS did not change significantly due to a reciprocal decrease in mean wall shear rate. These findings demonstrate that WSS is lower in hemodialysis patients than in control subjects, and that mean WSS is maintained at this low level despite an acute change in blood viscosity.

  4. Geotechnical assessment of road failure and slope monitoring along Nsukka-Adoru-Idah highway, Southeastern Nigeria.

    PubMed

    Maduka, Raphael Iweanya; Igwe, Ogbonnaya; Ayogu, Nnadozie Onyekachi; Ayogu, Chinero Nneka; Nwachukwu, Martin

    2017-01-01

    The quality of highway pavement is greatly influenced by the subgrade materials, the general geology of the area, and the materials used for construction. Investigation into the 75-km Nsukka-Adoru-Idah highway revealed that the pavement was underlain by three lithological units-Imo, Nsukka, and Ajali formations. The geotechnical evaluation carried out in the study includes the particle size distribution, Atterberg limit, specific gravity, compaction tests, and California bearing ratio (CBR). The base course has clay/silt (7-14%), fine sand (1-4%), medium sand (6-13%), and coarse sand (65-86%), while the subgrade presented clay/silt (74-82%), fine sand (6-9%), medium sand (10-17%), and coarse sand (1-3%). The average specific gravity results for the studied base course and subgrades are 2.58 and 2.52. Liquid limit (LL) result ranges from 27 to 60%, while plastic limit (PL) ranges between 17 and 24%, and plasticity index (PI) ranges from 5 to 39%. The maximum dry density (MDD) result ranges from 1.70 to 2.10 mg/m(3), while the optimum moisture content (OMC) for the samples ranges between 14.1 and 18.0%. The CBR result for soaked and unsoaked samples ranges from 37 to 74 and 48 to 83%, respectively. The low unsoaked CBR (<80%) and high Atterberg limits (LL > 30% and PI > 12%) failed the stipulated Nigerian standard, signifying the need for stabilization. A geotechnical model of a highway road cut generated a factor of safety of 1.45, indicating possibility of slope failure.

  5. Risk assessment for incident heart failure in individuals with atrial fibrillation

    PubMed Central

    Schnabel, Renate B.; Rienstra, Michiel; Sullivan, Lisa M.; Sun, Jenny X.; Moser, Carlee B.; Levy, Daniel; Pencina, Michael J.; Fontes, João D.; Magnani, Jared W.; McManus, David D.; Lubitz, Steven A.; Tadros, Thomas M.; Wang, Thomas J.; Ellinor, Patrick T.; Vasan, Ramachandran S.; Benjamin, Emelia J.

    2013-01-01

    Background Atrial fibrillation (AF) is a strong risk factor for heart failure (HF); HF onset in patients with AF is associated with increased morbidity and mortality. Risk factors that predict HF in individuals with AF in the community are not well established. Methods and results We examined clinical variables related to the 10-year incidence of HF in 725 individuals (mean 73.3 years, 45% women) with documented AF in the Framingham Heart Study. Event rates for incident HF (n = 161, 48% in women) were comparable in women (4.30 per 100 person-years) and men (3.34 per 100 person-years). Age, body mass index, ECG LV hypertrophy, diabetes, significant murmur, and history of myocardial infarction were positively associated with incident HF in multivariable models (C-statistic 0.71; 95% confidence interval 0.67–0.75). We developed a risk algorithm for estimating absolute risk of HF in AF patients with good model fit and calibration (adjusted calibration χ2 statistic 7.29; Pχ2 = 0.61). Applying the algorithm, 47.6% of HF events occurred in the top tertile in men compared with 13.1% in the bottom tertile, and 58.4% in women in the upper tertile compared with 18.2% in the lowest category. For HF type, women had a non-significantly higher incidence of HF with preserved EF compared with men. Conclusions We describe advancing age, LV hypertrophy, body mass index, diabetes, significant heart murmur, and history of myocardial infarction as clinical predictors of incident HF in individuals with AF. A risk algorithm may help identify individuals with AF at high risk of developing HF. PMID:23594831

  6. Root-cause analysis and health failure mode and effect analysis: two leading techniques in health care quality assessment.

    PubMed

    Shaqdan, Khalid; Aran, Shima; Daftari Besheli, Laleh; Abujudeh, Hani

    2014-06-01

    In this review article, the authors provide a detailed series of guidelines for effectively performing root-cause analysis (RCA) and health failure mode and effect analysis (HFMEA). RCA is a retrospective approach used to ascertain the "root cause" of a problem that has already occurred, whereas HFMEA is a prospective risk assessment tool whose aim is to recognize risks to patient safety. RCA and HFMEA are used for the prevention of errors or recurring errors to create a safer workplace, maintain high standards in health care quality, and incorporate time-saving and cost-saving modifications to favorably affect the patient care environment. The principles and techniques provided here should allow reviewers to better understand the features of RCA and HFMEA and how to apply these processes appropriately. These principles include how to organize a team, identify root causes, seed out proximate causes, graphically describe the process, conduct a hazard analysis, and develop and implement potential action plans.

  7. Risk assessment of Giardia from a full scale MBR sewage treatment plant caused by membrane integrity failure.

    PubMed

    Zhang, Yu; Chen, Zhimin; An, Wei; Xiao, Shumin; Yuan, Hongying; Zhang, Dongqing; Yang, Min

    2015-04-01

    Membrane bioreactors (MBR) are highly efficient at intercepting particles and microbes and have become an important technology for wastewater reclamation. However, many pathogens can accumulate in activated sludge due to the long residence time usually adopted in MBR, and thus may pose health risks when membrane integrity problems occur. This study presents data from a survey on the occurrence of water-borne Giardia pathogens in reclaimed water from a full-scale wastewater treatment plant with MBR experiencing membrane integrity failure, and assessed the associated risk for green space irrigation. Due to membrane integrity failure, the MBR effluent turbidity varied between 0.23 and 1.90 NTU over a period of eight months. Though this turbidity level still met reclaimed water quality standards (≤5 NTU), Giardia were detected at concentrations of 0.3 to 95 cysts/10 L, with a close correlation between effluent turbidity and Giardia concentration. All β-giardin gene sequences of Giardia in the WWTP influents were genotyped as Assemblages A and B, both of which are known to infect humans. An exponential dose-response model was applied to assess the risk of infection by Giardia. The risk in the MBR effluent with chlorination was 9.83×10(-3), higher than the acceptable annual risk of 1.0×10(-4). This study suggested that membrane integrity is very important for keeping a low pathogen level, and multiple barriers are needed to ensure the biological safety of MBR effluent. Copyright © 2015. Published by Elsevier B.V.

  8. Failures in risk assessment and risk management for cosmetic preservatives in Europe and the impact on public health.

    PubMed

    Schwensen, Jakob F; White, Ian R; Thyssen, Jacob P; Menné, Torkil; Johansen, Jeanne D

    2015-09-01

    In view of the current and unprecedented increase in contact allergy to methylisothiazolinone (MI), we characterized and evaluated two recent epidemics of contact allergy to preservatives used in cosmetic products to address failures in risk assessment and risk management. To evaluate temporal trends of preservative contact allergy. The study population included consecutive patch tested eczema patients seen at a university hospital between 1985 and 2013. A total of 23 138 patients were investigated for a contact allergy. The overall prevalence of contact allergy to at least one preservative increased significantly over the study period, from 6.7% in 1985 to 11.8% in 2013 (p < 0.001). Importantly, the preservatives methyldibromo glutaronitrile and MI rapidly resulted in high sensitization prevalence rates, which reached epidemic proportions. Although the proportion of patients with current clinical disease attributable to methyldibromo glutaronitrile contact allergy decreased significantly following the ban on its use in cosmetic products (p < 0.001), the sudden and high proportion of current sensitization to MI requires immediate attention (p < 0.001). The introduction of new preservatives in Europe with inadequate pre-market risk assessment has rapidly increased the overall burden of cutaneous disease caused by preservatives. We suggest that the cosmetic industry has a responsibility to react faster and replace troublesome preservatives when a preservative contact allergy epidemic is recognized, but the European Commission has the ultimate responsibility for failures in risk management after new, major sensitizing preservatives are introduced onto the market. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. A comprehensive assessment of the association between anemia, clinical covariates and outcomes in a population-wide heart failure registry.

    PubMed

    Jonsson, Asa; Hallberg, Ann-Charlotte; Edner, Magnus; Lund, Lars H; Dahlstrom, Ulf

    2016-05-15

    The aim was to investigate the prevalence of, predictors of, and association with mortality and morbidity of anemia in a large unselected cohort of patients with heart failure (HF) and reduced ejection fraction (HFrEF) and to explore if there were specific subgroups of high risk. In patients with HFrEF in the Swedish Heart Failure Registry, we assessed hemoglobin levels and associations between baseline characteristics and anemia with logistic regression. Using propensity scores for anemia, we assessed the association between anemia and outcomes with Cox regression, and performed interaction and sub-group analyses. There were 24,511 patients with HFrEF (8303 with anemia). Most important independent predictors of anemia were higher age, male gender and renal dysfunction. One-year survival was 75% with anemia vs. 81% without (p < 0.001). In the matched cohort after propensity score the hazard ratio associated with anemia was for all-cause death 1.34 (1.28-1.40; p < 0.0001), CV mortality 1.28 (1.20-1.36; p < 0.0001), and combined CV mortality or HF hospitalization 1.24 (1.18-1.30; p < 0.0001). In interaction analyses, anemia was associated with greater risk with lower age, male gender, EF 30-39%, and NYHA-class I-II. In HFrEF, anemia is associated with higher age, male gender and renal dysfunction and increased risk of mortality and morbidity. The influence of anemia on mortality was significantly greater in younger patients, in men, and in those with more stable HF. The clinical implication of these findings might be in the future to perform targeted treatment studies. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Australia's pesticide environmental risk assessment failure: the case of diuron and sugarcane.

    PubMed

    Holmes, Glen

    2014-11-15

    In November 2012, the Australian Pesticide and Veterinary Medicines Authority (APVMA) concluded a 12 year review of the PSII herbicide diuron. One of the primary concerns raised during the review was the potential impact on aquatic ecosystems, particularly in the catchments draining to the Great Barrier Reef. The environmental risk assessment process used by the APVMA utilised a runoff risk model developed and validated under European farming conditions. However, the farming conditions in the sugarcane regions of the Great Barrier Reef catchments have environmental parameters beyond the currently validated bounds of the model. The use of the model to assess environmental risk in these regions is therefore highly inappropriate, demonstrating the pitfalls of a one size fits all approach.

  11. Novel in vitro and in vivo neural interfaces: normal and accelerated failure assessment.

    PubMed

    Otto, Kevin; Williams, Justin

    2012-01-01

    Neural implantation of devices and the subsequent tissue response are complex and cascading physical and biological phenomena. Creation of reliable neural interfaces remains a significant challenge. Penetrating central nervous system interfaces persist as the most challenging to realize but continue to be the most attractive because of the information bandwidth advantages they provide. This rich information source is essential for achieving next-generation prosthetic control. Specific challenges of penetrating central nervous system interfaces arise because of the reactive tissue response to the initial injury due to device insertion as well as the continued response due to device indwelling. These responses consist of biochemical signaling events, microglial activation, and astrogliotic cell reorganization that result in biophysical changes of the tissue near the implanted device and finally, electrophysiological neural cell/signal loss (Figure 1). The ultimate realization of reliable penetrating neural interfaces will require careful science and engineering approaches incorporating knowledge of relevant and critical biological, physical, and chemical factors, especially their interrelationship. In this article, we describe a comprehensive strategy to assess the reliability of penetrating central neural interfaces based on the biology and pathology of the injury and indwelling tissue responses. Our strategy involves a parallel, self-informing approach by simultaneous development of new in vitro and in vivo assessment techniques as well as using these state-of-the-art techniques to conduct accelerated lifetime assessments of neural interface degradation.

  12. Incorporating cumulative effects into environmental assessments of mariculture: Limitations and failures of current siting methods

    SciTech Connect

    King, Sarah C. Pushchak, Ronald

    2008-11-15

    Assessing and evaluating the cumulative impacts of multiple marine aquaculture facilities has proved difficult in environmental assessment. A retrospective review of 23 existing mariculture farms in southwestern New Brunswick was conducted to determine whether cumulative interactions would have justified site approvals. Based on current scientific evidence of cumulative effects, six new criteria were added to a set of far-field impacts and other existing criteria were expanded to include regional and cumulative environmental impacts in Hargrave's [Hargrave BT. A traffic light decision system for marine finfish aquaculture siting. Ocean Coast Manag 2002; 45:215-35.] Traffic Light Decision Support System (DSS) presently used in Canadian aquaculture environmental assessments. Before mitigation, 19 of the 23 sites failed the amended set of criteria and after considering mitigation, 8 sites failed. Site and ecosystem indices yielded varying site acceptability scores; however, many sites would not have been approved if siting decisions had been made within a regional management framework and cumulative impact criteria were considered in the site evaluation process.

  13. Spectral Determinants on Mandelstam Diagrams

    NASA Astrophysics Data System (ADS)

    Hillairet, Luc; Kalvin, Victor; Kokotov, Alexey

    2016-04-01

    We study the regularized determinant of the Laplacian as a functional on the space of Mandelstam diagrams (noncompact translation surfaces glued from finite and semi-infinite cylinders). A Mandelstam diagram can be considered as a compact Riemann surface equipped with a conformal flat singular metric {|ω|^2}, where {ω} is a meromorphic one-form with simple poles such that all its periods are pure imaginary and all its residues are real. The main result is an explicit formula for the determinant of the Laplacian in terms of the basic objects on the underlying Riemann surface (the prime form, theta-functions, the canonical meromorphic bidifferential) and the divisor of the meromorphic form {ω}. As an important intermediate result we prove a decomposition formula of the type of Burghelea-Friedlander-Kappeler for the determinant of the Laplacian for flat surfaces with cylindrical ends and conical singularities.

  14. Hero's journey in bifurcation diagram

    NASA Astrophysics Data System (ADS)

    Monteiro, L. H. A.; Mustaro, P. N.

    2012-06-01

    The hero's journey is a narrative structure identified by several authors in comparative studies on folklore and mythology. This storytelling template presents the stages of inner metamorphosis undergone by the protagonist after being called to an adventure. In a simplified version, this journey is divided into three acts separated by two crucial moments. Here we propose a discrete-time dynamical system for representing the protagonist's evolution. The suffering along the journey is taken as the control parameter of this system. The bifurcation diagram exhibits stationary, periodic and chaotic behaviors. In this diagram, there are transition from fixed point to chaos and transition from limit cycle to fixed point. We found that the values of the control parameter corresponding to these two transitions are in quantitative agreement with the two critical moments of the three-act hero's journey identified in 10 movies appearing in the list of the 200 worldwide highest-grossing films.

  15. Anatomy of geodesic Witten diagrams

    NASA Astrophysics Data System (ADS)

    Chen, Heng-Yu; Kuo, En-Jui; Kyono, Hideki

    2017-05-01

    We revisit the so-called "Geodesic Witten Diagrams" (GWDs) [1], proposed to be the holographic dual configuration of scalar conformal partial waves, from the perspectives of CFT operator product expansions. To this end, we explicitly consider three point GWDs which are natural building blocks of all possible four point GWDs, discuss their gluing procedure through integration over spectral parameter, and this leads us to a direct identification with the integral representation of CFT conformal partial waves. As a main application of this general construction, we consider the holographic dual of the conformal partial waves for external primary operators with spins. Moreover, we consider the closely related "split representation" for the bulk to bulk spinning propagator, to demonstrate how ordinary scalar Witten diagram with arbitrary spin exchange, can be systematically decomposed into scalar GWDs. We also discuss how to generalize to spinning cases.

  16. Application of the Sequential Organ Failure Assessment Score to predict outcome in critically ill dogs: preliminary results.

    PubMed

    Ripanti, D; Dino, G; Piovano, G; Farca, A

    2012-08-01

    In human medicine the Sequential Organ Failure Assessment (SOFA) score is one of the most commonly organ dysfunction scoring systems used to assess critically ill patients and to predict the outcome in Intensive Care Units (ICUs). It is composed of scores from six organ systems (respiratory, cardiovascular, hepatic, coagulation, renal, and neurological) graded according to the degree of the dysfunction. The aim of the current study was to describe the applicability of the SOFA score in assessing the outcome of critically ill dogs. A total of 45 dogs admitted to the ICU was enrolled. Among these, 40 dogs completed the study: 50 % survived and left the veterinary clinic. The SOFA score was computed for each dog every 24 hours for the first 3 days of ICU stay, starting on the day of admission. A statistically significant correlation between SOFA score and death or survival was found. Most of the dogs showing an increase of the SOFA score in the first 3 days of hospitalization died, whereas the dogs with a decrease of the score survived. These results suggest that the SOFA score system could be considered a useful indicator of prognosis in ICUs hospitalized dogs.

  17. Quantum Dimer Model: Phase Diagrams

    NASA Astrophysics Data System (ADS)

    Goldstein, Garry; Chamon, Claudio; Castelnovo, Claudio

    We present new theoretical analysis of the Quantum Dimer Model. We study dimer models on square, cubic and triangular lattices and we reproduce their phase diagrams (which were previously known only numerically). We show that there are several types of dimer liquids and solids. We present preliminary analysis of several other models including doped dimers and planar spin ice, and some results on the Kagome and hexagonal lattices.

  18. Reliability computation from reliability block diagrams

    NASA Technical Reports Server (NTRS)

    Chelson, P. O.; Eckstein, E. Y.

    1975-01-01

    Computer program computes system reliability for very general class of reliability block diagrams. Four factors are considered in calculating probability of system success: active block redundancy, standby block redundancy, partial redundancy, and presence of equivalent blocks in the diagram.

  19. Scheil-Gulliver Constituent Diagrams

    NASA Astrophysics Data System (ADS)

    Pelton, Arthur D.; Eriksson, Gunnar; Bale, Christopher W.

    2017-06-01

    During solidification of alloys, conditions often approach those of Scheil-Gulliver cooling in which it is assumed that solid phases, once precipitated, remain unchanged. That is, they no longer react with the liquid or with each other. In the case of equilibrium solidification, equilibrium phase diagrams provide a valuable means of visualizing the effects of composition changes upon the final microstructure. In the present study, we propose for the first time the concept of Scheil-Gulliver constituent diagrams which play the same role as that in the case of Scheil-Gulliver cooling. It is shown how these diagrams can be calculated and plotted by the currently available thermodynamic database computing systems that combine Gibbs energy minimization software with large databases of optimized thermodynamic properties of solutions and compounds. Examples calculated using the FactSage system are presented for the Al-Li and Al-Mg-Zn systems, and for the Au-Bi-Sb-Pb system and its binary and ternary subsystems.

  20. Scheil-Gulliver Constituent Diagrams

    NASA Astrophysics Data System (ADS)

    Pelton, Arthur D.; Eriksson, Gunnar; Bale, Christopher W.

    2017-03-01

    During solidification of alloys, conditions often approach those of Scheil-Gulliver cooling in which it is assumed that solid phases, once precipitated, remain unchanged. That is, they no longer react with the liquid or with each other. In the case of equilibrium solidification, equilibrium phase diagrams provide a valuable means of visualizing the effects of composition changes upon the final microstructure. In the present study, we propose for the first time the concept of Scheil-Gulliver constituent diagrams which play the same role as that in the case of Scheil-Gulliver cooling. It is shown how these diagrams can be calculated and plotted by the currently available thermodynamic database computing systems that combine Gibbs energy minimization software with large databases of optimized thermodynamic properties of solutions and compounds. Examples calculated using the FactSage system are presented for the Al-Li and Al-Mg-Zn systems, and for the Au-Bi-Sb-Pb system and its binary and ternary subsystems.

  1. Phase diagram of crushed powders

    NASA Astrophysics Data System (ADS)

    Bodard, Sébastien; Jalbaud, Olivier; Saurel, Richard; Burtschell, Yves; Lapebie, Emmanuel

    2016-12-01

    Compression of monodisperse powder samples in quasistatic conditions is addressed in a pressure range such that particles fragmentation occurs while the solid remains incompressible (typical pressure range of 1-300 MPa for glass powders). For a granular bed made of particles of given size, the existence of three stages is observed during compression and crush up. First, classical compression occurs and the pressure of the granular bed increases along a characteristic curve as the volume decreases. Then, a critical pressure is reached for which fragmentation begins. During the fragmentation process, the granular pressure stays constant in a given volume range. At the end of this second stage, 20%-50% of initial grains are reduced to finer particles, depending on the initial size. Then the compression undergoes the third stage and the pressure increases along another characteristic curve, in the absence of extra fragmentation. The present paper analyses the analogies between the phase transition in liquid-vapour systems and powder compression with crush-up. Fragmentation diagram for a soda lime glass is determined by experimental means. The analogues of the saturation pressure and latent heat of phase change are determined. Two thermodynamic models are then examined to represent the crush-up diagram. The first one uses piecewise functions while the second one is of van der Waals type. Both equations of state relate granular pressure, solid volume fraction, and initial particle diameter. The piecewise functions approach provides reasonable representations of the phase diagram while the van der Waals one fails.

  2. Causal diagrams in systems epidemiology

    PubMed Central

    2012-01-01

    Methods of diagrammatic modelling have been greatly developed in the past two decades. Outside the context of infectious diseases, systematic use of diagrams in epidemiology has been mainly confined to the analysis of a single link: that between a disease outcome and its proximal determinant(s). Transmitted causes ("causes of causes") tend not to be systematically analysed. The infectious disease epidemiology modelling tradition models the human population in its environment, typically with the exposure-health relationship and the determinants of exposure being considered at individual and group/ecological levels, respectively. Some properties of the resulting systems are quite general, and are seen in unrelated contexts such as biochemical pathways. Confining analysis to a single link misses the opportunity to discover such properties. The structure of a causal diagram is derived from knowledge about how the world works, as well as from statistical evidence. A single diagram can be used to characterise a whole research area, not just a single analysis - although this depends on the degree of consistency of the causal relationships between different populations - and can therefore be used to integrate multiple datasets. Additional advantages of system-wide models include: the use of instrumental variables - now emerging as an important technique in epidemiology in the context of mendelian randomisation, but under-used in the exploitation of "natural experiments"; the explicit use of change models, which have advantages with respect to inferring causation; and in the detection and elucidation of feedback. PMID:22429606

  3. Acute renal failure requiring renal replacement therapy in the intensive care unit: impact on prognostic assessment for shared decision making.

    PubMed

    Johnson, Robert F; Gustin, Jillian

    2011-07-01

    A 69-year-old female was receiving renal replacement therapy (RRT) for acute renal failure (ARF) in an intensive care unit (ICU). Consultation was requested from the palliative medicine service to facilitate a shared decision-making process regarding goals of care. Clinician responsibility in shared decision making includes the formulation and expression of a prognostic assessment providing the necessary perspective for a spokesperson to match patient values with treatment options. For this patient, ARF requiring RRT in the ICU was used as a focal point for preparing a prognostic assessment. A prognostic assessment should include the outcomes of most importance to a discussion of goals of care: mortality risk and survivor functional status, in this case including renal recovery. A systematic review of the literature was conducted to document published data regarding these outcomes for adult patients receiving RRT for ARF in the ICU. Forty-one studies met the inclusion criteria. The combined mean values for short-term mortality, long-term mortality, renal-function recovery of short-term survivors, and renal-function recovery of long-term survivors were 51.7%, 68.6%, 82.0%, and 88.4%, respectively. This case example illustrates a process for formulating and expressing a prognostic assessment for an ICU patient requiring RRT for ARF. Data from the literature review provide baseline information that requires adjustment to reflect specific patient circumstances. The nature of the acute primary process, comorbidities, and severity of illness are key modifiers. Finally, the prognostic assessment is expressed during a family meeting using recommended principles of communication.

  4. Transthoracic sensor for noninvasive assessment of left ventricular contractility: validation in a minipig model of chronic heart failure.

    PubMed

    Gemignani, Vincenzo; Bianchini, Elisabetta; Faita, Francesco; Lionetti, Vincenzo; Campan, Manuela; Recchia, Fabio Anastasio; Picano, Eugenio; Bombardini, Tonino

    2010-07-01

    Invasively measured left ventricular (LV) dP/dt is the accepted standard for measuring acute and chronic directional changes in LV contractility. Recently, we developed a noninvasive force sensor based on an accelerometer positioned on the chest, which measures the vibrations generated by isovolumic myocardial contraction. The aim of this paper was to compare noninvasive (accelerometer) versus invasive (LV dP/dt) indices of myocardial contractility in a chronic minipig model of pacing-induced heart failure (HF). Comparative assessment was performed both at rest and following dobutamine infusion. In adult male minipigs (n = 6), LV contractility was simultaneously assessed both invasively (LV dP/dt, Millar catheter) and noninvasively (accelerometer) at rest and following dobutamine (up to 7.5 mcg/kg/min), both before and after development of HF by pacing the LV at 180 beats/min for 3 weeks. Invasive and noninvasive assessments were obtained in 24 conditions (12 at rest and 12 after dobutamine infusion). Sensor-based cardiac force changes were significantly related to positive peak LV dP/dt(max) changes following dobutamine infusion both in normal (r = 0.88, P < 0.001) and failing heart (r = 0.89, P < 0.001). The force-frequency relation showed a tight correlation between invasive and noninvasive assessment (r = 0.68, P = 0.02). The force-frequency relation can be assessed noninvasively by a transthoracic sensor based on an accelerometer. The method can efficiently detect the development of resting dysfunction and the contractile reserve at different HF steps, with potential for wearable HF monitoring.

  5. Probabilistic assessment of grass cover failure due to wave overtopping in dikes with roads

    NASA Astrophysics Data System (ADS)

    Aguilar-López, Juan Pablo; Bomers, Anouk; Warmink, Jord; Schielen, Ralph; Hulscher, Suzanne

    2017-04-01

    The present study aimed to include the turbulence effects derived from a road located over the crest of a dike, in its probabilistic safety assessment. This was done by building two different computation fluid dynamics models (RANS K-); one of a dike with a road on top and one without it. Both models were validated with experimental data collected from the Wave overtopping simulator experiments performed in the Netherlands. These models were used to produce training data sets which were later used for constructing emulators (computationally cheaper models) which allowed to reduce the computational burden from the required stochastic modelling. These new emulators allowed to calculate bottom shear stress time series in different locations along the dike profile. With these time series, it is possible to estimate the potential scouring depth per wave volume routed. These emulators allowed to model different probabilistic overtopping scenarios without running the CFD models again. The results showed that when assessed under extreme climate scenarios, the presence of a road may reduce the dike safety by almost 50% with respect to the case where no road is present. In addition, it is also concluded that the spatial grass quality distribution is a more important factor for determining dike safety than the spatial grass cover thickness.

  6. Arrows in Comprehending and Producing Mechanical Diagrams

    ERIC Educational Resources Information Center

    Heiser, Julie; Tversky, Barbara

    2006-01-01

    Mechanical systems have structural organizations--parts, and their relations--and functional organizations--temporal, dynamic, and causal processes--which can be explained using text or diagrams. Two experiments illustrate the role of arrows in diagrams of mechanical systems. In Experiment 1, people described diagrams with or without arrows,…

  7. Differential Effectiveness of Two Science Diagram Types.

    ERIC Educational Resources Information Center

    Holliday, William G.

    Reported is an Aptitude Treatment Instruction (ATI) Study designed to evaluate the aptitude of verbal comprehension in terms of two unitary complex science diagram types: a single complex block word diagram and a single complex picture word diagram.. ATI theory and research indicate that different effective instructional treatments tend to help…

  8. Additional predictive value of nutritional status in the prognostic assessment of heart failure patients.

    PubMed

    La Rovere, M T; Maestri, R; Olmetti, F; Paganini, V; Riccardi, G; Riccardi, R; Pinna, G D; Traversi, E

    2017-03-01

    Nutritional status (NS) is not routinely assessed in HF. We sought to evaluate whether NS may be additive to a comprehensive pre-discharge evaluation based on a clinical score that includes BMI (MAGGIC) and on an index of functional capacity (six minute walking test, 6mWT) in HF patients. The CONUT (Controlling Nutritional Status) score (including serum albumin level, total cholesterol and lymphocyte count) was computed in 466 consecutive patients (mean age 61 ± 11 years, NYHA class 2.6 ± 0.6, LVEF 34 ± 11%, BMI 27.2 ± 4.5) who had pre-discharge MAGGIC and 6MWT. The endpoint was all-cause mortality. Mild or moderate undernourishment was present in 54% of patients with no differences across BMI strata. The 12-month event rate was 7.7%. Deceased patients had a more compromised NS (CONUT 2.8 ± 1.5 vs 1.7 ± 1.3, p < 0.0001), and a more advanced HF (MAGGIC 28.2 ± 6.0 vs 22.0 ± 6.6, p < 0.0001; 6MWT 311.1 ± 102.2 vs. 408.9 ± 95.9 m, p < 0.0001). The 12-month mortality rate varied from 4% for well-nourished to 11% for undernourished patients (p = 0.008). At univariate analysis, the CONUT was predictive for all-cause mortality with a Hazard Ratio of 1.701 [95% CI 1.363-2.122], p < 0.0001. Multivariable analysis showed that the CONUT significantly added to the combination of MAGGIC and 6MWT and improved predictive discrimination and risk classification (c-index 0.82 [95% CI 0.75-0.88], integrated discrimination improvement 0.028 [95% CI 0.015-0.081]). In HF patients assessment of NS, significantly improves prediction of 12-month mortality on top of the information provided by clinical evaluation and functional capacity and should be incorporated in the overall assessment of HF patients. Copyright © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B

  9. Risk assessment of component failure modes and human errors using a new FMECA approach: application in the safety analysis of HDR brachytherapy.

