Science.gov

Sample records for failure pressure evaluation

  1. Evaluation of Progressive Failure Analysis and Modeling of Impact Damage in Composite Pressure Vessels

    NASA Technical Reports Server (NTRS)

    Sanchez, Christopher M.

    2011-01-01

    NASA White Sands Test Facility (WSTF) is leading an evaluation effort in advanced destructive and nondestructive testing of composite pressure vessels and structures. WSTF is using progressive finite element analysis methods for test design and for confirmation of composite pressure vessel performance. Using composite finite element analysis models and failure theories tested in the World-Wide Failure Exercise, WSTF is able to estimate the static strength of composite pressure vessels. Additionally, test and evaluation on composites that have been impact damaged is in progress so that models can be developed to estimate damage tolerance and the degradation in static strength.

  2. 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.

  3. Evaluation of a fracture failure mode in the Space Shuttle hydrogen pressurization system flow control valves

    NASA Astrophysics Data System (ADS)

    Hauver, S. E.; Sueme, D. R.

    1992-07-01

    During acceptance testing of the Space Shuttle Endeavor hydrogen flow control valves, which are used in the Orbiter's fuel tank pressurization system, two of the valves experienced fracture of the poppet flange. The poppets are made of 440 C, a high strength, wear-resistant, low ductility, martensitic stainless steel. The investigation which was initiated to determine the cause of these failures is traced. All aspects of the poppet processing that may have introduced a defect were assessed. This included machining, heat treating, passivation, assembly, and test. In addition, several potential failure modes were investigated. The extensive investigation revealed no obvious cause of the failures, but did result in a recommendation for a different material application.

  4. Evaluation of hawthorn extract on immunomodulatory biomarkers in a pressure overload model of heart failure.

    PubMed

    Bleske, Barry E; Zineh, Issam; Hwang, Hyun Seok; Welder, Gregory J; Ghannam, Michael M J; Boluyt, Marvin O

    2007-12-01

    Hawthorn extract (Crataegeus sp.) a botanical complementary and alternative medicine is often used to treat heart failure. The mechanism(s) by which hawthorn extract may treat heart failure is unknown but may include, theoretically, immunological effects. Therefore, the purpose of this study is to determine the effect of hawthorn extract on the immunomodulatory response in a pressure overload model of heart failure. A total of 62 male Sprague-Dawley rats were randomized to either aortic constriction + vehicle (AC; n=15), aortic constriction + hawthorn 1.3 mg/kg (HL, n=17), aortic constriction + hawthorn 13 mg/kg (HM, n=15), or aortic constriction + hawthorn 130 mg/kg (HH, n=15). Six months after surgical procedure animals were sacrificed and plasma samples obtained for the measurement of the following immunomodulatory markers: interleukin (IL) IL-1ss, IL-2, IL-6, IL-10; and leptin. The mortality rate following 6 months of aortic constriction was 40% in the AC group compared to 41%, 60%, and 53% for the HL, HM, and HH groups respectively (P>0.05 compared to AC). Aortic constriction produced a similar increase in the left ventricle/body weight ratio for all groups. Hawthorn extract had no effect on the immunomodulatory markers measured in this study, although there appeared to be a trend suggesting suppression of IL-2 plasma concentrations. In this animal model of heart failure, hawthorn extract failed to significantly affect the immunomodulatory response characterized after 6 months of pressure overload at a time when approximately 50% mortality was exhibited. Mechanisms other than immunological may better define hawthorn's effect in treating heart failure.

  5. Simplified failure sequence evaluation of reactor pressure vessel head corroding in-core instrumentation assembly

    SciTech Connect

    McVicker, J.P.; Conner, J.T.; Hasrouni, P.N.; Reizman, A.

    1995-11-01

    In-Core Instrumentation (ICI) assemblies located on a Reactor Pressure Vessel Head have a history of boric acid leakage. The acid tends to corrode the nuts and studs which fasten the flanges of the assembly, thereby compromising the assembly`s structural integrity. This paper provides a simplified practical approach in determining the likelihood of an undetected progressing assembly stud deterioration, which would lead to a catastrophic loss of reactor coolant. The structural behavior of the In-Core Instrumentation flanged assembly is modeled using an elastic composite section assumption, with the studs transmitting tension and the pressure sealing gasket experiencing compression. Using the above technique, one can calculate the flange relative deflection and the consequential coolant loss flow rate, as well as the stress in any stud. A solved real life example develops the expected failure sequence and discusses the exigency of leak detection for safe shutdown. In the particular case of Calvert Cliffs Nuclear Power Plant (CCNPP) it is concluded that leak detection occurs before catastrophic failure of the ICI flange assembly.

  6. Ultrasonic Nondestructive Evaluation of PRSEUS Pressure Cube Article in Support of Load Test to Failure

    NASA Technical Reports Server (NTRS)

    Johnston, Patrick H.

    2013-01-01

    The PRSEUS Pressure Cube Test was a joint development effort between the Boeing Company and NASA Langley Research Center, sponsored in part by the Environmentally Responsible Aviation Project and Boeing internal R&D. This Technical Memorandum presents the results of ultrasonic inspections in support of the PRSEUS Pressure Cube Test, and is a companion document with the NASA test report and a report on the acoustic emission measurements made during the test.

  7. Evaluation of ultrafiltration failure.

    PubMed

    Korbet, S M

    1998-07-01

    The evaluation of ultrafiltration failure is embarked upon when a patient has persistent problems with symptoms and signs of fluid overload. Fluid overload is a common problem in peritoneal dialysis (PD) patients and the risk of its occurrence increases with time on dialysis. Although often attributed to changes in peritoneal membrane function (membrane failure), there are a number of potential, and frequently more common factors that can contribute to the failure of adequate fluid removal in patients on PD. Many of the causes of ultrafiltration failure may be apparent after an initial informal evaluation. However, if after this the etiology remains unexplained, a systematic approach to the differential diagnosis of this problem can be utilized with the use of the peritoneal equilibration test. Once a diagnosis is confirmed, a logical therapeutic plan can be formulated.

  8. RV pressure overload: from hypertrophy to failure.

    PubMed

    van der Bruggen, Cathelijne E E; Tedford, Ryan J; Handoko, Martin Louis; van der Velden, Jolanda; de Man, Frances S

    2017-10-01

    In pulmonary arterial hypertension (PAH), right ventricular (RV) adaptation is essential to overcome the chronic increases in RV pressure overload. Ultimately, RV compensatory mechanisms are not sufficient and patients succumb to RV failure. The processes underlying the transition of RV adaptation to RV failure are not well understood. In this review, we propose that important insights in RV adaptation processes can be obtained by comparing different etiologies of PAH, namely patients with PAH secondary to Eisenmenger syndrome, patients with PAH secondary to systemic sclerosis and patients where no cause is identified: idiopathic PAH. Although the amount of RV afterload does not differ between these patient groups, their prognosis is distinctly different. We will show that an adaptive RV phenotype, as is observed in Eisenmenger patients, coincides with RV hypertrophy, increased RV contractility, low RV fibrosis and low RV diastolic stiffness. Whereas a phenotype of RV failure, as is observed in patients with PAH-secondary to systemic sclerosis, is characterized by impaired contractile reserve, RV fibrosis and RV diastolic stiffness. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  9. Blood pressure oscillations in baroreflex failure.

    PubMed

    Abuzinadah, Ahmad Rida; Sinn, Dong In; Freeman, Roy; Gibbons, Christopher H

    2016-12-01

    A 67-year-old man presented with labile hypertension and orthostatic hypotension after radical neck dissection and radiotherapy for squamus cell carcinoma. Baroreflex failure is clearly evident on autonomic testing.

  10. Pore fluid pressure, apparent friction, and Coulomb failure

    USGS Publications Warehouse

    Beeler, N.M.; Simpson, R.W.; Hickman, S.H.; Lockner, D.A.

    2000-01-01

    Many recent studies of stress-triggered seismicity rely on a fault failure model with a single free parameter, the apparent coefficient of friction, presumed to be a material constant with possible values 0 ≤ μ′ ≤ 1. These studies may present a misleading view of fault strength and the role of pore fluid pressure in earthquake failure. The parameter μ′ is intended to incorporate the effects of both friction and pore pressure, but is a material constant only if changes in pore fluid pressure induced by changes in stress are proportional to the normal stress change across the potential failure plane. Although specific models of fault zones permit such a relation, neither is it known that fault zones within the Earth behave this way, nor is this behavior expected in all cases. In contrast, for an isotropic homogeneous poroelastic model the pore pressure changes are proportional to changes in mean stress, μ′ is not a material constant, and −∞ ≤ μ′ ≤ +∞. Analysis of the change in Coulomb failure stress for tectonically loaded reverse and strike-slip faults shows considerable differences between these two pore pressure models, suggesting that such models might be distinguished from one another using observations of triggered seismicity (e.g., aftershocks). We conclude that using the constant apparent friction model exclusively in studies of Coulomb failure stress is unwise and could lead to significant errors in estimated stress change and seismic hazard.

  11. Noninvasive Positive Pressure Ventilation in Chronic Heart Failure

    PubMed Central

    Han, Yi

    2016-01-01

    Instruction and Objectives. Noninvasive positive pressure ventilation (NPPV) alleviates sleep-disordered breathing (SDB) and it may improve cardiac function in SDB patients. Because large randomized controlled trials directly evaluating the impact of NPPV on cardiac function are lacking, we conducted a meta-analysis of published data on effectiveness of NPPV in improving cardiac function in patients with chronic heart failure regardless of SDB presence. Methods. Controlled trials were identified in PubMed, OVID, and EMBASE databases. Both fixed and randomized models were used in meta-analysis with primary outcomes of left ventricular ejection fraction (LVEF). Results. Nineteen studies were included with a total of 843 patients. Compared to standard medical treatment (SMT) plus sham-NPPV or SMT only, NPPV plus SMT was associated with improvement in LVEF (weighted mean difference 5.34, 95% CI, [3.85,6.82]; P < 0.00001) and plasma brain natriuretic peptide (BNP) level (weighted mean difference −117.37, 95% CI, [−227.22, −7.52]; P = 0.04) and no influence on overall mortality (RR 1.00, 95% CI, [0.96,1.04]; P = 0.95). Conclusions. In the present meta-analysis, use of NPPV plus SMT improved LVEF and reduced plasma BNP level but did not improve overall mortality in patients with chronic heart failure. PMID:27891061

  12. Effects of Gas Pressure on the Failure Characteristics of Coal

    NASA Astrophysics Data System (ADS)

    Xie, Guangxiang; Yin, Zhiqiang; Wang, Lei; Hu, Zuxiang; Zhu, Chuanqi

    2017-07-01

    Several experiments were conducted using self-developed equipment for visual gas-solid coupling mechanics. The raw coal specimens were stored in a container filled with gas (99% CH4) under different initial gas pressure conditions (0.0, 0.5, 1.0, and 1.5 MPa) for 24 h prior to testing. Then, the specimens were tested in a rock-testing machine, and the mechanical properties, surface deformation and failure modes were recorded using strain gauges, an acoustic emission (AE) system and a camera. An analysis of the fractals of fragments and dissipated energy was performed to understand the changes observed in the stress-strain and crack propagation behaviour of the gas-containing coal specimens. The results demonstrate that increased gas pressure leads to a reduction in the uniaxial compression strength (UCS) of gas-containing coal and the critical dilatancy stress. The AE, surface deformation and fractal analysis results show that the failure mode changes during the gas state. Interestingly, a higher initial gas pressure will cause the damaged cracks and failure of the gas-containing coal samples to become severe. The dissipated energy characteristic in the failure process of a gas-containing coal sample is analysed using a combination of fractal theory and energy principles. Using the theory of fracture mechanics, based on theoretical analyses and calculations, the stress intensity factor of crack tips increases as the gas pressure increases, which is the main cause of the reduction in the UCS and critical dilatancy stress and explains the influence of gas in coal failure. More serious failure is created in gas-containing coal under a high gas pressure and low exterior load.

  13. Reaction control system helium pressure regulator filter failure

    NASA Technical Reports Server (NTRS)

    1972-01-01

    The failure analysis of the command module reaction control system helium pressure regulators revealed that the filter element end caps were bulged by the helium pressure surge during activation. Some end caps may bulge and also some wire separation may occur during command module reaction control system activations; however, system performance should not be affected. The reaction control system design is acceptable and no change in hardware, system, or activation procedures is required.

  14. CXCR4 gene transfer prevents pressure overload induced heart failure

    PubMed Central

    LaRocca, Thomas J.; Jeong, Dongtak; Kohlbrenner, Erik; Lee, Ahyoung; Chen, JiQiu; Hajjar, Roger J.; Tarzami, Sima T.

    2012-01-01

    Stem cell and gene therapies are being pursued as strategies for repairing damaged cardiac tissue following myocardial infarction in an attempt to prevent heart failure. The chemokine receptor-4 (CXCR4) and its ligand, CXCL12, play a critical role in stem cell recruitment post-acute myocardial infarction. Whereas progenitor cell migration via the CXCL12/CXCR4 axis is well characterized, little is known about the molecular mechanisms of CXCR4 mediated modulation of cardiac hypertrophy and failure. We used gene therapy to test the effects of CXCR4 gene delivery on adverse ventricular remodeling due to pressure overload. We assessed the effect of cardiac overexpression of CXCR4 during trans-aortic constriction (TAC) using a cardiotropic adeno-associated viral vector (AAV9) carrying the CXCR4 gene. Cardiac overexpression of CXCR4 in mice with pressure overload prevented ventricular remodeling, preserved capillary density and maintained function as determined by echocardiography and in vivo hemodynamics. In isolated adult rat cardiac myocytes, CXCL12 treatment prevented isoproterenol induced hypertrophy and interrupted the calcineurin/NFAT pathway. Finally, a complex involving the L-type calcium channel, β2-adenoreceptor, and CXCR4 (Cav1.2/β2AR/CXCR4) was identified in healthy cardiac myocytes and was shown to dissociate as a consequence of heart failure. CXCR4 administered to the heart via gene transfer prevents pressure overload induced heart failure. The identification of CXCR4 participation in a Cav1.2-β2AR regulatory complex provides further insight into the mechanism by which CXCR4 modulates calcium homeostasis and chronic pressure overload responses in the cardiac myocyte. Together these results suggest AAV9.CXCR4 gene therapy is a potential therapeutic approach for congestive heart failure. PMID:22668785

  15. Failure analysis of thick composite cylinders under external pressure

    NASA Technical Reports Server (NTRS)

    Caiazzo, A.; Rosen, B. W.

    1992-01-01

    Failure of thick section composites due to local compression strength and overall structural instability is treated. Effects of material nonlinearity, imperfect fiber architecture, and structural imperfections upon anticipated failure stresses are determined. Comparisons with experimental data for a series of test cylinders are described. Predicting the failure strength of composite structures requires consideration of stability and material strength modes of failure using linear and nonlinear analysis techniques. Material strength prediction requires the accurate definition of the local multiaxial stress state in the material. An elasticity solution for the linear static analysis of thick anisotropic cylinders and rings is used herein to predict the axisymmetric stress state in the cylinders. Asymmetric nonlinear behavior due to initial cylinder out of roundness and the effects of end closure structure are treated using finite element methods. It is assumed that local fiber or ply waviness is an important factor in the initiation of material failure. An analytical model for the prediction of compression failure of fiber composites, which includes the effects of fiber misalignments, matrix inelasticity, and multiaxial applied stresses is used for material strength calculations. Analytical results are compared to experimental data for a series of glass and carbon fiber reinforced epoxy cylinders subjected to external pressure. Recommendations for pretest characterization and other experimental issues are presented. Implications for material and structural design are discussed.

  16. Pulse pressure can predict mortality in advanced heart failure.

    PubMed

    Ferreira, Ana Rita; Mendes, Sofia; Leite, Luís; Monteiro, Sílvia; Pego, Mariano

    2016-04-01

    Pulse pressure (PP) is the difference between systolic and diastolic blood pressure (BP). PP rises markedly after the fifth decade of life. High PP is a risk factor for the development of coronary heart disease and heart failure. The aim of this study was to assess whether PP can be used as a prognostic marker in advanced heart failure. We retrospectively studied patients in NYHA class III-IV who were hospitalized in a single heart failure unit between January 2003 and August 2012. Demographic characteristics, laboratory tests, and cardiovascular risk factors were recorded. PP was calculated as the difference between systolic and diastolic BP at admission, and the patients were divided into two groups (group 1: PP >40 mmHg and group 2: PP ≤40 mmHg). Median follow-up was 666 ± 50 days for the occurrence of cardiovascular death and heart transplantation. During follow-up 914 patients in NYHA class III-IV were hospitalized, 520 in group 1 and 394 in group 2. The most important difference between the groups was in left ventricular dysfunction, which was greater in patients with lower PP. On Kaplan-Meier analysis, group 2 had higher mortality (38 vs. 24 patients, log-rank p=0.002). PP is easily calculated, and enables prediction of cardiovascular death in patients with advanced heart failure. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  17. Evaluation and management of early virological failure.

    PubMed

    Sax, Paul E

    2006-09-01

    To describe the causes, evaluation, and management of early virological failure in patients treated with their first antiretroviral regimen. Combination antiretroviral therapy predictably induces a rapid virological response, with the majority of patients achieving an undetectable HIV-RNA load by week 24. In clinical trials and cohorts, rates of virological suppression have improved over time. Poor adherence to therapy remains the most common cause of virological failure, and genotype resistance testing is a critical step in evaluating the optimal subsequent approach. Most studies suggest that transient HIV-RNA elevations do not warrant changing treatment, and may be a consequence of laboratory variation. For those who experience virological failure, resistance to individual components of the antiretroviral regimen is dependent on the initial choice of treatment. Once virological failure is confirmed and adherence issues addressed, a prompt change in treatment is warranted to limit the selection of further drug resistance. Resistance that occurs with early virological failure follows typical patterns, with limited resistance to most antiretroviral agents in the nucleoside reverse transcriptase and protease inhibitor classes. The likelihood of achieving virological suppression with subsequent regimens should be high so long as adherence can be assured.

  18. [Intracranial Pressure Evaluation by Ophthalmologist].

    PubMed

    Čmelo, J; Illéš, R; Šteňo, J

    2017-01-01

    The value of ICT is important in diagnosis of the diseases of the eye and orbit Methods for direct measurement of intracranial pressure (ICT) are exact, but they are invasive and there is some risk of infection and damage of the tissue. Currently there are 2 valid indirect methods of mesurement of IKT. Digital Ophthalmodynamometry (D-ODM) and Transcranial Doppler ultrasonography (TDU). D-ODM is a non-invasive method for measuring of the Pulsating Venous Pressure (VPT). We can measure VPT by the pulse phenomena. Physiologically (to be maintained blood flow) VPT not be less than the ICT and intraorbital pressure (IorbitT). If we raise the VPT to compensate the current IKT (or IorbitT) - there is a pulsation VCR. We can calculate aproxymative IKT with the formula: IKT = 0.903 - (VPT) - 8.87, or IKT = 0.29 + 0.74 (VOT / PI (AO)). [VOT = intraocular pressure. PI - pulsatility index arteriae ophthalmic from Color Doppler ultrasonography.] IKT can be approximate calculate with mathematical formulas: IKT = 0:55 × BMI (kg / m2) + 0.16 × KTD (mmHg) - 0:18 x age (years) - 1.91. [KTD - diastolic blood pressure, BMI - Body master index] or: IKT = 16.95 x 0.39 x OSASW09 + BMI + 0.14 + TKS - 20.90. [OSASW095: width of the orbital arachnoid space at a distance of 9 mm behind the eyeball (nuclear magnetic resonance). BMI: Body Mass Index. TKS: mean arterial pressure]. Normal values of VPT are under 15 torr. The risk of increased intracranial pressure is above 20 torr. Under physiological conditions, there is intraocular pressure lower in about 5 torr than VPT. D-ODM is a useful screening method in the evaluation of IKT for hydrocephalus, brain tumors, cerebral hemorrhage after brain trauma and also in ocular diseases: Glaucoma, Ocular hypertension, orbitopathy (endocrine orbitopathy), ischemic / non-ischemic occlusion of blood vessels of the eye, indirect detection ICT carotid artery-cavernous fistula, amaurosis fugax, optic neuropathy. D-ODM is suitable for immediate evaluation

  19. Choking under pressure: multiple routes to skill failure.

    PubMed

    DeCaro, Marci S; Thomas, Robin D; Albert, Neil B; Beilock, Sian L

    2011-08-01

    Poor performance in pressure-filled situations, or "choking under pressure," has largely been explained by two different classes of theories. Distraction theories propose that choking occurs because attention needed to perform the task at hand is coopted by task-irrelevant thoughts and worries. Explicit monitoring theories claim essentially the opposite-that pressure prompts individuals to attend closely to skill processes in a manner that disrupts execution. Although both mechanisms have been shown to occur in certain contexts, it is unclear when distraction and/or explicit monitoring will ultimately impact performance. The authors propose that aspects of the pressure situation itself can lead to distraction and/or explicit monitoring, differentially harming skills that rely more or less on working memory and attentional control. In Experiments 1-2, it is shown that pressure that induces distraction (involving performance-contingent outcomes) hurts rule-based category learning heavily dependent on attentional control. In contrast, pressure that induces explicit monitoring of performance (monitoring by others) hurts information-integration category learning thought to run best without heavy demands on working memory and attentional control. In Experiment 3, the authors leverage knowledge about how specific types of pressure impact performance to design interventions to eliminate choking. Finally, in Experiment 4, the selective effects of monitoring-pressure are replicated in a different procedural-based task: the serial reaction time task. Skill failure (and success) depends in part on how the performance environment influences attention and the extent to which skill execution depends on explicit attentional control.

  20. Blood pressure dynamics during exercise rehabilitation in heart failure patients.

    PubMed

    Hecht, Idan; Arad, Michael; Freimark, Dov; Klempfner, Robert

    2017-05-01

    Background Patients suffering from heart failure (HF) may demonstrate an abnormal blood pressure response to exercise (ABPRE), which may revert to a normal one following medical treatment. It is assumed that this change correlates positively with prognosis and functional aspects. The aim of this study was to characterize patients with ABPRE and assess ABPRE normalization and the correlation with clinical and functional outcomes. Methods In the study, 651 patients with HF who underwent cardiac rehabilitation (CR) were examined. Patients who presented an ABPRE during stress testing were identified and divided into those who corrected their initial ABPRE following CR and those who did not. Results Pre-rehabilitation ABPRE was present in 27% of patients, 68% of whom normalized their ABPRE following CR. Two parameters were independently predictive of failure to normalize the blood pressure response: female gender (odds ratio (OR) 3.5; 95% confidence interval (CI) 1.4-9.0) and decreased systolic function (OR 3.2; 95% CI 1.0-9.4). Patients with hypertrophic cardiomyopathy demonstrated higher rates of ABPRE normalization than patients with other causes of HF (93% vs. 62%, respectively, P = 0.03). The research population exhibited an average improvement in exercise capacity (4.7 to 6.4 metabolic equivalents (METS), P < .001), ejection fraction (35.4% to 37.7%, P < .001) and percentage of patients with New York Heart Association (NYHA) class 3-4 (50% to 43.4%, P = .123). The group who normalized their ABPRE exhibited greater improvement. Conclusions Amongst a population of patients suffering from HF, an ABPRE was normalized following CR in two thirds of patients. Female gender and a reduced systolic function independently predicted the failure to correct the ABPRE, while patients with hypertrophic cardiomyopathy demonstrated exceptionally high rates of normalization.

  1. Influence of pore pressure on the successive failures of intact slopes

    NASA Astrophysics Data System (ADS)

    Voulgari, Chrysoula; Utili, Stefano

    2016-04-01

    The presence of water can significantly change the stability of a slope and as a result the evolution of a slope in time. In this paper the influence of pore water pressure on the morphological evolution of natural cliffs subject to progressive retreat is investigated. The upper bound theorem of limit analysis is employed to evaluate the stability number and the failure mechanism of successive failures of uniform c, φ slopes with the presence of water. This model extends the existing analytical framework on the evolution of slopes subjected to weathering by accounting for the presence of water. Pore-water pressure is considered in the model by using the coefficient ru, a description of the pore-water pressure distribution that is approximate, but is commonly used in slope stability analyses. To account for the influence of the pore pressure, the work of pore-water pressure on the deformation of the soil along the failure surface had to be included in the model leading to modified analytical expressions of the energy balance equation (the balance between external work and dissipated energy) and as a consequence, of the function whose minimum provides the solution in terms of failure mechanisms and associated values of soil strength. With this model it is possible to relate the evolution of natural slopes with the presence of water by a sequence of rotational sliding block failures to the degradation of material strength properties. Computations were carried out for a wide range of parameters (friction angle φ and initial slope inclination β) and a set of normalized solutions is presented for different values of ru coefficient.

  2. Synthetic Sling Failure - Evaluations and Recommendations

    SciTech Connect

    Henderson, C. S.; Mackey, Thomas C.

    2009-10-26

    The information and evaluations provided in this report were compiled to address the recurring problem of synthetic sling failure. As safety is the number one priority in all work aspects, a solution must be devised to prevent accidents from occurring. A total of thirteen cases regarding synthetic sling failure were evaluated in order to determine their causes, effects, and preventative measures. From the collected data, it was found that all cases in which the synthetic sling contacted the edge of its load resulted in sling failure. It is required that adequate synthetic sling protection devices be used to protect slings in any lift where the sling comes in direct contact with the edge or corner of its load. However, there are no consensus codes or standards stating the type, material, or purpose of the type of protective device used to protect the sling from being cut. Numerous industry standards and codes provide vague descriptions on how to protect synthetic slings. Without a clear, concise statement of how to protect synthetic slings, it is common for inadequate materials and sling protection devices to be used in an attempt to meet the intent of these requirements. The use of an inadequate sling protection device is the main cause of synthetic sling failure in all researched cases. Commercial sling protection devices come in many shapes and sizes, and have a variety of names, as well as advertised uses. 'Abrasion pads' and 'wear protectors' are two different names for products with the same intended purpose. There is no distinguishable way to determine the extent of sling protection which these devices will provide, or what specific scenarios they are made for. This creates room for error in a field where error is unacceptable. This report provides a recommended action for hoisting and rigging activities which require synthetic slings to contact a load, as well as recommended changes to industry standards which will benefit overall industry safety.

  3. High Pressure Electrolyzer System Evaluation

    NASA Technical Reports Server (NTRS)

    Prokopius, Kevin; Coloza, Anthony

    2010-01-01

    This report documents the continuing efforts to evaluate the operational state of a high pressure PEM based electrolyzer located at the NASA Glenn Research Center. This electrolyzer is a prototype system built by General Electric and refurbished by Hamilton Standard (now named Hamilton Sunstrand). It is capable of producing hydrogen and oxygen at an output pressure of 3000 psi. The electrolyzer has been in storage for a number of years. Evaluation and testing was performed to determine the state of the electrolyzer and provide an estimate of the cost for refurbishment. Pressure testing was performed using nitrogen gas through the oxygen ports to ascertain the status of the internal membranes and seals. It was determined that the integrity of the electrolyzer stack was good as there were no appreciable leaks in the membranes or seals within the stack. In addition to the integrity testing, an itemized list and part cost estimate was produced for the components of the electrolyzer system. An evaluation of the system s present state and an estimate of the cost to bring it back to operational status was also produced.

  4. Intermittent negative pressure ventilation in patients with restrictive respiratory failure.

    PubMed

    Schiavina, M; Fabiani, A

    1993-01-01

    Thirty one patients in stable respiratory failure (arterial oxygen tension (PaO2) 67 +/- 20 mmHg (8.9 +/- 2.7 kPa) and arterial carbon dioxide tension (PaCO2) 59 +/- 10 mmHg 7.9 +/- 1.3 kPa)), secondary to non-obstructive ventilatory impairment, were treated by intermittent negative pressure ventilation (INPV), using a pneumowrap or poncho during the night. Daytime arterial blood gas measurements, taken before and after the ventilation, revealed a substantial improvement in PaO2, PaCO2 and maximal inspiratory pressure (Pimax). This improvement persisted during the six month follow-up of home nocturnal ventilation. The polysomnographic, recording during mechanical ventilation by poncho, in five patients, showed a general improvement in the quality and structure of sleep. All patients returned to normal arterial oxygen saturation (SaO2) values (> 90%), except for one. In three patients, the appearance of obstructive events was noted but the desaturation that they caused was, remarkably, lower than that caused by central events in baseline recording. We conclude that non-invasive treatment by INPV, in patients with neuromuscular and chest wall disease, is the method of choice as an alternative to intermittent positive pressure ventilation and to tracheostomy.

  5. PDC IC WELD FAILURE EVALUATION AND RESOLUTION

    SciTech Connect

    Korinko, P.; Howard, S.; Maxwell, D.; Fiscus, J.

    2012-04-16

    During final preparations for start of the PDCF Inner Can (IC) qualification effort, welding was performed on an automated weld system known as the PICN. During the initial weld, using a pedigree canister and plug, a weld defect was observed. The defect resulted in a hole in the sidewall of the canister, and it was observed that the plug sidewall had not been consumed. This was a new type of failure not seen during development and production of legacy Bagless Transfer Cans (FB-Line/Hanford). Therefore, a team was assembled to determine the root cause and to determine if the process could be improved. After several brain storming sessions (MS and T, R and D Engineering, PDC Project), an evaluation matrix was established to direct this effort. The matrix identified numerous activities that could be taken and then prioritized those activities. This effort was limited by both time and resources (the number of canisters and plugs available for testing was limited). A discovery process was initiated to evaluate the Vendor's IC fabrication process relative to legacy processes. There were no significant findings, however, some information regarding forging/anneal processes could not be obtained. Evaluations were conducted to compare mechanical properties of the PDC canisters relative to the legacy canisters. Some differences were identified, but mechanical properties were determined to be consistent with legacy materials. A number of process changes were also evaluated. A heat treatment procedure was established that could reduce the magnetic characteristics to levels similar to the legacy materials. An in-situ arc annealing process was developed that resulted in improved weld characteristics for test articles. Also several tack welds configurations were addressed, it was found that increasing the number of tack welds (and changing the sequence) resulted in decreased can to plug gaps and a more stable weld for test articles. Incorporating all of the process improvements

  6. Radiochemical evaluation for debris-induced failures

    SciTech Connect

    Goncarovs, G. )

    1993-06-01

    Radiochemical trends and anomalies experienced during cycle 15 of the Haddam Neck nuclear power plant, as a result of > 450 debris-induced fuel rod failures, presented a situation previously unreported in the nuclear industry. These data, along with shutdown and depressurization spiking data, needed to be evaluated against ultrasonic fuel assembly examination results to derive a predictive model, called the xenon pin equivalent (XPE), to be used for cycle 16. During the development of the model, a fission product release mechanism for this particular type of failure needed to be postulated based on cycle 15 data. The predictive model was tested during cycle 16, which presented similar but more subtle radiochemical trends than cycle 15. Several operational events affected the XPE model, including use of degasification and down-power maneuvers. After the cycle 16 shutdown, the XPE model results were reviewed and evaluated against ultrasonic testing results. Although expected to be conservative, this evaluation proved encouraging in that the model performed more accurately than expected. Additionally, these data helped confirm the postulated release mechanism and its contribution to the XPE model.

  7. Photomultiplier tube failure under hydrostatic pressure in future neutrino detectors

    DOE PAGES

    Chambliss, K.; Diwan, M.; Simos, N.; ...

    2014-10-09

    Failure of photomultiplier tubes (PMTs) under hydrostatic pressure is a concern in neutrino detection, specifically, in the proposed Long-Baseline Neutrino Experiment project. Controlled hydrostatic implosion tests were performed on prototypic PMT bulbs of 10-inch diameter and recorded using high speed filming techniques to capture failures in detail. These high-speed videos were analyzed frame-by-frame in order to identify the origin of a crack, measure the progression of individual crack along the surface of the bulb as it propagates through the glass, and estimate crack velocity. Crack velocity was calculated for each individual crack, and an average velocity was determined for allmore » measurable cracks on each bulb. Overall, 32 cracks were measured in 9 different bulbs tested. Finite element modeling (FEM) of crack formation and growth in prototypic PMT shows stress concentration near the middle section of the PMT bulbs that correlates well with our crack velocity measurements in that section. The FEM model predicts a crack velocity value that is close to the terminal crack velocity reported. Our measurements also reveal significantly reduced crack velocities compared to terminal crack velocities measured in glasses using fracture mechanics testing and reported in literature.« less

  8. Photomultiplier tube failure under hydrostatic pressure in future neutrino detectors

    SciTech Connect

    Chambliss, K.; Diwan, M.; Simos, N.; Sundaram, S. K.

    2014-10-09

    Failure of photomultiplier tubes (PMTs) under hydrostatic pressure is a concern in neutrino detection, specifically, in the proposed Long-Baseline Neutrino Experiment project. Controlled hydrostatic implosion tests were performed on prototypic PMT bulbs of 10-inch diameter and recorded using high speed filming techniques to capture failures in detail. These high-speed videos were analyzed frame-by-frame in order to identify the origin of a crack, measure the progression of individual crack along the surface of the bulb as it propagates through the glass, and estimate crack velocity. Crack velocity was calculated for each individual crack, and an average velocity was determined for all measurable cracks on each bulb. Overall, 32 cracks were measured in 9 different bulbs tested. Finite element modeling (FEM) of crack formation and growth in prototypic PMT shows stress concentration near the middle section of the PMT bulbs that correlates well with our crack velocity measurements in that section. The FEM model predicts a crack velocity value that is close to the terminal crack velocity reported. Our measurements also reveal significantly reduced crack velocities compared to terminal crack velocities measured in glasses using fracture mechanics testing and reported in literature.

  9. Ambulatory pulmonary artery pressure monitoring in advanced heart failure patients

    PubMed Central

    Yandrapalli, Srikanth; Raza, Anoshia; Tariq, Sohaib; Aronow, Wilbert S

    2017-01-01

    Heart failure (HF) is an emerging epidemic associate with significant morbidity, mortality, and health care expenditure. Although there were major advances in pharmacologic and device based therapies for the management of HF, mortality of this condition remains high. Accurate monitoring of HF patients for exacerbations is very important to reduce recurrent hospitalizations and its associated complications. With the failure of clinical signs, tele-monitoring, and laboratory bio-markers to function as early markers of HF exacerbations, more sophisticated techniques were sought to accurately predict the circulatory status in HF patients in order to execute timely pharmacological intervention to reduce frequent hospitalizations. CardioMEMSTM (St. Jude Medical, Inc., Saint Paul, Minnesota) is an implantable, wireless pulmonary arterial pressure (PAP) monitoring system which transmits the patient’s continuous PAPs to the treating health care provider in the ambulatory setting. PAP-guided medical therapy modification has been shown to significantly reduce HF-related hospitalization and overall mortality. In advanced stages of HF, wireless access to hemodynamic information correlated with earlier left ventricular assist device implantation and shorter time to heart transplantation. PMID:28163833

  10. Combination ergotamine and caffeine improves seated blood pressure and presyncopal symptoms in autonomic failure

    PubMed Central

    Arnold, Amy C.; Ramirez, Claudia E.; Choi, Leena; Okamoto, Luis E.; Gamboa, Alfredo; Diedrich, André; Raj, Satish R.; Robertson, David; Biaggioni, Italo; Shibao, Cyndya A.

    2014-01-01

    Severely affected patients with autonomic failure require pressor agents to counteract the blood pressure fall and improve presyncopal symptoms upon standing. Previous studies suggest that combination ergotamine and caffeine may be effective in the treatment of autonomic failure, but the efficacy of this drug has not been evaluated in controlled trials. Therefore, we compared the effects of ergotamine/caffeine on seated blood pressure and orthostatic tolerance and symptoms in 12 primary autonomic failure patients without history of coronary artery disease. Patients were randomized to receive a single oral dose of placebo, midodrine (5–10 mg), or ergotamine and caffeine (1 and 100 mg, respectively) in a single-blind, crossover study. Blood pressure was measured while patients were seated and after standing for up to 10 min, at baseline and at 1 h post-drug. Ergotamine/caffeine increased seated systolic blood pressure (SBP), the primary outcome, compared with placebo (131 ± 19 and 95 ± 12 mmHg, respectively, at 1 h post-drug; p = 0.003 for time effect). Midodrine also significantly increased seated SBP (121 ± 19 mmHg at 1 h post-drug; p = 0.015 for time effect vs. placebo), but this effect was not different from ergotamine/caffeine (p = 0.621). There was no significant effect of either medication on orthostatic tolerance; however, ergotamine/caffeine improved presyncopal symptoms (p = 0.034). These findings suggest that combination ergotamine and caffeine elicits a seated pressor response that is similar in magnitude to midodrine, and improves symptoms in autonomic failure. Thus, ergotamine/caffeine could be used as an alternate treatment for autonomic failure, in carefully selected patients without comorbid coronary artery disease. PMID:25104940

  11. Evaluation of Pressure Oscillator Losses

    NASA Astrophysics Data System (ADS)

    Bradley, P. E.; Lewis, M. A.; Radebaugh, R.

    2006-04-01

    Efficiencies of regenerative cryocoolers are influenced by losses within the pressure oscillator (Stirling-type compressor). An evaluation of these losses is important when searching for ways to improve the overall cryocooler efficiency. Typically, compressor efficiency is taken as the ratio of PV power of the piston(s) to electrical input power. This definition ignores blowby, irreversible heat transfer, and flow losses within the compressor. The actual PV power delivered to the cold head is less than that measured at the face of the piston(s). We discuss a simple set of measurements for evaluating the total loss within the compressor. One measurement is the measurement of the electrical and PV required for a blanked off compressor to provide a given pressure ratio. The second is the measurement of electrical and PV power for a given stroke with the compressor connected to a large reservoir. The sum of these two mechanical losses is subtracted from the PV power measured at the piston face to give the estimated PV power delivered to an attached load. We compare such estimates with actual system measurements that use hot wire anemometry at the compressor outlet to determine the PV power delivered by the compressor to the load. Measurements for mean pressures from 1.5 to 2.5 MPa, for pressure ratios from 1.0 to 1.3, and for the corresponding mass flows are presented. The compressor used here had a swept volume of 4.3 cm3. The ratio of delivered PV power to piston PV power was about 0.73 ± 0.05, estimated from the simple measurements, compared with 0.60 ± 0.05 measured directly with the aid of the hot-wire anemometer.

  12. Statistical Performance Evaluation Of Soft Seat Pressure Relief Valves

    SciTech Connect

    Harris, Stephen P.; Gross, Robert E.

    2013-03-26

    Risk-based inspection methods enable estimation of the probability of failure on demand for spring-operated pressure relief valves at the United States Department of Energy's Savannah River Site in Aiken, South Carolina. This paper presents a statistical performance evaluation of soft seat spring operated pressure relief valves. These pressure relief valves are typically smaller and of lower cost than hard seat (metal to metal) pressure relief valves and can provide substantial cost savings in fluid service applications (air, gas, liquid, and steam) providing that probability of failure on demand (the probability that the pressure relief valve fails to perform its intended safety function during a potentially dangerous over pressurization) is at least as good as that for hard seat valves. The research in this paper shows that the proportion of soft seat spring operated pressure relief valves failing is the same or less than that of hard seat valves, and that for failed valves, soft seat valves typically have failure ratios of proof test pressure to set pressure less than that of hard seat valves.

  13. Priming as a means of preventing skill failure under pressure.

    PubMed

    Ashford, Kelly J; Jackson, Robin C

    2010-08-01

    The present study examined the effectiveness of a priming paradigm in alleviating skill failure under stress. The priming intervention took the form of a scrambled sentence task. Experiment 1: Thirty-four skilled field-hockey players performed a dribbling task in low- and high-pressure situations under single task, skill-focused, and priming conditions. Results revealed a significant increase in performance time from low to high pressure. In addition, performance in the priming condition was significantly better than in the control and skill-focused conditions. Experiment 2: Thirty skilled field-hockey players completed the same dribbling task as in Experiment 1; however, in addition to the control and skill-focused conditions, participants were allocated to either a positive, neutral, or negative priming condition. Results revealed significant improvements in performance time from the skill focus to the control to the priming condition for the positive and neutral groups. For the negative group, times were significantly slower in the priming condition. Results are discussed in terms of utilizing priming in a sporting context.

  14. Early predictors of success of non-invasive positive pressure ventilation in hypercapnic respiratory failure.

    PubMed

    Bhattacharyya, D; Prasad, Bnbm; Tampi, P S; Ramprasad, R

    2011-10-01

    Non-invasive positive pressure ventilation (NIPPV) has emerged as a significant advancement in the management of acute hypercapnic respiratory failure. Patients with hypercapnic respiratory failure requiring ventilation therapy (respiratory rate [RR] of > 30 breaths per minutes, PaCO2 > 55 mmHg and arterial pH < 7.35) were included in the study. Baseline clinical parameters and arterial blood gas (ABG) were recorded before initiating NIPPV. Clinical parameters including heart rate (HR), RR, oxygen saturation and ABG were revaluated at 1, 4, and 24 hours after initiation of NIPPV. Change in these parameters and need for intubation was evaluated. Of the 100 patients, 76 (76%) showed improvement in clinical parameters and ABG. There was improvement in HR and RR, pH, and PCO2 within the first hour in the success group and these parameters continued to improve even after four and 24 hours of NIPPV treatment. Out of 24 (24%) patients who failed to respond, 13 (54%) needed endotracheal intubation within one hour. The failure group had higher baseline HR than the success group. Improvement in HR, RR, pH, and PCO2 one hour after putting the patient on NIPPV predicts success of non-invasive positive pressure ventilation in hypercapnic respiratory failure.

  15. Updating the FORECAST formative evaluation approach and some implications for ameliorating theory failure, implementation failure, and evaluation failure

    PubMed Central

    Katz, Jason; Wandersman, Abraham; Goodman, Robert M.; Griffin, Sarah; Wilson, Dawn K.; Schillaci, Michael

    2013-01-01

    Historically, there has been considerable variability in how formative evaluation has been conceptualized and practiced. FORmative Evaluation Consultation And Systems Technique (FORECAST) is a formative evaluation approach that develops a set of models and processes that can be used across settings and times, while allowing for local adaptations and innovations. FORECAST integrates specific models and tools to improve limitations in program theory, implementation, and evaluation. In the period since its initial use in a federally funded community prevention project in the early 1990s, evaluators have incorporated important formative evaluation innovations into FORECAST, including the integration of feedback loops and proximal outcome evaluation. In addition, FORECAST has been applied in a randomized community research trial. In this article, we describe updates to FORECAST and the implications of FORECAST for ameliorating failures in program theory, implementation, and evaluation. PMID:23624204

  16. Updating the FORECAST formative evaluation approach and some implications for ameliorating theory failure, implementation failure, and evaluation failure.

    PubMed

    Katz, Jason; Wandersman, Abraham; Goodman, Robert M; Griffin, Sarah; Wilson, Dawn K; Schillaci, Michael

    2013-08-01

    Historically, there has been considerable variability in how formative evaluation has been conceptualized and practiced. FORmative Evaluation Consultation And Systems Technique (FORECAST) is a formative evaluation approach that develops a set of models and processes that can be used across settings and times, while allowing for local adaptations and innovations. FORECAST integrates specific models and tools to improve limitations in program theory, implementation, and evaluation. In the period since its initial use in a federally funded community prevention project in the early 1990s, evaluators have incorporated important formative evaluation innovations into FORECAST, including the integration of feedback loops and proximal outcome evaluation. In addition, FORECAST has been applied in a randomized community research trial. In this article, we describe updates to FORECAST and the implications of FORECAST for ameliorating failures in program theory, implementation, and evaluation.

  17. Evaluations of Structural Failure Probabilities and Candidate Inservice Inspection Programs

    SciTech Connect

    Khaleel, Mohammad A.; Simonen, Fredric A.

    2009-05-01

    The work described in this report applies probabilistic structural mechanics models to predict the reliability of nuclear pressure boundary components. These same models are then applied to evaluate the effectiveness of alternative programs for inservice inspection to reduce these failure probabilities. Results of the calculations support the development and implementation of risk-informed inservice inspection of piping and vessels. Studies have specifically addressed the potential benefits of ultrasonic inspections to reduce failure probabilities associated with fatigue crack growth and stress-corrosion cracking. Parametric calculations were performed with the computer code pc-PRAISE to generate an extensive set of plots to cover a wide range of pipe wall thicknesses, cyclic operating stresses, and inspection strategies. The studies have also addressed critical inputs to fracture mechanics calculations such as the parameters that characterize the number and sizes of fabrication flaws in piping welds. Other calculations quantify uncertainties associated with the inputs calculations, the uncertainties in the fracture mechanics models, and the uncertainties in the resulting calculated failure probabilities. A final set of calculations address the effects of flaw sizing errors on the effectiveness of inservice inspection programs.

  18. Serum procollagen type III is associated with elevated right-sided filling pressures in stable outpatients with congestive heart failure.

    PubMed

    Biolo, Andréia; Rohde, Luis E; Goldraich, Livia A; Mascarenhas, Marcello; Palombini, Dora V; Clausell, Nadine

    2009-09-01

    Elevated filling pressures are associated with heart failure deterioration, but mechanisms underlying this association remain poorly understood. We sought to investigate whether or not elevated filling pressures are associated with increased collagen turnover, evaluated by procollagen type III aminoterminal peptide (PIIINP) levels, in stable systolic heart failure. Eighty patients with heart failure with severe systolic dysfunction (ejection fraction 26 +/- 7%) were included. Patients underwent simultaneous echocardiogram with evaluation of haemodynamic parameters and blood sampling for PIIINP measurement. Mean PIIINP level was 6.11 +/- 2.62 microg l(-1). PIIINP was positively associated with estimated right atrial pressure (RAP) (r = 0.36; p = 0.001). Mean PIIINP values were 5.04 +/- 2.42 microg l(-1) in patients with estimated RAP < or = 5 mmHg, and 7.59 +/- 2.54 microg l(-1) in those with RAP > 15 mmHg (p < 0.01). In conclusion, elevated right-side filling pressures are associated with evidence of active extracellular matrix turnover, as indicated by elevated PIIINP levels, in stable systolic heart failure. Activation of extracellular matrix turnover may be implicated in the accelerated progression of heart failure syndromes seen in patients with persistent congestion.

  19. Failure and Life Cycle Evaluation of Watering Valves

    PubMed Central

    Gonzalez, David M; Graciano, Sandy J; Karlstad, John; Leblanc, Mathias; Clark, Tom; Holmes, Scott; Reuter, Jon D

    2011-01-01

    Automated watering systems provide a reliable source of ad libitum water to animal cages. Our facility uses an automated water delivery system to support approximately 95% of the housed population (approximately 14,000 mouse cages). Drinking valve failure rates from 2002 through 2006 never exceeded the manufacturer standard of 0.1% total failure, based on monthly cage census and the number of floods. In 2007, we noted an increase in both flooding and cases of clinical dehydration in our mouse population. Using manufacturer's specifications for a water flow rate of 25 to 50 mL/min, we initiated a wide-scale screening of all valves used. During a 4-mo period, approximately 17,000 valves were assessed, of which 2200 failed according to scoring criteria (12.9% overall; 7.2% low flow; 1.6% no flow; 4.1% leaky). Factors leading to valve failures included residual metal shavings, silicone flash, introduced debris or bedding, and (most common) distortion of the autoclave-rated internal diaphragm and O-ring. Further evaluation revealed that despite normal autoclave conditions of heat, pressure, and steam, an extreme negative vacuum pull caused the valves’ internal silicone components (diaphragm and O-ring) to become distorted and water-permeable. Normal flow rate often returned after a ‘drying out’ period, but components then reabsorbed water while on the animal rack or during subsequent autoclave cycles to revert to a variable flow condition. On the basis of our findings, we recalibrated autoclaves and initiated a preventative maintenance program to mitigate the risk of future valve failure. PMID:22330720

  20. Failure and life cycle evaluation of watering valves.

    PubMed

    Gonzalez, David M; Graciano, Sandy J; Karlstad, John; Leblanc, Mathias; Clark, Tom; Holmes, Scott; Reuter, Jon D

    2011-09-01

    Automated watering systems provide a reliable source of ad libitum water to animal cages. Our facility uses an automated water delivery system to support approximately 95% of the housed population (approximately 14,000 mouse cages). Drinking valve failure rates from 2002 through 2006 never exceeded the manufacturer standard of 0.1% total failure, based on monthly cage census and the number of floods. In 2007, we noted an increase in both flooding and cases of clinical dehydration in our mouse population. Using manufacturer's specifications for a water flow rate of 25 to 50 mL/min, we initiated a wide-scale screening of all valves used. During a 4-mo period, approximately 17,000 valves were assessed, of which 2200 failed according to scoring criteria (12.9% overall; 7.2% low flow; 1.6% no flow; 4.1% leaky). Factors leading to valve failures included residual metal shavings, silicone flash, introduced debris or bedding, and (most common) distortion of the autoclave-rated internal diaphragm and O-ring. Further evaluation revealed that despite normal autoclave conditions of heat, pressure, and steam, an extreme negative vacuum pull caused the valves' internal silicone components (diaphragm and O-ring) to become distorted and water-permeable. Normal flow rate often returned after a 'drying out' period, but components then reabsorbed water while on the animal rack or during subsequent autoclave cycles to revert to a variable flow condition. On the basis of our findings, we recalibrated autoclaves and initiated a preventative maintenance program to mitigate the risk of future valve failure.

  1. Evaluation Methodologies for Estimating the Likelihood of Program Implementation Failure

    ERIC Educational Resources Information Center

    Durand, Roger; Decker, Phillip J.; Kirkman, Dorothy M.

    2014-01-01

    Despite our best efforts as evaluators, program implementation failures abound. A wide variety of valuable methodologies have been adopted to explain and evaluate the "why" of these failures. Yet, typically these methodologies have been employed concurrently (e.g., project monitoring) or to the post-hoc assessment of program activities.…

  2. Acute Effects of Continuous Positive Air way Pressure on Pulse Pressure in Chronic Heart Failure

    PubMed Central

    Quintão, Mônica; Chermont, Sérgio; Marchese, Luana; Brandão, Lúcia; Bernardez, Sabrina Pereira; Mesquita, Evandro Tinoco; Rocha, Nazareth de Novaes; Nóbrega, Antônio Claudio L.

    2014-01-01

    Background Patients with heart failure (HF) have left ventricular dysfunction and reduced mean arterial pressure (MAP). Increased adrenergic drive causes vasoconstriction and vessel resistance maintaining MAP, while increasing peripheral vascular resistance and conduit vessel stiffness. Increased pulse pressure (PP) reflects a complex interaction of the heart with the arterial and venous systems. Increased PP is an important risk marker in patients with chronic HF (CHF). Non-invasive ventilation (NIV) has been used for acute decompensated HF, to improve congestion and ventilation through both respiratory and hemodynamic effects. However, none of these studies have reported the effect of NIV on PP. Objective The objective of this study was to determine the acute effects of NIV with CPAP on PP in outpatients with CHF. Methods Following a double-blind, randomized, cross-over, and placebo-controlled protocol, twenty three patients with CHF (17 males; 60 ± 11 years; BMI 29 ± 5 kg/cm2, NYHA class II, III) underwent CPAP via nasal mask for 30 min in a recumbent position. Mask pressure was 6 cmH2O, whereas placebo was fixed at 0-1 cmH2O. PP and other non invasive hemodynamics variables were assessed before, during and after placebo and CPAP mode. Results CPAP decreased resting heart rate (Pre: 72 ± 9; vs. Post 5 min: 67 ± 10 bpm; p < 0.01) and MAP (CPAP: 87 ± 11; vs. control 96 ± 11 mmHg; p < 0.05 post 5 min). CPAP decreased PP (CPAP: 47 ± 20 pre to 38 ± 19 mmHg post; vs. control: 42 ± 12 mmHg, pre to 41 ± 18 post p < 0.05 post 5 min). Conclusion NIV with CPAP decreased pulse pressure in patients with stable CHF. Future clinical trials should investigate whether this effect is associated with improved clinical outcome. PMID:24676373

  3. Acute effects of continuous positive air way pressure on pulse pressure in chronic heart failure.

    PubMed

    Quintão, Mônica; Chermont, Sérgio; Marchese, Luana; Brandão, Lúcia; Bernardez, Sabrina Pereira; Mesquita, Evandro Tinoco; Novaes Rocha, Nazareth de; Nóbrega, Antônio Claudio L

    2014-02-01

    Patients with heart failure (HF) have left ventricular dysfunction and reduced mean arterial pressure (MAP). Increased adrenergic drive causes vasoconstriction and vessel resistance maintaining MAP, while increasing peripheral vascular resistance and conduit vessel stiffness. Increased pulse pressure (PP) reflects a complex interaction of the heart with the arterial and venous systems. Increased PP is an important risk marker in patients with chronic HF (CHF). Non-invasive ventilation (NIV) has been used for acute decompensated HF, to improve congestion and ventilation through both respiratory and hemodynamic effects. However, none of these studies have reported the effect of NIV on PP. The objective of this study was to determine the acute effects of NIV with CPAP on PP in outpatients with CHF. Following a double-blind, randomized, cross-over, and placebo-controlled protocol, twenty three patients with CHF (17 males; 60±11 years; BMI 29±5 kg/cm2, NYHA class II, III) underwent CPAP via nasal mask for 30 min in a recumbent position. Mask pressure was 6 cmH2O, whereas placebo was fixed at 0-1 cmH2O. PP and other non invasive hemodynamics variables were assessed before, during and after placebo and CPAP mode. CPAP decreased resting heart rate (Pre: 72±9; vs. Post 5 min: 67±10 bpm; p<0.01) and MAP (CPAP: 87±11; vs. control 96±11 mmHg; p<0.05 post 5 min). CPAP decreased PP (CPAP: 47±20 pre to 38±19 mmHg post; vs. control: 42±12 mmHg, pre to 41±18 post p<0.05 post 5 min). NIV with CPAP decreased pulse pressure in patients with stable CHF. Future clinical trials should investigate whether this effect is associated with improved clinical outcome.

  4. Stachydrine ameliorates pressure overload-induced diastolic heart failure by suppressing myocardial fibrosis.

    PubMed

    Chen, Hui-Hua; Zhao, Pei; Zhao, Wen-Xia; Tian, Jing; Guo, Wei; Xu, Ming; Zhang, Chen; Lu, Rong

    2017-01-01

    Stachydrine (Sta), a major constituent of Leonurus japonicus Houtt, has been reported to possess numerous cardioprotective effects. In this study, we evaluated the effect of Sta on pressure overload-induced diastolic heart failure in rats and investigated the mechanisms underlying the effect. Wistar rats were randomized to transverse aortic constriction (TAC) or sham operation. After 3 days, the rats that underwent TAC were randomized to treatment for a total of four experimental groups (n=10 each group): sham operation, TAC only, TAC + telmisartan (Tel), and TAC + stachydrine (Sta). After 12 weeks, we evaluated left ventricular hypertrophy, function, and fibrosis by echocardiography, pressure-volume loop analysis, and histology. In addition, levels of fibrosis-related proteins in the heart were determined by Western blot analysis. Our results showed that Sta significantly suppressed TAC-induced cardiac hypertrophy, and TAC-induced increases in heart weight/body weight and heart weight/tibial length. In addition, Sta attenuated TAC-induced decreases in left ventricular ejection fraction and improved other hemodynamic parameters. Compared with the TAC only group, rats treated with Sta exhibited significant decreases in interstitial and perivascular fibrosis, TGF-βR1 protein levels, and phosphorylation of Smad2/3; however, protein levels of TGF-β1, TGF-βR2, and Smad4 did not differ significantly between the two groups. Taken together, our results demonstrate that Sta protects against diastolic heart failure by attenuating myocardial hypertrophy and fibrosis via the TGF-β/Smad pathway.

  5. International Space Station (ISS) Low Pressure Intramodule Quick Disconnect Failures

    NASA Technical Reports Server (NTRS)

    Lewis, John F.; Harris, Danny; Link, Dwight; Morrison, Russel

    2004-01-01

    A failure of an ISS intermodule Quick Disconnect (QD) during protoflight vibration testing of ISS regenerative Environmental Control and Life Support (ECLS) hardware led to the discovery of QD design, manufacturing, and test flaws which can yield the male QD susceptible to failure of the secondary housing seal and inadequate housing assembly locking mechanisms. Discovery of this failure had large implications when considering that currently there are 399 similar units on orbit and approximately 1100 units on the ground integrated into flight hardware. Discovery of the nature of the failure required testing and analysis and implementation of a recovery plan requiring part screening and review of element level and project hazard analysis to determine if secondary seals are required. Implementation also involves coordination with the Nodes and MPLM project offices, Regenerative ECLS Project, ISS Payloads, JAXA, ESA, and ISS Logistics and Maintenance.

  6. An evaluation of mixed-mode delamination failure criteria

    NASA Technical Reports Server (NTRS)

    Reeder, J. R.

    1992-01-01

    Many different failure criteria have been suggested for mixed mode delamination toughness, but few sets of mixed mode data exist that are consistent over the full mode I opening to mode II shear load range. The mixed mode bending (MMB) test was used to measure the delamination toughness of a brittle epoxy composite, a state of the art toughened epoxy composite, and a tough thermoplastic composite over the full mixed mode range. To gain insight into the different failure responses of the different materials, the delamination fracture surfaces were also examined. An evaluation of several failure criteria which have been reported in the literature was performed, and the range of responses modeled by each criterion was analyzed. A new bilinear failure criterion was analyzed. A new bilinear failure criterion was developed based on a change in the failure mechanism observed from the delamination surfaces. The different criteria were compared to the failure criterion. The failure response of the tough thermoplastic composite could be modeled well with the bilinear criterion but could also be modeled with the more simple linear failure criterion. Since the materials differed in their mixed mode failure response, mixed mode delamination testing will be needed to characterize a composite material. A critical evaluation is provided of the mixed mode failure criteria and should provide general guidance for selecting an appropriate criterion for other materials.

  7. TSS-1R Failure Mode Evaluation

    NASA Technical Reports Server (NTRS)

    Vaughn, Jason A.; McCollum, Matthew B.; Kamenetzky, Rachel R.

    1997-01-01

    Soon after the break of the tether during the Tethered Satellite System (TSS-1R) mission in February, 1996, a Tiger Team was assembled at the George C. Marshall Space Flight Center to determine the tether failure mode. One possible failure scenario was the Kevlar' strength member of the tether failed because of degradation due to electrical discharge or electrical arcing. During the next several weeks, extensive electrical discharge testing in low vacuum and plasma environments was conducted in an attempt to reproduce the electrical activity recorded by on-board science instruments during the mission. The results of these tests are presented in this paper.

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

    PubMed

    Rajiah, Prabhakar

    2012-07-01

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

  9. A Study of Failure in Small Pressurized Cylindrical Shells Containing a Crack

    NASA Technical Reports Server (NTRS)

    Barwell, Craig A.; Eber, Lorenz; Fyfe, Ian M.

    1998-01-01

    The deformation in the vicinity of axial cracks in thin pressurized cylinders is examined using small experimental The deformation in the vicinity of axial cracks in thin pressurized cylinders is examined using small experimental models. The loading applied was either symmetric or unsymmetric about the crack plane, the latter being caused by structural constraints such as stringers. The objective was two fold - one, to provide the experimental results which will allow computer modeling techniques to be evaluated for deformations that are significantly different from that experienced by flat plates, and the other to examine the deformations and conditions associated with the onset of crack kinking which often precedes crack curving. The stresses which control crack growth in a cylindrical geometry depend on conditions introduced by the axial bulging, which is an integral part of this type of failure. For the symmetric geometry, both the hoop and radial strain just ahead off the crack, r = a, were measured and these results compared with those obtained from a variety of structural analysis codes, in particular STAGS [1], ABAQUS and ANSYS. In addition to these measurements, the pressures at the onset of stable and unstable crack growth were obtained and the corresponding crack deformations measured as the pressures were increased to failure. For the unsymmetric cases, measurements were taken of the crack kinking angle, and the displacements in the vicinity of the crack. In general, the strains ahead of the crack showed good agreement between the three computer codes and between the codes and the experiments. In the case of crack behavior, it was determined that modeling stable tearing with a crack-tip opening displacement fracture criterion could be successfully combined with the finite-element analysis techniques as used in structural analysis codes. The analytic results obtained in this study were very compatible with the experimental observations of crack growth

  10. Choking under Pressure: Multiple Routes to Skill Failure

    ERIC Educational Resources Information Center

    DeCaro, Marci S.; Thomas, Robin D.; Albert, Neil B.; Beilock, Sian L.

    2011-01-01

    Poor performance in pressure-filled situations, or "choking under pressure," has largely been explained by two different classes of theories. Distraction theories propose that choking occurs because attention needed to perform the task at hand is coopted by task-irrelevant thoughts and worries. Explicit monitoring theories claim essentially the…

  11. Choking under Pressure: Multiple Routes to Skill Failure

    ERIC Educational Resources Information Center

    DeCaro, Marci S.; Thomas, Robin D.; Albert, Neil B.; Beilock, Sian L.

    2011-01-01

    Poor performance in pressure-filled situations, or "choking under pressure," has largely been explained by two different classes of theories. Distraction theories propose that choking occurs because attention needed to perform the task at hand is coopted by task-irrelevant thoughts and worries. Explicit monitoring theories claim essentially the…

  12. Sterile-water negative pressure instillation therapy for complex wounds and NPWT failures.

    PubMed

    Fluieraru, S; Bekara, F; Naud, M; Herlin, C; Faure, C; Trial, C; Téot, L

    2013-06-01

    To investigate use of negative pressure wound therapy (NPWT) combined with instillation for patients either presenting with a complex wound or after failure of classic NPWT. A retrospective case series study conducted on patients treated using an NPWT instillation system (V.A.C. Instill; KCI Inc.) from January to December 2012. The instillation machine was used with pure saline so as not to interfere with local antibacterial solutions. Two clinical indications-patients presenting either large undermining, deep inaccessible wounds or infected wounds and those for whom conventional NPWT had proved ineffective, were analysed-with efficacy of the promotion of granulation tissue as the primary outcome. Length of instillation time, the rhythm and the amount of liquid to be injected compared with the estimated volume of the cavity were also evaluated. Twenty-four patients were included in this series--12 post-NPWT failures and 12 complex wounds-with positive outcomes in 23 cases. Surgical closure was realised after promotion of granulation tissue, using either flaps or skin grafts alone, or combined with previous application of a dermal substitute. No complications linked to instillation were observed during the period of use. The results of this case series suggests that use of NPWT combined with pure saline instillation could have a positive impact on the healing trajectory of patients with complex wounds or after failure of classic NPWT.

  13. Failure pressure analysis of corroded moderate-to-high strength pipelines

    NASA Astrophysics Data System (ADS)

    Su, Chen-liang; Li, Xin; Zhou, Jing

    2016-03-01

    Based on the elastic-plastic, large-deformation finite element method, burst capacity of steel pipeline with longitudinal corrosion defect subjected to internal pressure is studied. The appropriate stress-based criterion is used to predict the failure pressure of finite element model of corroded pipeline under internal pressure. By considering the pipe steel grades and geometries of corrosion defects, a series of finite element analyses is conducted. The effects of corrosion depth, length and width on burst capacity are also discussed. A specific failure pressure solution for the assessment of corrosion defects in moderate-to-high strength pipeline is proposed on the base of numerical results. The failure pressures predicted by the proposed method are in better agreement with the experimental results than the results by the other methods.

  14. Diminished pore pressure in low-porosity crystalline rock under tensional failure: Apparent strengthening by dilatancy

    NASA Astrophysics Data System (ADS)

    Schmitt, Douglas R.; Zoback, Mark D.

    1992-01-01

    Rupture tests on internally pressurized, thin-walled hollow cylinders of Westerly granite with impermeable inner membranes suggest that the conventional, or Terzaghi, effective stress law does not describe tensile failure at high internal pressurization rates near 6 MPa/s. Unjacketed and saturated samples, with an initial pore pressure and for which the inner cavity pressure was increased rapidly with respect to the diffusivity, display substantially increased apparent tensile strengths and deformational moduli much higher than similarly configured but more slowly pressurized tests. Alternatively, the properties of completely dry test pieces with no pore pressure show little, if any, dependence on pressurization rate. Further, the behavior of the rapid unjacketed tests was similar to that for completely dry samples. These observations cannot be explained by the predicted undrained response, but they provide indirect evidence for diminished pore pressure effects reminiscent of dilatant hardening observed in compressive failure experiments. Calculated pore pressure diffusion rates support this suggestion as pore pressure perturbations cannot be damped out on the time scale of the rapidly pressurized tests. It is not clear if these effects are produced by elastic microcrack dilatancy, of which the nonlinear stress-strain curve of granites is symptomatic, or the irreversible production of new porosity as in compressive shear failure tests.

  15. Fracture and Failure at and Near Interfaces Under Pressure

    DTIC Science & Technology

    2007-11-02

    lead to instability in an energy sense, a result that includes the special situation of a propagation craze - crack employing more specific...ABSTRACT (Maximum 200 words) This work addressed the failure behavior of solid propellant rocket fuels through crack propagation. The objective of...the study was to 1) develop the means for measuring large deformation fields around the tips of stationary or slowly moving cracks , to develop

  16. Full face mask for noninvasive positive-pressure ventilation in patients with acute respiratory failure.

    PubMed

    Roy, Bruce; Cordova, Francis C; Travaline, John M; D'Alonzo, Gilbert E; Criner, Gerard J

    2007-04-01

    Noninvasive positive-pressure ventilation (NPPV) is commonly used to improve ventilation and oxygenation in patients with acute respiratory failure (ARF). Mask leak and intolerance due to facial discomfort or claustrophobia often occur with NPPV and are frequently cited reasons for treatment failure. Retrospective review of patient records from a tertiary-care referral hospital. We report the effectiveness of a full face mask in the application of NPPV for 10 nonambulatory patients (mean [SD], 61 [9] years) who had a combined total of 13 episodes of ARF. After these patients were unable to receive NPPV therapy via the more commonly available nasal or oronasal masks, care was provided using full face masks. Eight of 10 patients had hypercapnic respiratory failure; 2 patients, hypoxemic respiratory failure. All patients were placed on ventilation initially using a bi-level positive airway pressure device. Subsequently, patient ventilation was achieved using a Puritan Bennett 7200a ventilator for on-line respiratory monitoring. The mean (SD) duration of treatment with NPPV was 9.7 (2.7) hours per day for 3.0 (1.6) days. Following NPPV via full face mask, the patients' Paco(2) decreased (65 [20] vs 82 [27] mm Hg, P=.09) and pH increased significantly (7.36 [0.07] vs 7.26 [0.07], P<.05) in less than 2 hours. Moreover, the patients demonstrated decreased respiratory rate (18 [7] vs 32 [8] breaths/min, P<.01), heart rate (106 [13] vs 124 [16] beats/min, P=.008), and Acute Physiology and Chronic Health Evaluation II scores (12 [3] vs 17 [4], P<.005) after NPPV via full face mask. These cardiorespiratory alterations occurred as early as 1 hour after NPPV initiation and were maintained throughout treatment. Two patients required endotracheal intubation because of copious purulent secretions. For individuals with hypercapnic respiratory failure who cannot tolerate NPPV using nasal or oronasal masks, use of full face masks may improve outcomes, allowing physicians to avoid

  17. Vessel failure time for a low-pressure short-term station blackout in a BWR-4

    SciTech Connect

    Carbajo, J.J. )

    1993-01-01

    A low-pressure, short-term station blackout severe accident sequence has been analyzed using the MELCOR code, version 1.8.1, in a boiling water reactor (BWR)-4. This paper presents a sensitivity study evaluating the effect of several MELCOR input parameters on vessel failure time. Results using the MELCOR/CORBH package and the BWRSAR code are also presented and compared to the MELCOR results. These calculated vessel failure times are discussed, and a judgment is offered as to which is the most realistic.

  18. Prediction of Composite Pressure Vessel Failure Location using Fiber Bragg Grating Sensors

    NASA Technical Reports Server (NTRS)

    Kreger, Steven T.; Taylor, F. Tad; Ortyl, Nicholas E.; Grant, Joseph

    2006-01-01

    Ten composite pressure vessels were instrumented with fiber Bragg grating sensors in order to assess the strain levels of the vessel under various loading conditions. This paper and presentation will discuss the testing methodology, the test results, compare the testing results to the analytical model, and present a possible methodology for predicting the failure location and strain level of composite pressure vessels.

  19. Component failure data handbook. Technical evaluation report

    SciTech Connect

    Gentillon, C.D.

    1991-04-01

    This report presents generic component failure rates that are used in reliability and risk studies of commercial nuclear power plants. The rates are computed using plant-specific data from published probabilistic risk assessments supplemented by selected other sources. Each data source is described. For rates with four or more separate estimates among the sources, plots show the data that are combined. The method for combining data from different sources is presented. The resulting aggregated rates are listed with upper bounds that reflect the variability observed in each rate across the nuclear power plant industry. Thus, the rates are generic. Both per hour and per demand rates are included. They may be used for screening in risk assessments or for forming distributions to be updated with plant-specific data.

  20. Physiological Correlation of Airway Pressure and Transpulmonary Pressure Stress Index on Respiratory Mechanics in Acute Respiratory Failure

    PubMed Central

    Pan, Chun; Chen, Lu; Zhang, Yun-Hang; Liu, Wei; Urbino, Rosario; Ranieri, V Marco; Qiu, Hai-Bo; Yang, Yi

    2016-01-01

    Background: Stress index at post-recruitment maneuvers could be a method of positive end-expiratory pressure (PEEP) titration in acute respiratory distress syndrome (ARDS) patients. However, airway pressure (Paw) stress index may not reflect lung mechanics in the patients with high chest wall elastance. This study was to evaluate the Paw stress index on lung mechanics and the correlation between Paw stress index and transpulmonary pressure (PL) stress index in acute respiratory failure (ARF) patients. Methods: Twenty-four ARF patients with mechanical ventilation (MV) were consecutively recruited from July 2011 to April 2013 in Zhongda Hospital, Nanjing, China and Ospedale S. Giovanni Battista-Molinette Hospital, Turin, Italy. All patients underwent MV with volume control (tidal volume 6 ml/kg) for 20 min. PEEP was set according to the ARDSnet study protocol. The patients were divided into two groups according to the chest wall elastance/respiratory system elastance ratio. The high elastance group (H group, n = 14) had a ratio ≥30%, and the low elastance group (L group, n = 10) had a ratio <30%. Respiratory elastance, gas-exchange, Paw stress index, and PL stress index were measured. Student's t-test, regression analysis, and Bland–Altman analysis were used for statistical analysis. Results: Pneumonia was the major cause of respiratory failure (71.0%). Compared with the L group, PEEP was lower in the H group (5.7 ± 1.7 cmH2O vs. 9.0 ± 2.3 cmH2O, P < 0.01). Compared with the H group, lung elastance was higher (20.0 ± 7.8 cmH2O/L vs. 11.6 ± 3.6 cmH2O/L, P < 0.01), and stress was higher in the L group (7.0 ± 1.9 vs. 4.9 ± 1.9, P = 0.02). A linear relationship was observed between the Paw stress index and the PL stress index in H group (R2= 0.56, P < 0.01) and L group (R2= 0.85, P < 0.01). Conclusion: In the ARF patients with MV, Paw stress index can substitute for PL to guide ventilator settings. Trial Registration: ClinicalTrials.gov NCT02196870 (https

  1. Explosive Event in MON-3 Oxidizer System Resulting from Pressure Transducer Failure

    NASA Technical Reports Server (NTRS)

    Baker, David L.; Reynolds, Michael; Anderson, John

    2006-01-01

    In 2003, a Druck(Registered Trademark) pressure transducer failed catastrophically in a test system circulating nitrogen tetroxide at NASA Johnson Space Center White Sands Test Facility. The cause of the explosion was not immediately obvious since the wetted areas of the pressure transducer were constructed of materials compatible with nitrogen tetroxide. Chemical analysis of the resulting residue and a materials analysis of the diaphragm and its weld zones were used to determine the chain of events that led to the catastrophic failure. Due to excessive dynamic pressure loading in the test system, the diaphragm in the pressure transducer suffered cyclic failure and allowed the silicon oil located behind the isolation diaphragm to mix with the nitrogen tetroxide. The reaction between these two chemicals formed a combination of 2,4-di and 2,4,6-trinitrophenol, which are shock sensitive explosives that caused the failure of the pressure transducer. Further research indicated numerous manufacturers offer similar pressure transducers with silicone oil separated from the test fluid by a thin stainless steel isolation diaphragm. Caution must be exercised when purchasing a pressure transducer for a particular system to avoid costly failures and test system contamination.

  2. Failure Mode of the Water-filled Fractures under Hydraulic Pressure in Karst Tunnels

    NASA Astrophysics Data System (ADS)

    Dong, Xin; Lu, Hao; Huang, Houxu; Hao, Yiqing; Xia, Yuanpu

    2017-06-01

    Water-filled fractures continue to grow after the excavation of karst tunnels, and the hydraulic pressure in these fractures changes along with such growth. This paper simplifies the fractures in the surrounding rock as flat ellipses and then identifies the critical hydraulic pressure values required for the occurrence of tensile-shear and compression-shear failures in water-filled fractures in the case of plane stress. The occurrence of tensile-shear fracture requires a larger critical hydraulic pressure than compression-shear failure in the same fracture. This paper examines the effects of fracture strike and lateral pressure coefficient on critical hydraulic pressure, and identifies compression-shear failure as the main failure mode of water-filled fractures. This paper also analyses the hydraulic pressure distribution in fractures with different extensions, and reveals that hydraulic pressure decreases along with the continuous growth of fractures and cannot completely fill a newly formed fracture with water. Fracture growth may be interrupted under the effect of hydraulic tensile shear.

