Stability of infinite slopes under transient partially saturated seepage conditions

NASA Astrophysics Data System (ADS)

Godt, Jonathan W.; ŞEner-Kaya, BaşAk; Lu, Ning; Baum, Rex L.

2012-05-01

Prediction of the location and timing of rainfall-induced shallow landslides is desired by organizations responsible for hazard management and warnings. However, hydrologic and mechanical processes in the vadose zone complicate such predictions. Infiltrating rainfall must typically pass through an unsaturated layer before reaching the irregular and usually discontinuous shallow water table. This process is dynamic and a function of precipitation intensity and duration, the initial moisture conditions and hydrologic properties of the hillside materials, and the geometry, stratigraphy, and vegetation of the hillslope. As a result, pore water pressures, volumetric water content, effective stress, and thus the propensity for landsliding vary over seasonal and shorter time scales. We apply a general framework for assessing the stability of infinite slopes under transient variably saturated conditions. The framework includes profiles of pressure head and volumetric water content combined with a general effective stress for slope stability analysis. The general effective stress, or suction stress, provides a means for rigorous quantification of stress changes due to rainfall and infiltration and thus the analysis of slope stability over the range of volumetric water contents and pressure heads relevant to shallow landslide initiation. We present results using an analytical solution for transient infiltration for a range of soil texture and hydrological properties typical of landslide-prone hillslopes and show the effect of these properties on the timing and depth of slope failure. We follow by analyzing field-monitoring data acquired prior to shallow landslide failure of a hillside near Seattle, Washington, and show that the timing of the slide was predictable using measured pressure head and volumetric water content and show how the approach can be used in a forward manner using a numerical model for transient infiltration.

Predictive and prognostic value of PET/CT imaging post-chemoradiotherapy and clinical decision-making consequences in locally advanced head & neck squamous cell carcinoma: a retrospective study.

PubMed

Kim, Ryul; Ock, Chan-Young; Keam, Bhumsuk; Kim, Tae Min; Kim, Jin Ho; Paeng, Jin Chul; Kwon, Seong Keun; Hah, J Hun; Kwon, Tack-Kyun; Kim, Dong-Wan; Wu, Hong-Gyun; Sung, Myung-Whun; Heo, Dae Seog

2016-02-17

The accuracy of (18)F-fluorodeoxygluocose positron emission tomography/computed tomography (PET/CT) in predicting immediate failure after radical chemoradiotherapy (CRT) for HNSCC is poorly characterized at present. The purpose of this study was to examine PET/CT as a predictive and prognostic gauge of immediate failure after CRT and determine the impact of these studies on clinical decision making in terms of salvage surgery. Medical records of 78 consecutive patients receiving radical CRT for locally advanced HNSCC were reviewed, analyzing PET/CTs done before and 3 months after CRT. Immediate failure was defined as residual disease or locoregional and/or systemic relapse within 6 months after CRT. Maximum standard uptake value (SUV) of post CRT PET/CT (postSUVmax) was found optimal for predicting immediate failure at a cutpoint of 4.4. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) were 90.0%, 83.8%, 98.3%, and 45.0%, respectively. Of 78 patients studied, postSUVmax ≥ 4.4 prevailed in 20 (25.6%), with postSUVmax <4.4 in 58 (74.4%). At postSUVmax ≥ 4.4 (vs. postSUVmax <4.4) OS was poorer by comparison (3-year OS: 56.9 vs. 87.7%; P = 0.005), as was progression-free survival (3-year PFS: 42.9 vs. 81.1%; P < 0.001). At postSUVmax ≥ 4.4, OS with and without immediate salvage surgery did not differ significantly (3-year OS: 60.0 vs. 55.6%; Log-rank P = 0.913). Post CRT PET/CT imaging has prognostic value in terms of OS and PFS and is useful in predicting immediate therapeutic failure, given its high NPV. However, OS was not significantly altered by early salvage surgery done on the basis of post CRT PET/CT findings.

Permethrin and malathion resistance in head lice: results of ex vivo and molecular assays.

PubMed

Bouvresse, Sophie; Berdjane, Zohra; Durand, Rémy; Bouscaillou, Julie; Izri, Arezki; Chosidow, Olivier

2012-12-01

Treatment of head lice infestation relies on the application of topical insecticides. Overuse of these products has led to the emergence of resistance to pyrethroids and malathion worldwide. Permethrin resistance in head lice is mostly conferred by the knockdown resistance (kdr) trait. To evaluate the occurrence of permethrin- and malathion-resistant head lice in Paris. A prospective survey was conducted in 74 elementary schools. Live lice collected on schoolchildren were randomly selected and submitted to ex vivo bioassays or underwent individual DNA extraction. A fragment of kdr-like gene was amplified and compared with wild-type sequences. Live head lice were detected in 574 children. Ex vivo assays showed no surviving lice after a 1-hour contact with malathion while most lice died after a 1-hour exposure to permethrin and piperonyl butoxide (85.7%, 95% confidence interval [CI]: 83.9-87.5). Among the 670 lice with workable DNA sequences, 661 lice (98.7%, 95% CI 97.7-99.3) had homozygous kdr mutations. The findings of this large-scale survey of the occurrence of insecticide-resistant head lice indicated a major insecticide pressure in the study population, but it was not sufficient to draw conclusions about other populations. The presence of T917I-L920F mutations in kdr gene may not correlate with treatment failure in prospective studies. The high occurrence of kdr mutant allele suggests that insecticide resistance was already strongly established in the studied population. This finding must be interpreted with caution as it may not be predictive of treatment failure. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Simplified realistic human head model for simulating Tumor Treating Fields (TTFields).

PubMed

Wenger, Cornelia; Bomzon, Ze'ev; Salvador, Ricardo; Basser, Peter J; Miranda, Pedro C

2016-08-01

Tumor Treating Fields (TTFields) are alternating electric fields in the intermediate frequency range (100-300 kHz) of low-intensity (1-3 V/cm). TTFields are an anti-mitotic treatment against solid tumors, which are approved for Glioblastoma Multiforme (GBM) patients. These electric fields are induced non-invasively by transducer arrays placed directly on the patient's scalp. Cell culture experiments showed that treatment efficacy is dependent on the induced field intensity. In clinical practice, a software called NovoTalTM uses head measurements to estimate the optimal array placement to maximize the electric field delivery to the tumor. Computational studies predict an increase in the tumor's electric field strength when adapting transducer arrays to its location. Ideally, a personalized head model could be created for each patient, to calculate the electric field distribution for the specific situation. Thus, the optimal transducer layout could be inferred from field calculation rather than distance measurements. Nonetheless, creating realistic head models of patients is time-consuming and often needs user interaction, because automated image segmentation is prone to failure. This study presents a first approach to creating simplified head models consisting of convex hulls of the tissue layers. The model is able to account for anisotropic conductivity in the cortical tissues by using a tensor representation estimated from Diffusion Tensor Imaging. The induced electric field distribution is compared in the simplified and realistic head models. The average field intensities in the brain and tumor are generally slightly higher in the realistic head model, with a maximal ratio of 114% for a simplified model with reasonable layer thicknesses. Thus, the present pipeline is a fast and efficient means towards personalized head models with less complexity involved in characterizing tissue interfaces, while enabling accurate predictions of electric field distribution.

Failure mechanisms and closed reduction of a constrained tripolar acetabular liner.

PubMed

Robertson, William J; Mattern, Christopher J; Hur, John; Su, Edwin P; Pellicci, Paul M

2009-02-01

Unlike traditional bipolar constrained liners, the Osteonics Omnifit constrained acetabular insert is a tripolar device, consisting of an inner bipolar bearing articulating within an outer, true liner. Every reported failure of the Omnifit tripolar implant has been by failure at the shell-bone interface (Type I failure), failure at the shell-liner interface (Type II failure), or failure of the locking mechanism resulting in dislocation of the bipolar-liner interface (Type III failure). In this report we present two cases of failure of the Omnifit tripolar at the bipolar-femoral head interface. To our knowledge, these are the first reported cases of failure at the bipolar-femoral head interface (Type IV failure). In addition, we described the first successful closed reduction of a Type IV failure.

Multiscale Analysis of Head Impacts in Contact Sports

NASA Astrophysics Data System (ADS)

Guttag, Mark; Sett, Subham; Franck, Jennifer; McNamara, Kyle; Bar-Kochba, Eyal; Crisco, Joseph; Blume, Janet; Franck, Christian

2012-02-01

Traumatic brain injury (TBI) is one of the world's major causes of death and disability. To aid companies in designing safer and improved protective gear and to aid the medical community in producing improved quantitative TBI diagnosis and assessment tools, a multiscale finite element model of the human brain, head and neck is being developed. Recorded impact data from football and hockey helmets instrumented with accelerometers are compared to simulated impact data in the laboratory. Using data from these carefully constructed laboratory experiments, we can quantify impact location, magnitude, and linear and angular accelerations of the head. The resultant forces and accelerations are applied to a fully meshed head-form created from MRI data by Simpleware. With appropriate material properties for each region of the head-form, the Abaqus finite element model can determine the stresses, strains, and deformations in the brain. Simultaneously, an in-vitro cellular TBI criterion is being developed to be incorporated into Abaqus models for the brain. The cell-based injury criterion functions the same way that damage criteria for metals and other materials are used to predict failure in structural materials.

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.

Trunnion Failure of the Recalled Low Friction Ion Treatment Cobalt Chromium Alloy Femoral Head.

PubMed

Urish, Kenneth L; Hamlin, Brian R; Plakseychuk, Anton Y; Levison, Timothy J; Higgs, Genymphas B; Kurtz, Steven M; DiGioia, Anthony M

2017-09-01

Gross trunnion failure (GTF) is a rare complication in total hip arthroplasty (THA) reported across a range of manufacturers. Specific lots of the Stryker low friction ion treatment (LFIT) anatomic cobalt chromium alloy (CoCr) V40 femoral head were recalled in August 2016. In part, the recall was based out of concerns for disassociation of the femoral head from the stem and GTF. We report on 28 patients (30 implants) with either GTF (n = 18) or head-neck taper corrosion (n = 12) of the LFIT CoCr femoral head and the Accolade titanium-molybdenum-zirconium-iron alloy femoral stems. All these cases were associated with adverse local tissue reactions requiring revision of the THA. In our series, a conservative estimate of the incidence of failure was 4.7% (n = 636 total implanted) at 8.0 ± 1.4 years from the index procedure. Failures were associated with a high-offset 127° femoral stem neck angle and increased neck lengths; 43.3% (13 of 30) of the observed failures included implant sizes outside the voluntary recall (27.8% [5 of 18] of the GTF and 75.0% [8 of 12] of the taper corrosion cases). Serum cobalt and chromium levels were elevated (cobalt: 8.4 ± 7.0 μg/mL; chromium: 3.4 ± 3.3 μ/L; cobalt/chromium ratio: 3.7). The metal artifact reduction sequence magnetic resonance imaging demonstrated large cystic fluid collections typical with adverse local tissue reactions. During revision, a pseudotumor was observed in all cases. Pathology suggested a chronic inflammatory response. Impending GTF could be diagnosed based on aspiration of black synovial fluid and an oblique femoral head as compared with the neck taper on radiographs. In our series of the recalled LFIT CoCr femoral head, the risk of impending GTF or head-neck taper corrosion should be considered as a potential diagnosis in a painful LFIT femoral head and Accolade titanium-molybdenum-zirconium-iron alloy THA with unknown etiology. Almost half of the failures we observed included sizes outside of the voluntary recall. Copyright © 2017 Elsevier Inc. All rights reserved.

Comparison of the discontinuation rates and side-effect profiles of pilocarpine and cevimeline for xerostomia in primary Sjögren's syndrome.

PubMed

Noaiseh, Ghaith; Baker, Joshua F; Vivino, Frederick B

2014-01-01

There are currently no head-to-head comparisons of sialagogues for Primary Sjögren's syndrome (pSS). We compared the tolerability and side effect profile of pilocarpine and cevimeline in patients with pSS and determined clinical, laboratory and pathological variables associated with therapeutic failure. We retrospectively reviewed the use of pilocarpine and cevimeline in 118 patients with pSS who fulfilled the 2002 American European Consensus Group criteria in a University-based setting. Clinical, laboratory and pathological baseline variables were collected. Failure of therapy was defined as the clinician or patient's decision to stop treatment either due to lack of efficacy or side effects. Cevimeline was associated with lower failure rates compared to pilocarpine among first-time users: 27% vs. 47% (p=0.02), and all users: 32% vs. 61% (p<0.001). Severe sweating was the most frequent side effect leading to cessation of therapy and occurred more frequently in pilocarpine (25%) than cevimeline (11%) users (p=0.02). Patients who previously failed one secretagogue were less likely to discontinue treatment with the other agent, 52% of first-time users vs. 27% of second-time users (p=0.004). Only ANA positivity was associated with failure: [59% vs. 38%] (p=0.03). pSS patients were more likely to continue cevimeline than pilocarpine long-term due to fewer reported side effects with cevimeline. Therapeutic failure of one secretagogue did not predict similar results with the other since second time users were more likely to continue long-term treatment.

Long-term local control rates of patients with adenoid cystic carcinoma of the head and neck managed by surgery and postoperative radiation.

PubMed

Ali, Safina; Palmer, Frank L; Katabi, Nora; Lee, Nancy; Shah, Jatin P; Patel, Snehal G; Ganly, Ian

2017-10-01

To report long-term local control in patients with adenoid cystic cancer (ACC) of the head and neck managed by surgery and identify factors predictive for local failure. Single-institution retrospective cohort study. Eighty-seven patients who had surgery for ACC between 1985 and 2009 were identified. Patient, tumor, and treatment characteristics were recorded. Local recurrence-free survival (LRFS) was recorded by the Kaplan-Meier method. Predictors of local control were identified. The median age was 54 years. Seventy-two (83%) patients had perineural invasion, 61 (70%) had close/positive margins, and 58 (67%) had pT 1T2. Fifty-nine (68%) patients had postoperative radiation therapy (PORT). With a median follow-up of 85 months, the 10-year LRFS was 78.7%. There were 14 local recurrences. On multivariable analysis, pathological tumor (T)3T4 stage and no PORT were independent predictors for local failure. Patients with no PORT had a 13-fold increased risk of local failure compared to patients treated with PORT (P = 0.003) after adjusting for stage. After adjusting for T stage, patients who do not get PORT are more likely to have local recurrence. 4. Laryngoscope, 127:2265-2269, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Characteristics and intraoperative treatments associated with head and neck free tissue transfer complications and failures.

PubMed

Hand, William R; McSwain, Julie R; McEvoy, Matthew D; Wolf, Bethany; Algendy, Abdalrahman A; Parks, Matthew D; Murray, John L; Reeves, Scott T

2015-03-01

To investigate the association between perioperative patient characteristics and treatment modalities (eg, vasopressor use and volume of fluid administration) with complications and failure rates in patients undergoing head and neck free tissue transfer (FTT). A retrospective review of medical records. Perioperative hospitalization for head and neck FTT at 1 tertiary care medical center between January 1, 2009, and October 31, 2011. Consecutive patients (N=235) who underwent head and neck FTT. Demographic, patient characteristic, and intraoperative data were extracted from medical records. Complication and failure rates within the first 30 days were collected In a multivariate analysis controlling for age, sex, ethnicity, reason for receiving flap, and type and volume of fluid given, perioperative complication was significantly associated with surgical blood loss (P=.019; 95% confidence interval [CI], 1.01-1.16), while the rate of intraoperative fluid administration did not reach statistical significance (P=.06; 95% CI, 0.99-1.28). In a univariate analysis, FTT failure was significantly associated with reason for surgery (odds ratio, 5.40; P=.03; 95% CI, 1.69-17.3) and preoperative diagnosis of coronary artery disease (odds ratio, 3.60; P=.03; 95% CI, 1.16-11.2). Intraoperative vasopressor administration was not associated with either FTT complication or failure rate. FTT complications were associated with surgical blood loss but not the use of vasoactive drugs. For patients undergoing FTT, judicious monitoring of blood loss may help stratify the risk of complication and failure. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

In-vessel coolability and retention of a core melt

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

Theofanous, T.G.; Liu, C.; Additon, S.

