Pilot Preferences on Displayed Aircraft Control Variables

NASA Technical Reports Server (NTRS)

Trujillo, Anna C.; Gregory, Irene M.

2013-01-01

The experiments described here explored how pilots want available maneuver authority information transmitted and how this information affects pilots before and after an aircraft failure. The aircraft dynamic variables relative to flight performance were narrowed to energy management variables. A survey was conducted to determine what these variables should be. Survey results indicated that bank angle, vertical velocity, and airspeed were the preferred variables. Based on this, two displays were designed to inform the pilot of available maneuver envelope expressed as bank angle, vertical velocity, and airspeed. These displays were used in an experiment involving control surface failures. Results indicate the displayed limitations in bank angle, vertical velocity, and airspeed were helpful to the pilots during aircraft surface failures. However, the additional information did lead to a slight increase in workload, a small decrease in perceived aircraft flying qualities, and no effect on aircraft situation awareness.

Using Faculty Learning Communities to Link FYE and High-Risk Core Courses: A Pilot Study

ERIC Educational Resources Information Center

Cuevas, Mo; Campbell, Kendra; Lowery-Hart, Russell D.; Mallard, Jessica; Andersen, Amy

2013-01-01

Can success rates in a gateway course be improved by linking it to a college success course? This article describes the results of a pilot study that linked a first-year biology course that had a high drop-out and failure rate to a college success course that included study skills. The proposal to link courses came from the work of a faculty…

Research on computer aided testing of pilot response to critical in-flight events

NASA Technical Reports Server (NTRS)

Giffin, W. C.; Rockwell, T. H.; Smith, P. J.

1984-01-01

Experiments on pilot decision making are described. The development of models of pilot decision making in critical in flight events (CIFE) are emphasized. The following tests are reported on the development of: (1) a frame system representation describing how pilots use their knowledge in a fault diagnosis task; (2) assessment of script norms, distance measures, and Markov models developed from computer aided testing (CAT) data; and (3) performance ranking of subject data. It is demonstrated that interactive computer aided testing either by touch CRT's or personal computers is a useful research and training device for measuring pilot information management in diagnosing system failures in simulated flight situations. Performance is dictated by knowledge of aircraft sybsystems, initial pilot structuring of the failure symptoms and efficient testing of plausible causal hypotheses.

Psychoeducational support to post cardiac surgery heart failure patients and their partners--a randomised pilot study.

PubMed

Ågren, Susanna; Berg, Sören; Svedjeholm, Rolf; Strömberg, Anna

2015-02-01

Postoperative heart failure is a serious complication that changes the lives of both the person who is critically ill and family in many ways. The purpose of this study was to evaluate the effects of an intervention in postoperative heart failure patient-partner dyads regarding health, symptoms of depression and perceived control. Pilot study with a randomised controlled design evaluating psychosocial support and education from an interdisciplinary team. Patients with postoperative heart failure and their partners. SF-36, Beck Depression Inventory, Perceived Control at baseline, 3 and 12 months. A total of 42 patient-partner completed baseline assessment. Partners in the intervention group increased health in the role emotional and mental health dimensions and patients increased health in vitality, social function and mental health dimensions compared with the control group. Patients' perceived control improved significantly in the intervention group over time. Psychoeducational support to post cardiac surgery heart failure dyads improved health in both patients and partners at short term follow-up and improved patients' perceived control at both short and long-term follow-up. Psychoeducational support appears to be a promising intervention but the results need to be confirmed in larger studies. Copyright © 2014 Elsevier Ltd. All rights reserved.

Analysis of rockbolt performance at the Waste Isolation Pilot Plant

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

Terrill, L.J.; Francke, C.T.; Saeb, S.

Rockbolt failures at the Waste Isolation Pilot Plant have been recorded since 1990 and are categorized in terms of mode of failure. The failures are evaluated in terms of physical location of installation within the mine, local excavation geometry and stratigraphy, proximity to other excavations or shafts, and excavation age. The database of failures has revealed discrete ares of the mine containing relatively large numbers of failures. The results of metallurgical analyses and standard rockbolt load testing have generally been in agreement with the in situ evaluations.

Different acute cardiovascular stress in response to resistance exercise leading to failure versus not to failure in elderly women with and without hypertension--a pilot study.

PubMed

Tajra, Vitor; Vieira, Denis C L; Tibana, Ramires A; Teixeira, Tatiane G; Silva, Alessandro O; Farias, Darlan L; Nascimento, Dahan da C; de Sousa, Nuno M F; Willardson, Jeffrey; Prestes, Jonato

2015-03-01

The purpose of the present study was to compare the effects of resistance exercise (RE) leading to failure versus not to failure on 24-h blood pressure (BP) and rate-pressure product (RPP) responses in normotensive and hypertensive trained elderly women. Seven normotensive women and seven women with medically documented hypertension randomly performed three experimental sessions: (i) a non-exercise control session that involved 30 min of seated rest, (ii) whole body RE leading to failure that involved three sets with an eight repetitions maximum (8RM) load and (iii) whole body RE not to failure that involved three sets with 70% of an 8RM load. Systolic BP (SBP), diastolic BP (DBP) and mean BP (MBP) responses during each hour of sleep and awake states were measured. Results of all subjects revealed that the RPP was higher (P ≤ 0.05) during afternoon and night hours after the RE session leading to failure versus not to failure and the non-exercise control session. For the hypertensive group during the night hours, SBP remained higher after the RE session not to failure (P = 0.047) versus non-exercise control session. For the normotensive group, DBP remained higher after the RE session leading to failure over the 24-h period (approximately 8 mmHg h(-1), P = 0.044) and the period upon awaking (approximately 5 mmHg h(-1), P = 0.044) versus the hypertensive group. The normotensive elderly women of this pilot study presented a greater cardiovascular response to RE leading to failure, as a consequence of the higher training intensity. © 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Development and pilot testing of a disease management program for low literacy patients with heart failure.

PubMed

DeWalt, Darren A; Pignone, Michael; Malone, Robb; Rawls, Cathy; Kosnar, Margaret C; George, Geeta; Bryant, Betsy; Rothman, Russell L; Angel, Bonnie

2004-10-01

Development and pilot testing of a disease management program for low literacy patients with heart failure. Randomized trials have shown that disease management programs can reduce hospitalizations and improve symptoms for patients with congestive heart failure. We sought to create and pilot test such a program for patients with low literacy skills. We used focus groups and individual cognitive response interviews (CRIs) to develop an educational booklet for low literacy patients with heart failure. We incorporated the booklet into a disease management intervention that also included an initial individualized 1-h educational session and scheduled supportive phone calls that were tapered over 6 weeks. We then conducted a 3-month before-after study on patients with low literacy skills (<9th grade literacy level) in a university internal medicine clinic to test the acceptability and efficacy of our program. Outcomes of interest included heart failure-related knowledge, self-care behavior and heart failure-related symptoms measured on the Minnesota Living with Heart Failure (MLwHF) scale. Twenty-five patients were enrolled and 23 (92%) completed 3-month follow-up. Mean age was 60 years (range 35-74), 60% were men, 60% were African-American, and 74% had household income under $15,000 per year. The median reading level was fifth grade with 32% reading at or below the third grade level. Mean knowledge score at baseline was 67% and did not improve after the intervention. The proportion of patients reporting weighing themselves daily increased from 32% at baseline to 100% at 12 weeks. Mean improvement on the MLwHF scale was 9.9 points over the 3-month trial (95% CI: 0.5, 19.2), which corresponds to an improvement in one class on the New York Heart Association heart failure scale. A heart failure disease management program designed specifically for patients with low literacy skills is acceptable and is associated with improvement in self-care behavior and heart failure related symptoms.

Pilots Rate Augmented Generalized Predictive Control for Reconfiguration

NASA Technical Reports Server (NTRS)

Soloway, Don; Haley, Pam

2004-01-01

The objective of this paper is to report the results from the research being conducted in reconfigurable fight controls at NASA Ames. A study was conducted with three NASA Dryden test pilots to evaluate two approaches of reconfiguring an aircraft's control system when failures occur in the control surfaces and engine. NASA Ames is investigating both a Neural Generalized Predictive Control scheme and a Neural Network based Dynamic Inverse controller. This paper highlights the Predictive Control scheme where a simple augmentation to reduce zero steady-state error led to the neural network predictor model becoming redundant for the task. Instead of using a neural network predictor model, a nominal single point linear model was used and then augmented with an error corrector. This paper shows that the Generalized Predictive Controller and the Dynamic Inverse Neural Network controller perform equally well at reconfiguration, but with less rate requirements from the actuators. Also presented are the pilot ratings for each controller for various failure scenarios and two samples of the required control actuation during reconfiguration. Finally, the paper concludes by stepping through the Generalized Predictive Control's reconfiguration process for an elevator failure.

Intelligent Pilot Aids for Flight Re-Planning in Emergencies

NASA Technical Reports Server (NTRS)

Pritchett, Amy R.; Ockerman, Jennifer

2005-01-01

Effective and safe control of an aircraft may be difficult or nearly impossible for a pilot following an unexpected system failure. Without prior training, the pilot must ascertain on the fly those changes in both manual control technique and procedures that will lead to a safe landing of the aircraft. Sophisticated techniques for determining the required control techniques are now available. Likewise, a body of literature on pilot decision making provides formalisms for examining how pilots approach discrete decisions framed as the selection between options. However, other aspects of behavior, such as the task of route planning and guidance, are not as well studied. Not only is the pilot faced with possible performance changes to the aircraft dynamics, but he or she is also tasked to create a plan of actions that will effectively take the aircraft down to a safe landing. In this plan, the many actions that the pilot can perform are closely intertwined with the trajectory of the aircraft, making it difficult to accurately predict the final outcome. Coupled with the vast number of potential actions to be taken, this problem may seem intractable. This is reflected in the lack of a pre-specified procedure capable of giving pilots the ability to find a resolution for this task. This report summarizes a multi-year effort to examine methods to aid pilots in planning an approach and arrival to an airport following an aircraft systems failure. Ultimately, we hypothesize that automatic assistance to pilots can be provided in real-time in the form of improving pilot control of a damaged aircraft and providing pilots with procedural directives suitable for critical flight conditions; such systems may also benefit pilot training and procedure design. To achieve this result, a systematic, comprehensive research program was followed, building on prior research. This approach included a pencil-and-paper study with airline pilots examining methods of representing a flight route in an immediately understandable manner, and in a manner that would allow the pilot to modify an automatically-generated route and/or detect any inappropriate elements in an automatically-generated route. Likewise, a flight simulator study examined different cockpit systems for the relative merits of providing pilots with any of a variety of automated functions for emergency flight planning. The results provide specific guidance for the design of such systems.

Modeling fault diagnosis as the activation and use of a frame system. [for pilot problem-solving rating

NASA Technical Reports Server (NTRS)

Smith, Philip J.; Giffin, Walter C.; Rockwell, Thomas H.; Thomas, Mark

1986-01-01

Twenty pilots with instrument flight ratings were asked to perform a fault-diagnosis task for which they had relevant domain knowledge. The pilots were asked to think out loud as they requested and interpreted information. Performances were then modeled as the activation and use of a frame system. Cognitive biases, memory distortions and losses, and failures to correctly diagnose the problem were studied in the context of this frame system model.

Prospective memory failures in aviation: effects of cue salience, workload, and individual differences.

PubMed

Van Benthem, Kathleen D; Herdman, Chris M; Tolton, Rani G; LeFevre, Jo-Anne

2015-04-01

Prospective memory allows people to complete intended tasks in the future. Prospective memory failures, such as pilots forgetting to inform pattern traffic of their locations, can have fatal consequences. The present research examined the impact of system factors (memory cue salience and workload) and individual differences (pilot age, cognitive health, and expertise) on prospective memory for communication tasks in the cockpit. Pilots (N = 101) flew a Cessna 172 simulator at a non-towered aerodrome while maintaining communication with traffic and attending to flight parameters. Memory cue salience (the prominence of cues that signal an intended action) and workload were manipulated. Prospective memory was measured as radio call completion rates. Pilots' prospective memory was adversely affected by low-salience cues and high workload. An interaction of cue salience, pilots' age, and cognitive health reflected the effects of system and individual difference factors on prospective memory failures. For example, younger pilots with low levels of cognitive health completed 78% of the radio calls associated with low-salience memory cues, whereas older pilots with low cognitive health scores completed just 61% of similar radio calls. Our findings suggest that technologies designed to signal intended future tasks should target those tasks with inherently low-salience memory cues. In addition, increasing the salience of memory cues is most likely to benefit pilots with lower levels of cognitive health in high-workload conditions.

Effects of visual and motion simulation cueing systems on pilot performance during takeoffs with engine failures

NASA Technical Reports Server (NTRS)

Parris, B. L.; Cook, A. M.

1978-01-01

Data are presented that show the effects of visual and motion during cueing on pilot performance during takeoffs with engine failures. Four groups of USAF pilots flew a simulated KC-135 using four different cueing systems. The most basic of these systems was of the instrument-only type. Visual scene simulation and/or motion simulation was added to produce the other systems. Learning curves, mean performance, and subjective data are examined. The results show that the addition of visual cueing results in significant improvement in pilot performance, but the combined use of visual and motion cueing results in far better performance.

Numerical and flight simulator test of the flight deterioration concept

NASA Technical Reports Server (NTRS)

Mccarthy, J.; Norviel, V.

1982-01-01

Manned flight simulator response to theoretical wind shear profiles was studied in an effort to calibrate fixed-stick and pilot-in-the-loop numerical models of jet transport aircraft on approach to landing. Results of the study indicate that both fixed-stick and pilot-in-the-loop models overpredict the deleterious effects of aircraft approaches when compared to pilot performance in the manned simulator. Although the pilot-in-the-loop model does a better job than does the fixed-stick model, the study suggests that the pilot-in-the-loop model is suitable for use in meteorological predictions of adverse low-level wind shear along approach and departure courses to identify situations in which pilots may find difficulty. The model should not be used to predict the success or failure of a specific aircraft. It is suggested that the pilot model be used as part of a ground-based Doppler radar low-level wind shear detection and warning system.

A failure effects simulation of a low authority flight control augmentation system on a UH-1H helicopter

NASA Technical Reports Server (NTRS)

Corliss, L. D.; Talbot, P. D.

1977-01-01

A two-pilot moving base simulator experiment was conducted to assess the effects of servo failures of a flight control system on the transient dynamics of a Bell UH-1H helicopter. The flight control hardware considered was part of the V/STOLAND system built with control authorities of from 20-40%. Servo hardover and oscillatory failures were simulated in each control axis. Measurements were made to determine the adequacy of the failure monitoring system time delay and the servo center and lock time constant, the pilot reaction times, and the altitude and attitude excursions of the helicopter at hover and 60 knots. Safe recoveries were made from all failures under VFR conditions. Pilot reaction times were from 0.5 to 0.75 sec. Reduction of monitor delay times below these values resulted in significantly reduced excursion envelopes. A subsequent flight test was conducted on a UH-1H helicopter with the V/STOLAND system installed. Series servo hardovers were introduced in hover and at 60 knots straight and level. Data from these tests are included for comparison.

Adaptive Controller Effects on Pilot Behavior

NASA Technical Reports Server (NTRS)

Trujillo, Anna C.; Gregory, Irene M.; Hempley, Lucas E.

2014-01-01

Adaptive control provides robustness and resilience for highly uncertain, and potentially unpredictable, flight dynamics characteristic. Some of the recent flight experiences of pilot-in-the-loop with an adaptive controller have exhibited unpredicted interactions. In retrospect, this is not surprising once it is realized that there are now two adaptive controllers interacting, the software adaptive control system and the pilot. An experiment was conducted to categorize these interactions on the pilot with an adaptive controller during control surface failures. One of the objectives of this experiment was to determine how the adaptation time of the controller affects pilots. The pitch and roll errors, and stick input increased for increasing adaptation time and during the segment when the adaptive controller was adapting. Not surprisingly, altitude, cross track and angle deviations, and vertical velocity also increase during the failure and then slowly return to pre-failure levels. Subjects may change their behavior even as an adaptive controller is adapting with additional stick inputs. Therefore, the adaptive controller should adapt as fast as possible to minimize flight track errors. This will minimize undesirable interactions between the pilot and the adaptive controller and maintain maneuvering precision.

Caregiving tasks and caregiver burden; effects of an psycho-educational intervention in partners of patients with post-operative heart failure.

PubMed

Ågren, Susanna; Strömberg, Anna; Jaarsma, Tiny; Luttik, Marie Louise A

2015-01-01

To evaluate the effects of a psycho-educational intervention on caregiver burden in partners of patients with postoperative heart failure. Since partners of cardiac surgery patients play a significant role in the patient's recovery, it is important to address their needs during hospitalization and after discharge. Forty-two patients with postoperative heart failure and their partners participated in a randomized controlled pilot study. Dyads in the intervention group received psycho-educational support from a multidisciplinary team. Dyads in the control group received usual care. No significant differences were found in the performance of caregiving tasks and perceived caregiver burden in the control versus the intervention group. A pilot study exploring the effects of a psycho-educational intervention in patients and their partners did not reveal significant effects with regard to reduced feelings of burden in partners. Alleviating caregiver burden in partners may need a more intense or specific approach. Copyright © 2015 Elsevier Inc. All rights reserved.

A Study of Longitudinal Control Problems at Low and Negative Damping and Stability with Emphasis on Effects of Motion Cues

NASA Technical Reports Server (NTRS)

Sadoff, Melvin; McFadden, Norman M.; Heinle, Donovan R.

1961-01-01

As part of a general investigation to determine the effects of simulator motions on pilot opinion and task performance over a wide range of vehicle longitudinal dynamics, a cooperative NASA-AMAL program was conducted on the centrifuge at Johnsville, Pennsylvania. The test parameters and measurements for this program duplicated those of earlier studies made at Ames Research Center with a variable-stability airplane and with a pitch-roll chair flight simulator. Particular emphasis was placed on the minimum basic damping and stability the pilots would accept and on the minimum dynamics they considered controllable in the event of stability-augmentation system failure. Results of the centrifuge-simulator program indicated that small positive damping was required by the pilots over most of the frequency range covered for configurations rated acceptable for emergency conditions only (e.g., failure of a pitch damper). It was shown that the pilot's tolerance for unstable dynamics was dependent primarily on the value of damping. For configurations rated acceptable for emergency operation only, the allowable instability and damping corresponded to a divergence time to double amplitude of about 1 second. Comparisons were made of centrifuge, pitch-chair and fixed-cockpit simulator tests with flight tests. Pilot ratings indicated that the effects of incomplete or spurious motion cues provided by these three modes of simulation were important only for high-frequency, lightly damped dynamics or unstable, moderately damped dynamics. The pitch- chair simulation, which provided accurate angular-acceleration cues to the pilot, compared most favorably with flight. For the centrifuge simulation, which furnished accurate normal accelerations but spurious pitching and longitudinal accelerations, there was a deterioration of pilots' opinion relative to flight results. Results of simulator studies with an analog pilot replacing the human pilot illustrated the adaptive capability of human pilots in coping with the wide range of vehicle dynamics and the control problems covered in this study. It was shown that pilot-response characteristics, deduced by the analog-pilot method, could be related to pilot opinion. Possible application of these results for predicting flight-control problems was illustrated by means of an example control-problem analysis. The results of a brief evaluation of a pencil-type side-arm controller in the centrifuge showed a considerable improvement in the pilots' ability to cope with high-frequency, low-damping dynamics, compared to results obtained with the center stick. This improvement with the pencil controller was attributed primarily to a marked reduction in the adverse effects of large and exaggerated pitching and longitudinal accelerations on pilot control precision.

Failure rates of mini-implants placed in the infrazygomatic region.

PubMed

Uribe, Flavio; Mehr, Rana; Mathur, Ajay; Janakiraman, Nandakumar; Allareddy, Veerasathpurush

2015-01-01

The purpose of this pilot study was to evaluate the failure rates of mini-implants placed in the infrazygomatic region and to evaluate factors that affect their stability. A retrospective cohort study of 30 consecutive patients (55 mini-implants) who had infrazygomatic mini-implants at a University Clinic were evaluated for failure rates. Patient, mini-implant, orthodontic, surgical, and mini-implant maintenance factors were evaluated by univariate logistic regression models for association to failure rates. A 21.8 % failure rate of mini-implants placed in the infazygomatic region was observed. None of the predictor variables were significantly associated with higher or lower odds for failed implants. Failure rates for infrazygomatic mini-implants were slightly higher than those reported in other maxilla-mandibular osseous locations. No predictor variables were found to be associated to the failure rates.

Inductive Learning Approaches for Improving Pilot Awareness of Aircraft Faults

NASA Technical Reports Server (NTRS)

Spikovska, Lilly; Iverson, David L.; Poll, Scott; Pryor, anna

2005-01-01

Neural network flight controllers are able to accommodate a variety of aircraft control surface faults without detectable degradation of aircraft handling qualities. Under some faults, however, the effective flight envelope is reduced; this can lead to unexpected behavior if a pilot performs an action that exceeds the remaining control authority of the damaged aircraft. The goal of our work is to increase the pilot s situational awareness by informing him of the type of damage and resulting reduction in flight envelope. Our methodology integrates two inductive learning systems with novel visualization techniques. One learning system, the Inductive Monitoring System (IMS), learns to detect when a simulation includes faulty controls, while two others, Inductive Classification System (INCLASS) and multiple binary decision tree system (utilizing C4.5), determine the type of fault. In off-line training using only non-failure data, IMS constructs a characterization of nominal flight control performance based on control signals issued by the neural net flight controller. This characterization can be used to determine the degree of control augmentation required in the pitch, roll, and yaw command channels to counteract control surface failures. This derived information is typically sufficient to distinguish between the various control surface failures and is used to train both INCLASS and C4.5. Using data from failed control surface flight simulations, INCLASS and C4.5 independently discover and amplify features in IMS results that can be used to differentiate each distinct control surface failure situation. In real-time flight simulations, distinguishing features learned during training are used to classify control surface failures. Knowledge about the type of failure can be used by an additional automated system to alter its approach for planning tactical and strategic maneuvers. The knowledge can also be used directly to increase the pilot s situational awareness and inform manual maneuver decisions. Our multi-modal display of this information provides speech output to issue control surface failure warnings to a lesser-used communication channel and provides graphical displays with pilot-selectable !eve!s of details to issues additional information about the failure. We also describe a potential presentation for flight envelope reduction that can be viewed separately or integrated with an existing attitude indicator instrument. Preliminary results suggest that the inductive approach is capable of detecting that a control surface has failed and determining the type of fault. Furthermore, preliminary evaluations suggest that the interface discloses a concise summary of this information to the pilot.

A case study in nonconformance and performance trend analysis

NASA Technical Reports Server (NTRS)

Maloy, Joseph E.; Newton, Coy P.

1990-01-01

As part of NASA's effort to develop an agency-wide approach to trend analysis, a pilot nonconformance and performance trending analysis study was conducted on the Space Shuttle auxiliary power unit (APU). The purpose of the study was to (1) demonstrate that nonconformance analysis can be used to identify repeating failures of a specific item (and the associated failure modes and causes) and (2) determine whether performance parameters could be analyzed and monitored to provide an indication of component or system degradation prior to failure. The nonconformance analysis of the APU did identify repeating component failures, which possibly could be reduced if key performance parameters were monitored and analyzed. The performance-trending analysis verified that the characteristics of hardware parameters can be effective in detecting degradation of hardware performance prior to failure.

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.

Quantifying Pilot Contribution to Flight Safety during Drive Shaft Failure

NASA Technical Reports Server (NTRS)

Kramer, Lynda J.; Etherington, Tim; Last, Mary Carolyn; Bailey, Randall E.; Kennedy, Kellie D.

2017-01-01

Accident statistics cite the flight crew as a causal factor in over 60% of large transport aircraft fatal accidents. Yet, a well-trained and well-qualified pilot is acknowledged as the critical center point of aircraft systems safety and an integral safety component of the entire commercial aviation system. The latter statement, while generally accepted, cannot be verified because little or no quantitative data exists on how and how many accidents/incidents are averted by crew actions. A joint NASA/FAA high-fidelity motion-base simulation experiment specifically addressed this void by collecting data to quantify the human (pilot) contribution to safety-of-flight and the methods they use in today's National Airspace System. A human-in-the-loop test was conducted using the FAA's Oklahoma City Flight Simulation Branch Level D-certified B-737-800 simulator to evaluate the pilot's contribution to safety-of-flight during routine air carrier flight operations and in response to aircraft system failures. These data are fundamental to and critical for the design and development of future increasingly autonomous systems that can better support the human in the cockpit. Eighteen U.S. airline crews flew various normal and non-normal procedures over a two-day period and their actions were recorded in response to failures. To quantify the human's contribution to safety of flight, crew complement was used as the experiment independent variable in a between-subjects design. Pilot actions and performance during single pilot and reduced crew operations were measured for comparison against the normal two-crew complement during normal and non-normal situations. This paper details the crew's actions, including decision-making, and responses while dealing with a drive shaft failure - one of 6 non-normal events that were simulated in this experiment.

Integrated Testing and Maintenance Technologies.

DTIC Science & Technology

1983-12-01

provides pilot cueing for mode failures of LRU’s. Equipment fail and status indicators are lighted displays that indicate specific failures within an...provided with appropriate display cueing only when a reversion results in some loss of capability or performance. Three forms of degraded mode advisories...are- a. Reversion to an alternative data source of equivalent accuracy with no pilot cueing . b. Reversion to an alternative data source of lesser

Growth failure, somatomedin and growth hormone levels in juvenile diabetes mellitus--a pilot study.

PubMed

Nash, H

1979-06-01

Growth hormone (hGH) responsiveness to exercise and somatomedin C (SmC) activity were measured in ten children with insulin-deficient diabetes mellitus. Four of the ten children showed a significant degree of growth retardation. Normal SmC activity was found in association with elevated hGH levels. The hypothesis that growth-retarded diabetics have a failure of Sm production despite high hGH levels (analogous to malnutrition and Laron dwarfism) was not substantiated by this study. Chronic deficiency of insulin, itself a somatomedin, may play a major role in diabetic growth failure.

An investigation of sensory information, levels of automation, and piloting experience on unmanned aircraft pilot performance.

DOT National Transportation Integrated Search

2012-03-01

"The current experiment was intended to examine the effect of sensory information on pilot reactions to system : failures within a UAS control station simulation. This research also investigated the level of automation used in : controlling the aircr...

Pilot testing of the effectiveness of nurse-guided, patient-centered heart failure education for older adults.

PubMed

Mathew, Shiny; Thukha, Henry

2017-12-13

Heart failure (HF) is the most common cause of hospitalization and rehospitalization among those 65 years and older. Effective HF self-management is recommended for reducing readmissions. This pilot study, through a one-group, pretest-posttest design, examines the effects of nurse-guided, patient-centered HF education on readmissions among older adults (n = 26) in a post-acute care unit. All selected participants received 3 sessions of tailored patient education. Their knowledge and self-care skills were measured pre- and post-intervention with the Atlanta Heart Failure Knowledge Test (A-HFKT) and the Self-Care of Heart Failure Index (SCHFI). Patients' HF-related knowledge and self-care skills showed statistically significant improvements, and only 1 patient was rehospitalized for any HF-related reason within 30 days post-discharge. These results suggest that HF rehabilitation teams could support better patient outcomes by assigning nursing staff to provide individualized patient education, as this can help ensure that patients understand discharge instructions for effective self-care. Copyright © 2017 Elsevier Inc. All rights reserved.

Congestive heart failure adherence redesign trial: a pilot study

PubMed Central

Mangla, Ashvarya; Doukky, Rami; Powell, Lynda H; Avery, Elizabeth; Richardson, DeJuran; Calvin, James E

2014-01-01

Objective Heart failure (HF) continues to be a leading cause of hospital admissions, particularly in underserved patients. We hypothesised that providing individualised self-management support to patients and feedback on use of evidence-based HF therapies (EBT) to physicians could lead to improvements in care and decrease hospitalisations. To assess the feasibility of conducting a larger trial testing the efficacy of this dual-level intervention, we conducted the Congestive Heart failure Adherence Redesign Trial Pilot (CHART-P), a proof-of-concept, quasi-experimental, feasibility pilot study. Setting A large tertiary care medical centre in Chicago. Participants Low-income patients (80% of interventions at 1 month and by study completion, respectively. Median sodium intake declined (3.5 vs 2.0 g; p<0.01). There was no statistically significant change in medication adherence based on electronic pill cap monitoring or the Morisky Medication Adherence Scale (MMAS); however, there was a trend towards improved adherence based on MMAS. All physicians received timely intervention. Conclusions This pilot study demonstrated that the protocol was feasible. It provided important insights about the need for intervention and the difficulties in treating patients with a variety of psychosocial problems that undercut their effective care. PMID:25475245

Preliminary Study Using Forward Reaction Control System Jets During Space Shuttle Entry

NASA Technical Reports Server (NTRS)

Restrepo, Carolina; Valasek, John

2006-01-01

Failure or degradation of the flight control system, or hull damage, can lead to loss of vehicle control during entry. Possible failure scenarios are debris impact and wing damage that could result in a large aerodynamic asymmetry which cannot be trimmed out without additional yaw control. Currently the space shuttle uses aerodynamic control surfaces and Reaction Control System jets to control attitude. The forward jets are used for orbital maneuvering only, while the aft jets are used for yaw control during entry. This paper develops a controller for using the forward reaction control system jets as an additional control during entry, and assesses its value and feasibility during failure situations. Forward-aft jet blending logic is created, and implemented on a simplified model of the space shuttle entry flight control system. The model is validated and verified on the nonlinear, six degree-of-freedom Shuttle Engineering Simulator. A rudimentary human factors study was undertaken using the forward cockpit simulator at Johnson Space Center, to assess flying qualities of the new system and pilot workload. Results presented in the paper show that the combination of forward and aft jets provides useful additional yaw control, in addition to potential fuel savings and the ability to balance the use of the fuel in the forward and aft tanks to meet availability constraints of both forward and aft fuel tanks. Piloted simulation studies indicated that using both sets of jets while flying a damaged space shuttle reduces pilot workload, and makes the vehicle more responsive.

Patient engagement with a mobile web-based telemonitoring system for heart failure self-management: a pilot study.

PubMed

Zan, Shiyi; Agboola, Stephen; Moore, Stephanie A; Parks, Kimberly A; Kvedar, Joseph C; Jethwani, Kamal

2015-04-01

Intensive remote monitoring programs for congestive heart failure have been successful in reducing costly readmissions, but may not be appropriate for all patients. There is an opportunity to leverage the increasing accessibility of mobile technologies and consumer-facing digital devices to empower patients in monitoring their own health outside of the hospital setting. The iGetBetter system, a secure Web- and telephone-based heart failure remote monitoring program, which leverages mobile technology and portable digital devices, offers a creative solution at lower cost. The objective of this pilot study was to evaluate the feasibility of using the iGetBetter system for disease self-management in patients with heart failure. This was a single-arm prospective study in which 21 ambulatory, adult heart failure patients used the intervention for heart failure self-management over a 90-day study period. Patients were instructed to take their weight, blood pressure, and heart rate measurements each morning using a WS-30 bluetooth weight scale, a self-inflating blood pressure cuff (Withings LLC, Issy les Moulineaux, France), and an iPad Mini tablet computer (Apple Inc, Cupertino, CA, USA) equipped with cellular Internet connectivity to view their measurements on the Internet. Outcomes assessed included usability and satisfaction, engagement with the intervention, hospital resource utilization, and heart failure-related quality of life. Descriptive statistics were used to summarize data, and matched controls identified from the electronic medical record were used as comparison for evaluating hospitalizations. There were 20 participants (mean age 53 years) that completed the study. Almost all participants (19/20, 95%) reported feeling more connected to their health care team and more confident in performing care plan activities, and 18/20 (90%) felt better prepared to start discussions about their health with their doctor. Although heart failure-related quality of life improved from baseline, it was not statistically significant (P=.55). Over half of the participants had greater than 80% (72/90 days) weekly and overall engagement with the program, and 15% (3/20) used the interactive voice response telephone system exclusively for managing their care plan. Hospital utilization did not differ in the intervention group compared to the control group (planned hospitalizations P=.23, and unplanned hospitalizations P=.99). Intervention participants recorded shorter average length of hospital stay, but no significant differences were observed between intervention and control groups (P=.30). This pilot study demonstrated the feasibility of a low-intensive remote monitoring program leveraging commonly used mobile and portable consumer devices in augmenting care for a fairly young population of ambulatory patients with heart failure. Further prospective studies with a larger sample size and within more diverse patient populations is necessary to determine the effect of mobile-based remote monitoring programs such as the iGetBetter system on clinical outcomes in heart failure.

40 CFR 49.4166 - Monitoring requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... burning pilot flame, electronically controlled automatic igniters, and monitoring system failures, using a... failure, electronically controlled automatic igniter failure, or improper monitoring equipment operation... and natural gas emissions in the event that natural gas recovered for pipeline injection must be...

40 CFR 49.4166 - Monitoring requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... burning pilot flame, electronically controlled automatic igniters, and monitoring system failures, using a... failure, electronically controlled automatic igniter failure, or improper monitoring equipment operation... and natural gas emissions in the event that natural gas recovered for pipeline injection must be...

Motion-base simulator study of control of an externally blown flap STOL transport aircraft after failure of an outboard engine during landing approach

NASA Technical Reports Server (NTRS)

Middleton, D. B.; Hurt, G. J., Jr.; Bergeron, H. P.; Patton, J. M., Jr.; Deal, P. L.; Champine, R. A.

1975-01-01

A moving-base simulator investigation of the problems of recovery and landing of a STOL aircraft after failure of an outboard engine during final approach was made. The approaches were made at 75 knots along a 6 deg glide slope. The engine was failed at low altitude and the option to go around was not allowed. The aircraft was simulated with each of three control systems, and it had four high-bypass-ratio fan-jet engines exhausting against large triple-slotted wing flaps to produce additional lift. A virtual-image out-the-window television display of a simulated STOL airport was operating during part of the investigation. Also, a simple heads-up flight director display superimposed on the airport landing scene was used by the pilots to make some of the recoveries following an engine failure. The results of the study indicated that the variation in visual cues and/or motion cues had little effect on the outcome of a recovery, but they did have some effect on the pilot's response and control patterns.

Proposed primary endpoints for use in clinical trials that compare treatment options for bloodstream infection in adults: a consensus definition.

PubMed

Harris, P N A; McNamara, J F; Lye, D C; Davis, J S; Bernard, L; Cheng, A C; Doi, Y; Fowler, V G; Kaye, K S; Leibovici, L; Lipman, J; Llewelyn, M J; Munoz-Price, S; Paul, M; Peleg, A Y; Rodríguez-Baño, J; Rogers, B A; Seifert, H; Thamlikitkul, V; Thwaites, G; Tong, S Y C; Turnidge, J; Utili, R; Webb, S A R; Paterson, D L

2017-08-01

To define standardized endpoints to aid the design of trials that compare antibiotic therapies for bloodstream infections (BSI). Prospective studies, randomized trials or registered protocols comparing antibiotic therapies for BSI, published from 2005 to 2016, were reviewed. Consensus endpoints for BSI studies were defined using a modified Delphi process. Different primary and secondary endpoints were defined for pilot (small-scale studies designed to evaluate protocol design, feasibility and implementation) and definitive trials (larger-scale studies designed to test hypotheses and influence clinical practice), as well as for Staphylococcus aureus and Gram-negative BSI. For pilot studies of S. aureus BSI, a primary outcome of success at day 7 was defined by: survival, resolution of fever, stable/improved Sequential Organ Failure Assessment (SOFA) score and clearance of blood cultures, with no microbiologically confirmed failure up to 90 days. For definitive S. aureus BSI studies, a primary outcome of success at 90 days was defined by survival and no microbiologically confirmed failure. For pilot studies of Gram-negative BSI, a primary outcome of success at day 7 was defined by: survival, resolution of fever and symptoms related to BSI source, stable or improved SOFA score and negative blood cultures. For definitive Gram-negative BSI studies, a primary outcome of survival at 90 days supported by a secondary outcome of success at day 7 (as previously defined) was agreed. These endpoints provide a framework to aid future trial design. Further work will be required to validate these endpoints with respect to patient-centred clinical outcomes. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. All rights reserved.

Reconfigurable multivariable control law for commercial airplane using a direct digital output feedback design

NASA Technical Reports Server (NTRS)

Ostroff, A. J.; Hueschen, R. M.

1984-01-01

The ability of a pilot to reconfigure the control surfaces on an airplane after a failure, allowing the airplane to recover to a safe condition for landing, becomes more difficult with increasing airplane complexity. Techniques are needed to stabilize and control the airplane immediately after a failure, allowing the pilot time to make longer range decisions. This paper shows a design of a discrete multivariable control law using four controls for the longitudinal channel of a B-737. Single control element failures are allowed in three of the four controls. The four controls design and failure cases are analyzed by means of a digital airplane simulation, with regard to tracking capability and ability to overcome severe windshear and turbulence during the aproach and landing phase of flight.

Causes of fatal accidents for instrument-certified and non-certified private pilots.

PubMed

Shao, Bob Siyuan; Guindani, Michele; Boyd, Douglas D

2014-11-01

Instrument certification (IFR) enhances a pilot's skills in precisely controlling the aircraft and requires a higher level of standards in maintaining heading and altitude compared with the less stringent private pilot certificate. However, there have been no prior studies to compare fatal accident causes for airmen with, and without, this rating, The NTSB accident database was queried for general aviation fatal accidents for private pilots with, and without IFR certification. Exact Poisson tests were used to calculate whether two rate parameters were equal (ratio of 1), normalized to the number of IFR-rated pilots and flight hours in the given time period. Proportion tests were used to determine whether there were significant differences in fatal accident causes between IFR-certified and non-certified pilots. A logistic regression for log-odds success was used in determining the trend and effect of age on fatal accident rates. IFR certification was associated with a reduced risk of accidents due to failure to maintain obstacle/terrain clearance and spatial disorientation for day and night operations respectively. In contrast, the likelihood of fatal accident due to equipment malfunction during day operations was higher for IFR-certified pilots. The fatal accident rate decreased over the last decade for IFR-certified but not for non-IFR-certified private pilots. However, the overall accident rate for IFR-certified private pilots was more than double that of the cohort lacking this certification. Finally, we found a trend for an increased fatality rate with advancing age for both group of pilots. Our findings informs on where training and/or technology should be focused. Both training for aerodynamic stalls, which causes over a quarter of all fatal accidents, should be intensified for both IFR-certified and non-certified private pilots. Similarly, adherence to minimum safe altitudes for both groups of pilots should be encouraged toward reducing the fatal accidents rate due to failure to maintain obstacle/terrain clearance. For night operations, the high percentage of accidents due to spatial disorientation for non-IFR certified airmen suggests that additional training be required for such operations or such flights carry restrictions for this subset of pilots. Copyright © 2014 Elsevier Ltd. All rights reserved.

Low literacy self-care management patient education for a multi-lingual heart failure population: Results of a pilot study.

PubMed

Dickson, Victoria Vaughan; Chyun, Deborah; Caridi, Cristina; Gregory, Jill K; Katz, Stuart

2016-02-01

The purpose of this pilot study was to test the impact of language-free, low literacy self-care management patient education materials in an ethnically diverse multilingual heart failure (HF) population. A one group pre-test-post-test design measured changes in self-care, knowledge and health-related quality of life (HRQL) after a 1 month intervention using language-free, low literacy self-care management patient education materials and delivered by a health educator. The ethnically diverse sample (n=21) was predominately male (72%), 48% Black, 42% Hispanic, and 28% marginal/inadequate literacy. There were significant improvements in self-care and knowledge but not HRQL. Language-free, low literacy self-care patient education may facilitate improved self-care and knowledge in diverse populations who are at risk for poor HF outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

Quantifying Pilot Contribution to Flight Safety During an In-Flight Airspeed Failure

NASA Technical Reports Server (NTRS)

Etherington, Timothy J.; Kramer, Lynda J.; Bailey, Randall E.; Kennedey, Kellie D.

2017-01-01

Accident statistics cite the flight crew as a causal factor in over 60% of large transport fatal accidents. Yet a well-trained and well-qualified crew is acknowledged as the critical center point of aircraft systems safety and an integral component of the entire commercial aviation system. A human-in-the-loop test was conducted using a Level D certified Boeing 737-800 simulator to evaluate the pilot's contribution to safety-of-flight during routine air carrier flight operations and in response to system failures. To quantify the human's contribution, crew complement was used as an independent variable in a between-subjects design. This paper details the crew's actions and responses while dealing with an in-flight airspeed failure. Accident statistics often cite flight crew error (Baker, 2001) as the primary contributor in accidents and incidents in transport category aircraft. However, the Air Line Pilots Association (2011) suggests "a well-trained and well-qualified pilot is acknowledged as the critical center point of the aircraft systems safety and an integral safety component of the entire commercial aviation system." This is generally acknowledged but cannot be verified because little or no quantitative data exists on how or how many accidents/incidents are averted by crew actions. Anecdotal evidence suggest crews handle failures on a daily basis and Aviation Safety Action Program data generally supports this assertion, even if the data is not released to the public. However without hard evidence, the contribution and means by which pilots achieve safety of flight is difficult to define. Thus, ways to improve the human ability to contribute or overcome deficiencies are ill-defined.

High satisfaction and low decisional conflict with advance care planning among chronically ill patients with advanced chronic obstructive pulmonary disease or heart failure using an online decision aid: A pilot study.

PubMed

Van Scoy, Lauren J; Green, Michael J; Dimmock, Anne Ef; Bascom, Rebecca; Boehmer, John P; Hensel, Jessica K; Hozella, Joshua B; Lehman, Erik B; Schubart, Jane R; Farace, Elana; Stewart, Renee R; Levi, Benjamin H

2016-09-01

Many patients with chronic illnesses report a desire for increased involvement in medical decision-making. This pilot study aimed to explore how patients with exacerbation-prone disease trajectories such as advanced heart failure or chronic obstructive pulmonary disease experience advance care planning using an online decision aid and to compare whether patients with different types of exacerbation-prone illnesses had varied experiences using the tool. Pre-intervention questionnaires measured advance care planning knowledge. Post-intervention questionnaires measured: (1) advance care planning knowledge; (2) satisfaction with tool; (3) decisional conflict; and (4) accuracy of the resultant advance directive. Comparisons were made between patients with heart failure and chronic obstructive pulmonary disease. Over 90% of the patients with heart failure (n = 24) or chronic obstructive pulmonary disease (n = 25) reported being "satisfied" or "highly satisfied" with the tool across all satisfaction domains; over 90% of participants rated the resultant advance directive as "very accurate." Participants reported low decisional conflict. Advance care planning knowledge scores rose by 18% (p < 0.001) post-intervention. There were no significant differences between participants with heart failure and chronic obstructive pulmonary disease. Patients with advanced heart failure and chronic obstructive pulmonary disease were highly satisfied after using an online advance care planning decision aid and had increased knowledge of advance care planning. This tool can be a useful resource for time-constrained clinicians whose patients wish to engage in advance care planning. © The Author(s) 2016.

Vigilance impossible: Diligence, distraction, and daydreaming all lead to failures in a practical monitoring task.

PubMed

Casner, Stephen M; Schooler, Jonathan W

2015-09-01

In laboratory studies of vigilance, participants watch for unusual events in a "sit and stare" fashion as their performance typically declines over time. But watch keepers in practical settings seldom approach monitoring in such simplistic ways and controlled environments. We observed airline pilots performing routine monitoring duties in the cockpit. Unlike laboratory studies, pilots' monitoring did not deteriorate amidst prolonged vigils. Monitoring was frequently interrupted by other pop-up tasks and misses followed. However, when free from these distractions, pilots reported copious mind wandering. Pilots often confined their mind wandering to times in which their monitoring performance would not conspicuously suffer. But when no convenient times were available, pilots mind wandered anyway and misses ensued. Real-world monitors may be caught between a continuous vigilance approach that is doomed to fail, a dynamic environment that cannot be fully controlled, and what may be an irresistible urge to let one's thoughts drift. Published by Elsevier Inc.

Do telemonitoring projects of heart failure fit the Chronic Care Model?

PubMed Central

Willemse, Evi; Adriaenssens, Jef; Dilles, Tinne; Remmen, Roy

2014-01-01

This study describes the characteristics of extramural and transmural telemonitoring projects on chronic heart failure in Belgium. It describes to what extent these telemonitoring projects coincide with the Chronic Care Model of Wagner. Background The Chronic Care Model describes essential components for high-quality health care. Telemonitoring can be used to optimise home care for chronic heart failure. It provides a potential prospective to change the current care organisation. Methods This qualitative study describes seven non-invasive home-care telemonitoring projects in patients with heart failure in Belgium. A qualitative design, including interviews and literature review, was used to describe the correspondence of these home-care telemonitoring projects with the dimensions of the Chronic Care Model. Results The projects were situated in primary and secondary health care. Their primary goal was to reduce the number of readmissions for chronic heart failure. None of these projects succeeded in a final implementation of telemonitoring in home care after the pilot phase. Not all the projects were initiated to accomplish all of the dimensions of the Chronic Care Model. A central role for the patient was sparse. Conclusion Limited financial resources hampered continuation after the pilot phase. Cooperation and coordination in telemonitoring appears to be major barriers but are, within primary care as well as between the lines of care, important links in follow-up. This discrepancy can be prohibitive for deployment of good chronic care. Chronic Care Model is recommended as basis for future. PMID:25114664

Do telemonitoring projects of heart failure fit the Chronic Care Model?

PubMed

Willemse, Evi; Adriaenssens, Jef; Dilles, Tinne; Remmen, Roy

2014-07-01

This study describes the characteristics of extramural and transmural telemonitoring projects on chronic heart failure in Belgium. It describes to what extent these telemonitoring projects coincide with the Chronic Care Model of Wagner. The Chronic Care Model describes essential components for high-quality health care. Telemonitoring can be used to optimise home care for chronic heart failure. It provides a potential prospective to change the current care organisation. This qualitative study describes seven non-invasive home-care telemonitoring projects in patients with heart failure in Belgium. A qualitative design, including interviews and literature review, was used to describe the correspondence of these home-care telemonitoring projects with the dimensions of the Chronic Care Model. The projects were situated in primary and secondary health care. Their primary goal was to reduce the number of readmissions for chronic heart failure. None of these projects succeeded in a final implementation of telemonitoring in home care after the pilot phase. Not all the projects were initiated to accomplish all of the dimensions of the Chronic Care Model. A central role for the patient was sparse. Limited financial resources hampered continuation after the pilot phase. Cooperation and coordination in telemonitoring appears to be major barriers but are, within primary care as well as between the lines of care, important links in follow-up. This discrepancy can be prohibitive for deployment of good chronic care. Chronic Care Model is recommended as basis for future.

Motion simulator study of longitudinal stability requirements for large delta wing transport airplanes during approach and landing with stability augmentation systems failed

NASA Technical Reports Server (NTRS)

Snyder, C. T.; Fry, E. B.; Drinkwater, F. J., III; Forrest, R. D.; Scott, B. C.; Benefield, T. D.

1972-01-01

A ground-based simulator investigation was conducted in preparation for and correlation with an-flight simulator program. The objective of these studies was to define minimum acceptable levels of static longitudinal stability for landing approach following stability augmentation systems failures. The airworthiness authorities are presently attempting to establish the requirements for civil transports with only the backup flight control system operating. Using a baseline configuration representative of a large delta wing transport, 20 different configurations, many representing negative static margins, were assessed by three research test pilots in 33 hours of piloted operation. Verification of the baseline model to be used in the TIFS experiment was provided by computed and piloted comparisons with a well-validated reference airplane simulation. Pilot comments and ratings are included, as well as preliminary tracking performance and workload data.

Simulation-based education with deliberate practice may improve intraoperative handoff skills: a pilot study.

PubMed

Pukenas, Erin W; Dodson, Gregory; Deal, Edward R; Gratz, Irwin; Allen, Elaine; Burden, Amanda R

2014-11-01

To examine the results of simulation-based education with deliberate practice on the acquisition of handoff skills by studying resident intraoperative handoff communication performances. Preinvention and postintervention pilot study. Simulated operating room of a university-affiliated hospital. Resident handoff performances during 27 encounters simulating elective surgery were studied. Ten residents (CA-1, CA-2, and CA-3) participated in a one-day simulation-based handoff course. Each resident repeated simulated handoffs to deliberately practice with an intraoperative handoff checklist. One year later, 7 of the 10 residents participated in simulated intraoperative handoffs. All handoffs were videotaped and later scored for accuracy by trained raters. A handoff assessment tool was used to characterize the type and frequency of communication failures. The percentage of handoff errors and omissions were compared before simulation and postsimulation-based education with deliberate practice and at one year following the course. Initially, the overall communication failure rate, defined as the percentage of handoff omissions plus errors, was 29.7%. After deliberate practice with the intraoperative handoff checklist, the communication failure rate decreased to 16.8%, and decreased further to 13.2% one year after the course. Simulation-based education using deliberate practice may result in improved intraoperative handoff communication and retention of skills at one year. Copyright © 2014 Elsevier Inc. All rights reserved.

Shuttle Primary Reaction Control Subsystem Thruster Fuel Valve Pilot Seal Extrusion: A Failure Correlation

NASA Technical Reports Server (NTRS)

Waller, Jess; Saulsberry, Regor L.

2003-01-01

Pilot operated valves (POVs) are used to control the flow of hypergolic propellants monomethylhydrazine (fuel) and nitrogen tetroxide (oxidizer) to the Shuttle orbiter Primary Reaction Control Subsystem (PRCS) thrusters. The POV incorporates a two-stage design: a solenoid-actuated pilot stage, which in turn controls a pressure-actuated main stage. Isolation of propellant supply from the thruster chamber is accomplished in part by a captive polytetrafluoroethylene (PTFE) pilot seal retained inside a Custom 455.1 stainless steel cavity. Extrusion of the pilot seal restricts the flow of fuel around the pilot poppet, thus impeding or preventing the main valve stage from opening. It can also prevent the main stage from staying open with adequate force margin, particularly if there is gas in the main stage actuation cavity. During thruster operation on-orbit, fuel valve pilot seal extrusion is commonly indicated by low or erratic chamber pressure or failure of the thruster to fire upon command (Fail-Off). During ground turnaround, pilot seal extrusion is commonly indicated by slow gaseous nitrogen (GN2) main valve opening times (greater than 38 ms) or slow water main valve opening response times (greater than 33 ms). Poppet lift tests and visual inspection can also detect pilot seal extrusion during ground servicing; however, direct metrology on the pilot seat assembly provides the most quantitative and accurate means of identifying extrusion. Minimizing PRCS fuel valve pilot seal extrusion has become an important issue in the effort to improve PRCS reliability and reduce associated life cycle costs.

Impact of High-Intensity-NIV on the heart in stable COPD: a randomised cross-over pilot study.

PubMed

Duiverman, Marieke Leontine; Maagh, Petra; Magnet, Friederike Sophie; Schmoor, Claudia; Arellano-Maric, Maria Paola; Meissner, Axel; Storre, Jan Hendrik; Wijkstra, Peter Jan; Windisch, Wolfram; Callegari, Jens

2017-05-02

Although high-intensity non-invasive ventilation has been shown to improve outcomes in stable COPD, it may adversely affect cardiac performance. Therefore, the aims of the present pilot study were to compare cardiac and pulmonary effects of 6 weeks of low-intensity non-invasive ventilation and 6 weeks of high-intensity non-invasive ventilation in stable COPD patients. In a randomised crossover pilot feasibility study, the change in cardiac output after 6 weeks of each NIV mode compared to baseline was assessed with echocardiography in 14 severe stable COPD patients. Furthermore, CO during NIV, gas exchange, lung function, and health-related quality of life were investigated. Three patients dropped out: two deteriorated on low-intensity non-invasive ventilation, and one presented with decompensated heart failure while on high-intensity non-invasive ventilation. Eleven patients were included in the analysis. In general, cardiac output and NTproBNP did not change, although individual effects were noticed, depending on the pressures applied and/or the co-existence of heart failure. High-intensity non-invasive ventilation tended to be more effective in improving gas exchange, but both modes improved lung function and the health-related quality of life. Long-term non-invasive ventilation with adequate pressure to improve gas exchange and health-related quality of life did not have an overall adverse effect on cardiac performance. Nevertheless, in patients with pre-existing heart failure, the application of very high inspiratory pressures might reduce cardiac output. The trial was registered in the Deutsches Register Klinischer Studien (DRKS-ID: DRKS00007977 ).

BASIC Training: A Pilot Study of Balance/Strengthening Exercises in Heart Failure.

PubMed

McGuire, Rita; Honaker, Julie; Pozehl, Bunny; Hertzog, Melody

2018-05-19

The aim of this pilot study was to evaluate the effect of a multicomponent balance and resistance training intervention on physical function, balance, and falls in older (≥65 years) community-dwelling heart failure (HF) patients. Randomized, two-group repeated-measures experimental design. The intervention involved once weekly supervised group sessions with home sessions encouraged twice weekly. Focus groups held pre/post intervention. Outcome variables included measures of physical function, balance confidence, and falling risk. In a sample size of 33, the Dynamic Gait Index change from baseline to 12 weeks was significantly different in the groups (p = .029). The number of reported falls declined from 0.92 to 0.54 per participant. A supervised group session intervention can increase mobility and gait and reduce fall rate for HF patients. This study was designed to improve lower extremity strength, balance, and falls in elderly HF patients, thus reducing costs and improving quality of life for this population.

Experiences of Patients Living With Heart Failure: A Descriptive Qualitative Study.

PubMed

Seah, Alvin Chuen Wei; Tan, Khoon Kiat; Huang Gan, Juvena Chew; Wang, Wenru

2016-07-01

The purpose of this study was to explore the experiences, needs, and coping strategies of patients living with heart failure in Singapore. A descriptive qualitative design was used. A purposive sample of 15 informants was recruited from two cardiology wards of a tertiary public hospital in Singapore. Individual face-to-face interviews were conducted with a semistructured interview guideline that was developed based on a review of the literature and a pilot study. Content analysis was adopted to analyze the data, and four main categories were identified: perceived causes, manifestations, and prognosis; enduring emotions; managing the condition; and needs from health care professionals. The informants were overwhelmed with the experience of living with heart failure due to the disruptive and uncertain nature of the condition. This study offers health care professionals practical and useful suggestions when providing holistic care for patients with heart failure. © The Author(s) 2015.

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

PubMed

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

2005-12-01

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

Investigation of control law reconfigurations to accommodate a control element failure on a commercial airplane

NASA Technical Reports Server (NTRS)

Ostroff, A. J.; Hueschen, R. M.

1984-01-01

The ability of a pilot to reconfigure the control surfaces on an airplane after a failure, allowing the airplane to recover to a safe condition, becomes more difficult with increasing airplane complexity. Techniques are needed to stabilize and control the airplane immediately after a failure, allowing the pilot more time to make longer range decisions. This paper presents a baseline design of a discrete multivariable control law using four controls for the longitudinal channel of a B-737. Non-reconfigured and reconfigured control laws are then evaluated, both analytically and by means of a digital airplane simulation, for three individual control element failures (stabilizer, elevator, spoilers). The simulation results are used to evaluate the effectiveness of the control reconfiguration on tracking ability during the approach and landing phase of flight with severe windshear and turbulence disturbing the airplane dynamics.

Features of successful bids for funding of applied health research: a cohort study.

PubMed

Turner, Sheila; Davidson, Peter; Stanton, Louise; Cawdeary, Victoria

2014-09-22

The literature suggests that research funding decisions may be influenced by criteria such as gender or institution of the principal investigator (PI). The aim of this study was to investigate the association between characteristics of funding applications and success when considered by a research funding board. We selected a retrospective cohort of 296 outline applications for primary research (mainly pragmatic clinical trials) submitted to the commissioning board of the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Programme between January 1st 2006 and December 31st 2009. We selected proposals submitted to the commissioned NIHR HTA work stream as they addressed issues which the programme already deemed to be important, hence the priority of the research question was not considered as one of the selection criteria for success or failure. Main outcome measures were success or failure at short-listing and in obtaining research funding. The characteristics of applications associated with success at shortlisting and funding were multi-disciplinarity of the team (OR 19.94 [5.13, 77.50], P < 0.0001), particularly inclusion of a statistician (OR 3.76 [2.21, 6.37], P < 0.0001), and the completion of a pilot/feasibility study (OR 4.11 [1.24, 13.62], P = 0.0209). The gender of the PI was not associated with success or failure at either stage. The PI's affiliation institution was not associated with success or failure at shortlisting. The gender of the PI was not associated with success or failure. The characteristics of research applications most strongly associated with success were related to the range of expertise in the team and the completion of a pilot or feasibility study.

Congestive heart failure adherence redesign trial: a pilot study.

PubMed

Mangla, Ashvarya; Doukky, Rami; Powell, Lynda H; Avery, Elizabeth; Richardson, DeJuran; Calvin, James E

2014-12-04

Heart failure (HF) continues to be a leading cause of hospital admissions, particularly in underserved patients. We hypothesised that providing individualised self-management support to patients and feedback on use of evidence-based HF therapies (EBT) to physicians could lead to improvements in care and decrease hospitalisations. To assess the feasibility of conducting a larger trial testing the efficacy of this dual-level intervention, we conducted the Congestive Heart failure Adherence Redesign Trial Pilot (CHART-P), a proof-of-concept, quasi-experimental, feasibility pilot study. A large tertiary care medical centre in Chicago. Low-income patients (80% of interventions at 1 month and by study completion, respectively. Median sodium intake declined (3.5 vs 2.0 g; p<0.01). There was no statistically significant change in medication adherence based on electronic pill cap monitoring or the Morisky Medication Adherence Scale (MMAS); however, there was a trend towards improved adherence based on MMAS. All physicians received timely intervention. This pilot study demonstrated that the protocol was feasible. It provided important insights about the need for intervention and the difficulties in treating patients with a variety of psychosocial problems that undercut their effective care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Death Spiral: Luftwaffe Airlift Training, Operation Stosser, and Lessons for the Mordern U.S. Air Force

DTIC Science & Technology

2015-05-22

long substitute, Pilot Check-Out ( PCO ), which re-taught the basics of air refueling and assault-zone landings as a "top­ off’ course. While some cost...saving occurred the failure rates and poor performance ofnew students at PIQ and PCO forced changes in the program. 132 Reoccurring failures reduced...AFB, TX: HQ AETC/A3ZM, February 2013. ---.Air Education and Training Command Syllabus C-17 Pilot Checkout ( PCO ). Randolph AFB, TX: HQ AETC/A3ZM

Inorganic nitrate as a treatment for acute heart failure: a protocol for a single center, randomized, double-blind, placebo-controlled pilot and feasibility study.

PubMed

Falls, Roman; Seman, Michael; Braat, Sabine; Sortino, Joshua; Allen, Jason D; Neil, Christopher J

2017-08-08

Acute heart failure (AHF) is a frequent reason for hospitalization worldwide and effective treatment options are limited. It is known that AHF is a condition characterized by impaired vasorelaxation, together with reduced nitric oxide (NO) bioavailability, an endogenous vasodilatory compound. Supplementation of inorganic sodium nitrate (NaNO 3 ) is an indirect dietary source of NO, through bioconversion. It is proposed that oral sodium nitrate will favorably affect levels of circulating NO precursors (nitrate and nitrite) in AHF patients, resulting in reduced systemic vascular resistance, without significant hypotension. We propose a single center, randomized, double-blind, placebo-controlled pilot trial, evaluating the feasibility of sodium nitrate as a treatment for AHF. The primary hypothesis that sodium nitrate treatment will result in increased systemic levels of nitric oxide pre-cursors (nitrate and nitrite) in plasma, in parallel with improved vasorelaxation, as assessed by non-invasively derived systemic vascular resistance index. Additional surrogate measures relevant to the known pathophysiology of AHF will be obtained in order to assess clinical effect on dyspnea and renal function. The results of this study will provide evidence of the feasibility of this novel approach and will be of interest to the heart failure community. This trial may inform a larger study.

14 CFR 27.143 - Controllability and maneuverability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... failure occurs with maximum continuous power and critical weight. No corrective action time delay for any... pilot reaction time (whichever is greater); and (ii) For any other condition, normal pilot reaction time...

Failures of Engagement: Lessons Learned from a Citizen Science Pilot Study

ERIC Educational Resources Information Center

Druschke, Caroline Gottschalk; Seltzer, Carrie E.

2012-01-01

Citizen science is growing in popularity, but little research addresses participant learning outcomes. We describe the Chicago Area Pollinator Study (CAPS), which relied on citizen scientists to gather information about urban bee diversity and abundance. Based on pre- and post-CAPS participant surveys, we determined that citizen scientists…

78 FR 65161 - Airworthiness Directives; Agusta S.p.A. (Type Certificate Currently Held by AgustaWestland S.p.A...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-31

... engine speeds during steady-state operations. These actions are intended to alert pilots to avoid certain... alert pilots to avoid certain engine speeds during steady-state operations, prevent failure of the third...

[Traumatology in hang-gliding accidents. Studies based on 100 cases].

PubMed

Reymond, M A; de Gottrau, P; Fournier, P E; Arnold, T; Jacomet, H; Rigo, M

1988-11-01

The number of paragliding accidents is growing up exponentially. We review in this study 39 paragliding accidents which occurred 1985-1987 in the Val d'Illiez (Switzerland). The REGA (Swiss air ambulance) rescued 1987 61 pilots, which are also included. Most of the accidents were related to a mistake of the pilot. None is due to a failure of the material. The most severe injuries occurred immediately after taking off. The most frequent injuries occurred during landing. There is a correlation between the altitude, the wind velocity and the severity of the injuries. The lower extremities and the backbone are often injured, which is explained through the axial trauma. The pilots need a better training programme, the performance of the material should be built up and the starting places should be equipped.

Pilot error in air carrier accidents: does age matter?

PubMed

Li, Guohua; Grabowski, Jurek G; Baker, Susan P; Rebok, George W

2006-07-01

The relationship between pilot age and safety performance has been the subject of research and controversy since the "Age 60 Rule" became effective in 1960. This study aimed to examine age-related differences in the prevalence and patterns of pilot error in air carrier accidents. Investigation reports from the National Transportation Safety Board for accidents involving Part 121 operations in the United States between 1983 and 2002 were reviewed to identify pilot error and other contributing factors. Accident circumstances and the presence and type of pilot error were analyzed in relation to pilot age using Chi-square tests. Of the 558 air carrier accidents studied, 25% resulted from turbulence, 21% from mechanical failure, 16% from taxiing events, 13% from loss of control at landing or takeoff, and 25% from other causes. Accidents involving older pilots were more likely to be caused by turbulence, whereas accidents involving younger pilots were more likely to be taxiing events. Pilot error was a contributing factor in 34%, 38%, 35%, and 34% of the accidents involving pilots ages 25-34 yr, 35-44 yr, 45-54 yr, and 55-59 yr, respectively (p = 0.87). The patterns of pilot error were similar across age groups. Overall, 26% of the pilot errors identified were inattentiveness, 22% flawed decisions, 22% mishandled aircraft kinetics, and 11% poor crew interactions. The prevalence and patterns of pilot error in air carrier accidents do not seem to change with pilot age. The lack of association between pilot age and error may be due to the "safe worker effect" resulting from the rigorous selection processes and certification standards for professional pilots.

Effect of hypercapnia on respiratory and peripheral skeletal muscle loss during critical illness - A pilot study.

PubMed

Twose, Paul; Jones, Una; Wise, Matt P

2018-06-01

Critical illness has profound effects on muscle strength and long-term physical morbidity. However, there remains a paucity of evidence for the aetiology of critical illness related weakness. Recent animal model research identified that hypercapnia may reduce the rate of muscle loss. The aim of this study was to determine the effect of hypercapnia on respiratory and peripheral skeletal muscle in patients with critical illness. A pilot observational study of mechanically ventilated critically ill patients at a tertiary critical care unit who were retrospectively categorised as: 1) Respiratory failure with normocapnia; 2) Respiratory failure with hypercapnia; and 3) brain injury. Diaphragm thickness and quadriceps rectus femoris cross-sectional area (RFCSA) were measured using ultrasound imaging at baseline and at days 3, 5, 7 and 10 of mechanical ventilation. Significant reductions in RFCSA muscle loss were observed for all time-points when compared to baseline [day 10: -14.9%±8.2 p< 0.001], and in diaphragm thickness between baseline and day 7 [day 7: -5.8%±9.5 p=0.029). No correlation was identified between the rate of muscle mass loss in the diaphragm and RFCSA. In this pilot study, peripheral skeletal muscle weakness occurred early and rapidly within the critical care population, irrespective of carbon dioxide levels. Copyright © 2018 Elsevier Inc. All rights reserved.

Integrated Neural Flight and Propulsion Control System

NASA Technical Reports Server (NTRS)

Kaneshige, John; Gundy-Burlet, Karen; Norvig, Peter (Technical Monitor)

2001-01-01

This paper describes an integrated neural flight and propulsion control system. which uses a neural network based approach for applying alternate sources of control power in the presence of damage or failures. Under normal operating conditions, the system utilizes conventional flight control surfaces. Neural networks are used to provide consistent handling qualities across flight conditions and for different aircraft configurations. Under damage or failure conditions, the system may utilize unconventional flight control surface allocations, along with integrated propulsion control, when additional control power is necessary for achieving desired flight control performance. In this case, neural networks are used to adapt to changes in aircraft dynamics and control allocation schemes. Of significant importance here is the fact that this system can operate without emergency or backup flight control mode operations. An additional advantage is that this system can utilize, but does not require, fault detection and isolation information or explicit parameter identification. Piloted simulation studies were performed on a commercial transport aircraft simulator. Subjects included both NASA test pilots and commercial airline crews. Results demonstrate the potential for improving handing qualities and significantly increasing survivability rates under various simulated failure conditions.

A new device for intraoperative renal blood flow measurement during open-heart surgery: an experimental study and the clinical pilot study.

PubMed

Tirilomis, Theodor; Popov, Aron F; Hanekop, Gunnar G; Braeuer, Anselm; Quintel, Michael; Schoendube, Friedrich A; Friedrich, Martin G

2013-10-01

Renal blood flow (RBF) may vary during cardiopulmonary bypass and low flow may cause insufficient blood supply of the kidney triggering renal failure postoperatively. Still, a valid intraoperative method of continuous RBF measurement is not available. A new catheter combining thermodilution and intravascular Doppler was developed, first calibrated in an in vitro model, and the catheter specific constant was determined. Then, application of the device was evaluated in a pilot study in an adult cardiovascular population. The data of the clinical pilot study revealed high correlation between the flow velocities detected by intravascular Doppler and the RBF measured by thermodilution (Pearson's correlation range: 0.78 to 0.97). In conclusion, the RBF can be measured excellently in real time using the new catheter, even under cardiopulmonary bypass. © 2013 Wiley Periodicals, Inc. and International Center for Artificial Organs and Transplantation.

Piloted simulation tests of propulsion control as backup to loss of primary flight controls for a mid-size jet transport

NASA Technical Reports Server (NTRS)

Bull, John; Mah, Robert; Davis, Gloria; Conley, Joe; Hardy, Gordon; Gibson, Jim; Blake, Matthew; Bryant, Don; Williams, Diane

1995-01-01

Failures of aircraft primary flight-control systems to aircraft during flight have led to catastrophic accidents with subsequent loss of lives (e.g. , DC-1O crash, B-747 crash, C-5 crash, B-52 crash, and others). Dryden Flight Research Center (DFRC) investigated the use of engine thrust for emergency flight control of several airplanes, including the B-720, Lear 24, F-15, C-402, and B-747. A series of three piloted simulation tests have been conducted at Ames Research Center to investigate propulsion control for safely landing a medium size jet transport which has experienced a total primary flight-control failure. The first series of tests was completed in July 1992 and defined the best interface for the pilot commands to drive the engines. The second series of tests was completed in August 1994 and investigated propulsion controlled aircraft (PCA) display requirements and various command modes. The third series of tests was completed in May 1995 and investigated PCA full-flight envelope capabilities. This report describes the concept of a PCA, discusses pilot controls, displays, and procedures; and presents the results of piloted simulation evaluations of the concept by a cross-section of air transport pilots.

Control Reallocation Strategies for Damage Adaptation in Transport Class Aircraft

NASA Technical Reports Server (NTRS)

Gundy-Burlet, Karen; Krishnakumar, K.; Limes, Greg; Bryant, Don

2003-01-01

This paper examines the feasibility, potential benefits and implementation issues associated with retrofitting a neural-adaptive flight control system (NFCS) to existing transport aircraft, including both cable/hydraulic and fly-by-wire configurations. NFCS uses a neural network based direct adaptive control approach for applying alternate sources of control authority in the presence of damage or failures in order to achieve desired flight control performance. Neural networks are used to provide consistent handling qualities across flight conditions, adapt to changes in aircraft dynamics and to make the controller easy to apply when implemented on different aircraft. Full-motion piloted simulation studies were performed on two different transport models: the Boeing 747-400 and the Boeing C-17. Subjects included NASA, Air Force and commercial airline pilots. Results demonstrate the potential for improving handing qualities and significantly increased survivability rates under various simulated failure conditions.

Pilot-in-the-Loop Analysis of Propulsive-Only Flight Control Systems

NASA Technical Reports Server (NTRS)

Chou, Hwei-Lan; Biezad, Daniel J.

1996-01-01

Longitudinal control system architectures are presented which directly couple flight stick motions to throttle commands for a multi-engine aircraft. This coupling enables positive attitude control with complete failure of the flight control system. The architectures chosen vary from simple feedback gains to classical lead-lag compensators with and without prefilters. Each architecture is reviewed for its appropriateness for piloted flight. The control systems are then analyzed with pilot-in-the-loop metrics related to bandwidth required for landing. Results indicate that current and proposed bandwidth requirements should be modified for throttles only flight control. Pilot ratings consistently showed better ratings than predicted by analysis. Recommendations are made for more robust design and implementation. The use of Quantitative Feedback Theory for compensator design is discussed. Although simple and effective augmented control can be achieved in a wide variety of failed configurations, a few configuration characteristics are dominant for pilot-in-the-loop control. These characteristics will be tested in a simulator study involving failed flight controls for a multi-engine aircraft.

Pilot age and error in air taxi crashes.

PubMed

Rebok, George W; Qiang, Yandong; Baker, Susan P; Li, Guohua

2009-07-01

The associations of pilot error with the type of flight operations and basic weather conditions are well documented. The correlation between pilot characteristics and error is less clear. This study aims to examine whether pilot age is associated with the prevalence and patterns of pilot error in air taxi crashes. Investigation reports from the National Transportation Safety Board for crashes involving non-scheduled Part 135 operations (i.e., air taxis) in the United States between 1983 and 2002 were reviewed to identify pilot error and other contributing factors. Crash circumstances and the presence and type of pilot error were analyzed in relation to pilot age using Chi-square tests. Of the 1751 air taxi crashes studied, 28% resulted from mechanical failure, 25% from loss of control at landing or takeoff, 7% from visual flight rule conditions into instrument meteorological conditions, 7% from fuel starvation, 5% from taxiing, and 28% from other causes. Crashes among older pilots were more likely to occur during the daytime rather than at night and off airport than on airport. The patterns of pilot error in air taxi crashes were similar across age groups. Of the errors identified, 27% were flawed decisions, 26% were inattentiveness, 23% mishandled aircraft kinetics, 15% mishandled wind and/or runway conditions, and 11% were others. Pilot age is associated with crash circumstances but not with the prevalence and patterns of pilot error in air taxi crashes. Lack of age-related differences in pilot error may be attributable to the "safe worker effect."

Report of ejections in the Spanish Air Force, 1979-1995: an epidemiological and comparative study.

PubMed

Moreno Vázquez, J M; Durán Tejeda, M R; García Alcón, J L

1999-07-01

Ejection seats have saved many lives with more than 80% of pilots having survived an ejection. Nevertheless, ejection injuries are seen in all modern air forces. An epidemiological study has been carried out on the 48 ejections made by the Spanish Air Force (SpAF) from 1979-1995. From data facilitated by the Flight Safety Section of the SpAF Staff, by the Flight Safety Section of Squadrons, and from personal reports of pilots who survived ejections a form was created. Relationships between data concerning aeronautical parameters, pilot data and injuries have been found, and a comparative study was made between these results and data shown by air forces of other countries. Of 48 pilots who ejected, 7 died, 25 had severe injuries, 11 had minor injuries and 5 had no injuries. The reason for the ejections included 35 cases of technical failure, and 13 cases of human error. Of 43 surviving pilots, 23 were injured only at the egress phase, 1 1 only at landing, and 9 cases at both moments. None of the five pilots who ejected outside the ejection envelope were able to adopt the correct position. However, of 43 pilots who ejected within the envelope, 19 were seated in good position. Of 13 pilots who maintained control of the airplane, 9 were able to adopt a correct position. Of 35 pilots who effected the ejection without control of the aircraft, 25 were not able to achieve a correct seated position. The pilot position in the ejection seat, plane control, ejection inside the envelope, the pilot's training in how to assume the necessary body position at both egress and landing phases are determining factors for successful ejections.

Health information systems: failure, success and improvisation.

PubMed

Heeks, Richard

2006-02-01

The generalised assumption of health information systems (HIS) success is questioned by a few commentators in the medical informatics field. They point to widespread HIS failure. The purpose of this paper was therefore to develop a better conceptual foundation for, and practical guidance on, health information systems failure (and success). Literature and case analysis plus pilot testing of developed model. Defining HIS failure and success is complex, and the current evidence base on HIS success and failure rates was found to be weak. Nonetheless, the best current estimate is that HIS failure is an important problem. The paper therefore derives and explains the "design-reality gap" conceptual model. This is shown to be robust in explaining multiple cases of HIS success and failure, yet provides a contingency that encompasses the differences which exist in different HIS contexts. The design-reality gap model is piloted to demonstrate its value as a tool for risk assessment and mitigation on HIS projects. It also throws into question traditional, structured development methodologies, highlighting the importance of emergent change and improvisation in HIS. The design-reality gap model can be used to address the problem of HIS failure, both as a post hoc evaluative tool and as a pre hoc risk assessment and mitigation tool. It also validates a set of methods, techniques, roles and competencies needed to support the dynamic improvisations that are found to underpin cases of HIS success.