    PubMed

    Giardina, M; Castiglia, F; Tomarchio, E

    2014-12-01

    Failure mode, effects and criticality analysis (FMECA) is a safety technique extensively used in many different industrial fields to identify and prevent potential failures. In the application of traditional FMECA, the risk priority number (RPN) is determined to rank the failure modes; however, the method has been criticised for having several weaknesses. Moreover, it is unable to adequately deal with human errors or negligence. In this paper, a new versatile fuzzy rule-based assessment model is proposed to evaluate the RPN index to rank both component failure and human error. The proposed methodology is applied to potential radiological over-exposure of patients during high-dose-rate brachytherapy treatments. The critical analysis of the results can provide recommendations and suggestions regarding safety provisions for the equipment and procedures required to reduce the occurrence of accidental events.

  10. An assessment of the state of the art in predicting the failure of ceramics: Final report

    SciTech Connect

    Boulet, J.A.M.

    1988-03-01

    The greatest weakness in existing design strategies for brittle fracture is in the narrow range of conditions for which the strategies are adequate. The primary reason for this weakness is the use of simplistic mechanical models of fracture processes and unverified statistical models of materials. To improve the design methodology, the models must first be improved. Specifically recommended research goals are: to develop models of cracks with realistic geometry under arbitrary stress states; to identify and model the most important relationships between fracture processes and microstructural features; to assess the technology available for acquiring statistical data on microstructure and flaw populations, and to establish the amount of data required for verification of statistical models; and to establish a computer-based fracture simulation that can incorporate a wide variety of mechanical and statistical models and crack geometries, as well as arbitrary stress states. 204 refs., 2 tabs.

  11. Telomere Length Assessment for Prediction of Organ Transplantation Outcome. Future or Failure: A Review of the Literature

    PubMed Central

    Kłoda, Karolina; Domański, Leszek; Mierzecki, Artur

    2017-01-01

    Telomeres are located at each end of eukaryotic chromosomes. Their functional role is genomic stability maintenance. The protective role of telomeres depends on various factors, including number of nucleotides repeats, telomere-binding proteins, and telomerase activity. Organ transplantation is the preferred replacement therapy in the case of chronic kidney disease and the only possibility of sustaining recipients’ life in the case of advanced liver failure. While the prevalence of acute rejection is constantly decreasing, prevention of transplanted organ long-term function loss is still challenging. It has been demonstrated that post-transplant stressors accelerate aging of the allografts manifested through telomere shortening. The aim of this paper was to evaluate the importance of telomere length assessment for prediction of organ transplantation outcome. Literature review included the 10 most important studies regarding linkage between allograft function and telomere erosion, including 2 of our own reports. Telomere length assessment is useful to predict organ transplantation outcome. The importance of telomere length as a prediction marker depends on the analyzed material. To obtain reliable results, both graft cells (donor material) and lymphocytes (recipient material) should be examined. In the case of kidney transplantation, assessment of telomere length in the early post-transplant period allows prediction of the long-term function of the transplanted organ. To increase the accuracy of transplantation outcome prediction, telomere length assessment should be combined with evaluation of other aging biomarkers, like CDKN2A (p16). Large-scale clinical studies regarding telomere length measurement, including genome wide association analysis introducing relevant genetic factors, are needed for the future. PMID:28076340

  12. Mapping basin-wide subaquatic slope failure susceptibility as a tool to assess regional seismic and tsunami hazards

    NASA Astrophysics Data System (ADS)

    Strasser, Michael; Hilbe, Michael; Anselmetti, Flavio S.

    2010-05-01

    occurred. Comparison of reconstructed critical stability conditions with the known distribution of landslide deposits reveals minimum and maximum threshold conditions for slopes that failed or remained stable, respectively. The resulting correlations reveal good agreements and suggest that the slope stability model generally succeeds in reproducing past events. The basin-wide mapping of subaquatic slope failure susceptibility through time thus can also be considered as a promising paleoseismologic tool that allows quantification of past earthquake ground shaking intensities. Furthermore, it can be used to assess the present-day slope failure susceptibility allowing for identification of location and estimation of size of future, potentially tsunamigenic subaquatic landslides. The new approach presented in our comprehensive lake study and resulting conceptual ideas can be vital to improve our understanding of larger marine slope instabilities and related seismic and oceanic geohazards along formerly glaciated ocean margins and closed basins worldwide.

  13. Diagram, a Learning Environment for Initiation to Object-Oriented Modeling with UML Class Diagrams

    ERIC Educational Resources Information Center

    Py, Dominique; Auxepaules, Ludovic; Alonso, Mathilde

    2013-01-01

    This paper presents Diagram, a learning environment for object-oriented modelling (OOM) with UML class diagrams. Diagram an open environment, in which the teacher can add new exercises without constraints on the vocabulary or the size of the diagram. The interface includes methodological help, encourages self-correcting and self-monitoring, and…

  14. Diagram, a Learning Environment for Initiation to Object-Oriented Modeling with UML Class Diagrams

    ERIC Educational Resources Information Center

    Py, Dominique; Auxepaules, Ludovic; Alonso, Mathilde

    2013-01-01

    This paper presents Diagram, a learning environment for object-oriented modelling (OOM) with UML class diagrams. Diagram an open environment, in which the teacher can add new exercises without constraints on the vocabulary or the size of the diagram. The interface includes methodological help, encourages self-correcting and self-monitoring, and…

  15. Prognostic value of pulmonary congestion assessed by lung ultrasound imaging during heart failure hospitalisation: A two-centre cohort study

    PubMed Central

    Coiro, Stefano; Porot, Guillaume; Rossignol, Patrick; Ambrosio, Giuseppe; Carluccio, Erberto; Tritto, Isabella; Huttin, Olivier; Lemoine, Simon; Sadoul, Nicolas; Donal, Erwan; Zannad, Faiez; Girerd, Nicolas

    2016-01-01

    Pulmonary congestion assessed at discharge by lung ultrasonography predicts poor prognosis in heart failure (HF) patients. We investigated the association of B-lines with indices of hemodynamic congestion [BNP, E/e’, pulmonary systolic arterial pressure (PAPs)] in HF patients, and their prognostic value overall and according to concomitant atrial fibrillation (AF), reduced (≤40%) ejection fraction (EF), and timing of quantification during hospitalisation for heart failure (HHF). In 110 HHF patients, B-lines were highly discriminative of BNP >400 pg/ml (AUC ≥ 0.80 for all), and moderately discriminative of PAPs >50 mmHg (AUC = 0.68, 0.56 to 0.80); conversely, B-lines poorly discriminated average E/e’ ≥ 15, except at discharge. B-line count significantly predicted mid-term recurrent HHF or death (overall and in subgroups), regardless of AF status, EF, and timing of quantification during HHF (all p for interaction >0.10). regardless, B-lines ≥30 at discharge were most predictive of outcome (HR = 7.11, 2.06–24.48; p = 0.002) while B-lines ≥45 early during HHF were most predictive of outcome (HR = 9.20, 1.82–46.61; p = 0.007). Lung ultrasound was able to identify patients with high BNP levels, but not with increased E/e’, also showing a prognostic role regardless of AF status, EF or timing of quantification; best B-line cut-off appears to vary according to the timing of quantification during hospitalization. PMID:27995971

  16. Bootstrapping & Separable Monte Carlo Simulation Methods Tailored for Efficient Assessment of Probability of Failure of Dynamic Systems

    NASA Astrophysics Data System (ADS)

    Jehan, Musarrat

    The response of a dynamic system is random. There is randomness in both the applied loads and the strength of the system. Therefore, to account for the uncertainty, the safety of the system must be quantified using its probability of survival (reliability). Monte Carlo Simulation (MCS) is a widely used method for probabilistic analysis because of its robustness. However, a challenge in reliability assessment using MCS is that the high computational cost limits the accuracy of MCS. Haftka et al. [2010] developed an improved sampling technique for reliability assessment called separable Monte Carlo (SMC) that can significantly increase the accuracy of estimation without increasing the cost of sampling. However, this method was applied to time-invariant problems involving two random variables only. This dissertation extends SMC to random vibration problems with multiple random variables. This research also develops a novel method for estimation of the standard deviation of the probability of failure of a structure under static or random vibration. The method is demonstrated on quarter car models and a wind turbine. The proposed method is validated using repeated standard MCS.

  17. A new Doppler method of assessing left ventricular ejection force in chronic congestive heart failure.

    PubMed

    Isaaz, K; Ethevenot, G; Admant, P; Brembilla, B; Pernot, C

    1989-07-01

    A noninvasive method using Doppler echocardiography was developed to determine the force exerted by the left ventricle in accelerating the blood into the aorta. The value of this new Doppler ejection index in the assessment of left ventricular (LV) performance was tested in 36 patients with chronic congestive heart disease undergoing cardiac catheterization and in 11 age-matched normal control subjects. The 36 patients were subgrouped into 3 groups based on angiographic ejection fraction (LV ejection fraction greater than 60, 41 to 60 and less than or equal to 40%). According to Newton's second law of motion (force = mass X acceleration), the LV ejection force was derived from the product of the mass of blood ejected during the acceleration time with the mean acceleration undergone during that time. In patients with LV ejection fraction less than or equal to 40%, LV ejection force, peak aortic velocity and mean acceleration were severely depressed when compared with the other groups (p less than 0.001). In patients with LV ejection fraction of 41 to 60%, LV ejection force was significantly reduced (22 +/- 3 kdynes) when compared with normal subjects (29 +/- 5 kdynes, p = 0.002) and with patients with LV ejection fraction greater than 60% (29 +/- 7 kdynes, p = 0.009); peak velocity and mean acceleration did not differ between these 3 groups. The LV ejection force showed a good linear correlation with LV ejection fraction (r = 0.86) and a better power fit (r = 0.91). Peak aortic blood velocity and mean acceleration showed less good linear correlations with LV ejection fraction (r = 0.73 and r = 0.66, respectively). The mass of blood ejected during the acceleration time also showed a weak linear correlation with LV ejection fraction (r = 0.64). An LV ejection force less than 20 kdynes was associated with a depressed LV performance (LV ejection fraction less than 50%) with 91% sensitivity and 90% specificity. Thus, these findings suggest that LV ejection force is a new

  18. Assessment of formulation robustness for nano-crystalline suspensions using failure mode analysis or derisking approach.

    PubMed

    Nakach, Mostafa; Authelin, Jean-René; Voignier, Cecile; Tadros, Tharwat; Galet, Laurence; Chamayou, Alain

    2016-06-15

    The small particle size of nano-crystalline suspensions can be responsible for their physical instability during drug product preparation (downstream processing), storage and administration. For that purpose, the commercial formulation needs to be sufficiently robust to various triggering conditions, such as ionic strength, shear rate, wetting/dispersing agent desorption by dilution, temperature and pH variation. In our previous work we described a systematic approach to select the suitable wetting/dispersant agent for the stabilization of nano-crystalline suspension. In this paper, we described the assessment of the formulation robustness (stabilized using a mixture of sodium dodecyl sulfate (SDS) and polyvinylpyrrolidone (PVP) and) by measuring the rate of perikinetic (diffusion-controlled) and orthokinetic (shear-induced) aggregation as a function of ionic strength, temperature, pH and dilution. The results showed that, using the SDS/PVP system, the critical coagulation concentration is about five times higher than that observed in the literature for suspension colloidaly stable at high concentration. The nano-suspension was also found to be very stable at ambient temperature and at different pH conditions. Desorption test confirmed the high affinity between API and wetting/dispersing agent. However, the suspension undergoes aggregation at high temperature due to the desorption of the wetting/dispersing agent and disaggregation of SDS micelles. Furthermore, aggregation occurs at very high shear rate (orhokinetic aggregation) by overcoming the energy barrier responsible for colloidal stability of the system.

  19. Reliability analysis based on the losses from failures.

    PubMed

    Todinov, M T

    2006-04-01

    The conventional reliability analysis is based on the premise that increasing the reliability of a system will decrease the losses from failures. On the basis of counterexamples, it is demonstrated that this is valid only if all failures are associated with the same losses. In case of failures associated with different losses, a system with larger reliability is not necessarily characterized by smaller losses from failures. Consequently, a theoretical framework and models are proposed for a reliability analysis, linking reliability and the losses from failures. Equations related to the distributions of the potential losses from failure have been derived. It is argued that the classical risk equation only estimates the average value of the potential losses from failure and does not provide insight into the variability associated with the potential losses. Equations have also been derived for determining the potential and the expected losses from failures for nonrepairable and repairable systems with components arranged in series, with arbitrary life distributions. The equations are also valid for systems/components with multiple mutually exclusive failure modes. The expected losses given failure is a linear combination of the expected losses from failure associated with the separate failure modes scaled by the conditional probabilities with which the failure modes initiate failure. On this basis, an efficient method for simplifying complex reliability block diagrams has been developed. Branches of components arranged in series whose failures are mutually exclusive can be reduced to single components with equivalent hazard rate, downtime, and expected costs associated with intervention and repair. A model for estimating the expected losses from early-life failures has also been developed. For a specified time interval, the expected losses from early-life failures are a sum of the products of the expected number of failures in the specified time intervals covering the

  20. Assessment of the factors affecting the failure to use inhaler devices before and after training.

    PubMed

    Aydemir, Yusuf

    2015-04-01

    Inhaler devices used for the treatment of chronic respiratory diseases are frequently incorrectly used by the patients. The effects of training on the correct use of these devices are unquestionable. However, despite the training provided on the correct technique of using the inhaler device, some patients still continue using the device incorrectly. The aims of the present study are to determine the rate of incorrect use of the inhaler devices, assess the parameters that affect the incorrect use, demonstrate the contribution of training, and determine the characteristics of the patients who use the devices incorrectly despite training. 342 consecutive patients were included in the study. The patients' ability to use the devices correctly was scored before and after face-to-face trainings. The parameters affecting incorrect use, the impact of training, and characteristics of the patients who continued the incorrect usage after training were evaluated. The rate of correct usage was 58.9% for dry powder inhalers (DPI) and 31.1% for pressurized metered dose inhalers (pMDI) before the training. The parameters affecting correct usage were educational status, gender, living in rural areas, duration of disease, and being diagnosed and followed-up by a chest diseases specialist. The rate of correct usage increased to 92.6% for DPI and 45.2% for pMDI after the training. The factors affecting continued incorrect usage after standard training were old age and the type of the pMDI device. The technique for using the inhaler device should be described to the patients in a face-to-face session by the prescribing physician. Device selection should be done on a "trial" basis and it should be considered that particularly older patients and those using pMDIs continue using the devices incorrectly despite training; hence, alternative treatment options should be reviewed for these patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Using Photographs and Diagrams to Test Young Children's Mass Thinking

    ERIC Educational Resources Information Center

    Cheeseman, Jill; McDonough, Andrea

    2013-01-01

    This paper reports the results of a pencil-and-paper test developed to assess young children's understanding of mass measurement. The innovative element of the test was its use of photographs. We found many children of the 295 6-8 year-old children tested could "read" the photographs and diagrams and recognise the images as…

  2. Maternal Obesity Class as a Predictor of Induction Failure: A Practical Risk Assessment Tool.

    PubMed

    Ronzoni, Stefania; Rosen, Hadar; Melamed, Nir; Porat, Shay; Farine, Dan; Maxwell, Cynthia

    2015-12-01

    To assess the impact of body mass index (BMI) on the rate of cesarean section (rCS) in induction of labor (IOL). A total of 7,543 singleton term pregnancies undergoing IOL (cervical dilatation at admission, CDA ≤ 3 cm) were divided according to BMI: underweight (n = 325); normal weight (NW) (n = 4,633); overweight (OW) (n = 1,610); and obese (n = 975). Age, parity, macrosomia, gestational age (GA), gestational weight gain (GWG), CDA, and IOL indications were considered. A higher rate of macrosomia (15.0 vs. 11.1%; p < 0.0001), earlier induction (GA 39.7 ± 1.3 vs. 40.1 ± 1.3 weeks; p < 0.0001) for maternal indications (39.1 vs. 21.1%; p < 0.001), and lower CDA (≤1cm; 66.4 vs. 61.4%; p < 0.005) were observed in obese versus NW. The rate of weight gain above the recommended range was higher in obese (obese 70.6% vs. NW 43.9%; p < 0.001), despite a significantly lower mean GWG compared with NW (14 ± 7.5 vs. 16.5 ± 5.6 kg; p < 0.001). Compared with NW, OW and obese demonstrated a significantly higher rCS (OW 31.1% and obese 36.9% vs. NW 24.7%; p < 0.001). BMI represented an independent factor affecting the rCS (vs. NW; OW odds ratio [OR] 1.4; confidence interval [CI] 1.2-1.7; p < 0.001; obese OR 2.3; CI 1.9-2.7 p < 0.001). In the case of IOL, obesity represents an independent factor associated with a significant increase of CS to be considered during induction counselling. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  3. Phase diagrams of polyelectrolyte solutions

    NASA Astrophysics Data System (ADS)

    Mahdi, Khaled A.

    We study the phase diagram of polyelectrolyte solutions in salt and salt-free environments. We examine the phase behavior of polyelectrolyte solutions, in the semidilute regime, using different physical models, namely the Random Phase Approximation (RPA) and the cross-linked model. In the RPA, we calculate the electrostatic free energy by summing all the fluctuations of the chains and all present ionic species. Within this approximation, the phase diagrams of salt-free polyelectrolyte solutions show phase separation even without including short-range attractions or ion condensation. We find that the phase behavior of large chains resembles the phase diagram of polymer network solutions. That is, the equilibrium is established between a network phase and a chain-free phase. Upon the addition of salt, the dissociated ions increase the entropy of the system and overcome the energy from the electrostatic fluctuations. When the short-range attraction between monomers is included in the model, the free energy predicts phase segregation for all salt valences at high salt concentrations (1 mol/l and higher). The phenomenon is called salting-out and occurs simply because the addition of salt reduces the quality of the solvent and induces precipitation. However, phase segregation in the presence of multivalent ions in polyelectrolyte solutions occurs at low salt concentrations (less than 1 mol/l). We propose that this phase separation is due to polyions cross-linked by multivalent ions. We constructed a phenomenological two-state model to examine this phenomenon. The two phases coexisting in the solution are a network-like phase and a polymer-free phase. The polymer-free phase is modeled using Debye-Huckel theory. In the cross-linked phase, each condensed multivalent ion attracts an equal number of monomers creating a neutral cluster. The energy of the cluster is evaluated by a simple Coulombic energy. The bare monomer charges between the linkages are treated as line of

  4. Voronoi Diagrams Without Bounding Boxes

    NASA Astrophysics Data System (ADS)

    Sang, E. T. K.

    2015-10-01

    We present a technique for presenting geographic data in Voronoi diagrams without having to specify a bounding box. The method restricts Voronoi cells to points within a user-defined distance of the data points. The mathematical foundation of the approach is presented as well. The cell clipping method is particularly useful for presenting geographic data that is spread in an irregular way over a map, as for example the Dutch dialect data displayed in Figure 2. The automatic generation of reasonable cell boundaries also makes redundant a frequently used solution to this problem that requires data owners to specify region boundaries, as in Goebl (2010) and Nerbonne et al (2011).

  5. Ultrasound Assessment of Kidney Volume in Patients with Acute Decompensated Heart Failure: A Predictor of Diuretic Resistance.

    PubMed

    Sugihara, Shinobu; Kinugasa, Yoshiharu; Takata, Tomoaki; Sugihara, Takaaki; Hosho, Keiko; Imai, Chitose; Ito, Hiromi; Yamada, Kensaku; Kato, Masahiko; Yamamoto, Kazuhiro

    2017-09-01

    Diuretics are essential for treating acute decompensated heart failure (ADHF), but the response is inconsistent. This study aimed to clarify whether kidney volume as assessed by ultrasound (US) predicts diuretic resistance in patients with ADHF. We enrolled 29 patients with ADHF and 32 controls. Height-adjusted kidney volume was assessed by US. We divided patients into two groups based on the median value of total daily use of furosemide (intravenous dose plus 0.5 × oral dose of furosemide equivalents) during 3 days from admission. Patients with ADHF had a significantly smaller left kidney volume than did control subjects (27.7 ± 10.0 vs. 32.8 ± 8.8 mL/m, P < 0.05). Patients in the high-dose furosemide group (≥ 51.7 mg/d) had a significantly lower estimated glomerular filtration rate (eGFR) and a significantly smaller kidney volume than did those in the low-dose furosemide group (eGFR: 43.9 ± 20.4 vs. 60.8 ± 21.6 mL/min/1.73 m(2), left kidney volume: 23.2 ± 5.2 vs. 32.6 ± 11.0 mL/m, right kidney volume: 26.5 ± 7.5 vs. 32.6 ± 7.9 mL/m, all P < 0.05). Multivariate logistic analysis showed that left kidney volume, but not eGFR, was independently associated with the requirement of high-dose furosemide (odds ratio: 0.856, 95% confidence interval: 0.735-0.997, P < 0.05). Kidney volume as assessed by US is a useful predictor of diuretic resistance in patients with ADHF.

  6. Preoperative three-dimensional echocardiography to assess risk of right ventricular failure after left ventricular assist device surgery.

    PubMed

    Kiernan, Michael S; French, Amy L; DeNofrio, David; Parmar, Yuvrajsinh J; Pham, Duc Thinh; Kapur, Navin K; Pandian, Natesa G; Patel, Ayan R

    2015-03-01

    Right ventricular failure (RVF) is associated with significant morbidity after left ventricular assist device (LVAD) surgery. Hemodynamic, clinical, and 2-dimensional echocardiographic variables poorly discriminate patients at risk of RVF. We examined the utility of 3-dimensional echocardiography (3DE) right ventricular (RV) volumetric assessment to identify patients at risk for RVF. RVF was defined as the need for inotropic infusion for >14 days after LVAD surgery or the need for biventricular assist device support. Preoperative RV volumes and ejection fraction (EF) were measured, blinded to clinical data, from transthoracic 3DE full volume data sets in 26 patients. Baseline variables and 3DE RV indices were compared between patients with and without RVF. Twenty-four patients received continuous-flow LVADs, and 2 required biventricular support devices. Ten patients required prolonged inotropes after LVAD placement. Baseline characteristics associated with RVF included higher right atrial pressure, higher right atrial pressure to pulmonary capillary wedge pressure ratio, and lower cardiac index and RV stroke work index (RVSWI). Echocardiographic indices associated with RVF included 3DE indexed RV end-diastolic and end-systolic volumes (RVEDVI and RVESVI) and RV ejection fraction (RVEF). The relationship between 3DE quantification of RV volumes and the development of RVF was independent from RVSWI: RVEDVI: odds ratio (OR) 1.16, 95% confidence interval (CI) 1.00-1.33 (P = .04); RVESVI: OR 1.14, 95% CI 1.01-1.28 (P = .03). Quantitative 3DE is a promising method for pre-LVAD RV assessment. RV volumes assessed by 3DE are predictive of RVF in LVAD recipients independently from hemodynamic correlates of RV function. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Managing family problems in advanced disease--a flow diagram.

    PubMed

    Smith, N; Regnard, C

    1993-01-01

    The interaction between patient, family and professional team can sometimes make difficult situations worse rather than better. This flow diagram attempts to clarify the process by which a professional assesses situations and suggests ways in which people can gain understanding about their difficulties. Once everyone has a greater understanding of what is or is not happening, the diagram points to ways in which professionals can use questions to help patient and family create a solution that is workable both for them and for the professionals.

  8. Serial Daily Organ Failure Assessment Beyond ICU Day 5 Does Not Independently Add Precision to ICU Risk-of-Death Prediction.

    PubMed

    Holder, Andre L; Overton, Elizabeth; Lyu, Peter; Kempker, Jordan A; Nemati, Shamim; Razmi, Fereshteh; Martin, Greg S; Buchman, Timothy G; Murphy, David J

    2017-09-12

    To identify circumstances in which repeated measures of organ failure would improve mortality prediction in ICU patients. Retrospective cohort study, with external validation in a deidentified ICU database. Eleven ICUs in three university hospitals within an academic healthcare system in 2014. Adults (18 yr old or older) who satisfied the following criteria: 1) two of four systemic inflammatory response syndrome criteria plus an ordered blood culture, all within 24 hours of hospital admission; and 2) ICU admission for at least 2 calendar days, within 72 hours of emergency department presentation. None MEASUREMENTS AND MAIN RESULTS:: Data were collected until death, ICU discharge, or the seventh ICU day, whichever came first. The highest Sequential Organ Failure Assessment score from the ICU admission day (ICU day 1) was included in a multivariable model controlling for other covariates. The worst Sequential Organ Failure Assessment scores from the first 7 days after ICU admission were incrementally added and retained if they obtained statistical significance (p < 0.05). The cohort was divided into seven subcohorts to facilitate statistical comparison using the integrated discriminatory index. Of the 1,290 derivation cohort patients, 83 patients (6.4%) died in the ICU, compared with 949 of the 8,441 patients (11.2%) in the validation cohort. Incremental addition of Sequential Organ Failure Assessment data up to ICU day 5 improved the integrated discriminatory index in the validation cohort. Adding ICU day 6 or 7 Sequential Organ Failure Assessment data did not further improve model performance. Serial organ failure data improve prediction of ICU mortality, but a point exists after which further data no longer improve ICU mortality prediction of early sepsis.

  9. The NaNO3-KNO3 phase diagram

    NASA Astrophysics Data System (ADS)

    Benages-Vilau, R.; Calvet, T.; Cuevas-Diarte, M. A.; Oonk, H. A. J.

    2016-01-01

    Many papers have been published in relation to the NaNO3-KNO3 phase diagram determination in the last 160 years. These papers fall in two categories: (1) the solid-liquid equilibrium is assumed to be of the eutectic type, and (2) the solid-liquid equilibrium is considered as a loop with a minimum. The discordance between the two views is related to the slow transition kinetics that complicate the assessment of thermal 'fluctuations', and also to the appearance of a metastable form of potassium nitrate. The main result of this paper is the experimental phase diagram constructed with new experimental data so that we can assure that the second option is correct. This phase diagram is defined by a eutectoid invariant, an asymmetric immiscibility gap and a continuous solid solution with a minimum of melting point. Additionally, the ABθ model simulates correctly the experimental piece of evidence.

  10. 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

    ... documents remitted to MMS for an Indian tribe or allottee. If the payment is made by EFT, the reporter/payor... 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...

  11. Phase diagrams for sonoluminescing bubbles

    NASA Astrophysics Data System (ADS)

    Hilgenfeldt, Sascha; Lohse, Detlef; Brenner, Michael P.

    1996-11-01

    Sound driven gas bubbles in water can emit light pulses. This phenomenon is called sonoluminescence (SL). Two different phases of single bubble SL have been proposed: diffusively stable and diffusively unstable SL. We present phase diagrams in the gas concentration versus forcing pressure state space and also in the ambient radius versus gas concentration and versus forcing pressure state spaces. These phase diagrams are based on the thresholds for energy focusing in the bubble and two kinds of instabilities, namely (i) shape instabilities and (ii) diffusive instabilities. Stable SL only occurs in a tiny parameter window of large forcing pressure amplitude Pa˜1.2-1.5 atm and low gas concentration of less than 0.4% of the saturation. The upper concentration threshold becomes smaller with increased forcing. Our results quantitatively agree with experimental results of Putterman's UCLA group on argon, but not on air. However, air bubbles and other gas mixtures can also successfully be treated in this approach if in addition (iii) chemical instabilities are considered. All statements are based on the Rayleigh-Plesset ODE approximation of the bubble dynamics, extended in an adiabatic approximation to include mass diffusion effects. This approximation is the only way to explore considerable portions of parameter space, as solving the full PDEs is numerically too expensive. Therefore, we checked the adiabatic approximation by comparison with the full numerical solution of the advection diffusion PDE and find good agreement.