1997-02-01

The efficacy of external flooding of a reactor vessel as a severe accident management strategy is assessed for an AP600-like reactor design. The overall approach is based on the Risk Oriented Accident Analysis Methodology (ROAAM), and the assessment includes consideration of bounding scenarios and sensitivity studies, as well as arbitrary parametric evaluations that allow the delineation of the failure boundaries. The technical treatment in this assessment includes: (a) new data on energy flow from either volumetrically heated pools or non-heated layers on top, boiling and critical heat flux in inverted, curved geometries, emissivity of molten (superheated) samples of steel, andmore » chemical reactivity proof tests, (b) a simple but accurate mathematical formulation that allows prediction of thermal loads by means of convenient hand calculations, (c) a detailed model programmed on the computer to sample input parameters over the uncertainty ranges, and to produce probability distributions of thermal loads and margins for departure from nucleate boiling at each angular position on the lower head, and (d) detailed structural evaluations that demonstrate that departure from nucleate boiling is a necessary and sufficient criterion for failure. Quantification of the input parameters is carried out for an AP600-like design, and the results of the assessment demonstrate that lower head failure is {open_quotes}physically unreasonable.{close_quotes} Use of this conclusion for any specific application is subject to verifying the required reliability of the depressurization and cavity-flooding systems, and to showing the appropriateness (in relation to the database presented here, or by further testing as necessary) of the thermal insulation design and of the external surface properties of the lower head, including any applicable coatings.« less

Probability of in-vessel steam explosion-induced containment failure for a KWU PWR

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

Esmaili, H.; Khatib-Rahbar, M.; Zuchuat, O.

During postulated core meltdown accidents in light water reactors, there is a likelihood for an in-vessel steam explosion when the melt contacts the coolant in the lower plenum. The objective of the work described in this paper is to determine the conditional probability of in-vessel steam explosion-induced containment failure for a Kraftwerk Union (KWU) pressurized water reactor (PWR). The energetics of the explosion depends on the mass of the molten fuel that mixes with the coolant and participates in the explosion and on the conversion of fuel thermal energy into mechanical work. The work can result in the generation ofmore » dynamic pressures that affect the lower head (and possibly lead to its failure), and it can cause acceleration of a slug (fuel and coolant material) upward that can affect the upper internal structures and vessel head and ultimately cause the failure of the upper head. If the upper head missile has sufficient energy, it can reach the containment shell and penetrate it. The analysis, must therefore, take into account all possible dissipation mechanisms.« less

Local control after intensity-modulated radiotherapy for head-and-neck rhabdomyosarcoma.

PubMed

Curtis, Amarinthia E; Okcu, M Fatih; Chintagumpala, Murali; Teh, Bin S; Paulino, Arnold C

2009-01-01

To examine the patterns of failure in patients treated with intensity-modulated radiotherapy (IMRT) for head-and-neck rhabdomyosarcoma (RMS). Between 1998 and 2005, 19 patients with a diagnosis of head-and-neck RMS received IMRT at The Methodist Hospital. There were 11 male and 8 female patients, with a median age of 6 years at time of irradiation. Tumor location was parameningeal in 7, orbital in 6, and other head-and-neck RMS in 6. Chemotherapy was given to all patients, with vincristine, actinomycin D, and cyclophosphamide being the most common regimen (n = 18). The median prescribed dose was 5040 cGy. The clinical target volume included the gross tumor volume with a 1.5-cm margin. The median duration of follow-up for surviving patients was 56 months. The 4-year overall survival and local control rates were 76% and 92.9%, respectively. One patient developed a local failure in the high-dose region of the radiation field; there were no marginal failures. Distant metastasis was seen in 4 patients. Overall survival was 42.9% for parameningeal sites and 100% for other sites (p < 0.01). Late toxicities were seen in 7 patients. Two secondary malignancies occurred in 1 child with embryonal RMS of the face and a p53 mutation. Local control was excellent in patients receiving IMRT for head-and-neck RMS. Patterns of local failure reveal no marginal failures in this group of patients.

The probability of containment failure by direct containment heating in Zion. Supplement 1

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

Pilch, M.M.; Allen, M.D.; Stamps, D.W.

1994-12-01

Supplement 1 of NUREG/CR-6075 brings to closure the DCH issue for the Zion plant. It includes the documentation of the peer review process for NUREG/CR-6075, the assessments of four new splinter scenarios defined in working group meetings, and modeling enhancements recommended by the working groups. In the four new scenarios, consistency of the initial conditions has been implemented by using insights from systems-level codes. SCDAP/RELAP5 was used to analyze three short-term station blackout cases with Different lead rates. In all three case, the hot leg or surge line failed well before the lower head and thus the primary system depressurizedmore » to a point where DCH was no longer considered a threat. However, these calculations were continued to lower head failure in order to gain insights that were useful in establishing the initial and boundary conditions. The most useful insights are that the RCS pressure is-low at vessel breach metallic blockages in the core region do not melt and relocate into the lower plenum, and melting of upper plenum steel is correlated with hot leg failure. THE SCDAP/RELAP output was used as input to CONTAIN to assess the containment conditions at vessel breach. The containment-side conditions predicted by CONTAIN are similar to those originally specified in NUREG/CR-6075.« less

A Fault Tolerance Mechanism for On-Road Sensor Networks

PubMed Central

Feng, Lei; Guo, Shaoyong; Sun, Jialu; Yu, Peng; Li, Wenjing

2016-01-01

On-Road Sensor Networks (ORSNs) play an important role in capturing traffic flow data for predicting short-term traffic patterns, driving assistance and self-driving vehicles. However, this kind of network is prone to large-scale communication failure if a few sensors physically fail. In this paper, to ensure that the network works normally, an effective fault-tolerance mechanism for ORSNs which mainly consists of backup on-road sensor deployment, redundant cluster head deployment and an adaptive failure detection and recovery method is proposed. Firstly, based on the N − x principle and the sensors’ failure rate, this paper formulates the backup sensor deployment problem in the form of a two-objective optimization, which explains the trade-off between the cost and fault resumption. In consideration of improving the network resilience further, this paper introduces a redundant cluster head deployment model according to the coverage constraint. Then a common solving method combining integer-continuing and sequential quadratic programming is explored to determine the optimal location of these two deployment problems. Moreover, an Adaptive Detection and Resume (ADR) protocol is deigned to recover the system communication through route and cluster adjustment if there is a backup on-road sensor mismatch. The final experiments show that our proposed mechanism can achieve an average 90% recovery rate and reduce the average number of failed sensors at most by 35.7%. PMID:27918483

A prospective observational study to assess the diagnostic accuracy of clinical decision rules for children presenting to emergency departments after head injuries (protocol): the Australasian Paediatric Head Injury Rules Study (APHIRST).

PubMed

Babl, Franz E; Lyttle, Mark D; Bressan, Silvia; Borland, Meredith; Phillips, Natalie; Kochar, Amit; Dalziel, Stuart R; Dalton, Sarah; Cheek, John A; Furyk, Jeremy; Gilhotra, Yuri; Neutze, Jocelyn; Ward, Brenton; Donath, Susan; Jachno, Kim; Crowe, Louise; Williams, Amanda; Oakley, Ed

2014-06-13

Head injuries in children are responsible for a large number of emergency department visits. Failure to identify a clinically significant intracranial injury in a timely fashion may result in long term neurodisability and death. Whilst cranial computed tomography (CT) provides rapid and definitive identification of intracranial injuries, it is resource intensive and associated with radiation induced cancer. Evidence based head injury clinical decision rules have been derived to aid physicians in identifying patients at risk of having a clinically significant intracranial injury. Three rules have been identified as being of high quality and accuracy: the Canadian Assessment of Tomography for Childhood Head Injury (CATCH) from Canada, the Children's Head Injury Algorithm for the Prediction of Important Clinical Events (CHALICE) from the UK, and the prediction rule for the identification of children at very low risk of clinically important traumatic brain injury developed by the Pediatric Emergency Care Applied Research Network (PECARN) from the USA. This study aims to prospectively validate and compare the performance accuracy of these three clinical decision rules when applied outside the derivation setting. This study is a prospective observational study of children aged 0 to less than 18 years presenting to 10 emergency departments within the Paediatric Research in Emergency Departments International Collaborative (PREDICT) research network in Australia and New Zealand after head injuries of any severity. Predictor variables identified in CATCH, CHALICE and PECARN clinical decision rules will be collected. Patients will be managed as per the treating clinicians at the participating hospitals. All patients not undergoing cranial CT will receive a follow up call 14 to 90 days after the injury. Outcome data collected will include results of cranial CTs (if performed) and details of admission, intubation, neurosurgery and death. The performance accuracy of each of the rules will be assessed using rule specific outcomes and inclusion and exclusion criteria. This study will allow the simultaneous comparative application and validation of three major paediatric head injury clinical decision rules outside their derivation setting. The study is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR)- ACTRN12614000463673 (registered 2 May 2014).

Accuracy of Computed Tomography for Predicting Pathologic Nodal Extracapsular Extension in Patients With Head-and-Neck Cancer Undergoing Initial Surgical Resection

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

Prabhu, Roshan S., E-mail: roshansprabhu@gmail.com; Winship Cancer Institute, Emory University, Atlanta, Georgia; Magliocca, Kelly R.

2014-01-01

Purpose: Nodal extracapsular extension (ECE) in patients with head-and-neck cancer increases the loco-regional failure risk and is an indication for adjuvant chemoradiation therapy (CRT). To reduce the risk of requiring trimodality therapy, patients with head-and-neck cancer who are surgical candidates are often treated with definitive CRT when preoperative computed tomographic imaging suggests radiographic ECE. The purpose of this study was to assess the accuracy of preoperative CT imaging for predicting pathologic nodal ECE (pECE). Methods and Materials: The study population consisted of 432 consecutive patients with oral cavity or locally advanced/nonfunctional laryngeal cancer who underwent preoperative CT imaging before initialmore » surgical resection and neck dissection. Specimens with pECE had the extent of ECE graded on a scale from 1 to 4. Results: Radiographic ECE was documented in 46 patients (10.6%), and pECE was observed in 87 (20.1%). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 43.7%, 97.7%, 82.6%, and 87.3%, respectively. The sensitivity of radiographic ECE increased from 18.8% for grade 1 to 2 ECE, to 52.9% for grade 3, and 72.2% for grade 4. Radiographic ECE criteria of adjacent structure invasion was a better predictor than irregular borders/fat stranding for pECE. Conclusions: Radiographic ECE has poor sensitivity, but excellent specificity for pECE in patients who undergo initial surgical resection. PPV and NPV are reasonable for clinical decision making. The performance of preoperative CT imaging increased as pECE grade increased. Patients with resectable head-and-neck cancer with radiographic ECE based on adjacent structure invasion are at high risk for high-grade pECE requiring adjuvant CRT when treated with initial surgery; definitive CRT as an alternative should be considered where appropriate.« less

Multimarker Strategy for Heart Failure Prognostication. Value of Neurohormonal Biomarkers: Neprilysin vs NT-proBNP.

PubMed

Bayes-Genis, Antoni; Barallat, Jaume; Galán, Amparo; de Antonio, Marta; Domingo, Mar; Zamora, Elisabet; Gastelurrutia, Paloma; Vila, Joan; Peñafiel, Judith; Gálvez-Montón, Carolina; Lupón, Josep

2015-12-01

Neprilysin breaks down numerous vasoactive peptides. The soluble form of neprilysin, which was recently identified in heart failure, is associated with cardiovascular outcomes. Within a multibiomarker strategy, we directly compared soluble neprilysin and N-terminal pro-B-type natriuretic peptide as risk stratifiers in a real-life cohort of heart failure patients. Soluble neprilysin, N-terminal pro-B-type natriuretic peptide, ST2, and high-sensitivity troponin T levels were measured in 797 consecutive ambulatory heart failure patients followed up for 4.7 years. Comprehensive multivariable analyses and soluble neprilysin vs N-terminal pro-B-type natriuretic peptide head-to-head assessments of performance were performed. A primary composite endpoint included cardiovascular death or heart failure hospitalization. A secondary endpoint explored cardiovascular death alone. Median soluble neprilysin and N-terminal pro-B-type natriuretic peptide concentrations were 0.64ng/mL and 1187 ng/L, respectively. Both biomarkers significantly correlated with age (P<.001) and ST2 (P<.001), but only N-terminal pro-B-type natriuretic peptide significantly correlated with estimated glomerular filtration rate (P<.001), body mass index (P<.001), left ventricular ejection fraction (P=.02) and high-sensitivity troponin T (P<.001). In multivariable Cox regression analyses, soluble neprilysin remained independently associated with the composite endpoint (hazard ratio=1.14; 95% confidence interval, 1.02-1.27; P=.03) and cardiovascular death (hazard ratio=1.15; 95% confidence interval, 1.01-1.31; P=.04), but N-terminal pro-B-type natriuretic peptide did not. The head-to-head soluble neprilysin vs N-terminal pro-B-type natriuretic peptide comparison showed good calibration and similar discrimination and reclassification for both neurohormonal biomarkers, but only soluble neprilysin improved overall goodness-of-fit. When added to a multimarker strategy, soluble neprilysin remained an independent prognosticator, while N-terminal pro-B-type natriuretic peptide lost significance as a risk stratifier in ambulatory patients with heart failure. Both biomarkers performed similarly in head-to-head analyses. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Characteristics and Intraoperative Treatments Associated with Head and Neck Free Tissue Transfer Complications and Failures

PubMed Central

Hand, William R.; McSwain, Julie R.; McEvoy, Matthew D.; Wolf, Bethany; Algendy, Abdalrahman A.; Parks, Matthew D.; Murray, John L.; Reeves, Scott T.

2015-01-01

Objective To investigate the association between perioperative patient characteristics and treatment modalities (eg, vasopressor use and volume of fluid administration) with complications and failure rates in patients undergoing head and neck free tissue transfer (FTT). Study Design A retrospective review of medical records. Setting Perioperative hospitalization for head and neck FTT at 1 tertiary care medical center between January 1, 2009, and October 31, 2011. Subjects and Methods Consecutive patients (N = 235) who underwent head and neck FTT. Demographic, patient characteristic, and intraoperative data were extracted from medical records. Complication and failure rates within the first 30 days were collected Results In a multivariate analysis controlling for age, sex, ethnicity, reason for receiving flap, and type and volume of fluid given, perioperative complication was significantly associated with surgical blood loss (P = .019; 95% confidence interval [CI], 1.01-1.16), while the rate of intraoperative fluid administration did not reach statistical significance (P = .06; 95% CI, 0.99-1.28). In a univariate analysis, FTT failure was significantly associated with reason for surgery (odds ratio, 5.40; P = .03; 95% CI, 1.69-17.3) and preoperative diagnosis of coronary artery disease (odds ratio, 3.60; P = .03; 95% CI, 1.16-11.2). Intraoperative vasopressor administration was not associated with either FTT complication or failure rate. Conclusions FTT complications were associated with surgical blood loss but not the use of vasoactive drugs. For patients undergoing FTT, judicious monitoring of blood loss may help stratify the risk of complication and failure. PMID:25550221

Skin Cancer of the Head and Neck With Perineural Invasion: Defining the Clinical Target Volumes Based on the Pattern of Failure

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

Gluck, Iris; Ibrahim, Mohannad; Popovtzer, Aron

2009-05-01

Purpose: To analyze patterns of failure in patients with head-and-neck cutaneous squamous cell carcinoma (HNCSCC) and clinical/radiologic evidence of perineural invasion (CPNI), in order to define neural clinical target volume (CTV) for treatment planning. Methods and Materials: Patients treated with three-dimensional (3D) conformal or intensity-modulated radiotherapy (IMRT) for HNCSCC with CPNI were included in the study. A retrospective review of the clinical charts, radiotherapy (RT) plans and radiologic studies has been conducted. Results: Eleven consecutive patients with HNCSCCs with CPNI were treated from 2000 through 2007. Most patients underwent multiple surgical procedures and RT courses. The most prevalent failure patternmore » was along cranial nerves (CNs), and multiple CNs were ultimately involved in the majority of cases. In all cases the involved CNs at recurrence were the main nerves innervating the primary tumor sites, as well as their major communicating nerves. We have found several distinct patterns of disease spread along specific CNs depending on the skin regions harboring the primary tumors, including multiple branches of CN V and VII. These patterns and the pertinent anatomy are detailed in the this article. Conclusions: Predictable disease spread patterns along cranial nerves supplying the primary tumor sites were found in this study. Awareness of these patterns, as well as knowledge of the relevant cranial nerve anatomy, should be the basis for CTV definition and delineation for RT treatment planning.« less

Hypertension and counter-hypertension mechanisms in giraffes.