Unsuspected neurologic disease in aviation personnel : survival following seizures in flight.

DOT National Transportation Integrated Search

1963-08-01

The increasing use of private and commercial air transportation combined with the steady increase in recreational aviation have inevitably increased the likelihood of pilot failure caused by medical disability simply because there are more pilots in ...

Occupational aviation fatalities--Alaska, 2000-2010.

PubMed

2011-07-01

Aircraft crashes are the second leading cause of occupational deaths in Alaska; during the 1990s, a total of 108 fatal aviation crashes resulted in 155 occupational fatalities. To update data and identify risk factors for occupational death from aircraft crashes, CDC reviewed data from the National Transportation Safety Board (NTSB) and the Alaska Occupational Injury Surveillance System. During 2000--2010, a total of 90 occupational fatalities occurred as a result of 54 crashes, an average of five fatal aircraft crashes and eight fatalities per year. Among those crashes, 21 (39%) were associated with intended takeoffs or landings at landing sites not registered with the Federal Aviation Administration (FAA). Fifteen crashes (28%) were associated with weather, including poor visibility, wind, and turbulence. In addition, 11 crashes (20%) resulted from pilots' loss of aircraft control; nine (17%) from pilots' failure to maintain clearance from terrain, water, or objects; and seven (13%) from engine, structure, or component failure. To reduce occupational fatalities resulting from aircraft crashes in the state, safety interventions should focus on providing weather and other flight information to increase pilots' situational awareness, maintaining pilot proficiency and decision-making abilities, and expanding the infrastructure used by pilots to fly by instruments.

A Randomized Pilot Trial of Remote Ischemic Preconditioning in Heart Failure with Reduced Ejection Fraction

PubMed Central

McDonald, Michael A.; Braga, Juarez R.; Li, Jing; Manlhiot, Cedric; Ross, Heather J.; Redington, Andrew N.

2014-01-01

Background Remote ischemic preconditioning (RIPC) induced by transient limb ischemia confers multi-organ protection and improves exercise performance in the setting of tissue hypoxia. We aimed to evaluate the effect of RIPC on exercise capacity in heart failure patients. Methods We performed a randomized crossover trial of RIPC (4×5-minutes limb ischemia) compared to sham control in heart failure patients undergoing exercise testing. Patients were randomly allocated to either RIPC or sham prior to exercise, then crossed over and completed the alternate intervention with repeat testing. The primary outcome was peak VO2, RIPC versus sham. A mechanistic substudy was performed using dialysate from study patient blood samples obtained after sham and RIPC. This dialysate was used to test for a protective effect of RIPC in a mouse heart Langendorff model of infarction. Mouse heart infarct size with RIPC or sham dialysate exposure was also compared with historical control data. Results Twenty patients completed the study. RIPC was not associated with improvements in peak VO2 (15.6+/−4.2 vs 15.3+/−4.6 mL/kg/min; p = 0.53, sham and RIPC, respectively). In our Langendorff sub-study, infarct size was similar between RIPC and sham dialysate groups from our study patients, but was smaller than expected compared to healthy controls (29.0%, 27.9% [sham, RIPC] vs 51.2% [controls]. We observed less preconditioning among the subgroup of patients with increased exercise performance following RIPC (p<0.04). Conclusion In this pilot study of RIPC in heart failure patients, RIPC was not associated with improvements in exercise capacity overall. However, the degree of effect of RIPC may be inversely related to the degree of baseline preconditioning. These data provide the basis for a larger randomized trial to test the potential benefits of RIPC in patients with heart failure. Trial Registration ClinicalTrials.gov +++++NCT01128790 PMID:25181050

Piloted Simulation Tests of Propulsion Control as Backup to Loss of Primary Flight Controls for a B747-400 Jet Transport

NASA Technical Reports Server (NTRS)

Bull, John; Mah, Robert; Hardy, Gordon; Sullivan, Barry; Jones, Jerry; Williams, Diane; Soukup, Paul; Winters, Jose

1997-01-01

Partial failures of aircraft primary flight control systems and structural damages to aircraft during flight have led to catastrophic accidents with subsequent loss of lives (e.g. DC-10, B-747, C-5, B-52, and others). Following the DC-10 accident at Sioux City, Iowa in 1989, the National Transportation Safety Board recommended 'Encourage research and development of backup flight control systems for newly certified wide-body airplanes that utilize an alternate source of motive power separate from that source used for the conventional control system.' This report describes the concept of a propulsion controlled aircraft (PCA), discusses pilot controls, displays, and procedures; and presents the results of a PCA piloted simulation test and evaluation of the B747-400 airplane conducted at NASA Ames Research Center in December, 1996. The purpose of the test was to develop and evaluate propulsion control throughout the full flight envelope of the B747-400 including worst case scenarios of engine failures and out of trim moments. Pilot ratings of PCA performance ranged from adequate to satisfactory. PCA performed well in unusual attitude recoveries at 35,000 ft altitude, performed well in fully coupled ILS approaches, performed well in single engine failures, and performed well at aft cg. PCA performance was primarily limited by out-of-trim moments.

Flight Test Comparison of Different Adaptive Augmentations for Fault Tolerant Control Laws for a Modified F-15 Aircraft

NASA Technical Reports Server (NTRS)

Burken, John J.; Hanson, Curtis E.; Lee, James A.; Kaneshige, John T.

2009-01-01

This report describes the improvements and enhancements to a neural network based approach for directly adapting to aerodynamic changes resulting from damage or failures. This research is a follow-on effort to flight tests performed on the NASA F-15 aircraft as part of the Intelligent Flight Control System research effort. Previous flight test results demonstrated the potential for performance improvement under destabilizing damage conditions. Little or no improvement was provided under simulated control surface failures, however, and the adaptive system was prone to pilot-induced oscillations. An improved controller was designed to reduce the occurrence of pilot-induced oscillations and increase robustness to failures in general. This report presents an analysis of the neural networks used in the previous flight test, the improved adaptive controller, and the baseline case with no adaptation. Flight test results demonstrate significant improvement in performance by using the new adaptive controller compared with the previous adaptive system and the baseline system for control surface failures.

Causes and Mitigation of Fuel Pilot Operated Valve Pilot Seal Extrusion in Space Shuttle Orbiter Primary RCS Thrusters

NASA Technical Reports Server (NTRS)

Waller, Jess M.; Roth, Tim E.; Saulsberry, Regor L.; Haney, William A.; Kelly, Terence S; Forsyth, Bradley S.

2004-01-01

Extrusion of a polytetrafluoroethylene (PTFE) pilot seal located in the Space Shuttle Orbiter Primary Reaction Control Subsystem (PRCS) thruster fuel valve has been implicated in 68 ground and on-orbit fuel valve failures. A rash of six extrusion-related in-flight anomalies over a six-mission span from December 2001 to October 2002 led to heightened activity at various NASA centers, and the formation of a multidisciplinary team to solve the problem. Empirical and theoretical approaches were used. For example, thermomechanical analysis (TMA) and exposure tests showed that some extrusion is produced by thermal cycling; however, a review of thruster service histories did not reveal a strong link between thermal cycling and extrusion. Calculations showed that the amount of observed extrusion often exceeded the amount allowed by thermally-induced stress relief. Failure analysis of failed hardware also revealed the presence of fuel-oxidizer reaction product (FORP) inside the fuel valve pilot seal cavity, and differential scanning calorimetry (DSC) showed that the FORP was intimately associated with the pilot seal material. Component-level exposure tests showed that FORP of similar composition could be produced by adjacent oxidizer valve leakage in the absence of thruster firing. Specific gravity data showed that extruded fuel valve pilot seals were less dense than new pilot seals or oxidizer valve pilot seals, indicating permanent modification of the PTFE occurred during service. It is concluded that some thermally-induced extrusion is unavoidable; however, oxidizer leakage-induced extrusion is mostly avoidable and can be mitigated. Several engineering level mitigation strategies are discussed.

An Intervention to Retrain Attributions Using CBT: A Pilot Study

ERIC Educational Resources Information Center

Bosnjak, Amira; Boyle, Christopher; Chodkiewicz, Alicia R.

2017-01-01

The role of affective and cognitive factors in learning have long been recognised as imperative determinants of the learning process. Maladaptive styles with which we perceive and explain accomplishments and failures in achievement outcomes have an important motivational impact upon approach and avoidance behaviours towards academic tasks.…

Use of a Modern Polymerization Pilot-Plant for Undergraduate Control Projects.

ERIC Educational Resources Information Center

Mendoza-Bustos, S. A.; And Others

1991-01-01

Described is a project where students gain experience in handling large volumes of hazardous materials, process start up and shut down, equipment failures, operational variations, scaling up, equipment cleaning, and run-time scheduling while working in a modern pilot plant. Included are the system design, experimental procedures, and results. (KR)

The retention of manual flying skills in the automated cockpit.

PubMed

Casner, Stephen M; Geven, Richard W; Recker, Matthias P; Schooler, Jonathan W

2014-12-01

The aim of this study was to understand how the prolonged use of cockpit automation is affecting pilots' manual flying skills. There is an ongoing concern about a potential deterioration of manual flying skills among pilots who assume a supervisory role while cockpit automation systems carry out tasks that were once performed by human pilots. We asked 16 airline pilots to fly routine and nonroutine flight scenarios in a Boeing 747-400 simulator while we systematically varied the level of automation that they used, graded their performance, and probed them about what they were thinking about as they flew. We found pilots' instrument scanning and manual control skills to be mostly intact, even when pilots reported that they were infrequently practiced. However, when pilots were asked to manually perform the cognitive tasks needed for manual flight (e.g., tracking the aircraft's position without the use of a map display, deciding which navigational steps come next, recognizing instrument system failures), we observed more frequent and significant problems. Furthermore, performance on these cognitive tasks was associated with measures of how often pilots engaged in task-unrelated thought when cockpit automation was used. We found that while pilots' instrument scanning and aircraft control skills are reasonably well retained when automation is used, the retention of cognitive skills needed for manual flying may depend on the degree to which pilots remain actively engaged in supervising the automation.

Quantifying Pilot Contribution to Flight Safety during Hydraulic Systems Failure

NASA Technical Reports Server (NTRS)

Kramer, Lynda J.; Etherington, Timothy J.; Bailey, Randall E.; Kennedy, Kellie D.

2017-01-01

Accident statistics cite the flight crew as a causal factor in over 60% of large transport aircraft fatal accidents. Yet, a well-trained and well-qualified pilot is acknowledged as the critical center point of aircraft systems safety and an integral safety component of the entire commercial aviation system. The latter statement, while generally accepted, cannot be verified because little or no quantitative data exists on how and how many accidents/incidents are averted by crew actions. A joint NASA/FAA high-fidelity motion-base human-in-the-loop test was conducted using a Level D certified Boeing 737-800 simulator to evaluate the pilot's contribution to safety-of-flight during routine air carrier flight operations and in response to aircraft system failures. To quantify the human's contribution, crew complement (two-crew, reduced crew, single pilot) was used as the independent variable in a between-subjects design. This paper details the crew's actions, including decision-making, and responses while dealing with a hydraulic systems leak - one of 6 total non-normal events that were simulated in this experiment.

Motion Cueing Algorithm Development: Piloted Performance Testing of the Cueing Algorithms

NASA Technical Reports Server (NTRS)

Houck, Jacob A. (Technical Monitor); Telban, Robert J.; Cardullo, Frank M.; Kelly, Lon C.

2005-01-01

The relative effectiveness in simulating aircraft maneuvers with both current and newly developed motion cueing algorithms was assessed with an eleven-subject piloted performance evaluation conducted on the NASA Langley Visual Motion Simulator (VMS). In addition to the current NASA adaptive algorithm, two new cueing algorithms were evaluated: the optimal algorithm and the nonlinear algorithm. The test maneuvers included a straight-in approach with a rotating wind vector, an offset approach with severe turbulence and an on/off lateral gust that occurs as the aircraft approaches the runway threshold, and a takeoff both with and without engine failure after liftoff. The maneuvers were executed with each cueing algorithm with added visual display delay conditions ranging from zero to 200 msec. Two methods, the quasi-objective NASA Task Load Index (TLX), and power spectral density analysis of pilot control, were used to assess pilot workload. Piloted performance parameters for the approach maneuvers, the vertical velocity upon touchdown and the runway touchdown position, were also analyzed but did not show any noticeable difference among the cueing algorithms. TLX analysis reveals, in most cases, less workload and variation among pilots with the nonlinear algorithm. Control input analysis shows pilot-induced oscillations on a straight-in approach were less prevalent compared to the optimal algorithm. The augmented turbulence cues increased workload on an offset approach that the pilots deemed more realistic compared to the NASA adaptive algorithm. The takeoff with engine failure showed the least roll activity for the nonlinear algorithm, with the least rudder pedal activity for the optimal algorithm.

ASTRONAUT CERNAN, EUGENE A. - MISC. (WALK AWAY FROM PAD - GEMINI-TITAN (GT)-9 POSTPONED) - CAPE

NASA Image and Video Library

1966-05-17

S66-34559 (17 May 1966) --- Astronauts Thomas P. Stafford (left), command pilot, and Eugene A. Cernan, pilot, walk away from Pad 19 after the Gemini-9 mission was postponed. Failure of the Agena Target Vehicle to achieve orbit caused the postponement of the mission. Photo credit: NASA

Assessment of ECG and respiration recordings from simulated emergency landings of ultra light aircraft.

PubMed

Bruna, Ondřej; Levora, Tomáš; Holub, Jan

2018-05-08

Pilots of ultra light aircraft have limited training resources, but with the use of low cost simulators it might be possible to train and test some parts of their training on the ground. The purpose of this paper is to examine possibility of stress inducement on a low cost flight simulator. Stress is assessed from electrocardiogram and respiration. Engine failure during flight served as a stress inducement stimuli. For one flight, pilots had access to an emergency navigation system. There were recorded some statistically significant changes in parameters regarding breathing frequency. Although no significant change was observed in ECG parameters, there appears to be an effect on respiration parameters. Physiological signals processed with analysis of variance suggest, that the moment of engine failure and approach for landing affected average breathing frequency. Presence of navigation interface does not appear to have a significant effect on pilots.

Complexity and Pilot Workload Metrics for the Evaluation of Adaptive Flight Controls on a Full Scale Piloted Aircraft

NASA Technical Reports Server (NTRS)

Hanson, Curt; Schaefer, Jacob; Burken, John J.; Larson, David; Johnson, Marcus

2014-01-01

Flight research has shown the effectiveness of adaptive flight controls for improving aircraft safety and performance in the presence of uncertainties. The National Aeronautics and Space Administration's (NASA)'s Integrated Resilient Aircraft Control (IRAC) project designed and conducted a series of flight experiments to study the impact of variations in adaptive controller design complexity on performance and handling qualities. A novel complexity metric was devised to compare the degrees of simplicity achieved in three variations of a model reference adaptive controller (MRAC) for NASA's F-18 (McDonnell Douglas, now The Boeing Company, Chicago, Illinois) Full-Scale Advanced Systems Testbed (Gen-2A) aircraft. The complexity measures of these controllers are also compared to that of an earlier MRAC design for NASA's Intelligent Flight Control System (IFCS) project and flown on a highly modified F-15 aircraft (McDonnell Douglas, now The Boeing Company, Chicago, Illinois). Pilot comments during the IRAC research flights pointed to the importance of workload on handling qualities ratings for failure and damage scenarios. Modifications to existing pilot aggressiveness and duty cycle metrics are presented and applied to the IRAC controllers. Finally, while adaptive controllers may alleviate the effects of failures or damage on an aircraft's handling qualities, they also have the potential to introduce annoying changes to the flight dynamics or to the operation of aircraft systems. A nuisance rating scale is presented for the categorization of nuisance side-effects of adaptive controllers.

IRAC Full-Scale Flight Testbed Capabilities

NASA Technical Reports Server (NTRS)

Lee, James A.; Pahle, Joseph; Cogan, Bruce R.; Hanson, Curtis E.; Bosworth, John T.

2009-01-01

Overview: Provide validation of adaptive control law concepts through full scale flight evaluation in a representative avionics architecture. Develop an understanding of aircraft dynamics of current vehicles in damaged and upset conditions Real-world conditions include: a) Turbulence, sensor noise, feedback biases; and b) Coupling between pilot and adaptive system. Simulated damage includes 1) "B" matrix (surface) failures; and 2) "A" matrix failures. Evaluate robustness of control systems to anticipated and unanticipated failures.

Pilot Age and Error in Air-Taxi Crashes

PubMed Central

Rebok, George W.; Qiang, Yandong; Baker, Susan P.; Li, Guohua

2010-01-01

Introduction The associations of pilot error with the type of flight operations and basic weather conditions are well documented. The correlation between pilot characteristics and error is less clear. This study aims to examine whether pilot age is associated with the prevalence and patterns of pilot error in air-taxi crashes. Methods Investigation reports from the National Transportation Safety Board for crashes involving non-scheduled Part 135 operations (i.e., air taxis) in the United States between 1983 and 2002 were reviewed to identify pilot error and other contributing factors. Crash circumstances and the presence and type of pilot error were analyzed in relation to pilot age using Chi-square tests. Results Of the 1751 air-taxi crashes studied, 28% resulted from mechanical failure, 25% from loss of control at landing or takeoff, 7% from visual flight rule conditions into instrument meteorological conditions, 7% from fuel starvation, 5% from taxiing, and 28% from other causes. Crashes among older pilots were more likely to occur during the daytime rather than at night and off airport than on airport. The patterns of pilot error in air-taxi crashes were similar across age groups. Of the errors identified, 27% were flawed decisions, 26% were inattentiveness, 23% mishandled aircraft kinetics, 15% mishandled wind and/or runway conditions, and 11% were others. Conclusions Pilot age is associated with crash circumstances but not with the prevalence and patterns of pilot error in air-taxi crashes. Lack of age-related differences in pilot error may be attributable to the “safe worker effect.” PMID:19601508

Identifying black swans in NextGen: predicting human performance in off-nominal conditions.

PubMed

Wickens, Christopher D; Hooey, Becky L; Gore, Brian F; Sebok, Angelia; Koenicke, Corey S

2009-10-01

The objective is to validate a computational model of visual attention against empirical data--derived from a meta-analysis--of pilots' failure to notice safety-critical unexpected events. Many aircraft accidents have resulted, in part, because of failure to notice nonsalient unexpected events outside of foveal vision, illustrating the phenomenon of change blindness. A model of visual noticing, N-SEEV (noticing-salience, expectancy, effort, and value), was developed to predict these failures. First, 25 studies that reported objective data on miss rate for unexpected events in high-fidelity cockpit simulations were identified, and their miss rate data pooled across five variables (phase of flight, event expectancy, event location, presence of a head-up display, and presence of a highway-in-the-sky display). Second, the parameters of the N-SEEV model were tailored to mimic these dichotomies. The N-SEEV model output predicted variance in the obtained miss rate (r = .73). The individual miss rates of all six dichotomous conditions were predicted within 14%, and four of these were predicted within 7%. The N-SEEV model, developed on the basis of an independent data set, was able to successfully predict variance in this safety-critical measure of pilot response to abnormal circumstances, as collected from the literature. As new technology and procedures are envisioned for the future airspace, it is important to predict if these may compromise safety in terms of pilots' failing to notice unexpected events. Computational models such as N-SEEV support cost-effective means of making such predictions.

An investigation into pilot and system response to critical in-flight events. Volume 2: Appendix

NASA Technical Reports Server (NTRS)

Rockwell, T. H.; Griffin, W. C.

1981-01-01

Materials relating to the study of pilot and system response to critical in-flight events (CIFE) are given. An annotated bibliography and a trip summary outline are presented, as are knowledge surveys with accompanying answer keys. Performance profiles of pilots and performance data from the simulations of CIFE's are given. The paper and pencil testing materials are reproduced. Conditions for the use of the additive model are discussed. A master summary of data for the destination diversion scenario is given. An interview with an aircraft mechanic demonstrates the feasibility of system problem diagnosis from a verbal description of symptoms and shows the information seeking and problem solving logic used by an expert to narrow the list of probable causes of aircraft failure.

75 FR 8001 - Airworthiness Directives; Hawker Beechcraft Corporation (Type Certificate No. A00010WI Previously...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-23

... the essential bus. The disabled equipment could include the autopilot, anti-skid system, hydraulic indicator, spoiler system, pilot primary flight display, audio panel, or the 1 air data computer. This... system, pilot primary flight display, audio panel, or the 1 air data computer. This failure could lead to...

Proceedings of the Workshop on Flight Testing to Identify Pilot Workload and Pilot Dynamics Held at the Edwards AFB, California on 19-21 January 1982

DTIC Science & Technology

1982-05-01

precognitive stages or, in other words, a *Adaptation changes strategy and performance in a new environment, whereas learning or skill development changes...expect the pursuit level of operation to have a lower PML than the compen- satory stage.. 3. Final stage ( precognitive control). At this level of skill...in degraded system performance, if not failure. The compensatory-pursuit- precognitive pathways structure is suitable to represent not only a pilot or

Review of performance, medical, and operational data on pilot aging issues

NASA Technical Reports Server (NTRS)

Stoklosa, J. H.

1992-01-01

An extensive review of the literature and studies relating to performance, medical, operational, and legal data regarding pilot aging issues was performed in order to determine what evidence there is, if any, to support mandatory pilot retirement. Popular misconceptions about aging, including the failure to distinguish between the normal aging process and disease processes that occur more frequently in older individuals, continue to contribute to much of the misunderstanding and controversy that surround this issue. Results: Review of medical data related to the pilot aging issue indicate that recent improvement in medical diagnostics and treatment technology have made it possible to identify to a high degree individuals who are at risk for developing sudden incapacitating illness and for treating those with disqualifying medical conditions. Performance studies revealed that after controlling for the presence of disease states, older pilots are able to perform as well as younger pilots on many performance tasks. Review of accident data showed that older, healthy pilots do not have higher accident rates than younger pilots, and indeeed, evidence suggests that older pilots have an advantage in the cockpit due to higher experience levels. The Man-Machine-Mission-Environment interface of factors can be managed through structured, supervised, and enhanced operations, maintenance, flight reviews, and safety procedures in order to ensure safe and productive operations by reducing the margin of error and by increasing the margin of safety. Conclusions: There is no evidence indicating any specific age as an arbitrary cut-off point for pilots to perform their fight duties. A combination of regular medical screening, performance evaluation, enhanced operational maintenance, and safety procedures can most effectively ensure a safe pilot population than can a mandatory retirement policy based on arbitrary age restrictions.

14 CFR 91.185 - IFR operations: Two-way radio communications failure.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false IFR operations: Two-way radio... RULES Flight Rules Instrument Flight Rules § 91.185 IFR operations: Two-way radio communications failure. (a) General. Unless otherwise authorized by ATC, each pilot who has two-way radio communications...

Why do entrepreneurial mHealth ventures in the developing world fail to scale?

PubMed

Sundin, Phillip; Callan, Jonathan; Mehta, Khanjan

Telemedicine is an increasingly common approach to improve healthcare access in developing countries with fledgling healthcare systems. Despite the strong financial, logistical and clinical support from non-governmental organisations (NGOs), government ministries and private actors alike, the majority of telemedicine projects do not survive beyond the initial pilot phase and achieve their full potential. Based on a review of 35 entrepreneurial telemedicine and mHealth ventures, and 17 reports that analyse their operations and challenges, this article provides a narrative review of recurring failure modes, i.e. factors that lead to failure of such venture pilots. Real-world examples of successful and failed ventures are examined for key take-away messages and practical strategies for creating commercial viable telemedicine operations. A better understanding of these failure modes can inform the design of sustainable and scalable telemedicine systems that effectively address the growing healthcare disparities in developing countries.

Factors Contributing to Pilot Valve Fuel Seal Extrusion in Orbiter PRCS Thrusters

NASA Technical Reports Server (NTRS)

Waller, J.M.; Saulsberry, R.L.; Albright, John D.

2000-01-01

Extrusion of the polytetrafluoroethylene (PTFE) pilot seal used in the monomethylhydrazine (fuel) valve of the Orbiter Primary Reaction Control System (PRCS) thrusters has been implicated in numerous on-orbit thruster failures and on-ground valve failures. Two extrusion mechanisms have been proposed, one or both may be occurring. The first mechanism is attributed to thermal expansion mismatch between adjacent PTFE and metal parts used in the fuel valve, and is referred to as thermal extrusion. The second mechanism is attributed to nitrogen tetroxide (oxidizer) leakage from the adjacent oxidizer valve on the same thruster during ground turnaround, and is referred to as oxidizer-induced extrusion. Model calculations of PTFE pilot seal in an exact pilot valve configuration show that extrusion can be caused by differential thermal expansion, without the intervening influence of oxidizer. Experimental data on semitrapped PTFE and TFM (modified PTFE) specimens simulating a fuel pilot valve configuration show that thermal extrusion 1) is incremental and irreversible, 2) increases with the size of the thermal excursion, 3) decreases with successive thermal cycling, and 4) is accompanied by gap formation. Both PTFE and TFM exhibit a higher affinity for oxidizer than fuel. The property changes associated with oxidizer uptake may explain why oxidizer seals do not exhibit extrusion. Impression replicas of fuel pilot seals removed from the Orbiter fleet show two types of extrusion: extrusion of the entire seal (loaded extrusion), or extrusion of non-sealing surface (unloaded extrusion). Both extrusion types may arise from differences in service history, rather than in failure mechanism. The plausibility oxidizer-induced extrusion was evaluated. Preliminary calculations suggest that enough energy, heat, or gas may be liberated under certain operational scenarios to cause catastrophic extrusion. However, given the lack of supporting data, conclusions implicating oxidizer leakage as a factor in extrusion must be made with caution.

Cognitive Workload and Psychophysiological Parameters During Multitask Activity in Helicopter Pilots.

PubMed

Gaetan, Sophie; Dousset, Erick; Marqueste, Tanguy; Bringoux, Lionel; Bourdin, Christophe; Vercher, Jean-Louis; Besson, Patricia

2015-12-01

Helicopter pilots are involved in a complex multitask activity, implying overuse of cognitive resources, which may result in piloting task impairment or in decision-making failure. Studies usually investigate this phenomenon in well-controlled, poorly ecological situations by focusing on the correlation between physiological values and either cognitive workload or emotional state. This study aimed at jointly exploring workload induced by a realistic simulated helicopter flight mission and emotional state, as well as physiological markers. The experiment took place in the helicopter full flight dynamic simulator. Six participants had to fly on two missions. Workload level, skin conductance, RMS-EMG, and emotional state were assessed. Joint analysis of psychological and physiological parameters associated with workload estimation revealed particular dynamics in each of three profiles. 1) Expert pilots showed a slight increase of measured physiological parameters associated with the increase in difficulty level. Workload estimates never reached the highest level and the emotional state for this profile only referred to positive emotions with low emotional intensity. 2) Non-Expert pilots showed increasing physiological values as the perceived workload increased. However, their emotional state referred to either positive or negative emotions, with a greater variability in emotional intensity. 3) Intermediate pilots were similar to Expert pilots regarding emotional states and similar to Non-Expert pilots regarding physiological patterns. Overall, high interindividual variability of these results highlight the complex link between physiological and psychological parameters with workload, and question whether physiology alone could predict a pilot's inability to make the right decision at the right time.

Navigation experience and mental representations of the environment: do pilots build better cognitive maps?

PubMed

Sutton, Jennifer E; Buset, Melanie; Keller, Mikayla

2014-01-01

A number of careers involve tasks that place demands on spatial cognition, but it is still unclear how and whether skills acquired in such applied experiences transfer to other spatial tasks. The current study investigated the association between pilot training and the ability to form a mental survey representation, or cognitive map, of a novel, ground-based, virtual environment. Undergraduate students who were engaged in general aviation pilot training and controls matched to the pilots on gender and video game usage freely explored a virtual town. Subsequently, participants performed a direction estimation task that tested the accuracy of their cognitive map representation of the town. In addition, participants completed the Object Perspective Test and rated their spatial abilities. Pilots were significantly more accurate than controls at estimating directions but did not differ from controls on the Object Perspective Test. Locations in the town were visited at a similar rate by the two groups, indicating that controls' relatively lower accuracy was not due to failure to fully explore the town. Pilots' superior performance is likely due to better online cognitive processing during exploration, suggesting the spatial updating they engage in during flight transfers to a non-aviation context.

Navigation Experience and Mental Representations of the Environment: Do Pilots Build Better Cognitive Maps?

PubMed Central

Sutton, Jennifer E.; Buset, Melanie; Keller, Mikayla

2014-01-01

A number of careers involve tasks that place demands on spatial cognition, but it is still unclear how and whether skills acquired in such applied experiences transfer to other spatial tasks. The current study investigated the association between pilot training and the ability to form a mental survey representation, or cognitive map, of a novel, ground-based, virtual environment. Undergraduate students who were engaged in general aviation pilot training and controls matched to the pilots on gender and video game usage freely explored a virtual town. Subsequently, participants performed a direction estimation task that tested the accuracy of their cognitive map representation of the town. In addition, participants completed the Object Perspective Test and rated their spatial abilities. Pilots were significantly more accurate than controls at estimating directions but did not differ from controls on the Object Perspective Test. Locations in the town were visited at a similar rate by the two groups, indicating that controls' relatively lower accuracy was not due to failure to fully explore the town. Pilots' superior performance is likely due to better online cognitive processing during exploration, suggesting the spatial updating they engage in during flight transfers to a non-aviation context. PMID:24603608

Pilot-scale verification of maximum tolerable hydrodynamic stress for mammalian cell culture.

PubMed

Neunstoecklin, Benjamin; Villiger, Thomas K; Lucas, Eric; Stettler, Matthieu; Broly, Hervé; Morbidelli, Massimo; Soos, Miroslav

2016-04-01

Although several scaling bioreactor models of mammalian cell cultures are suggested and described in the literature, they mostly lack a significant validation at pilot or manufacturing scale. The aim of this study is to validate an oscillating hydrodynamic stress loop system developed earlier by our group for the evaluation of the maximum operating range for stirring, based on a maximum tolerable hydrodynamic stress. A 300-L pilot-scale bioreactor for cultivation of a Sp2/0 cell line was used for this purpose. Prior to cultivations, a stress-sensitive particulate system was applied to determine the stress values generated by stirring and sparging. Pilot-scale data, collected from 7- to 28-Pa maximum stress conditions, were compared with data from classical 3-L cultivations and cultivations from the oscillating stress loop system. Results for the growth behavior, analyzed metabolites, productivity, and product quality showed a dependency on the different environmental stress conditions but not on reactor size. Pilot-scale conditions were very similar to those generated in the oscillating stress loop model confirming its predictive capability, including conditions at the edge of failure.

NHLBI's program for VAD therapy for moderately advanced heart failure: the REVIVE-IT pilot trial.

PubMed

Baldwin, J Timothy; Mann, Douglas L

2010-11-01

Ventricular assist devices (VADs) are used to bridge heart failure patients to transplantation, to allow their own hearts to recover, or as permanent ("destination") therapy. To date, the use of VADs has been limited to late-stage heart failure patients because of the associated device risks. In 2008, a National Heart, Lung, and Blood Institute (NHLBI) working group met to evaluate the treatment of heart failure using VADs and to advise the institute on how therapy for heart failure may be best advanced by clinical trials involving the devices. Recognizing the improvements in VAD technology and in patient care and selection over the past decade, the working group recommended that a trial be performed to assess the use of chronic VAD therapy in patients who are less ill than those currently eligible for destination therapy. The hypothesis proposed for the trial is that VAD therapy may improve both survival and quality of life in moderately advanced heart failure patients who are neither inotrope-dependent nor exercise-intolerant and have not yet developed serious consequences such as malnourishment, end-organ damage, and immobility. Based on the group's recommendations, NHLBI issued an RFP in 2009 for the REVIVE-IT Pilot Trail, which will serve to test the hypothesis and inform the pivotal trial. Published by Elsevier Inc.

46 CFR 163.002-21 - Approval tests.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 6 2014-10-01 2014-10-01 false Approval tests. 163.002-21 Section 163.002-21 Shipping...: SPECIFICATIONS AND APPROVAL CONSTRUCTION Pilot Hoist § 163.002-21 Approval tests. (a) General. If a pilot hoist fails one of the tests in this section the cause of the failure must be identified and any needed design...

Checklists and Monitoring in the Cockpit: Why Crucial Defenses Sometimes Fail

NASA Technical Reports Server (NTRS)

Dismukes, R. Key; Berman, Ben

2010-01-01

Checklists and monitoring are two essential defenses against equipment failures and pilot errors. Problems with checklist use and pilots failures to monitor adequately have a long history in aviation accidents. This study was conducted to explore why checklists and monitoring sometimes fail to catch errors and equipment malfunctions as intended. Flight crew procedures were observed from the cockpit jumpseat during normal airline operations in order to: 1) collect data on monitoring and checklist use in cockpit operations in typical flight conditions; 2) provide a plausible cognitive account of why deviations from formal checklist and monitoring procedures sometimes occur; 3) lay a foundation for identifying ways to reduce vulnerability to inadvertent checklist and monitoring errors; 4) compare checklist and monitoring execution in normal flights with performance issues uncovered in accident investigations; and 5) suggest ways to improve the effectiveness of checklists and monitoring. Cognitive explanations for deviations from prescribed procedures are provided, along with suggestions for countermeasures for vulnerability to error.

Designing and Testing an End-of-Life Discussion Intervention for African American Patients With Heart Failure and Their Families

PubMed Central

Piamjariyakul, Ubolrat; Smith, Carol E.; Werkowitch, Marilyn; Thompson, Noreen; Fox, Maria; Williamson, Karin Porter; Olson, Lori

2017-01-01

There is an escalating prevalence of heart failure (HF) with high mortality. Compared with other races, African Americans face a higher incidence of HF at earlier age of onset, with more rapid progression, and with increased family care burden and greater care costs and disparity in health care services at the end of life (EOL). Concomitant out-of-pocket HF costs and care demands indicate the need for early discussion of palliative and EOL care needs. We therefore developed and pilot tested a culturally sensitive intervention specific to the needs of African American HF patients and their families at the EOL. Our pilot study findings encompass patient and caregiver perspectives and align with the state of EOL science. The ultimate long-term goal of this intervention strategy is to translate into practice the preferred, culturally sensitive, and most cost-efficient EOL care recommendations for HF patients and families. PMID:29081717

Remediation Strategies for Learners at Risk of Failure: A Course Based Retention Model

ERIC Educational Resources Information Center

Gajewski, Agnes; Mather, Meera

2015-01-01

This paper presents an overview and discussion of a course based remediation model developed to enhance student learning and increased retention based on literature. This model focuses on course structure and course delivery in a compressed semester format. A comparative analysis was applied to a pilot study of students enrolled in a course…

NASA aviation safety reporting system

NASA Technical Reports Server (NTRS)

1978-01-01

The study deals with 165 inadvertent operations on or into inappropriate portions of the aircraft areas at controlled airports. Pilot-initiated and controller-initiated incursions are described and discussed. It was found that a majority of the pilot-initiated occurrences involved operation without a clearance; controller-initiated occurrences usually involved failure to maintain assured separation. The factors associated with these occurrences are analyzed. It appears that a major problem in these occurrences is inadequate coordination among the various system participants. Reasons for this, and some possible solutions to various aspects of the problem, are discussed. A sample of reports from pilots and controllers is presented. These relate to undesired occurrences in air transport, general aviation, and air traffic control operations; to ATC coordination problems; and to a recurrent problem in ASRS reports, parachuting operations. A sample of alert bulletins and responses to them is presented.

NHLBI’s Program for VAD Therapy for Moderately Advanced Heart Failure: The REVIVE-IT Pilot Trial

PubMed Central

Baldwin, J. Timothy; Mann, Douglas L.

2010-01-01

Background VADs are used to bridge heart failure patients to transplantation, to allow their own hearts to recover, or as permanent (“destination”) therapy. To date, the use of VADs has been limited to late-stage heart failure patients because of the associated device risks. In 2008, an NHLBI working group met to evaluate the treatment of heart failure using VADs and to advise the institute on how therapy for heart failure may be best advanced by clinical trials involving the devices. Discussion and Recommendations Recognizing the improvements in VAD technology and in patient care and selection over the past decade, the working group recommended that a trial be performed to assess the use of chronic VAD therapy in patients who are less ill than those currently eligible for destination therapy. The hypothesis proposed for the trial is that VAD therapy may improve both survival and quality of life in moderately advanced heart failure patients who are neither inotrope-dependent nor exercise-intolerant and have not yet developed serious consequences such as malnourishment, end-organ damage, and immobility. Based on the group’s recommendations, NHLBI issued an RFP in 2009 for the REVIVE-IT Pilot Trail which will serve to test the hypothesis and inform the pivotal trial. PMID:21055648

Simulator Investigation of Pilot Aids for Helicopter Terminal Area Operations with One Engine Inoperative

NASA Technical Reports Server (NTRS)

Iseler, Laura; Chen, Robert; Dearing, Munro; Decker, William; Aiken, Edwin W. (Technical Monitor)

1995-01-01

Two recent piloted simulation experiments have investigated advanced display concepts applied to civil transport helicopter terminal area operations. Civil Category A helicopter operations apply to multi-engine helicopters wherein a safe recovery (land or fly out) is required in the event of a single engine failure. The investigation used the NASA Ames Research Center Vertical Motion Simulator, which has a full six degrees of freedom, to simulate the flight task as closely as possible. The goal of these experiments was to use advanced cockpit displays to improve flight safety and enhance the mission performance of Category A terminal area operations in confined areas. The first experiment investigated the use of military display formats to assist civil rotorcraft in performing a Category A takeoff in confined terminal areas. Specifically, it addressed how well a difficult hovering backup path could be followed using conventional instruments in comparison to panel mounted integrated displays. The hovering backup takeoff, which enables pilots to land back to the confined area pad in the event of an engine failure, was chosen since it is a difficult task to perform. Seven NASA and Army test pilots participated in the experiment. Evaluations, based on task performance and pilot workload, showed that an integrated display enabled the pilot to consistently achieve adequate or desired performance with reasonable pilot workload. Use of conventional instruments, however, frequently resulted in unacceptable performance (poor flight path tracking), higher pilot workload, and poor situational awareness. Although OEI landbacks were considered a visual task, the improved performance on the backup portion, in conjunction with increased situational awareness resulting from use of integrated displays, enabled the pilots to handle an engine failure and land back safely. In contrast, use of conventional instruments frequently led to excessive rates of sink at touchdown. A second simulation (in progress - July - August) is being conducted to investigate the use of advanced displays to perform vertical and short takeoffs and landings. One Engine Inoperative trajectories, which were optimized based on safety of flight restrictions, are utilized. Based on comments from the first experiment and further analytic development, appropriate fly out and approach guidance was added. Displays include conventional instruments with raw data, and the following integrated displays: multi-view and side-view hover displays based on the Apache Pilot Night Vision System, and variations of the pathway-in-the-sky displays with a flight-path-vector, a leader and flight director modifications. Panel mounted and head-up displays are being evaluated. Engine modifications have been incorporated to simulate 30 second and 2 minute contingency power ratings. Evaluations are based on task performance and pilot workload. NASA, Army, FAA, and industry test pilots participated. Details concerning the design, conduct, and the results of the experiment will be reported in the proposed paper.

A pilot trial comparing the tear-out behavior in screw-sockets and cemented polyethylene acetabular components - a cadaveric study.

PubMed

Möbius, R; Schleifenbaum, S; Grunert, R; Löffler, S; Werner, M; Prietzel, T; Hammer, N

2016-10-01

The removal of well-fixed acetabular components following THA (total hip arthroplasty) is a difficult operation and could be accompanied by the loss of acetabular bone stock. The optimal method for fixation is still under debate. The aim of this pilot study was to compare the tear-out resistance and failure behavior between osseo-integrated and non-integrated screw cups. Furthermore, we examined whether there are differences in the properties mentioned between screw sockets and cemented polyethylene cups. Tear-out resistance and related mechanical work required for the tear-out of osseo-integrated screw sockets are higher than in non-integrated screw sockets. Ten human coxal bones from six cadavers with osseo-integrated screw sockets (n=4), non-integrated (implanted post-mortem, n=3) screw sockets and cemented polyethylene cups (n=3) were used for tear-out testing. The parameters axial failure load and mechanical work for tear-out were introduced as measures for determining the stability of acetabular components following THA. The osseo-integrated screw sockets yielded slightly higher tear-out resistance (1.61±0.26kN) and related mechanical work compared to the non-integrated screw sockets (1.23±0.39kN, P=0.4). The cemented polyethylene cups yielded the lowest tear-out resistance with a failure load of 1.18±0.24kN. Compared to the screw cups implanted while alive, they also differ on a non-significant level (P=0.1). Osseous failure patterns differed especially for the screw sockets compared to the cemented polyethylene cups. Osseo-integration did not greatly influence the tear-out stability in cementless screw sockets following axial loading. Furthermore, the strength of the bone-implant-interface of cementless screw sockets appears to be similar to cemented polyethylene cups. However, given the high failure load, high mechanical load and because of the related bone failure patterns, removal should not be performed by means of tear-out but rather by osteotomes or other curved cutting devices to preserve the acetabular bone stock. Level III, case-control-study. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

A pilot rating scale for evaluating failure transients in electronic flight control systems

NASA Technical Reports Server (NTRS)

Hindson, William S.; Schroeder, Jeffery A.; Eshow, Michelle M.

1990-01-01

A pilot rating scale was developed to describe the effects of transients in helicopter flight-control systems on safety-of-flight and on pilot recovery action. The scale was applied to the evaluation of hardovers that could potentially occur in the digital flight-control system being designed for a variable-stability UH-60A research helicopter. Tests were conducted in a large moving-base simulator and in flight. The results of the investigation were combined with existing airworthiness criteria to determine quantitative reliability design goals for the control system.

Enhancing the Possibility of Success by Measuring the Probability of Failure in an Educational Program.

ERIC Educational Resources Information Center

Brookhart, Susan M.; And Others

1997-01-01

Process Analysis is described as a method for identifying and measuring the probability of events that could cause the failure of a program, resulting in a cause-and-effect tree structure of events. The method is illustrated through the evaluation of a pilot instructional program at an elementary school. (SLD)

Piloted Simulation to Evaluate the Utility of a Real Time Envelope Protection System for Mitigating In-Flight Icing Hazards

NASA Technical Reports Server (NTRS)

Ranaudo, Richard J.; Martos, Borja; Norton, Bill W.; Gingras, David R.; Barnhart, Billy P.; Ratvasky, Thomas P.; Morelli, Eugene

2011-01-01

The utility of the Icing Contamination Envelope Protection (ICEPro) system for mitigating a potentially hazardous icing condition was evaluated by 29 pilots using the NASA Ice Contamination Effects Flight Training Device (ICEFTD). ICEPro provides real time envelope protection cues and alerting messages on pilot displays. The pilots participating in this test were divided into two groups; a control group using baseline displays without ICEPro, and an experimental group using ICEPro driven display cueing. Each group flew identical precision approach and missed approach procedures with a simulated failure case icing condition. Pilot performance, workload, and survey questionnaires were collected for both groups of pilots. Results showed that real time assessment cues were effective in reducing the number of potentially hazardous upset events and in lessening exposure to loss of control following an incipient upset condition. Pilot workload with the added ICEPro displays was not measurably affected, but pilot opinion surveys showed that real time cueing greatly improved their situation awareness of a hazardous aircraft state.

The preliminary design of a lift-cruise fan airplane flight control system

NASA Technical Reports Server (NTRS)

Gotlieb, P.

1977-01-01

This paper presents the preliminary design of a stability augmentation system for a NASA V/STOL research and technology airplane. This stability augmentation system is postulated as the simplest system that meets handling-quality levels for research and technology missions flown by NASA test pilots. The airplane studied in this report is a modified T-39 fitted with tilting lift/cruise fan nacelles and a nose fan. The propulsion system features a shaft that interconnects three variable-pitch fans and three powerplants. The mathematical modeling is based on pre-wind tunnel test estimated data. The selected stability augmentation system uses variable gains scheduled with airspeed. Failure analysis of the system illustrates the benign effect of engine failure. Airplane rate sensor failure must be solved with redundancy.

Preliminary design-lift/cruise fan research and technology airplane flight control system

NASA Technical Reports Server (NTRS)

Gotlieb, P.; Lewis, G. E.; Little, L. J.

1976-01-01

This report presents the preliminary design of a stability augmentation system for a NASA V/STOL research and technology airplane. This stability augmentation system is postulated as the simplest system that meets handling qualities levels for research and technology missions flown by NASA test pilots. The airplane studied in this report is a T-39 fitted with tilting lift/cruise fan nacelles and a nose fan. The propulsion system features a shaft interconnecting the three variable pitch fans and three power plants. The mathematical modeling is based on pre-wind tunnel test estimated data. The selected stability augmentation system uses variable gains scheduled with airspeed. Failure analysis of the system illustrates the benign effect of engine failure. Airplane rate sensor failure must be solved with redundancy.

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

PubMed

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

2016-08-01

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

78 FR 65206 - Airworthiness Directives; Bell Helicopter Textron Canada Limited (Bell) Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-31

... engine speeds during steady- state operations. These actions are intended to alert pilots to avoid... intended to alert pilots to avoid certain engine speeds during steady- state operations, prevent failure of... decal as described in Bell Alert Service Bulletin (ASB) No. 430-05-34, dated June 10, 2005 (ASB 430-05...

The Influence of Loss of Visual Cues on Pilot Performance During the Final Approach and Landing Phase of a Remotely Piloted Vehicle Mission

NASA Technical Reports Server (NTRS)

Howard, James C.

1976-01-01

Remotely piloted research vehicles (RPRVS) are currently being flown from fixed-base control centers, and visual information is supplied to the remote pilot by a TV camera mounted in the vehicle. In these circumstances, the possibility of a TV failure or an interruption in the downlink to the pilot must be considered. To determine the influence of loss of TV information on pilot performance during the final approach and landing phase of a mission, an experiment was conducted in which pilots were asked to fly a fixed-base simulation of a Piper PA-30 aircraft with loss of TV information occurring at altitudes of 15.24, 30.48, and 45.72 m (50, 100, and 150 ft). For this experiment, a specially designed display configuration was presented to four pilots in accordance with a Latin square design. Initial results indicate that pilots could not ensure successful landings from altitudes exceeding 15.24 m (.50 ft) without the visual cues supplied by the TV picture.

Advanced control technology and airworthiness flying qualities requirements

NASA Technical Reports Server (NTRS)

Snyder, C. T.

1976-01-01

Flying quality requirements are specified in terms of the complete pilot-airframe-systems loop, the task, and the environment. Results from a study of flying qualities are reported. A review of the treatment of failure cases in various flying quality requirements is presented along with a description of the methods used and relevant lessons learned from recent Autoland certification programs.

Non-invasive high-frequency ventilation versus bi-phasic continuous positive airway pressure (BP-CPAP) following CPAP failure in infants <1250 g: a pilot randomized controlled trial.

PubMed

Mukerji, A; Sarmiento, K; Lee, B; Hassall, K; Shah, V

2017-01-01

Non-invasive high-frequency ventilation (NIHFV), a relatively new modality, is gaining popularity despite limited data. We sought to evaluate the effectiveness of NIHFV versus bi-phasic continuous positive airway pressure (BP-CPAP) in preterm infants failing CPAP. Infants with BW<1250 g on CPAP were randomly assigned to NIHFV or BP-CPAP if they met pre-determined criteria for CPAP failure. Infants were eligible for randomization after 72 h age and until 2000 g. Guidelines for adjustment of settings and criteria for failure of assigned mode were implemented. The primary aim was to assess feasibility of a larger trial. In addition, failure of assigned non-invasive respiratory support (NRS) mode, invasive mechanical ventilation (MV) 72 h and 7 days post-randomization, and bronchopulmonary dysplasia (BPD) were assessed. Thirty-nine infants were randomized to NIHFV (N=16) or BP-CPAP (N=23). There were no significant differences in mean (s.d.) postmenstrual age (28.6 (1.5) versus 29.0 (2.3) weeks, P=0.47), mean (s.d.) weight at randomization (965.0 (227.0) versus 958.1 (310.4) g, P=0.94) or other baseline demographics between the groups. Failure of assigned NRS mode was lower with NIHFV (37.5 versus 65.2%, P=0.09), although not statistically significant. There were no differences in rates of invasive MV 72 h and 7 days post-randomization or BPD. NIHFV was not superior to BP-CPAP in this pilot study. Effectiveness of NIHFV needs to be proven in larger multi-center, appropriately powered trials before widespread implementation.

Failure to detect critical auditory alerts in the cockpit: evidence for inattentional deafness.

PubMed

Dehais, Frédéric; Causse, Mickaël; Vachon, François; Régis, Nicolas; Menant, Eric; Tremblay, Sébastien

2014-06-01

The aim of this study was to test whether inattentional deafness to critical alarms would be observed in a simulated cockpit. The inability of pilots to detect unexpected changes in their auditory environment (e.g., alarms) is a major safety problem in aeronautics. In aviation, the lack of response to alarms is usually not attributed to attentional limitations, but rather to pilots choosing to ignore such warnings due to decision biases, hearing issues, or conscious risk taking. Twenty-eight general aviation pilots performed two landings in a flight simulator. In one scenario an auditory alert was triggered alone, whereas in the other the auditory alert occurred while the pilots dealt with a critical windshear. In the windshear scenario, II pilots (39.3%) did not report or react appropriately to the alarm whereas all the pilots perceived the auditory warning in the no-windshear scenario. Also, of those pilots who were first exposed to the no-windshear scenario and detected the alarm, only three suffered from inattentional deafness in the subsequent windshear scenario. These findings establish inattentional deafness as a cognitive phenomenon that is critical for air safety. Pre-exposure to a critical event triggering an auditory alarm can enhance alarm detection when a similar event is encountered subsequently. Case-based learning is a solution to mitigate auditory alarm misperception.

Enhanced Flight Vision Systems Operational Feasibility Study Using Radar and Infrared Sensors

NASA Technical Reports Server (NTRS)

Etherington, Timothy J.; Kramer, Lynda J.; Severance, Kurt; Bailey, Randall E.; Williams, Steven P.; Harrison, Stephanie J.

2015-01-01

Approach and landing operations during periods of reduced visibility have plagued aircraft pilots since the beginning of aviation. Although techniques are currently available to mitigate some of the visibility conditions, these operations are still ultimately limited by the pilot's ability to "see" required visual landing references (e.g., markings and/or lights of threshold and touchdown zone) and require significant and costly ground infrastructure. Certified Enhanced Flight Vision Systems (EFVS) have shown promise to lift the obscuration veil. They allow the pilot to operate with enhanced vision, in lieu of natural vision, in the visual segment to enable equivalent visual operations (EVO). An aviation standards document was developed with industry and government consensus for using an EFVS for approach, landing, and rollout to a safe taxi speed in visibilities as low as 300 feet runway visual range (RVR). These new standards establish performance, integrity, availability, and safety requirements to operate in this regime without reliance on a pilot's or flight crew's natural vision by use of a fail-operational EFVS. A pilot-in-the-loop high-fidelity motion simulation study was conducted at NASA Langley Research Center to evaluate the operational feasibility, pilot workload, and pilot acceptability of conducting straight-in instrument approaches with published vertical guidance to landing, touchdown, and rollout to a safe taxi speed in visibility as low as 300 feet RVR by use of vision system technologies on a head-up display (HUD) without need or reliance on natural vision. Twelve crews flew various landing and departure scenarios in 1800, 1000, 700, and 300 RVR. This paper details the non-normal results of the study including objective and subjective measures of performance and acceptability. The study validated the operational feasibility of approach and departure operations and success was independent of visibility conditions. Failures were handled within the lateral confines of the runway for all conditions tested. The fail-operational concept with pilot in the loop needs further study.

[Pilot study of levosimendan : Effect on liver blood flow and liver function in acute decompensated heart failure].

PubMed

Lenz, K; Gegenhuber, A; Firlinger, F; Lohr, G; Piringer, P

2014-05-01

In a pilot study, 9 patients (39-48 years) with acute decompensated heart failure and a cardiac index (CI) of 1.9 ± 0.3 l/min/m(2) were included after exclusion of an underlying hepatic disease. The effect of levosimendan on liver blood flow and liver function was measured with the LiMON(®) system using the indocyane green plasma disappearance rate (ICG PDR). Levosimendan (Simdax(®)) infusion resulted in a significant increase of the CI, thus, achieving normal ranges of 2.9 ± 0.9 l/min/m(2) after 4 h and 3.3 ± 1 l/min/m(2) (p = 0.003) after 24 h. ICG PDR increased from 8.2 ± 0.8 % to 10.2 + 1.8 % after 4 h and to 11.9 ± 2.9 % after 24 h (p = 0.04). The reason for the early increase in systemic blood flow with no concomitant change in ICG PDR is not clear. A primary increase in liver blood flow with sustained low liver function might be one explanation; a low flow-mediated increased release of cytokines from liver cells with consequent deterioration of liver function is another possible explanation.

A heart failure initiative to reduce the length of stay and readmission rates.

PubMed

White, Sabrina Marie; Hill, Alethea

2014-01-01

The purpose of this pilot was to improve multidisciplinary coordination of care and patient education and foster self-management behaviors. The primary and secondary outcomes achieved from this pilot were to decrease the 30-day readmission rate and heart failure length of stay. The primary practice site was an inpatient medical-surgical nursing unit. The length of stay decreased from 6.05% to 4.42% for heart failure diagnostic-related group 291 as a result of utilizing the model. The length of stay decreased from 3.9% to 3.09%, which was also less than the national rate of 3.8036% for diagnostic-related group 292. In addition, the readmission rate decreased from 23.1% prior to January 2013 to 12.9%. Implementation of standards of care coordination can decrease length of stay, readmission rate, and improve self-management. Implementation of evidence-based heart failure guidelines, improved interdisciplinary coordination of care, patient education, self-management skills, and transitional care at the time of discharge improved overall heart failure outcome measures. Utilizing the longitudinal model of care to transition patients to home aided in evaluating social support, resource allocation and utilization, access to care postdischarge, and interdisciplinary coordination of care. The collaboration between disciplines improved continuity of care, patient compliance to their discharge regimen, and adequate discharge follow-up.

The effects of motion and g-seat cues on pilot simulator performance of three piloting tasks

NASA Technical Reports Server (NTRS)

Showalter, T. W.; Parris, B. L.

1980-01-01

Data are presented that show the effects of motion system cues, g-seat cues, and pilot experience on pilot performance during takeoffs with engine failures, during in-flight precision turns, and during landings with wind shear. Eight groups of USAF pilots flew a simulated KC-135 using four different cueing systems. The basic cueing system was a fixed-base type (no-motion cueing) with visual cueing. The other three systems were produced by the presence of either a motion system or a g-seat, or both. Extensive statistical analysis of the data was performed and representative performance means were examined. These data show that the addition of motion system cueing results in significant improvement in pilot performance for all three tasks; however, the use of g-seat cueing, either alone or in conjunction with the motion system, provides little if any performance improvement for these tasks and for this aircraft type.

[The French translation and cultural adaptation of the SRI questionnaire. A questionnaire to assess health-related quality of life in patients with chronic respiratory failure and domiciliary ventilation].

PubMed

Cuvelier, A; Lamia, B; Molano, L-C; Muir, J-F; Windisch, W

2012-05-01

We performed the French translation and cross-cultural adaptation of the Severe Respiratory Insufficiency (SRI) questionnaire. Written and validated in German, this questionnaire evaluates health-related quality of life in patients treated with domiciliary ventilation for chronic respiratory failure. Four bilingual German-French translators and a linguist were recruited to produce translations and back-translations of the questionnaire constituted of 49 items in seven domains. Two successive versions were generated and compared to the original questionnaire. The difficulty of the translation and the naturalness were quantified for each item using a 1-10 scale and their equivalence to their original counterpart was graded from A to C. The translated questionnaire was finally tested in a pilot study, which included 15 representative patients. The difficulty of the first translation and the first back-translation was respectively quantified as 2.5 (range 1-5.5) and 1.5 (range 1-6) on the 10-point scale (P=0.0014). The naturalness and the equivalence of 8/49 items were considered as insufficient, which led to the production of a second translation and a second back-translation. The meanings of two items needed clarification during the pilot study. The French translation of the SRI questionnaire represents a new instrument for clinical research in patients treated with domiciliary ventilation for chronic respiratory failure. Its validity needs to be tested in a multicenter study. Copyright © 2012 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Instrument Failure, Stress, and Spatial Disorientation Leading to a Fatal Crash With a Large Aircraft.

PubMed

Tribukait, Arne; Eiken, Ola

2017-11-01

An aircraft's orientation relative to the ground cannot be perceived via the sense of balance or the somatosensory system. When devoid of external visual references, the pilot must rely on instruments. A sudden unexpected instrument indication is a challenge to the pilot, who might have to question the instrument instead of responding with the controls. In this case report we analyze, from a human-factors perspective, how a limited instrument failure led to a fatal accident. During straight-ahead level flight in darkness, at 33,000 ft, the commander of a civil cargo airplane was suddenly confronted by an erroneous pitch-up indication on his primary flight display. He responded by pushing the control column forward, making a bunt maneuver with reduced/negative Gz during approximately 15 s. The pilots did not communicate rationally or cross-check instruments. Recordings of elevator and aileron positions suggest that the commander made intense efforts to correct for several extreme and erroneous roll and pitch indications. Gz displayed an increasing trend with rapid fluctuations and peaks of approximately 3 G. After 50 s the aircraft entered a turn with decreasing radius and finally hit the ground in an inverted attitude. A precipitate maneuvring response can, even if occurring in a large aircraft at high altitude, result in a seemingly inexorable course of events, ending with a crash. In the present case both pilots were probably incapacitated by acute psychological stress and spatial disorientation. Intense variations in Gz may have impaired the copilot's reading of the functioning primary flight display.Tribukait A, Eiken O. Instrument failure, stress, and spatial disorientation leading to a fatal crash with a large aircraft. Aerosp Med Hum Perform. 2017; 88(11):1043-1048.

Case conferences between general practitioners and specialist teams to plan end of life care of people with end stage heart failure and lung disease: an exploratory pilot study

PubMed Central

2014-01-01

Background Most people die of non-malignant disease, but most patients of specialist palliative care services have cancer. Adequate end of life care for people with non-malignant disease requires acknowledgement of their limited prognosis and appropriate care planning. Case conferences between specialist palliative care services and GPs improve outcomes in cancer-based populations. We report a pilot study of case conferences between the patient’s GP and specialist staff to facilitate care planning for people with end stage heart failure or non-malignant lung disease in a regional health service in Queensland Australia. Methods Single face to face case conferences about patients with a primary diagnosis of advanced heart failure or respiratory failure from non-malignant disease were conducted between a palliative care consultant, a case management nurse and the patient’s GP. Annualised rates of service utilisation (emergency department [ED] presentations, ED discharges back to home, hospital admissions, and admission length of stay) before and after case conference were calculated. Content and counts of case conference recommendations, and the rate of adherence to recommendations were also assessed. A process evaluation of case conferences was undertaken. Results Twenty-three case conferences involving 21 GPs were conducted between November 2011 and November 2012. One GP refused to participate. Ten patients died, three at home. Of 82 management recommendations made, 55 (67%) were enacted. ED admissions fell from 13.9 per annum (pa) to 2.1 (difference 11.8, 95% CI 2.2-21.3, p = 0.001); ED admissions leading to discharge home from 3.9 to 0.4 pa (difference 3.5, 95% CI -0.4-7.5, p = 0.05); hospital admissions from 11.4 to 3.5 pa (difference 7.9, 95% CI 2.2-13.7, p = 0.002); and length of stay from 7.0 to 3.7 days (difference 3.4, 95% CI 0.9-5.8, p = 0.007). Participating health professionals were enthusiastic about the process. Conclusions This pilot is the initial step in the development and testing of a complex intervention based on a model of integrated care. A single case conference involving the patient’s heart or lung failure team is associated with significant reductions in service utilization, apparently by improving case coordination, enhancing symptom management and assessing and managing carer needs. A randomized controlled trial is being developed. Trial registration Australian and New Zealand Controlled Trials Register ACTRN12613001377729: Registered 16/12/2013. PMID:24829539

Analysis of Operational Hazards and Safety Requirements for Traffic Aware Strategic Aircrew Requests (TASAR)

NASA Technical Reports Server (NTRS)

Koczo, Stefan, Jr.

2013-01-01

Safety analyses of the Traffic Aware Strategic Aircrew Requests (TASAR) Electronic Flight Bag (EFB) application are provided to establish its Failure Effects Classification which affects certification and operational approval requirements. TASAR was developed by NASA Langley Research Center to offer flight path improvement opportunities to the pilot during flight for operational benefits (e.g., reduced fuel, flight time). TASAR, using own-ship and network-enabled information concerning the flight and its environment, including weather and Air Traffic Control (ATC) system constraints, provides recommended improvements to the flight trajectory that the pilot can choose to request via Change Requests to ATC for revised clearance. This study reviews the Change Request process of requesting updates to the current clearance, examines the intended function of TASAR, and utilizes two safety assessment methods to establish the Failure Effects Classification of TASAR. Considerable attention has been given in this report to the identification of operational hazards potentially associated with TASAR.

Old-and With Severe Heart Failure: Telemonitoring by Using Digital Pen Technology in Specialized Homecare: System Description, Implementation, and Early Results.

PubMed

Lind, Leili; Carlgren, Gunnar; Karlsson, Daniel

2016-08-01

Telehealth programs for heart failure have been studied using a variety of techniques. Because currently a majority of the elderly are nonusers of computers and Internet, we developed a home telehealth system based on digital pen technology. Fourteen patients (mean age, 84 years [median, 83 years]) with severe heart failure participated in a 13-month pilot study in specialized homecare. Participants communicated patient-reported outcome measures daily using the digital pen and health diary forms, submitting a total of 3 520 reports. The reports generated a total of 632 notifications when reports indicated worsening health. Healthcare professionals reviewed reports frequently, more than 4700 times throughout the study, and acted on the information provided. Patients answered questionnaires and were observed in their home environment when using the system. Results showed that the technology was accepted by participants: patients experienced an improved contact with clinicians; they felt more compliant with healthcare professionals' advice, and they felt more secure and more involved in their own care. Via the system, the healthcare professionals detected heart failure-related deteriorations at an earlier stage, and as a consequence, none of the patients were admitted into hospital care during the study.

Aquatic Exercise Training is Effective in Maintaining Exercise Performance in Trained Heart Failure Patients: A Randomised Crossover Pilot Trial.

PubMed

Adsett, Julie; Morris, Norman; Kuys, Suzanne; Hwang, Rita; Mullins, Robert; Khatun, Mohsina; Paratz, Jennifer; Mudge, Alison

2017-06-01

Providing flexible models and a variety of exercise options are fundamental to supporting long-term exercise participation for patients with heart failure (HF). The aim of this pilot study was to determine the feasibility and efficacy of aquatic exercise training during a maintenance phase for a clinical heart failure population. In this 2 x 2 crossover design trial, individuals who had previously completed HF rehabilitation were randomised into either a land-based or aquatic training program once per week for six weeks, after which time they changed to the alternate exercise training protocol for an additional six weeks. Six-minute walk test (6MWT), grip strength, walk speed, and measures of balance were compared for the two training protocols. Fifty-one participants (43 males, mean age 69.2 yrs) contributed data for the analysis. Both groups maintained function during the follow-up period, however improvements in 6MWT were greater in the land-based training group (95% CI: 0.7, 22.5; p=0.038), by a mean difference of 10.8 metres. No significant difference was observed for other parameters when the two training protocols were compared. Attending an aquatic exercise program once per week is feasible for patients with stable HF and may provide a suitable option to maintain functional performance in select patients. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

Renal Denervation for Chronic Heart Failure: Background and Pathophysiological Rationale.

PubMed

Böhm, Michael; Ewen, Sebastian; Mahfoud, Felix

2017-01-01

The activation of the sympathetic nervous system is associated with cardiovascular hospitalizations and death in heart failure. Renal denervation has been shown to effectively reduce sympathetic overdrive in certain patients with uncontrolled hypertension. Pilot trials investigating renal denervation as a potential treatment approach for heart failure were initiated. Heart failure comorbidities like obstructive sleep apnea, metabolic syndrome and arrhythmias could also be targets for renal denervation, because these occurrences are also mediated by the activation of the sympathetic nervous system. Therefore, renal denervation in heart failure is worthy of further investigation, although its effectiveness still has to be proven. Herein, we describe the pathophysiological rationale and the effect of renal denervation on surrogates of the heart failure syndrome.

Renal Denervation for Chronic Heart Failure: Background and Pathophysiological Rationale

PubMed Central

Ewen, Sebastian; Mahfoud, Felix

2017-01-01

The activation of the sympathetic nervous system is associated with cardiovascular hospitalizations and death in heart failure. Renal denervation has been shown to effectively reduce sympathetic overdrive in certain patients with uncontrolled hypertension. Pilot trials investigating renal denervation as a potential treatment approach for heart failure were initiated. Heart failure comorbidities like obstructive sleep apnea, metabolic syndrome and arrhythmias could also be targets for renal denervation, because these occurrences are also mediated by the activation of the sympathetic nervous system. Therefore, renal denervation in heart failure is worthy of further investigation, although its effectiveness still has to be proven. Herein, we describe the pathophysiological rationale and the effect of renal denervation on surrogates of the heart failure syndrome. PMID:28154583

14 CFR 23.367 - Unsymmetrical loads due to engine failure.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Unsymmetrical loads due to engine failure. 23.367 Section 23.367 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... may be based on the limit pilot forces specified in § 23.397 except that lower forces may be assumed...

14 CFR 23.367 - Unsymmetrical loads due to engine failure.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Unsymmetrical loads due to engine failure. 23.367 Section 23.367 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... may be based on the limit pilot forces specified in § 23.397 except that lower forces may be assumed...

14 CFR 23.367 - Unsymmetrical loads due to engine failure.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Unsymmetrical loads due to engine failure. 23.367 Section 23.367 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... may be based on the limit pilot forces specified in § 23.397 except that lower forces may be assumed...

Adaptive Flight Control for Aircraft Safety Enhancements

NASA Technical Reports Server (NTRS)

Nguyen, Nhan T.; Gregory, Irene M.; Joshi, Suresh M.

2008-01-01

This poster presents the current adaptive control research being conducted at NASA ARC and LaRC in support of the Integrated Resilient Aircraft Control (IRAC) project. The technique "Approximate Stability Margin Analysis of Hybrid Direct-Indirect Adaptive Control" has been developed at NASA ARC to address the needs for stability margin metrics for adaptive control that potentially enables future V&V of adaptive systems. The technique "Direct Adaptive Control With Unknown Actuator Failures" is developed at NASA LaRC to deal with unknown actuator failures. The technique "Adaptive Control with Adaptive Pilot Element" is being researched at NASA LaRC to investigate the effects of pilot interactions with adaptive flight control that can have implications of stability and performance.

Failure detection and identification for a reconfigurable flight control system

NASA Technical Reports Server (NTRS)

Dallery, Francois

1987-01-01

Failure detection and identification logic for a fault-tolerant longitudinal control system were investigated. Aircraft dynamics were based upon the cruise condition for a hypothetical transonic business jet transport configuration. The fault-tolerant control system consists of conventional control and estimation plus a new outer loop containing failure detection, identification, and reconfiguration (FDIR) logic. It is assumed that the additional logic has access to all measurements, as well as to the outputs of the control and estimation logic. The pilot may also command the FDIR logic to perform special tests.

Determination of optimal trajectories for an aircraft returning to the runway following a complete loss of thrust after takeoff

NASA Astrophysics Data System (ADS)

Gordon, Craig A.

This thesis examines the ability of a small, single-engine airplane to return to the runway following an engine failure shortly after takeoff. Two sets of trajectories are examined. One set of trajectories has the airplane fly a straight climb on the runway heading until engine failure. The other set of trajectories has the airplane perform a 90° turn at an altitude of 500 feet and continue until engine failure. Various combinations of wind speed, wind direction, and engine failure times are examined. The runway length required to complete the entire flight from the beginning of the takeoff roll to wheels stop following the return to the runway after engine failure is calculated for each case. The optimal trajectories following engine failure consist of three distinct segments: a turn back toward the runway using a large bank angle and angle of attack; a straight glide; and a reversal turn to align the airplane with the runway. The 90° turn results in much shorter required runway lengths at lower headwind speeds. At higher headwind speeds, both sets of trajectories are limited by the length of runway required for the landing rollout, but the straight climb cases generally require a lower angle of attack to complete the flight. The glide back to the runway is performed at an airspeed below the best glide speed of the airplane due to the need to conserve potential energy after the completion of the turn back toward the runway. The results are highly dependent on the rate of climb of the airplane during powered flight. The results of this study can aid the pilot in determining whether or not a return to the runway could be performed in the event of an engine failure given the specific wind conditions and runway length at the time of takeoff. The results can also guide the pilot in determining the takeoff profile that would offer the greatest advantage in returning to the runway.

Airline Transport Pilot Preferences for Predictive Information

NASA Technical Reports Server (NTRS)

Trujillo, Anna C.

1996-01-01

This experiment assessed certain issues about the usefulness of predictive information: (1) the relative time criticality of failures, (2) the subjective utility of predictive information for different parameters or sensors, and (3) the preferred form and prediction time for displaying predictive information. To address these issues, three separate tasks were administered to 22 airline pilots. As shown by the data, these pilots preferred predictive information on parameters they considered vital to the safety of the flight. These parameters were related to the checklists performed first for alert messages. These pilots also preferred to know whether a parameter was changing abnormally and the time to a certain value being reached. Furthermore, they considered this information most useful during the cruise, the climb, and the descent phases of flight. Lastly, these pilots preferred the information to predict as far ahead as possible.

Disease management: remote monitoring in heart failure patients with implantable defibrillators, resynchronization devices, and haemodynamic monitors.

PubMed

Abraham, William T

2013-06-01

Heart failure represents a major public health concern, associated with high rates of morbidity and mortality. A particular focus of contemporary heart failure management is reduction of hospital admission and readmission rates. While optimal medical therapy favourably impacts the natural history of the disease, devices such as cardiac resynchronization therapy devices and implantable cardioverter defibrillators have added incremental value in improving heart failure outcomes. These devices also enable remote patient monitoring via device-based diagnostics. Device-based measurement of physiological parameters, such as intrathoracic impedance and heart rate variability, provide a means to assess risk of worsening heart failure and the possibility of future hospitalization. Beyond this capability, implantable haemodynamic monitors have the potential to direct day-to-day management of heart failure patients to significantly reduce hospitalization rates. The use of a pulmonary artery pressure measurement system has been shown to significantly reduce the risk of heart failure hospitalization in a large randomized controlled study, the CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients (CHAMPION) trial. Observations from a pilot study also support the potential use of a left atrial pressure monitoring system and physician-directed patient self-management paradigm; these observations are under further investigation in the ongoing LAPTOP-HF trial. All these devices depend upon high-intensity remote monitoring for successful detection of parameter deviations and for directing and following therapy.

Predictive value of daily living score in acute respiratory failure of COPD patients requiring invasive mechanical ventilation pilot study.

PubMed

Langlet, Ketty; Van Der Linden, Thierry; Launois, Claire; Fourdin, Caroline; Cabaret, Philippe; Kerkeni, Nadia; Barbe, Coralie; Lebargy, François; Deslée, Gaetan

2012-10-18

Mechanical ventilation (MV) is imperative in many forms of acute respiratory failure (ARF) in COPD patients. Previous studies have shown the difficulty to identify parameters predicting the outcome of COPD patients treated by invasive MV. Our hypothesis was that a non specialized score as the activities daily living (ADL) score may help to predict the outcome of these patients. We studied the outcome of 25 COPD patients admitted to the intensive care unit for ARF requiring invasive MV. The patients were divided into those weaning success (group A n = 17, 68%) or failure (group B n = 8, 32%). We investigated the correlation between the ADL score and the outcome and mortality. The ADL score was higher in group A (5.1 ±1.1 vs 3.7 ± 0.7 in group B, p < 0.01). Weaning was achieved in 76.5% of the cases with an ADL score ≥ 4 and in 23.5% of the cases with an ADL score < 4 (p < 0.05). Pulmonary function test, arterial blood gases collected during period of clinical stability and at admission and nutritional status were similar in both groups. The mortality, at six months, was 36%. The ADL score was a significant predictor of 6-month mortality (80 with an ADL score <4, 20 with an ADL score ≥4, p < 0.01). Our pilot study demonstrates that the ADL score is predictive of weaning success and mortality at 6 months, suggesting that the assessment of daily activities should be an important component of ARF management in COPD patients.

Neurodevelopmental and health outcomes in term infants treated with surfactant for severe respiratory failure.

PubMed

Auten, R L; Merzbach, J; Myers, G; Goldstein, R F; Palumbo, D

2000-01-01

Analysis of health, neurodevelopmental, and school performance outcomes in a pilot study of term and near-term infants with respiratory failure due to pneumonia or meconium aspiration treated with surfactant. Retrospective review of medical records, neurodevelopmental and psychosocial evaluations, and parent and teacher surveys. Of the 14 patients enrolled, only one was rehospitalized, for pneumonia. Three were reported to have episodes of wheezing, two of whom required bronchodilators. One patient had unilateral hearing loss, one had a full-scale intelligence quotient that was below normal, and all but one patient for whom complete results were obtained were performing at or above grade level. Term and near-term newborns with moderately severe respiratory failure treated with surfactant can, in general, be expected to recover completely and have normal general health, neurodevelopmental outcome, and school performance.

Memokath Stent Failure in Recurrent Bulbar Urethral Strictures: Results From an Investigative Pilot Stage 2A Study.