  12. Asteroseismology Across the HR Diagram

    NASA Astrophysics Data System (ADS)

    Thompson, M. J.; Cunha, M. S.; Monteiro, M. J. P. F. G.

    2003-05-01

    Ground-based observations have detected solar-like oscillations on Sun-like stars, and diagnostics similar to those used in helioseismology are now being used to test and constrain the physics and evolutionary state of these stars. Multi-mode oscillations are being observed in an abundance of other stars, including slowly pulsating B stars (SPB stars), delta-Scuti stars, Ap stars and the pulsating white dwarfs. New classes of pulsators continue to be discovered across the Herzsprung-Russell diagram. Yet the chances still to be faced to make asteroseismology across the HR diagram a reality are formidable. Observation, data analysis and theory all pose hard problems to be overcome. This book, reflecting the goal of the meeting, aims to facilitate a cross-fertilisation of ideas and approaches between fields covering different pulsators and with different areas of expertise. The book successfully covers most known types of pulsators, reflecting a highly productive and far reaching interchange of ideas which we believe is conveyed by the papers and posters published, making it a reference for researchers and postgraduate students working on stellar structure and evolution. Link: http://www.wkap.nl/prod/b/1-4020-1173-3

  13. Phase Diagrams of Nuclear Pasta

    NASA Astrophysics Data System (ADS)

    Caplan, Matthew; Horowitz, Chuck; Berry, Don; da Silva Schneider, Andre

    2016-03-01

    In the inner crust of neutrons stars, where matter is near the saturation density, protons and neutrons arrange themselves into complex structures called nuclear pasta. Early theoretical work predicted a simple graduated hierarchy of pasta phases, consisting of spheres, cylinders, slabs, and uniform matter with voids. Previous work has simulated these phases with a simple classical model and has shown that the formation of these structures is dependent on the temperature, density, and proton fraction. However, previous work only studied a limited range of these parameters due to computational limitations. Thanks to recent advances in computing it is now possible to survey the structure of nuclear pasta for a larger range of parameters. By simulating nuclear pasta with constant temperature and proton fraction in an expanding simulation volume we are able to study the phase transitions in nuclear pasta, and thus produce a set of phase diagrams. We report on these phase diagrams as well as newly identified phases of nuclear pasta and discuss their implications for neutron star observables.

  14. The Importance of Design in Learning from Node-Link Diagrams

    ERIC Educational Resources Information Center

    van Amelsvoort, Marije; van der Meij, Jan; Anjewierden, Anjo; van der Meij, Hans

    2013-01-01

    Diagrams organize by location. They give spatial cues for finding and recognizing information and for making inferences. In education, diagrams are often used to help students understand and recall information. This study assessed the influence of perceptual cues on reading behavior and subsequent retention. Eighty-two participants were assigned…

  15. The Importance of Design in Learning from Node-Link Diagrams

    ERIC Educational Resources Information Center

    van Amelsvoort, Marije; van der Meij, Jan; Anjewierden, Anjo; van der Meij, Hans

    2013-01-01

    Diagrams organize by location. They give spatial cues for finding and recognizing information and for making inferences. In education, diagrams are often used to help students understand and recall information. This study assessed the influence of perceptual cues on reading behavior and subsequent retention. Eighty-two participants were assigned…

  16. Generalized discriminant analysis for congestive heart failure risk assessment based on long-term heart rate variability.

    PubMed

    Shahbazi, Fatemeh; Asl, Babak Mohammadzadeh

    2015-11-01

    The aims of this study are summarized in the following items: first, to investigate the class discrimination power of long-term heart rate variability (HRV) features for risk assessment in patients suffering from congestive heart failure (CHF); second, to introduce the most discriminative features of HRV to discriminate low risk patients (LRPs) and high risk patients (HRPs), and third, to examine the influence of feature dimension reduction in order to achieve desired accuracy of the classification. We analyzed two public Holter databases: 12 data of patients suffering from mild CHF (NYHA class I and II), labeled as LRPs and 32 data of patients suffering from severe CHF (NYHA class III and IV), labeled as HRPs. A K-nearest neighbor classifier was used to evaluate the performance of feature set in the classification. Moreover, to reduce the number of features as well as the overlap of the samples of two classes in feature space, we used generalized discriminant analysis (GDA) as a feature extraction method. By applying GDA to the discriminative nonlinear features, we achieved sensitivity and specificity of 100% having the least number of features. Finally, the results were compared with other similar conducted studies regarding the performance of feature selection procedure and classifier besides the number of features used in training.

  17. Small Explorer WIRE Failure Investigation Report

    NASA Technical Reports Server (NTRS)

    Katz, Richard B.

    1999-01-01

    This paper presents the Small Explorer WIRE Failure Investigation Report in viewgraph form. Some of the diagrams include: 1) Overview of the Pyro Box and key interfaces; 2) Schematic Diagram of the A1020 FPGA (Field Programmable Gate Array) inputs; 3) Three critical FPGA reset signals shown in detail; 4) State machines for firing the cover pyrotechnic devices; 5) Oscillator Overview; and 6) General Crystal Oscillator Startup Characteristics.

  18. The value of serum immunoglobulin free light chain assessment in patients with monoclonal gammopathies and acute renal failure.

    PubMed

    Cirit, Mustafa; Uzüm, Atilla; Ozen, Pınar; Sentürk, Banu A; Bozkaya, Giray; Payzin, Bahriye; Ural, Orçun

    2012-12-01

    Immunoglobulin free light chain (FLC) abnormalities are common in patients with monoclonal gammopathies and the kidneys are the most affected organs. Immunoassays that provide quantitative measurement of FLC in serum indicate monoclonal FLC production based on the presence of an abnormal FLC kappa:lambda (κ:λ) ratio. The aim of this study was to assess the utility of serum FLC measurement as a diagnostic tool for detecting plasma cell dyscrasias in comparison to standard assays, and to ascertain its sensitivity and specificity in patients with acute renal failure (ARF). Sera from 82 patients with ARF were assessed using serum protein electrophoresis (SPE), serum immunofixation electrophoresis (SIFE), and FLC measurement. The sensitivity and specificity of the FLC ratio in identifying which ARF patients had multiple myeloma (MM) was compared to those of SPE and SIFE. Among the 82 patients with ARF, 7 were diagnosed as MM using SPE, SIFE, and bone marrow biopsy techniques. In total, 8 patients did not have a FLC κ:λ ratio that was within the published reference range (0:26-1:65); the FLC κ:λ ratio based on FLC measurement had a specificity of 96% and sensitivity of 71%, and positive and negative predictive values of 62.9% and 97.3%, respectively, for the diagnosis of MM. The sensitivity and specificity of the FLC κ:λ ratio for diagnosing MM in patients that presented with ARF were lower than those of SPE and SIFE. To further delineate the utility of the FLC κ:λ ratio additional prospective, well-designed large-scale studies are needed. None declared.

  19. Phase diagrams for high Tc superconductors

    SciTech Connect

    Whitler, J.D.; Roth, R.S. NIST, Gaithersburg, MD )

    1991-01-01

    The phase diagrams of ternary and quaternary systems containing superconducting phases are presented, as are the phase diagrams of the associated binary systems. The diagrams are divided into two large groups: (1) alkaline earth-rare earth-copper-oxygen diagrams, and (2) alkaline earth-bismuth/lead-copper-oxygen diagrams. The first group includes BaO-REO-CuO systems followed by SrO-REO-CuO or Nd2O3-CeO-CuO systems. The second group includes systems related to the AE-Bi2O3-CuO and AE-PbO-CuO systems. The phase diagrams are accompanied by notes relating procedures used in the studies, results obtained, and comparisons with the results in the literature for the same system.

  20. Continuation of point clouds via persistence diagrams

    NASA Astrophysics Data System (ADS)

    Gameiro, Marcio; Hiraoka, Yasuaki; Obayashi, Ippei

    2016-11-01

    In this paper, we present a mathematical and algorithmic framework for the continuation of point clouds by persistence diagrams. A key property used in the method is that the persistence map, which assigns a persistence diagram to a point cloud, is differentiable. This allows us to apply the Newton-Raphson continuation method in this setting. Given an original point cloud P, its persistence diagram D, and a target persistence diagram D‧, we gradually move from D to D‧, by successively computing intermediate point clouds until we finally find a point cloud P‧ having D‧ as its persistence diagram. Our method can be applied to a wide variety of situations in topological data analysis where it is necessary to solve an inverse problem, from persistence diagrams to point cloud data.

  1. Hubble's diagram and cosmic expansion.

    PubMed

    Kirshner, Robert P

    2004-01-06

    Edwin Hubble's classic article on the expanding universe appeared in PNAS in 1929 [Hubble, E. P. (1929) Proc. Natl. Acad. Sci. USA 15, 168-173]. The chief result, that a galaxy's distance is proportional to its redshift, is so well known and so deeply embedded into the language of astronomy through the Hubble diagram, the Hubble constant, Hubble's Law, and the Hubble time, that the article itself is rarely referenced. Even though Hubble's distances have a large systematic error, Hubble's velocities come chiefly from Vesto Melvin Slipher, and the interpretation in terms of the de Sitter effect is out of the mainstream of modern cosmology, this article opened the way to investigation of the expanding, evolving, and accelerating universe that engages today's burgeoning field of cosmology.

  2. Gravity on-shell diagrams

    DOE PAGES

    Herrmann, Enrico; Trnka, Jaroslav

    2016-11-22

    Here, we study on-shell diagrams for gravity theories with any number of super-symmetries and find a compact Grassmannian formula in terms of edge variables of the graphs. Unlike in gauge theory where the analogous form involves only d log-factors, in gravity there is a non-trivial numerator as well as higher degree poles in the edge variables. Based on the structure of the Grassmannian formula for N = 8 supergravity we conjecture that gravity loop amplitudes also possess similar properties. In particular, we find that there are only logarithmic singularities on cuts with finite loop momentum and that poles at infinitymore » are present, in complete agreement with the conjecture presented in.« less

  3. Gravity on-shell diagrams

    SciTech Connect

    Herrmann, Enrico; Trnka, Jaroslav

    2016-11-22

    Here, we study on-shell diagrams for gravity theories with any number of super-symmetries and find a compact Grassmannian formula in terms of edge variables of the graphs. Unlike in gauge theory where the analogous form involves only d log-factors, in gravity there is a non-trivial numerator as well as higher degree poles in the edge variables. Based on the structure of the Grassmannian formula for N = 8 supergravity we conjecture that gravity loop amplitudes also possess similar properties. In particular, we find that there are only logarithmic singularities on cuts with finite loop momentum and that poles at infinity are present, in complete agreement with the conjecture presented in.

  4. Hubble's diagram and cosmic expansion

    PubMed Central

    Kirshner, Robert P.

    2004-01-01

    Edwin Hubble's classic article on the expanding universe appeared in PNAS in 1929 [Hubble, E. P. (1929) Proc. Natl. Acad. Sci. USA 15, 168–173]. The chief result, that a galaxy's distance is proportional to its redshift, is so well known and so deeply embedded into the language of astronomy through the Hubble diagram, the Hubble constant, Hubble's Law, and the Hubble time, that the article itself is rarely referenced. Even though Hubble's distances have a large systematic error, Hubble's velocities come chiefly from Vesto Melvin Slipher, and the interpretation in terms of the de Sitter effect is out of the mainstream of modern cosmology, this article opened the way to investigation of the expanding, evolving, and accelerating universe that engages today's burgeoning field of cosmology. PMID:14695886

  5. A Regime Diagram for Subduction

    NASA Astrophysics Data System (ADS)

    Stegman, D. R.; Farrington, R.; Capitanio, F. A.; Schellart, W. P.

    2009-12-01

    Regime diagrams and associated scaling relations have profoundly influenced our understanding of planetary dynamics. Previous regime diagrams characterized the regimes of stagnant-lid, small viscosity contrast, transitional, and no-convection for temperature-dependent (Moresi and Solomatov, 1995), and non-linear power law rheologies (Solomatov and Moresi, 1997) as well as stagnant-lid, sluggish-lid, and mobile-lid regimes once the finite strength of rock was considered (Moresi and Solomatov, 1998). Scalings derived from such models have been the cornerstone for parameterized models of thermal evolution of rocky planets and icy moons for the past decade. While such a theory can predict the tectonic state of a planetary body, it is still rather incomplete in regards to predicting tectonics. For example, the mobile-lid regime is unspecific as to how continuous lithospheric recycling should occur on a terrestrial planet. Towards this goal, Gerya et al., (2008) advanced a new regime diagram aiming to characterize when subduction would manifest itself as a one-sided or two-sided downwelling and either symmetric or asymmetric. Here, we present a regime diagram for the case of a single-sided, asymmetric type of subduction (most Earth-like type). Using a 3-D numerical model of a free subduction, we describe a total of 5 different styles of subduction that can possibly occur. Each style is distinguished by its upper mantle slab morphology resulting from the sinking kinematics. We provide movies to illustrate the different styles and their progressive time-evolution. In each regime, subduction is accommodated by a combination of plate advance and slab rollback, with associated motions of forward plate velocity and trench retreat, respectively. We demonstrate that the preferred subduction mode depends upon two essential controlling factors: 1) buoyancy of the downgoing plate and 2) strength of plate in resisting bending at the hinge. We propose that a variety of subduction

  6. Gravity on-shell diagrams

    NASA Astrophysics Data System (ADS)

    Herrmann, Enrico; Trnka, Jaroslav

    2016-11-01

    We study on-shell diagrams for gravity theories with any number of super-symmetries and find a compact Grassmannian formula in terms of edge variables of the graphs. Unlike in gauge theory where the analogous form involves only d log-factors, in gravity there is a non-trivial numerator as well as higher degree poles in the edge variables. Based on the structure of the Grassmannian formula for {N}=8 supergravity we conjecture that gravity loop amplitudes also possess similar properties. In particular, we find that there are only logarithmic singularities on cuts with finite loop momentum and that poles at infinity are present, in complete agreement with the conjecture presented in [1].

  7. Phase diagram of Hertzian spheres

    NASA Astrophysics Data System (ADS)

    Pàmies, Josep C.; Cacciuto, Angelo; Frenkel, Daan

    2009-07-01

    We report the phase diagram of interpenetrating Hertzian spheres. The Hertz potential is purely repulsive, bounded at zero separation, and decreases monotonically as a power law with exponent 5/2, vanishing at the overlapping threshold. This simple functional describes the elastic interaction of weakly deformable bodies and, therefore, it is a reliable physical model of soft macromolecules, like star polymers and globular micelles. Using thermodynamic integration and extensive Monte Carlo simulations, we computed accurate free energies of the fluid phase and a large number of crystal structures. For this, we defined a general primitive unit cell that allows for the simulation of any lattice. We found multiple re-entrant melting and first-order transitions between crystals with cubic, trigonal, tetragonal, and hexagonal symmetries.

  8. Phase diagram of ammonium nitrate

    NASA Astrophysics Data System (ADS)

    Dunuwille, M.; Yoo, C. S.

    2014-05-01

    Ammonium Nitrate (AN) has often subjected to uses in improvised explosive devices, due to its wide availability as a fertilizer and its capability of becoming explosive with slight additions of organic and inorganic compounds. Yet, the origin of enhanced energetic properties of impure AN (or AN mixtures) is neither chemically unique nor well understood -resulting in rather catastrophic disasters in the past1 and thereby a significant burden on safety in using ammonium nitrates even today. To remedy this situation, we have carried out an extensive study to investigate the phase stability of AN at high pressure and temperature, using diamond anvil cells and micro-Raman spectroscopy. The present results confirm the recently proposed phase IV-to-IV' transition above 17 GPa2 and provide new constraints for the melting and phase diagram of AN to 40 GPa and 400 °C.

  9. Phase diagram of ammonium nitrate

    NASA Astrophysics Data System (ADS)

    Dunuwille, Mihindra; Yoo, Choong-Shik

    2013-12-01

    Ammonium Nitrate (AN) is a fertilizer, yet becomes an explosive upon a small addition of chemical impurities. The origin of enhanced chemical sensitivity in impure AN (or AN mixtures) is not well understood, posing significant safety issues in using AN even today. To remedy the situation, we have carried out an extensive study to investigate the phase stability of AN and its mixtures with hexane (ANFO-AN mixed with fuel oil) and Aluminum (Ammonal) at high pressures and temperatures, using diamond anvil cells (DAC) and micro-Raman spectroscopy. The results indicate that pure AN decomposes to N2, N2O, and H2O at the onset of the melt, whereas the mixtures, ANFO and Ammonal, decompose at substantially lower temperatures. The present results also confirm the recently proposed phase IV-IV' transition above 17 GPa and provide new constraints for the melting and phase diagram of AN to 40 GPa and 400°C.

  10. Influence Diagrams: Automated Analysis with Dynamic Programming

    DTIC Science & Technology

    1988-12-01

    demonstrating both the efficiency of the dynamic programming features and the limitations of influence diagrams in modeling problems with significant...Introduction 1.1 General Background Influence diagrams are a -eccntly developed graphical modeling tool for repre- senting both the conceptual elements and the...the model [9:10]. The types of node included in basic influence diagrams are (see Figure 1): Chance Node The chance node represents a random variable

  11. Process Flow Diagrams for Training and Operations

    NASA Astrophysics Data System (ADS)

    Venter, Jacobus

    This paper focuses on the use of process flow diagrams for training first responders who execute search and seizure warrants at electronic crime scenes. A generic process flow framework is presented, and the design goals and layout characteristics of process flow diagrams are discussed. An evaluation of the process flow diagrams used in training courses indicates that they are beneficial to first responders performing searches and seizures, and they speed up investigations, including those conducted by experienced personnel.

  12. Assessment of the risk of failure of high voltage substations due to environmental conditions and pollution on insulators.

    PubMed

    Castillo Sierra, Rafael; Oviedo-Trespalacios, Oscar; Candelo, John E; Soto, Jose D

    2015-07-01

    Pollution on electrical insulators is one of the greatest causes of failure of substations subjected to high levels of salinity and environmental pollution. Considering leakage current as the main indicator of pollution on insulators, this paper focuses on establishing the effect of the environmental conditions on the risk of failure due to pollution on insulators and determining the significant change in the magnitude of the pollution on the insulators during dry and humid periods. Hierarchical segmentation analysis was used to establish the effect of environmental conditions on the risk of failure due to pollution on insulators. The Kruskal-Wallis test was utilized to determine the significant changes in the magnitude of the pollution due to climate periods. An important result was the discovery that leakage current was more common on insulators during dry periods than humid ones. There was also a higher risk of failure due to pollution during dry periods. During the humid period, various temperatures and wind directions produced a small change in the risk of failure. As a technical result, operators of electrical substations can now identify the cause of an increase in risk of failure due to pollution in the area. The research provides a contribution towards the behaviour of the leakage current under conditions similar to those of the Colombian Caribbean coast and how they affect the risk of failure of the substation due to pollution.

  13. Origin and use of crystallization phase diagrams

    PubMed Central

    Rupp, Bernhard

    2015-01-01

    Crystallization phase diagrams are frequently used to conceptualize the phase relations and also the processes taking place during the crystallization of macromolecules. While a great deal of freedom is given in crystallization phase diagrams owing to a lack of specific knowledge about the actual phase boundaries and phase equilibria, crucial fundamental features of phase diagrams can be derived from thermodynamic first principles. Consequently, there are limits to what can be reasonably displayed in a phase diagram, and imagination may start to conflict with thermodynamic realities. Here, the commonly used ‘crystallization phase diagrams’ are derived from thermodynamic excess properties and their limitations and appropriate use is discussed. PMID:25760697

  14. Influence Diagram Use With Respect to Technology Planning and Investment

    NASA Technical Reports Server (NTRS)

    Levack, Daniel J. H.; DeHoff, Bryan; Rhodes, Russel E.

    2009-01-01

    Influence diagrams are relatively simple, but powerful, tools for assessing the impact of choices or resource allocations on goals or requirements. They are very general and can be used on a wide range of problems. They can be used for any problem that has defined goals, a set of factors that influence the goals or the other factors, and a set of inputs. Influence diagrams show the relationship among a set of results and the attributes that influence them and the inputs that influence the attributes. If the results are goals or requirements of a program, then the influence diagram can be used to examine how the requirements are affected by changes to technology investment. This paper uses an example to show how to construct and interpret influence diagrams, how to assign weights to the inputs and attributes, how to assign weights to the transfer functions (influences), and how to calculate the resulting influences of the inputs on the results. A study is also presented as an example of how using influence diagrams can help in technology planning and investment. The Space Propulsion Synergy Team (SPST) used this technique to examine the impact of R&D spending on the Life Cycle Cost (LCC) of a space transportation system. The question addressed was the effect on the recurring and the non-recurring portions of LCC of the proportion of R&D resources spent to impact technology objectives versus the proportion spent to impact operational dependability objectives. The goals, attributes, and the inputs were established. All of the linkages (influences) were determined. The weighting of each of the attributes and each of the linkages was determined. Finally the inputs were varied and the impacts on the LCC determined and are presented. The paper discusses how each of these was accomplished both for credibility and as an example for future studies using influence diagrams for technology planning and investment planning.

  15. Additive prognostic value of subjective assessment with respect to clinical cardiological data in patients with chronic heart failure.

    PubMed

    Majani, Giuseppina; Pierobon, Antonia; Pinna, Gian Domenico; Giardini, Anna; Maestri, Roberto; La Rovere, Maria Teresa

    2011-12-01

    Health-related quality of life tools that better reflect the unique subjective perception of heart failure (HF) are needed for patients with this disorder. The aim of this study was to explore whether subjective satisfaction of HF patients about daily life may provide additional prognostic information with respect to clinical cardiological data. One hundred and seventy-eight patients (age 51 ± 9 years) with moderate to severe HF [New York Heart Association (NYHA) class 2.0 ± 0.7; left ventricular ejection fraction (LVEF) 29 ± 8%] in stable clinical condition underwent a standard clinical evaluation and compiled the Satisfaction Profile (SAT-P) questionnaire focusing on subjective satisfaction with daily life. Cox regression analysis was used to assess whether SAT-P factors (psychological functioning, physical functioning, work, sleep/eating/leisure, social functioning) had any prognostic value. Forty-six cardiac deaths occurred during a median of 30 months. Patients who died had higher NYHA class, more depressed left ventricular function, reduced systolic blood pressure (SBP), increased heart rate (HR), and worse biochemistry (all p < 0.05). Among the SAT-P factors, only physical functioning (PF) was significantly reduced in the patients who died (p = 0.003). Using the best subset selection procedure, resistance to physical fatigue (RPF) was selected from among the items of the PF factor. RPF showed independent predictive value when entered into a prognostic model including NYHA class, LVEF, SBP, and HR with an adjusted hazard ratio of 0.86 per 10 units increase (95% CI 0.75-0.98, p = 0.02). Patients' dissatisfaction with physical functioning is associated with reduced long-term survival, after adjustment for known risk factors in HF. Given its user-friendly structure, simplicity, and significant prognostic value, the RPF score may represent a useful instrument in clinical practice.

  16. Pivotal role of bedside Doppler echocardiography in the assessment of patients with acute heart failure and mitral regurgitation.

    PubMed

    Ennezat, Pierre Vladimir; Bellouin, Annaïk; Maréchaux, Sylvestre; Juthier, Francis; Fayad, Georges; Vincentelli, André; Berrébi, Alain; Auffray, Jean Luc; Bauchart, Jean Jacques; Mouquet, Frédéric; Montaigne, David; Asseman, Philippe; Le Jemtel, Thierry H; Pibarot, Philippe

    2009-01-01

    Patients presenting with mitral regurgitation and acute heart failure remain a challenge for the clinicians. Bedside echocardiography ascertains the functional or primary nature of mitral regurgitation, thereby allowing to focus therapy on the left ventricle and mitral valve apparatus in patients with functional mitral regurgitation and to hasten mitral valve repair or replacement when acute heart failure results from primary mitral regurgitation. This short article reviews the evaluation by bedside echocardiography to guide management of these patients. Copyright 2009 S. Karger AG, Basel.

  17. Longitudinal load and cascading failure risk assessment (CASE): Bonneville Power Administration`s 230/500-kV Longview-Olympia transmission line. Final report

    SciTech Connect

    Ostendorp, M.

    1998-12-01

    The Electric Power Research Institute`s (EPRI) Cascading Failure Risk Assessment (CASE) methodology was used to determine extreme event, unbalanced loads on Bonneville Power Administration`s (BPA) 230/500-kV, single circuit, Longview-Olympia transmission line and to identify the cascading potential of the line under five different loading conditions. More specifically, BPA wanted to evaluate the cascading potential of the Type 2L, Type 2A1, and Type 238M tangent structures which comprise a significant portion of the line. While other cascading assessment methods primarily focus on the magnitude of the unbalanced loads acting on the first structure from the initiating event, EPRI`s CASE method incorporates the dynamic response and damping characteristics of the transmission line to determine the unbalanced longitudinal loads at any structure away from the initiating failure event. The CASE application constituted an investigation into the nature of the extreme loads that are expected to occur on the 230/500-kV Longview-Olympia transmission line during a cascading failure and the corresponding dynamic response. The goals of the investigation were: to quantify unbalanced longitudinal loads acting on structures adjacent to the broken insulator, shield wire, or conductor failure as well as down-line structures; and to assess the cascading potential of the Longview-Olympia transmission line by considering the energy dissipation at successive spans and supports. The results of the CASE method showed that BPA`s longitudinal loading criteria for the Type 2L, 2A1, and 238 M lattice towers satisfy BPA`s containment failure design philosophy with the addition of fiber optic cable. BPA`s longitudinal loading criteria applied simultaneously with extreme ice or wind does not provide adequate strength to prevent a cascade of less than ten towers.

  18. Longitudinal load and cascading failure risk assessment (CASE): Tennessee Valley Authority`s 161-kV Lowndes-West Point transmission line. Final report

    SciTech Connect

    Ostendorp, M.

    1998-03-01

    The Electric Power Research Institute`s (EPRI) Cascading Failure Risk Assessment (CASE) methodology was used to determine extreme event, unbalanced loads on Tennessee Valley Authority`s (TVA) 161-kV, single circuit, Lowndes-West Point transmission line and to identify the cascading potential of the line under five different loading conditions. More specifically, TVA wanted to evaluate the cascading potential of the Type HS-1G and BHS-1G tangent structures which comprise the majority of the line. While other cascading assessment methods primarily focus on the magnitude of the unbalanced loads acting on the first structure from the initiating event, EPRI`s CASE method incorporates the dynamic response and damping characteristics of the transmission line to determine the unbalanced longitudinal loads at any structure away from the initiating failure event. The CASE application constituted an investigation into the nature of the extreme loads that are expected to occur on the 161-kV Lowndes-West Point transmission line during a cascading failure and the corresponding dynamic response. The goals of the investigation were: to quantify unbalanced longitudinal loads acting on structures adjacent to the broken insulator, shield wire, or conductor failure as well as down-line structures; to assess the cascading potential of the Lowndes-West Point transmission line by considering the energy dissipation at successive spans and supports. The results of the CASE method indicate that the lack of longitudinal strength of the Type HS-1G and BHS-1G steel pole H-frame coupled with the dynamic characteristics of the Lowndes-West Point line was likely to result in a cascading failure for the more severe initiating event and load case combinations.

  19. Assessment of an educational intervention on nurses' knowledge and retention of heart failure self-care principles and the Teach Back method.

    PubMed

    Mahramus, Tara; Penoyer, Daleen Aragon; Frewin, Sarah; Chamberlain, Lyne; Wilson, Debra; Sole, Mary Lou

    2014-01-01

    Nurses must have optimum knowledge of heart failure self-care principles to adequately prepare patients for self-care at home. However, study findings demonstrate that nurses have knowledge deficits in self-care concepts for heart failure. A quasi-experimental, repeated measures design was used to assess nurses' knowledge of heart failure self-care before, immediately after, and 3-months following an educational intervention, which also included the Teach Back method. Follow-up reinforcement was provided after the educational intervention. One hundred fifty nurses participated in the study. Significant differences were found between pre-test (65.1%) and post-test (80.6%) scores (p < 0.001). Teach Back proficiency was achieved by 98.3%. Only 61 participants completed the 3-month assessment of knowledge. In this group, mean knowledge scores increased significantly across all three measurements (p < 0.001): 66.5% (pre-test); 82.1% (post-test); 89.5% (follow up post-test). Participation in a comprehensive educational program resulted in increased nurses' knowledge of heart failure self-care principles and the knowledge was sustained and increased over time. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Mechanisms of failure of locked-plate fixation of the proximal humerus: acoustic emissions as a novel assessment modality.