PubMed

Zhang, Qiong Gus

2006-03-01

The giraffe is unique as its head is 2500-3000 millimeters above its heart, thus the giraffe's heart must pump hard enough to overcome the huge hydrostatic pressure generated by the tall column of blood in its neck in order to provide its head with sufficient nutrients and oxygen. Giraffes therefore have exceptionally high blood pressure (hypertension) by human standards. Interestingly, the "unnaturally" high blood pressure in giraffes does not culminate in severe vascular lesions, nor does it lead to heart and kidney failure, whereas in humans, the same blood pressure is exceedingly dangerous and will cause severe vascular damage. Intrinsically, natural selection likely has provided an important protective mechanism, because hypertension develops as soon as the giraffe stands up and erects its neck immediately after birth. Therefore, those individual giraffes who did not tolerate the burden of hypertension presumably developed acute heart failure and renal failure, not surviving to reproductive age. The genes and genotypes of animals that did not survive are thus predicted to have been gradually eliminated from the gene pool by natural selection. By the same process, genes that protect against hypertensive damage would be preserved and inherited from generation to generation. Some unique ingredients of the giraffe's diet may also provide an extrinsic mechanism for the prevention of hypertension and the prevention of fatal end-stage organ damage. The fascinating nature of the protective mechanisms in giraffes may provide a conceptual framework for further experimental investigations into mechanisms as well as prevention and treatment of human hypertension and cardiovascular disease.

Postdischarge growth and development in a predominantly Hispanic, very low birth weight population.

PubMed

Powers, George C; Ramamurthy, Rajam; Schoolfield, John; Matula, Kathleen

2008-12-01

The goals were to assess postdischarge growth and developmental progress of very low birth weight (birth weight: <1500 g) premature infants in a predominantly Hispanic population and to identify predictors for neurodevelopmental impairment at 3 years of age. A cohort of 135 very low birth weight infants (gestational age: 23 to 35 weeks) were monitored to 3 years of age. Maternal and neonatal characteristics, anthropometric z scores, and developmental performance (using corrected age until 24 months) were analyzed collectively and according to gestational age groups. Specific criteria for failure to thrive and microcephaly were used. A characteristic pattern of poor weight gain in the first 12 months was followed by accelerated weight gain starting at 18 months, whereas head growth decreased at 18 months, with recovery beginning at 30 months of age. Infants born at gestational age of or=27 weeks achieved catch-up growth by 30 months of age. Mean developmental scores also decreased in infancy, with improvements in motor development emerging at 18 months and cognitive skills at 30 months. Growth z scores, particularly for head growth, correlated with developmental scores. Infants born at gestational age of

One versus two venous anastomoses in microsurgical head and neck reconstruction: a cumulative meta-analysis.

PubMed

Christianto, S; Lau, A; Li, K Y; Yang, W F; Su, Y X

2018-05-01

Venous compromise is still the most common cause of free flap failure. The use of two venous anastomoses has been advocated to reduce venous compromise. However, the effectiveness of this approach remains controversial. A systematic review and cumulative meta-analysis was performed to assess the effect of one versus two venous anastomoses on venous compromise and free flap failure in head and neck microsurgical reconstruction. A total of 27 articles reporting 7389 flaps were included in this study. On comparison of one versus two venous anastomoses, the odds ratio (OR) for flap failure was 1.66 (95% confidence interval 1.11-2.50; P=0.014) and for venous compromise was 1.50 (95% confidence interval 1.10-2.05; P=0.011), suggesting a significant increase in the flap failure rate and venous compromise rate in the single venous anastomosis group. These results show that the execution of two venous anastomoses has significant effects on reducing the vascular compromise and free flap failure rate in head and neck reconstruction. Copyright © 2018 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Estimation of body density based on hydrostatic weighing without head submersion in young Japanese adults.

PubMed

Demura, S; Sato, S; Kitabayashi, T

2006-06-01

This study examined a method of predicting body density based on hydrostatic weighing without head submersion (HWwithoutHS). Donnelly and Sintek (1984) developed a method to predict body density based on hydrostatic weight without head submersion. This method predicts the difference (D) between HWwithoutHS and hydrostatic weight with head submersion (HWwithHS) from anthropometric variables (head length and head width), and then calculates body density using D as a correction factor. We developed several prediction equations to estimate D based on head anthropometry and differences between the sexes, and compared their prediction accuracy with Donnelly and Sintek's equation. Thirty-two males and 32 females aged 17-26 years participated in the study. Multiple linear regression analysis was performed to obtain the prediction equations, and the systematic errors of their predictions were assessed by Bland-Altman plots. The best prediction equations obtained were: Males: D(g) = -164.12X1 - 125.81X2 - 111.03X3 + 100.66X4 + 6488.63, where X1 = head length (cm), X2 = head circumference (cm), X3 = head breadth (cm), X4 = head thickness (cm) (R = 0.858, R2 = 0.737, adjusted R2 = 0.687, standard error of the estimate = 224.1); Females: D(g) = -156.03X1 - 14.03X2 - 38.45X3 - 8.87X4 + 7852.45, where X1 = head circumference (cm), X2 = body mass (g), X3 = head length (cm), X4 = height (cm) (R = 0.913, R2 = 0.833, adjusted R2 = 0.808, standard error of the estimate = 137.7). The effective predictors in these prediction equations differed from those of Donnelly and Sintek's equation, and head circumference and head length were included in both equations. The prediction accuracy was improved by statistically selecting effective predictors. Since we did not assess cross-validity, the equations cannot be used to generalize to other populations, and further investigation is required.

Cyclic fatigue testing of nickel-titanium endodontic instruments.

PubMed

Pruett, J P; Clement, D J; Carnes, D L

1997-02-01

Cyclic fatigue of nickel-titanium, engine-driven instruments was studied by determining the effect of canal curvature and operating speed on the breakage of Lightspeed instruments. A new method of canal curvature evaluation that addressed both angle and abruptness of curvature was introduced. Canal curvature was simulated by constructing six curved stainless-steel guide tubes with angles of curvature of 30, 45, or 60 degrees, and radii of curvature of 2 or 5 mm. Size #30 and #40 Light-speed instruments were placed through the guide tubes and the heads secured in the collet of a Mangtrol Dynamometer. A simulated operating load of 10 g-cm was applied. Instruments were able to rotate freely in the test apparatus at speeds of 750, 1300, or 2000 rpm until separation occurred. Cycles to failure were determined. Cycles to failure were not affected by rpm. Instruments did not separate at the head, but rather at the point of maximum flexure of the shaft, corresponding to the midpoint of curvature within the guide tube. The instruments with larger diameter shafts, #40, failed after significantly fewer cycles than did #30 instruments under identical test conditions. Multivariable analysis of variance indicated that cycles to failure significantly decreased as the radius of curvature decreased from 5 mm to 2 mm and as the angle of curvature increased greater than 30 degrees (p < 0.05, power = 0.9). Scanning electron microscopic evaluation revealed ductile fracture as the fatigue failure mode. These results indicate that, for nickel-titanium, engine-driven rotary instruments, the radius of curvature, angle of curvature, and instrument size are more important than operating speed for predicting separation. This study supports engineering concepts of cyclic fatigue failure and suggests that standardized fatigue tests of nickel-titanium rotary instruments should include dynamic operation in a flexed state. The results also suggest that the effect of the radius of curvature as an independent variable should be considered when evaluating studies of root canal instrumentation.

Microstructure Evolution and Failure Analysis of an Aluminum-Copper Cathode Conductive Head Produced by Explosive Welding

NASA Astrophysics Data System (ADS)

Wei, Yanni; Luo, Yongguang; Qu, Hongtao; Zou, Juntao; Liang, Shuhua

2017-12-01

In this paper, microstructure evolution and failure analysis of the aluminum-copper interface of cathode conductive heads during their use were studied. The interface morphologies, compositions, conductivity and mechanical properties were investigated and analyzed. Obvious corrosion was found on the surface of the contact interface, which was more prevalent on an Al matrix. The crack increased sharply in the local metallurgical bonding areas on the interface, with the compound volume having no significant change. The phase transformation occurred on the interface during use, which was investigated using the elemental composition and x-ray diffraction pattern. The microhardness near the interface increased accordingly. An obvious electrical conductivity decrease appeared on the Al/Cu interface of the cathode conductive head after use over a specific time interval. Therefore, the deterioration of the microstructures and corrosion are the primary factors that affect the electrical conductivity and effective bonding, which will lead to eventual failure.

Risk Factors for Free Flap Failure in 2,846 Patients With Head and Neck Cancer: A National Database Study in Japan.

PubMed

Ishimaru, Miho; Ono, Sachiko; Suzuki, Sayaka; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo

2016-06-01

The risk factors for an unfavorable outcome after microvascular free flap reconstruction in head and neck cancer are not fully understood. We sought to identify factors affecting the occurrence of free flap failure. This was a retrospective cohort study using data from the national inpatient database in Japan between 2010 and 2012. We identified patients diagnosed with head and neck cancer who underwent tumor resection and consecutive free flap reconstruction. Cox proportional hazards regression was used to assess risk factors for free flap failure. The threshold for significance was P < .05. Missing data were imputed by using multiple imputation. We identified 2,846 eligible patients. The overall proportion of free flap failure was 3.3%. Free flap failure was associated with diabetes mellitus (hazard ratio [HR], 1.80; 95% confidence interval [95% CI], 1.18 to 2.76; P = .007), peripheral vascular disease (HR, 4.49; 95% CI, 1.61 to 12.52; P = .004), renal failure (HR, 3.67; 95% CI, 1.45 to 9.33; P = .006), preoperative radiotherapy (HR, 2.14; 95% CI, 1.11 to 4.13; P = .022), and duration of anesthesia greater than 18 hours (compared with <12 hours; HR, 2.72; 95% CI, 1.19 to 6.22; P = .018). Diabetes mellitus, peripheral vascular disease, renal failure, preoperative radiotherapy, and a longer duration of anesthesia were significant predictors of the occurrence of free flap failure. Copyright © 2016 The American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

[The anesthesiological procedure for correcting preloading in the surgery of acquired mitral valve defects].

PubMed

Kiselev, V O; Shipulin, V M; Evtushenko, A V; Podoksenov, Iu K; Shishneva, E V

2000-01-01

Intraoperative correction of preload in patients with acquired valvular disease (AVD) complicated by right-ventricular failure and severe pulmonary hypertension necessitates search for pathogenetically based algorithms of anesthesiological strategy. The objective of this study was to develop a strategy of assessing and treating the preload at the stage of induction anesthesia in patients with right-ventricular failure. During surgery central hemodynamic parameters and their response to a short head-down-tilt (15-20 degrees) were evaluated in patients (n = 42) with cardiac index (CI) less than 2 l/min/m2 after induction anesthesia. The patients were divided into 2 groups with different severity of preoperative status. Group 1 (main) included 24 patients with stages II-III cardiac failure (according to N. Strazhesko and B. Vasilenko) and group 2 (control) consisted of 18 patients with stage IIA cardiac failure. Progressing preoperative cardiac failure resulted in decrease of cardiac index and failure of compensatory hemodynamic mechanisms in AVD patients. The level of right-ventricular preload, pulmonary resistance, and stroke index were lower in group 1 than in the controls; however, 8% of group 1 patients responded positively to increased preload. In the control group 50% responded favorably to head-down-tilt. Hence, comprehensive assessment of cardiac index, central hemodynamic parameters and their response to head-down tilt help individually choose the anesthesiological strategy.

Risk factors of avascular necrosis of the femoral head and fixation failure in patients with valgus angulated femoral neck fractures over the age of 50 years.

PubMed

Song, Hyung Keun; Choi, Ho June; Yang, Kyu Hyun

2016-12-01

The aim of our study was to identify the risk factors for avascular necrosis of the femoral head (AVN) and fixation failure (FF) after screw osteosynthesis in patients with valgus angulated femoral neck fractures. We conducted a retrospective study of 308 patients (mean age, 72.5 years, range, 50-97 years), with a mean follow-up of 21.4 months (range, 12-64 months). The risk for failure in treatment (FIT) associated with patient- and fracture-related factors was evaluated by logistic regression analyses. FIT was identified in 32 cases (10.3%): 22 cases (7.1%) of AVN and 10 cases (3.2%) of FF. Initial valgus tilt>15° (p=0.023), posterior tilt>15° (p=0.012), and screw sliding distance (p=0.037) were significantly associated with FIT. FIT occurred in 7 patients (5.2%) with B1.2.1 fractures and 17 patients (48.6%) with B1.1.2 fractures (p<0.001). The odds of FIT were 17-fold higher in patients with initial valgus and posterior tilts>15° (B1.1.2) compared to patients with <15° of tilt in both planes (B1.2.1). The severity of initial deformity predicts AVN and FF in patients with valgus angulated femoral neck fractures. Patients with an initial valgus and posterior tilt>15° are reasonable candidates for primary arthroplasty due to high risk of FIT. Copyright © 2016 Elsevier Ltd. All rights reserved.

More heads choose better than one: Group decision making can eliminate probability matching.

PubMed

Schulze, Christin; Newell, Ben R

2016-06-01

Probability matching is a robust and common failure to adhere to normative predictions in sequential decision making. We show that this choice anomaly is nearly eradicated by gathering individual decision makers into small groups and asking the groups to decide. The group choice advantage emerged both when participants generated responses for an entire sequence of choices without outcome feedback (Exp. 1a) and when participants made trial-by-trial predictions with outcome feedback after each decision (Exp. 1b). We show that the dramatic improvement observed in group settings stands in stark contrast to a complete lack of effective solitary deliberation. These findings suggest a crucial role of group discussion in alleviating the impact of hasty intuitive responses in tasks better suited to careful deliberation.

The Expression of Checkpoint and DNA Repair Genes in Head and Neck Cancer as Possible Predictive Factors.

PubMed

Rusz, Orsolya; Pál, Margit; Szilágyi, Éva; Rovó, László; Varga, Zoltán; Tomisa, Bernadett; Fábián, Gabriella; Kovács, Levente; Nagy, Olga; Mózes, Petra; Reisz, Zita; Tiszlavicz, László; Deák, Péter; Kahán, Zsuzsanna

2017-04-01

DNA damage response failure may influence the efficacy of DNA-damaging treatments. We determined the expression of 16 genes involved in distinct DNA damage response pathways, in association with the response to standard therapy. Twenty patients with locoregionally advanced, squamous cell head and neck carcinoma were enrolled. The treatment included induction chemotherapy (iChT) with docetaxel, cisplatin and 5-fluorouracil followed by concomitant chemoradiotherapy (ChRT) or radiotherapy (RT) alone. The volumetric metabolic therapeutic response was determined by [18F]FDG-PET/CT. In the tumor and matched normal tissues collected before treatment, the gene expressions were examined via the quantitative real-time polymerase chain reaction (qRT-PCR). The down-regulation of TP53 was apparently associated with a poor response to iChT, its up-regulation with complete regression in 2 cases. 7 cases with down-regulated REV1 expression showed complete regression after ChRT/RT, while 1 case with REV1 overexpression was resistant to RT. The overexpression of WRN was an independent predictor of tumor relapse. Our results suggest that an altered expression of REV1 predicts sensitivity to RT, while WRN overexpression is an unfavorable prognostic factor.

Effect of cup inclination on predicted contact stress-induced volumetric wear in total hip replacement.

PubMed

Rijavec, B; Košak, R; Daniel, M; Kralj-Iglič, V; Dolinar, D

2015-01-01

In order to increase the lifetime of the total hip endoprosthesis, it is necessary to understand mechanisms leading to its failure. In this work, we address volumetric wear of the artificial cup, in particular the effect of its inclination with respect to the vertical. Volumetric wear was calculated by using mathematical models for resultant hip force, contact stress and penetration of the prosthesis head into the cup. Relevance of the dependence of volumetric wear on inclination of the cup (its abduction angle ϑA) was assessed by the results of 95 hips with implanted endoprosthesis. Geometrical parameters obtained from standard antero-posterior radiographs were taken as input data. Volumetric wear decreases with increasing cup abduction angle ϑA. The correlation within the population of 95 hips was statistically significant (P = 0.006). Large cup abduction angle minimises predicted volumetric wear but may increase the risk for dislocation of the artificial head from the cup in the one-legged stance. Cup abduction angle and direction of the resultant hip force may compensate each other to achieve optimal position of the cup with respect to wear and dislocation in the one-legged stance for a particular patient.