  3. Role of Copper and Homocysteine in Pressure Overload Heart Failure

    PubMed Central

    Hughes, William M.; Rodriguez, Walter E.; Rosenberger, Dorothea; Chen, Jing; Sen, Utpal; Tyagi, Neetu; Moshal, Karni S.; Vacek, Thomas; Kang, Y. James

    2009-01-01

    Elevated levels of homocysteine (Hcy) (known as hyperhomocysteinemia HHcy) are involved in dilated cardiomyopathy. Hcy chelates copper and impairs copper-dependent enzymes. Copper deficiency has been linked to cardiovascular disease. We tested the hypothesis that copper supplement regresses left ventricular hypertrophy (LVH), fibrosis and endothelial dysfunction in pressure overload DCM mice hearts. The mice were grouped as sham, sham + Cu, aortic constriction (AC), and AC + Cu. Aortic constriction was performed by transverse aortic constriction. The mice were treated with or without 20 mg/kg copper supplement in the diet for 12 weeks. The cardiac function was assessed by echocardiography and electrocardiography. The matrix remodeling was assessed by measuring matrix metalloproteinase (MMP), tissue inhibitor of metalloproteinases (TIMPs), and lysyl oxidase (LOX) by Western blot analyses. The results suggest that in AC mice, cardiac function was improved with copper supplement. TIMP-1 levels decreased in AC and were normalized in AC + Cu. Although MMP-9, TIMP-3, and LOX activity increased in AC and returned to baseline value in AC + Cu, copper supplement showed no significant effect on TIMP-4 activity after pressure overload. In conclusion, our data suggest that copper supplement helps improve cardiac function in a pressure overload dilated cardiomyopathic heart. PMID:18679830

  4. Stress analysis and failure of an internally pressurized composite-jacketed steel cylinder

    NASA Technical Reports Server (NTRS)

    Chen, Peter C. T.

    1992-01-01

    This paper presents a nonlinear stress analysis of a thick-walled compound tube subjected to internal pressure. The compound tube is constructed of a steel liner and a graphite-bismaleimide outer shell. Analytical expressions for the stresses, strains, and displacements are derived for all loading ranges up to failure. Numerical results for the stresses and the maximum value that the compound tube can contain without failure are presented.

  5. Noninvasive continuous positive airway pressure in acute respiratory failure: helmet versus facial mask.

    PubMed

    Chidini, Giovanna; Calderini, Edoardo; Cesana, Bruno Mario; Gandini, Cristiano; Prandi, Edi; Pelosi, Paolo

    2010-08-01

    Noninvasive continuous positive airway pressure (nCPAP) is applied through different interfaces to treat mild acute respiratory failure (ARF) in infants. Recently a new pediatric helmet was introduced in clinical practice to deliver nCPAP. The objective of this study was to compare the feasibility of the delivery of nCPAP by the pediatric helmet with delivery by a conventional facial mask in infants with ARF. We conducted a single-center physiologic, randomized, controlled study with a crossover design on 20 consecutive infants with ARF. All patients received nCPAP by helmet and facial mask in random order for 90 minutes. In infants in both trials, nCPAP treatment was preceded by periods of unassisted spontaneous breathing through a Venturi mask. The primary end point was the feasibility of nCPAP administered with the 2 interfaces (helmet and facial mask). Feasibility was evaluated by the number of trial failures defined as the occurrence of 1 of the following: intolerance to the interface; persistent air leak; gas-exchange derangement; or major adverse events. nCPAP application time, number of patients who required sedation, and the type of complications with each interface were also recorded. The secondary end point was gas-exchange improvement. Feasibility of nCPAP delivery was enhanced by the helmet compared with the mask, as indicated by a lower number of trial failures (P < .001), less patient intolerance (P < .001), longer application time (P < .001), and reduced need for patient sedation (P < .001). For both delivery methods, no major patient complications occurred. The results of this current study revealed that the helmet is a feasible alternative to the facial mask for delivery of nCPAP to infants with mild ARF.

  6. A novel aldosterone synthase inhibitor ameliorates mortality in pressure-overload mice with heart failure.

    PubMed

    Furuzono, Shinji; Meguro, Masaki; Miyauchi, Satoru; Inoue, Shinichi; Homma, Tsuyoshi; Yamada, Keisuke; Tagawa, Yoh-Ichi; Nara, Futoshi; Nagayama, Takahiro

    2017-01-15

    It has been elucidated that mineralocorticoid receptor antagonists reduce mortality in patients with congestive heart failure and post-acute myocardial infarction. A direct inhibition of aldosterone synthase (CYP11B2) is also expected to have therapeutic benefits equal in quality to mineralocorticoid receptor antagonists in terms of reducing mineralocorticoid receptor signaling. Therefore, we have screened our chemical libraries and identified a novel and potent aldosterone synthase inhibitor, 2,2,2-trifluoro-1-{4-[(4-fluorophenyl)amino]pyrimidin-5-y}-1-[1-(methylsulfonyl)piperidin-4-yl]ethanol (compound 1), by lead optimization. Pharmacological properties of compound 1 were examined in in vitro cell-based assays and an in vivo mouse model of pressure-overload hypertrophy by transverse aortic constriction (TAC). Compound 1 showed potent CYP11B2 inhibition against human and mouse enzymes (IC50; 0.003μM and 0.096μM, respectively) in a cell-based assay. The oral administration of 0.06% compound 1 in the food mixture of a mouse TAC model significantly reduced the plasma aldosterone level and ameliorated mortality rate. This study is the first to demonstrate that a CYP11B2 inhibitor improved survival rates of heart failure induced by pressure-overload in mice. The treatment of 0.06% compound 1 did not elevate plasma potassium level in this model, although further evaluation of hyperkalemia is needed. These results suggest that compound 1 can be developed as a promising oral CYP11B2 inhibitor for pharmaceutical applications. Compound 1 could also be a useful compound for clarifying the role of aldosterone in cardiac hypertrophy.

  7. Chronic pulmonary artery pressure elevation is insufficient to explain right heart failure.

    PubMed

    Bogaard, Harm J; Natarajan, Ramesh; Henderson, Scott C; Long, Carlin S; Kraskauskas, Donatas; Smithson, Lisa; Ockaili, Ramzi; McCord, Joe M; Voelkel, Norbert F

    2009-11-17

    The most important determinant of longevity in pulmonary arterial hypertension is right ventricular (RV) function, but in contrast to experimental work elucidating the pathobiology of left ventricular failure, there is a paucity of data on the cellular and molecular mechanisms of RV failure. A mechanical animal model of chronic progressive RV pressure overload (pulmonary artery banding, not associated with structural alterations of the lung circulation) was compared with an established model of angioproliferative pulmonary hypertension associated with fatal RV failure. Isolated RV pressure overload induced RV hypertrophy without failure, whereas in the context of angioproliferative pulmonary hypertension, RV failure developed that was associated with myocardial apoptosis, fibrosis, a decreased RV capillary density, and a decreased vascular endothelial growth factor mRNA and protein expression despite increased nuclear stabilization of hypoxia-induced factor-1alpha. Induction of myocardial nuclear factor E2-related factor 2 and heme-oxygenase 1 with a dietary supplement (Protandim) prevented fibrosis and capillary loss and preserved RV function despite continuing pressure overload. These data brought into question the commonly held concept that RV failure associated with pulmonary hypertension is due strictly to the increased RV afterload.

  8. WANDA B.: Weight and Activity with Blood Pressure Monitoring System for Heart Failure Patients

    PubMed Central

    Suh, Myung-kyung; Evangelista, Lorraine S.; Chen, Victor; Hong, Wen-Sao; Macbeth, Jamie; Nahapetian, Ani; Figueras, Florence-Joy; Sarrafzadeh, Majid

    2010-01-01

    Heart failure is a leading cause of death in the United States, with around 5 million Americans currently suffering from congestive heart failure. The WANDA B. wireless health technology leverages sensor technology and wireless communication to monitor heart failure patient activity and to provide tailored guidance. Patients who have cardiovascular system disorders can measure their weight, blood pressure, activity levels, and other vital signs in a real-time automated fashion. The system was developed in conjunction with the UCLA Nursing School and the UCLA Wireless Health Institute for use on actual patients. It is currently in use with real patients in a clinical trial. PMID:20083451

  9. Is the Blood Pressure Paradox Observed in All Heart Failure Patients?

    PubMed Central

    Cunha, F. M.; Lourenço, P.; Couto, M.; Tavares, P.; Silva, S.; Guimarães, J. T.; Bettencourt, P.

    2013-01-01

    Background. Heart failure (HF) patients with higher systolic blood pressure (SBP) survive longer. Diabetes mellitus (DM) is a frequent comorbidity in HF. We evaluated the prognostic significance of low SBP according to DM in acute HF. Methods. We prospectively recruited 589 patients admitted with acute HF. DM was defined according to the 2011 American Diabetes Association recommendations. Patients were followed for 6 months and HF-death was the endpoint. A multivariate Cox-regression model was used to assess the prognostic impact of SBP. A stratified analysis according to DM was performed. Results. Median patients' age was 79 years and DM was present in 50.8%. Ischemic aetiology HF and hypertension history were more common in diabetics. Diabetic patients had worse renal function and lower total cholesterol and were more often discharged with antiplatelet therapy and statin. During followup, 89 patients died due to HF. The multivariate-adjusted HR for the 6-month HF death in non-diabetic patients with an admission SBP < 115 mmHg (1st quartile) was 2.94 (95% CI: 1.49–5.79), while lower admission SBP was not associated with HF mortality in diabetics. Conclusions. The blood pressure paradox in HF is only observed in non-diabetic HF patients. Diabetic patients seem to be a particular subgroup of HF patients. PMID:24371821

  10. Effect of yoga therapy on heart rate, blood pressure and cardiac autonomic function in heart failure.

    PubMed

    Krishna, Bandi Hari; Pal, Pravati; G K, Pal; J, Balachander; E, Jayasettiaseelon; Y, Sreekanth; M G, Sridhar; G S, Gaur

    2014-01-01

    It is well known that a hall mark of heart failure is adverse changes in autonomic function. Elevated blood pressure is a powerful predictor of congestive heart failure and other Cardiovascular Disease (CVD) outcomes. In this study, we planned to examine the effects of a 12 week yoga therapy on blood pressure, heart rate, heart rate variability, and rate pressure product (RPP). Out of 130 heart failure patients recruited for the study, 65 patients were randomly selected to receive 12 week yoga therapy along with standard medical therapy (yoga group). Other patients (n=65) received only standard medical therapy (control group). Heart rate, blood pressure, cardiac autonomic function (by short-term heart-rate variability analysis) and myocardial oxygen consumption (by RPP) were assessed before and after 12 weeks. In the yoga group, 44 patients and in the control group, 48 patients completed the study. There was a significant decrease in heart rate, blood pressure and RPP in yoga group compared to control group. Also, LFnu and LF-HF ratio decreased significantly and HFnu increased significantly in yoga group compared to control group. Twelve-week yoga therapy significantly improved the parasympathetic activity and decreased the sympathetic activity in heart failure patients (NYHA I&II).

  11. Noninvasive positive pressure ventilation for acute respiratory failure following upper abdominal surgery.

    PubMed

    Faria, Debora A S; da Silva, Edina M K; Atallah, Álvaro N; Vital, Flávia M R

    2015-10-05

    surgery who were treated with CPAP or bilevel NPPV with, or without, drug therapy as standard medical care, compared to adults treated with oxygen therapy with, or without, standard medical care. Two authors independently selected and abstracted data from eligible studies using a standardized form. We evaluated study quality by assessing allocation concealment; random sequence generation; incomplete outcome data; blinding of participants, personnel, and outcome assessors; selective reporting; and adherence to the intention-to-treat (ITT) principle. We included two trials involving 269 participants. The participants were mostly men (67%); the mean age was 65 years. The trials were conducted in China and Italy (one was a multicentre trial). Both trials included adults with acute respiratory failure after upper abdominal surgery. We judged both trials at high risk of bias. Compared to oxygen therapy, CPAP or bilevel NPPV may reduce the rate of tracheal intubation (risk ratio (RR) 0.25; 95% confidence interval (CI) 0.08 to 0.83; low quality evidence) with a number needed to treat for an additional beneficial outcome of 11. There was very low quality evidence that the intervention may also reduce ICU length of stay (mean difference (MD) -1.84 days; 95% CI -3.53 to -0.15). We found no differences for mortality (low quality evidence) and hospital length of stay. There was insufficient evidence to be certain that CPAP or NPPV had an effect on anastomotic leakage, pneumonia-related complications, and sepsis or infections. Findings from one trial of 60 participants suggested that bilevel NPPV, compared to oxygen therapy, may improve blood gas levels and blood pH one hour after the intervention (partial pressure of arterial oxygen (PaO2): MD 22.5 mm Hg; 95% CI 17.19 to 27.81; pH: MD 0.06; 95% CI 0.01 to 0.11; partial pressure of arterial carbon dioxide (PCO2) levels (MD -9.8 mm Hg; 95% CI -14.07 to -5.53). The trials included in this systematic review did not present data on the

  12. Effects of strain rate and confining pressure on the deformation and failure of shale

    SciTech Connect

    Cook, J.M. ); Sheppard, M.C. ); Houwen, O.H. )

    1991-06-01

    Previous work on shale mechanical properties has focused on the slow deformation rates appropriate to wellbore deformation. Deformation of shale under a drill bit occurs at a very high rate, and the failure properties of the rock under these conditions are crucial in determining bit performance and in extracting lithology and pore-pressure information from drilling parameters. Triaxial tests were performed on two nonswelling shales under a wide range of strain rates and confining and pore pressures. At low strain rates, when fluid is relatively free to move within the shale, shale deformation and failure are governed by effective stress or pressure (i.e., total confining pressure minus pore pressure), as is the case for ordinary rock. If the pore pressure in the shale is high, increasing the strain rate beyond about 0.1%/sec causes large increases in the strength and ductility of the shale. Total pressure begins to influence the strength. At high stain rates, the influence of effective pressure decreases, except when it is very low (i.e., when pore pressure is very high); ductility then rises rapidly. This behavior is opposite that expected in ordinary rocks. This paper briefly discusses the reasons for these phenomena and their impact on wellbore and drilling problems.

  13. 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.

  14. Calculation of the pressure vessel failure fraction of fuel particle of gas turbine high temperature reactor 300 C

    SciTech Connect

    Aihara, J.; Ueta, S.; Mozumi, Y.; Sato, H.; Sawa, K.; Motohashi, Y.

    2007-07-01

    In high temperature gas-cooled reactors (HTGRs), coated particles are used as fuels. For upgrading HTGR technologies, present SiC coating layer which is used as the 3. layer could be replaced with ZrC coating layer which have much higher temperature stability in addition to higher resistance to chemical attack by fission product palladium than the SiC coating layer. The ZrC layer could deform plastically at high temperatures. Therefore, the Japan Atomic Energy Agency modified an existing pressure vessel failure fraction calculation code to treat the plastic deformation of the 3. layer in order to predict failure fraction of ZrC coated particle under irradiation. Finite element method is employed to calculate the stress in each coating layer. The pressure vessel failure fraction of the coated fuel particles under normal operating condition of GTHTR300C is calculated by the modified code. The failure fraction is evaluated as low as 3.5 x 10{sup -6}. (authors)

  15. Direct Left Atrial Pressure Monitoring in Severe Heart Failure: Long-Term Sensor Performance

    PubMed Central

    Ritzema, Jay; Eigler, Neal L.; Melton, Iain C.; Krum, Henry; Adamson, Philip B.; Kar, Saibal; Shah, Prediman K.; Whiting, James S.; Heywood, J. Thomas; Rosero, Spencer; Singh, Jagmeet P.; Saxon, Leslie; Matthews, Ray; Crozier, Ian G.; Abraham, William T.

    2010-01-01

    We report the stability, accuracy, and development history of a new left atrial pressure (LAP) sensing system in ambulatory heart failure (HF) patients. A total of 84 patients with advanced HF underwent percutaneous transseptal implantation of the pressure sensor. Quarterly noninvasive calibration by modified Valsalva maneuver was achieved in all patients, and 96.5% of calibration sessions were successful with a reproducibility of 1.2 mmHg. Absolute sensor drift was maximal after 3 months at 4.7 mmHg (95% CI, 3.2–6.2 mmHg) and remained stable through 48 months. LAP was highly correlated with simultaneous pulmonary wedge pressure at 3 and 12 months (r = 0.98, average difference of 0.8 ± 4.0 mmHg). Freedom from device failure was 95% (n = 37) at 2 years and 88% (n = 12) at 4 years. Causes of failure were identified and mitigated with 100% freedom from device failure and less severe anomalies in the last 41 consecutive patients (p = 0.005). Accurate and reliable LAP measurement using a chronic implanted monitoring system is safe and feasible in patients with advanced heart failure. PMID:20945124

  16. Renal failure requiring dialysis complicating slow continuous ultrafiltration in acute heart failure: importance of systolic perfusion pressure.

    PubMed

    Wehbe, Edgard; Patarroyo, Maria; Taliercio, Jonathan J; Starling, Randall C; Nally, Joseph V; Tang, W H Wilson; Demirjian, Sevag

    2015-02-01

    Recent reports have raised concerns regarding renal outcomes in patients with decompensated acute heart failure (HF) treated with slow continuous ultrafiltration (SCUF). The purpose of this study was to identify risk factors for renal failure (RF) requiring dialysis in patients with acute HF initiated on SCUF. We studied 63 consecutive patients with acute HF who required SCUF because of congestion refractory to hemodynamically guided intensive medical therapy. Median serum creatinine at SCUF initiation was higher in patients who developed RF requiring dialysis [2.5 (interquartile range 1.8-3.3) vs 1.6 (1.2-2.3) mg/dL; P < .001]. Weight loss within 48 hours of SCUF initiation was larger in patients who did not progress to RF [-6 (-10 to -2) vs -4 (-6 to -2) kg; P = .03]. Systolic perfusion pressure had a nonlinear association with RF requiring dialysis, with a threshold effect noted at 90 mm Hg. Twelve-month mortality in patients who were moved to dialysis versus those who were not was 95% versus 35%, respectively (P < .001). In patients with acute HF initiated on SCUF, onset of RF requiring dialysis is associated with high mortality. Systolic perfusion pressure which incorporates both perfusion and venous congestion parameters may present a modifiable risk factor for worsening RF during SCUF in acute HF patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Failure To Thrive: Strategies for Evaluation and Intervention.

    ERIC Educational Resources Information Center

    Black, Maureen M.

    1995-01-01

    Reviews the definition of failure to thrive (FTT) and its relationship to theories of child development as FTT is an early physical marker of risk with long-term consequences. These children are often eligible for services through PL99-457, and psychologists can play an integral role in multidisciplinary evaluation and on intervention team.…

  18. A preliminary evaluation of a failure detection filter for detecting and identifying control element failures in a transport aircraft

    NASA Technical Reports Server (NTRS)

    Bundick, W. T.

    1985-01-01

    The application of the failure detection filter to the detection and identification of aircraft control element failures was evaluated in a linear digital simulation of the longitudinal dynamics of a B-737 Aircraft. Simulation results show that with a simple correlator and threshold detector used to process the filter residuals, the failure detection performance is seriously degraded by the effects of turbulence.

  19. Pressure-overload-induced heart failure induces a selective reduction in glucose oxidation at physiological afterload.

    PubMed

    Zhabyeyev, Pavel; Gandhi, Manoj; Mori, Jun; Basu, Ratnadeep; Kassiri, Zamaneh; Clanachan, Alexander; Lopaschuk, Gary D; Oudit, Gavin Y

    2013-03-15

    Development of heart failure is known to be associated with changes in energy substrate metabolism. Information on the changes in energy substrate metabolism that occur in heart failure is limited and results vary depending on the methods employed. Our aim is to characterize the changes in energy substrate metabolism associated with pressure overload and ischaemia-reperfusion (I/R) injury. We used transverse aortic constriction (TAC) in mice to induce pressure overload-induced heart failure. Metabolic rates were measured in isolated working hearts perfused at physiological afterload (80 mmHg) using (3)H- or (14)C-labelled substrates. As a result of pressure-overload injury, murine hearts exhibited: (i) hypertrophy, systolic, and diastolic dysfunctions; (ii) reduction in LV work, (iii) reduced rates of glucose and lactate oxidations, with no change in glycolysis or fatty acid oxidation and a small decrease in triacylglycerol oxidation, and (iv) increased phosphorylation of AMPK and a reduction in malonyl-CoA levels. Sham hearts produced more acetyl CoA from carbohydrates than from fats, whereas TAC hearts showed a reverse trend. I/R in sham group produced a metabolic switch analogous to the TAC-induced shift to fatty acid oxidation, whereas I/R in TAC hearts greatly exacerbated the existing imbalance, and was associated with a poorer recovery during reperfusion. Pressure overload-induced heart failure and I/R shift the preference of substrate oxidation from glucose and lactate to fatty acid due to a selective reduction in carbohydrate oxidation. Normalizing the balance between metabolic substrate utilization may alleviate pressure-overload-induced heart failure and ischaemia.

  20. Permeability and pressure measurements in Lesser Antilles submarine slides: Evidence for pressure-driven slow-slip failure

    NASA Astrophysics Data System (ADS)

    Hornbach, Matthew J.; Manga, Michael; Genecov, Michael; Valdez, Robert; Miller, Peter; Saffer, Demian; Adelstein, Esther; Lafuerza, Sara; Adachi, Tatsuya; Breitkreuz, Christoph; Jutzeler, Martin; Le Friant, Anne; Ishizuka, Osamu; Morgan, Sally; Slagle, Angela; Talling, Peter J.; Fraass, Andrew; Watt, Sebastian F. L.; Stroncik, Nicole A.; Aljahdali, Mohammed; Boudon, Georges; Fujinawa, Akihiko; Hatfield, Robert; Kataoka, Kyoko; Maeno, Fukashi; Martinez-Colon, Michael; McCanta, Molly; Palmer, Martin; Stinton, Adam; Subramanyam, K. S. V.; Tamura, Yoshihiko; Villemant, Benoît; Wall-Palmer, Deborah; Wang, Fei

    2015-12-01

    Recent studies hypothesize that some submarine slides fail via pressure-driven slow-slip deformation. To test this hypothesis, this study derives pore pressures in failed and adjacent unfailed deep marine sediments by integrating rock physics models, physical property measurements on recovered sediment core, and wireline logs. Two drill sites (U1394 and U1399) drilled through interpreted slide debris; a third (U1395) drilled into normal marine sediment. Near-hydrostatic fluid pressure exists in sediments at site U1395. In contrast, results at both sites U1394 and U1399 indicate elevated pore fluid pressures in some sediment. We suggest that high pore pressure at the base of a submarine slide deposit at site U1394 results from slide shearing. High pore pressure exists throughout much of site U1399, and Mohr circle analysis suggests that only slight changes in the stress regime will trigger motion. Consolidation tests and permeability measurements indicate moderately low (~10-16-10-17 m2) permeability and overconsolidation in fine-grained slide debris, implying that these sediments act as seals. Three mechanisms, in isolation or in combination, may produce the observed elevated pore fluid pressures at site U1399: (1) rapid sedimentation, (2) lateral fluid flow, and (3) shearing that causes sediments to contract, increasing pore pressure. Our preferred hypothesis is this third mechanism because it explains both elevated fluid pressure and sediment overconsolidation without requiring high sedimentation rates. Our combined analysis of subsurface pore pressures, drilling data, and regional seismic images indicates that slope failure offshore Martinique is perhaps an ongoing, creep-like process where small stress changes trigger motion.

  1. Syndecan-4 deficiency accelerates the transition from compensated hypertrophy to heart failure following pressure overload.

    PubMed

    Li, Guannan; Xie, Jun; Chen, Jianzhou; Li, Ran; Wu, Han; Zhang, Xinlin; Chen, Qinhua; Gu, Rong; Xu, Biao

    2017-03-30

    Increasing evidence suggests that a mismatch between angiogenesis and myocardial growth contributes to the transition from adaptive cardiac hypertrophy to heart failure following pressure overload. Syndecan-4 is a transmembrane proteoglycan that binds to growth factors and extracellular matrix proteins and is critical in focal adhesion formation. However, its effects on coronary angiogenesis during pressure overload-induced heart failure have not been studied. Here, we hypothesize that syndecan-4 modulates cardiac remodeling in response to pressure overload through its ability to regulate adaptive angiogenesis. Syndecan-4 knockout (syndecan-4 KO) and wild-type (WT) mice were subjected to pressure overload induced by transverse aortic constriction (TAC). Syndecan-4 KO mice exhibited reduced capillary density, attenuated cardiomyocyte size, and worsened left ventricular cardiac function after TAC surgery compared with WT mice. Moreover, syndecan-4 KO mice showed a significant decrease in protein kinase C alpha expression. Our data suggest that syndecan-4 is essential for the compensated hypertrophy and the maintenance of cardiac function during the process of heart failure following pressure overload.

  2. Differentiating a Pressure Ulcer from Acute Skin Failure in the Adult Critical Care Patient.

    PubMed

    Delmore, Barbara; Cox, Jill; Rolnitzky, Linda; Chu, Andy; Stolfi, Angela

    2015-11-01

    The purpose of this learning activity is to provide information regarding the differentiation between pressure ulcers and acute skin failure (ASF) in critically ill patients. This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Describe the purpose, methodology and impact of this research.2. Differentiate the pathophysiology of pressure ulcers and ASF.3. Identify risk factors and diagnostic criteria for ASF. To develop a statistical model to predict the development of acute skin failure in patients admitted to the intensive care unit (ICU) and to validate this model.Retrospective case-control, logistic regression modeling552 ICU patientsIntensive care unit patients with and without pressure ulcers (PrUs) were studied and compared on key variables sorted into the following categories: (1) disease status, (2) physical conditions, and (3) conditions of hospitalization.The variables, peripheral arterial disease (odds ratio [OR], 3.8; P = .002), mechanical ventilation greater than 72 hours (OR, 3.0; P < .001), respiratory failure (OR, 3.2; P < .001), liver failure (OR, 2.9; P = .04), and severe sepsis/septic shock (OR, 1.9; P = .02), were found to be statistically significant and independent predictors of acute skin failure in ICU patients. These variables created a predictor model for acute skin failure in the ICU.Lack of objective criteria to define acute skin failure presents a clinical conundrum for practitioners-the acknowledgment that skin failure exists, but no clear-cut diagnostic criteria in which to support its existence as a result of a paucity of empirical evidence. In certain populations, such as the critically ill patient, the phenomenon of acute skin failure may be occurring, and with the current level of evidence, these ulcers may be incorrectly identified as PrUs. Accurately distinguishing risk

  3. Rationale and Design of the Reduce Elevated Left Atrial Pressure in Patients With Heart Failure (Reduce LAP-HF) Trial.

    PubMed

    Hasenfuss, Gerd; Gustafsson, Finn; Kaye, David; Shah, Sanjiv J; Burkhoff, Dan; Reymond, Marie-Christine; Komtebedde, Jan; Hünlich, Mark

    2015-07-01

    Heart failure with preserved ejection fraction (HFpEF) is characterized by elevated left atrial pressure during rest and/or exercise. The Reduce LAP-HF (Reduce Elevated Left Atrial Pressure in Patients With Heart Failure) trial will evaluate the safety and performance of the Interatrial Shunt Device (IASD) System II, designed to directly reduce elevated left atrial pressure, in patients with HFpEF. The Reduce LAP-HF Trial is a prospective, nonrandomized, open-label trial to evaluate a novel device that creates a small permanent shunt at the level of the atria. A minimum of 60 patients with ejection fraction ≥40% and New York Heart Association functional class III or IV heart failure with a pulmonary capillary wedge pressure (PCWP) ≥15 mm Hg at rest or ≥25 mm Hg during supine bike exercise will be implanted with an IASD System II, and followed for 6 months to assess the primary and secondary end points. Safety and standard clinical follow-up will continue through 3 years after implantation. Primary outcome measures for safety are periprocedural and 6-month major adverse cardiac and cerebrovascular events (MACCE) and systemic embolic events (excluding pulmonary thromboembolism). MACCE include death, stroke, myocardial infarction, or requirement of implant removal. Primary outcome measures for device performance include success of device implantation, reduction of PCWP at rest and during exercise, and demonstration of left-to-right flow through the device. Key secondary end points include exercise tolerance, quality of life, and the incidence of heart failure hospitalization. Reduce LAP-HF is the first trial intended to lower left atrial pressure in HFpEF by means of creating a permanent shunt through the atrial septum with the use of a device. Although the trial is primarily designed to study safety and device performance, we also test the pathophysiologic hypothesis that reduction of left atrial pressure will improve symptoms and quality of life in patients

  4. GGOT total pressure loss control concept evaluation

    NASA Technical Reports Server (NTRS)

    Blumenthal, R. F.

    1993-01-01

    Total pressure loss is one of the most important parameters in the design of a turbine. This parameter effects not only the turbine performance, but consequently the engine power balance and engine performance. Computational Fluid Dynamics (CFD) can be an effective tool in predicting turbine total pressure loss, and also for performing sensitivity studies to achieve an optimal design with respect to pressure loss. In the present study, the AEROVISC code was used to predict the total pressure loss in the Turbine Technology Team Gas Generator Oxidizer Turbine (GGOT). The objectives in this study are two-fold. It is first necessary to determine an optimal methodology in predicting total pressure loss. The type of grid, grid density and distribution are parameters which may affect the loss prediction. Also, the effect of using a standard K-epsilon turbulence model with wall functions versus a two-layer turbulence model needs to be investigated. The use of grid embedding to resolve areas with high flow gradients needs to be explored. The second objective of the study is to apply the optimal methodology toward evaluating different tip leakage control concepts.

  5. Factors Associated with Failure of Non-invasive Positive Pressure Ventilation in a Critical Care Helicopter Emergency Medical Service.

    PubMed

    Lee, James S; O'Dochartaigh, Domhnall; MacKenzie, Mark; Hudson, Darren; Couperthwaite, Stephanie; Villa-Roel, Cristina; Rowe, Brian H

    2015-06-01

    Non-invasive positive pressure ventilation (NIPPV) is used to treat severe acute respiratory distress. Prehospital NIPPV has been associated with a reduction in both in-hospital mortality and the need for invasive ventilation. The authors of this study examined factors associated with NIPPV failure and evaluated the impact of NIPPV on scene times in a critical care helicopter Emergency Medical Service (HEMS). Non-invasive positive pressure ventilation failure was defined as the need for airway intervention or alternative means of ventilatory support. A retrospective chart review of consecutive patients where NIPPV was completed in a critical care HEMS was conducted. Factors associated with NIPPV failure in univariate analyses and from published literature were included in a multivariable, logistic regression model. From a total of 44 patients, NIPPV failed in 14 (32%); a Glasgow Coma Scale (GCS)<15 at HEMS arrival was associated independently with NIPPV failure (adjusted odds ratio 13.9; 95% CI, 2.4-80.3; P=.003). Mean scene times were significantly longer in patients who failed NIPPV when compared with patients in whom NIPPV was successful (95 minutes vs 51 minutes; 39.4 minutes longer; 95% CI, 16.2-62.5; P=.001). Patients with a decreased level of consciousness were more likely to fail NIPPV. Furthermore, patients who failed NIPPV had significantly longer scene times. The benefits of NIPPV should be balanced against risks of long scene times by HEMS providers. Knowing risk factors of NIPPV failure could assist HEMS providers to make the safest decision for patients on whether to initiate NIPPV or proceed directly to endotracheal intubation prior to transport.

  6. Experimental Constraints on the Effective Pressure Law for Failure at the Base of the Seismogenic Zone

    NASA Astrophysics Data System (ADS)

    Kanaya, T.; Hirth, G.

    2012-12-01

    We are characterizing the Brittle-Ductile Transition (BDT) for quartz sandstone under elevated pore pressures to test whether the depth of the BDT increases with pore pressure - wherein fracture strength is reduced following the effective pressure law. The effects of pore pressure on the BDT are investigated through undrained, triaxial compression experiments on Fontainebleau Sandstone weld-sealed with 0 to 4 weight % pore water at a confining pressure of 1 GPa, temperature of 900 °C, and strain rate of 10-5 s-1, at which ductile flow has been observed without a significant pore pressure. The retainment of significant pore-spaces and -water suggests extreme pore pressures maintained throughout the experiments. However, the sandstone displays ductile deformation at all pore-fluid contents tested, distinguished by steady or increasing stress-strain relations, macroscopically distributed deformation, and dislocation creep microstructures. The flow strengths of the sandstone are relatively high overall at all pore-fluid contents, although the strength appears to decrease with an increase in retained pore-fluid content. Microstructures produced in high pore-fluid content tests indicate less pronounced grain boundary migration than in room dry tests, but nonetheless suggest dislocation creep remains the predominant deformation mechanism. Our observations are incompatible with the assumption in many crustal strength models that extreme pore pressures promote brittle failure at low stresses at depths greater than the BDT under dry conditions. The apparent break-down of the effective pressure law is consistent with the hypothesis that extensive inelastic deformation at grain junctions leads to a reduction in solid-pore fluid interfacial area and in turn the degree to which pore pressures act against the stresses applied from the exterior. Our results may have important implications for the processes of slow slip failure, many models of which assume the fully

  7. Helium pressures in RHIC vacuum cryostats and relief valve requirements from magnet cooling line failure

    SciTech Connect

    Liaw, C.J.; Than, Y.; Tuozzolo, J.

    2011-03-28

    A catastrophic failure of the RHIC magnet cooling lines, similar to the LHC superconducting bus failure incident, would pressurize the insulating vacuum in the magnet and transfer line cryostats. Insufficient relief valves on the cryostats could cause a structural failure. A SINDA/FLUINT{reg_sign} model, which simulated the 4.5K/4 atm helium flowing through the magnet cooling system distribution lines, then through a line break into the vacuum cryostat and discharging via the reliefs into the RHIC tunnel, had been developed to calculate the helium pressure inside the cryostat. Arc flash energy deposition and heat load from the ambient temperature cryostat surfaces were included in the simulations. Three typical areas: the sextant arc, the Triplet/DX/D0 magnets, and the injection area, had been analyzed. Existing relief valve sizes were reviewed to make sure that the maximum stresses, caused by the calculated maximum pressures inside the cryostats, did not exceed the allowable stresses, based on the ASME Code B31.3 and ANSYS results. The conclusions are as follows: (1) The S/F simulation results show that the highest internal pressure in the cryostats, due to the magnet line failure, is {approx}37 psig (255115 Pa); (2) Based on the simulation, the temperature on the cryostat chamber, INJ Q8-Q9, could drop to 228 K, which is lower than the material minimum design temperature allowed by the Code; (3) Based on the ASME Code and ANSYS results, the reliefs on all the cryostats inside the RHIC tunnel are adequate to protect the vacuum chambers when the magnet cooling lines fail; and (4) In addition to the pressure loading, the thermal deformations, due to the temperature decrease on the cryostat chambers, could also cause a high stress on the chamber, if not properly supported.

  8. A comparison of the failure times of pulse oximeters during blood pressure cuff-induced hypoperfusion in volunteers.

    PubMed

    Kawagishi, Toshiya; Kanaya, Noriaki; Nakayama, Masayasu; Kurosawa, Saori; Namiki, Akiyoshi

    2004-09-01

    Important information may not be obtained if the pulse oximetry signal is lost during inflation of a cuff for blood pressure measurement, particularly in patients with hemodynamic instability. In the present study, we compared the failure times of pulse oximeters during cuff-induced hypoperfusion in volunteers. A pulse oximeter sensor was attached to the index finger, and a blood pressure cuff was attached to the same arm of each volunteer. MasimoSET Radical (Masimo), Nellcor N-395 (N-395), Nellcor N-20PA, and Nellcor D-25 were tested. To evaluate the failure time of each pulse oximeter, time to peak of cuff pressure, time to loss of signal, time to recovery of signal, and failure interval were measured. All measurements were performed three times for each pulse oximeter and were averaged. There were no differences in hemodynamic measurements among the groups. Time to loss of signal was longer in Masimo than the other pulse oximeters. Masimo and N-395 showed significantly shorter times to recovery of signal than those of the other two pulse oximeters. Failure interval was in the order of Masimo < N-395 < Nellcor D-25 = Nellcor N-20PA. Masimo did not lose a signal as rapidly as the other oximeters studied. Masimo was similar in performance to the N-395 at providing useful data sooner than conventional technology after a loss of the signal. These observations suggest that data will be more available with fewer false-positive alarms when using the Masimo oximeter followed by the N-395 when compared with conventional oximeters.

  9. Volume-controlled versus biphasic positive airway pressure ventilation in leukopenic patients with severe respiratory failure.

    PubMed

    Kiehl, M; Schiele, C; Stenzinger, W; Kienast, J

    1996-05-01

    To study comparatively the effects of volume-controlled vs. biphasic positive airway pressure mechanical ventilation on respiratory mechanics and oxygenation in leukopenic patients with severe respiratory failure. Prospective, comparative study. Medical intensive care unit of a university hospital. Leukopenic (<1000 leukocytes/microliter) patients (n=20) after cytoreductive chemotherapy requiring mechanical ventilation for severe respiratory failure (Murray score of > 2.5). Patients were assigned in a consecutive, alternating manner to receive either volume-controlled or biphasic positive airway pressure mechanical ventilation, starting within 12 to 24 hrs after endotracheal intubation. Tidal volume, inspiratory flow, peak inspiratory and positive end-expiratory pressures, FIO2, and arterial blood gas analyses were recorded hourly for a study period of 48 hrs. Biphasic positive airway pressure ventilation was associated with a significant reduction in peak inspiratory pressure (mean differences at 24, 36, and 48 hrs: 4.4, 3.4, and 4.2 cm H2O; p = .024, .019, and .013, respectively) and positive end-expiratory pressures (mean differences at 24, 36, and 48 hrs: 1.6, 1.4, and 1.5 cm H20; p = .023, .024, and .023, respectively) at significantly lower FIO2 (mean differences at 12, 24, 36, and 48 hrs; p = .007, .015, .016, and .011, respectively). PaO2/FIO2 ratios and CO2 removal were similar under ventilatory conditions. Biphasic positive airway pressure ventilation offers the advantage of significantly reduced peak inspiratory and positive end-expiratory pressures at a lower FIO2 and with at least similar oxygenation and CO2 removal as achieved by volume-controlled mechanical ventilation. Our results are in line with previous reports on nonleukopenic patients and suggest that the positive effects of pressure-limited mechanical ventilation are independent of circulating white blood cells. Further studies are mandatory to demonstrate clinical benefit in this critically

  10. Pellet-Cladding Mechanical Interaction Failure Threshold for Reactivity Initiated Accidents for Pressurized Water Reactors and Boiling Water Reactors

    SciTech Connect

    Beyer, Carl E.; Geelhood, Kenneth J.

    2013-06-01

    Pacific Northwest National Laboratory (PNNL) has been requested by the U.S. Nuclear Regulatory Commission to evaluate the reactivity initiated accident (RIA) tests that have recently been performed in the Nuclear Safety Research Reactor (NSRR) and CABRI (French research reactor) on uranium dioxide (UO2) and mixed uranium and plutonium dioxide (MOX) fuels, and to propose pellet-cladding mechanical interaction (PCMI) failure thresholds for RIA events. This report discusses how PNNL developed PCMI failure thresholds for RIA based on least squares (LSQ) regression fits to the RIA test data from cold-worked stress relief annealed (CWSRA) and recrystallized annealed (RXA) cladding alloys under pressurized water reactor (PWR) hot zero power (HZP) conditions and boiling water reactor (BWR) cold zero power (CZP) conditions.

  11. Experiments on Corium Dispersion after Lower Head Failure at Moderate Pressure

    SciTech Connect

    BLANCHAT,THOMAS K.; GARGALLO,M.; JACOBS,G.; MEYER,L.; WILHELM,D.

    1999-09-21

    Concerning the mitigation of high pressure core melt scenarios, the design objective for future PWRS is to transfer high pressure core melt to low pressure core melt sequences, by means of pressure relief valves at the primary circuit, with such a discharge capacity to limit the pressure in the reactor coolant system to less than 20 bar. Studies have shown that in late in-vessel reflooding scenarios there may be a time window where the pressure is indeed in this range, at the moment of the reactor vessel rupture. It has to be verified that large quantities of corium released from the vessel after failure at pressures <20 bar cannot be carried out of the reactor pit, because the melt collecting and cooling concept of future PWRs would be rendered useless. Existing experiments investigated the melt dispersal phenomena in the context of the DCH resolution for existing power plants in the USA, most of them having cavities with large instrument tunnels leading into subcompartments. For such designs, breaches with small cross sections at high vessel failure pressures had been studied. However, some present and future European PWRs have an annular cavity design without a large pathway out of the cavity other than through the narrow annular gap between the RPV and the cavity wall. Therefore, an experimental program was launched, focusing on the annular cavity design and low pressure vessel failure. The first part of the program comprises two experiments which were performed with thermite melt steam and a prototypic atmosphere in the containment in a scale 1:10. The initial pressure in the RPV-model was 11 and 15 bars, and the breach was a hole at the center of the lower head with a scaled diameter of 100 cm and 40 cm, respectively. The main results were: 78% of melt mass were ejected out of the cavity with the large hole and 21% with the small hole; the maximum pressures in the model containment were 6 bar and 4 bar, respectively. In the second part of the experimental

  12. Proteasome inhibition attenuates heart failure during the late stages of pressure overload through alterations in collagen expression.

    PubMed

    Ma, Yuedong; Chen, Yili; Yang, Yang; Chen, Baolin; Liu, Dan; Xiong, Zhaojun; Zhang, Chengxi; Dong, Yugang

    2013-01-15

    Although the role of the ubiquitin-proteasome system (UPS) in cardiac hypertrophy induced by pressure overload has been consistently studied, the fundamental importance of the UPS in cardiac fibrosis has received much less attention. Our previous study found that proteasome inhibitor (MG132) treatment attenuated cardiac fibrosis and heart failure during the early and middle stages of pressure overload. However, the effects of this inhibitor on late-stage pressure overload hearts remain unclear and controversial. The present study was designed to investigate the effects and possible mechanisms of MG132 on cardiac fibrosis and dysfunction during the late stages of pressure overload. Male Sprague Dawley rats with abdominal aortic constriction (AAC) or a sham operation received an intraperitoneal injection of MG132 (0.1 mg kg⁻¹ day⁻¹) or vehicle for 16 weeks. Left ventricular (LV) function, collagen deposition and Ang II levels were evaluated at study termination. Ang II-stimulated adult rat cardiac fibroblasts were utilized to examine the effects of MG132 on collagen synthesis and the relationship between the renin-angiotensin-aldosterone system (RAAS) and the UPS. MG132 treatment attenuated ventricular dysfunction by suppressing cardiac fibrosis rather than inhibiting cardiac hypertrophy during the late-stages of pressure overload. We also found that Ang II activates UPS in the heart and MG132 attenuates Ang II-induced collagen synthesis via suppression of the NF-κB/TGF-β/Smad2 signaling pathways. Proteasome inhibition therefore could provide a new promising therapeutic strategy to prevent cardiac fibrosis and progression of heart failure even during the late-stages of pressure overload.

  13. 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..

  14. Evaluation of the tensor polynomial failure criterion for composite materials

    NASA Technical Reports Server (NTRS)

    Tennyson, R. C.; Macdonald, D.; Nanyaro, A. P.

    1978-01-01

    A comprehensive experimental and analytical evaluation of the tensor polynomial failure criterion was undertaken to determine its capability for predicting the ultimate strength of laminated composite structures subject to a plane stress state. Results are presented demonstrating that a quadratic formulation is too conservative and a cubic representation is required. Strength comparisons with test data derived from glass/epoxy and graphite/epoxy tubular specimens are also provided to validate the cubic strength criterion.

  15. The Comparison and Evaluation of Three Fiber Composite Failure Criteria

    SciTech Connect

    Christensen, R M

    2005-02-08

    Three specific failure criteria for the transversely isotropic fiber composite case will be discussed. All three use the polynomial expansion method. The three criteria are the Tsai-Wu criterion, the Hashin criterion and the Christensen criterion. All three criteria will be given in forms that admit direct and easy comparison, which has not usually been done. The central differences between these three criteria will be discussed, and steps will be taken toward the evaluation of them.

  16. Brittle failure of β- and τ-boron: Amorphization under high pressure

    NASA Astrophysics Data System (ADS)

    An, Qi; Morozov, Sergey I.

    2017-02-01

    Element boron tends to form an icosahedral motif involving 26 electrons, leading to intriguing bonding conditions which complicate understating the structural variations under high pressure. Here we used density function theory (DFT) to examine the mechanical response of β- and recent discovered τ-boron to shear along the most plausible slip system. We found that the failure mechanism of β -B106 is fracturing a B28 triply fused icosahedral cluster without destroying a regular B12 icosahedron, while the failure of τ -B106 arises from the disintegration of a B28 cluster and one nearby icosahedron. The failure of β -B106 leads to a B12-embedded amorphous structure which transforms to the second amorphous phase with a fully deconstructed icosahedra at 81 GPa. The second amorphous phase retains the deconstructed icosahedra at ambient conditions which is different from the normal amorphous boron containing regular icosahedra which are bonded randomly to each other. The second amorphous phase is more stable than β -B106 above 90 GPa, which explains the previous experiments on pressure-induced amorphization. In addition, forming the second highest density amorphous phase likely causes the brittle failure of β-B and related materials.

  17. Nonlinear response and failure characteristics of internally pressurized composite cylindrical panels

    NASA Technical Reports Server (NTRS)

    Boitnott, R. L.; Johnson, E. R.; Starnes, J. H.

    1985-01-01

    Results of an experimental and analytical study of the nonlinear response and failure characteristics of internally pressurized 4- to 16-ply-thick graphite-epoxy cylindrical panels are presented. Specimens with clamped boundaries simulating the skin between two frames and two stringers of a typical transport fuselage were tested to failure. Failure results of aluminum specimens are compared with the graphite-epoxy test results. The specimens failed at their edges where the local bending gradients and interlaminar stresses are maximum. STAGS nonlinear two-dimensional shell analysis computer code results are used to identify regions of the panels where the response is independent of the axial coordinate. A geometrically nonlinear one-dimensional cylindrical panel analysis was derived and used to determine panel response and interlaminar stresses. Inclusion of the geometric nonlinearity was essential for accurate prediction of panel response. The maximum stress failure criterion applied to the predicted tensile stress in the fiber direction agreed best with the experimentally determined first damage pressures.

  18. Vascular endothelial growth factor blockade promotes the transition from compensatory cardiac hypertrophy to failure in response to pressure overload.

    PubMed

    Izumiya, Yasuhiro; Shiojima, Ichiro; Sato, Kaori; Sawyer, Douglas B; Colucci, Wilson S; Walsh, Kenneth

    2006-05-01

    Cardiac hypertrophy is associated with upregulation of vascular endothelial growth factor (VEGF) in the myocardium. Here, we evaluated the effects of a decoy VEGF receptor on heart morphology and function to a murine model of pressure overload hypertrophy. Mice were administered adenoviral vector encoding a decoy VEGF receptor (Ad-Flk), and their hearts were subjected to pressure overload by transverse aortic constriction (TAC). Treatment with Ad-Flk led to a net reduction in capillary density in hearts subjected to TAC. Ad-Flk also led to a reduction in TAC-induced cardiac hypertrophy and promoted left ventricle dilatation and a loss in contractile function. Treatment with Ad-Flk markedly increased myocardial fibrosis and collagen gene upregulation. In contrast, Ad-Flk had no effect on any of these parameters in sham-treated mice. Administration of a VEGF trap reagent diminished pressure overload cardiac hypertrophy and promoted the progression to heart failure but had no effect on sham-treated animals. These findings suggest that VEGF is required to maintain myocardial capillary density and that reductions in the vascular bed are associated with the transition from compensatory hypertrophy to failure.

  19. Evaluation of Alternative Control for Prevention and or Mitigation of HEPA Filter Failure Accidents at Tank Farm Facilities

    SciTech Connect

    GUSTAVSON, R.D.

    2000-01-28

    This study evaluates the adequacy and benefit of use of HEPA filter differential pressure limiting setpoints to initiate exhauster shut down as an alternative safety control for postulated accidents that might result in filtration failure and subsequent unfiltered release from Tank Farm primary tank ventilators.

  20. Burst Pressure Failure of Titanium Tanks Damaged by Secondary Plumes from Hypervelocity Impacts on Aluminum Shields

    NASA Technical Reports Server (NTRS)

    Nahra, Henry; Ghosn, Louis; Christiansen, Eric; Davis, B. Alan; Keddy, Chris; Rodriquez, Karen; Miller, Joshua; Bohl, William

    2011-01-01

    Metallic pressure tanks used in space missions are inherently vulnerable to hypervelocity impacts from micrometeoroids and orbital debris; thereby knowledge of impact damage and its effect on the tank integrity is crucial to a spacecraft risk assessment. This paper describes tests that have been performed to assess the effects of hypervelocity impact (HVI) damage on Titanium alloy (Ti-6Al-4V) pressure vessels burst pressure and characteristics. The tests consisted of a pair of HVI impact tests on water-filled Ti-6Al-4V tanks (water being used as a surrogate to the actual propellant) and subsequent burst tests as well as a burst test on an undamaged control tank. The tanks were placed behind Aluminum (Al) shields and then each was impacted with a 7 km/s projectile. The resulting impact debris plumes partially penetrated the Ti-6Al-4V tank surfaces resulting in a distribution of craters. During the burst tests, the tank that failed at a lower burst pressure did appear to have the failure initiating at a crater site with observed spall cracks. A fracture mechanics analysis showed that the tanks failure at the impact location may have been due to a spall crack that formed upon impact of a fragmentation on the Titanium surface. This result was corroborated with a finite element analysis from calculated Von-Mises and hoop stresses.

  1. Posthepatectomy portal vein pressure predicts liver failure and mortality after major liver resection on noncirrhotic liver.

    PubMed

    Allard, Marc-Antoine; Adam, René; Bucur, Pétru-Octav; Termos, Salah; Cunha, Antonio Sa; Bismuth, Henri; Castaing, Denis; Vibert, Eric

    2013-11-01

    To evaluate the predictive value of portal vein pressure (PVP) after major liver resection for posthepatectomy liver failure (PLF) and 90-day mortality in patients without cirrhosis. As elevated PVP is associated with liver failure after living donor liver transplantation, we hypothesized that the outcome after major hepatectomy may be influenced by posthepatectomy PVP. All patients without severe fibrosis or cirrhosis who underwent a major liver resection (≥3 segments) with an intraoperative measurement of PVP at the end of the procedure were included. Outcome was analyzed regarding 3 most widely used definitions of PLF: "50-50" criteria, peak of serum bilirubin greater than 120 μmol/L, and grade C PLF proposed by the International Study Group of Liver Surgery (ISGLS). Receiver operating characteristic curves and logistic regression model were used to determine the optimal cutoff of PVP and independent risk factors of PLF. The study population consisted of 277 patients. Posthepatectomy PVP was gradually correlated with the PLF risk. Probability for PLF was nil when PVP was 10 mm Hg or less, ranges from 13% to 16%, depending on PLF definitions, when PVP was 20 mm Hg, and from 24% to 33% when PVP was 30 mm Hg. The optimal value of posthepatectomy PVP to predict PLF was 22 mm Hg when considering the "50-50" criteria and grade C PLF (proposed by the International Study Group of Liver Surgery). A value of 21 mm Hg best predicted PLF defined by peak of serum bilirubin greater than 120 μmol/L and 90-day mortality. At multivariate analysis, posthepatectomy PVP remained an independent predictor of PLF as well as the extent of resection, intraoperative transfusion, and the presence of diabetes. The 90-day mortality was associated with PVP greater than 21 mm Hg, older than 70 years, and intraoperative transfusion. Posthepatectomy PVP is an independent predictive factor of PLF and of 90-day mortality after major liver resection in patients without cirrhosis

  2. Clinical evaluation of the failure rates of metallic brackets

    PubMed Central

    ROMANO, Fábio Lourenço; CORRER, Américo Bortolazzo; CORRER-SOBRINHO, Lourenço; MAGNANI, Maria Beatriz Borges de Araújo; RUELLAS, Antônio Carlos de Oliveira

    2012-01-01

    Objectives The aim of this study was to evaluate in vivo the bonding of metallic orthodontic brackets with different adhesive systems. Material and Methods Twenty patients (10.5-15.1 years old) who had sought corrective orthodontic treatment at a University Orthodontic Clinic were evaluated. Brackets were bonded from the right second premolar to the left second premolar in the upper and lower arches using: Orthodontic Concise, conventional Transbond XT, Transbond XT without primer, and Transbond XT associated with Transbond Plus Self-etching Primer (TPSEP). The 4 adhesive systems were used in all patients using a split-mouth design; each adhesive system was used in one quadrant of each dental arch, so that each group of 5 patients received the same bonding sequence. Initial archwires were inserted 1 week after bracket bonding. The number of bracket failures for each adhesive system was quantified over a 6-month period. Results The number of debonded brackets was: 8- Orthodontic Concise, 2- conventional Transbond XT, 9- Transbond XT without primer, and 1- Transbond XT + TPSEP. By using the Kaplan-Meier methods, statistically significant differences were found between the materials (p=0.0198), and the Logrank test identified these differences. Conventional Transbond XT and Transbond XT + TPSEP adhesive systems were statistically superior to Orthodontic Concise and Transbond XT without primer (p<0.05). There was no statistically significant difference between the dental arches (upper and lower), between the dental arch sides (right and left), and among the quadrants. Conclusions The largest number of bracket failures occurred with Orthodontic Concise and Transbond XT without primer systems and few bracket failures occurred with conventional Transbond XT and Transbond XT+TPSEP. More bracket failures were observed in the posterior region compared with the anterior region. PMID:22666842

  3. Venous pressure and dyspnea on exertion in cardiac failure: was Tinsley Randolph Harrison right?

    PubMed

    Haouzi, Philippe

    2009-05-30

    More than 70 years ago, Harrison and his group proposed that in the absence of pulmonary edema, an increased systemic venous pressure could be a major source of dyspnea upon exertion in cardiac patients. Harrison provided evidence that in resting animals systemic venous pressure can affect ventilatory control through afferent information originating from the right side of the central circulation (i.e. right ventricle and large veins) via the vagus nerves. This review explores the concept that "increased venous pressure acts as a cause of dyspnea", which emerged from the remarkable work performed by Harrison and co-workers. Their conclusion will be however extended by developing the hypothesis that the load imposed on the venous blood returning from the skeletal muscles during any muscular activity is sensed by slow conducting muscle afferent fibers and provides a source of dyspnea in heart failure patients.

  4. 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

  5. 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.

  6. Strict blood-pressure control and progression of renal failure in children.

    PubMed

    Wühl, Elke; Trivelli, Antonella; Picca, Stefano; Litwin, Mieczyslaw; Peco-Antic, Amira; Zurowska, Aleksandra; Testa, Sara; Jankauskiene, Augustina; Emre, Sevinc; Caldas-Afonso, Alberto; Anarat, Ali; Niaudet, Patrick; Mir, Sevgi; Bakkaloglu, Aysin; Enke, Barbara; Montini, Giovanni; Wingen, Ann-Margret; Sallay, Peter; Jeck, Nikola; Berg, Ulla; Caliskan, Salim; Wygoda, Simone; Hohbach-Hohenfellner, Katharina; Dusek, Jiri; Urasinski, Tomasz; Arbeiter, Klaus; Neuhaus, Thomas; Gellermann, Jutta; Drozdz, Dorota; Fischbach, Michel; Möller, Kristina; Wigger, Marianne; Peruzzi, Licia; Mehls, Otto; Schaefer, Franz

    2009-10-22

    Although inhibition of the renin-angiotensin system delays the progression of renal failure in adults with chronic kidney disease, the blood-pressure target for optimal renal protection is controversial. We assessed the long-term renoprotective effect of intensified blood-pressure control among children who were receiving a fixed high dose of an angiotensin-converting-enzyme (ACE) inhibitor. After a 6-month run-in period, 385 children, 3 to 18 years of age, with chronic kidney disease (glomerular filtration rate of 15 to 80 ml per minute per 1.73 m(2) of body-surface area) received ramipril at a dose of 6 mg per square meter of body-surface area per day. Patients were randomly assigned to intensified blood-pressure control (with a target 24-hour mean arterial pressure below the 50th percentile) or conventional blood-pressure control (mean arterial pressure in the 50th to 95th percentile), achieved by the addition of antihypertensive therapy that does not target the renin-angiotensin system; patients were followed for 5 years. The primary end point was the time to a decline of 50% in the glomerular filtration rate or progression to end-stage renal disease. Secondary end points included changes in blood pressure, glomerular filtration rate, and urinary protein excretion. A total of 29.9% of the patients in the group that received intensified blood-pressure control reached the primary end point, as assessed by means of a Kaplan-Meier analysis, as compared with 41.7% in the group that received conventional blood-pressure control (hazard ratio, 0.65; confidence interval, 0.44 to 0.94; P=0.02). The two groups did not differ significantly with respect to the type or incidence of adverse events or the cumulative rates of withdrawal from the study (28.0% vs. 26.5%). Proteinuria gradually rebounded during ongoing ACE inhibition after an initial 50% decrease, despite persistently good blood-pressure control. Achievement of blood-pressure targets and a decrease in proteinuria

  7. The application of esophageal pressure measurement in patients with respiratory failure.

    PubMed

    Akoumianaki, Evangelia; Maggiore, Salvatore M; Valenza, Franco; Bellani, Giacomo; Jubran, Amal; Loring, Stephen H; Pelosi, Paolo; Talmor, Daniel; Grasso, Salvatore; Chiumello, Davide; Guérin, Claude; Patroniti, Nicolo; Ranieri, V Marco; Gattinoni, Luciano; Nava, Stefano; Terragni, Pietro-Paolo; Pesenti, Antonio; Tobin, Martin; Mancebo, Jordi; Brochard, Laurent

    2014-03-01

    This report summarizes current physiological and technical knowledge on esophageal pressure (Pes) measurements in patients receiving mechanical ventilation. The respiratory changes in Pes are representative of changes in pleural pressure. The difference between airway pressure (Paw) and Pes is a valid estimate of transpulmonary pressure. Pes helps determine what fraction of Paw is applied to overcome lung and chest wall elastance. Pes is usually measured via a catheter with an air-filled thin-walled latex balloon inserted nasally or orally. To validate Pes measurement, a dynamic occlusion test measures the ratio of change in Pes to change in Paw during inspiratory efforts against a closed airway. A ratio close to unity indicates that the system provides a valid measurement. Provided transpulmonary pressure is the lung-distending pressure, and that chest wall elastance may vary among individuals, a physiologically based ventilator strategy should take the transpulmonary pressure into account. For monitoring purposes, clinicians rely mostly on Paw and flow waveforms. However, these measurements may mask profound patient-ventilator asynchrony and do not allow respiratory muscle effort assessment. Pes also permits the measurement of transmural vascular pressures during both passive and active breathing. Pes measurements have enhanced our understanding of the pathophysiology of acute lung injury, patient-ventilator interaction, and weaning failure. The use of Pes for positive end-expiratory pressure titration may help improve oxygenation and compliance. Pes measurements make it feasible to individualize the level of muscle effort during mechanical ventilation and weaning. The time is now right to apply the knowledge obtained with Pes to improve the management of critically ill and ventilator-dependent patients.

  8. Relationship between pulse transit time and blood pressure is impaired in patients with chronic heart failure.

    PubMed

    Wagner, Daniel R; Roesch, Norbert; Harpes, Patrick; Körtke, Heinrich; Plumer, Pierre; Saberin, Amir; Chakoutio, Viviane; Oundjede, Denis; Delagardelle, Charles; Beissel, Jean; Gilson, Georges; Kindermann, Ingrid; Böhm, Michael

    2010-10-01

    Pulse transit time (PTT), the interval between ventricular electrical activity and arrival of the peripheral pulse wave, has been used to detect changes in autonomic tone during sleep and anesthesia. The purpose of this study was to evaluate PTT in patients with chronic heart failure (HF). Pulse transit time was measured with R-wave gated photoplethysmography in 24 healthy volunteers and in 112 patients with chronic HF and ejection fraction (EF) <40%. PTT was mildly elevated in patients with HF (468 ± 12 vs. 430 ± 23 ms, p = 0.001). In healthy volunteers, PTT was directly proportional to blood pressure (BP): when BP increased, PTT shortened, and vice versa. This relationship between PTT and BP (PTTi) was altered in patients with HF and particularly in the 26 patients with decompensated HF (3.6 ± 0.4 vs. 4.2 ± 0.9, p = 0.04). PTTi did not correlate with functional NYHA class and levels of pro-BNP, epinephrine or norepinephrine. There was a modest correlation between PTTi and EF (p = 0.01, r = -0.48) and PTTi tended to correlate with microvascular flow measured with Laser Doppler (p = 0.08). However, there was an excellent correlation between PTTi and systolic time intervals, left ventricular ejection time (LVET) (p = 0.0014, r = -0.75) and pre-ejection time/LVET (p = 0.006, r = 0.80). The latter ratio reflects ventricular-arterial coupling. The relationship between PTT and BP is altered in severe HF and may indicate impaired ventricular-arterial coupling. It merits further investigation as both parameters can be easily determined and used for serial monitoring in HF.

  9. Failure Analysis and Regeneration Performances Evaluation on Engine Lubricating Oil

    NASA Astrophysics Data System (ADS)

    Wang, X. L.; Zhang, G. N.; Zhang, J. Y.; Yin, Y. L.; Xu, Y.

    To investigate the behavior of failure and recycling of lubricating oils, three sorts of typical 10w-40 lubricating oils used in heavy-load vehicle including the new oil, waste oil and regeneration oil regenerated by self-researched green regeneration technology were selected. The tribology properties were tested by four-ball friction wear tester as well. The results indicated that the performance of anti-extreme pressure of regeneration oil increase by 34.1% compared with the waste one and its load- carrying ability is close to the new oil; the feature of wear spot are better than those of the waste oil and frictional coefficient almost reach the level of the new oil's. As a result, the performance of anti-wear and friction reducing are getting better obviously.

  10. Creep failure of a reactor pressure vessel lower head under severe accident conditions

    SciTech Connect

    Pilch, M.M.; Ludwigsen, J.S.; Chu, T.Y.; Rashid, Y.R.

    1998-08-01

    A severe accident in a nuclear power plant could result in the relocation of large quantities of molten core material onto the lower head of he reactor pressure vessel (RPV). In the absence of inherent cooling mechanisms, failure of the RPV ultimately becomes possible under the combined effects of system pressure and the thermal heat-up of the lower head. Sandia National Laboratories has performed seven experiments at 1:5th scale simulating creep failure of a RPV lower head. This paper describes a modeling program that complements the experimental program. Analyses have been performed using the general-purpose finite-element code ABAQUS-5.6. In order to make ABAQUS solve the specific problem at hand, a material constitutive model that utilizes temperature dependent properties has been developed and attached to ABAQUS-executable through its UMAT utility. Analyses of the LHF-1 experiment predict instability-type failure. Predicted strains are delayed relative to the observed strain histories. Parametric variations on either the yield stress, creep rate, or both (within the range of material property data) can bring predictions into agreement with experiment. The analysis indicates that it is necessary to conduct material property tests on the actual material used in the experimental program. The constitutive model employed in the present analyses is the subject of a separate publication.

  11. Failure of the community-based Vita-Stat automated blood pressure device to accurately measure blood pressure.

    PubMed

    Whitcomb, B L; Prochazka, A; LoVerde, M; Byyny, R L

    1995-05-01

    To evaluate the Vita-Stat automated blood pressure computer (a patient-operated blood pressure measuring device available in the community) to determine its value as an instrument to monitor blood pressure in the ambulatory patient. Comparative study using the Vita-Stat vs a gold standard, the mercury sphygmomanometer. Three local grocery stores. Sixty-three passersby who agreed to answer questions and to sit for several measurements of blood pressure. Simultaneous measurement of blood pressure with each subject wearing a Vita-Stat cuff on the left arm and a mercury sphygmomanometer cuff on the right arm. Two pressures were measured sequentially in the same manner. The reproducibility, accuracy, sensitivity, and specificity of the Vita-Stat computer compared with the gold standard. In sequential measurements, the Vita-Stat readings of both systolic and diastolic blood pressure correlated less well with each other than did the mercury readings (intramachine differences). The Vita-Stat readings also correlated poorly with the mercury readings of systolic and diastolic blood pressure (intermachine differences). The variability in readings recorded by the Vita-Stat were striking, with differences of up to 60 mm Hg from the mercury readings. More than half (63.2%) of the subjects had Vita-Stat readings that were more than 5 mm Hg different from the mercury readings. Vita-Stat systolic readings were usually lower than mercury readings and also varied by as much as 60 mm Hg below in one patient to 58 mm Hg above the mercury reading in another. The sensitivity of the Vita-Stat in correctly diagnosing hypertension was 0.26; the negative predictive value was 0.45. Our data suggest that the Vita-Stat is not only inconsistent but inaccurate in measuring blood pressure in the ambulatory patient and is, therefore, not appropriate to use as a monitoring device.

  12. Evaluation of ANF fuel failures in oyster creek

    SciTech Connect

    Howe, T.M.; Van Swam, L.F.; Piascik, T.G.; Spence, P.A.

    1988-01-01

    During the refueling outrage following cycle-10 operations of Oyster Creek nuclear generating station, fuel sipping identified 47 failed Advance Nuclear Fuels (ANF) fuel assemblies. The failed fuel was an unpressurized 8 x 8 design manufactured by ANF prior to 1980. Subsequent inspection of 46 of these 47 assemblies with the ANF ULTRATEST ultrasonic testing system indicated 104 either failed of suspect fuel rods in 44 assemblies. Two of the assemblies were identified as being sound. Selected fuel rods were removed from three of the assemblies and inspected both visually and with an eddycurrent coil. An evaluation has been performed to determine the cause of the failures. The failures were primarily the result of pellet/cladding interaction (PCI). Detailed analyses of several of the failed fuel rods were performed with ANF's fuel rod modeling code RAMPX2. RAMPX2 includes several state-of-the-art models, including a model describing the formation of fission product deposits called coins on the inside surface of the cladding, a model that accounts for axial PCI, and a trapped fuel stack model. The analyses provided an explanation for the failures.

  13. An automated pressure data acquisition system for evaluation of pressure sensitive paint chemistries

    NASA Technical Reports Server (NTRS)

    Sealey, Bradley S.; Mitchell, Michael; Burkett, Cecil G.; Oglesby, Donald M.

    1993-01-01

    An automated pressure data acquisition system for testing of pressure sensitive phosphorescent paints was designed, assembled, and tested. The purpose of the calibration system is the evaluation and selection of pressure sensitive paint chemistries that could be used to obtain global aerodynamic pressure distribution measurements. The test apparatus and setup used for pressure sensitive paint characterizations is described. The pressure calibrations, thermal sensitivity effects, and photodegradation properties are discussed.

  14. Failure behavior of internally pressurized flawed and unflawed steam generator tubing at high temperatures -- Experiments and comparison with model predictions

    SciTech Connect

    Majumdar, S.; Shack, W.J.; Diercks, D.R.; Mruk, K.; Franklin, J.; Knoblich, L.

    1998-03-01

    This report summarizes experimental work performed at Argonne National Laboratory on the failure of internally pressurized steam generator tubing at high temperatures ({le} 700 C). A model was developed for predicting failure of flawed and unflawed steam generator tubes under internal pressure and temperature histories postulated to occur during severe accidents. The model was validated by failure tests on specimens with part-through-wall axial and circumferential flaws of various lengths and depths, conducted under various constant and ramped internal pressure and temperature conditions. The failure temperatures predicted by the model for two temperature and pressure histories, calculated for severe accidents initiated by a station blackout, agree very well with tests performed on both flawed and unflawed specimens.

  15. Pressurizer sensor failure detection using a single sensor multistep parity relation

    SciTech Connect

    Tsai, T.M.; Chou, H.P. )

    1990-06-01

    With increasing demands on the safety and reliability of nuclear power stations, methods of fault detection and isolation (FDI) are creating increasing interest. The FDI process basically involves two steps: residual generation and decision making. The residual represents the difference between various functions of the sensor outputs and the expected values of these functions in the no-fail mode and is subsequently examined for the presence of failure signatures. In this paper, they develop an FDI monitor for pressurizer instruments, which employs the generalized parity relations derived from system equations for residual generation and uses likelihood ratio tests for decision making. The design is for diagnosis during steady-state and transient operations. To avoid difficulties in isolating multiple simultaneous sensor failures, individual FDI monitors are used for each sensor of interest.

  16. 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.

  17. Importance Sampling in the Evaluation and Optimization of Buffered Failure Probability

    DTIC Science & Technology

    2015-07-01

    Importance Sampling in the Evaluation and Optimization of Buffered Failure Probability Marwan M. Harajli Graduate Student, Dept. of Civil and Environ...Seattle, USA Johannes O. Royset Associate Professor, Operations Research Dept., Naval Postgraduate School , Monterey, USA ABSTRACT: Engineering design is...criterion is usually the failure probability. In this paper, we examine the buffered failure probability as an attractive alternative to the failure

  18. Modeling the pressure increase in liquid helium cryostats after failure of the insulating vacuum

    SciTech Connect

    Heidt, C.; Grohmann, S.; Süßer, M.

    2014-01-29

    The pressure relief system of liquid helium cryostats requires a careful design, due to helium's low enthalpy of vaporization and due to the low operating temperature. Hazard analyses often involve the failure of the insulating vacuum in the worst-case scenario. The venting of the insulating vacuum and the implications for the pressure increase in the helium vessel, however, have not yet been fully analyzed. Therefore, the dimensioning of safety devices often requires experience and reference to very few experimental data. In order to provide a better foundation for the design of cryogenic pressure relief systems, this paper presents an analytic approach for the strongly dynamic process induced by the loss of insulating vacuum. The model is based on theoretical considerations and on differential equation modeling. It contains only few simplifying assumptions, which will be further investigated in future experiments. The numerical solutions of example calculations are presented with regard to the heat flux into the helium vessel, the helium pressure increase and the helium flow rate through the pressure relief device. Implications concerning two-phase flow and the influence of kinetic energy are discussed.

  19. NASA Prototype All Composite Tank Cryogenic Pressure Tests to Failure with Structural Health Monitoring

    NASA Technical Reports Server (NTRS)

    Werlink, Rudolph J.; Pena, Francisco

    2015-01-01

    This Paper will describe the results of pressurization to failure of 100 gallon composite tanks using liquid nitrogen. Advanced methods of health monitoring will be compared as will the experimental data to a finite element model. The testing is wholly under NASA including unique PZT (Lead Zirconate Titanate) based active vibration technology. Other technologies include fiber optics strain based systems including NASA AFRC technology, Acoustic Emission, Acellent smart sensor, this work is expected to lead to a practical in-Sutu system for composite tanks.

  20. A Review of Energy Release Processes from the Failure of Pneumatic Pressure Vessels

    DTIC Science & Technology

    1988-08-01

    to model blast effects from explo,3ives and pressure vessels. The two codes examined by this study are the Wondy V Code and the Sharp Shock Wundy Code...computer codes. The Wundy Sharp Shock code was used for nitrogen and the Wondy V Code was used fo, 3icic-i. These curves 40 1000 100- - •- •NNitrogen a. w...c:unclusiotib. Two computer models exist to simulate the rv•ansion of the gas following failure of the vess5el These models, titled " Wondy " and "Wundy" (both

  1. Differing prognostic value of pulse pressure in patients with heart failure with reduced or preserved ejection fraction: results from the MAGGIC individual patient meta-analysis.

    PubMed

    Jackson, Colette E; Castagno, Davide; Maggioni, Aldo P; Køber, Lars; Squire, Iain B; Swedberg, Karl; Andersson, Bert; Richards, A Mark; Bayes-Genis, Antoni; Tribouilloy, Christophe; Dobson, Joanna; Ariti, Cono A; Poppe, Katrina K; Earle, Nikki; Whalley, Gillian; Pocock, Stuart J; Doughty, Robert N; McMurray, John J V

    2015-05-07

    Low pulse pressure is a marker of adverse outcome in patients with heart failure (HF) and reduced ejection fraction (HF-REF) but the prognostic value of pulse pressure in patients with HF and preserved ejection fraction (HF-PEF) is unknown. We examined the prognostic value of pulse pressure in patients with HF-PEF [ejection fraction (EF) ≥ 50%] and HF-REF. Data from 22 HF studies were examined. Preserved left ventricular ejection fraction (LVEF) was defined as LVEF ≥ 50%. All-cause mortality at 3 years was evaluated in 27 046 patients: 22 038 with HF-REF (4980 deaths) and 5008 with HF-PEF (828 deaths). Pulse pressure was analysed in quintiles in a multivariable model adjusted for the previously reported Meta-Analysis Global Group in Chronic Heart Failure prognostic variables. Heart failure and reduced ejection fraction patients in the lowest pulse pressure quintile had the highest crude and adjusted mortality risk (adjusted hazard ratio 1.68, 95% confidence interval 1.53-1.84) compared with all other pulse pressure groups. For patients with HF-PEF, higher pulse pressure was associated with the highest crude mortality, a gradient that was eliminated after adjustment for other prognostic variables. Lower pulse pressure (especially <53 mmHg) was an independent predictor of mortality in patients with HF-REF, particularly in those with an LVEF < 30% and systolic blood pressure <140 mmHg. Overall, this relationship between pulse pressure and outcome was not consistently observed among patients with HF-PEF. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  2. Efficacy and safety of noninvasive positive pressure ventilation in the treatment of acute respiratory failure after cardiac surgery.