PubMed

Barbagli, Guido; Rimondi, Claudio; Balò, Sofia; Butnaru, Denis; Sansalone, Salvatore; Lazzeri, Massimo

2017-09-01

To evaluate the efficacy of the Memokath stent in managing recurrent bulbar urethral strictures. This is an investigative pilot stage 2A study in patients with a recurrent bulbar urethral stricture who underwent a Memokath stent implant from January 2014 to January 2016 in a single high-volume center for urethral reconstruction. The Memokath stent (Pnn Medical A/S, Kvistgaard, Denmark) was manufactured from nitinol, a biocompatible alloy of nickel and titanium, which was endoscopically placed. It had a 24-Fr outside diameter and was preloaded on a disposable delivery device. When correctly positioned, the stent was anchored by a warm water (55°C) instillation, which expanded the proximal end of the stent from 24 to 42 Fr .The stent was provided in lengths of 3-7 cm in 1-cm increments. Sixteen patients were included in the study. The median follow-up was 16 months. In 7 patients (43.7%), the stent was removed within 1 year. The main adverse events were pain, encrustations, stones, and recurrent strictures. Four patients (25%) were considered a success and 12 (75%) were failures. Study limitations include the small sample. The Memokath stent was deemed to be not clinically helpful and had significant side effects, and therefore should not be considered a treatment option for men with bulbar urethral strictures. Copyright © 2017 Elsevier Inc. All rights reserved.

Piloting considerations for terminal area operations of civil tiltwing and tiltrotor aircraft

NASA Technical Reports Server (NTRS)

Hindson, William S.; Hardy, Gordon H.; Tucker, George E.; Decker, William A.

1993-01-01

The existing body of research to investigate airworthiness, performance, handling, and operational requirements for STOL and V/STOL aircraft was reviewed for its applicability to the tiltrotor and tiltwing design concepts. The objective of this study was to help determine the needs for developing civil certification criteria for these aircraft concepts. Piloting tasks that were considered included configuration and thrust vector management, glidepath control, deceleration to hover, and engine failure procedures. Flight control and cockpit display systems that have been found necessary to exploit the low-speed operating characteristics of these aircraft are described, and beneficial future developments are proposed.

Investigation of the cross-ship comparison monitoring method of failure detection in the HIMAT RPRV. [digital control techniques using airborne microprocessors

NASA Technical Reports Server (NTRS)

Wolf, J. A.

1978-01-01

The Highly maneuverable aircraft technology (HIMAT) remotely piloted research vehicle (RPRV) uses cross-ship comparison monitoring of the actuator RAM positions to detect a failure in the aileron, canard, and elevator control surface servosystems. Some possible sources of nuisance trips for this failure detection technique are analyzed. A FORTRAN model of the simplex servosystems and the failure detection technique were utilized to provide a convenient means of changing parameters and introducing system noise. The sensitivity of the technique to differences between servosystems and operating conditions was determined. The cross-ship comparison monitoring method presently appears to be marginal in its capability to detect an actual failure and to withstand nuisance trips.

Pilot perception and confidence of location during a simulated helicopter navigation task.

PubMed

Yang, Ji Hyun; Cowden, Bradley T; Kennedy, Quinn; Schramm, Harrison; Sullivan, Joseph

2013-09-01

This paper aims to provide insights into human perception, navigation performance, and confidence in helicopter overland navigation. Helicopter overland navigation is a challenging mission area because it is a complex cognitive task, and failing to recognize when the aircraft is off-course can lead to operational failures and mishaps. A human-in-the-loop experiment to investigate pilot perception during simulated overland navigation by analyzing actual navigation trajectory, pilots' perceived location, and corresponding confidence levels was designed. There were 15 military officers with prior overland navigation experience who completed 4 simulated low-level navigation routes, 2 of which entailed auto-navigation. This route was paused roughly every 30 s for the subject to mark their perceived location on the map and their confidence level using a customized program. Analysis shows that there is no correlation between perceived and actual location of the aircraft, nor between confidence level and actual location. There is, however, some evidence that there is a correlation (rho = -0.60 to approximately 0.65) between perceived location and intended route of flight, suggesting that there is a bias toward believing one is on the intended flight route. If aviation personnel can proactively identify the circumstances in which usual misperceptions occur in navigation, they may reduce mission failure and accident rate. Fleet squadrons and instructional commands can benefit from this study to improve operations that require low-level flight while also improving crew resource management.

Wetware, Hardware, or Software Incapacitation: Observational Methods to Determine When Autonomy Should Assume Control

NASA Technical Reports Server (NTRS)

Trujillo, Anna C.; Gregory, Irene M.

2014-01-01

Control-theoretic modeling of human operator's dynamic behavior in manual control tasks has a long, rich history. There has been significant work on techniques used to identify the pilot model of a given structure. This research attempts to go beyond pilot identification based on experimental data to develop a predictor of pilot behavior. Two methods for pre-dicting pilot stick input during changing aircraft dynamics and deducing changes in pilot behavior are presented This approach may also have the capability to detect a change in a subject due to workload, engagement, etc., or the effects of changes in vehicle dynamics on the pilot. With this ability to detect changes in piloting behavior, the possibility now exists to mediate human adverse behaviors, hardware failures, and software anomalies with autono-my that may ameliorate these undesirable effects. However, appropriate timing of when au-tonomy should assume control is dependent on criticality of actions to safety, sensitivity of methods to accurately detect these adverse changes, and effects of changes in levels of auto-mation of the system as a whole.

Verification and Validation of Adaptive and Intelligent Systems with Flight Test Results

NASA Technical Reports Server (NTRS)

Burken, John J.; Larson, Richard R.

2009-01-01

F-15 IFCS project goals are: a) Demonstrate Control Approaches that can Efficiently Optimize Aircraft Performance in both Normal and Failure Conditions [A] & [B] failures. b) Advance Neural Network-Based Flight Control Technology for New Aerospace Systems Designs with a Pilot in the Loop. Gen II objectives include; a) Implement and Fly a Direct Adaptive Neural Network Based Flight Controller; b) Demonstrate the Ability of the System to Adapt to Simulated System Failures: 1) Suppress Transients Associated with Failure; 2) Re-Establish Sufficient Control and Handling of Vehicle for Safe Recovery. c) Provide Flight Experience for Development of Verification and Validation Processes for Flight Critical Neural Network Software.

A Piloted Evaluation of Damage Accommodating Flight Control Using a Remotely Piloted Vehicle

NASA Technical Reports Server (NTRS)

Cunningham, Kevin; Cox, David E.; Murri, Daniel G.; Riddick, Stephen E.

2011-01-01

Toward the goal of reducing the fatal accident rate of large transport airplanes due to loss of control, the NASA Aviation Safety Program has conducted research into flight control technologies that can provide resilient control of airplanes under adverse flight conditions, including damage and failure. As part of the safety program s Integrated Resilient Aircraft Control Project, the NASA Airborne Subscale Transport Aircraft Research system was designed to address the challenges associated with the safe and efficient subscale flight testing of research control laws under adverse flight conditions. This paper presents the results of a series of pilot evaluations of several flight control algorithms used during an offset-to-landing task conducted at altitude. The purpose of this investigation was to assess the ability of various flight control technologies to prevent loss of control as stability and control characteristics were degraded. During the course of 8 research flights, data were recorded while one task was repeatedly executed by a single evaluation pilot. Two generic failures, which degraded stability and control characteristics, were simulated inflight for each of the 9 different flight control laws that were tested. The flight control laws included three different adaptive control methodologies, several linear multivariable designs, a linear robust design, a linear stability augmentation system, and a direct open-loop control mode. Based on pilot Cooper-Harper Ratings obtained for this test, the adaptive flight control laws provided the greatest overall benefit for the stability and control degradation scenarios that were considered. Also, all controllers tested provided a significant improvement in handling qualities over the direct open-loop control mode.

Development and Feasibility of a Structured Goals of Care Communication Guide.

PubMed

Bekelman, David B; Johnson-Koenke, Rachel; Ahluwalia, Sangeeta C; Walling, Anne M; Peterson, Jamie; Sudore, Rebecca L

2017-09-01

Discussing goals of care and advance care planning is beneficial, yet how to best integrate goals of care communication into clinical care remains unclear. To develop and determine the feasibility of a structured goals of care communication guide for nurses and social workers. Developmental study with providers in an academic and Veterans Affairs (VA) health system (n = 42) and subsequent pilot testing with patients with chronic obstructive pulmonary disease or heart failure (n = 15) and informal caregivers (n = 4) in a VA health system. During pilot testing, the communication guide was administered, followed by semistructured, open-ended questions about the content and process of communication. Changes to the guide were made iteratively, and subsequent piloting occurred until no additional changes emerged. Provider and patient feedback to the communication guide. Iterative input resulted in the goals of care communication guide. The guide included questions to elicit patient understanding of and attitudes toward the future of illness, clarify values and goals, identify end-of-life preferences, and agree on a follow-up plan. Revisions to guide content and phrasing continued during development and pilot testing. In pilot testing, patients validated the importance of the topic; none said the goals of care discussion should not be conducted. Patients and informal caregivers liked the final guide length (∼30 minutes), felt it flowed well, and was clear. In this developmental and pilot study, a structured goals of care communication guide was iteratively designed, implemented by nurses and social workers, and was feasible based on administration time and acceptability by patients and providers.

[Multicenter paragliding accident study 1990].

PubMed

Lautenschlager, S; Karli, U; Matter, P

1992-01-01

During the period from 1.1.90 until 31.12.90, 86 injuries associated with paragliding were analyzed in a prospective study in 12 different Swiss hospitals with reference to causes, patterns, and frequencies. The injuries showed a mean score of over 2 and were classified as severe. Most frequent spine injuries (36%) and lesions of the lower extremity (35%) with a high risk of the ankles were diagnosed. One accident was fatal. 60% of the accidents happened during landing, 26% during launching and 14% during flight. Half of the pilots were affected during their primary training course. Most accidents were caused by inflight error of judgement--especially incorrect estimation of wind conditions--and further the choice of unfavourable landing sites. In contrast to previous injury-reports, only one equipment failure could be noted, but often the equipment was not corresponding with the experience and the weight of the pilot. To reduce the frequency of paragliding-injuries an accurate choice of equipment and an increased attention to environmental factors is mandatory. Furthermore an education-program regarding the attitude and intelligence of the pilot should be included in training courses.

Rehabilitation Enablement in Chronic Heart Failure-a facilitated self-care rehabilitation intervention in patients with heart failure with preserved ejection fraction (REACH-HFpEF) and their caregivers: rationale and protocol for a single-centre pilot randomised controlled trial.

PubMed

Eyre, V; Lang, C C; Smith, K; Jolly, K; Davis, R; Hayward, C; Wingham, J; Abraham, C; Green, C; Warren, F C; Britten, N; Greaves, C J; Doherty, P; Austin, J; Van Lingen, R; Singh, S; Buckingham, S; Paul, K; Taylor, R S; Dalal, H M

2016-10-25

The Rehabilitation EnAblement in CHronic Heart Failure in patients with Heart Failure (HF) with preserved ejection fraction (REACH-HFpEF) pilot trial is part of a research programme designed to develop and evaluate a facilitated, home-based, self-help rehabilitation intervention to improve self-care and quality of life (QoL) in heart failure patients and their caregivers. We will assess the feasibility of a definitive trial of the REACH-HF intervention in patients with HFpEF and their caregivers. The impact of the REACH-HF intervention on echocardiographic outcomes and bloodborne biomarkers will also be assessed. A single-centre parallel two-group randomised controlled trial (RCT) with 1:1 individual allocation to the REACH-HF intervention plus usual care (intervention) or usual care alone (control) in 50 HFpEF patients and their caregivers. The REACH-HF intervention comprises a REACH-HF manual with supplementary tools, delivered by trained facilitators over 12 weeks. A mixed methods approach will be used to assess estimation of recruitment and retention rates; fidelity of REACH-HF manual delivery; identification of barriers to participation and adherence to the intervention and study protocol; feasibility of data collection and outcome burden. We will assess the variance in study outcomes to inform a definitive study sample size and assess methods for the collection of resource use and intervention delivery cost data to develop the cost-effectiveness analyses framework for any future trial. Patient outcomes collected at baseline, 4 and 6 months include QoL, psychological well-being, exercise capacity, physical activity and HF-related hospitalisation. Caregiver outcomes will also be assessed, and a substudy will evaluate impact of the REACH-HF manual on resting global cardiovascular function and bloodborne biomarkers in HFpEF patients. The study is approved by the East of Scotland Research Ethics Service (Ref: 15/ES/0036). Findings will be disseminated via journals and presentations to clinicians, commissioners and service users. ISRCTN78539530; Pre-results . Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Flight Crew Task Management in Non-Normal Situations

NASA Technical Reports Server (NTRS)

Schutte, Paul C.; Trujillo, Anna C.

1996-01-01

Task management (TM) is always performed on the flight deck, although not always explicitly, consistently, or rigorously. Nowhere is TM as important as it is in dealing with non-normal situations. The objective of this study was to analyze pilot TM behavior for non-normal situations. Specifically, the study observed pilots performance in a full workload environment in order to discern their TM strategies. This study identified four different TM prioritization and allocation strategies: Aviate-Navigate-Communicate-Manage Systems; Perceived Severity; Procedure Based; and Event/Interrupt Driven. Subjects used these strategies to manage their personal workload and to schedule monitoring and assessment of the situation. The Perceived Severity strategy for personal workload management combined with the Aviate-Navigate-Communicate-Manage Systems strategy for monitoring and assessing appeared to be the most effective (fewest errors and fastest response times) in responding to the novel system failure used in this study.

Helicopter crashes related to oil and gas operations in the Gulf of Mexico.

PubMed

Baker, Susan P; Shanahan, Dennis F; Haaland, Wren; Brady, Joanne E; Li, Guohua

2011-09-01

The hazards inherent in flight operations in the Gulf of Mexico prompted investigation of the number and circumstances of crashes related to oil and gas operations in the region. The National Transportation Safety Board (NTSB) database was queried for helicopter crashes during 1983 through 2009 related to Gulf of Mexico oil or gas production. The crashes were identified based on word searches confirmed by a narrative statement indicating that the flight was related to oil or gas operations. During 1983-2009, the NTSB recorded a total of 178 helicopter crashes related to oil and gas operations in the Gulf of Mexico, with an average of 6.6 crashes per year (5.6 annually during 1983-1999 vs. 8.2 during 2000-2009). The crashes resulted in a total of 139 fatalities, including 41 pilots. Mechanical failure was the most common precipitating factor, accounting for 68 crashes (38%). Bad weather led to 29 crashes (16%), in which 40% of the 139 deaths occurred. Pilot error was cited by the NTSB in 83 crashes (47%). After crashes or emergency landings on water, 15 helicopters sank when flotation devices were not activated automatically or by pilots. Mechanical failure, non-activation of flotation, and pilot error are major problems to be addressed if crashes and deaths in this lethal environment are to be reduced.

Evaluating an Art-Based Intervention to Improve Practicing Nurses' Observation, Description, and Problem Identification Skills.

PubMed

Nease, Beth M; Haney, Tina S

Astute observation, description, and problem identification skills provide the underpinning for nursing assessment, surveillance, and prevention of failure to rescue events. Art-based education has been effective in nursing schools for improving observation, description, and problem identification. The authors describe a randomized controlled pilot study testing the effectiveness of an art-based educational intervention aimed at improving these skills in practicing nurses.

The ATLAS PanDA Pilot in Operation

NASA Astrophysics Data System (ADS)

Nilsson, P.; Caballero, J.; De, K.; Maeno, T.; Stradling, A.; Wenaus, T.; ATLAS Collaboration

2011-12-01

The Production and Distributed Analysis system (PanDA) [1-2] was designed to meet ATLAS [3] requirements for a data-driven workload management system capable of operating at LHC data processing scale. Submitted jobs are executed on worker nodes by pilot jobs sent to the grid sites by pilot factories. This paper provides an overview of the PanDA pilot [4] system and presents major features added in light of recent operational experience, including multi-job processing, advanced job recovery for jobs with output storage failures, gLExec [5-6] based identity switching from the generic pilot to the actual user, and other security measures. The PanDA system serves all ATLAS distributed processing and is the primary system for distributed analysis; it is currently used at over 100 sites worldwide. We analyze the performance of the pilot system in processing real LHC data on the OSG [7], EGI [8] and Nordugrid [9-10] infrastructures used by ATLAS, and describe plans for its evolution.

Winged Auxiliaries: Women Pilots in the UK and US during World War Two

NASA Astrophysics Data System (ADS)

Schrader, Helena P.

2006-05-01

During World War II women in the US and the UK were given the then unprecedented opportunity to fly military aircraft. Yet while the women flying in the UK soon gained the privileges and status enjoyed by their male colleagues, the American women pilots were expressly denied the same status, rank, pay, and benefits as USAAF pilots. In fact, after an ugly slander campaign against the women pilots' organisation, the US programme was discontinued and the women were sent home before their job was done. The American women pilots were not less dedicated or inherently less capable than the women flying in Britain. Rather, key environmental and organisational differences and above all a failure of leadership accounts for their fate. This paper summarises the differences and their impact. The complete findings of the comparative research on the experiences of women pilots in the US and the UK during WWII will be published by Pen & Sword Books Inc early in 2006 under the title Sisters in Arms.

Incretin-related drug therapy in heart failure.

PubMed

Vest, Amanda R

2015-02-01

The new pharmacological classes of GLP-1 agonists and DPP-4 inhibitors are now widely used in diabetes and have been postulated as beneficial in heart failure. These proposed benefits arise from the inter-related pathophysiologies of diabetes and heart failure (diabetes increases the risk of heart failure, and heart failure can induce insulin resistance) and also in light of the dysfunctional myocardial energetics seen in heart failure. The normal heart utilizes predominantly fatty acids for energy production, but there is some evidence to suggest that increased myocardial glucose uptake may be beneficial for the failing heart. Thus, GLP-1 agonists, which stimulate glucose-dependent insulin release and enhance myocardial glucose uptake, have become a focus of investigation in both animal models and humans with heart failure. Limited pilot data for GLP-1 agonists shows potential improvements in systolic function, hemodynamics, and quality of life, forming the basis for current phase II trials.

The Emergency Landing Planner Experiment

NASA Technical Reports Server (NTRS)

Meuleau, Nocolas F.; Neukom, Christian; Plaunt, Christian John; Smith, David E.; Smith, Tristan B.

2011-01-01

In previous work, we described an Emergency Landing Planner (ELP) designed to assist pilots in choosing the best emergency landing site when damage or failures occur in an aircraft. In this paper, we briefly describe the system, but focus on the integration of this system into the cockpit of a 6 DOF full-motion simulator and a study designed to evaluate the ELP. We discuss the results of this study, the lessons learned, and some of the issues involved in advancing this work further.

Optimal Trajectories and Control Strategies for the Helicopter in One-Engine-Inoperative Terminal-Area Operations

NASA Technical Reports Server (NTRS)

Chen, Robert T. N.; Zhao, Yi-Yuan; Aiken, Edwin W. (Technical Monitor)

1995-01-01

Engine failure represents a major safety concern to helicopter operations, especially in the critical flight phases of takeoff and landing from/to small, confined areas. As a result, the JAA and FAA both certificate a transport helicopter as either Category-A or Category-B according to the ability to continue its operations following engine failures. A Category-B helicopter must be able to land safely in the event of one or all engine failures. There is no requirement, however, for continued flight capability. In contrast, Category-A certification, which applies to multi-engine transport helicopters with independent engine systems, requires that they continue the flight with one engine inoperative (OEI). These stringent requirements, while permitting its operations from rooftops and oil rigs and flight to areas where no emergency landing sites are available, restrict the payload of a Category-A transport helicopter to a value safe for continued flight as well as for landing with one engine inoperative. The current certification process involves extensive flight tests, which are potentially dangerous, costly, and time consuming. These tests require the pilot to simulate engine failures at increasingly critical conditions, Flight manuals based on these tests tend to provide very conservative recommendations with regard to maximum takeoff weight or required runway length. There are very few theoretical studies on this subject to identify the fundamental parameters and tradeoff factors involved. Furthermore, a capability for real-time generation of OEI optimal trajectories is very desirable for providing timely cockpit display guidance to assist the pilot in reducing his workload and to increase safety in a consistent and reliable manner. A joint research program involving NASA Ames Research Center, the FAA, and the University of Minnesota is being conducted to determine OEI optimal control strategies and the associated optimal,trajectories for continued takeoff (CTO), rejected takeoff (RTO), balked landing (BL), and continued landing (CL) for a twin engine helicopter in both VTOL and STOL terminal-area operations. This proposed paper will present the problem formulation, the optimal control solution methods, and the key results of the trajectory optimization studies for both STOL and VTOL OEI operations. In addition, new results concerning the recently developed methodology, which enable a real-time generation of optimal OEI trajectories, will be presented in the paper. This new real-time capability was developed to support the second piloted simulator investigation on cockpit displays for Category-A operations being scheduled for the NASA Ames Vertical Motion Simulator in June-August of 1995. The first VMS simulation was conducted in 1994 and reported.

The business concept of leader pricing as applied to heart failure disease management.

PubMed

Hauptman, Paul J; Bednarek, Heather L

2004-01-01

The implementation of a disease management approach for patients with heart failure has been promoted as a way to improve outcomes, including a decrease in hospitalizations. However, in the absence of rigorous cost analyses and with revenues limited by professional fees, heart failure disease management programs may appear to operate at a loss. The literature outlining the importance of disease management for patients with heart failure is summarized. We review the limitations of current cost analyses and outline the economic concepts of leader pricing, vertical integration and transaction costs to argue that heart failure disease management programs may provide significant "downstream" revenue for an integrated system of health care delivery in a fee-for-service payment structure, while reducing overall costs of care. Pilot data from a university-based program are used in support of this argument. In addition, the favorable impact on patient satisfaction and loyalty can enhance market share, a vital consideration for all health systems. Options for improving the reputation of heart failure disease management within a health system are suggested. Viewed as a loss leader, disease management provides not only quality care for patients with heart failure but also appears to provide financial benefits to the health system that funds the infrastructure and administration of the program. The actual magnitude of this benefit and the degree to which it mitigates overall administration costs requires further study.

What a difference two days make: "personalized" embryo transfer (pET) paradigm: a case report and pilot study.

PubMed

Ruiz-Alonso, M; Galindo, N; Pellicer, A; Simón, C

2014-06-01

Embryo implantation requires that the blastocyst will attach during the receptive stage of the endometrium, known as window of implantation (WOI). Historically, it has been assumed that the WOI is always constant in all women. However, molecular analyses of endometrial receptivity demonstrates a personalized WOI (pWOI) that is displaced in one out of four patients suffering from recurrent implantation failure (RIF) of endometrial origin and illustrates the utility of a personalized endometrial diagnostic approach. Here, we report a clinical case of successful personalized embryo transfer (pET) after four IVF and three oocyte donation failed attempts in which different embryo transfer strategies were attempted. This case report is complemented by a pilot study of 17 patients undergoing oocyte donation and who suffered failed implantations with routine embryo transfer (ET) but were then treated with pET after the personalized diagnosis of their WOI.

Engaging patients and families to create a feasible clinical trial integrating palliative and heart failure care: results of the ENABLE CHF-PC pilot clinical trial.

PubMed

Bakitas, Marie; Dionne-Odom, J Nicholas; Pamboukian, Salpy V; Tallaj, Jose; Kvale, Elizabeth; Swetz, Keith M; Frost, Jennifer; Wells, Rachel; Azuero, Andres; Keebler, Konda; Akyar, Imatullah; Ejem, Deborah; Steinhauser, Karen; Smith, Tasha; Durant, Raegan; Kono, Alan T

2017-08-31

Early palliative care (EPC) is recommended but rarely integrated with advanced heart failure (HF) care. We engaged patients and family caregivers to study the feasibility and site differences in a two-site EPC trial, ENABLE CHF-PC (Educate, Nurture, Advise, Before Life Ends Comprehensive Heartcare for Patients and Caregivers). We conducted an EPC feasibility study (4/1/14-8/31/15) for patients with NYHA Class III/IV HF and their caregivers in academic medical centers in the northeast and southeast U.S. The EPC intervention comprised: 1) an in-person outpatient palliative care consultation; and 2) telephonic nurse coach sessions and monthly calls. We collected patient- and caregiver-reported outcomes of quality of life (QOL), symptom, health, anxiety, and depression at baseline, 12- and 24-weeks. We used linear mixed-models to assess baseline to week 24 longitudinal changes. We enrolled 61 patients and 48 caregivers; between-site demographic differences included age, race, religion, marital, and work status. Most patients (69%) and caregivers (79%) completed all intervention sessions; however, we noted large between-site differences in measurement completion (38% southeast vs. 72% northeast). Patients experienced moderate effect size improvements in QOL, symptoms, physical, and mental health; caregivers experienced moderate effect size improvements in QOL, depression, mental health, and burden. Small-to-moderate effect size improvements were noted in patients' hospital and ICU days and emergency visits. Between-site demographic, attrition, and participant-reported outcomes highlight the importance of intervention pilot-testing in culturally diverse populations. Observations from this pilot feasibility trial allowed us to refine the methodology of an in-progress, full-scale randomized clinical efficacy trial. Clinicaltrials.gov NCT03177447 (retrospectively registered, June 2017).

Rigid versus flexible dentine-like endodontic posts--clinical testing of a biomechanical concept: seven-year results of a randomized controlled clinical pilot trial on endodontically treated abutment teeth with severe hard tissue loss.

PubMed

Sterzenbach, Guido; Franke, Alexandra; Naumann, Michael

2012-12-01

This is the first clinical long-term pilot study that tested the biomimetic concept of using more flexible, dentine-like (low Young modulus) glass fiber-reinforced epoxy resin posts (GFREPs) compared with rather rigid, stiff (higher Young modulus) titanium posts (TPs) in order to improve the survival rate of severely damaged endodontically treated teeth. Ninety-one subjects in need of postendodontic restorations in teeth with 2 or less remaining cavity walls were randomly assigned to receive either a tapered TP (n = 46) or a tapered GFREP (n = 45). The posts were adhesively luted using self-adhesive resin cement. The composite core build-ups were prepared ensuring a circumferential 2-mm ferrule. The primary endpoint was a loss of restoration for any reason. To study group differences, the log-rank test was calculated (P < .05). Hazard plots were constructed. After 84 months of observation (mean = 71.2 months), 7 restorations failed (ie, 4 GFREPs and 3 TPs). The failure modes were as follows: GFREP:root fracture (n = 3), core fracture (n = 1) and TP:endodontic failure (n = 3). No statistical difference was found between the survival rates (GFREPs = 90.2%, TPs = 93.5%, P = .642). The probability of no failure was comparable for both post materials (risk ratio; 95% confidence interval, 0.965-0.851/1.095). When using self-adhesive luted prefabricated posts in severely destroyed abutment teeth with 2 or less cavity walls and a 2-mm ferrule, postendodontic restorations achieved high long-term survival rates irrespective of the post material used (ie, glass fiber vs titanium). Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Impact of N-acetylcysteine on endothelial function, B-type natriuretic peptide and renal function in patients with the cardiorenal syndrome: a pilot cross over randomised controlled trial.

PubMed

Camuglia, Anthony C; Maeder, Micha T; Starr, Jennifer; Farrington, Catherine; Kaye, David M

2013-04-01

Both heart and renal failure are characterised by increased systemic oxidative stress and endothelial dysfunction and occur in the cardiorenal syndrome (CRS). The aim of the present study was to assess the impact of N-acetylcysteine (NAC), a potent antioxidant, on endothelial function, B-type natriuretic peptide (BNP) and renal function in patients with CRS. In a double blind, placebo controlled manner, we randomised nine stable outpatients with both heart failure (LVEF<40% and NYHA class II or III) and renal failure (Cockroft Gault clearance of 20-60ml/min) to placebo or NAC (500mg orally twice daily) for 28 days followed by a wash out period (>7 days) and crossover to the other treatment. Eight patients completed the study and all data (N=9) was used in the analysis. Mean forearm blood flow improved significantly with NAC with mean ratio of improvement of 1.99 (SEM: ±0.49) for NAC and 0.73 (SEM: ±0.23) for placebo with a p-value of 0.047. There was no significant difference in BNP (p=0.25), renal function (p=0.71) or NYHA class (p=0.5). No deaths occurred during the trial. In this pilot trial of patients with CRS, NAC therapy was associated with improved forearm blood flow. This may represent a general improvement in endothelial function and warrants further investigation of antioxidant therapy in these patients. Copyright © 2012 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.

Development of a pilot-scale kinetic extruder feeder system and test program. Phase II. Verification testing. Final report

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

Not Available

1984-01-12

This report describes the work done under Phase II, the verification testing of the Kinetic Extruder. The main objective of the test program was to determine failure modes and wear rates. Only minor auxiliary equipment malfunctions were encountered. Wear rates indicate useful life expectancy of from 1 to 5 years for wear-exposed components. Recommendations are made for adapting the equipment for pilot plant and commercial applications. 3 references, 20 figures, 12 tables.

Solid Rocket Booster Large Main and Drogue Parachute Reliability Analysis

NASA Technical Reports Server (NTRS)

Clifford, Courtenay B.; Hengel, John E.

2009-01-01

The parachutes on the Space Transportation System (STS) Solid Rocket Booster (SRB) are the means for decelerating the SRB and allowing it to impact the water at a nominal vertical velocity of 75 feet per second. Each SRB has one pilot, one drogue, and three main parachutes. About four minutes after SRB separation, the SRB nose cap is jettisoned, deploying the pilot parachute. The pilot chute then deploys the drogue parachute. The drogue chute provides initial deceleration and proper SRB orientation prior to frustum separation. At frustum separation, the drogue pulls the frustum from the SRB and allows the main parachutes that are mounted in the frustum to unpack and inflate. These chutes are retrieved, inspected, cleaned, repaired as needed, and returned to the flight inventory and reused. Over the course of the Shuttle Program, several improvements have been introduced to the SRB main parachutes. A major change was the replacement of the small (115 ft. diameter) main parachutes with the larger (136 ft. diameter) main parachutes. Other modifications were made to the main parachutes, main parachute support structure, and SRB frustum to eliminate failure mechanisms, improve damage tolerance, and improve deployment and inflation characteristics. This reliability analysis is limited to the examination of the SRB Large Main Parachute (LMP) and drogue parachute failure history to assess the reliability of these chutes. From the inventory analysis, 68 Large Main Parachutes were used in 651 deployments, and 7 chute failures occurred in the 651 deployments. Logistic regression was used to analyze the LMP failure history, and it showed that reliability growth has occurred over the period of use resulting in a current chute reliability of R = .9983. This result was then used to determine the reliability of the 3 LMPs on the SRB, when all must function. There are 29 drogue parachutes that were used in 244 deployments, and no in-flight failures have occurred. Since there are no observed drogue chute failures, Jeffreys Prior was used to calculate a reliability of R =.998. Based on these results, it is concluded that the LMP and drogue parachutes on the Shuttle SRB are suited to their mission and changes made over their life have improved the reliability of the parachute.

Pilot study of an Internet patient-physician communication tool for heart failure disease management.

PubMed

Wu, Robert C; Delgado, Diego; Costigan, Jeannine; Ross, Heather; MacIver, Jane

2006-01-01

Internet disease management has the promise of improving care in patients with heart failure but evidence supporting its use is limited. We have designed a Heart Failure Internet Communication Tool (HFICT), allowing patients to enter messages for clinicians, as well as their daily symptoms, weight, blood pressure and heart rate. Clinicians review the information on the same day and provide feedback. This pilot study evaluated the feasibility and patients' acceptability of using the Internet to communicate with patients with symptomatic heart failure. Patients with symptomatic heart failure were instructed how to use the Internet communication tool. The primary outcome measure was the proportion of patients who used the system regularly by entering information on average at least once per week for at least 3 months. Secondary outcomes measures included safety and maintainability of the tool. We also conducted a content analysis of a subset of the patient and clinician messages entered into the comments field. Between 3 May 1999 and 1 November 2002, 62 patients (mean age 48.7 years) were enrolled. At 3 months 58 patients were alive and without a heart transplant. Of those, 26 patients (45%; 95% Confidence Interval, 0.33-0.58) continued using the system at 3 months. In 97% of all entries by participants weight was included; 68% of entries included blood pressure; and 71% of entries included heart rate. In 3,386 entries out of all 5,098 patient entries (66%), comments were entered. Functions that were not used included the tracking of diuretics, medications and treatment goals. The tool appeared to be safe and maintainable. Workload estimates for clinicians for entering a response to each patient's entry ranged from less than a minute to 5 minutes or longer for a detailed response. Patients sent 3,386 comments to the Heart Function Clinic. Based on the content analysis of 100 patient entries, the following major categories of communication were identified: patient information; patient symptoms; patient questions regarding their condition; patient coordinating own care; social responses. The number of comments decreased over time for both patients and clinicians. While the majority of patients discontinued use, 45% of the patients used the system and continued to use it on average for 1.5 years. An Internet tool is a feasible method of communication in a substantial proportion of patients with heart failure. Further study is required to determine whether clinical outcomes, such as quality of life or frequency of hospitalization, are improved.

Epidural extension failure in obese women is comparable to that of non-obese women.

PubMed

Eley, V A; Chin, A; Tham, I; Poh, J; Aujla, P; Glasgow, E; Brown, H; Steele, K; Webb, L; van Zundert, A

2018-07-01

Management of labor epidurals in obese women is difficult and extension to surgical anesthesia is not always successful. Our previous retrospective pilot study found epidural extension was more likely to fail in obese women. This study used a prospective cohort to compare the failure rate of epidural extension in obese and non-obese women and to identify risk factors for extension failure. One hundred obese participants (Group O, body mass index ≥ 40 kg/m 2 ) were prospectively identified and allocated two sequential controls (Group C, body mass index ≤ 30 kg/m 2 ). All subjects utilized epidural labor analgesia and subsequently required anesthesia for cesarean section. The primary outcome measure was failure of the labor epidural to be used as the primary anesthetic technique. Risk factors for extension failure were identified using Chi-squared and logistic regression. The odds ratio (OR) of extension failure was 1.69 in Group O (20% vs. 13%; 95% CI: 0.88-3.21, P = 0.11). Risk factors for failure in obese women included ineffective labor analgesia requiring anesthesiologist intervention, (OR 3.94, 95% CI: 1.16-13.45, P = 0.028) and BMI > 50 kg/m 2 (OR 3.42, 95% CI: 1.07-10.96, P = 0.038). The failure rate of epidural extension did not differ significantly between the groups. Further research is needed to determine the influence of body mass index > 50 kg/m 2 on epidural extension for cesarean section. © 2018 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

Improving student critical thinking skills through a root cause analysis pilot project.

PubMed

Tschannen, Dana; Aebersold, Michelle

2010-08-01

The Essentials of Baccalaureate Education for Professional Nursing Practice provides a framework for building the baccalaureate education for the twenty-first century. One of the exemplars included in the essentials toolkit includes student participation in an actual root cause analysis (RCA) or failure mode effects analysis. To align with this exemplar, faculty at the University of Michigan School of Nursing developed a pilot RCA project for the senior-level Leadership and Management course. While working collaboratively with faculty and unit liaisons at the University Health System, students completed an RCA on a nursing sensitive indicator (pain assessment or plan of care compliance). An overview of the pilot project, including the implementation process, is described. Each team of students identified root causes and recommendations for improvement on clinical and documentation practice within the context of the unit. Feedback from both the unit liaisons and the students confirmed the pilot's success.

Development of a practice tool for community-based nurses: the Heart Failure Palliative Approach to Care (HeFPAC).

PubMed

Strachan, Patricia H; Joy, Cathy; Costigan, Jeannine; Carter, Nancy

2014-04-01

Patients living with advanced heart failure (HF) require a palliative approach to reduce suffering. Nurses have described significant knowledge gaps about the disease-specific palliative care (PC) needs of these patients. An intervention is required to facilitate appropriate end-of-life care for HF patients. The purpose of this study was to develop a user-friendly, evidence-informed HF-specific practice tool for community-based nurses to facilitate care and communication regarding a palliative approach to HF care. Guided by the Knowledge to Action framework, we identified key HF-specific issues related to advanced HF care provision within the context of a palliative approach to care. Informed by current evidence and subsequent iterative consultation with community-based and specialist PC and HF nurses, a pocket guide tool for community-based nurses was created. We developed the Heart Failure Palliative Approach to Care (HeFPAC) pocket guide to promote communication and a palliative approach to care for HF patients. The HeFPAC has potential to improve the quality of care and experiences for patients with advanced HF. It will be piloted in community-based practice and in a continuing education program for nurses. The HeFPAC pocket guide offers PC nurses a concise, evidence-informed and practical point-of care tool to communicate with other clinicians and patients about key HF issues that are associated with improving disease-specific HF palliative care and the quality of life of patients and their families. Pilot testing will offer insight as to its utility and potential for modification for national and international use.

The Penn State Heart Assistant: A pilot study of a web-based intervention to improve self-care of heart failure patients.

PubMed

Lloyd, Tom; Buck, Harleah; Foy, Andrew; Black, Sara; Pinter, Antony; Pogash, Rosanne; Eismann, Bobby; Balaban, Eric; Chan, John; Kunselman, Allen; Smyth, Joshua; Boehmer, John

2017-05-01

The Penn State Heart Assistant, a web-based, tablet computer-accessed, secure application was developed to conduct a proof of concept test, targeting patient self-care activities of heart failure patients including daily medication adherence, weight monitoring, and aerobic activity. Patients (n = 12) used the tablet computer-accessed program for 30 days-recording their information and viewing a short educational video. Linear random coefficient models assessed the relationship between weight and time and exercise and time. Good medication adherence (66% reporting taking 75% of prescribed medications) was reported. Group compliance over 30 days for weight and exercise was 84 percent. No persistent weight gain over 30 days, and some indication of weight loss (slope of weight vs time was negative (-0.17; p value = 0.002)), as well as increased exercise (slope of exercise vs time was positive (0.08; p value = 0.04)) was observed. This study suggests that mobile technology is feasible, acceptable, and has potential for cost-effective opportunities to manage heart failure patients safely at home.

Cluster Sampling Bias in Government-Sponsored Evaluations: A Correlational Study of Employment and Welfare Pilots in England

PubMed Central

2016-01-01

For pilot or experimental employment programme results to apply beyond their test bed, researchers must select ‘clusters’ (i.e. the job centres delivering the new intervention) that are reasonably representative of the whole territory. More specifically, this requirement must account for conditions that could artificially inflate the effect of a programme, such as the fluidity of the local labour market or the performance of the local job centre. Failure to achieve representativeness results in Cluster Sampling Bias (CSB). This paper makes three contributions to the literature. Theoretically, it approaches the notion of CSB as a human behaviour. It offers a comprehensive theory, whereby researchers with limited resources and conflicting priorities tend to oversample ‘effect-enhancing’ clusters when piloting a new intervention. Methodologically, it advocates for a ‘narrow and deep’ scope, as opposed to the ‘wide and shallow’ scope, which has prevailed so far. The PILOT-2 dataset was developed to test this idea. Empirically, it provides evidence on the prevalence of CSB. In conditions similar to the PILOT-2 case study, investigators (1) do not sample clusters with a view to maximise generalisability; (2) do not oversample ‘effect-enhancing’ clusters; (3) consistently oversample some clusters, including those with higher-than-average client caseloads; and (4) report their sampling decisions in an inconsistent and generally poor manner. In conclusion, although CSB is prevalent, it is still unclear whether it is intentional and meant to mislead stakeholders about the expected effect of the intervention or due to higher-level constraints or other considerations. PMID:27504823

Cluster Sampling Bias in Government-Sponsored Evaluations: A Correlational Study of Employment and Welfare Pilots in England.

PubMed

Vaganay, Arnaud

2016-01-01

For pilot or experimental employment programme results to apply beyond their test bed, researchers must select 'clusters' (i.e. the job centres delivering the new intervention) that are reasonably representative of the whole territory. More specifically, this requirement must account for conditions that could artificially inflate the effect of a programme, such as the fluidity of the local labour market or the performance of the local job centre. Failure to achieve representativeness results in Cluster Sampling Bias (CSB). This paper makes three contributions to the literature. Theoretically, it approaches the notion of CSB as a human behaviour. It offers a comprehensive theory, whereby researchers with limited resources and conflicting priorities tend to oversample 'effect-enhancing' clusters when piloting a new intervention. Methodologically, it advocates for a 'narrow and deep' scope, as opposed to the 'wide and shallow' scope, which has prevailed so far. The PILOT-2 dataset was developed to test this idea. Empirically, it provides evidence on the prevalence of CSB. In conditions similar to the PILOT-2 case study, investigators (1) do not sample clusters with a view to maximise generalisability; (2) do not oversample 'effect-enhancing' clusters; (3) consistently oversample some clusters, including those with higher-than-average client caseloads; and (4) report their sampling decisions in an inconsistent and generally poor manner. In conclusion, although CSB is prevalent, it is still unclear whether it is intentional and meant to mislead stakeholders about the expected effect of the intervention or due to higher-level constraints or other considerations.

Factors related to pilot survival in helicopter commuter and air taxi crashes.

PubMed

Krebs, M B; Li, G; Baker, S P

1995-02-01

We examined factors related to pilot survival in 167 consecutive helicopter commuter and air taxi crashes that occurred during 1983-88. Case fatality rates and adjusted odds ratios from multivariate logistic regression models were determined using data from the National Transportation Safety Board (NTSB). During this 6-year period, 29 pilots-in-command died in 167 helicopter commuter and air taxi crashes, a case fatality rate of 17.4%. Factors significantly associated with increased risk of pilot fatality were aircraft fire [odds ratio (OR) 20.0, 95% confidence interval (CI) 4.6-86.8], not using shoulder harnesses (OR 9.2, 95% CI 2.2-37.3), and aircraft with two engines (OR 4.8, 95% CI 1.3-17.4). In addition, we present data regarding success and failure of emergency flotation devices. The results suggest that the likelihood of pilot survival in helicopter crashes could be greatly improved by preventing crash associated fires and promoting the usage of shoulder restraints.

Pilot study of once-daily simplification therapy with abacavir/lamivudine/zidovudine and efavirenz for treatment of HIV-1 infection.

PubMed

Ruane, Peter; Lang, Joseph; DeJesus, Edwin; Berger, Daniel S; Dretler, Robin; Rodriguez, Allan; Ward, Douglas J; Lim, Michael L; Liao, Qiming; Reddy, Sunila; Clair, Marty St; Vila, Tania; Shaefer, Mark S

2006-01-01

The purpose of this pilot study was to explore the efficacy and safety of the abacavir/lamivudine/zidovudine fixed-dose combination tablet administered as two tablets once daily (qd) versus one tablet twice daily (bid) in combination with efavirenz (EFV). This was a prospective, randomized, open-label, multicenter study with a 24-week treatment period in 7 outpatient HIV clinics in the United States. Patients currently receiving an initial regimen of abacavir/lamivudine/zidovudine bid plus EFV qd for at least 6 months with HIV-1 RNA <50 copies/mL for at least 3 months and a screening CD4+ cell count > or = 200 cells/mm3 were eligible. Thirty-six patients enrolled, and 35 (97%) completed the study. Participants were randomized to switch to 2 tablets of abacavir/lamivudine/zidovudine qd plus EFV qd (QD arm) or continue current treatment (BID arm) for 24 weeks. Efficacy, safety, and adherence were evaluated. Median baseline CD4+ cell count was 521 cells/mm3. At week 24, HIV-1 RNA <50 copies/mL was achieved for 94% of participants in the QD arm and 89% in the BID arm by intent-to-treat, missing = failure analysis (95% confidence interval for difference: > or = 0.29 to +0.18, p = 1.000). At week 24, median CD4+ cell count change from baseline was +26 cells/mm3 for the QD arm and -39 cells/mm3 for BID arm. One patient randomized to the QD arm met virologic failure criteria (confirmed HIV-1 RNA >120 copies/mL) at week 20 and viral genotype showed M184V. After failure, this patient revealed he never took EFV throughout the entire study after randomization, effectively receiving only abacavir/lamivudine/zidovudine qd alone. Median adherence was slightly higher in the QD arm, although both arms had broad variability and overlapping interquartile ranges. Adverse events were infrequent and occurred with similar frequency between arms; treatment-related adverse events were abdominal pain, flatulence, nausea, headache, and abnormal dreams (1 patient [3%] for each adverse event). No patients withdrew due to adverse events, and no abacavir hypersensitivity reactions were reported. In this pilot study of patients suppressed on abacavir/lamivudine/zidovudine bid plus EFV, 94% of participants switching to abacavir/lamivudine/zidovudine qd plus EFV maintained virologic suppression, compared to 89% of participants continuing abacavir/lamivudine/zidovudine bid plus EFV.

Hydrotherapy in advanced heart failure: the cardio-HKT pilot study.

PubMed

Municinó, Annamaria; Nicolino, Annamaria; Milanese, Manlio; Gronda, Edoardo; Andreuzzi, Bruno; Oliva, Fabrizio; Chiarella, Francesco

2006-12-01

In-water exercise, hydrotherapy, may offer an attractive alternative to conventional training in markedly compromised patients with advanced HF. This Pilot Study evaluates the safety and efficacy of Cardio-Hydrokinesitherapy (Cardio-HKT) in patients with advanced HF on optimal medical therapy. Cardio-HKT is a novel rehabilitation program that includes training sessions in warm water (31 degrees C), integrated by educational and psycho-behavioural sessions to promote healthy life style modifications. We studied 18 adult patients with advanced HF, LVEF < 35%, NYHA functional class > II and peak oxygen uptake (peak VO2) < 18 ml/kg/min. Cardio-HKT consisted of a 3 weeks daily in-water training, combined to educational and psycho-behavioural sessions. Patients underwent a six-minute-walking-test (6mWT), a cardiopulmonary exercise test at baseline and after 3 weeks of Cardio-HKT. Quality of life was assessed with the Minnesota Living with Heart Failure Questionnaire (MLHF). All patients completed the Cardio-HKT rehabilitation program without complications. The 6mWT improved from 453 +/- 172 m to 571 +/- 120 m (p < 0.01), peak VO2 from 13.0 +/- 3.1 to 14.5 +/- 2.9 ml/kg/min (p = 0.03), whereas VE/ CO2 slope declined from 37 +/- 10 to 33 +/- 9 (p = 0.01). MLHF markedly improved from 56 (68-27) to 18 (40-7) (p < 0.01). Our results support the safety and efficacy of the innovative Cardio-HKT rehabilitation program in patients with advanced HF.

Evaluation of a strapless heart rate monitor during simulated flight tasks.

PubMed

Wang, Zhen; Fu, Shan

2016-01-01

Pilots are under high task demands during flight. Monitoring pilot's physiological status is very important in the evaluation of pilot's workload and flight safety. Recently, physiological status monitor (PSM) has been embedded into a watch that can be used without a conventional chest strap. This makes it possible to unobtrusively monitor, log and transmit pilot's physiological measurements such as heart rate (HR) during flight tasks. The purpose of this study is to validate HR recorded by a strapless heart rate watch against criterion ECG-derived HR. Ten commercial pilots (mean ± SD : age: 39.1 ± 7.8 years; total flight hours 7173.2 ± 5270.9 hr) performed three routinely trained flight tasks in a full flight simulator: wind shear go-around (WG), takeoff and climb (TC), and hydraulic failure (HF). For all tasks combined (overall) and for each task, differences between the heart rate watch measurements and the criterion data were small (mean difference [95% CI]: overall: -0.71 beats/min [-0.85, -0.57]; WG: -0.90 beats/min [-1.15, -0.65]; TC: -0.69 beats/min [-0.98, -0.40]; HF: -0.61 beats/min [-0.80, -0.42]). There were high correlations between the heart rate watch measurements and the ECG-derived HR for all tasks (r ≥ 0.97, SEE < 3). Bland-Altman plots also show high agreements between the watch measurements and the criterion HR. These results suggest that the strapless heart rate watch provides valid measurements of HR during simulated flight tasks and could be a useful tool for pilot workload evaluation.

Adaptive State Predictor Based Human Operator Modeling on Longitudinal and Lateral Control

NASA Technical Reports Server (NTRS)

Trujillo, Anna C.; Gregory, Irene M.; Hempley, Lucas E.

2015-01-01

Control-theoretic modeling of the human operator dynamic behavior in manual control tasks has a long and rich history. In the last two decades, there has been a renewed interest in modeling the human operator. There has also been significant work on techniques used to identify the pilot model of a given structure. The purpose of this research is to attempt to go beyond pilot identification based on collected experimental data and to develop a predictor of pilot behavior. An experiment was conducted to categorize these interactions of the pilot with an adaptive controller compensating during control surface failures. A general linear in-parameter model structure is used to represent a pilot. Three different estimation methods are explored. A gradient descent estimator (GDE), a least squares estimator with exponential forgetting (LSEEF), and a least squares estimator with bounded gain forgetting (LSEBGF) used the experiment data to predict pilot stick input. Previous results have found that the GDE and LSEEF methods are fairly accurate in predicting longitudinal stick input from commanded pitch. This paper discusses the accuracy of each of the three methods - GDE, LSEEF, and LSEBGF - to predict both pilot longitudinal and lateral stick input from the flight director's commanded pitch and bank attitudes.

JPL Test Effectiveness Analysis

NASA Technical Reports Server (NTRS)

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

2008-01-01

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

Sustainable reduction of bioreactor contamination in an industrial fermentation pilot plant.

PubMed

Junker, Beth; Lester, Michael; Leporati, James; Schmitt, John; Kovatch, Michael; Borysewicz, Stan; Maciejak, Waldemar; Seeley, Anna; Hesse, Michelle; Connors, Neal; Brix, Thomas; Creveling, Eric; Salmon, Peter

2006-10-01

Facility experience primarily in drug-oriented fermentation equipment (producing small molecules such as secondary metabolites, bioconversions, and enzymes) and, to a lesser extent, in biologics-oriented fermentation equipment (producing large molecules such as recombinant proteins and microbial vaccines) in an industrial fermentation pilot plant over the past 15 years is described. Potential approaches for equipment design and maintenance, operational procedures, validation/verification testing, medium selection, culture purity/sterility analysis, and contamination investigation are presented, and those approaches implemented are identified. Failure data collected for pilot plant operation for nearly 15 years are presented and best practices for documentation and tracking are outlined. This analysis does not exhaustively discuss available design, operational and procedural options; rather it selectively presents what has been determined to be beneficial in an industrial pilot plant setting. Literature references have been incorporated to provide background and context where appropriate.

Alternative Methods to Standby Gain Scheduling Following Air Data System Failure

DTIC Science & Technology

2009-09-01

in the event of air data system failures. There are two problems with this current method. First, the pilot must take time away from other ...pertinent tasks to manually position the standby-gains via the landing gear handle, air-to-air refueling door switch or some other means. Second, the...the way, the original airspeed estimator was improved and two other alternatives to standby-gain-scheduling were investigated. Knowing what

Piloted Flight Simulator Developed for Icing Effects Training

NASA Technical Reports Server (NTRS)

Ratvasky, Thomas P.

2005-01-01

In an effort to expand pilot training methods to avoid icing-related accidents, the NASA Glenn Research Center and Bihrle Applied Research Inc. have developed the Ice Contamination Effects Flight Training Device (ICEFTD). ICEFTD simulates the flight characteristics of the NASA Twin Otter Icing Research Aircraft in a no-ice baseline and in two ice configurations simulating ice-protection-system failures. Key features of the training device are the force feedback in the yoke, the instrument panel and out-the-window graphics, the instructor s workstation, and the portability of the unit.

A pilot hole does not reduce the strains or risk of fracture to the lateral cortex during and following a medial opening wedge high tibial osteotomy in cadaveric specimens.

PubMed

Bujnowski, K; Getgood, A; Leitch, K; Farr, J; Dunning, C; Burkhart, T A

2018-02-01

It has been suggested that the use of a pilot-hole may reduce the risk of fracture to the lateral cortex. Therefore the purpose of this study was to determine the effect of a pilot hole on the strains and occurrence of fractures at the lateral cortex during the opening of a high tibial osteotomy (HTO) and post-surgery loading. A total of 14 cadaveric tibias were randomized to either a pilot hole (n = 7) or a no-hole (n = 7) condition. Lateral cortex strains were measured while the osteotomy was opened 9 mm and secured in place with a locking plate. The tibias were then subjected to an initial 800 N load that increased by 200 N every 5000 cycles, until failure or a maximum load of 2500 N. There was no significant difference in the strains on the lateral cortex during HTO opening between the pilot hole and no-hole conditions. Similarly, the lateral cortex and fixation plate strains were not significantly different during cyclic loading between the two conditions. Using a pilot hole did not significantly decrease the strains experienced at the lateral cortex, nor did it reduce the risk of fracture. The nonsignificant differences found here most likely occurred because the pilot hole merely translated the stress concentration laterally to a parallel point on the surface of the hole. Cite this article : K. Bujnowski, A. Getgood, K. Leitch, J. Farr, C. Dunning, T. A. Burkhart. A pilot hole does not reduce the strains or risk of fracture to the lateral cortex during and following a medial opening wedge high tibial osteotomy in cadaveric specimens. Bone Joint Res 2018;7:166-172. DOI: 10.1302/2046-3758.72.BJR-2017-0337.R1.

Pre-implantation genetic screening using fluorescence in situ hybridization in couples of Indian ethnicity: Is there a scope?

PubMed Central

Saxena, Shailaja Gada; Desai, Kundanbala; Shewale, Lata; Ranjan, Prabhat

2014-01-01

CONTEXT: There is a high incidence of numerical chromosomal aberration in couples with repeated in vitro fertilization (IVF) failure, advanced maternal age, repeated unexplained abortions, severe male factor infertility and unexplained infertility. Pre-implantation genetic screening (PGS), a variant of pre-implantation genetic diagnosis, screens numerical chromosomal aberrations in couples with normal karyotype, experiencing poor reproductive outcome. The present study includes the results of the initial pilot study on 9 couples who underwent 10 PGS cycles. AIM: The aim of the present study was to evaluate the beneficial effects of PGS in couples with poor reproductive outcome. SETTINGS AND DESIGN: Data of initial 9 couples who underwent 10 PGS for various indications was evaluated. SUBJECTS AND METHODS: Blastomere biopsy was performed on cleavage stage embryos and subjected to two round fluorescence in situ hybridization (FISH) testing for chromosomes 13, 18, 21, X and Y as a two-step procedure. RESULTS: Six of the 9 couples (10 PGS cycles) conceived, including a twin pregnancy in a couple with male factor infertility, singleton pregnancies in a couple with secondary infertility, in three couples with adverse obstetric outcome in earlier pregnancies and in one couple with repeated IVF failure. CONCLUSION: In the absence of availability of array-comparative genomic hybridization in diagnostic clinical scenario for PGS and promising results with FISH based PGS as evident from the current pilot study, it is imperative to offer the best available services in the present scenario for better pregnancy outcome for patients. PMID:24829527

A systematic review of validated methods for identifying acute respiratory failure using administrative and claims data.

PubMed

Jones, Natalie; Schneider, Gary; Kachroo, Sumesh; Rotella, Philip; Avetisyan, Ruzan; Reynolds, Matthew W

2012-01-01

The Food and Drug Administration's (FDA) Mini-Sentinel pilot program initially aims to conduct active surveillance to refine safety signals that emerge for marketed medical products. A key facet of this surveillance is to develop and understand the validity of algorithms for identifying health outcomes of interest (HOIs) from administrative and claims data. This paper summarizes the process and findings of the algorithm review of acute respiratory failure (ARF). PubMed and Iowa Drug Information Service searches were conducted to identify citations applicable to the anaphylaxis HOI. Level 1 abstract reviews and Level 2 full-text reviews were conducted to find articles using administrative and claims data to identify ARF, including validation estimates of the coding algorithms. Our search revealed a deficiency of literature focusing on ARF algorithms and validation estimates. Only two studies provided codes for ARF, each using related yet different ICD-9 codes (i.e., ICD-9 codes 518.8, "other diseases of lung," and 518.81, "acute respiratory failure"). Neither study provided validation estimates. Research needs to be conducted on designing validation studies to test ARF algorithms and estimating their predictive power, sensitivity, and specificity. Copyright © 2012 John Wiley & Sons, Ltd.

Follow-up on hang gliding injuries in Colorado.

PubMed

Krissoff, W B

1976-01-01

In a period extending from July 1973 to December 1975, seven fatal hang glider accidents were recorded in Colorado, all among experienced pilots. In addition, 11 serious nonfatal injuries were reported, which may represent only a fraction of those occurring. Accidents were noted to be multifactorial, caused by (1) pilot error, (2) equipment failure, (3) terrain hazards, and (4) possible design shortcomings. Accidents can be expected to decline in frequency with improved pilot training programs, grading and regulation of sites, and standardized safety clothing. No doubt over time, the less safe standard Rogallo wing will be replaced by the more stable Superkites and controlled collapsibles, which offer a higher safety margin. In the last analysis, this sport will remain a popular yet high risk endeavor (Figs. 2 through 5).

Bubble vs conventional continuous positive airway pressure for prevention of extubation failure in preterm very low birth weight infants: a pilot study.

PubMed

Yadav, Sucheta; Thukral, Anu; Sankar, M Jeeva; Sreenivas, V; Deorari, Ashok K; Paul, Vinod K; Agarwal, Ramesh

2012-09-01

To compare the efficacy of bubble and conventional nasal continuous positive airway pressure (CPAP) in preventing extubation failure (EF) in preterm infants. Infants of gestation ≤32 wk and birth weight <1500 g, ready for initial extubation within first wk of life were randomly allocated to either bubble (n = 16) or conventional (n = 16) CPAP. A standardized protocol was used for extubation. Bubble CPAP was delivered by Fischer and Paykel equipment using short binasal prongs and conventional CPAP was delivered by a ventilator using Argyle short binasal prongs. CPAP was initiated at a pressure of 4-6 cm of H(2)O and FiO(2) of 0.4-0.5 and adjusted to maintain normal saturation (90-93%) and comfortable breathing. Primary outcome was EF, defined as need for mechanical ventilation within 72 h of extubation. Baseline characteristics including birth weight (g; 1027 ± 243 vs. 1018 ± 227; p = 0.83), gestation (wk; 28.7 ± 1.8 vs. 28.4 ± 1.6; p = 0.30), infants <28 wk gestation (6 vs. 7, p = 0.72) were comparable between the two groups. Respiratory distress syndrome was the indication for ventilation in 13 (81%) and 14 (87%) infants on bubble CPAP and conventional CPAP groups respectively. (p = 0.99). There was no difference in the EF rates between the bubble (n = 4) and conventional CPAP (n = 9) groups. (RR 0.49; 95% CI 0.20-1.2; p = 0.14). Median time to extubation failure was also comparable between the two groups (h; median [range]: 29 [14-49] vs. 17 [7-28]; p = 0.35). The possibility that bubble CPAP may be associated with reduced EF as suggested in this pilot study requires further investigation in an adequately powered multicentric study.

A pilot randomized study of a gratitude journaling intervention on HRV and inflammatory biomarkers in Stage B heart failure patients

PubMed Central

Redwine, Laura; Henry, Brook L.; Pung, Meredith A.; Wilson, Kathleen; Chinh, Kelly; Knight, Brian; Jain, Shamini; Rutledge, Thomas; Greenberg, Barry; Maisel, Alan; Mills, Paul J

2016-01-01

Objective Stage B, asymptomatic heart failure (HF) presents a therapeutic window for attenuating disease progression and development of HF symptoms, and improving quality of life. Gratitude, the practice of appreciating positive life features, is highly related to quality of life, leading to development of promising clinical interventions. However, few gratitude studies have investigated objective measures of physical health; most relied on self-report measures. We conducted a pilot study in Stage B HF patients to examine whether gratitude journaling improved biomarkers related to HF prognosis. Methods Patients (N = 70; mean age = 66.2 years, SD = 7.6) were randomized to an 8-week gratitude journaling intervention or treatment as usual (TAU). Baseline (T1) assessments included 6-item Gratitude Questionnaire (GQ-6), resting heart rate variability (HRV), and an inflammatory biomarker index. At T2 (mid-intervention) GQ6 was measured. At T3 (post-intervention), T1 measures were repeated but also included a gratitude journaling task. Results The gratitude intervention was associated with improved trait gratitude scores (F = 6.0, p = .017, η2 = .10), reduced inflammatory biomarker index score over time (F = 9.7, p = .004, η2 = .21) and increased parasympathetic HRV responses during the gratitude journaling task (F = 4.2, p = .036, η2 = .15), compared with TAU. However, there were no resting pre- to post-intervention group differences in HRV (p's > .10). Conclusions Gratitude journaling may improve biomarkers related to HF morbidity, such as reduced inflammation; large-scale studies with active control conditions are needed to confirm these findings. PMID:27187845

Quantifying Safety Margin Using the Risk-Informed Safety Margin Characterization (RISMC)

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

Grabaskas, David; Bucknor, Matthew; Brunett, Acacia

2015-04-26

The Risk-Informed Safety Margin Characterization (RISMC), developed by Idaho National Laboratory as part of the Light-Water Reactor Sustainability Project, utilizes a probabilistic safety margin comparison between a load and capacity distribution, rather than a deterministic comparison between two values, as is usually done in best-estimate plus uncertainty analyses. The goal is to determine the failure probability, or in other words, the probability of the system load equaling or exceeding the system capacity. While this method has been used in pilot studies, there has been little work conducted investigating the statistical significance of the resulting failure probability. In particular, it ismore » difficult to determine how many simulations are necessary to properly characterize the failure probability. This work uses classical (frequentist) statistics and confidence intervals to examine the impact in statistical accuracy when the number of simulations is varied. Two methods are proposed to establish confidence intervals related to the failure probability established using a RISMC analysis. The confidence interval provides information about the statistical accuracy of the method utilized to explore the uncertainty space, and offers a quantitative method to gauge the increase in statistical accuracy due to performing additional simulations.« less

Addressing Control Research Issues Leading to Piloted Simulations in Support of the IFCS F-15

NASA Technical Reports Server (NTRS)

Napolitano, Marcello; Perhinschi, Mario; Campa, Giampiero; Seanor, Brad

2004-01-01

This report summarizes the research effort by a team of researchers at West Virginia University in support of the NASA Intelligent Flight Control System (IFCS) F-15 program. In particular, WVU researchers assisted NASA Dryden researchers in the following technical tasks leading to piloted simulation of the 'Gen_2' IFCS control laws. Task #1- Performance comparison of different neural network (NN) augmentation for the Dynamic Inversion (DI) -based VCAS 'Gen_2' control laws. Task #2- Development of safety monitor criteria for transition to research control laws with and without failure during flight test. Task #3- Fine-tuning of the 'Gen_2' control laws for cross-coupling reduction at post-failure conditions. Matlab/Simulink-based simulation codes were provided to the technical monitor on a regular basis throughout the duration of the project. Additional deliverables for the project were Power Point-based slides prepared for different project meetings. This document provides a description of the methodology and discusses the general conclusions from the simulation results.

A bioprosthetic total artificial heart for end-stage heart failure: Results from a pilot study.

PubMed

Latrémouille, Christian; Carpentier, Alain; Leprince, Pascal; Roussel, Jean-Christian; Cholley, Bernard; Boissier, Elodie; Epailly, Eric; Capel, Antoine; Jansen, Piet; Smadja, David M

2018-01-01

The electro-hydraulically actuated Carmat total artificial heart (C-TAH) is designed to replace the heart in patients with end-stage heart failure, either as bridge to transplant or destination therapy. It provides pulsatile flow and contains bio-prosthetic blood contacting materials. A clinical feasibility study was conducted to evaluate the C-TAH safety and performance. Hospitalized patients, at imminent risk of death from irreversible biventricular failure despite optimal medical management, and not eligible for transplant or eligible but on extracorporeal life support, were enrolled. The primary endpoint was 30-days survival. Four patients were implanted with the C-TAH, three as destination therapy (ages 76, 68, 74) and one as bridge to transplant (age 58). They had implant times of 74, 270, 254 and 20 days respectively. All patients were free from hemolysis, clinical neurologic events, clinical evidence of thrombus and device-related infections. Hemodynamic and physical recovery allowed two patients to be discharged home for a cumulative duration of 7 months. The anticoagulation management strategy comprised initial unfractionated heparin, from postoperative day 2, followed by low molecular weight heparin and aspirin. An increased D-dimer level was observed in all patients during months 1 to 4. Temporary suspension of heparin anticoagulation resulted in thrombocytopenia and increased fibrin monomer, reversed by resuming anticoagulation with heparin. Causes of death were device-related (2 cases), respiratory failure and multi-organ failure. Preliminary clinical results with the C-TAH demonstrated good safety and performance profiles in patients suffering from biventricular failure, which need to be confirmed in a pivotal study. Copyright © 2018 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Step 1: Human System Integration (HSI) FY05 Pilot-Technology Interface Requirements for Contingency Management

NASA Technical Reports Server (NTRS)

2005-01-01

This document involves definition of technology interface requirements for Contingency Management. This was performed through a review of Contingency Management-related, HSI requirements documents, standards, and recommended practices. Technology concepts in use by the Contingency Management Work Package were considered. Beginning with HSI high-level functional requirements for Contingency Management, and Contingency Management technology elements, HSI requirements for the interface to the pilot were identified. Results of the analysis describe (1) the information required by the pilot to have knowledge of system failures and associated contingency procedures, and (2) the control capability needed by the pilot to obtain system status and procedure information. Fundamentally, these requirements provide the candidate Contingency Management technology concepts with the necessary human-related elements to make them compatible with human capabilities and limitations. The results of the analysis describe how Contingency Management operations and functions should interface with the pilot to provide the necessary Contingency Management functionality to the UA-pilot system. Requirements and guidelines for Contingency Management are partitioned into four categories: (1) Health and Status and (2) Contingency Management. Each requirement is stated and is supported with a rationale and associated reference(s).

Pilot Randomized Study of a Gratitude Journaling Intervention on Heart Rate Variability and Inflammatory Biomarkers in Patients With Stage B Heart Failure.

PubMed

Redwine, Laura S; Henry, Brook L; Pung, Meredith A; Wilson, Kathleen; Chinh, Kelly; Knight, Brian; Jain, Shamini; Rutledge, Thomas; Greenberg, Barry; Maisel, Alan; Mills, Paul J

2016-01-01

Stage B, asymptomatic heart failure (HF) presents a therapeutic window for attenuating disease progression and development of HF symptoms, and improving quality of life. Gratitude, the practice of appreciating positive life features, is highly related to quality of life, leading to development of promising clinical interventions. However, few gratitude studies have investigated objective measures of physical health; most relied on self-report measures. We conducted a pilot study in Stage B HF patients to examine whether gratitude journaling improved biomarkers related to HF prognosis. Patients (n = 70; mean [standard deviation] age = 66.2 [7.6] years) were randomized to an 8-week gratitude journaling intervention or treatment as usual. Baseline (T1) assessments included the six-item Gratitude Questionnaire, resting heart rate variability (HRV), and an inflammatory biomarker index. At T2 (midintervention), the six-item Gratitude Questionnaire was measured. At T3 (postintervention), T1 measures were repeated but also included a gratitude journaling task. The gratitude intervention was associated with improved trait gratitude scores (F = 6.0, p = .017, η = 0.10), reduced inflammatory biomarker index score over time (F = 9.7, p = .004, η = 0.21), and increased parasympathetic HRV responses during the gratitude journaling task (F = 4.2, p = .036, η = 0.15), compared with treatment as usual. However, there were no resting preintervention to postintervention group differences in HRV (p values > .10). Gratitude journaling may improve biomarkers related to HF morbidity, such as reduced inflammation; large-scale studies with active control conditions are needed to confirm these findings. Clinicaltrials.govidentifier:NCT01615094.

A systematic review of discontinued trials suggested that most reasons for recruitment failure were preventable.

PubMed

Briel, Matthias; Olu, Kelechi Kalu; von Elm, Erik; Kasenda, Benjamin; Alturki, Reem; Agarwal, Arnav; Bhatnagar, Neera; Schandelmaier, Stefan

2016-12-01

To collect and classify reported reasons for recruitment failure in discontinued randomized controlled trials (RCTs) and to assess reporting quality. We systematically searched MEDLINE and EMBASE (2010-2014) and a previous cohort of RCTs for published RCTs reporting trial discontinuation due to poor recruitment. Teams of two investigators selected eligible RCTs working independently and extracted information using standardized forms. We used an iterative approach to classify reasons for poor recruitment. We included 172 RCTs discontinued due to poor recruitment (including 26 conference abstracts and 63 industry-funded RCTs). Of those, 131 (76%) reported one or more reasons for discontinuation due to poor recruitment. We identified 28 different reasons for recruitment failure; most frequently mentioned were overestimation of prevalence of eligible participants and prejudiced views of recruiters and participants on trial interventions. Few RCTs reported relevant details about the recruitment process such as how eligible participants were identified, the number of patients assessed for eligibility, and who actually recruited participants. Our classification could serve as a checklist to assist investigators in the planning of RCTs. Most reasons for recruitment failure seem preventable with a pilot study that applies the planned informed consent procedure. Copyright © 2016 Elsevier Inc. All rights reserved.

Electronic problem-solving treatment: description and pilot study of an interactive media treatment for depression.

PubMed

Cartreine, James Albert; Locke, Steven E; Buckey, Jay C; Sandoval, Luis; Hegel, Mark T

2012-09-25

Computer-automated depression interventions rely heavily on users reading text to receive the intervention. However, text-delivered interventions place a burden on persons with depression and convey only verbal content. The primary aim of this project was to develop a computer-automated treatment for depression that is delivered via interactive media technology. By using branching video and audio, the program simulates the experience of being in therapy with a master clinician who provides six sessions of problem-solving therapy. A secondary objective was to conduct a pilot study of the program's usability, acceptability, and credibility, and to obtain an initial estimate of its efficacy. The program was produced in a professional multimedia production facility and incorporates video, audio, graphics, animation, and text. Failure analyses of patient data are conducted across sessions and across problems to identify ways to help the user improve his or her problem solving. A pilot study was conducted with persons who had minor depression. An experimental group (n = 7) used the program while a waitlist control group (n = 7) was provided with no treatment for 6 weeks. All of the experimental group participants completed the trial, whereas 1 from the control was lost to follow-up. Experimental group participants rated the program high on usability, acceptability, and credibility. The study was not powered to detect clinical improvement, although these pilot data are encouraging. Although the study was not powered to detect treatment effects, participants did find the program highly usable, acceptable, and credible. This suggests that the highly interactive and immersive nature of the program is beneficial. Further clinical trials are warranted. ClinicalTrials.gov NCT00906581; http://clinicaltrials.gov/ct2/show/NCT00906581 (Archived by WebCite at http://www.webcitation.org/6A5Ni5HUp).

A simulation evaluation of the engine monitoring and control system display

NASA Technical Reports Server (NTRS)

Abbott, Terence S.

1990-01-01

The Engine Monitoring and Control System (E-MACS) display is a new concept for an engine instrument display, the purpose of which is to provide an enhanced means for a pilot to control and monitor aircraft engine performance. It provides graphically-presented information about performance capabilities, current performance, and engine component or subsystem operational conditions relative to nominal conditions. The concept was evaluated by sixteen pilot-subjects against a traditional, state-of-the-art electronic engine display format. The results of this evaluation showed a substantial pilot preference for the E-MACS display relative to the traditional display. The results of the failure detection portion of the evaluation showed a 100 percent detection rate for the E-MACS display relative to a 57 percent rate for the traditional display. From these results, it is concluded that by providing this type of information in the cockpit, a reduction in pilot workload and an enhanced ability for detecting degraded or off-nominal conditions is probable, thus leading to an increase in operational safety.

Pilot Study of Veterinary Student Mindset and Association with Academic Performance and Perceived Stress.

PubMed

Root Kustritz, Margaret V

Individuals with a growth mindset believe that all failures are opportunities and that their baseline intelligence and talent can be used for continuous improvement. Individuals with a fixed mindset believe that baseline intelligence and talent cannot be developed. A growth mindset is associated with greater academic success and greater resilience in the face of failure or stress. Second-year veterinary students completed three surveys to determine mindset, perceived levels of stress, and life change score. Of 57 students, 70% had a strong growth mindset or a growth mindset with some fixed ideas. No students had a strong fixed mindset. Mindset was not correlated with GPA or perceived stress level. Colleges of veterinary medicine can assist students by providing resources and training for stress management, including training in how to further develop a growth mindset.

Fatal light aircraft accidents in Ontario: a five year study.

PubMed

Shkrum, M J; Hurlbut, D J; Young, J G

1996-03-01

Fatal civil aviation crashes in Ontario from 1985 to 1989 were studied. Data regarding accident circumstances, injury patterns and medical factors (disease, alcohol/drugs) which could have contributed to accident causation was obtained from a review of the files of the Chief Coroner for Ontario in Toronto and the aviation occurrence reports of the Transportation Safety Board of Canada. Forty-seven crashes involving mainly general aviation type aircraft but also 2 gyroplanes, 2 ultralights and a glider were reviewed. About half occurred during the cruise phase of the flight. Seventy (40 pilots; 30 passengers) of the 98 occupants died. The bodies of 68 victims were recovered; 63 were dead at the scene and 5 survived up to ten hours after impact. Multiple trauma killed about half of all the victims (n = 34); 29% (n = 20) drowned; 16% (n = 11) and 3% (n = 2) died of head/neck injuries and coronary disease respectively. Neck trauma was observed mostly in pilots and was the most frequent major blunt trauma injury in drowning victims. Passengers sustained relatively more craniofacial fractures and abdominal/retroperitoneal trauma. Pilot error was the most frequent cause of crashes (55%; 26/47 impacts) followed by mechanical failure (15%; 7/47) and adverse weather/environmental conditions (11%; 5/47). Coronary artery disease incapacitated two pilots (4% of crashes) and ethanol intoxication was implicated in two other accidents. Other drugs did not appear to be a definite factor in accident causation.