Fukushima Daiichi Unit 1 Ex-Vessel Prediction: Core Concrete Interaction

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

Robb, Kevin R; Farmer, Mitchell; Francis, Matthew W

Lower head failure and corium concrete interaction were predicted to occur at Fukushima Daiichi Unit 1 (1F1) by several different system-level code analyses, including MELCOR v2.1 and MAAP5. Although these codes capture a wide range of accident phenomena, they do not contain detailed models for ex-vessel core melt behavior. However, specialized codes exist for analysis of ex-vessel melt spreading (e.g., MELTSPREAD) and long-term debris coolability (e.g., CORQUENCH). On this basis, an analysis was carried out to further evaluate ex-vessel behavior for 1F1 using MELTSPREAD and CORQUENCH. Best-estimate melt pour conditions predicted by MELCOR v2.1 and MAAP5 were used as input.more » MELTSPREAD was then used to predict the spatially dependent melt conditions and extent of spreading during relocation from the vessel. The results of the MELTSPREAD analysis are reported in a companion paper. This information was used as input for the long-term debris coolability analysis with CORQUENCH.« less

Fukushima Daiichi Unit 1 ex-vessel prediction: Core melt spreading

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

Farmer, M. T.; Robb, K. R.; Francis, M. W.

Lower head failure and corium-concrete interaction were predicted to occur at Fukushima Daiichi Unit 1 (1F1) by several different system-level code analyses, including MELCOR v2.1 and MAAP5. Although these codes capture a wide range of accident phenomena, they do not contain detailed models for ex-vessel core melt behavior. However, specialized codes exist for analysis of ex-vessel melt spreading (e.g., MELTSPREAD) and long-term debris coolability (e.g., CORQUENCH). On this basis, an analysis has been carried out to further evaluate ex-vessel behavior for 1F1 using MELTSPREAD and CORQUENCH. Best-estimate melt pour conditions predicted by MELCOR v2.1 and MAAP5 were used as input.more » MELTSPREAD was then used to predict the spatially-dependent melt conditions and extent of spreading during relocation from the vessel. Lastly, this information was then used as input for the long-term debris coolability analysis with CORQUENCH that is reported in a companion paper.« less

Fukushima Daiichi Unit 1 ex-vessel prediction: Core melt spreading

DOE PAGES

Farmer, M. T.; Robb, K. R.; Francis, M. W.

2016-10-31

Lower head failure and corium-concrete interaction were predicted to occur at Fukushima Daiichi Unit 1 (1F1) by several different system-level code analyses, including MELCOR v2.1 and MAAP5. Although these codes capture a wide range of accident phenomena, they do not contain detailed models for ex-vessel core melt behavior. However, specialized codes exist for analysis of ex-vessel melt spreading (e.g., MELTSPREAD) and long-term debris coolability (e.g., CORQUENCH). On this basis, an analysis has been carried out to further evaluate ex-vessel behavior for 1F1 using MELTSPREAD and CORQUENCH. Best-estimate melt pour conditions predicted by MELCOR v2.1 and MAAP5 were used as input.more » MELTSPREAD was then used to predict the spatially-dependent melt conditions and extent of spreading during relocation from the vessel. Lastly, this information was then used as input for the long-term debris coolability analysis with CORQUENCH that is reported in a companion paper.« less

Modeling bicortical screws under a cantilever bending load.

PubMed

James, Thomas P; Andrade, Brendan A

2013-12-01

Cyclic loading of surgical plating constructs can precipitate bone screw failure. As the frictional contact between the plate and the bone is lost, cantilever bending loads are transferred from the plate to the head of the screw, which over time causes fatigue fracture from cyclic bending. In this research, analytical models using beam mechanics theory were developed to describe the elastic deflection of a bicortical screw under a statically applied load. Four analytical models were developed to simulate the various restraint conditions applicable to bicortical support of the screw. In three of the models, the cortical bone near the tip of the screw was simulated by classical beam constraints (1) simply supported, (2) cantilever, and (3) split distributed load. In the final analytical model, the cortices were treated as an elastic foundation, whereby the response of the constraint was proportional to screw deflection. To test the predictive ability of the new analytical models, 3.5 mm cortical bone screws were tested in a synthetic bone substitute. A novel instrument was developed to measure the bending deflection of screws under radial loads (225 N, 445 N, and 670 N) applied by a surrogate surgical plate at the head of the screw. Of the four cases considered, the analytical model utilizing an elastic foundation most accurately predicted deflection at the screw head, with an average difference of 19% between the measured and predicted results. Determination of the bending moments from the elastic foundation model revealed that a maximum moment of 2.3 N m occurred near the middle of the cortical wall closest to the plate. The location of the maximum bending moment along the screw axis was consistent with the fracture location commonly observed in clinical practice.

The applicability of a computer model for predicting head injury incurred during actual motor vehicle collisions.

PubMed

Moran, Stephan G; Key, Jason S; McGwin, Gerald; Keeley, Jason W; Davidson, James S; Rue, Loring W

2004-07-01

Head injury is a significant cause of both morbidity and mortality. Motor vehicle collisions (MVCs) are the most common source of head injury in the United States. No studies have conclusively determined the applicability of computer models for accurate prediction of head injuries sustained in actual MVCs. This study sought to determine the applicability of such models for predicting head injuries sustained by MVC occupants. The Crash Injury Research and Engineering Network (CIREN) database was queried for restrained drivers who sustained a head injury. These collisions were modeled using occupant dynamic modeling (MADYMO) software, and head injury scores were generated. The computer-generated head injury scores then were evaluated with respect to the actual head injuries sustained by the occupants to determine the applicability of MADYMO computer modeling for predicting head injury. Five occupants meeting the selection criteria for the study were selected from the CIREN database. The head injury scores generated by MADYMO were lower than expected given the actual injuries sustained. In only one case did the computer analysis predict a head injury of a severity similar to that actually sustained by the occupant. Although computer modeling accurately simulates experimental crash tests, it may not be applicable for predicting head injury in actual MVCs. Many complicating factors surrounding actual MVCs make accurate computer modeling difficult. Future modeling efforts should consider variables such as age of the occupant and should account for a wider variety of crash scenarios.

Context-Dependent Effects of Genome-Wide Association Study Genotypes and Macro-Environmental Factors on Time to Biochemical (PSA) Failure after Prostatectomy

PubMed Central

Rebbeck, Timothy R.; Weber, Anita L.; Walker, Amy H.; Stefflova, Klara; Tran, Teo V.; Spangler, Elaine; Chang, Bao-Li; Zeigler-Johnson, Charnita M.

2010-01-01

Background Disparities in cancer defined by race, age, or gender are well established. However, demographic metrics are surrogates for the complex contributions of genotypes, exposures, health care, socioeconomic and sociocultural environment, and many other factors. Macro-environmental factors represent novel surrogates for exposures, lifestyle and other factors that are difficult to measure but may influence cancer outcomes. Methods We applied a “multilevel molecular epidemiology” approach using a prospective cohort of 444 White prostate cancer cases who underwent prostatectomy and were followed until biochemical failure (BF) or censoring without BF. We applied Cox regression models to test for joint effects of 86 genome-wide association study-identified genotypes and macro-environmental contextual effects after geocoding all cases to their residential census tracts. All analyses were adjusted for age at diagnosis and tumor aggressiveness. Results Residents living in macroenvironments with a high proportion of older single heads of household, high rates of vacant housing, or high unemployment had shorter time until BF post-surgery after adjustment for patient age and tumor aggressiveness. After correction for multiple testing, genotypes alone did not predict time to BF, but interactions predicting time to BF were observed for MSMB (rs10993994) and percent of older single head of households (p=0.0004), and for HNF1B/TCF2 (rs4430796) and macroenvironment per capita income (p=0.0002). Conclusions Context-specific macro-environmental effects of genotype may improve the ability to identify groups that may experience poor prostate cancer outcomes. Impact Risk estimation and clinical translation of genotype information may require an understanding of both individual-level and macroenvironmental context. PMID:20826827

Context-dependent effects of genome-wide association study genotypes and macroenvironment on time to biochemical (prostate specific antigen) failure after prostatectomy.

PubMed

Rebbeck, Timothy R; Weber, Anita L; Walker, Amy H; Stefflova, Klara; Tran, Teo V; Spangler, Elaine; Chang, Bao-Li; Zeigler-Johnson, Charnita M

2010-09-01

Disparities in cancer defined by race, age, or gender are well established. However, demographic metrics are surrogates for the complex contributions of genotypes, exposures, health care, socioeconomic and sociocultural environment, and many other factors. Macroenvironmental factors represent novel surrogates for exposures, lifestyle, and other factors that are difficult to measure but might influence cancer outcomes. We applied a "multilevel molecular epidemiology" approach using a prospective cohort of 444 White prostate cancer cases who underwent prostatectomy and were followed until biochemical failure (BF) or censoring without BF. We applied Cox regression models to test for joint effects of 86 genome-wide association study-identified genotypes and macroenvironment contextual effects after geocoding all cases to their residential census tracts. All analyses were adjusted for age at diagnosis and tumor aggressiveness. Residents living in census tracts with a high proportion of older single heads of household, high rates of vacant housing, or high unemployment had shorter time until BF postsurgery after adjustment for patient age and tumor aggressiveness. After correction for multiple testing, genotypes alone did not predict time to BF, but interactions predicting time to BF were observed for MSMB (rs10993994) and percentage of older single heads of households (P = 0.0004), and for HNF1B/TCF2 (rs4430796) and census tract per capita income (P = 0.0002). The context-specific macroenvironmental effects of genotype might improve the ability to identify groups that might experience poor prostate cancer outcomes. Risk estimation and clinical translation of genotype information might require an understanding of both individual- and macroenvironment-level context. (c) 2010 AACR.

The impact of proximal femoral morphology on failure strength with a mid-head resection short-stem hip arthroplasty.

PubMed

Olsen, Michael; Al Saied, Mohamed; Morison, Zachary; Sellan, Michael; Waddell, James P; Schemitsch, Emil H

2014-12-01

Mid-head resection short-stem hip arthroplasty is a conservative alternative to conventional total hip replacement and addresses proximal fixation challenges in patients not suitable for hip resurfacing. It is unclear whether proximal femoral morphology impacts the ultimate failure load of mid-head resection implanted femurs, thus the aim of this study was to investigate the effect of native neck-shaft angle (NSA) and coronal implant alignment on proximal femoral strength. In total, 36 synthetic femurs with two different proximal femoral morphologies were utilized in this study. Of them, 18 femurs with a varus NSA of 120° and 18 femurs with a valgus NSA of 135° were each implanted with a mid-head resection prosthesis. Femurs within the two different femoral morphology groups were divided into three equal coronal implant alignment groups: 10° valgus, 10° varus or neutral alignment. Prepared femurs were tested for stiffness and to failure in axial compression. There was no significant difference in stiffness nor failure load between femurs implanted with valgus-, varus- or neutrally aligned implants in femurs with a NSA of 120° (p = 0.396, p = 0.111, respectively). Femurs implanted in valgus orientation were significantly stiffer and failed at significantly higher loads than those implanted in varus alignment in femurs with a NSA of 135° (p = 0.001, p = 0.007, respectively). A mid-head resection short-stem hip arthroplasty seems less sensitive to clinically relevant variations of coronal implant alignment and may be more forgiving upon implantation in some femoral morphologies, however, a relative valgus component alignment is recommended. © IMechE 2014.

Analysis of the rivets from the RMS Titanic using experimental and theoretical techniques

NASA Astrophysics Data System (ADS)

Hooper, Jennifer Jo

Earlier studies of Titanic wrought iron rivets revealed an anisotropic, inhomogeneous composite material composed of glassy iron silicate (slag) particles embedded in a ferrite matrix. Micrographs indicated a directional character to the slag "stringers" that follows the method of processing---aligned parallel to the shaft in the center of the rivet, but oriented perpendicular to the shaft within the inner section of each head. It was proposed that the re-orientation of large slag particles in the rivet head weakened this region, predisposing the rivets to fail as a result of collision with the iceberg. Using quantitative metallography, mechanical testing, and a combination of modeling techniques, this hypothesis was tested using 35 Titanic rivets and additional contemporary wrought iron. Results revealed that the wrought iron microstructure showed a high slag content that was very coarse and unevenly distributed. Results from micro structural, chemical and mechanical analysis, as well as supporting historical evidence, suggested that two types of rivets, both wrought iron and steel, were used on the Titanic. Tensile testing results indicated that the longitudinal orientation in wrought iron possesses an average of 20% higher tensile strength and nearly four times the ductility of the transverse orientation. Results for Titanic rivet steel suggest a 100MPa enhancement in yield strength and tensile strength over wrought iron. Sequential imaging during mechanical testing, supported by micromechanical modeling predictions, indicated that the mechanical behavior of wrought iron is strongly affected by the orientation, distribution and content of slag within the matrix. Finite element analysis of a wrought iron rivet with anisotropic properties demonstrated that, because of poor ductility produced by the re-orientation of slag within the head, a Titanic rivet could not withstand a 5mm displacement of the hull's steel plates. Due to its low ultimate tensile strength, the wrought iron rivet would fail after an additional load that is 2.5 times less than that required for the steel rivet failure. This evidence suggests that as a result of the collision with the iceberg, failure at the junction of the head and shaft caused "popping" of rivet's heads and the opening of riveted seams.

Failure Rate of Direct High-Viscosity Glass-Ionomer Versus Hybrid Resin Composite Restorations in Posterior Permanent Teeth - a Systematic Review

PubMed Central

Mickenautsch, Steffen; Yengopal, Veerasamy

2015-01-01

Purpose Traditionally, resin composite restorations are claimed by reviews of the dental literature as being superior to glass-ionomer fillings in terms of restoration failures in posterior permanent teeth. The aim of this systematic review is to answer the clinical question, whether conventional high-viscosity glass-ionomer restorations, in patients with single and/or multi-surface cavities in posterior permanent teeth, have indeed a higher failure rate than direct hybrid resin composite restorations. Methods Eight databases were searched until December 02, 2013. Trials were assessed for bias risks, in-between datasets heterogeneity and statistical sample size power. Effects sizes were computed and statistically compared. A total of 55 citations were identified through systematic literature search. From these, 46 were excluded. No trials related to high-viscosity glass-ionomers versus resin composite restorations for direct head-to-head comparison were found. Three trials related to high-viscosity glass-ionomers versus amalgam and three trials related to resin composite versus amalgam restorations could be included for adjusted indirect comparison, only. Results The available evidence suggests no difference in the failure rates between both types of restoration beyond the play of chance, is limited by lack of head-to-head comparisons and an insufficient number of trials, as well as by high bias and in-between-dataset heterogeneity risk. The current clinical evidence needs to be regarded as too poor in order to justify superiority claims regarding the failure rates of both restoration types. Sufficiently large-sized, parallel-group, randomised control trials with high internal validity are needed, in order to justify any clinically meaningful judgment to this topic. PMID:26962372

Multiple Small Diameter Drillings Increase Femoral Neck Stability Compared with Single Large Diameter Femoral Head Core Decompression Technique for Avascular Necrosis of the Femoral Head.

PubMed

Brown, Philip J; Mannava, Sandeep; Seyler, Thorsten M; Plate, Johannes F; Van Sikes, Charles; Stitzel, Joel D; Lang, Jason E

2016-10-26

Femoral head core decompression is an efficacious joint-preserving procedure for treatment of early stage avascular necrosis. However, postoperative fractures have been described which may be related to the decompression technique used. Femoral head decompressions were performed on 12 matched human cadaveric femora comparing large 8mm single bore versus multiple 3mm small drilling techniques. Ultimate failure strength of the femora was tested using a servo-hydraulic material testing system. Ultimate load to failure was compared between the different decompression techniques using two paired ANCOVA linear regression models. Prior to biomechanical testing and after the intervention, volumetric bone mineral density was determined using quantitative computed tomography to account for variation between cadaveric samples and to assess the amount of bone disruption by the core decompression. Core decompression, using the small diameter bore and multiple drilling technique, withstood significantly greater load prior to failure compared with the single large bore technique after adjustment for bone mineral density (p< 0.05). The 8mm single bore technique removed a significantly larger volume of bone compared to the 3mm multiple drilling technique (p< 0.001). However, total fracture energy was similar between the two core decompression techniques. When considering core decompression for the treatment of early stage avascular necrosis, the multiple small bore technique removed less bone volume, thereby potentially leading to higher load to failure.