    PubMed

    Hymes, Robert A; Levine, Matthew J; Schulman, Jeff E; Westbrook, Ryan D; Li, Jihui

    2013-07-01

    Locking plates are the predominant implants used for proximal humerus fractures. Despite a preponderance of good clinical outcomes, failures continue to occur. The purpose of this study was to investigate the failure mechanism of locked proximal humeral plate fixation and its relationship with bone density and screw length. Human cadaveric humeri were subjected to cyclic bending loads after an unstable 2-part fracture (Orthopedic Trauma Association classification 11 A-3) was created and stabilized with a locking proximal humeral plate. Acoustic emission (AE) sensors were mounted on the specimens to detect fracture displacement and generation of microcracks. The data were analyzed to evaluate construct failure. Eight of 10 locking plate constructs in cadaver specimens failed in varus collapse. The primary influences on failure were cancellous bone density and cancellous bone screw length. AE monitoring demonstrated patterns of microcrack progression, predominantly along the inferior screws. The progression trends according to AE were similar to their respective actuator displacement versus time curves. Cancellous bone density and total cancellous screw depth penetration seem to be critical variables. Although the patients' bone density cannot be controlled, surgeons may decrease the risk of failure by maximizing the length of the screws within the cancellous bone. Analysis of microcrack formation revealed that failures begin at the midportion and tips of the inferior screws and at the bone-plate interface of the inferior screws.

  1. Diagrams Benefit Symbolic Problem-Solving

    ERIC Educational Resources Information Center

    Chu, Junyi; Rittle-Johnson, Bethany; Fyfe, Emily R.

    2017-01-01

    Background: The format of a mathematics problem often influences students' problem-solving performance. For example, providing diagrams in conjunction with story problems can benefit students' understanding, choice of strategy, and accuracy on story problems. However, it remains unclear whether providing diagrams in conjunction with symbolic…

  2. Pressure-temperature phase diagrams of biomolecules.

    PubMed

    Smeller, László

    2002-03-25

    The pressure-temperature phase diagram of various biomolecules is reviewed. Special attention is focused on the elliptic phase diagram of proteins. The phenomenological thermodynamic theory describing this diagram explains the heat, cold and pressure denaturations in a unified picture. The limitations and possible developments of this theory are discussed as well. It is pointed out that a more complex diagram can be obtained when the intermolecular interactions are also taken into account. In this case metastable states appear on the pressure-temperature (p-T) diagram due to intermolecular interactions. Pressure-temperature phase diagrams of other biopolymers are also discussed. While the p-T diagrams of helix-coil transition of nucleic acids and of gel-liquid crystal transition of lipid bilayers are non-elliptical, those of gelatinization of starch and of phase separation of some synthetic polymers show an elliptic profile, similar to that of proteins. Finally, the p-T diagram of bacterial inactivation is shown to be elliptic. From the point of view of basic science, this fact shows that the key factor of inactivation should be the protein type, and from the viewpoint of practical applications, it serves as the theoretical basis of pressure treatment of biosystems.

  3. Vesicle deformation by microtubules: A phase diagram

    NASA Astrophysics Data System (ADS)

    Emsellem, Virginie; Cardoso, Olivier; Tabeling, Patrick

    1998-10-01

    The experimental investigation of vesicles deformed by the growth of encapsulated microtubules shows that the axisymmetric morphologies can be classified into ovals, lemons, φ, cherries, dumbbells, and pearls. A geometrical phase diagram is established. Numerical minimization of the elastic energy of the membrane reproduces satisfactorily well the observed morphologies and the corresponding phase diagram.

  4. Modified log-activity diagrams as a tool for modelling corrosion of nuclear waste container materials, with particular reference to copper

    NASA Astrophysics Data System (ADS)

    Mohr, David W.; McNeil, Michael B.

    1992-08-01

    Thermochemical data are used to construct a modified log-activity diagram for the system Cu sbnd H sbnd O sbnd Cl sbnd (CO 2). This diagram, restricted to standard state of pressure and temperature, serves as a complement to Pourbaix diagrams for the study of equilibria appropriate to solid phases and aqueous ionic species of copper in chloride-bearing waters. Coordinate axes represent activities of chloride and aqueous copper species; other thermodynamic variables are collapsed onto the diagram. Equilibria involving chlorination reactions, some of which cannot be displayed on a Pourbaix diagram, are presented. Also displayed are the various permissible geometric relationships of lines on a Pourbaix diagram. Modified log-activity diagrams may be used to model localized corrosion of copper and are potentially useful for the analysis and prediction of failure mechanisms in high level waste packages.

  5. Heber Geothermal Binary Demonstration Project. Final design availability assessment. Revision 1

    SciTech Connect

    Mulvihill, R.J.; Reny, D.A.; Geumlek, J.M.; Purohit, G.P.

    1983-02-01

    An availability assessment of the principal systems of the Heber Geothermal Power Plant has been carried out based on the final issue of the process descriptions, process flow diagrams, and the approved for design P and IDs prepared by Fluor Power Services, Inc. (FPS). The principal systems are those which contribute most to plant unavailability. The plant equivalent availability, considering forced and deferred corrective maintenance outages, was computed using a 91 state Markov model to represent the 29 principal system failure configurations and their significant combinations. The failure configurations and associated failure and repair rates were defined from system/subsystem availability assessments that were conducted using the availability assessments based on the EPRI GO methodology and availability block diagram models. The availability and unavailability ranking of the systems and major equipment is presented.

  6. Influence Diagrams as Decision-Making Tools for Pesticide Risk Management

    EPA Science Inventory

    The pesticide policy arena is filled with discussion of probabilistic approaches to assess ecological risk, however, similar discussions about implementing formal probabilistic methods in pesticide risk decision making are less common. An influence diagram approach is proposed f...

  7. Influence Diagrams as Decision-Making Tools for Pesticide Risk Management

    EPA Science Inventory

    The pesticide policy arena is filled with discussion of probabilistic approaches to assess ecological risk, however, similar discussions about implementing formal probabilistic methods in pesticide risk decision making are less common. An influence diagram approach is proposed f...

  8. Diagrams Showing Actions for Reducing Exposures to Polychlorinated Biphenyls (PCBs) in Indoor Building Environments

    EPA Pesticide Factsheets

    This diagram compliments the document, PCBs in Building Materials: Q's & A's, on how exposure to PCBs can be assessed and reduced in school buildings. It describes actions for reducing exposures to PCBs in indoor school building environments.

  9. The morphological diagram of spinels

    SciTech Connect

    Ziolkowski, J.

    1996-02-01

    Catalytic anisotropy in mild oxidation reactions results from the varying activity of different crystal faces. Here, spinels exposing (100), (110), and (111) faces have been considered and their Curie-Wulff plots have been drawn, admitting that the relative G(hkl) surface free energies may change in a wide range as a function of composition, inversion, and segregation degree. The normalized free surface energies are defined as A = G(100)/G(111), B = G(110)/G(111), and C = G(111)/G(111) = 1 = const. This made it possible to construct bidimensional morphological diagrams (morphology = f(A,B) at C = const) in the exposed-face-type, solid-type, and exposure-percentage versions. Eleven morphological habits of grains have been identified, including (100)-cube, (110)-dodecahedron, (111)-hexagons, 18-hedron, 20-hedron, and up to 26-hedra bordered with (i) 6 (100)-octagons, 12 (110)-rectangles, and 8 (111)-hexagons, (ii) 6 (100)-squares, 12 (110)-rectangles, and 8 (111)-triangles, or (iii) 6 (100)-squares, 12 (110)-octagons, and 8 (100)-triangles. The analysis is valid for all compounds crystallizing in the cubic system and preferentially exposing the three enumerated faces.

  10. Phase diagram of ammonium nitrate

    SciTech Connect

    Dunuwille, Mihindra; Yoo, Choong-Shik

    2013-12-07

    Ammonium Nitrate (AN) is a fertilizer, yet becomes an explosive upon a small addition of chemical impurities. The origin of enhanced chemical sensitivity in impure AN (or AN mixtures) is not well understood, posing significant safety issues in using AN even today. To remedy the situation, we have carried out an extensive study to investigate the phase stability of AN and its mixtures with hexane (ANFO–AN mixed with fuel oil) and Aluminum (Ammonal) at high pressures and temperatures, using diamond anvil cells (DAC) and micro-Raman spectroscopy. The results indicate that pure AN decomposes to N{sub 2}, N{sub 2}O, and H{sub 2}O at the onset of the melt, whereas the mixtures, ANFO and Ammonal, decompose at substantially lower temperatures. The present results also confirm the recently proposed phase IV-IV{sup ′} transition above 17 GPa and provide new constraints for the melting and phase diagram of AN to 40 GPa and 400°C.

  11. Phase Diagram of Ammonium Nitrate

    NASA Astrophysics Data System (ADS)

    Dunuwille, Mihindra; Yoo, Choong-Shik

    2013-06-01

    Ammonium Nitrate (AN) has often been subjected to uses in improvised explosive devices, due to its wide availability as a fertilizer and its capability of becoming explosive with slight additions of organic and inorganic compounds. Yet, the origin of enhanced energetic properties of impure AN (or AN mixtures) is neither chemically unique nor well understood - resulting in rather catastrophic disasters in the past1 and thereby a significant burden on safety, in using ammonium nitrates even today. To remedy this situation, we have carried out an extensive study to investigate the phase stability of AN, in different chemical environments, at high pressure and temperature, using diamond anvil cells and micro-Raman spectroscopy. The present results confirm the recently proposed phase IV-to-IV' transition above 15 GPa2 and provide new constraints for the melting and phase diagram of AN to 40 GPa and 673 K. The present study has been supported by the U.S. DHS under Award Number 2008-ST-061-ED0001.

  12. Phase diagram of elastic spheres.

    PubMed

    Athanasopoulou, L; Ziherl, P

    2017-02-15

    Experiments show that polymeric nanoparticles often self-assemble into several non-close-packed lattices in addition to the face-centered cubic lattice. Here, we explore theoretically the possibility that the observed phase sequences may be associated with the softness of the particles, which are modeled as elastic spheres interacting upon contact. The spheres are described by two finite-deformation theories of elasticity, the modified Saint-Venant-Kirchhoff model and the neo-Hookean model. We determine the range of indentations where the repulsion between the spheres is pairwise additive and agrees with the Hertz theory. By computing the elastic energies of nine trial crystal lattices at densities far beyond the Hertzian range, we construct the phase diagram and find the face- and body-centered cubic lattices as well as the A15 lattice and the simple hexagonal lattice, with the last two being stable at large densities where the spheres are completely faceted. These results are qualitatively consistent with observations, suggesting that deformability may indeed be viewed as a generic property that determines the phase behavior in nanocolloidal suspensions.

  13. The five-point Likert scale for dyspnea can properly assess the degree of pulmonary congestion and predict adverse events in heart failure outpatients.

    PubMed

    Weber, Cristina K; Miglioranza, Marcelo H; Moraes, Maria A P de; Sant'anna, Roberto T; Rover, Marciane M; Kalil, Renato A K; Leiria, Tiago Luiz L

    2014-01-01

    Proper assessment of dyspnea is important in patients with heart failure. Our aim was to evaluate the use of the 5-point Likert scale for dyspnea to assess the degree of pulmonary congestion and to determine the prognostic value of this scale for predicting adverse events in heart failure outpatients. We undertook a prospective study of outpatients with moderate to severe heart failure. The 5-point Likert scale was applied during regular outpatient visits, along with clinical assessments. Lung ultrasound with ≥15 B-lines and an amino-terminal portion of pro-B-type natriuretic peptide (NT-proBNP) level >1000 pg/mL were used as a reference for pulmonary congestion. The patients were then assessed every 30 days during follow-up to identify adverse clinical outcomes. We included 58 patients (65.5% male, age 43.5 ± 11 years) with a mean left ventricular ejection fraction of 27 ± 6%. In total, 29.3% of these patients had heart failure with ischemic etiology. Additionally, pulmonary congestion, as diagnosed by lung ultrasound, was present in 58% of patients. A higher degree of dyspnea (3 or 4 points on the 5-point Likert scale) was significantly correlated with a higher number of B-lines (p = 0.016). Patients stratified into Likert = 3-4 were at increased risk of admission compared with those in class 1-2 after adjusting for age, left ventricular ejection fraction, New York Heart Association functional class and levels of NT-proBNP >1000 pg/mL (HR = 4.9, 95% CI 1.33-18.64, p = 0.017). In our series, higher baseline scores on the 5-point Likert scale were related to pulmonary congestion and were independently associated with adverse events during follow-up. This simple clinical tool can help to identify patients who are more likely to decompensate and whose treatment should be intensified.

  14. Failure mode and effects analysis based risk profile assessment for stereotactic radiosurgery programs at three cancer centers in Brazil

    SciTech Connect

    Teixeira, Flavia C.

    2016-01-15

    Purpose: The goal of this study was to evaluate the safety and quality management program for stereotactic radiosurgery (SRS) treatment processes at three radiotherapy centers in Brazil by using three industrial engineering tools (1) process mapping, (2) failure modes and effects analysis (FMEA), and (3) fault tree analysis. Methods: The recommendations of Task Group 100 of American Association of Physicists in Medicine were followed to apply the three tools described above to create a process tree for SRS procedure for each radiotherapy center and then FMEA was performed. Failure modes were identified for all process steps and values of risk priority number (RPN) were calculated from O, S, and D (RPN = O × S × D) values assigned by a professional team responsible for patient care. Results: The subprocess treatment planning was presented with the highest number of failure modes for all centers. The total number of failure modes were 135, 104, and 131 for centers I, II, and III, respectively. The highest RPN value for each center is as follows: center I (204), center II (372), and center III (370). Failure modes with RPN ≥ 100: center I (22), center II (115), and center III (110). Failure modes characterized by S ≥ 7, represented 68% of the failure modes for center III, 62% for center II, and 45% for center I. Failure modes with RPNs values ≥100 and S ≥ 7, D ≥ 5, and O ≥ 5 were considered as high priority in this study. Conclusions: The results of the present study show that the safety risk profiles for the same stereotactic radiotherapy process are different at three radiotherapy centers in Brazil. Although this is the same treatment process, this present study showed that the risk priority is different and it will lead to implementation of different safety interventions among the centers. Therefore, the current practice of applying universal device-centric QA is not adequate to address all possible failures in clinical processes at different

  15. Predominance zone diagrams and their application to solvent extraction techniques.

    PubMed

    Páez-Hernández, M E; Ramírez, M T; Rojas-Hernández, A

    2000-01-24

    Predominance zone diagrams have been useful tools in solving problems in analytical chemistry. They can be used to establish the best conditions for separation of mixtures or to optimize recovery procedures for a given species. The few reports on predominance zone diagrams for the participant species in liquid-liquid extraction systems, describe their construction as diagrams of the Pourbaix type (epsilon/pH). With the generalized species and equilibria method (GSEM) it is possible to elaborate Predominance zone diagrams for extraction (PZDE) in proper spaces and with parameters strictly related to these processes such as pH and the volume ratio, r. Therefore, using the GSEM, PZDE that allow us to determine the best conditions for the extraction of a given substance have been elaborated. The stoichiometry of the species been extracted can also be determined from the experimental conditions. It has been demonstrated that with the GSEM, PZDE can be constructed for systems of one and two components. In this work, we intend to demonstrate that the algorithm is valid for the elaboration of PZDE in systems of three and four components. Examples of analytical interest are presented such as lead (II) extraction with diphenyltiocarbazone (dithizone) and that for cadmium (II) with 8-hydroxyquinolein (oxine) in chloroform. The influence of a masking agent, the etilendiaminotetraacetic acid (EDTA) over the extraction of both metals was also assessed.

  16. A Population Health Driver Diagram to Address Neonatal Abstinence Syndrome.

    PubMed

    Erwin, Paul Campbell; Meschke, Laurie L; Ehrlich, Samantha F; Moran, John W

    2017-02-08

    This article describes the process for developing a population health driver diagram to address a priority health issue in East Tennessee: neonatal abstinence syndrome (NAS). Population health driver diagrams are used in quality improvement processes for determining and aligning actions that a community can take to achieve a specified outcome. The Tennessee Department of Health contracted with the University of Tennessee's Department of Public Health to conduct a community participatory process to contribute to a statewide health improvement plan. Colleagues in local public health practice identified NAS as the leading perinatal health issue, and community engagement was achieved by involving community health councils. Qualitative and quantitative data were collected, analyzed, and provided to these councils. A region-wide stakeholders' meeting resulted in the development of a population health driver diagram to address NAS. We describe this process and provide lessons learned that can be valuable in other settings. Population health diagrams have important implications for practice because of their use as a framework for community action, especially in the context of a community health assessment.

  17. Diagnostic accuracy of salivary creatinine, urea, and potassium levels to assess dialysis need in renal failure patients

    PubMed Central

    Bagalad, Bhavana S.; Mohankumar, K. P.; Madhushankari, G. S.; Donoghue, Mandana; Kuberappa, Puneeth Horatti

    2017-01-01

    Background: The prevalence of chronic renal failure is increasing because of increase in chronic debilitating diseases and progressing age of population. These patients experience accumulation of metabolic byproducts and electrolyte imbalance, which has harmful effects on their health. Timely hemodialysis at regular intervals is a life-saving procedure for these patients. Salivary diagnostics is increasingly used as an alternative to the traditional methods. Thus, the aim of the present study was to determine the diagnostic efficacy of saliva in chronic renal failure patients. Materials and Methods: This case–control study included 82 individuals, of which 41 were chronic renal failure patients and 41 were age- and sex-matched controls. Blood and saliva were collected and centrifuged. Serum and supernatant saliva were used for biochemical analysis. Serum and salivary urea, creatinine, sodium, potassium, calcium, and phosphorus were evaluated and correlated in chronic renal failure patients using unpaired t-test, Pearson's correlation coefficient, diagnostic validity tests, and receiver operative curve. Results: When compared to serum; salivary urea, creatinine, sodium, and potassium showed diagnostic accuracy of 93%, 91%, 73%, and 89%, respectively, based on the findings of study. Conclusion: It can be concluded that salivary investigation is a dependable, noninvasive, noninfectious, simple, and quick method for screening the mineral and metabolite values of high-risk patients and monitoring the renal failure patients.

  18. Gait failure.

    PubMed

    Sudarsky, L

    1987-11-01

    Gait failure is a common presentation in the Emergency Department, and one that may herald an acute neurologic episode. This article reviews the mechanisms of gait failure, some of their causes, and the appropriate examination techniques for determining possible diagnoses.

  19. Respiratory Failure

    MedlinePlus

    Respiratory failure happens when not enough oxygen passes from your lungs into your blood. Your body's organs, ... brain, need oxygen-rich blood to work well. Respiratory failure also can happen if your lungs can' ...

  20. Comparisons of Noninvasive Methods Used to Assess Exercise Stroke Volume in Heart Failure with Preserved Ejection Fraction.

    PubMed

    VAN Iterson, Erik H; Olson, Thomas P; Borlaug, Barry A; Johnson, Bruce D; Snyder, Eric M

    2017-09-01

    Cardiopulmonary exercise testing (CPET) plays an important role in properly phenotyping signs and symptoms of heart failure with preserved ejection fraction (HFpEF). The prognostic value of CPET is strengthened when accompanied by cardiac hemodynamic measurements. Although recognized as the "gold" standard, cardiac catheterization is impractical for routine CPET. Thus, advancing the scientific/methodologic understanding of noninvasive techniques for exercise cardiac hemodynamic assessment is clinically impactful in HFpEF. This study tested the concurrent validity of noninvasive acetylene gas (C2H2) uptake, echocardiography (ECHO), and oxygen pulse (O2pulse) for measuring/predicting exercise stroke volume (SV) in HFpEF. Eighteen white HFpEF and 18 age-/sex-matched healthy controls participated in upright CPET (ages, 69 ± 9 yr vs 63 ± 9 yr). At rest, 20 W, and peak exercise, SV was measured at steady-state via C2H2 rebreathe (SVACET) and ECHO (SVECHO), whereas O2pulse was derived (=V˙O2/HR). Resting relationships between SVACET and SVECHO, SVECHO and O2pulse, or SVACET and O2pulse were significant in HFpEF (R = 0.30, 0.36, 0.67), but not controls (R = 0.07, 0.01, 0.09), respectively. Resting relationships persisted to 20 W in HFpEF (R = 0.70, 0.53, 0.70) and controls (R = 0.05, 0.07, 0.21), respectively. Peak exercise relationships were significant in HFpEF (R = 0.62, 0.24, 0.64), but only for SVACET versus O2pulse in controls (R = 0.07, 0.04, 0.33), respectively. Standardized standard error of estimate between techniques was strongest in HFpEF at 20 W: SVACET versus SVECHO = 0.57 ± 0.22; SVECHO versus O2pulse = 0.71 ± 0.28; SVACET versus O2pulse = 0.56 ± 0.22. Constituting a clinically impactful step towards construct validation testing, these data suggest SVACET, SVECHO, and O2pulse demonstrate moderate-to-strong concurrent validity for measuring/predicting exercise SV in HFpEF.

  1. Application of Failure Mode and Effect Analysis (FMEA) and cause and effect analysis in conjunction with ISO 22000 to a snails (Helix aspersa) processing plant; A case study.

    PubMed

    Arvanitoyannis, Ioannis S; Varzakas, Theodoros H

    2009-08-01

    Failure Mode and Effect Analysis (FMEA) has been applied for the risk assessment of snails manufacturing. A tentative approach of FMEA application to the snails industry was attempted in conjunction with ISO 22000. Preliminary Hazard Analysis was used to analyze and predict the occurring failure modes in a food chain system (snails processing plant), based on the functions, characteristics, and/or interactions of the ingredients or the processes, upon which the system depends. Critical Control points have been identified and implemented in the cause and effect diagram (also known as Ishikawa, tree diagram, and fishbone diagram). In this work a comparison of ISO22000 analysis with HACCP is carried out over snails processing and packaging. However, the main emphasis was put on the quantification of risk assessment by determining the RPN per identified processing hazard. Sterilization of tins, bioaccumulation of heavy metals, packaging of shells and poisonous mushrooms, were the processes identified as the ones with the highest RPN (280, 240, 147, 144, respectively) and corrective actions were undertaken. Following the application of corrective actions, a second calculation of RPN values was carried out leading to considerably lower values (below the upper acceptable limit of 130). It is noteworthy that the application of Ishikawa (Cause and Effect or Tree diagram) led to converging results thus corroborating the validity of conclusions derived from risk assessment and FMEA. Therefore, the incorporation of FMEA analysis within the ISO22000 system of a snails processing industry is considered imperative.

  2. An assessment of BWR (boiling water reactor) Mark III containment challenges, failure modes, and potential improvements in performance

    SciTech Connect

    Schroeder, J.A.; Pafford, D.J.; Kelly, D.L.; Jones, K.R.; Dallman, F.J. )

    1991-01-01

    This report describes risk-significant challenges posed to Mark III containment systems by severe accidents as identified for Grand Gulf. Design similarities and differences between the Mark III plants that are important to containment performance are summarized. The accident sequences responsible for the challenges and the postulated containment failure modes associated with each challenge are identified and described. Improvements are discussed that have the potential either to prevent or delay containment failure, or to mitigate the offsite consequences of a fission product release. For each of these potential improvements, a qualitative analysis is provided. A limited quantitative risk analysis is provided for selected potential improvements. 21 refs., 5 figs., 46 tabs.

  3. Assessment of Canyon Wall Failure Process and Disturbance Gradients from Multibeam Bathymetry and Remotely Operated Vehicle (ROV) Observations, Puerto Rico and the U.S. Atlantic Continental Margin

    NASA Astrophysics Data System (ADS)

    Chaytor, J. D.; Demopoulos, A. W.; Ten Brink, U. S.; Quattrini, A.

    2016-02-01

    Over the last several years, canyons around Puerto Rico and along the U.S. Atlantic continental margin between Georges Bank and Cape Hatteras have been investigated using high-resolution multibeam bathymetry and Remotely Operated Vehicle (ROV) dives utilizing the exploration vessels E/V Nautilus and NOAA Ship Okeanos Explorer. The imaging capabilities of these ROVs have provided the opportunity to begin to investigate the size of canyon wall failures, the processes responsible for their occurrence and to develop a conceptual framework for determining their relative age. Bed and formation scale lithologies exposed in the canyons and localized structural features (bedding planes, fracture planes, etc.) appear to be the primary control on the style of failures observed. Near vertical walls, sedimented benches, talus slopes, and canyon floor debris aprons were present in most canyons visited. Evidence of brittle failure over different spatial and temporal scales, physical abrasion by downslope moving flows, and bio-erosion in the form of burrows and surficial scrape marks provide insight into the modification processes active in these canyons. The level of colonization by sessile species (e.g., corals, sponges) on the canyon walls and displaced material, especially on substrates affected by failure and sediment bioturbation, provide a critical, but as yet, poorly understood chronological record of geologic processes within these systems. Therefore, comparison of the processes among these geologically, oceanographically, and ecologically different regions provides the opportunity to critically assess the wide range of drivers that control recolonization of sessile fauna influenced by continuous or episodic disturbances.

  4. Increased crop failure due to climate change: assessing adaptation options using models and socio-economic data for wheat in China

    NASA Astrophysics Data System (ADS)

    Challinor, Andrew J.; Simelton, Elisabeth S.; Fraser, Evan D. G.; Hemming, Debbie; Collins, Mathew

    2010-07-01

    Tools for projecting crop productivity under a range of conditions, and assessing adaptation options, are an important part of the endeavour to prioritize investment in adaptation. We present ensemble projections of crop productivity that account for biophysical processes, inherent uncertainty and adaptation, using spring wheat in Northeast China as a case study. A parallel 'vulnerability index' approach uses quantitative socio-economic data to account for autonomous farmer adaptation. The simulations show crop failure rates increasing under climate change, due to increasing extremes of both heat and water stress. Crop failure rates increase with mean temperature, with increases in maximum failure rates being greater than those in median failure rates. The results suggest that significant adaptation is possible through either socio-economic measures such as greater investment, or biophysical measures such as drought or heat tolerance in crops. The results also show that adaptation becomes increasingly necessitated as mean temperature and the associated number of extremes rise. The results, and the limitations of this study, also suggest directions for research for linking climate and crop models, socio-economic analyses and crop variety trial data in order to prioritize options such as capacity building, plant breeding and biotechnology.

  5. ACE inhibitor intolerance and lessons learned from the candesartan in heart failure: assessment of reduction in mortality and morbidity (CHARM) trials.

    PubMed

    Sica, Domenic A

    2004-01-01

    The Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) trials looked at the effects of candesartan in addition to best possible treatment for heart failure in 7601 patients. CHARM encompassed three studies in discrete populations, including patients with left ventricular dysfunction taking angiotensin-converting enzyme (ACE) inhibitors (CHARM-Added), patients with maintained left ventricular function (CHARM-Preserved), and patients with left ventricular dysfunction and an intolerance to ACE inhibitors (CHARM-Alternative). CHARM-Alternative was considered a success in that its participants experienced a significant reduction in each component of the study's primary end point, which was a composite of cardiovascular death or hospitalization for heart failure, over a median follow-up of 34 months. Candesartan was by and large well tolerated in these ACE-inhibitor intolerant patients; thus, the findings of this study provide additional support for the effectiveness of angiotensin receptor blocker therapy in heart failure patients poorly tolerant of an ACE inhibitor; however, candesartan was not convincingly shown to improve the incidence/severity of hypotension, hyperkalemia, and glomerular filtration rate reductions that were the basis for ACE inhibitor intolerance in approximately 25% of the study population.

  6. Supervisory Control State Diagrams to Depict Autonomous Activity

    DTIC Science & Technology

    2013-06-01

    such as flowcharts, binary decision trees, goal graphs, finite state machine diagrams, and petri nets were assessed for their potential application...Horizons, 2010 p. 42). For future unmanned aerial vehicle (UAV) systems, the operator’s central responsibility conceivably shifts from teleoperation to...mission management and control for a team comprised of unmanned aerial vehicles (UAVs), unattended ground sensors (UGS), dismounted warfighters with

  7. Heart Failure

    MedlinePlus

    Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. Heart failure does not mean that your heart has stopped ... Tiredness and shortness of breath Common causes of heart failure are coronary artery disease, high blood pressure and ...

  8. Microtensile bond strength test and failure analysis to assess bonding characteristics of different adhesion approaches to ground versus unground enamel.