To Err is Human Case Reports of Two Military Aircraft Accidents

PubMed Central

Dikshit, Mohan B

2010-01-01

It has been postulated that pilot error or in-flight incapacitation may be the main contributory factors to 70–80% of aircraft accidents. Two fatal aircraft accidents are presented in which either of the above possibilities may have played a role. The first case report describes an erroneous decision by a fighter pilot to use a seat position adjustment of the ejection seat leading to fatal injuries when he had to eject from his aircraft. Injuries to the body of the pilot, and observations on the state of his flying clothing and the ejection seat were used to postulate the mechanism of fatal injury and establish the cause of the accident. The second case report describes the sequence of events which culminated in the incapacitation of a fighter pilot while executing a routine manouevre. This resulted in a fatal air crash. Possible contributions of environmental factors which may have resulted in failure of his physiological mechanisms are discussed. PMID:21509093

[Effect of alcohol intake on the ability to pilot aircraft].

PubMed

Ushakov, I B; Egorov, S V

1996-01-01

During the initial 4 hours after alcohol intake at a dose of 1.9 g/kg aircraft operators displayed disturbances in the psychic processes and functions responsible for each (from information reception and processing up to decision-making and building-up the controlling actions) structural elements in their activity resulting in considerable limitation or a complete failure to pilot aircraft. Main disorders included inability to correctly analyse flight situation and loss of skills to automatically control simulator, a sudden depletion of psychophysiological reserves and deterioration of operator's reliability. Less elaborated professional skills appear to be the most vulnerable.

Assessment of weaning indexes based on diaphragm activity in mechanically ventilated subjects after cardiovascular surgery. A pilot study

PubMed Central

Ortega, Isabel Cristina Muñoz; Valdivieso, Alher Mauricio Hernández; Lopez, Joan Francesc Alonso; Villanueva, Miguel Ángel Mañanas; Lopez, Luis Horacio Atehortúa

2017-01-01

Objective The aim of this pilot study was to evaluate the feasibility of surface electromyographic signal derived indexes for the prediction of weaning outcomes among mechanically ventilated subjects after cardiac surgery. Methods A sample of 10 postsurgical adult subjects who received cardiovascular surgery that did not meet the criteria for early extubation were included. Surface electromyographic signals from diaphragm and ventilatory variables were recorded during the weaning process, with the moment determined by the medical staff according to their expertise. Several indexes of respiratory muscle expenditure from surface electromyography using linear and non-linear processing techniques were evaluated. Two groups were compared: successfully and unsuccessfully weaned patients. Results The obtained indexes allow estimation of the diaphragm activity of each subject, showing a correlation between high expenditure and weaning test failure. Conclusion Surface electromyography is becoming a promising procedure for assessing the state of mechanically ventilated patients, even in complex situations such as those that involve a patient after cardiovascular surgery. PMID:28977261

A pilot trial of bordered polyurethane dressings, tissue adhesive and sutureless devices compared with standard polyurethane dressings for securing short-term arterial catheters.

PubMed

Edwards, Melannie; Rickard, Claire M; Rapchuk, Ivan; Corley, Amanda; Marsh, Nicole; Spooner, Amy J; Mihala, Gabor; Fraser, John F

2014-09-01

To improve arterial catheter (AC) securement and reduce AC failure; to assess feasibility of a large randomised controlled trial. A four-arm, parallel, randomised, controlled, non-blinded pilot trial with 195 intensive care patients taking part, in a tertiary referral hospital in Brisbane, Australia from May to November 2012. Standard polyurethane (SPU) dressing (controls); bordered polyurethane (BPU) + SPU dressing; tissue adhesive (TA) + SPU dressing; and sutureless securement device (SSD) + SPU dressing (no sutures used). AC failure, ie, complete dislodgement, occlusion (monitor failure, inability to infuse or fluid leaking), pain or infection (local or blood). Median AC dwell time was 26.2 hours and was comparable between groups. AC failure occurred in 26/195 patients (13%). AC failure was significantly worse with SPU dressings (10/47 [21%]) than with BPU + SPU dressings (2/ 43 [5%]; P = 0.03), but not significantly different to TA + SPU (6/56 [11%]; P = 0.18) or SSD + SPU (8/49 [16%]; P = 0.61). The dressing applied at AC insertion lasted until AC removal in 68% of controls; 56% of BPU + SPU dressings; 73% of TA + SPU dressings; and 80% of SSD + SPU dressings (all P > 0.05). There were no infections or serious adverse events. Patient and staff satisfaction with all products was high. Median costs (labour and materials) for securement per patient were significantly higher in all groups compared with the control group (SPU, $3.48 [IQR, $3.48-$9.79]; BPU + SPU, $5.07 [IQR, $5.07-$12.99]; SSD + SPU, $10.90 [IQR, $10.90-$10.90]; TA + SPU, $17.70 [IQR, $17.70-$38.36]; all P < 0.01). AC failure occurred significantly less often with BPU + SPU dressings than with SPU dressings. TA + SPU and SSD + SPU dressings should be further investigated and compared with BPU + SPU dressings as controls. The novel approach of TA + SPU dressings appeared safe and feasible.

Using tablet technology and instructional videos to enhance preclinical dental laboratory learning.

PubMed

Gadbury-Amyot, Cynthia C; Purk, John H; Williams, Brian Joseph; Van Ness, Christopher J

2014-02-01

The purpose of this pilot study was to examine if tablet technology with accompanying instructional videos enhanced the teaching and learning outcomes in a preclinical dental laboratory setting. Two procedures deemed most challenging in Operative Dentistry II were chosen for the development of instructional videos. A random sample of thirty students was chosen to participate in the pilot. Comparison of faculty evaluations of the procedures between the experimental (tablet) and control (no tablet) groups resulted in no significant differences; however, there was a trend toward fewer failures in the experimental group. Examination of the ability to accurately self-assess was compared by exploring correlations between faculty and student evaluations. While correlations were stronger in the experimental group, the control group had significant correlations for all three procedures, while the experimental group had significant correlations on only two of the procedures. Students strongly perceived that the tablets and videos helped them perform better and more accurately self-assess their work products. Students did not support requiring that they purchase/obtain a specific brand of technology. As a result of this pilot study, further development of ideal and non-ideal videos are in progress, and the school will be implementing a "Bring Your Own Device" policy with incoming students.

Analysis of Convair 990 rejected-takeoff accident with emphasis on decision making, training and procedures

NASA Technical Reports Server (NTRS)

Batthauer, Byron E.

1987-01-01

This paper analyzes a NASA Convair 990 (CV-990) accident with emphasis on rejected-takeoff (RTO) decision making, training, procedures, and accident statistics. The NASA Aircraft Accident Investigation Board was somewhat perplexed that an aircraft could be destroyed as a result of blown tires during the takeoff roll. To provide a better understanding of tire failure RTO's, The Board obtained accident reports, Federal Aviation Administration (FAA) studies, and other pertinent information related to the elements of this accident. This material enhanced the analysis process and convinced the Accident Board that high-speed RTO's in transport aircraft should be given more emphasis during pilot training. Pilots should be made aware of various RTO situations and statistics with emphasis on failed-tire RTO's. This background information could enhance the split-second decision-making process that is required prior to initiating an RTO.

Pilot simulation tests of propulsion control as backup to loss of primary flight controls for a mid-size jet transport

DOT National Transportation Integrated Search

1995-12-01

Partial failures of aircraft primary flight-control systems and structural : damages to aircraft during flight have led to catastrophic accidents with : subsequent loss of life. These accidents can be prevented if sufficient : alternate control autho...

F-16 Class A mishaps in the U.S. Air Force, 1975-93.

PubMed

Knapp, C J; Johnson, R

1996-08-01

All USAF F-16 fighter Class A (major) aircraft mishaps from 1975-93 were analyzed, using records from the U.S. Air Force Safety Agency (AFSA). There were 190 Class A mishaps involving 204 F-16's and 217 aircrew during this 19-yr period. The overall Class A rate was 5.09 per 100,000 flight hours, more than double the overall USAF rate. The mishaps are categorized by year, month, time of day and model of aircraft in relation to mishap causes as determined and reported by AFSA. Formation position, phase of flight and primary cause of the mishap indicate that maneuvering, cruise and low-level phases account for the majority of the mishaps (71%), with air-to-air engagements associated with a higher proportion of pilot error (71%) than was air-to-ground (49%). Engine failure was the number one cause of mishaps (35%), and collision with the ground the next most frequent (24%). Pilot error was determined as causative in 55% of all the mishaps. Pilot error was often associated with other non-pilot related causes. Channelized attention, loss of situational awareness, and spatial disorientation accounted for approximately 30% of the total pilot error causes found. Pilot demographics, flight hour/sortie profiles, and aircrew injuries are also listed. Fatalities occurred in 27% of the mishaps, with 97% of those involving pilot errors.

Intraperitoneal Vancomycin Plus Either Oral Moxifloxacin or Intraperitoneal Ceftazidime for the Treatment of Peritoneal Dialysis-Related Peritonitis: A Randomized Controlled Pilot Study.

PubMed

Xu, Rong; Yang, Zhikai; Qu, Zhen; Wang, Huan; Tian, Xue; Johnson, David W; Dong, Jie

2017-07-01

Intraperitoneal administration of antibiotics is recommended as a first treatment for managing peritoneal dialysis (PD)-related peritonitis. However, the efficacy of oral administration of quinolones has not been well studied. Randomized controlled pilot study. 80 eligible patients with PD-related peritonitis from Peking University First Hospital (40 in each arm). Intraperitoneal vancomycin, 1g, every 5 days plus oral moxifloxacin, 400mg, every day (treatment group) versus intraperitoneal vancomycin, 1g, every 5 days plus intraperitoneal ceftazidime, 1g, every day (control group). The primary end point was complete resolution of peritonitis, and secondary end points were primary or secondary treatment failure. PD effluent white blood cell count. Baseline demographic and clinical characteristics of the 2 groups were comparable. There were 24 and 22 Gram-positive organisms, 6 and 7 Gram-negative organisms, 9 and 10 culture-negative samples, and 1 and 1 fungal sample in the treatment and control groups, respectively. Complete resolution of peritonitis was achieved in 78% and 80% of cases in the treatment and control groups, respectively (OR, 0.86; 95% CI, 0.30-2.52; P=0.8). There were 3 and 1 cases of relapse in the treatment and control groups, respectively. Primary and secondary treatment failure rates were not significantly different (33% vs 20% and 10% vs 13%, respectively). In each group, there was 1 peritonitis-related death and 6 transfers to hemodialysis therapy. During the 3-month follow-up period, 7 and 3 successive episodes of peritonitis occurred in the treatment and control groups, respectively. Only 2 adverse drug reactions (mild nausea and mild rash, respectively) were observed in the 2 groups. Sample size was relatively small and the eligibility ratio was low. Also, the number of peritonitis episodes was low, limiting the power to detect a difference between groups. This pilot study suggests that intraperitoneal vancomycin with oral moxifloxacin is a safe, well-tolerated, practical, and effective first-line treatment for PD-related peritonitis. Larger adequately powered clinical trials are warranted. Copyright © 2016 National Kidney Foundation, Inc. All rights reserved.

A randomized comparison of 5 versus 12 hours per day of cardiac contractility modulation treatment for heart failure patients: A preliminary report.

PubMed

Kloppe, Axel; Mijic, Dejan; Schiedat, Fabian; Bogossian, Harilaos; Mügge, Andreas; Rousso, Benny; Lemke, Bernd

2016-01-01

Cardiac contractility modulation (CCM) signals are non-excitatory electrical signals delivered during the absolute refractory period intended to improve contraction and cardiac function. Clinical trials have shown that CCM treatment significantly improves exercise tolerance and quality of life in symptomatic heart failure patients. Studies with CCM therapy typically include CCM delivery for 3, 5 or 7 h per day, although other configurations are also commonly used. Each has been associated with improved outcomes in heart failure, but it is not clear whether different application durations are associated with the various degrees of benefit. The purpose of the current pilot evaluation study was to evaluate the quality of life, exercise tolerance, and cardiac function, over a 6-month period when CCM was delivered for 5 h/day vs. 12 h/day. Increasing the daily CCM therapy duration is safe and as good as the standard CCM periods of application per day. This single center pilot evaluation study involved 19 medically refractory symptomatic patients with heart failure and reduced left ventricular function who underwent implantation of an Optimizer™ system (Impulse Dynamics, Orangeburg, NY, USA). Patients were randomized into one of two treatment groups; 5 h/day CCM treatment or 12 h/day CCM treatment. Subjects and evaluating physicians were blinded to the study group. Subjects returned to the hospital after 12 and 24 weeks. Efficacy evaluations included changes from baseline to 24 weeks in Minnesota Living With Heart Failure Questionnaire score (MLWHFQ), maximal oxygen consumption in the cardio-pulmonary stress test (peak VO2), New York Heart Association classification (NYHA), 6-min walk distance (6MWD), and ejection fraction (EF). At the end of 24 weeks, clinical improvement was observed in the entire cohort in all efficacy measures (mean change from baseline of -17.1 in MLWHFQ, -0.86 in NYHA, and improvement trend of 1.48 mL O2/kg/min in peak VO2, 31.3 m in 6MWD, and 2.25% in EF). There were no significant differences, either clinically or statistically, between the groups receiving CCM for 5 h/day vs. 12 h/day. Three subjects were voluntarily withdrawn before completing the study. One subject died from pneumonia after 125 days, and 6 serious adverse events were reported, none of which was classified as related to either the device or the procedure. Together with previously reported experience with CCM, delivery of CCM therapy is equally safe and appears similarly effective over the range of shorter (5 h) to longer (12 h) daily periods of application. Given the small sample size, further studies are warranted.

Pilot personality and crew coordination - Implications for training and selection

NASA Technical Reports Server (NTRS)

Chidester, Thomas R.; Helmreich, Robert L.; Gregorich, Steven E.; Geis, Craig E.

1991-01-01

It is contended that past failures to find linkages between performance and personality were due to a combination of premature performance evaluation, inadequate statistical modeling, and/or the reliance on data gathered in contrived as opposed to realistic situations. The goal of the research presented is to isolate subgroups of pilots along performance-related personality dimensions and to document limits on the impact of crew coordination training between the groups. Three different profiles were identified through cluster analysis of personality scales that replicated across samples and predicted attitude change following training in crew coordination.

Aviation and insurance

NASA Technical Reports Server (NTRS)

Mayo, R H

1922-01-01

This article considers some of the causes which hinder the development of aircraft insurance. Different risks are discussed as well as the causes of aircraft accidents. Pilot error, poor airdromes, weather conditions, poorly adapted airplanes, and engine failures are all examined and some conclusions are made.

Piloted Simulation Assessment of a High-Speed Civil Transport Configuration. [conducted with the Langley six-degree-of-freedom Visual Motion Simulator

NASA Technical Reports Server (NTRS)

Jackson, E. Bruce; Raney, David L.; Glaab, Louis J.; Derry, Stephen D.

2002-01-01

An assessment of a proposed configuration of a high-speed civil transport was conducted by using NASA and industry research pilots. The assessment was conducted to evaluate operational aspects of the configuration from a pilot's perspective, with the primary goal being to identify potential deficiencies in the configuration. The configuration was evaluated within and at the limits of the design operating envelope to determine the suitability of the configuration to maneuver in a typical mission as well as in emergency or envelope-limit conditions. The Cooper-Harper rating scale was used to evaluate the flying qualities of the configuration. A summary flying qualities metric was also calculated. The assessment was performed in the Langley six-degree-of-freedom Visual Motion Simulator. The effect of a restricted cockpit field-of-view due to obstruction by the vehicle nose was not included in this study. Tasks include landings, takeoffs, climbs, descents, overspeeds, coordinated turns, and recoveries from envelope limit excursions. Emergencies included engine failures, loss of stability augmentation, engine inlet unstarts, and emergency descents. Minimum control speeds and takeoff decision, rotation, and safety speeds were also determined.

Investigation of display issues relevant to the presentation of aircraft fault information

NASA Technical Reports Server (NTRS)

Allen, Donald M.

1989-01-01

This research, performed as a part of NASA Langley's Faultfinder project, investigated display implementation issues related to the introduction of real time fault diagnostic systems into next generation commercial aircraft. Three major issues were investigated: visual display styles for presenting fault related information to the crew, the form the output from the expert system should take, and methods for filtering fault related information for presentation to the crew. Twenty-four flight familiar male volunteers participated as subjects. Five subjects were NASA test pilots, six were Commercial Airline Pilots, seven were Air Force Lear Jet pilots, and six were NASA personnel familiar with flight (non-pilots). Subjects were presented with aircraft subsystem information on a CRT screen. They were required to identify the subsystems presented in a display and to remember the state (normal or abnormal) of subsystem parameter information contained in the display. The results of the study indicated that in the simpler experimental test cases (i.e., those involving single subsystem failures and composite hypothesis displays) subjects' performance did not differ across the different display formats. However, for the more complex cases (i.e., those involving multiple subsystem faults and multiple hypotheses displays), subjects' performance was superior in the text- and picture-based display formats compared to the symbol-based format. In addition, the findings suggest that a layered approached to information display is appropriate.

Clinical Outcome, Social Impact and Patient Expectation: a Purposive Sampling Pilot Evaluation of Patients in Benin Seven Years After Surgery.

PubMed

White, Michelle C; Randall, Kirsten; Avara, Esther; Mullis, Jenny; Parker, Gary; Shrime, Mark G

2018-05-01

Access to affordable and timely surgery is not equitable around the world. Five billion people lack access, and while non-governmental organizations (NGOs) help to meet this need, long-term surgical outcomes, social impact or patient experience is rarely reported. In 2016, Mercy Ships, a surgical NGO, undertook an evaluation of patients who had received surgery seven years earlier with Mercy Ships in 2009 in Benin. Using purposive sampling, patients who had received maxillofacial, plastics or orthopedic surgery were invited to attend a surgical evaluation day. In this pilot study, we used semi-structured interviews and questionnaire responses to assess patient expectation, surgical and social outcome. Our results show that seven years after surgery 35% of patients report surgery-related pain and 18% had sought further care for a clinical complication of their condition. However, 73% of patients report gaining social benefit from surgery, and overall patient satisfaction was 89%, despite 35% of patients saying that they were unclear what to expect after surgery indicating a mismatch of doctor/patient expectations and failure of the consent process. In conclusion, our pilot study shows that NGO surgery in Benin provided positive social impact associated with complication rates comparable to high-income countries when assessed seven years later. Key areas for further study in LMICs are: evaluation and treatment of chronic pain, consent and access to further care.

Are your students ready for anatomy and physiology? Developing tools to identify students at risk for failure.

PubMed

Gultice, Amy; Witham, Ann; Kallmeyer, Robert

2015-06-01

High failure rates in introductory college science courses, including anatomy and physiology, are common at institutions across the country, and determining the specific factors that contribute to this problem is challenging. To identify students at risk for failure in introductory physiology courses at our open-enrollment institution, an online pilot survey was administered to 200 biology students. The survey results revealed several predictive factors related to academic preparation and prompted a comprehensive analysis of college records of >2,000 biology students over a 5-yr period. Using these historical data, a model that was 91% successful in predicting student success in these courses was developed. The results of the present study support the use of surveys and similar models to identify at-risk students and to provide guidance in the development of evidence-based advising programs and pedagogies. This comprehensive approach may be a tangible step in improving student success for students from a wide variety of backgrounds in anatomy and physiology courses. Copyright © 2015 The American Physiological Society.

Cultural variation of perceptions of crew behaviour in multi-pilot aircraft.

PubMed

Hörmann, H J

2001-09-01

As the "last line of defence" pilots in commercial aviation often have to counteract effects of unexpected system flaws that could endanger the safety of a given flight. In order to timely detect and mitigate consequences of latent or active failures, effective team behaviour of the crew members is an indispensable condition. While this fact is generally agreed in the aviation community, there seems to be a wide range of concepts how crews should interact most effectively. Within the framework of the European project JARTEL the cultural robustness of evaluations of crew behaviour was examined. 105 instructor pilots from 14 different airlines representing 12 European countries participated in this project. The instructors' evaluations of crew behaviours in eight video scenarios will be compared in relation to cultural differences on Hofstede's dimensions of Power Distance and Individualism.

Nutritional Interventions in Heart Failure: Challenges and Opportunities.

PubMed

Kerley, Conor P

2018-06-01

There is a growing body of evidence that nutritional factors influence the incidence of heart failure (HF). The current manuscript aims to collate evidence relating to nutritional intervention in the treatment of HF as well as to provide context regarding challenges and opportunities in the field. Despite the accepted importance of nutritional factors relating to cardiovascular disease severity, there is surprisingly little human intervention research regarding dietary intake and HF. Further, existing nutritional interventions in HF were mostly pilot studies with small samples and short follow-up. There is consistent evidence that nutritional factors majorly influence HF. Despite limited research, there is evidence that nutritional modification can rapidly and profoundly influence multiple aspects of HF. There is an urgent need for well-conducted research to ascertain if nutritional modification can alter the long-term course of HF.

Objective Motion Cueing Criteria Investigation Based on Three Flight Tasks

NASA Technical Reports Server (NTRS)

Zaal, Petrus M. T.; Schroeder, Jeffery A.; Chung, William W.

2015-01-01

This paper intends to help establish fidelity criteria to accompany the simulator motion system diagnostic test specified by the International Civil Aviation Organization. Twelve air- line transport pilots flew three tasks in the NASA Vertical Motion Simulator under four different motion conditions. The experiment used three different hexapod motion configurations, each with a different tradeoff between motion filter gain and break frequency, and one large motion configuration that utilized as much of the simulator's motion space as possible. The motion condition significantly affected: 1) pilot motion fidelity ratings, and sink rate and lateral deviation at touchdown for the approach and landing task, 2) pilot motion fidelity ratings, roll deviations, maximum pitch rate, and number of stick shaker activations in the stall task, and 3) heading deviation after an engine failure in the takeoff task. Significant differences in pilot-vehicle performance were used to define initial objective motion cueing criteria boundaries. These initial fidelity boundaries show promise but need refinement.

Robust Modal Filtering and Control of the X-56A Model with Simulated Fiber Optic Sensor Failures

NASA Technical Reports Server (NTRS)

Suh, Peter M.; Chin, Alexander W.; Marvis, Dimitri N.

2014-01-01

The X-56A aircraft is a remotely-piloted aircraft with flutter modes intentionally designed into the flight envelope. The X-56A program must demonstrate flight control while suppressing all unstable modes. A previous X-56A model study demonstrated a distributed-sensing-based active shape and active flutter suppression controller. The controller relies on an estimator which is sensitive to bias. This estimator is improved herein, and a real-time robust estimator is derived and demonstrated on 1530 fiber optic sensors. It is shown in simulation that the estimator can simultaneously reject 230 worst-case fiber optic sensor failures automatically. These sensor failures include locations with high leverage (or importance). To reduce the impact of leverage outliers, concentration based on a Mahalanobis trim criterion is introduced. A redescending M-estimator with Tukey bisquare weights is used to improve location and dispersion estimates within each concentration step in the presence of asymmetry (or leverage). A dynamic simulation is used to compare the concentrated robust estimator to a state-of-the-art real-time robust multivariate estimator. The estimators support a previously-derived mu-optimal shape controller. It is found that during the failure scenario, the concentrated modal estimator keeps the system stable.

Robust Modal Filtering and Control of the X-56A Model with Simulated Fiber Optic Sensor Failures

NASA Technical Reports Server (NTRS)

Suh, Peter M.; Chin, Alexander W.; Mavris, Dimitri N.

2016-01-01

The X-56A aircraft is a remotely-piloted aircraft with flutter modes intentionally designed into the flight envelope. The X-56A program must demonstrate flight control while suppressing all unstable modes. A previous X-56A model study demonstrated a distributed-sensing-based active shape and active flutter suppression controller. The controller relies on an estimator which is sensitive to bias. This estimator is improved herein, and a real-time robust estimator is derived and demonstrated on 1530 fiber optic sensors. It is shown in simulation that the estimator can simultaneously reject 230 worst-case fiber optic sensor failures automatically. These sensor failures include locations with high leverage (or importance). To reduce the impact of leverage outliers, concentration based on a Mahalanobis trim criterion is introduced. A redescending M-estimator with Tukey bisquare weights is used to improve location and dispersion estimates within each concentration step in the presence of asymmetry (or leverage). A dynamic simulation is used to compare the concentrated robust estimator to a state-of-the-art real-time robust multivariate estimator. The estimators support a previously-derived mu-optimal shape controller. It is found that during the failure scenario, the concentrated modal estimator keeps the system stable.

Improvement of cardiac function with device-based diaphragmatic stimulation in chronic heart failure patients: the randomized, open-label, crossover Epiphrenic II Pilot Trial.

PubMed

Beeler, Remo; Schoenenberger, Andreas W; Bauer, Peter; Kobza, Richard; Bergner, Michael; Mueller, Xavier; Schlaepfer, Reinhard; Zuber, Michel; Erne, Susanne; Erne, Paul

2014-03-01

Device-based pacing-induced diaphragmatic stimulation (PIDS) may have therapeutic potential for chronic heart failure (HF) patients. We studied the effects of PIDS on cardiac function and functional outcomes. In 24 chronic HF patients with CRT, an additional electrode was attached to the left diaphragm. Randomized into two groups, patients received the following PIDS modes for 3 weeks in a different sequence: (i) PIDS off (control group); (ii) PIDS 0 ms mode (PIDS simultaneously with ventricular CRT pulse); or (iii) PIDS optimized mode (PIDS with optimized delay to ventricular CRT pulse). For PIDS optimization, acoustic cardiography was used. Effects of each PIDS mode on dyspnoea, power during exercise testing, and LVEF were assessed. Dyspnoea improved with the PIDS 0 ms mode (P = 0.057) and the PIDS optimized mode (P = 0.034) as compared with the control group. Maximal power increased from median 100.5 W in the control group to 104.0 W in the PIDS 0 ms mode (P = 0.092) and 109.5 W in the PIDS optimized mode (P = 0.022). Median LVEF was 33.5% in the control group, 33.0% in the PIDS 0 ms mode, and 37.0% in the PIDS optimized mode (P = 0.763 and P = 0.009 as compared with the control group, respectively). PIDS was asymptomatic in all patients. PIDS improves dyspnoea, working capacity, and LVEF in chronic HF patients over a 3 week period in addition to CRT. This pilot study demonstrates proof of principle of an innovative technology which should be confirmed in a larger sample. NCT00769678. © 2013 The Authors. European Journal of Heart Failure © 2013 European Society of Cardiology.

Proton Beam Therapy as a Nonsurgical Approach to Mucosal Melanoma of the Head and Neck: A Pilot Study

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

Zenda, Sadamoto, E-mail: szenda@east.ncc.go.jp; Kawashima, Mitsuhiko; Nishio, Teiji

2011-09-01

Purpose: The aim of this pilot study was to assess the clinical benefit of proton beam therapy for mucosal melanoma of the head and neck. Methods and Materials: Patients with mucosal melanoma of the head and neck with histologically confirmed malignant melanoma and N0 and M0 disease were enrolled. Proton therapy was delivered three times per week with a planned total dose of 60 Gy equivalents (GyE) in 15 fractions. Results: Fourteen consecutive patients were enrolled from January 2004 through February 2008. Patient characteristics were as follows: median age 73 years old (range, 56 to 79 years); male/female ratio, 7/7;more » and T stage 1/2/3/4, 3/2/0/9. All patients were able to receive the full dose of proton therapy. The most common acute toxicities were mucositis (grade 3, 21%) and mild dermatitis (grade 3, 0%). As for late toxicity, 2 patients had a unilateral decrease in visual acuity, although blindness did not occur. No treatment-related deaths occurred throughout the study. Initial local control rate was 85.7%, and, with a median follow-up period of 36.7 months, median progression-free survival was 25.1 months, and 3-year overall survival rates were 58.0%. The most frequent site of first failure was cervical lymph nodes (6 patients), followed by local failure in 1 patient and lung metastases in 1 patient. On follow-up, 5 patients died of disease, 4 died due to cachexia caused by distant metastases, and 1 patient by carotid artery perforation cause by lymph nodes metastases. Conclusions: Proton beam radiotherapy showed promising local control benefits and would benefit from ongoing clinical study.« less

The Local Wind Pump for Marginal Societies in Indonesia: A Perspective of Fault Tree Analysis

NASA Astrophysics Data System (ADS)

Gunawan, Insan; Taufik, Ahmad

2007-10-01

There are many efforts to reduce a cost of investment of well established hybrid wind pump applied to rural areas. A recent study on a local wind pump (LWP) for marginal societies in Indonesia (traditional farmers, peasant and tribes) was one of the efforts reporting a new application area. The objectives of the study were defined to measure reliability value of the LWP due to fluctuated wind intensity, low wind speed, economic point of view regarding a prolong economic crisis occurring and an available local component of the LWP and to sustain economics productivity (agriculture product) of the society. In the study, a fault tree analysis (FTA) was deployed as one of three methods used for assessing the LWP. In this article, the FTA has been thoroughly discussed in order to improve a better performance of the LWP applied in dry land watering system of Mesuji district of Lampung province-Indonesia. In the early stage, all of local component of the LWP was classified in term of its function. There were four groups of the components. Moreover, all of the sub components of each group were subjected to failure modes of the FTA, namely (1) primary failure modes; (2) secondary failure modes and (3) common failure modes. In the data processing stage, an available software package, ITEM was deployed. It was observed that the component indicated obtaining relative a long life duration of operational life cycle in 1,666 hours. Moreover, to enhance high performance the LWP, maintenance schedule, critical sub component suffering from failure and an overhaul priority have been identified in term of quantity values. Throughout a year pilot project, it can be concluded that the LWP is a reliable product to the societies enhancing their economics productivities.

Rockfall monitoring by Terrestrial Laser Scanning - case study of the basaltic rock face at Castellfollit de la Roca (Catalonia, Spain)

NASA Astrophysics Data System (ADS)

Abellán, A.; Vilaplana, J. M.; Calvet, J.; García-Sellés, D.; Asensio, E.

2011-03-01

This case study deals with a rock face monitoring in urban areas using a Terrestrial Laser Scanner. The pilot study area is an almost vertical, fifty meter high cliff, on top of which the village of Castellfollit de la Roca is located. Rockfall activity is currently causing a retreat of the rock face, which may endanger the houses located at its edge. TLS datasets consist of high density 3-D point clouds acquired from five stations, nine times in a time span of 22 months (from March 2006 to January 2008). The change detection, i.e. rockfalls, was performed through a sequential comparison of datasets. Two types of mass movement were detected in the monitoring period: (a) detachment of single basaltic columns, with magnitudes below 1.5 m3 and (b) detachment of groups of columns, with magnitudes of 1.5 to 150 m3. Furthermore, the historical record revealed (c) the occurrence of slab failures with magnitudes higher than 150 m3. Displacements of a likely slab failure were measured, suggesting an apparent stationary stage. Even failures are clearly episodic, our results, together with the study of the historical record, enabled us to estimate a mean detachment of material from 46 to 91.5 m3 year-1. The application of TLS considerably improved our understanding of rockfall phenomena in the study area.

An artificial intelligence approach to onboard fault monitoring and diagnosis for aircraft applications

NASA Technical Reports Server (NTRS)

Schutte, P. C.; Abbott, K. H.

1986-01-01

Real-time onboard fault monitoring and diagnosis for aircraft applications, whether performed by the human pilot or by automation, presents many difficult problems. Quick response to failures may be critical, the pilot often must compensate for the failure while diagnosing it, his information about the state of the aircraft is often incomplete, and the behavior of the aircraft changes as the effect of the failure propagates through the system. A research effort was initiated to identify guidelines for automation of onboard fault monitoring and diagnosis and associated crew interfaces. The effort began by determining the flight crew's information requirements for fault monitoring and diagnosis and the various reasoning strategies they use. Based on this information, a conceptual architecture was developed for the fault monitoring and diagnosis process. This architecture represents an approach and a framework which, once incorporated with the necessary detail and knowledge, can be a fully operational fault monitoring and diagnosis system, as well as providing the basis for comparison of this approach to other fault monitoring and diagnosis concepts. The architecture encompasses all aspects of the aircraft's operation, including navigation, guidance and controls, and subsystem status. The portion of the architecture that encompasses subsystem monitoring and diagnosis was implemented for an aircraft turbofan engine to explore and demonstrate the AI concepts involved. This paper describes the architecture and the implementation for the engine subsystem.

Alpha-fetoprotein as a prognostic marker in acute liver failure: a pilot study.

PubMed

Varshney, Anshul; Gupta, Rohit; Verma, Sanjiv K; Ahmad, Sohaib

2017-07-01

Prognostic markers of acute liver failure (ALF) are based on clinical, laboratory or radiological parameters. Most of the biochemical markers are based on hepatic degeneration. We studied the impact of serial serum alpha-fetoprotein (AFP) levels, a marker of liver regeneration, on the outcome of the patients with ALF. AFP levels were estimated on days 1 and 3 of hospitalisation of 32 patients with ALF and the ratio (AFP day3/day1) was calculated. All subjects were categorised as group A (expired) or group B (survived). The AFP ratio was 0.84  +  0.15 in group A (n = 20) versus 1.55  +  0.70 in group B (n = 10); P < 0.001. However, the absolute initial AFP values were not associated with the outcome, favourable or unfavourable. We conclude that AFP levels change dynamically during ALF and have the potential to be used as a predictor of outcome in isolation or in combination with well-established prognostic markers.

Representational constraints on the development of memory and metamemory: a developmental-representational theory.

PubMed

Ceci, Stephen J; Fitneva, Stanka A; Williams, Wendy M

2010-04-01

Traditional accounts of memory development suggest that maturation of prefrontal cortex (PFC) enables efficient metamemory, which enhances memory. An alternative theory is described, in which changes in early memory and metamemory are mediated by representational changes, independent of PFC maturation. In a pilot study and Experiment 1, younger children failed to recognize previously presented pictures, yet the children could identify the context in which they occurred, suggesting these failures resulted from inefficient metamemory. Older children seldom exhibited such failure. Experiment 2 established that this was not due to retrieval-time recoding. Experiment 3 suggested that young children's representation of a picture's attributes explained their metamemory failure. Experiment 4 demonstrated that metamemory is age-invariant when representational quality is controlled: When stimuli were equivalently represented, age differences in memory and metamemory declined. These findings do not support the traditional view that as children develop, neural maturation permits more efficient monitoring, which leads to improved memory. These findings support a theory based on developmental-representational synthesis, in which constraints on metamemory are independent of neurological development; representational features drive early memory to a greater extent than previously acknowledged, suggesting that neural maturation has been overimputed as a source of early metamemory and memory failure. PsycINFO Database Record (c) 2010 APA, all rights reserved.

Development of Airport Surface Required Navigation Performance (RNP)

NASA Technical Reports Server (NTRS)

Cassell, Rick; Smith, Alex; Hicok, Dan

1999-01-01

The U.S. and international aviation communities have adopted the Required Navigation Performance (RNP) process for defining aircraft performance when operating the en-route, approach and landing phases of flight. RNP consists primarily of the following key parameters - accuracy, integrity, continuity, and availability. The processes and analytical techniques employed to define en-route, approach and landing RNP have been applied in the development of RNP for the airport surface. To validate the proposed RNP requirements several methods were used. Operational and flight demonstration data were analyzed for conformance with proposed requirements, as were several aircraft flight simulation studies. The pilot failure risk component was analyzed through several hypothetical scenarios. Additional simulator studies are recommended to better quantify crew reactions to failures as well as additional simulator and field testing to validate achieved accuracy performance, This research was performed in support of the NASA Low Visibility Landing and Surface Operations Programs.

Piloting through the Recession: Continuing Higher Education in Europe and the United Kingdom

ERIC Educational Resources Information Center

Roffe, Ian

2009-01-01

In common with the United States, Europe is currently experiencing a serious economic recession. The crisis, which started in the financial sector, is now rippling out and affecting heavily other economic sectors: construction, property, retailing, manufacturing, etc. The arguable cause of the crisis was a failure of management in financial…

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

La, Trang H.; Wolden, Suzanne L.; Rodeberg, David A.

Purpose: To evaluate the incidence and prognostic factors for regional failure, with attention to the in-transit pathways of spread, in children with nonmetastatic rhabdomyosarcoma of the extremity. Methods and Materials: The Intergroup rhabdomyosarcoma studies III, IV-Pilot, and IV enrolled 226 children with rhabdomyosarcoma of the extremity. Failure at the in-transit (epitrochlear/brachial and popliteal) and proximal (axillary/infraclavicular and inguinal/femoral) lymph nodes was evaluated. The median follow-up for the surviving patients was 10.4 years. Results: Of the 226 children, 55 (24%) had clinical or pathologic evidence of either in-transit and/or proximal lymph node involvement at diagnosis. The actuarial 5-year risk of regionalmore » failure was 12%. The prognostic factors for poor regional control were female gender and lymph node involvement at diagnosis. In the 116 patients with a distal extremity primary tumor, 5% had in-transit lymph node involvement at diagnosis. The estimated 5-year incidences of in-transit and proximal nodal failure was 12% and 8%, respectively. The in-transit failure rate was 0% for patients who underwent radiotherapy and/or underwent lymph node sampling of the in-transit nodal site but was 15% for those who did not (p = .07). However, the 5-year event-free survival rate did not differ between these two groups (64% vs. 55%, respectively, p = .47). Conclusion: The high incidence of regional involvement necessitates aggressive identification and treatment of regional lymph nodes in patients with rhabdomyosarcoma of the extremity. In patients with distal extremity tumors, in-transit failures were as common as failures in more proximal regional sites. Patients who underwent complete lymph node staging with appropriate radiotherapy to the in-transit nodal site, if indicated, were at a slightly lower risk of in-transit failure.« less

Design and Testing of CPAS Main Deployment Bag Energy Modulator

NASA Technical Reports Server (NTRS)

Mollmann, Catherine

2017-01-01

During the developmental testing program for CPAS (Capsule Parachute Assembly System), the parachute system for the NASA Orion Crew Module, simulation revealed that high loads may be experienced by the pilot risers during the most devere deployment conditions. As the role of the pilot parachutes is to deploy the main parachutes, these high loads introduced the possibility of main deployment failure. In order to mitigate these high loads, a set of energy modulators was incorporated between the pilot riser and the main deployment bag. An extensive developmental program was implemented to ensure the adequacy of these energy modulators. After initial design comparisons, the energy modulator design was validated through slow-speed joint tests as well as through high-speed bungee tests. This paper documents the design, development, and results of multiple tests completed on the final design.

The Use of Novel Therapies to Reconstitute Blood Cell Production Production and Promote Organ Performance, Using Bone Marrow Failure as Modela Model

DTIC Science & Technology

2015-10-01

reported to be on Zenpep for gastro intestinal absorption issues and there are no data on the absorption of Leucine in this setting) . There was one...gastrointestinal absorption issues. As there are no data on the absorption of Leucine in this setting , the subject was withdrawn. 19DEC2014 Subject 12-002... Leucine is one of the branched chain amino acids and has been shown to upregulate protein translation . This is a pilot study to test the feasibility of

Comparison of two humidification systems for long-term noninvasive mechanical ventilation.

PubMed

Nava, S; Cirio, S; Fanfulla, F; Carlucci, A; Navarra, A; Negri, A; Ceriana, P

2008-08-01

There is no consensus concerning the best system of humidification during long-term noninvasive mechanical ventilation (NIMV). In a technical pilot randomised crossover 12-month study, 16 patients with stable chronic hypercapnic respiratory failure received either heated humidification or heat and moisture exchanger. Compliance with long-term NIMV, airway symptoms, side-effects and number of severe acute pulmonary exacerbations requiring hospitalisation were recorded. Two patients died. Intention-to-treat statistical analysis was performed on 14 patients. No significant differences were observed in compliance with long-term NIMV, but 10 out of 14 patients decided to continue long-term NIMV with heated humidification at the end of the trial. The incidence of side-effects, except for dry throat (significantly more often present using heat and moisture exchanger), hospitalisations and pneumonia were not significantly different. In the present pilot study, the use heated humidification and heat and moisture exchanger showed similar tolerance and side-effects, but a higher number of patients decided to continue long-term noninvasive mechanical ventilation with heated humidification. Further larger studies are required in order to confirm these findings.

Comparison of Pilots' Situational Awareness While Monitoring Autoland Approaches Using Conventional and Advanced Flight Display Formats

NASA Technical Reports Server (NTRS)

Kramer, Lynda J.; Busquets, Anthony M.

2000-01-01

A simulation experiment was performed to assess situation awareness (SA) and workload of pilots while monitoring simulated autoland operations in Instrument Meteorological Conditions with three advanced display concepts: two enhanced electronic flight information system (EFIS)-type display concepts and one totally synthetic, integrated pictorial display concept. Each concept incorporated sensor-derived wireframe runway and iconic depictions of sensor-detected traffic in different locations on the display media. Various scenarios, involving conflicting traffic situation assessments, main display failures, and navigation/autopilot system errors, were used to assess the pilots' SA and workload during autoland approaches with the display concepts. From the results, for each scenario, the integrated pictorial display concept provided the pilots with statistically equivalent or substantially improved SA over the other display concepts. In addition to increased SA, subjective rankings indicated that the pictorial concept offered reductions in overall pilot workload (in both mean ranking and spread) over the two enhanced EFIS-type display concepts. Out of the display concepts flown, the pilots ranked the pictorial concept as the display that was easiest to use to maintain situational awareness, to monitor an autoland approach, to interpret information from the runway and obstacle detecting sensor systems, and to make the decision to go around.

Rationale and design of a randomized controlled trial of allogeneic mesenchymal stem cells in patients with nonischemic cardiomyopathy.

PubMed

Greene, Stephen J; Epstein, Stephen E; Kim, Raymond J; Quyyumi, Arshed A; Cole, Robert T; Anderson, Allen S; Wilcox, Jane E; Skopicki, Hal A; Sikora, Sergey; Verkh, Lev; Tankovich, Nikolai I; Gheorghiade, Mihai; Butler, Javed

2017-04-01

This article describes an ongoing study investigating the safety and efficacy of ischemia-tolerant mesenchymal stem cell (MSC) therapy in patients with nonischemic heart failure and dysfunctional viable myocardium without scarring. This study will follow principles of the previously described mechanistic translational-phase concept whereby the effect of the study agent on laboratory and imaging markers of cardiac structure and function will be tested in a small homogenous cohort with the goal to enhance the understanding of the effect of interventions on cardiac remodeling and performance. This single-blind, placebo-controlled, crossover, multicenter, randomized study will assess the safety, tolerability, and preliminary efficacy of a single intravenous (i.v.) dose of allogeneic ischemia-tolerant MSCs in individuals with heart failure of nonischemic cause, ejection fraction 40% or less, and dysfunctional viable myocardium who have been receiving guideline-directed medical therapy. Eligible patients will have no evidence of baseline replacement scarring on delayed-enhancement cardiac magnetic resonance (CMR). Approximately 20 patients will be randomized in a 1 : 1 ratio to receive an i.v. infusion of ischemia-tolerant MSCs or placebo. At 90 days, the two groups will undergo crossover and received the alternative treatment. The primary endpoint is safety, as evaluated through at least 1-year post-MSC infusion. Additional efficacy endpoints will include measures of cardiac structure and function, as evaluated by serial cine-CMR and transthoracic echocardiography at 90 and 180 days post-initial infusion. This pilot study will explore the safety and effects on cardiac structure and function of i.v. injection of ischemia-tolerant MSCs in a small homogenous cohort of nonischemic heart failure patients with reduced ejection fraction and absent replacement scarring on CMR. This study also represents a prospective mechanistic translational-phase study using baseline and serial CMR imaging in heart failure patients and serves as a potential model for design of future heart failure trials (ClinicalTrials.gov identifier: NCT02467387).

Modeling Immunization To Infliximab in Children With Crohn's Disease Using Population Pharmacokinetics: A Pilot Study.

PubMed

Petitcollin, Antoine; Leuret, Oriane; Tron, Camille; Lemaitre, Florian; Verdier, Marie-Clémence; Paintaud, Gilles; Bouguen, Guillaume; Willot, Stéphanie; Bellissant, Eric; Ternant, David

2018-05-18

Antidrug antibodies (ADAs) dramatically increase infliximab clearance and are responsible for underexposure to the drug, leading to treatment failure. This pilot study aimed at developing a population pharmacokinetic model to detect and describe an early increase in infliximab clearance due to ADA. Twenty children with Crohn's disease (CD) were followed for 1 year or until treatment failure. Infliximab trough concentration, ADA, C-reactive protein (CRP), and Paediatric Crohn's Disease Activity Index (PCDAI) were recorded at each visit. A time-varying clearance population pharmacokinetic model was built to detect and describe an increase in infliximab clearance, independent from ADA testing. Factors associated with clearance variation and the relationships between infliximab concentrations, clearance variation, and clinical response were investigated. The model detected important increases in clearance in 4 patients. These patients had suboptimal early response, with higher mean PCDAI (P = 0.0086) and CRP (P = 0.028) compared with other patients. Two of them had detectable ADA. Clearance increase as described by the model and lower infliximab trough concentration at week 2 were associated with poorer outcomes in a multivariate Cox model (P = 0.001 and P = 0.0048, respectively). Being able to detect an increase in infliximab clearance, this model could allow the early detection of immunization to infliximab and therefore could help with dose adjustment in patients with CD. Moreover, the results suggest that clearance variations could be used as a predictive marker of clinical response. These findings need to be confirmed in a larger cohort, however, and predictive factors of clearance increase have to be investigated.

Influence of the menstrual cycle on flight simulator performance after alcohol ingestion.

PubMed

Mumenthaler, M S; O'Hara, R; Taylor, J L; Friedman, L; Yesavage, J A

2001-07-01

Previous studies investigating the influence of the menstrual cycle on cognitive functioning of women after alcohol ingestion have obtained inconsistent results. The present study tested the hypothesis that flight simulator performance during acute alcohol intoxication and 8 hours after drinking differs between the menstrual and the luteal phase of the menstrual cycle. White female pilots (N = 24) were tested during the menstrual and the luteal phases of their menstrual cycles. On each test day they performed a baseline simulator flight, consumed 0.67 g/kg ethanol, and performed an acute-intoxication and an 8-hour-carryover simulator flight. Subjects reached highly significant increases in estradiol (E2) as well as progesterone (P) levels during the luteal test day. Yet, there were no significant differences in overall flight performance after alcohol ingestion between the menstrual and luteal phases during acute intoxication or at 8-hour carryover. We found no correlations between E, or P levels and overall flight performance. However, there was a statistically significant Phase x Order interaction: Pilots who started the experiment with their menstrual day were less susceptible to the effects of alcohol during the second test day than were pilots who started with their luteal day. The tested menstrual cycle phases and varying E2 and P levels did not significantly influence postdrink flight performance. Because the present study included a comparatively large sample size and because it involved complex "real world" tasks (piloting an aircraft), we believe that the present findings are important. We hope that our failure to detect menstrual cycle effects will encourage researchers to include women in their investigations of alcohol effects and human performance.

Extending Validated Human Performance Models to Explore NextGen Concepts

NASA Technical Reports Server (NTRS)

Gore, Brian Francis; Hooey, Becky Lee; Mahlstedt, Eric; Foyle, David C.

2012-01-01

To meet the expected increases in air traffic demands, NASA and FAA are researching and developing Next Generation Air Transportation System (NextGen) concepts. NextGen will require substantial increases in the data available to pilots on the flight deck (e.g., weather,wake, traffic trajectory predictions, etc.) to support more precise and closely coordinated operations (e.g., self-separation, RNAV/RNP, and closely spaced parallel operations, CSPOs). These NextGen procedures and operations, along with the pilot's roles and responsibilities, must be designed with consideration of the pilot's capabilities and limitations. Failure to do so will leave the pilots, and thus the entire aviation system, vulnerable to error. A validated Man-machine Integration and design Analysis System (MIDAS) v5 model was extended to evaluate anticipated changes to flight deck and controller roles and responsibilities in NextGen approach and Land operations. Compared to conditions when the controllers are responsible for separation on decent to land phase of flight, the output from these model predictions suggest that the flight deck response time to detect the lead aircraft blunder will decrease, pilot scans to the navigation display will increase, and workload will increase.

Coenzyme Q10 for the treatment of heart failure: a review of the literature

PubMed Central

DiNicolantonio, James J; Bhutani, Jaikrit; McCarty, Mark F; O'Keefe, James H

2015-01-01

Coenzyme Q10 (CoQ10) is an endogenously synthesised and diet-supplied lipid-soluble cofactor that functions in the mitochondrial inner membrane to transfer electrons from complexes I and II to complex III. In addition, its redox activity enables CoQ10 to act as a membrane antioxidant. In patients with congestive heart failure, myocardial CoQ10 content tends to decline as the degree of heart failure worsens. A number of controlled pilot trials with supplemental CoQ10 in heart failure found improvements in functional parameters such as ejection fraction, stroke volume and cardiac output, without side effects. Subsequent meta-analyses have confirmed these findings, although the magnitude of benefit tends to be less notable in patients with severe heart failure, or within the context of ACE inhibitor therapy. The multicentre randomised placebo-controlled Q-SYMBIO trial has assessed the impact of supplemental CoQ10 on hard endpoints in heart failure. A total of 420 patients received either CoQ10 (100 mg three times daily) or placebo and were followed for 2 years. Although short-term functional endpoints were not statistically different in the two groups, CoQ10 significantly reduced the primary long-term endpoint—a major adverse cardiovascular event—which was observed in 15% of the treated participants compared to 26% of those receiving placebo (HR=0.50, CI 0.32 to 0.80, p=0.003). Particularly in light of the excellent tolerance and affordability of this natural physiological compound, supplemental CoQ10 has emerged as an attractive option in the management of heart failure, and merits evaluation in additional large studies. PMID:26512330

Autorotation flight control system

NASA Technical Reports Server (NTRS)

Bachelder, Edward N. (Inventor); Aponso, Bimal L. (Inventor); Lee, Dong-Chan (Inventor)

2011-01-01

The present invention provides computer implemented methodology that permits the safe landing and recovery of rotorcraft following engine failure. With this invention successful autorotations may be performed from well within the unsafe operating area of the height-velocity profile of a helicopter by employing the fast and robust real-time trajectory optimization algorithm that commands control motion through an intuitive pilot display, or directly in the case of autonomous rotorcraft. The algorithm generates optimal trajectories and control commands via the direct-collocation optimization method, solved using a nonlinear programming problem solver. The control inputs computed are collective pitch and aircraft pitch, which are easily tracked and manipulated by the pilot or converted to control actuator commands for automated operation during autorotation in the case of an autonomous rotorcraft. The formulation of the optimal control problem has been carefully tailored so the solutions resemble those of an expert pilot, accounting for the performance limitations of the rotorcraft and safety concerns.

A Problem-Solving Workshop on Border Conflicts in Eastern Africa

ERIC Educational Resources Information Center

Walton, Richard E.

1970-01-01

Six participants each from Somalia, Ethiopia, and Kenya participated in a workshop to search for solutions to the border disputes between Somalia and her two neighbors. This pilot venture, a mixture of successes and failures, can provide the basis for improvement and extension of the concept. Followed by critical comments by John E. Harr, Otto…

14 CFR 29.672 - Stability augmentation, automatic, and power-operated systems.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Design and Construction Control Systems § 29.672 Stability augmentation, automatic, and power-operated systems. If the... unsafe condition if the pilot is unaware of the failure. Warning systems must not activate the control...

14 CFR 27.672 - Stability augmentation, automatic, and power-operated systems.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Control Systems § 27.672 Stability augmentation, automatic, and power-operated systems. If the... unsafe condition if the pilot is unaware of the failure. Warning systems must not activate the control...

Handling Qualities Evaluations of Low Complexity Model Reference Adaptive Controllers for Reduced Pitch and Roll Damping Scenarios

NASA Technical Reports Server (NTRS)

Hanson, Curt; Schaefer, Jacob; Burken, John J.; Johnson, Marcus; Nguyen, Nhan

2011-01-01

National Aeronautics and Space Administration (NASA) researchers have conducted a series of flight experiments designed to study the effects of varying levels of adaptive controller complexity on the performance and handling qualities of an aircraft under various simulated failure or damage conditions. A baseline, nonlinear dynamic inversion controller was augmented with three variations of a model reference adaptive control design. The simplest design consisted of a single adaptive parameter in each of the pitch and roll axes computed using a basic gradient-based update law. A second design was built upon the first by increasing the complexity of the update law. The third and most complex design added an additional adaptive parameter to each axis. Flight tests were conducted using NASA s Full-scale Advanced Systems Testbed, a highly modified F-18 aircraft that contains a research flight control system capable of housing advanced flight controls experiments. Each controller was evaluated against a suite of simulated failures and damage ranging from destabilization of the pitch and roll axes to significant coupling between the axes. Two pilots evaluated the three adaptive controllers as well as the non-adaptive baseline controller in a variety of dynamic maneuvers and precision flying tasks designed to uncover potential deficiencies in the handling qualities of the aircraft, and adverse interactions between the pilot and the adaptive controllers. The work was completed as part of the Integrated Resilient Aircraft Control Project under NASA s Aviation Safety Program.

The Results of a Simulator Study to Determine the Effects on Pilot Performance of Two Different Motion Cueing Algorithms and Various Delays, Compensated and Uncompensated

NASA Technical Reports Server (NTRS)

Guo, Li-Wen; Cardullo, Frank M.; Telban, Robert J.; Houck, Jacob A.; Kelly, Lon C.

2003-01-01

A study was conducted employing the Visual Motion Simulator (VMS) at the NASA Langley Research Center, Hampton, Virginia. This study compared two motion cueing algorithms, the NASA adaptive algorithm and a new optimal control based algorithm. Also, the study included the effects of transport delays and the compensation thereof. The delay compensation algorithm employed is one developed by Richard McFarland at NASA Ames Research Center. This paper reports on the analyses of the results of analyzing the experimental data collected from preliminary simulation tests. This series of tests was conducted to evaluate the protocols and the methodology of data analysis in preparation for more comprehensive tests which will be conducted during the spring of 2003. Therefore only three pilots were used. Nevertheless some useful results were obtained. The experimental conditions involved three maneuvers; a straight-in approach with a rotating wind vector, an offset approach with turbulence and gust, and a takeoff with and without an engine failure shortly after liftoff. For each of the maneuvers the two motion conditions were combined with four delay conditions (0, 50, 100 & 200ms), with and without compensation.

Human Factors of Remotely Piloted Aircraft

NASA Technical Reports Server (NTRS)

Hobbs, Alan Neville

2014-01-01

The civilian use of remotely piloted, or unmanned aircraft is expected to increase rapidly in the years ahead. Despite being referred to as unmanned some of the major challenges confronting this emerging sector relate to human factors. As unmanned aircraft systems (UAS) are introduced into civil airspace, a failure to adequately consider human factors could result in preventable accidents that may not only result in loss of life, but may also undermine public confidence in remotely piloted operations. Key issues include pilot situational awareness, collision avoidance in the absence of an out-the-window view, the effects of time delays in communication and control systems, control handovers, the challenges of very long duration flights, and the design of the control station. Problems have included poor physical layout of controls, non-intuitive automation interfaces, an over-reliance on text displays, and complicated sequences of menu selection to perform routine tasks. Some of the interface problems may have been prevented had an existing regulation or cockpit design principle been applied. In other cases, the design problems may indicate a lack of suitable guidance material.

Designing Tailor-Made Academic Paths for University Language Students

ERIC Educational Resources Information Center

Beseghi, Micol; Bertolotti, Greta

2013-01-01

The Language Centre of the University of Parma is responsible for the organization and administration of foreign language tests to a large number of university students. In order to reduce the high rate of test failures, the Language Centre has recently devised a pilot programme as an alternative to more established modes of language learning,…

SILHIL Replication of Electric Aircraft Powertrain Dynamics and Inner-Loop Control for V&V of System Health Management Routines

NASA Technical Reports Server (NTRS)

Bole, Brian; Teubert, Christopher Allen; Cuong Chi, Quach; Hogge, Edward; Vazquez, Sixto; Goebel, Kai; George, Vachtsevanos

2013-01-01

Software-in-the-loop and Hardware-in-the-loop testing of failure prognostics and decision making tools for aircraft systems will facilitate more comprehensive and cost-effective testing than what is practical to conduct with flight tests. A framework is described for the offline recreation of dynamic loads on simulated or physical aircraft powertrain components based on a real-time simulation of airframe dynamics running on a flight simulator, an inner-loop flight control policy executed by either an autopilot routine or a human pilot, and a supervisory fault management control policy. The creation of an offline framework for verifying and validating supervisory failure prognostics and decision making routines is described for the example of battery charge depletion failure scenarios onboard a prototype electric unmanned aerial vehicle.

From community-based pilot testing to region-wide systems change: lessons from a local quality improvement collaborative.

PubMed

Keyser, Donna J; Pincus, Harold Alan

2010-01-01

A community-based collaborative conducted a 2-year pilot study to inform efforts for improving maternal and child health care practice and policy in Allegheny County, Pennsylvania. (1) To test whether three small-scale versions of an evidence-based, systems improvement approach would be workable in local community settings and (2) to identify specific policy/infrastructure reforms for sustaining improvements. A mixed methods approach was used, including quantitative performance measurement supplemented with qualitative data about factors related to outcomes of interest, as well as key stakeholder interviews and a literature review/Internet search. Quantitative performance results varied; qualitative data revealed critical factors for the success and failure of the practices tested. Policy/infrastructure recommendations were developed to address specific practice barriers. This information was important for designing a region-wide quality improvement initiative focused on maternal depression. The processes and outcomes provide valuable insights for other communities interested in conducting similar quality improvement initiatives.

Cockpit Interruptions and Distractions: Effective Management Requires a Careful Balancing Act

NASA Technical Reports Server (NTRS)

Dismukes, R. K.; Young, Grant E.; Sumwalt, Robert L., III; Null, Cynthia H. (Technical Monitor)

1998-01-01

Managing several tasks concurrently is an everyday part of cockpit operations. For the most part, crews handle concurrent task demands efficiently, yet crew preoccupation with one task to the detriment of performing other tasks is one of the more common forms of error in the cockpit. Most pilots are familiar with the December 1972 L1011 crash that occurred when the crew became preoccupied with a landing gear light malfunction and failed to notice that someone had inadvertently bumped off the autopilot. More recently a DC-9 landed gear-up in Houston when the crew, preoccupied with an stabilized approach, failed to recognize that the gear was not down because they had not switched the hydraulic pumps to high. We have recently started a research project to study why crews are vulnerable to these sorts of errors. As part of that project we reviewed NTSB reports of accidents attributed to crew error; we concluded that nearly half of these accidents involved lapses of attention associated with interruptions, distractions, or preoccupation with one task to the exclusion of another task. We have also analyzed 107 ASRS reports involving competing tasks; we present here some of our conclusions from those ASRS reports. These 107 reports involved 21 different types of routine tasks crews neglected at a critical moment while attending to another task. Sixty-nine percent of the neglected tasks involved either failure to monitor the current status or position of the aircraft or failure to monitor the actions of the pilot flying or taxiing. Thirty-four different types of competing activities distracted or preoccupied the pilots. Ninety percent of these competing activities fell into one of four broad categories: communication (e.g., discussion among crew or radio communication), heads-down work (e.g., programming the FMS or reviewing approach plates), responding to abnormals, or searching for VMC traffic. We will discuss examples of each of these four categories and suggest things crews can do to reduce their vulnerability to these and similar situations.

Remote operation of an orbital maneuvering vehicle in simulated docking maneuvers

NASA Technical Reports Server (NTRS)

Brody, Adam R.

1990-01-01

Simulated docking maneuvers were performed to assess the effect of initial velocity on docking failure rate, mission duration, and delta v (fuel consumption). Subjects performed simulated docking maneuvers of an orbital maneuvering vehicle (OMV) to a space station. The effect of the removal of the range and rate displays (simulating a ranging instrumentation failure) was also examined. Naive subjects were capable of achieving a high success rate in performing simulated docking maneuvers without extensive training. Failure rate was a function of individual differences; there was no treatment effect on failure rate. The amount of time subjects reserved for final approach increased with starting velocity. Piloting of docking maneuvers was not significantly affected in any way by the removal of range and rate displays. Radial impulse was significant both by subject and by treatment. NASA's 0.1 percent rule, dictating an approach rate no greater than 0.1 percent of the range, is seen to be overly conservative for nominal docking missions.

Feasibility and acceptability of a nursing intervention with family caregiver on self-care among heart failure patients: a randomized pilot trial.

PubMed

Cossette, Sylvie; Belaid, Hayet; Heppell, Sonia; Mailhot, Tanya; Guertin, Marie-Claude

2016-01-01

Self-care practices in heart failure (HF) contribute to quality of life, symptom stabilization, and extended life expectancy. However, adherence to practices such as liquid and salt restriction or symptom monitoring require high motivation on a daily basis. The aim was to assess the feasibility, acceptability, and potential effectiveness of a nursing intervention with family caregivers, aimed at improving self-care practice of HF patients. This pilot study involved 32 HF patient-caregiver dyads (16/group) randomized to an experimental (EG) or control group (CG). The intervention, based on the Self-Determination Theory, was designed to enhance patients' autonomy and motivation in self-care practices, by involving their caregivers' support. Five encounters were planned with the EG dyads-two face-to-face during hospitalization and three by telephone after discharge. The feasibility of delivering the protocol was evaluated as well as the acceptability of the intervention. The potential effectiveness of the intervention was assessed based on patient outcomes, including general self-care management and self-care specific to HF, perceived competence to manage HF, autonomous motivation (A-motivation, external extrinsic motivation, internal extrinsic motivation, and intrinsic motivation), and perceived support from the caregiver. Caregiver outcomes included level of support provided to the patient. Despite recruitment challenges, the intervention was feasible, with 12 of the 16 dyads receiving all 5 encounters delivered per protocol. The 4 other dyads received the two hospital encounters, but at least 1 of the 3 post-discharge planned telephone encounters was not feasible because the patients had been re-hospitalized or was deceased. Participant's satisfaction with the intervention was high. Outcomes favoring the EG include self-care specific to HF, internal extrinsic motivation, intrinsic motivation, and caregiver's feeling that they provide a higher level of support. Caregiver involvement was found to be both a feasible and acceptable means of supporting self-care practice in HF patients. This approach presents a potential avenue for enhancing patients' efforts in this regard. However, this pilot study offers preliminary findings only, which need to be replicated in a phase 3 clinical trial.

Dipeptidyl peptidase-4 inhibitors and risk of heart failure in type 2 diabetes: systematic review and meta-analysis of randomised and observational studies.

PubMed

Li, Ling; Li, Sheyu; Deng, Ke; Liu, Jiali; Vandvik, Per Olav; Zhao, Pujing; Zhang, Longhao; Shen, Jiantong; Bala, Malgorzata M; Sohani, Zahra N; Wong, Evelyn; Busse, Jason W; Ebrahim, Shanil; Malaga, German; Rios, Lorena P; Wang, Yingqiang; Chen, Qunfei; Guyatt, Gordon H; Sun, Xin

2016-02-17

To examine the association between dipeptidyl peptidase-4 (DPP-4) inhibitors and the risk of heart failure or hospital admission for heart failure in patients with type 2 diabetes. Systematic review and meta-analysis of randomised and observational studies. Medline, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov searched up to 25 June 2015, and communication with experts. Randomised controlled trials, non-randomised controlled trials, cohort studies, and case-control studies that compared DPP-4 inhibitors against placebo, lifestyle modification, or active antidiabetic drugs in adults with type 2 diabetes, and explicitly reported the outcome of heart failure or hospital admission for heart failure. Teams of paired reviewers independently screened for eligible studies, assessed risk of bias, and extracted data using standardised, pilot tested forms. Data from trials and observational studies were pooled separately; quality of evidence was assessed by the GRADE approach. Eligible studies included 43 trials (n=68,775) and 12 observational studies (nine cohort studies, three nested case-control studies; n=1,777,358). Pooling of 38 trials reporting heart failure provided low quality evidence for a possible similar risk of heart failure between DPP-4 inhibitor use versus control (42/15,701 v 33/12,591; odds ratio 0.97 (95% confidence interval 0.61 to 1.56); risk difference 2 fewer (19 fewer to 28 more) events per 1000 patients with type 2 diabetes over five years). The observational studies provided effect estimates generally consistent with trial findings, but with very low quality evidence. Pooling of the five trials reporting admission for heart failure provided moderate quality evidence for an increased risk in patients treated with DPP-4 inhibitors versus control (622/18,554 v 552/18,474; 1.13 (1.00 to 1.26); 8 more (0 more to 16 more)). The pooling of adjusted estimates from observational studies similarly suggested (with very low quality evidence) a possible increased risk of admission for heart failure (adjusted odds ratio 1.41, 95% confidence interval 0.95 to 2.09) in patients treated with DPP-4 inhibitors (exclusively sitagliptin) versus no use. The relative effect of DPP-4 inhibitors on the risk of heart failure in patients with type 2 diabetes is uncertain, given the relatively short follow-up and low quality of evidence. Both randomised controlled trials and observational studies, however, suggest that these drugs may increase the risk of hospital admission for heart failure in those patients with existing cardiovascular diseases or multiple risk factors for vascular diseases, compared with no use. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

14 CFR 23.775 - Windshields and windows.

Code of Federal Regulations, 2011 CFR

2011-01-01

... loadings and flight loads, or compliance with the fail-safe requirements of paragraph (d) of this section... loads combined with critical aerodynamic pressure and temperature effects, after failure of any load... in front of the pilots must be arranged so that, assuming the loss of vision through any one panel...

14 CFR 23.775 - Windshields and windows.

Code of Federal Regulations, 2010 CFR

2010-01-01

... loadings and flight loads, or compliance with the fail-safe requirements of paragraph (d) of this section... loads combined with critical aerodynamic pressure and temperature effects, after failure of any load... in front of the pilots must be arranged so that, assuming the loss of vision through any one panel...

14 CFR 23.775 - Windshields and windows.

Code of Federal Regulations, 2014 CFR

2014-01-01

... loadings and flight loads, or compliance with the fail-safe requirements of paragraph (d) of this section... loads combined with critical aerodynamic pressure and temperature effects, after failure of any load... in front of the pilots must be arranged so that, assuming the loss of vision through any one panel...

14 CFR 23.775 - Windshields and windows.

Code of Federal Regulations, 2013 CFR

2013-01-01

... loadings and flight loads, or compliance with the fail-safe requirements of paragraph (d) of this section... loads combined with critical aerodynamic pressure and temperature effects, after failure of any load... in front of the pilots must be arranged so that, assuming the loss of vision through any one panel...

14 CFR 23.775 - Windshields and windows.

Code of Federal Regulations, 2012 CFR

2012-01-01

... loadings and flight loads, or compliance with the fail-safe requirements of paragraph (d) of this section... loads combined with critical aerodynamic pressure and temperature effects, after failure of any load... in front of the pilots must be arranged so that, assuming the loss of vision through any one panel...

Development of LRFD procedures for bridge pile foundations in Iowa - volume I : an electronic database for PIle LOad Tests (PILOT).

DOT National Transportation Integrated Search

2011-01-01

For well over 100 years, the Working Stress Design (WSD) approach has been the traditional basis for geotechnical design with regard to settlements or failure conditions. However, considerable effort has been put forth over the past couple of decades...

14 CFR 25.672 - Stability augmentation and automatic and power-operated systems.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY AIRPLANES Design and Construction Control Systems § 25.672 Stability augmentation and automatic and power-operated systems. If the... the pilot were not aware of the failure. Warning systems must not activate the control systems. (b...

14 CFR 25.672 - Stability augmentation and automatic and power-operated systems.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY AIRPLANES Design and Construction Control Systems § 25.672 Stability augmentation and automatic and power-operated systems. If the... the pilot were not aware of the failure. Warning systems must not activate the control systems. (b...

14 CFR 25.672 - Stability augmentation and automatic and power-operated systems.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY AIRPLANES Design and Construction Control Systems § 25.672 Stability augmentation and automatic and power-operated systems. If the... the pilot were not aware of the failure. Warning systems must not activate the control systems. (b...

14 CFR 25.672 - Stability augmentation and automatic and power-operated systems.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY AIRPLANES Design and Construction Control Systems § 25.672 Stability augmentation and automatic and power-operated systems. If the... the pilot were not aware of the failure. Warning systems must not activate the control systems. (b...

Demonstration Advanced Avionics System (DAAS). Phase 1 report

NASA Technical Reports Server (NTRS)

1981-01-01

An integrated avionics system which provides expanded functional capabilities that significantly enhance the utility and safety of general aviation at a cost commensurate with the general aviation market is discussed. Displays and control were designed so that the pilot can use the system after minimum training. Functional and hardware descriptions, operational evaluation and failure modes effects analysis are included.

Appropriateness and acceptability of a Tele-Yoga intervention for people with heart failure and chronic obstructive pulmonary disease: qualitative findings from a controlled pilot study.

PubMed

Selman, Lucy; McDermott, Kelly; Donesky, DorAnne; Citron, Tracie; Howie-Esquivel, Jill

2015-02-07

Heart failure (HF) and chronic obstructive pulmonary disease (COPD) are highly prevalent and associated with a large symptom burden, that is compounded in a dual HF-COPD diagnosis. Yoga has potential benefit for symptom relief; however functional impairment hinders access to usual yoga classes. We developed a Tele-Yoga intervention and evaluated it in a controlled pilot trial. This paper reports on the appropriateness and acceptability of the intervention and the evaluation design. A controlled, non-randomised trial was conducted of an 8-week Tele-Yoga intervention versus an educational control (information leaflets mailed to participants with one phone call a week). Biweekly one-hour Tele-Yoga classes were implemented via multipoint videoconferencing that connected participants to live classes via an Internet connection to their televisions. Semi-structured qualitative interviews were conducted with participants post study exit to explore reasons for and experiences of participating, including views of study outcome measures and physiological tests. Transcribed interviews were analysed using thematic content analysis. Fifteen people participated in the pilot study (7 in the intervention group, 8 in the control). Of these, 12 participants were interviewed, 6 in each group, mean age 71.2 years (SD 10.09); 3 were male. Themes are reported in the following categories: acceptability and appropriateness of the intervention, potential active ingredients of the intervention, acceptability and appropriateness of the control, participation in the research, and acceptability of the testing procedures. The intervention was acceptable and appropriate: the intervention group reported enjoying yoga and valuing the home-based aspect and participants described a high symptom burden and social isolation. However, technological problems resulted in poor video-streaming quality for some participants. Potential active ingredients included physical postures, breathing exercises and guidance in relaxation and meditation. The educational control intervention was acceptable and appropriate, with participants reporting little effect on their well-being and no impact on mechanisms hypothesised to explain yoga's effectiveness. The questionnaires and home physiological testing were acceptable to participants. Tele-Yoga is an acceptable and appropriate intervention in people with HF and COPD and further research is warranted to refine the technology used in its delivery. Findings provide guidance for researchers working in tele-interventions, yoga, and similar populations. ClinicalTrials.gov Identifier: NCT02078739 (4 March 2014).

Doxorubicin and ifosfamide combination chemotherapy in previously treated acute leukemia in adults: a Southwest Oncology Group pilot study.

PubMed

Ryan, D H; Bickers, J N; Vial, R H; Hussein, K; Bottomley, R; Hewlett, J S; Wilson, H E; Stuckey, W J

1980-01-01

The Southwest Oncology Group did a limited institutional pilot study of the combination of doxorubicin and ifosfamide in the treatment of previously treated adult patients with acute leukemia. Thirty-four patients received one or two courses of the combination. All patients had received prior chemotherapy and 32 had received prior anthracycline chemotherapy. Three patients died before their responses could be fully evaluated. Fourteen patients achieved complete remission (41%) and one patient achieved partial remission. The complete remission rate was 27% for patients with acute myeloblastic leukemia (myelomonoblastic leukemia, monoblastic leukemia, and erythroleukemia) and 89% for patients with acute lymphocytic and undifferentiated leukemia (ALL). Toxic effects included severe hematologic reactions in 33 of 34 patients, hematuria in six patients, altered sensorium in one patient, and congestive heart failure in one patient. The safety of the combination was established and toxic side effects of this therapy were tolerable. The 89% complete remission rate for previously treated patients with ALL suggests that the combination of doxorubicin and ifosfamide may be particularly effective in ALL.

Introduction of the Tools for Economic Analysis of Patient Management Interventions in Heart Failure Costing Tool: a user-friendly spreadsheet program to estimate costs of providing patient-centered interventions.

PubMed

Reed, Shelby D; Li, Yanhong; Kamble, Shital; Polsky, Daniel; Graham, Felicia L; Bowers, Margaret T; Samsa, Gregory P; Paul, Sara; Schulman, Kevin A; Whellan, David J; Riegel, Barbara J

2012-01-01

Patient-centered health care interventions, such as heart failure disease management programs, are under increasing pressure to demonstrate good value. Variability in costing methods and assumptions in economic evaluations of such interventions limit the comparability of cost estimates across studies. Valid cost estimation is critical to conducting economic evaluations and for program budgeting and reimbursement negotiations. Using sound economic principles, we developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure (TEAM-HF) Costing Tool, a spreadsheet program that can be used by researchers and health care managers to systematically generate cost estimates for economic evaluations and to inform budgetary decisions. The tool guides users on data collection and cost assignment for associated personnel, facilities, equipment, supplies, patient incentives, miscellaneous items, and start-up activities. The tool generates estimates of total program costs, cost per patient, and cost per week and presents results using both standardized and customized unit costs for side-by-side comparisons. Results from pilot testing indicated that the tool was well-formatted, easy to use, and followed a logical order. Cost estimates of a 12-week exercise training program in patients with heart failure were generated with the costing tool and were found to be consistent with estimates published in a recent study. The TEAM-HF Costing Tool could prove to be a valuable resource for researchers and health care managers to generate comprehensive cost estimates of patient-centered interventions in heart failure or other conditions for conducting high-quality economic evaluations and making well-informed health care management decisions.