76 FR 32085 - Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System-Update for Rate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-03

... description of comorbidity for chronic renal failure. In addition, we inadvertently omitted from Table 11 the comorbidity code ``V4511'' for chronic renal failure. These changes are not substantive changes to the... heading ``Diagnoses codes,'' for the renal failure, chronic diagnoses codes, replace code ``V451'' with...

Failure to Obtain Computed Tomography Imaging in Head Trauma: A Review of Relevant Case Law.

PubMed

Lindor, Rachel A; Boie, Eric T; Campbell, Ronna L; Hess, Erik P; Sadosty, Annie T

2015-12-01

The objectives were to describe lawsuits against providers for failing to order head computed tomography (CT) in cases of head trauma and to determine the potential effects of available clinical decision rules (CDRs) on each lawsuit. The authors collected jury verdicts, settlements, and court opinions regarding alleged malpractice for failure to order head CT in the setting of head trauma from 1972 through February 2014 from an online legal research tool (WestlawNext). Data were abstracted onto a standardized data form. The performance of five CDRs was evaluated. Sixty relevant cases were identified (52 adult, eight children). Of 48 cases with known outcomes, providers were found negligent in 10 cases (six adult, four pediatric), settled in 11 cases (nine adult, two pediatric), and were found not liable in 27 cases. In all 10 cases in which providers were found negligent, every applicable CDR studied would have indicated the need for head CT. In all eight cases involving children, the applicable CDR would have suggested the need for head CT or observation. A review of legal cases reported in a major online legal research system revealed 60 lawsuits in which providers were sued for failing to order head CTs in cases of head trauma. In all cases in which providers were found negligent, CT imaging or observation would have been indicated by every applicable CDR. © 2015 by the Society for Academic Emergency Medicine.

Enhancing the Reliability of Head Nodes in Underwater Sensor Networks

PubMed Central

Min, Hong; Cho, Yookun; Heo, Junyoung

2012-01-01

Underwater environments are quite different from terrestrial environments in terms of the communication media and operating conditions associated with those environments. In underwater sensor networks, the probability of node failure is high because sensor nodes are deployed in harsher environments than ground-based networks. The sensor nodes are surrounded by salt water and moved around by waves and currents. Many studies have focused on underwater communication environments in an effort to improve the data transmission throughput. In this paper, we present a checkpointing scheme for the head nodes to quickly recover from a head node failure. Experimental results show that the proposed scheme enhances the reliability of the networks and makes them more efficient in terms of energy consumption and the recovery latency compared to the previous scheme without checkpointing. PMID:22438707

Head lice infestations: A clinical update.

PubMed

Cummings, Carl; Finlay, Jane C; MacDonald, Noni E

2018-02-01

Head lice ( Pediculus humanus capitis ) infestations are not a primary health hazard or a vector for disease, but they are a societal problem with substantial costs. Diagnosis of head lice infestation requires the detection of a living louse. Although pyrethrins and permethrin remain first-line treatments in Canada, isopropyl myristate/ST-cyclomethicone solution and dimeticone can be considered as second-line therapies when there is evidence of treatment failure.

A preliminary assessment of the effects of heat flux distribution and penetration on the creep rupture of a reactor vessel lower head

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

Chu, T.Y.; Bentz, J.; Simpson, R.

1997-02-01

The objective of the Lower Head Failure (LHF) Experiment Program is to experimentally investigate and characterize the failure of the reactor vessel lower head due to thermal and pressure loads under severe accident conditions. The experiment is performed using 1/5-scale models of a typical PWR pressure vessel. Experiments are performed for various internal pressure and imposed heat flux distributions with and without instrumentation guide tube penetrations. The experimental program is complemented by a modest modeling program based on the application of vessel creep rupture codes developed in the TMI Vessel Investigation Project. The first three experiments under the LHF programmore » investigated the creep rupture of simulated reactor pressure vessels without penetrations. The heat flux distributions for the three experiments are uniform (LHF-1), center-peaked (LHF-2), and side-peaked (LHF-3), respectively. For all the experiments, appreciable vessel deformation was observed to initiate at vessel wall temperatures above 900K and the vessel typically failed at approximately 1000K. The size of failure was always observed to be smaller than the heated region. For experiments with non-uniform heat flux distributions, failure typically occurs in the region of peak temperature. A brief discussion of the effect of penetration is also presented.« less

Time-elapsed screw insertion with microCT imaging.

PubMed

Ryan, M K; Mohtar, A A; Cleek, T M; Reynolds, K J

2016-01-25

Time-elapsed analysis of bone is an innovative technique that uses sequential image data to analyze bone mechanics under a given loading regime. This paper presents the development of a novel device capable of performing step-wise screw insertion into excised bone specimens, within the microCT environment, whilst simultaneously recording insertion torque, compression under the screw head and rotation angle. The system is computer controlled and screw insertion is performed in incremental steps of insertion torque. A series of screw insertion tests to failure were performed (n=21) to establish a relationship between the torque at head contact and stripping torque (R(2)=0.89). The test-device was then used to perform step-wise screw insertion, stopping at intervals of 20%, 40%, 60% and 80% between screw head contact and screw stripping. Image data-sets were acquired at each of these time-points as well as at head contact and post-failure. Examination of the image data revealed the trabecular deformation as a result of increased insertion torque was restricted to within 1mm of the outer diameter of the screw thread. Minimal deformation occurred prior to the step between the 80% time-point and post-failure. The device presented has allowed, for the first time, visualization of the micro-mechanical response in the peri-implant bone with increased tightening torque. Further testing on more samples is expected to increase our understanding of the effects of increased tightening torque at the micro-structural level, and the failure mechanisms of trabeculae. Copyright © 2015 Elsevier Ltd. All rights reserved.

Analysis on Sealing Reliability of Bolted Joint Ball Head Component of Satellite Propulsion System

NASA Astrophysics Data System (ADS)

Guo, Tao; Fan, Yougao; Gao, Feng; Gu, Shixin; Wang, Wei

2018-01-01

Propulsion system is one of the important subsystems of satellite, and its performance directly affects the service life, attitude control and reliability of the satellite. The Paper analyzes the sealing principle of bolted joint ball head component of satellite propulsion system and discuss from the compatibility of hydrazine anhydrous and bolted joint ball head component, influence of ground environment on the sealing performance of bolted joint ball heads, and material failure caused by environment, showing that the sealing reliability of bolted joint ball head component is good and the influence of above three aspects on sealing of bolted joint ball head component can be ignored.

Introducing anisotropic Minkowski functionals and quantitative anisotropy measures for local structure analysis in biomedical imaging

NASA Astrophysics Data System (ADS)

Wismüller, Axel; De, Titas; Lochmüller, Eva; Eckstein, Felix; Nagarajan, Mahesh B.

2013-03-01

The ability of Minkowski Functionals to characterize local structure in different biological tissue types has been demonstrated in a variety of medical image processing tasks. We introduce anisotropic Minkowski Functionals (AMFs) as a novel variant that captures the inherent anisotropy of the underlying gray-level structures. To quantify the anisotropy characterized by our approach, we further introduce a method to compute a quantitative measure motivated by a technique utilized in MR diffusion tensor imaging, namely fractional anisotropy. We showcase the applicability of our method in the research context of characterizing the local structure properties of trabecular bone micro-architecture in the proximal femur as visualized on multi-detector CT. To this end, AMFs were computed locally for each pixel of ROIs extracted from the head, neck and trochanter regions. Fractional anisotropy was then used to quantify the local anisotropy of the trabecular structures found in these ROIs and to compare its distribution in different anatomical regions. Our results suggest a significantly greater concentration of anisotropic trabecular structures in the head and neck regions when compared to the trochanter region (p < 10-4). We also evaluated the ability of such AMFs to predict bone strength in the femoral head of proximal femur specimens obtained from 50 donors. Our results suggest that such AMFs, when used in conjunction with multi-regression models, can outperform more conventional features such as BMD in predicting failure load. We conclude that such anisotropic Minkowski Functionals can capture valuable information regarding directional attributes of local structure, which may be useful in a wide scope of biomedical imaging applications.

Introducing Anisotropic Minkowski Functionals and Quantitative Anisotropy Measures for Local Structure Analysis in Biomedical Imaging

PubMed Central

Wismüller, Axel; De, Titas; Lochmüller, Eva; Eckstein, Felix; Nagarajan, Mahesh B.

2017-01-01

The ability of Minkowski Functionals to characterize local structure in different biological tissue types has been demonstrated in a variety of medical image processing tasks. We introduce anisotropic Minkowski Functionals (AMFs) as a novel variant that captures the inherent anisotropy of the underlying gray-level structures. To quantify the anisotropy characterized by our approach, we further introduce a method to compute a quantitative measure motivated by a technique utilized in MR diffusion tensor imaging, namely fractional anisotropy. We showcase the applicability of our method in the research context of characterizing the local structure properties of trabecular bone micro-architecture in the proximal femur as visualized on multi-detector CT. To this end, AMFs were computed locally for each pixel of ROIs extracted from the head, neck and trochanter regions. Fractional anisotropy was then used to quantify the local anisotropy of the trabecular structures found in these ROIs and to compare its distribution in different anatomical regions. Our results suggest a significantly greater concentration of anisotropic trabecular structures in the head and neck regions when compared to the trochanter region (p < 10−4). We also evaluated the ability of such AMFs to predict bone strength in the femoral head of proximal femur specimens obtained from 50 donors. Our results suggest that such AMFs, when used in conjunction with multi-regression models, can outperform more conventional features such as BMD in predicting failure load. We conclude that such anisotropic Minkowski Functionals can capture valuable information regarding directional attributes of local structure, which may be useful in a wide scope of biomedical imaging applications. PMID:29170580

Acute liver failure following recreational use of psychotropic "head shop" compounds.

PubMed

Fröhlich, S; Lambe, E; O'Dea, J

2011-03-01

The recreational use of the so-called "legal-highs" has been in both the medical and political arena over the last year as a result of the appearance of "head shops" in many towns in Ireland. These shops specialized in selling new psychotropic compounds that circumvented established drug legislation. Little is known about the potentially harmful effects of these substances but case reports suggest a plethora of harmful psychological and physical effects. Our case describes for the first time acute liver failure associated with the ingestion of two of these amphetamine type compounds.

Press-fit bipolar radial head arthroplasty, midterm results.

PubMed

Kodde, Izaäk F; Heijink, Andras; Kaas, Laurens; Mulder, Paul G H; van Dijk, C Niek; Eygendaal, Denise

2016-08-01

Theoretical advantages of bipolar compared with monopolar radial head arthroplasty include better accommodation of radiocapitellar malalignment, reduction of capitellar abrasion, and reduction of stress at the bone-implant interfaces. Our purpose was to report the midterm results of press-fit bipolar radial head arthroplasty. Thirty patients were treated by press-fit bipolar radial head arthroplasty for acute fracture of the radial head, failed earlier treatment, or post-traumatic sequelae. Three patients were lost to follow-up. Results are presented for the remaining 27 patients. At mean follow-up of 48 months (range, 28-73), there had been 3 (11%) revisions. Two involved conversion to prosthetic radiocapitellar hemiarthroplasty for symptomatic capitellar abrasion; a third involved exchange of the articular component (ie, head) for instability. In all, the stems appeared well fixed. A prosthesis in a subluxed position accounted for the 1 (4%) additional radiologic failure. The average flexion-extension arc was 136° (range, 120°-145°), and the average pronation-supination arc was 138° (range, 70°-180°). According to the Mayo Elbow Performance Score, the combined excellent and good results accounted for 70%. The overall midterm outcome of this series of 30 press-fit bipolar radial head arthroplasties can be considered favorable. Although the revision rate was 11%, the stems were well fixed in all. There was 1 (4%) additional radiologic failure. We suggest considering a press-fit bipolar radial head prosthesis for acute comminuted radial head fractures with limited bone loss of the proximal radius. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

The Study of Cognitive Function and Related Factors in Patients With Heart Failure

PubMed Central

Ghanbari, Atefeh; Moaddab, Fatemeh; Salari, Arsalan; Kazemnezhad Leyli, Ehsan; Sedghi Sabet, Mitra; Paryad, Ezzat

2013-01-01

Background: Cognitive impairment is increasingly recognized as a common adverse consequence of heart failure. Both Heart failure and cognitive impairment are associated with frequent hospitalization and increased mortality, particularly when they occur simultaneously. Objectives: To determine cognitive function and related factors in patients with heart failure. Materials and Methods: In this descriptive cross-sectional study, we assessed 239 patients with heart failure. Data were collected by Mini Mental status Examination, Charlson comorbidity index and NYHA classification system. Data were analyzed using descriptive statistics, Kolmogorov-Smirnov test, chi-square test, t-test and logistic regression analysis. Results: The mean score of cognitive function was 21.68 ± 4.51. In total, 155 patients (64.9%) had cognitive impairment. Significant associations were found between the status of cognitive impairment and gender (P < 0.002), education level (P < 0.000), living location (P < 0.000), marital status (P < 0.03), living arrangement (P < 0.001 ), employment status (P < 0.000), income (P < 0.02), being the head of family (P < 0.03), the family size (P < 0.02), having a supplemental insurance (P < 0.003) and the patient’s comorbidities (P < 0.02). However, in logistic regression analysis, only education and supplementary insurance could predict cognitive status which indicates that patients with supplementary insurance and higher education levels were more likely to maintain optimal cognitive function. Conclusions: More than a half of the subjects had cognitive impairment. As the level of patients cognitive functioning affects their behaviors and daily living activities, it is recommended that patients with heart failure should be assessed for their cognitive functioning. PMID:25414874

Ceramic port shields cast in an iron engine head

NASA Technical Reports Server (NTRS)

Hakim, Nabil S.; Groeneweg, Mark A.

1989-01-01

Silicon nitride exhaust and intake port shields have been successfully cast into a gray iron cylinder head of a heavy duty diesel single cylinder research engine. Careful design considerations, finite element, and probability of survival analyses indicated viability of the design. Foundry experience, NDE, and failure investigations are reported.

Collaborative Instructional Design for College Readiness

ERIC Educational Resources Information Center

Boyer, Brenda L.

2015-01-01

High school seniors' success in making the transition to college hinges greatly on their ability to perform college-level research. Studies pointing out failure to provide this critical preparation abound (Head 2013; Head and Eisenberg 2010). Helping students make this leap is the topic of much research and discussion between members of the…

The head and neck discomfort of autonomic failure: an unrecognized aetiology of headache

NASA Technical Reports Server (NTRS)

Robertson, D.; Kincaid, D. W.; Haile, V.; Robertson, R. M.

1994-01-01

Information concerning the frequency, severity, character, location, duration, diurnal pattern of headache and ancillary symptoms were obtained in 25 patients with autonomic failure and 44 control subjects. Precipitating and ameliorating factors were identified. Autonomic failure patients had more head and neck discomfort than controls. Their discomfort was much more likely to localize in the occiput, nape of the neck and shoulder, compared with controls. There was a greater tendency for the discomfort to occur in the morning and after meals. It was sometimes less than 5 min in duration and was often associated with dimming, blurring, or tunnelling of vision. It was provoked by upright posture and relieved by lying down. Patients with severe autonomic failure and orthostatic hypotension often present with a posture-dependent headache or neck pain. Because the relationship of these symptoms to posture is often not recognized, the fact that these findings may signal an underlying autonomic disorder is underappreciated, and the opportunity to consider this aetiology for the headache may be missed.

Parental determinants of offspring head circumference using a sample of patients attending a government hospital in Lagos, Nigeria.

PubMed

Taiwo, I A; Adeleye, A

2013-01-01

Head circumference at birth is an important neonatal parameter in view of its association with perinatal and postnatal morbidity and mortality. It is an indicator of brain volume and a tool for assessing the development of the central nervous system. Being a complex hereditary trait, predicting baby's head circumference from parental anthropometrics could complement the already existing ultrasonographic method of prediction. To identify the parental anthropometric determinants of baby's head circumference in Lagos, Nigeria, using a sample of patients attending a government hospital. Parental anthropometric parameters were obtained from 250 couples. The baby's head circumference was measured immediately after birth. The data were subjected to multivariate analysis. The parental variables that were most predictive of babies' head circumference were mid-parental weight, maternal height, maternal weight gain during pregnancy and maternal age. Assessment of these parental attributes can complement ultrasonographic data in predicting baby's head circumference for better perinatal outcome.