    PubMed

    Hipólito, Vinicius Di; Alonso, Roberta Caroline Bruschi; Carrilho, Marcela Rocha de Oliveira; Anauate Netto, Camillo; Sinhoreti, Mário Alexandre Coelho; Goes, Mario Fernando de

    2011-01-01

    This study evaluated the bonding characteristics to ground and unground enamel obtained with different strategies. For this purpose, 24 sound third-molars were bisected mesiodistally to obtain tooth halves. A flat enamel area was delimited in the tooth sections, which were randomly distributed into 8 groups (n=6), according to the enamel condition (ground and unground) and adhesive system (Adper Single Bond 2 - SB2; Adper Prompt L-Pop - PLP; Adper Prompt - AD; Clearfil SE Bond - SE). Each system was applied according manufacturers' instructions and a 6-mm-high resin composite "crown" was incrementally built up on bonded surfaces. Hourglass-shaped specimens with 0.8 mm(2) cross-section were produced. Microtensile bond strength (μTBS) was recorded and the failure patterns were classified. Results were analyzed by two-way ANOVA and Tukey's test (α=0.05). There were no statistically significant differences among the μTBS values of SB2, PLP and AD (p>0.05). SE values were significantly lower (p0.05). There was prevalence of cohesive failure within enamel, adhesive system and resin composite for SB2. The self-etch systems produced higher incidence of cohesive failures in the adhesive system. Enamel condition did not determine significant differences on bonding characteristics for the same bonding system. In conclusion, the bonding systems evaluated in this study resulted in specific μTBS and failure patterns due to the particular interaction with enamel.

  9. Counting planar diagrams with various restrictions

    NASA Astrophysics Data System (ADS)

    't Hooft, Gerard

    1999-01-01

    Explicit expressions are considered for the generating functions concerning the number of planar diagrams with given numbers of 3- and 4-point vertices. It is observed that planar renormalization theory requires diagrams with restrictions, in the sense that one wishes to omit 'tadpole' insertions and 'seagull' insertions; at a later stage also self-energy insertions are to be removed, and finally also the dressed 3-point insertions and the dressed 4-point insertions. Diagrams with such restrictions can all be counted exactly. This results in various critical lines in the λ- g plane, where λ and g are effective zero-dimensional coupling constants. These lines can be localized exactly.

  10. Phase diagrams of self-organizing maps

    NASA Astrophysics Data System (ADS)

    Bauer, H.-U.; Riesenhuber, M.; Geisel, T.

    1996-09-01

    We present a method which allows the analytic determination of phase diagrams in the self-organizing map, a model for the formation of topographic projection patterns in the brain and in signal processing applications. The method only requires an ansatz for the tesselation of the data space induced by the map, not for the explicit state of the map. We analytically obtain phase diagrams for various examples, including models for the development of orientation and ocular-dominance maps. The latter phase diagram exhibits transitions to broadening ocular-dominance patterns as observed in a recent experiment.

  11. Optimized goodman diagram for the analysis of fiberglass composites used in wind turbine blades.

    SciTech Connect

    Mandell, John F.; Sutherland, Herbert J.

    2004-10-01

    Mandell, et al have recently presented an updated Goodman diagram for a fiberglass composite that is a typical wind turbine blade material. Their formulation uses the MSU/DOE Fatigue Data Base to develop a Goodman diagram with detailed S-N information at thirteen R-values. This diagram is the most detailed to date, and it includes several loading conditions that have been poorly represented in earlier studies. Sutherland and Mandell have used this formulation to analyze typical loads data from operating wind farms and the failure of coupons subjected to spectral loading. The detailed Goodman diagram used in these analyses requires a significant investment in materials testing that is usually outside the bounds of typical design standards for wind turbine blades. Thus, the question has become: How many S-N curves are required for the construction of a Goodman diagram that is sufficient for an 'accurate' prediction of equivalent fatigue loads and service lifetimes? To answer this question, the loads data from two operating wind turbines and the failure of coupons tested using the WISPERX spectra are analyzed using both a linear and a non-linear damage model. For the analysis, the predicted service lifetimes that are based on the Goodman diagram constructed from 13 R-values are compared to the predictions for Goodman diagrams constructed with fewer R-values. The results illustrate the optimum number of R-values is 5 with them concentrated between R-values of -2 and 0.5, or -2 and 0.7.

  12. CADDIS Volume 5. Causal Databases: Interactive Conceptual Diagrams (ICDs)

    EPA Pesticide Factsheets

    In Interactive Conceptual Diagram (ICD) section of CADDIS allows users to create conceptual model diagrams, search a literature-based evidence database, and then attach that evidence to their diagrams.

  13. Covariant diagrams for one-loop matching

    DOE PAGES

    Zhang, Zhengkang

    2017-05-30

    Here, we present a diagrammatic formulation of recently-revived covariant functional approaches to one-loop matching from an ultraviolet (UV) theory to a low-energy effective fi eld theory. Various terms following from a covariant derivative expansion (CDE) are represented by diagrams which, unlike conventional Feynman diagrams, involve gauge-covariant quantities and are thus dubbed "covariant diagrams." The use of covariant diagrams helps organize and simplify one-loop matching calculations, which we illustrate with examples. Of particular interest is the derivation of UV model-independent universal results, which reduce matching calculations of specifi c UV models to applications of master formulas. We also show how suchmore » derivation can be done in a more concise manner than the previous literature, and discuss how additional structures that are not directly captured by existing universal results, including mixed heavy-light loops, open covariant derivatives, and mixed statistics, can be easily accounted for.« less

  14. Some Geometric Aspects of the Ternary Diagram.

    ERIC Educational Resources Information Center

    Philip, G. M.; Watson, D. F.

    1989-01-01

    Uses the process of normalization in the Cartesian coordinate system which entails radial projection onto a transect to compare different compositions of minerals. Warns that the ternary diagram should not be used as a framework for calculations. (MVL)

  15. An Improved Mnemonic Diagram for Thermodynamic Relationships.

    ERIC Educational Resources Information Center

    Rodriguez, Joaquin; Brainard, Alan J.

    1989-01-01

    Considers pressure, volume, entropy, temperature, Helmholtz free energy, Gibbs free energy, enthalpy, and internal energy. Suggests the mnemonic diagram is for use with simple systems that are defined as macroscopically homogeneous, isotropic, uncharged, and chemically inert. (MVL)

  16. Covariant diagrams for one-loop matching

    NASA Astrophysics Data System (ADS)

    Zhang, Zhengkang

    2017-05-01

    We present a diagrammatic formulation of recently-revived covariant functional approaches to one-loop matching from an ultraviolet (UV) theory to a low-energy effective field theory. Various terms following from a covariant derivative expansion (CDE) are represented by diagrams which, unlike conventional Feynman diagrams, involve gauge-covariant quantities and are thus dubbed "covariant diagrams." The use of covariant diagrams helps organize and simplify one-loop matching calculations, which we illustrate with examples. Of particular interest is the derivation of UV model-independent universal results, which reduce matching calculations of specific UV models to applications of master formulas. We show how such derivation can be done in a more concise manner than the previous literature, and discuss how additional structures that are not directly captured by existing universal results, including mixed heavy-light loops, open covariant derivatives, and mixed statistics, can be easily accounted for.

  17. Architecture flow diagrams under teamwork reg sign

    SciTech Connect

    Nicinski, T.

    1992-02-01

    The Teamwork CASE tool allows Data Flow Diagrams (DFDs) to be maintained for structured analysis. Fermilab has extended teamwork under UNIX{trademark} to permit Hatley and Pirbhai Architecture Flow Diagrams (AFDs) to be associated with DFDs and subsequently maintained. This extension, called TWKAFD, allows a user to open an AFD, graphically edit it, and replace it into a TWKAFD maintained library. Other aspects of Hatley and Pirbhai's methodology are supported. This paper presents a quick tutorial on Architecture Diagrams. It then describes the user's view of TWKAFD, the experience incorporating it into teamwork, and the successes with using the Architecture Diagram methodology along with the shortcomings of using the teamwork/TWKAFD tool. 8 refs.

  18. Veitch diagram plotter simplifies Boolean functions

    NASA Technical Reports Server (NTRS)

    Rubin, D. K.

    1964-01-01

    This device for simplifying the plotting of a Veitch diagram consists of several overlays for blocking out the unwanted squares. This method of plotting the various input combinations to a computer is used in conjunction with the Boolean functions.

  19. An Improved Mnemonic Diagram for Thermodynamic Relationships.

    ERIC Educational Resources Information Center

    Rodriguez, Joaquin; Brainard, Alan J.

    1989-01-01

    Considers pressure, volume, entropy, temperature, Helmholtz free energy, Gibbs free energy, enthalpy, and internal energy. Suggests the mnemonic diagram is for use with simple systems that are defined as macroscopically homogeneous, isotropic, uncharged, and chemically inert. (MVL)

  20. A Smart Thermal Block Diagram Tool

    NASA Technical Reports Server (NTRS)

    Tsuyuki, Glenn; Miyake, Robert; Dodge, Kyle

    2008-01-01

    The presentation describes a Smart Thermal Block Diagram Tool. It is used by JPL's Team X in studying missions during the Pre-Phase A. It helps generate cost and mass estimates using proprietary data bases.

  1. Non-Invasive Ventilation (NIV) and Homeostatic Model Assessment (HOMA) Index in Stable Chronic Obstructive Pulmonary Disease (COPD) Patients with Chronic Hypercapnic Respiratory Failure: A Pilot Study.

    PubMed

    Dimoulis, Andreas; Pastaka, Chaido; Tsolaki, Vasiliki; Tsilioni, Irini; Pournaras, Spyridon; Liakos, Nikolaos; Georgoulias, Panagiotis; Gourgoulianis, Konstantinos

    2015-08-01

    The effects of Non-invasive Ventilation (NIV) on Insulin Resistance (IR) in stable Chronic Obstructive Pulmonary Disease (COPD) patients have not been fully explored. The aim of this study was to assess the effects of NIV on IR and adiponectin levels during one year application of NIV in stable COPD patients with Chronic Hypercapnic Respiratory Failure. Twenty-five (25) stable COPD patients with Chronic Hypercapnic Respiratory Failure and with no self-reported comorbidities completed the study. NIV was administered in the spontaneous/timed mode via a full face mask using a bi-level positive airway pressure system. Spirometry, blood pressure, arterial blood gases, dyspnea, daytime sleepiness, serum fasting glucose and insulin levels were assessed. IR was assessed with the calculation of the Homeostatic Model Assessment (HOMA) index. Adiponectin was measured with radioimmunoassay. Study participants were re-evaluated on the first, third, sixth, ninth and twelfth month after the initial evaluation. There was a significant improvement in FEV1 values from the first month (34.1 ± 11.6% vs 37 ± 12.3%, p = 0.05). There was a significant decrease in IR by the ninth month of NIV use (3.4 ± 2.3 vs 2.2 ± 1.4, p < 0.0001), while adiponectin levels significantly improved from the first month of NIV use. Stepwise regression analysis revealed that baseline HOMA index was associated with paCO2 (β = 0.07 ± 0.02, p = 0.001), while baseline adiponectin levels were associated with FVC (β = 0.05 ± 0.02, p = 0.035) and the concentration of serum bicarbonate (HCO3-) (-β = 0.18 ± 0.06, p = 0.002). Insulin sensitivity and glucose metabolism as well as adiponectin levels improved along with the improvements in respiratory failure.

  2. Gluing Ladder Feynman Diagrams into Fishnets

    DOE PAGES

    Basso, Benjamin; Dixon, Lance J.

    2017-08-14

    We use integrability at weak coupling to compute fishnet diagrams for four-point correlation functions in planar Φ 4 theory. Our results are always multilinear combinations of ladder integrals, which are in turn built out of classical polylogarithms. The Steinmann relations provide a powerful constraint on such linear combinations, which leads to a natural conjecture for any fishnet diagram as the determinant of a matrix of ladder integrals.

  3. Lattice and Phase Diagram in QCD

    SciTech Connect

    Lombardo, Maria Paola

    2008-10-13

    Model calculations have produced a number of very interesting expectations for the QCD Phase Diagram, and the task of a lattice calculations is to put these studies on a quantitative grounds. I will give an overview of the current status of the lattice analysis of the QCD phase diagram, from the quantitative results of mature calculations at zero and small baryochemical potential, to the exploratory studies of the colder, denser phase.

  4. A universal structured-design diagramer

    NASA Technical Reports Server (NTRS)

    1981-01-01

    Program (FLOWCHARTER) generates standardized flowcharts and concordances for development and debugging of programs in any language. User describes programming-language grammar, providing syntax rules in Backus-Naur form (BNF), list of semantic rules, and set of concordance rules. Once grammar is described, user supplies only source code of program to be diagrammed. FLOWCHARTER automatically produces flow diagram and concordance. Source code for program is written for PASCAL Release 2 compiler, as distributed by University of Minnesota.

  5. Elementary diagrams in nuclear and neutron matter

    SciTech Connect

    Wiringa, R.B.

    1995-08-01

    Variational calculations of nuclear and neutron matter are currently performed using a diagrammatic cluster expansion with the aid of nonlinear integral equations for evaluating expectation values. These are the Fermi hypernetted chain (FHNC) and single-operator chain (SOC) equations, which are a way of doing partial diagram summations to infinite order. A more complete summation can be made by adding elementary diagrams to the procedure. The simplest elementary diagrams appear at the four-body cluster level; there is one such E{sub 4} diagram in Bose systems, but 35 diagrams in Fermi systems, which gives a level of approximation called FHNC/4. We developed a novel technique for evaluating these diagrams, by computing and storing 6 three-point functions, S{sub xyz}(r{sub 12}, r{sub 13}, r{sub 23}), where xyz (= ccd, cce, ddd, dde, dee, or eee) denotes the exchange character at the vertices 1, 2, and 3. All 35 Fermi E{sub 4} diagrams can be constructed from these 6 functions and other two-point functions that are already calculated. The elementary diagrams are known to be important in some systems like liquid {sup 3}He. We expect them to be small in nuclear matter at normal density, but they might become significant at higher densities appropriate for neutron star calculations. This year we programmed the FHNC/4 contributions to the energy and tested them in a number of simple model cases, including liquid {sup 3}He and Bethe`s homework problem. We get reasonable, but not exact agreement with earlier published work. In nuclear and neutron matter with the Argonne v{sub 14} interaction these contributions are indeed small corrections at normal density and grow to only 5-10 MeV/nucleon at 5 times normal density.

  6. Gluing Ladder Feynman Diagrams into Fishnets

    NASA Astrophysics Data System (ADS)

    Basso, Benjamin; Dixon, Lance J.

    2017-08-01

    We use integrability at weak coupling to compute fishnet diagrams for four-point correlation functions in planar ϕ4 theory. The results are always multilinear combinations of ladder integrals, which are in turn built out of classical polylogarithms. The Steinmann relations provide a powerful constraint on such linear combinations, leading to a natural conjecture for any fishnet diagram as the determinant of a matrix of ladder integrals.

  7. Reliability computation from reliability block diagrams

    NASA Technical Reports Server (NTRS)

    Chelson, P. O.; Eckstein, R. E.

    1971-01-01

    A method and a computer program are presented to calculate probability of system success from an arbitrary reliability block diagram. The class of reliability block diagrams that can be handled include any active/standby combination of redundancy, and the computations include the effects of dormancy and switching in any standby redundancy. The mechanics of the program are based on an extension of the probability tree method of computing system probabilities.

  8. ISS EPS Orbital Replacement Unit Block Diagrams

    NASA Technical Reports Server (NTRS)

    Schmitz, Gregory V.

    2001-01-01

    The attached documents are being provided to Switching Power Magazine for information purposes. This magazine is writing a feature article on the International Space Station Electrical Power System, focusing on the switching power processors. These units include the DC-DC Converter Unit (DDCU), the Bi-directional Charge/Discharge Unit (BCDU), and the Sequential Shunt Unit (SSU). These diagrams are high-level schematics/block diagrams depicting the overall functionality of each unit.

  9. Failure Mechanisms and Evolution Assessment of the Excavation Damaged Zones in a Large-Scale and Deeply Buried Underground Powerhouse

    NASA Astrophysics Data System (ADS)

    Li, Hai-bo; Liu, Ming-chang; Xing, Wan-bo; Shao, Shuai; Zhou, Jia-wen

    2017-07-01

    The Jinping I underground powerhouse is deeply buried and is one of the largest underground powerhouses in China. As a result of high levels of in situ stress, complex geological conditions and the effects of excavation in adjacent caverns, the surrounding rock mass has been severely deformed and broken, and excavation damaged zones (EDZs) have become major obstacles to the design of cavern excavation and support. Field investigations and monitoring data indicated that there are two main modes of failure: high tangential stress induced failure and progressive failure, which have occurred on the mountain side and the river valley side of the Jinping I underground powerhouse. These two main modes of failure were due to strong secondary principal stress forces in the sub-parallel directions and sub-vertical directions, acting on the axes of the main powerhouse on the mountain side and on the river valley side, respectively. Deformations and EDZs on the river valley side were generally larger than those found along the mountain side, and the distribution of deformations was consistent with the distribution of EDZs. The evolution of the EDZ on the river valley side has clearly been time dependent, especially along the downstream arch abutment, and the EDZ was considerably enlarged with further excavation. Additionally, the deformation of the surrounding rock mass was first initiated from the edge of the excavation area and gradually extended to deeper areas away from the opening. However, the EDZ on the mountain side was enlarged only during the first two phases of excavation. The extension of pre-existing cracks and the creation of new fractures has mainly occurred in the oldest EDZ section, and the HDZ has been visibly enlarged, whereas the EDZ has shown little change in other excavation phases.

  10. Maintaining Interrater Agreement of Core Assessment Instruments in a Multisite Randomized Controlled Clinical Trial: The Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE) Trial.

    PubMed

    Lebet, Ruth; Hayakawa, Jennifer; Chamblee, Tracy B; Tala, Joana A; Singh, Nakul; Wypij, David; Curley, Martha A Q

    RESTORE (Randomized Evaluation of Sedation Titration for Respiratory Failure) was a cluster randomized clinical trial evaluating a sedation strategy in children 2 weeks to <18 years of age with acute respiratory failure supported on mechanical ventilation. A total of 31 U.S. pediatric intensive care units (PICUs) participated in the trial. Staff nurse rater agreement on measures used to assess a critical component of treatment fidelity was essential throughout the 4-year data collection period. The purpose of the study is to describe the method of establishing and maintaining interrater agreement (IRA) of two core clinical assessment instruments over the course of the clinical trial. IRA cycles were carried out at all control and intervention sites and included a minimum of five measurements of the State Behavioral Scale (SBS) and Withdrawal Assessment Tool-Version 1 (WAT-1). Glasgow Coma Scale scores were also obtained. PICUs demonstrating <80% agreement repeated their IRA cycle. Fleiss's kappa coefficient was used to assess IRA. Repeated IRA cycles were required for 8% of 226 SBS cycles and 2% of 222 WAT-1 cycles. Fleiss's kappa coefficients from more than 1,350 paired assessments were .86 for SBS and .92 for WAT-1, demonstrating strong agreement and similar to .91 for the Glasgow Coma Scale. There was no difference in Fleiss's kappa for any of the instruments based on unit size or timing of assessment (earlier or later in the study). For SBS scores, Fleiss's kappa was significantly different in larger and smaller PICUs (.82 vs. .92, p = .003); however, Fleiss's kappa for both groups indicated excellent agreement. Monitoring measurement reliability is an essential step in ensuring treatment fidelity and, thus, the validity of study results. Standardization on the use of these core assessment instruments among participating sites was achieved and maintained throughout the trial.

  11. Structured LSA Task 301. Functional Requirements Icentification. Subtask 301.2.4.1. Failure Mode, Effect & Criticality Analysis (FMECA)

    DTIC Science & Technology

    1988-04-01

    DEVELOP GROuE RULES AND ASSUMPTIONS) ITK/FUN ITEM ACRONYMS: FMlA - FAILURE MODE AND EFFECT ANALYSIS FUNCTION L8AR - LOGISTIC SUPPORT ANALYSIS RECORD...Fiu/BLK/DIA FUNCTIONAL ACRONM: FMLA ...FAILURE MODE AND EFFECTS ANALYSIS BLOCK DIAGRAM PURPOSE OF DATA: ALLOW TUE ANALYST ACCESS TO THE FUNCTIONAL BLOCK DIAGRAMS NEEDED TO COPLETE TUE FMlA

  12. Reliability block diagrams to model the management of colorectal cancer.

    PubMed

    Sonnenberg, A; Inadomi, J M

    1999-02-01

    The present study aims to show how various medical and nonmedical components contribute to success and failure in the management of colorectal cancer. The first encounter, subsequent diagnosis, and surgical therapy of a patient with Dukes B sigmoid cancer is modeled as a reliability block diagram with a serial and parallel arrangement of various components. The overall probability of a patient with new-onset colorectal cancer to visit a physician, be correctly diagnosed, and undergo successful therapy is 69%. The reduction in the overall success, despite the fact that the majority of components are assumed to function with failure rates of 5% or less, is a reflection of the multitude of serial subsystems involved in the management of the patient. In contrast, the parallel arrangement of subsystems results in a relative insensitivity of the overall system to failure, a greater stability, and an improved performance. Since no medical system functions perfectly, redundancy associated with parallel subsystems assures a better overall outcome. System analysis of health care provides a means to improve its performance.

  13. The laboratory comparison of shear bond strength and microscopic assessment of failure modes for a glass-ionomer cement and dentin bonding systems combined with silver nanoparticles.

    PubMed

    Porenczuk, Alicja; Firlej, Piotr; Szczepańska, Grażyna; Kolenda, Adam; Olczak-Kowalczyk, Dorota

    2016-01-01

    More than half of the cavity restorations are replaced due to bacterial microleakage. A need for disinfection agents arises. Application of silver nanoparticles (AgNPs) may be beneficial, yet their impact on the adhesives' shear bond strength to dentin remains unknown. The aim was to assess the shear bond strength to dentin of different dental materials combined with AgNPs. Failure modes were also examined using SEM/FIB, SEM/EDS and endodontic microscopes. The results showed no impact of AgNPs addition to dental materials in terms of shear bond strength to dentin. A change of the failure mode of the self-etch bonding system, Clearfil SE Bond, combined with AgNPs was observed. The new failure modes depended upon the order of application of the materials onto dentin. The microscopic evaluation of the samples showed the presence of AgNPs agglomerations gathered on the dentin's surface. AgNPs connection with self-etching dentin bonding system may have a serious clinical impact.

  14. Economic impact assessment from the use of a mobile app for the self-management of heart diseases by patients with heart failure in a Spanish region.

    PubMed

    Cano Martín, José Antonio; Martínez-Pérez, Borja; de la Torre-Díez, Isabel; López-Coronado, Miguel

    2014-09-01

    Currently, cardiovascular diseases are the deadliest diseases with a total of 17 million deaths worldwide. Hence, they are the focus of many mobile applications for smartphones and tablets. This paper will assess the ex-ante economic impact as well as will determine the cost-effectiveness analysis that the use of one of this app, CardioManager, by patients with heart failure will have in a Spanish community, Castile and Leon. For this, a cost-effectiveness analysis using the hidden Markov model were performed in a hypothetical cohort of patients diagnosed with heart failure, based on the information of epidemiological parameters and the costs derived from the management and care of heart failure patients by the Public Health Care System of Castile and Leon. The costs of patient care were estimated from the perspective of the Ministry of Health of Spain using a discount rate of 3 %. Finally, an estimation of the ex-ante impact that would suppose the introduction of CardioManager in the Health Care System is performed. It is concluded that the introduction of CardioManager may generate a 33 % reduction in the cost of management and treatment of the disease. This means that CardioManager may be able to save more than 9,000 € per patient to the local Health Care System of Castile and Leon, which can be translated in a saving of 0.31 % of the total health expenditure of the region.

  15. The five-point Likert scale for dyspnea can properly assess the degree of pulmonary congestion and predict adverse events in heart failure outpatients

    PubMed Central

    Weber, Cristina K; Miglioranza, Marcelo H; de Moraes, Maria A P; Sant'anna, Roberto T; Rover, Marciane M; Kalil, Renato A K; Leiria, Tiago Luiz L

    2014-01-01

    OBJECTIVES: Proper assessment of dyspnea is important in patients with heart failure. Our aim was to evaluate the use of the 5-point Likert scale for dyspnea to assess the degree of pulmonary congestion and to determine the prognostic value of this scale for predicting adverse events in heart failure outpatients. METHODS: We undertook a prospective study of outpatients with moderate to severe heart failure. The 5-point Likert scale was applied during regular outpatient visits, along with clinical assessments. Lung ultrasound with ≥15 B-lines and an amino-terminal portion of pro-B-type natriuretic peptide (NT-proBNP) level >1000 pg/mL were used as a reference for pulmonary congestion. The patients were then assessed every 30 days during follow-up to identify adverse clinical outcomes. RESULTS: We included 58 patients (65.5% male, age 43.5±11 years) with a mean left ventricular ejection fraction of 27±6%. In total, 29.3% of these patients had heart failure with ischemic etiology. Additionally, pulmonary congestion, as diagnosed by lung ultrasound, was present in 58% of patients. A higher degree of dyspnea (3 or 4 points on the 5-point Likert scale) was significantly correlated with a higher number of B-lines (p = 0.016). Patients stratified into Likert = 3-4 were at increased risk of admission compared with those in class 1-2 after adjusting for age, left ventricular ejection fraction, New York Heart Association functional class and levels of NT-proBNP >1000 pg/mL (HR = 4.9, 95% CI 1.33-18.64, p = 0.017). CONCLUSION: In our series, higher baseline scores on the 5-point Likert scale were related to pulmonary congestion and were independently associated with adverse events during follow-up. This simple clinical tool can help to identify patients who are more likely to decompensate and whose treatment should be intensified. PMID:24838900

  16. Investigating the Impact of Different Suspicion of Infection Criteria on the Accuracy of Quick Sepsis-Related Organ Failure Assessment, Systemic Inflammatory Response Syndrome, and Early Warning Scores.

    PubMed

    Churpek, Matthew M; Snyder, Ashley; Sokol, Sarah; Pettit, Natasha N; Edelson, Dana P

    2017-07-21

    Studies in sepsis are limited by heterogeneity regarding what constitutes suspicion of infection. We sought to compare potential suspicion criteria using antibiotic and culture order combinations in terms of patient characteristics and outcomes. We further sought to determine the impact of differing criteria on the accuracy of sepsis screening tools and early warning scores. Observational cohort study. Academic center from November 2008 to January 2016. Hospitalized patients outside the ICU. None. Six criteria were investigated: 1) any culture, 2) blood culture, 3) any culture plus IV antibiotics, 4) blood culture plus IV antibiotics, 5) any culture plus IV antibiotics for at least 4 of 7 days, and 6) blood culture plus IV antibiotics for at least 4 of 7 days. Accuracy of the quick Sepsis-related Organ Failure Assessment score, Sepsis-related Organ Failure Assessment score, systemic inflammatory response syndrome criteria, the National and Modified Early Warning Score, and the electronic Cardiac Arrest Risk Triage score were calculated for predicting ICU transfer or death within 48 hours of meeting suspicion criteria. A total of 53,849 patients met at least one infection criteria. Mortality increased from 3% for group 1 to 9% for group 6 and percentage meeting Angus sepsis criteria increased from 20% to 40%. Across all criteria, score discrimination was lowest for systemic inflammatory response syndrome (median area under the receiver operating characteristic curve, 0.60) and Sepsis-related Organ Failure Assessment score (median area under the receiver operating characteristic curve, 0.62), intermediate for quick Sepsis-related Organ Failure Assessment (median area under the receiver operating characteristic curve, 0.65) and Modified Early Warning Score (median area under the receiver operating characteristic curve 0.67), and highest for National Early Warning Score (median area under the receiver operating characteristic curve 0.71) and electronic Cardiac Arrest

  17. Support for Training Effectiveness Assessment and Data Interoperability (STEADI)

    DTIC Science & Technology

    2017-05-02

    3 STEADI use case diagram working draft ............................................14 Fig. 4 STEADI Architecture Design Methodology and Tool...15 Fig. 5 STEADI use cases diagram .................................................................16 Fig. 6 STEADI architecture... diagram .............................................................17 List of Tables Table 1 Rifle marksmanship assessment constructs

  18. No Such Thing as Failure, Only Feedback: Designing Innovative Opportunities for E-Assessment and Technology-Mediated Feedback

    ERIC Educational Resources Information Center

    Miller, Charles; Doering, Aaron; Scharber, Cassandra

    2010-01-01

    In this paper we challenge designers, researchers, teachers, students, and parents to re-assess and re-envision the value of technology-mediated feedback and e-assessment by examining the innovative roles feedback and assessment played in the design of three contemporary web-based learning environments. These environments include 1) an…

  19. A practical approach to assess leg muscle oxygenation during ramp-incremental cycle ergometry in heart failure.

    PubMed

    Barroco, A C; Sperandio, P A; Reis, M; Almeida, D R; Neder, J A

    2017-10-02

    Heart failure is characterized by the inability of the cardiovascular system to maintain oxygen (O2) delivery (i.e., muscle blood flow in non-hypoxemic patients) to meet O2 demands. The resulting increase in fractional O2 extraction can be non-invasively tracked by deoxygenated hemoglobin concentration (deoxi-Hb) as measured by near-infrared spectroscopy (NIRS). We aimed to establish a simplified approach to extract deoxi-Hb-based indices of impaired muscle O2 delivery during rapidly-incrementing exercise in heart failure. We continuously probed the right vastus lateralis muscle with continuous-wave NIRS during a ramp-incremental cardiopulmonary exercise test in 10 patients (left ventricular ejection fraction <35%) and 10 age-matched healthy males. Deoxi-Hb is reported as % of total response (onset to peak exercise) in relation to work rate. Patients showed lower maximum exercise capacity and O2 uptake-work rate than controls (P<0.05). The deoxi-Hb response profile as a function of work rate was S-shaped in all subjects, i.e., it presented three distinct phases. Increased muscle deoxygenation in patients compared to controls was demonstrated by: i) a steeper mid-exercise deoxi-Hb-work rate slope (2.2±1.3 vs 1.0±0.3% peak/W, respectively; P<0.05), and ii) late-exercise increase in deoxi-Hb, which contrasted with stable or decreasing deoxi-Hb in all controls. Steeper deoxi-Hb-work rate slope was associated with lower peak work rate in patients (r=-0.73; P=0.01). This simplified approach to deoxi-Hb interpretation might prove useful in clinical settings to quantify impairments in O2 delivery by NIRS during ramp-incremental exercise in individual heart failure patients.