A comparitive clinical study between self tapping and drill free screws as a source of rigid orthodontic anchorage.

PubMed

Gupta, Nishant; Kotrashetti, S M; Naik, Vijay

2012-03-01

Self-tapping miniscrews are commonly being used as a temporary anchorage device for orthodontic purpose. A prerequisite for the insertion of these screws is the preparation of a pilot hole, which is time consuming and may result in damage to nerves, tooth root, drill bit breakage and thermal necrosis of bone. On the other hand the design of drill-free screws enables them to be inserted without drilling. The aim of this prospective study was to compare the stability and clinical response of the soft tissue around the self tapping and drill free screws when used for orthodontic anchorage for en mass retraction of maxillary anterior teeth. The study sample consisted of 20 patients requiring retraction of maxillary anterior teeth. The screws were placed in the alveolar bone between maxillary 2nd premolar and 1st molar bilaterally at the junction of attached gingiva and moveable mucosa. Pilot hole was drilled on the side which was selected for insertion of the self tapping screw under copious irrigation, after which it was inserted. Drill free screw was inserted on the contralateral side without predrilling. All screws were immediately loaded with 150-200 gm of retraction force. Patients were recalled for regular follow up for a period of 6 months. If the screws became mobile or showed any signs of inflammation during the course of the study, they were considered to be a failure. After a period of 6 months an overall success rate of 77.5% was noted. Four self tapping and five drill-free screws failed during the study. There was no statistically significant difference between the two types of screws with respect to success/failure. Mobility was found to be the major cause for the failure. Both self-tapping and the drill-free screws are effective anchorage units. But the latter have an edge over the conventional self-tapping screws because of decrease in operative time, little bone debris, less thermal damage, lower morbidity, and minimal patient discomfort as predrilling is not required, thus they can be used as a viable alternative. But self-tapping screws are still recommended for areas with high bone density and thick cortical bone.

Hazards of mountain flying: crashes in the Colorado Rockies.

PubMed

Baker, S P; Lamb, M W

1989-06-01

Between 1964 and 1987, 232 airplanes crashed within 50 nautical miles of Aspen, CO; 90% were general aviation crashes. A total of 202 people died and 69 were seriously injured. The societal cost averaged more than $4 million annually. Most pilots were experienced and many were flight instructors, but 44% had flown less than 100 hours in the type of plane in which they crashed. Forty-one percent of the pilots were out-of-state residents. Crashes in the study area were more likely to be fatal than in the rest of Colorado. Airplanes with three or four occupants and low-powered four-seater aircraft were over-represented among crashes involving failure to outclimb rising terrain. In a subset of crashes examined for restraint use, 50% of the front seat occupants using only lap belts were killed, compared to 13% of those who also wore shoulder restraints. Preventive recommendations include shoulder restraint use and better training in mountain flying, with incentives provided by the FAA and insurance companies.

77 FR 5990 - Special Conditions: Learjet Inc., Model LJ-200-1A10 Airplane, Pilot-Compartment View Through...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-07

... airflow to maintain a clear-vision area. The heavy rain and high speed conditions specified in the current... to maintain a sufficiently clear area of the windshield in low-speed flight or during surface... airflow disturbance or separation on the windshield could cause failure to maintain a clear-vision area on...

A Pilot Randomized Controlled Trial of Novel Dressing and Securement Techniques in 101 Pediatric Patients.

PubMed

Kleidon, Tricia M; Ullman, Amanda J; Gibson, Victoria; Chaseling, Brett; Schoutrop, Jason; Mihala, Gabor; Rickard, Claire M

2017-11-01

To evaluate feasibility of an efficacy trial comparing peripherally inserted central catheter (PICC) dressing and securement techniques to prevent complications and failure. This pilot, 3-armed, randomized controlled trial was undertaken at Royal Children's Hospital and Lady Cilento Children's Hospital, Brisbane, Australia, between April 2014 and September 2015. Pediatric participants (N = 101; age range, 0-18 y) were assigned to standard care (bordered polyurethane [BPU] dressing, sutureless securement device), tissue adhesive (TA) (plus BPU dressing), or integrated securement dressings (ISDs). Average PICC dwell time was 8.1 days (range, 0.2-27.7 d). Primary outcome was trial feasibility including PICC failure. Secondary outcomes were PICC complications, dressing performance, and parent and staff satisfaction. Protocol feasibility was established. PICC failure was 6% (2/32) with standard care, 6% (2/31) with ISD, and 3% (1/32) with TA. PICC complications were 16% across all groups. TA provided immediate postoperative hemostasis, prolonging the first dressing change until 5.5 days compared with 3.5 days and 2.5 days with standard care and ISD respectively. Bleeding was the most common reason for first dressing change: standard care (n = 18; 75%), ISD (n = 11; 69%), TA (n = 4; 27%). Parental satisfaction (median 9.7/10; P = .006) and staff feedback (9.2/10; P = .002) were most positive for ISD. This research suggests safety and acceptability of different securement dressings compared with standard care; securement dressings may also reduce dressing changes after insertion. Further research is required to confirm clinically cost-effective methods to prevent PICC failure. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

Provision of contraception after emergency contraception from the pharmacy: evaluating the acceptability of pharmacy for providing sexual and reproductive health services.

PubMed

Michie, L; Cameron, S T; Glasier, A; Chen, Z E; Milne, D; Wilson, S

2016-06-01

Community pharmacies in the United Kingdom (UK) provide sexual and reproductive health (SRH) services such as emergency contraception (EC), although there is scope for provision of additional services. We conducted a pilot study of pharmacy based interventions for initiating effective contraception after EC. By determining the views of participating women and pharmacists we aimed to identify barriers and facilitators to providing interventions from pharmacies routinely. In the pilot study, women presenting for levonorgestrel EC to community pharmacies, were provided with either standard care or one of two interventions: one packet of progestogen-only pills (POPs); or an invitation to present the empty EC packet to a local family planning clinic for contraception. A sample of women participating were asked to undergo a further interview. Operational difficulties with research in the community pharmacy were also documented by the research team. Semi-structured interviews were conducted with 12 women, four from each arm of the pilot study, using a standardised topic guide. Pre- and post-study interviews were conducted with the pharmacists involved. All women welcomed the interventions indicating the benefit of having different options available. They also identified possible advantages and disadvantages of each intervention. All pharmacists were positive about their involvement in the study. Methodological problems included difficulty in retention of participating pharmacists, slow recruitment and failure to accurately complete study paperwork. Women welcomed the interventions offered. Pharmacists viewed their participation in the study positively. The problems encountered provide valuable feedback to inform the development larger scale studies of such interventions. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Cortical activity and functional hyperconnectivity by simultaneous EEG recordings from interacting couples of professional pilots.

PubMed

Astolfi, L; Toppi, J; Borghini, G; Vecchiato, G; He, E J; Roy, A; Cincotti, F; Salinari, S; Mattia, D; He, B; Babiloni, F

2012-01-01

Controlling an aircraft during a flight is a compelling condition, which requires a strict and well coded interaction between the crew. The interaction level between the Captain and the First Officer changes during the flight, ranging from a maximum (during takeoff and landing, as well as in case of a failure of the instrumentation or other emergency situations) to a minimum during quiet mid-flight. In this study, our aim is to investigate the neural correlates of different kinds and levels of interaction between couples of professional crew members by means of the innovative technique called brain hyperscanning, i.e. the simultaneous recording of the hemodynamic or neuroelectrical activity of different human subjects involved in interaction tasks. This approach allows the observation and modeling of the neural signature specifically dependent on the interaction between subjects, and, even more interestingly, of the functional links existing between the brain activities of the subjects interacting together. In this EEG hyperscanning study, different phases of a flight were reproduced in a professional flight simulator, which allowed, on one side, to reproduce the ecological setting of a real flight, and, on the other, to keep under control the different levels of interaction induced in the crew by means of systematic and simulated failures of the aircraft instrumentation. Results of the procedure of linear inverse estimation, together with functional hyperconnectivity estimated by means of Partial Directed Coherence, showed a dense network of connections between the activity in the two brains in the takeoff and landing phases, when the cooperation between the crew is maximal, while conversely no significant links were shown during the phases in which the activity of the two pilots was independent.

Second Chance Schools: The Results of a European Pilot Project. Report.

ERIC Educational Resources Information Center

Commission of the European Communities, Brussels (Belgium). Directorate-General for Education and Culture.

Thirteen Second Chance Schools in 11 countries attempt to fight school failure and social exclusion in the European Union (EU) by enabling pupils who have at most completed lower secondary school to acquire basic skills that will allow them to embark on a strategy of lifelong learning while supporting the innovation and the growth of the European…

Evaluation of a computer-generated perspective tunnel display for flight path following

NASA Technical Reports Server (NTRS)

Grunwald, A. J.; Robertson, J. B.; Hatfield, J. J.

1980-01-01

The display was evaluated by monitoring pilot performance in a fixed base simulator with the vehicle dynamics of a CH-47 tandem rotor helicopter. Superposition of the predicted future vehicle position on the tunnel image was also investigated to determine whether, and to what extent, it contributes to better system performance (the best predicted future vehicle position was sought). Three types of simulator experiments were conducted: following a desired trajectory in the presence of disturbances; entering the trajectory from a random position, outside the trajectory; detecting and correcting failures in automatic flight. The tunnel display with superimposed predictor/director symbols was shown to be a very successful combination, which outperformed the other two displays in all three experiments. A prediction time of 4 to 7 sec. was found to optimize trajectory tracking for the given vehicle dynamics and flight condition. Pilot acceptance of the tunnel plus predictor/director display was found to be favorable and the time the pilot needed for familiarization with the display was found to be relatively short.

Development and Flight Evaluation of an Emergency Digital Flight Control System Using Only Engine Thrust on an F-15 Airplane

NASA Technical Reports Server (NTRS)

Burcham, Frank W., Jr.; Maine, Trindel A.; Fullerton, C. Gordon; Webb, Lannie Dean

1996-01-01

A propulsion-controlled aircraft (PCA) system for emergency flight control of aircraft with no flight controls was developed and flight tested on an F-15 aircraft at the NASA Dryden Flight Research Center. The airplane has been flown in a throttles-only manual mode and with an augmented system called PCA in which pilot thumbwheel commands and aircraft feedback parameters were used to drive the throttles. Results from a 36-flight evaluation showed that the PCA system can be used to safety land an airplane that has suffered a major flight control system failure. The PCA system was used to recover from a severe upset condition, descend, and land. Guest pilots have also evaluated the PCA system. This paper describes the principles of throttles-only flight control; a history of loss-of-control accidents; a description of the F-15 aircraft; the PCA system operation, simulation, and flight testing; and the pilot comments.

Assessment of dyspnoea in the emergency department by numeric and visual scales: A pilot study.

PubMed

Placido, Rui; Gigaud, Carine; Gayat, Etienne; Ferry, Axelle; Cohen-Solal, Alain; Plaisance, Patrick; Mebazaa, Alexandre; Laribi, Said

2015-04-01

Dyspnoea is a common and often debilitating symptom that affects up to 50% of patients admitted to acute tertiary care hospitals. The primary purpose of this study was to compare the numeric rating scale (NRS) and the visual analogue scale (VAS) for dyspnoea evaluation in the ED setting. This was a cohort study of patients admitted to the ED in a university hospital, with dyspnoea as the chief complaint. The agreement of the two dyspnoea scales was assessed using the intraclass correlation coefficient (ICC). One hundred and seventeen patients were included in this analysis. The median age for the whole study population was 67 years and 42% of patients were male. The aetiology of dyspnoea was acute heart failure (AHF) in 35% of patients. There was good agreement between the two scores (ICC=0.795; 95% CI=0.717-0.853; P<0.001). This pilot study demonstrated that numerical rating and visual analogue scales agree well when assessing the severity of dyspnoea in the ED. Further studies with larger cohorts of patients are needed to confirm these preliminary results. Copyright © 2015 Société française d’anesthésie et de réanimation (Sfar). All rights reserved.

Interrater reliability of the international consensus definition of drug-resistant epilepsy: a pilot study.

PubMed

Hao, Xiao-ting; Wong, Irina S M; Kwan, Patrick

2011-10-01

We evaluated the interrater reliability of the consensus definition of drug-resistant epilepsy proposed by the International League Against Epilepsy. According to the definition framework, outcome of each antiepileptic drug (AED) trial was categorized as "seizure freedom" or "treatment failure." This level 1 assessment was used to determine the level 2 classification, which defined drug-resistant epilepsy as the failure of adequate trials of two or more AED schedules to achieve sustained seizure freedom. Two raters classified treatment outcomes of 150 patients independently. The patients had received a total of 428 trials of AEDs. Categorization of level 1 outcome to individual AED trials by the raters was consistent in 413 (96.5%). For the level 2 classification of drug-resistant or drug-responsive epilepsy, there was absolute agreement between the raters in 141 patients (94%), with a κ index of 0.91 (P<0.001). The definition appeared to have a high degree of interrater reliability in this setting. Copyright © 2011 Elsevier Inc. All rights reserved.

Ultra Barrier Topsheet Film for Flexible Photovoltaics with 3M Company

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

Funkenbusch, Arnie; Ruth, Charles

2014-12-30

In this DOE sponsored program, 3M achieved the critical UBT features to enable durable flexible high efficiency modules to be produced by a range of customers who have now certified the 3M UBT and are actively developing said flexible modules. The specific objectives and accomplishments of the work under this program were; Scale-up the current Generation-1 UBT from 12” width, as made on 3M’s pilot line, to 1+meter width full-scale manufacturing, while maintaining baseline performance metrics (see table below); This objective was fully met; Validate service life of Generation-1 UBT for the 25+ year lifetime demanded by the photovoltaic market;more » Aggressive testing revealed potential failure modes in the Gen 1 UBT. Deficiencies were identified and corrective action taken in the Gen 2 UBT; Develop a Generation-2 UBT on the pilot line, targeting improved performance relative to baseline, including higher %T (percent transmission), lower water vapor transmission rate (WVTR) with targets based on what the technology needs for 25 year lifetime, proven lifetime of 25 years in solar module construction in the field, and lower cost; Testing of UBT Gen 2 under a wide range of conditions presented in this report failed to reveal any failure mode. Therefore UBT Gen 2 is known to be highly durable. 3M will continue to test towards statistically validating a 25 year lifetime under 3M funding; Transfer Generation-2 UBT from the pilot line to the full-scale manufacturing line within three years; and This objective was fully met.« less

Supporting Caregivers of Children With Acute Lymphoblastic Leukemia via a Smartphone App: A Pilot Study of Usability and Effectiveness.

PubMed

Wang, Jingting; Yao, Nengliang; Shen, Min; Zhang, Xiaoyan; Wang, Yuanyuan; Liu, Yanyan; Geng, Zhaohui; Yuan, Changrong

2016-11-01

Smartphone applications are widely used for self-help interventions in adult cancer survivors. However, applications for parents of pediatric cancer patients are limited. We developed an applications to assist parents of children with acute lymphoblastic leukemia. The aim of this study is to evaluate the app's usability and effectiveness in a preliminary way. A stepwise approach and mixed methods were used. The application was initially tested by healthcare providers, and their comments and suggestions were used to develop an updated version. This version was tested by parents of children with acute lymphoblastic leukemia. Comments and nonverbal expressions of parents were recorded during a 2-week pilot test. The qualitative study was followed by a quantitative study using audit log data from the administration portal to understand how parents use the application. Six healthcare providers and 15 parents participated. Parents gained a greater knowledge of leukemia, confidence in caregiving, social support, and information on how to reduce stress. Over usability was rated as stable, useful, simple, and self-explanatory. No software failure occurred. Applications have the potential to support caregivers of pediatric cancer patients. We plan to address limitations and perform an empirical interventional study to examine its clinical effectiveness.

14 CFR 25.775 - Windshields and windows.

Code of Federal Regulations, 2010 CFR

2010-01-01

... differential loads combined with critical aerodynamic pressure and temperature effects after any single failure... front of the pilots must be arranged so that, assuming the loss of vision through any one panel, one or... flight and landing. [Doc. No. 5066, 29 FR 18291, Dec. 24, 1964, as amended by Amdt. 25-23, 35 FR 5676...

14 CFR 25.775 - Windshields and windows.

Code of Federal Regulations, 2013 CFR

2013-01-01

... differential loads combined with critical aerodynamic pressure and temperature effects after any single failure... front of the pilots must be arranged so that, assuming the loss of vision through any one panel, one or... flight and landing. [Doc. No. 5066, 29 FR 18291, Dec. 24, 1964, as amended by Amdt. 25-23, 35 FR 5676...

14 CFR 25.775 - Windshields and windows.

Code of Federal Regulations, 2012 CFR

2012-01-01

... differential loads combined with critical aerodynamic pressure and temperature effects after any single failure... front of the pilots must be arranged so that, assuming the loss of vision through any one panel, one or... flight and landing. [Doc. No. 5066, 29 FR 18291, Dec. 24, 1964, as amended by Amdt. 25-23, 35 FR 5676...

14 CFR 25.775 - Windshields and windows.

Code of Federal Regulations, 2014 CFR

2014-01-01

... differential loads combined with critical aerodynamic pressure and temperature effects after any single failure... front of the pilots must be arranged so that, assuming the loss of vision through any one panel, one or... flight and landing. [Doc. No. 5066, 29 FR 18291, Dec. 24, 1964, as amended by Amdt. 25-23, 35 FR 5676...

14 CFR 25.775 - Windshields and windows.

Code of Federal Regulations, 2011 CFR

2011-01-01

... differential loads combined with critical aerodynamic pressure and temperature effects after any single failure... front of the pilots must be arranged so that, assuming the loss of vision through any one panel, one or... flight and landing. [Doc. No. 5066, 29 FR 18291, Dec. 24, 1964, as amended by Amdt. 25-23, 35 FR 5676...

Parachuting to Safety

NASA Technical Reports Server (NTRS)

2002-01-01

NASA's Langley Research Center awarded Ballistic Recovery Systems, Inc., three Small Business Innovation Research (SBIR) contracts to research and develop a new, low cost, lightweight recovery system for aircraft in both civilian and military markets. The company responded with a unique ballistic parachute system that lowers an entire aircraft to the ground in the event of an emergency. BRS parachutes are designed to provide a safe landing for pilots and passengers while keeping them in their aircraft. They currently fit ultralights, kit-built aircraft, and certified small business aircraft. The parachutes are lifesavers in cases of engine failure, mid-air collisions, pilot disorientation or incapacitation, unrecovered spins, extreme icing, and fuel exhaustion. To date, over 148 lives were saved as a result of a BRS parachute system.

Aviation-Related Wildland Firefighter Fatalities--United States, 2000-2013.

PubMed

Butler, Corey R; O'Connor, Mary B; Lincoln, Jennifer M

2015-07-31

Airplanes and helicopters are integral to the management and suppression of wildfires, often operating in high-risk, low-altitude environments. To update data on aviation-related wildland firefighting fatalities, identify risk factors, and make recommendations for improved safety, CDC's National Institute for Occupational Safety and Health (NIOSH) analyzed reports from multiple data sources for the period 2000-2013. Among 298 wildland firefighter fatalities identified during 2000-2013, 78 (26.2%) were aviation-related occupational fatalities that occurred during 41 separate events involving 42 aircraft. Aircraft crashes accounted for 38 events. Pilots, copilots, and flight engineers represented 53 (68%) of the aviation-related fatalities. The leading causes of fatal aircraft crashes were engine, structure, or component failure (24%); pilot loss of control (24%); failure to maintain clearance from terrain, water, or objects (20%); and hazardous weather (15%). To reduce fatalities from aviation-related wildland firefighting activities, stringent safety guidelines need to be followed during all phases of firefighting, including training exercises. Crew resource management techniques, which use all available resources, information, equipment, and personnel to achieve safe and efficient flight operations, can be applied to firefighting operations.

Flight testing a propulsion-controlled aircraft emergency flight control system on an F-15 airplane

NASA Technical Reports Server (NTRS)

Burcham, F. W., Jr.; Burken, John; Maine, Trindel A.

1994-01-01

Flight tests of a propulsion-controlled aircraft (PCA) system on an F-15 airplane have been conducted at the NASA Dryden Flight Research Center. The airplane was flown with all flight control surfaces locked both in the manual throttles-only mode and in an augmented system mode. In the latter mode, pilot thumbwheel commands and aircraft feedback parameters were used to position the throttles. Flight evaluation results showed that the PCA system can be used to land an airplane that has suffered a major flight control system failure safely. The PCA system was used to recover the F-15 airplane from a severe upset condition, descend, and land. Pilots from NASA, U.S. Air Force, U.S. Navy, and McDonnell Douglas Aerospace evaluated the PCA system and were favorably impressed with its capability. Manual throttles-only approaches were unsuccessful. This paper describes the PCA system operation and testing. It also presents flight test results and pilot comments.

Investigation of air transportation technology at Princeton University, 1990-1991

NASA Technical Reports Server (NTRS)

Stengel, Robert F.

1991-01-01

The Air Transportation Technology Program at Princeton University is a program that emphasizes graduate and undergraduate student research. The program proceeded along six avenues during the past year: microburst hazards to aircraft, intelligent failure tolerant control, computer-aided heuristics for piloted flight, stochastic robustness of flight control systems, neural networks for flight control, and computer-aided control system design.

Air Force Female Pilots Program: Initial Performance and Attitudes

DTIC Science & Technology

1979-02-01

you conduct most of your training? a. Controlled (Control Tower) b. FSS (Airport Advisory Service) c. Unicorn d. Uncontrolled (No Unicom or FSS) 9...Travel_____ b. Business c, Employment _____ d. Sport_____ e. Education_____ f. Other (Specify) ____________________ 26...Ceiling 6. High Winds 3. Turbulence 7. Mud or Snow 4. Airframe Icing 8. Darkness d. Equipment Failure 1. Engine Operations 3. Malfunction(s): Equipment

The feasibility of a telephone coaching program on heart failure home management for family caregivers

PubMed Central

Piamjariyakul, Ubolrat; Smith, Carol E.; Russell, Christy; Werkowitch, Marilyn; Elyachar, Andrea

2012-01-01

Objectives To test the feasibility of delivery and evaluate the helpfulness of a coaching heart failure (HF) home management program for family caregivers. Background The few available studies on providing instruction for family caregivers are limited in content for managing HF home care and guidance for program implementation. Method This pilot study employed a mixed methods design. The measures of caregiver burden, confidence, and preparedness were compared at baseline and 3 months post-intervention. Descriptive statistics were used to summarize program costs and demographic data. Content analysis research methods were used to evaluate program feasibility and helpfulness. Results Caregiver (n=10) burden scores were significantly reduced and raw scores of confidence and preparedness for HF home management improved 3 months after the intervention. Content analyses of nurse and caregiver post-intervention data found caregivers rated the program as helpful and described how they initiated HF management skills based on the program. Conclusion The program was feasible to implement. These results suggest the coaching program should be further tested with a larger sample size to evaluate its efficacy. PMID:23116654

Peripheral Intravenous Volume Assessment (PIVA) for Quantitating Volume Overload in Patients Hospitalized with Acute Decompensated Heart Failure-a Pilot Study.

PubMed

Miles, Merrick; Alvis, Bret D; Hocking, Kyle; Baudenbacher, Franz; Guth, Christy; Lindenfeld, JoAann; Brophy, Colleen; Eagle, Susan

2018-05-16

To determine the feasibility of Peripheral Intravenous Volume Assessment (PIVA) of venous waveforms for assessing volume overload in patients admitted to the hospital with acute decompensated heart failure (ADHF). Venous waveforms were captured from a peripheral intravenous catheter in subjects admitted for ADHF and healthy age-matched controls. Admission PIVA signal, brain natriuretic peptide, and chest radiographic measurements were related to the net volume removed during diuresis. ADHF patients had a significantly greater PIVA signal on admission compared to the control group (P=0.0013, n=18). At discharge, ADHF patients had a PIVA signal similar to the control group. PIVA signal, not BNP or chest radiographic measures, accurately predicted the amount of volume removed during diuresis (R 2 =0.781, n=14). PIVA signal at time of discharge greater than 0.20, demonstrated 83.3% 120-day readmission rate. This study demonstrates the feasibility of PIVA for assessment of volume overload in patients admitted to the hospital with ADHF. Copyright © 2018. Published by Elsevier Inc.

Use of a systematic risk analysis method to improve safety in the production of paediatric parenteral nutrition solutions

PubMed Central

Bonnabry, P; Cingria, L; Sadeghipour, F; Ing, H; Fonzo-Christe, C; Pfister, R

2005-01-01

Background: Until recently, the preparation of paediatric parenteral nutrition formulations in our institution included re-transcription and manual compounding of the mixture. Although no significant clinical problems have occurred, re-engineering of this high risk activity was undertaken to improve its safety. Several changes have been implemented including new prescription software, direct recording on a server, automatic printing of the labels, and creation of a file used to pilot a BAXA MM 12 automatic compounder. The objectives of this study were to compare the risks associated with the old and new processes, to quantify the improved safety with the new process, and to identify the major residual risks. Methods: A failure modes, effects, and criticality analysis (FMECA) was performed by a multidisciplinary team. A cause-effect diagram was built, the failure modes were defined, and the criticality index (CI) was determined for each of them on the basis of the likelihood of occurrence, the severity of the potential effect, and the detection probability. The CIs for each failure mode were compared for the old and new processes and the risk reduction was quantified. Results: The sum of the CIs of all 18 identified failure modes was 3415 for the old process and 1397 for the new (reduction of 59%). The new process reduced the CIs of the different failure modes by a mean factor of 7. The CI was smaller with the new process for 15 failure modes, unchanged for two, and slightly increased for one. The greatest reduction (by a factor of 36) concerned re-transcription errors, followed by readability problems (by a factor of 30) and chemical cross contamination (by a factor of 10). The most critical steps in the new process were labelling mistakes (CI 315, maximum 810), failure to detect a dosage or product mistake (CI 288), failure to detect a typing error during the prescription (CI 175), and microbial contamination (CI 126). Conclusions: Modification of the process resulted in a significant risk reduction as shown by risk analysis. Residual failure opportunities were also quantified, allowing additional actions to be taken to reduce the risk of labelling mistakes. This study illustrates the usefulness of prospective risk analysis methods in healthcare processes. More systematic use of risk analysis is needed to guide continuous safety improvement of high risk activities. PMID:15805453

Use of a systematic risk analysis method to improve safety in the production of paediatric parenteral nutrition solutions.

PubMed

Bonnabry, P; Cingria, L; Sadeghipour, F; Ing, H; Fonzo-Christe, C; Pfister, R E

2005-04-01

Until recently, the preparation of paediatric parenteral nutrition formulations in our institution included re-transcription and manual compounding of the mixture. Although no significant clinical problems have occurred, re-engineering of this high risk activity was undertaken to improve its safety. Several changes have been implemented including new prescription software, direct recording on a server, automatic printing of the labels, and creation of a file used to pilot a BAXA MM 12 automatic compounder. The objectives of this study were to compare the risks associated with the old and new processes, to quantify the improved safety with the new process, and to identify the major residual risks. A failure modes, effects, and criticality analysis (FMECA) was performed by a multidisciplinary team. A cause-effect diagram was built, the failure modes were defined, and the criticality index (CI) was determined for each of them on the basis of the likelihood of occurrence, the severity of the potential effect, and the detection probability. The CIs for each failure mode were compared for the old and new processes and the risk reduction was quantified. The sum of the CIs of all 18 identified failure modes was 3415 for the old process and 1397 for the new (reduction of 59%). The new process reduced the CIs of the different failure modes by a mean factor of 7. The CI was smaller with the new process for 15 failure modes, unchanged for two, and slightly increased for one. The greatest reduction (by a factor of 36) concerned re-transcription errors, followed by readability problems (by a factor of 30) and chemical cross contamination (by a factor of 10). The most critical steps in the new process were labelling mistakes (CI 315, maximum 810), failure to detect a dosage or product mistake (CI 288), failure to detect a typing error during the prescription (CI 175), and microbial contamination (CI 126). Modification of the process resulted in a significant risk reduction as shown by risk analysis. Residual failure opportunities were also quantified, allowing additional actions to be taken to reduce the risk of labelling mistakes. This study illustrates the usefulness of prospective risk analysis methods in healthcare processes. More systematic use of risk analysis is needed to guide continuous safety improvement of high risk activities.

STS-93 Crew Interview: Michel Tognini

NASA Technical Reports Server (NTRS)

1999-01-01

This NASA Johnson Space Center (JSC) video release presents a one-on-one interview with Mission Specialist 3, Michel Tognini (Col., French Air Force and Centre Nacional Etudes Spatiales (CNES) Astronaut). Subjects discussed include early influences that made Michel want to be a pilot and astronaut, his experience as a French military pilot and his flying history. Also discussed were French participation in building the International Space Station (ISS), the STS-93 primary mission objective, X-ray observation using the Advanced X-ray Astrophysics Facility (AXAF), and failure scenarios associated with AXAF deployment. The STS-93 mission objective was to deploy the Advanced X-ray Astrophysics Facility (AXAF), later renamed the Chandra X-Ray Observatory in honor of the late Indian-American Nobel Laureate Subrahmanyan Chandrasekhar.

Epidemiology of Hookworm Infection in Kintampo North Municipality, Ghana: Patterns of Malaria Coinfection, Anemia, and Albendazole Treatment Failure

PubMed Central

Humphries, Debbie; Mosites, Emily; Otchere, Joseph; Twum, Welbeck Amoani; Woo, Lauren; Jones-Sanpei, Hinckley; Harrison, Lisa M.; Bungiro, Richard D.; Benham-Pyle, Blair; Bimi, Langbong; Edoh, Dominic; Bosompem, Kwabena; Wilson, Michael; Cappello, Michael

2011-01-01

A cross-sectional pilot study of hookworm infection was carried out among 292 subjects from 62 households in Kintampo North, Ghana. The overall prevalence of hookworm infection was 45%, peaking in those 11–20 years old (58.5%). In children, risk factors for hookworm infection included coinfection with malaria and increased serum immunoglobulin G reactivity to hookworm secretory antigens. Risk factors for infection in adults included poor nutritional status, not using a latrine, not wearing shoes, and occupation (farming). Although albendazole therapy was associated with an overall egg reduction rate of 82%, 37 subjects (39%) remained infected. Among those who failed therapy, treatment was not associated with a significant reduction in egg excretion, and nearly one-third had higher counts on repeat examination. These data confirm a high prevalence of low-intensity hookworm infection in central Ghana and its association with poor nutritional status. The high rate of albendazole failure raises concern about emerging resistance. PMID:21540391

Towards an Improved Pilot-Vehicle Interface for Highly Automated Aircraft: Evaluation of the Haptic Flight Control System

NASA Technical Reports Server (NTRS)

Schutte, Paul; Goodrich, Kenneth; Williams, Ralph

2012-01-01

The control automation and interaction paradigm (e.g., manual, autopilot, flight management system) used on virtually all large highly automated aircraft has long been an exemplar of breakdowns in human factors and human-centered design. An alternative paradigm is the Haptic Flight Control System (HFCS) that is part of NASA Langley Research Center s Naturalistic Flight Deck Concept. The HFCS uses only stick and throttle for easily and intuitively controlling the actual flight of the aircraft without losing any of the efficiency and operational benefits of the current paradigm. Initial prototypes of the HFCS are being evaluated and this paper describes one such evaluation. In this evaluation we examined claims regarding improved situation awareness, appropriate workload, graceful degradation, and improved pilot acceptance. Twenty-four instrument-rated pilots were instructed to plan and fly four different flights in a fictitious airspace using a moderate fidelity desktop simulation. Three different flight control paradigms were tested: Manual control, Full Automation control, and a simplified version of the HFCS. Dependent variables included both subjective (questionnaire) and objective (SAGAT) measures of situation awareness, workload (NASA-TLX), secondary task performance, time to recognize automation failures, and pilot preference (questionnaire). The results showed a statistically significant advantage for the HFCS in a number of measures. Results that were not statistically significant still favored the HFCS. The results suggest that the HFCS does offer an attractive and viable alternative to the tactical components of today s FMS/autopilot control system. The paper describes further studies that are planned to continue to evaluate the HFCS.

Yoga for heart failure patients: a feasibility pilot study with a multiethnic population.

PubMed

Kubo, Ai; Hung, Yun-Yi; Ritterman, Jeffrey

2011-01-01

Congestive heart failure (CHF) is highly prevalent and the most costly cardiovascular illness in the United States. Yoga is known to be effective in lowering stress, lessening depression, and increasing physical fitness and may be used as an adjuvant management program for CHF patients. To determine the feasibility of a yoga intervention program among a multiethnic CHF population living in underserved neighborhoods. Uncontrolled intervention trial. Kaiser Permanente Medical Centers, Richmond and Oakland, California. 14 CHF patients (7 female), mean age 64 (SD=6.4) years, and 62% African-American. Eight-week, 2x/week, 1-hr yoga classes that included meditation, breathing exercises, gentle yoga poses, and relaxation. The intervention feasibility was measured by recruitment rates, participant retention and adherence. Body weight and self-reported depression and quality of life were measured before and after the intervention. Among the 14 patients enrolled, 13 completed the intervention. Of those who completed the trial, 92% attended at least 50% of the classes. There was a significant reduction in weight (-3.5 lb, p=0.01) and improvement in the severity of depression (p<0.05), as well as a trend toward increased quality of life (p=08). No adverse events were observed. This pilot trial demonstrates that it is feasible for patients with CHF to incorporate yoga into their lifestyle. Yoga may help with routine disease management, prevention of fluid retention, and improvement of depression and quality of life. A larger trial is needed to confirm efficacy and to determine the long-term effects on other important outcomes, such as hospital re-admission rates or prognostic biomarkers.

An open pilot study of ambulatory photodynamic therapy using a wearable low-irradiance organic light-emitting diode light source in the treatment of nonmelanoma skin cancer.

PubMed

Attili, S K; Lesar, A; McNeill, A; Camacho-Lopez, M; Moseley, H; Ibbotson, S; Samuel, I D W; Ferguson, J

2009-07-01

Photodynamic therapy (PDT) is a popular treatment for nonmelanoma skin cancer with clearance rates of between 70% and 100%. Although reported to have a superior cosmetic outcome, the inconvenience of hospital visits and discomfort during therapy are considered drawbacks. To present an open pilot study of a low-irradiance, potentially disposable, lightweight, organic light-emitting diode (OLED), which is an area-emitting light source (2 cm diameter), suitable for ambulatory PDT. Twelve patients with Bowen's disease (eight) and superficial basal cell carcinoma (four) < 2 cm in diameter were recruited into the study following histological confirmation of the diagnosis. Two treatments (45-60 J cm(-2) red light, 550-750 nm, peak 620 nm, irradiance 5 mW cm(-2)) were administered 1 month apart following application of aminolaevulinic acid for 4 h. At the 12-month follow-up, seven of the 12 patients remained clear, with four of the nonresponders demonstrating peripheral margin failure. Patients were scored for pain during and immediately after treatment using the numerical rating scale (NRS; 1-10). All 12 subjects scored pain as < 2 using the NRS (median score 1). In contrast, a similar cohort of 50 consecutive patients from our routine PDT clinic (Aktilite inorganic LED source; 75 J cm(-2), irradiance 80 mW cm(-2)) scored a median of 6 on the NRS. Pain and inconvenience are practical barriers to the use of conventional PDT. This pilot study suggests that OLED-PDT is less painful than conventional PDT with the added advantage of being lightweight, and therefore has the potential for more convenient 'home PDT'. These results need to be validated in larger studies.

Robot-assisted training for heart failure patients - a small pilot study.

PubMed

Schoenrath, Felix; Markendorf, Susanne; Brauchlin, Andreas Emil; Frank, Michelle; Wilhelm, Markus Johannes; Saleh, Lanja; Riener, Robert; Schmied, Christian Marc; Falk, Volkmar

2015-12-01

The objective of this study was assess robot-assisted gait therapy with the Lokomat® system in heart failure patients. Patients (n = 5) with stable heart failure and a left ventricular ejection fraction of less than 45% completed a four-week aerobic training period with three trainings per week and an integrated dynamic resistance training of the lower limbs. Patients underwent testing of cardiac and inflammatory biomarkers. A cardiopulmonary exercise test, a quality of life score and an evaluation of the muscular strength by measuring the peak quadriceps force was performed. No adverse events occurred. The combined training resulted in an improvement in peak work rate (range: 6% to 36%) and peak quadriceps force (range: 3% to 80%) in all participants. Peak oxygen consumption (range: –3% to + 61%) increased in three, and oxygen pulse (range: –7% to + 44%) in four of five patients. The quality of life assessment indicated better well-being in all participants. NT-ProBNP (+233 to –733 ng/ml) and the inflammatory biomarkers (hsCRP and IL6) decreased in four of five patients (IL 6: +0.5 to –2 mg/l, hsCRP: +0.2 to –6.5 mg/l). Robot-assisted gait therapy with the Lokomat® System is feasible in heart failure patients and was safe in this trial. The combined aerobic and resistance training intervention with augmented feedback resulted in benefits in exercise capacity, muscle strength and quality of life, as well as an improvement of cardiac (NT-ProBNP) and inflammatory (IL6, hsCRP) biomarkers. Results can only be considered as preliminary and need further validation in larger studies. (ClinicalTrials.gov number, NCT 02146196)

Implementation of an interprofessional communication and collaboration intervention to improve care capacity for heart failure management in long-term care.

PubMed

Boscart, Veronique M; Heckman, George A; Huson, Kelsey; Brohman, Lisa; Harkness, Karen I; Hirdes, John; McKelvie, Robert S; Stolee, Paul

2017-09-01

Heart failure affects up to 20% of nursing home residents and is associated with high morbidity, mortality, and transfers to acute care. A major barrier to heart failure management in nursing home settings is limited interprofessional communication. Guideline-based heart failure management programs in nursing homes can reduce hospitalisation rates, though sustainability is limited when interprofessional communication is not addressed. A pilot intervention, 'Enhancing Knowledge and Interprofessional Care for Heart Failure', was implemented on two units in two conveniently selected nursing homes to optimise interprofessional care processes amongst the care team. A core heart team was established, and participants received tailored education focused on heart failure management principles and communication processes, as well as weekly mentoring. Our previous work provided evidence for this intervention's acceptability and implementation fidelity. This paper focuses on the preliminary impact of the intervention on staff heart failure knowledge, communication, and interprofessional collaboration. To determine the initial impact of the intervention on selected staff outcomes, we employed a qualitative design, using a social constructivist interpretive framework. Findings indicated a perceived increase in team engagement, interprofessional collaboration, communication, knowledge about heart failure, and improved clinical outcomes. Individual interviews with staff revealed innovative ways to enhance communication, supporting one another with knowledge and engagement in collaborative practices with residents and families. Engaging teams, through the establishment of core heart teams, was successful to develop interprofessional communication processes for heart failure management. Further steps to be undertaken include assessing the sustainability and effectiveness of this approach with a larger sample.

Denver Spirited Heart: Mixed-Methods Pilot Study of a Psychospiritual Intervention for Heart Failure Patients.

PubMed

Hooker, Stephanie A; Ross, Kaile; Masters, Kevin S; Park, Crystal L; Hale, Amy E; Allen, Larry A; Bekelman, David B

Increased spiritual well-being is related to quality of life (QOL) in patients with heart failure (HF). However, consistent and deliberate integration of spirituality into HF patient care has received limited attention. The aim of this study was to evaluate the feasibility, acceptability, and preliminary evidence regarding the efficacy of a resource-sparing psychospiritual intervention to improve QOL in HF patients. A 12-week mail-based intervention addressing spirituality, stress, coping, and adjusting to illness was developed and tested using a mixed-methods, 1-group pretest-posttest pilot study design. A convenience sample of patients with HF completed prestudy and poststudy questionnaires, including the Kansas City Cardiomyopathy Questionnaire, Patient Health Questionnaire, Meaning in Life Questionnaire, and Functional Assessment of Chronic Illness Therapy-Spiritual. Research staff conducted semistructured interviews with program completers. Interviews were coded and analyzed using conventional content analysis. Participants (N = 33; 82% male; mean age, 61 years) completed 87% of baseline data collection, an average of 9 intervention modules, and 55% of poststudy questionnaires. Participants rated all the modules as at least moderately helpful, and qualitative themes suggested that patients found the intervention acceptable and beneficial. Most participants believed spirituality should continue to be included, although they disagreed on the extent to which religion should remain. Participants who completed the intervention reported evidence suggesting increased QOL (Kansas City Cardiomyopathy Questionnaire; effect size [ES], 0.53), decreased depressive symptoms (Patient Health Questionnaire-9; ES, 0.62), and less searching for meaning (Meaning in Life Questionnaire; ES, 0.52). Results indicate that a module-based program integrating spirituality and psychosocial coping strategies was feasible and acceptable and may improve QOL. This preliminary study suggests that clinicians be open to issues of spirituality as they may relate to QOL in patients with HF. Future research will test a revised intervention.

Intelligent Control Approaches for Aircraft Applications

NASA Technical Reports Server (NTRS)

Gundy-Burlet, Karen; KrishnaKumar, K.; Soloway, Don; Kaneshige, John; Clancy, Daniel (Technical Monitor)

2001-01-01

This paper presents an overview of various intelligent control technologies currently being developed and studied under the Intelligent Flight Control (IFC) program at the NASA Ames Research Center. The main objective of the intelligent flight control program is to develop the next generation of flight controllers for the purpose of automatically compensating for a broad spectrum of damaged or malfunctioning aircraft components and to reduce control law development cost and time. The approaches being examined include: (a) direct adaptive dynamic inverse controller and (b) an adaptive critic-based dynamic inverse controller. These approaches can utilize, but do not require, fault detection and isolation information. Piloted simulation studies are performed to examine if the intelligent flight control techniques adequately: 1) Match flying qualities of modern fly-by-wire flight controllers under nominal conditions; 2) Improve performance under failure conditions when sufficient control authority is available; and 3) Achieve consistent handling qualities across the flight envelope and for different aircraft configurations. Results obtained so far demonstrate the potential for improving handling qualities and significantly increasing survivability rates under various simulated failure conditions.

Transitioning Adolescents and Young Adults With HIV Infection to Adult Care: Pilot Testing the "Movin' Out" Transitioning Protocol.

PubMed

Maturo, Donna; Powell, Alexis; Major-Wilson, Hannah; Sanchez, Kenia; De Santis, Joseph P; Friedman, Lawrence B

2015-01-01

Advances in care and treatment of adolescents/young adults with HIV infection have made survival into adulthood possible, requiring transition to adult care. Researchers have documented that the transition process is challenging for adolescents/young adults. To ensure successful transition, a formal transition protocol is needed. Despite existing research, little quantitative evaluation of the transition process has been conducted. The purpose of the study was to pilot test the "Movin' Out" Transitioning Protocol, a formalized protocol developed to assist transition to adult care. A retrospective medical/nursing record review was conducted with 38 clients enrolled in the "Movin' Out" Transitioning Protocol at a university-based adolescent medicine clinic providing care to adolescents/young adults with HIV infection. Almost half of the participants were able to successfully transition to adult care. Reasons for failure to transition included relocation, attrition, lost to follow-up, and transfer to another adult service. Failure to transition to adult care was not related to adherence issues, X(2) (1, N=38)=2.49, p=.288; substance use, X(2) (1, N=38)=1.71, p=.474; mental health issues, X(2) (1, N=38)=2.23, p=.322; or pregnancy/childrearing, X(2) (1, N=38)=0.00, p=.627). Despite the small sample size, the "Movin' Out" Transitioning Protocol appears to be useful in guiding the transition process of adolescents/young adults with HIV infection to adult care. More research is needed with a larger sample to fully evaluate the "Movin' Out" Transitioning Protocol. Copyright © 2015 Elsevier Inc. All rights reserved.

Ultrawideband Electromagnetic Interference to Aircraft Radios

NASA Technical Reports Server (NTRS)

Ely, Jay J.; Fuller, Gerald L.; Shaver, Timothy W.

2002-01-01

A very recent FCC Final Rule now permits marketing and operation of new products that incorporate Ultrawideband (UWB) technology into handheld devices. Wireless product developers are working to rapidly bring this versatile, powerful and expectedly inexpensive technology into numerous consumer wireless devices. Past studies addressing the potential for passenger-carried portable electronic devices (PEDs) to interfere with aircraft electronic systems suggest that UWB transmitters may pose a significant threat to aircraft communication and navigation radio receivers. NASA, United Airlines and Eagles Wings Incorporated have performed preliminary testing that clearly shows the potential for handheld UWB transmitters to cause cockpit failure indications for the air traffic control radio beacon system (ATCRBS), blanking of aircraft on the traffic alert and collision avoidance system (TCAS) displays, and cause erratic motion and failure of instrument landing system (ILS) localizer and glideslope pointers on the pilot horizontal situation and attitude director displays. This paper provides details of the preliminary testing and recommends further assessment of aircraft systems for susceptibility to UWB electromagnetic interference.

Compact dual-mode diffuse optical system for blood perfusion monitoring in a porcine model of microvascular tissue flaps

NASA Astrophysics Data System (ADS)

Lee, Seung Yup; Pakela, Julia M.; Helton, Michael C.; Vishwanath, Karthik; Chung, Yooree G.; Kolodziejski, Noah J.; Stapels, Christopher J.; McAdams, Daniel R.; Fernandez, Daniel E.; Christian, James F.; O'Reilly, Jameson; Farkas, Dana; Ward, Brent B.; Feinberg, Stephen E.; Mycek, Mary-Ann

2017-12-01

In reconstructive surgery, the ability to detect blood flow interruptions to grafted tissue represents a critical step in preventing postsurgical complications. We have developed and pilot tested a compact, fiber-based device that combines two complimentary modalities-diffuse correlation spectroscopy (DCS) and diffuse reflectance spectroscopy-to quantitatively monitor blood perfusion. We present a proof-of-concept study on an in vivo porcine model (n=8). With a controllable arterial blood flow supply, occlusion studies (n=4) were performed on surgically isolated free flaps while the device simultaneously monitored blood flow through the supplying artery as well as flap perfusion from three orientations: the distal side of the flap and two transdermal channels. Further studies featuring long-term monitoring, arterial failure simulations, and venous failure simulations were performed on flaps that had undergone an anastomosis procedure (n=4). Additionally, benchtop verification of the DCS system was performed on liquid flow phantoms. Data revealed relationships between diffuse optical measures and state of occlusion as well as the ability to detect arterial and venous compromise. The compact construction of the device, along with its noninvasive and quantitative nature, would make this technology suitable for clinical translation.

Greater than 95% success with 14-day bismuth quadruple anti- Helicobacter pylori therapy: a pilot study in US Hispanics.

PubMed

Salazar, Cesar O; Cardenas, Victor M; Reddy, Rita K; Dominguez, Delfina C; Snyder, Lindsey K; Graham, David Y

2012-10-01

A combination capsule of bismuth, metronidazole, and tetracycline plus omeprazole given as 10-day therapy has an overall effectiveness of 92-93% in per-protocol analysis (Grade B) with eradication of 86-91% of metronidazole-resistant Helicobacter pylori. This study aimed to explore whether extending the duration to 14 days would improve overall effectiveness per protocol to ≥95% (Grade A) in a population in which metronidazole resistance was anticipated to exist. A one-arm, open-label pilot study of H. pylori-infected, asymptomatic/mildly dyspeptic adults, Hispanic residents of El Paso, Texas, received a 14-day course of omeprazole, plus the combination capsule. We cultured and Gram-stained specimens obtained using a minimally invasive orogastric brush. Helicobacter pylori status was determined by (13)C-urea breath test at 4 or more weeks post-therapy. Forty-seven subjects (7 men and 40 women, average age 42 years) were entered. The per-protocol effectiveness was 97.1% (33/34) (95% mid-P CI: 86.3, 99.9); 100% of metronidazole-resistant strains were eradicated. Side effects were mild and self-limited but contributed to nonadherence. Therapy taken for <10 days was more likely to result in eradication failure (p < .001). Office-based orogastric brushing was well tolerated; positive cultures were obtained in 95%. Gram staining showed H. pylori-like forms in all specimens. This pilot study supports the concept that 14-day OBMT therapy is likely to be more efficacious for H. pylori eradication (Grade A, PP basis) than a 10-day course where metronidazole resistance is suspected. If confirmed, 14 days should be recommended in populations where metronidazole resistance is common. © 2012 Blackwell Publishing Ltd.

Lower Neurocognitive Function in U-2 Pilots: Relationship to White Matter Hyperintensities

DTIC Science & Technology

2014-07-09

dysfunction and cognition in older adults with heart failure. Cogn Behav Neurol 2008;21:65–72. 14. Gunstad J, Keary TA, Spitznagel MB, et al. Blood...pressure and cognitive function in older adults with cardiovascular disease. Int J Neurosci 2009;119:2228–2242. 15. Kantarci K, Weigand SD, Przybelski SA, et

Robust Aircraft Squadron Scheduling in the Face of Absenteeism

DTIC Science & Technology

2008-03-01

Complicating matters is absenteeism . If one or more pilots are unable to perform their previously assigned tasks, due to sickness, aircraft failure, or...ROBUST AIRCRAFT SQUADRON SCHEDULING IN THE FACE OF ABSENTEEISM THESIS Osman B Gokcen, 1st...or the United States Government. AFIT/GOR/ENS/08-06 ROBUST AIRCRAFT SQUADRON SCHEDULING IN THE FACE OF ABSENTEEISM THESIS

Treatment of Aspergillus fumigatus in patients with cystic fibrosis: a randomized, placebo-controlled pilot study.

PubMed

Aaron, Shawn D; Vandemheen, Katherine L; Freitag, Andreas; Pedder, Linda; Cameron, William; Lavoie, Annick; Paterson, Nigel; Wilcox, Pearce; Rabin, Harvey; Tullis, Elizabeth; Morrison, Nancy; Ratjen, Felix

2012-01-01

Many patients with cystic fibrosis develop persistent airway infection/colonization with Aspergillus fumigatus, however the impact of A. fumigatus on clinical outcomes remains unclear. The objective of this study was to determine whether treatment directed against Aspergillus fumigatus improves pulmonary function and clinical outcomes in patients with cystic fibrosis (CF). We performed a double-blind randomized placebo-controlled pilot clinical trial involving 35 patients with CF whose sputum cultures were chronically positive for A. fumigatus. Participants were centrally randomized to receive either oral itraconazole 5 mg/kg/d (N = 18) or placebo (N = 17) for 24 weeks. The primary outcome was the proportion of patients who experienced a respiratory exacerbation requiring intravenous antibiotics over the 24 week treatment period. Secondary outcomes included changes in FEV(1) and quality of life. Over the 24 week treatment period, 4 of 18 (22%) patients randomized to itraconazole experienced a respiratory exacerbation requiring intravenous antibiotics, compared to 5 of 16 (31%) placebo treated patients, P = 0.70. FEV(1) declined by 4.62% over 24 weeks in the patients randomized to itraconazole, compared to a 0.32% improvement in the placebo group (between group difference = -4.94%, 95% CI: -15.33 to 5.45, P = 0.34). Quality of life did not differ between the 2 treatment groups throughout the study. Therapeutic itraconazole blood levels were not achieved in 43% of patients randomized to itraconazole. We did not identify clinical benefit from itraconazole treatment for CF patients whose sputum was chronically colonized with A. fumigatus. Limitations of this pilot study were its small sample size, and failure to achieve therapeutic levels of itraconazole in many patients. ClinicalTrials.gov NCT00528190.

Disseminating Success for All: Lessons for Policy and Practice. Report No. 30.

ERIC Educational Resources Information Center

Slavin, Robert E.; Madden, Nancy A.

Success for All, a comprehensive schoolwide reform program for elementary schools serving many children placed at risk of school failure, was first piloted in one Baltimore (Maryland) elementary school in the 1987-88 school year. Since then, the program has expanded rapidly; as of 1998-99, it was in more than 1,100 schools in 300 districts in 44…

Measures of Situation Awareness: An Experimental Evaluation

DTIC Science & Technology

1991-10-01

occurrence from non- occurrence of the target event, referred to as sensitivity (Macmillan and Creelman , 1990). Because sensitivity declines if pilots are...Pollack and Norman, 1964; see also Craig, 1979; Macmillan and Creelman , 1990). Finally, avoidance failures were measured simply as the number of times...Wesley. Macmillan, N. A., & Creelman , C. D. (1990). Response bias: Characteristics of detection theory, threshold theory, and "non- parametric" indexes

The use of laterally vectored thrust to counter thrust asymmetry in a tactical jet aircraft

NASA Technical Reports Server (NTRS)

1983-01-01

A nonlinear, six degree-of-freedom flight simulator for a twin engine tactical jet was built on a hybrid computer to investigate lateral vectoring of the remaining thrust component for the case of a single engine failure at low dynamic pressures. Aircraft control was provided by an automatic controller rather than a pilot, and thrust vector control was provided by an open-loop controller that deflected a vane (located on the periphery of each exhaust jet and normally streamlined for noninterference with the flow). Lateral thrust vectoring decreased peak values of lateral control deflections, eliminated the requirement for steady-state lateral aerodynamic control deflections, and decreased the amount of altitude lost for a single engine failure.

V-22 Osprey Tilt-Rotor Aircraft

DTIC Science & Technology

2009-01-02

Station, VA, killing seven people and destroying the aircraft. This accident was caused by a fire resulting from hydraulic component failures and...April 5, 2001, the Marine Corps reported that the crash was caused by a burst hydraulic line in one of the Osprey’s two engine casings, and a software...malfunction that caused the aircraft to accelerate and decelerate unpredictably and violently when the pilots tried to compensate for the hydraulic

Lung Ultrasound Pattern Is Normal during the Last Gestational Weeks: An Observational Pilot Study.

PubMed

Arbeid, Erik; Demi, Alessio; Brogi, Etrusca; Gori, Elisa; Giusto, Teresa; Soldati, Gino; Vetrugno, Luigi; Giunta, Francesco; Forfori, Francesco

2017-01-01

The normal lung ultrasound (US) pattern during a regular pregnancy has not been evaluated extensively in the current literature. Pregnancy-related changes in the respiratory tract affect maternal predisposition to several respiratory complications; consequently, it is important to differentiate between a physiologic pattern during pregnancy and a pathologic lung pattern, due to respiratory failure. The goal of our study was to assess the normal US lung pattern in women without known comorbidities in the last weeks of pregnancy. We conducted a prospective cross-sectional observational pilot study. Chest wall was examined in 8 areas, 1 scan for each area with women in supine position. One hundred fifty parturients were enrolled during the 36th-38th gestational weeks. None of the participants showed pleural effusion, pneumothorax or lung consolidation. None presented an interstitial syndrome US pattern. One hundred thirteen participants out of 150 (75%) showed A-lines in all the regions. The remaining 25% showed 1 or 2 B-lines in at least 3 regions. Only 2 participants showed 2 positive regions also. We found that, in the majority of the women examined, the lung US pattern matches the physiological pattern in non-pregnant patients. Lung US assessment is a feasible and a helpful diagnostic tool during pregnancy. © 2016 S. Karger AG, Basel.

Immunity-Based Aircraft Fault Detection System

NASA Technical Reports Server (NTRS)

Dasgupta, D.; KrishnaKumar, K.; Wong, D.; Berry, M.

2004-01-01

In the study reported in this paper, we have developed and applied an Artificial Immune System (AIS) algorithm for aircraft fault detection, as an extension to a previous work on intelligent flight control (IFC). Though the prior studies had established the benefits of IFC, one area of weakness that needed to be strengthened was the control dead band induced by commanding a failed surface. Since the IFC approach uses fault accommodation with no detection, the dead band, although it reduces over time due to learning, is present and causes degradation in handling qualities. If the failure can be identified, this dead band can be further A ed to ensure rapid fault accommodation and better handling qualities. The paper describes the application of an immunity-based approach that can detect a broad spectrum of known and unforeseen failures. The approach incorporates the knowledge of the normal operational behavior of the aircraft from sensory data, and probabilistically generates a set of pattern detectors that can detect any abnormalities (including faults) in the behavior pattern indicating unsafe in-flight operation. We developed a tool called MILD (Multi-level Immune Learning Detection) based on a real-valued negative selection algorithm that can generate a small number of specialized detectors (as signatures of known failure conditions) and a larger set of generalized detectors for unknown (or possible) fault conditions. Once the fault is detected and identified, an adaptive control system would use this detection information to stabilize the aircraft by utilizing available resources (control surfaces). We experimented with data sets collected under normal and various simulated failure conditions using a piloted motion-base simulation facility. The reported results are from a collection of test cases that reflect the performance of the proposed immunity-based fault detection algorithm.

A pilot study on the functional performance and acceptability of an innovative female condom (Wondaleaf®) in Malaysia.

PubMed

Ting, Rachel Sing-Kiat; Wong, Ee-Lynn; Tnay, Jessie Koh-Sing

2018-01-01

Female condom (FC) has been available for over 30 years, but it still lacks wide acceptability. To overcome misdirection and invagination occurring in FC and to provide a wider area of protection, Wondaleaf ® (WL), a new-generation adhesive FC, was recently invented. This pioneering study sought to assess the acceptability and functional performance of WL among Malaysian women. A mixed method survey was conducted in three cities of Malaysia, recruiting sexually active heterosexual women, aged 18-50, by snowball sampling method. Participants were provided with WL and initially surveyed to rate its performance in five coital usages over 2 months. After that, the participants underwent a second survey to rate their satisfaction and acceptability toward WL. Descriptive statistics on clinical failure rates were tabulated with correlational analysis performed to identify major variables contributing to WL's functional performance and acceptability. Out of the 51 enrolled participants, 31 women completed the required surveys. WL's total clinical failure rate was 2.60% (out of 155 condom uses) with above-average ratings of functional performance. The ease of use significantly correlated with ratings of no slippage and no misdirection. The confidence in WL's safety features significantly correlated with a sense of empowerment and protection. WL has a relatively low risk of clinical failures and an overall favorable acceptability among Malaysian women. However, this study also showed that its future usage largely depends on partner acceptability. It may have the potential of complementing the existing barrier toward contraceptive use. Further studies are needed to understand the global acceptability of WL.

Peripheral muscle training with resistance exercise bands in patients with chronic heart failure. Long-term effects on walking distance and quality of life; a pilot study.

PubMed

Lans, Charlotta; Cider, Åsa; Nylander, Eva; Brudin, Lars

2018-04-01

This study aimed to describe a method of peripheral muscle training with resistance bands in patients with chronic heart failure (CHF) and to evaluate its effects on the 6 min walk test and quality of life up to 12 months using a home-based programme. Twenty-two patients with stable CHF (19 men and 3 women), mean age 63.2 years (SD 8.1), New York Heart Association class II-III were randomized to individual home-based training (HT group), or home-based training with a group-based start-up in a hospital setting (GT group). A 6 min walk test, the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and Short Form with 36 items (SF-36) were administered at baseline and after 3, 6, 9, and 12 months. Exercise training resulted in statistically significant increased walking distance in both groups. The HT group increased on average 107 (80) m from baseline to 12 months, and the GT group by 100 (96) m. Health-related quality of life, measured with MLHFQ and SF-36, reached statistically significant improvements in both groups but at different time points. There were no statistically significant differences between groups on any parameters or follow-ups. Long-term home-based peripheral muscle training in patients with CHF, with or without an introductory period in a hospital setting, can be used for initial improvement and retention of walking distance and health-related quality of life. © 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

Introduction of the TEAM-HF Costing Tool: A User-Friendly Spreadsheet Program to Estimate Costs of Providing Patient-Centered Interventions

PubMed Central

Reed, Shelby D.; Li, Yanhong; Kamble, Shital; Polsky, Daniel; Graham, Felicia L.; Bowers, Margaret T.; Samsa, Gregory P.; Paul, Sara; Schulman, Kevin A.; Whellan, David J.; Riegel, Barbara J.

2011-01-01

Background Patient-centered health care interventions, such as heart failure disease management programs, are under increasing pressure to demonstrate good value. Variability in costing methods and assumptions in economic evaluations of such interventions limit the comparability of cost estimates across studies. Valid cost estimation is critical to conducting economic evaluations and for program budgeting and reimbursement negotiations. Methods and Results Using sound economic principles, we developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure (TEAM-HF) Costing Tool, a spreadsheet program that can be used by researchers or health care managers to systematically generate cost estimates for economic evaluations and to inform budgetary decisions. The tool guides users on data collection and cost assignment for associated personnel, facilities, equipment, supplies, patient incentives, miscellaneous items, and start-up activities. The tool generates estimates of total program costs, cost per patient, and cost per week and presents results using both standardized and customized unit costs for side-by-side comparisons. Results from pilot testing indicated that the tool was well-formatted, easy to use, and followed a logical order. Cost estimates of a 12-week exercise training program in patients with heart failure were generated with the costing tool and were found to be consistent with estimates published in a recent study. Conclusions The TEAM-HF Costing Tool could prove to be a valuable resource for researchers and health care managers to generate comprehensive cost estimates of patient-centered interventions in heart failure or other conditions for conducting high-quality economic evaluations and making well-informed health care management decisions. PMID:22147884

Dolutegravir-lamivudine as initial therapy in HIV-1 infected, ARV-naive patients, 48-week results of the PADDLE (Pilot Antiretroviral Design with Dolutegravir LamivudinE) study.

PubMed

Cahn, Pedro; Rolón, María José; Figueroa, María Inés; Gun, Ana; Patterson, Patricia; Sued, Omar

2017-05-09

A proof-of-concept study was designed to evaluate the antiviral efficacy, safety and tolerability of a two-drug regimen with dolutegravir 50 mg once daily (QD) plus lamivudine 300 mg once daily as initial highly active antiretroviral therapy (HAART) among antiretroviral (ARV)-naive patients. PADDLE is a pilot study including 20 treatment-naive adults. To be selected, participants had no IAS-USA-defined resistance, HIV-1 RNA ≤100,000 copies/mL at screening and negative HBsAg. Plasma viral load (pVL) was measured at baseline; days 2, 4, 7, 10, 14, 21 and 28; weeks 6, 8 and 12; and thereafter every 12 weeks up to 96 weeks. Primary endpoint was the proportion of patients with HIV-1 RNA <50 copies/mL in an intention to treat (ITT)-exposed analysis at 48 weeks (the FDA snapshot algorithm). Median HIV-1 RNA at entry was 24,128 copies/mL (interquartile range (IQR): 11,686-36,794). Albeit as per protocol, all patients had pVL ≤100,000 copies/mL at screening as required by inclusion criteria, four patients had ≥100,000 copies/mL at baseline. Median baseline CD4+ T-cell count was 507 per cubic millimetre (IQR: 296-517). A rapid decline in pVL was observed (median VL decay from baseline to week 12 was 2.74 logs). All patients were suppressed at week 8 onwards up to week 24. At week 48, 90% (18/20) reached the primary endpoint of a pVL <50 copies/mL. Median change in CD4 cell count between baseline and week 48 was 267 cells/mm 3 (IQR: 180-462). No major tolerability/toxicity issues were observed. Nineteen patients completed 48 weeks of the study, and one patient (with undetectable VL at last visit) committed suicide. One patient presented a low-level protocol-defined confirmed virological failure at week 36, being the only observed failure. This patient had pVL <50 copies/mL at the end-of-study visit without having changed the two-drug regimen. Observed failure rate was 5%. This is the first report of integrase strand transfer inhibitor/lamivudine dual regimen in ARV-naive patients. This novel dual regimen of dolutegravir and lamivudine warrants further clinical research and consideration as a potential therapeutic option for ARV-therapy-naive patients. NCT02211482.

Sensor-enhanced 3D conformal cueing for safe and reliable HC operation in DVE in all flight phases

NASA Astrophysics Data System (ADS)

Münsterer, Thomas; Schafhitzel, Tobias; Strobel, Michael; Völschow, Philipp; Klasen, Stephanus; Eisenkeil, Ferdinand

2014-06-01

Low level helicopter operations in Degraded Visual Environment (DVE) still are a major challenge and bear the risk of potentially fatal accidents. DVE generally encompasses all degradations to the visual perception of the pilot ranging from night conditions via rain and snowfall to fog and maybe even blinding sunlight or unstructured outside scenery. Each of these conditions reduce the pilots' ability to perceive visual cues in the outside world reducing his performance and finally increasing risk of mission failure and accidents, like for example Controlled Flight Into Terrain (CFIT). The basis for the presented solution is a fusion of processed and classified high resolution ladar data with database information having a potential to also include other sensor data like forward looking or 360° radar data. This paper reports on a pilot assistance system aiming at giving back the essential visual cues to the pilot by means of displaying 3D conformal cues and symbols in a head-tracked Helmet Mounted Display (HMD) and a combination with synthetic view on a head-down Multi-Function Display (MFD). Each flight phase and each flight envelope requires different symbology sets and different possibilities for the pilots to select specific support functions. Several functionalities have been implemented and tested in a simulator as well as in flight. The symbology ranges from obstacle warning symbology via terrain enhancements through grids or ridge lines to different waypoint symbols supporting navigation. While some adaptations can be automated it emerged as essential that symbology characteristics and completeness can be selected by the pilot to match the relevant flight envelope and outside visual conditions.

"Hospital at home" for neuromuscular disease patients with respiratory tract infection: a pilot study.

PubMed

Vianello, Andrea; Savoia, Francesca; Pipitone, Emanuela; Nordio, Beatrice; Gallina, Giulia; Paladini, Luciana; Concas, Alessandra; Arcaro, Giovanna; Gallan, Federico; Pegoraro, Elena

2013-12-01

The "hospital-at-home" model may provide adequate care without an adverse effect on clinical outcome, and is generally well received by users. Our objective was to compare hospital-at-home and in-patient hospital care for neuromuscular disease (NMD) patients with respiratory tract infections. We conducted a prospective randomized controlled trial in a university teaching hospital offering secondary care service to a population of approximately 500,000. We recruited selected NMD patients with respiratory tract infection for whom hospital admission had been recommended after medical assessment. Hospital-at-home was provided as an alternative to in-patient admission. The main outcome measures were need for hospitalization, treatment failure, time to recovery, death during the first 3 months following exacerbation, and cost of patient care. Among 59 consecutive NMD patients eligible for the study, 53 met the criteria for hospital-at-home. Twenty-six subjects were randomized to home care and 27 to hospital care. No significant differences were found in treatment failure (8/26 vs 13/27, P = .19), time to recovery (8.9 ± 4.6 vs 9 ± 8.9 d, P = .21), or mortality at 3 months (3/26 vs 4/27 deaths, P = .42) between the groups. Hospital-at-home failure was independently correlated with type of NMD (P = .004) with an odds ratio of failure of 17.3 (95% CI 2.1 to infinity) for subjects with amyotrophic lateral sclerosis. The total and daily direct cost of patient healthcare was significantly lower for the subjects who were successfully treated at home, compared to the hospitalized individuals. Hospital-at-home is an effective alternative to hospital admission for selected NMD patients with respiratory tract infections.

V-22 Osprey Tilt-Rotor Aircraft

DTIC Science & Technology

2007-03-13

destroying the aircraft. This accident was caused by a fire resulting from hydraulic component failures and design problems in the engine nacelles.3 Flight...the Marine Corps reported that the crash was caused by a burst hydraulic line in one of the Osprey’s two engine casings, and a software malfunction...that caused the aircraft to accelerate and decelerate unpredictably and violently when the pilots tried to compensate for the hydraulic CRS-6 7 An un

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

NASA Technical Reports Server (NTRS)

Bailey, P. S.

1986-01-01

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

Review of Research On Angle-of-Attack Indicator Effectiveness

NASA Technical Reports Server (NTRS)

Le Vie, Lisa R.

2014-01-01

The National Aeronautics and Space Administration (NASA) conducted a literature review to determine the potential benefits of a display of angle-of-attack (AoA) on the flight deck of commercial transport that may aid a pilot in energy state awareness, upset recovery, and/or diagnosis of air data system failure. This literature review encompassed an exhaustive list of references available and includes studies on the benefits of displaying AoA information during all phases of flight. It also contains information and descriptions about various AoA indicators such as dial, vertical and horizontal types as well as AoA displays on the primary flight display and the head up display. Any training given on the use of an AoA indicator during the research studies or experiments is also included for review

Effects of neuromuscular electrostimulation in patients with heart failure admitted to ward.

PubMed

de Araújo, Carlos José Soares; Gonçalves, Fernanda Souza; Bittencourt, Hugo Souza; dos Santos, Noélia Gonçalves; Mecca Junior, Sérgio Vitor; Neves, Júlio Leal Bandeira; Fernandes, André Maurício Souza; Aras Junior, Roque; dos Reis, Francisco José Farias Borges; Guimarães, Armênio Costa; Rodrigues Junior, Erenaldo de Souza; Carvalho, Vitor Oliveira

2012-11-15

Neuromuscular electrostimulation has become a promising issue in cardiovascular rehabilitation. However there are few articles published in the literature regarding neuromuscular electrostimulation in patients with heart failure during hospital stay. This is a randomized controlled pilot trial that aimed to investigate the effect of neuromuscular electrostimulation in the walked distance by the six-minute walking test in 30 patients admitted to ward for heart failure treatment in a tertiary cardiology hospital. Patients in the intervention group performed a conventional rehabilitation and neuromuscular electrostimulation. Patients underwent 60 minutes of electrostimulation (wave frequency was 20 Hz, pulse duration of 20 us) two times a day for consecutive days until hospital discharge. The walked distance in the six-minute walking test improved 75% in the electrostimulation group (from 379.7 ± 43.5 to 372.9 ± 46.9 meters to controls and from 372.9 ± 62.4 to 500 ± 68 meters to electrostimulation, p<0.001). On the other hand, the walked distance in the control group did not change. The neuromuscular electrostimulation group showed greater improvement in the walked distance in the six-minute walking test in patients admitted to ward for compensation of heart failure.

The effect of fluid intake on chronic kidney transplant failure: a pilot study.

PubMed

Magpantay, Laurene; Ziai, Farzad; Oberbauer, Rainer; Haas, Martin

2011-11-01

Transplant recipients are generally instructed to increase their daily fluid intake so as to preserve kidney function. However, studies supporting this hypothesis are lacking. Prospective, randomized study at a tertiary care university hospital. Patients with chronic kidney transplant failure. Assignment to normal fluid intake (NFI: 2 L/day) or high fluid intake (HFI: 4 L/day) for 12 months. The effect of fluid intake on the decrease in estimated glomerular filtration rate (eGFR) was estimated by a mixed-effects general linear model. The analysis was adjusted for the observation period, age, intake of angiotensin-converting enzyme inhibitors or angiotensin II type 1 receptor blockers, diuretics, and transplant duration. A total of 33 patients were randomized to NFI and 29 to HFI. After 12 months, the mean eGFR had decreased to a similar extent in both groups (NFI: 44 ± 9 mL/min vs. 41 ± 9 mL/min; HFI: 46 ± 15 mL/min vs. 44 ± 15 mL/min). In the multivariate analysis, only the observation period had a significant effect on the decrease in eGFR. Randomization to NFI or HFI nor any other variable was associated with kidney function. The association between urine volume and urine osmolality was lost after 12 months. Recommendation of higher fluid intake does not seem to improve chronic kidney transplant failure. However, the lack of association between urine osmolality and reported urine volume at a later stage implies a loss of adherence to fluid intake over time. Copyright © 2011 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Non-Invasive Ventilation (NIV) and Homeostatic Model Assessment (HOMA) Index in Stable Chronic Obstructive Pulmonary Disease (COPD) Patients with Chronic Hypercapnic Respiratory Failure: A Pilot Study.

PubMed

Dimoulis, Andreas; Pastaka, Chaido; Tsolaki, Vasiliki; Tsilioni, Irini; Pournaras, Spyridon; Liakos, Nikolaos; Georgoulias, Panagiotis; Gourgoulianis, Konstantinos

2015-08-01

The effects of Non-invasive Ventilation (NIV) on Insulin Resistance (IR) in stable Chronic Obstructive Pulmonary Disease (COPD) patients have not been fully explored. The aim of this study was to assess the effects of NIV on IR and adiponectin levels during one year application of NIV in stable COPD patients with Chronic Hypercapnic Respiratory Failure. Twenty-five (25) stable COPD patients with Chronic Hypercapnic Respiratory Failure and with no self-reported comorbidities completed the study. NIV was administered in the spontaneous/timed mode via a full face mask using a bi-level positive airway pressure system. Spirometry, blood pressure, arterial blood gases, dyspnea, daytime sleepiness, serum fasting glucose and insulin levels were assessed. IR was assessed with the calculation of the Homeostatic Model Assessment (HOMA) index. Adiponectin was measured with radioimmunoassay. Study participants were re-evaluated on the first, third, sixth, ninth and twelfth month after the initial evaluation. There was a significant improvement in FEV1 values from the first month (34.1 ± 11.6% vs 37 ± 12.3%, p = 0.05). There was a significant decrease in IR by the ninth month of NIV use (3.4 ± 2.3 vs 2.2 ± 1.4, p < 0.0001), while adiponectin levels significantly improved from the first month of NIV use. Stepwise regression analysis revealed that baseline HOMA index was associated with paCO2 (β = 0.07 ± 0.02, p = 0.001), while baseline adiponectin levels were associated with FVC (β = 0.05 ± 0.02, p = 0.035) and the concentration of serum bicarbonate (HCO3-) (-β = 0.18 ± 0.06, p = 0.002). Insulin sensitivity and glucose metabolism as well as adiponectin levels improved along with the improvements in respiratory failure.

Effect of evaporation of solvents from one-step, self-etching adhesives.