49 CFR 571.202 - Standard No. 202; Head restraints; Applicable at the manufacturers option until September 1, 2009.

Code of Federal Regulations, 2010 CFR

2010-10-01

....2, S4.4 or S4.5 of this section. S4.2Except for school buses, a head restraint that conforms to... position. For school buses, a head restraint that conforms to either S4.2 (a) or (b) of this section must... one of the following occurs: (i) Failure of the seat or seat back; or, (ii) Application of a load of...

49 CFR 571.202 - Standard No. 202; Head restraints; Applicable at the manufacturers option until September 1, 2009.

Code of Federal Regulations, 2011 CFR

2011-10-01

....2, S4.4 or S4.5 of this section. S4.2Except for school buses, a head restraint that conforms to... position. For school buses, a head restraint that conforms to either S4.2 (a) or (b) of this section must... one of the following occurs: (i) Failure of the seat or seat back; or, (ii) Application of a load of...

Rolling-element fatigue life of AMS 5900 balls

NASA Technical Reports Server (NTRS)

Parker, R. J.

1983-01-01

The rolling-element fatigue life of AMS 5900 12.7-mm (1/2-in.) dia was determined in five-ball fatigue testers. The 10% life with the warm headed AMS 5900 balls was equivalent to that of AMS 5749 and over eight times that of AISI M-50. The AMS balls fabricated by cold heading had small surface cracks which initiated fatigue spalls where these cracks were crossed by running tracks. The cold-headed AMS 5900 balls had a 10% fatigue life an order of magnitude less than that of the warm headed balls even when failures on the cold headed balls at visible surface cracks were omitted.

Head and neck squamous cell carcinoma of unknown primary: Outcomes of a pre-defined institutional treatment policy in a region with a high prevalence of skin cancer.

PubMed

Huo, Michael; Panizza, Benedict; Bernard, Anne; Porceddu, Sandro V

2018-02-01

To determine the rate of subsequent primary site failure in patients with head and neck squamous cell carcinoma of unknown primary (UKP HNSCC) in a region with a high prevalence of cutaneous squamous cell carcinoma, according to a pre-determined institutional policy. Secondary aims included regional and distant control, and overall survival. Patients presenting between April 2005 and June 2016 to the Princess Alexandra Hospital Head and Neck Multidisciplinary Meeting with UKP HNSCC from either presumed mucosal or cutaneous sites treated with curative intent were eligible. Patients with presumed mucosal origin were treated with radiation therapy (RT) with or without chemotherapy, while patients with presumed cutaneous SCC were treated with surgery and post-operative RT with or without chemotherapy. A total of 63 patients met the inclusion criteria. Median follow up duration was 3.9 years (IQR 2.07-5.14). There were no subsequent primary site failures. The rate of nodal failure among presumed mucosal patients was 11.5%, and 8.1% among presumed cutaneous patients. The rate of distant metastatic failure was 11.1% among all patients. The estimated 5 year overall survival was 71.2% (95% CI 59.2-85.7%). Treatment according to our pre-defined institutional policy for UKP HNSCC in a region with a high prevalence of cutaneous SCC appears to be safe and effective with low rates of mucosal primary emergence and nodal failure. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Driving with hemianopia: IV. Head scanning and detection at intersections in a simulator.

PubMed

Bowers, Alex R; Ananyev, Egor; Mandel, Aaron J; Goldstein, Robert B; Peli, Eli

2014-03-13

Using a driving simulator, we examined the effects of homonymous hemianopia (HH) on head scanning behaviors at intersections and evaluated the role of inadequate head scanning in detection failures. Fourteen people with complete HH and without cognitive decline or visual neglect and 12 normally sighted (NV) current drivers participated. They drove in an urban environment following predetermined routes, which included multiple intersections. Head scanning behaviors were quantified at T-intersections (n = 32) with a stop or yield sign. Participants also performed a pedestrian detection task. The relationship between head scanning and detection was examined at 10 intersections. For HH drivers, the first scan was more likely to be toward the blind than the seeing hemifield. They also made a greater proportion of head scans overall to the blind side than did the NV drivers to the corresponding side (P = 0.003). However, head scan magnitudes of HH drivers were smaller than those of the NV group (P < 0.001). Drivers with HH had impaired detection of blind-side pedestrians due either to not scanning in the direction of the pedestrian or to an insufficient scan magnitude (left HH detected only 46% and right HH 8% at the extreme left and right of the intersection, respectively). Drivers with HH demonstrated compensatory head scan patterns, but not scan magnitudes. Inadequate scanning resulted in blind-side detection failures, which might place HH drivers at increased risk for collisions at intersections. Scanning training tailored to specific problem areas identified in this study might be beneficial.

45 CFR 1303.14 - Appeal by a grantee from a termination of financial assistance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM APPEAL PROCEDURES FOR HEAD START GRANTEES AND... termination action without prejudice, or the remand of that action for the purpose of reissuing it with the... dismissed with prejudice. (2) If the Departmental Appeals Board concludes that the grantee's failures are...

Children's Needs in the 70's: A Federal Perspective.

ERIC Educational Resources Information Center

Zigler, Edward

A national indifference to children is indicated by the system of foster child care and by the treatment of mental retardates. Another manifestation is the attack on Head Start. Criticism based on the program's failure to raise standardized intelligence or aptitude scores is misplaced. Head Start is a broad developmental program having many…

Transcranial magnetic stimulation over the cerebellum delays predictive head movements in the coordination of gaze.

PubMed

Zangemeister, W H; Nagel, M

2001-01-01

We investigated coordinated saccadic eye and head movements following predictive horizontal visual targets at +/- 30 degrees by applying transcranial magnetic stimulation (TMS) over the cerebellum before the start of the gaze movement in 10 young subjects. We found three effects of TMS on eye-head movements: 1. Saccadic latency effect. When stimulation took place shortly before movements commenced (75-25 ms before), significantly shorter latencies were found between predictive target presentation and initiation of saccades. Eye latencies were significantly decreased by 45 ms on average, but head latencies were not. 2. Gaze amplitude effect. Without TMS, for the 60 degrees target amplitudes, head movements usually preceded eye movements, as expected (predictive gaze type 3). With TMS 5-75 ms before the gaze movement, the number of eye movements preceding head movements by 20-50 ms was significantly increased (p < 0.001) and the delay between eye and head movements was reversed (p < 0.001), i.e. we found eye-predictive gaze type 1. 3. Saccadic peak velocity effect. For TMS 5-25 s before the start of head movement, mean peak velocity of synkinetic eye saccades increased by 20-30% up to 600 degrees/s, compared to 350-400 degrees/s without TMS. We conclude that transient functional cerebellar deficits exerted by means of TMS can change the central synkinesis of eye-head coordination, including the preprogramming of the saccadic pulse and step of a coordinated gaze movement.

Methods, apparatus and system for notification of predictable memory failure

DOEpatents

Cher, Chen-Yong; Andrade Costa, Carlos H.; Park, Yoonho; Rosenburg, Bryan S.; Ryu, Kyung D.

2017-01-03

A method for providing notification of a predictable memory failure includes the steps of: obtaining information regarding at least one condition associated with a memory; calculating a memory failure probability as a function of the obtained information; calculating a failure probability threshold; and generating a signal when the memory failure probability exceeds the failure probability threshold, the signal being indicative of a predicted future memory failure.

Artificial neural networks: Predicting head CT findings in elderly patients presenting with minor head injury after a fall.

PubMed

Dusenberry, Michael W; Brown, Charles K; Brewer, Kori L

2017-02-01

To construct an artificial neural network (ANN) model that can predict the presence of acute CT findings with both high sensitivity and high specificity when applied to the population of patients≥age 65years who have incurred minor head injury after a fall. An ANN was created in the Python programming language using a population of 514 patients ≥ age 65 years presenting to the ED with minor head injury after a fall. The patient dataset was divided into three parts: 60% for "training", 20% for "cross validation", and 20% for "testing". Sensitivity, specificity, positive and negative predictive values, and accuracy were determined by comparing the model's predictions to the actual correct answers for each patient. On the "cross validation" data, the model attained a sensitivity ("recall") of 100.00%, specificity of 78.95%, PPV ("precision") of 78.95%, NPV of 100.00%, and accuracy of 88.24% in detecting the presence of positive head CTs. On the "test" data, the model attained a sensitivity of 97.78%, specificity of 89.47%, PPV of 88.00%, NPV of 98.08%, and accuracy of 93.14% in detecting the presence of positive head CTs. ANNs show great potential for predicting CT findings in the population of patients ≥ 65 years of age presenting with minor head injury after a fall. As a good first step, the ANN showed comparable sensitivity, predictive values, and accuracy, with a much higher specificity than the existing decision rules in clinical usage for predicting head CTs with acute intracranial findings. Copyright © 2016 Elsevier Inc. All rights reserved.

First stereo video dataset with ground truth for remote car pose estimation using satellite markers

NASA Astrophysics Data System (ADS)

Gil, Gustavo; Savino, Giovanni; Pierini, Marco

2018-04-01

Leading causes of PTW (Powered Two-Wheeler) crashes and near misses in urban areas are on the part of a failure or delayed prediction of the changing trajectories of other vehicles. Regrettably, misperception from both car drivers and motorcycle riders results in fatal or serious consequences for riders. Intelligent vehicles could provide early warning about possible collisions, helping to avoid the crash. There is evidence that stereo cameras can be used for estimating the heading angle of other vehicles, which is key to anticipate their imminent location, but there is limited heading ground truth data available in the public domain. Consequently, we employed a marker-based technique for creating ground truth of car pose and create a dataset∗ for computer vision benchmarking purposes. This dataset of a moving vehicle collected from a static mounted stereo camera is a simplification of a complex and dynamic reality, which serves as a test bed for car pose estimation algorithms. The dataset contains the accurate pose of the moving obstacle, and realistic imagery including texture-less and non-lambertian surfaces (e.g. reflectance and transparency).

Matched computed tomography segmentation and demographic data for oropharyngeal cancer radiomics challenges

PubMed Central

Elhalawani, Hesham; Mohamed, Abdallah S.R.; White, Aubrey L.; Zafereo, James; Wong, Andrew J.; Berends, Joel E.; AboHashem, Shady; Williams, Bowman; Aymard, Jeremy M.; Kanwar, Aasheesh; Perni, Subha; Rock, Crosby D.; Cooksey, Luke; Campbell, Shauna; Ding, Yao; Lai, Stephen Y.; Marai, Elisabeta G.; Vock, David; Canahuate, Guadalupe M.; Freymann, John; Farahani, Keyvan; Kalpathy-Cramer, Jayashree; Fuller, Clifton D.

2017-01-01

Cancers arising from the oropharynx have become increasingly more studied in the past few years, as they are now epidemic domestically. These tumors are treated with definitive (chemo)radiotherapy, and have local recurrence as a primary mode of clinical failure. Recent data suggest that ‘radiomics’, or extraction of image texture analysis to generate mineable quantitative data from medical images, can reflect phenotypes for various cancers. Several groups have shown that developed radiomic signatures, in head and neck cancers, can be correlated with survival outcomes. This data descriptor defines a repository for head and neck radiomic challenges, executed via a Kaggle in Class platform, in partnership with the MICCAI society 2016 annual meeting.These public challenges were designed to leverage radiomics and/or machine learning workflows to discriminate HPV phenotype in one challenge (HPV status challenge) and to identify patients who will develop a local recurrence in the primary tumor volume in the second one (Local recurrence prediction challenge) in a segmented, clinically curated anonymized oropharyngeal cancer (OPC) data set. PMID:28675381

An accelerating precursor to predict "time-to-failure" in creep and volcanic eruptions

NASA Astrophysics Data System (ADS)

Hao, Shengwang; Yang, Hang; Elsworth, Derek

2017-09-01

Real-time prediction by monitoring of the evolution of response variables is a central goal in predicting rock failure. A linear relation Ω˙Ω¨-1 = C(tf - t) has been developed to describe the time to failure, where Ω represents a response quantity, C is a constant and tf represents the failure time. Observations from laboratory creep failure experiments and precursors to volcanic eruptions are used to test the validity of the approach. Both cumulative and simple moving window techniques are developed to perform predictions and to illustrate the effects of data selection on the results. Laboratory creep failure experiments on granites show that the linear relation works well during the final approach to failure. For blind prediction, the simple moving window technique is preferred because it always uses the most recent data and excludes effects of early data deviating significantly from the predicted trend. When the predicted results show only small fluctuations, failure is imminent.

Measurement of nutritional status in simulated microgravity by bioelectrical impedance spectroscopy

NASA Technical Reports Server (NTRS)

Bartok, Cynthia; Atkinson, Richard L.; Schoeller, Dale A.

2003-01-01

The potential of bioelectrical impedance spectroscopy (BIS) for assessing nutritional status in spaceflight was tested in two head-down-tilt bed-rest studies. BIS-predicted extracellular water (ECW), intracellular water (ICW), and total body water (TBW) measured using knee-elbow electrode placement were compared with deuterium and bromide dilution (DIL) volumes in healthy, 19- to 45-yr-old subjects. BIS was accurate during 44 h of head-down tilt with mean differences (BIS - DIL) of 0-0.1 kg for ECW, 0.3-0.5 for ICW, and 0.4-0.6 kg for TBW (n = 28). At 44 h, BIS followed the within-individual change in body water compartments with a relative prediction error (standard error of the estimate/baseline volume) of 2.0-3.6% of water space. In the second study, BIS did not detect an acute decrease (-1.41 +/- 0.91 kg) in ICW secondary to 48 h of a protein-free, 800 kcal/day diet (n = 18). BIS's insensitivity to ICW losses may be because they were predominantly (65%) localized to the trunk and/or because there was a general failure of BIS to measure ICW independently of ECW and TBW. BIS may have potential for measuring nutritional status during spaceflight, but its limitations in precision and insensitivity to acute ICW changes warrant further validation studies.

Reactor vessel lower head integrity

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

Rubin, A.M.

1997-02-01

On March 28, 1979, the Three Mile Island Unit 2 (TMI-2) nuclear power plant underwent a prolonged small break loss-of-coolant accident that resulted in severe damage to the reactor core. Post-accident examinations of the TMI-2 reactor core and lower plenum found that approximately 19,000 kg (19 metric tons) of molten material had relocated onto the lower head of the reactor vessel. Results of the OECD TMI-2 Vessel Investigation Project concluded that a localized hot spot of approximately 1 meter diameter had existed on the lower head. The maximum temperature on the inner surface of the reactor pressure vessel (RPV) inmore » this region reached 1100{degrees}C and remained at that temperature for approximately 30 minutes before cooling occurred. Even under the combined loads of high temperature and high primary system pressure, the TMI-2 RPV did not fail. (i.e. The pressure varied from about 8.5 to 15 MPa during the four-hour period following the relocation of melt to the lower plenum.) Analyses of RPV failure under these conditions, using state-of-the-art computer codes, predicted that the RPV should have failed via local or global creep rupture. However, the vessel did not fail; and it has been hypothesized that rapid cooling of the debris and the vessel wall by water that was present in the lower plenum played an important role in maintaining RPV integrity during the accident. Although the exact mechanism(s) of how such cooling occurs is not known, it has been speculated that cooling in a small gap between the RPV wall and the crust, and/or in cracks within the debris itself, could result in sufficient cooling to maintain RPV integrity. Experimental data are needed to provide the basis to better understand these phenomena and improve models of RPV failure in severe accident codes.« less

Advantages and limitations of multiple-trait genomic prediction for Fusarium head blight severity in hybrid wheat (Triticum aestivum L.).