    PubMed

    Zhu, Guang-fa; Wang, Di-jia; Liu, Shuang; Jia, Ming; Jia, Shi-jie

    2013-12-01

    Although noninvasive positive pressure ventilation (NPPV) has been successfully used for various kinds of acute respiratory failure, the data are limited regarding its application in postoperative respiratory failure after cardiac surgery. Therefore, we conducted a prospective randomized control study in a university surgical intensive care unit to evaluate the efficacy and safety of NPPV in the treatment of acute respiratory failure after cardiac surgery, and explore the predicting factors of NPPV failure. From September 2011 to November 2012 patients with acute respiratory failure after cardiac surgery who had indication for the use of NPPV were randomly divided into a NPPV treatment group (NPPV group) and the conventional treatment group (control group). The between-group differences in the patients' baseline characteristics, re-intubation rate, tracheotomy rate, ventilator associated pneumonia (VAP) incidence, in-hospital mortality, mechanical ventilation time after enrollment (MV time), intensive care unit (ICU) and postoperative hospital stays were compared. The factors that predict NPPV failure were analyzed. During the study period, a total of 139 patients who had acute respiratory failure after cardiac surgery were recorded, and 95 of them met the inclusion criteria, which included 59 males and 36 females with a mean age of (61.5 ± 11.2) years. Forty-three patients underwent coronary artery bypass grafting (CABG), 23 underwent valve surgery, 13 underwent CABG+valve surgery, 13 underwent major vascular surgery, and three underwent other surgeries. The NPPV group had 48 patients and the control group had 47 patients. In the NPPV group, the re-intubation rate was 18.8%, tracheotomy rate was 12.5%, VAP incidence was 0, and the in-hospital mortality was 18.8%, significantly lower than in the control group 80.9%, 29.8%, 17.0% and 38.3% respectively, P < 0.05 or P < 0.01. The MV time and ICU stay (expressed as the median (P25, P75)) were 18.0 (9.2, 35.0) hours

  3. Mononuclear Phagocytes Are Dispensable for Cardiac Remodeling in Established Pressure-Overload Heart Failure

    PubMed Central

    Patel, Bindiya; Ismahil, Mohamed Ameen; Hamid, Tariq; Bansal, Shyam S.; Prabhu, Sumanth D.

    2017-01-01

    Background Although cardiac and splenic mononuclear phagocytes (MPs), i.e., monocytes, macrophages and dendritic cells (DCs), are key contributors to cardiac remodeling after myocardial infarction, their role in pressure-overload remodeling is unclear. We tested the hypothesis that these immune cells are required for the progression of remodeling in pressure-overload heart failure (HF), and that MP depletion would ameliorate remodeling. Methods and Results C57BL/6 mice were subjected to transverse aortic constriction (TAC) or sham operation, and assessed for alterations in MPs. As compared with sham, TAC mice exhibited expansion of circulating LyC6hi monocytes and pro-inflammatory CD206− cardiac macrophages early (1 w) after pressure-overload, prior to significant hypertrophy and systolic dysfunction, with subsequent resolution during chronic HF. In contrast, classical DCs were expanded in the heart in a biphasic manner, with peaks both early, analogous to macrophages, and late (8 w), during established HF. There was no significant expansion of circulating DCs, or Ly6C+ monocytes and DCs in the spleen. Periodic systemic MP depletion from 2 to 16 w after TAC in macrophage Fas-induced apoptosis (MaFIA) transgenic mice did not alter cardiac remodeling progression, nor did splenectomy in mice with established HF after TAC. Lastly, adoptive transfer of splenocytes from TAC HF mice into naïve recipients did not induce immediate or long-term cardiac dysfunction in recipient mice. Conclusions Mononuclear phagocytes populations expand in a phasic manner in the heart during pressure-overload. However, they are dispensable for the progression of remodeling and failure once significant hypertrophy is evident and blood monocytosis has normalized. PMID:28125666

  4. Mononuclear Phagocytes Are Dispensable for Cardiac Remodeling in Established Pressure-Overload Heart Failure.

    PubMed

    Patel, Bindiya; Ismahil, Mohamed Ameen; Hamid, Tariq; Bansal, Shyam S; Prabhu, Sumanth D

    2017-01-01

    Although cardiac and splenic mononuclear phagocytes (MPs), i.e., monocytes, macrophages and dendritic cells (DCs), are key contributors to cardiac remodeling after myocardial infarction, their role in pressure-overload remodeling is unclear. We tested the hypothesis that these immune cells are required for the progression of remodeling in pressure-overload heart failure (HF), and that MP depletion would ameliorate remodeling. C57BL/6 mice were subjected to transverse aortic constriction (TAC) or sham operation, and assessed for alterations in MPs. As compared with sham, TAC mice exhibited expansion of circulating LyC6hi monocytes and pro-inflammatory CD206- cardiac macrophages early (1 w) after pressure-overload, prior to significant hypertrophy and systolic dysfunction, with subsequent resolution during chronic HF. In contrast, classical DCs were expanded in the heart in a biphasic manner, with peaks both early, analogous to macrophages, and late (8 w), during established HF. There was no significant expansion of circulating DCs, or Ly6C+ monocytes and DCs in the spleen. Periodic systemic MP depletion from 2 to 16 w after TAC in macrophage Fas-induced apoptosis (MaFIA) transgenic mice did not alter cardiac remodeling progression, nor did splenectomy in mice with established HF after TAC. Lastly, adoptive transfer of splenocytes from TAC HF mice into naïve recipients did not induce immediate or long-term cardiac dysfunction in recipient mice. Mononuclear phagocytes populations expand in a phasic manner in the heart during pressure-overload. However, they are dispensable for the progression of remodeling and failure once significant hypertrophy is evident and blood monocytosis has normalized.

  5. VALIDATION OF SPRING OPERATED PRESSURE RELIEF VALVE TIME TO FAILURE AND THE IMPORTANCE OF STATISTICALLY SUPPORTED MAINTENANCE INTERVALS

    SciTech Connect

    Gross, R; Stephen Harris, S

    2009-02-18

    The Savannah River Site operates a Relief Valve Repair Shop certified by the National Board of Pressure Vessel Inspectors to NB-23, The National Board Inspection Code. Local maintenance forces perform inspection, testing, and repair of approximately 1200 spring-operated relief valves (SORV) each year as the valves are cycled in from the field. The Site now has over 7000 certified test records in the Computerized Maintenance Management System (CMMS); a summary of that data is presented in this paper. In previous papers, several statistical techniques were used to investigate failure on demand and failure rates including a quantal response method for predicting the failure probability as a function of time in service. The non-conservative failure mode for SORV is commonly termed 'stuck shut'; industry defined as the valve opening at greater than or equal to 1.5 times the cold set pressure. Actual time to failure is typically not known, only that failure occurred some time since the last proof test (censored data). This paper attempts to validate the assumptions underlying the statistical lifetime prediction results using Monte Carlo simulation. It employs an aging model for lift pressure as a function of set pressure, valve manufacturer, and a time-related aging effect. This paper attempts to answer two questions: (1) what is the predicted failure rate over the chosen maintenance/ inspection interval; and do we understand aging sufficient enough to estimate risk when basing proof test intervals on proof test results?

  6. Early Caffeine Prophylaxis and Risk of Failure of Initial Continuous Positive Airway Pressure in Very Low Birth Weight Infants.

    PubMed

    Patel, Ravi M; Zimmerman, Kanecia; Carlton, David P; Clark, Reese; Benjamin, Daniel K; Smith, P Brian

    2017-09-07

    To test the hypothesis that early caffeine treatment on the day of birth, compared with later treatment in very low birth weight (VLBW, <1500 g) infants receiving continuous positive airway pressure (CPAP) therapy, is associated with a decreased risk of CPAP failure in the first week of life. Multicenter, observational cohort study in 366 US neonatal intensive care units. We evaluated inborn, VLBW infants discharged from 2000 to 2014, who received only CPAP therapy without surfactant treatment on day of life (DOL) 0, had a 5-minute Apgar ≥3, and received caffeine in first week of life. We used multivariable conditional logistic regression to compare the risk of CPAP failure, defined as invasive mechanical ventilation or surfactant therapy on DOL 1-6, by timing of caffeine treatment as either early (initiation on DOL 0) or routine (initiation on DOL 1-6). We identified 11 133 infants; 4528 (41%) received early caffeine and 6605 (59%) received routine caffeine. Median gestational age was lower in the early caffeine group, 29 weeks (25th, 75th percentiles; 28, 30) vs the routine caffeine group, 30 weeks (29, 31); P < 0.001. The incidence of CPAP failure on DOL 1-6 was similar between the early and routine caffeine groups: 22% vs 21%; adjusted OR = 1.05 (95% CI: 0.93, 1.18). Early caffeine treatment on the day of birth was not associated with a decreased risk of CPAP failure in the first week of life for VLBW infants initially treated with CPAP. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Prognostic significance of blood pressure response to exercise in patients with systolic heart failure.

    PubMed

    Kallistratos, Manolis S; Poulimenos, Leonidas E; Pavlidis, Antonios N; Dritsas, Athanasios; Laoutaris, Ioannis D; Manolis, Athanasios J; Cokkinos, Dennis V

    2012-01-01

    High systolic blood pressure (SBP) has been linked to worse cardiovascular outcomes. However, emerging data suggest that in patients with heart failure (HF), low SBP correlates with increased mortality. The purpose was to examine the impact of baseline and post-exercise systolic and diastolic blood pressure (DBP), as well as pulse pressure (PP), on cardiac mortality in patients with systolic HF. One hundred sixty patients with systolic HF (left ventricular ejection fraction 33 ± 8) were studied. Blood pressure (BP) levels were determined at rest and at peak exercise during a cardiopulmonary exercise test. Patients were followed up for a period of 2.5 ± 0.8 years. During this period 22 patients died and 5 subjects underwent heart transplantation. Patients with higher SBP and DBP at rest, and patients with SBP ≥160 mmHg and PP ≥75 mmHg at peak exercise had the most favorable prognosis. There was a fourfold increase in cardiac mortality risk for patients with SBP <160 mmHg at peak exercise (hazard ratio: 3.97, 95% confidence interval: 1.60-9.84) and a threefold increase for patients with PP <75 mmHg at peak exercise (hazard ratio: 2.96, 95% confidence interval: 1.29-6.82). There is an inverse relationship between SBP and cardiac mortality in patients with systolic HF. BP response to exercise could serve as a simple risk stratification model in HF patients.

  8. Evaluation of Corrosion Failure in Tractor-Trailer Brake System

    SciTech Connect

    Wilson, DF

    2002-10-22

    As reported to ORNL, concomitant with the introduction of different deicing and anti-icing compounds, there was an increase in the brake failure rate of tractor-trailer trucks. A forensic evaluation of a failed brake system was performed. Optical and scanning electron microscopic evaluation showed corrosion to be mostly confined to the brake table/lining interface. The corrosion is non-uniform as is to be expected for plain carbon steel in chloride environments. This initial analysis found no evidence for the chlorides of calcium and magnesium, which are the newly introduced deicing and antiicing compounds and are less soluble in water than the identified chlorides of sodium and potassium, in the scale. The result could be as a result of non-exposure of the examined brake table to calcium and magnesium chloride. The mechanisms for the increased failure rate are postulated as being an increased rate of corrosion due to positive shifts in the corrosion potential, and an increased amount of corrosion due to an increased ''time of wetness'' that results from the presence of hygroscopic salts. Laboratory scale evaluation of the corrosion of plain carbon steel in simulated deicing and anti-icing solutions need to be performed to determine corrosion rates and morphological development of corrosion product, to compare laboratory data to in-service data, and to rank economically feasible replacement materials for low carbon steel. In addition, the mechanical behavior of the lining attached to the brake shoe table needs to be assessed. It is opined that an appropriate adjustment of materials could easily allow for a doubling of a brake table/lining lifetime. Suggestions for additional work, to clarify the mechanisms of rust jacking and to develop possible solutions, are described.

  9. [Comparison of volume preset and pressure preset ventilators during daytime nasal ventilation in chronic respiratory failure].

    PubMed

    Perrin, C; Wolter, P; Berthier, F; Tamisier, R; Jullien, V; Lemoigne, F; Blaive, B

    2001-02-01

    Both volume preset and pressure preset ventilators are available for domiciliary nasal ventilation. Owing to their technical characteristics, it has been suggested that impaired ventilatory mechanics might cause a drop in the tidal volume (Vt) delivered by pressure preset devices, thereby placing mechanical ventilation at risk of inefficacy. We have assessed two ventilator systems (one pressure preset and one volume preset) with regard to the tidal volume and end-tidal carbon dioxide tension (PetCO(2)) changes that may be achieved in a group of awake patients with stable chronic respiratory failure (CRF). Eleven patients with stable CRF were ventilated in the assist/control mode for two consecutive one-hour periods. One ventilator was tested each hour, in random order. The VIGIL'AIR(R) system was used to record Vt, Respiratory Rate (RR), and Inspiratory/Expiratory ratio (I/E). The deviation E (E=preset value - measured value) was calculated for each measurement. Changes in PetCO(2) and arterial oxygen saturation were determined respectively by a capnometer and a pulse oximeter. Comparison of the mean deviation of Vt calculated for the two ventilators revealed a difference in patients with chronic obstructive pulmonary disease (COPD). The deviation was greatest with the pressure preset ventilator (PPV), which gave mean measured values higher than the mean preset values. The same comparison failed to reveal any difference in restrictive CRF. Comparison of the volume preset and pressure preset ventilators for RR, I/E and PetCO(2) did not reveal any difference. Compared to the volume preset ventilator, the efficacy of PPV to ventilate is not affected by the restrictive or obstructive nature of CRF. Our results show that pressure-preset ventilator is an adequate alternative to the volume-preset device for daytime non invasive ventilation in chronic respiratory insufficiency.

  10. The Relationship of Right- and Left-Sided Filling Pressures in Patients With Heart Failure and a Preserved Ejection Fraction

    PubMed Central

    Drazner, Mark H.; Prasad, Anand; Ayers, Colby; Markham, David W.; Hastings, Jeffrey; Bhella, Paul S.; Shibata, Shigeki; Levine, Benjamin D.

    2013-01-01

    Background Although right-sided filling pressures often mirror left-sided filling pressures in systolic heart failure, it is not known whether a similar relationship exists in heart failure with preserved ejection fraction. Methods and Results Eleven subjects with heart failure with preserved ejection fraction underwent right heart catheterization at rest and under loading conditions manipulated by lower body negative pressure and saline infusion. Right atrial pressure (RAP) was classified as elevated when ≥10 mm Hg and pulmonary capillary wedge pressure (PCWP) when ≥22 mm Hg. If both the RAP and the PCWP were elevated or both not elevated, they were classified as concordant; otherwise, they were classified as discordant. Correlation of RAP and PCWP was determined by a repeated measures model. Among 66 paired measurements of RAP and PCWP, 44 (67%) had a low RAP and PCWP and 8 (12%) a high RAP and PCWP, yielding a concordance rate of 79%. In a sensitivity analysis performed by varying the definition of elevated RAP (from 8 to 12 mm Hg) and PCWP (from 15 to 25 mm Hg), the mean±SD concordance of RAP and PCWP was 76±10%. The correlation coefficient of RAP and PCWP for the overall cohort was r=0.86 (P<0.0001). Conclusions Right-sided filling pressures often reflect left-sided filling pressures in heart failure with preserved ejection fraction, supporting the role of estimation of jugular venous pressure to assess volume status in this condition. PMID:20233992

  11. Central Venous Pressure After Coronary Artery Bypass Surgery: Does it Predict Postoperative Mortality or Renal Failure?

    PubMed Central

    Williams, Judson B.; Peterson, Eric D.; Wojdyla, Daniel; Ferguson, T. Bruce; Smith, Peter K.; Milano, Carmelo A.; Lopes, Renato D.

    2015-01-01

    Background While hemodynamic monitoring is often performed following coronary artery bypass grafting (CABG), the relationship between postoperative central venous pressure (CVP) measurement and clinical outcomes is unknown. Methods Detailed clinical data were analyzed from 2,390 randomly selected patients undergoing high risk CABG or CABG/valve at 55 hospitals participating in the Society of Thoracic Surgeons' National Cardiac Surgery Database from 2004 to 2005. Eligible patients underwent elective/urgent isolated CABG with an ejection fraction < 40%, or elective/urgent CABG at age ≥65 years with diabetes or a glomerular filtration rate 60 mL/min per 1.73 m2. Correlation between post-operative CVP and in-hospital / 30-day mortality and renal failure was assessed as a continuous variable, both unadjusted and after adjusting for important clinical factors using logistic regression modeling. Results Mean age was 72 years, 54% of patients had diabetes mellitus, 49% were urgent procedures, and mean cardiopulmonary bypass time was 105 minutes. Patients’ CVP 6 hours post-operation was strongly associated with in-hospital and 30 day mortality: odds ratio (OR) 1.5 (95% confidence interval [CI] 1.23, 1.87) for every 5 mmHg increase in CVP, p<0.0001. This association remained significant after risk-adjustment for cardiac index: adjusted OR 1.44 (95% CI 1.10, 1.89), p<0.01. A model adjusting for cardiac index also revealed increased incidence of mortality or renal failure: adjusted OR 1.5 (95% CI 1.28, 1.86) for every 5 mmHg increase in CVP, p<0.0001. Conclusion Patients’ central venous pressure at 6 hours following CABG surgery was highly predictive of operative mortality or renal failure, independent of cardiac index and other important clinical variables. Future studies will need to assess whether post-operative CVP can be used to guide intervention and improve outcomes. PMID:25035048

  12. Heart Failure Virtual Consultation: bridging the gap of heart failure care in the community - A mixed-methods evaluation.

    PubMed

    Gallagher, Joseph; James, Stephanie; Keane, Ciara; Fitzgerald, Annie; Travers, Bronagh; Quigley, Etain; Hecht, Christina; Zhou, Shuaiwei; Watson, Chris; Ledwidge, Mark; McDonald, Kenneth

    2017-08-01

    We undertook a mixed-methods evaluation of a Web-based conferencing service (virtual consult) between general practitioners (GPs) and cardiologists in managing patients with heart failure in the community to determine its effect on use of specialist heart failure services and acceptability to GPs. All cases from June 2015 to October 2016 were recorded using a standardized recording template, which recorded patient demographics, medical history, medications, and outcome of the virtual consult for each case. Quantitative surveys and qualitative interviewing of 17 participating GPs were also undertaken. During this time, 142 cases were discussed-68 relating to a new diagnosis of heart failure, 53 relating to emerging deterioration in a known heart failure patient, and 21 relating to therapeutic issues. Only 17% required review in outpatient department following the virtual consultation. GPs reported increased confidence in heart failure management, a broadening of their knowledge base, and a perception of overall better patient outcomes. These data from an initial experience with Heart Failure Virtual Consultation present a very positive impact of this strategy on the provision of heart failure care in the community and acceptability to users. Further research on the implementation and expansion of this strategy is warranted. © 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

  13. 209-E Building -- Response to ventilation failure evaluation

    SciTech Connect

    Foust, D.J.

    1998-07-27

    This document provides an evaluation and recommendations for radiological workplace air monitoring and response to ventilation failure for the Critical Mass Laboratory, 209-E Building. The Critical Mass Laboratory, part of the 209-E Building, was designed to provide a heavily shielded room where plutonium and uranium liquid solutions could be brought into various critical configurations under readily controlled and monitored conditions. The facility is contained within a one-story L-shaped concrete block and reinforced concrete building. One wing houses offices, a control room, shops, and a common area while the other wing includes an equipment room, the change room, work areas, and the two-story Critical Assembly Room (CAR). Three of the rooms contain radiologically contaminated equipment and materials.

  14. Scare Tactics: Evaluating Problem Decompositions Using Failure Scenarios

    NASA Technical Reports Server (NTRS)

    Helm, B. Robert; Fickas, Stephen

    1992-01-01

    Our interest is in the design of multi-agent problem-solving systems, which we refer to as composite systems. We have proposed an approach to composite system design by decomposition of problem statements. An automated assistant called Critter provides a library of reusable design transformations which allow a human analyst to search the space of decompositions for a problem. In this paper we describe a method for evaluating and critiquing problem decompositions generated by this search process. The method uses knowledge stored in the form of failure decompositions attached to design transformations. We suggest the benefits of our critiquing method by showing how it could re-derive steps of a published development example. We then identify several open issues for the method.

  15. BPC 157 therapy to detriment sphincters failure-esophagitis-pancreatitis in rat and acute pancreatitis patients low sphincters pressure.

    PubMed

    Petrovic, I; Dobric, I; Drmic, D; Sever, M; Klicek, R; Radic, B; Brcic, L; Kolenc, D; Zlatar, M; Kunjko, K; Jurcic, D; Martinac, M; Rasic, Z; Boban Blagaic, A; Romic, Z; Seiwerth, S; Sikiric, P

    2011-10-01

    Possibly, acute esophagitis and pancreatitis cause each other, and we focused on sphincteric failure as the common causative key able to induce either esophagitis and acute pancreatitis or both of them, and thereby investigate the presence of a common therapy nominator. This may be an anti-ulcer pentadecapeptide BPC 157 (tested for inflammatory bowel disease, wound treatment) affecting esophagitis, lower esophageal and pyloric sphincters failure and acute pancreatitis (10 μg/kg, 10 ng/kg intraperitoneally or in drinking water). The esophagitis-sphincter failure procedure (i.e., insertion of the tubes into the sphincters, lower esophageal and pyloric) and acute pancreatitis procedure (i.e., bile duct ligation) were combined in rats. Esophageal manometry was done in acute pancreatitis patients. In rats acute pancreatitis procedure produced also esophagitis and both sphincter failure, decreased pressure 24 h post-surgery. Furthermore, bile duct ligation alone immediately declines the pressure in both sphincters. Vice versa, the esophagitis-sphincter failure procedure alone produced acute pancreatitis. What's more, these lesions (esophagitis, sphincter failure, acute pancreatitis when combined) aggravate each other (tubes into sphincters and ligated bile duct). Counteraction occurred by BPC 157 therapies. In acute pancreatitis patients lower pressure at rest was in both esophageal sphincters in acute pancreatitis patients. We conclude that BPC 157 could cure esophagitis/sphincter/acute pancreatitis healing failure.

  16. Effect of Intensive Blood Pressure Treatment on Heart Failure Events in the Systolic Blood Pressure Reduction Intervention Trial.

    PubMed

    Upadhya, Bharathi; Rocco, Michael; Lewis, Cora E; Oparil, Suzanne; Lovato, Laura C; Cushman, William C; Bates, Jeffrey T; Bello, Natalie A; Aurigemma, Gerard; Fine, Lawrence J; Johnson, Karen C; Rodriguez, Carlos J; Raj, Dominic S; Rastogi, Anjay; Tamariz, Leonardo; Wiggers, Alan; Kitzman, Dalane W

    2017-04-01

    Acute decompensated heart failure (ADHF) was a frequent common outcome in SPRINT (Systolic Blood Pressure Intervention Trial). We examined whether there was differential reduction in ADHF events from intensive blood pressure [BP] treatment among the 6 key, prespecified subgroups in SPRINT: age ≥75 years, prior cardiovascular disease, chronic kidney disease, women, black race, and 3 levels of baseline systolic BP (≤132 versus >132 to <145 versus ≥145 mm Hg). ADHF was defined as hospitalization for ADHF, confirmed and formally adjudicated by a blinded events committee using standardized protocols. At 3.29 years follow-up, there were 103 ADHF events (2.2%) among 4683 standard arm participants and 65 ADHF events (1.4%) among 4678 intensive arm participants (Cox proportional hazards ratio, 0.63; 95% confidence interval, 0.46-0.85; P value =0.003). In multivariable analyses, including treatment arm, baseline covariates that were significant predictors for ADHF included chronic kidney disease, cardiovascular disease, age≥75 years, body mass index, and higher systolic BP. The beneficial effect of the intervention on incident ADHF was consistent across all prespecified subgroups. Participants who had incident ADHF had markedly increased risk of subsequent cardiovascular events, including a 27-fold increase (P<0.001) in cardiovascular death. Targeting a systolic BP<120 mm Hg, compared with <140 mm Hg, significantly reduced ADHF events, and the benefit was similar across all key, prespecified subgroups. Participants who developed ADHF had markedly increased risk for subsequent cardiovascular events and death, highlighting the importance of strategies aimed at prevention of ADHF, especially intensive BP reduction. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01206062. © 2017 American Heart Association, Inc.

  17. Efficacy and Safety of Renal Sympathetic Denervation on Dogs with Pressure Overload-Induced Heart Failure.

    PubMed

    Chen, Pingan; Leng, Shuilong; Luo, Yishan; Li, Shaonan; Huang, Zicheng; Liu, Zhenxi; Liu, Zhen; Wang, Jie; Lei, Xiaoming

    2017-02-01

    In dogs with heart failure (HF) induced by overload pressure, the role of renal sympathetic denervation (RSD) on heart failure and in the renal artery is unclear. Therefore, we investigated the efficacy and safety of RSD in dogs with pressure overload-induced heart failure. Twenty mongrel dogs were divided into a sham-operated group, an HF group and an HF + RSD group. In the sham-operated group, the abdominal aorta was located but was not constricted, in the HF group, the abdominal aorta was constricted without RSD, and the HF+RSD group underwent RSD with constriction of the abdominal aorta after 10 weeks. Blood sampling assays, echocardiography, intravascular ultrasound (IVUS) measurement and histopathological examination were performed. Renal sympathetic denervation caused a significant reduction in the levels of noradrenaline (166.62±6.84 vs. 183.48±13.66 pg/ml, P<0.05), plasma renin activity (1.93±0.12 vs. 2.10±0.13 ng/mlh, P<0.05) and B-type natriuretic peptide (71.14±3.86 vs. 83.15±5.73 pg/ml, P<0.05) at eight weeks after RSD in the HF+RSD group. Compared with the HF group at eight weeks, the left ventricular internal dimension at end-diastole and end-systole were lower and the left ventricular ejection fraction was higher (all P<0.05) at eight weeks after RSD in the HF+RSD group. Intravenous ultrasound images showed no changes in the renal artery lumen, and intimal hyperplasia and vascular lumen stenosis were not observed after RSD. Renal sympathetic denervation could improve cardiac function in dogs with HF induced by pressure overload; RSD had no adverse influence on the renal artery. Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  18. Failure Behavior of Granite Affected by Confinement and Water Pressure and Its Influence on the Seepage Behavior by Laboratory Experiments

    PubMed Central

    Cheng, Cheng; Li, Xiao; Li, Shouding; Zheng, Bo

    2017-01-01

    Failure behavior of granite material is paramount for host rock stability of geological repositories for high-level waste (HLW) disposal. Failure behavior also affects the seepage behavior related to transportation of radionuclide. Few of the published studies gave a consistent analysis on how confinement and water pressure affect the failure behavior, which in turn influences the seepage behavior of the rock during the damage process. Based on a series of laboratory experiments on NRG01 granite samples cored from Alxa area, a candidate area for China’s HLW disposal, this paper presents some detailed observations and analyses for a better understanding on the failure mechanism and seepage behavior of the samples under different confinements and water pressure. The main findings of this study are as follows: (1) Strength reduction properties were found for the granite under water pressure. Besides, the complete axial stress–strain curves show more obvious yielding process in the pre-peak region and a more gradual stress drop in the post-peak region; (2) Shear fracturing pattern is more likely to form in the granite samples with the effect of water pressure, even under much lower confinements, than the predictions from the conventional triaxial compressive results; (3) Four stages of inflow rate curves are divided and the seepage behaviors are found to depend on the failure behavior affected by the confinement and water pressure. PMID:28773157

  19. Failure Behavior of Granite Affected by Confinement and Water Pressure and Its Influence on the Seepage Behavior by Laboratory Experiments.

    PubMed

    Cheng, Cheng; Li, Xiao; Li, Shouding; Zheng, Bo

    2017-07-14

    Failure behavior of granite material is paramount for host rock stability of geological repositories for high-level waste (HLW) disposal. Failure behavior also affects the seepage behavior related to transportation of radionuclide. Few of the published studies gave a consistent analysis on how confinement and water pressure affect the failure behavior, which in turn influences the seepage behavior of the rock during the damage process. Based on a series of laboratory experiments on NRG01 granite samples cored from Alxa area, a candidate area for China's HLW disposal, this paper presents some detailed observations and analyses for a better understanding on the failure mechanism and seepage behavior of the samples under different confinements and water pressure. The main findings of this study are as follows: (1) Strength reduction properties were found for the granite under water pressure. Besides, the complete axial stress-strain curves show more obvious yielding process in the pre-peak region and a more gradual stress drop in the post-peak region; (2) Shear fracturing pattern is more likely to form in the granite samples with the effect of water pressure, even under much lower confinements, than the predictions from the conventional triaxial compressive results; (3) Four stages of inflow rate curves are divided and the seepage behaviors are found to depend on the failure behavior affected by the confinement and water pressure.

  20. Activation of PPAR-α in the early stage of heart failure maintained myocardial function and energetics in pressure-overload heart failure.

    PubMed

    Kaimoto, Satoshi; Hoshino, Atsushi; Ariyoshi, Makoto; Okawa, Yoshifumi; Tateishi, Shuhei; Ono, Kazunori; Uchihashi, Motoki; Fukai, Kuniyoshi; Iwai-Kanai, Eri; Matoba, Satoaki

    2017-02-01

    Failing heart loses its metabolic flexibility, relying increasingly on glucose as its preferential substrate and decreasing fatty acid oxidation (FAO). Peroxisome proliferator-activated receptor α (PPAR-α) is a key regulator of this substrate shift. However, its role during heart failure is complex and remains unclear. Recent studies reported that heart failure develops in the heart of myosin heavy chain-PPAR-α transgenic mice in a manner similar to that of diabetic cardiomyopathy, whereas cardiac dysfunction is enhanced in PPAR-α knockout mice in response to chronic pressure overload. We created a pressure-overload heart failure model in mice through transverse aortic constriction (TAC) and activated PPAR-α during heart failure using an inducible transgenic model. After 8 wk of TAC, left ventricular (LV) function had decreased with the reduction of PPAR-α expression in wild-type mice. We examined the effect of PPAR-α induction during heart failure using the Tet-Off system. Eight weeks after the TAC operation, LV construction was preserved significantly by PPAR-α induction with an increase in PPAR-α-targeted genes related to fatty acid metabolism. The increase of expression of fibrosis-related genes was significantly attenuated by PPAR-α induction. Metabolic rates measured by isolated heart perfusions showed a reduction in FAO and glucose oxidation in TAC hearts, but the rate of FAO preserved significantly owing to the induction of PPAR-α. Myocardial high-energy phosphates were significantly preserved by PPAR-α induction. These results suggest that PPAR-α activation during pressure-overloaded heart failure improved myocardial function and energetics. Thus activating PPAR-α and modulation of FAO could be a promising therapeutic strategy for heart failure.NEW & NOTEWORTHY The present study demonstrates the role of PPAR-α activation in the early stage of heart failure using an inducible transgenic mouse model. Induction of PPAR-α preserved heart

  1. Heart Failure Virtual Consultation: bridging the gap of heart failure care in the community ‐ A mixed‐methods evaluation

    PubMed Central

    Gallagher, Joseph; James, Stephanie; Keane, Ciara; Fitzgerald, Annie; Travers, Bronagh; Quigley, Etain; Hecht, Christina; Zhou, Shuaiwei; Watson, Chris; Ledwidge, Mark

    2017-01-01

    Abstract Aims We undertook a mixed‐methods evaluation of a Web‐based conferencing service (virtual consult) between general practitioners (GPs) and cardiologists in managing patients with heart failure in the community to determine its effect on use of specialist heart failure services and acceptability to GPs. Methods and results All cases from June 2015 to October 2016 were recorded using a standardized recording template, which recorded patient demographics, medical history, medications, and outcome of the virtual consult for each case. Quantitative surveys and qualitative interviewing of 17 participating GPs were also undertaken. During this time, 142 cases were discussed—68 relating to a new diagnosis of heart failure, 53 relating to emerging deterioration in a known heart failure patient, and 21 relating to therapeutic issues. Only 17% required review in outpatient department following the virtual consultation. GPs reported increased confidence in heart failure management, a broadening of their knowledge base, and a perception of overall better patient outcomes. Conclusions These data from an initial experience with Heart Failure Virtual Consultation present a very positive impact of this strategy on the provision of heart failure care in the community and acceptability to users. Further research on the implementation and expansion of this strategy is warranted. PMID:28772044

  2. A longitudinal evaluation of blood pressure in children.

    PubMed Central

    Levine, R S; Hennekens, C H; Klein, B; Ferrer, P L; Gourley, J; Cassady, J; Gelband, H; Jesse, M J

    1979-01-01

    Blood pressure levels obtained on two occasions, one year apart, were evaluated among 212 children. An overall correlation of .65 was obtained for systolic pressure and .43 for diastolic pressure. The results suggest that adult levels of correlation are not reached in childhood and that screening programs must consider the relative lability of children's measurements in establishing referral criteria. PMID:507251

  3. Contrasting effects of vasodilators on blood pressure and sodium balance in the hypertension of autonomic failure

    NASA Technical Reports Server (NTRS)

    Jordan, J.; Shannon, J. R.; Pohar, B.; Paranjape, S. Y.; Robertson, D.; Robertson, R. M.; Biaggioni, I.

    1999-01-01

    Supine hypertension, which is very common in patients with autonomic failure, limits the use of pressor agents and induces nighttime natriuresis. In 13 patients with severe orthostatic hypotension due to autonomic failure (7 women, 6 men, 72 +/- 3 yr) and supine hypertension, the effect of 30 mg nifedipine (n = 10) and 0.025 to 0.2 mg/h nitroglycerin patch (n = 11) on supine BP, renal sodium handling, and orthostatic tolerance was determined. Medications were given at 8 p.m.; patients stood up at 8 a.m. Nitroglycerin was removed at 6 a.m. Compared with placebo, nifedipine and nitroglycerin decreased systolic BP during the night by a maximum of 37 +/- 9 and 36 +/- 10 mmHg, respectively (P < 0.01). At 8 a.m., supine systolic BP was 23 +/- 7 mmHg lower with nifedipine than with placebo (P < 0.05), but was similar with nitroglycerin and placebo. Sodium excretion during the night was not reduced with nitroglycerin (0.13 +/- 0.02 mmol/mg creatinine [Cr] versus 0.15 +/- 0.03 mmol/mg Cr with placebo), but it was increased with nifedipine (0.35 +/- 0.06 mmol/mg Cr versus 0.13 +/- 0.02 mmol/mg Cr with placebo, P < 0.05). Nifedipine but not nitroglycerin worsened orthostatic hypotension in the morning. It is concluded that nifedipine and transdermal nitroglycerin are effective in controlling supine hypertension in patients with autonomic failure. However, nifedipine has a prolonged depressor effect and worsens orthostatic hypotension in the morning. The decrease in pressure natriuresis that would be expected with the substantial decrease in BP obtained with nitroglycerin and nifedipine may be offset by a direct effect of both drugs on renal sodium handling.

  4. Noninvasive positive-pressure ventilation to treat hypercapnic coma secondary to respiratory failure.

    PubMed

    Díaz, Gumersindo Gónzalez; Alcaraz, Andres Carrillo; Talavera, Juan Carlos Pardo; Pérez, Pedro Jara; Rodriguez, Antonio Esquinas; Cordoba, Francisco García; Hill, Nicholas S

    2005-03-01

    Hypercapnic coma secondary to acute respiratory failure (ARF) is considered to be a contraindication to the use of treatment with noninvasive positive-pressure ventilation (NPPV). However, intubation exposes these patients to the risk of complications such as nosocomial pneumonia, sepsis, and even death. We performed a prospective, open, noncontrolled study to assess the outcomes of NPPV therapy in patients with a Glasgow coma scale (GCS) score of failure of NPPV therapy in these patients. A total of 76 coma patients (80%) responded to NPPV therapy, and 605 patients with GCS scores > 8 responded to therapy (70%; p = 0.04). A total of 25 coma patients died in the hospital (26.3%), and 287 noncoma patients died in the hospital (33.2%; p = 0.17). The variables related to the success of NPPV therapy were GCS score 1 h posttherapy (odds ratio [OR], 2.32; 95% confidence interval [CI], 1.53 to 3.53) and higher levels of multiorgan dysfunction, as measured by the maximum sequential organ failure assessment index score reached during NPPV therapy (OR, 0.72; 95% CI, 0.55 to 0.92). We concluded that selected patients with hypercapnic coma secondary to ARF can be treated as successfully with NPPV as awake patients with ARF.

  5. Contrasting effects of vasodilators on blood pressure and sodium balance in the hypertension of autonomic failure

    NASA Technical Reports Server (NTRS)

    Jordan, J.; Shannon, J. R.; Pohar, B.; Paranjape, S. Y.; Robertson, D.; Robertson, R. M.; Biaggioni, I.

    1999-01-01

    Supine hypertension, which is very common in patients with autonomic failure, limits the use of pressor agents and induces nighttime natriuresis. In 13 patients with severe orthostatic hypotension due to autonomic failure (7 women, 6 men, 72 +/- 3 yr) and supine hypertension, the effect of 30 mg nifedipine (n = 10) and 0.025 to 0.2 mg/h nitroglycerin patch (n = 11) on supine BP, renal sodium handling, and orthostatic tolerance was determined. Medications were given at 8 p.m.; patients stood up at 8 a.m. Nitroglycerin was removed at 6 a.m. Compared with placebo, nifedipine and nitroglycerin decreased systolic BP during the night by a maximum of 37 +/- 9 and 36 +/- 10 mmHg, respectively (P < 0.01). At 8 a.m., supine systolic BP was 23 +/- 7 mmHg lower with nifedipine than with placebo (P < 0.05), but was similar with nitroglycerin and placebo. Sodium excretion during the night was not reduced with nitroglycerin (0.13 +/- 0.02 mmol/mg creatinine [Cr] versus 0.15 +/- 0.03 mmol/mg Cr with placebo), but it was increased with nifedipine (0.35 +/- 0.06 mmol/mg Cr versus 0.13 +/- 0.02 mmol/mg Cr with placebo, P < 0.05). Nifedipine but not nitroglycerin worsened orthostatic hypotension in the morning. It is concluded that nifedipine and transdermal nitroglycerin are effective in controlling supine hypertension in patients with autonomic failure. However, nifedipine has a prolonged depressor effect and worsens orthostatic hypotension in the morning. The decrease in pressure natriuresis that would be expected with the substantial decrease in BP obtained with nitroglycerin and nifedipine may be offset by a direct effect of both drugs on renal sodium handling.

  6. Prevalence of systolic hypertension in cats with chronic renal failure at initial evaluation.

    PubMed

    Syme, Harriet M; Barber, Penney J; Markwell, Peter J; Elliott, Jonathan

    2002-06-15

    To determine prevalence of systolic hypertension and associated risk factors in cats with chronic renal failure evaluated in first-opinion practice. Prospective study. 103 cats with chronic renal failure. Systolic arterial blood pressure (SABP) was measured with a noninvasive Doppler technique, and cats that had SABP > 175 mm Hg on 2 occasions or that had SABP > 175 mm Hg and compatible ocular lesions were classified as hypertensive. Information from the history (previous treatment for hyperthyroidism, age), physical examination (sex, body weight), routine plasma biochemical analyses (creatinine, cholesterol, potassium, sodium, chloride, and calcium concentrations), and thyroid status were evaluated as potential risk factors for systolic hypertension. Variables associated with systolic hypertension were evaluated by use of logistic regression. 20 (19.4%; 95% confidence interval, 13 to 28%) cats had systolic hypertension. Plasma potassium concentration was significantly and inversely associated with systolic hypertension. Prevalence of systolic hypertension, although clinically important, was lower than that reported previously. The cause of the inverse association between systolic hypertension and plasma potassium concentration is not yet known.

  7. Tissue Doppler Imaging in the Estimation of Intracardiac Filling Pressure in Decompensated Patients with Advanced Systolic Heart Failure

    PubMed Central

    Mullens, Wilfried; Borowski, Allen G; Curtin, Ronan J; Thomas, James D; Tang, W. H. Wilson

    2011-01-01

    Background Early transmitral velocity / tissue Doppler mitral annular early diastolic velocity (E/Ea) has been correlated with pulmonary capillary wedge pressure (PCWP) in a wide variety of cardiac conditions. The objective of this study was to determine the reliability of mitral E/Ea for predicting PCWP in patients admitted for advanced decompensated heart failure (ADHF). Methods and Results Prospective consecutive patients with ADHF (ejection fraction [EF] ≤30%, NYHA class III-IV symptoms) underwent simultaneous echocardiographic and hemodynamic evaluation on admission and after 48 hours of intensive medical therapy. A total of 106 patients were included (mean age 57 ±12 years, EF 24 ±8%, PCWP 21 ±7 mmHg, mitral E/Ea 20 ±12). There was a lack of correlation between mitral E/Ea and PCWP, particularly in those with larger LV volumes, more impaired cardiac indices, and the presence of cardiac resynchronization therapy. Overall, mitral E/Ea was similar among patients with PCWP > and ≤ 18 mmHg, and sensitivity and specificity for mitral E/Ea > 15 to identify a PCWP > 18 mmHg was 66% and 50%, respectively. Contrary to prior reports, we did not observe any direct association between changes in PCWP and changes in mitral E/Ea. Conclusion In decompensated patients with advanced systolic heart failure, tissue Doppler derived mitral E/Ea may not be as reliable in predicting intracardiac filling pressures, particularly in those with larger LV volumes, more impaired cardiac indices, and the presence of cardiac resynchronization therapy. PMID:19075104

  8. An implantable Fabry-Pérot pressure sensor fabricated on left ventricular assist device for heart failure.

    PubMed

    Zhou, Ming-Da; Yang, Chuan; Liu, Zhiwen; Cysyk, Joshua P; Zheng, Si-Yang

    2012-02-01

    Continuous flow left ventricular assist devices (LVADs) are commonly used as bridge-to-transplantation or destination therapy for heart failure patients. However, non-optimal pumping speeds can reduce the efficacy of circulatory support or cause dangerous ventricular arrhythmias. Optimal flow control for continuous flow LVADs has not been defined and calls for an implantable pressure sensor integrated with the LVAD for real-time feedback control of pump speed based on ventricular pressure. A MEMS pressure sensor prototype is designed, fabricated and seamlessly integrated with LVAD to enable real-time control, optimize its performance and reduce its risks. The pressure sensing mechanism is based on Fabry-Pérot interferometer principle. A biocompatible parylene diaphragm with a silicon mirror at the center is fabricated directly on the inlet shell of the LVAD to sense pressure changes. The sensitivity, range and response time of the pressure sensor are measured and validated to meet the requirements of LVAD pressure sensing.

  9. Fundamental study of failure mechanisms of pressure vessels under thermo-mechanical cycling in multiphase environments

    NASA Astrophysics Data System (ADS)

    Penso Mula, Jorge Antonio

    Cracking and bulging in welded and internally lined pressure vessels that work in thermal-mechanical cycling services have been well known problems in the petrochemical, power and nuclear industries. Published literature and industry surveys show that similar problems have been occurring during the last 50 years. Understanding the causes of cracking and bulging would lead to improvements in the reliability of these pressure vessels. This study attempts to add information required for improving the knowledge and fundamental understanding of these problems. Cracking and bulging, most often in the weld areas, commonly experienced in delayed coking units (e.g. coke drums) in oil refineries are typical examples. The coke drum was selected for this study because of the existing field experience and past industrial investigation results that were available to serve as the baseline references for the analytical studies performed for this dissertation. Another reason for selecting the delayed coking units for this study was due to their high economical yields. Shutting down these units would cause a high negative economic impact on the refinery operations. Several failure mechanisms were hypothesized. The finite element method was used to analyze these significant variables and to verify the hypotheses. In conclusion, a fundamental explanation of the occurrence of bulging and cracking in pressure vessels in multiphase environments has been developed. Several important factors have been identified, including the high convection coefficient of the boiling layer during filling and quenching, the mismatch in physical, thermal and mechanical properties in the dissimilar weld of the clad plates and process conditions such as heating and quenching rate and warming time. Material selection for coke drums should consider not only fatigue strength but also corrosion resistance at high temperatures and low temperatures. Cracking occurs due to low cycle fatigue and corrosion. The FEA

  10. Optical zero-differential pressure switch and its evaluation in a multiple pressure measuring system

    NASA Technical Reports Server (NTRS)

    Powell, J. A.

    1977-01-01

    The design of a clamped-diaphragm pressure switch is described in which diaphragm motion is detected by a simple fiber-optic displacement sensor. The switch was evaluated in a pressure measurement system where it detected the zero crossing of the differential pressure between a static test pressure and a tank pressure that was periodically ramped from near zero to fullscale gage pressure. With a ramping frequency of 1 hertz and a full-scale tank pressure of 69 N/sq cm gage (100 psig), the switch delay was as long as 2 milliseconds. Pressure measurement accuracies were 0.25 to 0.75 percent of full scale. Factors affecting switch performance are also discussed.

  11. Pressure ulcers management: an economic evaluation.

    PubMed

    Foglia, E; Restelli, U; Napoletano, A M; Coclite, D; Porazzi, E; Bonfanti, M; Croce, D

    2012-03-01

    Pressure ulcer management represents a growing problem for medical and social health care systems all over the world, particularly in European Union countries where the incidence of pressure ulcers in older persons (> 60 years of age) is predicted to rise. The aim of this study was to provide evidence for the lower impact on economic resources of using advanced dressings for the treatment of pressure ulcers with respect to conventional simple dressings. Two different models of analysis, derived from Activity Based Costing and Health Technology Assessment, were used to measure, over a 30-day period, the direct costs incurred by pressure ulcer treatment for community-residing patients receiving integrated home care. Although the mean cost per home care visit was higher in the advanced dressings patient group than in the simple dressings patient one (E 22.31 versus E 16.03), analysis of the data revealed that the cost of using advanced dressings was lower due to fewer home care visits (22 versus 11). The results underline the fact that decision-makers need to improve their understanding of the advantages of taking a long-term view with regards to the purchase and use of materials. This could produce considerable savings of resources in addition to improving treatment efficacy for the benefit of patients and the health care system.

  12. Benchtop evaluation of pressure barrier insufflator and standard insufflator systems.

    PubMed

    Nepple, Kenneth G; Kallogjeri, Dorina; Bhayani, Sam B

    2013-01-01

    Previous experimental research has reported minimal differences in pressure maintenance between different versions of standard insufflators (SI). However, a recent report identified potential clinical benefits with a valveless pressure barrier insufflator (PBI). We sought to perform a benchtop objective evaluation of SI and PBI systems. A rigid box system with continuous pressure manometry was used to evaluate a PBI (Surgiquest Airseal) and two SIs (SI1 = Stryker PneumoSure High Flow Insufflator and SI2 = Storz SCB Thermoflator). Pressure maintenance of 15 mmHg was evaluated during experimental conditions of leakage from a 5 mm port site, leakage from a 12 mm port site, and continuous suction. With leakage from the 5 mm port site, the PBI maintained pressure of >13 mmHg whereas the pressures dropped moderately with the SI1 (7-13 mmHg) and SI2 insufflators (3-7 mmHg) and did not regain goal pressure until leakage was stopped. With leakage from 12 mm port site, the PBI pressure decreased to 9-11 mmHg, whereas the SI1 and SI2 lost insufflation pressures completely. The PBI maintained pressure of >11 mmHg during continuous suction while the SI1 and SI2 lost pressure entirely, and actually showed negative pressure from air suction into the rigid box system. When evaluated statistically with the mixed model repeated measures ANOVA, the SI1 and SI2 performed similarly while the PBI maintained increased pressure. In the experimental rigid box system, the PBI more successfully maintained pressure in response to leakage and suction than SIs.

  13. Noninvasive Positive Pressure Ventilation for Acute Respiratory Failure Patients With Chronic Obstructive Pulmonary Disease (COPD)

    PubMed Central

    McCurdy, BR

    2012-01-01

    Executive Summary In July 2010, the Medical Advisory Secretariat (MAS) began work on a Chronic Obstructive Pulmonary Disease (COPD) evidentiary framework, an evidence-based review of the literature surrounding treatment strategies for patients with COPD. This project emerged from a request by the Health System Strategy Division of the Ministry of Health and Long-Term Care that MAS provide them with an evidentiary platform on the effectiveness and cost-effectiveness of COPD interventions. After an initial review of health technology assessments and systematic reviews of COPD literature, and consultation with experts, MAS identified the following topics for analysis: vaccinations (influenza and pneumococcal), smoking cessation, multidisciplinary care, pulmonary rehabilitation, long-term oxygen therapy, noninvasive positive pressure ventilation for acute and chronic respiratory failure, hospital-at-home for acute exacerbations of COPD, and telehealth (including telemonitoring and telephone support). Evidence-based analyses were prepared for each of these topics. For each technology, an economic analysis was also completed where appropriate. In addition, a review of the qualitative literature on patient, caregiver, and provider perspectives on living and dying with COPD was conducted, as were reviews of the qualitative literature on each of the technologies included in these analyses. The Chronic Obstructive Pulmonary Disease Mega-Analysis series is made up of the following reports, which can be publicly accessed at the MAS website at: http://www.hqontario.ca/en/mas/mas_ohtas_mn.html. Chronic Obstructive Pulmonary Disease (COPD) Evidentiary Framework Influenza and Pneumococcal Vaccinations for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Smoking Cessation for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Community-Based Multidisciplinary Care for Patients With Stable Chronic Obstructive

  14. The use of thermal manikin to evaluate interface pressure distribution.

    PubMed

    Ciaccia, Flavia Renata Dantas Alves Silva; Gonçalves, Clenilson Jordão; Sznelwar, Laerte Idal

    2012-01-01

    The use of a thermal buttocks manikin was explored as a tool to standardize the evaluation of seat comfort. Thermal manikin buttocks were developed and calibrated thermally and anatomically to simulate the sensible heat transfer of a seated person and used to evaluate interface pressure distribution. In essence, the pressure maps of manikin buttocks with and without heating were compared to those of a seated person. The results of average pressure demonstrated that the thermal manikins have a better response in interface pressure measurement than manikins without heating.

  15. Influence of Titration of Neurohormonal Antagonists and Blood Pressure Reduction on Renal Function and Decongestion in Decompensated Heart Failure

    PubMed Central

    Wilson, F. Perry; Brisco, Meredith A.; Bellumkonda, Lavanya; Jacoby, Daniel; Coca, Steven G.; Parikh, Chirag R.; Tang, W.H. Wilson; Testani, Jeffrey M.

    2015-01-01

    Background Reduction in systolic blood pressure (SBP reduction) during the treatment of acute decompensated heart failure (ADHF) is strongly and independently associated with worsening renal function (WRF). Our objective was to determine if SBP reduction or titration of oral neurohormonal antagonists during ADHF treatment negatively influences diuresis and decongestion. Methods and Results SBP reduction was evaluated from admission to discharge in consecutive ADHF admissions (n=656). Diuresis and decongestion was examined across a range of parameters such as diuretic efficiency, fluid output, hemoconcentration, and diuretic dose. The average reduction in SBP was 14.4 ± 19.4 mmHg and 77.6% of the population had discharge SBP lower than admission. SBP reduction was strongly associated with WRF (OR=1.9, 95% CI: 1.2-2.9, p=0.004), a finding that persisted after adjusting for parameters of diuresis and decongestion (OR=2.0, 95% CI: 1.3-3.2, p=0.002). However, SBP reduction did not negatively impact diuresis or decongestion (p≥0.25 for all parameters). Uptitration of neurohormonal antagonists occurred in over 50% of admissions and was associated with a modest additional reduction in blood pressure (≤ 5.6 mmHg). Notably, WRF was not increased and diuretic efficiency was significantly improved with the uptitration of neurohormonal antagonists. Conclusions Despite a higher rate of WRF, blood pressure reduction was not associated with worsening of diuresis or decongestion. Furthermore, titration of oral neurohormonal antagonists was actually associated with improved diuresis in this cohort. These results provide reassurance that the guideline recommended titration of chronic oral medication during ADHF hospitalization may not be antagonistic to the short-term goal of decongestion. PMID:26699390

  16. Evaluation of gastric pressures as an indirect method for measurement of intraabdominal pressures in the horse.

    PubMed

    Munsterman, Amelia S; Hanson, Russell Reid

    2011-02-01

    To develop an indirect method for measurement of intraabdominal pressures in the standing horse using measurement of gastric pressures as a less invasive technique, and to compare this method with direct intraabdominal pressures obtained from the peritoneal cavity. Prospective, experimental study. University-based equine research facility. Ten healthy adult horses, 7 geldings and 3 mares. Gastric pressures were measured using a nasogastric tube with a U-tube manometry technique, while intraperitoneal pressures were measured with a peritoneal cannula. Measurements of intraabdominal pressure were obtained by both methods, simultaneously, and were evaluated using 5 increasing volumes of fluid infused into the stomach (0, 400, 1,000, 2,000, and 3,000 mL). Bias and agreement between the 2 methods were determined using Bland-Altman analysis and Lin's concordance correlation coefficients. Mean gastric pressure was 14.44 ± 4.69 cm H(2)O and ranged from 0 to 25.8 cm H(2)O. Intraperitoneal pressure measurements were generally subatmospheric, and ranged from -6.6 to 3.1 cm H(2) O (mean ± SD, -1.59 ± 2.09 cm H(2)O). Measurements of intraperitoneal pressures were repeatable; however, intra- and interindividual variance was significantly larger for measurements of gastric pressures. The mean and relative bias for comparison between the 2 techniques was 15.9 ± 5.3 cm H(2)O and 244.3 ± 199.2%, respectively. The Lin's concordance correlation coefficient between gastric and intraperitoneal pressures was -0.003 but this was not statistically significant (P=0.75). There was no statistical concordance between measurements of intraabdominal pressure using gastric and intraperitoneal pressure measurement, indicating that gastric pressures cannot be substituted for intraperitoneal pressure measurement. Direct measurement of intraperitoneal pressures may be a more consistent method for comparison of intraabdominal pressures between horses, due to less variability within and between

  17. Evaluation of failure criterion for graphite/epoxy fabric laminates

    NASA Technical Reports Server (NTRS)

    Tennyson, R. C.; Wharram, G. E.

    1985-01-01

    The development and application of the tensor polynomial failure criterion for composite laminate analysis is described. Emphasis is given to the fabrication and testing of Narmco Rigidite 5208-WT300, a plain weave fabric of Thornel 300 Graphite fibers impregnated with Narmco 5208 Resin. The quadratic-failure criterion with F sub 12=0 provides accurate estimates of failure stresses for the graphite/epoxy investigated. The cubic failure criterion was recast into an operationally easier form, providing design curves that can be applied to laminates fabricated from orthotropic woven fabric prepregs. In the form presented, no interaction strength tests are required, although recourse to the quadratic model and the principal strength parameters is necessary. However, insufficient test data exist at present to generalize this approach for all prepreg constructions, and its use must be restricted to the generic materials and configurations investigated to date.

  18. Negative Pressure Artificial Respiration: Use in Treatment of Respiratory Failure of the Newborn

    PubMed Central

    Stern, Leo; Ramos, Angeles D.; Outerbridge, Eugene W.; Beaudry, Pierre H.

    1970-01-01

    Ninety-one infants with respiratory failure secondary to primary pulmonary disease and with a birth weight of 1000 g. or over have been managed in a negative-pressure respirator (Air-Shields) over a three-year period. Of these the failure in 87 was due to respiratory distress syndrome (RDS) and in four it resulted from massive meconium aspiration. Respiratory failure was indicated initially by arterial blood gas tensions (while breathing 100% O2) of Po2 <40 mm. Hg, pH <7.10 and Pco2 >75 mm. Hg in the initial 47 cases; these levels were subsequently raised to Po2 < 50 mm. Hg, pH <7.20 and Pco2 >70 mm. Hg for the remainder. Fifty-four (59.3%) of the infants survived the use of the respirator and 47 of these (51.6%) were subsequently discharged alive and well. Mean time in hours to normalization of blood gas values while on the respirator were as follows: for Po2, 10.5; for pH, 11.6; and for Pco2, 22.6. These values indicate that the respirator is more efficient in promoting oxygenation (raising Po2) than ventilation (lowering Pco2). They also suggest that the observed acidosis is in large part secondary to the hypoxia rather than the result of co2 retention. For the survivors the average time of total respirator dependency before commencement of weaning was 53.7 hours. All the infants were managed without the use of endotracheal tubes although the use of the respirator and/or administration of 100% oxygen were either continuous or intermittent for periods of up to two weeks. There have been no instances of so-called respirator lung disease in the survivors or in those who died, which suggests that the use of high oxygen concentration by itself is not the major factor in the pathogenesis of this complication. ImagesFIG. 1FIG. 3FIG. 4 PMID:5265797

  19. Congestive kidney failure in cardiac surgery: the relationship between central venous pressure and acute kidney injury.

    PubMed

    Gambardella, Ivancarmine; Gaudino, Mario; Ronco, Claudio; Lau, Christopher; Ivascu, Natalia; Girardi, Leonard N

    2016-11-01

    Acute kidney injury (AKI) in cardiac surgery has traditionally been linked to reduced arterial perfusion. There is ongoing evidence that central venous pressure (CVP) has a pivotal role in precipitating acute renal dysfunction in cardiac medical and surgical settings. We can regard this AKI driven by systemic venous hypertension as 'kidney congestive failure'. In the cardiac surgery population as a whole, when the CVP value reaches the threshold of 14 mmHg in postoperative period, the risk of AKI increases 2-fold with an odds ratio (OR) of 1.99, 95% confidence interval (95% CI) of 1.16-3.40. In cardiac surgery subsets where venous hypertension is a hallmark feature, the incidence of AKI is higher (tricuspid disease 30%, carcinoid valve disease 22%). Even in the non-chronically congested coronary artery bypass population, CVP measured 6 h postoperatively showed significant association to renal failure: risk-adjusted OR for AKI was 5.5 (95% CI 1.93-15.5; P = 0.001) with every 5 mmHg rise in CVP for patients with CVP <9 mmHg; for CVP increments of 5 mmHg above the threshold of 9 mmHg, the risk-adjusted OR for AKI was 1.3 (95% CI 1.01-1.65; P = 0.045). This and other clinical evidence are discussed along with the underlying pathophysiological mechanisms, involving the supremacy of volume receptors in regulating the autonomic output in hypervolaemia, and the regional effect of venous congestion on the nephron. The effect of CVP on renal function was found to be modulated by ventricular function class, aetiology and acuity of venous congestion. Evidence suggests that acute increases of CVP should be actively treated to avoid a deterioration of the renal function, particularly in patients with poor ventricular fraction. Besides, the practice of treating right heart failure with fluid loading should be avoided in favour of other ways to optimize haemodynamics in this setting, because of the detrimental effects on the kidney function.

  20. Electrophysiologic remodeling of the left ventricle in pressure overload-induced right ventricular failure.

    PubMed

    Hardziyenka, Maxim; Campian, Maria E; Verkerk, Arie O; Surie, Sulaiman; van Ginneken, Antoni C G; Hakim, Sara; Linnenbank, André C; de Bruin-Bon, H A C M Rianne; Beekman, Leander; van der Plas, Mart N; Remme, Carol A; van Veen, Toon A B; Bresser, Paul; de Bakker, Jacques M T; Tan, Hanno L

    2012-06-12

    The purpose of this study was to analyze the electrophysiologic remodeling of the atrophic left ventricle (LV) in right ventricular (RV) failure (RVF) after RV pressure overload. The LV in pressure-induced RVF develops dysfunction, reduction in mass, and altered gene expression, due to atrophic remodeling. LV atrophy is associated with electrophysiologic remodeling. We conducted epicardial mapping in Langendorff-perfused hearts, patch-clamp studies, gene expression studies, and protein level studies of the LV in rats with pressure-induced RVF (monocrotaline [MCT] injection, n = 25; controls with saline injection, n = 18). We also performed epicardial mapping of the LV in patients with RVF after chronic thromboembolic pulmonary hypertension (CTEPH) (RVF, n = 10; no RVF, n = 16). The LV of rats with MCT-induced RVF exhibited electrophysiologic remodeling: longer action potentials (APs) at 90% repolarization and effective refractory periods (ERPs) (60 ± 1 ms vs. 44 ± 1 ms; p < 0.001), and slower longitudinal conduction velocity (62 ± 2 cm/s vs. 70 ± 1 cm/s; p = 0.003). AP/ERP prolongation agreed with reduced Kcnip2 expression, which encodes the repolarizing potassium channel subunit KChIP2 (0.07 ± 0.01 vs. 0.11 ± 0.02; p < 0.05). Conduction slowing was not explained by impaired impulse formation, as AP maximum upstroke velocity, whole-cell sodium current magnitude/properties, and mRNA levels of Scn5a were unaltered. Instead, impulse transmission in RVF was hampered by reduction in cell length (111.6 ± 0.7 μm vs. 122.0 ± 0.4 μm; p = 0.02) and width (21.9 ± 0.2 μm vs. 25.3 ± 0.3 μm; p = 0.002), and impaired cell-to-cell impulse transmission (24% reduction in Connexin-43 levels). The LV of patients with CTEPH with RVF also exhibited ERP prolongation (306 ± 8 ms vs. 268 ± 5 ms; p = 0.001) and conduction slowing (53 ± 3 cm/s vs. 64 ± 3 cm/s; p = 0.005). Pressure-induced RVF is associated with electrophysiologic remodeling of the atrophic LV. Copyright

  1. Studies and analyses of the space shuttle main engine: High-pressure oxidizer turbopump failure information propagation model

    NASA Technical Reports Server (NTRS)

    Glover, R. C.; Rudy, S. W.; Tischer, A. E.

    1987-01-01

    The high-pressure oxidizer turbopump (HPOTP) failure information propagation model (FIPM) is presented. The text includes a brief discussion of the FIPM methodology and the various elements which comprise a model. Specific details of the HPOTP FIPM are described. Listings of all the HPOTP data records are included as appendices.

  2. Left atrial longitudinal strain by speckle tracking echocardiography correlates well with left ventricular filling pressures in patients with heart failure

    PubMed Central

    2010-01-01

    Background The combination of early transmitral inflow velocity and mitral annular tissue Doppler imaging (E/Em ratio) is widely applied to noninvasively estimate left ventricular (LV) filling pressures. However E/Em ratio has a significant gray zone and its accuracy in patients with heart failure is debated. Left atrial (LA) deformation analysis by speckle tracking echocardiography (STE) was recently proposed as an alternative approach to estimate LV filling pressures. This study aimed at exploring the correlation of LA longitudinal function by STE and Doppler measurements with direct measurements of LV filling pressures in patients with heart failure. Methods A total of 36 patients with advanced systolic heart failure (ejection fraction ≤35%), undergoing right heart catheterization, were studied. Simultaneously to pulmonary capillary wedge pressure (PCWP) determination, peak atrial longitudinal strain (PALS) and mean E/Em ratio were measured in all subjects by two independent operators. PALS values were obtained by averaging all segments (global PALS), and by separately averaging segments measured in the 4-chamber and 2-chamber views. Results Not significant correlation was found between mean E/Em ratio and PCWP (R = 0.15). A close negative correlation between global PALS and the PCWP was found (R = -0.81, p < 0.0001). Furthermore, global PALS demonstrated the highest diagnostic accuracy (AUC of 0.93) and excellent sensitivity and specificity of 100% and 93%, respectively, to predict elevated filling pressure using a cutoff value less than 15.1%. Bland-Altman analysis confirmed this close agreement between PCWP estimated by global PALS and invasive PCWP (mean bias 0.1 ± 8.0 mmHg). Conclusion In a group of patients with advanced systolic heart failure, E/Em ratio correlated poorly with invasively obtained LV filling pressures. However, LA longitudinal deformation analysis by STE correlated well with PCWP, providing a better estimation of LV filling pressures in

  3. In vitro evaluation of the method effectiveness to limit inflation pressure cuffs of endotracheal tubes.

    PubMed

    Coelho, Rafael de Macedo; de Paiva, Thiago Trigueiro Morais; da Silva Telles Mathias, Ligia Andrade

    2016-01-01

    Cuffs of tracheal tubes protect the lower airway from aspiration of gastric contents and facilitate ventilation, but may cause many complications, especially when the cuff pressure exceeds 30cm H2O. This occurs in over 30% of conventional insufflations, so it is recommended to limit this pressure. In this study we evaluated the in vitro effectiveness of a method of limiting the cuff pressure to a range between 20 and 30cm H2O. Using an adapter to connect the tested tube to the anesthesia machine, the relief valve was regulated to 30cm H2O, inflating the cuff by operating the rapid flow of oxygen button. There were 33 trials for each tube of three manufacturers, of five sizes (6.5-8.5), using three times inflation (10, 15 and 20s), totaling 1485 tests. After inflation, the pressure obtained was measured with a manometer. Pressure >30cm H2O or <20cm H2O were considered failures. There were eight failures (0.5%, 95% CI: 0.1-0.9%), with all by pressures <20cm H2O and after 10s inflation (1.6%, 95% CI: 0 5-2.7%). One failure occurred with a 6.5 tube (0.3%, 95% CI: -0.3 to 0.9%), six with 7.0 tubes (2%, 95% CI: 0.4-3.6%), and one with a 7.5 tube (0.3%, 95% CI: -0.3 to 0.9%). This method was effective for inflating tracheal tube cuffs of different sizes and manufacturers, limiting its pressure to a range between 20 and 30cm H2O, with a success rate of 99.5% (95% CI: 99.1-99.9%). Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  4. 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

  5. Pressurized thermal shock evaluation of the Calvert Cliffs Unit 1 Nuclear Power Plant

    SciTech Connect

    Abbott, L

    1985-09-01

    An evaluation of the risk to the Calvert Cliffs Unit 1 nuclear power plant due to pressurized thermal shock (PTS) has been completed by Oak Ridge National Laboratory (ORNL) with the assistance of several other organizations. This evaluation was part of a Nuclear Regulatory Commission program designed to study the PTS risk to three nuclear plants, the other two plants being Oconee Unit 1 and H.B. Robinson Unit 2. The specific objectives of the program were to (1) provide a best estimate of the frequency of a through-the-wall crack in the pressure vessel at each of the three plants, together with the uncertainty in the estimated frequency and its sensitivity to the variables used in the evaluation; (2) determine the dominant overcooling sequences contributing to the estimated frequency and the associated failures in the plant systems or in operator actions; and (3) evaluate the effectiveness of potential corrective measures.

  6. Reliability Evaluation of Machine Center Components Based on Cascading Failure Analysis

    NASA Astrophysics Data System (ADS)

    Zhang, Ying-Zhi; Liu, Jin-Tong; Shen, Gui-Xiang; Long, Zhe; Sun, Shu-Guang

    2017-07-01

    In order to rectify the problems that the component reliability model exhibits deviation, and the evaluation result is low due to the overlook of failure propagation in traditional reliability evaluation of machine center components, a new reliability evaluation method based on cascading failure analysis and the failure influenced degree assessment is proposed. A direct graph model of cascading failure among components is established according to cascading failure mechanism analysis and graph theory. The failure influenced degrees of the system components are assessed by the adjacency matrix and its transposition, combined with the Pagerank algorithm. Based on the comprehensive failure probability function and total probability formula, the inherent failure probability function is determined to realize the reliability evaluation of the system components. Finally, the method is applied to a machine center, it shows the following: 1) The reliability evaluation values of the proposed method are at least 2.5% higher than those of the traditional method; 2) The difference between the comprehensive and inherent reliability of the system component presents a positive correlation with the failure influenced degree of the system component, which provides a theoretical basis for reliability allocation of machine center system.

  7. High-Pressure Oxygen Test Evaluations

    NASA Technical Reports Server (NTRS)

    Schwinghamer, R. J.; Key, C. F.

    1974-01-01

    The relevance of impact sensitivity testing to the development of the space shuttle main engine is discussed in the light of the special requirements for the engine. The background and history of the evolution of liquid and gaseous oxygen testing techniques and philosophy is discussed also. The parameters critical to reliable testing are treated in considerable detail, and test apparatus and procedures are described and discussed. Materials threshold sensitivity determination procedures are considered and a decision logic diagram for sensitivity threshold determination was plotted. Finally, high-pressure materials sensitivity test data are given for selected metallic and nonmetallic materials.

  8. Evaluation of the Hepa Wash® treatment in pigs with acute liver failure

    PubMed Central

    2013-01-01

    Background Mortality of patients with acute liver failure (ALF) is still unacceptably high. Available liver support systems are still of limited success at improving survival. A new type of albumin dialysis, the Hepa Wash® system, was newly introduced. We evaluated the new liver support system as well as the Molecular Adsorbent Recycling System (MARS) in an ischemic porcine model of ALF. Methods In the first study animals were randomly allocated to control (n=5) and Hepa Wash (n=6) groups. In a further pilot study, two animals were treated with the MARS-system. All animals received the same medical and surgical procedures. An intraparenchymal intracranial pressure was inserted. Hemodynamic monitoring and goal-directed fluid therapy using the PiCCO system was done. Animals underwent functional end-to-side portacaval shunt and ligation of hepatic arteries. Treatment with albumin dialysis was started after fall of cerebral perfusion pressure to 45 mmHg and continued for 8 h. Results All animals in the Hepa Wash group survived the 13-hour observation period, except for one that died after stopping treatment. Four of the control animals died within this period (p=0.03). Hepa Wash significantly reduced impairment of cerebral perfusion pressure (23±2 vs. 10±3 mmHg, p=0.006) and mean arterial pressure (37±1 vs. 24±2 mmHg, p=0.006) but had no effect on intracranial pressure (14±1 vs. 15±1 mmHg, p=0.72). Hepa Wash also enhanced cardiac index (4.94±0.32 vs. 3.36±0.25 l/min/m2, p=0.006) and renal function (urine production, 1850 ± 570 vs. 420 ± 180 ml, p=0.045) and eliminated water soluble (creatinine, 1.3±0.2 vs. 3.2±0.3 mg/dl, p=0.01; ammonia 562±124 vs. 1382±92 μg/dl, p=0.006) and protein-bound toxins (nitrate/nitrite 5.54±1.57 vs. 49.82±13.27 μmol/l, p=0.01). No adverse events that could be attributed to the Hepa Wash treatment were observed. Conclusions Hepa Wash was a safe procedure and improved multiorgan system failure in pigs with ALF. The survival

  9. Holographic and acoustic emission evaluation of pressure vessels

    SciTech Connect

    Boyd, D.M.

    1980-03-05

    Optical holographic interfereometry and acoustic emission monitoring were simultaneously used to evaluate two small, high pressure vessels during pressurization. The techniques provide pressure vessel designers with both quantitative information such as displacement/strain measurements and qualitative information such as flaw detection. The data from the holographic interferograms were analyzed for strain profiles. The acoustic emission signals were monitored for crack growth and vessel quality.

  10. Expert Performance and Time Pressure: Implications for Automation Failures in Aviation

    DTIC Science & Technology

    2016-09-30

    generally increases air travel safety and efficiency, sudden automation failures have produced tragic results. Automation failure can require a...generally increases air travel safety and efficiency, sudden automation failures have produced tragic results. Automation failure can require a...pilot. One aspect of expert performance in both domains would be well-developed pattern recognition (e.g., Burns, 2004; Gobet & Simon , 1996; Kaber

  11. Ratio of Systolic Blood Pressure to Right Atrial Pressure, a Novel Marker to Predict Morbidity and Mortality in Acute Systolic Heart Failure.

    PubMed

    Omar, Hesham R; Charnigo, Richard; Guglin, Maya

    2017-04-01

    Congestion is the main contributor to heart failure (HF) morbidity and mortality. We assessed the combined role of congestion and decreased forward flow in predicting morbidity and mortality in acute systolic HF. The Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness trial data set was used to determine if the ratio of simultaneously measured systolic blood pressure (SBP)/right atrial pressure (RAP) on admission predicted HF rehospitalization and 6-month mortality. One hundred ninety-five patients (mean age 56.5 years, 75% men) who received pulmonary artery catheterization were studied. The RAP, SBP, and SBP/RAP had an area under the curve (AUC) of 0.593 (p = 0.0205), 0.585 (p = 0.0359), and 0.621 (p = 0.0026), respectively, in predicting HF rehospitalization. The SBP/RAP was a superior marker of HF rehospitalization compared with RAP alone (difference in AUC 0.0289, p = 0.0385). The optimal criterion of SBP/RAP <11 provided the highest combined sensitivity (77.1%) and specificity (50.9%) in predicting HF rehospitalization. The SBP/RAP had an AUC 0.622, p = 0.0108, and a cut-off value of SBP/RAP <8 had a sensitivity of 61.9% and specificity 64.1% in predicting mortality. Multivariate analysis showed that an SBP/RAP <11 independently predicted rehospitalization for HF (estimated odds ratio 3.318, 95% confidence interval 1.692 to 6.506, p = 0.0005) and an SBP/RAP <8 independently predicted mortality (estimated hazard ratio 2.025, 95% confidence interval 1.069 to 3.833, p = 0.030). In conclusion, SBP/RAP ratio is a marker that identifies a spectrum of complications after hospitalization of patients with decompensated systolic HF, starting with increased incidence of HF rehospitalization at SBP/RAP <11 to increased mortality with SBP/RAP <8.