  20. A practical approach to assess leg muscle oxygenation during ramp-incremental cycle ergometry in heart failure

    PubMed Central

    Barroco, A.C.; Sperandio, P.A.; Reis, M.; Almeida, D.R.; Neder, J.A.

    2017-01-01

    Heart failure is characterized by the inability of the cardiovascular system to maintain oxygen (O2) delivery (i.e., muscle blood flow in non-hypoxemic patients) to meet O2 demands. The resulting increase in fractional O2 extraction can be non-invasively tracked by deoxygenated hemoglobin concentration (deoxi-Hb) as measured by near-infrared spectroscopy (NIRS). We aimed to establish a simplified approach to extract deoxi-Hb-based indices of impaired muscle O2 delivery during rapidly-incrementing exercise in heart failure. We continuously probed the right vastus lateralis muscle with continuous-wave NIRS during a ramp-incremental cardiopulmonary exercise test in 10 patients (left ventricular ejection fraction <35%) and 10 age-matched healthy males. Deoxi-Hb is reported as % of total response (onset to peak exercise) in relation to work rate. Patients showed lower maximum exercise capacity and O2 uptake-work rate than controls (P<0.05). The deoxi-Hb response profile as a function of work rate was S-shaped in all subjects, i.e., it presented three distinct phases. Increased muscle deoxygenation in patients compared to controls was demonstrated by: i) a steeper mid-exercise deoxi-Hb-work rate slope (2.2±1.3 vs 1.0±0.3% peak/W, respectively; P<0.05), and ii) late-exercise increase in deoxi-Hb, which contrasted with stable or decreasing deoxi-Hb in all controls. Steeper deoxi-Hb-work rate slope was associated with lower peak work rate in patients (r=–0.73; P=0.01). This simplified approach to deoxi-Hb interpretation might prove useful in clinical settings to quantify impairments in O2 delivery by NIRS during ramp-incremental exercise in individual heart failure patients. PMID:28977120

  1. Key indicator tools for shallow slope failure assessment using soil chemical property signatures and soil colour variables.

    PubMed

    Othman, Rashidi; Hasni, Shah Irani; Baharuddin, Zainul Mukrim; Hashim, Khairusy Syakirin Has-Yun; Mahamod, Lukman Hakim

    2017-07-18

    Slope failure has become a major concern in Malaysia due to the rapid development and urbanisation in the country. It poses severe threats to any highway construction industry, residential areas, natural resources and tourism activities. The extent of damages that resulted from this catastrophe can be lessened if a long-term early warning system to predict landslide prone areas is implemented. Thus, this study aims to characterise the relationship between Oxisols properties and soil colour variables to be manipulated as key indicators to forecast shallow slope failure. The concentration of each soil property in slope soil was evaluated from two different localities that consist of 120 soil samples from stable and unstable slopes located along the North-South Highway (PLUS) and East-West Highway (LPT). Analysis of variance established highly significant difference (P < 0.0001) between the locations, the total organic carbon (TOC), soil pH, cation exchange capacity (CEC), soil texture, soil chromaticity and all combinations of interactions. The overall CIELAB analysis leads to the conclusion that the CIELAB variables lightness L*, c* (Chroma) and h* (Hue) provide the most information about soil colour and other related soil properties. With regard to the relationship between colour variables and soil properties, the analysis detected that soil texture, organic carbon, iron oxide and aluminium concentration were the key factors that strongly correlate with soil colour variables at the studied area. Indicators that could be used to predict shallow slope failure were high value of L*(62), low values of c* (20) and h* (66), low concentration of iron (53 mg kg(-1)) and aluminium oxide (37 mg kg(-1)), low soil TOC (0.5%), low CEC (3.6 cmol/kg), slightly acidic soil pH (4.9), high amount of sand fraction (68%) and low amount of clay fraction (20%).

  2. Heart failure in pregnancy.

    PubMed

    Rutherford, John D

    2012-12-01

    With increasing maternal age and the presence of comorbid conditions such as hypertension, cardiovascular assessment and monitoring is the responsibility of all clinicians caring for pregnant patients. Furthermore, there are specific conditions, such as mitral stenosis, peripartum cardiomyopathy, and preeclampsia, that can be associated with heart failure and secondary maternal (and fetal) mortality and morbidity. The important causes of heart failure in pregnancy are discussed.

  3. Proposal on How To Conduct a Biopharmaceutical Process Failure Mode and Effect Analysis (FMEA) as a Risk Assessment Tool.

    PubMed

    Zimmermann, Hartmut F; Hentschel, Norbert

    2011-01-01

    With the publication of the quality guideline ICH Q9 "Quality Risk Management" by the International Conference on Harmonization, risk management has already become a standard requirement during the life cycle of a pharmaceutical product. Failure mode and effect analysis (FMEA) is a powerful risk analysis tool that has been used for decades in mechanical and electrical industries. However, the adaptation of the FMEA methodology to biopharmaceutical processes brings about some difficulties. The proposal presented here is intended to serve as a brief but nevertheless comprehensive and detailed guideline on how to conduct a biopharmaceutical process FMEA. It includes a detailed 1-to-10-scale FMEA rating table for occurrence, severity, and detectability of failures that has been especially designed for typical biopharmaceutical processes. The application for such a biopharmaceutical process FMEA is widespread. It can be useful whenever a biopharmaceutical manufacturing process is developed or scaled-up, or when it is transferred to a different manufacturing site. It may also be conducted during substantial optimization of an existing process or the development of a second-generation process. According to their resulting risk ratings, process parameters can be ranked for importance and important variables for process development, characterization, or validation can be identified. Health authorities around the world ask pharmaceutical companies to manage risk during development and manufacturing of pharmaceuticals. The so-called failure mode and effect analysis (FMEA) is an established risk analysis tool that has been used for decades in mechanical and electrical industries. However, the adaptation of the FMEA methodology to pharmaceutical processes that use modern biotechnology (biopharmaceutical processes) brings about some difficulties, because those biopharmaceutical processes differ from processes in mechanical and electrical industries. The proposal presented here

  4. Assessment of nutritional status by composite index for anthropometric failure: a study among slum children in Bankura, West Bengal.

    PubMed

    Shit, Subhadeep; Taraphdar, Pranita; Mukhopadhyay, Dipta K; Sinhababu, Apurba; Biswas, Akhil B

    2012-01-01

    A community-based cross-sectional study was conducted to find out the prevalence of composite index of anthropometric failure (CIAF) among 117 slum dwelling under-five children in Bankura town, West Bengal and its relation with some common socio-economic factors. Among study population, the prevalence of underweight was 41.6%, whereas CIAF was 80.3%. CIAF gave a near complete estimation of undernutrition unlike underweight. Children who were unimmunized, with more number of siblings, living in a nuclear family, or with illiterate mothers were more likely to be undernourished.

  5. Assessing the Quality and Comparative Effectiveness of Team-Based Care for Heart Failure: Who, What, Where, When, and How.

    PubMed

    Cooper, Lauren B; Hernandez, Adrian F

    2015-07-01

    Team-based or multidisciplinary care may be a potential way to positively impact outcomes for heart failure (HF) patients by improving clinical outcomes, managing patient symptoms, and reducing costs. The multidisciplinary team includes the HF cardiologist, HF nurses, clinical pharmacists, dieticians, exercise specialists, mental health providers, social workers, primary care providers, and additional subspecialty providers. The timing and setting of multidisciplinary care depends on the needs of the patient and the resources available. Multidisciplinary HF teams should be evaluated based on their ability to achieve goals, as well as their potential for sustainability over time.

  6. Impact of hyperkalaemia definition on incidence assessment: implications for epidemiological research based on a large cohort study in newly diagnosed heart failure patients in primary care.

    PubMed

    Martín-Pérez, Mar; Ruigómez, Ana; Michel, Alexander; García Rodríguez, Luis A

    2016-05-04

    Various definitions of hyperkalaemia have been used in clinical research, and data from routine clinical practice on its incidence are sparse. We aimed to establish the incidence of hyperkalaemia in patients with newly diagnosed heart failure in the UK general population using different definitions for the condition. We conducted a large retrospective cohort study using data from The Health Improvement Network primary care database. Patients with newly diagnosed heart failure (N = 19,194) were identified and followed until the first occurrence of hyperkalaemia. Different serum potassium (K(+)) thresholds were evaluated as possible definitions for hyperkalaemia, and incidence rates (IRs) calculated using a final operational definition both overall and among patient sub-groups. IRs of hyperkalaemia ranged from 0.92-7.93 per 100 person-years according to the definition. Based on considerable differences in the serum K(+) normal range used between practices, 2176 (11.3 %) individuals were identified with a record of hyperkalaemia using our operational definition of a proportional increase of ≥10 % above the upper bound of the normal range: IR 2.90 per 100 person-years (95 % CI 2.78-3.02) over a mean follow-up of 3.91 years. Incidence rates were higher in older patients, and in those with diabetes or renal impairment. Hyperkalaemia is a common finding in heart failure patients in primary care, but its incidence can vary nearly ten-fold depending on its definition. Since assessment of hyperkalaemia risk is essential for therapeutic decision making in heart failure patients, this finding warrants consideration in future epidemiological studies.

  7. [Using routine data for quality of care assessments: a critical review, taking quality indicators for the "National Disease Management Guideline for Chronic Heart Failure" as an example].

    PubMed

    Laux, Gunter; Nothacker, Monika; Weinbrenner, Susanne; Störk, Stefan; Blozik, Eva; Peters-Klimm, Frank; Szecsenyi, Jürgen; Scherer, Martin

    2011-01-01

    In December 2009, the first version of the German Disease Management Guideline (DM-CPG) for chronic heart failure was completed, including a set of proposed quality indicators for heart failure. This article explores whether proposed indicators can be derived from data collected routinely in general practices. For this purpose, previous experiences and data from the research project CONTENT (CONTinuous morbidity registration Epidemiologic NeTwork) conducted under guidance of the Department of General Medicine and Health Services Research at the University of Heidelberg, Germany, were applied. The availability of numerators and denominators needed for calculating the four quality indicators for diagnosis and pharmacotherapy proposed in the DM-CPG was checked within so-called "routine data" from the existing dataset of the CONTENT project. Within the given context, routine data are defined as data that are periodically transmitted from health care providers to cost units within the health care system. A thorough assessment has revealed that within the given context only one indicator could be deduced from routine data collection. This was the indicator measuring the proportion of patients receiving beta receptor antagonists, compared to all patients with heart failure NYHA class II to IV. Indeed, this single indicator will only be computable if the NYHA grade of heart failure severity and the presence or absence of contraindications to beta receptor antagonist therapy are routinely collected and the data merged into a central database. Against the background of these results it is obvious that a fully developed, transsectoral concept for data collection and data transfer needs to be implemented.

  8. Mechanical Design Support System Based on Thinking Process Development Diagram

    NASA Astrophysics Data System (ADS)

    Mase, Hisao; Kinukawa, Hiroshi; Morii, Hiroshi; Nakao, Masayuki; Hatamura, Yotaro

    This paper describes a system that directly supports a design process in a mechanical domain. This system is based on a thinking process development diagram that draws distinctions between requirement, tasks, solutions, and implementation, which enables designers to expand and deepen their thoughts of design. The system provides five main functions that designers require in each phase of the proposed design process: (1) thinking process description support which enables designers to describe their thoughts, (2) creativity support by term association with thesauri, (3) timely display of design knowledge including know-how obtained through earlier failures, general design theories, standard-parts data, and past designs, (4) design problem solving support using 46 kinds of thinking operations, and (5) proper technology transfer support which accumulates not only design conclusions but also the design process. Though this system is applied to mechanical engineering as the first target domain, it can be easily expanded to many other domains such as architecture and electricity.

  9. Dynamic tactile diagram simplification on refreshable displays.

    PubMed

    Rastogi, Ravi; Pawluk, Dianne T V

    2013-01-01

    The increasing use of visual diagrams in educational and work environments, and even our daily lives, has created obstacles for individuals who are blind or visually impaired to independently access the information they represent. Although physical tactile pictures can be created to convey the visual information, it is typically a slow, cumbersome, and costly process. Refreshable haptic displays, which interact with computers, promise to make this access quicker, easier, and cheaper. One important aspect in converting visual to tactile diagrams is to simplify the diagram as otherwise it can be too difficult to interpret with touch. Enabling this to be under user control in an interactive environment, such as with refreshable displays, could allow users to avoid being overwhelmed by the diagrams at any instant in time while still retaining access to all information in "storage". Through this article the authors investigate whether two types of diagram simplification--boundary simplification and contextual simplification--showed potential utility in an interactive environment. Boundary simplification was found to be significantly helpful in answering general questions about borders on a geographic map, and contextual simplification was helpful in answering relational questions, as compared to using the original map unchanged.

  10. Pathway collages: personalized multi-pathway diagrams.

    PubMed

    Paley, Suzanne; O'Maille, Paul E; Weaver, Daniel; Karp, Peter D

    2016-12-13

    Metabolic pathway diagrams are a classical way of visualizing a linked cascade of biochemical reactions. However, to understand some biochemical situations, viewing a single pathway is insufficient, whereas viewing the entire metabolic network results in information overload. How do we enable scientists to rapidly construct personalized multi-pathway diagrams that depict a desired collection of interacting pathways that emphasize particular pathway interactions? We define software for constructing personalized multi-pathway diagrams called pathway-collages using a combination of manual and automatic layouts. The user specifies a set of pathways of interest for the collage from a Pathway/Genome Database. Layouts for the individual pathways are generated by the Pathway Tools software, and are sent to a Javascript Pathway Collage application implemented using Cytoscape.js. That application allows the user to re-position pathways; define connections between pathways; change visual style parameters; and paint metabolomics, gene expression, and reaction flux data onto the collage to obtain a desired multi-pathway diagram. We demonstrate the use of pathway collages in two application areas: a metabolomics study of pathogen drug response, and an Escherichia coli metabolic model. Pathway collages enable facile construction of personalized multi-pathway diagrams.

  11. Introduction to causal diagrams for confounder selection.

    PubMed

    Williamson, Elizabeth J; Aitken, Zoe; Lawrie, Jock; Dharmage, Shyamali C; Burgess, John A; Forbes, Andrew B

    2014-04-01

    In respiratory health research, interest often lies in estimating the effect of an exposure on a health outcome. If randomization of the exposure of interest is not possible, estimating its effect is typically complicated by confounding bias. This can often be dealt with by controlling for the variables causing the confounding, if measured, in the statistical analysis. Common statistical methods used to achieve this include multivariable regression models adjusting for selected confounding variables or stratification on those variables. Therefore, a key question is which measured variables need to be controlled for in order to remove confounding. An approach to confounder-selection based on the use of causal diagrams (often called directed acyclic graphs) is discussed. A causal diagram is a visual representation of the causal relationships believed to exist between the variables of interest, including the exposure, outcome and potential confounding variables. After creating a causal diagram for the research question, an intuitive and easy-to-use set of rules can be applied, based on a foundation of rigorous mathematics, to decide which measured variables must be controlled for in the statistical analysis in order to remove confounding, to the extent that is possible using the available data. This approach is illustrated by constructing a causal diagram for the research question: 'Does personal smoking affect the risk of subsequent asthma?'. Using data taken from the Tasmanian Longitudinal Health Study, the statistical analysis suggested by the causal diagram approach was performed.

  12. TIME-TEMPERATURE-TRANSFORMATION (TTT) DIAGRAMS FOR FUTURE WASTE COMPOSITIONS

    SciTech Connect

    Billings, A.; Edwards, T.

    2010-07-08

    As a part of the Waste Acceptance Product Specifications (WAPS) for Vitrified High-Level Waste Forms defined by the Department of Energy - Office of Environmental Management, the waste form stability must be determined for each of the projected high-level waste (HLW) types at the Savannah River Site (SRS). Specifically, WAPS 1.4.1 requires the glass transition temperature (T{sub g}) to be defined and time-temperature-transformation (TTT) diagrams to be developed. The T{sub g} of a glass is an indicator of the approximate temperature where the supercooled liquid converts to a solid on cooling or conversely, where the solid begins to behave as a viscoelastic solid on heating. A TTT diagram identifies the crystalline phases that can form as a function of time and temperature for a given waste type or more specifically, the borosilicate glass waste form. In order to assess durability, the Product Consistency Test (PCT) was used and the durability results compared to the Environmental Assessment (EA) glass. The measurement of glass transition temperature and the development of TTT diagrams have already been performed for the seven Defense Waste Processing Facility (DWPF) projected compositions as defined in the Waste Form Compliance Plan (WCP) and in SRNL-STI-2009-00025. Additional phase transformation information exists for other projected compositions, but overall these compositions did not cover composition regions estimated for future waste processing. To develop TTT diagrams for future waste types, the Savannah River National Laboratory (SRNL) fabricated two caches of glass from reagent grade oxides to simulate glass compositions which would be likely processed with and without Al dissolution. These were used for glass transition temperature measurement and TTT diagram development. The glass transition temperatures of both glasses were measured using differential scanning calorimetry (DSC) and were recorded to be 448 C and 452 C. Using the previous TTT diagrams as

  13. The spectroscopic Hertzsprung-Russell diagram of Galactic massive stars

    NASA Astrophysics Data System (ADS)

    Castro, N.; Fossati, L.; Langer, N.; Simón-Díaz, S.; Schneider, F. R. N.; Izzard, R. G.

    2014-10-01

    The distribution of stars in the Hertzsprung-Russell diagram narrates their evolutionary history and directly assesses their properties. Placing stars in this diagram however requires the knowledge of their distances and interstellar extinctions, which are often poorly known for Galactic stars. The spectroscopic Hertzsprung-Russell diagram (sHRD) tells similar evolutionary tales, but is independent of distance and extinction measurements. Based on spectroscopically derived effective temperatures and gravities of almost 600 stars, we derive for the first time the observational distribution of Galactic massive stars in the sHRD. While biases and statistical limitations in the data prevent detailed quantitative conclusions at this time, we see several clear qualitative trends. By comparing the observational sHRD with different state-of-the-art stellar evolutionary predictions, we conclude that convective core overshooting may be mass-dependent and, at high mass (≳15 M⊙), stronger than previously thought. Furthermore, we find evidence for an empirical upper limit in the sHRD for stars with Teff between 10 000 and 32 000 K and, a strikingly large number of objects below this line. This over-density may be due to inflation expanding envelopes in massive main-sequence stars near the Eddington limit. Appendix A is available in electronic form at http://www.aanda.org

  14. The Semiotic Structure of Geometry Diagrams: How Textbook Diagrams Convey Meaning

    ERIC Educational Resources Information Center

    Dimmel, Justin K.; Herbst, Patricio G.

    2015-01-01

    Geometry diagrams use the visual features of specific drawn objects to convey meaning about generic mathematical entities. We examine the semiotic structure of these visual features in two parts. One, we conduct a semiotic inquiry to conceptualize geometry diagrams as mathematical texts that comprise choices from different semiotic systems. Two,…

  15. The Semiotic Structure of Geometry Diagrams: How Textbook Diagrams Convey Meaning

    ERIC Educational Resources Information Center

    Dimmel, Justin K.; Herbst, Patricio G.

    2015-01-01

    Geometry diagrams use the visual features of specific drawn objects to convey meaning about generic mathematical entities. We examine the semiotic structure of these visual features in two parts. One, we conduct a semiotic inquiry to conceptualize geometry diagrams as mathematical texts that comprise choices from different semiotic systems. Two,…

  16. Fishbone Diagrams: Organize Reading Content with a "Bare Bones" Strategy

    ERIC Educational Resources Information Center

    Clary, Renee; Wandersee, James

    2010-01-01

    Fishbone diagrams, also known as Ishikawa diagrams or cause-and-effect diagrams, are one of the many problem-solving tools created by Dr. Kaoru Ishikawa, a University of Tokyo professor. Part of the brilliance of Ishikawa's idea resides in the simplicity and practicality of the diagram's basic model--a fish's skeleton. This article describes how…

  17. Fishbone Diagrams: Organize Reading Content with a "Bare Bones" Strategy

    ERIC Educational Resources Information Center

    Clary, Renee; Wandersee, James

    2010-01-01

    Fishbone diagrams, also known as Ishikawa diagrams or cause-and-effect diagrams, are one of the many problem-solving tools created by Dr. Kaoru Ishikawa, a University of Tokyo professor. Part of the brilliance of Ishikawa's idea resides in the simplicity and practicality of the diagram's basic model--a fish's skeleton. This article describes how…

  18. 49 CFR 1152.10 - System diagram map.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 8 2012-10-01 2012-10-01 false System diagram map. 1152.10 Section 1152.10... TRANSPORTATION UNDER 49 U.S.C. 10903 System Diagram § 1152.10 System diagram map. (a) Each carrier shall prepare a diagram of its rail system on a map, designating all lines in its system by the...

  19. Use of Affinity Diagrams as Instructional Tools in Inclusive Classrooms.

    ERIC Educational Resources Information Center

    Haselden, Polly G.

    2003-01-01

    This article describes how the affinity diagram, a tool for gathering information and organizing it into natural groupings, can be used in inclusive classrooms. It discusses how students can be taught to use an affinity diagram, how affinity diagrams can be used to reflect many voices, and how affinity diagrams can be used to plan class projects.…

  20. 49 CFR 1152.10 - System diagram map.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 8 2014-10-01 2014-10-01 false System diagram map. 1152.10 Section 1152.10... TRANSPORTATION UNDER 49 U.S.C. 10903 System Diagram § 1152.10 System diagram map. (a) Each carrier shall prepare a diagram of its rail system on a map, designating all lines in its system by the categories...

  1. 49 CFR 1152.10 - System diagram map.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 8 2013-10-01 2013-10-01 false System diagram map. 1152.10 Section 1152.10... TRANSPORTATION UNDER 49 U.S.C. 10903 System Diagram § 1152.10 System diagram map. (a) Each carrier shall prepare a diagram of its rail system on a map, designating all lines in its system by the categories...

  2. Looking Forward, Looking Back: Assessing Variations in Hospital Resource Use and Outcomes for Elderly Patients with Heart Failure

    PubMed Central

    Ong, Michael K.; Mangione, Carol M.; Romano, Patrick S.; Zhou, Qiong; Auerbach, Andrew D.; Chun, Alein; Davidson, Bruce; Ganiats, Theodore G.; Greenfield, Sheldon; Gropper, Michael A.; Malik, Shaista; Rosenthal, J. Thomas; Escarce, José J.

    2009-01-01

    Background Recent studies have found substantial variation in hospital resource utilization by expired Medicare beneficiaries with chronic illnesses. By analyzing only expired patients, these studies cannot identify differences across hospitals in health outcomes like mortality. This study examines the association between mortality and resource utilization at the hospital level, when all Medicare beneficiaries hospitalized for heart failure are examined. Methods and Results 3,999 individuals hospitalized with a principal diagnosis of heart failure at six California teaching hospitals between January 1, 2001 and June 30, 2005 were analyzed with multivariate risk-adjustment models for total hospital days, total hospital direct costs, and mortality within 180-days after initial admission (“Looking Forward”). A subset of 1,639 individuals who died during the study period were analyzed with multivariate risk-adjustment models for total hospital days and total hospital direct costs within 180-days prior to death (“Looking Back”). “Looking Forward” risk-adjusted hospital means ranged from 17.0% to 26.0% for mortality, 7.8 to 14.9 days for total hospital days, and 0.66 to 1.30 times the mean value for indexed total direct costs. Spearman rank correlation coefficients were −0.68 between mortality and hospital days, and −0.93 between mortality and indexed total direct costs. “Looking Back” risk-adjusted hospital means ranged from 9.1 to 21.7 days for total hospital days and 0.91 to 1.79 times the mean value for indexed total direct costs. Variation in resource utilization site ranks between expired and all individuals were due to insignificant differences. Conclusions California teaching hospitals that used more resources caring for patients hospitalized for heart failure had lower mortality rates. Focusing only on expired individuals may overlook mortality variation as well as associations between greater resource utilization and lower mortality

  3. Quality of life assessment for acute heart failure patients from emergency department presentation through 30 days after discharge: a pilot study with the Kansas City Cardiomyopathy Questionnaire.

    PubMed

    Sauser, Kori; Spertus, John A; Pierchala, Linda; Davis, Evan; Pang, Peter S

    2014-01-01

    There are no well validated patient-reported disease status instruments for acute heart failure (HF). We assessed the feasibility of using the Kansas City Cardiomyopathy Questionnaire (KCCQ) during acute heart failure hospitalization, and the association of acute changes with 30-day readmission. A convenience sample of acute HF patients were administered the KCCQ on presentation, discharge, and 30 days after discharge. We examined mean differences in KCCQ scores over time, and we stratified by readmission status to examine differences in hospital-based changes with the use of t test and logistic regression. Among 52 patients (mean age 63 ± 35 years, 56.9% male, 46.2% white), discharge and 30-day assessments were each completed by 90%. Scores were lowest at presentation, improved during hospitalization, and were highest at 30 days. The mean change was +11.9 ± 97.0 (P = .007) between presentation and discharge and +19.8 ± 87.8 (P < .001) between discharge and 30 days. Within the 30-day follow-up, 10 patients were readmitted, and there were no significant differences in score changes during hospitalization between patients with and without readmission (readmitted patients: +4.8 ± 81.5 vs no readmission +16.2 ± 27.4; P = .32). In this pilot study, the KCCQ is feasible to use during acute HF hospitalizations and demonstrates sensitivity to acute changes, but score changes during hospitalization did not predict 30-day readmission. Published by Elsevier Inc.

  4. The Butterfly diagram leopard skin pattern

    NASA Astrophysics Data System (ADS)

    Ternullo, Maurizio

    2011-08-01

    A time-latitude diagram where spotgroups are given proportional relevance to their area is presented. The diagram reveals that the spotted area distribution is higly dishomogeneous, most of it being concentrated in few, small portions (``knots'') of the Butterfly Diagram; because of this structure, the BD may be properly described as a cluster of knots. The description, assuming that spots scatter around the ``spot mean latitude'' steadily drifting equatorward, is challenged. Indeed, spots cluster around at as many latitudes as knots; a knot may appear at either lower or higher latitudes than previous ones, in a seemingly random way; accordingly, the spot mean latitude abruptly drifts equatorward or even poleward at any knot activation, in spite of any smoothing procedure. Preliminary analyses suggest that the activity splits, in any hemisphere, into two or more distinct ``activity waves'', drifting equatorward at a rate higher than the spot zone as a whole.

  5. A method for developing design diagrams for ceramic and glass materials using fatigue data

    NASA Technical Reports Server (NTRS)

    Heslin, T. M.; Magida, M. B.; Forrest, K. A.

    1986-01-01

    The service lifetime of glass and ceramic materials can be expressed as a plot of time-to-failure versus applied stress whose plot is parametric in percent probability of failure. This type of plot is called a design diagram. Confidence interval estimates for such plots depend on the type of test that is used to generate the data, on assumptions made concerning the statistical distribution of the test results, and on the type of analysis used. This report outlines the development of design diagrams for glass and ceramic materials in engineering terms using static or dynamic fatigue tests, assuming either no particular statistical distribution of test results or a Weibull distribution and using either median value or homologous ratio analysis of the test results.

  6. A pseudo-haptic knot diagram interface

    NASA Astrophysics Data System (ADS)

    Zhang, Hui; Weng, Jianguang; Hanson, Andrew J.