PubMed

Schulthess, Albert W; Zhao, Yusheng; Longin, C Friedrich H; Reif, Jochen C

2018-03-01

Predictabilities for wheat hybrids less related to the estimation set were improved by shifting from single- to multiple-trait genomic prediction of Fusarium head blight severity. Breeding for improved Fusarium head blight resistance (FHBr) of wheat is a very laborious and expensive task. FHBr complexity is mainly due to its highly polygenic nature and because FHB severity (FHBs) is greatly influenced by the environment. Associated traits plant height and heading date may provide additional information related to FHBr, but this is ignored in single-trait genomic prediction (STGP). The aim of our study was to explore the benefits in predictabilities of multiple-trait genomic prediction (MTGP) over STGP of target trait FHBs in a population of 1604 wheat hybrids using information on 17,372 single nucleotide polymorphism markers along with indicator traits plant height and heading date. The additive inheritance of FHBs allowed accurate hybrid performance predictions using information on general combining abilities or average performance of both parents without the need of markers. Information on molecular markers and indicator trait(s) improved FHBs predictabilities for hybrids less related to the estimation set. Indicator traits must be observed on the predicted individuals to benefit from MTGP. Magnitudes of genetic and phenotypic correlations along with improvements in predictabilities made plant height a better indicator trait for FHBs than heading date. Thus, MTGP having only plant height as indicator trait already maximized FHBs predictabilities. Provided a good indicator trait was available, MTGP could reduce the impacts of genotype environment [Formula: see text] interaction on STGP for hybrids less related to the estimation set.

Recurrent syncope, orthostatic hypotension and volatile hypertension: think outside the box.

PubMed

Aung, Thein; Fan, Wuqiang; Krishnamurthy, Mahesh

2013-01-01

The baroreceptors in the neck and aortic arch are important regulators of sudden blood pressure changes. They are innervated by CN IX and X and synapse in the brainstem. Baroreceptor failure is an under-recognized cause of recurrent syncope, orthostatic hypotension, and volatile hypertension, which is refractory to and may in fact worsen with conventional treatments. Baroreflex failure can be the result of neck and chest radiation, head and neck surgery, and cerebrovascular accidents involving the brainstem nuclei. The management of baroreflex failure is a challenge since patient education, lifestyle changes, and family support are extremely important in managing blood pressure. Leg exercises and Thrombo-Embolic Deterrent Stockings (TED) stockings are important in treating orthostatic hypotension. Clonidine is the antihypertensive of choice for supine hypertension. Low-dose benzodiazepines are helpful in suppressing sympathetic surges. We have encountered two patients with baroreflex failure after chemotherapy and radiation to the neck or upper chest. Temporal relationship between symptoms onset and the history of head, neck, and upper chest radiation or trauma is important in reaching a diagnosis.

Evaluation of a Progressive Failure Analysis Methodology for Laminated Composite Structures

NASA Technical Reports Server (NTRS)

Sleight, David W.; Knight, Norman F., Jr.; Wang, John T.

1997-01-01

A progressive failure analysis methodology has been developed for predicting the nonlinear response and failure of laminated composite structures. The progressive failure analysis uses C plate and shell elements based on classical lamination theory to calculate the in-plane stresses. Several failure criteria, including the maximum strain criterion, Hashin's criterion, and Christensen's criterion, are used to predict the failure mechanisms. The progressive failure analysis model is implemented into a general purpose finite element code and can predict the damage and response of laminated composite structures from initial loading to final failure.

Noncontact diffuse optical assessment of blood flow changes in head and neck free tissue transfer flaps (Conference Presentation)

NASA Astrophysics Data System (ADS)

Huang, Chong; Radabaugh, Jeffrey P.; Aouad, Rony K.; Lin, Yu; Gal, Thomas J.; Patel, Amit B.; Valentino, Joseph; Shang, Yu; Yu, Guoqiang

2016-02-01

Head and neck cancer accounts for 3 to 5% of all cancers in the United States. Primary or salvage surgeries are extensive and often lead to major head and neck defects that require complex reconstructions with local, regional, or free tissue transfer flaps. Knowledge of tissue blood flow (BF) changes after free tissue transfer may enable surgeons to predict the failure of flap thrombosis at an early stage. This study used our recently developed noncontact diffuse correlation spectroscopy to monitor dynamic BF changes in free flaps without getting in contact with the targeted tissue. Eight free flaps were elevated in patients with head and neck cancer; one of the flaps failed. Multiple BF measurements probing the transferred tissue were performed during and post the surgical operation. Postoperative BF values were normalized to the intraoperative baselines (assigning '1') for the calculation of relative BF change (rBF). The rBF changes over the seven successful flaps were 1.89 +/- 0.15, 2.26 +/- 0.13, and 2.43 +/- 0.13 (mean +/- standard error) respectively on postoperative days 2, 4, and 7. These postoperative values were significantly higher than the intraoperative baseline values (p < 0.001), indicating a gradual recovery of flap vascularity after the tissue transfer. By contrast, rBF changes observed from the unsuccessful flap were 1.14 and 1.34 respectively on postoperative days 2 and 4, indicating a less flow recovery. Measurement of BF recovery after flap anastomosis holds the potential to act early to salvage ischemic flaps.

Standardization of Sonographic Lung-to-Head Ratio Measurements in Isolated Congenital Diaphragmatic Hernia: Impact on the Reproducibility and Efficacy to Predict Outcomes.

PubMed

Britto, Ingrid Schwach Werneck; Sananes, Nicolas; Olutoye, Oluyinka O; Cass, Darrell L; Sangi-Haghpeykar, Haleh; Lee, Timothy C; Cassady, Christopher I; Mehollin-Ray, Amy; Welty, Stephen; Fernandes, Caraciolo; Belfort, Michael A; Lee, Wesley; Ruano, Rodrigo

2015-10-01

The purpose of this study was to evaluate the impact of standardization of the lung-to-head ratio measurements in isolated congenital diaphragmatic hernia on prediction of neonatal outcomes and reproducibility. We conducted a retrospective cohort study of 77 cases of isolated congenital diaphragmatic hernia managed in a single center between 2004 and 2012. We compared lung-to-head ratio measurements that were performed prospectively in our institution without standardization to standardized measurements performed according to a defined protocol. The standardized lung-to-head ratio measurements were statistically more accurate than the nonstandardized measurements for predicting neonatal mortality (area under the receiver operating characteristic curve, 0.85 versus 0.732; P = .003). After standardization, there were no statistical differences in accuracy between measurements regardless of whether we considered observed-to-expected values (P > .05). Standardization of the lung-to-head ratio did not improve prediction of the need for extracorporeal membrane oxygenation (P> .05). Both intraoperator and interoperator reproducibility were good for the standardized lung-to-head ratio (intraclass correlation coefficient, 0.98 [95% confidence interval, 0.97-0.99]; bias, 0.02 [limits of agreement, -0.11 to +0.15], respectively). Standardization of lung-to-head ratio measurements improves prediction of neonatal outcomes. Further studies are needed to confirm these results and to assess the utility of standardization of other prognostic parameters.

Three-dimensional MRI Analysis of Femoral Head Remodeling After Reduction in Patients With Developmental Dysplasia of the Hip.

PubMed

Tsukagoshi, Yuta; Kamada, Hiroshi; Kamegaya, Makoto; Takeuchi, Ryoko; Nakagawa, Shogo; Tomaru, Yohei; Tanaka, Kenta; Onishi, Mio; Nishino, Tomofumi; Yamazaki, Masashi

2018-05-02

Previous reports on patients with developmental dysplasia of the hip (DDH) showed that the prereduced femoral head was notably smaller and more nonspherical than the intact head, with growth failure observed at the proximal posteromedial area. We evaluated the shape of the femoral head cartilage in patients with DDH before and after reduction, with size and sphericity assessed using 3-dimensional (3D) magnetic resonance imaging (MRI). We studied 10 patients with unilateral DDH (all female) who underwent closed reduction. Patients with avascular necrosis of the femoral head on the plain radiograph 1 year after reduction were excluded. 3D MRI was performed before reduction and after reduction, at 2 years of age. 3D-image analysis software was used to reconstruct the multiplanes. After setting the axial, coronal, and sagittal planes in the software (based on the femoral shaft and neck axes), the smallest sphere that included the femoral head cartilage was drawn, the diameter was measured, and the center of the sphere was defined as the femoral head center. We measured the distance between the center and cartilage surface every 30 degrees on the 3 reconstructed planes. Sphericity of the femoral head was calculated using a ratio (the distance divided by each radius) and compared between prereduction and postreduction. The mean patient age was 7±3 and 26±3 months at the first and second MRI, respectively. The mean duration between the reduction and second MRI was 18±3 months. The femoral head diameter was 26.7±1.5 and 26.0±1.6 mm on the diseased and intact sides, respectively (P=0.069). The ratios of the posteromedial area on the axial plane and the proximoposterior area on the sagittal plane after reduction were significantly larger than before reduction (P<0.01). We demonstrated that the size of the reduced femoral head was nearly equal to that of the intact femoral head and that the growth failure area of the head before reduction, in the proximal posteromedial area, was remodeled after reduction. Level IV-case series.

Narrowed indications improve outcomes for hip resurfacing arthroplasty.

PubMed

Johnson, Aaron J; Zywiel, Michael G; Hooper, Hassan; Mont, Michael A

2011-01-01

Hip resurfacing arthroplasty has had excellent clinical outcomes from multiple centers. However, controversy exists regarding the most appropriate patient selection criteria. Many proponents of hip resurfacing believe that narrowing the patient indications with strict inclusion and exclusion criteria may lead to improved outcomes and decreased complication rates. The purpose of this study was to review the results of resurfacing performed by an experienced surgeon to determine if implant survival and complication rates were different between subgroups of patients with different demographic factors. We evaluated 311 patients who had a hip resurfacing arthroplasty performed after the initial learning curve and who had a minimum follow-up of 5 years (mean, 93 months). These patients were compared to a group of 93 patients (96 hips) who underwent resurfacings, with newer selection criteria based on the findings of the first cohort. Overall, there were 10 failures in the first patient cohort (97% survivorship), compared to no failures in the second cohort. Higher revision rates were associated with patients who had osteonecrosis or rheumatoid arthritis. Patients who had femoral component sizes larger than 50 millimeters had lower revision rates. There were no revisions in patients who were under 50 years of age, had head sizes greater than 50 millimeters, and who had a primary diagnosis of osteoarthritis. After evaluating our initial experience after the learning curve, the ideal patient selection criteria was determined to be young males who have femoral head sizes greater than 50 millimeters. The early results are encouraging in that, although resurfacing may not be appropriate for all patients, it can provide predictable, excellent survivorship in these patients.

Vacuum delivery at The Maternity Hospital Kuala Lumpur: a comparison of metal and silicone cups.

PubMed

Lee, H Y; Subramaniam, N; Nordin, M M

1996-02-01

To compare the advantages and disadvantages of the New Bird metal cups and silicone cups in terms of maternal and foetal outcome. To study the adverse effects and factors associated with failed vacuum deliveries. A prospective randomised study of all vacuum deliveries from 1 December 1991 to 31 April 1992. The Hanshin electrical vacuum pump was used. A large obstetric unit-The Maternity Hospital Kuala Lumpur (MHKL). Seventy-two consecutive patients where vacuum deliveries were indicated. Forty had metal and 32 had silicone cups. Another 7 vacuum deliveries using the manual vacuum pump were excluded. Success rate of vaginal delivery, birth canal injuries, post-partum haemorrhage, duration of hospital stay, Apgar score, foetal injuries (scalp-ecchymosis, haematomas) neonatal jaundice, the rate of special care nursery (SCN) admission and neonatal mortality rate. Failure to deliver with silicone cups alone was 21.9% compared to 10% for metal cups alone. Material morbidities and serious foetal scalp injuries were almost the same in both cups. However, minor foetal scalp injuries were significantly lower with silicone cups. Maternal height and baby's weight had no independent predictive values for successful vacuum delivery. When the foetal head was palpable per abdomen, the failure rate was 54.5% compared to 8.2% when it was not. Failed vacuum deliveries were associated with increased maternal and foetal morbidities. Silicone cups and metal cups can be equally dangerous to the baby. Although our sample size was small, we recommend that vacuum delivery be avoided if the foetal head is palpable per abdomen.

Social Pedagogy and Liberal Egalitarian Compensatory Programs: The Case of Head Start

ERIC Educational Resources Information Center

Counsell, Shelly Lynn; Boody, Robert M.

2013-01-01

Using Head Start as an example of a compensatory social program based on a liberal egalitarian view of justice, this paper shows how all such programs are fundamentally flawed. In spite of any good intentions, by creating a discourse of deficiency and attempting amelioration through segregation this approach contains the seeds of its own failure.…

Back-analysis of a large landslide in a heterogeneous rock mass

NASA Astrophysics Data System (ADS)

Berti, Matteo; Gamba, Alberto; Pizziolo, Marco

2014-05-01

On April 6, 2013 a large landslide occurred on the mountainside about 2 km above Castel dell'Alpi, a small community located on the Savena River valley (Province of Bologna, Northern Apennines, Italy). Three houses collapsed, two were seriously damaged, and the existing roads and infrastructures were destroyed. The landslide was a massive rotational slide about 900 m long, 600 m wide and covering an area of 0.3 km2. The estimated volume was about 3 million cubic meters. According to eyewitnesses, diffuse ground deformations appeared in the morning of April 6 along the road that runs at the toe of the slope, and became more and more prominent during the afternoon. The landslide suddenly accelerated during the night and moved downslope 50 to 100 m in a few hours. Fortunately, residents were alerted by the sound of cracking wood and left their houses in time, thus resulted in no fatalities or injuries. The landslide created a large, bowl-shaped scar with a steep scarp about 70 m height and 800 m long. The head of the landslide moved almost vertically downward and tilted backwards, while ground bulging and compressive structures occurred at the toe. These kinematic features indicate a strong rotational component of the slide, although the high degree of internal deformation suggests a non-perfectly circular slip surface. It is well known that rotational slides tend to occur in deep homogeneous material such as thick clay soils, weak rocks, or artificial fills. In this case, however, the failure involved a strongly heterogeneous flysch, apparently characterized by good mechanical resistance. The rock belongs to the Monghidoro Formation (Cretaceous sup.-Paleocene) and consists of thinly interbedded sandstone, marl, and shale. The rock mass outcropping on the main scarp is only slight to moderately weathered, with nearly-horizontal bedding planes. Therefore, failure conditions were probably reached within the "fresh" material and, despite its heterogeneity, the flysch behaved as an homogeneous medium at the slope scale. Such a behavior is typical of this rock. A number of old rotational slides can be found in the area, and they all show the morphological features (such as a steep arcuate scarp with exposed bedrock and sub-circular landslide deposit) that characterize rotational failures in homogeneous materials. The landslide of April 2013 thus provides the opportunity to investigate in depth the mechanical behavior of this complex formation. The analysis mainly focused on the evaluation of the mobilized shear strength at failure. The slope geometry before the failure was reconstructed by combining the pre-failure 5 m DEM, the post-failure 1 m DEM (LIDAR) and the kinematic interpretation of the geomorphological features. Mobilised shear strength parameters were compute by limit-equilibrium and finite-difference back-analyses, considering a wide variation of groundwater head levels, initial stress state, and slip surface depth. The results clearly indicate that the flysch is characterized by low mass strength and small effective cohesion (in the order of few tens of kPa). The mobilized cohesion is much lower than that predicted by the geomechanical classification of heterogeneous rock masses, and casts doubts on the reliability of such estimates for the prediction of large slope instability.

Heart failure after conventional metal-on-metal hip replacements

PubMed Central

Gillam, Marianne H; Pratt, Nicole L; Inacio, Maria C S; Roughead, Elizabeth E; Shakib, Sepehr; Nicholls, Stephen J; Graves, Stephen E

2017-01-01

Background and purpose — It is unclear whether metal particles and ions produced by mechanical wear and corrosion of hip prostheses with metal-on-metal (MoM) bearings have systemic adverse effects on health. We compared the risk of heart failure in patients with conventional MoM total hip arthroplasty (THA) and in those with metal-on-polyethylene (MoP) THA. Patients and methods — We conducted a retrospective cohort study using data from the Australian Government Department of Veterans’ Affairs health claims database on patients who received conventional THA for osteoarthritis between 2004 and 2012. The MoM THAs were classified into groups: Articular Surface Replacement (ASR) XL Acetabular System, other large-head (LH) (> 32 mm) MoM, and small-head (SH) (≤ 32 mm) MoM. The primary outcome was hospitalization for heart failure after THA. Results — 4,019 patients with no history of heart failure were included (56% women). Men with an ASR XL THA had a higher rate of hospitalization for heart failure than men with MoP THA (hazard ratio (HR) = 3.2, 95% CI: 1.6–6.5). No statistically significant difference in the rate of heart failure was found with the other LH MoM or SH MoM compared to MoP in men. There was no statistically significant difference in heart failure rate between exposure groups in women. Interpretation — An association between ASR XL and hospitalization for heart failure was found in men. While causality between ASR XL and heart failure could not be established in this study, it highlights an urgent need for further studies to investigate the possibility of systemic effects associated with MoM THA. PMID:27759468

Incomplete development of human spermatozoa is associated with increased creatine phosphokinase concentration and abnormal head morphology.