PubMed

Furuse, Adilson Yoshio; Peutzfeldt, Anne; Asmussen, Erik

2008-02-01

To investigate whether and to what extent the bonding capacity of one-step, self-etching adhesives is influenced by the degree to which solvent is evaporated. Seven one-step, self-etching adhesives were tested (Adper Prompt L-Pop, Clearfil S3 Bond, Futurabond NR, G-Bond, Hybrid Bond, iBond, Xeno III). The variation in degree of evaporation was obtained by varying the duration of the air-blowing step. The duration required to immobilize the adhesive layer, as established in a pilot study, was used as control. Two experimental air-blowing durations, shorter (half the control duration) and longer (double the control duration) than the control duration, were chosen. The resin composite Herculite XRV was bonded to flat human dentin surfaces treated with one of the adhesives following manufacturer's instructions, except for the air-blowing duration after application. After being stored in water at 37 degrees C for 1 week, the bonded specimens were broken in shear. Failure modes were evaluated under stereomicroscope. Air-blowing duration and brand of adhesive both had an effect on shear bond strength. An interaction was found between adhesive and air-blowing duration. Some adhesives were insensitive to variations in air-drying duration, but in general, air-blowing durations shorter than the control duration produced lower shear bond strengths. Significant effects of adhesive and air-blowing duration were also detected in relation to failure mode. More adhesive failures were observed with shorter air-blowing durations. A significant negative correlation between number of adhesive failures and bond strength was found. On the basis of this in vitro study, it may be concluded that the one-step, self-etching adhesives evaluated were sensitive to degree of evaporation of the solvents.

Modification to area navigation equipment for instrument two-segment approaches

NASA Technical Reports Server (NTRS)

1975-01-01

A two-segment aircraft landing approach concept utilizing an area random navigation (RNAV) system to execute the two-segment approach and eliminate the requirements for co-located distance measuring equipment (DME) was investigated. This concept permits non-precision approaches to be made to runways not equipped with ILS systems, down to appropriate minima. A hardware and software retrofit kit for the concept was designed, built, and tested on a DC-8-61 aircraft for flight evaluation. A two-segment approach profile and piloting procedure for that aircraft that will provide adequate safety margin under adverse weather, in the presence of system failures, and with the occurrence of an abused approach, was also developed. The two-segment approach procedure and equipment was demonstrated to line pilots under conditions which are representative of those encountered in air carrier service.

Performance Evaluation of Evasion Maneuvers for Parallel Approach Collision Avoidance

NASA Technical Reports Server (NTRS)

Winder, Lee F.; Kuchar, James K.; Waller, Marvin (Technical Monitor)

2000-01-01

Current plans for independent instrument approaches to closely spaced parallel runways call for an automated pilot alerting system to ensure separation of aircraft in the case of a "blunder," or unexpected deviation from the a normal approach path. Resolution advisories by this system would require the pilot of an endangered aircraft to perform a trained evasion maneuver. The potential performance of two evasion maneuvers, referred to as the "turn-climb" and "climb-only," was estimated using an experimental NASA alerting logic (AILS) and a computer simulation of relative trajectory scenarios between two aircraft. One aircraft was equipped with the NASA alerting system, and maneuvered accordingly. Observation of the rates of different types of alerting failure allowed judgement of evasion maneuver performance. System Operating Characteristic (SOC) curves were used to assess the benefit of alerting with each maneuver.

Selection and collection of multi parameter physiological data for cardiac rhythm diagnostic algorithm development

NASA Astrophysics Data System (ADS)

Bostock, J.; Weller, P.; Cooklin, M.

2010-07-01

Automated diagnostic algorithms are used in implantable cardioverter-defibrillators (ICD's) to detect abnormal heart rhythms. Algorithms misdiagnose and improved specificity is needed to prevent inappropriate therapy. Knowledge engineering (KE) and artificial intelligence (AI) could improve this. A pilot study of KE was performed with artificial neural network (ANN) as AI system. A case note review analysed arrhythmic events stored in patients ICD memory. 13.2% patients received inappropriate therapy. The best ICD algorithm had sensitivity 1.00, specificity 0.69 (p<0.001 different to gold standard). A subset of data was used to train and test an ANN. A feed-forward, back-propagation network with 7 inputs, a 4 node hidden layer and 1 output had sensitivity 1.00, specificity 0.71 (p<0.001). A prospective study was performed using KE to list arrhythmias, factors and indicators for which measurable parameters were evaluated and results reviewed by a domain expert. Waveforms from electrodes in the heart and thoracic bio-impedance; temperature and motion data were collected from 65 patients during cardiac electrophysiological studies. 5 incomplete datasets were due to technical failures. We concluded that KE successfully guided selection of parameters and ANN produced a usable system and that complex data collection carries greater risk of technical failure, leading to data loss.

Evaluation of ball and roller bearings restored by grinding

NASA Technical Reports Server (NTRS)

Parker, R. J.; Zaretsky, E. V.; Chen, S. M.

1976-01-01

A joint program was undertaken to restore by grinding those rolling-element bearings which are currently being discarded at aircraft engine and transmission overhaul. Three bearing types were selected from the UH-1 helicopter engine (T-53) and transmission for the pilot program. Groups of each of these bearings were visually and dimensionally inspected for suitability for restoration. A total of 250 bearings were restored by grinding. Of this number, 30 bearings from each type were endurance tested to a TBO of 1600 hours. No bearing failures occurred related to the restoration by grinding process. The two bearing failures which occurred were due to defective rolling elements and were typical of those which may occur in new bearings. The restorable component yield to the three groups was in excess of 90 percent.

Analysis and Test Correlation of Proof of Concept Box for Blended Wing Body-Low Speed Vehicle

NASA Technical Reports Server (NTRS)

Spellman, Regina L.

2003-01-01

The Low Speed Vehicle (LSV) is a 14.2% scale remotely piloted vehicle of the revolutionary Blended Wing Body concept. The design of the LSV includes an all composite airframe. Due to internal manufacturing capability restrictions, room temperature layups were necessary. An extensive materials testing and manufacturing process development effort was underwent to establish a process that would achieve the high modulus/low weight properties required to meet the design requirements. The analysis process involved a loads development effort that incorporated aero loads to determine internal forces that could be applied to a traditional FEM of the vehicle and to conduct detailed component analyses. A new tool, Hypersizer, was added to the design process to address various composite failure modes and to optimize the skin panel thickness of the upper and lower skins for the vehicle. The analysis required an iterative approach as material properties were continually changing. As a part of the material characterization effort, test articles, including a proof of concept wing box and a full-scale wing, were fabricated. The proof of concept box was fabricated based on very preliminary material studies and tested in bending, torsion, and shear. The box was then tested to failure under shear. The proof of concept box was also analyzed using Nastran and Hypersizer. The results of both analyses were scaled to determine the predicted failure load. The test results were compared to both the Nastran and Hypersizer analytical predictions. The actual failure occurred at 899 lbs. The failure was predicted at 1167 lbs based on the Nastran analysis. The Hypersizer analysis predicted a lower failure load of 960 lbs. The Nastran analysis alone was not sufficient to predict the failure load because it does not identify local composite failure modes. This analysis has traditionally been done using closed form solutions. Although Hypersizer is typically used as an optimizer for the design process, the failure prediction was used to help gain acceptance and confidence in this new tool. The correlated models and process were to be used to analyze the full BWB-LSV airframe design. The analysis and correlation with test results of the proof of concept box is presented here, including the comparison of the Nastran and Hypersizer results.

Wireless Technology to Track Surgical Patients after Discharge: A Pilot Study.

PubMed

Dawes, Aaron J; Reardon, Sarah; Chen, Victor L; Kaiser, William; Russell, Marcia M; Ko, Clifford Y; Lin, Anne Y

2015-10-01

Failure to detect changes in patients' postoperative health status increases the risk of adverse outcomes, including complications and readmission. We sought to design and implement a real-time surveillance system for postoperative colorectal surgery patients using wireless health technology. Participants were assigned a preprogrammed tablet computer during their inpatient hospitalization, and asked to complete a daily survey regarding their postoperative health status until their first clinic visit. Surveys were transmitted wirelessly to a secure database for review. As a pilot study, we report on our first 20 consecutively enrolled patients, monitored for 265 patient days. Overall compliance was 63 per cent (data available for 166 of the 265 days), but varied by patient from 26 to 100 per cent. We were able to reliably collect basic data on postoperative health status as well as patient-reported outcomes not previously captured by standard assessment techniques. Qualitative data suggest that the experience strengthened patients' relationship with their surgeon and aided in their recovery. Postoperative remote monitoring is feasible, and provides more detailed and complete information to the clinical team. Wireless health technology represents an opportunity to close the information gap between discharge and first clinic visit, and, eventually, to improve patient-provider communication, increase patient satisfaction, and prevent unnecessary readmissions.

Non-invasive preimplantation genetic screening using array comparative genomic hybridization on spent culture media: a proof-of-concept pilot study.

PubMed

Feichtinger, Michael; Vaccari, Enrico; Carli, Luca; Wallner, Elisabeth; Mädel, Ulrike; Figl, Katharina; Palini, Simone; Feichtinger, Wilfried

2017-06-01

The aim of this pilot study was to assess if array comparative genomic hybridization (aCGH), non-invasive preimplantation genetic screening (PGS) on blastocyst culture media is feasible. Therefore, aCGH analysis was carried out on 22 spent blastocyst culture media samples after polar body PGS because of advanced maternal age. All oocytes were fertilized by intracytoplasmic sperm injection and all embryos underwent assisted hatching. Concordance of polar body analysis and culture media genetic results was assessed. Thirteen out of 18 samples (72.2%) revealed general concordance of ploidy status (euploid or aneuploid). At least one chromosomal aberration was found concordant in 10 out of 15 embryos found to be aneuploid by both polar body and culture media analysis. Overall, 17 out of 35 (48.6%) single chromosomal aneuploidies were concordant between the culture media and polar body analysis. By analysing negative controls (oocytes with fertilization failure), notable maternal contamination was observed. Therefore, non-invasive PGS could serve as a second matrix after polar body or cleavage stage PGS; however, in euploid results, maternal contamination needs to be considered and results interpreted with caution. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Dual modality imaging of a novel rat model of ovarian carcinogenesis

NASA Astrophysics Data System (ADS)

Kanter, Elizabeth; Walker, Ross; Marion, Sam; Brewer, Molly A.; Hoyer, Patricia B.; Barton, Jennifer K.

2006-07-01

Ovarian cancer is the fifth leading cause of cancer death in women, in part because of the limited knowledge about early stage disease. We develop a novel rat model of ovarian cancer and perform a pilot study to examine the harvested ovaries with complementary optical imaging modalities. Rats are exposed to repeated daily dosing (20 days) with 4-vinylcyclohexene diepoxide (VCD) to cause early ovarian failure (model for postmenopause), and ovaries are directly exposed to 7,12-dimethylbenz(a)anthracene (DMBA) to cause abnormal ovarian proliferation and neoplasia. Harvested ovaries are examined with optical coherence tomography (OCT) and light-induced fluorescence (LIF) at one, three, and five months post-DMBA treatment. VCD causes complete ovarian follicle depletion within 8 months after onset of dosing. DMBA induces abnormal size, cysts, and neoplastic changes. OCT successfully visualizes normal and abnormal structures (e.g., cysts, bursa, follicular remnant degeneration) and the LIF spectra show statistically significant changes in the ratio of average emission intensity at 390:450 nm between VCD-treated ovaries and both normal cycling and neoplastic DMBA-treated ovaries. Overall, this pilot study demonstrates the feasibility of both the novel animal model for ovarian cancer and the ability of optical imaging techniques to visualize ovarian function and health.

Generating Options for Active Risk Control (GO-ARC): introducing a novel technique.

PubMed

Card, Alan J; Ward, James R; Clarkson, P John

2014-01-01

After investing significant amounts of time and money in conducting formal risk assessments, such as root cause analysis (RCA) or failure mode and effects analysis (FMEA), healthcare workers are left to their own devices in generating high-quality risk control options. They often experience difficulty in doing so, and tend toward an overreliance on administrative controls (the weakest category in the hierarchy of risk controls). This has important implications for patient safety and the cost effectiveness of risk management operations. This paper describes a before and after pilot study of the Generating Options for Active Risk Control (GO-ARC) technique, a novel tool to improve the quality of the risk control options generation process. The quantity, quality (using the three-tiered hierarchy of risk controls), variety, and novelty of risk controls generated. Use of the GO-ARC technique was associated with improvement on all measures. While this pilot study has some notable limitations, it appears that the GO-ARC technique improved the risk control options generation process. Further research is needed to confirm this finding. It is also important to note that improved risk control options are a necessary, but not sufficient, step toward the implementation of more robust risk controls. © 2013 National Association for Healthcare Quality.

Growth failure associated with early neglect: pilot comparison of neglected US children and international adoptees.

PubMed

Miller, Bradley S; Spratt, Eve G; Himes, John H; Condon, Doreen; Summer, Andrea; Papa, Carrie E; Brady, Kathleen T

2015-01-01

The long-lasting impact of different neglectful environments on growth in children is not well studied. Three groups of children, 3-10 years old, were recruited (n=60): previously institutionalized international adoptees living in stable home environments for at least 2 years (IA; n=15), children with a history of neglect born in the USA (USN; n=17), and controls (n=28). Children underwent physical examination, anthropometry, and collection of serum for growth parameters. Mean height standard deviation scores (SDS) were different (p<0.05). Age-adjusted head circumference (HC) was significantly smaller (p<0.05) in IAs. Insulin growth factor (IGF-1), a marker of growth hormone action, was higher in US neglected children. IGF-1 adjusted for age and weight SDS were different (p<0.05) between control and US neglect groups. The degree of growth failure in height and HC in IAs was more severe than neglected US children. These findings may reflect differences between the impact of chronic and intermittent deprivation on the growth hormone system.

Improving care transitions from hospital to home: standardized orders for home health nursing with remote telemonitoring.

PubMed

Heeke, Sheila; Wood, Felecia; Schuck, Jennifer

2014-01-01

A task force at a multihospital health care system partnered with home health agencies to improve gaps during the discharge transition process. A standardized order template for home health nursing and remote telemonitoring was developed to decrease discrepancies in communication between hospital health care providers and home health nurses caring for patients with heart failure. Pilot results showed significantly improved communication with no readmissions, using the order template.

Evaluation of ball and roller bearings restored by grinding

NASA Technical Reports Server (NTRS)

Parker, R. J.; Zaretsky, E. V.; Chen, S. M.

1976-01-01

The restoration by grinding of those rolling element bearings which are currently being discarded at aircaft engine and transmission overhaul is considered. Three bearing types were selected from the UH-1 helicopter engine and transmission for the pilot program. Groups of each of these bearings were visually and dimensionally inspected for suitability for restoration. A total of 250 bearings were restored by grinding. Of this number, 30 bearings from each type were endurance tested to a TBO of 1600 hours. No bearing failures occurred related to the restoration by grinding process. The two bearing failures which occurred were due to defective rolling elements and were typical of those which may occur in new bearings. The restorable component yield to the three groups was in excess of 90 percent.

A review of in-flight emergencies in the ASRS data base

NASA Technical Reports Server (NTRS)

Porter, R. F.

1981-01-01

A series of 154 in-flight emergencies as reported to the Aviation Safety Reporting System are described. The various types of emergencies are examined and an attempt is made to determine the human errors and other factors associated with each incident, as well as the measures taken to resolve the emergency. It is concluded that nearly one half of those emergencies reported were related to failure or malfunction of aircraft subsystems. Of all the emergencies, nearly one quarter were associated with power plant failure. Other frequently encountered emergency types are associated with operation in instrument meteorological conditions without appropriate clearance or qualification, and with low fuel state situations. Human error is prominently featured in many of the incidents, appearing in the actions of pilots and air traffic controllers.

Innovative dressing and securement of tunneled central venous access devices in pediatrics: a pilot randomized controlled trial.

PubMed

Ullman, Amanda J; Kleidon, Tricia; Gibson, Victoria; McBride, Craig A; Mihala, Gabor; Cooke, Marie; Rickard, Claire M

2017-08-30

Central venous access device (CVAD) associated complications are a preventable source of patient harm, frequently resulting in morbidity and delays to vital treatment. Dressing and securement products are used to prevent infectious and mechanical complications, however current complication rates suggest customary practices are inadequate. The aim of this study was to evaluate the feasibility of launching a full-scale randomized controlled efficacy trial of innovative dressing and securement products for pediatric tunneled CVAD to prevent complication and failure. An external, pilot, four-group randomized controlled trial of standard care (bordered polyurethane dressing and suture), in comparison to integrated securement-dressing, suture-less securement device, and tissue adhesive was undertaken across two large, tertiary referral pediatric hospitals in Australia. Forty-eight pediatric participants with newly inserted tunneled CVADs were consecutively recruited. The primary outcome of study feasibility was established by elements of eligibility, recruitment, attrition, protocol adherence, missing data, parent and healthcare staff satisfaction and acceptability, and effect size estimates for CVAD failure (cessation of function prior to completion of treatment) and complication (associated bloodstream infection, thrombosis, breakage, dislodgement or occlusion). Dressing integrity, product costs and site complications were also examined. Protocol feasibility was established. CVAD failure was: 17% (2/12) integrated securement-dressing; 8% (1/13) suture-less securement device; 0% tissue adhesive (0/12); and, 0% standard care (0/11). CVAD complications were: 15% (2/13) suture-less securement device (CVAD associated bloodstream infection, and occlusion and partial dislodgement); 8% (1/12) integrated securement-dressing (partial dislodgement); 0% tissue adhesive (0/12); and, 0% standard care (0/11). One CVAD-associated bloodstream infection occurred, within the suture-less securement device group. Overall satisfaction was highest in the integrated securement-dressing (mean 8.5/10; standard deviation 1.2). Improved dressing integrity was evident in the intervention arms, with the integrated securement-dressing associated with prolonged time to first dressing change (mean days 3.5). Improving the security and dressing integrity of tunneled CVADs is likely to improve outcomes for pediatric patients. Further research is necessary to identify novel, effective CVAD securement to reduce complications, and provide reliable vascular access for children. ACTRN12614000280606 ; prospectively registered on 17/03/2014.

Flight Testing an Iced Business Jet for Flight Simulation Model Validation

NASA Technical Reports Server (NTRS)

Ratvasky, Thomas P.; Barnhart, Billy P.; Lee, Sam; Cooper, Jon

2007-01-01

A flight test of a business jet aircraft with various ice accretions was performed to obtain data to validate flight simulation models developed through wind tunnel tests. Three types of ice accretions were tested: pre-activation roughness, runback shapes that form downstream of the thermal wing ice protection system, and a wing ice protection system failure shape. The high fidelity flight simulation models of this business jet aircraft were validated using a software tool called "Overdrive." Through comparisons of flight-extracted aerodynamic forces and moments to simulation-predicted forces and moments, the simulation models were successfully validated. Only minor adjustments in the simulation database were required to obtain adequate match, signifying the process used to develop the simulation models was successful. The simulation models were implemented in the NASA Ice Contamination Effects Flight Training Device (ICEFTD) to enable company pilots to evaluate flight characteristics of the simulation models. By and large, the pilots confirmed good similarities in the flight characteristics when compared to the real airplane. However, pilots noted pitch up tendencies at stall with the flaps extended that were not representative of the airplane and identified some differences in pilot forces. The elevator hinge moment model and implementation of the control forces on the ICEFTD were identified as a driver in the pitch ups and control force issues, and will be an area for future work.

MD-11 PCA - Research flight team photo

NASA Technical Reports Server (NTRS)

1995-01-01

On Aug. 30, 1995, a the McDonnell Douglas MD-11 transport aircraft landed equipped with a computer-assisted engine control system that has the potential to increase flight safety. In landings at NASA Dryden Flight Research Center, Edwards, California, on August 29 and 30, the aircraft demonstrated software used in the aircraft's flight control computer that essentially landed the MD-11 without a need for the pilot to manipulate the flight controls significantly. In partnership with McDonnell Douglas Aerospace (MDA), with Pratt & Whitney and Honeywell helping to design the software, NASA developed this propulsion-controlled aircraft (PCA) system following a series of incidents in which hydraulic failures resulted in the loss of flight controls. This new system enables a pilot to operate and land the aircraft safely when its normal, hydraulically-activated control surfaces are disabled. This August 29, 1995, photo shows the MD-11 team. Back row, left to right: Tim Dingen, MDA pilot; John Miller, MD-11 Chief pilot (MDA); Wayne Anselmo, MD-11 Flight Test Engineer (MDA); Gordon Fullerton, PCA Project pilot; Bill Burcham, PCA Chief Engineer; Rudey Duran, PCA Controls Engineer (MDA); John Feather, PCA Controls Engineer (MDA); Daryl Townsend, Crew Chief; Henry Hernandez, aircraft mechanic; Bob Baron, PCA Project Manager; Don Hermann, aircraft mechanic; Jerry Cousins, aircraft mechanic; Eric Petersen, PCA Manager (Honeywell); Trindel Maine, PCA Data Engineer; Jeff Kahler, PCA Software Engineer (Honeywell); Steve Goldthorpe, PCA Controls Engineer (MDA). Front row, left to right: Teresa Hass, Senior Project Management Analyst; Hollie Allingham (Aguilera), Senior Project Management Analyst; Taher Zeglum, PCA Data Engineer (MDA); Drew Pappas, PCA Project Manager (MDA); John Burken, PCA Control Engineer.

Solving bezel reliability and CRT obsolescence

NASA Astrophysics Data System (ADS)

Schwartz, Richard J.; Bowen, Arlen R.; Knowles, Terry

2003-09-01

Scientific Research Corporation designed a Smart Multi-Function Color Display with Positive Pilot Feedback under the funding of an U. S. Navy Small Business Innovative Research program. The Smart Multi-Function Color Display can replace the obsolete monochrome Cathode Ray Tube display currently on the T-45C aircraft built by Boeing. The design utilizes a flat panel color Active Matrix Liquid Crystal Display and TexZec's patented Touch Thru Metal bezel technology providing both visual and biomechanical feedback to the pilot in a form, fit, and function replacement to the current T-45C display. Use of an existing color AMLCD, requires the least adaptation to fill the requirements of this application, thereby minimizing risk associated with developing a new display technology and maximizing the investment in improved user interface technology. The improved user interface uses TexZec's Touch Thru Metal technology to eliminate all of the moving parts that traditionally have limited Mean-Time-Between-Failure. The touch detection circuit consists of Commercial-Off-The-Shelf components, creating touch detection circuitry, which is simple and durable. This technology provides robust switch activation and a high level of environmental immunity, both mechanical and electrical. Replacement of all the T-45C multi-function displays with this design will improve the Mean-Time-Between-Failure and drastically reduce display life cycle costs. The design methodology described in this paper can be adapted to any new or replacement display.

Individual reactions to stress predict performance during a critical aviation incident.

PubMed

Vine, Samuel J; Uiga, Liis; Lavric, Aureliu; Moore, Lee J; Tsaneva-Atanasova, Krasimira; Wilson, Mark R

2015-01-01

Understanding the influence of stress on human performance is of theoretical and practical importance. An individual's reaction to stress predicts their subsequent performance; with a "challenge" response to stress leading to better performance than a "threat" response. However, this contention has not been tested in truly stressful environments with highly skilled individuals. Furthermore, the effect of challenge and threat responses on attentional control during visuomotor tasks is poorly understood. Thus, this study aimed to examine individual reactions to stress and their influence on attentional control, among a cohort of commercial pilots performing a stressful flight assessment. Sixteen pilots performed an "engine failure on take-off" scenario, in a high-fidelity flight simulator. Reactions to stress were indexed via self-report; performance was assessed subjectively (flight instructor assessment) and objectively (simulator metrics); gaze behavior data were captured using a mobile eye tracker, and measures of attentional control were subsequently calculated (search rate, stimulus driven attention, and entropy). Hierarchical regression analyses revealed that a threat response was associated with poorer performance and disrupted attentional control. The findings add to previous research showing that individual reactions to stress influence performance and shed light on the processes through which stress influences performance.

Advances in Thrust-Based Emergency Control of an Airplane

NASA Technical Reports Server (NTRS)

Creech, Gray; Burken, John J.; Burcham, Bill

2003-01-01

Engineers at NASA's Dryden Flight Research Center have received a patent on an emergency flight-control method implemented by a propulsion-controlled aircraft (PCA) system. Utilizing the preexisting auto-throttle and engine-pressure-ratio trim controls of the airplane, the PCA system provides pitch and roll control for landing an airplane safely without using aerodynamic control surfaces that have ceased to function because of a primary-flight-control-system failure. The installation of the PCA does not entail any changes in pre-existing engine hardware or software. [Aspects of the method and system at previous stages of development were reported in Thrust-Control System for Emergency Control of an Airplane (DRC-96-07), NASA Tech Briefs, Vol. 25, No. 3 (March 2001), page 68 and Emergency Landing Using Thrust Control and Shift of Weight (DRC-96-55), NASA Tech Briefs, Vol. 26, No. 5 (May 2002), page 58.]. Aircraft flight-control systems are designed with extensive redundancy to ensure low probabilities of failure. During recent years, however, several airplanes have exhibited major flight-control-system failures, leaving engine thrust as the last mode of flight control. In some of these emergency situations, engine thrusts were successfully modulated by the pilots to maintain flight paths or pitch angles, but in other situations, lateral control was also needed. In the majority of such control-system failures, crashes resulted and over 1,200 people died. The challenge lay in creating a means of sufficient degree of thrust-modulation control to safely fly and land a stricken airplane. A thrust-modulation control system designed for this purpose was flight-tested in a PCA an MD-11 airplane. The results of the flight test showed that without any operational control surfaces, a pilot can land a crippled airplane (U.S. Patent 5,330,131). The installation of the original PCA system entailed modifications not only of the flight-control computer (FCC) of the airplane but also of each engine-control computer. Inasmuch as engine-manufacturer warranties do not apply to modified engines, the challenge became one of creating a PCA system that does not entail modifications of the engine computers.

A pilot study on the functional performance and acceptability of an innovative female condom (Wondaleaf®) in Malaysia

PubMed Central

Wong, Ee-Lynn; Tnay, Jessie Koh-Sing

2018-01-01

Background Female condom (FC) has been available for over 30 years, but it still lacks wide acceptability. To overcome misdirection and invagination occurring in FC and to provide a wider area of protection, Wondaleaf® (WL), a new-generation adhesive FC, was recently invented. This pioneering study sought to assess the acceptability and functional performance of WL among Malaysian women. Methods A mixed method survey was conducted in three cities of Malaysia, recruiting sexually active heterosexual women, aged 18–50, by snowball sampling method. Participants were provided with WL and initially surveyed to rate its performance in five coital usages over 2 months. After that, the participants underwent a second survey to rate their satisfaction and acceptability toward WL. Descriptive statistics on clinical failure rates were tabulated with correlational analysis performed to identify major variables contributing to WL’s functional performance and acceptability. Results Out of the 51 enrolled participants, 31 women completed the required surveys. WL’s total clinical failure rate was 2.60% (out of 155 condom uses) with above-average ratings of functional performance. The ease of use significantly correlated with ratings of no slippage and no misdirection. The confidence in WL’s safety features significantly correlated with a sense of empowerment and protection. Conclusion WL has a relatively low risk of clinical failures and an overall favorable acceptability among Malaysian women. However, this study also showed that its future usage largely depends on partner acceptability. It may have the potential of complementing the existing barrier toward contraceptive use. Further studies are needed to understand the global acceptability of WL. PMID:29440937

The meaning of computers to a group of men who are homeless.

PubMed

Miller, Kathleen Swenson; Bunch-Harrison, Stacey; Brumbaugh, Brett; Kutty, Rekha Sankaran; FitzGerald, Kathleen

2005-01-01

The purpose of this pilot study was to explore the experience with computers and the meaning of computers to a group of homeless men living in a long-term shelter. This descriptive exploratory study used semistructured interviews with seven men who had been given access to computers and had participated in individually tailored occupation based interventions through a Work Readiness Program. Three themes emerged from analyzing the interviews: access to computers, computers as a bridge to life-skill development, and changed self-perceptions as a result of connecting to technology. Because they lacked computer knowledge and feared failure, the majority of study participants had not sought out computers available through public access. The need for access to computers, the potential use of computers as a medium for intervention, and the meaning of computers to these men who represent the digital divide are described in this study.

Mindfulness-based exposure and response prevention for obsessive compulsive disorder: study protocol for a pilot randomised controlled trial.

PubMed

Strauss, Clara; Rosten, Claire; Hayward, Mark; Lea, Laura; Forrester, Elizabeth; Jones, Anna-Marie

2015-04-16

Obsessive Compulsive Disorder (OCD) is a distressing and debilitating condition affecting 1-2% of the population. Exposure and response prevention (ERP) is a behaviour therapy for OCD with the strongest evidence for effectiveness of any psychological therapy for the condition. Even so, only about half of people offered ERP show recovery after the therapy. An important reason for ERP failure is that about 25% of people drop out early, and even for those who continue with the therapy, many do not regularly engage in ERP tasks, an essential element of ERP. A mindfulness-based approach has the potential to reduce drop-out from ERP and to improve ERP task engagement with an emphasis on accepting difficult thoughts, feelings and bodily sessions and on becoming more aware of urges, rather than automatically acting on them. This is a pilot randomised controlled trial of mindfulness-based ERP (MB-ERP) with the aim of establishing parameters for a definitive trial. Forty participants diagnosed with OCD will be allocated at random to a 10-session ERP group or to a 10-session MB-ERP group. Primary outcomes are OCD symptom severity and therapy engagement. Secondary outcomes are depressive symptom severity, wellbeing and obsessive-compulsive beliefs. A semi-structured interview with participants will guide understanding of change processes. Findings from this pilot study will inform future research in this area, and if effect sizes on primary outcomes are in favour of MB-ERP in comparison to ERP, funding for a definitive trial will be sought. Current Controlled Trials registration number ISRCTN52684820. Registered on 30 January 2014.

Preliminary profiling of blood transcriptome in a rat model of hemorrhagic shock.

PubMed

Braga, D; Barcella, M; D'Avila, F; Lupoli, S; Tagliaferri, F; Santamaria, M H; DeLano, F A; Baselli, G; Schmid-Schönbein, G W; Kistler, E B; Aletti, F; Barlassina, C

2017-08-01

Hemorrhagic shock is a leading cause of morbidity and mortality worldwide. Significant blood loss may lead to decreased blood pressure and inadequate tissue perfusion with resultant organ failure and death, even after replacement of lost blood volume. One reason for this high acuity is that the fundamental mechanisms of shock are poorly understood. Proteomic and metabolomic approaches have been used to investigate the molecular events occurring in hemorrhagic shock but, to our knowledge, a systematic analysis of the transcriptomic profile is missing. Therefore, a pilot analysis using paired-end RNA sequencing was used to identify changes that occur in the blood transcriptome of rats subjected to hemorrhagic shock after blood reinfusion. Hemorrhagic shock was induced using a Wigger's shock model. The transcriptome of whole blood from shocked animals shows modulation of genes related to inflammation and immune response (Tlr13, Il1b, Ccl6, Lgals3), antioxidant functions (Mt2A, Mt1), tissue injury and repair pathways (Gpnmb, Trim72) and lipid mediators (Alox5ap, Ltb4r, Ptger2) compared with control animals. These findings are congruent with results obtained in hemorrhagic shock analysis by other authors using metabolomics and proteomics. The analysis of blood transcriptome may be a valuable tool to understand the biological changes occurring in hemorrhagic shock and a promising approach for the identification of novel biomarkers and therapeutic targets. Impact statement This study provides the first pilot analysis of the changes occurring in transcriptome expression of whole blood in hemorrhagic shock (HS) rats. We showed that the analysis of blood transcriptome is a useful approach to investigate pathways and functional alterations in this disease condition. This pilot study encourages the possible application of transcriptome analysis in the clinical setting, for the molecular profiling of whole blood in HS patients.

Operating a pilot-scale nitrification/distillation plant for complete nutrient recovery from urine.

PubMed

Fumasoli, Alexandra; Etter, Bastian; Sterkele, Bettina; Morgenroth, Eberhard; Udert, Kai M

2016-01-01

Source-separated urine contains most of the excreted nutrients, which can be recovered by using nitrification to stabilize the urine before concentrating the nutrient solution with distillation. The aim of this study was to test this process combination at pilot scale. The nitrification process was efficient in a moving bed biofilm reactor with maximal rates of 930 mg N L(-1) d(-1). Rates decreased to 120 mg N L(-1) d(-1) after switching to more concentrated urine. At high nitrification rates (640 mg N L(-1) d(-1)) and low total ammonia concentrations (1,790 mg NH4-N L(-1) in influent) distillation caused the main primary energy demand of 71 W cap(-1) (nitrification: 13 W cap(-1)) assuming a nitrogen production of 8.8 g N cap(-1) d(-1). Possible process failures include the accumulation of the nitrification intermediate nitrite and the selection of acid-tolerant ammonia-oxidizing bacteria. Especially during reactor start-up, the process must therefore be carefully supervised. The concentrate produced by the nitrification/distillation process is low in heavy metals, but high in nutrients, suggesting a good suitability as an integral fertilizer.

A Reconfiguration Scheme for Accommodating Actuator Failures in Multi-Input, Multi-Output Flight Control Systems

NASA Technical Reports Server (NTRS)

Siwakosit, W.; Hess, R. A.; Bacon, Bart (Technical Monitor); Burken, John (Technical Monitor)

2000-01-01

A multi-input, multi-output reconfigurable flight control system design utilizing a robust controller and an adaptive filter is presented. The robust control design consists of a reduced-order, linear dynamic inversion controller with an outer-loop compensation matrix derived from Quantitative Feedback Theory (QFT). A principle feature of the scheme is placement of the adaptive filter in series with the QFT compensator thus exploiting the inherent robustness of the nominal flight control system in the presence of plant uncertainties. An example of the scheme is presented in a pilot-in-the-loop computer simulation using a simplified model of the lateral-directional dynamics of the NASA F18 High Angle of Attack Research Vehicle (HARV) that included nonlinear anti-wind up logic and actuator limitations. Prediction of handling qualities and pilot-induced oscillation tendencies in the presence of these nonlinearities is included in the example.

A Comprehensive Analysis of the X-15 Flight 3-65 Accident

NASA Technical Reports Server (NTRS)

Dennehy, Cornelius J.; Orr, Jeb S.; Barshi, Immanuel; Statler, Irving C.

2014-01-01

The November 15, 1967, loss of X-15 Flight 3-65-97 (hereafter referred to as Flight 3-65) was a unique incident in that it was the first and only aerospace flight accident involving loss of crew on a vehicle with an adaptive flight control system (AFCS). In addition, Flight 3-65 remains the only incidence of a single-pilot departure from controlled flight of a manned entry vehicle in a hypersonic flight regime. To mitigate risk to emerging aerospace systems, the NASA Engineering and Safety Center (NESC) proposed a comprehensive review of this accident. The goal of the assessment was to resolve lingering questions regarding the failure modes of the aircraft systems (including the AFCS) and thoroughly analyze the interactions among the human agents and autonomous systems that contributed to the loss of the pilot and aircraft. This document contains the outcome of the accident review.

Generation of Antigen Microarrays to Screen for Autoantibodies in Heart Failure and Heart Transplantation.

PubMed

Chruscinski, Andrzej; Huang, Flora Y Y; Nguyen, Albert; Lioe, Jocelyn; Tumiati, Laura C; Kozuszko, Stella; Tinckam, Kathryn J; Rao, Vivek; Dunn, Shannon E; Persinger, Michael A; Levy, Gary A; Ross, Heather J

2016-01-01

Autoantibodies directed against endogenous proteins including contractile proteins and endothelial antigens are frequently detected in patients with heart failure and after heart transplantation. There is evidence that these autoantibodies contribute to cardiac dysfunction and correlate with clinical outcomes. Currently, autoantibodies are detected in patient sera using individual ELISA assays (one for each antigen). Thus, screening for many individual autoantibodies is laborious and consumes a large amount of patient sample. To better capture the broad-scale antibody reactivities that occur in heart failure and post-transplant, we developed a custom antigen microarray technique that can simultaneously measure IgM and IgG reactivities against 64 unique antigens using just five microliters of patient serum. We first demonstrated that our antigen microarray technique displayed enhanced sensitivity to detect autoantibodies compared to the traditional ELISA method. We then piloted this technique using two sets of samples that were obtained at our institution. In the first retrospective study, we profiled pre-transplant sera from 24 heart failure patients who subsequently received heart transplants. We identified 8 antibody reactivities that were higher in patients who developed cellular rejection (2 or more episodes of grade 2R rejection in first year after transplant as defined by revised criteria from the International Society for Heart and Lung Transplantation) compared with those who did have not have rejection episodes. In a second retrospective study with 31 patients, we identified 7 IgM reactivities that were higher in heart transplant recipients who developed antibody-mediated rejection (AMR) compared with control recipients, and in time course studies, these reactivities appeared prior to overt graft dysfunction. In conclusion, we demonstrated that the autoantibody microarray technique outperforms traditional ELISAs as it uses less patient sample, has increased sensitivity, and can detect autoantibodies in a multiplex fashion. Furthermore, our results suggest that this autoantibody array technology may help to identify patients at risk of rejection following heart transplantation and identify heart transplant recipients with AMR.

Generation of Antigen Microarrays to Screen for Autoantibodies in Heart Failure and Heart Transplantation

PubMed Central

Chruscinski, Andrzej; Huang, Flora Y. Y.; Nguyen, Albert; Lioe, Jocelyn; Tumiati, Laura C.; Kozuszko, Stella; Tinckam, Kathryn J.; Rao, Vivek; Dunn, Shannon E.; Persinger, Michael A.; Levy, Gary A.; Ross, Heather J.

2016-01-01

Autoantibodies directed against endogenous proteins including contractile proteins and endothelial antigens are frequently detected in patients with heart failure and after heart transplantation. There is evidence that these autoantibodies contribute to cardiac dysfunction and correlate with clinical outcomes. Currently, autoantibodies are detected in patient sera using individual ELISA assays (one for each antigen). Thus, screening for many individual autoantibodies is laborious and consumes a large amount of patient sample. To better capture the broad-scale antibody reactivities that occur in heart failure and post-transplant, we developed a custom antigen microarray technique that can simultaneously measure IgM and IgG reactivities against 64 unique antigens using just five microliters of patient serum. We first demonstrated that our antigen microarray technique displayed enhanced sensitivity to detect autoantibodies compared to the traditional ELISA method. We then piloted this technique using two sets of samples that were obtained at our institution. In the first retrospective study, we profiled pre-transplant sera from 24 heart failure patients who subsequently received heart transplants. We identified 8 antibody reactivities that were higher in patients who developed cellular rejection (2 or more episodes of grade 2R rejection in first year after transplant as defined by revised criteria from the International Society for Heart and Lung Transplantation) compared with those who did have not have rejection episodes. In a second retrospective study with 31 patients, we identified 7 IgM reactivities that were higher in heart transplant recipients who developed antibody-mediated rejection (AMR) compared with control recipients, and in time course studies, these reactivities appeared prior to overt graft dysfunction. In conclusion, we demonstrated that the autoantibody microarray technique outperforms traditional ELISAs as it uses less patient sample, has increased sensitivity, and can detect autoantibodies in a multiplex fashion. Furthermore, our results suggest that this autoantibody array technology may help to identify patients at risk of rejection following heart transplantation and identify heart transplant recipients with AMR. PMID:26967734

Fault tolerant attitude sensing and force feedback control for unmanned aerial vehicles

NASA Astrophysics Data System (ADS)

Jagadish, Chirag

Two aspects of an unmanned aerial vehicle are studied in this work. One is fault tolerant attitude determination and the other is to provide force feedback to the joy-stick of the UAV so as to prevent faulty inputs from the pilot. Determination of attitude plays an important role in control of aerial vehicles. One way of defining the attitude is through Euler angles. These angles can be determined based on the measurements of the projections of the gravity and earth magnetic fields on the three body axes of the vehicle. Attitude determination in unmanned aerial vehicles poses additional challenges due to limitations of space, payload, power and cost. Therefore it provides for almost no room for any bulky sensors or extra sensor hardware for backup and as such leaves no room for sensor fault issues either. In the face of these limitations, this study proposes a fault tolerant computing of Euler angles by utilizing multiple different computation methods, with each method utilizing a different subset of the available sensor measurement data. Twenty-five such methods have been presented in this document. The capability of computing the Euler angles in multiple ways provides a diversified redundancy required for fault tolerance. The proposed approach can identify certain sets of sensor failures and even separate the reference fields from the disturbances. A bank-to-turn maneuver of the NASA GTM UAV is used to demonstrate the fault tolerance provided by the proposed method as well as to demonstrate the method of determining the correct Euler angles despite interferences by inertial acceleration disturbances. Attitude computation is essential for stability. But as of today most UAVs are commanded remotely by human pilots. While basic stability control is entrusted to machine or the on-board automatic controller, overall guidance is usually with humans. It is therefore the pilot who sets the command/references through a joy-stick. While this is a good compromise between complete automation and complete human control, it still poses some unique challenges. Pilots of manned aircraft are present inside the cockpit of the aircraft they fly and thus have a better feel of the flying environment and also the limitations of the flight. The same might not be true for UAV pilots stationed on the ground. A major handicap is that visual feedback is the only one available for the UAV pilot. An additional parameter like force feedback on the remote control joy-stick can help the UAV pilot to physically feel the limitation of the safe flight envelope. This can make the flying itself easier and safer. A method proposed here is to design a joy-stick assembly with an additional actuator. This actuator is controlled so as to generate a force feedback on the joy-stick. The control developed for this system is such that the actuator allows free movement for the pilot as long as the UAV is within the safe flight envelope. On the other hand, if it is outside this safe range, the actuator opposes the pilot's applied torque and prevents him/her from giving erroneous commands to the UAV.

Hypochloremia and Diuretic Resistance in Heart Failure: Mechanistic Insights

PubMed Central

Hanberg, Jennifer S.; Rao, Veena; ter Maaten, Jozine M.; Laur, Olga; Brisco, Meredith A.; Wilson, F. Perry; Grodin, Justin L.; Assefa, Mahlet; Broughton, J. Samuel; Planavsky, Noah J.; Ahmad, Tariq; Bellumkonda, Lavanya; Wilson Tang, W. H.; Parikh, Chirag R.; Testani, Jeffrey M.

2016-01-01

Background Recent epidemiologic studies have implicated chloride, rather than sodium, as the driver of poor survival previously attributed to hyponatremia in heart failure (HF). Accumulating basic science evidence has identified chloride as a critical factor in renal salt sensing. Our goal was to probe the physiology bridging this basic and epidemiologic literature. Methods and Results Two HF cohorts were included: (1) Observational: Patients receiving loop diuretics at the Yale Transitional Care Center (YTCC; N=162); (2) Interventional Pilot: Stable outpatients receiving ≥80mg furosemide equivalents were studied before and after three days of 115 mmol/d supplemental lysine chloride (N=10). In YTCC, 31.5% of patients had hypochloremia (chloride ≤96 mmol/L). Plasma renin concentration correlated with serum chloride (r=−0.46, p<0.001) with no incremental contribution from serum sodium (p=0.49). Hypochloremic vs. non-hypochloremic patients exhibited renal wasting of chloride (p=0.04) and of chloride relative to sodium (p=0.01), despite better renal free water excretion (urine osmolality 372±94 mOsm/kg vs. 507±118, p<0.001). Hypochloremia was associated with poor diuretic response (OR=7.3, 95% CI 3.3–16.1, p<0.001). In the interventional pilot, lysine chloride supplementation was associated with an increase in serum chloride levels of 2.2±2.3 mmol/L and the majority of participants experienced findings such as hemoconcentration, weight loss, reduction in NT-proBNP, increased plasma renin activity, and increased blood urea nitrogen to creatinine ratio. Conclusions Hypochloremia is associated with neurohormonal activation and diuretic resistance with chloride depletion as a candidate mechanism. Sodium-free chloride supplementation was associated with increases in serum chloride and changes in several cardio-renal parameters. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT02031354. PMID:27507113

Simulation of the XV-15 tilt rotor research aircraft

NASA Technical Reports Server (NTRS)

Churchill, G. B.; Dugan, D. C.

1982-01-01

The effective use of simulation from issuance of the request for proposal through conduct of a flight test program for the XV-15 Tilt Rotor Research Aircraft is discussed. From program inception, simulation complemented all phases of XV-15 development. The initial simulation evaluations during the source evaluation board proceedings contributed significantly to performance and stability and control evaluations. Eight subsequent simulation periods provided major contributions in the areas of control concepts; cockpit configuration; handling qualities; pilot workload; failure effects and recovery procedures; and flight boundary problems and recovery procedures. The fidelity of the simulation also made it a valuable pilot training aid, as well as a suitable tool for military and civil mission evaluations. Simulation also provided valuable design data for refinement of automatic flight control systems. Throughout the program, fidelity was a prime issue and resulted in unique data and methods for fidelity evaluation which are presented and discussed.

A study of role expansion: a new GP role in cardiology care

PubMed Central

2014-01-01

Background The National Health Service is reconfiguring health care services in order to meet the increasing challenge of providing care for people with long-term conditions and to reduce the demand on specialised outpatient hospital services by enhancing primary care. A review of cardiology referrals to specialised care and the literature on referral management inspired the development of a new GP role in Cardiology. This new extended role was developed to enable GPs to diagnose and manage patients with mild to moderate heart failure or atrial fibrillation and to use a range of diagnostics effectively in primary care. This entailed GPs participating in a four-session short course with on-going clinical supervision. The new role was piloted in a small number of GP practices in one county in England for four months. This study explores the impact of piloting the Extended Cardiology role on the GP’s role, patients’ experience, service delivery and quality. Methods A mixed methods approach was employed including semi-structured interviews with GPs, a patient experience survey, a quality review of case notes, and analysis on activity and referral data. Results The participating GPs perceived the extended GP role as a professional development opportunity that had the potential to reduce healthcare utilisation and costs, through a reduction in referrals, whilst meeting the patient’s wishes for the provision of care closer to home. Patient experience of the new GP service was positive. The standard of clinical practice was judged acceptable. There was a fall in referrals during the study period. Conclusion This new role in cardiology was broadly welcomed as a model of care by the participating GPs and by patients, because of the potential to improve the quality of care for patients in primary care and reduce costs. As this was a pilot study further development and continuing evaluation of the model is recommended. PMID:24885826

Failure Mechanisms of High Temperature Semiconductor Lasers

DTIC Science & Technology

1993-12-01

91 V.3.2. Facet Degradation 92 V.3.3. Dark Defect Degradation 95 V.3.4. Lasers Inoperational at Elevated Tempatur 96 V.3.5. Degradation Mechanism...they will be fairly easy to incorporate into the business of communications and control applications. The Air Force has a few of its own proposed uses ...demands a ho data processing Af~t which could be handled by lasems. A &W[ proposed use is a pilot chum•t-mo ited laer prwoicr to higgtthe portant dam2

Flight Test Results from the NF-15B Intelligent Flight Control System (IFCS) Project with Adaptation to a Simulated Stabilator Failure

NASA Technical Reports Server (NTRS)

Bosworth, John T.; Williams-Hayes, Peggy S.

2007-01-01

Adaptive flight control systems have the potential to be more resilient to extreme changes in airplane behavior. Extreme changes could be a result of a system failure or of damage to the airplane. A direct adaptive neural-network-based flight control system was developed for the National Aeronautics and Space Administration NF-15B Intelligent Flight Control System airplane and subjected to an inflight simulation of a failed (frozen) (unmovable) stabilator. Formation flight handling qualities evaluations were performed with and without neural network adaptation. The results of these flight tests are presented. Comparison with simulation predictions and analysis of the performance of the adaptation system are discussed. The performance of the adaptation system is assessed in terms of its ability to decouple the roll and pitch response and reestablish good onboard model tracking. Flight evaluation with the simulated stabilator failure and adaptation engaged showed that there was generally improvement in the pitch response; however, a tendency for roll pilot-induced oscillation was experienced. A detailed discussion of the cause of the mixed results is presented.

Flight Test Results from the NF-15B Intelligent Flight Control System (IFCS) Project with Adaptation to a Simulated Stabilator Failure

NASA Technical Reports Server (NTRS)

Bosworth, John T.; Williams-Hayes, Peggy S.

2010-01-01

Adaptive flight control systems have the potential to be more resilient to extreme changes in airplane behavior. Extreme changes could be a result of a system failure or of damage to the airplane. A direct adaptive neural-network-based flight control system was developed for the National Aeronautics and Space Administration NF-15B Intelligent Flight Control System airplane and subjected to an inflight simulation of a failed (frozen) (unmovable) stabilator. Formation flight handling qualities evaluations were performed with and without neural network adaptation. The results of these flight tests are presented. Comparison with simulation predictions and analysis of the performance of the adaptation system are discussed. The performance of the adaptation system is assessed in terms of its ability to decouple the roll and pitch response and reestablish good onboard model tracking. Flight evaluation with the simulated stabilator failure and adaptation engaged showed that there was generally improvement in the pitch response; however, a tendency for roll pilot-induced oscillation was experienced. A detailed discussion of the cause of the mixed results is presented.

Bearing restoration by grinding

NASA Technical Reports Server (NTRS)

Hanau, H.; Parker, R. J.; Zaretsky, E. V.; Chen, S. M.; Bull, H. L.

1976-01-01

A joint program was undertaken by the NASA Lewis Research Center and the Army Aviation Systems Command to restore by grinding those rolling-element bearings which are currently being discarded at aircraft engine and transmission overhaul. Three bearing types were selected from the UH-1 helicopter engine (T-53) and transmission for the pilot program. No bearing failures occurred related to the restoration by grinding process. The risk and cost of a bearing restoration by grinding programs was analyzed. A microeconomic impact analysis was performed.

Physiological Self-Regulation and Adaptive Automation

NASA Technical Reports Server (NTRS)

Prinzell, Lawrence J.; Pope, Alan T.; Freeman, Frederick G.

2007-01-01

Adaptive automation has been proposed as a solution to current problems of human-automation interaction. Past research has shown the potential of this advanced form of automation to enhance pilot engagement and lower cognitive workload. However, there have been concerns voiced regarding issues, such as automation surprises, associated with the use of adaptive automation. This study examined the use of psychophysiological self-regulation training with adaptive automation that may help pilots deal with these problems through the enhancement of cognitive resource management skills. Eighteen participants were assigned to 3 groups (self-regulation training, false feedback, and control) and performed resource management, monitoring, and tracking tasks from the Multiple Attribute Task Battery. The tracking task was cycled between 3 levels of task difficulty (automatic, adaptive aiding, manual) on the basis of the electroencephalogram-derived engagement index. The other two tasks remained in automatic mode that had a single automation failure. Those participants who had received self-regulation training performed significantly better and reported lower National Aeronautics and Space Administration Task Load Index scores than participants in the false feedback and control groups. The theoretical and practical implications of these results for adaptive automation are discussed.

Pretest 3-D finite element modeling of the wedge pillar portion of the WIPP (Waste Isolation Pilot Plant) Geomechanical Evaluation (Room G) in situ experiment. [Waste Isolation Pilot Plant

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

Preece, D.S.

Pretest 3-D finite element calculations have been performed on the wedge pillar portion of the WIPP Geomechanical Evaluation Experiment. The wedge pillar separates two drifts that intersect at an angle of 7.5/sup 0/. Purpose of the experiment is to provide data on the creep behavior of the wedge and progressive failure at the tip. The first set of calculations utilized a symmetry plane on the center-line of the wedge which allowed treatment of the entire configuration by modeling half of the geometry. Two 3-D calculations in this first set were performed with different drift widths to study the influence ofmore » drift size on closure and maximum stress. A cross-section perpendicular to the wedge was also analyzed with 2-D finite element models and the results compared to the 3-D results. In another set of 3-D calculations both drifts were modeled but with less distance between the drifts and the outer boundaries. Results of these calculations are compared with results from the other calculations to better understand the influence of boundary conditions.« less

Real-Time Adaptive Control Allocation Applied to a High Performance Aircraft

NASA Technical Reports Server (NTRS)

Davidson, John B.; Lallman, Frederick J.; Bundick, W. Thomas

2001-01-01

Abstract This paper presents the development and application of one approach to the control of aircraft with large numbers of control effectors. This approach, referred to as real-time adaptive control allocation, combines a nonlinear method for control allocation with actuator failure detection and isolation. The control allocator maps moment (or angular acceleration) commands into physical control effector commands as functions of individual control effectiveness and availability. The actuator failure detection and isolation algorithm is a model-based approach that uses models of the actuators to predict actuator behavior and an adaptive decision threshold to achieve acceptable false alarm/missed detection rates. This integrated approach provides control reconfiguration when an aircraft is subjected to actuator failure, thereby improving maneuverability and survivability of the degraded aircraft. This method is demonstrated on a next generation military aircraft Lockheed-Martin Innovative Control Effector) simulation that has been modified to include a novel nonlinear fluid flow control control effector based on passive porosity. Desktop and real-time piloted simulation results demonstrate the performance of this integrated adaptive control allocation approach.

Bovine colostrum to children with short bowel syndrome: a randomized, double-blind, crossover pilot study.

PubMed

Aunsholt, Lise; Jeppesen, Palle Bekker; Lund, Pernille; Sangild, Per Torp; Ifaoui, Inge Bøtker Rasmussen; Qvist, Niels; Husby, Steffen

2014-01-01

Management of short bowel syndrome (SBS) aims to achieve intestinal autonomy to prevent fluid, electrolyte, and nutrient deficiencies and maintain adequate development. Remnant intestinal adaptation is required to obtain autonomy. In the newborn pig, colostrum has been shown to support intestinal development and hence adaptive processes. The efficacy of bovine colostrum to improve intestinal function in children with SBS was evaluated by metabolic balance studies. Nine children with SBS were included in a randomized, double-blind, crossover study. Twenty percent of enteral fluid intake was replaced with bovine colostrum or a mixed milk diet for 4 weeks, separated by a 4-week washout period. Intestinal absorption of energy and wet weight was used to assess intestinal function and the efficacy of colostrum. Colostrum did not improve energy or wet weight absorption compared with the mixed milk diet (P = 1.00 and P = .93, respectively). Growth as measured by weight and knemometry did not differ between diets (P = .93 and P = .28). In these patients, <150% enteral energy absorption of basal metabolic rate and 50% enteral fluid absorption of basal fluid requirement suggested intestinal failure and a need for parenteral nutrition (PN). Inclusion of bovine colostrum to the diet did not improve intestinal function. Metabolic nutrient and wet weight balance studies successfully assessed intestinal function, and this method may distinguish between intestinal insufficiency (non-PN-dependent) and intestinal failure (PN-dependent) patients.

Control methods for aiding a pilot during STOL engine failure transients

NASA Technical Reports Server (NTRS)

Nelson, E. R.; Debra, D. B.

1976-01-01

Candidate autopilot control laws that control the engine failure transient sink rates by demonstrating the engineering application of modern state variable control theory were defined. The results of approximate modal analysis were compared to those derived from full state analyses provided from computer design solutions. The aircraft was described, and a state variable model of its longitudinal dynamic motion due to engine and control variations was defined. The classical fast and slow modes were assumed to be sufficiently different to define reduced order approximations of the aircraft motion amendable to hand analysis control definition methods. The original state equations of motion were also applied to a large scale state variable control design program, in particular OPTSYS. The resulting control laws were compared with respect to their relative responses, ease of application, and meeting the desired performance objectives.

Results of the Medicare Health Support disease-management pilot program.

PubMed

McCall, Nancy; Cromwell, Jerry

2011-11-03

In the Medicare Modernization Act of 2003, Congress required the Centers for Medicare and Medicaid Services to test the commercial disease-management model in the Medicare fee-for-service program. The Medicare Health Support Pilot Program was a large, randomized study of eight commercial programs for disease management that used nurse-based call centers. We randomly assigned patients with heart failure, diabetes, or both to the intervention or to usual care (control) and compared them with the use of a difference-in-differences method to evaluate the effects of the commercial programs on the quality of clinical care, acute care utilization, and Medicare expenditures for Medicare fee-for-service beneficiaries. The study included 242,417 patients (163,107 in the intervention group and 79,310 in the control group). The eight commercial disease-management programs did not reduce hospital admissions or emergency room visits, as compared with usual care. We observed only 14 significant improvements in process-of-care measures out of 40 comparisons. These modest improvements came at substantial cost to the Medicare program in fees paid to the disease-management companies ($400 million), with no demonstrable savings in Medicare expenditures. In this large study, commercial disease-management programs using nurse-based call centers achieved only modest improvements in quality-of-care measures, with no demonstrable reduction in the utilization of acute care or the costs of care.

Repeated Induction of Inattentional Blindness in a Simulated Aviation Environment

NASA Technical Reports Server (NTRS)

Kennedy, Kellie D.; Stephens, Chad L.; Williams, Ralph A.; Schutte, Paul C.

2017-01-01

The study reported herein is a subset of a larger investigation on the role of automation in the context of the flight deck and used a fixed-based, human-in-the-loop simulator. This paper explored the relationship between automation and inattentional blindness (IB) occurrences in a repeated induction paradigm using two types of runway incursions. The critical stimuli for both runway incursions were directly relevant to primary task performance. Sixty non-pilot participants performed the final five minutes of a landing scenario twice in one of three automation conditions: full automation (FA), partial automation (PA), and no automation (NA). The first induction resulted in a 70 percent (42 of 60) detection failure rate with those in the PA condition significantly more likely to detect the incursion compared to the FA condition or the NA condition. The second induction yielded a 50 percent detection failure rate. Although detection improved (detection failure rates declined) in all conditions, those in the FA condition demonstrated the greatest improvement with doubled detection rates. The detection behavior in the first trial did not preclude a failed detection in the second induction. Group membership (IB vs. Detection) in the FA condition showed a greater improvement than those in the NA condition and rated the Mental Demand and Effort subscales of the NASA-TLX (NASA Task Load Index) significantly higher for Time 2 compared Time 1. Participants in the FA condition used the experience of IB exposure to improve task performance whereas those in the NA condition did not, indicating the availability and reallocation of attentional resources in the FA condition. These findings support the role of engagement in operational attention detriment and the consideration of attentional failure causation to determine appropriate mitigation strategies.

Attitudes towards chemistry among engineering students

NASA Astrophysics Data System (ADS)

Olivo Delgado, Carlos J.

The attitudes towards chemistry of the engineering students enrolled in an introductory course at the Polytechnic University of Puerto Rico were explored (n = 115). A mixed methodology was used in an exploratory-oriented research approach. The first stage consisted of the administration of a Likert scale attitudinal survey which was validated during the study's design process. The survey allowed collecting information about the participant's attitudes towards their personal opinion, their perspectives about peer's or relatives' opinion, relevant aspects of the discipline, and difficulty-increasing factors in the chemistry course. The scale internal reliability was measured in a pilot study with a convenience simple, obtaining an acceptable coefficient (Cronbach alpha = 0.731). Survey results evidenced a mainly neutral attitude towards the chemistry course, not highly negative or highly positive, in contrast with other studies in this field. On the other hand, the normality hypothesis was tested for the scores obtained by participants in the survey. Although the pilot study sample had an approximately normal distribution, the scores in obtained by the participants in the survey failed the normality test criteria. The second stage of the study was accomplished using a case study. Among the survey participants, some students were invited to in-depth interviews to elucidate the reasons why they have certain attitudes towards chemistry. Study time, instructor, motivation, term of study, and course schedule are the factors that interviewees agreed as contributors to success or failure in the chemistry course. Interview's participants emphasized that study time is determinant to pass the class. This methodological approach, quantitative followed by qualitative, was useful in describing the attitudes towards chemistry among university students of engineering.

Dolutegravir–lamivudine as initial therapy in HIV-1 infected, ARV-naive patients, 48-week results of the PADDLE (Pilot Antiretroviral Design with Dolutegravir LamivudinE) study

PubMed Central

Cahn, Pedro; Rolón, María José; Figueroa, María Inés; Gun, Ana; Patterson, Patricia; Sued, Omar

2017-01-01

Abstract Introduction: A proof-of-concept study was designed to evaluate the antiviral efficacy, safety and tolerability of a two-drug regimen with dolutegravir 50 mg once daily (QD) plus lamivudine 300 mg once daily as initial highly active antiretroviral therapy (HAART) among antiretroviral (ARV)-naive patients. Methods: PADDLE is a pilot study including 20 treatment-naive adults. To be selected, participants had no IAS-USA-defined resistance, HIV-1 RNA ≤100,000 copies/mL at screening and negative HBsAg. Plasma viral load (pVL) was measured at baseline; days 2, 4, 7, 10, 14, 21 and 28; weeks 6, 8 and 12; and thereafter every 12 weeks up to 96 weeks. Primary endpoint was the proportion of patients with HIV-1 RNA <50 copies/mL in an intention to treat (ITT)-exposed analysis at 48 weeks (the FDA snapshot algorithm). Results: Median HIV-1 RNA at entry was 24,128 copies/mL (interquartile range (IQR): 11,686–36,794). Albeit as per protocol, all patients had pVL ≤100,000 copies/mL at screening as required by inclusion criteria, four patients had ≥100,000 copies/mL at baseline. Median baseline CD4+ T-cell count was 507 per cubic millimetre (IQR: 296–517). A rapid decline in pVL was observed (median VL decay from baseline to week 12 was 2.74 logs). All patients were suppressed at week 8 onwards up to week 24. At week 48, 90% (18/20) reached the primary endpoint of a pVL <50 copies/mL. Median change in CD4 cell count between baseline and week 48 was 267 cells/mm3 (IQR: 180–462). No major tolerability/toxicity issues were observed. Nineteen patients completed 48 weeks of the study, and one patient (with undetectable VL at last visit) committed suicide. One patient presented a low-level protocol-defined confirmed virological failure at week 36, being the only observed failure. This patient had pVL <50 copies/mL at the end-of-study visit without having changed the two-drug regimen. Observed failure rate was 5%. This is the first report of integrase strand transfer inhibitor/lamivudine dual regimen in ARV-naive patients. Conclusions: This novel dual regimen of dolutegravir and lamivudine warrants further clinical research and consideration as a potential therapeutic option for ARV-therapy-naive patients. ClinicalTrials.gov Identifier: NCT02211482. PMID:28537061

Development of NASA's Accident Precursor Analysis Process Through Application on the Space Shuttle Orbiter

NASA Technical Reports Server (NTRS)

Maggio, Gaspare; Groen, Frank; Hamlin, Teri; Youngblood, Robert

2010-01-01

Accident Precursor Analysis (APA) serves as the bridge between existing risk modeling activities, which are often based on historical or generic failure statistics, and system anomalies, which provide crucial information about the failure mechanisms that are actually operative in the system. APA docs more than simply track experience: it systematically evaluates experience, looking for under-appreciated risks that may warrant changes to design or operational practice. This paper presents the pilot application of the NASA APA process to Space Shuttle Orbiter systems. In this effort, the working sessions conducted at Johnson Space Center (JSC) piloted the APA process developed by Information Systems Laboratories (ISL) over the last two years under the auspices of NASA's Office of Safety & Mission Assurance, with the assistance of the Safety & Mission Assurance (S&MA) Shuttle & Exploration Analysis Branch. This process is built around facilitated working sessions involving diverse system experts. One important aspect of this particular APA process is its focus on understanding the physical mechanism responsible for an operational anomaly, followed by evaluation of the risk significance of the observed anomaly as well as consideration of generalizations of the underlying mechanism to other contexts. Model completeness will probably always be an issue, but this process tries to leverage operating experience to the extent possible in order to address completeness issues before a catastrophe occurs.

Higher versus lower blood pressure targets for vasopressor therapy in shock: a multicentre pilot randomized controlled trial.

PubMed

Lamontagne, François; Meade, Maureen O; Hébert, Paul C; Asfar, Pierre; Lauzier, François; Seely, Andrew J E; Day, Andrew G; Mehta, Sangeeta; Muscedere, John; Bagshaw, Sean M; Ferguson, Niall D; Cook, Deborah J; Kanji, Salmaan; Turgeon, Alexis F; Herridge, Margaret S; Subramanian, Sanjay; Lacroix, Jacques; Adhikari, Neill K J; Scales, Damon C; Fox-Robichaud, Alison; Skrobik, Yoanna; Whitlock, Richard P; Green, Robert S; Koo, Karen K Y; Tanguay, Teddie; Magder, Sheldon; Heyland, Daren K

2016-04-01

In shock, hypotension may contribute to inadequate oxygen delivery, organ failure and death. We conducted the Optimal Vasopressor Titration (OVATION) pilot trial to inform the design of a larger trial examining the effect of lower versus higher mean arterial pressure (MAP) targets for vasopressor therapy in shock. We randomly assigned critically ill patients who were presumed to suffer from vasodilatory shock regardless of admission diagnosis to a lower (60-65 mmHg) versus a higher (75-80 mmHg) MAP target. The primary objective was to measure the separation in MAP between groups. We also recorded days with protocol deviations, enrolment rate, cardiac arrhythmias and mortality for prespecified subgroups. A total of 118 patients were enrolled from 11 centres (2.3 patients/site/month of screening). The between-group separation in MAP was 9 mmHg (95% CI 7-11). In the lower and higher MAP groups, we observed deviations on 12 versus 8% of all days on vasopressors (p = 0.059). Risks of cardiac arrhythmias (20 versus 36%, p = 0.07) and hospital mortality (30 versus 33%, p = 0.84) were not different between lower and higher MAP arms. Among patients aged 75 years or older, a lower MAP target was associated with reduced hospital mortality (13 versus 60%, p = 0.03) but not in younger patients. This pilot study supports the feasibility of a large trial comparing lower versus higher MAP targets for shock. Further research may help delineate the reasons for vasopressor dosing in excess of prescribed targets and how individual patient characteristics modify the response to vasopressor therapy.

Feasibility of Turing-Style Tests for Autonomous Aerial Vehicle "Intelligence"

NASA Technical Reports Server (NTRS)

Young, Larry A.

2007-01-01

A new approach is suggested to define and evaluate key metrics as to autonomous aerial vehicle performance. This approach entails the conceptual definition of a "Turing Test" for UAVs. Such a "UAV Turing test" would be conducted by means of mission simulations and/or tailored flight demonstrations of vehicles under the guidance of their autonomous system software. These autonomous vehicle mission simulations and flight demonstrations would also have to be benchmarked against missions "flown" with pilots/human-operators in the loop. In turn, scoring criteria for such testing could be based upon both quantitative mission success metrics (unique to each mission) and by turning to analog "handling quality" metrics similar to the well-known Cooper-Harper pilot ratings used for manned aircraft. Autonomous aerial vehicles would be considered to have successfully passed this "UAV Turing Test" if the aggregate mission success metrics and handling qualities for the autonomous aerial vehicle matched or exceeded the equivalent metrics for missions conducted with pilots/human-operators in the loop. Alternatively, an independent, knowledgeable observer could provide the "UAV Turing Test" ratings of whether a vehicle is autonomous or "piloted." This observer ideally would, in the more sophisticated mission simulations, also have the enhanced capability of being able to override the scripted mission scenario and instigate failure modes and change of flight profile/plans. If a majority of mission tasks are rated as "piloted" by the observer, when in reality the vehicle/simulation is fully- or semi- autonomously controlled, then the vehicle/simulation "passes" the "UAV Turing Test." In this regards, this second "UAV Turing Test" approach is more consistent with Turing s original "imitation game" proposal. The overall feasibility, and important considerations and limitations, of such an approach for judging/evaluating autonomous aerial vehicle "intelligence" will be discussed from a theoretical perspective.

A Pilot Randomized Controlled Trial to Promote Immunosuppressant Adherence in Adult Kidney Transplant Recipients.

PubMed

Cukor, Daniel; Ver Halen, Nisha; Pencille, Melissa; Tedla, Fasika; Salifu, Moro

2017-01-01

Nonadherence to immunosuppressant medication is a prevalent practice among kidney transplant recipients and has been associated with increased risk for graft failure and economic burden. The aim of this pilot study was to test whether a culturally sensitive cognitive-behavioral adherence promotion program could significantly improve medication adherence to tacrolimus prescription as measured by telephone pill counts among kidney transplant recipients. Thirty-three adult transplant recipients were less than 98% adherent to tacrolimus prescription based on 3 telephone pill counts and were randomized either to the 2-session cognitive-behavioral adherence promotion program or to standard care. The curriculum was developed from an iterative process with transplant recipients into a 2-session group program that provided psychoeducation, addressed barriers to adherence, fostered motivation to improve adherence behavior, and discussed cultural messages on adherence behavior. The intervention group displayed significantly higher levels of adherence when compared to the control group (t = 2.2, p = 0.04) and. similarly, when the amount of change was compared between the groups, the intervention group showed more change than the control condition (F (22,1) = 12.005, p = 0.003). Tacrolimus trough concentration levels were used as a secondary measure of adherence and, while there were no significant between-group differences for mean trough concentration levels, the variability in the trough levels did significantly decrease over time indicating more consistent pill-taking behavior in the intervention group. There is preliminary support for the pilot program as a successful intervention in helping patients with their immunosuppressant medication. © 2016 S. Karger AG, Basel.

Airplane automatic control force trimming device for asymmetric engine failures

NASA Technical Reports Server (NTRS)

Stewart, Eric C. (Inventor)

1987-01-01

The difference in dynamic pressure in the propeller slipstreams as measured by sensors is divided by the freestream dynamic pressure generating a quantity proportional to the differential thrust coefficient. This quantity is used to command an electric trim motor to change the position of trim tab thereby retrimming the airplane to the new asymmetric power condition. The change in position of the trim tab produced by the electric trim motor is summed with the pilot's input to produce the actual trim tab position.

An Investigation of Ways to Reduce the Failure Rate of Student Pilots during Flying Training in the Royal Australian Air Force.

DTIC Science & Technology

1987-09-01

Luthans (28) expanded the concept of learning as follows: 1. Learning involves a change, though not necessarily an improvement, in behaviour. Learning...that results in an unpleasant outcome is not likely to be repeated (36:244). Luthans and Kreitner (27) described the various forms of reinforcement as...four 33 alternatives (defined previously on page 24 and taken from Luthans ) of positive reinforcement, negative reinforcement, extinction and punishment

New human-centered linear and nonlinear motion cueing algorithms for control of simulator motion systems

NASA Astrophysics Data System (ADS)

Telban, Robert J.

While the performance of flight simulator motion system hardware has advanced substantially, the development of the motion cueing algorithm, the software that transforms simulated aircraft dynamics into realizable motion commands, has not kept pace. To address this, new human-centered motion cueing algorithms were developed. A revised "optimal algorithm" uses time-invariant filters developed by optimal control, incorporating human vestibular system models. The "nonlinear algorithm" is a novel approach that is also formulated by optimal control, but can also be updated in real time. It incorporates a new integrated visual-vestibular perception model that includes both visual and vestibular sensation and the interaction between the stimuli. A time-varying control law requires the matrix Riccati equation to be solved in real time by a neurocomputing approach. Preliminary pilot testing resulted in the optimal algorithm incorporating a new otolith model, producing improved motion cues. The nonlinear algorithm vertical mode produced a motion cue with a time-varying washout, sustaining small cues for longer durations and washing out large cues more quickly compared to the optimal algorithm. The inclusion of the integrated perception model improved the responses to longitudinal and lateral cues. False cues observed with the NASA adaptive algorithm were absent. As a result of unsatisfactory sensation, an augmented turbulence cue was added to the vertical mode for both the optimal and nonlinear algorithms. The relative effectiveness of the algorithms, in simulating aircraft maneuvers, was assessed with an eleven-subject piloted performance test conducted on the NASA Langley Visual Motion Simulator (VMS). Two methods, the quasi-objective NASA Task Load Index (TLX), and power spectral density analysis of pilot control, were used to assess pilot workload. TLX analysis reveals, in most cases, less workload and variation among pilots with the nonlinear algorithm. Control input analysis shows pilot-induced oscillations on a straight-in approach are less prevalent compared to the optimal algorithm. The augmented turbulence cues increased workload on an offset approach that the pilots deemed more realistic compared to the NASA adaptive algorithm. The takeoff with engine failure showed the least roll activity for the nonlinear algorithm, with the least rudder pedal activity for the optimal algorithm.

Probing the Initial Mass Function in Extended Ultraviolet (XUV) Disks

NASA Astrophysics Data System (ADS)

Koda, Jin

2013-01-01

"The GALEX UV satellite discovered tantalizing evidence of star formation (SF) far beyond the optical edge of galactic disks (i.e. extended UV disk, or XUV disk). This discovery provides a new opportunity for studying SF in the exceedingly low-density environment (˜1/10 of typical SF density), spurring intense debate on the universality of the initial mass function (IMF) in such exceptional environments. Our pilot S-Cam study of M83’s XUV disk led to support for the universal IMF at least in M83 (Koda et al. 2012). We propose an expansion of the pilot study by about an order of magnitude, by observing 6 XUV disks in NA656(Hα), B, I, and R-band with S-Cam in S13B. In conjunction with GALEX UV bands, these images will reveal the presence of O stars (Hα) and O&B stars (UV) in stellar clusters -thus, constraining the high-mass end of the IMF. These multi-broadband images will enable us to determine the masses of the clusters with much improved accuracy (previously, relied only on R). The proposed observations will not only increase the statistical significance of our previous result, but also enable us to analyze the stochastic effect of IMF sampling in very low-mass - clusters (10^{2+3} M_sun) - the regime of ongoing debate. Previously allocated 1+2 nights were cancelled (telescope failures)."

Computer-aided personal interviewing. A new technique for data collection in epidemiologic surveys.

PubMed

Birkett, N J

1988-03-01

Most epidemiologic studies involve the collection of data directly from selected respondents. Traditionally, interviewers are provided with the interview in booklet form on paper and answers are recorded therein. On receipt at the study office, the interview results are coded, transcribed, and keypunched for analysis. The author's team has developed a method of personal interviewing which uses a structured interview stored on a lap-sized computer. Responses are entered into the computer and are subject to immediate error-checking and correction. All skip-patterns are automatic. Data entry to the final data-base involves no manual data transcription. A pilot evaluation with a preliminary version of the system using tape-recorded interviews in a test/re-test methodology revealed a slightly higher error rate, probably related to weaknesses in the pilot system and the training process. Computer interviews tended to be longer but other features of the interview process were not affected by computer. The author's team has now completed 2,505 interviews using this system in a community-based blood pressure survey. It has been well accepted by both interviewers and respondents. Failure to complete an interview on the computer was uncommon (5 per cent) and well-handled by paper back-up questionnaires. The results show that computer-aided personal interviewing in the home is feasible but that further evaluation is needed to establish the impact of this methodology on overall data quality.