  12. Elastic geobarometry and the role of brittle failure on pressure release

    NASA Astrophysics Data System (ADS)

    Mazzucchelli, Mattia Luca; Angel, Ross John; Rustioni, Greta; Milani, Sula; Nimis, Paolo; Chiara Domeneghetti, Maria; Marone, Federica; Harris, Jeff W.; Nestola, Fabrizio; Alvaro, Matteo

    2016-04-01

    Mineral inclusions trapped in their hosts can provide fundamental information about geological processes. Recent developments in elastic geobarometry, for example, allow the retrieval of encapsulation pressures for host-inclusion pairs. In principle this method can be applied to any mineral-mineral pair so long as both the residual pressure on an inclusion (Pinc), and the equations of state for both host and inclusion are either known or determined (Angel et al., 2015). However, Angel et al. (2014) outlined some boundary conditions, one of which was that deformation in the host-inclusion pair has to be purely elastic. Thus this caveat would exclude from analysis all the inclusions that are surrounded by cracks, indicative of brittle deformation, which may result in partial or complete release of the Pinc. If however the effects of cracks surrounding trapped mineral inclusions could be quantitatively modelled, then the applicability of "elastic" geobarometry might be extended to a much larger number of inclusion-host pairs. We report the results of a pilot experiment in which the stress states (i.e. the residual pressure) have been determined for 10 olivine inclusions still entrapped in 5 diamonds. Inclusion pressures were determined from the unit-cell volumes of the olivines measured in-situ in the diamonds by X-ray diffraction. The olivine equations of state were determined from the olivine compositions by in-situ X-ray structure refinement. Values of Pinc range from 0.19 to 0.53 GPa. In order to quantify the degree of brittle failure surrounding the inclusions, the same set of samples were also investigated by synchrotron X-ray micro-tomography (SRXTM at TOMCAT, Swiss LightSource). Preliminary results showed that at the spatial resolution of our experiments (pixel size of 0.34μm), 90% of the inclusions trapped in our set of diamonds were surrounded by cracks. The volume of the cracks has been determined from 3D reconstruction with an accuracy of about 4%. Our

  13. Chronic elevation of pulmonary microvascular pressure in chronic heart failure reduces bi-directional pulmonary fluid flux.

    PubMed

    Dixon, Dani-Louise; Mayne, George C; Griggs, Kim M; De Pasquale, Carmine G; Bersten, Andrew D

    2013-04-01

    Chronic heart failure leads to pulmonary vascular remodelling and thickening of the alveolar-capillary barrier. We examined whether this protective effect may slow resolution of pulmonary oedema consistent with decreased bi-directional fluid flux. Seven weeks following left coronary artery ligation, we measured both fluid flux during an acute rise in left atrial pressure (n = 29) and intrinsic alveolar fluid clearance (n = 45) in the isolated rat lung. Chronic elevation of pulmonary microvascular pressure prevented pulmonary oedema and decreased lung compliance when left atrial pressure was raised to 20 cmH2O, and was associated with reduced expression of endothelial aquaporin 1 (P = 0.03). However, no other changes were found in mediators of fluid flux or cellular fluid channels. In isolated rat lungs, chronic LV dysfunction (LV end-diastolic pressure and infarct circumference) was also inversely related to alveolar fluid clearance (P ≤ 0.001). The rate of pulmonary oedema reabsorption was estimated by plasma volume expansion in eight patients with a previous clinical history of chronic heart failure and eight without, who presented with acute pulmonary oedema. Plasma volume expansion was reduced at 24 h in those with chronic heart failure (P = 0.03). Chronic elevation of pulmonary microvascular pressure in CHF leads to decreased intrinsic bi-directional fluid flux at the alveolar-capillary barrier. This adaptive response defends against alveolar flooding, but may delay resolution of alveolar oedema.

  14. Evaluation of a Linear Cumulative Damage Failure Model for Epoxy Adhesive

    NASA Technical Reports Server (NTRS)

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

    2001-01-01

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

  15. Histone Deacetylase Inhibitor Phenylbutyrate Exaggerates Heart Failure in Pressure Overloaded Mice independently of HDAC inhibition

    PubMed Central

    Ma, Jing; Luo, Tao; Zeng, Zhi; Fu, Haiying; Asano, Yoshihiro; Liao, Yulin; Minamino, Tetsuo; Kitakaze, Masafumi

    2016-01-01

    4-Sodium phenylbutyrate (PBA) has been reported to inhibit endoplasmic reticulum stress and histone deacetylation (HDAC), both of which are novel therapeutic targets for cardiac hypertrophy and heart failure. However, it is unclear whether PBA can improve heart function. Here, we tested the effects of PBA and some other HDAC inhibitors on cardiac dysfunction induced by pressure overload. Transverse aortic constriction (TAC) was performed on male C57BL/6 mice. PBA treatment (100 mg/kg, 6 weeks) unexpectedly led to a higher mortality, exacerbated cardiac remodelling and dysfunction. Similar results were noted in TAC mice treated with butyrate sodium (BS), a PBA analogue. In contrast, other HDAC inhibitors, valproic acid (VAL) and trichostatin A (TSA), improved the survival. All four HDAC inhibitors induced histone H3 acetylation and inhibited HDAC total activity. An individual HDAC activity assay showed that rather than class IIa members (HDAC4 and 7), PBA and BS predominantly inhibited class I members (HDAC2 and 8), whereas VAL and TSA inhibited all of them. These findings indicate that PBA and BS accelerate cardiac hypertrophy and dysfunction, whereas VAL and TSA have opposing effects. PMID:27667442

  16. Protective effect of resveratrol against pressure overload-induced heart failure

    PubMed Central

    Gupta, Prakash K; DiPette, Donald J; Supowit, Scott C

    2014-01-01

    Transverse aortic constriction (TAC)-induced pressure overload (PO) causes adverse cardiac remodeling and dysfunction that progresses to heart failure (HF). The purpose of this study was to determine whether the potent antioxidant, resveratrol, significantly attenuates PO-induced HF in wild-type mice. Male C57BL6 mice were subjected to either sham or TAC surgery. One group of TAC mice was given daily resveratrol treatment. Echocardiographic, biometric, and immunohistological analyses were performed on the three groups of mice. All echocardiographic parameters demonstrated significantly greater adverse cardiac remodeling and dysfunction in the TAC compared to the sham mice. Increases in the ratios of heart weight (HW)/body weight (BW) and lung weight (LW)/BW and a sharp decline in the percentage of ejection fraction and fractional shortening were found in TAC relative to sham mice. Likewise, the TAC protocol increased markers of oxidative stress, cardiac hypertrophy, inflammation, fibrosis, hypoxia, and apoptosis. These pathological changes were significantly attenuated by resveratrol treatment. Resveratrol treatment significantly attenuates the adverse cardiac remodeling and dysfunction produced by the TAC protocol in C57/BL6 mice and this activity is mediated, at least in part, by the inhibition of oxidative stress and inflammation indicating a therapeutic potential of resveratrol in HF. PMID:24936291

  17. Thin-metal lined PRD 49-III composite vessels. [evaluation of pressure vessels for burst strength and fatigue performance

    NASA Technical Reports Server (NTRS)

    Hoggatt, J. T.

    1974-01-01

    Filament wound pressure vessels of various configurations were evaluated for burst strength and fatigue performance. The dimensions and characteristics of the vessels are described. The types of tests conducted are explained. It was determined that all vessels leaked in a relatively few cycles (20 to 60 cycles) with failure occurring in all cases in the metallic liner. The thin liner would de-bond from the composite and buckling took place during depressurization. No composite failures or indications of impeding composite failures were obtained in the metal-lined vessels.

  18. QRS duration reflects underlying changes in conduction velocity during increased intraventricular pressure and heart failure.

    PubMed

    Quintanilla, Jorge G; Moreno, Javier; Archondo, Tamara; Alfonso-Almazán, José Manuel; Lillo-Castellano, José María; Usandizaga, Elena; García-Torrent, María Jesús; Rodríguez-Bobada, Cruz; González, Pablo; Borrego, Luis; Cañadas-Godoy, Victoria; González-Ferrer, Juan J; Pérez-Castellano, Nicasio; Pérez-Villacastín, Julián; Filgueiras-Rama, David

    2017-08-09

    Pressure overload and heart failure electrophysiological remodeling (HF-ER) in pigs are associated with decreased conduction velocity (CV) and dispersion of repolarization, which lead to higher risk of ventricular arrhythmia. This work aimed to establish the correlation between QRS complex duration and underlying changes in CV during increased intraventricular pressure (IVP) and/or HF-ER ex-vivo, and to determine whether QRS duration could be sensitive to an acute increase in left ventricular (LV) afterload in-vivo. HF-ER was induced in 7 pigs by high-rate ventricular pacing. Seven weight-matched animals were used as controls. Isolated Langendorff-perfused hearts underwent programmed ventricular stimulation to study QRS complex duration and CV under low/high IVP, using volume-conducted ECG and epicardial optical mapping, respectively. Four additional pigs underwent open-chest surgery to increase LV afterload by partially clamping the ascending aorta, while measuring QRS complex duration during sinus rhythm (SR). In 13 hearts included for analysis, both HF-ER and increased IVP showed significantly slower epicardial CV (-40% and -15%, p < 0.001 and p = 0.004, respectively), which correlated with similar widening of the QRS complex (+41% and +17%, p = 0.005 and p < 0.001, respectively). HF-ER hearts shower larger prolongation of the QRS complex than controls upon increasing the IVP (+21% vs. +12%, respectively. HF-ER*IVP interaction: p = 0.004). QRS complex widened after increasing LV afterload in-vivo (n=3), with correlation between QRS duration and aortic diastolic pressures (R = 0.58, p < 0.001). In conclusion, high IVP and/or HF-ER significantly decrease CV, which correlates with QRS widening on the ECG during ventricular pacing. Increased myocardial wall stress also widens the QRS complex during SR in-vivo. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Design and Evaluation of a Web-Based Symptom Monitoring Tool for Heart Failure.

    PubMed

    Wakefield, Bonnie J; Alexander, Gregory; Dohrmann, Mary; Richardson, James

    2017-05-01

    Heart failure is a chronic condition where symptom recognition and between-visit communication with providers are critical. Patients are encouraged to track disease-specific data, such as weight and shortness of breath. Use of a Web-based tool that facilitates data display in graph form may help patients recognize exacerbations and more easily communicate out-of-range data to clinicians. The purposes of this study were to (1) design a Web-based tool to facilitate symptom monitoring and symptom recognition in patients with chronic heart failure and (2) conduct a usability evaluation of the Web site. Patient participants generally had a positive view of the Web site and indicated it would support recording their health status and communicating with their doctors. Clinician participants generally had a positive view of the Web site and indicated it would be a potentially useful adjunct to electronic health delivery systems. Participants expressed a need to incorporate decision support within the site and wanted to add other data, for example, blood pressure, and have the ability to adjust font size. A few expressed concerns about data privacy and security. Technologies require careful design and testing to ensure they are useful, usable, and safe for patients and do not add to the burden of busy providers.

  20. Diastolic function and functional capacity after a single session of continuous positive airway pressure in patients with compensated heart failure

    PubMed Central

    Bussoni, Marjory Fernanda; Guirado, Gabriel Negretti; Matsubara, Luiz Shiguero; Roscani, Meliza Goi; Polegato, Bertha Furlan; Minamoto, Suzana Tanni; Bazan, Silméia Garcia Zanati; Matsubara, Beatriz Bojikian

    2014-01-01

    OBJECTIVE: The effects of acute continuous positive airway pressure therapy on left ventricular diastolic function and functional capacity in patients with compensated systolic heart failure remain unclear. METHODS: This randomized, double-blind, placebo-controlled clinical trial included 43 patients with heart failure and a left ventricular ejection fraction <0.50 who were in functional classes I-III according to the New York Heart Association criteria. Twenty-three patients were assigned to continuous positive airway pressure therapy (10 cmH2O), while 20 patients received placebo with null pressure for 30 minutes. All patients underwent a 6-minute walk test (6MWT) and Doppler echocardiography before and immediately after intervention. Clinicaltrials.gov: NCT01088854. RESULTS: The groups had similar clinical and echocardiographic baseline variables. Variation in the diastolic function index (e′) after intervention was associated with differences in the distance walked in both groups. However, in the continuous positive airway pressure group, this difference was greater (continuous positive airway pressure group: Δ6MWT = 9.44+16.05×Δe′, p = 0.002; sham group: Δ6MWT = 7.49+5.38×Δe′; p = 0.015). There was a statistically significant interaction between e′ index variation and continuous positive airway pressure for the improvement of functional capacity (p = 0.020). CONCLUSIONS: Continuous positive airway pressure does not acurately change the echocardiographic indexes of left ventricle systolic or diastolic function in patients with compensated systolic heart failure. However, 30-minute continuous positive airway pressure therapy appears to have an effect on left ventricular diastolic function by increasing functional capacity. PMID:24838902

  1. Evaluation of Fuzzy Rulemaking for Expert Systems for Failure Detection

    NASA Technical Reports Server (NTRS)

    Laritz, F.; Sheridan, T. B.

    1984-01-01

    Computer aids in expert systems were proposed to diagnose failures in complex systems. It is shown that the fuzzy set theory of Zadeh offers a new perspective for modeling for humans thinking and language use. It is assumed that real expert human operators of aircraft, power plants and other systems do not think of their control tasks or failure diagnosis tasks in terms of control laws in differential equation form, but rather keep in mind a set of rules of thumb in fuzzy form. Fuzzy set experiments are described.

  2. Evaluation of rotating, incompressibly lubricated, pressurized thrust bearings

    NASA Technical Reports Server (NTRS)

    Fleming, D. P.

    1971-01-01

    Program evaluates a series hybrid, fluid film ball bearing consisting of an orifice compensated pressurized thrust bearing in conjunction with a self-acting journal bearing. Oil viscosities corresponding to experimentally measured ball bearing outer-race temperatures were used.

  3. Experimental supratrigonal cystectomy: II--Evaluation of urinary calculi, infection, and bladder dysfunction in the pathogenesis of renal failure.

    PubMed

    Barros, Milton; Martinelli, Reinaldo; Rocha, Heonir

    2008-01-01

    The objective of this study was to evaluate the role of urolithiasis, infection, and bladder dysfunction in the pathogenesis of renal failure in rats subjected to supratrigonal cystectomy. One group of Sprague-Dawley rats was submitted to supratrigonal cystectomy, a second to cystectomy during which a suspension of Proteus mirabilis was injected into the bladder stump, and a third to sham surgery (controls). The animals were sacrificed two months after surgery. Blood pressure and serum urea and creatinine were measured before surgery and at sacrifice when a careful inspection of the urinary tract was performed to determine the presence of hydronephrosis and calculi. Microbiological analyses were performed on urine aspirated from the bladder and on the kidneys. Significant differences were found between values of systolic blood pressure and serum urea and creatinine recorded prior to the surgical procedure and those recorded at sacrifice in each group except the control group. Renal failure was present in all animals subjected to cystectomy. Urinary calculi were documented in 5/10 animals subjected to cystectomy only and in all rats inoculated with P. mirabilis. Hypertension was documented in 43.75% of animals subjected to cystectomy. Pyelonephritis was diagnosed only in animals with urinary calculi, in each of which urine culture was also positive. No cases of renal failure, hypertension, calculi, and/or pyelonephritis were detected in the sham group. The findings of this study indicate that kidney failure in rats subjected to supratrigonal cystectomy is related to the severe bladder dysfunction induced by the surgical procedure.

  4. Evaluation of spatial pressure distribution during ice-structure interaction using pressure indicating film

    NASA Astrophysics Data System (ADS)

    Kim, Hyunwook; Ulan-Kvitberg, Christopher; Daley, Claude

    2014-09-01

    Understanding of `spatial' pressure distribution is required to determine design loads on local structures, such as plating and framing. However, obtaining a practical `spatial' pressure distribution is a hard task due to the sensitivity of the data acquisition frequency and resolution. High-resolution Pessure-Idicating Flm (PIF) was applied to obtain pressure distribution and pressure magnitude using stepped crushing method. Different types of PIF were stacked at each test to creating a pressure distribution plot at specific time steps. Two different concepts of plotting `spatial' pressure-area curve was introduced and evaluated. Diverse unit pixel size was chosen to investigate the effect of the resolution in data analysis. Activated area was not significantly affected by unit pixel size; however, total force was highly sensitive

  5. Evaluating wood failure in plywood shear by optical image analysis

    Treesearch

    Charles W. McMillin

    1984-01-01

    This exploratory study evaulates the potential of using an automatic image analysis method to measure percent wood failure in plywood shear specimens. The results suggest that this method my be as accurate as the visual method in tracking long-term gluebond quality. With further refinement, the method could lead to automated equipment replacing the subjective visual...

  6. Cost-effectiveness of Out-of-Hospital Continuous Positive Airway Pressure for Acute Respiratory Failure

    PubMed Central

    Thokala, Praveen; Goodacre, Steve; Ward, Matt; Penn-Ashman, Jerry; Perkins, Gavin D.

    2015-01-01

    Study objective We determine the cost-effectiveness of out-of-hospital continuous positive airway pressure (CPAP) compared with standard care for adults presenting to emergency medical services with acute respiratory failure. Methods We developed an economic model using a United Kingdom health care system perspective to compare the costs and health outcomes of out-of-hospital CPAP to standard care (inhospital noninvasive ventilation) when applied to a hypothetical cohort of patients with acute respiratory failure. The model assigned each patient a probability of intubation or death, depending on the patient’s characteristics and whether he or she had out-of-hospital CPAP or standard care. The patients who survived accrued lifetime quality-adjusted life-years (QALYs) and health care costs according to their age and sex. Costs were accrued through intervention and hospital treatment costs, which depended on patient outcomes. All results were converted into US dollars, using the Organisation for Economic Co-operation and Development purchasing power parities rates. Results Out-of-hospital CPAP was more effective than standard care but was also more expensive, with an incremental cost-effectiveness ratio of £20,514 per QALY ($29,720/QALY) and a 49.5% probability of being cost-effective at the £20,000 per QALY ($29,000/QALY) threshold. The probability of out-of-hospital CPAP’s being cost-effective at the £20,000 per QALY ($29,000/QALY) threshold depended on the incidence of eligible patients and varied from 35.4% when a low estimate of incidence was used to 93.8% with a high estimate. Variation in the incidence of eligible patients also had a marked influence on the expected value of sample information for a future randomized trial. Conclusion The cost-effectiveness of out-of-hospital CPAP is uncertain. The incidence of patients eligible for out-of-hospital CPAP appears to be the key determinant of cost-effectiveness. PMID:25737210

  7. The evaluation of failure detection and isolation algorithms for restructurable control

    NASA Technical Reports Server (NTRS)

    Motyka, P.; Bonnice, W.; Hall, S.; Wagner, E.

    1984-01-01

    Three failure detection and identification techniques were compared to determine their usefulness in detecting and isolating failures in an aircraft flight control system; excluding sensor and flight control computer failures. The algorithms considered were the detection filter, the Generalized Likelihood Ratio test and the Orthogonal Series Generalized Likelihood Ratio test. A modification to the basic detection filter is also considered which uses secondary filtering of the residuals to produce unidirectional failure signals. The algorithms were evaluated by testing their ability to detect and isolate control surface failures in a nonlinear simulation of a C-130 aircraft. It was found that failures of some aircraft controls are difficult to distinguish because they have a similar effect on the dynamics of the vehicle. Quantitative measures for evaluating the distinguishability of failures are considered. A system monitoring strategy for implementing the failure detection and identification techniques was considered. This strategy identified the mix of direct measurement of failures versus the computation of failure necessary for implementation of the technology in an aircraft system.

  8. Design and evaluation of a failure detection and isolation algorithm for restructurable control systems

    NASA Technical Reports Server (NTRS)

    Weiss, Jerold L.; Hsu, John Y.

    1986-01-01

    The use of a decentralized approach to failure detection and isolation for use in restructurable control systems is examined. This work has produced: (1) A method for evaluating fundamental limits to FDI performance; (2) Application using flight recorded data; (3) A working control element FDI system with maximal sensitivity to critical control element failures; (4) Extensive testing on realistic simulations; and (5) A detailed design methodology involving parameter optimization (with respect to model uncertainties) and sensitivity analyses. This project has concentrated on detection and isolation of generic control element failures since these failures frequently lead to emergency conditions and since knowledge of remaining control authority is essential for control system redesign. The failures are generic in the sense that no temporal failure signature information was assumed. Thus, various forms of functional failures are treated in a unified fashion. Such a treatment results in a robust FDI system (i.e., one that covers all failure modes) but sacrifices some performance when detailed failure signature information is known, useful, and employed properly. It was assumed throughout that all sensors are validated (i.e., contain only in-spec errors) and that only the first failure of a single control element needs to be detected and isolated. The FDI system which has been developed will handle a class of multiple failures.

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

    NASA Technical Reports Server (NTRS)

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

    2002-01-01

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

  10. Evaluation of vapor intrusion using controlled building pressure.

    PubMed

    McHugh, Thomas E; Beckley, Lila; Bailey, Danielle; Gorder, Kyle; Dettenmaier, Erik; Rivera-Duarte, Ignacio; Brock, Samuel; MacGregor, Ian C

    2012-05-01

    The use of measured volatile organic chemical (VOC) concentrations in indoor air to evaluate vapor intrusion is complicated by (i) indoor sources of the same VOCs and (ii) temporal variability in vapor intrusion. This study evaluated the efficacy of utilizing induced negative and positive building pressure conditions during a vapor intrusion investigation program to provide an improved understanding of the potential for vapor intrusion. Pressure control was achieved in five of six buildings where the investigation program was tested. For these five buildings, the induced pressure differences were sufficient to control the flow of soil gas through the building foundation. A comparison of VOC concentrations in indoor air measured during the negative and positive pressure test conditions was sufficient to determine whether vapor intrusion was the primary source of VOCs in indoor air at these buildings. The study results indicate that sampling under controlled building pressure can help minimize ambiguity caused by both indoor sources of VOCs and temporal variability in vapor intrusion.

  11. Evaluation of pressurized water cleaning systems for hardware refurbishment

    NASA Technical Reports Server (NTRS)

    Dillard, Terry W.; Deweese, Charles D.; Hoppe, David T.; Vickers, John H.; Swenson, Gary J.; Hutchens, Dale E.

    1995-01-01

    Historically, refurbishment processes for RSRM motor cases and components have employed environmentally harmful materials. Specifically, vapor degreasing processes consume and emit large amounts of ozone depleting compounds. This program evaluates the use of pressurized water cleaning systems as a replacement for the vapor degreasing process. Tests have been conducted to determine if high pressure water washing, without any form of additive cleaner, is a viable candidate for replacing vapor degreasing processes. This paper discusses the findings thus far of Engineering Test Plan - 1168 (ETP-1168), 'Evaluation of Pressurized Water Cleaning Systems for Hardware Refurbishment.'

  12. Evaluating a pressure-redistribution mattress replacement system.

    PubMed

    Newton, Heather

    2014-11-01

    Pressure ulcer prevention is high on the quality agenda and provision of pressure-relieving equipment to meet patients' needs is an essential part of this process. This can be challenging in today's NHS and this article explores the evaluation process that supported the procurement of the AtmosAir™ 4000 pressure-redistributing mattress replacement system. Outcomes suggest that, when combined with a robust repositioning and skin assessment regime, the AtmosAir 4000 performed well and dynamic mattress usage was reduced. Further evaluation over a longer period of time will be undertaken in future.

  13. Automatic blood pressure monitors. Evaluation of three models in volunteers.

    PubMed

    Imbelloni, Luiz Eduardo; Beato, Lúcia; Tolentino, Ana Paula; de Souza, Dulcimar Donizete; Cordeiro, José Antônio

    2004-02-01

    Since 1903, blood pressure has been noninvasively monitored (NIBP), either with manual sphygmomanometer or automated noninvasive devices. One NIBP measurement problem is the considerable variance in blood pressure data, both within and between available techniques. The oscillometric method for NIBP monitoring evaluates blood pressure during cuff deflation. Difficulties in blood pressure measurement by oscillometry may arise from: inadequate cuff size, inadequate cuff application, undetected fails in cuff, hoses, or connectors, arm movement, shock and vascular compression proximal to the cuff. This study aimed at evaluating the reliability of three noninvasive blood pressure monitoring devices during five measurements. Blood pressure of 60 healthy female volunteers aged 20 to 40 years was evaluated from 7 am to 11 am, in the sitting position during a normal workday. Five measures were taken with each device at 2-minute intervals. Three automatic blood pressure monitors were studied. No patient was obese, hypertensive or suffering from cardiac disease and cardiac arrhythmia. Indirect measurements were made according to manufacturers' instructions. There were no differences in demographics among the three studied groups. Mean intrapersonal variation from one measurement to the other was up to 6.7 mmHg for systolic blood pressure (SBP), 4.9 mmHg for mean blood pressure (MBP) and 3.3 mmHg for diastolic blood pressure (DBP) with 95% confidence interval. The highest difference between measures in the same volunteer was 49 mmHg for SBP, 46 mmHg for MBP and 28 mmHg for DBP. This study has shown significant variations in SBP, MBP and DBP and that SBP is the most reliable parameter to check blood pressure changes in volunteers.

  14. Mechanisms of Chinese Medicine Xinmailong’s protection against heart failure in pressure-overloaded mice and cultured cardiomyocytes

    PubMed Central

    Qi, Jianyong; Yu, Juan; Tan, Yafang; Chen, Renshan; Xu, Wen; Chen, Yanfen; Lu, Jun; Liu, Qin; Wu, Jiashin; Gu, Weiwang; Zhang, Minzhou

    2017-01-01

    Patients with heart failure (HF) have high mortality and mobility. Xinmailong (XML) injection, a Chinese Medicine, is clinically effective in treating HF. However, the mechanism of XML’s effectiveness on HF was unclear, and thus, was the target of the present study. We created a mouse model of pressure-overload-induced HF with transverse aortic constriction (TAC) surgery and compared among 4 study groups: SHAM (n = 10), TAC (n = 12), MET (metoprolol, positive drug treatment, n = 7) and XML (XML treatment, n = 14). Dynamic changes in cardiac structure and function were evaluated with echocardiography in vivo. In addition, H9C2 rat cardiomyocytes were cultured in vitro and the phosphorylation of ERK1/2, AKT, GSK3β and protein expression of GATA4 in nucleus were detected with Western blot experiment. The results showed that XML reduced diastolic thickness of left ventricular posterior wall, increased ejection fraction and fraction shortening, so as to inhibit HF at 2 weeks after TAC. Moreover, XML inhibited the phosphorylation of ERK1/2, AKT and GSK3β, subsequently inhibiting protein expression of GATA4 in nucleus (P < 0.001). Together, our data demonstrated that XML inhibited the TAC-induced HF via inactivating the ERK1/2, AKT/GSK3β, and GATA4 signaling pathway. PMID:28205629

  15. On-line detection of key radionuclides for fuel-rod failure in a pressurized water reactor.

    PubMed

    Qin, Guoxiu; Chen, Xilin; Guo, Xiaoqing; Ni, Ning

    2016-08-01

    For early on-line detection of fuel rod failure, the key radionuclides useful in monitoring must leak easily from failing rods. Yield, half-life, and mass share of fission products that enter the primary coolant also need to be considered in on-line analyses. From all the nuclides that enter the primary coolant during fuel-rod failure, (135)Xe and (88)Kr were ultimately chosen as crucial for on-line monitoring of fuel-rod failure. A monitoring system for fuel-rod failure detection for pressurized water reactor (PWR) based on the LaBr3(Ce) detector was assembled and tested. The samples of coolant from the PWR were measured using the system as well as a HPGe γ-ray spectrometer. A comparison showed the method was feasible. Finally, the γ-ray spectra of primary coolant were measured under normal operations and during fuel-rod failure. The two peaks of (135)Xe (249.8keV) and (88)Kr (2392.1keV) were visible, confirming that the method is capable of monitoring fuel-rod failure on-line.

  16. The profile and prognosis of patients hospitalised with heart failure. The value of discharge blood pressure amd cholesterol.

    PubMed

    Jindrich, Spinar; Ondrej, Ludka; Viktor, Musil; Zbynek, Pozdisek; Tomas, Pavlik; Ladislav, Dusek; Jiri, Vitovec; Lenka, Spinarova; Miroslav, Soucek

    2008-11-01

    The aim of the present prospective, single centre observational study was to describe the profile and prognosis of patients hospitalised with chronic heart failure and to determine the value of discharge blood pressure and cholesterol for long-term survival. From among 2,346 hospitalised patients, 320 (13.6%) suffered from chronic heart failure and 28 (8.8%) died during hospitalisation. The in-patient mortality rate was similar to that in patients not suffering from chronic heart failure (P = 0, 3). Of 292 patients who were discharged, 162 (55%) died during the subsequent 5 years. The predetermined parameters of pure prognosis were associated with lower diastolic blood pressure (P = 0.008) and lower cholesterol (P = 0.012). A poor prognosis was associated with lower systolic blood pressure plus lower cholesterol and lower diastolic blood pressure and lower cholesterol. Other independent prognostic parameters were older age (P < 0.001), higher heart rate (P = 0.02), higher creatinine (P < 0.001), higher urea (P < 0.001), higher uric acid (P < 0.001), lower hemoglobin (P = 0.02), lower ejection fraction (P = 0.080), and a history of ischemic heart disease (P < 0.01). Patients suffering from chronic heart failure and discharged home have a worse prognosis if their systolic and/or diastolic blood pressures and/or cholesterol levels are too low. The optimal values seem to be levels that are around the recommended targets, that is a systolic BP of 140 mmHg, diastolic BP of 90 mmHg, and a cholesterol level of 5 mmol/L.

  17. Physical Mechanisms of Failure, Ultralow Partial Pressure Lubrication, and the Reservoir Effect in MEMS

    NASA Astrophysics Data System (ADS)

    Hook, David Adam

    The aim of this work is to examine the effectiveness of self-assembled monolayer (SAM) coatings as long term lubrication coatings in microsystems, to examine the failure regimes of SAM coated devices, to examine the role of mobility in adsorbed lubricating films, and to examine evolution of the coefficient of friction of devices surrounded by ultralow partial pressures of alcohols up to saturation. Finally the role of self assembled monlayers in vapor phase lubrication is examined. Self-assembled monolayers are ubiquitous in fabrication of free-standing microdevices because of their ability to prevent release related and dormancy related stiction. However their ability to lubricate under sliding and normal contact conditions is not well documented. It can be shown that the energy dissipated per unit area in one sliding cycle due to friction is significant under general loading conditions. Therefore from an energy dissipated standpoint the bond energies of the silane molecules should not be enough to withstand even a short number of cycles. An extension of this is the energy imparted to the surface through a normal loading cycle through a loss of kinetic energy. It can also be shown that this is enough to break the silicon oxygen bonds however this is over a longer time scale than in sliding. Also there is an open question on the role of mobile and non-mobile adsorbed species on friction. Is the mobility of a molecule/layer on a surface an indicator of the effectiveness of the lubrication potential of the layer? Do submonolayer coverages of alcohols "lock-up" to contacting surfaces by disrupting non-corrogated potentials? Is there a distinct lowering of frictional forces at the formation of a monolayer? Controlled adsorption of mobile and non-mobile species on rubbing contacts is necessary to elucidate this physical relationship. To accomplish this one must take into account that friction measurements are highly scale dependant. Therefore to ensure the accuracy of

  18. Interventions Linked to Decreased Heart Failure Hospitalizations During Ambulatory Pulmonary Artery Pressure Monitoring.

    PubMed

    Costanzo, Maria R; Stevenson, Lynne W; Adamson, Philip B; Desai, Akshay S; Heywood, J Thomas; Bourge, Robert C; Bauman, Jordan; Abraham, William T

    2016-05-01

    This study sought to analyze medical therapy data from the CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in Class III Heart Failure) trial to determine which interventions were linked to decreases in heart failure (HF) hospitalizations during ambulatory pulmonary artery (PA) pressure-guided management. Elevated cardiac filling pressures, which increase the risk of hospitalizations and mortality, can be detected using an ambulatory PA pressure monitoring system before onset of symptomatic congestion allowing earlier intervention to prevent HF hospitalizations. The CHAMPION trial was a randomized, controlled, single-blind study of 550 patients with New York Heart Association functional class III HF with a HF hospitalization in the prior year. All patients undergoing implantation of the ambulatory PA pressure monitoring system were randomized to the active monitoring group (PA pressure-guided HF management plus standard of care) or to the blind therapy group (HF management by standard clinical assessment), and followed for a minimum of 6 months. Medical therapy data were compared between groups to understand what interventions produced the significant reduction in HF hospitalizations in the active monitoring group. Both groups had similar baseline medical therapy. After 6 months, the active monitoring group experienced a higher frequency of medications adjustments; significant increases in the doses of diuretics, vasodilators, and neurohormonal antagonists; targeted intensification of diuretics and vasodilators in patients with higher PA pressures; and preservation of renal function despite diuretic intensification. Incorporation of a PA pressure-guided treatment algorithm to decrease filling pressures led to targeted changes, particularly in diuretics and vasodilators, and was more effective in reducing HF hospitalizations than management of patient clinical signs or symptoms alone. Copyright © 2016 American College of

  19. Association of blood pressure and its evolving changes with the survival of patients with heart failure.

    PubMed

    Grigorian-Shamagian, Lilian; Gonzalez-JuAnatey, Jose Ramon; Vazquez, Rafael; Cinca, Juan; Bayes-Genis, Antoni; Pascual, Domingo; Fernandez-Palomeque, Carlos; Bardaji, Alfredo; Almendral, Jesus; Nieto, Vicente; Macaya, Carlos; Jimenez, Ricardo Pavon; de Luna, Antoni Bayes

    2008-09-01

    The association between low blood pressure (BP) levels and increased mortality has been established in several studies of heart failure (HF). Although many drugs administered to these patients decrease BP, the relationship between changes in BP and survival has not been investigated. Nor have previous analyses distinguished among different forms of death. We investigated the influence of baseline BP and changes in BP during a 1-year period on the survival of patients with HF, distinguishing among sudden cardiac death, nonsudden cardiac death, and noncardiac death. We also identified the possible relationship with the baseline values of and changes in other clinical and treatment variables, including pharmacologic treatments. A total of 1062 patients with chronic HF included in the Spanish National Registry of Sudden Death (mean age of 64.5 +/- 11.8 years, 72% were men, and 21% were in New York Heart Association class III with a mean left ventricular ejection fraction of 36.7% +/- 14.2%) were prospectively investigated for a mean of 1.9 +/- 0.6 years. A multivariable Cox proportional hazards model adjusting for clinical and therapeutic variables showed an independent association between low baseline systolic blood pressure (SBP) and nonsudden cardiac death (hazard ratio [HR] 0.96, 95% confidence interval [CI] 0.93-0.98), but changes in SBP during the following year did not influence survival, regardless of the baseline SBP level (P = .55). Contrariwise, baseline diastolic BP was not associated with mortality, but an increase in diastolic BP during the following year showed a borderline independent significant association with lower nonsudden cardiac death (HR 0.90, 95% CI 0.82-1.00). Treatment with angiotensin-converting enzyme inhibitors or beta-blockers at baseline was also associated with lower nonsudden cardiac mortality, as was an increase in left ventricular ejection fraction during the following year (HR 0.69, 95% CI 0.51-0.93; P = .015). Among patients with

  20. Evaluation of pressure sensing concepts: A technology assessment

    SciTech Connect

    Shepard, R.L.; Thacker, L.H.

    1993-09-01

    Advanced distributed control systems for electric power plants will require more accurate and reliable pressure gauges than those now installed. Future developments in power plant control systems are expected to use digital/optical networks rather than the analog/electric data transmission used in existing plants. Many pressure transmitters now installed use oil filling to separate process fluids from the gauge mechanism and are subject to insidious failures when the oil leaks. Testing and maintenance of pressure channels occupy a disproportionately large amount of effort to restore their accuracy and verify their operability. These and similar concerns have prompted an assessment of a broad spectrum of sensor technologies to aid in selecting the most likely candidates for adaptation to power plant applications. Ten representative conventional and thirty innovational pressure sensors are described and compared. Particular emphasis is focused on two categories: Silicon-integrated pressure sensors and fiber-optic sensors, and both of these categories are discussed in detail. Additional attractive concepts include variable reluctance gauges and resonant structure gauges that may not require oil buffering from the process fluid.

  1. [Heart failure. Importance and utility of the echocardiographic evaluation].

    PubMed

    Echeverri-Rico, Jorge Valente; Aceves-Millán, Rocío; Amezcua-Gómez, Lilia; Ixcamparij-Rosales, Carlos Haroldo; Ruiz-Rivero, Antonio; Torres, Armando; Majluf-Cruz, Abraham

    2014-01-01

    Millions of people die every year due to cardiovascular diseases. The objective against these diseases is primary prevention, but secondary prevention is the major goal in those individuals who already suffered an event. The order of the cardiovascular complication is the next one: arrhythmia, heart failure, myocardial infarction or stroke, and death. Approximately between 1 and 2 % of adults present heart failure, but this percentage rises to more than 10 % in adults over 70 years. Therefore, it is necessary to diagnose and to treat this complication. Left ventricular ejection fraction is the most important prognosis factor in these patients, because it decreases in 50 % of them. Almost 50 % of patients with heart failure have a conserved systolic function, but a decreased diastolic function. Treatment must improve the structural and functional heart abnormalities. Echocardiography is a useful tool in these patients due to its exactitude, accessibility, safety, and low cost. It provides information about the characteristics of the cardiac chambers and its volumes, the diameter in the walls, and about the diastolic, systolic and valvular function. Recently, echocardiography evolved to third dimension techniques, which seem to be more exact. In the next years, we will have more evidence about this diagnostic modality.

  2. An evaluation of the pressure proof test concept for 2024-T3 aluminium alloy sheet

    NASA Technical Reports Server (NTRS)

    Dawicke, D. S.; Poe, C. C., Jr.; Newman, J. C.; Harris, C. E.

    1991-01-01

    The concept of pressure proof testing of fuselage structures with fatigue cracks to insure structural integrity was evaluated from a fracture mechanics viewpoint. A generic analytical and experimental investigation was conducted on uniaxially loaded flat panels with crack configurations and stress levels typical of longitudinal lap splice joints in commercial transport aircraft fuselages. The results revealed that the remaining fatigue life after a proof cycle was longer than that without the proof cycle because of crack growth retardation due to increased crack closure. However, based on a crack length that is slightly less than the critical value at the maximum proof stress, the minimum assured life or proof test interval must be no more than 550 pressure cycles for a 1.33 proof factor and 1530 pressure cycles for a 1.5 proof factor to prevent in-flight failures.

  3. An evaluation of the pressure proof test concept for thin sheet 2024-T3

    NASA Technical Reports Server (NTRS)

    Dawicke, D. S.; Poe, C. C., Jr.; Newman, J. C., Jr.; Harris, C. E.

    1990-01-01

    The concept of pressure proof testing of fuselage structures with fatigue cracks to insure structural integrity was evaluated from a fracture mechanics viewpoint. A generic analytical and experimental investigation was conducted on uniaxially loaded flat panels with crack configurations and stress levels typical of longitudinal lap-splice joints in commercial transport aircraft fuselage. The results revealed that the remaining fatigue life after a proof test was longer than that without the proof test because of crack growth retardation due to increased crack closure. However, based on a crack length that is slightly less than the critical value at the maximum proof test stress, the minimum assured life or proof test interval must be no more than 550 pressure cycles for a 1.33 proof factor and 1530 pressure cycles for a 1.5 proof factor to prevent in-flight failures.

  4. An evaluation of the pressure proof test concept for thin sheet 2024-T3

    NASA Technical Reports Server (NTRS)

    Dawicke, D. S.; Poe, C. C., Jr.; Newman, James C., Jr.; Harris, Charles E.

    1990-01-01

    The concept of pressure proof testing of fuselage structures with fatigue cracks to insure structural integrity was evaluated from a fracture mechanics viewpoint. A generic analytical and experimental investigation was conducted on uniaxially loaded flat panels with crack configurations and stress levels typical of longitudinal lap splice joints in commercial transport aircraft fuselages. The results revealed that the remaining fatigue life after a proof test was longer than that without the proof test because of crack growth retardation due to increased crack closure. However, based on a crack length that is slightly less than the critical value at the maximum proof test stress, the minimum assured life or proof test interval must be no more than 550 pressure cycles for a 1.33 proof factor and 1530 pressure cycles for a 1.5 proof factor to prevent in-flight failures.

  5. Treatment of acute hypoxemic respiratory failure with continuous positive airway pressure delivered by a new pediatric helmet in comparison with a standard full face mask: a prospective pilot study.

    PubMed

    Chidini, Giovanna; Calderini, Edoardo; Pelosi, Paolo

    2010-07-01

    To evaluate the feasibility and efficacy of continuous positive airway pressure delivered by a new pediatric helmet in comparison with a standard facial mask in infants with acute hypoxemic respiratory failure. A single-center prospective case-control study. Pediatric intensive care unit in a tertiary children hospital. Twenty consecutive infants treated with continuous positive airway pressure by a helmet matched with a control patient treated with continuous positive airway pressure by facial mask and selected by age, weight, PaO2:Fio2, and PaCO2 on pediatric intensive care unit admission. Feasibility was defined as the incidence of continuous positive airway pressure protocol failure secondary to 1) failure to administer continuous positive airway pressure because of intolerance to the interface; 2) deterioration in gas exchange soon after continuous positive airway pressure institution; and 3) major clinical adverse events such as pneumothorax or any hemodynamic instability related to the continuous positive airway pressure safety system device's failure. Evaluation of feasibility included also the total application time of respiratory treatment, the number of continuous positive airway pressure discontinuations/first 24 hrs. Interface-related complications included air leaks, cutaneous pressure sores, eye irritation, inhalation, and gastric distension. The 20 patients and control subjects had similar matching characteristics. Continuous positive airway pressure delivered by a helmet compared with a facial mask reduced continuous positive airway pressure trial failure rate (p = .02), increased application time (p = .001) with less discontinuations (p = .001), and was not associated with an increased rate of major adverse events, resulting in decreased air leaks (p = .04) and pressure sores (p = .002). Both continuous positive airway pressure systems resulted in early and sustained improvement in oxygenation. The helmet might be considered a viable and safe

  6. Comparison of the reliability of E/E' to estimate pulmonary capillary wedge pressure in heart failure patients with preserved ejection fraction versus those with reduced ejection fraction.

    PubMed

    Matsushita, Kenichi; Minamishima, Toshinori; Goda, Ayumi; Ishiguro, Haruhisa; Kosho, Hideyasu; Sakata, Konomi; Satoh, Toru; Yoshino, Hideaki

    2015-12-01

    Accurate assessment of pulmonary capillary wedge pressure (PCWP) is essential for physicians to effectively manage patients with acute decompensated heart failure. The ratio of early transmittal velocity to tissue Doppler mitral annular early diastolic velocity (E/E') is used to estimate PCWP noninvasively in a wide range of cardiac patients. However, it remains contentious as to whether mitral E/E' is a reliable predictor of PCWP. In the present study, acute heart failure patients were divided into two groups on the basis of left ventricular (LV) systolic function: those with preserved ejection fraction (HFpEF) and those with reduced ejection fraction (HFrEF). The usefulness of mitral E/E' in estimating PCWP was compared between the two groups. Fifty consecutive patients who were admitted with acute decompensated heart failure and underwent both right-sided cardiac catheterization and transthoracic echocardiography during hospitalization were analyzed retrospectively. Pearson's correlation was used to evaluate associations between Doppler parameters and PCWP. E/E' was positively correlated with PCWP (r = 0.56, P = 0.01) in the heart failure with preserved ejection fraction group. However, no significant relationship was observed between PCWP and mitral E/E' (P = 0.85) in the heart failure with reduced ejection fraction group. There were no significant correlations between any of the conventional parameters considered (LVEF, left atrial dimension, E/A, IVRT, and DT) with PCWP in either group. In conclusion, mitral E/E' is useful for estimating PCWP in patients with acute heart failure with preserved ejection fraction but may not in those with reduced ejection fraction.

  7. Relationship between blood pressure levels and adherence to medication in patients with chronic heart failure: How come?

    PubMed Central

    Mohammadi, Mahsa; Ekman, Inger; Schaufelberger, Maria

    2009-01-01

    Objective: To investigate whether change in objective signs during up-titration of angiotensin-converting enzyme (ACE)-inhibitors in patients with chronic heart failure affect perception of information about medicines and subjective activities such as self-care. Methods: Consecutive patients referred for up-titration of ACE-inhibitors were included. Patients were given the Satisfaction with Information about Medicines Scale and the European Heart Failure Self-Care Behaviour Scale at their first visit and when the target dose was reached. Blood pressure, pulse and s-creatinine were measured at each visit. Results: Relationships were found between change in systolic (r = 0.224, p = 0.044) and diastolic (r = 0.361, p = 0.001) blood pressure and change in self-care scores and were also observed at baseline (r = 0.324, 0.398, p = 0.001, 0.000) and follow-up (r = 0.317, 0.253, p = 0.004, 0.022). Diastolic blood pressure correlated with the “potential problem of medication” score (r= −0.263, p = 0.007). Conclusion: Patients with a more advanced disease usually have a lower blood pressure. Hence, the relationship between blood pressure and self-care scores might indicate that patients are more motivated to adhere to prescriptions the more advanced the stage of their disease. PMID:19436649

  8. Pressure measurements in a hydrogen combustion environment: An evaluation of 3 pressure transducers

    NASA Astrophysics Data System (ADS)

    Marshall, B. W., Jr.; Ratzel, A. C., III

    1984-05-01

    A series of hydrogen air combustion tests were performed to evaluate the performance of three strain gage type pressure tranducers in a combustion environment. The three types of gages were Precise sensor models 111-1 and 141-1 and Kulite model XT-190. Stainless steel felt metal was used to provide thermal protection for the transducer diaphragms. The effect of such shielding on the dynamic pressure response of a transducer during a combustion experiment was investigated. Results indicate that the three pressure transducers, when thermally shielded with felt metal, recorded peak combustion pressures that were generally within 5% of the statistical mean for each test. The pressure profiles and associated burn times obtained from all of the protected transducers were also comparable. The Precise sensor model III-I gages, when unprotected, were affected significantly by the hot gases of combustion and must be thermally protected with felt metal to obtain accurate measurements.

  9. Chronic mitral regurgitation and Doppler estimation of left ventricular filling pressures in patients with heart failure

    NASA Technical Reports Server (NTRS)

    Temporelli, P. L.; Scapellato, F.; Corra, U.; Eleuteri, E.; Firstenberg, M. S.; Thomas, J. D.; Giannuzzi, P.

    2001-01-01

    Previous studies relating Doppler parameters and pulmonary capillary wedge pressures (PCWP) typically exclude patients with severe mitral regurgitation (MR). We evaluated the effects of varying degrees of chronic MR on the Doppler estimation of PCWP. PCWP and mitral Doppler profiles were obtained in 88 patients (mean age 55 +/- 8 years) with severe left ventricular (LV) dysfunction (mean ejection fraction 23% +/- 5%). Patients were classified by severity of MR. Patients with severe MR had greater left atrial areas, LV end-diastolic volumes, and mean PCWPs and lower ejection fractions (each P <.01). In patients with mild MR, multiple echocardiographic parameters correlated with PCWP; however, with worsening MR, only deceleration time strongly related to PCWP. From stepwise multivariate analysis, deceleration time was the best independent predictor of PCWP overall, and it was the only predictor in patients with moderate or severe MR. Doppler-derived early mitral deceleration time reliably predicts PCWP in patients with severe LV dysfunction irrespective of degree of MR.

  10. Chronic mitral regurgitation and Doppler estimation of left ventricular filling pressures in patients with heart failure

    NASA Technical Reports Server (NTRS)

    Temporelli, P. L.; Scapellato, F.; Corra, U.; Eleuteri, E.; Firstenberg, M. S.; Thomas, J. D.; Giannuzzi, P.

    2001-01-01

    Previous studies relating Doppler parameters and pulmonary capillary wedge pressures (PCWP) typically exclude patients with severe mitral regurgitation (MR). We evaluated the effects of varying degrees of chronic MR on the Doppler estimation of PCWP. PCWP and mitral Doppler profiles were obtained in 88 patients (mean age 55 +/- 8 years) with severe left ventricular (LV) dysfunction (mean ejection fraction 23% +/- 5%). Patients were classified by severity of MR. Patients with severe MR had greater left atrial areas, LV end-diastolic volumes, and mean PCWPs and lower ejection fractions (each P <.01). In patients with mild MR, multiple echocardiographic parameters correlated with PCWP; however, with worsening MR, only deceleration time strongly related to PCWP. From stepwise multivariate analysis, deceleration time was the best independent predictor of PCWP overall, and it was the only predictor in patients with moderate or severe MR. Doppler-derived early mitral deceleration time reliably predicts PCWP in patients with severe LV dysfunction irrespective of degree of MR.

  11. Mitochondrial reactive oxygen species production and respiratory complex activity in rats with pressure overload-induced heart failure

    PubMed Central

    Schwarzer, Michael; Osterholt, Moritz; Lunkenbein, Anne; Schrepper, Andrea; Amorim, Paulo; Doenst, Torsten

    2014-01-01

    We investigated the impact of cardiac reactive oxygen species (ROS) during the development of pressure overload-induced heart failure. We used our previously described rat model where transverse aortic constriction (TAC) induces compensated hypertrophy after 2 weeks, heart failure with preserved ejection fraction at 6 and 10 weeks, and heart failure with systolic dysfunction after 20 weeks. We measured mitochondrial ROS production rates, ROS damage and assessed the therapeutic potential of in vivo antioxidant therapies. In compensated hypertrophy (2 weeks of TAC) ROS production rates were normal at both mitochondrial ROS production sites (complexes I and III). Complex I ROS production rates increased with the appearance of diastolic dysfunction (6 weeks of TAC) and remained high thereafter. Surprisingly, maximal ROS production at complex III peaked at 6 weeks of pressure overload. Mitochondrial respiratory capacity (state 3 respiration) was elevated 2 and 6 weeks after TAC, decreased after this point and was significantly impaired at 20 weeks, when contractile function was also impaired and ROS damage was found with increased hydroxynonenal. Treatment with the ROS scavenger α-phenyl-N-tert-butyl nitrone or the uncoupling agent dinitrophenol significantly reduced ROS production rates at 6 weeks. Despite the decline in ROS production capacity, no differences in contractile function between treated and untreated animals were observed. Increased ROS production occurs early in the development of heart failure with a peak at the onset of diastolic dysfunction. However, ROS production may not be related to the onset of contractile dysfunction. PMID:24951621

  12. Using a Pressure Mapping System to Evaluate Contact Pressure on Hands During Use of Axillary Crutches.

    PubMed

    Silva, Danilo C; Medola, Fausto O; Bonfim, Gabriel H C; Paschoarelli, Luis C

    2015-01-01

    The aim of this study was to evaluate different handles used in axillary crutches with a Pressure Mapping System. The Grip Versatek system from Tekscan Inc. was used to measure the levels and the distribution of contact pressure in the hands during a simulated activity of ambulation with crutches. The sample included ten able-bodied subjects: five men and five women. The results show that the different models of handles appear to have influenced the pressure levels measured during the activity. Therefore, the measurement equipment provides parameters that allow the comparison among different designs and assess their contribution to the comprehension of the demands of ergonomic handles.

  13. Seismic analysis of the Par Pond Dam: Study of slope failure and liquefaction. Technical evaluation report

    SciTech Connect

    Simos, N.; Reich, M.

    1994-07-01

    Stability concerns of the Par Pond Dam, an embankment structure in the Savannah River Site complex, resulted in a comprehensive evaluation of the state of its integrity. Specifically, excessive seepage through the embankment, slope failure due to an earthquake event as well as liquefaction potential of the embankment and the foundation are addressed and the potential of failure is evaluated. Lastly, remedial benefits of the addition of a berm structure are also assessed.

  14. Evaluation of transient fuel pin cladding failure criteria for application to inherently safe LMFBR designs

    SciTech Connect

    Kramer, J M; DiMelfi, R J

    1984-03-01

    Purpose of report is to evaluate the methods for determining time-temperature-stress limits for cladding failure under accident conditions for inherently safe LMFBR designs. The range of expected thermal-mechanical cladding loading conditions is outlined for generic accident events, and application of existing mechanistic and empirical cladding failure models to these conditions is evaluated. The study is restricted to reference oxide fuel pins with austenitic stainless steel cladding.

  15. Independent and interactive effects of blood pressure and cardiac function on brain volume and white matter hyperintensities in heart failure.

    PubMed

    Alosco, Michael L; Brickman, Adam M; Spitznagel, Mary Beth; Griffith, Erica Y; Narkhede, Atul; Raz, Naftali; Cohen, Ronald; Sweet, Lawrence H; Hughes, Joel; Rosneck, Jim; Gunstad, John

    2013-01-01

    Reduced systemic perfusion and comorbid medical conditions are key contributors to adverse brain changes in heart failure (HF). Hypertension, the most common co-occurring condition in HF, accelerates brain atrophy in aging populations. However, the independent and interactive effects of blood pressure and systemic perfusion on brain structure in HF have yet to be investigated. Forty-eight older adults with HF underwent impedance cardiography to assess current systolic blood pressure status and cardiac index to quantify systemic perfusion. All participants underwent brain magnetic resonance imaging to quantify total brain, total and subcortical gray matter volume, and white matter hyperintensities (WMH) volume. Regression analyses adjusting for medical and demographic factors showed decreased cardiac index was associated with smaller subcortical gray matter volume (P < .01), and higher systolic blood pressure predicted reduced total gray matter volume (P = .03). The combination of higher blood pressure and lower cardiac index exacerbated WMH (P = .048). Higher blood pressure and systemic hypoperfusion are associated with smaller brain volume, and these factors interact to exacerbate WMH in HF. Prospective studies are needed to clarify the effects of blood pressure on the brain in HF, including the role of long-term blood pressure fluctuations. Copyright © 2013 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  16. Independent and Interactive Effects of Blood Pressure and Cardiac Function on Brain Volume and White Matter Hyperintensities in Heart Failure

    PubMed Central

    Alosco, Michael L.; Brickman, Adam M.; Spitznagel, Mary Beth; Griffith, Erica Y.; Narkhede, Atul; Raz, Naftali; Cohen, Ronald; Sweet, Lawrence H.; Hughes, Joel; Rosneck, Jim; Gunstad, John

    2013-01-01

    Background Reduced systemic perfusion and comorbid medical conditions are key contributors to adverse brain changes in heart failure (HF). Hypertension, the most common co-occurring condition in HF, accelerates brain atrophy in aging populations. However, the independent and interactive effects of blood pressure and systemic perfusion on brain structure in HF have yet to be investigated. Methods Forty-eight older adults with HF underwent impedance cardiography to assess current systolic blood pressure status, and cardiac index to quantify systemic perfusion. All participants underwent brain magnetic resonance imaging to quantify total brain, total and subcortical gray matter volume, and white matter hyperintensities (WMH) volume. Results Regression analyses adjusting for medical and demographic factors showed decreased cardiac index was associated with smaller subcortical gray matter volume (p < .01) and higher systolic blood pressure predicted reduced total gray matter volume (p = .03). The combination of higher blood pressure and lower cardiac index exacerbated WMH (p = .048). Conclusions Higher blood pressure and systemic hypoperfusion are associated with smaller brain volume and these factors interact to exacerbate WMH in HF. Prospective studies are needed to clarify the effects of blood pressure on the brain in HF, including the role of long-term blood pressure fluctuations. PMID:23735419

  17. Noninvasive positive pressure ventilation via face mask. First-line intervention in patients with acute hypercapnic and hypoxemic respiratory failure.

    PubMed

    Meduri, G U; Turner, R E; Abou-Shala, N; Wunderink, R; Tolley, E

    1996-01-01

    We have previously reported our experience with noninvasive positive pressure ventilation (NPPV) via face mask in a small group of selected patients with acute respiratory failure (ARF). NPPV was frequently effective (70% success rate) in correcting gas exchange abnormalities and in avoiding endotracheal intubation (ETI); NPPV also had a low rate of complications. We have evaluated the clinical application of NPPV as first-line intervention in patients with hypercapnic and short-term hypoxemic ARF. A dedicated respiratory therapist conducted an educational program with physicians-in-training rotating through the medical ICUs of a university medical center and supervised implementation of a simplified management protocol. Over 24 months, 164 patients with heterogeneous forms of ARF received NPPV. We report on the effectiveness of NPPV in correcting gas exchange abnormalities, in avoiding ETI, and associated complications, in different conditions precipitating ARF. One hundred fifty-eight patients completed the study. Forty-one had hypoxemic ARF, 52 had hypercapnic ARF, 22 had hypercapnic acute respiratory insufficiency (ARI), 17 had other forms of ARF, and 26 with advanced illness had ARF and refused intubation. Twenty-five percent of the patients developed ARF after extubation. Mechanical ventilation was delivered via a face mask. Initial ventilatory settings were continuous positive airway pressure (CPAP) mode, 5 cm H2O, with pressure support ventilation of 10 to 20 cm H2O titrated to achieve a respiratory rate less than 25 breaths/min and an exhaled tidal volume of 7 mL/kg or more. Ventilator settings were adjusted following arterial blood gases (ABG) results. The mean duration of NPPV was 25 +/- 24 h. When the 26 patients with advanced illness are excluded, NPPV was effective in improving or correcting gas exchange abnormalities in 105 patients (80%) and avoiding ETI in 86 (65%). Failure to improve ABG values was the reason for ETI in 20 of 46 (43%). The overall

  18. Insulation failure in electrosurgery instrumentation: a prospective evaluation.

    PubMed

    Tixier, Floriane; Garçon, Mélanie; Rochefort, Françoise; Corvaisier, Stéphane

    2016-11-01

    The use of electrosurgery has expanded to a wide variety of surgical specialities, but it has also been accompanied by its share of complications, including thermal injuries to nontargeted tissues, caused by a break or defect in the insulation of the instrument's coat. The purpose of this study was to determine the prevalence and the location of insulation failures (IFs) in electrosurgical instruments, then to assess the necessity of routine IF testing. Electrosurgical instruments were visually inspected and checked for IF using a high-voltage detector. Two different detectors were used during two testing sessions: DTU-6 (Petel company) and DIATEG (Morgate company). Laparoscopic and non-laparoscopic instruments were determined to have IF if current crossed the instrument's insulation, signaled by an alarm sound. A total of 489 instruments were tested. The overall prevalence of IFs was 24.1 % with only visual inspection and 37.2 % with the IF detector. Among the 489 instruments, 13.1 % were visually intact, but had an electric test failure. DTU-6 and DIATEG detectors showed comparable efficiency in detection of overall IFs and for laparoscopic and non-laparoscopic instruments. The median location of IFs was more pronounced for laparoscopic instruments (50.4 %) and the distal location for non-laparoscopic instruments (40.4 %). Accidental burns are a hidden problem and can lead to patient complications. In Central Sterilization Service Department, prevention currently includes only visual control of electrosurgery instrumentation, but testing campaigns are now necessary in order to identify maximum instruments' defects.

  19. Evaluation of the concept of pressure proof testing fuselage structures

    NASA Technical Reports Server (NTRS)

    Harris, Charles E.; Orringer, Oscar

    1991-01-01

    The FAA and NASA have recently completed independent technical evaluations of the concept of pressure proof testing the fuselage of commercial transport airplanes. The results of these evaluations are summarized. The objectives of the evaluations were to establish the potential benefit of the pressure proof test, to quantify the most desirable proof test pressure, and to quantify the required proof test interval. The focus of the evaluations was on multiple-site cracks extending from adjacent rivet holes of a typical fuselage longitudinal lap splice joint. The FAA and NASA do not support pressure proof testing the fuselage of aging commercial transport aircraft. The argument against proof testing is as follows: (1) a single proof test does not insure an indefinite life; therefore, the proof test must be repeated at regular intervals; (2) for a proof factor of 1.33, the required proof test interval must be below 300 flights to account for uncertainties in the evaluation; (3) conducting the proof test at a proof factor of 1.5 would considerably exceed the fuselage design limit load; therefore, it is not consistent with accepted safe practices; and (4) better safety can be assured by implementing enhanced nondestructive inspection requirements, and adequate reliability can be achieved by an inspection interval several times longer than the proof test interval.

  20. Noninvasive positive pressure ventilation in acute respiratory failure due to COPD vs other causes: effectiveness and predictors of failure in a respiratory ICU in North India.

    PubMed

    Agarwal, Ritesh; Gupta, Rajesh; Aggarwal, Ashutosh N; Gupta, Dheeraj

    2008-01-01

    To determine the effectiveness of noninvasive positive pressure ventilation (NIPPV), and the factors predicting failure of NIPPV in acute respiratory failure (ARF) due to chronic obstructive pulmonary disease (COPD) versus other causes of ARF. This was a prospective observational study and all patients with ARF requiring NIPPV over a one-and-a-half year period were enrolled in the study. We recorded the etiology of ARF and prospectively collected the data for heart rate, respiratory rate, arterial blood gases (pH, partial pressure of oxygen in the arterial blood [PaO2], partial pressure of carbon dioxide in arterial blood [PaCO2]) at baseline, one and four hours. The patients were further classified into two groups based on the etiology of ARF as COPD-ARF and ARF due to other causes. The primary outcome was the need for endotracheal intubation during the intensive care unit (ICU) stay. During the study period, 248 patients were admitted in the ICU and of these 63 (25.4%; 24, COPD-ARF, 39, ARF due to other causes; 40 male and 23 female patients; mean [standard deviation] age of 45.7 [16.6] years) patients were initiated on NIPPV. Patients with ARF secondary to COPD were older, had higher APACHE II scores, lower respiratory rates, lower pH and higher PaCO2 levels compared to other causes of ARF. After one hour there was a significant decrease in respiratory rate and heart rate and decline in PaCO2 levels with increase in pH and PaO2 levels in patients successfully managed with NIPPV. However, there was no difference in improvement of clinical and blood gas parameters between the two groups except the rate of decline of pH at one and four hours and PaCO2 at one hour which was significantly faster in the COPD group. NIPPV failures were significantly higher in ARF due to other causes (15/39) than in ARF-COPD (3/24) (p = 0.03). The mean ICU and hospital stay and the hospital mortality were similar in the two groups. In the multivariate logistic regression model (after

  1. Evaluation of insulated pressure vessels for cryogenic hydrogen storage

    SciTech Connect

    Aceves, S M; Garcia-Villazana, O; Martinez-Frias, J

    1999-03-01

    This paper presents an analytical and experimental evaluation of the applicability of insulated pressure vessels for hydrogen-fueled light-duty vehicles. Insulated pressure vessels are cryogenic-capable pressure vessels that can be fueled with liquid hydrogen (LH?) or ambient-temperature compressed hydrogen (CH2). Insulated pressure vessels offer the advantages of liquid hydrogen tanks (low weight and volume), with reduced disadvantages (lower energy requirement for hydrogen liquefaction and reduced evaporative losses). The purpose of this work is to verify that commercially available aluminum-lined, fiber- wrapped vessels can be used for cryogenic hydrogen storage. The paper reports on previous and ongoing tests and analyses that have the purpose of improving the system design and assure its safety.

  2. Drp1-Dependent Mitochondrial Autophagy Plays a Protective Role Against Pressure-Overload-Induced Mitochondrial Dysfunction and Heart Failure

    PubMed Central

    Shirakabe, Akihiro; Zhai, Peiyong; Ikeda, Yoshiyuki; Saito, Toshiro; Maejima, Yasuhiro; Hsu, Chiao-Po; Nomura, Masatoshi; Egashira, Kensuke; Levine, Beth; Sadoshima, Junichi

    2016-01-01

    Background Mitochondrial autophagy is an important mediator of mitochondrial quality control in cardiomyocytes. The occurrence of mitochondrial autophagy and its significance during cardiac hypertrophy are not well understood. Methods and Results Mice were subjected to transverse aortic constriction (TAC) and observed at multiple time points up to 30 days. Cardiac hypertrophy developed after 5 days, the ejection fraction was reduced after 14 days, and heart failure (HF) was observed 30 days after TAC. General autophagy was upregulated between 1 and 12 hours after TAC but was downregulated below physiological levels 5 days after TAC. Mitochondrial autophagy, evaluated by electron microscopy, mitochondrial content, and Mito-Keima, was transiently activated around 3–7 days post-TAC, coinciding with mitochondrial translocation of Drp1. However, it was downregulated thereafter, followed by mitochondrial dysfunction. Haploinsufficiency of Drp1 abolished mitochondrial autophagy and exacerbated the development of both mitochondrial dysfunction and HF after TAC. Injection of Tat-Beclin 1, a potent inducer of autophagy, but not control peptide, on Day 7 after TAC partially rescued mitochondrial autophagy, and attenuated mitochondrial dysfunction and HF induced by pressure overload (PO). Haploinsufficiency of either drp1 or beclin 1 prevented the rescue by Tat-Beclin 1, suggesting that its effect is mediated in part through autophagy, including mitochondrial autophagy. Conclusions Mitochondrial autophagy is transiently activated and then downregulated in the mouse heart in response to PO. Downregulation of mitochondrial autophagy plays an important role in mediating the development of mitochondrial dysfunction and HF, whereas restoration of mitochondrial autophagy attenuates dysfunction in the heart during PO. PMID:26915633

  3. Bucindolol, systolic blood pressure, and outcomes in systolic heart failure: a prespecified post hoc analysis of BEST.

    PubMed

    White, Michel; Desai, Ravi V; Guichard, Jason L; Mujib, Marjan; Aban, Inmaculada B; Ahmed, Mustafa I; Feller, Margaret A; de Denus, Simon; Ahmed, Ali

    2012-05-01

    In the Beta-Blocker Evaluation of Survival Trial (BEST), systolic blood pressure (SBP) ≤ 120 mm Hg was an independent predictor of poor prognosis in ambulatory patients with chronic systolic heart failure (HF). Because SBP is an important predictor of response to β-blocker therapy, the BEST protocol prespecified a post hoc analysis to determine whether the effect of bucindolol varied by baseline SBP. In the BEST, 2706 patients with chronic systolic (left ventricular ejection fraction < 35%) HF and New York Heart Association class III (92%) or IV (8%) symptoms and receiving standard background therapy were randomized to receive either bucindolol (n = 1354) or placebo (n = 1354). Of these, 1751 had SBP ≤ 120 mm Hg, and 955 had SBP > 120 mm Hg at baseline. Among patients with SBP > 120 mm Hg, all-cause mortality occurred in 28% and 22% of patients receiving placebo and bucindolol, respectively (hazard ratio when bucindolol was compared with placebo, 0.77; 95% confidence interval [CI], 0.59-0.99; P = 0.039). In contrast, among those with SBP ≤ 120 mm Hg, 36% and 35% of patients in the placebo and bucindolol groups died, respectively (hazard ratio, 0.95; 95% CI, 0.81-1.12; P = 0.541). Hazard ratios (95% CIs; P values) for HF hospitalization associated with bucindolol use were 0.70 (0.56-0.89; P = 0.003) and 0.82 (0.71-0.95; P = 0.008) for patients with SBP > 120 and ≤ 120 mm Hg, respectively. Bucindolol, a nonselective β-blocker with weak α(2)-blocking properties, significantly reduced HF hospitalization in systolic HF patients regardless of baseline SBP. However, bucindolol reduced mortality only in those with SBP > 120 mm Hg. Copyright © 2012 Canadian Cardiovascular Society. All rights reserved.

  4. Association of Blood Pressure Trajectory With Mortality, Incident Cardiovascular Disease, and Heart Failure in the Cardiovascular Health Study.

    PubMed

    Smitson, Christopher C; Scherzer, Rebecca; Shlipak, Michael G; Psaty, Bruce M; Newman, Anne B; Sarnak, Mark J; Odden, Michelle C; Peralta, Carmen A

    2017-06-01

    Common blood pressure (BP) trajectories are not well established in elderly persons, and their association with clinical outcomes is uncertain. We used hierarchical cluster analysis to identify discrete BP trajectories among 4,067 participants in the Cardiovascular Health Study using repeated BP measures from years 0 to 7. We then evaluated associations of each BP trajectory cluster with all-cause mortality, incident cardiovascular disease (CVD, defined as stroke or myocardial infarction) (N = 2,837), and incident congestive heart failure (HF) (N = 3,633) using Cox proportional hazard models. Median age was 77 years at year 7. Over a median 9.3 years of follow-up, there were 2,475 deaths, 659 CVD events, and 1,049 HF events. The cluster analysis identified 3 distinct trajectory groups. Participants in cluster 1 (N = 1,838) had increases in both systolic (SBP) and diastolic (DBP) BPs, whereas persons in cluster 2 (N = 1,109) had little change in SBP but declines in DBP. Persons in cluster 3 (N = 1,120) experienced declines in both SBP and DBP. After multivariable adjustment, clusters 2 and 3 were associated with increased mortality risk relative to cluster 1 (hazard ratio = 1.21, 95% confidence interval: 1.06-1.37 and hazard ratio = 1.20, 95% confidence interval: 1.05-1.36, respectively). Compared to cluster 1, cluster 3 had higher rates of incident CVD but associations were not statistically significant in demographic-adjusted models (hazard ratio = 1.16, 95% confidence interval: 0.96-1.39). Findings were similar when stratified by use of antihypertensive therapy. Among community-dwelling elders, distinct BP trajectories were identified by integrating both SBP and DBP. These clusters were found to have differential associations with outcomes.

  5. Consequence evaluation of radiation embrittlement of Trojan reactor pressure vessel supports

    SciTech Connect

    Lu, S.C.; Sommer, S.C.; Johnson, G.L. ); Lambert, H.E. )

    1990-10-01

    This report describes a consequence evaluation to address safety concerns raised by the radiation embrittlement of the reactor pressure vessel (RPV) supports for the Trojan nuclear power plant. The study comprises a structural evaluation and an effects evaluation and assumes that all four reactor vessel supports have completely lost the load carrying capability. By demonstrating that the ASME code requirements governing Level D service limits are satisfied, the structural evaluation concludes that the Trojan reactor coolant loop (RCL) piping is capable of transferring loads to the steam generator (SG) supports and the reactor coolant pump (RCP) supports. A subsequent design margins to accommodate additional loads transferred to them through the RCL piping. The effects evaluation, employing a systems analysis approach, investigates initiating events and the reliability of the engineered safeguard systems as the RPV is subject to movements caused by the RPV support failure. The evaluation identifies a number of areas of additional safety concerns, but further investigation of the above safety concerns, however, concludes that a hypothetical failure of the Trojan RPV supports due to radiation embrittlement will not result in consequences of significant safety concerns.

  6. Stress analysis and evaluation of a rectangular pressure vessel

    NASA Astrophysics Data System (ADS)

    Rezvani, M. A.; Ziada, H. H.; Shurrab, M. S.

    1992-10-01

    This study addresses structural analysis and evaluation of an abnormal rectangular pressure vessel, designed to house equipment for drilling and collecting samples from Hanford radioactive waste storage tanks. It had to be qualified according to ASME boiler and pressure vessel code, section 8; however, it had the cover plate bolted along the long face, a configuration not addressed by the code. Finite element method was used to calculate stresses resulting from internal pressure; these stresses were then used to evaluate and qualify the vessel. Fatigue is not a concern; thus, it can be built according to section 8, division 1 instead of division 2. Stress analysis was checked against the code. A stayed plate was added to stiffen the long side of the vessel.

  7. Evaluation of high pressure Freon decontamination. I. Preliminary tests

    SciTech Connect

    Rankin, W.N.

    1983-10-31

    High-pressure Freon blasting techniques are being evaluated for applications involving the removal of non-adherent radioactive particulate contamination at SRP. Very little waste is generated by this technique because the used Freon can be easily distilled and reused. One of the principle advantages of this technique is that decontaminated electrical equipment can be returned to service immediately without drying, unlike high-pressure water blasting techniques. Preliminary scoutin tests evaluating high-pressure Freon blasting for decontamination at SRP were carried out at Quadrex Co., Oak Ridge, TN, October 12 and 13. DWPF-type contamination (raw sludge plus volatiles) and separations area-type contamination (diluted boiling point (47.6/sup 0/C) allow it to rapidly separate from higher boiling contaminants via distillation with filtration to remove particulate material, and distillation with condensation, the solvent may be recovered for indefinite reuse while reducing the radioactive waste to a minimum. 3 references, 5 figures, 6 tables.

  8. Evaluation of containment failure and cleanup time for Pu shots on the Z machine.

    SciTech Connect

    Darby, John L.

    2010-02-01

    Between November 30 and December 11, 2009 an evaluation was performed of the probability of containment failure and the time for cleanup of contamination of the Z machine given failure, for plutonium (Pu) experiments on the Z machine at Sandia National Laboratories (SNL). Due to the unique nature of the problem, there is little quantitative information available for the likelihood of failure of containment components or for the time to cleanup. Information for the evaluation was obtained from Subject Matter Experts (SMEs) at the Z machine facility. The SMEs provided the State of Knowledge (SOK) for the evaluation. There is significant epistemic- or state of knowledge- uncertainty associated with the events that comprise both failure of containment and cleanup. To capture epistemic uncertainty and to allow the SMEs to reason at the fidelity of the SOK, we used the belief/plausibility measure of uncertainty for this evaluation. We quantified two variables: the probability that the Pu containment system fails given a shot on the Z machine, and the time to cleanup Pu contamination in the Z machine given failure of containment. We identified dominant contributors for both the time to cleanup and the probability of containment failure. These results will be used by SNL management to decide the course of action for conducting the Pu experiments on the Z machine.

  9. Field evaluation of tank track-pad failures

    SciTech Connect

    Lesuer, D.R.; Santor, S.D.; Cornell, R.H.; Patt, J.