    2011-01-01

    To make progress in understanding knot theory, we will need to interact with the projected representations of mathematical knots which are of course continuous in 3D but significantly interrupted in the projective images. One way to achieve such a goal would be to design an interactive system that allows us to sketch 2D knot diagrams by taking advantage of a collision-sensing controller and explore their underlying smooth structures through a continuous motion. Recent advances of interaction techniques have been made that allow progress to be made in this direction. Pseudo-haptics that simulates haptic effects using pure visual feedback can be used to develop such an interactive system. This paper outlines one such pseudo-haptic knot diagram interface. Our interface derives from the familiar pencil-and-paper process of drawing 2D knot diagrams and provides haptic-like sensations to facilitate the creation and exploration of knot diagrams. A centerpiece of the interaction model simulates a "physically" reactive mouse cursor, which is exploited to resolve the apparent conflict between the continuous structure of the actual smooth knot and the visual discontinuities in the knot diagram representation. Another value in exploiting pseudo-haptics is that an acceleration (or deceleration) of the mouse cursor (or surface locator) can be used to indicate the slope of the curve (or surface) of whom the projective image is being explored. By exploiting these additional visual cues, we proceed to a full-featured extension to a pseudo-haptic 4D visualization system that simulates the continuous navigation on 4D objects and allows us to sense the bumps and holes in the fourth dimension. Preliminary tests of the software show that main features of the interface overcome some expected perceptual limitations in our interaction with 2D knot diagrams of 3D knots and 3D projective images of 4D mathematical objects.

  7. Assessment of Dyspnea Early in Acute Heart Failure: Patient Characteristics and Response Differences Between Likert and Visual Analog Scales

    PubMed Central

    Pang, Peter S.; Collins, Sean P.; Sauser, Kori; Andrei, Adin-Cristian; Storrow, Alan B.; Hollander, Judd E.; Tavares, Miguel; Spinar, Jindrich; Macarie, Cezar; Raev, Dimitar; Nowak, Richard; Gheorghiade, Mihai; Mebazaa, Alexandre

    2014-01-01

    Background Dyspnea is the most common symptom in acute heart failure (AHF), yet how to best measure it has not been well defined. Prior studies demonstrate differences in dyspnea improvement across various measurement scales, yet these studies typically enroll patients well after the ED phase of management. Objectives The aim of this study was to determine predictors of early dyspnea improvement for three different, commonly used dyspnea scales (i.e. five point absolute Likert scale, 10 cm visual analogue scale [VAS], or seven point relative Likert scale). Methods This was a post-hoc analysis of URGENT Dyspnea, an observational study of 776 patients in 17 countries enrolled within one hour of first physician encounter. Inclusion criteria were broad to reflect real-world clinical practice. Prior literature informed the a priori definition of clinically significant dyspnea improvement. Resampling-based multivariable models were created to determine patient characteristics significantly associated with dyspnea improvement. Results Of the 524 AHF patients, approximately 40% of patients did not report substantial dyspnea improvement within the first 6 hours. Baseline characteristics were similar between those who did or did not improve, though there were differences in history of heart failure, coronary artery disease, and initial systolic blood pressure. For those who did improve, patient characteristics differed across all three scales, with the exception of baseline dyspnea severity for the VAS and five point Likert scale (c-index ranged from 0.708 to 0.831 for each scale). Conclusions Predictors of early dyspnea improvement differ from scale to scale, with the exception of baseline dyspnea. Attempts to use one scale to capture the entirety of the dyspnea symptom may be insufficient. PMID:25039550

  8. Tape Versus Suture in Arthroscopic Rotator Cuff Repair: Biomechanical Analysis and Assessment of Failure Rates at 6 Months.

    PubMed

    Liu, Rui Wen; Lam, Patrick Hong; Shepherd, Henry M; Murrell, George A C

    2017-04-01

    Rotator cuff retears after surgical repair are associated with poorer subjective and objectives clinical outcomes than intact repairs. The aims of this study were to (1) examine the biomechanical differences between rotator cuff repair using No. 2 suture and tape in an ovine model and (2) compare early clinical outcomes between patients who had rotator cuff repair with tape and patients who had repair with No. 2 suture. Controlled laboratory study and cohort study; Level of evidence, 3. Biomechanical testing of footprint contact pressure and load to failure were conducted with 16 ovine shoulders using a tension band repair technique with 2 different types of sutures (No. 2 suture [FiberWire; Arthrex] and tape [FiberTape; Arthrex]) with the same knotless anchor system. A retrospective study of 150 consecutive patients (tape, n = 50; suture, n = 100) who underwent arthroscopic rotator cuff repair by a single surgeon with tear size larger than 1.5 × 1 cm was conducted. Ultrasound was used to evaluate the repair integrity at 6 months postsurgery. Rotator cuff repair using tape had greater footprint contact pressure (mean ± standard error of the mean, 0.33 ± 0.03 vs 0.11 ± 0.3 MPa; P < .0001) compared with repair using No. 2 sutures at 0° abduction with a 30-N load applied across the repaired tendon. The ultimate failure load of the tape repair was greater than that for suture repair (217 ± 28 vs 144 ± 14 N; P < .05). The retear rate was similar between the tape (16%; 8/50) and suture groups (17%; 17/100). Rotator cuff repair with the wider tape compared with No. 2 suture did not affect the retear rate at 6 months postsurgery, despite having superior biomechanical properties.

  9. Assessment of dyspnea early in acute heart failure: patient characteristics and response differences between likert and visual analog scales.

    PubMed

    Pang, Peter S; Collins, Sean P; Sauser, Kori; Andrei, Adin-Cristian; Storrow, Alan B; Hollander, Judd E; Tavares, Miguel; Spinar, Jindrich; Macarie, Cezar; Raev, Dimitar; Nowak, Richard; Gheorghiade, Mihai; Mebazaa, Alexandre

    2014-06-01

    Dyspnea is the most common symptom in acute heart failure (AHF), yet how to best measure it has not been well defined. Prior studies demonstrate differences in dyspnea improvement across various measurement scales, yet these studies typically enroll patients well after the emergency department (ED) phase of management. The aim of this study was to determine predictors of early dyspnea improvement for three different, commonly used dyspnea scales (i.e., five-point absolute Likert scale, 10-cm visual analog scale [VAS], or seven-point relative Likert scale). This was a post hoc analysis of URGENT Dyspnea, an observational study of 776 patients in 17 countries enrolled within 1 hour of first physician encounter. Inclusion criteria were broad to reflect real-world clinical practice. Prior literature informed the a priori definition of clinically significant dyspnea improvement. Resampling-based multivariable models were created to determine patient characteristics significantly associated with dyspnea improvement. Of the 524 AHF patients, approximately 40% of patients did not report substantial dyspnea improvement within the first 6 hours. Baseline characteristics were similar between those who did or did not improve, although there were differences in history of heart failure, coronary artery disease, and initial systolic blood pressure. For those who did improve, patient characteristics differed across all three scales, with the exception of baseline dyspnea severity for the VAS and five-point Likert scale (c-index ranged from 0.708 to 0.831 for each scale). Predictors of early dyspnea improvement differ from scale to scale, with the exception of baseline dyspnea. Attempts to use one scale to capture the entirety of the dyspnea symptom may be insufficient. © 2014 by the Society for Academic Emergency Medicine.

  10. Renormalized asymptotic enumeration of Feynman diagrams

    NASA Astrophysics Data System (ADS)

    Borinsky, Michael

    2017-10-01

    A method to obtain all-order asymptotic results for the coefficients of perturbative expansions in zero-dimensional quantum field is described. The focus is on the enumeration of the number of skeleton or primitive diagrams of a certain QFT and its asymptotics. The procedure heavily applies techniques from singularity analysis. To utilize singularity analysis, a representation of the zero-dimensional path integral as a generalized hyperelliptic curve is deduced. As applications the full asymptotic expansions of the number of disconnected, connected, 1PI and skeleton Feynman diagrams in various theories are given.

  11. [Heart failure and comorbidities].

    PubMed

    Boully, Clémence; Hanon, Olivier

    2015-03-01

    Heart failure is a frequent disease in the elderly. Its clinical presentation is less typical and the prognosis more severe than in younger subjects because heart failure occurs in patients with multiple comorbidities. A comprehensive geriatric assessment should therefore be performed to detect the vulnerabilities and manage the comorbidities. The main diseases associated with heart failure are dementia, depression, malnutrition, atrial fibrillation, coronary artery disease, orthostatic hypotension, renal failure, anemia and iron deficiency. Comorbidities worsen heart failure and makes its treatment more difficult. The identification and treatment of comorbidities improve the prognosis in terms of mortality but especially in terms of quality of life. Caution with drugs is necessary because of pharmacokinetic or pharmacodynamic changes related to aging and the comorbidities. In this context, clinical and laboratory monitoring should be increased, mostly during an acute event (acute heart failure, infection, dehydration, fall, new therapy…). Therefore, the follow-up of elderly patients with heart failure requires a multidisciplinary approach that involves close cooperation between cardiologists, geriatricians, general practitioners, nurses, and pharmacists.

  12. Testicular failure

    MedlinePlus

    ... Blood tests may show a low level of testosterone and high levels of prolactin, FSH , and LH . ... testes will be ordered. Testicular failure and low testosterone level may be hard to diagnose in older ...

  13. Margins in high temperature leak-before-break assessments

    SciTech Connect

    Budden, P.J.; Hooton, D.G.

    1997-04-01

    Developments in the defect assessment procedure R6 to include high-temperature mechanisms in Leak-before-Break arguments are described. In particular, the effect of creep on the time available to detect a leak and on the crack opening area, and hence leak rate, is discussed. The competing influence of these two effects is emphasized by an example. The application to Leak-before-Break of the time-dependent failure assessment diagram approach for high temperature defect assessment is then outlined. The approach is shown to be of use in assessing the erosion of margins by creep.

  14. Study flow diagrams in Cochrane systematic review updates: an adapted PRISMA flow diagram

    PubMed Central

    2014-01-01

    Cochrane systematic reviews are conducted and reported according to rigorous standards. A study flow diagram must be included in a new review, and there is clear guidance from the PRISMA statement on how to do this. However, for a review update, there is currently no guidance on how study flow diagrams should be presented. To address this, a working group was formed to find a solution and produce guidance on how to use these diagrams in review updates. A number of different options were devised for how these flow diagrams could be used in review updates, and also in cases where multiple searches for a review or review update have been conducted. These options were circulated to the Cochrane information specialist community for consultation and feedback. Following the consultation period, the working group refined the guidance and made the recommendation that for review updates an adapted PRISMA flow diagram should be used, which includes an additional box with the number of previously included studies feeding into the total. Where multiple searches have been conducted, the results should be added together and treated as one set of results. There is no existing guidance for using study flow diagrams in review updates. Our adapted diagram is a simple and pragmatic solution for showing the flow of studies in review updates. PMID:24886533

  15. Study flow diagrams in Cochrane systematic review updates: an adapted PRISMA flow diagram.

    PubMed

    Stovold, Elizabeth; Beecher, Deirdre; Foxlee, Ruth; Noel-Storr, Anna

    2014-05-29

    Cochrane systematic reviews are conducted and reported according to rigorous standards. A study flow diagram must be included in a new review, and there is clear guidance from the PRISMA statement on how to do this. However, for a review update, there is currently no guidance on how study flow diagrams should be presented. To address this, a working group was formed to find a solution and produce guidance on how to use these diagrams in review updates.A number of different options were devised for how these flow diagrams could be used in review updates, and also in cases where multiple searches for a review or review update have been conducted. These options were circulated to the Cochrane information specialist community for consultation and feedback. Following the consultation period, the working group refined the guidance and made the recommendation that for review updates an adapted PRISMA flow diagram should be used, which includes an additional box with the number of previously included studies feeding into the total. Where multiple searches have been conducted, the results should be added together and treated as one set of results.There is no existing guidance for using study flow diagrams in review updates. Our adapted diagram is a simple and pragmatic solution for showing the flow of studies in review updates.

  16. Positron emission tomography for assessing local failure after stereotactic body radiotherapy for non-small-cell lung cancer.

    PubMed

    Zhang, Xu; Liu, Hui; Balter, Peter; Allen, Pamela K; Komaki, Ritsuko; Pan, Tinsu; Chuang, Hubert H; Chang, Joe Y

    2012-08-01

    We analyzed whether positron emission tomography (PET)/computed tomography standardized uptake values (SUVs) after stereotactic body radiotherapy (SBRT) could predict local recurrence (LR) in non-small-cell lung cancer (NSCLC). This study comprised 128 patients with Stage I (n = 68) or isolated recurrent/secondary parenchymal (n = 60) NSCLC treated with image-guided SBRT to 50 Gy over 4 consecutive days; prior radiotherapy was allowed. PET/computed tomography scans were obtained before therapy and at 1 to 6 months after therapy, as well as subsequently as clinically indicated. Continuous variables were analyzed with Kruskal-Wallis tests and categorical variables with Pearson chi-square or Fisher exact tests. Actuarial local failure rates were calculated with the Kaplan-Meier method. At a median follow-up of 31 months (range, 6-71 months), the actuarial 1-, 2-, and 3-year local control rates were 100%, 98.5%, and 98.5%, respectively, in the Stage I group and 95.8%, 87.6%, and 85.8%, respectively, in the recurrent group. The cumulative rates of regional nodal recurrence and distant metastasis were 8.8% (6 of 68) and 14.7% (10 of 68), respectively, for the Stage I group and 11.7% (7 of 60) and 16.7% (10 of 60), respectively, for the recurrent group. Univariate analysis showed that SUVs obtained 12.1 to 24 months after treatment for the Stage I group (p = 0.007) and 6.1 to 12 months and 12.1 to 24 months after treatment for the recurrent group were associated with LR (p < 0.001 for both). Of the 128 patients, 17 (13.3%) had ipsilateral consolidation after SBRT but no elevated metabolic activity on PET; none had LR. The cutoff maximum SUV of 5 was found to have 100% sensitivity, 91% specificity, a 50% positive predictive value, and a 100% negative predictive value for predicting LR. PET was helpful for distinguishing SBRT-induced consolidation from LR. SUVs obtained more than 6 months after SBRT for NSCLC were associated with local failure. A maximum SUV greater than 5

  17. Application of ISO 22000 and Failure Mode and Effect Analysis (FMEA) for industrial processing of salmon: a case study.

    PubMed

    Arvanitoyannis, Ioannis S; Varzakas, Theodoros H

    2008-05-01

    The Failure Mode and Effect Analysis (FMEA) model was applied for risk assessment of salmon manufacturing. A tentative approach of FMEA application to the salmon industry was attempted in conjunction with ISO 22000. Preliminary Hazard Analysis was used to analyze and predict the occurring failure modes in a food chain system (salmon processing plant), based on the functions, characteristics, and/or interactions of the ingredients or the processes, upon which the system depends. Critical Control points were identified and implemented in the cause and effect diagram (also known as Ishikawa, tree diagram and fishbone diagram). In this work, a comparison of ISO 22000 analysis with HACCP is carried out over salmon processing and packaging. However, the main emphasis was put on the quantification of risk assessment by determining the RPN per identified processing hazard. Fish receiving, casing/marking, blood removal, evisceration, filet-making cooling/freezing, and distribution were the processes identified as the ones with the highest RPN (252, 240, 210, 210, 210, 210, 200 respectively) and corrective actions were undertaken. After the application of corrective actions, a second calculation of RPN values was carried out resulting in substantially lower values (below the upper acceptable limit of 130). It is noteworthy that the application of Ishikawa (Cause and Effect or Tree diagram) led to converging results thus corroborating the validity of conclusions derived from risk assessment and FMEA. Therefore, the incorporation of FMEA analysis within the ISO 22000 system of a salmon processing industry is anticipated to prove advantageous to industrialists, state food inspectors, and consumers.

  18. A national assessment of underground natural gas storage: identifying wells with designs likely vulnerable to a single-point-of-failure

    NASA Astrophysics Data System (ADS)

    Michanowicz, Drew R.; Buonocore, Jonathan J.; Rowland, Sebastian T.; Konschnik, Katherine E.; Goho, Shaun A.; Bernstein, Aaron S.

    2017-05-01

    The leak of processed natural gas (PNG) from October 2015 to February 2016 from the Aliso Canyon storage facility, near Los Angeles, California, was the largest single accidental release of greenhouse gases in US history. The Interagency Task Force on Natural Gas Storage Safety and California regulators recently recommended operators phase out single-point-of-failure (SPF) well designs. Here, we develop a national dataset of UGS well activity in the continental US to assess regulatory data availability and uncertainty, and to assess the prevalence of certain well design deficiencies including single-point-of-failure designs. We identified 14 138 active UGS wells associated with 317 active UGS facilities in 29 states using regulatory and company data. State-level wellbore datasets contained numerous reporting inconsistencies that limited data concatenation. We identified 2715 active UGS wells across 160 facilities that, like the failed well at Aliso Canyon, predated the storage facility, and therefore were not originally designed for gas storage. The majority (88%) of these repurposed wells are located in OH, MI, PA, NY, and WV. Repurposed wells have a median age of 74 years, and the 2694 repurposed wells constructed prior to 1979 are particularly likely to exhibit design-related deficiencies. An estimated 210 active repurposed wells were constructed before 1917—before cement zonal isolation methods were utilized. These wells are located in OH, PA, NY, and WV and represent the highest priority related to potential design deficiencies that could lead to containment loss. This national baseline assessment identifies regulatory data uncertainties, highlights a potentially widespread vulnerability of the natural gas supply chain, and can aid in prioritization and oversight for high-risk wells and facilities.

  19. Prognostic value of malnutrition assessed by Controlling Nutritional Status score for long-term mortality in patients with acute heart failure.

    PubMed

    Iwakami, Naotsugu; Nagai, Toshiyuki; Furukawa, Toshiaki A; Sugano, Yasuo; Honda, Satoshi; Okada, Atsushi; Asaumi, Yasuhide; Aiba, Takeshi; Noguchi, Teruo; Kusano, Kengo; Ogawa, Hisao; Yasuda, Satoshi; Anzai, Toshihisa

    2017-03-01

    The prognostic value of nutritional status is poorly understood and evidence-based nutritional assessment indices are required in acute heart failure (AHF). We investigated the prognostic value of malnutrition assessed by the Controlling Nutritional Status (CONUT) score (range 0-12, higher=worse, consisting of serum albumin, cholesterol and lymphocytes) in AHF patients. The CONUT score was measured on admission in 635 consecutive AHF patients. The primary outcome was all-cause death. Median CONUT score was 3 (interquartile range 2 to 5). During the median follow-up of 324days, CONUT score was independently associated with death (HR 1.26, 95% CI 1.11-1.42, P<0.001) after adjustment for confounders in a multivariate Cox model. The CONUT score demonstrated the best C-statistic for predicting death (0.71) among other common nutritional markers in HF. Furthermore, addition of the CONUT score to an established risk prediction model from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure study significantly increased the C-statistic from 0.75 to 0.77 (P=0.02). The net reclassification improvement afforded by CONUT score was 21% for all-cause death, 27% for survival and 49% overall (P<0.001). Malnutrition assessed by the CONUT score on admission was an independent determinant of long-term death in AHF, and its prognostic value outweighed that of other nutritional indices. Moreover, addition of the score to the existing risk prediction model significantly increased the predictive ability for death, indicating beneficial clinical application of the CONUT score in AHF patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Spatial-temporal forecasting the sunspot diagram

    NASA Astrophysics Data System (ADS)

    Covas, Eurico

    2017-09-01

    Aims: We attempt to forecast the Sun's sunspot butterfly diagram in both space (i.e. in latitude) and time, instead of the usual one-dimensional time series forecasts prevalent in the scientific literature. Methods: We use a prediction method based on the non-linear embedding of data series in high dimensions. We use this method to forecast both in latitude (space) and in time, using a full spatial-temporal series of the sunspot diagram from 1874 to 2015. Results: The analysis of the results shows that it is indeed possible to reconstruct the overall shape and amplitude of the spatial-temporal pattern of sunspots, but that the method in its current form does not have real predictive power. We also apply a metric called structural similarity to compare the forecasted and the observed butterfly cycles, showing that this metric can be a useful addition to the usual root mean square error metric when analysing the efficiency of different prediction methods. Conclusions: We conclude that it is in principle possible to reconstruct the full sunspot butterfly diagram for at least one cycle using this approach and that this method and others should be explored since just looking at metrics such as sunspot count number or sunspot total area coverage is too reductive given the spatial-temporal dynamical complexity of the sunspot butterfly diagram. However, more data and/or an improved approach is probably necessary to have true predictive power.

  1. Image Attributes: A Study of Scientific Diagrams.

    ERIC Educational Resources Information Center

    Brunskill, Jeff; Jorgensen, Corinne

    2002-01-01

    Discusses advancements in imaging technology and increased user access to digital images, as well as efforts to develop adequate indexing and retrieval methods for image databases. Describes preliminary results of a study of undergraduates that explored the attributes naive subjects use to describe scientific diagrams. (Author/LRW)

  2. Complexities of One-Component Phase Diagrams

    ERIC Educational Resources Information Center

    Ciccioli, Andrea; Glasser, Leslie

    2011-01-01

    For most materials, the solid at and near the triple-point temperature is denser than the liquid with which it is in equilibrium. However, for water and certain other materials, the densities of the phases are reversed, with the solid being less dense. The profound consequences for the appearance of the "pVT" diagram of one-component materials…

  3. Dynamic Tactile Diagram Simplification on Refreshable Displays

    ERIC Educational Resources Information Center

    Rastogi, Ravi; Pawluk, Dianne T. V.

    2013-01-01

    The increasing use of visual diagrams in educational and work environments, and even our daily lives, has created obstacles for individuals who are blind or visually impaired to "independently" access the information they represent. Although physical tactile pictures can be created to convey the visual information, it is typically a slow,…

  4. Computer-Generated Diagrams for the Classroom.

    ERIC Educational Resources Information Center

    Carle, Mark A.; Greenslade, Thomas B., Jr.

    1986-01-01

    Describes 10 computer programs used to draw diagrams usually drawn on chalkboards, such as addition of three vectors, vector components, range of a projectile, lissajous figures, beats, isotherms, Snell's law, waves passing through a lens, magnetic field due to Helmholtz coils, and three curves. Several programming tips are included. (JN)

  5. Complexities of One-Component Phase Diagrams

    ERIC Educational Resources Information Center

    Ciccioli, Andrea; Glasser, Leslie

    2011-01-01

    For most materials, the solid at and near the triple-point temperature is denser than the liquid with which it is in equilibrium. However, for water and certain other materials, the densities of the phases are reversed, with the solid being less dense. The profound consequences for the appearance of the "pVT" diagram of one-component materials…

  6. Fog Machines, Vapors, and Phase Diagrams

    ERIC Educational Resources Information Center

    Vitz, Ed

    2008-01-01

    A series of demonstrations is described that elucidate the operation of commercial fog machines by using common laboratory equipment and supplies. The formation of fogs, or "mixing clouds", is discussed in terms of the phase diagram for water and other chemical principles. The demonstrations can be adapted for presentation suitable for elementary…

  7. Diagram of Liquid Rocket Systems General Arrangement

    NASA Image and Video Library

    1964-05-21

    S64-05966 (1964) --- Diagram shows the general arrangement of the liquid rocket systems on the Gemini spacecraft are shown. The locations of the 25-pound, 85-pound and 100-pound thrusters of the orbital attitude and maneuver system and the 25-pound thrusters of the re-entry control system are shown.

  8. Spin wave Feynman diagram vertex computation package

    NASA Astrophysics Data System (ADS)

    Price, Alexander; Javernick, Philip; Datta, Trinanjan

    Spin wave theory is a well-established theoretical technique that can correctly predict the physical behavior of ordered magnetic states. However, computing the effects of an interacting spin wave theory incorporating magnons involve a laborious by hand derivation of Feynman diagram vertices. The process is tedious and time consuming. Hence, to improve productivity and have another means to check the analytical calculations, we have devised a Feynman Diagram Vertex Computation package. In this talk, we will describe our research group's effort to implement a Mathematica based symbolic Feynman diagram vertex computation package that computes spin wave vertices. Utilizing the non-commutative algebra package NCAlgebra as an add-on to Mathematica, symbolic expressions for the Feynman diagram vertices of a Heisenberg quantum antiferromagnet are obtained. Our existing code reproduces the well-known expressions of a nearest neighbor square lattice Heisenberg model. We also discuss the case of a triangular lattice Heisenberg model where non collinear terms contribute to the vertex interactions.

  9. The Classification of Diagrams in Perturbation Theory

    NASA Astrophysics Data System (ADS)

    Phillips, D. R.; Afnan, I. R.

    1995-06-01

    The derivation of scattering equations connecting the amplitudes obtained from diagrammatic expansions is of interest in many branches of physics. One method for deriving such equations is the classification-of-diagrams technique of Taylor. However, as we shall explain in this paper, there are certain points of Taylor's method which require clarification. Firstly, it is not clear whether Taylor's original method is equivalent to the simpler classification-of-diagrams scheme used by Thomas, Rinat, Afnan, and Blankleider (TRAB). Secondly, when the Taylor method is applied to certain problems in a time-dependent perturbation theory it leads to the over-counting of some diagrams. This paper first restates Taylor's method, in the process uncovering reasons why certain diagrams might be double-counted in the Taylor method. It then explores how far Taylor's method is equivalent to the simpler TRAB method. Finally, it examines precisely why the double-counting occurs in Taylor's method and derives corrections which compensate for this double-counting.

  10. Geometrical splitting and reduction of Feynman diagrams

    NASA Astrophysics Data System (ADS)

    Davydychev, Andrei I.

    2016-10-01

    A geometrical approach to the calculation of N-point Feynman diagrams is reviewed. It is shown that the geometrical splitting yields useful connections between Feynman integrals with different momenta and masses. It is demonstrated how these results can be used to reduce the number of variables in the occurring functions.

  11. Weight diagram construction of Lax operators

    SciTech Connect

    Carbon, S.L.; Piard, E.J.

    1991-10-01

    We review and expand methods introduced in our previous paper. It is proved that cyclic weight diagrams corresponding to representations of affine Lie algebras allow one to construct the associated Lax operator. The resultant Lax operator is in the Miura-like form and generates the modified KdV equations. The algorithm is extended to the super-symmetric case.

  12. Fluctuations and the QCD Phase Diagram

    SciTech Connect

    Koch, Volker; Bzdak, Adam

    2016-07-01

    Here, we will discuss how the study of various fluctuation observables may be used to explore the phase diagram of the strong interaction. Furthermore, we will briefly summarize the present study of experimental and theoretical research in this area. We will then discuss various corrections and issues which need to be understood and applied for a meaningful comparison of experimental measurements with theoretical predictions.

  13. Drawing conformal diagrams for a fractal landscape

    SciTech Connect

    Winitzki, Sergei

    2005-06-15

    Generic models of cosmological inflation and the recently proposed scenarios of a recycling universe and the string theory landscape predict spacetimes whose global geometry is a stochastic, self-similar fractal. To visualize the complicated causal structure of such a universe, one usually draws a conformal (Carter-Penrose) diagram. I develop a new method for drawing conformal diagrams, applicable to arbitrary 1+1-dimensional spacetimes. This method is based on a qualitative analysis of intersecting lightrays and thus avoids the need for explicit transformations of the spacetime metric. To demonstrate the power and simplicity of this method, I present derivations of diagrams for spacetimes of varying complication. I then apply the lightray method to three different models of an eternally inflating universe (scalar-field inflation, recycling universe, and string theory landscape) involving the nucleation of nested asymptotically flat, de Sitter and/or anti-de Sitter bubbles. I show that the resulting diagrams contain a characteristic fractal arrangement of lines.

  14. Dynamic Tactile Diagram Simplification on Refreshable Displays

    ERIC Educational Resources Information Center

    Rastogi, Ravi; Pawluk, Dianne T. V.

    2013-01-01

    The increasing use of visual diagrams in educational and work environments, and even our daily lives, has created obstacles for individuals who are blind or visually impaired to "independently" access the information they represent. Although physical tactile pictures can be created to convey the visual information, it is typically a slow,…

  15. The Keynesian Diagram: A Cross to Bear?

    ERIC Educational Resources Information Center

    Fleck, Juergen

    In elementary economics courses students are often introduced to the basic concepts of macroeconomics through very simplified static models, and the concept of a macroeconomic equilibrium is generally explained with the help of an aggregate demand/aggregate supply (AD/AS) model and an income/expenditure model (via the Keynesian cross diagram).…

  16. Fog Machines, Vapors, and Phase Diagrams

    ERIC Educational Resources Information Center

    Vitz, Ed

    2008-01-01

    A series of demonstrations is described that elucidate the operation of commercial fog machines by using common laboratory equipment and supplies. The formation of fogs, or "mixing clouds", is discussed in terms of the phase diagram for water and other chemical principles. The demonstrations can be adapted for presentation suitable for elementary…

  17. Computer-Generated Diagrams for the Classroom.

    ERIC Educational Resources Information Center

    Carle, Mark A.; Greenslade, Thomas B., Jr.