Assessment of melamine and cyanuric acid toxicity in cats.

PubMed

Puschner, Birgit; Poppenga, Robert H; Lowenstine, Linda J; Filigenzi, Michael S; Pesavento, Patricia A

2007-11-01

The major pet food recall associated with acute renal failure in dogs and cats focused initially on melamine as the suspect toxicant. In the course of the investigation, cyanuric acid was identified in addition to melamine in the offending food. The purpose of this study was to characterize the toxicity potential of melamine, cyanuric acid, and a combination of melamine and cyanuric acid in cats. In this pilot study, melamine was added to the diet of 2 cats at 0.5% and 1%, respectively. Cyanuric acid was added to the diet of 1 cat at increasing doses of 0.2%, 0.5%, and 1% over the course of 10 days. Melamine and cyanuric acid were administered together at 0%, 0.2%, 0.5%, and 1% to 1 cat per dose group. No effect on renal function was observed in cats fed with melamine or cyanuric acid alone. Cats dosed with a combination were euthanized at 48 hours after dosing because of acute renal failure. Urine and touch impressions of kidneys from all cats dosed with the combination revealed the presence of fan-shaped, birefringent crystals. Histopathologic findings were limited to the kidneys and included crystals primarily within tubules of the distal nephron, severe renal interstitial edema, and hemorrhage at the corticomedullary junction. The kidneys contained estimated melamine concentrations of 496 to 734 mg/kg wet weight and estimated cyanuric acid concentrations of 487 to 690 mg/kg wet weight. The results demonstrate that the combination of melamine and cyanuric acid is responsible for acute renal failure in cats.

Intraosseous Vascular Access through the Anterior Mandible – A Cadaver Model Pilot Study

PubMed Central

Goldschalt, Christin; Doll, Sara; Ihle, Brit; Kirsch, Joachim; Mutzbauer, Till Sebastian

2014-01-01

Background Several insertion sites have been described for intraosseous puncture in cases of emergencies when a conventional vascular access cannot be established. This pilot study has been designed to evaluate the feasibility of the mandibular bone for the use of an intraosseous vascular access in a cadaver model. Methodology/Principal Findings 17 dentistry and 16 medical students participating in a voluntary course received a short introduction into the method and subsequently used the battery powered EZ-IO system with a 15 mm cannula for a puncture of the anterior mandible in 33 cadavers. The time needed to perform each procedure was evaluated. India ink was injected into the accesses and during the anatomy course cadavers were dissected to retrace the success or failure of the puncture. Dental students needed 25.5±18.9(mean±standard deviation)s and medical students 33±20.4 s for the procedure (p = 0.18). Floor of mouth extravasation occurred in both groups in 3 cases. Success rates were 82 and 75% (p = 0.93). Conclusions/Significance Despite floor of mouth extravasation of injected fluid into a mandibular intraosseous access might severely complicate this procedure, the anterior mandible may be helpful as an alternative to other intraosseous and intravenous insertion sites when these are not available in medical emergencies. PMID:25405476

Randomised controlled pilot study to investigate the effectiveness of thoracic epidural and paravertebral blockade in reducing chronic post-thoracotomy pain: TOPIC feasibility study protocol.

PubMed

Yeung, Joyce; Melody, Teresa; Kerr, Amy; Naidu, Babu; Middleton, Lee; Tryposkiadis, Kostas; Daniels, Jane; Gao, Fang

2016-12-01

Open chest surgery (thoracotomy) is considered the most painful of surgical procedures. Forceful wound retraction, costochondral dislocation, posterior costovertebral ligament disruption, intercostal nerve trauma and wound movement during respiration combine to produce an acute, severe postoperative pain insult and persistent chronic pain many months after surgery is common. Three recent systematic reviews conclude that unilateral continuous paravertebral blockade (PVB) provides analgesia at least equivalent to thoracic epidural blockade (TEB) in the postoperative period, has a lower failure rate, and symptom relief that lasted months. Crucially, PVB may reduce the development of subsequent chronic pain by intercostal nerve protection or decreased nociceptive input. The overall aim is to determine in patients who undergo thoracotomy whether perioperative PVB results in reducing chronic post-thoracotomy pain (CPTP) compared with TEB. This pilot study will evaluate feasibility of a substantive trial. TOPIC is a randomised controlled trial comparing the effectiveness of TEB and PVB in reducing CPTP. This is a pilot study to evaluate feasibility of a substantive trial and study processes in 2 adult thoracic centres, Heart of England NHS Foundation Trust (HEFT) and University Hospital of South Manchester NHS Foundation Trust (UHSM). The primary objective is to establish the number of patients randomised as a proportion of those eligible. Secondary objectives include evaluation of study processes. Analyses of feasibility and patient-reported outcomes will primarily take the form of simple descriptive statistics and where appropriate, point estimates of effects sizes and associated 95% CIs. The study has obtained ethical approval from NHS Research Ethics Committee (REC number 14/EM/1280). Dissemination plan includes: informing patients and health professionals; engaging multidisciplinary professionals to support a proposal of a definitive trial and submission for a full HTA application dependent on the success of the study. ISRCTN45041624; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

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

PubMed

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

2017-03-01

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

A maintenance three-day-per-week schedule with the single tablet regimen efavirenz/emtricitabine/tenofovir disoproxil fumarate is effective and decreases sub-clinical toxicity: the A-TRI-WEEK pilot trial.

PubMed

Rojas, Jhon; Blanco, Jose L; Sanchez-Palomino, Sonsoles; Marcos, Maria A; Guardo, Alberto C; Gonzalez-Cordon, Ana; Lonca, Montserrat; Tricas, Amparo; Rodriguez, Ana; Romero, Anabel; Miro, Jose M; Mallolas, Josep; Gatell, Jose M; Plana, Montserrat; Martinez, Esteban

2018-05-09

Antiretroviral drugs contained in single tablet Atripla® have pharmacokinetic properties that could allow for longer than once-daily (OD) dosing. We hypothesized that simplifying Atripla® OD to 3-day per week would be feasible, able to maintain viral suppression and less toxic. Virologically suppressed (≥2 years) HIV+ adults on Atripla® OD, CD4 >350/mm at inclusion, and no prior documented virological failure or evidence of resistance mutations to efavirenz, tenofovir, or emtricitabine were randomized to maintain their OD regimen or to reduce it to 3 days (Mondays, Wednesdays, and Fridays) a week (3W). Primary end-point was the proportion of patients free of treatment failure (non-completer = failure) at 24 weeks. CD4 and CD8 cells, ultrasensitive HIV-1 RNA, Pittsburg Sleep Quality Index (PSQI), bone mineral density, plasma efavirenz levels, and fasting blood and urine chemistries were measured at baseline and 24 weeks. The study is registered at ClinicalTrials.gov, NCT01778413. Sixty-one patients were randomized. All patients in both arms remained free of treatment failure (estimated difference 0%; 95% confidence interval -14.1 to 14.1). Ultrasensitive plasma HIV-1 RNA below detection threshold showed no difference between arms (70% in the 3W arm vs. 71% in the OD arm, P = 0.933) at 24 weeks. Total cholesterol and femur T-score significantly increased, while PSQI, plasma efavirenz, albumin/creatinine and beta-2-microglobulin in urine significantly decreased in the 3W arm relative to OD arm. The A-TRI-WEEK study represents a proof of concept for the feasibility of three-day per week Atripla® maintenance that should be further confirmed in a larger, well-powered clinical trial.

Software Considerations for Subscale Flight Testing of Experimental Control Laws

NASA Technical Reports Server (NTRS)

Murch, Austin M.; Cox, David E.; Cunningham, Kevin

2009-01-01

The NASA AirSTAR system has been designed to address the challenges associated with safe and efficient subscale flight testing of research control laws in adverse flight conditions. In this paper, software elements of this system are described, with an emphasis on components which allow for rapid prototyping and deployment of aircraft control laws. Through model-based design and automatic coding a common code-base is used for desktop analysis, piloted simulation and real-time flight control. The flight control system provides the ability to rapidly integrate and test multiple research control laws and to emulate component or sensor failures. Integrated integrity monitoring systems provide aircraft structural load protection, isolate the system from control algorithm failures, and monitor the health of telemetry streams. Finally, issues associated with software configuration management and code modularity are briefly discussed.

Research pilot and former astronaut Gordon Fullerton is congratulated by retired astronaut Fred Haise upon Fullerton's induction into the Astronaut Hall of Fame

NASA Image and Video Library

2005-04-30

Former astronaut Gordon Fullerton (left), currently chief research pilot at NASA's Dryden Flight Research Center at Edwards Air Force Base, is congratulated by former astronaut Fred Haise (right) upon Fullerton's induction into the Astronaut Hall of Fame at the Kennedy Space Center (KSC) in Florida on April 30, 2005. Fullerton and Haise were one of two flight crews who flew the Approach and Landing Tests of the prototype Space Shuttle orbiter Enterprise at Dryden in 1977. Fullerton, who had served on the support crews for four Apollo moon landing missions in the early 1970s, went on to fly two Shuttle missions, STS-3 in 1982 and STS-51F in 1985. STS-3 became the only Shuttle mission to date to land at White Sands, N.M., and STS-51F was completed successfully despite the failure of one of the Shuttle's main engines during ascent to orbit. Haise, a member of the crew on the ill-fated Apollo 13 mission, was also a research pilot at NASA Dryden during his pre-astronaut career. Former astronauts Joseph Allen and Bruce McCandless were also inducted during the 2005 ceremonies at the KSC Visitor Center. In addition to honoring former members of NASA's astronaut corps who have made significant contributions to the advancement of space flight, the annual induction ceremonies serve as a fund-raiser for the Astronaut Scholarship Foundation. The foundation funded 17 $10,000 scholarships to college students studying science and engineering in 2004.

A tutorial on pilot studies: the what, why and how

PubMed Central

2010-01-01

Pilot studies for phase III trials - which are comparative randomized trials designed to provide preliminary evidence on the clinical efficacy of a drug or intervention - are routinely performed in many clinical areas. Also commonly know as "feasibility" or "vanguard" studies, they are designed to assess the safety of treatment or interventions; to assess recruitment potential; to assess the feasibility of international collaboration or coordination for multicentre trials; to increase clinical experience with the study medication or intervention for the phase III trials. They are the best way to assess feasibility of a large, expensive full-scale study, and in fact are an almost essential pre-requisite. Conducting a pilot prior to the main study can enhance the likelihood of success of the main study and potentially help to avoid doomed main studies. The objective of this paper is to provide a detailed examination of the key aspects of pilot studies for phase III trials including: 1) the general reasons for conducting a pilot study; 2) the relationships between pilot studies, proof-of-concept studies, and adaptive designs; 3) the challenges of and misconceptions about pilot studies; 4) the criteria for evaluating the success of a pilot study; 5) frequently asked questions about pilot studies; 7) some ethical aspects related to pilot studies; and 8) some suggestions on how to report the results of pilot investigations using the CONSORT format. PMID:20053272

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.

Gemini Simulator and Neil Armstrong

NASA Image and Video Library

1963-11-06

Astronaut Neil Armstrong (left) was one of 14 astronauts, 8 NASA test pilots, and 2 McDonnell test pilots who took part in simulator studies. Armstrong was the first astronaut to participate (November 6, 1963). A.W. Vogeley described the simulator in his paper "Discussion of Existing and Planned Simulators For Space Research," "Many of the astronauts have flown this simulator in support of the Gemini studies and they, without exception, appreciated the realism of the visual scene. The simulator has also been used in the development of pilot techniques to handle certain jet malfunctions in order that aborts could be avoided. In these situations large attitude changes are sometimes necessary and the false motion cues that were generated due to earth gravity were somewhat objectionable; however, the pilots were readily able to overlook these false motion cues in favor of the visual realism." Roy F. Brissenden, noted in his paper "Initial Operations with Langley's Rendezvous Docking Facility," "The basic Gemini control studies developed the necessary techniques and demonstrated the ability of human pilots to perform final space docking with the specified Gemini-Agena systems using only visual references. ... Results... showed that trained astronauts can effect the docking with direct acceleration control and even with jet malfunctions as long as good visual conditions exist.... Probably more important than data results was the early confidence that the astronauts themselves gained in their ability to perform the maneuver in the ultimate flight mission." Francis B. Smith, noted in his paper "Simulators for Manned Space Research," "Some major areas of interest in these flights were fuel requirements, docking accuracies, the development of visual aids to assist alignment of the vehicles, and investigation of alternate control techniques with partial failure modes. However, the familiarization and confidence developed by the astronaut through flying and safely docking the simulator during these tests was one of the major contributions. For example, it was found that fuel used in docking from 200 feet typically dropped from about 20 pounds to 7 pounds after an astronaut had made a few training flights." -- Published in Barton C. Hacker and James M. Grimwood, On the Shoulders of Titans: A History of Project Gemini, NASA SP-4203; A.W. Vogeley, "Discussion of Existing and Planned Simulators For Space Research," Paper presented at the Conference on the Role of Simulation in Space Technology, August 17-21, 1964; Roy F. Brissenden, "Initial Operations with Langley's Rendezvous Docking Facility," Langley Working Paper, LWP-21, 1964; Francis B. Smith, "Simulators for Manned Space Research," Paper presented at the 1966 IEEE International convention, March 21-25, 1966.

Impact of a novel online learning module on specialist palliative care nurses' pain assessment competencies and patients' reports of pain: Results from a quasi-experimental pilot study.

PubMed

Phillips, Jane L; Heneka, Nicole; Hickman, Louise; Lam, Lawrence; Shaw, Tim

2014-06-01

Pain is a complex multidimensional phenomenon moderated by consumer, provider and health system factors. Effective pain management cuts across professional boundaries, with failure to screen and assess contributing to the burden of unrelieved pain. To test the impact of an online pain assessment learning module on specialist palliative care nurses' pain assessment competencies, and to determine whether this education impacted positively on palliative care patients' reported pain ratings. A quasi-experimental pain assessment education pilot study utilising 'Qstream © ', an online methodology to deliver 11 case-based pain assessment learning scenarios, developed by an interdisciplinary expert panel and delivered to participants' work emails over a 28-day period in mid-2012. The 'Self-Perceived Pain Assessment Competencies' survey and chart audit data, including patient-reported pain intensity ratings, were collected pre-intervention (T1) and post-intervention (T2) and analysed using inferential statistics to determine key outcomes. Nurses working at two Australian inpatient specialist palliative care services in 2012. The results reported conform to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Guidelines. Participants who completed the education intervention ( n = 34) increased their pain assessment knowledge, assessment tool knowledge and confidence to undertake a pain assessment ( p < 0.001). Participants were more likely to document pain intensity scores in patients' medical records than non-participants (95% confidence interval = 7.3%-22.7%, p = 0.021). There was also a significant reduction in the mean patient-reported pain ratings between the admission and audit date at post-test of 1.5 (95% confidence interval = 0.7-2.3) units in pain score. This pilot confers confidence of the education interventions capacity to improve specialist palliative care nurses' pain assessment practices and to reduce patient-rated pain intensity scores.

Ultrawideband Electromagnetic Interference to Aircraft Radios: Results of Limited Functional Testing With United Airlines and Eagles Wings Incorporated, in Victorville, California

NASA Technical Reports Server (NTRS)

Ely, Jay J.; Shaver, Timothy W.; Fuller, Gerald L.

2002-01-01

On February 14, 2002, the FCC adopted a FIRST REPORT AND ORDER, released it on April 22, 2002, and on May 16, 2002 published in the Federal Register a Final Rule, permitting marketing and operation of new products incorporating UWB technology. Wireless product developers are working to rapidly bring this versatile, powerful and expectedly inexpensive technology into numerous consumer wireless devices. Past studies addressing the potential for passenger-carried portable electronic devices (PEDs) to interfere with aircraft electronic systems suggest that UWB transmitters may pose a significant threat to aircraft communication and navigation radio receivers. NASA, United Airlines and Eagles Wings Incorporated have performed preliminary testing that clearly shows the potential for handheld UWB transmitters to cause cockpit failure indications for the air traffic control radio beacon system (ATCRBS), blanking of aircraft on the traffic alert and collision avoidance system (TCAS) displays, and cause erratic motion and failure of instrument landing system (ILS) localizer and glideslope pointers on the pilot horizontal situation and attitude director displays. This report provides details of the preliminary testing and recommends further assessment of aircraft systems for susceptibility to UWB electromagnetic interference.

Electroencephalogram oscillations support the involvement of task-unrelated thoughts in the mechanism of boredom: A pilot study.

PubMed

Miyauchi, Eri; Kawasaki, Masahiro

2018-06-11

Boredom is a universal experience; however, the neural mechanisms underlying the phenomenon remain unclear. Previous research suggests that boredom is related to attentional failure and derives a possible explanation for the cognitive processes of boredom as a product of appraisals made about task-unrelated thoughts. There are little published data regarding proposed processes from neuroscientific perspectives. Therefore, the authors aimed to examine whether cognitive processes of boredom with task-unrelated thoughts followed by appraisals of them can be explained by examining oscillatory correlates. Electroencephalography was used to measure changes in neural oscillatory activity during subjective experiences of boredom or dislike in healthy subjects. Using this approach, temporal information of brain activity particular to the boredom experience was acquired. Additionally, the Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale was used to evaluate the effects of attentional deficits in the neural processing of boredom. Tonic increase in theta and transient increases in alpha activity were exhibited before the key press response for experiencing boredom; however, only tonic increases in theta amplitudes were boredom specific. The results of this pilot study suggest that the boredom experience is possibly associated with cognitive processes involved in task-unrelated thoughts, followed by their appraisals to be bored, mediated by alpha and theta activity. Copyright © 2018 Elsevier B.V. All rights reserved.

Sacubitril/valsartan and short-term changes in the 6-minute walk test: A pilot study.

PubMed

Beltrán, Paola; Palau, Patricia; Domínguez, Eloy; Faraudo, Mercedes; Núñez, Eduardo; Guri, Olga; Mollar, Anna; Sanchis, Juan; Bayés-Genís, Antoni; Núñez, Julio

2018-02-01

Impaired exercise capacity is the most disabling symptom in patients with heart failure with reduced ejection fraction (HFrEF). Despite sacubitril/valsartan showing reduced long-term morbidity and mortality over enalapril in HFrEF, its effects on short-term functional capacity remain uncertain. We sought to evaluate the effects of sacubitril/valsartan on a 30-day six-minute walk test in eligible patients with HFrEF. From November 1, 2016 to February 1, 2017, a total of 58 stable symptomatic patients with HFrEF were eligible for sacubitril/valsartan and underwent 6-MWT before and 30days after initiation of sacubitril/valsartan therapy. A mixed-effects model for repeated-measures was used to analyze the changes. Mean age was 70±11years. 72.4% males, 46.6% with ischemic heart disease, and 51.7% on NYHA functional class III were included. The mean (SD) values of baseline LVEF and 6MWT were 30±7%, and 300±89m, respectively. The median (IQR) of NT-proBNP at baseline was 2701pg/ml (1087-4200). Compared with baseline, the 6-MWT distance increased significantly at 30days by 13.9% (+∆=41.8m (33.4-50.2); p<0.001). In this pilot study, sacubitril/valsartan was associated with an improvement in exercise tolerance in symptomatic patients with HFrEF. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Combined systemic and intraventricular chemotherapy in primary CNS lymphoma: a pilot study

PubMed Central

Schlegel, U; Pels, H; Glasmacher, A; Kleinschmidt, R; Schmidt-Wolf, I; Helmstaedter, C; Fliessbach, K; Deckert, M; Van Roost, D; Fimmers, R; Bode, U; Klockgether, T

2001-01-01

The objective was to evaluate response rate, response duration, and toxicity after systemic and intraventricular chemotherapy in primary CNS lymphoma (PCNSL).
 From September 1995 to September 1998, 20 consecutive patients with PCNSL (median age 64, range 27 to 71 years) were enrolled in a pilot study evaluating chemotherapy without radiotherapy. A high dose methotrexate (MTX) (cycles 1, 2, 4, 5) and cytarabine (ara-C) (cycles 3, 6) based systemic therapy (including dexamethasone, vinca alkaloids, ifosfamide, and cyclophosphamide) was combined with intraventricular MTX, prednisolone, and ara-C.
 Complete response was achieved in 11 and partial remission in two patients; in one response could not be determined. Four patients showed progressive disease and two (70, 71 years) died from treatment related complications. Observation time was 2 to 59 months (median 31.5 months). Kaplan-Meier estimate for median time to treatment failure (TTF) was 20.5 months, and for median survival 54 months. Systemic toxicity was mainly hematological. Ommaya reservoir infection occurred in four patients and acute transient MTX induced encephalopathy in two (subacute in another). Cognitive dysfunction possibly due to treatment was seen in only one patient after relapse and after a total of 12 cycles (six at relapse).
 In conclusion, primary chemotherapy based on high dose MTX and ara-C is highly efficient in PCNSL. Toxicity is manageable in patients younger than 70years.

 PMID:11413277

Regaining Lost Separation in a Piloted Simulation of Autonomous Aircraft Operations

NASA Technical Reports Server (NTRS)

Barhydt, Richard; Eischeid, Todd M.; Palmer, Michael T.; Wing, David J.

2002-01-01

NASA is currently investigating a new concept of operations for the National Airspace System, designed to improve capacity while maintaining or improving current levels of safety. This concept, known as Distributed Air/Ground Traffic Management (DAG-TM), allows appropriately equipped autonomous aircraft to maneuver freely for flight optimization while resolving conflicts with other traffic and staying out of special use airspace and hazardous weather. While Airborne Separation Assurance System (ASAS) tools would normally allow pilots to resolve conflicts before they become hazardous, evaluation of system performance in sudden, near-term conflicts is needed in order to determine concept feasibility. If an acceptable safety level can be demonstrated in these situations, then operations may be conducted with lower separation minimums. An experiment was conducted in NASA Langley s Air Traffic Operations Lab to address issues associated with resolving near-term conflicts and the potential use of lower separation minimums. Sixteen commercial airline pilots flew a total of 32 traffic scenarios that required them to use prototype ASAS tools to resolve close range pop-up conflicts. Required separation standards were set at either 3 or 5 NM lateral spacing, with 1000 ft vertical separation being used for both cases. Reducing the lateral separation from 5 to 3 NM did not appear to increase operational risk, as indicated by the proximity to the intruder aircraft. Pilots performed better when they followed tactical guidance cues provided by ASAS than when they didn't follow the guidance. As air-air separation concepts are evolved, further studies will consider integration issues between ASAS and existing Airborne Collision Avoidance Systems (ACAS).These types of non-normal events will require the ASAS to provide effective alerts and resolutions prior to the time that an Airborne Collision Avoidance System (ACAS) would give a Resolution Advisory (RA). When an RA is issued, a pilot must take immediate action in order to avoid a potential near miss. The Traffic Alert and Collision Avoidance System (TCAS) II currently functions as an ACAS aboard commercial aircraft. Depending on the own aircraft s altitude, TCAS only issues RA s 15-35 seconds prior to the Closest Point of Approach (CPA). Prior to an RA, DAG-TM pilots operating autonomous aircraft must rely solely on ASAS for resolution guidance. An additional area of DAG-TM concept feasibility relates to a potential reduction in separation standards. Lower separation standards are likely needed in order to improve NAS efficiency and capacity. Current separation minimums are based in large part on the capabilities of older radar systems. Safety assessments are needed to determine the feasibility of reduced separation minimums. They will give strong consideration to surveillance system performance, including accuracy, integrity, and availability. Candidate surveillance systems include Automatic Dependent Surveillance-Broadcast (ADS-B) and multi-lateration systems. Considering studies done for Reduced Vertical Separation Minimums (RVSM) operations, it is likely that flight technical errors will also be considered. In addition to a thorough evaluation of surveillance system performance, a potential decision to lower the separation standards should also take operational considerations into account. An ASAS Safety Assessment study identified improper maneuvering in response to a conflict (due to ambiguous or improper resolution commands or a pilot s failure to comply with the resolution) as a potential safety risk. If near-term conflicts with lower separation minimums were determined to be more challenging for pilots, the severity of these risks could be even greater.

ACTG A5353: A Pilot Study of Dolutegravir Plus Lamivudine for Initial Treatment of Human Immunodeficiency Virus-1 (HIV-1)-infected Participants With HIV-1 RNA <500000 Copies/mL.

PubMed

Taiwo, Babafemi O; Zheng, Lu; Stefanescu, Andrei; Nyaku, Amesika; Bezins, Baiba; Wallis, Carole L; Godfrey, Catherine; Sax, Paul E; Acosta, Edward; Haas, David; Smith, Kimberly Y; Sha, Beverly; Van Dam, Cornelius; Gulick, Roy M

2018-05-17

Limited data exist on initial human immunodeficiency virus type 1 (HIV-1) treatment with dolutegravir plus lamivudine. A5353 is a phase 2, single-arm, pilot study of once-daily dolutegravir (50 mg) plus lamivudine (300 mg) in treatment-naive participants with HIV-1 RNA ≥1000 and <500000 copies/mL. Exclusion criteria included active hepatitis B or major protease, reverse transcriptase, or integrase resistance. The primary efficacy measure was the proportion with HIV-1 RNA <50 copies/mL (FDA [US Food and Drug Administration] Snapshot) at week 24. Virologic failure (VF) was confirmed HIV-1 RNA >400 copies/mL at week 16/20 or >200 copies/mL at or after week 24. Dolutegravir levels and drug resistance testing were performed at VF. One hundred and twenty participants (87% male, median age 30 years, 37 (31%) HIV-1 RNA >100000 copies/mL) initiated study treatment. Median entry HIV-1 RNA and CD4 count were 4.61 log10 copies/mL and 387 cells/mm3. Virologic efficacy at week 24 was 108/120 (90%, confidence interval [83%, 95%]), with comparable results in the >100000 copies/mL and ≤100000 copies/mL strata, that is, 89% (75%, 97%) and 90% (82%, 96%), respectively. Three participants with VF, had undetected plasma dolutegravir at ≥1 time points; the M184V and R263R/K mutations developed in 1 participant. Two participants experienced grade 3 possible/probable treatment-related adverse events; none discontinued treatment due to adverse events. Dolutegravir plus lamivudine demonstrated efficacy in individuals with pretreatment HIV-1 RNA up to 500000 copies/mL in this pilot trial, but a participant developed resistance mutations. NCT02582684.

Leading teams during simulated pediatric emergencies: a pilot study

PubMed Central

Coolen, Ester H; Draaisma, Jos M; den Hamer, Sabien; Loeffen, Jan L

2015-01-01

Purpose Leadership has been identified as a key variable for the functioning of teams and as one of the main reasons for success or failure of team-based work systems. Pediatricians often function as team leaders in the resuscitation of a critically ill child. However, pediatric residents often report having little opportunity to perform in the role of team leader during residency. In order to gain more insight into leadership skills and behaviors, we classified leadership styles of pediatric residents during simulated emergencies. Methods We conducted a prospective quantitative study to investigate leadership styles used by pediatric residents during simulated emergencies with clinical deterioration of a child at a pediatric ward. Using videotaped scenarios of 48 simulated critical events among 12 residents, we were able to classify verbal and nonverbal communication into different leadership styles according to the situational leadership theory. Results The coaching style (mean 54.5%, SD 7.8) is the most frequently applied by residents, followed by the directing style (mean 35.6%, SD 4.1). This pattern conforms to the task- and role-related requirements in our scenarios and it also conforms to the concept of situational leadership. We did not find any significant differences in leadership style according to the postgraduate year or scenario content. Conclusion The model used in this pilot study helps us to gain a better understanding of the development of effective leadership behavior and supports the applicability of situational leadership theory in training leadership skills during residency. PMID:25610010

Action-specific effects in aviation: what determines judged runway size?

PubMed

Gray, Rob; Navia, José Antonio; Allsop, Jonathan

2014-01-01

Several recent studies have shown that the performance of a skill that involves acting on a goal object can influence one's judgment of the size of that object. The present study investigated this effect in an aviation context. Novice pilots were asked to perform a series of visual approach and landing manoeuvres in a flight simulator. After each landing, participants next performed a task in which runway size was judged for different simulated altitudes. Gaze behaviour and control stick kinematics were also analyzed. There were significant relationships between judged runway size and multiple action-related variables including touchdown velocity, time fixating the runway, and the magnitude and frequency of control inputs. These findings suggest that relationship between the perception of a target object and action is not solely determined by performance success or failure but rather involves a relationship between multiple variables that reflect the actor's ability.

Evaluation of Silicone as an Artificial Lubricant in Osteoarthrotic Joints

PubMed Central

Wright, V.; Haslock, D. I.; Dowson, D.; Seller, P. C.; Reeves, B.

1971-01-01

Silicone 300 has been evaluated as an artificial lubricant in osteoarthrotic joints by means of a pilot study in five inpatients and a control trial of 25 outpatients with 40 osteoarthrotic knees. Sequential analysis showed a significant benefit from saline compared with silicone at one week follow-up and no significant difference at one month. Measurement of stiffness with a knee arthrograph showed no difference in reduction of stiffness between the two substances. In a study of 18 rabbits there was no evidence that silicone was retained in the joint cavity for longer than 48 hours. There was a failure of clearance of iodinated serum albumin for as long as three to four days after the injection of silicone, suggesting some obstruction to lymphatic outflow. Experimentally produced cartilaginous defects did not heal quicker with the injection of silicone into the joint. PMID:5575973

Why undertake a pilot in a qualitative PhD study? Lessons learned to promote success.

PubMed

Wray, Jane; Archibong, Uduak; Walton, Sean

2017-01-23

Background Pilot studies can play an important role in qualitative studies. Methodological and practical issues can be shaped and refined by undertaking pilots. Personal development and researchers' competence are enhanced and lessons learned can inform the development and quality of the main study. However, pilot studies are rarely published, despite their potential to improve knowledge and understanding of the research. Aim To present the main lessons learned from undertaking a pilot in a qualitative PhD study. Discussion This paper draws together lessons learned when undertaking a pilot as part of a qualitative research project. Important methodological and practical issues identified during the pilot study are discussed including access, recruitment, data collection and the personal development of the researcher. The resulting changes to the final study are also highlighted. Conclusion Sharing experiences of and lessons learned in a pilot study enhances personal development, improves researchers' confidence and competence, and contributes to the understanding of research. Implications for practice Pilots can be used effectively in qualitative studies to refine the final design, and provide the researcher with practical experience to enhance confidence and competence.

European Cardiomyopathy Pilot Registry: EURObservational Research Programme of the European Society of Cardiology.

PubMed

Elliott, Perry; Charron, Philippe; Blanes, Juan Ramon Gimeno; Tavazzi, Luigi; Tendera, Michal; Konté, Marème; Laroche, Cécile; Maggioni, Aldo P

2016-01-07

Cardiomyopathies are a heterogeneous group of disorders associated with premature death due to ventricular arrhythmia or heart failure. The purpose of this study was to examine the characteristics of patients enrolled in the pilot phase of the EURObservational Research Programme (EORP) cardiomyopathy registry. Between 1 December 2012 and 30 November 2013, four cardiomyopathy phenotypes were studied: hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), arrhythmogenic right ventricular cardiomyopathy (ARVC), and restrictive cardiomyopathy (RCM). Twenty-seven centres in 12 countries participated; 1115 patients were enrolled. The commonest cardiomyopathy was HCM (n = 681), followed by DCM (n = 346), ARVC (n = 59), and RCM (n = 29); 423 patients (46.4% of those reported) had familial disease; and 56 (5.0%) had rare disease phenocopies. Median age at enrolment and diagnosis was 54 [interquartile range (IQR), 42-64] and 46 years (IQR, 32-58), respectively; fewer patients with ARVC and more with RCM were diagnosed in the upper age quartile (P < 0.0001). There was a male predominance for all cardiomyopathies except RCM (P = 0.0023). Most patients were in New York Heart Association functional class I (n = 813) at enrolment; 139 (12.5%) reported syncope, most frequently in ARVC (P = 0.0009). Five hundred and seven (45.5%) patients underwent cardiac magnetic resonance imaging, 117 (10.6%) endomyocardial biopsy, and 462 (41.4%) genetic testing with a causative mutation reported in 236 individuals (51.1%). 1026 patients (92.0%) were receiving drug therapy; 316 (28.3%) had received an implantable cardioverter defibrillator (highest proportion in ARVC, P < 0.0001). This pilot study shows that services for patients with cardiomyopathy are complex, requiring access to a large range of invasive and non-invasive investigations and involvement of multidisciplinary teams. Treatment regimens are equally multifaceted and show that patients are likely to need long-term follow-up in close liaison with expert centres. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: Journals.permissions@oup.com.

How Miniature/Microminiature (2M) Repair Capabilities Can Reduce the Impact of No Evidence of Failure (NEOF) Among Repairables on the Navy’s Operations and Maintenance Account

DTIC Science & Technology

1988-06-01

and PCBs. The pilot program involved screening, testing , and repairing of EMs/PCBs for both COMNAVSEASYSCOM and Commander, Naval Electronic Systems...were chosen from the Support and Test Equipment Engineering Program (STEEP) tests rformed by"IMA San Diego duringl987. A statistical analysis and a Level...were chosen from the Support and Test Equipment Engineering Program (STEEP) tests performed by SIMA San Diego during 1987. A statistical analysis and a

Benefits assessment of active control technology and related cockpit technology for rotorcraft

NASA Technical Reports Server (NTRS)

Hampton, B. J.

1982-01-01

Two main-rotor active control concepts, one incorporating multicyclic actuators located just below the swashplate, and the other providing for the actuators and power supplies to be located in the rotating frame are considered. Each design concept is integrated with cockpit controllers and displays appropriate to the actuation concept in each case. The benefits of applying the defined ACT/RCT concepts to rotorcraft are quantified by comparison to the baseline model 412 helicopter. These benefits include, in the case of one active control concept; (1) up to 91% reduction in 4/rev hub shears; (2) a flight safety failure rate of 1.96 x 10 to the 8th power failures per flight-hour; (3) rotating controls/rotor hub drag reduction of 40%; (4) a 9% reduction in control system weight; and (5) vibratory deicing. The related cockpit concept reduces pilot workload for critical mission segments as much as 178% visual and 25% manual.

New early warning system for gravity-driven ruptures based on codetection of acoustic signal

NASA Astrophysics Data System (ADS)

Faillettaz, J.

2016-12-01

Gravity-driven rupture phenomena in natural media - e.g. landslide, rockfalls, snow or ice avalanches - represent an important class of natural hazards in mountainous regions. To protect the population against such events, a timely evacuation often constitutes the only effective way to secure the potentially endangered area. However, reliable prediction of imminence of such failure events remains challenging due to the nonlinear and complex nature of geological material failure hampered by inherent heterogeneity, unknown initial mechanical state, and complex load application (rainfall, temperature, etc.). Here, a simple method for real-time early warning that considers both the heterogeneity of natural media and characteristics of acoustic emissions attenuation is proposed. This new method capitalizes on codetection of elastic waves emanating from microcracks by multiple and spatially separated sensors. Event-codetection is considered as surrogate for large event size with more frequent codetected events (i.e., detected concurrently on more than one sensor) marking imminence of catastrophic failure. Simple numerical model based on a Fiber Bundle Model considering signal attenuation and hypothetical arrays of sensors confirms the early warning potential of codetection principles. Results suggest that although statistical properties of attenuated signal amplitude could lead to misleading results, monitoring the emergence of large events announcing impeding failure is possible even with attenuated signals depending on sensor network geometry and detection threshold. Preliminary application of the proposed method to acoustic emissions during failure of snow samples has confirmed the potential use of codetection as indicator for imminent failure at lab scale. The applicability of such simple and cheap early warning system is now investigated at a larger scale (hillslope). First results of such a pilot field experiment are presented and analysed.

Emergency Flight Control of a Twin-Jet Commercial Aircraft using Manual Throttle Manipulation

NASA Technical Reports Server (NTRS)

Cole, Jennifer H.; Cogan, Bruce R.; Fullerton, C. Gordon; Burken, John J.; Venti, Michael W.; Burcham, Frank W.

2007-01-01

The Department of Homeland Security (DHS) created the PCAR (Propulsion-Controlled Aircraft Recovery) project in 2005 to mitigate the ManPADS (man-portable air defense systems) threat to the commercial aircraft fleet with near-term, low-cost proven technology. Such an attack could potentially cause a major FCS (flight control system) malfunction or other critical system failure onboard the aircraft, despite the extreme reliability of current systems. For the situations in which nominal flight controls are lost or degraded, engine thrust may be the only remaining means for emergency flight control [ref 1]. A computer-controlled thrust system, known as propulsion-controlled aircraft (PCA), was developed in the mid 1990s with NASA, McDonnell Douglas and Honeywell. PCA's major accomplishment was a demonstration of an automatic landing capability using only engine thrust [ref 11. Despite these promising results, no production aircraft have been equipped with a PCA system, due primarily to the modifications required for implementation. A minimally invasive option is TOC (throttles-only control), which uses the same control principles as PCA, but requires absolutely no hardware, software or other aircraft modifications. TOC is pure piloting technique, and has historically been utilized several times by flight crews, both military and civilian, in emergency situations stemming from a loss of conventional control. Since the 1990s, engineers at NASA Dryden Flight Research Center (DFRC) have studied TOC, in both simulation and flight, for emergency flight control with test pilots in numerous configurations. In general, it was shown that TOC was effective on certain aircraft for making a survivable landing. DHS sponsored both NASA Dryden Flight Research Center (Edwards, CA) and United Airlines (Denver, Colorado) to conduct a flight and simulation study of the TOC characteristics of a twin-jet commercial transport, and assess the ability of a crew to control an aircraft down to a survivable runway landing using TOC. The PCAR project objective was a set of pilot procedures for operation of a specific aircraft without hydraulics that (a) have been validated in both simulation and flight by relevant personnel, and (b) mesh well with existing commercial operations, maintenance, and training at a minimum cost. As a result of this study, a procedure has been developed to assist a crew in making a survivable landing using TOC. In a simulation environment, line pilots with little or no previous TOC experience performed survivable runway landings after a few practice TOC approaches. In-flight evaluations put line pilots in a simulated emergency situation where TOC was used to recover the aircraft, maneuver to a landing site, and perform an approach down to 200 feet AGL. The results of this research, including pilot observations, procedure comments, recommendations, future work and lessons learned, will he discussed. Flight data and video footage of TOC approaches may also be shown.

Modified Sainsbury tool: an initial risk assessment tool for primary care mental health and learning disability services.

PubMed

Stein, W

2005-10-01

Risk assessments by health and social care professionals must encompass risk of suicide, of harm to others, and of neglect. The UK's National Confidential Inquiry into Homicide and Suicide paints a picture of failure to predict suicides and homicides, failure to identify opportunities for prevention and a failure to manage these opportunities. Assessing risk at 'first contact' with the mental health service assumes a special place in this regard. The initial opportunity to be alerted to, and thus to influence, risk, usually falls to the general psychiatric service (as opposed to forensic specialists) or to a joint health and local authority community mental health team. The Mental Health and Learning Disabilities Directorate of Renfrewshire & Inverclyde Primary Care NHS Trust, Scotland, determined to standardize their approach to risk assessment and selected a modified version of the Sainsbury Risk Assessment Tool. A year-long pilot revealed general support for its service-wide introduction but also some misgivings to address, including: (i) rejection of the tool by some medical staff; (ii) concerns about limited training; and (iii) a perceived failure on the part of the management to properly resource its use. The tool has the potential to fit well with the computer-networked needs assessment system used in joint-working with partner local authorities to allocate care resources.

Impact of Corrections to the Spallings Volume Calculation on Waste Isolation Pilot Plant Performance Assessment

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

Kicker, Dwayne Curtis; Herrick, Courtney G; Zeitler, Todd

2015-11-01

The numerical code DRSPALL (from direct release spallings) is written to calculate the volume of Waste Isolation Pilot Plant solid waste subject to material failure and transport to the surface (i.e., spallings) as a result of a hypothetical future inadvertent drilling intrusion into the repository. An error in the implementation of the DRSPALL finite difference equations was discovered and documented in a software problem report in accordance with the quality assurance procedure for software requirements. This paper describes the corrections to DRSPALL and documents the impact of the new spallings data from the modified DRSPALL on previous performance assessment calculations.more » Updated performance assessments result in more simulations with spallings, which generally translates to an increase in spallings releases to the accessible environment. Total normalized radionuclide releases using the modified DRSPALL data were determined by forming the summation of releases across each potential release pathway, namely borehole cuttings and cavings releases, spallings releases, direct brine releases, and transport releases. Because spallings releases are not a major contributor to the total releases, the updated performance assessment calculations of overall mean complementary cumulative distribution functions for total releases are virtually unchanged. Therefore, the corrections to the spallings volume calculation did not impact Waste Isolation Pilot Plant performance assessment calculation results.« less

Novel hybrid technology for early diagnostics of sepsis

NASA Astrophysics Data System (ADS)

Saknite, Inga; Grabovskis, Andris; Kazune, Sigita; Rubins, Uldis; Marcinkevics, Zbignevs; Volceka, Karina; Kviesis-Kipge, Edgars; Spigulis, Janis

2017-02-01

Sepsis is a potentially fatal disease with mortality rate as high as 50% in patients with septic shock; mortality rate can increase by 7.6% per hour if appropriate treatment is not started. Internationally accepted guidelines for diagnosis of sepsis rely on vital sign monitoring and laboratory tests in order to recognize organ failure. This pilot study aims to explore the potential of hyperspectral and thermal imaging techniques to identify and quantify early alterations in skin oxygenation and perfusion induced by sepsis. The study comprises both physiological model experiments on healthy volunteers in a laboratory environment, as well as screening case series of patients with septic shock in the intensive care department. Hyperspectral imaging is used to determine one of the main characteristic visual signs of skin oxygenation abnormalities - skin mottling, whereas changes in peripheral perfusion have been visualized by thermal imaging as heterogeneous skin temperature areas. In order to mimic septic skin mottling in a reproducible way in laboratory environment, arterial occlusion provocation test was utilized on healthy volunteers. Visualization of oxygen saturation by hyperspectral imaging allows diagnosing microcirculatory alterations induced by sepsis earlier than visual assessment of mottling. Thermal images of sepsis patients in the clinic clearly reveal hotspots produced by perforating arteries, as well as cold regions of low blood supply. The results of this pilot study show that thermal imaging in combination with hyperspectral imaging allows the determination of oxygen supply and utilization in critically ill septic patients.

Rehabilitation of postrior atrophic edentulous jaws: prostheses supported by 5 mm short implants or by longer implants in augmented bone? One-year results from a pilot randomised clinical trial.

PubMed

Esposito, Marco; Pellegrino, Gerardo; Pistilli, Roberto; Felice, Pietro

2011-01-01

To evaluate whether 5 mm short dental implants could be an alternative to augmentation with anorganic bovine bone and placement of at least 10 mm long implants in posterior atrophic jaws. Fifteen patients with bilateral atrophic mandibles (5-7 mm bone height above the mandibular canal), and 15 patients with bilateral atrophic maxillae (4-6 mm bone height below the maxillary sinus) and bone thickness of at least 8 mm, were randomised according to a splitmouth design to receive one to three 5 mm short implants or at least 10 mm long implants in augmented bone. Mandibles were vertically augmented with interpositional bone blocks and maxillary sinuses with particulated bone via a lateral window. Implants were placed after 4 months, submerged and loaded, after 4 months, with provisional prostheses. Four months later, definitive provisionally cemented prostheses were delivered. Outcome measures were: prosthesis and implant failures, any complication and peri-implant marginal bone level changes. In 5 augmented mandibles, the planned 10 mm long implants could not be placed and shorter implants (7 and 8.5 mm) had to be used instead. One year after loading no patient dropped out. Two long (8.5 mm in the mandible and 13 mm in the maxilla) implants and one 5 mm short maxillary implant failed. There were no statistically significant differences in failures or complications. Patients with short implants lost on average 1 mm of peri-implant bone and patients with longer implants lost 1.2 mm. This difference was statistically significant. This pilot study suggests that 1 year after loading, 5 mm short implants achieve similar if not better results than longer implants placed in augmented bone. Short implants might be a preferable choice to bone augmentation since the treatment is faster, cheaper and associated with less morbidity, however their long-term prognosis is unknown.

A Top Pilot Tunnel Preconditioning Method for the Prevention of Extremely Intense Rockbursts in Deep Tunnels Excavated by TBMs

NASA Astrophysics Data System (ADS)

Zhang, Chuanqing; Feng, Xiating; Zhou, Hui; Qiu, Shili; Wu, Wenping

2012-05-01

The headrace tunnels at the Jinping II Hydropower Station cross the Jinping Mountain with a maximum overburden depth of 2,525 m, where 80% of the strata along the tunnels consist of marble. A number of extremely intense rockbursts occurred during the excavation of the auxiliary tunnels and the drainage tunnel. In particular, a tunnel boring machine (TBM) was destroyed by an extremely intense rockburst in a 7.2-m-diameter drainage tunnel. Two of the four subsequent 12.4-m-diameter headrace tunnels will be excavated with larger size TBMs, where a high risk of extremely intense rockbursts exists. Herein, a top pilot tunnel preconditioning method is proposed to minimize this risk, in which a drilling and blasting method is first recommended for the top pilot tunnel excavation and support, and then the TBM excavation of the main tunnel is conducted. In order to evaluate the mechanical effectiveness of this method, numerical simulation analyses using the failure approaching index, energy release rate, and excess shear stress indices are carried out. Its construction feasibility is discussed as well. Moreover, a microseismic monitoring technique is used in the experimental tunnel section for the real-time monitoring of the microseismic activities of the rock mass in TBM excavation and for assessing the effect of the top pilot tunnel excavation in reducing the risk of rockbursts. This method is applied to two tunnel sections prone to extremely intense rockbursts and leads to a reduction in the risk of rockbursts in TBM excavation.

Training the secretary in community mental health: a second model for integrating secretaries into the therapeutic team in community mental health.

PubMed

Nyman, G W; Watson, D; Schmidt, D; James, S E

1975-01-01

The secretaries in community mental health centers have functions that transcend their job descriptions. Their performance of these functions contributes to the success or failure of their centers' therapeutic programs. The Mental Health Training Institute of North Carolina initiated two separate pilot training programs within 1971-1972, aimed at heightening the secretaries' appreciation of their role within their centers and at facilitating their integration into the therapeutic team. This paper is a discussion of the second of these two programs.

Pilot interaction with automated airborne decision making systems

NASA Technical Reports Server (NTRS)

Rouse, W. B.; Hammer, J. M.; Mitchell, C. M.; Morris, N. M.; Lewis, C. M.; Yoon, W. C.

1985-01-01

Progress was made in the three following areas. In the rule-based modeling area, two papers related to identification and significane testing of rule-based models were presented. In the area of operator aiding, research focused on aiding operators in novel failure situations; a discrete control modeling approach to aiding PLANT operators was developed; and a set of guidelines were developed for implementing automation. In the area of flight simulator hardware and software, the hardware will be completed within two months and initial simulation software will then be integrated and tested.

The Design of Model-Based Training Programs

NASA Technical Reports Server (NTRS)

Polson, Peter; Sherry, Lance; Feary, Michael; Palmer, Everett; Alkin, Marty; McCrobie, Dan; Kelley, Jerry; Rosekind, Mark (Technical Monitor)

1997-01-01

This paper proposes a model-based training program for the skills necessary to operate advance avionics systems that incorporate advanced autopilots and fight management systems. The training model is based on a formalism, the operational procedure model, that represents the mission model, the rules, and the functions of a modem avionics system. This formalism has been defined such that it can be understood and shared by pilots, the avionics software, and design engineers. Each element of the software is defined in terms of its intent (What?), the rationale (Why?), and the resulting behavior (How?). The Advanced Computer Tutoring project at Carnegie Mellon University has developed a type of model-based, computer aided instructional technology called cognitive tutors. They summarize numerous studies showing that training times to a specified level of competence can be achieved in one third the time of conventional class room instruction. We are developing a similar model-based training program for the skills necessary to operation the avionics. The model underlying the instructional program and that simulates the effects of pilots entries and the behavior of the avionics is based on the operational procedure model. Pilots are given a series of vertical flightpath management problems. Entries that result in violations, such as failure to make a crossing restriction or violating the speed limits, result in error messages with instruction. At any time, the flightcrew can request suggestions on the appropriate set of actions. A similar and successful training program for basic skills for the FMS on the Boeing 737-300 was developed and evaluated. The results strongly support the claim that the training methodology can be adapted to the cockpit.

A Study of the Characteristics of Human-Pilot Control Response to Simulated Aircraft Lateral Motions

NASA Technical Reports Server (NTRS)

Cheatham, Donald C

1954-01-01

Report presents the results of studies made in an attempt to provide information on the control operations of the human pilot. These studies included an investigation of the ability of pilots to control simulated unstable yawing oscillations, a study of the basic characteristics of human-pilot control response, and a study to determine whether and to what extent pilot control response can be represented in an analytical form.

Shape optimization of tibial prosthesis components

NASA Technical Reports Server (NTRS)

Saravanos, D. A.; Mraz, P. J.; Davy, D. T.

1993-01-01

NASA technology and optimal design methodologies originally developed for the optimization of composite structures (engine blades) are adapted and applied to the optimization of orthopaedic knee implants. A method is developed enabling the shape tailoring of the tibial components of a total knee replacement implant for optimal interaction within the environment of the tibia. The shape of the implant components are optimized such that the stresses in the bone are favorably controlled to minimize bone degradation, to improve the mechanical integrity of the implant/interface/bone system, and to prevent failures of the implant components. A pilot tailoring system is developed and the feasibility of the concept is demonstrated and evaluated. The methodology and evolution of the existing aerospace technology from which this pilot optimization code was developed is also presented and discussed. Both symmetric and unsymmetric in-plane loading conditions are investigated. The results of the optimization process indicate a trend toward wider and tapered posts as well as thicker backing trays. Unique component geometries were obtained for the different load cases.

The Effects of Longitudinal Control-System Dynamics on Pilot Opinion and Response Characteristics as Determined from Flight Tests and from Ground Simulator Studies

NASA Technical Reports Server (NTRS)

Sadoff, Melvin

1958-01-01

The results of a fixed-base simulator study of the effects of variable longitudinal control-system dynamics on pilot opinion are presented and compared with flight-test data. The control-system variables considered in this investigation included stick force per g, time constant, and dead-band, or stabilizer breakout force. In general, the fairly good correlation between flight and simulator results for two pilots demonstrates the validity of fixed-base simulator studies which are designed to complement and supplement flight studies and serve as a guide in control-system preliminary design. However, in the investigation of certain problem areas (e.g., sensitive control-system configurations associated with pilot- induced oscillations in flight), fixed-base simulator results did not predict the occurrence of an instability, although the pilots noted the system was extremely sensitive and unsatisfactory. If it is desired to predict pilot-induced-oscillation tendencies, tests in moving-base simulators may be required. It was found possible to represent the human pilot by a linear pilot analog for the tracking task assumed in the present study. The criterion used to adjust the pilot analog was the root-mean-square tracking error of one of the human pilots on the fixed-base simulator. Matching the tracking error of the pilot analog to that of the human pilot gave an approximation to the variation of human-pilot behavior over a range of control-system dynamics. Results of the pilot-analog study indicated that both for optimized control-system dynamics (for poor airplane dynamics) and for a region of good airplane dynamics, the pilot response characteristics are approximately the same.

Correlation between melphalan pharmacokinetics and hepatic toxicity following hyperthermic isolated liver perfusion for unresectable metastatic disease.

PubMed

Mocellin, Simone; Pilati, Pierluigi; Da Pian, Pierpaolo; Forlin, Marco; Corazzina, Susanna; Rossi, Carlo Riccardo; Innocente, Federico; Ori, Carlo; Casara, Dario; Ujka, Francesca; Nitti, Donato; Lise, Mario

2007-02-01

In the present work, we report on the results of our pilot study of hyperthermic isolated hepatic perfusion (IHP) with melphalan alone for patients with unresectable metastatic liver tumors refractory to conventional treatments, with particular regard to the correlation between pharmacokinetic findings and hepatic toxicity. Inclusion criteria were unresectable liver metastases, hepatic parenchyma replacement

Polysomnography versus limited respiratory monitoring and nurse-led titration to optimise non-invasive ventilation set-up: a pilot randomised clinical trial.

PubMed

Patout, Maxime; Arbane, Gill; Cuvelier, Antoine; Muir, Jean Francois; Hart, Nicholas; Murphy, Patrick Brian

2018-03-30

Polysomnography (PSG) is recommended for non-invasive ventilation (NIV) set-up in patients with chronic respiratory failure. In this pilot randomised clinical trial, we compared the physiological effectiveness of NIV set-up guided by PSG to limited respiratory monitoring (LRM) and nurse-led titration in patients with COPD-obstructive sleep apnoea (OSA) overlap. The principal outcome of interest was change in daytime arterial partial pressure of carbon dioxide (PaCO 2 ) at 3 months. Fourteen patients with daytime PaCO 2 >6 kPa and body mass index >30 kg/m 2 were recruited. At 3 months, PaCO 2 was reduced by -0.88 kPa (95% CI -1.52 to -0.24 kPa) in the LRM group and by -0.36 kPa (95% CI -0.96 to 0.24 kPa) in the PSG group. These pilot data provide support to undertake a clinical trial investigating the clinical effectiveness of attended limited respiratory monitoring and PSG to establish NIV in patients with COPD-OSA overlap. Results, NCT02444806. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Flight test of takeoff performance monitoring system

NASA Technical Reports Server (NTRS)

Middleton, David B.; Srivatsan, Raghavachari; Person, Lee H., Jr.

1994-01-01

The Takeoff Performance Monitoring System (TOPMS) is a computer software and hardware graphics system that visually displays current runway position, acceleration performance, engine status, and other situation advisory information to aid pilots in their decision to continue or to abort a takeoff. The system was developed at the Langley Research Center using the fixed-base Transport Systems Research Vehicle (TSRV) simulator. (The TSRV is a highly modified Boeing 737-100 research airplane.) Several versions of the TOPMS displays were evaluated on the TSRV B-737 simulator by more than 40 research, United States Air Force, airline and industry and pilots who rated the system satisfactory and recommended further development and testing. In this study, the TOPMS was flight tested on the TSRV. A total of 55 takeoff and 30 abort situations were investigated at 5 airfields. TOPMS displays were observed on the navigation display screen in the TSRV research flight deck during various nominal and off-nominal situations, including normal takeoffs; reduced-throttle takeoffs; induced-acceleration deficiencies; simulated-engine failures; and several gross-weight, runway-geometry, runway-surface, and ambient conditions. All tests were performed on dry runways. The TOPMS software executed accurately during the flight tests and the displays correctly depicted the various test conditions. Evaluation pilots found the displays easy to monitor and understand. The algorithm provides pretakeoff predictions of the nominal distances that are needed to accelerate the airplane to takeoff speed and to brake it to a stop; these predictions agreed reasonably well with corresponding values measured during several fully executed and aborted takeoffs. The TOPMS is operational and has been retained on the TSRV for general use and demonstration.

Eradication of Cytomegalovirus from Human Milk by Microwave Irradiation: A Pilot Study.

PubMed

Ben-Shoshan, Moshe; Mandel, Dror; Lubetzky, Ronit; Dollberg, Shaul; Mimouni, Francis B

2016-05-01

Cytomegalovirus (CMV)-infected human milk (HM) can lead to significant CMV morbidity and mortality in preterm very-low-birth weight infants. The eradication of CMV in HM while preserving its properties poses a major clinical challenge. We aimed to compare two methods used to neutralize the virus in HM, one recognized as partially effective (freezing) and another not tested to date (microwave exposure). We sampled HM from 31 CMV-seropositive mothers whose infants were hospitalized at the Lis Maternity Hospital. Fifteen samples that were positive for CMV antigen were divided into five 5 mL aliquots: the first a control, the second was frozen at -20°C for 1 day, the third was frozen at -200°C for 3 days, and the fourth and fifth aliquots were exposed for 30 seconds to microwave radiation at a low-power setting (500 W) and high-power setting (750 W), respectively. Only microwave radiation at a high-power setting led to complete neutralization of CMV in all samples. Low-power microwave irradiation had a 13% failure rate while 3-day freezing and 1-day freezing had failure rates of 7% and 20%, respectively. It is possible to eradicate CMV successfully in HM by using microwave radiation at a high-power setting. Further studies are needed to evaluate the effect of microwave heating on breast milk properties.

Workload management and geographic disorientation in aviation incidents: A review of the ASRS data base

NASA Technical Reports Server (NTRS)

Williams, Henry P.; Tham, Mingpo; Wickens, Christopher D.

1993-01-01

NASA's Aviation Safety Reporting System (ASRS) incident reports are reviewed in two related areas: pilots' failures to appropriately manage tasks, and breakdowns in geographic orientation. Examination of 51 relevant reports on task management breakdowns revealed that altitude busts and inappropriate runway usee were the most frequently reported consequences. Task management breakdowns appeared to occur at all levels of expertise, and prominent causal factors were related to breakdowns in crew communications, over-involvement with the flight management system and, for small (general aviation) aircraft, preoccupation with weather. Analysis of the 83 cases of geographic disorientation suggested that these too occurred at all levels of pilot experience. With regard to causal factors, a majority was related to poor cockpit resource management, in which inattention led to a loss of geographic awareness. Other leading causes were related to poor weather and poor decision making. The potential of the ASRS database for contributing to research and design issues is addressed.

Mrs. Haise in viewing room overlooking FCR

NASA Image and Video Library

1970-04-14

S70-34900 (14 April 1970) --- Mrs. Mary Haise receives an explanation of the revised flight plan of the Apollo 13 mission from astronaut Gerald P. Carr in the viewing room of the Mission Control Center (MCC), Building 30, at the Manned Spacecraft Center (MSC). Her husband, astronaut Fred W. Haise Jr., lunar module pilot for the Apollo 13 mission, was joining fellow crew members, astronauts James A. Lovell Jr., and John L. Swigert Jr. in making correction in their spacecraft following discovery of an oxygen cell failure several hours earlier.

Preliminary profiling of blood transcriptome in a rat model of hemorrhagic shock

PubMed Central

Braga, D; Barcella, M; D’Avila, F; Lupoli, S; Tagliaferri, F; Santamaria, MH; DeLano, FA; Baselli, G; Schmid-Schönbein, GW; Kistler, EB; Aletti, F

2017-01-01

Hemorrhagic shock is a leading cause of morbidity and mortality worldwide. Significant blood loss may lead to decreased blood pressure and inadequate tissue perfusion with resultant organ failure and death, even after replacement of lost blood volume. One reason for this high acuity is that the fundamental mechanisms of shock are poorly understood. Proteomic and metabolomic approaches have been used to investigate the molecular events occurring in hemorrhagic shock but, to our knowledge, a systematic analysis of the transcriptomic profile is missing. Therefore, a pilot analysis using paired-end RNA sequencing was used to identify changes that occur in the blood transcriptome of rats subjected to hemorrhagic shock after blood reinfusion. Hemorrhagic shock was induced using a Wigger’s shock model. The transcriptome of whole blood from shocked animals shows modulation of genes related to inflammation and immune response (Tlr13, Il1b, Ccl6, Lgals3), antioxidant functions (Mt2A, Mt1), tissue injury and repair pathways (Gpnmb, Trim72) and lipid mediators (Alox5ap, Ltb4r, Ptger2) compared with control animals. These findings are congruent with results obtained in hemorrhagic shock analysis by other authors using metabolomics and proteomics. The analysis of blood transcriptome may be a valuable tool to understand the biological changes occurring in hemorrhagic shock and a promising approach for the identification of novel biomarkers and therapeutic targets. Impact statement This study provides the first pilot analysis of the changes occurring in transcriptome expression of whole blood in hemorrhagic shock (HS) rats. We showed that the analysis of blood transcriptome is a useful approach to investigate pathways and functional alterations in this disease condition. This pilot study encourages the possible application of transcriptome analysis in the clinical setting, for the molecular profiling of whole blood in HS patients. PMID:28661205

Telemedicine in South Africa: success or failure?

PubMed

Gulube, S M; Wynchank, S

2001-01-01

A national telemedicine system for South Africa was planned in 1998. In the first phase, starting in 1999, 28 pilot sites were established in six provinces. The initial applications were teleradiology, tele-ultrasound for antenatal services, telepathology and tele-ophthalmology. Telemedicine equipment was connected by ISDN at 256 kbit/s. From January to September 2000, 2663 radiographic studies were performed at the three Northwest Province teleradiology transmission sites, of which 264 studies (10%) were selected for specialist radiologist reporting by teleradiology. From June to August 2000, nine antenatal care tele-ultrasound consultations were performed in the Northern Cape Province and four transfers were avoided through the use of telemedicine. One area of concern is the relatively low usage of the telemedicine system, which raises questions about its cost-effectiveness. The experience of telemedicine in South Africa confirmed, as others have found, that common problems relate to the technical and organizational challenges of introducing telemedicine.

Risk Taking and Decision Making in Kidney Paired Donation: A Qualitative Study by Semistructured Interviews.

PubMed

Baines, L S; Dulku, H; Jindal, R M; Papalois, V

2018-06-01

Despite excellent outcomes of kidney paired donation (KPD), little is known about how a patient's frame (apply cognitive bias) or weight (attribute value) and concerns relating to risk, justice, and equity affect his or her decision-making process. A pilot study consisting of 3 KPD transplant recipients and 3 KPD kidney donors in the last year was conducted to identify and explore themes in decision making and risk taking. The pilot study was followed by the main study comprised of 20 recipients who had already undergone KPD transplantation and 20 donors who had undergone donor nephrectomy. We conducted semistructured interviews in this cohort and analyzed the data thematically. Each donor-recipient pair was interviewed together to facilitate dyadic conversation and provide deeper insight into the decision-making process leading to transplant and donation. Common themes to both recipient and donor decision making included quality of life; characteristics of the unknown donor and post-transplant expectations. Recipient-specific themes included failure to reach life span milestones, experiences of fellow patients, and altruistic desire to expand the donor pool. Donor-specific themes included balancing existing life commitments with the recipient's need for a kidney, equity and mental accounting in kidney exchange (comparable quality of the kidney received versus the kidney donated), and logistical justice for the recipient. Donors and recipients frame and weight the concepts of risk, justice, and equity differently. This may have direct implications to facilitating patient-centered communication and engagement in KPD pairs. Copyright © 2018 Elsevier Inc. All rights reserved.

A randomized trial of enema versus polyethylene glycol 3350 for fecal disimpaction in children presenting to an emergency department.

PubMed

Miller, Melissa K; Dowd, Mary Denise; Friesen, Craig A; Walsh-Kelly, Christine M

2012-02-01

This study aimed to compare efficacy of enema versus polyethylene glycol (PEG) 3350 for pediatric fecal impaction treatment. We conducted a prospective, randomized comparison of treatments of fecal impaction in children in a pediatric emergency department (ED). Treatment arms were a single milk and molasses enema in the ED or PEG 3350 for 3 days outpatient. Telephone follow-up was done on days 1, 3, and 5. The primary outcome was main symptom improvement. Additional outcomes were stool frequency, consistency, and ease of stool passage. Treatment failures (home enema, ED return, or hospital admission) were tracked. Seventy-nine subjects participated (39 PEG; 40 enema). At day 1, PEG subjects were less likely to have improved main symptom (odds ratio [OR], 0.3; 95% confidence interval [CI], 0.1-0.8) but no difference in other outcomes. Half (54%) in enema arm were reported as upset by ED therapy, whereas no children in PEG arm were upset (P < 0.05). At day 3, more patients in enema arm reported ideal stool consistency (74% vs 38%; P < 0.05). At day 5, no difference between groups was noted. Most treatment failures were in PEG arm (83%; P = 0.08). This pilot study suggests that disimpaction by enema may be superior to PEG for immediate relief of symptoms. Larger trials are needed to assess any advantage.

Spectral analysis of major heart tones

NASA Astrophysics Data System (ADS)

Lejkowski, W.; Dobrowolski, A. P.; Majka, K.; Olszewski, R.

2018-04-01

The World Health Organization (WHO) figures clearly indicate that cardiovascular disease is the most common cause of death and disability in the world. Early detection of cardiovascular pathologies may contribute to reducing such a high mortality rate. Auscultatory examination is one of the first and most important step in cardiologic diagnostics. Unfortunately, proper diagnosis is closely related to long-term practice and medical experience. The article presents the author's system of recording phonocardiograms and the way of saving data, as well as the outline of the analysis algorithm, which will allow to assign a case to a patient with heart failure or healthy voluntaries' with a certain high probability. The results of a pilot study of phonocardiographic signals were also presented as an introduction to further research aimed at the development of an efficient diagnostic algorithm based on spectral analysis of the heart tone.

A study evaluating if targeted training for startle effect can improve pilot reactions in handling unexpected situations in a flight simulator

NASA Astrophysics Data System (ADS)

Gillen, Michael William

Recent airline accidents point to a crew's failure to make correct and timely decisions following a sudden and unusual event that startled the crew. This study sought to determine if targeted training could augment decision making during a startle event. Following a startle event cognitive function is impaired for a short duration of time (30-90 seconds). In aviation, critical decisions are often required to be made during this brief, but critical, time frame. A total of 40 volunteer crews (80 individual pilots) were solicited from a global U.S. passenger airline. Crews were briefed that they would fly a profile in the simulator but were not made aware of what the profile would entail. The study participants were asked to complete a survey on their background and flying preferences. Every other crew received training on how to handle a startle event. The training consisted of a briefing and simulator practice. Crew members (subjects) were either presented a low altitude or high altitude scenario to fly in a full-flight simulator. The maneuver scenarios were analyzed using a series of one-way ANOVAs, t-tests and regression for the main effect of training on crew performance. The data indicated that the trained crews flew the maneuver profiles significantly better than the untrained crews and significantly better than the Federal Aviation Administration (FAA) Airline Transport Pilot (ATP) standards. Each scenario's sub factors were analyzed using regression to examine for specific predictors of performance. The results indicate that in the case of the high altitude profile, problem diagnosis was a significant factor, in the low altitude profile, time management was also a significant factor. These predicators can be useful in further targeting training. The study's findings suggest that targeted training can help crews manage a startle event, leading to a potential reduction of inflight loss of control accidents. The training was broad and intended to cover an overall aircraft handling approach rather than being aircraft specific. Inclusion of this type of training by airlines has the potential to better aid crews in handling sudden and unusual events.

A Human Factors Approach to Bridging Systems and Introducing New Technologies

NASA Technical Reports Server (NTRS)

Kanki, Barbara G.

2011-01-01

The application of human factors in aviation has grown to cover a wide range of disciplines and methods capable of assessing human-systems integration at many levels. For example, at the individual level, pilot workload may be studied while at the team level, coordinated workload distribution may be the focal point. At the organizational level, the way in which individuals and teams are supported by training and standards, policies and procedures may introduce additional, relevant topics. A consideration of human factors at each level contributes to our understanding of successes and failures in pilot performance, but this system focused on the flight deck alone -- is only one part of the airspace system. In the FAA's NextGen plan to overhaul the National Airspace System (NAS), new capabilities will enhance flightdeck systems (pilots), flight operations centers (dispatchers) and air traffic control systems (controllers and air traffic managers). At a minimum, the current roles and responsibilities of these three systems are likely to change. Since increased automation will be central to many of the enhancements, the role of automation is also likely to change. Using NextGen examples, a human factors approach for bridging complex airspace systems will be the main focus of this presentation. It is still crucial to consider the human factors within each system, but the successful implementation of new technologies in the NAS requires an understanding of the collaborations that occur when these systems intersect. This human factors approach to studying collaborative systems begins with detailed task descriptions within each system to establish a baseline of the current operations. The collaborative content and context are delineated through the review of regulatory and advisory materials, letters of agreement, policies, procedures and documented practices. Field observations and interviews also help to fill out the picture. Key collaborative functions across systems are identified and placed on a phase-of-flight timeline including information requirements, decision authority and use of automation, as well as level of frequency and criticality.

Balloon Dilation of the Cartilaginous Portion of the Eustachian Tube.

PubMed

Silvola, Juha; Kivekäs, Ilkka; Poe, Dennis S

2014-07-01

Studies of balloon Eustachian tuboplasty (BET) have shown encouraging results in small series with short follow-ups. Our pilot study suggested that patients with protracted otitis media with effusion (OME) or atelectasis of the tympanic membrane (TM) could benefit from BET. A prospective study where subjects act as their own controls. Patients from the pilot study and additional cases were enrolled in this cohort with long-term follow-up. Regional Academic Center. Out of 80 patients who underwent BET, 41 consecutive Eustachian tube (ET) operations were included. Subjects' inclusion criteria were OME and/or TM atelectasis, type B or C tympanograms, and inability to inflate their middle ears by Valsalva maneuver. All patients had longstanding ET dysfunction relieved only by repeated tympanostomies. Outcomes included ability to perform a Valsalva maneuver, audiometry, tympanometry, videoendoscopy of the ET with mucosal inflammation rating scores, and otomicroscopy. All cases were dilated successfully, without significant complications. Mean follow-up was 2.5 years (range, 1.5-4.2 years). Eighty percent (33/41) could do a Valsalva maneuver postoperatively; none of these ears required new tympanostomy tubes and subjective symptoms were relieved. Tympanometry results showed overall improvement. Nine patients had persistent perforations and 3 declined removal of the tube. Subjective symptoms were not relieved for 10% (4/41). The results show that BET can effectively improve ET function in ears with OME or atelectasis. The procedure is well tolerated and without significant complications. The follow-up continues and we are investigating possible reasons for failures. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

Pilot Certification, Age of Pilot, and Drug Use in Fatal Civil Aviation Accidents.

PubMed

Akparibo, Issaka Y; Stolfi, Adrienne

2017-10-01

This study examined the association between mean age of pilot, pilot license, pilot medical certificate and drug use trends in pilots fatally injured in aircraft accidents. The prevalence of prescription drugs, OTC drugs, controlled drugs and drugs that may be potentially impairing was also examined. This study was a descriptive observational study in which the NTSB Aviation Accident Database was searched from the period beginning January 1, 2012 to December 31, 2014. During the study period a total of 706 accidents involving 711 fatalities were investigated by the NTSB. This study included 633 of these accidents, involving 646 fatalities. Of these pilots, 42.1% had drugs in their biological samples. The prevalence of prescription drugs, controlled drugs, OTC drugs, opioids, and potentially impairing drugs in the fatally injured pilot population over the study period was 28.9%, 15.0%, 20.1%, 5.1%, and 25.5%, respectively. Pilots with any drugs in their samples were significantly older than those without drugs. Medical certificate held was associated with drug use; pilots who held third class certificates had the highest prevalence at 54.1%. Pilot license was not associated with drug use. In 3.8% of the accidents, drugs were a contributing factor in the cause. Despite current FAA medical regulations, potentially impairing drugs are frequently found in biological samples of fatally injured pilots in the U.S. More education of airmen by aviation medical examiners is needed on the safety of drug use.Akparibo IY, Stolfi A. Pilot certification, age of pilot, and drug use in fatal civil aviation accidents. Aerosp Med Hum Perform. 2017; 88(10):931-936.

Conceptual design study of a Harrier V/STOL research aircraft

NASA Technical Reports Server (NTRS)

Bode, W. E.; Berger, R. L.; Elmore, G. A.; Lacey, T. R.

1978-01-01

MCAIR recently completed a conceptual design study to define modification approaches to, and derive planning prices for the conversion of a two place Harrier to a V/STOL control, display and guidance research aircraft. Control concepts such as rate damping, attitude stabilization, velocity command, and cockpit controllers are to be demonstrated. Display formats will also be investigated, and landing, navigation and guidance systems flight tested. The rear cockpit is modified such that it can be quickly adapted to faithfully simulate the controls, displays and handling qualities of a Type A or Type B V/STOL. The safety pilot always has take command capability. The modifications studied fall into two categories: basic modifications and optional modifications. Technical descriptions of the basic modifications and of the optional modifications are presented. The modification plan and schedule as well as the test plan and schedule are presented. The failure mode and effects analysis, aircraft performance, aircraft weight, and aircraft support are discussed.

Pilot-model analysis and simulation study of effect of control task desired control response

NASA Technical Reports Server (NTRS)

Adams, J. J.; Gera, J.; Jaudon, J. B.

1978-01-01

A pilot model analysis was performed that relates pilot control compensation, pilot aircraft system response, and aircraft response characteristics for longitudinal control. The results show that a higher aircraft short period frequency is required to achieve superior pilot aircraft system response in an altitude control task than is required in an attitude control task. These results were confirmed by a simulation study of target tracking. It was concluded that the pilot model analysis provides a theoretical basis for determining the effect of control task on pilot opinions.

Treatment of dogs with compensated myxomatous mitral valve disease with spironolactone-a pilot study.

PubMed

Hezzell, M J; Boswood, A; López-Alvarez, J; Lötter, N; Elliott, J

2017-08-01

Spironolactone improves outcome in dogs with advanced myxomatous mitral valve disease (MMVD). Its efficacy in preclinical MMVD is unknown. The hypothesis was the administration of spironolactone to dogs with compensated MMVD demonstrating risk factors for poorer prognosis will decrease the rate of disease progression. The aim was to provide pilot data to evaluate preliminary effects and sample size calculation for a definitive clinical trial. Twenty-five client-owned dogs with MMVD with at least one of the following; left atrial to aortic ratio (LA:Ao) ≥ 1.5, normalized left ventricular internal diameter in diastole ≥ 1.6), N-terminal pro-B-type natriuretic peptide (NT-proBNP) > 550 pmol/L, cardiac troponin I > 0.025 ng/mL. Prospective, single-center, equally randomized, placebo-controlled, double-blinded, parallel grouped pilot study. No dogs were receiving medications for cardiac disease before the enrollment. Twelve dogs received placebo; 13 received spironolactone. One dog in the spironolactone group died suddenly, 1 developed congestive heart failure, and 2 received suboptimal spironolactone doses. At enrollment, NT-proBNP was significantly higher in the spironolactone group (p=0.005). Left atrial to aortic ratio (p=0.002) and left ventricular internal diameter in diastole (p=0.005) increased over time in the placebo group, but not the spironolactone group; the change did not differ significantly between groups. The change in biomarker concentrations did not differ significantly between groups; there was a tendency toward an increase in NT-proBNP over time in the placebo group. Enrollment of 76 dogs would be necessary to demonstrate a difference in the change in LA:Ao over 6 months between the groups. Preliminary results support undertaking a larger clinical trial of treatment of dogs with preclinical MMVD with spironolactone. Copyright © 2017 Elsevier B.V. All rights reserved.