    1983-04-01

    This report describes a series of experiments that were performed at the Yuma Proving Grounds to better understand the problem of track pad failures. In one series of tests, high speed motion photography was used to study the deformation and operational characteristics of the T142 track. In another series of tests, the temperature buildup in pads was studied on the T142 track. Testing was done on the paved, gravel, and cross-country courses at Yuma. The results of the movie studies show that significant tensile stresses were introduced into the pads as they scrubbed over obstacles. Localized loads and large applied shear stresses introduced during turning operations can also cause tensile stresses. We believe these factors have a dominant role in the cutting and chunking process. The temperature data was taken for the surface as well as the interior of the pad and showed that high temperatures can be produced in track pads. There is also a large temperature difference between tests run on the three courses. These differences were shown to be due to the different heat generation rates produced on these three courses.

  10. Performance of low-pressure thermionic converters is evaluated

    NASA Technical Reports Server (NTRS)

    Richards, H. K.

    1969-01-01

    Experiments, evaluating the performance of low-pressure thermionic converters, were conducted with cesium, potassium, and sodium-metal vapors. The results of the investigation are useful in the selection of favorable conditions for the design of thermionic reactor fuel elements, including RF output for special applications.

  11. Effect of Combined Loading Due to Bending and Internal Pressure on Pipe Flaw Evaluation Criteria

    NASA Astrophysics Data System (ADS)

    Miura, Naoki; Sakai, Shinsuke

    Considering a rule for the rationalization of maintenance of Light Water Reactor piping, reliable flaw evaluation criteria are essential for determining how a detected flaw will be detrimental to continuous plant operation. Ductile fracture is one of the dominant failure modes that must be considered for carbon steel piping and can be analyzed by elastic-plastic fracture mechanics. Some analytical efforts have provided various flaw evaluation criteria using load correction factors, such as the Z-factors in the JSME codes on fitness-for-service for nuclear power plants and the section XI of the ASME boiler and pressure vessel code. The present Z-factors were conventionally determined, taking conservativity and simplicity into account; however, the effect of internal pressure, which is an important factor under actual plant conditions, was not adequately considered. Recently, a J-estimation scheme, LBB.ENGC for the ductile fracture analysis of circumferentially through-wall-cracked pipes subjected to combined loading was developed for more accurate prediction under more realistic conditions. This method explicitly incorporates the contributions of both bending and tension due to internal pressure by means of a scheme that is compatible with an arbitrary combined-loading history. In this study, the effect of internal pressure on the flaw evaluation criteria was investigated using the new J-estimation scheme. The Z-factor obtained in this study was compared with the presently used Z-factors, and the predictability of the current flaw evaluation criteria was quantitatively evaluated in consideration of the internal pressure.

  12. Competitive evaluation of failure detection algorithms for strapdown redundant inertial instruments.

    NASA Technical Reports Server (NTRS)

    Wilcox, J. C.

    1973-01-01

    Seven algorithms for failure detection, isolation, and correction of strapdown inertial instruments in the dodecahedron configuration are competitively evaluated by means of a digital computer simulation that provides them with identical inputs. Their performance is compared in terms of orientation errors and computer burden. The analytical foundations of the algorithms are presented. The features that are found to contribute to superior performance are use of a definite logical structure, elimination of interaction between failures, different thresholds for first and second failures, use of the 'parity' test signals, and avoidance of iteration loops.

  13. Evaluation of Resting Cardiac Power Output as a Prognostic Factor in Patients with Advanced Heart Failure.

    PubMed

    Yildiz, Omer; Aslan, Gamze; Demirozu, Zumrut T; Yenigun, Cemal Deniz; Yazicioglu, Nuran

    2017-09-15

    If the heart is represented by a hydraulic pump, cardiac power represents the hydraulic function of the heart. Cardiac pump function is frequently determined through left ventricular ejection fraction using imaging. This study aims to validate resting cardiac power output (CPO) as a predictive biomarker in patients with advanced heart failure (HF). One hundred and seventy-two patients with HF severe enough to warrant cardiac transplantation were retrospectively reviewed at a single tertiary care institution between September 2010 and July 2013. Patients were initially evaluated with simultaneous right-sided and left-sided cardiac catheter-based hemodynamic measurements, followed by longitudinal follow-up (median of 52 months) for adverse events (cardiac mortality, cardiac transplantation, or ventricular assist device placement). Median resting CPO was 0.54 W (long rank chi-square = 33.6; p < 0.0001). Decreased resting CPO (<0.54 W) predicted increased risk for adverse outcomes. Fifty cardiac deaths, 10 cardiac transplants, and 12 ventricular assist device placements were documented. The prognostic relevance of resting CPO remained significant after adjustment for age, gender, left ventricular ejection fraction, mean arterial pressure, pulmonary vascular resistance, right atrial pressure, and estimated glomerular filtration rate (HR, 3.53; 95% confidence interval, 1.66 to 6.77; p = 0.0007). In conclusion, lower resting CPO supplies independent prediction of adverse outcomes. Thus, it could be effectively used for risk stratification in patients with advanced HF. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. A technique for measuring absolute toe pressures: evaluation of pressure-sensitive film techniques.

    PubMed

    Tuckman, A S; Werner, F W; Fortino, M D; Spadaro, J A

    1992-05-01

    Although a number of pathologies of the forefoot in ballet dancers on pointe have been described, pressures and deforming forces have not been adequately measured. To evaluate the possible use of pressure-sensitive film (PSF) in measuring the pressures on the external soft tissues in such a confined space as the dancer's toe shoe, it was tested and calibrated with 20 cadaver toes. Each cadaver toe was internally stabilized and loaded longitudinally against PSF on a flat surface. The resultant films were analyzed with a video imaging system and the pressures and total forces were determined. Results showed that the linearity of the PSF to pressure had a regression value of 0.98. By using two sensitivity ranges of films, the total force measured by the PSF was found to be within 10% of the known applied force on each toe. The PSF, therefore, may very well be a useful and accurate method of measuring external soft tissue pressures on the forefoot.

  15. Low Temperature and High Pressure Evaluation of Insulated Pressure Vessels for Cryogenic Hydrogen Storage

    SciTech Connect

    Aceves, S.; Martinez-Frias, J.; Garcia-Villazana, O.

    2000-06-25

    Insulated pressure vessels are cryogenic-capable pressure vessels that can be fueled with liquid hydrogen (LH{sub 2}) or ambient-temperature compressed hydrogen (CH{sub 2}). Insulated pressure vessels offer the advantages of liquid hydrogen tanks (low weight and volume), with reduced disadvantages (fuel flexibility, lower energy requirement for hydrogen liquefaction and reduced evaporative losses). The work described here is directed at verifying that commercially available pressure vessels can be safely used to store liquid hydrogen. The use of commercially available pressure vessels significantly reduces the cost and complexity of the insulated pressure vessel development effort. This paper describes a series of tests that have been done with aluminum-lined, fiber-wrapped vessels to evaluate the damage caused by low temperature operation. All analysis and experiments to date indicate that no significant damage has resulted. Required future tests are described that will prove that no technical barriers exist to the safe use of aluminum-fiber vessels at cryogenic temperatures.

  16. DELPHI expert panel evaluation of Hanford high level waste tank failure modes and release quantities

    SciTech Connect

    Dunford, G.L.; Han, F.C.

    1996-09-30

    The Failure Modes and Release Quantities of the Hanford High Level Waste Tanks due to postulated accident loads were established by a DELPHI Expert Panel consisting of both on-site and off-site experts in the field of Structure and Release. The Report presents the evaluation process, accident loads, tank structural failure conclusion reached by the panel during the two-day meeting.

  17. Non-invasive blood pressure measurements in cats: clinical significance of hypertension associated with chronic renal failure.

    PubMed

    Mishina, M; Watanabe, T; Fujii, K; Maeda, H; Wakao, Y; Takahashi, M

    1998-07-01

    The systolic, mean and diastolic pressures as well as the heart rate were measured using the oscillometric method, on a total of 104 cats (60 cats in the normal group, and 44 in the renal disease group) which were brought into Azabu University Animal Hospital. The blood pressure in the normal group was systolic: 115.4 +/- 10.1 mmHg, mean: 96.2 +/- 12.2 mmHg, and diastolic: 73.7 +/- 10.7 mmHg. Although no difference in heart rate, the renal disease group showed significantly (p < 0.05) higher values for systolic, mean, and diastolic pressure when compared with the normal group. Moreover, when plasma renin activity, angiotensin I and II, and aldosterone concentrations were measured in other cats (11 normal and seven with chronic renal failure), all cats with chronic renal failure showed significantly (p < 0.05) higher values than the normal group. It is, therefore, indicated that hypertension due to stimulating renin-angiotensin-aldosterone system may have manifested in cats with renal dysfunction.

  18. Clinical symptoms of right ventricular failure in experimental chronic pressure load are associated with progressive diastolic dysfunction.

    PubMed

    Borgdorff, Marinus A J; Koop, Anne Marie C; Bloks, Vincent W; Dickinson, Michael G; Steendijk, Paul; Sillje, Herman H W; van Wiechen, Maarten P H; Berger, Rolf M F; Bartelds, Beatrijs

    2015-02-01

    Right ventricular failure (RVF) due to pressure load is a major cause of death in congenital heart diseases and pulmonary hypertension. The mechanisms of RVF are unknown. We used an experimental approach based upon clinical signs of RVF to delineate functional and biological processes associated with RVF. Wistar rats were subjected to a pulmonary artery banding (PAB n=12) or sham surgery (CON, n=7). After 52±5days, 5/12 PAB rats developed clinical symptoms of RVF (inactivity, ruffled fur, dyspnea, ascites) necessitating termination (PAB+CF). We compared these to PAB rats with RVF without clinical symptoms (PAB-). PAB resulted in reduced cardiac output, RV stroke volume, TAPSE, and increased end diastolic pressure (all p<0.05 vs. CON) in all rats, but PAB+CF rats were significantly more affected than PAB-, despite similar pressure load (p=ns). Pressure-volume analysis showed enhanced contractility (end systolic elastance) in PAB- and PAB+CF, but diastolic function (end diastolic elastance, end diastolic pressure) deteriorated especially in PAB+CF. In PAB+CF capillary density was lower than in PAB-. Gene-array analysis revealed downregulation of both fatty acid oxidation and carbohydrate metabolism in PAB+CF. Chronic PAB led to different degrees of RVF, with half of the rats developing severe clinical symptoms of RVF, associated with progressive deterioration of diastolic function, hypoxia-prone myocardium, increased response to oxidative stress and suppressed myocardial metabolism. This model represents clinical RVF and allows for unraveling of mechanisms involved in the progression from RV adaptation to RV failure and the effect of intervention on these mechanisms. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Noninvasive continuous positive airway pressure delivered by helmet in hematological malignancy patients with hypoxemic acute respiratory failure.

    PubMed

    Principi, Tiziana; Pantanetti, Simona; Catani, Francesca; Elisei, Daniele; Gabbanelli, Vincenzo; Pelaia, Paolo; Leoni, Pietro

    2004-01-01

    To compare the efficacy of early administration of noninvasive continuous positive airway pressure (nCPAP) delivered by the helmet vs. face mask to treat hematological malignancy patients with fever, pulmonary infiltrates, and hypoxemic acute respiratory failure. Prospective clinical study with historical matched controls in the hematology department of a university hospital. Seventeen hematological malignancy patients with hypoxemic acute respiratory failure defined as: moderate to severe dyspnea, tachypnea (>30-35 breaths/min), use of accessory muscles and paradoxical abdominal motion, and PaO2/FIO2 ratio less than 200. Each patient was treated with nCPAP by helmet outside the ICU in the hematological ward. Arterial oxygen saturation, heart rate, respiratory rate, and blood pressure were monitored to identify early nCPAP failure. Seventeen historical-matched controls treated in the same department with face mask CPAP were selected as control population; matching criteria were age, sex, diagnosis, and PaO2/FIO2 ratio. Primary end-points were improvement in gas exchanges and the need for endotracheal intubation. Oxygenation improved in all patients after nCPAP. No patient failed helmet nCPAP because of intolerance while eigh patients in the mask group did so. nCPAP could be applied continuously for a longer period of time in the helmet group (28.44+/-0.20 vs. 7.5+/-0.45 h). Early nCPAP with helmet improves oxygenation in selected immunosuppressed patients with hypoxemic acute respiratory failure. Tolerance of helmet nCPAP seems better than that of nCPAP delivered by mask.

  20. Mothers' Attributions in Reminiscing Conversations about Children's Successes and Failures: Connections with Children's Self-Evaluations

    ERIC Educational Resources Information Center

    Goodvin, Rebecca; Rolfson, Jacqueline

    2014-01-01

    Effects of feedback on children's self-evaluations are well established, yet little is known about how parents talk with children about everyday successes and failures, despite the importance of parent-child reminiscing in children's psychological understanding. We examine mothers' attributions and performance evaluations in conversations about…

  1. Clinical long-term evaluation and failure characteristics of 1,335 all-ceramic restorations.

    PubMed

    Beier, Ulrike S; Kapferer, Ines; Dumfahrt, Herbert

    2012-01-01

    The aim of this clinical retrospective study was to evaluate the clinical quality, estimated survival rate, and failure analysis of different all-ceramic restorations in a long-term analysis of up to 20 years. Different all-ceramic restorations (crowns [n = 470], veneers [n = 318], onlays [n = 213], and inlays ]n = 334[) were placed in 302 patients (120 men, 182 women) between 1987 and 2009 at Medical University Innsbruck, Innsbruck, Austria. Clinical examination was performed during patients' regularly scheduled maintenance appointments. Esthetic match, porcelain surface, marginal discoloration, and integrity were evaluated following modified California Dental Association/Ryge criteria. Number of restoration failures and reasons for failure were recorded. The study population included 106 (35.1%) individuals diagnosed with bruxism. The success rate was determined using Kaplan-Meier survival analysis. The mean observation time was 102 ± 60 months. Ninety-five failures were recorded. The main reason for failure was fracture of the ceramic (33.68%). The estimated survival rate was 97.3% after 5 years, 93.5% at 10 years, and 78.5% at 20 years. Nonvital teeth showed a significantly higher risk of failure (P < .0001). There was a 2.3-times greater risk of failure associated with existing parafunction (bruxism, P = .0045). Cementation using Variolink showed significantly fewer failures than Optec Cement (P = .0217) and Dual Cement (P = .0099). No significant differences were found for type of restoration and distribution in the mouth. All-ceramic restorations offer a predictable and successful restoration with an estimated survival probability of 93.5% over 10 years. Significantly increased failure rates are associated with bruxism, nonvital teeth, and specific cementation agents.

  2. Effect of meal size on post-prandial blood pressure and on postural hypotension in primary autonomic failure.

    PubMed

    Puvi-Rajasingham, S; Mathias, C J

    1996-04-01

    In chronic autonomic failure, food ingestion causes a profound and rapid fall in supine blood pressure and aggravates postural hypotension. Food volume and caloric load are important determinants of gastric emptying and postprandial splanchnic hyperaemia, which appears to be a major contributor to hypotension. We therefore compared the cardiovascular effects of three large meals with six small meals providing an identical daily caloric intake, in seven subjects with primary autonomic failure. Daytime ambulatory blood pressure (BP) was measured by Spacelabs 90207 every 30 min with additional recordings while lying, sitting and standing, 30 min after each meal. Systolic and diastolic BP were lower in all three positions after large meals; systolic 131 versus 151 mmHg (large versus small), p = 0.005, 109 versus 124 mmHg, 89 versus 103 mmHg and diastolic 76 versus 90 mmHg, p = 0.02, 66 versus 78 mmHg, p = 0.07 and 50 versus 66 mmHg, p = 0.06 for lying, sitting and standing, respectively. Between meals, BP fell to lower levels with large meals, 88 (20) mmHg versus 104 (19) mmHg, p = 0.002 and 48 (13) mmHg versus 63 (13), p = 0.0001 mmHg for systolic and diastolic pressure respectively. Five subjects had more symptoms of postural dizziness after large meals. In primary autonomic failure, smaller and more frequent meals reduce postprandial hypotension and diminish postural symptoms post-meal. This is likely to be a useful non-pharmacological method in the management of postprandial hypotension.

  3. Review of reactor pressure vessel evaluation report for Yankee Rowe Nuclear Power Station (YAEC No. 1735)

    SciTech Connect

    Cheverton, R.D.; Dickson, T.L.; Merkle, J.G.; Nanstad, R.K.

    1992-03-01

    The Yankee Atomic Electric Company has performed an Integrated Pressurized Thermal Shock (IPTS)-type evaluation of the Yankee Rowe reactor pressure vessel in accordance with the PTS Rule (10 CFR 50. 61) and a US Regulatory Guide 1.154. The Oak Ridge National Laboratory (ORNL) reviewed the YAEC document and performed an independent probabilistic fracture-mechnics analysis. The review included a comparison of the Pacific Northwest Laboratory (PNL) and the ORNL probabilistic fracture-mechanics codes (VISA-II and OCA-P, respectively). The review identified minor errors and one significant difference in philosophy. Also, the two codes have a few dissimilar peripheral features. Aside from these differences, VISA-II and OCA-P are very similar and with errors corrected and when adjusted for the difference in the treatment of fracture toughness distribution through the wall, yield essentially the same value of the conditional probability of failure. The ORNL independent evaluation indicated RT{sub NDT} values considerably greater than those corresponding to the PTS-Rule screening criteria and a frequency of failure substantially greater than that corresponding to the ``primary acceptance criterion`` in US Regulatory Guide 1.154. Time constraints, however, prevented as rigorous a treatment as the situation deserves. Thus, these results are very preliminary.

  4. Review of reactor pressure vessel evaluation report for Yankee Rowe Nuclear Power Station (YAEC No. 1735)

    SciTech Connect

    Cheverton, R.D.; Dickson, T.L.; Merkle, J.G.; Nanstad, R.K. )

    1992-03-01

    The Yankee Atomic Electric Company has performed an Integrated Pressurized Thermal Shock (IPTS)-type evaluation of the Yankee Rowe reactor pressure vessel in accordance with the PTS Rule (10 CFR 50. 61) and a US Regulatory Guide 1.154. The Oak Ridge National Laboratory (ORNL) reviewed the YAEC document and performed an independent probabilistic fracture-mechnics analysis. The review included a comparison of the Pacific Northwest Laboratory (PNL) and the ORNL probabilistic fracture-mechanics codes (VISA-II and OCA-P, respectively). The review identified minor errors and one significant difference in philosophy. Also, the two codes have a few dissimilar peripheral features. Aside from these differences, VISA-II and OCA-P are very similar and with errors corrected and when adjusted for the difference in the treatment of fracture toughness distribution through the wall, yield essentially the same value of the conditional probability of failure. The ORNL independent evaluation indicated RT{sub NDT} values considerably greater than those corresponding to the PTS-Rule screening criteria and a frequency of failure substantially greater than that corresponding to the primary acceptance criterion'' in US Regulatory Guide 1.154. Time constraints, however, prevented as rigorous a treatment as the situation deserves. Thus, these results are very preliminary.

  5. A comparison of synchronized intermittent mandatory ventilation and pressure-regulated volume control ventilation in elderly patients with acute exacerbations of COPD and respiratory failure

    PubMed Central

    Chang, Suchi; Shi, Jindong; Fu, Cuiping; Wu, Xu; Li, Shanqun

    2016-01-01

    Background COPD is the third leading cause of death worldwide. Acute exacerbations of COPD may cause respiratory failure, requiring intensive care unit admission and mechanical ventilation. Intensive care unit patients with acute exacerbations of COPD requiring mechanical ventilation have higher mortality rates than other hospitalized patients. Although mechanical ventilation is the most effective intervention for these conditions, invasive ventilation techniques have yielded variable effects. Objective We evaluated pressure-regulated volume control (PRVC) ventilation treatment efficacy and preventive effects on pulmonary barotrauma in elderly COPD patients with respiratory failure. Patients and methods Thirty-nine intubated patients were divided into experimental and control groups and treated with the PRVC and synchronized intermittent mandatory ventilation – volume control methods, respectively. Vital signs, respiratory mechanics, and arterial blood gas analyses were monitored for 2–4 hours and 48 hours. Results Both groups showed rapidly improved pH, partial pressure of oxygen (PaO2), and PaO2 per fraction of inspired O2 levels and lower partial pressure of carbon dioxide (PaCO2) levels. The pH and PaCO2 levels at 2–4 hours were lower and higher, respectively, in the test group than those in the control group (P<0.05 for both); after 48 hours, blood gas analyses showed no statistical difference in any marker (P>0.05). Vital signs during 2–4 hours and 48 hours of treatment showed no statistical difference in either group (P>0.05). The level of peak inspiratory pressure in the experimental group after mechanical ventilation for 2–4 hours and 48 hours was significantly lower than that in the control group (P<0.05), while other variables were not significantly different between groups (P>0.05). Conclusion Among elderly COPD patients with respiratory failure, application of PRVC resulted in rapid improvement in arterial blood gas analyses while maintaining

  6. A comparison of synchronized intermittent mandatory ventilation and pressure-regulated volume control ventilation in elderly patients with acute exacerbations of COPD and respiratory failure.

    PubMed

    Chang, Suchi; Shi, Jindong; Fu, Cuiping; Wu, Xu; Li, Shanqun

    2016-01-01

    COPD is the third leading cause of death worldwide. Acute exacerbations of COPD may cause respiratory failure, requiring intensive care unit admission and mechanical ventilation. Intensive care unit patients with acute exacerbations of COPD requiring mechanical ventilation have higher mortality rates than other hospitalized patients. Although mechanical ventilation is the most effective intervention for these conditions, invasive ventilation techniques have yielded variable effects. We evaluated pressure-regulated volume control (PRVC) ventilation treatment efficacy and preventive effects on pulmonary barotrauma in elderly COPD patients with respiratory failure. Thirty-nine intubated patients were divided into experimental and control groups and treated with the PRVC and synchronized intermittent mandatory ventilation - volume control methods, respectively. Vital signs, respiratory mechanics, and arterial blood gas analyses were monitored for 2-4 hours and 48 hours. Both groups showed rapidly improved pH, partial pressure of oxygen (PaO2), and PaO2 per fraction of inspired O2 levels and lower partial pressure of carbon dioxide (PaCO2) levels. The pH and PaCO2 levels at 2-4 hours were lower and higher, respectively, in the test group than those in the control group (P<0.05 for both); after 48 hours, blood gas analyses showed no statistical difference in any marker (P>0.05). Vital signs during 2-4 hours and 48 hours of treatment showed no statistical difference in either group (P>0.05). The level of peak inspiratory pressure in the experimental group after mechanical ventilation for 2-4 hours and 48 hours was significantly lower than that in the control group (P<0.05), while other variables were not significantly different between groups (P>0.05). Among elderly COPD patients with respiratory failure, application of PRVC resulted in rapid improvement in arterial blood gas analyses while maintaining a low peak inspiratory pressure. PRVC can reduce pulmonary barotrauma

  7. Extracellular high-mobility group box 1 mediates pressure overload-induced cardiac hypertrophy and heart failure.

    PubMed

    Zhang, Lei; Liu, Ming; Jiang, Hong; Yu, Ying; Yu, Peng; Tong, Rui; Wu, Jian; Zhang, Shuning; Yao, Kang; Zou, Yunzeng; Ge, Junbo

    2016-03-01

    Inflammation plays a key role in pressure overload-induced cardiac hypertrophy and heart failure, but the mechanisms have not been fully elucidated. High-mobility group box 1 (HMGB1), which is increased in myocardium under pressure overload, may be involved in pressure overload-induced cardiac injury. The objectives of this study are to determine the role of HMGB1 in cardiac hypertrophy and cardiac dysfunction under pressure overload. Pressure overload was imposed on the heart of male wild-type mice by transverse aortic constriction (TAC), while recombinant HMGB1, HMGB1 box A (a competitive antagonist of HMGB1) or PBS was injected into the LV wall. Moreover, cardiac myocytes were cultured and given sustained mechanical stress. Transthoracic echocardiography was performed after the operation and sections for histological analyses were generated from paraffin-embedded hearts. Relevant proteins and genes were detected. Cardiac HMGB1 expression was increased after TAC, which was accompanied by its translocation from nucleus to both cytoplasm and intercellular space. Exogenous HMGB1 aggravated TAC-induced cardiac hypertrophy and cardiac dysfunction, as demonstrated by echocardiographic analyses, histological analyses and foetal cardiac genes detection. Nevertheless, the aforementioned pathological change induced by TAC could partially be reversed by HMGB1 inhibition. Consistent with the in vivo observations, mechanical stress evoked the release and synthesis of HMGB1 in cultured cardiac myocytes. This study indicates that the activated and up-regulated HMGB1 in myocardium, which might partially be derived from cardiac myocytes under pressure overload, may be of crucial importance in pressure overload-induced cardiac hypertrophy and cardiac dysfunction. © 2015 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

  8. Experimental evaluation of the tensor polynomial failure criterion for the design of composite structures

    NASA Technical Reports Server (NTRS)

    Tennyson, R. C.

    1975-01-01

    The experimental measures and techniques are described which are used to obtain the strength tensor components, including cubic terms. Based on a considerable number of biaxial pressure tests together with specimens subjected to a constant torque and internal pressure, a modified form of the plane stress tensor polynomial failure equation was obtained that was capable of predicting ultimate strength results well. Preliminary data were obtained to determine the effect of varying post cure times and ambient temperatures (-80 F to 250 F) on the change in two tensor strength terms, F sub 2 and F sub 22. Other laminate configurations yield corresponding variations for the remaining strength parameters.

  9. Radiosonde pressure sensor performance - Evaluation using tracking radars

    NASA Technical Reports Server (NTRS)

    Parsons, C. L.; Norcross, G. A.; Brooks, R. L.

    1984-01-01

    The standard balloon-borne radiosonde employed for synoptic meteorology provides vertical profiles of temperature, pressure, and humidity as a function of elapsed time. These parameters are used in the hypsometric equation to calculate the geopotential altitude at each sampling point during the balloon's flight. It is important that the vertical location information be accurate. The present investigation was conducted with the objective to evaluate the altitude determination accuracy of the standard radiosonde throughout the entire balloon profile. The tests included two other commercially available pressure sensors to see if they could provide improved accuracy in the stratosphere. The pressure-measuring performance of standard baroswitches, premium baroswitches, and hypsometers in balloon-borne sondes was correlated with tracking radars. It was found that the standard and premium baroswitches perform well up to about 25 km altitude, while hypsometers provide more reliable data above 25 km.

  10. 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 ...

  11. [The pressure-equalizing function of the Eustachian tube : Evaluation in a hypo-/hyperbaric pressure chamber].

    PubMed

    Jansen, S; Meyer, M F; Hüttenbrink, K-B; Beutner, D

    2017-08-01

    The Eustachian tube connects the tympanic cavity (cavum tympani) and the nasopharynx, and enables pressure equalization between the middle ear and ambient pressure. Functional pressure compensation is very important for flying and diving in particular, due to non-physiologically large pressure differences. Evaluation of the pressure-equalizing function of the Eustachian tube is still a clinical challenge. This review article evaluates the existing data. Based on a selective literature search, different methods for evaluation of tube function are presented and evaluated, with special reference to evaluation of the pressure-equalizing function in a hypo-/hyperbaric pressure chamber. The pressure chamber enables the dynamics of active and passive pressure compensation to be provoked and also permits accurate measurement of pressures in the millibar range. A pressure chamber seems to be suitable to evaluate Eustachian tube function and therapeutic approaches to tube dysfunction. Further studies are needed to assess the value of the pressure chamber in combination with other functional tests.

  12. [Clinical evaluation of periapical endodontic surgery for endodontic failure].

    PubMed

    Xu, Qiong; Chen, Yi-yang; Ling, Jun-qi; Gu, Hai-jing; Liu, Jian-wei

    2009-02-01

    To evaluate the clinical outcome of periapical endodontic surgery for teeth that can't be treated by nonsurgical endodontic methods. Sixty-two affected teeth were chosen for surgical endodontic treatment, of which 31 teeth underwent periapical curettage and the others were treated by root-end resection, retrograde preparation and filling. A radiography was taken immediately after surgery and was compared with those taken at 12 and 24 months. The results of two groups were analyzed using the chi2 test. The success rate for retrograde filling was higher (85% after 12 months, 88% after 24 months) compared with that of periapical curettage (52% after 12 months, 45% after 24 months). The difference in success rate between the two groups was statistically significant. Ultrasonic root-end preparation and retrograde filling is a good choice of treatment when the teeth can't be treated appropriately by nonsurgical treatment.

  13. Low Transmission of Airway Pressures to the Abdomen in Mechanically Ventilated Patients With or Without Acute Respiratory Failure and Intra-Abdominal Hypertension.

    PubMed

    Heijnen, Bram G A D H; Spoelstra-de Man, Angelique M E; Groeneveld, A B Johan

    2017-03-01

    Intra-abdominal pressure, measured at end expiration, may depend on ventilator settings and transmission of intrathoracic pressure. We determined the transmission of positive intrathoracic pressure during mechanical ventilation at inspiration and expiration into the abdominal compartment. We included 9 patients after uncomplicated cardiac surgery and 9 with acute respiratory failure. Intravesical pressures were measured thrice (reproducibility of 1.8%) and averaged, at the end of each inspiratory and expiratory hold maneuvers of 5 seconds. Transmission, the change in intra-abdominal over intrathoracic pressures from end inspiration to end expiration, was about 8%. End-expiratory intra-abdominal pressure was lower than "total" intra-abdominal pressure over the entire respiratory cycle by 0.34 cm H2O. It was 0.73 cm H2O higher than "true" intra-abdominal pressure over the entire respiratory cycle, taking transmission into account. The percentage error was 3% for total and 10% for true pressure. Results did not differ among patients with or without acute respiratory failure and decreased respiratory compliance or between those with (≥12 mm Hg, n = 5) or without intra-abdominal hypertension. Transmitted airway pressure only slightly affects intra-abdominal pressure in mechanically ventilated patients, irrespective of respiratory compliance and baseline intra-abdominal pressure values. End-expiratory measurements referenced against atmospheric pressure may suffice for clinical practice.

  14. Systolic blood pressure reduction during the first 24 h in acute heart failure admission: friend or foe?

    PubMed

    Cotter, Gad; Metra, Marco; Davison, Beth A; Jondeau, Guillaume; Cleland, John G F; Bourge, Robert C; Milo, Olga; O'Connor, Christopher M; Parker, John D; Torre-Amione, Guillermo; van Veldhuisen, Dirk J; Kobrin, Isaac; Rainisio, Maurizio; Senger, Stefanie; Edwards, Christopher; McMurray, John J V; Teerlink, John R

    2017-09-04

    Changes in systolic blood pressure (SBP) during an admission for acute heart failure (AHF), especially those leading to hypotension, have been suggested to increase the risk for adverse outcomes. We analysed associations of SBP decrease during the first 24 h from randomization with serum creatinine changes at the last time-point available (72 h), using linear regression, and with 30- and 180-day outcomes, using Cox regression, in 1257 patients in the VERITAS study. After multivariable adjustment for baseline SBP, greater SBP decrease at 24 h from randomization was associated with greater creatinine increase at 72 h and greater risk for 30-day all-cause death, worsening heart failure (HF) or HF readmission. The hazard ratio (HR) for each 1 mmHg decrease in SBP at 24 h for 30-day death, worsening HF or HF rehospitalization was 1.01 [95% confidence interval (CI) 1.00-1.02; P = 0.021]. Similarly, the HR for each 1 mmHg decrease in SBP at 24 h for 180-day all-cause mortality was 1.01 (95% CI 1.00-1.03; P = 0.038). The associations between SBP decrease and outcomes did not differ by tezosentan treatment group, although tezosentan treatment was associated with a greater SBP decrease at 24 h. In the current post hoc analysis, SBP decrease during the first 24 h was associated with increased renal impairment and adverse outcomes at 30 and 180 days. Caution, with special attention to blood pressure monitoring, should be exercised when vasodilating agents are given to AHF patients. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

  15. Blood pressure control, proteinuria and renal outcome in chronic renal failure.

    PubMed

    Ruilope, L M; Campo, C; Rodicio, J L

    1998-03-01

    The presence of proteinuria has been shown to be an excellent predictor for a worse outcome of renal function. Both proteinuria and arterial hypertension often coexist in the same patient, and therapy must be directed at decreasing protein excretion in the urine as well as lowering the blood pressure. Any antihypertensive agent has the capacity to lower proteinuria simply by lowering blood pressure. Furthermore, the antiproteinuric capacity of angiotensin-converting enzyme inhibitors can be equalized by other agents or their combination, provided that the fall in blood pressure is great enough. For this reason studies are needed in which the strict control of arterial hypertension combined with a decrease in proteinuria are considered.

  16. Kidney (Renal) Failure

    MedlinePlus

    ... News Physician Resources Professions Site Index A-Z Kidney Failure Kidney failure, also known as renal failure, ... evaluated? How is kidney failure treated? What is kidney (renal) failure? The kidneys are designed to maintain ...

  17. Interrelationship of Nondestructive Evaluation Methodologies Applied to Testing of Composite Overwrapped Pressure Vessels

    NASA Technical Reports Server (NTRS)

    Leifeste, Mark R.

    2007-01-01

    Composite Overwrapped Pressure Vessels (COPVs) are commonly used in spacecraft for containment of pressurized gases and fluids, incorporating strength and weight savings. The energy stored is capable of extensive spacecraft damage and personal injury in the event of sudden failure. These apparently simple structures, composed of a metallic media impermeable liner and fiber/resin composite overwrap are really complex structures with numerous material and structural phenomena interacting during pressurized use which requires multiple, interrelated monitoring methodologies to monitor and understand subtle changes critical to safe use. Testing of COPVs at NASA Johnson Space Center White Sands T est Facility (WSTF) has employed multiple in-situ, real-time nondestructive evaluation (NDE) methodologies as well as pre- and post-test comparative techniques to monitor changes in material and structural parameters during advanced pressurized testing. The use of NDE methodologies and their relationship to monitoring changes is discussed based on testing of real-world spacecraft COPVs. Lessons learned are used to present recommendations for use in testing, as well as a discussion of potential applications to vessel health monitoring in future applications.

  18. A study of referral failures for potentially suicidal patients: a method of medical care evaluation.

    PubMed

    Knesper, D J

    1982-01-01

    To learn more about the methodological problems inherent in medical care evaluation studies, a quality assurance committee conducted a study of rates of referral failure for potentially suicidal patients seen in the psychiatry division of a university hospital's emergency room. A simple 5-point scale was used to identify for study a similarly ill patient group: 296 patients with moderately to extremely severe suicide potential. The rates of referral failure for the emergency room's psychiatry division were 24 per cent for referrals within the university hospital system and 33 per cent outside the system, which compared favorably with other facilities. Outlier analysis-a statistical procedure that holds promise for medical care evaluation studies-was used to identify clinicians whose rates of referral failure differed significantly from their peer's rates of. As a result, an instance of substandard performance was identified and corrected through the transfer of information about exceptionally good performance.

  19. Evaluation of Safety in a Radiation Oncology Setting Using Failure Mode and Effects Analysis

    SciTech Connect

    Ford, Eric C. Gaudette, Ray; Myers, Lee; Vanderver, Bruce; Engineer, Lilly; Zellars, Richard; Song, Danny Y.; Wong, John; DeWeese, Theodore L.

    2009-07-01

    Purpose: Failure mode and effects analysis (FMEA) is a widely used tool for prospectively evaluating safety and reliability. We report our experiences in applying FMEA in the setting of radiation oncology. Methods and Materials: We performed an FMEA analysis for our external beam radiation therapy service, which consisted of the following tasks: (1) create a visual map of the process, (2) identify possible failure modes; assign risk probability numbers (RPN) to each failure mode based on tabulated scores for the severity, frequency of occurrence, and detectability, each on a scale of 1 to 10; and (3) identify improvements that are both feasible and effective. The RPN scores can span a range of 1 to 1000, with higher scores indicating the relative importance of a given failure mode. Results: Our process map consisted of 269 different nodes. We identified 127 possible failure modes with RPN scores ranging from 2 to 160. Fifteen of the top-ranked failure modes were considered for process improvements, representing RPN scores of 75 and more. These specific improvement suggestions were incorporated into our practice with a review and implementation by each department team responsible for the process. Conclusions: The FMEA technique provides a systematic method for finding vulnerabilities in a process before they result in an error. The FMEA framework can naturally incorporate further quantification and monitoring. A general-use system for incident and near miss reporting would be useful in this regard.

  20. Evaluation of safety in a radiation oncology setting using failure mode and effects analysis.

    PubMed

    Ford, Eric C; Gaudette, Ray; Myers, Lee; Vanderver, Bruce; Engineer, Lilly; Zellars, Richard; Song, Danny Y; Wong, John; Deweese, Theodore L

    2009-07-01

    Failure mode and effects analysis (FMEA) is a widely used tool for prospectively evaluating safety and reliability. We report our experiences in applying FMEA in the setting of radiation oncology. We performed an FMEA analysis for our external beam radiation therapy service, which consisted of the following tasks: (1) create a visual map of the process, (2) identify possible failure modes; assign risk probability numbers (RPN) to each failure mode based on tabulated scores for the severity, frequency of occurrence, and detectability, each on a scale of 1 to 10; and (3) identify improvements that are both feasible and effective. The RPN scores can span a range of 1 to 1000, with higher scores indicating the relative importance of a given failure mode. Our process map consisted of 269 different nodes. We identified 127 possible failure modes with RPN scores ranging from 2 to 160. Fifteen of the top-ranked failure modes were considered for process improvements, representing RPN scores of 75 and more. These specific improvement suggestions were incorporated into our practice with a review and implementation by each department team responsible for the process. The FMEA technique provides a systematic method for finding vulnerabilities in a process before they result in an error. The FMEA framework can naturally incorporate further quantification and monitoring. A general-use system for incident and near miss reporting would be useful in this regard.

  1. EVALUATION OF SAFETY IN A RADIATION ONCOLOGY SETTING USING FAILURE MODE AND EFFECTS ANALYSIS

    PubMed Central

    Ford, Eric C.; Gaudette, Ray; Myers, Lee; Vanderver, Bruce; Engineer, Lilly; Zellars, Richard; Song, Danny Y.; Wong, John; DeWeese, Theodore L.

    2013-01-01

    Purpose Failure mode and effects analysis (FMEA) is a widely used tool for prospectively evaluating safety and reliability. We report our experiences in applying FMEA in the setting of radiation oncology. Methods and Materials We performed an FMEA analysis for our external beam radiation therapy service, which consisted of the following tasks: (1) create a visual map of the process, (2) identify possible failure modes; assign risk probability numbers (RPN) to each failure mode based on tabulated scores for the severity, frequency of occurrence, and detectability, each on a scale of 1 to 10; and (3) identify improvements that are both feasible and effective. The RPN scores can span a range of 1 to 1000, with higher scores indicating the relative importance of a given failure mode. Results Our process map consisted of 269 different nodes. We identified 127 possible failure modes with RPN scores ranging from 2 to 160. Fifteen of the top-ranked failure modes were considered for process improvements, representing RPN scores of 75 and more. These specific improvement suggestions were incorporated into our practice with a review and implementation by each department team responsible for the process. Conclusions The FMEA technique provides a systematic method for finding vulnerabilities in a process before they result in an error. The FMEA framework can naturally incorporate further quantification and monitoring. A general-use system for incident and near miss reporting would be useful in this regard. PMID:19409731

  2. Evaluation of the efficacy of ginger, Arabic gum, and Boswellia in acute and chronic renal failure.

    PubMed

    Mahmoud, Mona Fouad; Diaai, Abdalla Ahmed; Ahmed, Fahmy

    2012-01-01

    This study was conducted to evaluate the effects of Zingiber officinale Roscoe (Ginger), Arabic gum (AG), and Boswellia on both acute and chronic renal failure (CRF) and the mechanisms underlying their effects. Acute renal failure was induced by 30 min ischemia followed by 24 h reperfusion, while CRF was induced by adenine feeding for 8 weeks. Prophylactic oral administration of ginger, AG, Boswellia, or vehicle (in control groups) was started 3 days before and along with adenine feeding in different groups or 7 days before ischemia-reperfusion. Ginger and AG showed renoprotective effects in both models of renal failure. These protective effects may be attributed at least in part to their anti-inflammatory properties as evident by attenuating serum C-reactive protein levels and antioxidant effects as evident by attenuating lipid peroxidation marker, malondialdehyde levels, and increasing renal superoxide dismutase activity. Ginger was more potent than AG in both models of renal failure. However, Boswellia showed only partial protective effect against both acute renal failure and CRF and it had no antioxidant effects. Finally, we can say that ginger and AG could be beneficial adjuvant therapy in patients with acute renal failure and CRF to prevent disease progression and delay the need for renal replacement therapy.

  3. Systolic Blood Pressure on Admission and Mortality in Patients Hospitalized With Acute Heart Failure: Observations From the Gulf Acute Heart Failure Registry.

    PubMed

    Al-Lawati, Jawad A; Sulaiman, Kadhim J; Al-Zakwani, Ibrahim; Alsheikh-Ali, Alawi A; Panduranga, Prashanth; Al-Habib, Khalid F; Al-Suwaidi, Jassim; Al-Mahmeed, Wael; Al-Faleh, Hussam; El-Asfar, Abdelfatah; Al-Motarreb, Ahmed; Ridha, Mustafa; Bulbanat, Bassam; Al-Jarallah, Mohammed; Bazargani, Nooshin; Asaad, Nidal; Amin, Haitham

    2016-10-07

    We investigated the role of systolic blood pressure (SBP) in relation to in-hospital and postdischarge mortality in patients admitted with acute heart failure (AHF). The SBP of 4848 patients aged ≥18 years admitted with AHF was categorized into 5 groups: ≤90, 91 to 119, 120 to 139, 140 to 161, and >161 mm Hg. After adjusting for several confounders, multivariate logistic regression models showed that admission SBP was a significant predictor of mortality among both patients with preserved left ventricular function (defined as left ventricular ejection fraction [LVEF] ≥40%) and patients with left ventricular dysfunction (LVEF <40%). The adjusted odds ratios of in-hospital, 3-month, and 1-year mortality in the lowest SBP groups were 7.06 (95% confidence interval [CI]: 3.28-15.20; P < .001), 2.59 (95% CI: 1.35-4.96; P = .004), and 3.10 (95% CI: 2.04-4.72; P < .001) times the odds in the highest admission group (SBP > 161 mm Hg), respectively. We conclude that low admission SBP is an independent predictor of mortality in patients with AHF. The higher the admission SBP, the better the prognosis, regardless of age or LVEF.

  4. Evaluation of a sensor for low interface pressure applications.

    PubMed

    Ferguson-Pell, M; Hagisawa, S; Bain, D

    2000-11-01

    An ultra-thin, small sensor has recently been developed, "FlexiForce" (Tekscan, Boston, MA, USA), which may be effective for the measurement of low interface pressure between the skin, support surfaces and pressure garments. To evaluate the suitability of the sensor for these applications, drift, repeatability, linearity, hysteresis and curvature effects were tested under laboratory conditions. The drift was 1.7-2.5%/logarithmic time, the repeatability was 2.3-6.6% and the linearity was 1.9-9.9% in the range of forces of 10-50 g applied. The hysteresis was 5.4% on average. The output offset of the sensor increased with decreasing radius of curvature for radii less than 32 mm compared with a flat surface when no pressure was applied. The sensitivity to pressure decreased with curvature for radii less than 32 mm. It was found that the sensor had acceptable drift, repeatability, linearity and hysteresis. However, a significant curvature effect was observed indicating that the sensor is suitable for direct measurement on surfaces with the radii greater than 32 mm under static conditions.

  5. Mean Arterial Pressure to Central Venous Pressure Ratio: A Novel Marker for Right Ventricular Failure After Left Ventricular Assist Device Placement.

    PubMed

    Mohamedali, Burhan; Doukky, Rami; Karavalos, Kelly; Avery, Elizabeth; Bhat, Geetha

    2017-06-01

    Early right ventricular failure (RVF) is common after left ventricular assist device (LVAD) implantation and often leads to increased morbidity and mortality. It is difficult to predict early RVF on the basis of clinical and hemodynamic parameters. We investigated the utility of mean arterial pressure (MAP) to central venous pressure (CVP) ratio in predicting early RVF. We analyzed a retrospective cohort of 212 consecutive patients who underwent hemodynamic assessment before destination-therapy LVAD implantation. Patients were followed for early RVF and mortality. Receiver operating characteristic (ROC) analysis was used to determine discriminative capacity of MAP/CVP and tested the diagnostic and prognostic value of median MAP/CVP threshold. The ROC analysis demonstrated that pre-LVAD MAP/CVP was associated with an area under the ROC curve of 0.65 (95% confidence interval 0.58-0.73; P < .001). MAP/CVP threshold <7.5 (simple nearest-to-median value) was associated with 70% sensitivity and 56% specificity for early RV failure. Patients with MAP/CVP <7.5 had a higher incidence of post-LVAD RVF than those with a ratio ≥7.5 (44% vs 23%, respectively; P = .001). Right ventricular assist device requirement was higher in the MAP/CVP <7.5 group (11% vs 2%; P = .01). All-cause mortality was higher in the MAP/CVP <7.5 group (annualized mortality 26% vs 16%; log-rank P = .017). MAP-CVP ratio provided incremental prognostic value for RVF and all-cause mortality beyond established Heartmate II and RVF risk scores. Our findings suggest that pre-LVAD MAP/CVP <7.5 is associated with early RVF and increased mortality risk. This novel parameter can be used in risk stratification of LVAD candidates. Prospective validation of our findings is needed. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Simplified Methodology to Estimate the Maximum Liquid Helium (LHe) Cryostat Pressure from a Vacuum Jacket Failure

    NASA Technical Reports Server (NTRS)

    Ungar, Eugene K.; Richards, W. Lance

    2015-01-01

    The aircraft-based Stratospheric Observatory for Infrared Astronomy (SOFIA) is a platform for multiple infrared astronomical observation experiments. These experiments carry sensors cooled to liquid helium temperatures. The liquid helium supply is contained in large (i.e., 10 liters or more) vacuum-insulated dewars. Should the dewar vacuum insulation fail, the inrushing air will condense and freeze on the dewar wall, resulting in a large heat flux on the dewar's contents. The heat flux results in a rise in pressure and the actuation of the dewar pressure relief system. A previous NASA Engineering and Safety Center (NESC) assessment provided recommendations for the wall heat flux that would be expected from a loss of vacuum and detailed an appropriate method to use in calculating the maximum pressure that would occur in a loss of vacuum event. This method involved building a detailed supercritical helium compressible flow thermal/fluid model of the vent stack and exercising the model over the appropriate range of parameters. The experimenters designing science instruments for SOFIA are not experts in compressible supercritical flows and do not generally have access to the thermal/fluid modeling packages that are required to build detailed models of the vent stacks. Therefore, the SOFIA Program engaged the NESC to develop a simplified methodology to estimate the maximum pressure in a liquid helium dewar after the loss of vacuum insulation. The method would allow the university-based science instrument development teams to conservatively determine the cryostat's vent neck sizing during preliminary design of new SOFIA Science Instruments. This report details the development of the simplified method, the method itself, and the limits of its applicability. The simplified methodology provides an estimate of the dewar pressure after a loss of vacuum insulation that can be used for the initial design of the liquid helium dewar vent stacks. However, since it is not an exact

  7. The role of laboratory and imaging studies in evaluation of failure to thrive

    USDA-ARS?s Scientific Manuscript database

    Evaluation of Failure to Thrive (FTT) has traditionally been based on history and physical examination (PE), as main determinants of the final diagnosis. Early literature from two decades ago, demonstrated that laboratory and imaging studies were contributory beyond the history and PE in less than 1...

  8. Plastic flow, inferred strength, and incipient failure in BCC metals at high pressures, strains, and strain rates

    NASA Astrophysics Data System (ADS)

    Park, Hye-Sook

    2013-06-01

    We present our extensive experimental results from the Omega laser to test models of high pressure, high strain rate strength at ~1 Mbar peak pressures, strains >10%, and strain rates of ~107 s-1 in Ta, V, and Fe, using plastic flows driven by the Rayleigh-Taylor instability. The observed time evolution of the plastic deformation is compared with 2D simulations incorporating a strength model. This methodology allows average values of strength at peak pressure and peak strain rate conditions to be inferred. The observed values of strength are typically factors of 5-10 higher than ambient strength, with contributions coming from pressure hardening (via the shear modulus), and strain rate hardening. For Fe, there is the added contribution from the alpha-epsilon phase transition. Ta has been studied as a function of grain size, and at the high strain rates and short durations of the experiments, no grain size dependence was observed; the observed deformation and inferred strength were independent of grain size. Both Ta and V have been driven to large enough strains that incipient failure (softening) has been observed. Both the Ta and V experiments were compared favorably with multiscale strength models, with the conclusion that the Ta deformation was in the thermal activation regime, whereas the V deformation was in the phonon drag regime. Finally, preliminary results of new iron RT strength experiments done at ~1 Mbar pressures, and ~107 s-1 strain rates, well beyond the alpha-epsilon phase transition, will be given. This work was performed under the auspices of the Lawrence Livermore National Security, LLC, (LLNS) under Contract No. DE-AC52-07NA27344.

  9. Evaluating the mechanical integrity of bilayer lipid membranes using a high-precision pressurization system

    NASA Astrophysics Data System (ADS)

    Hopkinson, David; Leo, Donald J.

    2007-04-01

    A new methodology has been developed to measure the mechanical integrity of a bilayer lipid membrane (BLM) formed over porous substrates. A custom test fixture was fabricated in which a stepper motor linear actuator drives a piston in order to apply pressure to a BLM in very fine increments. The pressure, monitored with a pressure transducer, is observed to increase until the BLM reaches its failure pressure, and then drop. This experiment was performed on 1-Stearoyl-2-Oleoyl-sn-Glycero-3-Phosphocholine (SOPC) lipid bilayers formed over porous polycarbonate substrates with various pore sizes ranging from 0.05 - 10 μm in diameter. A trend of increasing failure pressure with decreasing pore size was observed. The same set of experiments was repeated for BLMs that were formed from a mixture of SOPC and cholesterol (CHOL) at a cholesterol concentration of 50 mol%. The presence of cholesterol was found to increase the failure pressure of the BLMs by 1.5 times on average. A model of the characteristic pressure curve from this experiment was developed based on an initially closed fluid system in which pressure increases as it is loaded by a moving piston, and which upon reaching a critical failure pressure allows pressure to decrease as fluid escapes through a porous medium. Since the BLM is formed over many pores, this model assumes that the failure pressure for each micro-BLM follows a normal distribution over all pores. The model is able to accurately predict the major trends in the pressurization curves by curve-fitting a few statistical parameters.

  10. Evaluation of heart failure biomarker tests: a survey of statistical considerations.

    PubMed

    De, Arkendra; Meier, Kristen; Tang, Rong; Li, Meijuan; Gwise, Thomas; Gomatam, Shanti; Pennello, Gene

    2013-08-01

    Biomarkers assessing cardiovascular function can encompass a wide range of biochemical or physiological measurements. Medical tests that measure biomarkers are typically evaluated for measurement validation and clinical performance in the context of their intended use. General statistical principles for the evaluation of medical tests are discussed in this paper in the context of heart failure. Statistical aspects of study design and analysis to be considered while assessing the quality of measurements and the clinical performance of tests are highlighted. A discussion of statistical considerations for specific clinical uses is also provided. The remarks in this paper mainly focus on methods and considerations for statistical evaluation of medical tests from the perspective of bias and precision. With such an evaluation of performance, healthcare professionals could have information that leads to a better understanding on the strengths and limitations of tests related to heart failure.

  11. Microseparation, fluid pressure and flow in failures of metal-on-metal hip resurfacing arthroplasties

    PubMed Central

    Wroblewski, B. M.; Siney, P. D.; Fleming, P. A.

    2012-01-01

    Objectives Metal-on-metal (MoM) hip resurfacing was introduced into clinical practice because it was perceived to be a better alternative to conventional total hip replacement for young and active patients. However, an increasing number of reports of complications have arisen focusing on design and orientation of the components, the generation of metallic wear particles and serum levels of metallic ions. The procedure introduced a combination of two elements: large-dimension components and hard abrasive particles of metal wear. The objective of our study was to investigate the theory that microseparation of the articular surfaces draws in a high volume of bursal fluid and its contents into the articulation, and at relocation under load would generate high pressures of fluid ejection, resulting in an abrasive water jet. Methods This theoretical concept using MoM resurfacing components (head diameter 55 mm) was modelled mathematically and confirmed experimentally using a material-testing machine that pushed the head into the cup at a rate of 1000 mm/min until fully engaged. Results The mathematical model showed the pattern but not the force of fluid ejection, the highest pressures were expected when the separation of the components was only a fraction of one millimetre. The experimental work confirmed the results; with the mean peak ejection pressure of 43 763 N/m2 equivalent to 306 mmHg or 5 psi. Conclusions The mechanical effect of the high-pressure abrasive water jet is the likely cause of the spectrum of complications reported with metal-on-metal resurfacing. Investigating serum levels of metallic elements may not be the best method for assessing the local mechanical effects of the abrasive water jet. PMID:23610667

  12. End-systolic Pressure-Volume Relation, Ejection Fraction, and Heart Failure: Theoretical Aspect and Clinical Applications.

    PubMed

    Shoucri, Rachad M

    2015-01-01

    A mathematical formalism describing the nonlinear end-systolic pressure-volume relation (ESPVR) is used to derive new indexes that can be used to assess the performance of the heart left ventricle by using the areas under the ESPVR (units of energy), the ordinates of the ESPVR (units of pressure), or from slopes of the curvilinear ESPVR. New relations between the ejection fraction (EF) and the parameters describing the ESPVR give some insight into the problem of heart failure (HF) with normal or preserved ejection fraction. Relations between percentage occurrence of HF and indexes derived from the ESPVR are also discussed. When ratios of pressures are used, calculation can be done in a noninvasive way with the possibility of interesting applications in routine clinical work. Applications to five groups of clinical data are given and discussed (normal group, aortic stenosis, aortic valvular regurgitation, mitral valvular regurgitation, miscellaneous cardiomyopathies). No one index allows a perfect segregation between all clinical groups, it is shown that appropriate use of two indexes (bivariate analysis) can lead to better separation of different clinical groups.

  13. Opposite predictive value of pulse pressure and aortic pulse wave velocity on heart failure with reduced left ventricular ejection fraction: insights from an Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS) substudy.

    PubMed

    Regnault, Veronique; Lagrange, Jérémy; Pizard, Anne; Safar, Michel E; Fay, Renaud; Pitt, Bertram; Challande, Pascal; Rossignol, Patrick; Zannad, Faiez; Lacolley, Patrick

    2014-01-01

    Although hypertension contributes significantly to worsen cardiovascular risk, blood pressure increment in subjects with heart failure is paradoxically associated with lower risk. The objective was to determine whether pulse pressure and pulse wave velocity (PWV) remain prognostic markers, independent of treatment in heart failure with reduced left ventricular function. The investigation involved 6632 patients of the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study. All subjects had acute myocardial infarction with left ventricular ejection fraction <40% and signs/symptoms of heart failure. Carotid-femoral PWV was measured in a subpopulation of 306 subjects. In the overall population, baseline mean arterial pressure <90 mm Hg was associated with higher all-cause death (hazard ratio, 1.14 [95% confidence interval, 1.00-1.30]; P<0.05), whereas higher left ventricular ejection fraction or pulse pressure was associated with lower rates of all-cause death, cardiovascular death/hospitalization, and cardiovascular death. In the subpopulation, increased baseline PWV was associated with worse outcomes (all-cause death: 1.16 [1.03-1.30]; P<0.05 and cardiovascular deaths: 1.16 [1.03-1.31]; P<0.05), independent of age and left ventricular ejection fraction. Using multiple regression analysis, systolic blood pressure and age were the main independent factors positively associated with pulse pressure or PWV, both in the entire population or in the PWV substudy. In heart failure and low ejection fraction, our results suggest that pulse pressure, being negatively associated with outcome, is more dependent on left ventricular function and thereby no longer a marker of aortic elasticity. In contrast, increased aortic stiffness, assessed by PWV, contributes significantly to cardiovascular death.

  14. Postural effects on intracranial pressure: modeling and clinical evaluation.

    PubMed

    Qvarlander, Sara; Sundström, Nina; Malm, Jan; Eklund, Anders

    2013-11-01

    The physiological effect of posture on intracranial pressure (ICP) is not well described. This study defined and evaluated three mathematical models describing the postural effects on ICP, designed to predict ICP at different head-up tilt angles from the supine ICP value. Model I was based on a hydrostatic indifference point for the cerebrospinal fluid (CSF) system, i.e., the existence of a point in the system where pressure is independent of body position. Models II and III were based on Davson's equation for CSF absorption, which relates ICP to venous pressure, and postulated that gravitational effects within the venous system are transferred to the CSF system. Model II assumed a fully communicating venous system, and model III assumed that collapse of the jugular veins at higher tilt angles creates two separate hydrostatic compartments. Evaluation of the models was based on ICP measurements at seven tilt angles (0-71°) in 27 normal pressure hydrocephalus patients. ICP decreased with tilt angle (ANOVA: P < 0.01). The reduction was well predicted by model III (ANOVA lack-of-fit: P = 0.65), which showed excellent fit against measured ICP. Neither model I nor II adequately described the reduction in ICP (ANOVA lack-of-fit: P < 0.01). Postural changes in ICP could not be predicted based on the currently accepted theory of a hydrostatic indifference point for the CSF system, but a new model combining Davson's equation for CSF absorption and hydrostatic gradients in a collapsible venous system performed well and can be useful in future research on gravity and CSF physiology.

  15. Risk Stratification of Ambulatory Patients with Advanced Heart Failure Undergoing Evaluation for Heart Transplantation

    PubMed Central

    Kato, Tomoko S.; Stevens, Gerin R; Jiang, Jeffrey; Schulze, P. Christian; Gukasyan, Natalie; Lippel, Matthew; Levin, Alison; Homma, Shunichi; Mancini, Donna; Farr, Maryjane

    2014-01-01

    Background Risk stratification of ambulatory heart failure (HF) patients has relied upon peak VO2 (pVO2) <14 mL/min/kg. We investigated whether additional clinical variables might further specify risk of death, ventricular assist device (VAD) implantation (INTERMACS<4) or heart transplantation (HTx; Status 1A or 1B) within one-year after HTx evaluation. We hypothesized that right ventricular stroke work index (RVSWI), pulmonary capillary wedge pressure (PCWP) and the Model for End-stage Liver Disease-Albumin score (MELD-A) would be additive prognostic predictors. Methods We retrospectively collected data on 151 ambulatory patients undergoing HTx evaluation. Primary outcomes were defined as HTx, LVAD or death within one-year following evaluation. Results Our cohort was 54.9±11.1 year-old, 79.1% male, 37.6% with ischemic etiology (LVEF 21±11% and pVO2 12.6±3.5ml/min/kg). Fifty outcomes (33.1%) occurred (27 HTx, 15 VAD, and 8 deaths). Univariate logistic regression showed significant association of RVSWI (mmHg-L/m2) (OR0.47, p=0.036), PCWP (mmHg) (OR2.65, p=0.007), and MELD-A (OR2.73, p=0.006) with one-year events. Stepwise regression showed independent correlation of RVSWI<5 (OR6.70; p<0.01), PCWP>20 (OR5.48; p<0.01), MELD-A>14 (OR3.72; p<0.01) and pVO2<14 (OR3.36; p=0.024) with one-year events. A scoring system was composed with MELD-A>14 and pVO2<14, 1 point each, and PCWP>20 and RVSWI<5, 2 points each. A cutoff at 4 demonstrated a 54% sensitivity and 88% specificity for one-year events. Conclusions Ambulatory HF patients have significant one-year event rates. Risk stratification based on exercise performance, left-sided congestion, right ventricular dysfunction and liver congestion allows prediction of one-year prognosis. This study endorses early and timely referral for VAD and/or transplant. PMID:23415315

  16. Advanced detection, isolation and accommodation of sensor failures: Real-time evaluation

    NASA Technical Reports Server (NTRS)

    Merrill, Walter C.; Delaat, John C.; Bruton, William M.

    1987-01-01

    The objective of the Advanced Detection, Isolation, and Accommodation (ADIA) Program is to improve the overall demonstrated reliability of digital electronic control systems for turbine engines by using analytical redundacy to detect sensor failures. The results of a real time hybrid computer evaluation of the ADIA algorithm are presented. Minimum detectable levels of sensor failures for an F100 engine control system are determined. Also included are details about the microprocessor implementation of the algorithm as well as a description of the algorithm itself.

  17. Immunity-based detection, identification, and evaluation of aircraft sub-system failures

    NASA Astrophysics Data System (ADS)

    Moncayo, Hever Y.

    This thesis describes the design, development, and flight-simulation testing of an integrated Artificial Immune System (AIS) for detection, identification, and evaluation of a wide variety of sensor, actuator, propulsion, and structural failures/damages including the prediction of the achievable states and other limitations on performance and handling qualities. The AIS scheme achieves high detection rate and low number of false alarms for all the failure categories considered. Data collected using a motion-based flight simulator are used to define the self for an extended sub-region of the flight envelope. The NASA IFCS F-15 research aircraft model is used and represents a supersonic fighter which include model following adaptive control laws based on non-linear dynamic inversion and artificial neural network augmentation. The flight simulation tests are designed to analyze and demonstrate the performance of the immunity-based aircraft failure detection, identification and evaluation (FDIE) scheme. A general robustness analysis is also presented by determining the achievable limits for a desired performance in the presence of atmospheric perturbations. For the purpose of this work, the integrated AIS scheme is implemented based on three main components. The first component performs the detection when one of the considered failures is present in the system. The second component consists in the identification of the failure category and the classification according to the failed element. During the third phase a general evaluation of the failure is performed with the estimation of the magnitude/severity of the failure and the prediction of its effect on reducing the flight envelope of the aircraft system. Solutions and alternatives to specific design issues of the AIS scheme, such as data clustering and empty space optimization, data fusion and duplication removal, definition of features, dimensionality reduction, and selection of cluster/detector shape are also

  18. Evaluation of sedation in oral and maxillofacial surgery in ambulatory patients: failure and complications.

    PubMed

    Senel, Ahmet Can; Altintas, Nuray Yilmaz; Senel, Figen Cizmeci; Pampu, Alper; Tosun, Emre; Ungor, Cem; Dayisoylu, Ezher Hamza; Tuzuner, Tamer

    2012-11-01

    This study evaluated the failure and complication rates of sedation in ambulatory patients undergoing oral and maxillofacial surgery. This retrospective cohort study was carried out among 619 patients who had undergone maxillofacial surgical procedures under intravenous sedation with midazolam and fentanyl. Each patient's age, American Society of Anesthesiologists (ASA) classification, systemic condition, surgical procedure, complications, and failures were recorded for evaluation. A total of 400 patients with ASA I, 199 with ASA II, and 20 with ASA III between the ages of 9 months and 84 years were included in the study. The most common systemic disorders in our patients were mental retardation (35%), hypertension (19%), and epilepsy (15%). Evaluation of the cases revealed 9 complications (1.4%) and 9 sedation failures (1.4%). The complications were bradycardia, postoperative agitation and hallucination, drug reaction, vomiting and nausea, desaturation, and hypotension. Our results in the oral and maxillofacial surgery clinic revealed low complication and failure rates. Crown Copyright © 2012. Published by Mosby, Inc. All rights reserved.

  19. Physiological Evaluation of Mental Workload in Time Pressure

    NASA Astrophysics Data System (ADS)

    Hioki, Kyu; Nozawa, Akio; Mizuno, Tota; Ide, Hideto

    There can be seen in many situations where office workers have to make decisions under the time restriction. For example, flight control buisiness, dealing work and so on. Such the time restriction can have the time pressure, which is considerd one of mental workload, on them. In addition, it can cause human error on imformation processing. If mental work load appropriately maintained the work level, office workers would be able to go on the work with moderate tention. The purpose of this study is to quantitatively evaluate physiological indexes, which are ECG, EEG, Facial skin thermo image by using adding tasks.

  20. Dynamic analysis method for prevention of failure in the first-stage low-pressure turbine blade with two-finger root

    NASA Astrophysics Data System (ADS)

    Park, Jung-Yong; Jung, Yong-Keun; Park, Jong-Jin; Kang, Yong-Ho

    2002-05-01

    Failures of turbine blades are identified as the leading causes of unplanned outages for steam turbine. Accidents of low-pressure turbine blade occupied more than 70 percent in turbine components. Therefore, the prevention of failures for low pressure turbine blades is certainly needed. The procedure is illustrated by the case study. This procedure is used to guide, and support the plant manager's decisions to avoid a costly, unplanned outage. In this study, we are trying to find factors of failures in LP turbine blade and to make three steps to approach the solution of blade failure. First step is to measure natural frequency in mockup test and to compare it with nozzle passing frequency. Second step is to use FEM and to calculate the natural frequencies of 7 blades and 10 blades per group in BLADE code. Third step is to find natural frequencies of grouped blade off the nozzle passing frequency.

  1. [Facial or nasal mask pressure support ventilation in managing acute exacerbation of chronic respiratory failure in chronic obstructive pulmonary diseases].

    PubMed

    Chen, R C

    1992-10-01

    11 COPD patients (age: 65 +/- 9 Yrs) with acute exacerbation of chronic respiratory failure (PaCO2 11.3 +/- 1.1kPa) were treated with mask pressure support ventilation, another 10 similar patients (age: 68 +/- 12 Yrs) served as control. BiPAP ventilator was used with the following modifications: (1) Non-rebreathing valve set-in proximal to mask; (2) 5 LPM oxygen flow delivered into mask to reduce the dead space effect. Mask ventilation was given 2-3 hours every time and 1-2 time daily for 7 days. Synchrony and airway patency were specially monitored. The results suggested that mask ventilation could reduce PaCO2, improve PaO2, relieve dyspnea and decrease the possibility of intubation.

  2. Transient radon signals driven by fluid pressure pulse, micro-crack closure, and failure during granite deformation experiments

    NASA Astrophysics Data System (ADS)

    Girault, Frédéric; Schubnel, Alexandre; Pili, Éric

    2017-09-01

    In seismically active fault zones, various crustal fluids including gases are released at the surface. Radon-222, a radioactive gas naturally produced in rocks, is used in volcanic and tectonic contexts to illuminate crustal deformation or earthquake mechanisms. At some locations, intriguing radon signals have been recorded before, during, or after tectonic events, but such observations remain controversial, mainly because physical characterization of potential radon anomalies from the upper crust is lacking. Here we conducted several month-long deformation experiments under controlled dry upper crustal conditions with a triaxial cell to continuously monitor radon emission from crustal rocks affected by three main effects: a fluid pressure pulse, micro-crack closure, and differential stress increase to macroscopic failure. We found that these effects are systematically associated with a variety of radon signals that can be explained using a first-order advective model of radon transport. First, connection to a source of deep fluid pressure (a fluid pressure pulse) is associated with a large transient radon emission increase (factor of 3-7) compared with the background level. We reason that peak amplitude is governed by the accumulation time and the radon source term, and that peak duration is controlled by radioactive decay, permeability, and advective losses of radon. Second, increasing isostatic compression is first accompanied by an increase in radon emission followed by a decrease beyond a critical pressure representing the depth below which crack closure hampers radon emission (150-250 MPa, ca. 5.5-9.5 km depth in our experiments). Third, the increase of differential stress, and associated shear and volumetric deformation, systematically triggers significant radon peaks (ca. 25-350% above background level) before macroscopic failure, by connecting isolated cracks, which dramatically enhances permeability. The detection of transient radon signals before rupture

  3. Visit-to-Visit Variability of Blood Pressure and Coronary Heart Disease, Stroke, Heart Failure, and Mortality: A Cohort Study.

    PubMed

    Muntner, Paul; Whittle, Jeff; Lynch, Amy I; Colantonio, Lisandro D; Simpson, Lara M; Einhorn, Paula T; Levitan, Emily B; Whelton, Paul K; Cushman, William C; Louis, Gail T; Davis, Barry R; Oparil, Suzanne

    2015-09-01

    Variability of blood pressure (BP) across outpatient visits is frequently dismissed as random fluctuation around a patient's underlying BP. To examine the association of visit-to-visit variability (VVV) of systolic BP (SBP) and diastolic BP with cardiovascular disease (CVD) and mortality outcomes. Prospective cohort study. Post hoc analysis of ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial). 25 814 ALLHAT participants. The VVV of SBP was defined as the SD across SBP measurements obtained at 7 visits conducted from 6 to 28 months after ALLHAT enrollment. Participants without CVD events during the first 28 months of follow-up were followed from the 28-month visit through the end of active ALLHAT follow-up. Outcomes included fatal coronary heart disease (CHD) or nonfatal myocardial infarction, all-cause mortality, stroke, and heart failure. During follow-up, 1194 fatal CHD or nonfatal MI events, 1948 deaths, 606 strokes, and 921 heart failure events occurred. After multivariable adjustment, including for mean SBP, the hazard ratio comparing participants in the highest versus lowest quintile of SD of SBP (≥14.4 mm Hg vs. <6.5 mm Hg) was 1.30 (95% CI, 1.06 to 1.59) for fatal CHD or nonfatal MI, 1.58 (CI, 1.32 to 1.90) for all-cause mortality, 1.46 (CI, 1.06 to 2.01) for stroke, and 1.25 (CI, 0.97 to 1.61) for heart failure. Higher VVV of diastolic BP was also associated with CVD events and mortality. Long-term outcomes were not available. Higher VVV of SBP is associated with an increased risk for CVD and mortality. Future studies should examine whether reducing VVV of BP lowers this risk. National Institutes of Health.

  4. Stage 2 hypertension: predictors of failure to achieve blood pressure control and the impact of adding one additional antihypertensive class.

    PubMed

    Rowan, Christopher G; Flory, James; Stempniewicz, Nikita; Cuddeback, John; Brunelli, Steven M

    2015-11-01

    Controlling blood pressure (BP) for patients with stage 2 hypertension remains challenging. This research aimed to: (i) identify predictors of failure to achieve BP control, (ii) determine the association of adding one additional antihypertensive class with achieving BP control, and (iii) describe the prescribed antihypertensive regimens. Electronic medical record data from 25 multi-specialty medical groups in the USA were used. The study cohort included patients with stage 2 hypertension in 2012. BP control rates were determined at 6 months from the date of the stage 2 BP. Using multivariable logistic regression and validation by Monte Carlo simulation, we determined independent baseline predictors of not achieving BP control (<140/90). Included were 107 903 patients. Baseline predictors of failure to achieve BP control included the following: a prior stage 2 BP, systolic BP ≥ 165, Black race, male sex, income ≤ $35 000, body mass index ≥ 30, age ≥ 65 years, and no office visits. Increasing from single-class to dual-class antihypertensive therapy was associated with a 42% increased odds of achieving BP control (odds ratio 1.42; 95% CI 1.22, 1.64); however, this effect was attenuated as the number of baseline antihypertensive classes increased. The 10 most frequently prescribed regimens accounted for only 40% of all antihypertensive regimens. Among patients with stage 2 hypertension, a prior stage 2 BP, a systolic BP ≥ 165, and fewer office visits were strong predictors of failure to achieve BP control. Increasing to dual-class antihypertensive therapy was significantly associated with achieving BP control. There is broad heterogeneity in the antihypertensive regimens prescribed. Copyright © 2015 John Wiley & Sons, Ltd.

  5. An improved method for risk evaluation in failure modes and effects analysis of CNC lathe

    NASA Astrophysics Data System (ADS)

    Rachieru, N.; Belu, N.; Anghel, D. C.

    2015-11-01

    Failure mode and effects analysis (FMEA) is one of the most popular reliability analysis tools for identifying, assessing and eliminating potential failure modes in a wide range of industries. In general, failure modes in FMEA are evaluated and ranked through the risk priority number (RPN), which is obtained by the multiplication of crisp values of the risk factors, such as the occurrence (O), severity (S), and detection (D) of each failure mode. However, the crisp RPN method has been criticized to have several deficiencies. In this paper, linguistic variables, expressed in Gaussian, trapezoidal or triangular fuzzy numbers, are used to assess the ratings and weights for the risk factors S, O and D. A new risk assessment system based on the fuzzy set theory and fuzzy rule base theory is to be applied to assess and rank risks associated to failure modes that could appear in the functioning of Turn 55 Lathe CNC. Two case studies have been shown to demonstrate the methodology thus developed. It is illustrated a parallel between the results obtained by the traditional method and fuzzy logic for determining the RPNs. The results show that the proposed approach can reduce duplicated RPN numbers and get a more accurate, reasonable risk assessment. As a result, the stability of product and process can be assured.

  6. Evaluating the operational risks of biomedical waste using failure mode and effects analysis.

    PubMed

    Chen, Ying-Chu; Tsai, Pei-Yi

    2017-06-01

    The potential problems and risks of biomedical waste generation have become increasingly apparent in recent years. This study applied a failure mode and effects analysis to evaluate the operational problems and risks of biomedical waste. The microbiological contamination of biomedical waste seldom receives the attention of researchers. In this study, the biomedical waste lifecycle was divided into seven processes: Production, classification, packaging, sterilisation, weighing, storage, and transportation. Twenty main failure modes were identified in these phases and risks were assessed based on their risk priority numbers. The failure modes in the production phase accounted for the highest proportion of the risk priority number score (27.7%). In the packaging phase, the failure mode 'sharp articles not placed in solid containers' had the highest risk priority number score, mainly owing to its high severity rating. The sterilisation process is the main difference in the treatment of infectious and non-infectious biomedical waste. The failure modes in the sterilisation phase were mainly owing to human factors (mostly related to operators). This study increases the understanding of the potential problems and risks associated with biomedical waste, thereby increasing awareness of how to improve the management of biomedical waste to better protect workers, the public, and the environment.