    1986-01-01

    Describes 10 computer programs used to draw diagrams usually drawn on chalkboards, such as addition of three vectors, vector components, range of a projectile, lissajous figures, beats, isotherms, Snell's law, waves passing through a lens, magnetic field due to Helmholtz coils, and three curves. Several programming tips are included. (JN)

  18. Image Attributes: A Study of Scientific Diagrams.

    ERIC Educational Resources Information Center

    Brunskill, Jeff; Jorgensen, Corinne

    2002-01-01

    Discusses advancements in imaging technology and increased user access to digital images, as well as efforts to develop adequate indexing and retrieval methods for image databases. Describes preliminary results of a study of undergraduates that explored the attributes naive subjects use to describe scientific diagrams. (Author/LRW)

  19. Valid Structure Diagrams and Chemical Gibberish

    ERIC Educational Resources Information Center

    Tauber, Stephen J.; Rankin, Kirk

    1972-01-01

    Chemical structure diagrams are considered as utterances in a written language. Two types of grammars are considered for this language: topological grammars and geometric grammars. The hypothesis is presented that compact computer storage may become accessible via grammars. (15 references) (Author/NH)

  20. Nonverbal Poetry: Family Life-Space Diagrams.

    ERIC Educational Resources Information Center

    Bardill, Donald R.

    2001-01-01

    Examines life-space diagrams as a form of nonverbal poetry which taps personal feelings, tells a story, and characterizes a particular life situation, forming a useful therapy technique that provides a family the opportunity to examine its internal family relationships. Offers two case studies, discusses five levels of knowing and awareness, and…

  1. The Binary Temperature-Composition Phase Diagram

    ERIC Educational Resources Information Center

    Sanders, Philip C.; Reeves, James H.; Messina, Michael

    2006-01-01

    The equations for the liquid and gas lines in the binary temperature-composition phase diagram are derived by approximating that delta(H)[subscript vap] of the two liquids are equal. It is shown that within this approximation, the resulting equations are not too difficult to present in an undergraduate physical chemistry lecture.

  2. Constructing Causal Diagrams to Learn Deliberation

    ERIC Educational Resources Information Center

    Easterday, Matthew W.; Aleven, Vincent; Scheines, Richard; Carver, Sharon M.

    2009-01-01

    Policy problems like "What should we do about global warming?" are ill-defined in large part because we do not agree on a system to represent them the way we agree Algebra problems should be represented by equations. As a first step toward building a policy deliberation tutor, we investigated: (a) whether causal diagrams help students learn to…

  3. Phase diagram of spiking neural networks

    PubMed Central

    Seyed-allaei, Hamed

    2015-01-01

    In computer simulations of spiking neural networks, often it is assumed that every two neurons of the network are connected by a probability of 2%, 20% of neurons are inhibitory and 80% are excitatory. These common values are based on experiments, observations, and trials and errors, but here, I take a different perspective, inspired by evolution, I systematically simulate many networks, each with a different set of parameters, and then I try to figure out what makes the common values desirable. I stimulate networks with pulses and then measure their: dynamic range, dominant frequency of population activities, total duration of activities, maximum rate of population and the occurrence time of maximum rate. The results are organized in phase diagram. This phase diagram gives an insight into the space of parameters – excitatory to inhibitory ratio, sparseness of connections and synaptic weights. This phase diagram can be used to decide the parameters of a model. The phase diagrams show that networks which are configured according to the common values, have a good dynamic range in response to an impulse and their dynamic range is robust in respect to synaptic weights, and for some synaptic weights they oscillates in α or β frequencies, independent of external stimuli. PMID:25788885

  4. On phase diagrams of magnetic reconnection

    SciTech Connect

    Cassak, P. A.; Drake, J. F.

    2013-06-15

    Recently, “phase diagrams” of magnetic reconnection were developed to graphically organize the present knowledge of what type, or phase, of reconnection is dominant in systems with given characteristic plasma parameters. Here, a number of considerations that require caution in using the diagrams are pointed out. First, two known properties of reconnection are omitted from the diagrams: the history dependence of reconnection and the absence of reconnection for small Lundquist number. Second, the phase diagrams mask a number of features. For one, the predicted transition to Hall reconnection should be thought of as an upper bound on the Lundquist number, and it may happen for considerably smaller values. Second, reconnection is never “slow,” it is always “fast” in the sense that the normalized reconnection rate is always at least 0.01. This has important implications for reconnection onset models. Finally, the definition of the relevant Lundquist number is nuanced and may differ greatly from the value based on characteristic scales. These considerations are important for applications of the phase diagrams. This is demonstrated by example for solar flares, where it is argued that it is unlikely that collisional reconnection can occur in the corona.

  5. A pilot study to assess the feasibility of a submaximal exercise test to measure individual response to cardiac medication in dogs with acquired heart failure.

    PubMed

    Ferasin, L; Marcora, S

    2007-08-01

    Exercise testing is not commonly used in canine medicine because of several limitations. The aim of this study was to investigate the suitability of a treadmill test to measure the exercise capacity of untrained canine cardiac patients and to measure some biological parameters that might reflect the tolerance of dogs with heart failure to submaximal exercise. The exercise capacity of seven dogs with naturally occurring heart failure was evaluated before the institution of cardiac medication and 7 days after the beginning of the study. An additional re-examination was requested after 28 days. The exercise test was performed on a motorized treadmill at three different speeds (0.5 m/s, 1.0 m/s and 1.5 m/s). The following parameters were measured at the end of each stage and after 20 min recovery: heart rate, rectal temperature, glucose, lactate, aspartate aminotransferase, creatine kinase, PvO(2), PvCO(2), pH, haematocrit, bicarbonate, sodium, potassium and chloride. Serum cardiac troponin-I was also measured at the beginning of the test and at the end of the recovery period. Owners' perception reflected the ability of their dogs to exercise on the treadmill. Lactate level increased noticeably with the intensity of the exercise test, and its variation coincided with different exercise tolerance observed by the owners. Heart rate seemed to follow a similar trend in the few dogs presented in sinus rhythm. None of the remaining parameters appeared to be sensitive indicators of activity level in the dogs used in this study. The treadmill exercise test in dogs with acquired heart failure is feasible and might provide useful information for assessing individual response to cardiac medication. Lactate and heart rate seemed to reflect individual levels of exercise tolerance, although further studies are necessary to confirm the reliability and repeatability of this test.

  6. Radial dyssynchrony assessed by cardiovascular magnetic resonance in relation to left ventricular function, myocardial scarring and QRS duration in patients with heart failure

    PubMed Central

    2009-01-01

    Background Intuitively, cardiac dyssynchrony is the inevitable result of myocardial injury. We hypothezised that radial dyssynchrony reflects left ventricular remodeling, myocardial scarring, QRS duration and impaired LV function and that, accordingly, it is detectable in all patients with heart failure. Methods 225 patients with heart failure, grouped according to QRS duration of <120 ms (A, n = 75), between 120-149 ms (B, n = 75) or ≥150 ms (C, n = 75), and 50 healthy controls underwent assessment of radial dyssynchrony using the cardiovascular magnetic resonance tissue synchronization index (CMR-TSI = SD of time to peak inward endocardial motion in up to 60 myocardial segments). Results Compared to 50 healthy controls (21.8 ± 6.3 ms [mean ± SD]), CMR-TSI was higher in A (74.8 ± 34.6 ms), B (92.4 ± 39.5 ms) and C (104.6 ± 45.6 ms) (all p < 0.0001). Adopting a cut-off CMR-TSI of 34.4 ms (21.8 plus 2xSD for controls) for the definition of dyssynchrony, it was present in 91% in A, 95% in B and 99% in C. Amongst patients in NYHA class III or IV, with a LVEF<35% and a QRS>120 ms, 99% had dyssynchrony. Amongst those with a QRS<120 ms, 91% had dyssynchrony. Across the study sample, CMR-TSI was related positively to left ventricular volumes (p < 0.0001) and inversely to LVEF (CMR-TSI = 178.3 e (-0.033 LVEF) ms, p < 0.0001). Conclusion Radial dyssynchrony is almost universal in patients with heart failure. This vies against the notion that a lack of response to CRT is related to a lack of dyssynchrony. PMID:19930713

  7. Use of serial assessment of disease severity and liver biopsy for indication for liver transplantation in pediatric Epstein-Barr virus-induced fulminant hepatic failure.

    PubMed

    Nakazawa, Atsuko; Nakano, Natsuko; Fukuda, Akinari; Sakamoto, Seisuke; Imadome, Ken-Ichi; Kudo, Toyoichiro; Matsuoka, Kentaro; Kasahara, Mureo

    2015-03-01

    The decision to perform liver transplantation (LT) in patients with Epstein-Barr virus (EBV)-induced fulminant hepatic failure (FHF) relies on a precise assessment of laboratory and pathological findings. In this study, we analyzed clinical and laboratory data as well as the pathological features of the liver in order to evaluate the pathogenesis and the need for LT in 5 patients with EBV-induced FHF. According to the King's College criteria, the Acute Liver Failure Early Dynamic (ALFED) model, and the Japanese criteria (from the Acute Liver Failure Study Group of Japan), only 1 patient was considered to be a candidate for LT. However, explanted liver tissues in 3 cases exhibited massive hepatocellular necrosis together with diffuse CD8-positive T cell infiltration in both the portal area and the sinusoid. EBV was detected in the liver, plasma, and peripheral blood mononuclear cells (PBMNCs). In 2 cases indicated to be at moderate risk by the ALFED model, liver biopsy showed CD8-positive and EBV-encoded RNA signal-positive lymphocytic infiltration predominantly in the portal area, but massive hepatocellular necrosis was not observed. These patients were treated with immunosuppressants and etoposide under the diagnosis of EBV-induced hemophagocytic lymphohistiocytosis or systemic EBV-positive T cell lymphoproliferative disease of childhood. EBV DNA was detected at a high level in PBMNCs, although it was negative in plasma. On the basis of the pathological analysis of the explanted liver tissues, LT was proposed for the restoration of liver function and the removal of the EBV-infected lymphocytes concentrated in the liver. Detecting EBV DNA by a quantitative polymerase chain reaction in plasma and PBMNCs was informative. An accurate evaluation of the underlying pathogenesis is essential for developing a treatment strategy in patients with EBV-induced FHF. © 2015 American Association for the Study of Liver Diseases.

  8. Heart failure

    PubMed Central

    2011-01-01

    Introduction Heart failure occurs in 3% to 4% of adults aged over 65 years, usually as a consequence of coronary artery disease or hypertension, and causes breathlessness, effort intolerance, fluid retention, and increased mortality. The 5-year mortality in people with systolic heart failure ranges from 25% to 75%, often owing to sudden death following ventricular arrhythmia. Risks of cardiovascular events are increased in people with left ventricular systolic dysfunction (LVSD) or heart failure. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of multidisciplinary interventions for heart failure? What are the effects of exercise in people with heart failure? What are the effects of drug treatments for heart failure? What are the effects of devices for treatment of heart failure? What are the effects of coronary revascularisation for treatment of heart failure? What are the effects of drug treatments in people at high risk of heart failure? What are the effects of treatments for diastolic heart failure? We searched: Medline, Embase, The Cochrane Library, and other important databases up to August 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 80 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: aldosterone receptor antagonists, amiodarone, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, anticoagulation, antiplatelet agents, beta-blockers, calcium

  9. Assessment of the effect of welding fumes on welders' cognitive failure and health-related quality of life.

    PubMed

    Rahmani, Abdolrasoul; Golbabaei, Farideh; Dehghan, Somayeh Farhang; Mazlomi, Adel; Akbarzadeh, Arash

    2016-09-01

    This study examined whether cognitive symptoms and health-related quality of life can be affected by welding fume exposure. Participants consisted of welders (n = 40) and welder assistants (n = 25) from welding units as the exposed group, and office workers (n = 44) as the non-exposed group. All participants were studied using ambient air monitoring and two types of questionnaires: the Cognitive Failures Questionnaire (CFQ) and the 36-item Short Form Health Survey (SF-36). Welders and welder assistants were exposed to higher concentrations of all airborne metals than office employees, except for aluminum and chromium (p < 0.05). Mean (95% confidence interval) CFQ score was higher in welders (26.42 (12.74)) compared with welder assistants (22.68 (14.37)) and the non-exposed group (21.38 (8.75)), although these differences were not statistically significant. Mean total score of the SF-36 significantly differed among the three groups (p < 0.05) and welders had the lowest score (M (SD) = 54.84 (17.88)). The relationships between total CFQ score and the measured concentration of nickel at peak work rate was significant for welders. Cognitive symptoms and health-related quality of life were not related to the measures of welding fume exposure and further research should be performed to find other influencing factors.

  10. Visualization of geologic stress perturbations using Mohr diagrams.

    PubMed

    Crossno, Patricia; Rogers, David H; Brannon, Rebecca M; Coblentz, David; Fredrich, Joanne T

    2005-01-01

    Huge salt formations, trapping large untapped oil and gas reservoirs, lie in the deepwater region of the Gulf of Mexico. Drilling in this region is high-risk and drilling failures have led to well abandonments, with each costing tens of millions of dollars. Salt tectonics plays a central role in these failures. To explore the geomechanical interactions between salt and the surrounding sand and shale formations, scientists have simulated the stresses in and around salt diapirs in the Gulf of Mexico using nonlinear finite element geomechanical modeling. In this paper, we describe novel techniques developed to visualize the simulated subsurface stress field. We present an adaptation of the Mohr diagram, a traditional paper-and-pencil graphical method long used by the material mechanics community for estimating coordinate transformations for stress tensors, as a new tensor glyph for dynamically exploring tensor variables within three-dimensional finite element models. This interactive glyph can be used as either a probe or a filter through brushing and linking.

  11. Accuracy of Seattle Heart Failure Model and HeartMate II Risk Score in Non-Inotrope-Dependent Advanced Heart Failure Patients: Insights From the ROADMAP Study (Risk Assessment and Comparative Effectiveness of Left Ventricular Assist Device and Medical Management in Ambulatory Heart Failure Patients).

    PubMed

    Lanfear, David E; Levy, Wayne C; Stehlik, Josef; Estep, Jerry D; Rogers, Joseph G; Shah, Keyur B; Boyle, Andrew J; Chuang, Joyce; Farrar, David J; Starling, Randall C

    2017-05-01

    Timing of left ventricular assist device (LVAD) implantation in advanced heart failure patients not on inotropes is unclear. Relevant prediction models exist (SHFM [Seattle Heart Failure Model] and HMRS [HeartMate II Risk Score]), but use in this group is not established. ROADMAP (Risk Assessment and Comparative Effectiveness of Left Ventricular Assist Device and Medical Management in Ambulatory Heart Failure Patients) is a prospective, multicenter, nonrandomized study of 200 advanced heart failure patients not on inotropes who met indications for LVAD implantation, comparing the effectiveness of HeartMate II support versus optimal medical management. We compared SHFM-predicted versus observed survival (overall survival and LVAD-free survival) in the optimal medical management arm (n=103) and HMRS-predicted versus observed survival in all LVAD patients (n=111) using Cox modeling, receiver-operator characteristic (ROC) curves, and calibration plots. In the optimal medical management cohort, the SHFM was a significant predictor of survival (hazard ratio=2.98; P<0.001; ROC area under the curve=0.71; P<0.001) but not LVAD-free survival (hazard ratio=1.41; P=0.097; ROC area under the curve=0.56; P=0.314). SHFM showed adequate calibration for survival but overestimated LVAD-free survival. In the LVAD cohort, the HMRS had marginal discrimination at 3 (Cox P=0.23; ROC area under the curve=0.71; P=0.026) and 12 months (Cox P=0.036; ROC area under the curve=0.62; P=0.122), but calibration was poor, underestimating survival across time and risk subgroups. In non-inotrope-dependent advanced heart failure patients receiving optimal medical management, the SHFM was predictive of overall survival but underestimated the risk of clinical worsening and LVAD implantation. Among LVAD patients, the HMRS had marginal discrimination and underestimated survival post-LVAD implantation. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01452802. © 2017 American Heart Association

  12. Failure to Identify Behavioral Symptoms of People with Dementia and the Need for Follow-Up Physical Assessment

    PubMed Central

    Kovach, Christine R.; Logan, Brent R.; Joosse, Laura L.; Noonan, Patricia E.

    2011-01-01

    This descriptively designed study examined sensitivity and specificity of staff nurses identification of behavior change in nursing home residents with dementia. Behavior changes and whether further physical assessment was indicated were described and compared to judgments made by one expert advanced practice nurse. The convenience sample included 155 residents and 38 staff nurses from eleven nursing homes. Verbal symptoms and body part cues were the most prevalent behaviors regardless of the assessor. Sensitivity, or probability of identifying a real behavior change, was generally low for the staff nurses, ranging between 35–65% for the different types of behaviors, while specificity was quite high at over 95%. Additional assessment was felt to be needed for 51% of residents by the staff nurse and for 73% of residents by the expert. This study found that staff nurses are under-identifying behavior changes and the need for additional physical assessment. PMID:21598865

  13. Teacher Alert System: A Guide for Teacher Managed Assessment of Students Who Are "At Risk" of School Failure.

    ERIC Educational Resources Information Center

    Alberta Education Response Centre, Edmonton.

    The Teacher Alert System was designed in Alberta, Canada, for classroom teachers and school personnel concerned about the needs of "at risk" students. The guide can assist in the identification, assessment, and intervention process for children who have special needs. The student's problems may be related to learning, emotions, or…

  14. Role of Biomarkers for the Prevention, Assessment, and Management of Heart Failure: A Scientific Statement From the American Heart Association.

    PubMed

    Chow, Sheryl L; Maisel, Alan S; Anand, Inder; Bozkurt, Biykem; de Boer, Rudolf A; Felker, G Michael; Fonarow, Gregg C; Greenberg, Barry; Januzzi, James L; Kiernan, Michael S; Liu, Peter P; Wang, Thomas J; Yancy, Clyde W; Zile, Michael R

    2017-05-30

    Natriuretic peptides have led the way as a diagnostic and prognostic tool for the diagnosis and management of heart failure (HF). More recent evidence suggests that natriuretic peptides along with the next generation of biomarkers may provide added value to medical management, which could potentially lower risk of mortality and readmissions. The purpose of this scientific statement is to summarize the existing literature and to provide guidance for the utility of currently available biomarkers. The writing group used systematic literature reviews, published translational and clinical studies, clinical practice guidelines, and expert opinion/statements to summarize existing evidence and to identify areas of inadequacy requiring future research. The panel reviewed the most relevant adult medical literature excluding routine laboratory tests using MEDLINE, EMBASE, and Web of Science through December 2016. The document is organized and classified according to the American Heart Association to provide specific suggestions, considerations, or contemporary clinical practice recommendations. A number of biomarkers associated with HF are well recognized, and measuring their concentrations in circulation can be a convenient and noninvasive approach to provide important information about disease severity and helps in the detection, diagnosis, prognosis, and management of HF. These include natriuretic peptides, soluble suppressor of tumorgenicity 2, highly sensitive troponin, galectin-3, midregional proadrenomedullin, cystatin-C, interleukin-6, procalcitonin, and others. There is a need to further evaluate existing and novel markers for guiding therapy and to summarize their data in a standardized format to improve communication among researchers and practitioners. HF is a complex syndrome involving diverse pathways and pathological processes that can manifest in circulation as biomarkers. A number of such biomarkers are now clinically available, and monitoring their

  15. Assessment of the knowledge and perception of support of patients with heart failure SOPICA study IN SPAIN.

    PubMed

    Miró, Ò; Escoda, R; Martín-Sánchez, F J; Herrero, P; Jacob, J; Rizzi, M; Aguirre, A; Andueza, J A; Bueno, H; Llorens, P

    2016-01-01

    To understand the perceptions of patients with heart failure (HF) concerning their disease, treatment and support, as well as the specialists who provide care after a decompensation, and to determine whether there is a relationship between the type of specialist involved in the follow-up and the medium-term prognosis. A multicentre, prospective cohort study consecutively included patients with acute HF in the emergency department. The patients were interviewed by telephone 91-180days after their emergency department visit. We investigated the relationship between the type of specialist who performed the follow-up and the emergency department visits or hospitalisations using Cox regression models, with progressive adjustment by groups of potential confounders of these relationships. We interviewed 785 patients. Thirty-three percent (95%CI: 30%-36%) considered their disease mild, 64% (60%-67%) required help from third parties for daily activities, 65% (61%-68%) had no recent therapeutic changes, and 69% (67%-72%) received the same treatment in the exacerbations. The perceived support varied significantly depending on the factor under consideration (from greater to lesser: family, hospital, emergency department, health centre, religion and patient associations; p<.05 in all comparisons). Thirty-nine percent (36%-43%) of the patients with decompensations consulted directly with the emergency department, with no prior changes in treatment. At discharge, general practitioners (74%, 71%-77%) and cardiologists (74%, 70%-77%) were the most involved in the follow-up, although the specialty was not related to the prognosis. There are various aspects of the perception of patients with HF concerning their disease that are susceptible to future interventions. Patient follow-up involves various specialties, but all achieve similar results in the medium term. Copyright © 2016. Published by Elsevier España, S.L.U.

  16. Assessment of ISGLS definition of posthepatectomy liver failure and its effect on outcome in patients with hepatocellular carcinoma.

    PubMed

    Fukushima, Kenji; Fukumoto, Takumi; Kuramitsu, Kaori; Kido, Masahiro; Takebe, Atsushi; Tanaka, Motofumi; Itoh, Tomoo; Ku, Yonson

    2014-04-01

    Posthepatectomy liver failure (PHLF) is a major complication after hepatectomy. As there was no standardized definition, the International Study Group of Liver Surgery (ISGLS) defined PHLF as increased international normalized ratio and hyperbilirubinemia on or after postoperative day 5 in 2010. We evaluated the impact of the ISGLS definition of PHLF on hepatocellular carcinoma (HCC) patients. We retrospectively analyzed 210 consecutive HCC patients who underwent curative hepatectomy at our facility from 2005 to 2010. The median follow-up period after hepatectomy was 35.2 months. Thirty-nine (18.6%) patients fulfilled the ISGLS definition of PHLF. Overall survival (OS) rates at 1, 3, and 5 years in patients with/without PHLF were 69.1/93.5, 45.1/72.5, and 45.1/57.8%, respectively (P = 0.002). Recurrence-free survival (RFS) rates at 1, 3, and 5 years in patients with/without PHLF were 40.9/65.9, 15.7/38.3, and 15.7/20.3%, respectively (P = 0.003). Multivariate analysis revealed that PHLF was significantly associated with both OS (P = 0.047) and RFS (P = 0.019). Extent of resection (P < 0.001), intraoperative blood loss (P = 0.002), and fibrosis stage (P = 0.040) were identified as independent risk factors for developing PHLF. The ISGLS definition of PHLF was associated with OS and RFS in HCC patients, and long-term survival will be improved by reducing the incidence of PHLF.

  17. A Simple Approach for Boundary Improvement of Euler Diagrams.

    PubMed

    Simonetto, Paolo; Archambault, Daniel; Scheidegger, Carlos

    2016-01-01

    General methods for drawing Euler diagrams tend to generate irregular polygons. Yet, empirical evidence indicates that smoother contours make these diagrams easier to read. In this paper, we present a simple method to smooth the boundaries of any Euler diagram drawing. When refining the diagram, the method must ensure that set elements remain inside their appropriate boundaries and that no region is removed or created in the diagram. Our approach uses a force system that improves the diagram while at the same time ensuring its topological structure does not change. We demonstrate the effectiveness of the approach through case studies and quantitative evaluations.

  18. Premature ovarian failure.

    PubMed

    Kalantaridou, S N; Davis, S R; Nelson, L M

    1998-12-01

    In 1% of women, premature ovarian failure develops by 40 years of age, a condition causing amenorrhea, infertility, sex steroid deficiency, and elevated gonadotropins. Early loss of ovarian function has significant psychosocial sequelae and major health implications. These young women have a nearly two-fold age-specific increase in mortality rate. Among women with spontaneous premature ovarian failure who have a normal karyotype, half have ovarian follicles remaining in the ovary that function intermittently. Indeed, pregnancies have occurred after the diagnosis of premature ovarian failure. Thus, premature ovarian failure should not be considered as a premature menopause. Young women with this disorder have a 5% to 10% chance for spontaneous pregnancy. Attempts at ovulation induction using various regimens fail to induce ovulation rates greater than those seen in untreated patients; however, oocyte donation for women desiring fertility is an option. Young women with premature ovarian failure need a thorough assessment, sex steroid replacement, and long-term surveillance to monitor therapy. Estrogen-progestin replacement therapy should be instituted as soon as the diagnosis is made. Androgen replacement should also be considered for women with low libido, persistent fatigue, and poor well-being despite taking adequate estrogen replacement. Women with premature ovarian failure should be followed up for the presence of associated autoimmune endocrine disorders such as hypothyroidism, adrenal insufficiency, and diabetes mellitus.

  19. Quality of life assessment for acute heart failure patients from emergency department presentation through 30 days after discharge: A pilot study with the Kansas City Cardiomyopathy Questionnaire.

    PubMed

    Sauser, Kori; Spertus, John A; Pierchala, Linda; Davis, Evan; Pang, Peter S

    2014-05-01

    Background: There are no well validated patient-reported disease status instruments for acute heart failure(HF). We assessed the feasibility of using the Kansas City Cardiomyopathy Questionnaire (KCCQ)during acute heart failure hospitalization, and the association of acute changes with 30-day readmission.Methods and Results: A convenience sample of acute HF patients were administered the KCCQ on presentation,discharge, and 30 days after discharge. We examined mean differences in KCCQ scores overtime, and we stratified by readmission status to examine differences in hospital-based changes with the use of t test and logistic regression. Among 52 patients (mean age 63 ± 15 years, 56.9% male, 46.2% white), discharge and 30-day assessments were each completed by 90%. Scores were lowest at presentation,improved during hospitalization, and were highest at 30 days. The mean change was +11.9 ± 27.0(P 5 .007) between presentation and discharge and +19.8 ± 17.8 (P <. .001) between discharge and 30 days. Within the 30-day follow-up, 10 patients were readmitted, and there were no significant differences in score changes during hospitalization between patients with and without readmission (readmitted patients: +4.8 ± 21.5 vs no readmission +16.2 ± 27.4; P = .32).Conclusions: In this pilot study, the KCCQ is feasible to use during acute HF hospitalizations and demonstrates sensitivity to acute changes, but score changes during hospitalization did not predict 30-day readmission.

  20. Beat-to-beat assessment of QT/RR interval ratio in severe heart failure and overt myocardial ischemia: a measure of electrical integrity in diseased hearts.

    PubMed

    Faber, Thomas S; Grom, Andreas; Schöpflin, Markus; Brunner, Michael; Bode, Christoph; Zehender, Manfred

    2003-04-01

    The study was designed to assess the beat-to-beat variation of ventricular repolarization in patients with myocardial ischemia, hear failure, and in normal subjects. Autonomic tone may alter the dynamic QT/RR interval relation and thus may be involved in ventricular arrhythmia development, especially in the diseased heart. The study included 145 patients (age 16-86 years) with CHF (LVEF < or = 0.30) or unstable angina pectoris (LVEF > 0.60). The control group consisted of healthy volunteers giving physiological baseline measures for the evaluated parameters: cycle length, QT interval, and QT/RR interval ratio during three time periods. In patients with myocardial ischemia (LVEF > 0.60) and healthy subjects the QT/RR interval ratio did not reveal significant differences between both groups (QT/RR(CAD) = 0.36 +/- 0.77 vs QT/RR(controls) = 0.28 +/- 0.83; NS). In sharp contrast, in patients with severe heart failure, RR dependent instantaneous variation of the QT interval was almost missing and regression line analysis disclosed a QT/RR interval slope substantially enhanced by 196% (compared to normal subjects) and 131% (compared to CAD patients; P < 0.05) with a complete loss of circadian modulation (QT/RR(CHF) = 0.83 +/- 0.71 vs QT/RR(CAD) = 0.36 +/- 0.77 vs QT/RR(controls) = 0.28 +/- 0.83; P < 0.05). Beat-to-beat QT interval assessment provides a dynamic parameter of physiological and altered repolarization in defined study groups. Compared to other groups (preserved LVEF), patients with left ventricular impairment exhibited a significantly increased sensitivity of repolarization to cycle length (enhanced QT/RR interval ratio) and a blunted circadian modulation of the QT interval. This is consistent with concept that increased repolarization disparity may be deleterious being a potential pathophysiological basis for enhanced arrhythmic risk.