Analysis of Aircraft Control Performance using a Fuzzy Rule Base Representation of the Cooper-Harper Aircraft Handling Quality Rating

NASA Technical Reports Server (NTRS)

Tseng, Chris; Gupta, Pramod; Schumann, Johann

2006-01-01

The Cooper-Harper rating of Aircraft Handling Qualities has been adopted as a standard for measuring the performance of aircraft since it was introduced in 1966. Aircraft performance, ability to control the aircraft, and the degree of pilot compensation needed are three major key factors used in deciding the aircraft handling qualities in the Cooper- Harper rating. We formulate the Cooper-Harper rating scheme as a fuzzy rule-based system and use it to analyze the effectiveness of the aircraft controller. The automatic estimate of the system-level handling quality provides valuable up-to-date information for diagnostics and vehicle health management. Analyzing the performance of a controller requires a set of concise design requirements and performance criteria. Ir, the case of control systems fm a piloted aircraft, generally applicable quantitative design criteria are difficult to obtain. The reason for this is that the ultimate evaluation of a human-operated control system is necessarily subjective and, with aircraft, the pilot evaluates the aircraft in different ways depending on the type of the aircraft and the phase of flight. In most aerospace applications (e.g., for flight control systems), performance assessment is carried out in terms of handling qualities. Handling qualities may be defined as those dynamic and static properties of a vehicle that permit the pilot to fully exploit its performance in a variety of missions and roles. Traditionally, handling quality is measured using the Cooper-Harper rating and done subjectively by the human pilot. In this work, we have formulated the rules of the Cooper-Harper rating scheme as fuzzy rules with performance, control, and compensation as the antecedents, and pilot rating as the consequent. Appropriate direct measurements on the controller are related to the fuzzy Cooper-Harper rating system: a stability measurement like the rate of change of the cost function can be used as an indicator if the aircraft is under control; the tracking error is a good measurement for performance needed in the rating scheme. Finally, the change of the control amount or the output of a confidence tool, which has been developed by the authors, can be used as an indication of pilot compensation. We use a number of known aircraft flight scenarios with known pilot ratings to calibrate our fuzzy membership functions. These include normal flight conditions and situations in which partial or complete failure of tail, aileron, engine, or throttle occurs.

Hobbs 3T MRI

DTIC Science & Technology

2009-08-01

A .  3T MRI Installation and Testing    The  Philips Achieva 3.0T MRI system was  installed  on  September 1, 2007 and was accepted...access to  a  dedicated parking  lot.  The  clinic  is  located  on   the  same  level as  the  DHS‐2  Imaging  Center, which contains  the  3T MRI, DEXA scanner... the   acoustical  activities of  the  heart. Our pilot data using this technique is based  on   a  study of 36 subjects with systolic  heart  failure. 

Comparison of myocardial ischemia during intense mental stress using flight simulation in airline pilots with coronary artery disease to that produced with conventional mental and treadmill exercise stress testing.

PubMed

Doorey, Andrew; Denenberg, Barry; Sagar, Vidya; Hanna, Tracy; Newman, Jack; Stone, Peter H

2011-09-01

Mental stress increases cardiovascular morbidity and mortality. Although laboratory mental stress often causes less myocardial ischemia than exercise stress (ES), it is unclear whether mental stress is intrinsically different or differences are due to less hemodynamic stress with mental stress. We sought to evaluate the hemodynamic and ischemic response to intense realistic mental stress created by modern flight simulators and compare this response to that of exercise treadmill testing and conventional laboratory mental stress (CMS) testing in pilots with coronary disease. Sixteen airline pilots with angiographically documented coronary disease and documented myocardial ischemia during ES were studied using maximal treadmill ES, CMS, and aviation mental stress (AMS) testing. AMS testing was done in a sophisticated simulator using multiple system failures as stressors. Treadmill ES testing resulted in the highest heart rate, but AMS caused a higher blood pressure response than CMS. Maximal rate-pressure product was not significantly different between ES and AMS (25,646 vs 23,347, p = 0.08), although these were higher than CMS (16,336, p <0.0001). Despite similar hemodynamic stress induced by ES and AMS, AMS resulted in significantly less ST-segment depression and nuclear ischemia than ES. Differences in induction of ischemia by mental stress compared to ES do not appear to be due to the creation of less hemodynamic stress. In conclusion, even with equivalent hemodynamic stress, intense realistic mental stress induced by flight simulators results in significantly less myocardial ischemia than ES as measured by ST-segment depression and nuclear ischemia. Copyright © 2011 Elsevier Inc. All rights reserved.

The NHLBI REVIVE-IT study: Understanding its discontinuation in the context of current left ventricular assist device therapy.

PubMed

Pagani, Francis D; Aaronson, Keith D; Kormos, Robert; Mann, Douglas L; Spino, Cathie; Jeffries, Neal; Taddei-Peters, Wendy C; Mancini, Donna M; McNamara, Dennis M; Grady, Kathleen L; Gorcsan, John; Petrucci, Ralph; Anderson, Allen S; Glick, Henry A; Acker, Michael A; Eduardo Rame, J; Goldstein, Daniel J; Pamboukian, Salpy V; Miller, Marissa A; Timothy Baldwin, J

2016-11-01

The National Institutes of Health National Heart, Lung, and Blood Institute convened a working group in March 2008 to discuss how therapies for heart failure (HF) might be best advanced using clinical trials involving left ventricular assist devices (LVAD). This group opined that the field was ready for a trial to assess the use of long-term ventricular assist device therapy in patients who are less ill than patients currently eligible for destination therapy, which resulted in the Randomized Evaluation of VAD InterVEntion before Inotropic Therapy (REVIVE-IT) pilot study. The specific objective of REVIVE-IT was to compare LVAD therapy with optimal medical management in patients with less advanced HF than current LVAD indications to determine if wider application of permanent LVAD use to less ill patients would be associated with improved survival, quality of life, or functional capacity. REVIVE-IT represented an extraordinary effort to provide data from a randomized clinical trial to inform clinicians, scientists, industry, and regulatory agencies about the efficacy and safety of LVAD therapy in a population with less advanced HF. Despite significant support from the medical community, industry, and governmental agencies, REVIVE-IT failed to accomplish its goal. The reasons for its failure are instructive, and the lessons learned from the REVIVE-IT experience are likely to be relevant to any future study of LVAD therapy in a population with less advanced HF. Copyright © 2016 International Society for Heart and Lung Transplantation. All rights reserved.

APCAP--activated protein C in acute pancreatitis: a double-blind randomized human pilot trial.

PubMed

Pettilä, Ville; Kyhälä, Lea; Kylänpää, Marja-Leena; Leppäniemi, Ari; Tallgren, Minna; Markkola, Antti; Puolakkainen, Pauli; Repo, Heikki; Kemppainen, Esko

2010-01-01

Previous human studies have shown low activity of protein C (APC) in severe acute pancreatitis (SAP). This, together with the findings in animal models, suggests that activated protein C (APC) may protect against pancreatic injury and ameliorate the disease. We, therefore, evaluated its effect on multiple organ dysfunction (MOD) measured by the SOFA (Sequential Organ Failure Assessment) and on organ-failure-free days, and the safety of APC in SAP. A prospective double blind randomized pilot study was use. The study occurred in one university hospital tertiary intensive care unit (ICU) with eight beds. The patients were chosen according to the following inclusion criteria: 1) Those admitted to the hospital < 96 h from the onset of pain, 2) Those who had a three-fold increase in serum amylase over normal upper range or/and in whom computed tomography (CT) verification of SAP was noted, 3) Those who had one or more organ dysfunction (OD), and 4) Those in whom less than 48 hours had passed since their first OD. Of a total of 215 adult patients with SAP screened between June 2003 and August 2007, 158 fulfilled the study inclusion criteria. After exclusions 32 patients were randomized to the study. The intervention consisted of APC (N = 16) administered intravenously for 96 hours with a dose of 24 μg/kg/hour or placebo (N = 16) with a similar infusion rate. The sample size for the study was calculated according to the primary end-point: the change in SOFA during study drug infusion (Days 0 and 5). Comparisons between the study groups were performed using patient-related changes and calculation of difference in means (DIM, 95% CIs) and regarding categorical variables with Fisher's exact test. For all comparisons P < 0.05 was considered significant. No serious bleeding was detected clinically or by CT scans in either group. No significant difference in SOFA score change between the APC and placebo groups was found (difference in means (DIM) +2.3, 95% CI -0.7 to +5.3). Treatment with APC was associated with an increase in serum levels of both total and conjugated bilirubin. No differences in ventilator-free days, in renal replacement therapy-free days, in vasopressor-free days, or in days alive outside the hospital were detected. No serious bleeding or differences in the evolution of MOD were detected between APC and the placebo. Instead we found an increase in serum bilirubin in the APC group compared to the placebo group in patients with SAP. ClinicalTrials.gov NCT01017107.

SUPERFUND TREATABILITY CLEARINGHOUSE: SOIL STABILIZATION PILOT STUDY, UNITED CHROME NPL SITE PILOT STUDY AND HEALTH AND SAFETY PROGRAM, UNITED CHROME NPL SITE PILOT STUDY

EPA Science Inventory

This document is a project plan for a pilot study at the United Chrome NPL site, Corvallis, Oregon and includes the health and safety and quality assurance/quality control plans. The plan reports results of a bench-scale study of the treatment process as iieasured by the ...

Levetiracetam versus lorazepam in status epilepticus: a randomized, open labeled pilot study.

PubMed

Misra, U K; Kalita, J; Maurya, P K

2012-04-01

For the management of status epilepticus (SE), lorazepam (LOR) is recommended as the first and phenytoin or fosphenytoin as the second choice. Both these drugs have significant toxicity. Intravenous levetiracetam (LEV) has become available, but its efficacy and safety has not been reported in comparison to LOR. We report a randomized, open labeled pilot study comparing the efficacy and safety of LEV and LOR in SE. Consecutive patients with convulsive or subtle convulsive SE were randomized to LEV 20 mg/kg IV over 15 min or LOR 0.1 mg/kg over 2-4 min. Failure to control SE within 10 min of administration of one study drug was treated by the other study drug. The primary endpoint was clinical seizure cessation and secondary endpoints were 24 h freedom from seizure, hospital mortality, and adverse events. Our results are based on 79 patients. Both LEV and LOR were equally effective. In the first instance, the SE was controlled by LEV in 76.3% (29/38) and by LOR in 75.6% (31/41) of patients. In those resistant to the above regimen, LEV controlled SE in 70.0% (7/10) and LOR in 88.9% (8/9) patients. The 24-h freedom from seizure was also comparable: by LEV in 79.3% (23/29) and LOR in 67.7% (21/31). LOR was associated with significantly higher need of artificial ventilation and insignificantly higher frequency of hypotension. For the treatment of SE, LEV is an alternative to LOR and may be preferred in patients with respiratory compromise and hypotension.

Dose-adjusted arsenic trioxide for acute promyelocytic leukaemia in chronic renal failure.

PubMed

Firkin, Frank; Roncolato, Fernando; Ho, Wai Khoon

2015-10-01

To determine the potential for arsenic trioxide (ATO) to be safely and effectively incorporated into induction therapy of newly diagnosed acute promyelocytic leukaemia (APL) in patients with severe chronic renal failure (CRF) by reduction of the ATO dosage to compensate for reduced renal elimination of arsenic in CRF. Two of the four CRF patients with APL in the study were dialysis-dependent, and two had eGFRs of 18 and 19 mL/min/1.73 m(2) . ATO dosage schedules were adjusted to obtain comparable whole-blood arsenic levels to those in APL patients with normal renal function who achieved molecular remission (MR) while receiving 10 mg ATO daily for 28 d. Average ATO administered per day in CRF patients ranged from 36 to 50% of the ATO administered to APL patients with normal renal function. No clinically significant cardiac, hepatic or other toxicities were detected. RT-PCR-negative MR was achieved after one treatment course in two patients and after two courses in the others. Relapse-free survival is 155, 60, 43 and 5 months. The observations in this pilot study have demonstrated whole-blood arsenic levels can provide a guide to adjustments of ATO dosage schedules that permit safe and effective therapeutic outcomes in APL patients with severely compromised renal function. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Integrating kidney transplantation into value-based care for people with renal failure.

PubMed

Hippen, Benjamin E; Maddux, Franklin W

2018-01-01

Healthcare reimbursement is increasingly tied to value instead of volume, with special attention paid to resource-intensive populations such as patients with renal disease. To this end, Medicare has sponsored pilot projects to encourage providers to develop care coordination and population health management strategies to provide quality care while reducing resource utilization. In this Personal Viewpoint essay, we argue in favor of expanding one such pilot project-the Comprehensive ESRD Care (CEC) initiative-to include patients with advanced chronic kidney disease and kidney transplant recipients. The implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) offers a time-sensitive incentive for transplant centers in particular to align with extant CECs. An "expanded" CEC model proffers opportunity for robust cooperation between general nephrology practices, dialysis providers, and transplant centers to develop care coordination strategies for all patients with renal disease, realign incentives for all clinical stakeholders to increase kidney transplantation rates, and reduce total costs of care. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

Favorable Effect on Blood Volume Control in Hemodialysis Patients with Type 2 Diabetes after Switching from Insulin Therapy to Liraglutide, a Human Glucagon-like Peptide-1 Analog--Results from a Pilot Study in Japan-.

PubMed

Kondo, Masumi; Toyoda, Masao; Kimura, Moritsugu; Ishida, Naoto; Fukagawa, Masafumi

2017-04-20

Hemodialysis patients are advised to limit the intake of foods in order to control volume status and body weight (BW). We report the clinical course of five Japanese hemodialysis patients with type 2 diabetes mellitus (T2DM) who were switched from insulin to liraglutide, and the efficacy of the treatment, especially in terms of changes in interdialysis weight gain (IDWG). This retrospective pilot study included 5 Japanese hemodialysis patients with T2DM. Insulin and other oral hypoglycemic agents, if any, were discontinued before switching to liraglutide. The initial dose of liraglutide was set at 0.3 mg/day for more than 1 week, increased to 0.6 mg/day for more than 1 week and then, to 0.9 mg/day if needed. At baseline, the mean body mass index (BMI) was 23.2 ± 1.2 kg/m 2 and mean IDWG was 2.0 ± 0.4 kg. The required dose of liraglutide ranged from 0.3 to 0.9 mg/day. At the end of 3-month treatment, liraglutide reduced HbA1c level, BMI, and IDWG. A significant decrease in cardiothoracic ratio was confirmed on chest radiography. Switching from insulin to liraglutide seems effective in hemodialysis patients with T2DM, especially in those with difficult blood fluid volume control associated with failure of dietary restriction.

Atraumatic restorative treatment with resin-modified glass ionomer material: short-term results of a pilot study.

PubMed

Dülgergil, Coruh Türksel; Soyman, Mübin; Civelek, Arzu

2005-01-01

The aim of this study was to assess the feasibility of the resin-modified glass ionomer (RMGI) material in atraumatic restorative treatment (ART) approach and compare RMGI with the high-strength traditional glass ionomer cement (GIC) in permanent teeth with one or more surface-carious cavities. This study was conducted in a village school in rural southeastern Anatolia, Turkey. The RMGI and GIC restorations with the ART technique were placed randomly employing a split mouth design. In addition, the ART approach was used when necessary for both primary and/or permanent teeth with no pulpal involvement and no perceived pain before treatment. Ninety-one fillings were placed on contralateral molar pairs of 37 children. Baseline and 6-month evaluation of the fillings were made with the classic ART, modified Ryge and USPHS criteria. Based on the ART criteria, 100% of RMGI and 92.4% of GIC restorations were classified as successful after 6 months, and the difference between the 2 groups was statistically significant (p=0.009). While marginal discoloration was the commonest failure in the RMGI group according to both the modified Ryge and USPHS criteria, unsatisfactory surface texture and low anatomic form were the commonly seen failures in the ART technique. Generally, for each rating system, RMGI exhibited better clinical performance than GIC in all categories, except for marginal discoloration. Results based on the 6-month evaluation show that RMGI can be an alternative material to the GIC. Copyright (c) 2005 S. Karger AG, Basel.

Model Based Autonomy for Robust Mars Operations

NASA Technical Reports Server (NTRS)

Kurien, James A.; Nayak, P. Pandurang; Williams, Brian C.; Lau, Sonie (Technical Monitor)

1998-01-01

Space missions have historically relied upon a large ground staff, numbering in the hundreds for complex missions, to maintain routine operations. When an anomaly occurs, this small army of engineers attempts to identify and work around the problem. A piloted Mars mission, with its multiyear duration, cost pressures, half-hour communication delays and two-week blackouts cannot be closely controlled by a battalion of engineers on Earth. Flight crew involvement in routine system operations must also be minimized to maximize science return. It also may be unrealistic to require the crew have the expertise in each mission subsystem needed to diagnose a system failure and effect a timely repair, as engineers did for Apollo 13. Enter model-based autonomy, which allows complex systems to autonomously maintain operation despite failures or anomalous conditions, contributing to safe, robust, and minimally supervised operation of spacecraft, life support, In Situ Resource Utilization (ISRU) and power systems. Autonomous reasoning is central to the approach. A reasoning algorithm uses a logical or mathematical model of a system to infer how to operate the system, diagnose failures and generate appropriate behavior to repair or reconfigure the system in response. The 'plug and play' nature of the models enables low cost development of autonomy for multiple platforms. Declarative, reusable models capture relevant aspects of the behavior of simple devices (e.g. valves or thrusters). Reasoning algorithms combine device models to create a model of the system-wide interactions and behavior of a complex, unique artifact such as a spacecraft. Rather than requiring engineers to all possible interactions and failures at design time or perform analysis during the mission, the reasoning engine generates the appropriate response to the current situation, taking into account its system-wide knowledge, the current state, and even sensor failures or unexpected behavior.

Adjunctive therapy (whole body hyperthermia versus lonidamine) to total body irradiation for the treatment of favorable B-cell neoplasms: a report of two pilot clinical trials and laboratory investigations.

PubMed

Robins, H I; Longo, W L; Steeves, R A; Cohen, J D; Schmitt, C L; Neville, A J; O'Keefe, S; Lagoni, R; Riggs, C

1990-04-01

Based on earlier clinical and preclinical investigations, we designed two different pilot trials for patients with nodular lymphoma or chronic lymphocytic leukemia. These studies evaluated the use of either 41.8 degrees C whole body hyperthermia (WBH), or the nonmyelosuppressive chemotherapeutic drug, lonidamine (LON), as an adjunct to total body irradiation (TBI) (12.5 cGy twice a week, every other week for a planned total dose of 150 cGy). Whole body hyperthermia was initiated approximately 10 min after total body irradiation; lonidamine was administered orally (420 mg/m2) on a daily basis. Although entry to the studies was nonrandomized, the two patient populations were accrued during the same time frame and were comparable in terms of histology, stage of disease, performance status, and prior therapy. Of 8 patients entered on the TBI/WBH study, we observed 3 complete responses (CR), 4 partial responses (PR), and 1 improvement (i.e., a 48% decrease in tumor burden). Of 10 patients entered in the TBI/LON study, there was 1 CR and 4 PR. For the TBI/WBH study, myelosuppression was not treatment-limiting; there were no instances of infection or bleeding and platelet support was never required. The median survival time for the TBI/WBH study is 52.5 months based on Kaplan Meir estimates. Two patients remain in a CR. The median time to treatment failure (MTTF) is 9.4 months (90% confidence interval = 7-15.4 months). In the TBI/LON study, 50% of patients receiving TBI required treatment modification due to platelet-count depression during therapy, but there were no instances of infection or bleeding. Frequently observed LON-related toxicities included myalgias, testicular pain, photophobia and ototoxicity. For the TBI/LON study, median survival is 7.6 months; MTTF was 2.4 months. In analyzing the results of these pilot studies, our subjective clinical impressions lead to the hypothesis that WBH protected against TBI-induced thrombocytopenia during therapy, whereas LON had no effect on TBI-induced myelosuppression. This speculation was tested and confirmed in a series of in vitro and in vivo experiments.

Assessing flight safety differences between the United States regional and major airlines

NASA Astrophysics Data System (ADS)

Sharp, Broderick H.

During 2008, the U.S. domestic airline departures exceeded 28,000 flights per day. Thirty-nine or less than 0.2 of 1% of these flights resulted in operational incidents or accidents. However, even a low percentage of airline accidents and incidents continue to cause human suffering and property loss. The charge of this study was the comparison of U.S. major and regional airline safety histories. The study spans safety events from January 1982 through December 2008. In this quantitative analysis, domestic major and regional airlines were statistically tested for their flight safety differences. Four major airlines and thirty-seven regional airlines qualified for the safety study which compared the airline groups' fatal accidents, incidents, non-fatal accidents, pilot errors, and the remaining six safety event probable cause types. The six other probable cause types are mechanical failure, weather, air traffic control, maintenance, other, and unknown causes. The National Transportation Safety Board investigated each airline safety event, and assigned a probable cause to each event. A sample of 500 events was randomly selected from the 1,391 airlines' accident and incident population. The airline groups' safety event probabilities were estimated using the least squares linear regression. A probability significance level of 5% was chosen to conclude the appropriate research question hypothesis. The airline fatal accidents and incidents probability levels were 1.2% and 0.05% respectively. These two research questions did not reach the 5% significance level threshold. Therefore, the airline groups' fatal accidents and non-destructive incidents probabilities favored the airline groups' safety differences hypothesis. The linear progression estimates for the remaining three research questions were 71.5% for non-fatal accidents, 21.8% for the pilot errors, and 7.4% significance level for the six probable causes. These research questions' linear regressions are greater than the 5% level. Consequently, these three research questions favored airline groups' safety similarities hypothesis. The study indicates the U.S. domestic major airlines were safer than the regional airlines. Ideas for potential airline safety progress can examine pilot fatigue, the airline groups' hiring policies, the government's airline oversight personnel, or the comparison of individual airline's operational policies.

Design validation and performance of closed loop gas recirculation system

NASA Astrophysics Data System (ADS)

Kalmani, S. D.; Joshi, A. V.; Majumder, G.; Mondal, N. K.; Shinde, R. R.

2016-11-01

A pilot experimental set up of the India Based Neutrino Observatory's ICAL detector has been operational for the last 4 years at TIFR, Mumbai. Twelve glass RPC detectors of size 2 × 2 m2, with a gas gap of 2 mm are under test in a closed loop gas recirculation system. These RPCs are continuously purged individually, with a gas mixture of R134a (C2H2F4), isobutane (iC4H10) and sulphur hexafluoride (SF6) at a steady rate of 360 ml/h to maintain about one volume change a day. To economize gas mixture consumption and to reduce the effluents from being released into the atmosphere, a closed loop system has been designed, fabricated and installed at TIFR. The pressure and flow rate in the loop is controlled by mass flow controllers and pressure transmitters. The performance and integrity of RPCs in the pilot experimental set up is being monitored to assess the effect of periodic fluctuation and transients in atmospheric pressure and temperature, room pressure variation, flow pulsations, uniformity of gas distribution and power failures. The capability of closed loop gas recirculation system to respond to these changes is also studied. The conclusions from the above experiment are presented. The validations of the first design considerations and subsequent modifications have provided improved guidelines for the future design of the engineering module gas system.

Promoting Resilience in High-risk Children in Jamaica: A Pilot Study of a Multimodal Intervention.

PubMed

Guzder, Jaswant; Paisley, Vanessa; Robertson-Hickling, Hilary; Hickling, Frederick W

2013-05-01

To assess the effectiveness of a multimodal afterschool and summer intervention called the Dream-A-World (DAW) Project for a cohort of school-aged Jamaican children from an impoverished, disadvantaged inner-city community in Kingston, Jamaica. Children were selected by their teachers based on severe disruptive disorders and academic underachievement and compared with a matched control group. The pilot was a child focused therapeutic modality without parental intervention for disruptive conduct and academic failure. A group psychotherapeutic intervention of creative arts therapies and remedial academic support adapted for the Jamaican context was implemented with 30 children from an inner-city primary school. The intervention was implemented over 2½ years spanning grade three to six with evaluation of outcomes using the ASEBA Teacher Report Form (TRF) and end of term grades for the intervention group versus matched controls who were offered usual school supports. The intervention group made significant improvements in school social and behavior adjustment measured by the TRF, with more successful outcome amongst boys for behavioral gains. No significant improvements were made by the girls. Limitations of cohort size, lack of parent data and questions of gender disparities in outcome were unresolved interpretative issues. This multi-modal mental health and academic intervention for high-risk children living in an impoverished, violent neighbourhood, improved global functioning of boys more than girls, and raised questions for design of further preventive planning.

Treatment of carcinoma in situ of the urinary bladder with an alpha-emitter immunoconjugate targeting the epidermal growth factor receptor: a pilot study.

PubMed

Autenrieth, Michael E; Seidl, Christof; Bruchertseifer, Frank; Horn, Thomas; Kurtz, Florian; Feuerecker, Benedikt; D'Alessandria, Calogero; Pfob, Christian; Nekolla, Stephan; Apostolidis, Christos; Mirzadeh, Saed; Gschwend, Jürgen E; Schwaiger, Markus; Scheidhauer, Klemens; Morgenstern, Alfred

2018-07-01

Patients with carcinoma in situ (CIS) of the bladder refractory to bacillus Calmette-Guérin (BCG) treatment are usually treated with cystectomy. Therefore, new treatment options with preservation of the urinary bladder are needed. The objective of the study was to investigate the feasibility, safety and efficacy of a novel targeted alpha-emitter immunotherapy for CIS after BCG treatment failure. A pilot study was conducted in 12 patients (age range 64-86 years, ten men, two women) with biopsy-proven CIS of the bladder refractory to BCG treatment. The patients were treated intravesically with a single instillation (one patient was treated twice) of the alpha-emitter 213 Bi coupled to an anti-EGFR antibody (366-821 MBq). The primary aims of the study were to determine the feasibility of treatment with the 213 Bi-immunoconjugate and evaluation of adverse effects. Therapeutic efficacy was monitored by histological mapping of the urinary bladder 8 weeks after treatment and at different time points thereafter. The study proved that intravesical instillation of the 213 Bi-immunoconjugate targeting EGFR is feasible. No adverse effects were observed and all blood and urine parameters determined remained in their normal ranges. Therapeutic efficacy was considered satisfactory, in that three of the 12 patients showed no signs of CIS 44, 30 and 3 months after treatment. Intravesical instillation of 213 Bi-anti-EGFR monoclonal antibody was well tolerated and showed therapeutic efficacy. Repeated instillation and/or instillation of higher activities of the 213 Bi-immunoconjugate might lead to better therapeutic outcomes. A phase I clinical trial is planned.

Expertise and responsibility effects on pilots' reactions to flight deck alerts in a simulator.

PubMed

Zheng, Yiyuan; Lu, Yanyu; Yang, Zheng; Fu, Shan

2014-11-01

Flight deck alerts provide system malfunction information designed to lead corresponding pilot reactions aimed at guaranteeing flight safety. This study examined the roles of expertise and flight responsibility and their relationship to pilots' reactions to flight deck alerts. There were 17 pilots composing 12 flight crews that were assigned into pairs according to flight hours and responsibilities. The experiment included 9 flight scenarios and was carried out in a CRJ-200 flight simulator. Pilot performance was recorded by a wide angle video camera, and four kinds of reactions to alerts were defined for analysis. Pilots tended to have immediate reactions to uninterrupted cautions, with a turning off rate as high as 75%. However, this rate decreased sharply when pilots encountered interrupted cautions and warnings; they also exhibited many wrong reactions to warnings. Pilots with more expertise had more reactions to uninterrupted cautions than those with less expertise, both as pilot flying and pilot monitoring. Meanwhile, the pilot monitoring, regardless of level of expertise, exhibited more reactions than the pilot flying. In addition, more experienced pilots were more likely to have wrong reactions to warnings while acting as the monitoring pilot. These results suggest that both expertise and flight responsibility influence pilots' reactions to alerts. Considering crew pairing strategy, when a pilot flying is a less experienced pilot, a more experience pilot is suggested to be the monitoring pilot. The results of this study have implications for understanding pilots' behaviors to flight deck alerts, calling for specialized training and design of approach alarms on the flight deck.

Randomized Crossover Study of the Natural Restorative Environment Intervention to Improve Attention and Mood in Heart Failure.

PubMed

Jung, Miyeon; Jonides, John; Northouse, Laurel; Berman, Marc G; Koelling, Todd M; Pressler, Susan J

In heart failure (HF), attention may be decreased because of lowered cerebral blood flow and increased attentional demands needed for self-care. Guided by the Attention Restoration Theory, the objective was to test the efficacy of the natural restorative environment (NRE) intervention on improving attention and mood among HF patients and healthy adults. A randomized crossover pilot study was conducted among 20 HF patients and an age- and education-matched comparison group of 20 healthy adults to test the efficacy of the NRE intervention compared with an active control intervention. Neuropsychological tests were administered to examine attention, particularly attention span, sustained attention, directed attention, and attention switching, at before and after the intervention. Mood was measured with the Positive and Negative Affect Schedule. No significant differences were found in attention and mood after the NRE intervention compared with the control intervention among the HF patients and the healthy adults. In analyses with HF patients and healthy adults combined (n = 40), significant differences were found. Compared with the control intervention, sustained attention improved after the NRE intervention (P = .001) regardless of the presence of HF. Compared with the healthy adults, HF patients performed significantly worse on attention switching after the control intervention (P = .045). The NRE intervention may be efficacious in improving sustained attention in HF patients. Future studies are needed to enhance the NRE intervention to be more efficacious and tailored for HF patients and test the efficacy in a larger sample of HF patients.

Accident of the DC-10 EC-DEG aircraft at Malaga on September 13, 1982

NASA Technical Reports Server (NTRS)

1986-01-01

The present analysis of the abortive takeoff-type accident of a DC-10 at Malaga airport gives attention to the velocity profiles of the aircraft from takeoff to ground impact. A fire followed ground impact. Takeoff was initiated by the crew with only 1295 m of runway left beneath the aircraft. On the basis of the data obtained by this analysis, it is recommended that both pilots and other flight crew members be trained to respond to takeoff failures due to causes other than loss of engine power, such as landing gear collapse.

Aerospace clinical psychology and its role in serving practitioners of hazardous activities.

PubMed

King, R

1999-04-01

Aerospace clinical psychology is defined as a special application of psychology to the hazardous and stressful occupations associated with aviation and space flight. Aerospace clinical psychological services usually are offered on a unit or organizational level, though interventions can be designed for individuals and their families. The application of aerospace clinical psychology to the "failing aviator" is described and the current status of the field is provided. The roles of flight surgeons and mental health providers are explained. Associations between poor pilot coping skills and failure at crew resource management are explored. Areas for future research are detailed.

The psychophysiological assessment method for pilot's professional reliability.

PubMed

Zhang, L M; Yu, L S; Wang, K N; Jing, B S; Fang, C

1997-05-01

Previous research has shown that a pilot's professional reliability depends on two relative factors: the pilot's functional state and the demands of task workload. The Psychophysiological Reserve Capacity (PRC) is defined as a pilot's ability to accomplish additive tasks without reducing the performance of the primary task (flight task). We hypothesized that the PRC was a mirror of the pilot's functional state. The purpose of this study was to probe the psychophysiological method for evaluating a pilot's professional reliability on a simulator. The PRC Comprehensive Evaluating System (PRCCES) which was used in the experiment included four subsystems: a) quantitative evaluation system for pilot's performance on simulator; b) secondary task display and quantitative estimating system; c) multiphysiological data monitoring and statistical system; and d) comprehensive evaluation system for pilot PRC. Two studies were performed. In study one, 63 healthy and 13 hospitalized pilots participated. Each pilot performed a double 180 degrees circuit flight program with and without secondary task (three digit operation). The operator performance, score of secondary task and cost of physiological effort were measured and compared by PRCCES in the two conditions. Then, each pilot's flight skill in training was subjectively scored by instructor pilot ratings. In study two, 7 healthy pilots volunteered to take part in the experiment on the effects of sleep deprivation on pilot's PRC. Each participant had PRC tested pre- and post-8 h sleep deprivation. The results show that the PRC values of a healthy pilot was positively correlated with abilities of flexibility, operating and correcting deviation, attention distribution, and accuracy of instrument flight in the air (r = 0.27-0.40, p < 0.05), and negatively correlated with emotional anxiety in flight (r = -0.40, p < 0.05). The values of PRC in healthy pilots (0.61 +/- 0.17) were significantly higher than that of hospitalized pilots (0.43 +/- 0.15) (p < 0.05). The PRC value after 8 h sleep loss (0.50 +/- 0.17) was significantly lower than those before sleep loss (0.70 +/- 0.15) (p < 0.05). We conclude that a pilot's PRC, which was closely related to flight ability and functional state, could partly represent the pilot's professional reliability. It is worthwhile to further research using a pilot's PRC as a predictor of mental workload in aircraft design.

Material Selection for Cable Gland to Improved Reliability of the High-hazard Industries

NASA Astrophysics Data System (ADS)

Vashchuk, S. P.; Slobodyan, S. M.; Deeva, V. S.; Vashchuk, D. S.

2018-01-01

The sealed cable glands (SCG) are available to ensure safest connection sheathed single wire for the hazard production facility (nuclear power plant and others) the same as pilot cable, control cables, radio-frequency cables et al. In this paper, we investigate the specifics of the material selection of SCG with the express aim of hazardous man-made facility. We discuss the safe working conditions for cable glands. The research indicates the sintering powdered metals cables provide the reliability growth due to their properties. A number of studies have demonstrated the verification of material selection. On the face of it, we make findings indicating that double glazed sealed units could enhance reliability. We had evaluated sample reliability under fire conditions, seismic load, and pressure containment failure. We used the samples mineral insulated thermocouple cable.

Digital Fly-By-Wire Flight Control Validation Experience

NASA Technical Reports Server (NTRS)

Szalai, K. J.; Jarvis, C. R.; Krier, G. E.; Megna, V. A.; Brock, L. D.; Odonnell, R. N.

1978-01-01

The experience gained in digital fly-by-wire technology through a flight test program being conducted by the NASA Dryden Flight Research Center in an F-8C aircraft is described. The system requirements are outlined, along with the requirements for flight qualification. The system is described, including the hardware components, the aircraft installation, and the system operation. The flight qualification experience is emphasized. The qualification process included the theoretical validation of the basic design, laboratory testing of the hardware and software elements, systems level testing, and flight testing. The most productive testing was performed on an iron bird aircraft, which used the actual electronic and hydraulic hardware and a simulation of the F-8 characteristics to provide the flight environment. The iron bird was used for sensor and system redundancy management testing, failure modes and effects testing, and stress testing in many cases with the pilot in the loop. The flight test program confirmed the quality of the validation process by achieving 50 flights without a known undetected failure and with no false alarms.

Verification of geomechanical integrity and prediction of long-term mineral trapping for the Ketzin CO2 storage pilot site

NASA Astrophysics Data System (ADS)

Kempka, Thomas; De Lucia, Marco; Kühn, Michael

2014-05-01

Static and dynamic numerical modelling generally accompany the entire CO2 storage site life cycle. Thereto, it is required to match the employed models with field observations on a regular basis in order to predict future site behaviour. We investigated the coupled processes at the Ketzin CO2 storage pilot site [1] using a model coupling concept focusing on the temporal relevance of processes involved (hydraulic, chemical and mechanical) at given time-scales (site operation, abandonment and long-term stabilization). For that purpose, long-term dynamic multi-phase flow simulations [2], [3] established the basis for all simulations discussed in the following. Hereby, pressure changes resulting in geomechanical effects are largest during site operation, whereas geochemical reactions are governed by slow kinetics resulting in a long-term stabilization. To account for mechanical integrity, which may be mainly affected during site operation, we incorporated a regional-scale coupled hydro-mechanical model. Our simulation results show maximum ground surface displacements of about 4 mm, whereas shear and tensile failure are not observed. Consequently, the CO2 storage operation at the Ketzin pilot site does not compromise reservoir, caprock and fault integrity. Chemical processes responsible for mineral trapping are expected to mainly occur during long-term stabilization at the Ketzin pilot site [4]. Hence, our previous assessment [3] was extended by integrating two long-term mineral trapping scenarios. Thereby, mineral trapping contributes to the trapping mechanisms with 11.7 % after 16,000 years of simulation in our conservative and with 30.9 % in our maximum reactivity scenarios. Dynamic flow simulations indicate that only 0.2 % of the CO2 injected (about 67,270 t CO2 in total) is in gaseous state, but structurally trapped after 16,000 years. Depending on the studied long-term scenario, CO2 dissolution is the dominating trapping mechanism with 68.9 % and 88.1 %, respectively. We verified the mechanical integrity of the storage system during site operation and predicted the trapping mechanisms for the Ketzin pilot site based on a time-dependent integration of relevant processes for a time period of 16,000 years. Supported by our coupled modelling results, we conclude that CO2 storage at the Ketzin site is safe and reliable on the pilot scale. References [1] Martens, S., Kempka, T., Liebscher, A., Lüth, S., Möller, F., Myrttinen, A., Norden, B., Schmidt-Hattenberger, C., Zimmer, M., Kühn, M. Europe's longest-operating on-shore CO2 storage site at Ketzin, Germany: a progress report after three years of injection. Environmental Earth Sciences 2012 67(2): 323-334. [2] Kempka, T., Kühn, M. Numerical simulations of CO2 arrival times and reservoir pressure coincide with observations from the Ketzin pilot site, Germany. Environmental Earth Sciences 2013 70(8): 3675-3685. [3] Kempka, T., Klein, E., De Lucia, M., Tillner, E., Kühn, M. Assessment of Long-term CO2 Trapping Mechanisms at the Ketzin Pilot Site (Germany) by Coupled Numerical Modelling. Energy Procedia 2013 37: 5419-5426. [4] Klein, E., De Lucia, M., Kempka, T., Kühn, M. Evaluation of long-term mineral trapping at the Ketzin pilot site for CO2 storage: An integrative approach using geochemical modelling and reservoir simulation. International Journal of Greenhouse Gas Control 2013 19: 720-730.

Rehabilitation of executive functioning with training in attention regulation applied to individually defined goals: a pilot study bridging theory, assessment, and treatment.

PubMed

Novakovic-Agopian, Tatjana; Chen, Anthony J-W; Rome, Scott; Abrams, Gary; Castelli, Holli; Rossi, Annemarie; McKim, Ryan; Hills, Nancy; D'Esposito, Mark

2011-01-01

To assess feasibility and effects of training in goal-oriented attentional self-regulation for patients with brain injury and chronic executive dysfunction. Sixteen individuals with chronic brain injury and mild to moderate executive dysfunction. Participants were divided into 2 groups: one group completed goal-oriented attentional self-regulation training during the first 5 weeks, followed by a brief (2-hour) educational instruction session as a control midway through the second 5 weeks; the other group participated in reverse order. Neuropsychological and functional performance assessed at baseline and at weeks 5 and 10. Participants found training in goal-oriented attentional self-regulation engaging, incorporated some trained strategies into daily life, and reported subjective improvements in personal functioning. At week 5, participants who completed goals training significantly improved on tests of attention and executive function and had fewer functional task failures, while performance did not change after educational instruction. At week 10, participants who crossed over from educational instruction to goals training also significantly improved on attention and executive function tests. Participants who crossed from goals training to educational instruction maintained their week 5 gains. Training in goal-oriented attentional self-regulation is theoretically driven and feasible in a research setting. Pilot results suggest improvements in cognitive and functional domains targeted by the intervention.

Demonstration-scale evaluation of a novel high-solids anaerobic digestion process for converting organic wastes to fuel gas and compost.

PubMed

Rivard, C J; Duff, B W; Dickow, J H; Wiles, C C; Nagle, N J; Gaddy, J L; Clausen, E C

1998-01-01

Early evaluations of the bioconversion potential for combined wastes such as tuna sludge and sorted municipal solid waste (MSW) were conducted at laboratory scale and compared conventional low-solids, stirred-tank anaerobic systems with the novel, high-solids anaerobic digester (HSAD) design. Enhanced feedstock conversion rates and yields were determined for the HSAD system. In addition, the HSAD system demonstrated superior resiliency to process failure. Utilizing relatively dry feedstocks, the HSAD system is approximately one-tenth the size of conventional low-solids systems. In addition, the HSAD system is capable of organic loading rates (OLRs) on the order of 20-25 g volatile solids per liter digester volume per d (gVS/L/d), roughly 4-5 times those of conventional systems. Current efforts involve developing a demonstration-scale (pilot-scale) HSAD system. A two-ton/d plant has been constructed in Stanton, CA and is currently in the commissioning/startup phase. The purposes of the project are to verify laboratory- and intermediate-scale process performance; test the performance of large-scale prototype mechanical systems; demonstrate the long-term reliability of the process; and generate the process and economic data required for the design, financing, and construction of full-scale commercial systems. This study presents conformational fermentation data obtained at intermediate-scale and a snapshot of the pilot-scale project.

Defining Feasibility and Pilot Studies in Preparation for Randomised Controlled Trials: Development of a Conceptual Framework.

PubMed

Eldridge, Sandra M; Lancaster, Gillian A; Campbell, Michael J; Thabane, Lehana; Hopewell, Sally; Coleman, Claire L; Bond, Christine M

2016-01-01

We describe a framework for defining pilot and feasibility studies focusing on studies conducted in preparation for a randomised controlled trial. To develop the framework, we undertook a Delphi survey; ran an open meeting at a trial methodology conference; conducted a review of definitions outside the health research context; consulted experts at an international consensus meeting; and reviewed 27 empirical pilot or feasibility studies. We initially adopted mutually exclusive definitions of pilot and feasibility studies. However, some Delphi survey respondents and the majority of open meeting attendees disagreed with the idea of mutually exclusive definitions. Their viewpoint was supported by definitions outside the health research context, the use of the terms 'pilot' and 'feasibility' in the literature, and participants at the international consensus meeting. In our framework, pilot studies are a subset of feasibility studies, rather than the two being mutually exclusive. A feasibility study asks whether something can be done, should we proceed with it, and if so, how. A pilot study asks the same questions but also has a specific design feature: in a pilot study a future study, or part of a future study, is conducted on a smaller scale. We suggest that to facilitate their identification, these studies should be clearly identified using the terms 'feasibility' or 'pilot' as appropriate. This should include feasibility studies that are largely qualitative; we found these difficult to identify in electronic searches because researchers rarely used the term 'feasibility' in the title or abstract of such studies. Investigators should also report appropriate objectives and methods related to feasibility; and give clear confirmation that their study is in preparation for a future randomised controlled trial designed to assess the effect of an intervention.

Human factors in aviation crashes involving older pilots.

PubMed

Li, Guohua; Baker, Susan P; Lamb, Margaret W; Grabowski, Jurek G; Rebok, George W

2002-02-01

Pilot errors are recognized as a contributing factor in as many as 80% of aviation crashes. Experimental studies using flight simulators indicate that due to decreased working memory capacity, older pilots are outperformed by their younger counterparts in communication tasks and flight summary scores. This study examines age-related differences in crash circumstances and pilot errors in a sample of pilots who flew commuter aircraft or air taxis and who were involved in airplane or helicopter crashes. A historical cohort of 3306 pilots who in 1987 flew commuter aircraft or air taxis and were 45-54 yr of age was constructed using the Federal Aviation Administration's airmen information system. Crash records of the study subjects for the years 1983-1997 were obtained from the National Transportation Safety Board (NTSB) by matching name and date of birth. NTSB's investigation reports were reviewed to identify pilot errors and other contributing factors. Comparisons of crash circumstances and human factors were made between pilots aged 40-49 yr and pilots aged 50-63 yr. A total of 165 crash records were studied, with 52% of these crashes involving pilots aged 50-63 yr. Crash circumstances, such as time and location of crash, type and phase of flight, and weather conditions, were similar between the two age groups. Pilot error was a contributing factor in 73% of the crashes involving younger pilots and in 69% of the crashes involving older pilots (p = 0.50). Age-related differences in the pattern of pilot errors were statistically insignificant. Overall, 23% of pilot errors were attributable to inattentiveness, 20% to flawed decisions, 18% to mishandled aircraft kinetics, and 18% to mishandled wind/runway conditions. Neither crash circumstances nor the prevalence and patterns of pilot errors appear to change significantly as age increases from the 40s to the 50s and early 60s.

Differential subsidence and its effect on subsurface infrastructure: predicting probability of pipeline failure (STOOP project)

NASA Astrophysics Data System (ADS)

de Bruijn, Renée; Dabekaussen, Willem; Hijma, Marc; Wiersma, Ane; Abspoel-Bukman, Linda; Boeije, Remco; Courage, Wim; van der Geest, Johan; Hamburg, Marc; Harmsma, Edwin; Helmholt, Kristian; van den Heuvel, Frank; Kruse, Henk; Langius, Erik; Lazovik, Elena

2017-04-01

Due to heterogeneity of the subsurface in the delta environment of the Netherlands, differential subsidence over short distances results in tension and subsequent wear of subsurface infrastructure, such as water and gas pipelines. Due to uncertainties in the build-up of the subsurface, however, it is unknown where this problem is the most prominent. This is a problem for asset managers deciding when a pipeline needs replacement: damaged pipelines endanger security of supply and pose a significant threat to safety, yet premature replacement raises needless expenses. In both cases, costs - financial or other - are high. Therefore, an interdisciplinary research team of geotechnicians, geologists and Big Data engineers from research institutes TNO, Deltares and SkyGeo developed a stochastic model to predict differential subsidence and the probability of consequent pipeline failure on a (sub-)street level. In this project pipeline data from company databases is combined with a stochastic geological model and information on (historical) groundwater levels and overburden material. Probability of pipeline failure is modelled by a coupling with a subsidence model and two separate models on pipeline behaviour under stress, using a probabilistic approach. The total length of pipelines (approx. 200.000 km operational in the Netherlands) and the complexity of the model chain that is needed to calculate a chance of failure, results in large computational challenges, as it requires massive evaluation of possible scenarios to reach the required level of confidence. To cope with this, a scalable computational infrastructure has been developed, composing a model workflow in which components have a heterogeneous technological basis. Three pilot areas covering an urban, a rural and a mixed environment, characterised by different groundwater-management strategies and different overburden histories, are used to evaluate the differences in subsidence and uncertainties that come with different types of land use. Furthermore, the model provides results with a measure of reliability, and determines what is the limiting input factor causing most uncertainty. The model results can be validated and further improved using inSAR data for these pilot areas, by iteratively revising model parameters. The design of the model is such, that it can be applied to the whole of the Netherlands. By assessing differential subsidence and its effect on pipelines over time, the model helps to establish when and where maintenance is due, by indicating what areas are particularly vulnerable, thereby increasing safety and lowering maintenance costs.

Patent foramen ovale and asymptomatic brain lesions in military fighter pilots.

PubMed

Kang, Kyung Wook; Kim, Joon-Tae; Choi, Won-Ho; Park, Won-Ju; Shin, Young Ho; Choi, Kang-Ho

2014-10-01

Previous studies have reported higher incidence of white matter lesions (WMLs) in military pilots. The anti-gravity straining maneuver, which fighter military pilots perform numerously during a flight is identical to the valsalva maneuver. We sought to investigate the prevalence of right-to-left shunt (RLS) associated with WMLs in military pilots. A prospective study was performed involving military pilots who visited the Airomedical Center. The pilots underwent brain magnetic resonance imaging (MRI) scan and transcranial Doppler (TCD) with intravenous injection of agitated saline solution for the detection of RLS. Periventricular WMLs (PVWMLs) on MRI were graded using Fazeka's scale, and deep WMLs (DWMLs) were graded using Scheltens's scale. This study included 81 military pilots. RLS on TCD was observed less frequently in non-fighter pilots than in fighter pilots (35.5% vs. 64.5%, p=0.011). Fighter pilot was an independently associated factor with RLS on the TCD. DWMLs were independently associated with RLSs through a patent foramen ovale (PFO) (OR 3.507, 95% CI 1.223-10.055, p=0.02). The results suggest that DWMLs in military pilots may significantly be associated with RLS via PFO. Additional investigations are warranted. Copyright © 2014 Elsevier B.V. All rights reserved.

Arab-American adolescent tobacco use: four pilot studies.

PubMed

Rice, Virginia Hill; Templin, Thomas; Kulwicki, Anahid

2003-11-01

Four pilot studies were conducted to determine the (1) current tobacco use patterns and predictors among 14- to 18-year-old Arab-American youths; (2) psychometric properties of study measures (English and Arabic); (3) cultural appropriateness of Project Toward No Tobacco (TNT) for intervention; (4) accessible population for a longitudinal study. Three studies were descriptive and one used a pretest-posttest design. From four Pilot Focus groups (N = 28 smokers) key tobacco use themes emerged along with information on study measures and the Project TNT intervention; Pilot Intervention tested the tailored Project TNT intervention with 9 Arab-American teens; Pilot Clinic (N = 44) determined the characteristics of the accessible teen health clinic population; and Pilot School (N = 119) obtained tobacco use data only. From Pilot Focus seven themes (being cool, "nshar ma'a al shabab" [hanging out with the guys], present [time] orientation, smoking feels and tastes good, keeps your mind off trouble, easy to get, and (many) "barriers to quitting") emerged from the data. In the Pilot Intervention a 37.5% cessation rate was found. In the Pilot Clinic study, 24% males and 17% females smoked. The current smoking rate in the Pilot School (N = 119) sample was 17%; 34% admitted to having ever smoked (even a puff). Significant predictors for current tobacco use included poor grades, stress, having many family members and peers who smoke, being exposed to many hours of smoking each day, receiving offers of tobacco products, advertising and mail, and believing that tobacco can help one to make friends. The four pilots contributed unique and essential knowledge for designing a longitudinal clinical trial on tobacco use by Arab-American adolescents.

Causes and risk factors for fatal accidents in non-commercial twin engine piston general aviation aircraft.

PubMed

Boyd, Douglas D

2015-04-01

Accidents in twin-engine aircraft carry a higher risk of fatality compared with single engine aircraft and constitute 9% of all general aviation accidents. The different flight profile (higher airspeed, service ceiling, increased fuel load, and aircraft yaw in engine failure) may make comparable studies on single-engine aircraft accident causes less relevant. The objective of this study was to identify the accident causes for non-commercial operations in twin engine aircraft. A NTSB accident database query for accidents in twin piston engine airplanes of 4-8 seat capacity with a maximum certified weight of 3000-8000lbs. operating under 14CFR Part 91 for the period spanning 2002 and 2012 returned 376 accidents. Accident causes and contributing factors were as per the NTSB final report categories. Total annual flight hour data for the twin engine piston aircraft fleet were obtained from the FAA. Statistical analyses employed Chi Square, Fisher's Exact and logistic regression analysis. Neither the combined fatal/non-fatal accident nor the fatal accident rate declined over the period spanning 2002-2012. Under visual weather conditions, the largest number, n=27, (27%) of fatal accidents was attributed to malfunction with a failure to follow single engine procedures representing the most common contributing factor. In degraded visibility, poor instrument approach procedures resulted in the greatest proportion of fatal crashes. Encountering thunderstorms was the most lethal of all accident causes with all occupants sustaining fatal injuries. At night, a failure to maintain obstacle/terrain clearance was the most common accident cause leading to 36% of fatal crashes. The results of logistic regression showed that operations at night (OR 3.7), off airport landings (OR 14.8) and post-impact fire (OR 7.2) all carried an excess risk of a fatal flight. This study indicates training areas that should receive increased emphasis for twin-engine training/recency. First, increased training should be provided on single engine procedures in the event of an engine failure. Second, more focus should be placed on instrument approaches and recovery from unusual aircraft attitude where visibility is degraded. Third, pilots should be made aware of appropriate speed selection for inadvertent flights in convective weather. Finally, emphasizing the importance of conducting night operations under instrument flight rules with its altitude restrictions should lead to a diminished proportion of accidents attributed to failure to maintain obstacle/terrain clearance. Copyright © 2015 Elsevier Ltd. All rights reserved.

Probiotic Amelioration of Azotemia in 5/6th Nephrectomized Sprague-Dawley Rats

PubMed Central

Ranganathan, Natarajan; Patel, Beena; Ranganathan, Pari; Marczely, Joseph; Dheer, Rahul; Chordia, Tushar; Dunn, Stephen R.; Friedman, Eli A.

2005-01-01

The present study was to test the hypothesis that selected bacteria instilled into the gastrointestinal tract could help in converting nitrogenous wastes accumulated due to renal insufficiency into nontoxic compounds; thereby, ameliorating the biochemical imbalance. Herein we describe a prospective, blinded, placebo-controlled pilot study, using 5/6th nephrectomized Sprague Dawley rat as a chronic renal failure model. The study group consisted of 36 nephrectomized and 7 non-nephrectomized (control) rats. After two-week nephrectomy stabilization, cohorts of six nephrectomized rats were fed casein-based diet plus one of the following regimens: (A) Control, (B) Placebo (casein-based diet without probiotics), (C) Bacillus pasteurii, (D) Sporolac®, (E) Kibow cocktail, (F) CHR Hansen Cocktail, and (G) ECONORMTM. Subsequently, blood (retro-orbital) and urine (collected for measurements of blood urea-nitrogen and creatinine respectively), body weight and bacterial counts (feces) were obtained at regular intervals. The study end-points were to determine if any of the probiotic dietary supplements facilitated, (1) decreased blood concentrations of uremic toxins, (2) altered renal function, and (3) prolonged survival. After 16 weeks of treatment, regimens C and D significantly prolonged the life span of uremic rats, in addition to showing a reduction in blood urea-nitrogen levels, concluding that supplementation of probiotic formulation to uremic rats slows the progression of azotemia, which may correlate with prolonged life span of uremic rats. Derivative trials of probiotic treatment of larger animals and humans will further assess the potential role of probiotic formulations in delaying the onset and clinical severity of clinical illness at different stages of renal failure. PMID:16127597

Handheld computers and the 21st century surgical team: a pilot study.

PubMed

Aziz, Omer; Panesar, Sukhmeet S; Netuveli, Gopalakrishnan; Paraskeva, Paraskevas; Sheikh, Aziz; Darzi, Ara

2005-08-18

The commercial development and expansion of mobile phone networks has led to the creation of devices combining mobile phones and personal digital assistants, which could prove invaluable in a clinical setting. This pilot study aimed to look at how one such device compared with the current pager system in facilitating inter-professional communication in a hospital clinical team. The study looked at a heterogeneous team of doctors (n = 9) working in a busy surgical setting at St. Mary's Hospital in London and compared the use of a personal digital assistant with mobile phone and web-browsing facilities to the existing pager system. The primary feature of this device being compared to the conventional pager was its use as a mobile phone, but other features evaluated included the ability to access the internet, and reference data on the device. A crossover study was carried out for 6 weeks in 2004, with the team having access to the personal digital assistant every alternate week. The primary outcome measure for assessing efficiency of communication was the length of time it took for clinicians to respond to a call. We also sought to assess the ease of adoption of new technology by evaluating the perceptions of the team (n = 9) to personal digital assistants, by administering a questionnaire. Doctors equipped with a personal digital assistant rather than a pager, responded more quickly to a call and had a lower of failure to respond rate (RR: 0.44; 95%CI 0.20-0.93). Clinicians also found this technology easy to adopt as seen by a significant reduction in perceptions of nervousness to the technology over the six-week study period (mean (SD) week 1: 4.10 (SD 1.69) vs. mean (SD) week 6: 2.20 (1.99); p = 0.04). The results of this pilot study show the possible effects of replacing the current hospital pager with a newer, more technologically advanced device, and suggest that a combined personal digital assistant and mobile phone device may improve communication between doctors. In the light of these encouraging preliminary findings, we propose a large-scale clinical trial of the use of these devices in facilitating inter-professional communication in a hospital setting.

[Comparative results of preimplantation genetic screening by array comparative genomic hybridization and new-generation sequencing].

PubMed

Aleksandrova, N V; Shubina, E S; Ekimov, A N; Kodyleva, T A; Mukosey, I S; Makarova, N P; Kulakova, E V; Levkov, L A; Barkov, I Yu; Trofimov, D Yu; Sukhikh, G T

2017-01-01

Aneuploidies as quantitative chromosome abnormalities are a main cause of failed development of morphologically normal embryos, implantation failures, and early reproductive losses. Preimplantation genetic screening (PGS) allows a preselection of embryos with a normal karyotype, thus increasing the implantation rate and reducing the frequency of early pregnancy loss after IVF. Modern PGS technologies are based on a genome-wide analysis of the embryo. The first pilot study in Russia was performed to assess the possibility of using semiconductor new-generation sequencing (NGS) as a PGS method. NGS data were collected for 38 biopsied embryos and compared with the data from array comparative genomic hybridization (array-CGH). The concordance between the NGS and array-CGH data was 94.8%. Two samples showed the karyotype 47,XXY by array-CGH and a normal karyotype by NGS. The discrepancies may be explained by loss of efficiency of array-CGH amplicon labeling.

Enhanced Psychosocial Support for Caregiver Burden for Patients With Chronic Kidney Failure Choosing Not to Be Treated by Dialysis or Transplantation: A Pilot Randomized Controlled Trial.

PubMed

Chan, Kwok Ying; Yip, Terence; Yap, Desmond Y H; Sham, Mau Kwong; Wong, Yim Chi; Lau, Vikki Wai Kee; Li, Cho Wing; Cheng, Benjamin Hon Wai; Lo, Wai Kei; Chan, Tak Mao

2016-04-01

Family caregivers of patients with chronic kidney failure have increased burden, as reflected by their high frequency of physical and mental disturbances. The impact of enhanced psychosocial support to caregivers of patients with chronic kidney failure remains unclear. Open-label randomized controlled trial. All new patients referred to the renal palliative clinic were screened. Caregivers of patients who met the following criteria were recruited: (1) chronic kidney failure as defined by creatinine clearance < 15 mL/min, (2) opted for conservative management by nephrology team or patient, (3) never treated with dialysis or transplantation, and (4) able to provide informed consent. Random assignment to treatment with enhanced psychosocial support or standard renal care (control). Enhanced psychosocial support included counseling and psychosocial interventions by an on-site palliative care nurse and designated social worker. Each caregiver was followed up at 2- to 4-week intervals for up to 6 months. Zarit Burden Inventory (ZBI) and Hospital Anxiety and Depression Scale (HADS) in caregivers and McGill Quality of Life scores in patients of both groups were compared. 29 pairs of family caregivers/patients with chronic kidney failure were randomly assigned (intervention, n=14; control, n=15). Mean ages of patients and caregivers were 81.6 ± 5.1 and 59.8 ± 14.2 (SD) years, respectively. The intervention group showed significantly lower ZBI scores than the control group at 1 and 3 months (22.0 ± 5.3 vs 31.6 ± 9.5 and 21.3 ± 6.6 vs 33.4 ± 7.2; P=0.006 and P=0.009, respectively). HADS anxiety scores of caregivers who received the intervention were significantly lower than those of controls at 1 and 3 months (7.1 ± 3.2 vs 10.1 ± 2.2 and 6.5 ± 4.5 vs 11.0 ± 3.1; P=0.01 and P=0.03, respectively). Insignificant reductions in ZBI and HADS scores were found at 6 months. 19 patients died (intervention, n=10; control, n=9) during the study period. The study is limited by a relatively small sample size and short duration. Enhanced psychosocial support program in patients with chronic kidney failure and caregivers resulted in an early significant reduction in caregiver burden and anxiety. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Persian Registry Of cardioVascular diseasE (PROVE): Design and methodology.

PubMed

Givi, Mahshid; Sarrafzadegan, Nizal; Garakyaraghi, Mohammad; Yadegarfar, Ghasem; Sadeghi, Masoumeh; Khosravi, Alireza; Azhari, Amir Hossein; Samienasab, Mohammad Reza; Shafie, Davood; Saadatnia, Mohammad; Roohafza, Hamidreza; Paydari, Navid; Soleimani, Azam; Hosseinzadeh, Mohsen; Ahmadi, Seyed Abdulah; Dehghani, Leila; Najafian, Jamshid; Andalib, Elham; Shahabi, Javad; Sabri, Mohammad Reza

2017-09-01

Our aim was to create and establish a database called "Persian Registry Of cardioVascular diseasE (PROVE)" in order to be used for future research and in addition, as a tool to develop national guidelines for diagnosis, treatment, and prevention of cardiovascular disease (CVD). In this paper, the design and methodology of the PROVE pilot study will be discussed, launched in Isfahan, Iran, in 2015-2016. Through establishing PROVE, patients' data were collected from hospitals and outpatient clinics prospectively or retrospectively and followed up for a maximum of three years based on the type of CVDs. The inclusion criteria were as patients with acute coronary syndrome (ACS), ST elevation myocardial infarction (STEMI), stroke, atrial fibrillation (AF), heart failure (HF), congenital heart disease (CHD), percutaneous coronary intervention (PCI), and chronic ischemic cardiovascular disease (CICD). Specific protocols, questionnaires, and glossaries were developed for each registry. In order to ensure the validation of the protocols, questionnaires, data collection, management, and analysis, a well-established quality control (QC) protocol was developed and implemented. Data confidentiality was considered. In order to register patients with ACS, STEMI, stroke, HF, PCI, and CICD, the hospital recorded data were used, whereas, in case of AF and CHD registries, the data were collected from hospitals and outpatient clinics. During the pilot phase of the study in Isfahan, from March 2015 to September 2016, 9427 patients were registered as ACS including 809 as STEMI, 1195 patients with HF, 363 with AF, 761 with stroke, 1136 with CHD, 1200 with PCI, and 9 with CICD. Data collection and management were performed under the supervision of the QC group. PROVE was developed and implemented in Isfahan as a pilot study, in order to be implemented at national level in future. It provides a valuable source of valid data that could be used for future research, re-evaluation of current CVD management and more specifically, gap analysis and as a tool for assessment of the type of CVDs, prevention, treatment, and control by health care decision makers.

SUPERFUND TREATABILITY CLEARINGHOUSE: PILOT STUDY OF ENCLOSED THERMAL SOIL AERATION FOR REMOVAL OF VOLATILE ORGANIC CONTAMINATION AT THE MCKIN SUPERFUND SITE

EPA Science Inventory

This paper reports on the results of a pilot study that treated vadose zone soil contaminated with VOCs in an enclosed thermal aeration system. The McKin site, an NPL site in Grey, Maine, was the location of the pilot study. The pilot study was chosen to demonstrate the viabili...

Correlation between gonial angle and dynamic tongue collapse in children with snoring/sleep disordered breathing - an exploratory pilot study.

PubMed

Anderson, S; Alsufyani, N; Isaac, A; Gazzaz, M; El-Hakim, H

2018-06-04

Drug induced sleep endoscopy (DISE) is hoped to identify reasons of failure of adenotonsillectomy (AT) in treating pediatric sleep disordered breathing (SDB). Maxillomandibular disproportion has been studied as another association which may explain alternative pathogenesis of SDB. We aimed to explore the relation between the size of the gonial angle and inclination of the epiglottis measured from cone beam CT (CBCT) and tongue base collapse based on DISE in children with SDB. A retrospective chart review was conducted at a tertiary pediatric center. Children (6-17 years old) assessed at a multi-disciplinary Upper Airway Clinic, diagnosed with SDB and maxillo-mandibular disproportion (MMD), and who underwent DISE were eligible. Variables obtained from the electronic medical records of the clinic and prospective database included demographics, comorbidities, surgeries performed, investigations, DISE findings and CBCT findings. The gonial angle of subjects with and without tongue base collapse (TBC) on SNP were compared. In total 29 patients (13 male, 8 female) age 6-17 (median= 9) were eligible for the study from January 2009 - July 2016. We included 11 subjects, and 10 comparators. The mean gonial angle of the TBC group was 139.3°± 7.6°, while that of the comparison group was 129.4°±3.5 (mean difference -9.937, 95% CI of -15.454 to - 4.421, P = 0.001, power of test 0.95). Additionally, the mean inclination of the epiglottis had a mild positive correlation (r=0.32, p<0.05) with the gonial angle, in the whole cohort. This pilot study suggests that TBC may be mediated by a wider gonial angle in children with SDB patients. The posterior tilt of the epiglottis on CBCT may be a surrogate sign of TBC.

The Langley-Newcomb brouhaha over the flying machine

NASA Astrophysics Data System (ADS)

Carter, W. E.; Carter, M. S.

One century after the Wright brothers proved it was possible to build a piloted heavier-than-air “flying machine,” several airlines will soon, perhaps as early as October 2005, begin to operate the largest passenger aircraft ever built, the Airbus A380. The A380 is nearly half again as large, in terms of passenger floor space, as the Boeing 747-400. It can be configured to hold as many as 840 passengers, and it has a takeoff weight of 550,000 kg, a maximum range of 15,000 km, and a cruising speed of Mach 0.85.The remarkable advances in aeronautics realized during the past century make it difficult to understand how anyone, let alone Simon Newcomb, one of the most prominent U.S. scientists at the turn of the twentieth century, could have opposed efforts by Samuel Pierpont Langley to build a piloted winged aircraft for the military. Newcomb argued that Langley was doomed to failure because the technology required to build such an aircraft was not then available, and he bemoaned the “waste” of scarce government funds toward the effort.

Anthropometric accommodation in USAF cockpits

NASA Technical Reports Server (NTRS)

Zehner, Gregory F.

1994-01-01

Over the past three years, a new set of methodologies has been developed to specify and evaluate anthropometric accommodation in USAF crewstation designs. These techniques are used to improve the ability of the pilot to reach controls, to safely escape the aircraft, to achieve adequate mobility and comfort, and to assure full access to the visual field both inside and outside the aircraft. This paper summarized commonly encountered aircraft accommodation problems, explains the failure of the traditional 'percentile man' design concept to resolve these difficulties, and suggests an alternative approach for improving cockpit design to better accommodate today's more heterogeneous flying population.

Using street view imagery for 3-D survey of rock slope failures

NASA Astrophysics Data System (ADS)

Voumard, Jérémie; Abellán, Antonio; Nicolet, Pierrick; Penna, Ivanna; Chanut, Marie-Aurélie; Derron, Marc-Henri; Jaboyedoff, Michel

2017-12-01

We discuss here different challenges and limitations of surveying rock slope failures using 3-D reconstruction from image sets acquired from street view imagery (SVI). We show how rock slope surveying can be performed using two or more image sets using online imagery with photographs from the same site but acquired at different instances. Three sites in the French alps were selected as pilot study areas: (1) a cliff beside a road where a protective wall collapsed, consisting of two image sets (60 and 50 images in each set) captured within a 6-year time frame; (2) a large-scale active landslide located on a slope at 250 m from the road, using seven image sets (50 to 80 images per set) from five different time periods with three image sets for one period; (3) a cliff over a tunnel which has collapsed, using two image sets captured in a 4-year time frame. The analysis include the use of different structure from motion (SfM) programs and a comparison between the extracted photogrammetric point clouds and a lidar-derived mesh that was used as a ground truth. Results show that both landslide deformation and estimation of fallen volumes were clearly identified in the different point clouds. Results are site- and software-dependent, as a function of the image set and number of images, with model accuracies ranging between 0.2 and 3.8 m in the best and worst scenario, respectively. Although some limitations derived from the generation of 3-D models from SVI were observed, this approach allowed us to obtain preliminary 3-D models of an area without on-field images, allowing extraction of the pre-failure topography that would not be available otherwise.

Pretest parametric calculations for the heated pillar experiment in the WIPP In-Situ Experimental Area

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

Branstetter, L.J.

Results are presented for a pretest parametric study of several configurations and heat loads for the heated pillar experiment (Room H) in the Waste Isolation Pilot Plant (WIPP) In Situ Experimental Area. The purpose of this study is to serve as a basis for selection of a final experiment geometry and heat load. The experiment consists of a pillar of undisturbed rock salt surrounded by an excavated annular room. The pillar surface is covered by a blanket heat source which is externally insulated. A total of five thermal and ten structural calculations are described in a four to five yearmore » experimental time frame. Results are presented which include relevant temperature-time histories, deformations, rock salt stress component and effective stress profiles, and maximum stresses in anhydrite layers which are in close proximity to the room. Also included are predicted contours of a conservative post-processed measure of potential salt failure. Observed displacement histories are seen to be highly dependent on pillar and room height, but insensitive to other geometrical variations. The use of a tensile cutoff across slidelines is seen to produce more accurate predictions of anhydrite maximum stress, but to have little effect on rock salt stresses. The potential for salt failure is seen to be small in each case for the time frame of interest, and is only seen at longer times in the center of the room floor.« less

Neural Flight Control System

NASA Technical Reports Server (NTRS)

Gundy-Burlet, Karen

2003-01-01

The Neural Flight Control System (NFCS) was developed to address the need for control systems that can be produced and tested at lower cost, easily adapted to prototype vehicles and for flight systems that can accommodate damaged control surfaces or changes to aircraft stability and control characteristics resulting from failures or accidents. NFCS utilizes on a neural network-based flight control algorithm which automatically compensates for a broad spectrum of unanticipated damage or failures of an aircraft in flight. Pilot stick and rudder pedal inputs are fed into a reference model which produces pitch, roll and yaw rate commands. The reference model frequencies and gains can be set to provide handling quality characteristics suitable for the aircraft of interest. The rate commands are used in conjunction with estimates of the aircraft s stability and control (S&C) derivatives by a simplified Dynamic Inverse controller to produce virtual elevator, aileron and rudder commands. These virtual surface deflection commands are optimally distributed across the aircraft s available control surfaces using linear programming theory. Sensor data is compared with the reference model rate commands to produce an error signal. A Proportional/Integral (PI) error controller "winds up" on the error signal and adds an augmented command to the reference model output with the effect of zeroing the error signal. In order to provide more consistent handling qualities for the pilot, neural networks learn the behavior of the error controller and add in the augmented command before the integrator winds up. In the case of damage sufficient to affect the handling qualities of the aircraft, an Adaptive Critic is utilized to reduce the reference model frequencies and gains to stay within a flyable envelope of the aircraft.

Learning to BREATHE: A Pilot Study of a Mindfulness-Based Intervention to Support Marginalized Youth

PubMed Central

Eva, Amy L.; Thayer, Natalie M.

2017-01-01

Mindfulness-based curricular interventions can support adolescents who are at risk of school failure as they negotiate the transition from high school into young adulthood. Researchers hypothesized that a 6-week mindfulness-based intervention would lower participants’ perceived stress while increasing their reported levels of self-esteem. Participants (N = 23) ranged in age from 17 to 20 years while the majority were male students of color. Pre- and postintervention survey mean responses revealed statistically significant differences on the Single-Item Self-Esteem Scale and 3 items on the Perceived Stress Scale (with small to moderate effect sizes). Postintervention focus group (n = 8) data indicated that the most valued daily practice was the body scan technique. Open coding of the focus group data also revealed several key themes in the form of overarching codes as participants discussed intervention benefits. These included (a) self-regulation, (b) attention-awareness, and (c) positive thinking. PMID:29228794

Placental Growth Factor Levels in Populations with High Versus Low Risk for Cardiovascular Disease and Stressful Physiological Environments such as Microgravity: A Pilot Study

NASA Astrophysics Data System (ADS)

Sundaresan, Alamelu; Mehta, Satish K.; Schlegel, Todd. T.; Russomano, Thais; Pierson, Duane L.; Mann, Vivek; Mansoor, Elvedina; Olamigoke, Loretta; Okoro, Elvis

2017-02-01

This pilot study compared placental growth factor (PIGF) levels in populations with high versus low risk for cardiovascular disease. Previous experiments from our laboratory (Sundaresan et al. 2005, 2009) revealed that the angiogenic factor PIGF was up regulated in modeled microgravity conditions in human lymphocytes leading to possible atherogenesis and pathogenesis in microgravity. Since the findings came from microgravity analog experiments, there is a strong link to its usefulness in the microgravity field as a biomarker. It is important to understand, that these findings came from both studies on expression levels of this cardiovascular marker in human lymphocytes in microgravity ( in vitro microgravity analog), and a follow up gene expression study in hind limb suspended mice ( in vivo microgravity analog). The relevance is enhanced because in life on earth, PIGF is an inflammatory biomarker for cardiovascular disease. Studies on the levels of PIGF would help to reduce the risk and prevention of heart failures in astronauts. If we can use this marker to predict and reduce the risk of cardiac events in astronauts and pilots, it would significantly help aerospace medicine operations. The investigations here confirmed that in a cardiovascular stressed population such as coronary artery disease (CAD) and acute coronary syndrome (ACS) patients, PIGF could be overexpressed. We desired to re-evaluate this marker in patients with cardiovascular disease in our own study. PIGF is a marker of inflammation and a predictor of short-term and long-term adverse outcome in ACS. In addition, elevated PIGF levels may be associated with increased risk for CAD.PIGF levels were determined in thirty-one patients undergoing cardiovascular catheterization for reasons other than ACS and in thirty-three low-risk asymptomatic subjects. Additional data on traditional cardiovascular risk factors for both populations were also compiled and compared. We found that PIGF levels were significantly higher in the high-risk population as compared to low-risk population. Also we were able to ascertain that PIGF levels were inversely correlated with HDL-cholesterol but directly correlated with the triglyceride levels. With further validation, PIGF may prove a useful addition to the armamentarium of noninvasive biomarkers for cardiovascular disease including a new area of stressful physiological conditions such as microgravity.