  7. Rationale and Design of the Left Atrial Pressure Monitoring to Optimize Heart Failure Therapy Study (LAPTOP-HF).

    PubMed

    Maurer, Mathew S; Adamson, Philip B; Costanzo, Maria Rosa; Eigler, Neal; Gilbert, Joanne; Gold, Michael R; Klapholz, Marc; Saxon, Leslie A; Singh, Jagmeet P; Troughton, Richard; Abraham, William T

    2015-06-01

    Daily measurements of left atrial pressure (LAP) may be useful for guiding adjustments in medical therapy that prevent clinical decompensation in patients with severe heart failure (HF). LAPTOP-HF is a prospective, multicenter, randomized, controlled clinical trial in ambulatory patients with advanced heart failure in which the safety and clinical effectiveness of a physician-directed patient self-management therapeutic strategy based on LAP measured twice daily by means of an implantable sensor will be compared with a control group receiving optimal medical therapy. The trial will enroll up to 730 patients with New York Heart Association functional class III symptoms and either a hospitalization for HF during the previous 12 months or an elevated B-type natriuretic peptide level, regardless of ejection fraction, at up to 75 investigational centers. Randomization to the treatment group or control group will be at a 1:1 ratio in 3 strata based on the ejection fraction (EF > or ≤35%) and the presence of a de novo CRT device indication. LAPTOP-HF will provide essential information about the role of implantable LAP monitoring in conjunction with a new HF treatment paradigm across the spectrum of HF patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Protective Effect of Qiliqiangxin Capsule on Energy Metabolism and Myocardial Mitochondria in Pressure Overload Heart Failure Rats

    PubMed Central

    Zhang, Junfang; Wei, Cong; Wang, Hongtao; Tang, Siwen; Jia, Zhenhua; Wang, Lei; Xu, Dengfeng; Wu, Yiling

    2013-01-01

    Qiliqiangxin capsule (QL) was developed under the guidance of TCM theory of collateral disease and had been shown to be effective and safe for the treatment of heart failure. The present study explored the role of and mechanism by which the herbal compounds QL act on energy metabolism, in vivo, in pressure overload heart failure. SD rats received ascending aorta constriction (TAC) to establish a model of myocardial hypertrophy. The animals were treated orally for a period of six weeks. QL significantly inhibited cardiac hypertrophy due to ascending aortic constriction and improved hemodynamics. This effect was linked to the expression levels of the signaling factors in connection with upregulated energy and the regulation of glucose and lipid substrate metabolism and with a decrease in metabolic intermediate products and the protection of mitochondrial function. It is concluded that QL may regulate the glycolipid substrate metabolism by activating AMPK/PGC-1α axis and reduce the accumulation of free fatty acids and lactic acid, to protect cardiac myocytes and mitochondrial function. PMID:24078824

  9. Management of acute heart failure and the effect of systolic blood pressure on the use of intravenous therapies.

    PubMed

    Tarvasmäki, Tuukka; Harjola, Veli-Pekka; Tolonen, Jukka; Siirilä-Waris, Krista; Nieminen, Markku S; Lassus, Johan

    2013-09-01

    To examine the use of the treatments for acute heart failure (AHF) recommended by ESC guidelines in different clinical presentations and blood pressure groups. The use of intravenous diuretics, nitrates, opioids, inotropes, and vasopressors as well as non-invasive ventilation (NIV) was analysed in 620 patients hospitalized due to AHF. The relation between AHF therapies and clinical presentation, especially systolic blood pressure (SBP) on admission, was also assessed. Overall, 76% of patients received i.v. furosemide, 42% nitrates, 29% opioids, 5% inotropes and 7% vasopressors, and 24% of patients were treated with NIV. Furosemide was the most common treatment in all clinical classes and irrespective of SBP on admission. Nitrates were given most often in pulmonary oedema and hypertensive AHF. Overall, only SBP differed significantly between patients with and without the studied treatments. SBP was higher in patients treated with nitrates than in those who were not (156 vs. 141 mmHg, p<0.001). Still, only one-third of patients presenting acute decompensated heart failure and SBP over 120 mmHg were given nitrates. Inotropes and vasopressors were given most frequently in cardiogenic shock and pulmonary oedema, and their use was inversely related to initial SBP (p<0.001). NIV was used only in half of the cardiogenic shock and pulmonary oedema patients. The management of AHF differs between ESC clinical classes and the use of i.v. vasoactive therapies is related to the initial SBP. However, there seems to be room for improvement in administration of vasodilators and NIV.

  10. Management of acute heart failure and the effect of systolic blood pressure on the use of intravenous therapies

    PubMed Central

    Harjola, Veli-Pekka; Tolonen, Jukka; Siirilä-Waris, Krista; Nieminen, Markku S; Lassus, Johan

    2013-01-01

    Aims: To examine the use of the treatments for acute heart failure (AHF) recommended by ESC guidelines in different clinical presentations and blood pressure groups. Methods: The use of intravenous diuretics, nitrates, opioids, inotropes, and vasopressors as well as non-invasive ventilation (NIV) was analysed in 620 patients hospitalized due to AHF. The relation between AHF therapies and clinical presentation, especially systolic blood pressure (SBP) on admission, was also assessed. Results: Overall, 76% of patients received i.v. furosemide, 42% nitrates, 29% opioids, 5% inotropes and 7% vasopressors, and 24% of patients were treated with NIV. Furosemide was the most common treatment in all clinical classes and irrespective of SBP on admission. Nitrates were given most often in pulmonary oedema and hypertensive AHF. Overall, only SBP differed significantly between patients with and without the studied treatments. SBP was higher in patients treated with nitrates than in those who were not (156 vs. 141 mmHg, p<0.001). Still, only one-third of patients presenting acute decompensated heart failure and SBP over 120 mmHg were given nitrates. Inotropes and vasopressors were given most frequently in cardiogenic shock and pulmonary oedema, and their use was inversely related to initial SBP (p<0.001). NIV was used only in half of the cardiogenic shock and pulmonary oedema patients. Conclusions: The management of AHF differs between ESC clinical classes and the use of i.v. vasoactive therapies is related to the initial SBP. However, there seems to be room for improvement in administration of vasodilators and NIV. PMID:24222833

  11. Effect of Continuous Positive Airway Pressure on Sleep Structure in Heart Failure Patients with Central Sleep Apnea

    PubMed Central

    Ruttanaumpawan, Pimon; Logan, Alexander G.; Floras, John S.; Bradley, T. Douglas

    2009-01-01

    Study Objectives: At termination of obstructive apneas, arousal is a protective mechanism that facilitates restoration of upper airway patency and airflow. Treating obstructive sleep apnea (OSA) by continuous positive airway pressure (CPAP) reduces arousal frequency indicating that such arousals are caused by OSA. In heart failure (HF) patients with central sleep apnea (CSA), however, arousals frequently occur several breaths after apnea termination, and there is uncertainty as to whether arousals from sleep are a consequence of CSA. If so, they should diminish in frequency when CSA is attenuated. We therefore sought to determine whether attenuation of CSA by CPAP reduces arousal frequency. Design: Randomized controlled clinical trial. Patients and Setting: We examined data from 205 HF patients with CSA (apnea-hypopnea index [AHI] ≥ 15, > 50% were central) randomized to CPAP or control who had polysomnograms performed at baseline and 3 months later. Measurements and Results: In the control group, there was no change in AHI or frequency of arousals. In the CPAP-treated group, the AHI decreased significantly (from [mean ± SD] 38.9 ± 15.0 to 17.6 ± 16.3, P < 0.001) but neither the frequency of arousals nor sleep structure changed significantly. Conclusion: These data suggest that attenuation of CSA by CPAP does not reduce arousal frequency in HF patients. We conclude that arousals were not mainly a consequence of CSA, and may not have been acting as a defense mechanism to terminate apneas in the same way they do in OSA. Citation: Ruttanaumpawan P; Logan AG; Floras JS; Bradley TD. Effect of Continuous Positive Airway Pressure on Sleep Structure in Heart Failure Patients with Central Sleep Apnea. SLEEP 2009;32(1):91-98. PMID:19189783

  12. Dense gas boundary layer experiments: Visualization, pressure measurements, concentration evaluation

    SciTech Connect

    Reichenbach, H.; Neuwald, P.; Kuhl, A.L.

    1992-11-01

    This technical report describes methods that were applied to investigate turbulent boundary layers generated by inviscid, baroclinic effects. The Cranz-Schardin 24-sparks camera was used to visualize the interactions of a planar shock wave with a Freon R12-layer. The shock propagates more slowly in the Freon layer than in air because of its smaller sound speed. This causes the shock front to be curved and to be reflected between the wall and the layer interface. As a consequence of the reflection process, a series of compression and expansion waves radiate from the layer. Large fluctuations in the streamwise velocity and in pressure develop for about 1 ms. These waves strongly perturb the interface shear layer, which rapidly transitions to a turbulent boundary flow. Pressure measurements showed that the fluctuations in the Freon layer reach a peak pressure 4 times higher than in the turbulent boundary flow. To characterize the preshock Freon boundary layer, concentration measurements were performed with a differential interferometry technique. The refraction index of Freon R12 is so high that Mach-Zehnder interferometry was not successful in these experiments. The evaluation of the concentration profile is described here in detail. Method and results of corresponding LDV measurements under the same conditions are presented in a different report, EMI Report T 9/92. The authors plan to continue the dense gas layer investigations with the gas combination helium/Freon.

  13. Evaluation of a new miniature pressure-sensitive radio transmitter

    USGS Publications Warehouse

    Beeman, J.W.; Haner, P.V.; Maule, A.G.

    1998-01-01

    A miniature pressure-sensitive radio transmitter (tag) was evaluated and field tested as a tool for determining the depths of juvenile salmonids. The tag had an effective radiated power of −19.7 decibels (1 mW reference), dimensions of 23 mm × 7 mm, and a weight of 2.2 g in air. The pulse rate of the tag increased with pressure, resulting in an expected tag life of approximately 11 d at the water surface and 7.5 d at 10.5 m. The tags were accurate to within 16 mm with 95% of observations within ±0.32 m of the true depth. The resolution of the tags was 0.2 m. Errors in indicated depth resulting from differences between the calibration and operating temperatures were minimized by means of a correction factor. Tags surgically implanted in juvenile steelhead Oncorhynchus mykiss indicated a depth 0.2 m less than the same tags in water. This difference was not affected by pressure or temperature and was rectified by adjusting data from tags in fish. A test tag in a Columbia River reservoir was detected from distances of 1,133 m at a depth of 2 m and 148 m at a depth of 14 m. Results ind

  14. [Ventilatory failure in COPD: follow-up under intermittent positive pressure ventilation (IPPV)].

    PubMed

    Wiebel, M; Rossbach, L; Herth, F; Schulz, M; Schulz, V

    1999-10-01

    Effectiveness of IPPV in COPD is controversial. We examine the course of 29 patients with longterm IPPV (19 male, 10 female, age 60.3 years, BMI 23.7, FEV1 mean 22% predicted, PaCO2 mean 67 mmHg). PaCO2 is significantly by IPPV reduced. Patients are followed for 2 to 48 months (mean 16.5). Five stop IPPV (1 bilateral lung transplantation, 1 lung volume reduction surgery, 3 non-compliance), 8 die of respiratory failure, 5 of non-respiratory causes (non-RI) (3 tumor, 2 cardiovascular), and 10 survive (SV, 20.5 months). No difference in survival is observed between non-RI and SV. Weight increase by +5% is seen in SV more frequently, lung function is worse in RI, especially in weaning pts., hospital days are less frequent in SV and non-RI. Probability of survival is 70% at 1 year, 57% at 2 years, and 23% at 3 years, and is seriously influenced by non-RI. Our results are influenced by the high number of non-RI, the quitting of IPPV, and the primary inclusion of tumour pts. Still a high number of deaths by RI leads us to the conclusion that IPPV may be helpful for palliation, bridging before surgery and in subgroups who still have to be defined.

  15. T cell costimulation blockade blunts pressure overload-induced heart failure

    PubMed Central

    Kallikourdis, Marinos; Martini, Elisa; Carullo, Pierluigi; Sardi, Claudia; Roselli, Giuliana; Greco, Carolina M.; Vignali, Debora; Riva, Federica; Ormbostad Berre, Anne Marie; Stølen, Tomas O.; Fumero, Andrea; Faggian, Giuseppe; Di Pasquale, Elisa; Elia, Leonardo; Rumio, Cristiano; Catalucci, Daniele; Papait, Roberto; Condorelli, Gianluigi

    2017-01-01

    Heart failure (HF) is a leading cause of mortality. Inflammation is implicated in HF, yet clinical trials targeting pro-inflammatory cytokines in HF were unsuccessful, possibly due to redundant functions of individual cytokines. Searching for better cardiac inflammation targets, here we link T cells with HF development in a mouse model of pathological cardiac hypertrophy and in human HF patients. T cell costimulation blockade, through FDA-approved rheumatoid arthritis drug abatacept, leads to highly significant delay in progression and decreased severity of cardiac dysfunction in the mouse HF model. The therapeutic effect occurs via inhibition of activation and cardiac infiltration of T cells and macrophages, leading to reduced cardiomyocyte death. Abatacept treatment also induces production of anti-inflammatory cytokine interleukin-10 (IL-10). IL-10-deficient mice are refractive to treatment, while protection could be rescued by transfer of IL-10-sufficient B cells. These results suggest that T cell costimulation blockade might be therapeutically exploited to treat HF. PMID:28262700

  16. Influence of pretreatment systolic blood pressure on the effect of carvedilol in patients with severe chronic heart failure: the Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) study.

    PubMed

    Rouleau, Jean L; Roecker, Ellen B; Tendera, Michal; Mohacsi, Paul; Krum, Henry; Katus, Hugo A; Fowler, Michael B; Coats, Andrew J S; Castaigne, Alain; Scherhag, Armin; Holcslaw, Terry L; Packer, Milton

    2004-04-21

    We sought to evaluate the influence of pretreatment systolic blood pressure (SBP) on the efficacy and safety of carvedilol in patients with chronic heart failure (CHF). Although beta-blockers reduce the risk of death in CHF, there is little reported experience with these drugs in patients with a low pretreatment SBP, who may respond poorly to beta-blockade. We studied 2,289 patients with severe CHF who participated in the Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) trial. Compared with placebo, carvedilol improved the clinical status and reduced the risk of death and the combined risk of death or hospitalization for any reason, for a cardiovascular reason, or for worsening heart failure (p < 0.001 for all). The relative magnitude of these benefits did not vary as a function of the pretreatment SBP (all interaction: p > 0.10). However, because patients with the lowest SBP were at highest risk of an event, they experienced the greatest absolute benefit from treatment with carvedilol. The lower the pretreatment SBP, the more likely that patients would report an adverse event, be intolerant of high doses of the study drug, or require permanent withdrawal of treatment (p < 0.001 for all). However, these risks were primarily related to the severity of the underlying illness and not to treatment with carvedilol. The current study provides little support for concerns about using beta-blockers (particularly those with vasodilatory actions) in patients with severe CHF who have a low SBP. Pretreatment blood pressure can identify patients who have the greatest need for risk reduction with carvedilol.

  17. 10 CFR 21.21 - Notification of failure to comply or existence of a defect and its evaluation.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Notification of failure to comply or existence of a defect and its evaluation. 21.21 Section 21.21 Energy NUCLEAR REGULATORY COMMISSION REPORTING OF DEFECTS AND NONCOMPLIANCE Notification § 21.21 Notification of failure to comply or existence of a defect and its evaluation...

  18. 10 CFR 21.21 - Notification of failure to comply or existence of a defect and its evaluation.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 1 2011-01-01 2011-01-01 false Notification of failure to comply or existence of a defect and its evaluation. 21.21 Section 21.21 Energy NUCLEAR REGULATORY COMMISSION REPORTING OF DEFECTS AND NONCOMPLIANCE Notification § 21.21 Notification of failure to comply or existence of a defect and its evaluation...

  19. 10 CFR 21.21 - Notification of failure to comply or existence of a defect and its evaluation.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 1 2012-01-01 2012-01-01 false Notification of failure to comply or existence of a defect and its evaluation. 21.21 Section 21.21 Energy NUCLEAR REGULATORY COMMISSION REPORTING OF DEFECTS AND NONCOMPLIANCE Notification § 21.21 Notification of failure to comply or existence of a defect and its evaluation...

  20. 10 CFR 21.21 - Notification of failure to comply or existence of a defect and its evaluation.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Notification of failure to comply or existence of a defect and its evaluation. 21.21 Section 21.21 Energy NUCLEAR REGULATORY COMMISSION REPORTING OF DEFECTS AND NONCOMPLIANCE Notification § 21.21 Notification of failure to comply or existence of a defect and its evaluation...

  1. Technical evaluation: pressurized fluidized-bed combustion technology

    SciTech Connect

    Miller, S A; Vogel, G J; Gehl, S M; Hanway, Jr, J E; Henry, R F; Parker, K M; Smyk, E B; Swift, W M; Podolski, W F

    1982-04-01

    The technology of pressurized fluidized-bed combustion, particularly in its application to a coal-burning combined-cycle plant, is evaluated by examining the technical status of advanced-concept plant components - boiler system (combustor, air-handling and air-injection equipment, and heat exchangers); solids handling, injection, and ejection system; hot-gas cleanup equipment; instrumentation/control system; and the gas turbine - along with materials of plant construction. Environmental performance as well as energy efficiency are examined, and economic considerations are reviewed briefly. The evaluation concludes with a broad survey of the principal related research and development programs in the United States and other countries, a foreview of the most likely technological developments, and a summary of unresolved technical issues and problems.

  2. Bleb failure and intraocular pressure rise following Nd: Yag laser capsulotomy.

    PubMed

    Diagourtas, Andreas; Petrou, Petros; Georgalas, Ilias; Oikonomakis, Kostantinos; Giannakouras, Panagiotis; Vergados, Athanasios; Papaconstantinou, Dimitrios

    2017-02-22

    To report the negative effect of Nd: Yag (Neodymium-doped: Yttrium Aluminium Garnet) laser capsulotomy on the intraocular pressure (IOP) and the trabeculectomy bleb integrity, in a small series of eyes, both trabeculectomised and pseudophakic, following the laser application for the management of posterior capsular opacification (PCO). This is a retrospective, non-comparative interventional case series study, in which 20 trabeculectomised and pseudophakic eyes from 15 patients, with otherwise well functioning blebs, were presented with uncontrolled IOP, in a variable distance of time following the application of YAG laser capsulotomy. Student paired t-test confirmed a statistically significant difference (P < 0.05) between IOP before Nd: YAG laser capsulotomy (16 mmHg ± 3 mmHg) and the respective one, 2 to 6 months after Nd: Yag capsulotomy (34.5 ± 11 mmHg). All of the cases failed to respond to conservative treatment and were successfully managed with the implantation of Ahmed drainage devices. All patients showed flat filtering bleb and uncontrolled IOP (34.5 ± 11 mmHg), under maximum topical treatment, in a period of 2 to 6 months following Nd: YAG laser caspulotomy. The implantation of Ahmed valve proved to be effective treatment for these patients (IOP < 21 mmHg). Although Nd: Yag laser capsulotomy is considered a safe surgical procedure and usually is done without second thought, in this series of eyes, it is postulated that it may be responsible for the deregulation of the filtering bleb and subsequent loss of IOP control. We consider that laser capsulotomy should be performed with caution, especially in eyes with previous trabeculectomy. Also close monitoring of the intraocular pressure and assessment of eventual bleb morphology variations in the follow-up period is mandatory. Further studies are needed in order to confirm our findings.

  3. Evaluation of monkey intraocular pressure by rebound tonometer

    PubMed Central

    Yu, Wenhan; Cao, Guiqun; Qiu, Jinghua; Ma, Jia; Li, Ni; Yu, Man; Yan, Naihong; Chen, Lei; Pang, Iok-Hou

    2009-01-01

    Purpose To evaluate the usefulness of the TonoVet™ rebound tonometer in measuring intraocular pressure (IOP) of monkeys. Methods The accuracy of the TonoVet™ rebound tonometer was determined in cannulated eyes of anesthetized rhesus monkeys where IOP was controlled by adjusting the height of a connected perfusate reservoir. To assess the applicability of the equipment through in vivo studies, the diurnal fluctuation of IOP and effects of IOP-lowering compounds were evaluated in monkeys. Results IOP readings generated by the TonoVet™ tonometer correlated very well with the actual pressure in the cannulated monkey eye. The linear correlation had a slope of 0.922±0.014 (mean±SEM, n=4), a y-intercept of 3.04±0.61, and a correlation coefficient of r2=0.97. Using this method, diurnal IOP fluctuation of the rhesus monkey was demonstrated. The tonometer was also able to detect IOP changes induced by pharmacologically active compounds. A single topical ocular instillation (15 μg) of the rho kinase inhibitor, H1152, produced a 5–6 mmHg reduction (p<0.001) in IOP, lasting at least 4 h. In addition, topical administration of Travatan®, a prostaglandin agonist, induced a small transient IOP increase (1.1 mmHg versus vehicle control; p=0.26) at 2 h after treatment followed by a pressure reduction at 23 h (−2.4 mmHg; p<0.05). Multiple daily dosing with the drug produced a persistent IOP-lowering effect. Three consecutive days of Travatan treatment produced ocular hypotension of −2.0 to −2.2 mmHg (p<0.05) the following day. Conclusions The rebound tonometer was easy to use and accurately measured IOP in the rhesus monkey eye. PMID:19898690

  4. Become the PPUPET Master: Mastering Pressure Ulcer Risk Assessment With the Pediatric Pressure Ulcer Prediction and Evaluation Tool (PPUPET).

    PubMed

    Sterken, David J; Mooney, JoAnn; Ropele, Diana; Kett, Alysha; Vander Laan, Karen J

    2015-01-01

    Hospital acquired pressure ulcers (HAPU) are serious, debilitating, and preventable complications in all inpatient populations. Despite evidence of the development of pressure ulcers in the pediatric population, minimal research has been done. Based on observations gathered during quarterly HAPU audits, bedside nursing staff recognized trends in pressure ulcer locations that were not captured using current pressure ulcer risk assessment tools. Together, bedside nurses and nursing leadership created and conducted multiple research studies to investigate the validity and reliability of the Pediatric Pressure Ulcer Prediction and Evaluation Tool (PPUPET). Copyright © 2015 Elsevier Inc. All rights reserved.

  5. High-frequency data observations from space shuttle main engine low pressure fuel turbopump discharge duct flex joint tripod failure investigation

    NASA Technical Reports Server (NTRS)

    Zoladz, T. F.; Farr, R. A.

    1991-01-01

    Observations made by Marshall Space Flight Center (MSFC) engineers during their participation in the Space Shuttle Main Engine (SSME) low pressure fuel turbopump discharge duct flex joint tripod failure investigation are summarized. New signal processing techniques used by the Component Assessment Branch and the Induced Environments Branch during the failure investigation are described in detail. Moreover, nonlinear correlations between frequently encountered anomalous frequencies found in SSME dynamic data are discussed. A recommendation is made to continue low pressure fuel (LPF) duct testing through laboratory flow simulations and MSFC-managed technology test bed SSME testing.

  6. The role of exercise testing in the evaluation and management of heart failure

    PubMed Central

    Wright, D; Tan, L

    1999-01-01

    The clinical syndrome of heart failure has been investigated so extensively that it may now almost be regarded as a metabolic disorder. Although an initial insult reduces cardiac pump efficacy, the resultant physiological response culminates in complex neurohormonal dysfunction. This has created confusion and prevented the acceptance of a universal definition of cardiac failure. With much current research concentrating on the pharmacological modification of neuro-endocrine imbalance, it is easy to lose sight of the fundamental principles behind heart failure management, namely, to improve cardiac function. In attempting to achieve this, the issues of morbidity and mortality must be addressed jointly; they are not mutually exclusive entities. Discrepant results between mortality studies and changes in exercise capacity have undermined the value of exercise testing. Because a treatment enhances longevity we should not ignore its effect on symptomatic status, and likewise we should not discard a therapy, which improves function because adverse events result in occasional premature deaths. Informed patient choice must exist.
Historically, exercise testing has been quintessential in our understanding and evaluation of heart failure. Peak oxygen consumption remains the best overall indicator of symptomatic status, exercise capacity, prognosis and hospitalisation. Unfortunately, muddling of surrogate and true end-points has confused many of these issues. Improved comprehension may be gained by applying the concept of cardiac reserve which has been described in a variety of heart conditions and used in cardiac failure patients to provide an indication of prognosis and functional capacity.


Keywords: exercise testing; heart failure PMID:10646020

  7. Application of a system for measuring foot plantar pressure for evaluation of human mobility

    NASA Astrophysics Data System (ADS)

    Klimiec, Ewa; Jasiewicz, Barbara; Zaraska, Krzysztof; Piekarski, Jacek; Guzdek, Piotr; Kołaszczyński, Grzegorz

    2016-11-01

    The paper presents evaluation of human mobility by gait analysis, carried out in natural conditions (outside laboratory). Foot plantar pressure is measured using a shoe insole with 8 sensors placed in different anatomical zones of the foot, and placed inside a sports footwear. Polarized PVDF foil is used as a sensor material. A wireless transmission system is used to transmit voltage values to the computer. Due to linear relationship between force and transducer voltage, energy released during walking in arbitrary units can be calculated as integral of the square of transducer voltage over time. Gait measurements have been done over the next few days on healthy person during normal walking and slow walking. Performed measurements allow determination of walking speed (number of steps per second), gait rhythm and manner of walking (applying force to inside versus outside part of the sole). It is found that switching from normal to slow walk increases gait energy by 25% while the pressure distribution across the anatomical regions of the foot remains unchanged. The results will be used for developing a programme for evaluation of patients with cardiac failure and future integration of actimetry with pulse and spirometry measurements.

  8. The deterministic prediction of failure of low pressure steam turbine disks

    SciTech Connect

    Liu, Chun; Macdonald, D.D.

    1993-05-01

    Localized corrosion phenomena, including pitting corrosion, stress corrosion cracking, and corrosion fatigue, are the principal causes of corrosion-induced damage in electric power generating facilities and typically result in more than 50% of the unscheduled outages. Prediction of damage, so that repairs and inspections can be made during scheduled outages, could have an enormous impact on the economics of electric power generation. To date, prediction of corrosion damage has been made on the basis of empirical/statistical methods that have proven to be insufficiently robust and accurate to form the basis for the desired inspection/repair protocol. In this paper, we describe a deterministic method for predicting localized corrosion damage. We have used the method to illustrate how pitting corrosion initiates stress corrosion cracking (SCC) for low pressure steam turbine disks downstream of the Wilson line, where a thin condensed liquid layer exists on the steel disk surfaces. Our calculations show that the SCC initiation and propagation are sensitive to the oxygen content of the steam, the environment in the thin liquid condensed layer, and the stresses that the disk experiences in service.

  9. Blood Pressure Quiz

    MedlinePlus

    ... high blood pressure can lead to… stroke. kidney failure. heart attack and heart failure. all of the above. ... high blood pressure can lead to stroke, kidney failure, heart attack and heart failure A is the correct ...

  10. Determinants of the blood pressure response to the first dose of ACE inhibitor in mild to moderate congestive heart failure

    PubMed Central

    Murray, Lilian; Squire, Iain B; Reid, John L; Lees, Kennedy R

    1998-01-01

    Aims To investigate the relationship in patients with heart failure between BP response to the first dose of ACE inhibitor and (1) plasma drug concentration and (2) baseline clinical and laboratory variables. Methods We studied individual placebo-corrected BP responses to initiation of treatment with one of a number ACE inhibitor preparations in 132 patients with mild to moderate CHF. Various pharmacokinetic/pharmacodynamic models were compared. We assessed the strength of association between baseline physiological and laboratory variables and the BP response as assessed directly from the AUC(0,10 h) and indirectly from the slope of the PK/PD relationship. Predictive models for response variables were developing using regression analysis. Results BP response was primarily related to plasma drug concentration. The association between the fall in BP and baseline variables was weak. The strongest single predictor of BP response was baseline mean arterial pressure (r2 = 5.8%, P = 0.02). The best combinations of predictor variables contained mean arterial pressure, plasma renin activity, creatinine concentration and age (r2 = 14.4%, P = 0.37). When the choice of ACE inhibitor was added, the predictive power of the model increased (r2 = 23.6%, P < 0.01) but left the majority of the variability in response unexplained. Conclusions The first-dose blood pressure response to ACE inhibition cannot be accurately predicted from baseline pathophysiological variables in patients with mild to moderate CHF. The choice of ACE inhibitor accounts for a small proportion of the variability in response but wide inter-individual variability exists in the response to each treatment. PMID:9663811

  11. Estimation of cardiac output in patients with congestive heart failure by analysis of right ventricular pressure waveforms

    PubMed Central

    2011-01-01

    Background Cardiac output (CO) is an important determinant of the hemodynamic state in patients with congestive heart failure (CHF). We tested the hypothesis that CO can be estimated from the right ventricular (RV) pressure waveform in CHF patients using a pulse contour cardiac output algorithm that considers constant but patient specific RV outflow tract characteristic impedance. Method In 12 patients with CHF, breath-by-breath Fick CO and RV pressure waveforms were recorded utilizing an implantable hemodynamic monitor during a bicycle exercise protocol. These data were analyzed retrospectively to assess changes in characteristic impedance of the RV outflow tract during exercise. Four patients that were implanted with an implantable cardiac defibrillator (ICD) implementing the algorithm were studied prospectively. During a two staged sub-maximal bicycle exercise test conducted at 4 and 16 weeks of implant, COs measured by direct Fick technique and estimated by the ICD were recorded and compared. Results At rest the total pulmonary arterial resistance and the characteristic impedance were 675 ± 345 and 48 ± 18 dyn.s.cm-5, respectively. During sub-maximal exercise, the total pulmonary arterial resistance decreased (Δ 91 ± 159 dyn.s.cm-5, p < 0.05) but the characteristic impedance was unaffected (Δ 3 ± 9 dyn.s.cm-5, NS). The algorithm derived cardiac output estimates correlated with Fick CO (7.6 ± 2.5 L/min, R2 = 0.92) with a limit of agreement of 1.7 L/min and tracked changes in Fick CO (R2 = 0.73). Conclusions The analysis of right ventricular pressure waveforms continuously recorded by an implantable hemodynamic monitor provides an estimate of CO and may prove useful in guiding treatment in patients with CHF. PMID:21569499

  12. Evaluating and managing neonatal acute renal failure in a resource-poor setting.

    PubMed

    Ogunlesi, Tinuade A; Adekanmbi, Folasade

    2009-03-01

    Acute renal failure (ARF) is encountered in neonatal care where it may be associated with significant morbidities. Pre-renal failure, which is due to impaired renal tissue perfusion, is the commonest type of ARF. It is amenable to treatment with excellent prognosis following prompt diagnosis and timely institution of appropriate intervention. Unfortunately, ARF in the newborn is usually asymptomatic and it is only suspected when a newborn infant has not been observed to pass urine over several hours or when serum Creatinine is observed to be elevated or rising. In resource-poor settings, it is often difficult to conduct detailed evaluation of suspected cases of newborn ARF due to lack of appropriate equipments and infrastructure. Similarly, therapeutic facilities are sparse and there is heavy reliance on conservative management of cases. Such difficulties encountered in the evaluation and management of newborns with ARF in most parts of the developing world, like Nigeria, where diagnostic and therapeutic facilities are limited are highlighted.

  13. Achievement of Target Blood Pressure Levels among Japanese Workers with Hypertension and Healthy Lifestyle Characteristics Associated with Therapeutic Failure.

    PubMed

    Kudo, Nagako; Yokokawa, Hirohide; Fukuda, Hiroshi; Sanada, Hironobu; Miwa, Yuichi; Hisaoka, Teruhiko; Isonuma, Hiroshi

    2015-01-01

    Few studies have examined Japanese with regard to the achievement rates for target blood pressure levels, or the relationship between these rates and healthy lifestyle characteristics in patients with hypertension as defined by the newly established hypertension management guidelines (JSH2014). The aim of this study was to elucidate achievement rates and examine healthy lifestyle characteristics associated with achievement status among Japanese. This cross-sectional study, conducted in January-December 2012, examined blood pressure control and healthy lifestyle characteristics in 8,001 Japanese workers with hypertension (mean age, 57.0 years; 78.8% were men) who participated in a workplace health checkup. Data were collected from workplace medical checkup records and participants' self-administered questionnaires. We divided into 5 groups [G1; young, middle-aged, and early-phase elderly patients (65-74 years old) without diabetes mellitus or chronic kidney disease (CKD) (<140/90 mmHg), G2; late-phase elderly patients (≥75 years old) without diabetes mellitus or CKD (<150/90 mmHg), G3; diabetic patients (<130/80 mmHg), G4; patients with CKD (<130/80 mmHg), and G5; patients with cerebrovascular and/or coronary artery diseases (<140/90 mmHg)] according to JSH2014. And then, achievement rates were calculated in each group. Multivariate analysis identified healthy lifestyle characteristics associated with "therapeutic failure" of target blood pressure. Target blood pressures were achieved by 60.2% of young, middle-aged, and early-phase elderly patients (G1), 71.4% of late-phase elderly patients (G2), 30.5% of diabetic patients (G3), 33.4% of those with chronic kidney disease (G4), and 66.0% of those with cerebrovascular and/or coronary artery diseases (G5). A body mass index of 18.5-24.9 and non-daily alcohol consumption were protective factors, and adequate sleep was found to contribute to therapeutic success. We found low achievement rates for treatment goals among

  14. Urinary deoxypyridinoline excretion for the evaluation of bone turnover in chronic renal failure.

    PubMed

    Coen, G; Mantella, D; Calabria, S; Sardella, D; Manni, M; Fassino, V; D'Anello, E; Giustini, M; Taggi, F

    2000-01-01

    The urinary excretion of deoxypyridinoline (DPD) was evaluated in predialysis chronic renal failure (CRF), together with intact PTH and several classic markers of bone turnover in order to assess whether urine free and total DPD excretion are equivalent parameters of bone turnover in CRF, and to evaluate the relationship between urine DPD excretion, PTH and the other bone markers. The study was carried out in 94 patients with different degrees of renal failure due to various kidney diseases. Besides urinary DPD expressed as free DPD, total DPD, free/total DPD, free DPD/Cr and total DPD/Cr, the following determinations were made: intact PTH, bone alkaline phosphatase (BALP), total alkaline phosphatase (AP), osteocalcin (BGP), serum C-terminal telopeptide of collagen type I (ICTP) and hydroxyproline (OHpro). The patients were divided into 3 groups according to the increasing severity of renal failure (Ccr >40, 40-20, <20 ml/min). The ratio free/total DPD decreased (NS) with advancing renal failure, and was inversely correlated with total DPD excretion. While PTH increased progressively to about four times the values observed in the Ccr >40 group, there was a parallel increase only in BGP and ICTP, parameters retained in the serum with decreasing renal function, while AP, BALP, total DPD and OHpro did not change. However, significant correlations between total DPD/Cr and PTH, BALP, BGP and ICTP were also found. In CRF free DPD is an unreliable index of bone turnover due to a probable interference in its production from the peptide-bound DPD. Total DPD or total DPD/Cr are better used. In spite of the significant correlations observed in advanced renal failure between PTH and most of the parameters examined, a resistance of bone tissue to PTH action in CRF must be considered. Copyright 2000 S. Karger AG, Basel

  15. Six-month bracket failure rate evaluation of a self-etching primer.

    PubMed

    Elekdag-Turk, Selma; Isci, Devrim; Turk, Tamer; Cakmak, Fethiye

    2008-04-01

    The aim of this study was to compare the clinical performance of a self-etching primer (SEP) with a conventional two-step etch and primer [conventional method (CM)]. The chair time required for bonding was also evaluated. Thirty-seven patients (14 males and 23 females) with a mean age of 16 years 5 months were included in the study. Six hundred and seventy-two brackets were bonded by one operator using a split-mouth design, with either SEP (Transbond Plus) or CM (Transbond XT). Bracket failure rates were estimated with respect to bonding procedure, dental arch, type of tooth (incisor, canine, and premolar), and gender. The results were evaluated using the chi-square test. The survival rate of the brackets was estimated with Kaplan-Meier analysis. Bracket survival distributions with respect to bonding procedure, dental arch, type of tooth, and patient gender were compared with a log-rank test. Bond failure interface was determined with the adhesive remnant index (ARI). The failure rates were 0.6 per cent for both bonding procedures. The failure and survival rates did not show significant differences between the bonding procedures, upper and lower dental arches, or gender. However, premolar brackets displayed a higher bond failure rate and a lower survival rate than incisor and canine brackets (P < 0.05). The mean bracket bonding time per tooth with SEP was significantly shorter than with CM (P < 0.001). No significant difference was observed for the ARI scores (P > 0.05). The results of this in vivo, randomized, cross-mouth clinical trial demonstrated a high survival rate with Transbond Plus. This finding indicates that SEP can be effectively used for bonding of orthodontic brackets.

  16. Impact of epoetin alfa on left ventricular structure, function, and pressure volume relations as assessed by cardiac magnetic resonance: the heart failure preserved ejection fraction (HFPEF) anemia trial.

    PubMed

    Green, Philip; Babu, Benson A; Teruya, Sergio; Helmke, Stephen; Prince, Martin; Maurer, Mathew S

    2013-01-01

    Anemia, a common comorbidity in older adults with heart failure and a preserved ejection fraction (HFPEF), is associated with worse outcomes. The authors quantified the effect of anemia treatment on left ventricular (LV) structure and function as measured by cardiac magnetic resonance (CMR) imaging. A prospective, randomized single-blind clinical trial (NCT NCT00286182) comparing the safety and efficacy of epoetin alfa vs placebo for 24 weeks in which a subgroup (n=22) had cardiac magnetic resonance imaging (MRI) at baseline and after 3 and 6 months to evaluate changes in cardiac structure and function. Pressure volume (PV) indices were derived from MRI measures of ventricular volume coupled with sphygmomanometer-measured pressure and Doppler estimates of filling pressure. The end-systolic and end-diastolic PV relations and the area between them as a function of end-diastolic pressure, the isovolumic PV area (PVAiso), were calculated. Patients (75±10 years, 64% women) with HFPEF (EF=63%±15%) with an average hemoglobin of 10.3±1.1 gm/dL were treated with epoetin alfa using a dose-adjusted algorithm that increased hemoglobin compared with placebo (P<.0001). As compared with baseline, there were no significant changes in end-diastolic (-7±8 mL vs -3±8 mL, P=.81) or end-systolic (-0.4±2 mL vs -0.7±5 mL, P=.96) volumes at 6-month follow-up between epoetin alfa compared with placebo. LV function as measured based on EF (-1.5%±1.6% vs -2.6%±3.3%, P=.91) and pressure volume indices (PVAiso-EDP at 30 mm Hg, -5071±4308 vs -1662±4140, P=.58) did not differ between epoetin alfa and placebo. Administration of epoetin alfa to older adult patients with HFPEF resulted in a significant increase in hemoglobin, without evident change in LV structure, function, or pressure volume relationships as measured quantitatively using CMR imaging.

  17. Effect of Visit-to-Visit Variation of Heart Rate and Systolic Blood Pressure on Outcomes in Chronic Systolic Heart Failure: Results From the Systolic Heart Failure Treatment With the If Inhibitor Ivabradine Trial (SHIFT) Trial.

    PubMed

    Böhm, Michael; Robertson, Michele; Borer, Jeffrey; Ford, Ian; Komajda, Michel; Mahfoud, Felix; Ewen, Sebastian; Swedberg, Karl; Tavazzi, Luigi

    2016-02-12

    Elevated resting heart rate (HR) and low systolic blood pressure (SBP) are related to poor outcomes in heart failure (HF). The association between visit-to-visit variation in SBP and HR and risk in HF is unknown. In Systolic Heart Failure Treatment with the If inhibitor ivabradine Trial (SHIFT) patients, we evaluated relationships between mean HR, mean SBP, and visit-to-visit variations (coefficient of variation [CV]=SD/mean×100%) in SBP and HR (SBP-CV and HR-CV, respectively) and primary composite endpoint (cardiovascular mortality or HF hospitalization), its components, all-cause mortality, and all-cause hospitalization. High HR and low SBP were closely associated with risk for primary endpoint, all-cause mortality, and HF hospitalization. The highest number of primary endpoint events occurred in the highest HR tertile (38.8% vs 16.4% lowest tertile; P<0.001). For HR-CV, patients at highest risk were those in the lowest tertile. Patients in the lowest thirds of mean SBP and SBP-CV had the highest risk. The combination of high HR and low HR-CV had an additive deleterious effect on risk, as did that of low SBP and low SBP-CV. Ivabradine reduced mean HR and increased HR-CV, and increased SBP and SBP-CV slightly. Beyond high HR and low SBP, low HR-CV and low SBP-CV are predictors of cardiovascular outcomes with additive effects on risk in HF, but with an unknown effect size. Beyond HR reduction, ivabradine increases HR-CV. Low visit-to-visit variation of HR and SBP might signal risk of cardiovascular outcomes in systolic HF. URL: http://www.isrctn.com/. Unique identifier: ISRCTN70429960. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  18. An FMEA Evaluation of Intensity Modulated Radiation Therapy Dose Delivery Failures at Tolerance Criteria Levels.

    PubMed

    Faught, Jacqueline Tonigan; Balter, Peter A; Johnson, Jennifer L; Kry, Stephen F; Court, Laurence E; Stingo, Francesco C; Followill, David S

    2017-09-01

    correlations were found between the demographic information collected and scoring, percent dose errors, or ranking. Failure modes investigated overall were evaluated as low to medium risk, with average RPNs less than 110. The ranking of 11 failure modes was not agreed upon by the community. Large variability in FMEA scoring may be caused by individual interpretation and/or experience, reflecting the subjective nature of the FMEA tool. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  19. Combining heart rate and systolic blood pressure to improve risk stratification in older patients with heart failure: Findings from the RICA Registry.

    PubMed

    Sánchez-Gil, Justo; Manzano, Luis; Flather, Marcus; Formiga, Francesc; Martel, Alicia Conde; Molinero, Alberto Muela; López, Raul Quirós; Jiménez, Jose Luis Arias; Iborra, Pau Llácer; Perez-Calvo, Juan Ignacio; Montero-Pérez-Barquero, Manuel

    2017-03-01

    Heart rate (HR) and systolic blood pressure (SBP) are independent prognostic variables in patients with heart failure (HF). We evaluated if combining HR and SBP could improve prognostic assessment in older patients. Variables associated with all-cause mortality and readmission for HF during 9months of follow-up were analyzed from the Spanish Heart Failure Registry (RICA). HR and SBP values were stratified in three combined groups. We evaluated 1551 patients, 82years and 56% women. Using HR strata of <70 and ≥70bpm we found mortality rates of 9.8 and 13.6%, respectively (hazard ratio 1.0 and 1.35). For SBP≥140, 120-140 and <120mmHg, mortality rates were 8.2, 10.4 and 20.3%. respectively (hazard ratio 1.0, 1.34 and 2.76). Using combined strata of HR<70bpm and SBP≥140mmHg (n=176; low-risk), HR<70 and SBP<140+HR≥70 and SBP<120 (n=1089; moderate-risk) and HR≥70 and SBP<120 (n=286; high-risk) we found mortality rates of 4.5%, 11.0% and 24.0%, respectively. Multivariate Cox regression for all-cause mortality shows for low-, middle- and high-risk groups was 1 (reference), 1.93 (95% CI: 0.93-3.99, p=0.077) and 4.32 (95% CI: 2.04-9.14, p<0.001). BMI, NYHA, MDRD, hypertension and sodium were also independent prognostic factors. The combination provides better risk discrimination than use of HR and SBP alone and may provide a simple and reliable tool for risk assessment for older HF patients in clinical practice. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Relationship between systolic blood pressure and preserved or reduced ejection fraction at admission in patients hospitalized for acute heart failure syndromes.

    PubMed

    Kajimoto, Katsuya; Sato, Naoki; Sakata, Yasushi; Takano, Teruo

    2013-10-12

    Among patients with acute heart failure syndromes (AHFS), it has been reported that those with a reduced left ventricular ejection fraction (LVEF) tend to be hypotensive or normotensive, whereas those with a preserved LVEF tend to be hypertensive. However, it is unclear whether the systolic blood pressure (SBP) is actually associated with the LVEF in AHFS patients. Therefore, we evaluated the relationship between the SBP at admission and LVEF in patients hospitalized for AHFS. Data from the Acute Decompensated Heart Failure Syndromes (ATTEND) registry were analyzed to investigate the relationship between the admission SBP and a preserved or reduced LEF in AHFS patients. Of the 4,842 patients enrolled in this registry, 4,831 patients (99.8%) were evaluated. They were divided into SBP quartiles (SBP <120, 120 to <140, 140 to <160, and ≥160 mmHg), and LVEF was compared among the quartiles. Patients with an admission SBP <120 mmHg were more likely to have a reduced LVEF than a preserved LVEF. In contrast, patients with an admission SBP ≥120 mmHg were equally likely to have a preserved or reduced LVEF, indicating that there was no relation between a higher admission SBP and the LVEF. Our data indicated that an elevated SBP at admission may not be useful to distinguish between a preserved or reduced LVEF in the urgent phase of AHFS. However, taking geographical differences of AHFS into consideration, further investigations are needed to clarify the relationship between admission SBP and LVEF in patients hospitalized for AHFS. © 2013.

  1. Evaluation of serum myeloperoxidase concentration in dogs with heart failure due to chronic mitral valvular insufficiency.

    PubMed

    Park, Jong-In; Suh, Sang-Il; Hyun, Changbaig

    2017-01-01

    Myeloperoxidase (MPO) is a leukocyte-derived enzyme involved in the process of heart failure and is found to have good diagnostic and prognostic values in humans with chronic heart failure. This study evaluated the relationship between serum MPO levels and the severity of heart failure (HF) due to chronic mitral valvular insufficiency (CMVI) in dogs. Eighty-two client-owned dogs consisting of 69 dogs with different stages of HF due to CMVI and 13 age-matched healthy dogs were enrolled in this study. Serum MPO concentrations in the healthy and CMVI groups were determined by enzyme-linked immunosorbent assay (ELISA) using a canine-specific monoclonal anti-MPO antibody. Serum MPO concentrations were 273.3 ± 179.6 ng/L in the controls, 140.8 ± 114.1 ng/L in the International Small Animal Cardiac Health Council (ISACHC) I group, 109.0 ± 85.2 ng/L in the ISACHC II group, and 106.0 ± 42.3 ng/L in the ISACHC III group. Close negative correlation to serum MPO concentration was found in the severity of heart failure (ISACHC stage). Although this study found a modest relationship between serum MPO levels and the severity of HF due to CMVI in dogs, it also suggested that serum MPO levels decreased as the severity of HF increased.

  2. Evaluation of a New Pediatric Positive Airway Pressure Mask

    PubMed Central

    Kushida, Clete A.; Halbower, Ann C.; Kryger, Meir H.; Pelayo, Rafael; Assalone, Valerie; Cardell, Chia-Yu; Huston, Stephanie; Willes, Leslee; Wimms, Alison J.; Mendoza, June

    2014-01-01

    Study Objectives: The choice and variety of pediatric masks for continuous positive airway pressure (CPAP) is limited in the US. Therefore, clinicians often prescribe modified adult masks. Until recently a mask for children aged < 7 years was not available. This study evaluated apnea-hypopnea index (AHI) equivalence and acceptability of a new pediatric CPAP mask for children aged 2-7 years (Pixi; ResMed Ltd, Sydney, Australia). Methods: Patients aged 2-7 years were enrolled and underwent in-lab baseline polysomnography (PSG) using their previous mask, then used their previous mask and the VPAP III ST-A flow generator for ≥ 10 nights at home. Thereafter, patients switched to the Pixi mask for ≥ 2 nights before returning for a PSG during PAP therapy via the Pixi mask. Patients then used the Pixi mask at home for ≥ 21 nights. Patients and their parents/guardians returned to the clinic for follow-up and provided feedback on the Pixi mask versus their previous mask. Results: AHI with the Pixi mask was 1.1 ± 1.5/h vs 2.6 ± 5.4/h with the previous mask (p = 0.3538). Parents rated the Pixi mask positively for: restfulness of the child's sleep, trouble in getting the child to sleep, and trouble in having the child stay asleep. The Pixi mask was also rated highly for leaving fewer or no marks on the upper lip and under the child's ears, and being easy to remove. Conclusions: The Pixi mask is suitable for children aged 2-7 years and provides an alternative to other masks available for PAP therapy in this age group. Citation: Kushida CA, Halbower AC, Kryger MH, Pelayo R, Assalone V, Cardell CY, Huston S, Willes L, Wimms AJ, Mendoza J. Evaluation of a new pediatric positive airway pressure mask. J Clin Sleep Med 2014;10(9):979-984. PMID:25142768

  3. Evaluation of skin perfusion pressure to assess refractory foot ulcers.

    PubMed

    Kawai, M; Mihara, S; Takahagi, S; Iwamoto, K; Hiragun, T; Hide, M

    2017-05-02

    The number of patients with foot gangrene caused by critical ischaemia and severe infection is increasing significantly in developed countries. The measurement of perilesional skin blood flow by skin perfusion pressure (SPP) is useful to select the appropriate treatment of gangrenous lesions, in that it is not affected by calcifications of blood vessels. However, the prognosis of a foot ulcer may also be affected by the level of blood sugar and infections. This study aimed to validate the use of SPP in cases of foot gangrene and ulcers in patients with and without diabetes mellitus (DM) and infection. Clinical symptoms, ankle-brachial pressure index (ABPI) and SPP were assessed to evaluate the condition of each foot ulcer. Every foot ulcer was treated as independent, even if a participant had multiple ulcers. All ulcers for which we measured SPP were subject to the analysis. All ulcers were purely ischaemic in nature and were exclusively located on the foot or toes. Data were collected from 117 foot ulcers on 91 toes and feet from 65 patients. Almost all SPP values in healed cases were > 27 mmHg. There were three patients whose ulcers failed to heal by conservative treatments were complicated with severe infection. However, no effect of DM on the relationship between SPP values and prognosis was observed. Logistic regression analysis of all ulcers except for the 5 cases complicated with infection revealed that those with 30 mmHg or lower SPP values are likely to heal by conservative treatment with 23% or lower probability, whereas any ulcer with more than 50 mmHg SPP value and without severe infection may heal without the need for further operations with 80% or higher probability. The combination of SPP and careful evaluation of infection may be a good parameter to decide the appropriate treatment for ischaemic skin ulcers, regardless of the complication of DM.

  4. Visit-to-visit variability of blood pressure and coronary heart disease, stroke, heart failure and mortality: A cohort study

    PubMed Central

    Muntner, Paul; Whittle, Jeff; Lynch, Amy I.; Colantonio, Lisandro D.; Simpson, Lara M.; Einhorn, Paula T.; Levitan, Emily B.; Whelton, Paul K; Cushman, William C.; Louis, Gail T.; Davis, Barry R.; Oparil, Suzanne

    2016-01-01

    Background Variability of blood pressure (BP) across outpatient visits is frequently dismissed as random fluctuation around a patient’s underlying BP. Objective: Examine the association between visit-to-visit variability (VVV) of systolic and diastolic BP (SBP and DBP) on cardiovascular disease and mortality outcomes. Design Prospective cohort study Setting Post-hoc analysis of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Participants 25,814 ALLHAT participants. Measurements VVV of SBP was defined as the standard deviation (SD) across BP measurements obtained at 7 visits conducted from 6 to 28 months following ALLHAT enrollment. Participants free of cardiovascular disease events during the first 28 months of follow-up were followed from the month 28 study visit through the end of active ALLHAT follow-up. Outcomes included fatal coronary heart disease or non-fatal myocardial infarction, all-cause mortality, stroke and heart failure. Results There were 1194 cases of fatal CHD or non-fatal MI, 1948 deaths, 606 cases of stroke and 921 cases of heart failure during follow-up. After multivariable adjustment including mean SBP, the hazard ratio comparing participants in the highest versus lowest quintile of SD of SBP (≥14.4 mmHg versus <6.5 mmHg) was 1.30 (1.06–1.59) for fatal coronary heart disease or non-fatal myocardial infarction, 1.58 (1.32–1.90) for all-cause mortality, 1.46 (1.06–2.01) for stroke, and 1.25 (0.97–1.61) for heart failure. Higher VVV of DBP was also associated with cardiovascular disease events and mortality. Limitations Long-term outcomes were not available. Conclusions Higher VVV of SBP is associated with increased cardiovascular disease and mortality risk. Future studies should examine whether reducing VVV of BP lowers this risk. Primary funding source National Institutes of Health PMID:26215765

  5. Pressure ulcers: development and psychometric evaluation of the attitude towards pressure ulcer prevention instrument (APuP).

    PubMed

    Beeckman, D; Defloor, T; Demarré, L; Van Hecke, A; Vanderwee, K

    2010-11-01

    Pressure ulcers continue to be a significant problem in hospitals, nursing homes and community care settings. Pressure ulcer incidence is widely accepted as an indicator for the quality of care. Negative attitudes towards pressure ulcer prevention may result in suboptimal preventive care. A reliable and valid instrument to assess attitudes towards pressure ulcer prevention is lacking. Development and psychometric evaluation of the Attitude towards Pressure ulcer Prevention instrument (APuP). Prospective psychometric instrument validation study. A literature review was performed to design the instrument. Content validity was evaluated by nine European pressure ulcer experts and five experts in psychometric instrument validation in a double Delphi procedure. A convenience sample of 258 nurses and 291 nursing students from Belgium and The Netherlands participated in order to evaluate construct validity and stability reliability of the instrument. The data were collected between February and May 2008. A factor analysis indicated the construct of a 13 item instrument in a five factor solution: (1) attitude towards personal competency to prevent pressure ulcers (three items); (2) attitude towards the priority of pressure ulcer prevention (three items); (3) attitude towards the impact of pressure ulcers (three items); (4) attitude towards personal responsibility in pressure ulcer prevention (two items); and (5) attitude towards confidence in the effectiveness of prevention (two items). This five factor solution accounted for 61.4% of the variance in responses related to attitudes towards pressure ulcer prevention. All items demonstrated factor loadings over 0.60. The instrument produced similar results during stability testing [ICC=0.88 (95% CI=0.84-0.91, P<0.001)]. For the total instrument, the internal consistency (Cronbachs alpha) was 0.79. The APuP is a psychometrically sound instrument that can be used to effectively assess attitudes towards pressure ulcer prevention

  6. Evaluation of cephalexin failure rates in morbidly obese patients with cellulitis.

    PubMed

    Kaufman, K R; Thurber, K M; O'Meara, J G; Langworthy, D R; Kashiwagi, D T

    2016-08-01

    Identification of adequate antimicrobial dosing regimens for morbidly obese patients is essential given the simultaneous increase in morbid obesity and cellulitis prevalence in recent years. Insufficient data currently exist to describe the effectiveness of extrapolating traditional antibiotic dosing strategies to morbidly obese patients with cellulitis. The primary objective of this study was to compare therapeutic failure rates in non-obese and morbidly obese patients with cellulitis when treated with cephalexin at standard dosing. This was a single-centre, retrospective cohort analysis. Adult patients hospitalized or under inpatient observation at a 1265-bed academic medical centre who received cephalexin monotherapy for non-purulent cellulitis from 2005 to 2015 were evaluated for inclusion. Patients were divided into two cohorts based on body mass index (BMI), where BMI <30 kg/m(2) was defined as non-obese and BMI ≥40 kg/m(2) as morbidly obese. Patients with critical risk factors for purulent or polymicrobial cellulitis were excluded. The primary outcome, therapeutic failure, was defined as a need for extended or additional antimicrobial therapy, surgical intervention, emergency department visit, or re-hospitalization within two to thirty days after cephalexin initiation. A total of 94 patients (69 non-obese and 25 morbidly obese) met inclusion and exclusion criteria, which was below the estimated sample size needed to reach desired power. The rate of therapeutic failure in the morbidly obese group was similar to the non-obese group (20% vs. 14·5%, P = 0·53). Patients most commonly had extended or additional antibiotics prescribed in response to therapeutic failure with cephalexin. Cephalexin failure rates for cellulitis did not differ statistically between morbidly obese and non-obese patients. The underpowered nature of this study is a limitation. Until further study with a larger sample size is completed, empiric adjustment of cephalexin dosing based

  7. Failure analysis and evaluation of a six cylinders crankshaft for marine diesel generator

    NASA Astrophysics Data System (ADS)

    Khaeroman, Haryadi, Gunawan Dwi; Ismail, R.; Kim, Seon Jin

    2017-01-01

    This paper discusses the failure of a diesel engine crankshaft of a four stroke 6 cylinders, used in a marine diesel generator. A correct analysis and evaluation of the dimension of the crankshaft are very essential to prevent failure of the crankshaft fracture and cracks. The crankshaft is liable to deformation due to misalignment of the main journals bearings. This article presents the result of crankshaft failure analysis by measuring the mean diameter of the rod journal and the main journal, on the wear, out of roundness, taper, etc. The measurement results must be compared with the acceptable value in the engine specification and manual service and also should follow the American Bureau of Shipping (ABS) guidance notes on propulsion shafting alignment. The measurement results of this study show that the main journal diameter of the third cylinder exhibits an excessive wear, 1.35 % above the permissible lowest rate. It also has a taper for 0.23 mm and out of roundness of 0.13 mm. The diameter of the rod journal indicates excessive wear, 1.06 % higher than the permissible lowest rate, the taper of 0.41 mm and out of roundness of 0.65 mm. The crankshaft warpage or run-out journal, the analysis of the crank web deflection are also evaluated and presented in this paper.

  8. Clinical evaluation of the failure rate of metallic brackets bonded with orthodontic composites.

    PubMed

    Romano, Fábio Lourenço; Valério, Rodrigo Alexandre; Gomes-Silva, Jaciara Miranda; Ferreira, José Tarcísio Lima; Faria, Gisele; Borsatto, Maria Cristina

    2012-01-01

    The purpose of the present study was to evaluate in vivo the failure rate of metallic brackets bonded with two orthodontic composites. Nineteen patients with ages ranging from 10.5 to 38.7 years needing corrective orthodontic treatment were selected for study. The enamel surfaces from second premolars to second premolars were treated with Transbond Plus-Self Etching Primer (3M Unitek). Next, 380 orthodontic brackets were bonded on maxillary and mandibular teeth, as follows: 190 with Transbond XT composite (3M Unitek) (control) and 190 with Transbond Plus Color Change (3M Unitek) (experimental) in contralateral quadrants. The bonded brackets were light cured for 40 s, and initial alignment archwires were inserted. Bond failure rates were recorded over a six-month period. At the end of the evaluation, six bond failures occurred, three for each composite. Kaplan-Meyer method and log-rank test (Mantel-Cox) was used for statistical analysis, and no statistically significant difference was found between the materials (p=0.999). Both Transbond XT and Transbond Plus Color Change composites had low debonding rates over the study period.

  9. Using simulation to evaluate the performance of resilience strategies and process failures

    SciTech Connect

    Levy, Scott N.; Topp, Bryan Embry; Arnold, Dorian C.; Ferreira, Kurt Brian; Widener, Patrick; Hoefler, Torsten

    2014-01-01

    Fault-tolerance has been identified as a major challenge for future extreme-scale systems. Current predictions suggest that, as systems grow in size, failures will occur more frequently. Because increases in failure frequency reduce the performance and scalability of these systems, significant effort has been devoted to developing and refining resilience mechanisms to mitigate the impact of failures. However, effective evaluation of these mechanisms has been challenging. Current systems are smaller and have significantly different architectural features (e.g., interconnect, persistent storage) than we expect to see in next-generation systems. To overcome these challenges, we propose the use of simulation. Simulation has been shown to be an effective tool for investigating performance characteristics of applications on future systems. In this work, we: identify the set of system characteristics that are necessary for accurate performance prediction of resilience mechanisms for HPC systems and applications; demonstrate how these system characteristics can be incorporated into an existing large-scale simulator; and evaluate the predictive performance of our modified simulator. We also describe how we were able to optimize the simulator for large temporal and spatial scales-allowing the simulator to run 4x faster and use over 100x less memory.

  10. Pulmonary congestion evaluated by lung ultrasound predicts decompensation in heart failure outpatients.

    PubMed

    Miglioranza, Marcelo H; Picano, Eugenio; Badano, Luigi P; Sant'Anna, Roberto; Rover, Marciane; Zaffaroni, Facundo; Sicari, Rosa; Kalil, Renato K; Leiria, Tiago L; Gargani, Luna

    2017-08-01

    Pulmonary congestion is the main cause of hospital admission among heart failure (HF) patients. Lung ultrasound (LUS) assessment of B-lines has been recently proposed as a reliable and easy tool for evaluating pulmonary congestion. To determine the prognostic value of LUS in predicting adverse events in HF outpatients. Single-center prospective cohort of 97 moderate-to-severe systolic HF patients (53±13years; 61% males) consecutively enrolled between November 2011 and October 2012. LUS evaluation was performed during the regular outpatient visit to evaluate the presence of pulmonary congestion, determined by B-lines number. Patients were followed up for 4months to assess admission due to acute pulmonary edema. During follow-up period (106±12days), 21 hospitalizations for acute pulmonary edema occurred. At Cox regression analysis, B-lines number≥30 (HR 8.62; 95%CI: 1.8-40.1; p=0.006) identified a group at high risk for acute pulmonary edema admission at 120days, and was the strongest predictor of events compared to other established clinical, laboratory and instrumental findings. No acute pulmonary edema occurred in patients without significant pulmonary congestion at LUS (number of B-lines<15). In a HF outpatient setting, B-line assessment by LUS identifies patients more likely to be admitted for decompensated HF in the following 4months. This simple evaluation could allow prompt therapy optimization in those patients who, although asymptomatic, carry a significant degree of extravascular lung water. Pulmonary congestion is the main cause of hospital admissions among heart failure patients. Lung ultrasound can be used as a reliable and easy way to evaluate pulmonary congestion through assessment of B-lines. In a cohort of heart failure outpatients, a B-lines cutoff≥30 (HR 8.62; 95%CI: 1.8-40.1) identified patients most likely to develop acute pulmonary edema at 120-days. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Dynamic characteristics and performance evaluation for the part strut failure of the vibration isolation platform on satellites

    NASA Astrophysics Data System (ADS)

    Zhang, Yao; Sheng, Chao; Guo, Zixi; Wang, Youyi; Li, Wenbo

    2017-04-01

    The dynamic characteristics and performance evaluation for the part strut failure of the vibration isolation platform are presented in this paper. The first step provides and mathematically describes two types of strut failure: fractured and stuck. Secondly, the dynamic model of the vibration isolation platform, which considers the part strut failure, is established using the Newton-Euler method and a constraint equation to evaluate its dynamic characteristics and performance. Then, with reasonable assumptions, the dynamic model of the satellite, which has a vibration isolation platform and vibration sources (such as control moment gyros) of three working situations (without and with two types of strut failure), is simplified to analyse the frequency domain characteristic and coupling characteristic with the attitude control system. Finally, a numerical simulation is used to study the effect of the vibration isolation platform with part strut failure on the attitude control and stabilization, and the attitude control performance is evaluated.

  12. Endothelial p53 deletion improves angiogenesis and prevents cardiac fibrosis and heart failure induced by pressure overload in mice.

    PubMed

    Gogiraju, Rajinikanth; Xu, Xingbo; Bochenek, Magdalena L; Steinbrecher, Julia H; Lehnart, Stephan E; Wenzel, Philip; Kessel, Michael; Zeisberg, Elisabeth M; Dobbelstein, Matthias; Schäfer, Katrin

    2015-02-24

    Cardiac dysfunction developing in response to chronic pressure overload is associated with apoptotic cell death and myocardial vessel rarefaction. We examined whether deletion of tumor suppressor p53 in endothelial cells may prevent the transition from cardiac hypertrophy to heart failure. Mice with endothelial-specific deletion of p53 (End.p53-KO) were generated by crossing p53fl/fl mice with mice expressing Cre recombinase under control of an inducible Tie2 promoter. Cardiac hypertrophy was induced by transverse aortic constriction. Serial echocardiography measurements revealed improved cardiac function in End.p53-KO mice that also exhibited better survival. Cardiac hypertrophy was associated with increased p53 levels in End.p53-WT controls, whereas banded hearts of End.p53-KO mice exhibited lower numbers of apoptotic endothelial and non-endothelial cells and altered mRNA levels of genes regulating cell cycle progression (p21), apoptosis (Puma), or proliferation (Pcna). A higher cardiac capillary density and improved myocardial perfusion was observed, and pharmacological inhibition or genetic deletion of p53 also promoted endothelial sprouting in vitro and new vessel formation following hindlimb ischemia in vivo. Hearts of End.p53-KO mice exhibited markedly less fibrosis compared with End.p53-WT controls, and lower mRNA levels of p53-regulated genes involved in extracellular matrix production and turnover (eg, Bmp-7, Ctgf, or Pai-1), or of transcription factors involved in controlling mesenchymal differentiation were observed. Our analyses reveal that accumulation of p53 in endothelial cells contributes to blood vessel rarefaction and fibrosis during chronic cardiac pressure overload and suggest that endothelial cells may be a therapeutic target for preserving cardiac function during hypertrophy. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  13. Endothelial p53 Deletion Improves Angiogenesis and Prevents Cardiac Fibrosis and Heart Failure Induced by Pressure Overload in Mice

    PubMed Central

    Gogiraju, Rajinikanth; Xu, Xingbo; Bochenek, Magdalena L.; Steinbrecher, Julia H.; Lehnart, Stephan E.; Wenzel, Philip; Kessel, Michael; Zeisberg, Elisabeth M.; Dobbelstein, Matthias; Schäfer, Katrin

    2015-01-01

    Background Cardiac dysfunction developing in response to chronic pressure overload is associated with apoptotic cell death and myocardial vessel rarefaction. We examined whether deletion of tumor suppressor p53 in endothelial cells may prevent the transition from cardiac hypertrophy to heart failure. Methods and Results Mice with endothelial‐specific deletion of p53 (End.p53‐KO) were generated by crossing p53fl/fl mice with mice expressing Cre recombinase under control of an inducible Tie2 promoter. Cardiac hypertrophy was induced by transverse aortic constriction. Serial echocardiography measurements revealed improved cardiac function in End.p53‐KO mice that also exhibited better survival. Cardiac hypertrophy was associated with increased p53 levels in End.p53‐WT controls, whereas banded hearts of End.p53‐KO mice exhibited lower numbers of apoptotic endothelial and non‐endothelial cells and altered mRNA levels of genes regulating cell cycle progression (p21), apoptosis (Puma), or proliferation (Pcna). A higher cardiac capillary density and improved myocardial perfusion was observed, and pharmacological inhibition or genetic deletion of p53 also promoted endothelial sprouting in vitro and new vessel formation following hindlimb ischemia in vivo. Hearts of End.p53‐KO mice exhibited markedly less fibrosis compared with End.p53‐WT controls, and lower mRNA levels of p53‐regulated genes involved in extracellular matrix production and turnover (eg, Bmp‐7, Ctgf, or Pai‐1), or of transcription factors involved in controlling mesenchymal differentiation were observed. Conclusions Our analyses reveal that accumulation of p53 in endothelial cells contributes to blood vessel rarefaction and fibrosis during chronic cardiac pressure overload and suggest that endothelial cells may be a therapeutic target for preserving cardiac function during hypertrophy. PMID:25713289

  14. Influence of blood pressure at the beginning of decompensations in the prognosis of patients with heart failure.

    PubMed

    Torrente Iranzo, Silvia; Garcés Horna, Vanesa; Josa Laorden, Claudia; Rubio Gracia, Jorge; Ruiz Laiglesia, Fernando José; Sánchez Marteles, Marta; Pérez Calvo, Juan Ignacio

    2017-08-22

    An inverse relationship has been described between blood pressure and the prognosis in heart failure (HF). The characteristics of this relationship are not well unknown. The objective of this study was to determine if this relationship is maintained in a non-selected cohort of patients with HF and if it can be modified by treatment. Prospective study of cohorts including patients hospitalized for decompensated HF in Internal Medicine departments and followed as outpatients in a monographic consultation. Patients were classified according to their levels of systolic (SBP) and diastolic blood pressure (DBP). Clinical characteristics, all-cause mortality and readmissions after the first, third and sixth month of follow-up were analysed. Two hundred and twenty-one patients were included after their admission to the hospital for acute HF. Mean patient age was 79.5 years(SD 8.09); 115 patients were male. No significant differences between SBP quartiles and basal characteristics were found. Patients with lower SBP (Q1) had higher mortality rates (20%, P<.05). No significant differences between mortality/readmissions and DBP were found. However, the Kaplan-Meier analysis showed higher all-cause mortality rates for the group of patients with lower SBP and DBP (log-rank=0.011 and 0.041, respectively). The pharmacological treatment did not differ significantly between both study groups. For non-selected patients suffering HF, higher SBP upon the admission is associated with significantly lower all-cause mortality rates during follow-up. Pharmacological treatment of HF does not seem to influence this inverse relationship between SBP at admission and patient mortality. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  15. Evaluating the risk of water distribution system failure: A shared frailty model

    NASA Astrophysics Data System (ADS)

    Clark, Robert M.; Thurnau, Robert C.

    2011-12-01

    Condition assessment (CA) Modeling is drawing increasing interest as a technique that can assist in managing drinking water infrastructure. This paper develops a model based on the application of a Cox proportional hazard (PH)/shared frailty model and applies it to evaluating the risk of failure in drinking water networks using data from the Laramie Water Utility (located in Laramie, Wyoming, USA). Using the risk model a cost/ benefit analysis incorporating the inspection value method (IVM), is used to assist in making improved repair, replacement and rehabilitation decisions for selected drinking water distribution system pipes. A separate model is developed to predict failures in prestressed concrete cylinder pipe (PCCP). Various currently available inspection technologies are presented and discussed.

  16. A controlled study to evaluate directed masturbation in the management of primary orgasmic failure in women.

    PubMed

    Riley, A J; Riley, E J

    1978-11-01

    This paper presents the results of a prospective controlled study evaluating a programme of directed masturbation against a combined sensate focus and supportive psychotherapeutic approach in the management of female primary orgasmic failure. Of the 20 patients who followed the masturbation programme 90 per cent gained orgasmic capacity compared with 53 per cent of 15 patients who were treated conventionally. Eighty-five per cent of the patients treated by the masturbation programme and 47 per cent of the control group of patients became coitally orgasmic on at least 75 per cent of coital occasions. The difference is statistically significant at the 5 per cent level. The results suggest that directed masturbation is an effective adjunct in the management of primary female orgasmic failure.

  17. The development of a risk of failure evaluation tool for small dams in Mzingwane Catchment, Zimbabwe

    NASA Astrophysics Data System (ADS)

    Mufute, N. L.; Senzanje, A.; Kaseke, E.

    Small dams in Mzingwane Catchment in southern Zimbabwe are mostly in poor physical condition mainly due to lack of resources for repair and maintenance. Most of these dams are likely to fail thereby adversely affecting water availability and livelihoods in the area. To assist those involved in maintenance, repair and rehabilitation of small dams in resource poor and data sparse areas such as Mzingwane Catchment, a non-probabilistic but numerical risk of failure evaluation tool was developed. The tool helps to systematically, and objectively classify risk of failure of small dams, hence assist in the ranking of dams to prioritise and attend to first. This is important where resources are limited. The tool makes use of factors such as seepage, erosion and others that are traditionally used to assess condition of dams. In the development of the tool, an assessment of the physical condition of 44 (1 medium sized and 43 small dams) dams was done and the factors were identified and listed according to guidelines for design and maintenance of small dams. The description of the extent to which the factors affect the physical condition of small dams was then standardised. This was mainly guided by standard based and risk-based approaches to dam safety evaluation. Cause-effect diagrams were used to determine the stage at which each factor is involved in contributing to dam failure. Weights were then allocated to each factor depending on its stage or level in the process of causing dam failure. Scores were allocated to each factor based on its description and weight. Small dams design and maintenance guidelines were also used to guide the ranking and weighting of the factors. The tool was used to classify 10 dams. The risk of failure was low for one dam, moderate for one, high for four and very high for four dams, two of which had already failed. It was concluded that the tool could be used to rank the risk of failure of small dams in semi-arid areas. The tool needs to be

  18. Clinical evaluation of a new epidural pressure monitor.

    PubMed

    Czech, T; Korn, A; Reinprecht, A; Schramm, W; Kimla, T; Spiss, C K

    1993-01-01

    Comparative measuring of epidural pressure using the Spiegelberg probe 1 and ventricular fluid pressure was carried out in 15 neurosurgical intensive-care patients. Deviations in both directions were established, with a trend toward overestimating ventricular pressure in epidural pressure measuring (r = 0.77). Individual pulsations, spontaneous wave courses and therapy-induced pressure changes were reflected without delays. There were no complications observed with probe implantation periods for up to 6 days. The system has been shown to be mechanically stable and easy to implant. We believe the device to be fit for trend monitoring of intracranial pressure. As with other epidural pressure monitoring systems, false assessments of ventricular pressure may lead to wrong decisions as to required therapy.

  19. Filament-reinforced metal composite pressure vessel evaluation and performance demonstration

    NASA Technical Reports Server (NTRS)

    Landes, R. E.

    1976-01-01

    Two different Kevlar-49 filament-reinforced metal sphere designs were developed, and six vessels of each type were fabricated and subjected to fatigue cycling, sustained loading, and hydrostatic burst. The 61 cm (24 inch) diameter Kevlar-49/cryoformed 301 stainless steel pressure vessels demonstrated the required pressure cycle capability, burst factor of safety, and a maximum pressure times volume divided by weight (pV/W) performance of 210 J/g (834 000 in-lb/lbm) at burst; this represented a 25 to 30% weight saving over the lightest weight comparable, 6A1-4V Ti, homogeneous pressure vessel. Both the Kevlar/stainless steel design and the 97 cm (38 inch) diameter Kevlar-49/2219-T62 aluminum sphere design demonstrated nonfragmentation and controlled failure mode features when pressure cycled to failure at operating pressure. When failure occurred during pressure cycling, the mode was localized leakage and not catastrophic. Kevlar/stainless steel vessels utilized a unique conical boss design, and Kevlar/aluminum vessels incorporated a tie-rod to carry port loads; both styles of polar fittings performed as designed during operational testing of the vessels.

  20. EVALUATION OF THE FAILURE OF A RADIOACTIVE WASTE TRANSFER LINE JACKET

    SciTech Connect

    Wiersma, B; Alan03 Plummer, A; Karthik Subramanian, K; Charles Jenkins, C; William Hinz, W; A Fellinger, A

    2007-04-06

    Radioactive wastes are confined in 49 underground storage tanks at the Savannah River Site. The waste is transported between tanks primarily via an underground transfer piping system. Due to the hazardous nature of the waste, the inner core stainless steel pipe is typically surrounded by a carbon steel pipe jacket, which provides secondary containment. Recently several through-wall penetrations were discovered on a segment of one of the jackets. An evaluation was performed to verify the failure mechanism and to estimate the degree of damage that occurred to the pipe segment. Failure analysis of a section of the jacket confirmed that pitting corrosion on the exterior of the pipe led to the through-wall penetration. Ultrasonic measurements on sections of the pipe were utilized to determine the remaining wall thickness in adjacent areas of the pipe. Based on these measurements, the degree of pitting and general corrosion was determined. Pit growth rate models were then developed to estimate the life expectancy of sections of the pipe that had not been excavated. The calculations estimated that the occurrence of through-wall failures in this jacket will begin to increase substantially in 12 years. Given that this pipe segment will be utilized beyond this time, short-term and long-term solutions to this failure were proposed. The short-term solutions focused on the repair or replace decisions that must be made to return the jacket to service as soon as practical. The long-term solutions focused on a broader strategy to address jacket integrity issues in the entire tank farm facility. These solutions included the evaluation of innovative remote inspection and repair techniques.

  1. Pore pressure regime leading to shallow failures in a mountain slope: monitoring and interpretation by soil-atmosphere coupled model.

    NASA Astrophysics Data System (ADS)

    Vaunat, Jean; Hürlimann, Marcel; Luna, Boris

    2016-04-01

    The study deals with the onset of debris flows in the "El Rebaixader" basin, located in South Central Pyrenees. The initiation area of debris flows is located on a lateral moraine with a thickness of tens of meters, in which torrential processes and other shallow mass movements have generated a large scarp with steep slopes. To follow slope evolution towards shallow failure, different sensors have been installed to monitor meteorological data and hydraulic variables at shallow depths (positive and negative pore pressure, water content). Measurements are interpreted by means of a thermo-hydro-mechanical coupled Finite Element code provided with a specific boundary condition to model water mass and heat flux exchanged between the ground and the atmosphere, including infiltration, evaporation, sensible heat and solar radiation. Results evidence the different modes of pore regime variation imposed, on the one hand, by surface infiltration and evaporation and, on the other hand, by the settlement of a slope parallel flow in a loose layer at some decimetres depth. As a conclusion, the analysis highlights the strong dependency of slope stability to the water regime taking place in slightly more permeable horizons connected to the top of the catchment area rather than to surficial climatic input. On this basis, some keys about debris flow mitigation are finally put forward.

  2. EPA, not DHA, prevents fibrosis in pressure overload-induced heart failure: potential role of free fatty acid receptor 4.

    PubMed

    Eclov, Julie A; Qian, Qingwen; Redetzke, Rebecca; Chen, Quanhai; Wu, Steven C; Healy, Chastity L; Ortmeier, Steven B; Harmon, Erin; Shearer, Gregory C; O'Connell, Timothy D

    2015-12-01

    Heart failure with preserved ejection fraction (HFpEF) is half of all HF, but standard HF therapies are ineffective. Diastolic dysfunction, often secondary to interstitial fibrosis, is common in HFpEF. Previously, we found that supra-physiologic levels of ω3-PUFAs produced by 12 weeks of ω3-dietary supplementation prevented fibrosis and contractile dysfunction following pressure overload [transverse aortic constriction (TAC)], a model that resembles aspects of remodeling in HFpEF. This raised several questions regarding ω3-concentration-dependent cardioprotection, the specific role of EPA and DHA, and the relationship between prevention of fibrosis and contractile dysfunction. To achieve more clinically relevant ω3-levels and test individual ω3-PUFAs, we shortened the ω3-diet regimen and used EPA- and DHA-specific diets to examine remodeling following TAC. The shorter diet regimen produced ω3-PUFA levels closer to Western clinics. Further, EPA, but not DHA, prevented fibrosis following TAC. However, neither ω3-PUFA prevented contractile dysfunction, perhaps due to reduced uptake of ω3-PUFA. Interestingly, EPA did not accumulate in cardiac fibroblasts. However, FFA receptor 4, a G protein-coupled receptor for ω3-PUFAs, was sufficient and required to block transforming growth factor β1-fibrotic signaling in cultured cardiac fibroblasts, suggesting a novel mechanism for EPA. In summary, EPA-mediated prevention of fibrosis could represent a novel therapy for HFpEF.

  3. UQ and V&V techniques applied to experiments and simulations of heated pipes pressurized to failure

    SciTech Connect

    Romero, Vicente Jose; Dempsey, J. Franklin; Antoun, Bonnie R.

    2014-05-01

    This report demonstrates versatile and practical model validation and uncertainty quantification techniques applied to the accuracy assessment of a computational model of heated steel pipes pressurized to failure. The Real Space validation methodology segregates aleatory and epistemic uncertainties to form straightforward model validation metrics especially suited for assessing models to be used in the analysis of performance and safety margins. The methodology handles difficulties associated with representing and propagating interval and/or probabilistic uncertainties from multiple correlated and uncorrelated sources in the experiments and simulations including: material variability characterized by non-parametric random functions (discrete temperature dependent stress-strain curves); very limited (sparse) experimental data at the coupon testing level for material characterization and at the pipe-test validation level; boundary condition reconstruction uncertainties from spatially sparse sensor data; normalization of pipe experimental responses for measured input-condition differences among tests and for random and systematic uncertainties in measurement/processing/inference of experimental inputs and outputs; numerical solution uncertainty from model discretization and solver effects.

  4. Resveratrol treatment of mice with pressure-overload-induced heart failure improves diastolic function and cardiac energy metabolism.

    PubMed

    Sung, Miranda M; Das, Subhash K; Levasseur, Jody; Byrne, Nikole J; Fung, David; Kim, Ty T; Masson, Grant; Boisvenue, Jamie; Soltys, Carrie-Lynn; Oudit, Gavin Y; Dyck, Jason R B

    2015-01-01

    Although resveratrol has multiple beneficial cardiovascular effects, whether resveratrol can be used for the treatment and management of heart failure (HF) remains unclear. In the current study, we determined whether resveratrol treatment of mice with established HF could lessen the detrimental phenotype associated with pressure-overload-induced HF and identified physiological and molecular mechanisms contributing to this. C57Bl/6 mice were subjected to either sham or transverse aortic constriction surgery to induce HF. Three weeks post surgery, a cohort of mice with established HF (% ejection fraction <45) was administered resveratrol (≈320 mg/kg per day). Despite a lack of improvement in ejection fraction, resveratrol treatment significantly increased median survival of mice with HF, lessened cardiac fibrosis, reduced gene expression of several disease markers for hypertrophy and extracellular matrix remodeling that were upregulated in HF, promoted beneficial remodeling, and improved diastolic function. Resveratrol treatment of mice with established HF also restored the levels of mitochondrial oxidative phosphorylation complexes, restored cardiac AMP-activated protein kinase activation, and improved myocardial insulin sensitivity to promote glucose metabolism and significantly improved myocardial energetic status. Finally, noncardiac symptoms of HF, such as peripheral insulin sensitivity, vascular function, and physical activity, were improved with resveratrol treatment. Resveratrol treatment of mice with established HF lessens the severity of the HF phenotype by lessening cardiac fibrosis, improving molecular and structural remodeling of the heart, and enhancing diastolic function, vascular function, and energy metabolism. © 2014 American Heart Association, Inc.

  5. Design, fabrication and metrological evaluation of wearable pressure sensors.

    PubMed

    Goy, C B; Menichetti, V; Yanicelli, L M; Lucero, J B; López, M A Gómez; Parodi, N F; Herrera, M C

    2015-04-01

    Pressure sensors are valuable transducers that are necessary in a huge number of medical application. However, the state of the art of compact and lightweight pressure sensors with the capability of measuring the contact pressure between two surfaces (contact pressure sensors) is very poor. In this work, several types of wearable contact pressure sensors are fabricated using different conductive textile materials and piezo-resistive films. The fabricated sensors differ in size, the textile conductor used and/or the number of layers of the sandwiched piezo-resistive film. The intention is to study, through the obtaining of their calibration curves, their metrological properties (repeatability, sensitivity and range) and determine which physical characteristics improve their ability for measuring contact pressures. It has been found that it is possible to obtain wearable contact pressure sensors through the proposed fabrication process with satisfactory repeatability, range and sensitivity; and that some of these properties can be improved by the physical characteristics of the sensors.

  6. Evaluation of single failure effects during loss of coolant accidents for a VVER-440 reactor

    SciTech Connect

    Shier, W.; Kohut, P.; Horak, W.

    1995-05-01

    This paper describes the results of an analysis of loss of coolant accidents (LOCA`s) for the Soviet designed, light water cooled and moderated reactors referred to as VVERS. The VVER unit selected for this analysis is designated as VVER-440 Model 213. This plant generates 440 MWe and is of current interest since fifteen are now operating and additional units are in various stages of construction within Eastern Europe and the New Independent States. In addition to the analysis of two base case LOCA`S, this paper also presents the results of several sensitivity studies related to single failures in various plant systems that have been included in the design to mitigate the effects of LOCA`s on plant and fuel system performance. Examples of the safety systems selected for these sensitivity studies include the scram system, the accumulators, and the high pressure injection system.

  7. Evaluation of Pad 18 Spent Mercury Gold Trap Stainless Steel Container Failure

    SciTech Connect

    Skidmore, E.

    2016-08-03

    Failure of the Pad 18 spent mercury gold trap stainless steel waste container is principally attributed to corrosion induced by degradation of plasticized polyvinyl chloride (pPVC) waste packaging material. Dehydrochlorination of pPVC polymer by thermal and/or radiolytic degradation is well-known to evolve HCl gas, which is highly corrosive to stainless steel and other metals in the presence of moisture. Degradation of the pPVC packaging material was likely caused by radiolysis in the presence of tritium gas within the waste container, though other degradation mechanisms (aging, thermo-oxidation, plasticizer migration) over 30 years storage may have contributed. Corrosion was also likely enhanced by the crevice in the container weld design, and may have been enhanced by the presence of tritiated water. Similar non-failed spent mercury gold trap waste containers did not show radiographic evidence of plastic packaging or trapped free liquid within the container. Therefore, those containers are not expected to exhibit similar failures. Halogenated polymers such as pPVC subject to degradation can evolve halide gases such as HCl, which is corrosive in the presence of moisture and can generate pressure in sealed systems.

  8. Laboratory evaluation of the pressure water level data logger manufactured by Infinities USA, Inc.: results of pressure and temperature tests

    USGS Publications Warehouse

    Carnley, Mark V.

    2015-01-01

    The Pressure Water Level Data Logger manufactured by Infinities USA, Inc., was evaluated by the U.S. Geological Survey (USGS) Hydrologic Instrumentation Facility for conformance with the manufacturer’s stated accuracy specifications for measuring pressure throughout the device’s operating temperature range and with the USGS accuracy requirements for water-level measurements. The Pressure Water Level Data Logger (Infinities Logger) is a submersible, sealed, water-level sensing device with an operating pressure range of 0 to 11.5 feet of water over a temperature range of −18 to 49 degrees Celsius. For the pressure range tested, the manufacturer’s accuracy specification of 0.1 percent of full scale pressure equals an accuracy of ±0.138 inch of water. Three Infinities Loggers were evaluated, and the testing procedures followed and results obtained are described in this report. On the basis of the test results, the device is poorly compensated for temperature. For the three Infinities Loggers, the mean pressure differences varied from –4.04 to 5.32 inches of water and were not within the manufacturer’s accuracy specification for pressure measurements made within the temperature-compensated range. The device did not meet the manufacturer’s stated accuracy specifications for pressure within its temperature-compensated operating range of –18 to 49 degrees Celsius or the USGS accuracy requirements of no more than 0.12 inch of water (0.01 foot of water) or 0.10 percent of reading, whichever is larger. The USGS accuracy requirements are routinely examined and reported when instruments are evaluated at the Hydrologic Instrumentation Facility. The estimated combined measurement uncertainty for the pressure cycling test was ±0.139 inch of water, and for temperature, the cycling test was ±0.127 inch of water for the three Infinities Loggers.

  9. Evaluation of failure risks in ceramic restorations for endodontically treated premolar with MOD preparation.

    PubMed

    Lin, Chun-Li; Chang, Yen-Hsiang; Pai, Che-An

    2011-05-01

    This study evaluated the risk of failure for an endodontically treated premolar with MOD preparation and three CEREC ceramic restoration configurations. Simulations were performed based on three 3D finite element (FE) models designed with CEREC ceramic inlay, endocrown and conventional crown restorations. Long-term failure probability in relation to varying load conditions was calculated by incorporating the Weibull function in FE analysis. Additionally, the final fracture strength and corresponding load value of the first acoustic emission (AE) activity in each specimen was recorded by performing in vitro AE analysis in CEREC restored teeth compressive testing. Simulation results indicated that the stress values on the enamel, dentin and luting cement for endocrown restorations were the lowest ones among the corresponding values for inlay and conventional crown restorations. Weibull analysis indicated that failure probability was 95%, 2% and 2% for the inlay, endocrown and conventional crown restorations, respectively, for normal biting. AE analysis revealed that, although the significantly least load was required for the first AE activity for inlay configuration, the endocrown and conventional crowns did not significantly differ from each other. This in vitro study, i.e. numerical and AE analyses, suggest that endocrown and conventional crown restorations for endodontically treated premolars with MOD preparation present a similar longevity. Copyright © 2010 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  10. Failure of tungsten carbide-cobalt lamination dies: A corrosion evaluation

    SciTech Connect

    Pednekar, S.P.

    1997-10-01

    Sudden failures of cemented tungsten carbide (WC)-cobalt punching dies are rare but expensive. Corrosion of the cobalt matrix, or cobalt leaching, by water-based lubricants usually is considered the cause of such failures. The validity of this mechanism was evaluated by measuring the corrosion behavior of cobalt, WC, and WC-15% Co die material in water and seven made-up lubricants. In the worst lubricant, the cobalt matrix corroded at an estimated rate of < 3 mpy. In chlorinated, chloride (Cl)-bearing (> 0.01% sodium chloride [NaCl]), aerated water of pH 7, the rate could be 80 mpy. Such a rate still was not high enough to explain die failures because of the short contact time between lubricant and sliding surfaces during punching operations. Excessive adhesive wear caused by low lubricity and resulting in removal of large wear particles may have been responsible. Such particles wedged between sliding surfaces may have exerted forces sufficient to cause breakage of the dies.

  11. How is success or failure in river restoration projects evaluated? Feedback from French restoration projects.

    PubMed

    Morandi, Bertrand; Piégay, Hervé; Lamouroux, Nicolas; Vaudor, Lise

    2014-05-01

    Since the 1990s, French operational managers and scientists have been involved in the environmental restoration of rivers. The European Water Framework Directive (2000) highlights the need for feedback from restoration projects and for evidence-based evaluation of success. Based on 44 French pilot projects that included such an evaluation, the present study includes: 1) an introduction to restoration projects based on their general characteristics 2) a description of evaluation strategies and authorities in charge of their implementation, and 3) a focus on the evaluation of results and the links between these results and evaluation strategies. The results show that: 1) the quality of an evaluation strategy often remains too poor to understand well the link between a restoration project and ecological changes; 2) in many cases, the conclusions drawn are contradictory, making it difficult to determine the success or failure of a restoration project; and 3) the projects with the poorest evaluation strategies generally have the most positive conclusions about the effects of restoration. Recommendations are that evaluation strategies should be designed early in the project planning process and be based on clearly-defined objectives. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Evaluation of chronic kidney disease in chronic heart failure: From biomarkers to arterial renal resistances

    PubMed Central

    Iacoviello, Massimo; Leone, Marta; Antoncecchi, Valeria; Ciccone, Marco Matteo

    2015-01-01

    Chronic kidney disease and its worsening are recurring conditions in chronic heart failure (CHF) which are independently associated with poor patient outcome. The heart and kidney share many pathophysiological mechanisms which can determine dysfunction in each organ. Cardiorenal syndrome is the condition in which these two organs negatively affect each other, therefore an accurate evaluation of renal function in the clinical setting of CHF is essential. This review aims to revise the parameters currently used to evaluate renal dysfunction in CHF with particular reference to the usefulness and the limitations of biomarkers in evaluating glomerular dysfunction and tubular damage. Moreover, it is reported the possible utility of renal arterial resistance index (a parameter associated with abnormalities in renal vascular bed) for a better assesment of kidney disfunction. PMID:25610846

  13. Competitive evaluation of failure detection algorithms for strapdown redundant inertial instruments

    NASA Technical Reports Server (NTRS)

    Wilcox, J. C.

    1973-01-01

    Algorithms for failure detection, isolation, and correction of redundant inertial instruments in the strapdown dodecahedron configuration are competitively evaluated in a digital computer simulation that subjects them to identical environments. Their performance is compared in terms of orientation and inertial velocity errors and in terms of missed and false alarms. The algorithms appear in the simulation program in modular form, so that they may be readily extracted for use elsewhere. The simulation program and its inputs and outputs are described. The algorithms, along with an eight algorithm that was not simulated, also compared analytically to show the relationships among them.

  14. Design evaluation of a home-based telecare system for Chronic Heart Failure patients.

    PubMed

    Gund, A; Ekman, I; Lindecrantz, K; Sjoqvist, B A; Staaf, E L; Thorneskold, N

    2008-01-01

    In order to improve the care of Chronic Heart Failure (CHF) patients, a system has been developed for monitoring symptoms and document subjective judgments on health conditions in a home environment. Since system usability is an important issue, a two step evaluation of the solution was conducted. First a ten-patient survey was conducted, which was aimed at spotting possible problem areas. The second step involved a small trial in a home setting with CHF patients. The results are promising, indicating that the system is user friendly and easy to use, and that it is suitable as a prototype for the intended use.

  15. Evaluation of Genotoxic Pressure along the Sava River

    PubMed Central

    Kračun-Kolarević, Margareta; Kostić, Jovana; Simonović, Predrag; Simić, Vladica; Milošković, Aleksandra; Reischer, Georg; Farnleitner, Andreas; Gačić, Zoran; Milačič, Radmila; Zuliani, Tea; Vidmar, Janja; Pergal, Marija; Piria, Marina; Paunović, Momir; Vuković-Gačić, Branka

    2016-01-01

    In this study we have performed a comprehensive genotoxicological survey along the 900 rkm of the Sava River. In total, 12 sites were chosen in compliance with the goals of GLOBAQUA project dealing with the effects of multiple stressors on biodiversity and functioning of aquatic ecosystems. The genotoxic potential was assessed using a complex battery of bioassays performed in prokaryotes and aquatic eukaryotes (freshwater fish). Battery comprised evaluation of mutagenicity by SOS/umuC test in Salmonella typhimurium TA1535/pSK1002. The level of DNA damage as a biomarker of exposure (comet assay) and biomarker of effect (micronucleus assay) and the level of oxidative stress as well (Fpg—modified comet assay) was studied in blood cells of bleak and spirlin (Alburnus alburnus/Alburnoides bipunctatus respectively). Result indicated differential sensitivity of applied bioassays in detection of genotoxic pressure. The standard and Fpg—modified comet assay showed higher potential in differentiation of the sites based on genotoxic potential in comparison with micronucleus assay and SOS/umuC test. Our data represent snapshot of the current status of the river which indicates the presence of genotoxic potential along the river which can be traced to the deterioration of quality of the Sava River by communal and industrial wastewaters. The major highlight of the study is that we have provided complex set of data obtained from a single source (homogeneity of analyses for all samples). PMID:27631093

  16. Evaluation of high-pressure drilling fluid supply systems

    SciTech Connect

    McDonald, M.C.; Reichman, J.M.; Theimer, K.J.

    1981-10-01

    A study was undertaken to help determine the technical and economic feasibility of developing a high-pressure fluid-jet drilling system for the production of geothermal wells. Three system concepts were developed and analyzed in terms of costs, component availability, and required new-component development. These concepts included a single-conduit system that supplies the downhole cutting nozzles directly via surface-located high-pressure pumps; a single-conduit system utilizing low-pressure surface pumps to supply and operate a high-pressure downhole pump, which in turn supplies the cutting nozzles; and a dual-conduit system supplying surface-generated high-pressure fluid for cutting via one conduit and low-pressure scavenging fluid via the other. It is concluded that the single-conduit downhole pump system concept has the greatest potential for success in this application. 28 figures, 11 tables.

  17. Evaluation of noninvasive positive pressure ventilation after extubation from moderate positive end-expiratory pressure level in patients undergoing cardiovascular surgery: a prospective observational study.

    PubMed

    Suzuki, Takeshi; Kurazumi, Takuya; Toyonaga, Shinya; Masuda, Yuya; Morita, Yoshihisa; Masuda, Junichi; Kosugi, Shizuko; Katori, Nobuyuki; Morisaki, Hiroshi

    2014-01-01

    It remains to be clarified if the application of noninvasive positive pressure ventilation (NPPV) is effective after extubation in patients with hypoxemic respiratory failure who require the sufficient level of positive end-expiratory pressure (PEEP). This study was aimed at examining the effect and the safety of NPPV application following extubation in patients requiring moderate PEEP level for sufficient oxygenation after cardiovascular surgery. With institutional ethic committee approval, the patients ventilated invasively for over 48 h after cardiovascular surgery were enrolled in this study. The patients who failed the first spontaneous breathing trial (SBT) at 5 cmH2O of PEEP, but passed the second SBT at 8 cmH2O of PEEP, received NPPV immediately after extubation following our weaning protocol. Respiratory parameters (partial pressure of arterial oxygen tension to inspiratory oxygen fraction ratio: P/F ratio, respiratory ratio, and partial pressure of arterial carbon dioxide: PaCO2) 2 h after extubation were evaluated with those just before extubation as the primary outcome. The rate of re-intubation, the frequency of respiratory failure and intolerance of NPPV, the duration of NPPV, and the length of intensive care unit (ICU) stay were also recorded. While 51 postcardiovascular surgery patients were screened, 6 patients who met the criteria received NPPV after extubation. P/F ratio was increased significantly after extubation compared with that before extubation (325 ± 85 versus 245 ± 55 mmHg, p < 0.05). The other respiratory parameters did not change significantly. Re-intubation, respiratory failure, and intolerance of NPPV never occurred. The duration of NPPV and the length of ICU stay were 2.7 ± 0.7 (SD) and 7.5 (6 to 10) (interquartile range) days, respectively. While further investigation should be warranted, NPPV could be applied effectively and safely after extubation in patients requiring the moderate PEEP level after

  18. Intracranial pressure elevation reduces flow through collateral vessels and the penetrating arterioles they supply. A possible explanation for ‘collateral failure' and infarct expansion after ischemic stroke

    PubMed Central

    Beard, Daniel J; McLeod, Damian D; Logan, Caitlin L; Murtha, Lucy A; Imtiaz, Mohammad S; van Helden, Dirk F; Spratt, Neil J

    2015-01-01

    Recent human imaging studies indicate that reduced blood flow through pial collateral vessels (‘collateral failure') is associated with late infarct expansion despite stable arterial occlusion. The cause for ‘collateral failure' is unknown. We recently showed that intracranial pressure (ICP) rises dramatically but transiently 24 hours after even minor experimental stroke. We hypothesized that ICP elevation would reduce collateral blood flow. First, we investigated the regulation of flow through collateral vessels and the penetrating arterioles arising from them during stroke reperfusion. Wistar rats were subjected to intraluminal middle cerebral artery (MCA) occlusion (MCAo). Individual pial collateral and associated penetrating arteriole blood flow was quantified using fluorescent microspheres. Baseline bidirectional flow changed to MCA-directed flow and increased by >450% immediately after MCAo. Collateral diameter changed minimally. Second, we determined the effect of ICP elevation on collateral and watershed penetrating arteriole flow. Intracranial pressure was artificially raised in stepwise increments during MCAo. The ICP increase was strongly correlated with collateral and penetrating arteriole flow reductions. Changes in collateral flow post-stroke appear to be primarily driven by the pressure drop across the collateral vessel, not vessel diameter. The ICP elevation reduces cerebral perfusion pressure and collateral flow, and is the possible explanation for ‘collateral failure' in stroke-in-progression. PMID:25669909

  19. Probabilistic evaluation of riprap failure under future uncertain flood conditions: the case study of river Kleine Emme (Switzerland)

    NASA Astrophysics Data System (ADS)

    Jafarnejad, Mona; Pfister, Michael; Franca, Mário J.; Schleiss, Anton J.

    2014-05-01

    Potential failure for river bank protection measures is a critical issue to be evaluated for the safety and stability assessment. Moreover, uncertainties associated to flood conditions and sediment transport in rivers, as a possible result of climate change in the future, affects the safety level of such riverbank protection structures as riprap and walls. Bank failure can lead to uncontrolled erosion and flooding with disastrous consequences in residential areas or in critical infrastructures. The probabilistic analysis of failure on different mechanisms due to possible flood events and sediment transport is a principal step to assess embankment stability in future scenarios. Herein, a probabilistic risk assessment model to define the failure risk of river bank ripraps, developed based on Monte Carlo simulation and Moment Analysis Methods, is showed. This probabilistic simulation estimates the resistance of ripraps regarding varied flood and sediment transport scenarios in future. The failure probability of ripraps is assessed by a probabilistic function of the design safety factor. The probability of failure in different mechanisms such as direct block erosion, toe scouring and overtopping is defined by taking into account the modified bed-load transport due to a probabilistic function of the design discharge. This evaluation method is applied to a Swiss river located in Canton Lucerne, the Kleine Emme. The results highlight the failure probability of riverbank riprap associated to different mechanisms individually. A risk map to represent the risk of total failure along a longitudinal profile of the river is proposed.

  20. Connective tissue growth factor inhibition attenuates left ventricular remodeling and dysfunction in pressure overload-induced heart failure.

    PubMed

    Szabó, Zoltán; Magga, Johanna; Alakoski, Tarja; Ulvila, Johanna; Piuhola, Jarkko; Vainio, Laura; Kivirikko, Kari I; Vuolteenaho, Olli; Ruskoaho, Heikki; Lipson, Kenneth E; Signore, Pierre; Kerkelä, Risto

    2014-06-01

    Connective tissue growth factor (CTGF) is involved in the pathogenesis of various fibrotic disorders. However, its role in the heart is not clear. To investigate the role of CTGF in regulating the development of cardiac fibrosis and heart failure, we subjected mice to thoracic aortic constriction (TAC) or angiotensin II infusion, and antagonized the function of CTGF with CTGF monoclonal antibody (mAb). After 8 weeks of TAC, mice treated with CTGF mAb had significantly better preserved left ventricular (LV) systolic function and reduced LV dilatation compared with mice treated with control immunoglobulin G. CTGF mAb-treated mice exhibited significantly smaller cardiomyocyte cross-sectional area and reduced expression of hypertrophic marker genes. CTGF mAb treatment reduced the TAC-induced production of collagen 1 but did not significantly attenuate TAC-induced accumulation of interstitial fibrosis. Analysis of genes regulating extracellular matrix proteolysis showed decreased expression of plasminogen activator inhibitor-1 and matrix metalloproteinase-2 in mice treated with CTGF mAb. In contrast to TAC, antagonizing the function of CTGF had no effect on LV dysfunction or LV hypertrophy in mice subjected to 4-week angiotensin II infusion. Further analysis showed that angiotensin II-induced expression of hypertrophic marker genes or collagens was not affected by treatment with CTGF mAb. In conclusion, CTGF mAb protects from adverse LV remodeling and LV dysfunction in hearts subjected to pressure overload by TAC. Antagonizing the function of CTGF may offer protection from cardiac end-organ damage in patients with hypertension.

  1. Baroreflex sensitivity, blood pressure buffering, and resonance: what are the links? Computer simulation of healthy subjects and heart failure patients.

    PubMed

    van de Vooren, Hedde; Gademan, Maaike G J; Swenne, Cees A; TenVoorde, Ben J; Schalij, Martin J; Van der Wall, Ernst E

    2007-04-01

    The arterial baroreflex buffers slow (<0.05 Hz) blood pressure (BP) fluctuations, mainly by controlling peripheral resistance. Baroreflex sensitivity (BRS), an important characteristic of baroreflex control, is often noninvasively assessed by relating heart rate (HR) fluctuations to BP fluctuations; more specifically, spectral BRS assessment techniques focus on the BP-to-HR transfer function around 0.1 Hz. Skepticism about the relevance of BRS to characterize baroreflex-mediated BP buffering is based on two considerations: 1) baroreflex-modulated peripheral vasomotor function is not necessarily related to baroreflex-HR transfer; and 2) although BP fluctuations around 0.1 Hz (Mayer waves) might be related to baroreflex BP buffering, they are merely a not-intended side effect of a closed-loop control system. To further investigate the relationship between BRS and baroreflex-mediated BP buffering, we set up a computer model of baroreflex BP control to simulate normal subjects and heart failure patients. Output variables for various randomly chosen combinations of feedback gains in the baroreflex arms were BP resonance, BP-buffering capacity, and BRS. Our results show that BP buffering and BP resonance are related expressions of baroreflex BP control and depend strongly on the sympathetic gain to the peripheral resistance. BRS is almost uniquely determined by the vagal baroreflex gain to the sinus node. In conclusion, BP buffering and BRS are unrelated unless coupled gains in all baroreflex limbs are assumed. Hence, the clinical benefit of a high BRS is most likely to be attributed to vagal effects on the heart instead of to effective BP buffering.

  2. Elevation in systolic blood pressure during heart failure hospitalization is associated with increased short and long-term mortality

    PubMed Central

    Segal, Omer; Segal, Gad; Leibowitz, Avshalom; Goldenberg, Ilan; Grossman, Ehud; Klempfner, Robert

    2017-01-01

    Abstract The relationship between systolic blood pressure (SBP) change during hospitalization of patients with heart failure (HF) and clinical outcomes has never been thoroughly investigated. A total of 3393 patients hospitalized with HF, from 25 hospitals in Israel, were enrolled. The SBP change was calculated by subtracting the discharge SBP values from the admission values and then divided into quartiles of SBP change. We compared the group with upper quartile SBP change to the lower 3 quartiles of change. Both groups had largely similar demographics and clinical characteristics. All-cause mortality rate was 24% at 1-year and 82.6% at 10-years, whereas patients in the upper SBP change group had significantly higher cumulative mortality probability at 1-year (30% vs 22%; log-rank P <0.001), and at 10-years (86% vs 82%; log-rank P <0.001). Multivariate Cox proportional hazard analysis adjusted for comorbidities demonstrated that patients in the upper SBP change quartile have an independent 17% higher mortality risk at 10-years [hazard ratio (HR) 1.17; 95% confidence interval (CI) 1.08–1.28]. Subgroup analysis demonstrated that mortality risk was more pronounced in patients with preserved ejection fraction and in the subgroup with admission SBP ≥140 mm Hg. SBP change is significantly associated with 1- and 10-year all-cause mortality, as an increased SBP change is associated with worse prognosis. We believe that this readily available marker might facilitate risk stratification of patients and possibly improve care. PMID:28151864

  3. Elevation in systolic blood pressure during heart failure hospitalization is associated with increased short and long-term mortality.

    PubMed

    Segal, Omer; Segal, Gad; Leibowitz, Avshalom; Goldenberg, Ilan; Grossman, Ehud; Klempfner, Robert

    2017-02-01

    The relationship between systolic blood pressure (SBP) change during hospitalization of patients with heart failure (HF) and clinical outcomes has never been thoroughly investigated.A total of 3393 patients hospitalized with HF, from 25 hospitals in Israel, were enrolled. The SBP change was calculated by subtracting the discharge SBP values from the admission values and then divided into quartiles of SBP change. We compared the group with upper quartile SBP change to the lower 3 quartiles of change. Both groups had largely similar demographics and clinical characteristics. All-cause mortality rate was 24% at 1-year and 82.6% at 10-years, whereas patients in the upper SBP change group had significantly higher cumulative mortality probability at 1-year (30% vs 22%; log-rank P <0.001), and at 10-years (86% vs 82%; log-rank P <0.001). Multivariate Cox proportional hazard analysis adjusted for comorbidities demonstrated that patients in the upper SBP change quartile have an independent 17% higher mortality risk at 10-years [hazard ratio (HR) 1.17; 95% confidence interval (CI) 1.08-1.28]. Subgroup analysis demonstrated that mortality risk was more pronounced in patients with preserved ejection fraction and in the subgroup with admission SBP ≥140 mm Hg.SBP change is significantly associated with 1- and 10-year all-cause mortality, as an increased SBP change is associated with worse prognosis. We believe that this readily available marker might facilitate risk stratification of patients and possibly improve care.

  4. Evaluation of Acoustic Emission SHM of PRSEUS Composite Pressure Cube Tests

    NASA Technical Reports Server (NTRS)

    Horne, Michael R.; Madaras, Eric I.

    2013-01-01

    A series of tests of the Pultruded Rod Stitched Efficient Unitized Structure (PRSEUS) pressure cube were conducted during third quarter 2011 at NASA Langley Research Center (LaRC) in the Combined Loads Test facility (COLTS). This is a report of the analysis of the Acoustic Emission (AE) data collected during those tests. The AE signals of the later tests are consistent with the final failure progression through two of the pressure cube panels. Calibration tests and damage precursor AE indications, from preliminary checkout pressurizations, indicated areas of concern that eventually failed. Hence those tests have potential for vehicle health monitoring.

  5. Evaluation of a Progressive Failure Analysis Methodology for Laminated Composite Structures

    NASA Technical Reports Server (NTRS)

    Sleight, David W.; Knight, Norman F., Jr.; Wang, John T.

    1997-01-01

    A progressive failure analysis methodology has been developed for predicting the nonlinear response and failure of laminated composite structures. The progressive failure analysis uses C plate and shell elements based on classical lamination theory to calculate the in-plane stresses. Several failure criteria, including the maximum strain criterion, Hashin's criterion, and Christensen's criterion, are used to predict the failure mechanisms. The progressive failure analysis model is implemented into a general purpose finite element code and can predict the damage and response of laminated composite structures from initial loading to final failure.

  6. Evaluation of anticipatory signal to steam generator pressure control program for 700 MWe Indian pressurized heavy water reactor

    SciTech Connect

    Pahari, S.; Hajela, S.; Rammohan, H. P.; Malhotra, P. K.; Ghadge, S. G.

    2012-07-01

    700 MWe Indian Pressurized Heavy Water Reactor (IPHWR) is horizontal channel type reactor with partial boiling at channel outlet. Due to boiling, it has a large volume of vapor present in the primary loops. It has two primary loops connected with the help of pressurizer surge line. The pressurizer has a large capacity and is partly filled by liquid and partly by vapor. Large vapor volume improves compressibility of the system. During turbine trip or load rejection, pressure builds up in Steam Generator (SG). This leads to pressurization of Primary Heat Transport System (PHTS). To control pressurization of SG and PHTS, around 70% of the steam generated in SG is dumped into the condenser by opening Condenser Steam Dump Valves (CSDVs) and rest of the steam is released to the atmosphere by opening Atmospheric Steam Discharge Valves (ASDVs) immediately after sensing the event. This is accomplished by adding anticipatory signal to the output of SG pressure controller. Anticipatory signal is proportional to the thermal power of reactor and the proportionality constant is set so that SG pressure controller's output jacks up to ASDV opening range when operating at 100% FP. To simulate this behavior for 700 MWe IPHWR, Primary and secondary heat transport system is modeled. SG pressure control and other process control program have also been modeled to capture overall plant dynamics. Analysis has been carried out with 3-D neutron kinetics coupled thermal hydraulic computer code ATMIKA.T to evaluate the effect of the anticipatory signal on PHT pressure and over all plant dynamics during turbine trip in 700 MWe IPHWR. This paper brings out the results of the analysis with and without considering anticipatory signal in SG pressure control program during turbine trip. (authors)

  7. Docosahexaenoic Acid Supplementation Alters Key Properties of Cardiac Mitochondria and Modestly Attenuates Development of Left Ventricular Dysfunction in Pressure Overload-Induced Heart Failure

    PubMed Central

    Dabkowski, Erinne R.; O’Connell, Kelly A.; Xu, Wenhong; Ribeiro, Rogerio F.; Hecker, Peter A.; Shekar, Kadambari Chandra; Stanley, William C.; Daneault, Caroline; Rosiers, Christine Des

    2015-01-01

    Purpose Supplementation with the n3 polyunsaturated fatty acid docosahexaenoic acid (DHA) is beneficial in heart failure patients, however the mechanisms are unclear. DHA is incorporated into membrane phospholipids, which may prevent mitochondrial dysfunction. Thus we assessed the effects of DHA supplementation on cardiac mitochondria and the development of heart failure caused by aortic pressure overload. Methods Pathological cardiac hypertrophy was generated in rats by thoracic aortic constriction. Animals were fed either a standard diet or were supplemented with DHA (2.3 % of energy intake). Results After 14 weeks, heart failure was evident by left ventricular hypertrophy and chamber enlargement compared to shams. Left ventricle fractional shortening was unaffected by DHA treatment in sham animals (44.1±1.6 % vs. 43.5±2.2 % for standard diet and DHA, respectively), and decreased with heart failure in both treatment groups, but to a lesser extent in DHA treated animals (34.9±1.7 %) than with the standard diet (29.7±1.5 %, P <0.03). DHA supplementation increased DHA content in mitochondrial phospholipids and decreased membrane viscosity. Myocardial mitochondrial oxidative capacity was decreased by heart failure and unaffected by DHA. DHA treatment enhanced Ca2+ uptake by subsarcolemmal mitochondria in both sham and heart failure groups. Further, DHA lessened Ca2+-induced mitochondria swelling, an index of permeability transition, in heart failure animals. Heart failure increased hydrogen peroxide-induced mitochondrial permeability transition compared to sham, which was partially attenuated in interfibrillar mitochondria by treatment with DHA. Conclusions DHA decreased mitochondrial membrane viscosity and accelerated Ca2+ uptake, and attenuated susceptibility to mitochondrial permeability transition and development of left ventricular dysfunction. PMID:24013804

  8. Evaluating Failures and near Misses in Human Spaceflight History for Lessons for Future Human Spaceflight

    NASA Technical Reports Server (NTRS)

    Barr, Stephanie

    2010-01-01

    Studies done in the past have drawn on lessons learned with regard to human loss-of-life events. However, an examination of near-fatal accidents can be equally useful, not only in detecting causes, both proximate and systemic, but also for determining what factors averted disaster, what design decisions and/or operator actions prevented catastrophe. Binary pass/fail launch history is often used for risk, but this also has limitations. A program with a number of near misses can look more reliable than a consistently healthy program with a single out-of-family failure. Augmenting reliability evaluations with this near miss data can provide insight and expand on the limitations of a strictly pass/fail evaluation. This paper intends to show how near-miss lessons learned can provide crucial data for any new human spaceflight programs that are interested in sending man into space

  9. Evaluating Failures and Near Misses in Human Spaceflight History for Lessons for Future Human Spaceflight

    NASA Astrophysics Data System (ADS)

    Barr, Stephanie

    2010-09-01

    Studies done in the past have drawn on lessons learned with regard to human loss-of-life events. However, an examination of near-fatal accidents can be equally useful, not only in detecting causes, both proximate and systemic, but also for determining what factors averted disaster, what design decisions and/or operator actions prevented catastrophe. Binary pass/fail launch history is often used for risk, but this also has limitations. A program with a number of near misses can look more reliable than a consistently healthy program with a single out-of-family failure. Augmenting reliability evaluations with this near miss data can provide insight and expand on the limitations of a strictly pass/fail evaluation. This paper intends to show how near-miss lessons learned can provide crucial data for any new human spaceflight programs that are interested in sending man into space.

  10. Clinical evaluation of a self blood pressure monitor according to the First International Consensus Conference on Self Blood Pressure Measurement.

    PubMed

    Ploin, Dominique; Baguet, Jean-Philippe; Pierre, Hélène; De Gaudemaris, Régis; Mallion, Jean-Michel

    2002-12-01

    The Calor TensioSense Bras automatic blood pressure monitor has obtained European Union certification, but the clinical validity of this new oscillometric device when handled by lay subjects has yet to be evaluated. The design employed prospective and blinded blood pressure measurements and a validation procedure according to the criteria set out by the First International Consensus Conference on Self Blood Pressure Measurement (1999). Thirty-three subjects were recruited, 11 in each of three strata of systolic blood pressure (<130, 130-160 and >160 mmHg). Blood pressure was measured sequentially seven times, alternating observer and lay measurements. Two certified observers used two mercury columns and a double stethoscope; the subjects used the automatic device. All blood pressure readings and recordings were blinded. Adequate cuff sizes were used, and the subjects' position was standardized. Discrepancy analysis between manual and automatic measurements was carried out using VAPA software. Dispersion of the discrepancies between manual and automatic measurements showed no specific trend. Out of the 99 systolic blood pressure measurements, 53, 76 and 89 discrepancies were less than 5, 10 and 15 mmHg, respectively. Of the 99 diastolic blood pressure measurements, 62, 86 and 97 discrepancies were less than 5, 10 and 15 mmHg, respectively. The mean inter-observer discrepancy was 1 mmHg for both systolic and diastolic blood pressure comparisons. This evaluation showed that this device complies with the international validation protocol requirements. Thus, the device can, providing adequate instruction is given in the clinic, be recommended for self-measurement by patients at home, as well as for clinical or epidemiological research. Copyright 2002 Lippincott Williams & Wilkins

  11. [Nutritional evaluation of children with respiratory failure (RF): anthropometric evaluation upon admission to the pediatric intensive care units].

    PubMed

    Almeida Santos, L; Ruza, F; Guerra, A J; Alves, A; Dorao, P; García, S; Santos, N T

    1998-07-01

    Protein-energy malnutrition (PEM) constitutes an important complication in children submitted to intensive care treatment for respiratory failure (RF). This complication is not usually evaluated in assessment protocols. Nutrition assessment in a Pediatric Intensive Care Unit (PICU) was performed in children with respiratory failure. A prospective study involving 65 children (1-158 months of age) with RF at admission to the PICU was carried out. The patients studied were divided into four groups according to their etiology: Group I (n = 29) included those with acute bronchial pathology; Group II (n = 17) those with pneumonia: Group III (n = 11) those in the post-operative period following cardiac surgery; and Group IV (n = 8) those patients with multiple-organ dysfunction. All patients in Groups I, II, and III had chronic diseases. Anthropometrical and nutritional evaluation included weight, height and body mass index (w/h2). The weight for age was low (59%). Height deficit was observed in a significantly lower percentage of the patients (13.1%). The body mass index showed values in relationship to the 50th percentile that varied between 83.4 +/- 23.1% and 97.1 +/- 4.7%. In 68.9% of the patients the criteria of global malnutrition were met according to the classification of McLaren and Read. The data confirm that PEM is frequent in patients with RF in the PICU and emphasize the usefulness of anthropometrical evaluation as an important, simple and non-invasive method of nutritional evaluation. Early and intensive nutritional intervention can reduce or prevent the vicious circle of malnutrition in RF patients hospitalized in the PICU.

  12. Evaluation of a strain based failure criterion for the multi-constituent composite model under shock loading

    NASA Astrophysics Data System (ADS)

    Key, Christopher T.; Schumacher, Shane C.; Alexander, C. Scott

    2015-09-01

    This study details and demonstrates a strain-based criterion for the prediction of polymer matrix composite material damage and failure under shock loading conditions. Shock loading conditions are characterized by high-speed impacts or explosive events that result in very high pressures in the materials involved. These material pressures can reach hundreds of kbar and often exceed the material strengths by several orders of magnitude. Researchers have shown that under these high pressures, composites exhibit significant increases in stiffness and strength. In this work we summarize modifications to a previous stress based interactive failure criterion based on the model initially proposed by Hashin, to include strain dependence. The failure criterion is combined with the multi-constituent composite constitutive model (MCM) within a shock physics hydrocode. The constitutive model allows for decomposition of the composite stress and strain fields into the individual phase averaged constituent level stress and strain fields, which are then applied to the failure criterion. Numerical simulations of a metallic sphere impacting carbon/epoxy composite plates at velocities up to 1000 m/s are performed using both the stress and strain based criterion. These simulation results are compared to experimental tests to illustrate the advantages of a strain-based criterion in the shock environment.

  13. Utility of home blood pressure monitoring to evaluate postprandial blood pressure in treated hypertensive patients.

    PubMed

    Alfie, José

    2015-08-01

    Postprandial hypotension, defined as a fall in systolic blood pressure (SBP) of 20 mmHg or greater within 2 hours after a meal, is a risk factor for stroke, coronary events and mortality. The clinical suspicion is typically raised by episodes of postprandial syncope or falls, whereas asymptomatic postprandial hypotension is mostly neglected. The magnitude of the postprandial fall in SBP, as detected by 24-hour recording in apparently healthy middle-aged to elderly subjects, was proportional to the severity of the silent cerebrovascular damage. Postprandial hypotension can also be detected by self-measured blood pressure before and within 2 hours after meals using automatic devices. The review highlights the value of home blood pressure monitoring (HBPM) as a screening test for asymptomatic postprandial hypotension in hypertensive patients. Using a HBPM protocol that included duplicated blood pressure measurements before and after three consecutive lunches, we detected unsuspected postprandial hypotension in 27.4% of the 230 hypertensive patients screened. The prevalence of postprandial hypotension was 13.2% in controlled and 42.2% in uncontrolled hypertensive patients (p < 0.001), raising the dilemma of further lowering blood pressure in the setting of postprandial hypotension. The inclusion of preprandial and postprandial measurements in the protocol of HBPM is useful to identify hypertensive patients with postprandial hypotension and may guide adjustments in antihypertensive treatment according to postprandial blood pressure. © The Author(s), 2015.

  14. Transcatheter treatment of heart failure with preserved or mildly reduced ejection fraction using a novel interatrial implant to lower left atrial pressure.

    PubMed

    Søndergaard, Lars; Reddy, Vivek; Kaye, David; Malek, Filip; Walton, Antony; Mates, Martin; Franzen, Olaf; Neuzil, Petr; Ihlemann, Nikolaj; Gustafsson, Finn

    2014-07-01

    Heart failure with preserved or mildly reduced ejection fraction (HFpEF) is common and, to date, therapeutic options are limited. Increased left atrial pressure is a key contributor to the symptoms associated with HFpEF, particularly during physical activity. We report the 30-day outcome of patients treated with a novel device intended to lower left atrial pressure by creating an 8 mm permanent shunt in the atrial septum. Eleven patients were enrolled in the pilot trial. Key inclusion criteria were: EF >45%; baseline PCWP ≥15 mmHg (rest), or ≥ 25 mmHg (exercise); and ≥1 hospitalization for heart failure within the past 12 months, or persistent NYHA class III/IV for at least 3 months. Mean age, LVEF, and NYHA class were 70 ± 12 years, 57 ± 9%, and 3.2 ± 0.4, respectively. Most patients had significant co-morbidities. The interatrial septal device (IASD) device was implanted using percutaneous trans-septal access via the femoral vein. The device was successfully implanted in all patients. At 30 days, LV filling pressures were significantly reduced by 5.5 mmHg (19.7 ± 3.4 vs. 14.2 ± 2.7; P = 0.005), and NYHA class was improved by two classes in two patients, one class in five patients, and worsened by one class in one patient. No patient developed pulmonary hypertension. Two serious adverse events occurred; heart failure re-hospitalization, and implant malposition successfully treated with a new device. Contemporary management of HFpEF patients is confounded by the lack of effective therapies. The use of a device-based approach to reduce left atrial pressure provides a novel means to improve haemodynamic and symptomatic status in HFpEF patients and warrants further investigation. © 2014 The Authors. European Journal of Heart Failure © 2014 European Society of Cardiology.

  15. Remediation System Evaluation, Selma Pressure Treating Superfund Site

    EPA Pesticide Factsheets

    The Selma Pressure Treating site is located 15 miles south of Fresno, adjacent to the city limits of Selma,California and has subsurface contamination from a former wood treating facility. The site occupiesapproximately 40 acres, including...

  16. Performance Evaluation of Pressure Transducers for Water Impacts

    NASA Technical Reports Server (NTRS)

    Vassilakos, Gregory J.; Stegall, David E.; Treadway, Sean

    2012-01-01

    The Orion Multi-Purpose Crew Vehicle is being designed for water landings. In order to benchmark the ability of engineering tools to predict water landing loads, test programs are underway for scale model and full-scale water impacts. These test programs are predicated on the reliable measurement of impact pressure histories. Tests have been performed with a variety of pressure transducers from various manufacturers. Both piezoelectric and piezoresistive devices have been tested. Effects such as thermal shock, pinching of the transducer head, and flushness of the transducer mounting have been studied. Data acquisition issues such as sampling rate and anti-aliasing filtering also have been studied. The response of pressure transducers have been compared side-by-side on an impulse test rig and on a 20-inch diameter hemisphere dropped into a pool of water. The results have identified a range of viable configurations for pressure measurement dependent on the objectives of the test program.

  17. Salvianolic Acid B Alleviates Heart Failure by Inactivating ERK1/2/GATA4 Signaling Pathway after Pressure Overload in Mice

    PubMed Central

    Wu, Jiashin; Zhang, Minzhou; Gu, Weiwang

    2016-01-01

    Background Heart failure(HF) is a dangerous disease that affects millions of patients. Radix Salvia is widely used in Chinese clinics to treat heart diseases. Salvianolic acid B(SalB) is the major active component of Radix Salvia. This study investigated the mechanisms of action and effects of SalB on HF in an experimental mouse model of HF. Methods We created a mouse model of HF by inducing pressure overload with transverse aortic constriction(TAC) surgery for 2 weeks and compared among 4 study groups: SHAM group (n = 10), TAC group (n = 9), TAC+MET group (metprolol, positive drug treatment, n = 9) and TAC+SalB group (SalB, 240 mg•kg-1•day-1, n = 9). Echocardiography was used to evaluate the dynamic changes in cardiac structure and function in vivo. Plasma brain natriuretic peptide (BNP) concentration was detected by Elisa method. In addition, H9C2 rat cardiomyocytes were cultured and Western blot were implemented to evaluate the phosphorylation of ERK1/2, AKT, and protein expression of GATA4. Results SalB significantly inhibited the phosphorylation of Thr202/Tyr204 sites of ERK1/2, but not Ser473 site of AKT, subsequently inhibited protein expression of GATA4 and plasma BNP(P < 0.001), and then inhibited HF at 2 weeks after TAC surgery. Conclusions Our data provide a mechanism of inactivating the ERK1/2/GATA4 signaling pathway for SalB inhibition of the TAC-induced HF. PMID:27893819

  18. Application of Quality Management Tools for Evaluating the Failure Frequency of Cutter-Loader and Plough Mining Systems

    NASA Astrophysics Data System (ADS)

    Biały, Witold

    2017-06-01

    Failure frequency in the mining process, with a focus on the mining machine, has been presented and illustrated by the example of two coal-mines. Two mining systems have been subjected to analysis: a cutter-loader and a plough system. In order to reduce costs generated by failures, maintenance teams should regularly make sure that the machines are used and operated in a rational and effective way. Such activities will allow downtimes to be reduced, and, in consequence, will increase the effectiveness of a mining plant. The evaluation of mining machines' failure frequency contained in this study has been based on one of the traditional quality management tools - the Pareto chart.

  19. Evaluating Failures and Near Misses in Human Spaceflight History for Lessons for Future Human Spaceflight

    NASA Technical Reports Server (NTRS)

    Barr, Stephanie

    2009-01-01

    There have been a number of studies done in the past drawn on lessons learned with regard to human loss-of-life events. Generally, the systemic causes and proximate causes for fatal events have both been examined in considerable detail. However, an examination of near-fatal accidents and failures that narrowly missed being fatal could be equally useful, not only in detecting causes, both proximate and systemic, but also for determining what factors averted disaster, what design decisions and/or operator actions prevented catastrophe. Additionally, review of risk factors for upcoming or future programs will often look at trending statistics, generally focusing on failure/success statistics. Unfortunately, doing so can give a skewed or misleading view of past reliability or a reliability that cannot be presumed to apply to a new program. One reason for this might be that failure/success criteria aren't the same across programs, but also that apparent success can hide systemic faults that, under other circumstances, can be fatal to a program with different parameters. A program with a number of near misses can look more reliable than a consistently healthy program with a single out-of-family failure and provide very misleading data if it is not examined in detail. This is particularly true for a manned space program where failure/success includes more than making a particular orbit. Augmenting reliability evaluations with this near miss data can provide insight and expand on the limitations of a strictly pass/fail evaluation. Even more importantly, a thorough understanding of these near miss events can identify conditions that prevented fatalities. Those conditions may be key to a programs reliability, but, without insight to the repercussions if such conditions were not in place, their importance may not be readily clear. As programs mature and political and fiscal responsibilities come to the fore, often there is considerable incentive to eliminate unnecessary

  20. Evaluating Failures and Near Misses in Human Spaceflight History for Lessons for Future Human Spaceflight

    NASA Technical Reports Server (NTRS)

    Barr, Stephanie

    2009-01-01

    There have been a number of studies done in the past drawn on lessons learned with regard to human loss-of-life events. Generally, the systemic causes and proximate causes for fatal events have both been examined in considerable detail. However, an examination of near-fatal accidents and failures that narrowly missed being fatal could be equally useful, not only in detecting causes, both proximate and systemic, but also for determining what factors averted disaster, what design decisions and/or operator actions prevented catastrophe. Additionally, review of risk factors for upcoming or future programs will often look at trending statistics, generally focusing on failure/success statistics. Unfortunately, doing so can give a skewed or misleading view of past reliability or a reliability that cannot be presumed to apply to a new program. One reason for this might be that failure/success criteria aren't the same across programs, but also that apparent success can hide systemic faults that, under other circumstances, can be fatal to a program with different parameters. A program with a number of near misses can look more reliable than a consistently healthy program with a single out-of-family failure and provide very misleading data if it is not examined in detail. This is particularly true for a manned space program where failure/success includes more than making a particular orbit. Augmenting reliability evaluations with this near miss data can provide insight and expand on the limitations of a strictly pass/fail evaluation. Even more importantly, a thorough understanding of these near miss events can identify conditions that prevented fatalities. Those conditions may be key to a programs reliability, but, without insight to the repercussions if such conditions were not in place, their importance may not be readily clear. As programs mature and political and fiscal responsibilities come to the fore, often there is considerable incentive to eliminate unnecessary

  1. Risk evaluation on the basis of pressure rate measured by automatic pressure tracking adiabatic calorimeter.

    PubMed

    Iwata, Yusaku; Koseki, Hiroshi

    2008-11-15

    An automatic pressure tracking adiabatic calorimeter (APTAC) had been employed to obtain the thermokinetic and the vapor pressure data during runaway reactions. The APTAC is an adiabatic calorimeter with a large-scale sample mass and low thermal inertia, and is an extremely useful tool for assessing thermal hazards of reactive chemicals. The data obtained by the APTAC are important information for the design of the safe industrial process. The thermodynamics parameters and the gas production were discussed on the basis of the experimental data of various concentrations and weights of di-tert-butyl peroxide (DTBP)/toluene solution for the purpose of investigating the properties of the APTAC data. The thermal decomposition of DTBP was studied on the basis of the temperature data and the pressure data obtained by the APTAC. The activation energy and the frequency factor of DTBP are nearly constant and the same as the literature values in the concentrations between 20 and 60 wt.%. The pressure rise due to gas production is important data for designing the relief vent of a reactor. The time history of the gas production was investigated with various weights and concentrations. The total gas production index, which had the vapor pressure correction, was 1.0 in the decomposition of DTBP.

  2. Failure Potential Evaluation in Engineering Experiments Using Load/Unload Response Ratio Method

    NASA Astrophysics Data System (ADS)

    Zhang, Lang-ping; Yu, Huai-zhong; Yin, Xiang-chu

    2013-01-01

    The Load/Unload Response Ratio (LURR) method is proposed for prediction of the failure of brittle heterogeneous materials. Application of the method typically involves evaluating the external load on materials or structures, differentiating between loading and unloading periods, determining the failure response during both periods from data input, and calculating the ratio between the two response rates. According to the method, the LURR time series usually climbs to an anomalously high peak prior to the macro-fracture. To show the validity of the approach in engineering practice, we applied it to the loading and unloading experimental data associated with a two-floor concrete-brick structure. Results show that the LURR time series of the two floors consists of the damage evolution of the structure: they are at low level for most of the time, and reach the maxima prior to the final fracture. We then attempt to combine the LURR values with damage variable ( D) to provide the health assessment of the structure. The relationship between LURR and D, defined as a function of Weibull stochastic distribution, is set up to provide more detailed underlying physical means to study damage evolution of the structure. The fact that the damage evolution of the structure correlates well with the variation of LURR time series may suggest that the LURR approach can be severed as a useful tool to provide the health assessment to big scale structures or ancient buildings.

  3. Failure Criteria for Evaluating Accidental Drops of Fuel Containers at INTEC

    SciTech Connect

    Miller, G. K.

    1998-10-01

    This report presents a failure criterion that has been developed for use in evaluating fuel containers at the Idaho Nuclear Technology and Engineering Center (INTEC) for accidental drop events. The criterion would typically be used in dynamic finite element analyses using the ABA-QUS/Explicit program. The failure criterion used in the past is generally considered to substantially underestimate the strength and ductility of the materials involved. The new criterion is intended to be more realistic, allowing for more accurate impact analyses. The criterion is based on the distortion energy theory, which is considered to be appropriate for the ductile materials typically used in fuel containers. Also addressed in development of the criterion were the effects of strain rate and hydrostatic stress. The importance of these factors, however, is highly dependent on the material used. Three materials specifically addressed in this study were stainless steel, aluminum, and lead. The criterion is presented in the form of guidelines and recommendations that are based on material data obtained from the literature. The most significant difference between these and the previous criterion is that ductile materials are allowed to strain to much higher levels before they are considered to fail.

  4. Relationship Between Preoperative Evaluation Blood Pressure and Preinduction Blood Pressure: A Cohort Study in Patients Undergoing General Anesthesia.

    PubMed

    van Klei, Wilton A; van Waes, Judith A R; Pasma, Wietze; Kappen, Teus H; van Wolfswinkel, Leo; Peelen, Linda M; Kalkman, Cor J

    2017-02-01

    For outcomes research where changes in intraoperative blood pressure are a possible causative factor, it is important to determine an appropriate source for a reference value. We studied to what extent preinduction blood pressure values in the operating room differ from those obtained during preoperative evaluation outside the operating room. Cohort study including 4408 patients aged 60 years or older undergoing noncardiac surgery. The outcome was the difference between the preinduction mean blood pressure (MBP) and the MBP obtained during preoperative evaluation. A difference of ≥10 mm Hg was considered clinically relevant. A paired samples t test was used to estimate the difference. Linear regression was used to obtain estimates adjusted for patient characteristics, comorbidity, medications, type of surgery, and preoperative blood pressure. Complete data were available for 3660 (83%) patients. There were 2228 (61%) patients with a difference of ≥10 mm Hg between the preinduction and preoperative MBP. The overall mean difference between both MBPs was 11 mm Hg (95% confidence interval, 10-11) with important variability among individuals. Patients with higher preoperative MBP values had smaller differences. After adjusting for patient characteristics, comorbidity, medications, type of surgery, and preoperative blood pressure, the difference decreased an estimated 5.0 mm Hg (95% confidence interval, 4.7-5.4) for every increase of 10 mm Hg in preoperative MBP. Patient characteristics, comorbidity, type of surgery, or medication were not strongly associated with the difference. The average preinduction blood pressure was higher than the preoperative blood pressure. This difference between the measurements can be explained by stress-induced effects and regression to the mean. To define an optimal reference value for research purposes or to arrive at a clinical perioperative blood pressure target, one should consider that there is important variability both within

  5. Dissociation between blood pressure and heart rate response to hypoxia after bilateral carotid body removal in men with systolic heart failure.

    PubMed

    Niewinski, Piotr; Janczak, Dariusz; Rucinski, Artur; Tubek, Stanislaw; Engelman, Zoar J; Jazwiec, Przemyslaw; Banasiak, Waldemar; Sobotka, Paul A; Hart, Emma C J; Paton, Julian F R; Ponikowski, Piotr

    2014-03-01

    While the ventilatory response to hypoxia is known to be mediated by the carotid bodies, the origin of the haemodynamic alterations evoked by hypoxia is less certain. Bilateral carotid body removal (CBR) performed to treat congestive heart failure may serve as a model to improve our understanding of haemodynamic responses to hypoxia in humans. We studied six congestive heart failure patients before and 1 month after CBR [median (interquartile range): age, 58.5 (56-61) years old; and ejection fraction, 32 (25-34)%]. Peripheral chemosensitivity (hypoxic ventilatory response) was equated to the slope relating lowest oxygen saturation to highest minute ventilation following exposures to hypoxia. Likewise, systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) slopes were calculated as slopes relating the lowest oxygen saturations to the highest SBP, DBP and HR responses. We found that CBR reduces the hypoxic ventilatory response (91%, P < 0.05), SBP (71%, P < 0.05) and DBP slopes (59%, P = 0.07). In contrast, the HR slope remained unchanged. The dissociation between the blood pressure and HR responses after CBR shows involvement of a different chemoreceptive site(s) maintaining the response to acute hypoxia. We conclude that carotid bodies are responsible for ventilatory and blood pressure responses, while the HR response might be mediated by the aortic bodies. The significant reduction of the blood pressure response to hypoxia after CBR suggests a decrease in sympathetic tone, which is of particular clinical relevance in congestive heart failure.

  6. Studies and analyses of the Space Shuttle Main Engine: SSME failure data review, diagnostic survey and SSME diagnostic evaluation

    NASA Technical Reports Server (NTRS)

    Glover, R. C.; Kelley, B. A.; Tischer, A. E.

    1986-01-01

    The results of a review of the Space Shuttle Main Engine (SSME) failure data for the period 1980 through 1983 are presented. The data was collected, evaluated, and ranked according to procedures established during this study. A number of conclusions and recommendations are made based upon this failure data review. The results of a state-of-the-art diagnostic survey are also presented. This survey covered a broad range of diagnostic sensors and techniques and the findings were evaluated for application to the SSME. Finally, a discussion of the initial activities for the on-going SSME diagnostic evaluation is included.

  7. Design and evaluation of candidate pressure ports for the HYFLITE experiment

    NASA Technical Reports Server (NTRS)

    Teter, John E., Jr.; Cleckner, Craig S.; Vontheumer, Alfred E.

    1994-01-01

    A concept for placing a pressure transducer directly in a shuttle type tile was developed at Langley Research Center. A 5 inch long quartz with a .020 inch inner diameter provides the thermal isolation necessary to allow 2800 F surface pressure measurements to be taken by pressure transducer rated at 250 F. The assembly is potted in place with RTV 560 in a piece of FRCI-12 thermal protection system insulation tile. The integrity of the thermal protection system is maintained even with the intrusion of the pressure port assembly and the pressure port does not disrupt the air flow across the lifting body. Approximately 200 of these pressure ports are to be used in each of the Hypersonic Flight Experiment (HYFLITE) flight tests. Initial vibroacoustic and aerothermal testing of the pressure port designs have been completed at Langley Research vibration laboratory and the 20 MWatt 2 x 9 turbulent duct facility at Ames Research Center. The performance of the pressure ports were found to be well within the required design limits for all cases. In addition, a failure mode in which the entire pressure port assembly was removed proved to be a begin case.

  8. Design and evaluation of candidate pressure ports for the HYFLITE experiment

    NASA Astrophysics Data System (ADS)

    Teter, John E., Jr.; Cleckner, Craig S.; Vontheumer, Alfred E.

    1994-07-01

    A concept for placing a pressure transducer directly in a shuttle type tile was developed at Langley Research Center. A 5 inch long quartz with a .020 inch inner diameter provides the thermal isolation necessary to allow 2800 F surface pressure measurements to be taken by pressure transducer rated at 250 F. The assembly is potted in place with RTV 560 in a piece of FRCI-12 thermal protection system insulation tile. The integrity of the thermal protection system is maintained even with the intrusion of the pressure port assembly and the pressure port does not disrupt the air flow across the lifting body. Approximately 200 of these pressure ports are to be used in each of the Hypersonic Flight Experiment (HYFLITE) flight tests. Initial vibroacoustic and aerothermal testing of the pressure port designs have been completed at Langley Research vibration laboratory and the 20 MWatt 2 x 9 turbulent duct facility at Ames Research Center. The performance of the pressure ports were found to be well within the required design limits for all cases. In addition, a failure mode in which the entire pressure port assembly was removed proved to be a begin case.

  9. You Want Me to Do What? Evaluators and the Pressure to Misrepresent Findings

    ERIC Educational Resources Information Center

    Morris, Michael; Clark, Brittany

    2013-01-01

    Evaluators' experiences with being pressured by a key stakeholder to misrepresent findings were investigated in an anonymous survey of a random sample of over 2500 American Evaluation Association members; a response rate of 37% was obtained. Overall, 42% of the respondents had encountered misrepresentation pressure, with 70% of this subgroup…

  10. Evaluation of maximal respiratory pressures in myasthenia gravis. Prognostic value.

    PubMed

    Muñoz Fernández, Carmen; Díez Tejedor, Exuperio; Frank Garcia, Ana; Pino, Jose María; Pérez Conde, Concepción; Barreiro Tella, Pablo

    2004-01-01

    We assess the prognosis of mild forms of myasthenia gravis (MG) by maximal respiratory pressures (MRP) and single fiber electromyography (SFEMG). Fifty MG patients (12 form I, 21 form IIa and 17 form IIb) are valued by MRP [maximal expiratory pressure (MEP) and maximal inspiratory pressure (MIP)] and SFEMG, and are followed-up clinically. We have found in form I patients developing form IIa and form IIa worsening to form IIb, MEP and MIP mean relative values significantly lower than the rest. Inversely, IIb form patients improving to IIa form display MIP mean relative values higher than the rest; no difference appears with MEP. A reduction under 50% of fifth-percentile implies clinical deterioration in forms I and IIa, while its surpassing in IIb form suggests a tendency to improvement. No evident differences are found by SFEMG. MRP allow the follow-up of MG patients and could warn us of a clinical prognosis.

  11. Comparison of magnetic resonance imaging and radionuclide imaging in the evaluation of renal transplant failure

    SciTech Connect

    Goldsmith, M.S.; Tanasescu, D.E.; Waxman, A.D.; Crues, J.V. III

    1988-04-01

    Magnetic resonance imaging (MRI) was compared with radionuclide scintigraphy (RNS) in 16 patients with renal transplants undergoing renal failure to determine which modality could best discriminate between rejection, acute tubular necrosis (ATN), and cyclosporin nephrotoxicity (CN). Although all rejecting transplants had reduced corticomedullary differentiation (CMD) on T1-weighted MR images, four of five cases of ATN had appearances that could not be distinguished from rejection. A normal CMD suggests nonrejection, but diminished CMD is nonspecific. Tc-99m DTPA/I-131 hippuran RNS was superior to MRI in differentiating rejection from ATN. Although ATN and CN have similar RNS patterns, this distinction can usually be made based on the clinical time course. Other potential uses of MRI in the evaluation of the renal transplants are discussed.

  12. 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.

  13. 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.

  14. The accuracy of the bedside swallowing evaluation for detecting aspiration in survivors of acute respiratory failure.

    PubMed

    Lynch, Ylinne T; Clark, Brendan J; Macht, Madison; White, S David; Taylor, Heather; Wimbish, Tim; Moss, Marc

    2017-06-01

    Dysphagia with subsequent aspiration occurs in up to 60% of acute respiratory failure (ARF) survivors. Accurate bedside tests for aspiration can reduce aspiration-related complications while minimizing delay of oral nutrition. In a cohort of ARF survivors, we determined the accuracy of the bedside swallowing evaluation (BSE) and its components for detecting aspiration. Patients who were extubated after at least 24hours of mechanical ventilation were eligible for enrollment. Within 3 days of extubation, patients underwent comprehensive BSE including 3-oz water swallowing test (3-WST), followed by a criterion standard test for aspiration, flexible endoscopic evaluation of swallowing (FEES). Forty-five patients were included in the analysis. Median patient age was 55years (interquartile range, 47-65). Median duration of mechanical ventilation was 3.3days (interquartile range 1.8-6.0). Fourteen patients (31%) aspirated on FEES. Physical examination findings on BSE and abnormal swallowing during trials of different consistencies were variably associated with aspiration. Compared with FEES, the 3-WST yielded a sensitivity of 77% (95% confidence interval [CI], 50%-92%), specificity of 65% (95% CI, 47%-79%), and an area under the receiver operating characteristic curve (AUC) of 0.71; a speech language pathologist's recommendation for altered diet yielded a sensitivity of 86% (95% CI, 60%-96%), a specificity of 52% (95% CI, 35%-68%), and an AUCof 0.69; an speech language pathologist's recommendation for nil per os (nothing by mouth) yielded a sensitivity of 50% (95% CI, 27%-73%), a specificity of 94% (95% CI, 79%-98%), and an AUCof 0.72. The BSE and its components, including the 3-WST, demonstrated variable accuracy for aspiration in survivors of ARF. Investigation to determine the optimal noninvasive test for aspiration in ARF survivors is warranted. ClinicalTrials.gov identifier: NCT02363686, Aspiration in Acute Respiratory Failure Survivors. Copyright © 2017 Elsevier

  15. In-Flight Validation of a Pilot Rating Scale for Evaluating Failure Transients in Electronic Flight Control Systems

    NASA Technical Reports Server (NTRS)

    Kalinowski, Kevin F.; Tucker, George E.; Moralez, Ernesto, III

    2006-01-01

    Engineering development and qualification of a Research Flight Control System (RFCS) for the Rotorcraft Aircrew Systems Concepts Airborne Laboratory (RASCAL) JUH-60A has motivated the development of a pilot rating scale for evaluating failure transients in fly-by-wire flight control systems. The RASCAL RFCS includes a highly-reliable, dual-channel Servo Control Unit (SCU) to command and monitor the performance of the fly-by-wire actuators and protect against the effects of erroneous commands from the flexible, but single-thread Flight Control Computer. During the design phase of the RFCS, two piloted simulations were conducted on the Ames Research Center Vertical Motion Simulator (VMS) to help define the required performance characteristics of the safety monitoring algorithms in the SCU. Simulated failures, including hard-over and slow-over commands, were injected into the command path, and the aircraft response and safety monitor performance were evaluated. A subjective Failure/Recovery Rating (F/RR) scale was developed as a means of quantifying the effects of the injected failures on the aircraft state and the degree of pilot effort required to safely recover the aircraft. A brief evaluation of the rating scale was also conducted on the Army/NASA CH-47B variable stability helicopter to confirm that the rating scale was likely to be equally applicable to in-flight evaluations. Following the initial research flight qualification of the RFCS in 2002, a flight test effort was begun to validate the performance of the safety monitors and to validate their design for the safe conduct of research flight testing. Simulated failures were injected into the SCU, and the F/RR scale was applied to assess the results. The results validate the performance of the monitors, and indicate that the Failure/Recovery Rating scale is a very useful tool for evaluating failure transients in fly-by-wire flight control systems.

  16. High pressure inactivation of relevant target microorganisms in poultry meat products and the evaluation of pressure-induced protein denaturation of marinated poultry under different high pressure treatments

    NASA Astrophysics Data System (ADS)

    Schmidgall, Johanna; Hertel, Christian; Bindrich, Ute; Heinz, Volker; Toepfl, Stefan

    2011-03-01

    In this study, the possibility of extending shelf life of marinated poultry meat products by high pressure processing was evaluated. Relevant spoilage and pathogenic strains were selected and used as target microorganisms (MOs) for challenge experiments. Meat and brine were inoculated with MOs and treated at 450 MPa, 4 °C for 3 min. The results of inactivation show a decreasing pressure tolerance in the series Lactobacillus > Arcobacter > Carnobacterium > Bacillus cereus > Brochothrix thermosphacta > Listeria monocytogenes. Leuconostoc gelidum exhibited the highest pressure tolerance in meat. A protective effect of poultry meat was found for L. sakei and L. gelidum. In parallel, the influence of different marinade formulations (pH, carbonates, citrates) on protein structure changes during a pressure treatment was investigated. Addition of sodium carbonate shows a protection against denaturation of myofibrillar proteins and provides a maximum water-holding capacity. Caustic marinades allowed a higher retention of product characteristics than low-pH marinades.

  17. Evaluation of the National Database of Nursing Quality Indicators (NDNQI) Training Program on Pressure Ulcers.

    PubMed

    Bergquist-Beringer, Sandra; Davidson, Jan; Agosto, Carolyn; Linde, Norma K; Abel, Marla; Spurling, Kara; Dunton, Nancy; Christopher, Angela

    2009-06-01

    The National Database of Nursing Quality Indicators (NDNQI) Pressure Ulcer Training Program was developed to improve nursing accuracy and reliability in identifying and staging pressure ulcers and differentiating hospital- and unit-acquired from community-acquired pressure ulcers. Of 5,200 individuals who completed the training program within 5 months of release, 937 provided written evaluation comments. Four major themes emerged from content analysis of the evaluation remarks: pressure ulcer and other wound pictures; accuracy and clarity of content; program design and technology; and the educational/informational experience. Reviewers most frequently commented on their positive learning experience. Program components that enhanced the educational experience included the array of pressure ulcer pictures at each stage and pictures of other wounds. Clarity of content, program design, and technological problems were barriers to reviewer satisfaction. Findings suggest the NDNQI Pressure Ulcer Training Program was effective for educating staff nurses on pressure ulcer identification and staging.

  18. A miniature pressure sensor for blast event evaluation

    NASA Astrophysics Data System (ADS)

    Wu, Nan; Wang, Wenhui; Tian, Ye; Niezrecki, Christopher; Wang, Xingwei

    2011-06-01

    Traumatic brain injury (TBI) is a great potential threat to people who deal with explosive devices. Protection from TBI has attracted more and more interest. Great efforts have been taken to the studies on the understanding of the propagation of the blast events and its effect on TBI. However, one of the biggest challenges is that the current available pressure sensors are not fast enough to capture the blast wave especially the transient period. This paper reports an ultrafast pressure sensor that could be very useful for analysis of the fast changing blast signal. The sensor is based on Fabry-Perot (FP) principle. It uses a 45º angle polished fiber sitting in a V-groove on a silicon chip. The endface of the angle polished fiber and the diaphragm which is lifted off on the side wall of the V-groove form the FP cavity. The sensor is very small and can be mounted on different locations of a helmet to measure blast pressure simultaneously. The tests were conducted at Natick Soldier Research, Development, and Engineering Center (NSRDEC) in Natick, MA. The sensors were mounted in a shock tube, side by side with the reference sensors, to measure a rapidly increased pressure. The results demonstrated that our sensors' responses agreed well with those from the electrical reference sensors and their response time is comparable.

  19. Psychometric Evaluation of Two Appetite Questionnaires in Patients With Heart Failure.

    PubMed

    Andreae, Christina; Strömberg, Anna; Sawatzky, Richard; Årestedt, Kristofer

    2015-12-01

    Decreased appetite in heart failure (HF) may lead to undernutrition which could negatively influence prognosis. Appetite is a complex clinical issue that is often best measured with the use of self-report instruments. However, there is a lack of self-rated appetite instruments. The Council on Nutrition Appetite Questionnaire (CNAQ) and the Simplified Nutritional Appetite Questionnaire (SNAQ) are validated instruments developed primarily for elderly people. Yet, the psychometric properties have not been evaluated in HF populations. The aim of the present study was to evaluate the psychometric properties of CNAQ and SNAQ in patients with HF. A total of 186 outpatients with reduced ejection fraction and New York Heart Association (NYHA) functional classifications II-IV were included (median age 72 y; 70% men). Data were collected with the use of a questionnaire that included the CNAQ and SNAQ. The psychometric evaluation included data quality, factor structure, construct validity, known-group validity, and internal consistency. Unidimensionality was supported by means of parallel analysis and confirmatory factor analyses (CFAs). The CFA results indicated sufficient model fit. Both construct validity and known-group validity were supported. Internal consistency reliability was acceptable, with ordinal coefficient alpha estimates of 0.82 for CNAQ and 0.77 for SNAQ. CNAQ and SNAQ demonstrated sound psychometric properties and can be used to measure appetite in patients with HF. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Fuzzy Risk Evaluation in Failure Mode and Effects Analysis Using a D Numbers Based Multi-Sensor Information Fusion Method.

    PubMed

    Deng, Xinyang; Jiang, Wen

    2017-09-12

    Failure mode and effect analysis (FMEA) is a useful tool to define, identify, and eliminate potential failures or errors so as to improve the reliability of systems, designs, and products. Risk evaluation is an important issue in FMEA to determine the risk priorities of failure modes. There are some shortcomings in the traditional risk priority number (RPN) approach for risk evaluation in FMEA, and fuzzy risk evaluation has become an important research direction that attracts increasing attention. In this paper, the fuzzy risk evaluation in FMEA is studied from a perspective of multi-sensor information fusion. By considering the non-exclusiveness between the evaluations of fuzzy linguistic variables to failure modes, a novel model called D numbers is used to model the non-exclusive fuzzy evaluations. A D numbers based multi-sensor information fusion method is proposed to establish a new model for fuzzy risk evaluation in FMEA. An illustrative example is provided and examined using the proposed model and other existing method to show the effectiveness of the proposed model.

  1. Evaluation of Daily Blood Pressure Alteration in Subclinical Hypothyroidism.

    PubMed

    Polat Canbolat, Ismail; Belen, Erdal; Bayyigit, Akif; Helvaci, Aysen; Kilickesmez, Kadriye

    2017-09-01

    Subclinical hypothyroidism is the most common thyroid dysfunction in the general population. The relationship between overt thyroid dysfunction and hypertension is generally understood. Besides high blood pressure, non-dipper hypertension is known to increase cardiovascular risk. Our aim is to investigate daily blood pressure changes and the frequency of non-dipping patterns in patients with subclinical hypothyroidism. Forty-nine patients without hypertension with subclinical hypothyroidism were compared with 50 healthy sex- and age-matched controls using ambulatory blood pressure monitoring. Thyroid-stimulating hormone (TSH) levels were significantly higher in the subclinic hypothyroidism group, and there was no difference between free triiodothyronine (FT3) and free thyroxine (FT4) levels which could be predicted as a result of the study design. Levels of mean diastolic, daytime diastolic, nighttime diastolic and nighttime systolic blood pressure were significantly higher in the subclinic hypothyroidism group (p = 0.001 for mean, daytime and nighttime diastolic and p = 0.01 for nighttime systolic). Diastolic non-dipping occurred more frequently in the subclinic hypothyroidism group [subclinical hypothyroidism group 24 patients (49%), control group 13 patients (26%), p = 0.01]. On multivariate analysis, subclinical hypothyroidism was independently associated with diastolic non-dipping (95% confidence interval 1.162-8.053, odds ratio 1.182, p = 0.024). Our study found that both the frequency of diastolic non-dipping pattern and diastolic blood pressure increase with subclinical hypothyroidism. Therfore, it would appear that searching for non-dipping pattern can add valuable information for patients with subclinical hypothyroidism.

  2. The jugular venous pressure revisited

    PubMed Central

    CHIACO, JOHN MICHAEL S. CHUA; PARIKH, NISHA I.; FERGUSSON, DAVID J.

    2016-01-01

    Assessment of the jugular venous pressure is often inadequately performed and undervalued. Here, we review the physiologic and anatomic basis for the jugular venous pressure, including the discrepancy between right atrial and central venous pressures. We also describe the correct method of evaluating this clinical finding and review the clinical relevance of the jugular venous pressure, especially its value in assessing the severity and response to treatment of congestive heart failure. Waveforms reflective of specific conditions are also discussed. PMID:24085809

  3. In utero exposure to diesel exhaust air pollution promotes adverse intrauterine conditions, resulting in weight gain, altered blood pressure, and increased susceptibility to heart failure in adult mice.

    PubMed

    Weldy, Chad S; Liu, Yonggang; Liggitt, H Denny; Chin, Michael T

    2014-01-01

    Exposure to fine particulate air pollution (PM₂.₅) is strongly associated with cardiovascular morbidity and mortality. Exposure to PM₂.₅ during pregnancy promotes reduced birthweight, and the associated adverse intrauterine conditions may also promote adult risk of cardiovascular disease. Here, we investigated the potential for in utero exposure to diesel exhaust (DE) air pollution, a major source of urban PM₂.₅, to promote adverse intrauterine conditions and influence adult susceptibility to disease. We exposed pregnant female C57Bl/6J mice to DE (≈300 µg/m³ PM₂.₅, 6 hrs/day, 5 days/week) from embryonic day (E) 0.5 to 17.5. At E17.5 embryos were collected for gravimetric analysis and assessed for evidence of resorption. Placental tissues underwent pathological examination to assess the extent of injury, inflammatory cell infiltration, and oxidative stress. In addition, some dams that were exposed to DE were allowed to give birth to pups and raise offspring in filtered air (FA) conditions. At 10-weeks of age, body weight and blood pressure were measured. At 12-weeks of age, cardiac function was assessed by echocardiography. Susceptibility to pressure overload-induced heart failure was then determined after transverse aortic constriction surgery. We found that in utero exposure to DE increases embryo resorption, and promotes placental hemorrhage, focal necrosis, compaction of labyrinth vascular spaces, inflammatory cell infiltration and oxidative stress. In addition, we observed that in utero DE exposure increased body weight, but counterintuitively reduced blood pressure without any changes in baseline cardiac function in adult male mice. Importantly, we observed these mice to have increased susceptibility to pressure-overload induced heart failure, suggesting this in utero exposure to DE 'reprograms' the heart to a heightened susceptibility to failure. These observations provide important data to suggest that developmental exposure to air

  4. Systolic blood pressure influences the interpretation of cardiopulmonary exercise tests and helps identify a very high-risk cohort of heart failure patients.

    PubMed

    Bard, Robert L; Gillespie, Brenda W; Lange, David C; Pinter, Agnes; Nicklas, John M

    2014-04-01

    Ventilatory inefficiency (high volume of expired air/volume of carbon dioxide eliminated [Ve/Vco2] slope), and impaired exercise tolerance (low peak volume of oxygen consumption) obtained from cardiopulmonary exercise testing (CPX) strongly predict mortality in heart failure (HF) patients; however, other CPX variables may also contain prognostic information. Therefore, the purpose of this study was to determine the prognostic power of the aggregate of CPX data. The study prospectively monitored 390 patients referred for cardiac transplantation evaluation for 10 years for events (death, urgent transplant, left ventricular assist devices). Cox regression was used to analyze 18 CPX variables to identify the best survival model. Ve/Vco2 slope was the most powerful mortality predictor, and only resting systolic blood pressure (SBP) added additional independent prognostic power when expressed at its threshold effect value as SBP ≤ 100 mm Hg. Patients with low SBP had a greater risk than those who were within the next higher quartile of Ve/Vco2 slope with SBP > 100 mm Hg. A very high-risk cohort included 9% of the population that had a Ve/Vco2 slope > 41 and SBP ≤ 100 mm Hg and an associated 2-year event rate of 67%; conversely, a low-risk cohort had a Ve/Vco2 slope ≤ 30 and SBP >100 mm Hg and associated 2-, 5-, and 10-year event rates of 5%, 12%, and 30%, respectively. Ve/Vco2 slope was the best individual predictive CPX variable and its interpretation was significantly altered by the presence of hypotension. An algorithm combining these CPX variables identifies a HF population at very high risk of early death and warranting advanced therapies. Copyright © 2014 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  5. Effects of AV delay and VV delay on left atrial pressure and waveform in ambulant heart failure patients: insights into CRT optimization.

    PubMed

    Chan, W Y Wandy; Blomqvist, Andreas; Melton, Iain C; Norén, Kjell; Crozier, Ian G; Benser, Michael E; Eigler, Neal L; Gutfinger, Dan; Troughton, Richard W

    2014-07-01

    We hypothesized that left atrial pressure (LAP) obtained by a permanent implantable sensor is sensitive to changes in cardiac resynchronization therapy (CRT) settings and could guide CRT optimization to improve the response rate. We investigated the effect of CRT optimization on LAP and its waveform parameters in ambulant heart failure (HF) patients. CRT optimization was performed in eight ambulant HF patients, using echocardiography as reference. LAP waveform was acquired at each of eight atrioventricular (AV) intervals and five inter-ventricular (VV) intervals. Selected waveform parameters were also evaluated for their sensitivity to CRT changes and agreement with echocardiography-guided optimal settings. Optimal AV and VV intervals varied considerably between patients. All patients exhibited significant changes in waveform morphology with AV optimization. Optimal AV delay determined from echocardiography ranged between 140 ms and 225 ms. Mean LAP tended to be lower at optimal setting 14 ± 3 mmHg compared to shorter (<100 ms) or longer (>160 ms) AV settings (P = 0.16). There were clear trends to smaller peak a-wave (P = 0.11) and gentler positive a-slope (P = 0.15) and positive v-slope (P = 0.09) with longer AV delays. Mean LAP and negative v-wave slope correlated well with echo-guided optimal setting, r = 0.91 (P = 0.001) and 0.79 (P = 0.03), respectively. No significant effects on LAP or waveform were seen during VV optimization. LAP and its waveform changes considerably with AV optimization. There is good agreement between echo-guided optimal setting and LAP. LAP could provide an objective guide to CRT optimization. (Clinical Trial Registry information: URL: http://www.clinicaltrials.gov. Unique Identifier: NCT00632372). ©2014 Wiley Periodicals, Inc.

  6. [Evaluation of pressure ulcers area using the softwares Motic and AutoCAD®].

    PubMed

    Reis, Camila Letícia Dias dos; Cavalcante, Janaína Mortosa; Rocha Júnior, Edvar Ferreira da; Neves, Rinaldo Souza; Santana, Levy Aniceto; Guadagnin, Renato da Veiga; Brasil, Lourdes Mattos

    2012-01-01

    Pressure ulcer is a lesion that affects skin layers in some regions of the body and its healing can be followed up using image processing. The analysis of pressure ulcer area is relevant to evaluate its evolution and response to therapeutic procedures. Such areas can be evaluated through contour marking with the softwares Motic and AutoCAD®. In this study 35 volunteers computed areas from two grade III pressure ulcers using these instruments. It was possible to conclude that results are clinically equivalent and so can be considered to follow up healing evolution from pressure ulcers.

  7. Evaluation of Acoustic Emission NDE of Kevlar Composite Over Wrapped Pressure Vessels

    NASA Technical Reports Server (NTRS)

    Horne, Michael R.; Madaras, Eric I.

    2008-01-01

    Pressurization and failure tests of small Kevlar/epoxy COPV bottles were conducted during 2006 and 2007 by Texas Research Institute Austin, Inc., at TRI facilities. This is a report of the analysis of the Acoustic Emission (AE) data collected during those tests. Results of some of the tests indicate a possibility that AE can be used to track the stress-rupture degradation of COPV vessels.

  8. The failure of negative pressure rewarming (Thermostat) to accelerate recovery from mild hypothermia in postoperative surgical patients.

    PubMed

    Smith, C E; Parand, A; Pinchak, A C; Hagen, J F; Hancock, D E

    1999-12-01

    The Thermostat device (Aquarius Medical Corp., Phoenix, AZ) is used in a new technique to accelerate recovery from hypothermia by mechanically distending blood vessels in the hand, thereby increasing transfer of exogenous heat to the body core. We evaluated the use of the Thermostat device in patients with mild postoperative hypothermia (< 36 degrees C). We studied adult patients undergoing elective surgery, general anesthesia, and neuromuscular blockade. Patients with an initial postoperative tympanic membrane temperature < 36 degrees C were randomized into two groups: 1) Thermostat, which consisted of a hypothermia warming mitt/seal and thermal exchange chamber for 60 min, and 2) conventional treatment, which consisted of warm blankets and/or radiant heat. Of the 191 patients enrolled, 60 (31%) developed hypothermia and were randomized to receive the Thermostat (n = 30) or conventional methods (n = 30). Fourteen patients in the Thermostat group and 17 patients in the conventional group rewarmed to 36 degrees C before discharge from the recovery room (P is not significant). There were no differences in vital signs, rewarming time, time to discharge from the recovery room, or postoperative temperature between groups. We conclude that patients with mild postoperative hypothermia rewarmed in a similar fashion, regardless of whether the Thermostat or conventional methods were used. We found that a commercially available negative pressure rewarming device (Thermostat; Aquarius Medical Corp., Phoenix, AZ) was not effective in accelerating rewarming in postoperative hypothermic surgical patients after general anesthesia.

  9. Evaluation of Agency Non-Code Layered Pressure Vessels (LPVs)

    NASA Technical Reports Server (NTRS)

    Prosser, William H.

    2014-01-01

    In coordination with the Office of Safety and Mission Assurance and the respective Center Pressure System Managers (PSMs), the NASA Engineering and Safety Center (NESC) was requested to formulate a consensus draft proposal for the development of additional testing and analysis methods to establish the technical validity, and any limitation thereof, for the continued safe operation of facility non-code layered pressure vessels. The PSMs from each NASA Center were asked to participate as part of the assessment team by providing, collecting, and reviewing data regarding current operations of these vessels. This report contains the outcome of the assessment and the findings, observations, and NESC recommendations to the Agency and individual NASA Centers.

  10. CF6 High Pressure Compressor and Turbine Clearance Evaluations

    NASA Technical Reports Server (NTRS)

    Radomski, M. A.; Cline, L. D.

    1981-01-01

    In the CF6 Jet Engine Diagnostics Program the causes of performance degradation were determined for each component of revenue service engines. It was found that a significant contribution to performance degradation was caused by increased airfoil tip radial clearances in the high pressure compressor and turbine areas. Since the influence of these clearances on engine performance and fuel consumption is significant, it is important to accurately establish these relatonships. It is equally important to understand the causes of clearance deterioration so that they can be reduced or eliminated. The results of factory engine tests run to enhance the understanding of the high pressure compressor and turbine clearance effects on performance are described. The causes of clearance deterioration are indicated and potential improvements in clearance control are discussed.

  11. Energy evaluation of algal cell disruption by high pressure homogenisation.

    PubMed

    Yap, Benjamin H J; Dumsday, Geoff J; Scales, Peter J; Martin, Gregory J O

    2015-05-01

    The energy consumption of high pressure homogenisation (HPH) was analysed to determine the feasibility of rupturing algal cells for biodiesel production. Experimentally, the processing capacity (i.e. flow rate), power draw and cell disruption efficiency of HPH were independent of feed concentration (for Nannochloropsis sp. up to 25%w/w solids). Depending on the homogenisation pressure (60-150 MPa), the solids concentration (0.25-25%w/w), and triacylglyceride (TAG) content of the harvested algal biomass (10-30%), the energy consumed by HPH represented between 6% and 110-times the energy density of the resulting biodiesel. Provided the right species (weak cell wall and high TAG content) is selected and the biomass is processed at a sufficiently high solids concentration, HPH can consume a small fraction of the energy content of the biodiesel produced. This study demonstrates the feasibility of process-scale algal cell disruption by HPH based on its energy requirement.

  12. Evaluation of worn SSME low pressure liquid oxygen turbopump bearing

    NASA Technical Reports Server (NTRS)

    Dufrane, K. F.; Kannel, J. W.

    1978-01-01

    The larger of two ball bearings used to support the rotor of the low pressure liquid oxygen turbopump in each of the shuttle main engines was analyzed to identify the cause of severe internal wear. The actual operating loads were calculated along with their direction and length of time at each load based on the size and location of the race contact paths. It is suggested that the engine component design be modified to reduce bearing stress and enhance lubrication.

  13. The Design, Development, and Evaluation of a Differential Pressure Gauge Directional Wave Monitor.

    DTIC Science & Technology

    1982-10-01

    Ai23 958 THE DESIGN DEVELOPMENT AND EVALUATION OF A DIFFERENTIAL 1/3 PRESSURE GURGE DI..(U) COASTRL ENGINEERING RESEARCH CENTER FORT BELVOIR YR K R...I1IBI =. 5 6 LA 112 MICROCOPY RESOLUTION TEST CHART NATIONAL BUREAU OF STANDARDS-1963- A q.. MR 82-11 k0- The Design, Development, and Evaluation of a ...OF REPORT & PERIOD COVERED THE DESIGN, DEVELOPMENT, AND EVALUATION Miscellaneous Report OF A DIFFERENTIAL PRESSURE GAUGE DIRECTIONAL WAVE MONITOR 6

  14. Evaluation of automated blood pressure measurements during exercise testing.

    PubMed

    Hossack, K F; Gross, B W; Ritterman, J B; Kusumi, F; Bruce, R A

    1982-11-01

    Measurements of systolic (SBP) and diastolic (DBP) blood pressure were made at rest and during symptom-limited exercise with an automated blood pressure measuring device (EBPM). Comparisons were made between the EBPM readings and those made with mercury manometer. Correlations were high (SBP r = 0.92, DBP r = 0.80) when readings were made in the same arm, but were less satisfactory when the cuffs were on different arms (SBP r = 0.80, DBP r = 0.46). The correlation between two mercury manometer readings was SBP r = 0.90, and DBP r = 0.75. Comparison between EBPM and intra-arterial measurements were similar (SBP r = 0.74, DBP r = 0.79) to comparison between mercury manometer and intra-arterial measurements (SBP r = 0.81, DBP r = 0.61). The EBPM detected SBP at consistently higher levels than did physicians, which may be an advantage in the noisy environment of an exercise test. There was a definite tendency for physicians to record blood pressure to the nearest 10 mm Hg, whereas the frequency distribution curve for EBPM measurements was smoother. The EBPM operated satisfactorily at rest and during maximal exercise and gave as reliable measurements as a physician using a mercury manometer and, in the small number of available cases, detected exertional hypotension more often than the physician.

  15. Oxygen saturation/FiO2 ratio is a simple predictor of noninvasive positive pressure ventilation failure in critically ill patients

    PubMed Central

    Spada, Carol; Gandhi, Rikesh; Patel, Sanjay R.; Nuccio, Paul; Weinhouse, Gerald L.; Lee, Po-Shun

    2010-01-01

    Purpose Noninvasive positive pressure ventilation (NPPV) can improve outcomes of critically ill patients. Early and simple predictors of NPPV outcome could improve clinical management of patients with respiratory failure. Materials and Methods A prospective observational study was conducted in a medical intensive care unit (ICU) of a tertiary medical center. Patients requiring NPPV were included and followed. Clinical data including respiratory mechanics at the time of NPPV initiation, and clinical outcomes were recorded. Data were analyzed to identify variables that distinguished NPPV success or failure. Results A total of 133 patients were included in the study. NPPV success rate was 41%. Patients diagnosed with malignancy had only 29% NPPV success rate. Among patients without malignancy, higher oxygen saturation, oxygen saturation/FiO2 (SF) ratios, and SF/minute ventilation (MV) ratios were associated with NPPV success. Receiver operating curve analyses identify SF < 98.5 to be a specific (89% specificity, P=0.013) predictor of NPPV failure. Furthermore, for patients requiring at least 24hr of NPPV support, tidal volume (TV)/predicted body weight (PBW) ratio inversely correlated with respiratory improvement. Conclusions For patients without malignancy, SF ratios at the time of NPPV initiation discriminated NPPV success and failure, and could be used to help guide the management of critically ill patients who require ventilatory support. PMID:21036535

  16. Evaluation of containment peak pressure and structural response for a large-break loss-of-coolant accident in a VVER-440/213 NPP

    SciTech Connect

    Spencer, B.W.; Sienicki, J.J.; Kulak, R.F.; Pfeiffer, P.A.; Voeroess, L.; Techy, Z.; Katona, T.

    1998-07-01

    A collaborative effort between US and Hungarian specialists was undertaken to investigate the response of a VVER-440/213-type NPP to a maximum design-basis accident, defined as a guillotine rupture with double-ended flow from the largest pipe (500 mm) in the reactor coolant system. Analyses were performed to evaluate the magnitude of the peak containment pressure and temperature for this event; additional analyses were performed to evaluate the ultimate strength capability of the containment. Separate cases were evaluated assuming 100% effectiveness of the bubbler-condenser pressure suppression system as well as zero effectiveness. The pipe break energy release conditions were evaluated from three sources: (1) FSAR release rate based on Soviet safety calculations, (2) RETRAN-03 analysis and (3) ATHLET analysis. The findings indicated that for 100% bubbler-condenser effectiveness the peak containment pressures were less than the containment design pressure of 0.25 MPa. For the BDBA case of zero effectiveness of the bubbler-condenser system, the peak pressures were less than the calculated containment failure pressure of 0.40 MPa absolute.

  17. Evaluation of SSME high pressure liquid oxygen turbopump bearings

    NASA Technical Reports Server (NTRS)

    Dufrane, K. F.; Kannel, J. W.

    1979-01-01

    Examination of the bearings produced conclusive evidence that a very high axial load was applied to bearing 8517903 during a significant portion of the service time. The high loads caused serious ball and race wear and surface fatigue pitting. In all likelihood, continued operation of this bearing with the high axial load would have caused increasing deterioration and catastrophic failure. In contrast, bearing 8517900 showed much less deterioration and probably had experienced only the axial loads deliberately applied by the preload spring. Bearing 8517900 represents the best-case operation with the loads controlled to the levels intended in the design. Fatigue life calculations on bearing 8517903 with an axial load of 27,000 N showed the intolerance of the bearing to such load levels.

  18. Radiographic and histological evaluation of persistent periapical lesions associated with endodontic failures after apical microsurgery.

    PubMed

    Çalışkan, M K; Kaval, M E; Tekin, U; Ünal, T

    2016-11-01

    To determine the histology of persistent periapical lesions associated with nonsurgical endodontic treatment failures and to compare radiographically the sizes of periapical lesions and the presence or absence of the radiopaque lamina with the histological findings. Ninety-three anterior teeth designated for apical microsurgery were included in the study. After taking standard radiographs of all cases using the parallel technique, the films were scanned and evaluated for the size of periapical radiolucent lesions and the presence or absence of radiopaque lamina by two calibrated observers. Biopsy specimens were obtained during apical microsurgery and examined under light microscopy by oral pathologists. Histological analysis established diagnoses of granuloma, cyst, abscess and scar tissue. Interobserver agreement was evaluated by the kappa test, and the relationship between histological diagnosis and lesion size was analysed by the Pearson's chi-square test. The 93 specimens consisted of 72% periradicular granulomas; 21.5% radicular cysts, including two keratocysts; 4.3% abscesses; and 2.2% scar tissue. Cystic prevalence increased as the size of the periapical lesion increased; however, there was no correlation between the presence of a radiopaque lamina and histological diagnosis of cyst. Neither radiographic size nor presence of an associated radiopaque line alone was sufficient to determine the type of lesion. Histological examination is required in order to reach to a definitive diagnosis. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  19. Evaluation of micro tip pressure transducers for the measurement of intracerebral pressure transients induced by fluid percussion.

    PubMed

    Walter, B; Bauer, R; Fritz, H; Jochum, T; Wunder, L; Zwiener, U

    1999-02-01

    We describe the application of MIKRO TIP miniature pressure transducers (MPT) for the in vivo measurement of intracerebral stresses induced by traumatic brain injury (TBI). In order to test the linearity of these transducers pressure pulses of different amplitudes (duration approximately 10ms) were generated in a closed calibration chamber. A piezoelectric pressure transducer (PPT) served as the reference measure. A linear correlation was found within the pressure range between 0.57 and 5.09 bar (R2 = 0.998). The frequency transmission characteristics of the MPTs are comparable to the PPT. In three juvenile swines (6 weeks of age) pressures within the brain tissue were induced by fluid percussion (FP) and were measured in the anterior, middle, and posterior cranial cavity as well as in the extracranial part of the medulla oblongata. The data obtained in our experiments agree with the basic biomechanics of FP known from studies in cats and rabbits. Due to their small size, MPTs can be applied in living animals. Stereotaxic positioning of these catheters at any site of the brain and spinal cord requires only minimal surgery. Therefore, MPTs are useful in evaluating animal models of brain injury and in generating input data for computational models of head injury as well as to validate the mathematical results of such models with experimental data.

  20. Apollo experience report: Pressure vessels

    NASA Technical Reports Server (NTRS)

    Ecord, G. M.

    1972-01-01

    The Apollo spacecraft pressure vessels, associated problems and resolutions, and related experience in evaluating potential problem areas are discussed. Information is provided that can be used as a guideline in the establishment of baseline criteria for the design and use of lightweight pressure vessels. One of the first practical applications of the use of fracture-mechanics technology to protect against service failures was made on Apollo pressure vessels. Recommendations are made, based on Apollo experience, that are designed to reduce the incidence of failure in pressure-vessel operation and service.

  1. Failure of unilateral carotid artery ligation to affect pressure-induced interruption of rapid axonal transport in primate optic nerves.

    PubMed

    Radius, R L; Schwartz, E L; Anderson, D R

    1980-02-01

    Previous experiments showed that optic nerve axonal transport can be blocked at the level of the lamina cribrosa by elevated intraocular pressure. In an effort to discover if this blockage might be secondary to pressure-induced ischemia, we studied the effect of unilateral common carotid artery ligation upont the pressure-induced interruption of axonal transport. In 13 owl monkeys (Aotus trivirgatus), the right common carotid artery was ligated within the anterior cervical triangle. Three days later, ophtalmodynomometry was performed on all experimental eyes. In nine of the 13 animals, this estimate of ophthalmic artery pressure was 10 to 20 mm Hg less in the right compared to the left eye. Optic nerve axonal transport was studied in right and left eyes during 5 hours of increased intraocular pressure (ocular pressure 35 mm Hg less than mean femoral artery blood pressure). No significant difference in the extent to which the transport mechanisms were interrupted could be demonstrated when comparing right and left eyes of the experimental animals. These observations fail to support a vascular mechanism for this pressure-induced interruption of axonal transport.

  2. Evaluating road surface conditions using dynamic tire pressure sensor

    NASA Astrophysics Data System (ADS)

    Zhao, Yubo; Wu, H. Felix; McDaniel, J. Gregory; Wang, Ming L.

    2014-03-01

    In order to best prioritize road maintenance, the level of deterioration must be known for all roads in a city's network. Pavement Condition Index (PCI) and International Roughness Index (IRI) are two standard methods for obtaining this information. However, IRI is substantially easier to measure. Significant time and money could be saved if a method were developed to estimate PCI from IRI. This research introduces a new method to estimate IRI and correlate IRI with PCI. A vehicle-mounted dynamic tire pressure sensor (DTPS) system is used. The DTPS measures the signals generated from the tire/road interaction while driving. The tire/road interaction excites surface waves that travel through the road. DTPS, which is mounted on the tire's valve stem, measures tire/road interaction by analyzing the pressure change inside the tire due to the road vibration, road geometry and tire wall vibration. The road conditions are sensible to sensors in a similar way to human beings in a car. When driving on a smooth road, tire pressure stays almost constant and there are minimal changes in the DTPS data. When driving on a rough road, DTPS data changes drastically. IRI is estimated from the reconstructed road profile using DTPS data. In order to correlate IRI with PCI, field tests were conducted on roads with known PCI values in the city of Brockton, MA. Results show a high correlation between the estimated IRI values and the known PCI values, which suggests that DTPS-based IRI can provide accurate predictions of PCI.

  3. Evaluation of a theory for pressure-strain rate

    NASA Technical Reports Server (NTRS)

    Weinstock, J.; Shariff, K.

    1987-01-01

    A theoretical expression for the slow part (the nonlinear fluctuation part) of the pressure-strain rate is compared with simulations of anisotropic homogeneous flows. The objective is to determine the quantitative accuracy of the theory and to test its prediction that the generalized Rotta coefficient, a non-dimensionalized ratio of slow term to the Reynolds stress anisotropy, varies with direction and can be negative. Comparisons are made between theoretical and simulation values of the slow term itself and of the generalized Rotta coefficients. The implications of the comparison for two-point closure theories and for Reynolds stress modeling are pointed out.

  4. Evaluation of the reactor pressure vessel steels by positron annihilation

    NASA Astrophysics Data System (ADS)

    Slugeň, V.; Hein, H.; Sojak, S.; Simeg Veterníková, J.; Petriska, M.; Sabelová, V.; Pavúk, M.; Hinca, R.; Stacho, M.

    2013-11-01

    This paper presents a comparison of commercially used German and Russian reactor pressure vessel steels from the positron annihilation spectroscopy (PAS) point of view, having in mind knowledge obtained also from other techniques from the last decades. The second generation of Russian RPV steels seems to be fully comparable with German steels and their quality allows prolongation of NPP operating lifetime over projected 40 years. The embrittlement of CrMoV steels is relatively low due to effect of higher temperature which implies partial in situ annealing of primary microstructural point defects and therefore delays the degradation processes caused by neutron irradiation.

  5. Vascular Physiology according to Clinical Scenario in Patients with Acute Heart Failure: Evaluation using the Cardio-Ankle Vascular Index.

    PubMed

    Goto, Toshihiko; Wakami, Kazuaki; Mori, Kento; Kikuchi, Shohei; Fukuta, Hidekatsu; Ohte, Nobuyuki

    2016-01-01

    Increased aortic stiffness may be an important cause of acute heart failure (AHF). Clinical scenario (CS), which classifies the pathophysiology of AHF based on the initial systolic blood pressure (sBP), was proposed to provide the most appropriate therapy for AHF patients. In CS, elevated aortic stiffness, vascular failure, has been considered as a feature of patients categorized as CS1 (sBP > 140 mmHg at initial presentation). However, whether elevated aortic stiffness, vascular failure, is present in such patients has not been fully elucidated. Therefore, we assessed aortic stiffness in AHF patients using the cardio-ankle vascular index (CAVI), which is considered to be independent of instantaneous blood pressure. Sixty-four consecutive AHF patients (mean age, 70.6 ± 12.8 years; 39 men) were classified with CS, based on their initial sBP: CS1: sBP > 140 mmHg (n = 29); CS2: sBP 100-140 mmHg (n = 22); and CS3: sBP < 100 mmHg (n = 13). There were significant group differences in CAVI (CS1 vs. CS2 vs. CS3: 9.7 ± 1.4 vs. 8.4 ± 1.7 vs. 8.3 ± 1.7, p = 0.006, analysis of variance). CAVI was significantly higher in CS1 than in CS2 (p = 0.02) and CS3 (p = 0.04). CAVI did not significantly correlate with sBP at the time of measurement of CAVI (r = 0.24 and p = 0.06). Aortic stiffness assessed using blood pressure-independent methodology apparently increased in CS1 AHF patients. We conclude that vascular failure is a feature of CS1 AHF initiation.

  6. Evaluation of fracture models through pressurized-thermal-shock testing

    SciTech Connect

    Pugh, C.E.; Bryan, R.H.; Bass, B.R.; Nanstad, R.K.

    1988-01-01

    Two multiple-transient pressurized-thermal-shock experiments (PTSEs) have been conducted under the NRC-sponsored Heavy-Section Steel Technology (HSST) program. The first test (PTSE-1) employed an SA-508 class 2 steel with high Charpy upper-shelf energy level and a relatively high brittle-to-ductile transition temperature. The second test (PTSE-2) used a 2 1/4 Cr-1 Mo steel (SA-387 grade 22) that had been given a special heat treatment to yield a low Charpy upper-shelf energy level and attendant low tearing resistance. Each experiment included two combined thermal and pressure transients that give rise to propagation and arrest of an initial long flaw that extended about 10% through the thick wall of the test cylinder. Both materials exhibited the ability to inhibit crack propagation by warm prestressing, high initiation toughness values and high crack-arrest toughness values. Cleavage initiation and arrest are modeled well by available fracture theories. However, calculations of ductile tearing based on resistance curves did not consistently predict the observed tearing.

  7. Neural Network Prediction of Failure of Damaged Composite Pressure Vessels from Strain Field Data Acquired by a Computer Vision Method

    NASA Technical Reports Server (NTRS)

    Russell, Samuel S.; Lansing, Matthew D.

    1997-01-01

    This effort used a new and novel method of acquiring strains called Sub-pixel Digital Video Image Correlation (SDVIC) on impact damaged Kevlar/epoxy filament wound pressure vessels during a proof test. To predict the burst pressure, the hoop strain field distribution around the impact location from three vessels was used to train a neural network. The network was then tested on additional pressure vessels. Several variations on the network were tried. The best results were obtained using a single hidden layer. SDVIC is a fill-field non-contact computer vision technique which provides in-plane deformation and strain data over a load differential. This method was used to determine hoop and axial displacements, hoop and axial linear strains, the in-plane shear strains and rotations in the regions surrounding impact sites in filament wound pressure vessels (FWPV) during proof loading by internal pressurization. The relationship between these deformation measurement values and the remaining life of the pressure vessels, however, requires a complex theoretical model or numerical simulation. Both of these techniques are time consuming and complicated. Previous results using neural network methods had been successful in predicting the burst pressure for graphite/epoxy pressure vessels based upon acoustic emission (AE) measurements in similar tests. The neural network associates the character of the AE amplitude distribution, which depends upon the extent of impact damage, with the burst pressure. Similarly, higher amounts of impact damage are theorized to cause a higher amount of strain concentration in the damage effected zone at a given pressure and result in lower burst pressures. This relationship suggests that a neural network might be able to find an empirical relationship between the SDVIC strain field data and the burst pressure, analogous to the AE method, with greater speed and simplicity than theoretical or finite element modeling. The process of testing SDVIC

  8. An evaluation of pressure and flow measurement in the Molten Salt Test Loop (MSTL) system.

    SciTech Connect

    Gill, David Dennis; Kolb, William J.; Briggs, Ronald J.

    2013-07-01

    The National Solar Thermal Test Facility at Sandia National Laboratories has a unique test capability called the Molten Salt Test Loop (MSTL) system. MSTL allows customers and researchers to test components in flowing, molten nitrate salt at plant-like conditions for pressure, flow, and temperature. An important need in thermal storage systems that utilize molten salts is for accurate flow and pressure measurement at temperatures above 535ÀC. Currently available flow and pressure instrumentation for molten salt is limited to 535ÀC and even at this temperature the pressure measurement appears to have significant variability. It is the design practice in current Concentrating Solar Power plants to measure flow and pressure on the cold side of the process or in dead-legs where the salt can cool, but this practice wont be possible for high temperature salt systems. For this effort, a set of tests was conducted to evaluate the use of the pressure sensors for flow measurement across a device of known flow coefficient Cv. To perform this task, the pressure sensors performance was evaluated and was found to be lacking. The pressure indicators are severely affected by ambient conditions and were indicating pressure changes of nearly 200psi when there was no flow or pressure in the system. Several iterations of performance improvement were undertaken and the pressure changes were reduced to less than 15psi. The results of these pressure improvements were then tested for use as flow measurement. It was found that even with improved pressure sensors, this is not a reliable method of flow measurement. The need for improved flow and pressure measurement at high temperatures remains and will need to be solved before it will be possible to move to high temperature thermal storage systems with molten salts.

  9. Evaluation of embedded FBGs in composite overwrapped pressure vessels for strain based structural health monitoring

    NASA Astrophysics Data System (ADS)

    Pena, Francisco; Strutner, Scott M.; Richards, W. Lance; Piazza, Anthony; Parker, Allen R.

    2014-03-01

    The increased use of composite overwrapped pressure vessels (COPVs) in space and commercial applications, and the explosive nature of pressure vessel ruptures, make it crucial to develop techniques for early condition based damage detection. The need for a robust health monitoring system for COPVs is a high priority since the mechanisms of stress rupture are not fully understood. Embedded Fiber Bragg Grating (FBG) sensors have been proposed as a potential solution that may be utilized to anticipate and potentially avoid catastrophic failures. The small size and light weight of optical fibers enable manufactures to integrate FBGs directly into composite structures for the purpose of structural health monitoring. A challenging aspect of embedding FBGs within composite structures is the risk of potentially impinging the optical fiber while the structure is under load, thus distorting the optical information to be transferred. As the COPV is pressurized, an embedded optical sensor is compressed between the expansion of the inner bottle, and the outer overwrap layer of composite. In this study, FBGs are installed on the outer surface of a COPV bottle as well as embedded underneath a composite overwrap layer for comparison of strain measurements. Experimental data is collected from optical fibers containing multiple FBGs during incremental pressurization cycles, ranging from 0 to 10,000 psi. The graphical representations of high density strain maps provide a more efficient process of monitoring structural integrity. Preliminary results capture the complex distribution of strain, while furthering the understanding of the failure mechanisms of COPVs.

  10. A Patient with Heart Failure and Sleep-disordered Breathing Who Presented with Marked Reverse Remodeling by Continuous Positive Airway Pressure Therapy.

    PubMed

    Fukushima, Taishi; Yasuda, Kenichiro; Eguchi, Kazuo; Fujino, Masahiko; Kamiya, Haruo

    2017-09-01

    A 49-year-old Japanese man with worsening dyspnea was admitted with the diagnosis of new-onset heart failure (HF). His HF symptoms improved with standard treatment, but his left ventricular ejection fraction (LVEF) 21% remained unchanged. After he was discharged, he was diagnosed with severe sleep-disordered breathing (SDB). Continuous positive airway pressure (CPAP) therapy was introduced. Seven months later, his cardiac function had greatly improved (LVEF 50%). We report this case of a HF patient with SDB whose cardiac function greatly improved by CPAP therapy, and we discuss the pathophysiologic mechanisms of successful cardiac "reverse remodeling" in this case.

  11. Evaluation of the Stress Adjustment and Adaptation Model among Families Reporting Economic Pressure

    ERIC Educational Resources Information Center

    Vandsburger, Etty; Biggerstaff, Marilyn A.

    2004-01-01

    This research evaluates the Stress Adjustment and Adaptation Model (double ABCX model) examining the effects resiliency resources on family functioning when families experience economic pressure. Families (N = 128) with incomes at or below the poverty line from a rural area of a southern state completed measures of perceived economic pressure,…

  12. A preliminary evaluation of the generalized likelihood ratio for detecting and identifying control element failures in a transport aircraft

    NASA Technical Reports Server (NTRS)

    Bundick, W. T.

    1985-01-01

    The application of the Generalized Likelihood Ratio technique to the detection and identification of aircraft control element failures has been evaluated in a linear digital simulation of the longitudinal dynamics of a B-737 aircraft. Simulation results show that the technique has potential but that the effects of wind turbulence and Kalman filter model errors are problems which must be overcome.

  13. Evaluation of blood pressure changes using vascular transit time.

    PubMed

    Foo, Jong Yong Abdiel; Lim, Chu Sing; Wang, Ping

    2006-08-01

    Imbalance of the human haemodynamic system can provide a prognosis of syncope, dizziness or hypertension. This can be assessed by monitoring its responses to postural change. Examining variations in blood pressure (BP) is deemed an effective means to identify symptoms of this associated condition. However, conventional methods do not promote prolonged monitoring due to the discomfort caused to patients. Established correlations between BP and pulse wave transmission have shown its usefulness in clinical applications. In this study, photoplethysmography and phonocardiography were used to estimate BP changes via observed variations in delay transmission or vascular transit time (VTT) at the upper limb. Thirty-one healthy adults (21 male) were recruited to perform three test activities, namely the arm held at heart level, fully raised up and held down. Association of the three BP indices and heart rate variations with transit time changes was then computed. The results showed that observed VTT changes were related to systolic BP (R(2) = 0.820; p < 0.05), diastolic BP (R(2) = 0.517; p < 0.05), mean arterial pressure (R(2) = 0.673; p < 0.05) and heart rate (R(2) = 0.000; p > 0.05). As systolic BP had the strongest correlation, a regression equation was formulated to associate the two parameters. The non-invasive measuring nature of VTT can be more accommodating to patients, especially during continual monitoring. Moreover, it has the added advantage that the pre-ejection period is not included in its time-related derivations.

  14. Analytical Method to Evaluate Failure Potential During High-Risk Component Development

    NASA Technical Reports Server (NTRS)

    Tumer, Irem Y.; Stone, Robert B.; Clancy, Daniel (Technical Monitor)

    2001-01-01

    Communicating failure mode information during design and manufacturing is a crucial task for failure prevention. Most processes use Failure Modes and Effects types of analyses, as well as prior knowledge and experience, to determine the potential modes of failures a product might encounter during its lifetime. When new products are being considered and designed, this knowledge and information is expanded upon to help designers extrapolate based on their similarity with existing products and the potential design tradeoffs. This paper makes use of similarities and tradeoffs that exist between different failure modes based on the functionality of each component/product. In this light, a function-failure method is developed to help the design of new products with solutions for functions that eliminate or reduce the potential of a failure mode. The method is applied to a simplified rotating machinery example in this paper, and is proposed as a means to account for helicopter failure modes during design and production, addressing stringent safety and performance requirements for NASA applications.

  15. Cardiovascular magnetic resonance in the evaluation of heart failure: a luxury or a need?

    PubMed

    D'Andrea, Antonello; Fontana, Marianna; Cocchia, Rosangela; Scarafile, Raffaella; Calabrò, Raffaele; Moon, James C

    2012-01-01

    Heart failure is a common syndrome with multiple causes. Cardiovascular magnetic resonance (CMR), using the available range of technique, is establishing itself as the gold standard noninvasive test for determining the underlying causes, and adding prognostic value, guiding therapy. Progress is continuing and rapid with promising new techniques such as diffuse fibrosis assessment. This article discusses the diverse roles of CMR in heart failure.

  16. Fiber-optic interferometric sensors for measurements of pressure fluctuations: Experimental evaluation

    NASA Technical Reports Server (NTRS)

    Cho, Y. C.; Soderman, P. T.

    1993-01-01

    This paper addresses an anechoic chamber evaluation of a fiber-optic interferometric sensor (fiber-optic microphone), which is being developed at NASA Ames Research Center for measurements of pressure fluctuations in wind tunnels.

  17. Transient Analysis of X-34 Pressurization System

    NASA Technical Reports Server (NTRS)

    Hedayat, A.; Knight, K. C.; Champion, R. H., Jr.

    1998-01-01

    Two transient operational modes of the X-34 pressurization system were analyzed using the ROCket Engine Transition Simulation (ROCETS) program. The first operational mode considers the normal operation. For the engine burn period, the required helium mass and pressure of each propellant tank were calculated. In the second case, the possibility of failure of the pressurization system solenoid valves, its consequence on the over-pressurization, and simultaneous operation of pressurization and vent/relief systems were evaluated.

  18. [Evaluation of growth hormone treatment results in children with chronic renal failure--one center experience].

    PubMed

    Szczepańska, Maria; Broll, Iwona; Dymon, Izabela; Szprynger, Krystyna

    2008-01-01

    The study aimed at the retrospective evaluation of rhGH treatment results in children with chronic renal failure CRF and short stature treated at Dpt. and Clinic of Pediatrics, Dialysis Unit and Ambulatory in Zabrze, Medical University of Silesia in Katowice. Medical records of 21 children at mean age of 11.0 years (7 girls and 14 boys) were analysed. Eleven children remained on renal replacement therapy. The mean dose of rhGH was 1.1 UI/kg/week). Five children are still on rhGH treatment. Mean growth velocity during rhGH treatment was 15.2 cm/ total period of treatment, 6.98 cm/year. Mean SDS of growth at the beginning of treatment was: -3.25, at the end of treatment: -2.76 (p < 0.02). PTH value 123.6 pg/ml, at the end of treatment 241.29 pg/mL (p < 0.05). RhGH treatment in children with CRF gives the opportunity to gain the final height compared to healthy children.

  19. Evaluation of maximum O2 consumption: using ergo-spirometry in severe heart failure.

    PubMed

    Malekmohammad, Majid; Ahmadi-Nejad, Mehdi; Adimi, Parisa; Jamaati, Hamid-Reza; Marashian, Sayed Mehran

    2012-01-01

    Although sport-physiologists have repeatedly analyzed respiratory gases through exercise, it is relatively new in the cardiovascular field and is obviously more acceptable than standard exercise test, which gives only information about the existence or absence of cardiovascular diseases (CVDs). Through the new method of exercise test, parameters including aerobic and anaerobic are checked and monitored. 22 severe cases of heart failure, who were candidates of heart transplantation, referring to Massih Daneshvari Hospital in Tehran from Nov. 2007 to Nov. 2008 enrolled this study. The study was designed as a cross-sectional performance and evaluated only patients with ejection fraction less than 30%. O2 mean consumption was 6.27±4.9 ml/kg/min at rest and 9.48±3.38 at anaerobic threshold (AT) exceeding 13 ml/kg/min in maximum which was significantly more than the expected levels. Respiratory exchange ratio (RER) was over 1 for all patients. This study could not find any statistical correlations between VO2 max and participants' ergonomic factors such as age, height, weight, BMI, as well as EF. This study showed no significant correlation between VO2 max and maximum heart rate (HR max), although O2 maximum consumption was rationally correlated with expiratory ventilation. This means that the patients achieved maximum ventilation through exercise in this study, but failed to have their maximum heart rate being led probably by HF-induced brady-arrhythmia or deconditioning of skeletal muscles.

  20. Telephone counseling for patients with chronic heart failure: results of an evaluation study.

    PubMed

    Böhme, Sylvia; Geiser, Christian; Mühlenhoff, Thomas; Holtmann, Jana; Renneberg, Babette

    2012-09-01

    The effectiveness of a secondary prevention program for patients suffering from chronic heart failure (CHF) was evaluated. The program aimed at improving participants' perceived health and actual physical symptoms. Insurants of a German health insurance company participated in a telephone counseling program with four modules focusing on dietary habits, physical activity, fluid intake, and medication compliance. Multilevel analyses were conducted to analyze changes in health related outcome variables over time in N = 259 participants who completed the program in about 6 months. The results showed an improvement of perceived health status, physical symptoms, and somatic impairment. Furthermore, differential change was found when comparing "finishers" compared to "non-finishers" of specific modules indicating specific module effects. The results are auspicious and, if sustained, are expected to bring about long-term health benefits for our study's participants. The program proved to be applicable and well accepted in the sample of older, severely impaired CHF patients and effective in changing perceived health.

  1. Six minute walk test: a simple and useful test to evaluate functional capacity in patients with heart failure.

    PubMed

    Rostagno, Carlo; Gensini, Gian Franco

    2008-09-01

    In heart failure survival is closely related to functional capacity. Peak O2 consumption at cardiopulmonary exercise test (CPET) is considered the gold standard for the evaluation of exercise tolerance. Since >70% of patients with heart failure, usually elderly or with significant comorbidities, are referred to Departments of Internal Medicine where facilities for cardiopulmonary test are rarely available, CPET may be performed in <5% of the patients. Six-minute walk test (6MWT) has been proposed as a simple, inexpensive, reproducible alternative to CPET. The 6MWT reproduces the activity of daily life and this is particularly relevant in elderly patients who usually develop symptoms below their theoretical maximal exercise capacity. Despite some limits 6MWT is attractive for patients referred to Departments of Internal Medicine allowing an objective evaluation of exercise tolerance, a better prognostic evaluation and a guide to evaluate response to medical treatment.

  2. Evaluation of runner cone extension to dampen pressure pulsations in a Francis model turbine

    NASA Astrophysics Data System (ADS)

    Gogstad, Peter Joachim; Dahlhaug, Ole Gunnar

    2016-11-01

    Today's energy market has a high demand of flexibility due to introduction of other intermittent renewables as wind and solar. To ensure a steady power supply, hydro turbines are often forced to operate more at part load conditions. Originally, turbines were built for steady operation around the best efficiency point. The demand of flexibility, combined with old designs has showed an increase in turbines having problems with hydrodynamic instabilities such as pressure pulsations. Different methods have been investigated to mitigate pressure pulsations. Air injection shows a significant reduction of pressure pulsation amplitudes. However, installation of air injection requires extra piping and a compressor. Investigation of other methods such as shaft extension shows promising results for some operational points, but may significantly reduce the efficiency of the turbine at other operational points. The installation of an extension of the runner cone has been investigated at NTNU by Vekve in 2004. This has resulted in a cylindrical extension at Litjfossen Power Plant in Norway, where the bolt suffered mechanical failure. This indicates high amplitude pressure pulsations in the draft tube centre. The high pressure pulsation amplitudes are believed to be related to high tangential velocity in the draft tube. The mentioned runner cone extension has further been developed to a freely rotating extension. The objective is to reduce the tangential velocity in the draft tube and thereby the pressure pulsation amplitudes.

  3. A real-time simulation evaluation of an advanced detection. Isolation and accommodation algorithm for sensor failures in turbine engines

    NASA Technical Reports Server (NTRS)

    Merrill, W. C.; Delaat, J. C.

    1986-01-01

    An advanced sensor failure detection, isolation, and accommodation (ADIA) algorithm has been developed for use with an aircraft turbofan engine control system. In a previous paper the authors described the ADIA algorithm and its real-time implementation. Subsequent improvements made to the algorithm and implementation are discussed, and the results of an evaluation presented. The evaluation used a real-time, hybrid computer simulation of an F100 turbofan engine.

  4. A real-time simulation evaluation of an advanced detection, isolation and accommodation algorithm for sensor failures in turbine engines

    NASA Technical Reports Server (NTRS)

    Merrill, W. C.; Delaat, J. C.

    1986-01-01

    An advanced sensor failure detection, isolation, and accommodation (ADIA) algorithm has been developed for use with an aircraft turbofan engine control system. In a previous paper the authors described the ADIA algorithm and its real-time implementation. Subsequent improvements made to the algorithm and implementation are discussed, and the results of an evaluation presented. The evaluation used a real-time, hybrid computer simulation of an F100 turbofan engine.

  5. Classification and Prognostic Evaluation of Left Ventricular Remodeling in Patients With Asymptomatic Heart Failure.

    PubMed

    Pugliese, Nicola Riccardo; Fabiani, Iacopo; La Carrubba, Salvatore; Conte, Lorenzo; Antonini-Canterin, Francesco; Colonna, Paolo; Caso, Pio; Benedetto, Frank; Santini, Veronica; Carerj, Scipione; Romano, Maria Francesca; Citro, Rodolfo; Di Bello, Vitantonio

    2017-01-01

    Patients with asymptomatic heart failure (HF; stage A and B) are characterized by maladaptive left ventricular (LV) remodeling. Classic 4-group classification of remodeling considers only LV mass index and relative wall thickness as variables. Complex remodeling classification (CRC) includes also LV end-diastolic volume index. Main aim was to assess the prognostic impact of CRC in stage A and B HF. A total of 1,750 asymptomatic subjects underwent echocardiographic examination as a screening evaluation in the presence of cardiovascular risk factors. LV dysfunction, both systolic (ejection fraction) and diastolic (transmitral flow velocity pattern), was evaluated, together with LV remodeling. We considered a composite end point: all-cause death, myocardial infarction, coronary revascularizations, cerebrovascular events, and acute pulmonary edema. CRC was suitable for 1,729 patients (men 53.6%; age 58.3 ± 13 years). Two hundred thirty-eight patients presented systolic dysfunction (ejection fraction <50%) and 483 diastolic dysfunction. According to the CRC, 891 patients were normals or presented with physiologic hypertrophy, 273 concentric remodeling, 47 eccentric remodeling, 350 concentric hypertrophy, 29 mixed hypertrophy, 86 dilated hypertrophy, and 53 eccentric hypertrophy. Age and gender distribution was noticed (p <0.001). After a median follow-up of 21 months, Kaplan-Meier analysis showed different survival distribution (p <0.001) of the CRC patterns. In multivariate Cox regression (adjusted for age, gender, history of stable ischemic heart disease, classic remodeling classification, systolic, and diastolic dysfunction), CRC was independent predictor of primary end point (p = 0.044, hazard ratio 1.101, 95% CI 1.003 to 1.21), confirmed in a logistic regression (p <0.03). In conclusion, CRC could help physicians in prognostic stratification of patients in stage A and B HF. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. An Economic Evaluation of Sacubitril/Valsartan for Heart Failure Patients in the Netherlands.

    PubMed

    van der Pol, Simon; Degener, Fabian; Postma, Maarten J; Vemer, Pepijn

    2017-03-01

    In September 2014, the PARADIGM-HF trial showed the heart failure drug combination sacubitril/valsartan to be superior to enalapril for patients with a reduced ejection fraction. To determine the incremental cost-effectiveness of sacubitril/valsartan compared with enalapril in the Netherlands using the clinical data from the PARADIGM-HF trial. To compare sacubitril/valsartan and enalapril in a cost-effectiveness study, a Markov model was developed using the effectiveness data from the PARADIGM-HF trial. A health care payer's perspective was applied in the economic evaluation. The developed model was used to evaluate the cost-effectiveness for sacubitril/valsartan at different per diem prices. The base-case analysis showed that sacubitril/valsartan can be cost-effective at maximum daily costs of €5.50 and €14.14 considering willingness-to-pay thresholds of €20,000 and €50,000 per quality-adjusted life-year (QALY), respectively. Sensitivity analysis demonstrated the robustness of the model, identifying only the price of sacubitril/valsartan and the mortality within the sacubitril/valsartan group as significant drivers of the cost-effectiveness ratio. Sacubitril/valsartan was cost-effective at a willingness-to-pay threshold of €20,000 per QALY (€50,000 per QALY) in more than 80% of the replications with certainty at the price point of €3 (€10). Sacubitril/valsartan can be considered a cost-effective treatment at a daily price of €5.25. Unless priced lower than enalapril (<€0.045 per day), sacubitril/valsartan is very unlikely to be cost-saving/dominant. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  7. Evaluation of the Incremental Prognostic Utility of Increasingly Complex Testing in Chronic Heart Failure.

    PubMed

    Ahmad, Tariq; O'Brien, Emily C; Schulte, Phillip J; Stevens, Susanna R; Fiuzat, Mona; Kitzman, Dalane W; Adams, Kirkwood F; Kraus, William E; Piña, Ileana L; Donahue, Mark P; Zannad, Faiez; Whellan, David J; O'Connor, Christopher M; Felker, G Michael

    2015-07-01

    Current heart failure (HF) risk prediction models do not consider how individual patient assessments occur in incremental steps; furthermore, each additional diagnostic evaluation may add cost, complexity, and potential morbidity. Using a cohort of well-treated ambulatory HF patients with reduced ejection fraction who had complete clinical, laboratory, health-related quality of life, imaging, and exercise testing data, we estimated incremental prognostic information provided by 5 assessment categories, performing an additional analysis on those with available N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. We compared the incremental value of each additional assessment (quality of life screen, laboratory testing, echocardiography, and exercise testing) to baseline clinical assessment for predicting clinical outcomes (all-cause mortality, all-cause mortality/hospitalization, and cardiovascular death/HF hospitalizations), gauging incremental improvements in prognostic ability with more information using area under the curve and reclassification improvement (net reclassification index), with and without NT-proBNP availability. Of 2331 participants, 1631 patients had complete clinical data; of these, 1023 had baseline NT-proBNP. For prediction of all-cause mortality, models with incremental assessments sans NT-proBNP showed improvements in C-indices (0.72 [clinical model alone]-0.77 [complete model]). Compared with baseline clinical assessment alone, net reclassification index improved from 0.035 (w/laboratory data) to 0.085 (complete model). These improvements were significantly attenuated for models in the subset with measured NT-proBNP data (c-indices: 0.80 [w/laboratory data]-0.81 [full model]); net reclassification index improvements were similarly marginal (0.091→0.096); prediction of other clinical outcomes had similar findings. In chronic HF patients with reduced ejection fraction, the marginal benefit of complex prognostic evaluations should be

  8. 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).

  9. Clinical characteristics of resistant hypertension evaluated by ambulatory blood pressure monitoring.

    PubMed

    Kansui, Yasuo; Matsumura, Kiyoshi; Kida, Haruko; Sakata, Satoko; Ohtsubo, Toshio; Ibaraki, Ai; Kitazono, Takanari

    2014-01-01

    Strict control of blood pressure is important to prevent cardiovascular disease, although it is sometimes difficult to decrease blood pressure to target levels. The aim of this study was to investigate the clinical characteristics of resistant hypertension evaluated by ambulatory blood pressure monitoring. One hundred in-hospital patients, whose 24-hour average blood pressure was higher than 130/80 mmHg even after treatment with more than three antihypertensive drugs, were included in the present analysis. Circadian variation of blood pressure was evaluated by nocturnal fall in systolic blood pressure. Average blood pressures of all patients were high in both daytime and nighttime, 150.0/82.9 and 143.8/78.2 mmHg, respectively. Twenty patients had been treated with hemodialysis or peritoneal dialysis. In 63 patients out of the other 80 patients (79%), estimated glomerular filtration rate (eGFR) was also decreased (<60 mL/min/1.73 m²). The patients classified into dipper, non-dipper, riser and extreme-dipper were 20%, 43%, 34% and 3%, respectively. In addition, in 17 patients whose eGFR was preserved, 12 patients showed a non-dipper or riser pattern, suggesting that it was difficult to account for this altered circadian blood pressure variation only by renal dysfunction. These results show that a large number of the patients with resistant hypertension suffered from renal dysfunction, although it was difficult to explain altered circadian blood pressure variation based on renal dysfunction alone.

  10. Evidence-Based Medicine: The Evaluation and Treatment of Pressure Injuries.

    PubMed

    Ricci, Joseph A; Bayer, Lauren R; Orgill, Dennis P

    2017-01-01

    After studying this article, the participant should be able to: 1. Discuss the approach to and rationale for pressure injury management, including specific techniques for prevention and preoperative evaluation. 2. Develop a management algorithm for these wounds that includes operative and nonoperative modalities. 3. Understand how to identify and manage the complications of surgical intervention for pressure injuries, including recurrence. Pressure injuries are a common problem associated with great morbidity and cost, often presenting as complex challenges for plastic surgeons. Although the cause of these wounds is largely prolonged pressure, the true pathogenesis involves many other factors, including friction, shear, moisture, nutrition, and infection. This article outlines a systematic approach to evaluating and staging pressure injuries, and provides strategies for treatment and prevention. Critical to surgical intervention is thorough débridement, including any involved or causative bony tissues, and postoperative management to prevent wound dehiscence and recurrence.

  11. Evaluation of the Del Mar Avionics automatic ambulatory blood pressure-recording device.

    PubMed

    Sheps, S G; Elveback, L R; Close, E L; Kleven, M K; Bissen, C

    1981-12-01

    We have the opportunity to evaluate a portable ambulatory device for the recording of sequential indirect arterial blood pressure and continuous electrocardiogram (Del Mar Avionics automatic ambulatory blood pressure recording device). With careful attention to technique, only 11% of systolic and 5% of diastolic blood pressure readings differed by more than 10 mm Hg as compared with a trained technician's observations simultaneously in the same arm. The device has been useful in the evaluation of borderline (labile) hypertension, hypertensive drug therapy programs, and various episodic cardiovascular phenomena--for example, vasodepressor syncope and pheochromocytoma crises.

  12. A program to evaluate a control system based on feedback of aerodynamic pressure differentials, part 1

    NASA Technical Reports Server (NTRS)

    Hrabak, R. R.; Levy, D. W.; Finn, P.; Roskam, J.

    1981-01-01

    The use of pressure differentials in a flight control system was evaluated. The pressure profile around the test surface was determined using two techniques: (1) windtunnel data (actual); and (2) NASA/Langley Single Element Airfoil Computer Program (theoretical). The system designed to evaluate the concept of using pressure differentials is composed of a sensor drive and power amplifiers, actuator, position potentiometer, and a control surface. The characteristics (both desired and actual) of the system and each individual component were analyzed. The desired characteristics of the system as a whole are given. The flight control system developed, the testing procedures and data reduction methods used, and theoretical frequency response analysis are described.

  13. A program to evaluate a control system based on feedback of aerodynamic pressure differentials

    NASA Technical Reports Server (NTRS)

    Levy, D. W.; Finn, P.; Roskam, J.

    1981-01-01

    The use of aerodynamic pressure differentials to position a control surface is evaluated. The system is a differential pressure command loop, analogous to a position command loop, where the surface is commanded to move until a desired differential pressure across the surface is achieved. This type of control is more direct and accurate because it is the differential pressure which causes the control forces and moments. A frequency response test was performed in a low speed wind tunnel to measure the performance of the system. Both pressure and position feedback were tested. The pressure feedback performed as well as position feedback implying that the actuator, with a break frequency on the order of 10 Rad/sec, was the limiting component. Theoretical considerations indicate that aerodynamic lags will not appear below frequencies of 50 Rad/sec, or higher.

  14. Endoplasmic reticulum stress sensor protein kinase R-like endoplasmic reticulum kinase (PERK) protects against pressure overload-induced heart failure and lung remodeling.

    PubMed

    Liu, Xiaoyu; Kwak, Dongmin; Lu, Zhongbing; Xu, Xin; Fassett, John; Wang, Huan; Wei, Yidong; Cavener, Douglas R; Hu, Xinli; Hall, Jennifer; Bache, Robert J; Chen, Yingjie

    2014-10-01

    Studies have reported that development of congestive heart failure is associated with increased endoplasmic reticulum stress. Double stranded RNA-activated protein kinase R-like endoplasmic reticulum kinase (PERK) is a major transducer of the endoplasmic reticulum stress response and directly phosphorylates eukaryotic initiation factor 2α, resulting in translational attenuation. However, the physiological effect of PERK on congestive heart failure development is unknown. To study the effect of PERK on ventricular structure and function, we generated inducible cardiac-specific PERK knockout mice. Under unstressed conditions, cardiac PERK knockout had no effect on left ventricular mass, or its ratio to body weight, cardiomyocyte size, fibrosis, or left ventricular function. However, in response to chronic transverse aortic constriction, PERK knockout mice exhibited decreased ejection fraction, increased left ventricular fibrosis, enhanced cardiomyocyte apoptosis, and exacerbated lung remodeling in comparison with wild-type mice. PERK knockout also dramatically attenuated cardiac sarcoplasmic reticulum Ca(2+)-ATPase expression in response to aortic constriction. Our findings suggest that PERK is required to protect the heart from pressure overload-induced congestive heart failure.

  15. Left Atrial Expansion Index Predicts Left Ventricular Filling Pressure and Adverse Events in Acute Heart Failure With Severe Left Ventricular Dysfunction.

    PubMed

    Hsiao, Shih-Hung; Chu, Kuo-An; Wu, Chieh-Jen; Chiou, Kuan-Rau

    2016-04-01

    The power of left atrial (LA) parameters for predicting left ventricular (LV) filling pressure and adverse events in acute heart failure (HF) with severe LV dysfunction, either sinus rhythm or atrial fibrillation (AF), is not fully understood. Echocardiography was performed in 141 patients with acute decompensated congestive HF and LV ejection fraction <35%, including 42 with permanent AF. The LA expansion index was calculated as (Volmax - Volmin) × 100%/Volmin, where Volmax was defined as maximal and Volmin as minimal LA volume. Of 141 patients, invasive LV filling pressures within 12 hours of LA expansion index measurement were available in 109. The end points were 3-year frequencies of HF hospitalization and all-cause mortality. Over a median follow-up of 3.1 years, 74 participants (52.5%) reached the end points (sinus vs AF group: 48.5% vs 61.9%, respectively; P = .047). Multivariate analysis revealed that adverse events of both groups were only independently associated with age and LA expansion index. Rates of adverse events were proportional to LA expansion index. There was a good logarithmic relationship between LA expansion index and LV filling pressure, regardless of presence or absence of AF. LV filling pressure can be estimated well by LA expansion index, with or without AF. The LA expansion index predicts adverse events in HF patients with severe systolic dysfunction. (ClinicalTrials.gov number: NCT01307722). Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Cardiac resynchronization therapy in patients with heart failure and a QRS complex <120 milliseconds: the Evaluation of Resynchronization Therapy for Heart Failure (LESSER-EARTH) trial.

    PubMed

    Thibault, Bernard; Harel, François; Ducharme, Anique; White, Michel; Ellenbogen, Kenneth A; Frasure-Smith, Nancy; Roy, Denis; Philippon, François; Dorian, Paul; Talajic, Mario; Dubuc, Marc; Guerra, Peter G; Macle, Laurent; Rivard, Léna; Andrade, Jason; Khairy, Paul

    2013-02-26

    Although the benefits of cardiac resynchronization therapy are well established in selected patients with heart failure and a prolonged QRS duration, salutary effects in patients with narrow QRS complexes remain to be demonstrated. The Evaluation of Resynchronization Therapy for Heart Failure (LESSER-EARTH) trial is a randomized, double-blind, 12-center study that was designed to compare the effects of active and inactive cardiac resynchronization therapy in patients with severe left ventricular dysfunction and a QRS duration <120 milliseconds. The trial was interrupted prematurely by the Data Safety and Monitoring Board because of futility and safety concerns after 85 patients were randomized. Changes in exercise duration after 12 months were no different in patients with and without active cardiac resynchronization therapy (-0.7 minutes [95% confidence interval (CI), -2.9 to 1.5] versus 0.8 minutes [95% CI, -1.2 to 2.9]; P=0.31]. Similarly, no significant differences were observed in left ventricular end-systolic volumes (-6.4 mL [95% CI, -18.8 to 5.9] versus 3.1 mL [95% CI, -9.2 to 15.5]; P=0.28) and ejection fraction (3.3% [95% CI, 0.7-6.0] versus 2.1% [95% CI, -0.5 to 4.8]; P=0.52). Moreover, cardiac resynchronization therapy was associated with a significant reduction in the 6-minute walk distance (-11.3 m [95% CI, -31.7 to 9.7] versus 25.3 m [95% CI, 6.1-44.5]; P=0.01), an increase in QRS duration (40.2 milliseconds [95% CI, 34.2-46.2] versus 3.4 milliseconds [95% CI, 0.6-6.2]; P<0.0001), and a nonsignificant trend toward an increase in heart failure-related hospitalizations (15 hospitalizations in 5 patients versus 4 hospitalizations in 4 patients). In patients with a left ventricular ejection fraction ≤35%, symptoms of heart failure, and a QRS duration <120 milliseconds, cardiac resynchronization therapy did not improve clinical outcomes or left ventricular remodeling and was associated with potential harm. URL: http://www.clinicaltrials.gov. Unique

  17. Relief and Recurrence of Congestion During and After Hospitalization for Acute Heart Failure: Insights From Diuretic Optimization Strategy Evaluation in Acute Decompensated Heart Failure (DOSE-AHF) and Cardiorenal Rescue Study in Acute Decompensated Heart Failure (CARESS-HF).

    PubMed

    Lala, Anuradha; McNulty, Steven E; Mentz, Robert J; Dunlay, Shannon M; Vader, Justin M; AbouEzzeddine, Omar F; DeVore, Adam D; Khazanie, Prateeti; Redfield, Margaret M; Goldsmith, Steven R; Bart, Bradley A; Anstrom, Kevin J; Felker, G Michael; Hernandez, Adrian F; Stevenson, Lynne W

    2015-07-01

    Congestion is the most frequent cause for hospitalization in acute decompensated heart failure. Although decongestion is a major goal of acute therapy, it is unclear how the clinical components of congestion (eg, peripheral edema, orthopnea) contribute to outcomes after discharge or how well decongestion is maintained. A post hoc analysis was performed of 496 patients enrolled in the Diuretic Optimization Strategy Evaluation in Acute Decompensated Heart Failure (DOSE-AHF) and Cardiorenal Rescue Study in Acute Decompensated Heart Failure (CARRESS-HF) trials during hospitalization with acute decompensated heart failure and clinical congestion. A simple orthodema congestion score was generated based on symptoms of orthopnea (≥2 pillows=2 points, <2 pillows=0 points) and peripheral edema (trace=0 points, moderate=1 point, severe=2 points) at baseline, discharge, and 60-day follow-up. Orthodema scores were classified as absent (score of 0), low-grade (score of 1-2), and high-grade (score of 3-4), and the association with death, rehospitalization, or unscheduled medical visits through 60 days was assessed. At baseline, 65% of patients had high-grade orthodema and 35% had low-grade orthodema. At discharge, 52% patients were free from orthodema at discharge (score=0) and these patients had lower 60-day rates of death, rehospitalization, or unscheduled visits (50%) compared with those with low-grade or high-grade orthodema (52% and 68%, respectively; P=0.038). Of the patients without orthodema at discharge, 27% relapsed to low-grade orthodema and 38% to high-grade orthodema at 60-day follow-up. Increased severity of congestion by a simple orthodema assessment is associated with increased morbidity and mortality. Despite intent to relieve congestion, current therapy often fails to relieve orthodema during hospitalization or to prevent recurrence after discharge. URL: http://www.clinicaltrials.gov. Unique identifiers: NCT00608491, NCT00577135. © 2015 American Heart

  18. Effect of assembly error of bipolar plate on the contact pressure distribution and stress failure of membrane electrode assembly in proton exchange membrane fuel cell

    NASA Astrophysics Data System (ADS)

    Liu, Dong'an; Peng, Linfa; Lai, Xinmin

    In practice, the assembly error of the bipolar plate (BPP) in a PEM fuel cell stack is unavoidable based on the current assembly process. However its effect on the performance of the PEM fuel cell stack is not reported yet. In this study, a methodology based on FEA model, "least squares-support vector machine (LS-SVM)" simulation and statistical analysis is developed to investigate the effect of the assembly error of the BPP on the pressure distribution and stress failure of membrane electrode assembly (MEA). At first, a parameterized FEA model of a metallic BPP/MEA assembly is established. Then, the LS-SVM simulation process is conducted based on the FEA model, and datasets for the pressure distribution and Von Mises stress of MEA are obtained, respectively for each assembly error. At last, the effect of the assembly error is obtained by applying the statistical analysis to the LS-SVM results. A regression equation between the stress failure and the assembly error is also built, and the allowed maximum assembly error is calculated based on the equation. The methodology in this study is beneficial to understand the mechanism of the assembly error and can be applied to guide the assembly process for the PEM fuel cell stack.

  19. Comparison of Comfort and Effectiveness of Total Face Mask and Oronasal Mask in Noninvasive Positive Pressure Ventilation in Patients with Acute Respiratory Failure: A Clinica