PubMed

Huszar, G; Vigue, L

1993-03-01

Our previous creatine phosphokinase (CK) activity studies in human sperm revealed differences among men and among sperm populations within the same specimen. Samples with low sperm concentrations, high incidence of abnormal sperm morphology, and diminished fertility had higher per sperm CK activity. In the present work, we demonstrated, with 14C-FDNB covalent CK active site modification and with direct CK immunocytochemistry, that the higher CK activity is related to an increased content of CK and of other proteins in sperm. Also, sperm heads with higher CK content were significantly larger and rounder and showed a higher incidence of amorph configuration. We suggest that these biochemical and morphological irregularities are related and are due to a failure of spermatogenesis, more specifically, to a higher retention of cytoplasm, which in normal sperm development is lost to the Sertoli cells as residual bodies. Thus higher CK activity and larger or irregular head size in human sperm signify cellular immaturity and a failure to complete spermatogenesis.

Predictive Compensator Optimization for Head Tracking Lag in Virtual Environments

NASA Technical Reports Server (NTRS)

Adelstein, Barnard D.; Jung, Jae Y.; Ellis, Stephen R.

2001-01-01

We examined the perceptual impact of plant noise parameterization for Kalman Filter predictive compensation of time delays intrinsic to head tracked virtual environments (VEs). Subjects were tested in their ability to discriminate between the VE system's minimum latency and conditions in which artificially added latency was then predictively compensated back to the system minimum. Two head tracking predictors were parameterized off-line according to cost functions that minimized prediction errors in (1) rotation, and (2) rotation projected into translational displacement with emphasis on higher frequency human operator noise. These predictors were compared with a parameterization obtained from the VE literature for cost function (1). Results from 12 subjects showed that both parameterization type and amount of compensated latency affected discrimination. Analysis of the head motion used in the parameterizations and the subsequent discriminability results suggest that higher frequency predictor artifacts are contributory cues for discriminating the presence of predictive compensation.

Predicting Failure Under Laboratory Conditions: Learning the Physics of Slow Frictional Slip and Dynamic Failure

NASA Astrophysics Data System (ADS)

Rouet-Leduc, B.; Hulbert, C.; Riviere, J.; Lubbers, N.; Barros, K.; Marone, C.; Johnson, P. A.

2016-12-01

Forecasting failure is a primary goal in diverse domains that include earthquake physics, materials science, nondestructive evaluation of materials and other engineering applications. Due to the highly complex physics of material failure and limitations on gathering data in the failure nucleation zone, this goal has often appeared out of reach; however, recent advances in instrumentation sensitivity, instrument density and data analysis show promise toward forecasting failure times. Here, we show that we can predict frictional failure times of both slow and fast stick slip failure events in the laboratory. This advance is made possible by applying a machine learning approach known as Random Forests1(RF) to the continuous acoustic emission (AE) time series recorded by detectors located on the fault blocks. The RF is trained using a large number of statistical features derived from the AE time series signal. The model is then applied to data not previously analyzed. Remarkably, we find that the RF method predicts upcoming failure time far in advance of a stick slip event, based only on a short time window of data. Further, the algorithm accurately predicts the time of the beginning and end of the next slip event. The predicted time improves as failure is approached, as other data features add to prediction. Our results show robust predictions of slow and dynamic failure based on acoustic emissions from the fault zone throughout the laboratory seismic cycle. The predictions are based on previously unidentified tremor-like acoustic signals that occur during stress build up and the onset of macroscopic frictional weakening. We suggest that the tremor-like signals carry information about fault zone processes and allow precise predictions of failure at any time in the slow slip or stick slip cycle2. If the laboratory experiments represent Earth frictional conditions, it could well be that signals are being missed that contain highly useful predictive information. 1Breiman, L. Random forests. Machine Learning 45, 5-32 (2001). 2Rouet-Leduc, B. C. Hulbert, N. Lubbers, K. Barros and P. A. Johnson, Learning the physics of failure, in review (2016).

Accurate Prediction of Motor Failures by Application of Multi CBM Tools: A Case Study

NASA Astrophysics Data System (ADS)

Dutta, Rana; Singh, Veerendra Pratap; Dwivedi, Jai Prakash

2018-02-01

Motor failures are very difficult to predict accurately with a single condition-monitoring tool as both electrical and the mechanical systems are closely related. Electrical problem, like phase unbalance, stator winding insulation failures can, at times, lead to vibration problem and at the same time mechanical failures like bearing failure, leads to rotor eccentricity. In this case study of a 550 kW blower motor it has been shown that a rotor bar crack was detected by current signature analysis and vibration monitoring confirmed the same. In later months in a similar motor vibration monitoring predicted bearing failure and current signature analysis confirmed the same. In both the cases, after dismantling the motor, the predictions were found to be accurate. In this paper we will be discussing the accurate predictions of motor failures through use of multi condition monitoring tools with two case studies.

Failure Criteria for FRP Laminates in Plane Stress

NASA Technical Reports Server (NTRS)

Davila, Carlos G.; Camanho, Pedro P.

2003-01-01

A new set of six failure criteria for fiber reinforced polymer laminates is described. Derived from Dvorak's fracture mechanics analyses of cracked plies and from Puck's action plane concept, the physically-based criteria, denoted LaRC03, predict matrix and fiber failure accurately without requiring curve-fitting parameters. For matrix failure under transverse compression, the fracture plane is calculated by maximizing the Mohr-Coulomb effective stresses. A criterion for fiber kinking is obtained by calculating the fiber misalignment under load, and applying the matrix failure criterion in the coordinate frame of the misalignment. Fracture mechanics models of matrix cracks are used to develop a criterion for matrix in tension and to calculate the associated in-situ strengths. The LaRC03 criteria are applied to a few examples to predict failure load envelopes and to predict the failure mode for each region of the envelope. The analysis results are compared to the predictions using other available failure criteria and with experimental results. Predictions obtained with LaRC03 correlate well with the experimental results.

Bending fatigue study of nickel-titanium Gates Glidden drills.

PubMed

Luebke, Neill H; Brantley, William A; Alapati, Satish B; Mitchell, John C; Lausten, Leonard L; Daehn, Glenn S

2005-07-01

ProFile nickel-titanium Gates Glidden drills were tested in bending fatigue to simulate clinical conditions. Ten samples each in sizes #1 through #6 were placed in a device that deflected the drill head 4 mm from the axis. The drill head was placed inside a ball bearing fixture, which allowed it to run free at 4000 rpm, and the total number of revolutions was recorded until failure. Fracture surfaces were examined with a scanning electron microscope to determine the initiation site and nature of the failure process. Mean +/- SD for the number of revolutions to failure for the drill sizes were: #1: 1826.3 +/- 542.5; #2: 5395.7 +/- 2581.5; #3: 694.4 +/- 516.8; #4: 261.0 +/- 138.0; #5: 49.6 +/- 14.9; #6: 195.9 +/- 78.5. All drills failed in a ductile mode, and fracture initiation sites appeared to be coincident with machining grooves or other flaws, suggesting the need for improved manufacturing procedures.

Atomic-Scale Mechanisms of Defect-Induced Retention Failure in Ferroelectrics.

PubMed

Li, Linze; Zhang, Yi; Xie, Lin; Jokisaari, Jacob R; Beekman, Christianne; Yang, Jan-Chi; Chu, Ying-Hao; Christen, Hans M; Pan, Xiaoqing

2017-06-14

The ability to switch the ferroelectric polarization using an electric field makes ferroelectrics attractive for application in nanodevices such as high-density memories. One of the major challenges impeding this application, however, has been known as "retention failure", which is a spontaneous process of polarization back-switching that can lead to data loss. This process is generally thought to be caused by the domain instability arising from interface boundary conditions and countered by defects, which can pin the domain wall and impede the back-switching. Here, using in situ transmission electron microscopy and atomic-scale scanning transmission electron microscopy, we show that the polarization retention failure can be induced by commonly observed nanoscale impurity defects in BiFeO 3 thin films. The interaction between polarization and the defects can also lead to the stabilization of novel functional nanodomains with mixed-phase structures and head-to-head polarization configurations. Thus, defect engineering provides a new route for tuning properties of ferroelectric nanosystems.

Magnetic force microscopy study on wide adjacent track erasure in perpendicular magnetic write heads

NASA Astrophysics Data System (ADS)

Ruksasakchai, P.; Saengkaew, K.; Cheowanish, I.; Damrongsak, B.

2017-09-01

We used a phase-contrast magnetic force microscopy (MFM) to observe and analyze the failure of magnetic write heads due to the WATEr problem, which limits the off-track performance. During MFM imaging, the magnetic write head was energized by a DC current. The induced out-of-plane magnetic field was then detected by scanning a MFM probe across the surface of the magnetic write head. MFM images were then mapped with WATEr measured results from a spin stand method. Results showed that WATEr effect can be generated by several factors, i.e. the structure of magnetic domains and walls from material discontinuities and the magnetic field leakage at different locations on magnetic write heads. Understanding WATEr mechanisms is useful for design and process development engineers.

Relationship between respiratory failure and plasma noradrenaline levels in amyotrophic lateral sclerosis.

PubMed

Yamashita, A; Koike, Y; Takahashi, A; Hirayama, M; Murakami, N; Sobue, G

1997-08-01

We evaluated plasma noradrenaline (NA) levels at test and during head-up tilt test in 20 patients with sporadic amyotrophic lateral sclerosis (ALS). Their fasting plasma NA levels ranged from 195 to 4227 pg/ml. The average plasma NA level was 483 pg/ml in five ambulatory patients, 341 in two wheelchair-bound patients, 1264 in 11 bedridden patients, and 208 in two respirator-dependent patients whose disability grading was the worst among the four groups. Arterial carbon dioxide (PCO2) was evaluated as a measure of respiratory function. The coefficient of correlation between PCO2 and plasma NA was r = 0.654 (p < 0.01). Either respiratory failure or lower motor neuron dysfunction may relate to the elevation of plasma NA levels. In the two bedridden patients, plasma NA levels and heart rate at rest increased significantly as the disease progressed. Cardiovascular responses to head-up tilting were normal. These data suggest that the elevation of plasma NA levels may be related to progression of respiratory failure and lower motor neuron dysfunction. In conclusion, sympathetic hyperactivity in ALS is considered to be not primary, but secondary to somatic motor disabilities and respiratory failure.

Using the abbreviated injury severity and Glasgow Coma Scale scores to predict 2-week mortality after traumatic brain injury.

PubMed

Timmons, Shelly D; Bee, Tiffany; Webb, Sharon; Diaz-Arrastia, Ramon R; Hesdorffer, Dale

2011-11-01

Prediction of outcome after traumatic brain injury (TBI) remains elusive. We tested the use of a single hospital Glasgow Coma Scale (GCS) Score, GCS Motor Score, and the Head component of the Abbreviated Injury Scale (AIS) Score to predict 2-week cumulative mortality in a large cohort of TBI patients admitted to the eight U.S. Level I trauma centers in the TBI Clinical Trials Network. Data on 2,808 TBI patients were entered into a centralized database. These TBI patients were categorized as severe (GCS score, 3-8), moderate (9-12), or complicated mild (13-15 with positive computed tomography findings). Intubation and chemical paralysis were recorded. The cumulative incidence of mortality in the first 2 weeks after head injury was calculated using Kaplan-Meier survival analysis. Cox proportional hazards regression was used to estimate the magnitude of the risk for 2-week mortality. Two-week cumulative mortality was independently predicted by GCS, GCS Motor Score, and Head AIS. GCS Severity Category and GCS Motor Score were stronger predictors of 2-week mortality than Head AIS. There was also an independent effect of age (<60 vs. ≥60) on mortality after controlling for both GCS and Head AIS Scores. Anatomic and physiologic scales are useful in the prediction of mortality after TBI. We did not demonstrate any added benefit to combining the total GCS or GCS Motor Scores with the Head AIS Score in the short-term prediction of death after TBI.

Prognostic value of computed tomographic coronary angiography and exercise electrocardiography for cardiovascular events

PubMed Central

Kim, Kye-Hwan; Jeon, Kyung Nyeo; Kang, Min Gyu; Ahn, Jong Hwa; Koh, Jin-Sin; Park, Yongwhi; Hwang, Seok-Jae; Jeong, Young-Hoon; Kwak, Choong Hwan; Hwang, Jin-Yong; Park, Jeong Rang

2016-01-01

Background/Aims: This study is a head-to-head comparison of predictive values for long-term cardiovascular outcomes between exercise electrocardiography (ex-ECG) and computed tomography coronary angiography (CTCA) in patients with chest pain. Methods: Four hundred and forty-two patients (mean age, 56.1 years; men, 61.3%) who underwent both ex-ECG and CTCA for evaluation of chest pain were included. For ex-ECG parameters, the patients were classified according to negative or positive results, and Duke treadmill score (DTS). Coronary artery calcium score (CACS), presence of plaque, and coronary artery stenosis were evaluated as CTCA parameters. Cardiovascular events for prognostic evaluation were defined as unstable angina, acute myocardial infarction, revascularization, heart failure, and cardiac death. Results: The mean follow-up duration was 2.8 ± 1.1 years. Fifteen patients experienced cardiovascular events. Based on pretest probability, the low- and intermediate-risks of coronary artery disease were 94.6%. Odds ratio of CACS > 40, presence of plaque, coronary stenosis ≥ 50% and DTS ≤ 4 were significant (3.79, p = 0.012; 9.54, p = 0.030; 6.99, p < 0.001; and 4.58, p = 0.008, respectively). In the Cox regression model, coronary stenosis ≥ 50% (hazard ratio, 7.426; 95% confidence interval, 2.685 to 20.525) was only significant. After adding DTS ≤ 4 to coronary stenosis ≥ 50%, the integrated discrimination improvement and net reclassification improvement analyses did not show significant. Conclusions: CTCA was better than ex-ECG in terms of predicting long-term outcomes in low- to intermediate-risk populations. The predictive value of the combination of CTCA and ex-ECG was not superior to that of CTCA alone. PMID:27017387

Prediction of skull fracture risk for children 0-9 months old through validated parametric finite element model and cadaver test reconstruction.

PubMed

Li, Zhigang; Liu, Weiguo; Zhang, Jinhuan; Hu, Jingwen

2015-09-01

Skull fracture is one of the most common pediatric traumas. However, injury assessment tools for predicting pediatric skull fracture risk is not well established mainly due to the lack of cadaver tests. Weber conducted 50 pediatric cadaver drop tests for forensic research on child abuse in the mid-1980s (Experimental studies of skull fractures in infants, Z Rechtsmed. 92: 87-94, 1984; Biomechanical fragility of the infant skull, Z Rechtsmed. 94: 93-101, 1985). To our knowledge, these studies contained the largest sample size among pediatric cadaver tests in the literature. However, the lack of injury measurements limited their direct application in investigating pediatric skull fracture risks. In this study, 50 pediatric cadaver tests from Weber's studies were reconstructed using a parametric pediatric head finite element (FE) model which were morphed into subjects with ages, head sizes/shapes, and skull thickness values that reported in the tests. The skull fracture risk curves for infants from 0 to 9 months old were developed based on the model-predicted head injury measures through logistic regression analysis. It was found that the model-predicted stress responses in the skull (maximal von Mises stress, maximal shear stress, and maximal first principal stress) were better predictors than global kinematic-based injury measures (peak head acceleration and head injury criterion (HIC)) in predicting pediatric skull fracture. This study demonstrated the feasibility of using age- and size/shape-appropriate head FE models to predict pediatric head injuries. Such models can account for the morphological variations among the subjects, which cannot be considered by a single FE human model.

Updated numerical model with uncertainty assessment of 1950-56 drought conditions on brackish-water movement within the Edwards aquifer, San Antonio, Texas

USGS Publications Warehouse

Brakefield, Linzy K.; White, Jeremy T.; Houston, Natalie A.; Thomas, Jonathan V.

2015-01-01

Predictive results of total spring discharge during the 7-year period, as well as head predictions at Bexar County index well J-17, were much different than the dissolved-solids concentration change results at the production wells. These upper bounds are an order of magnitude larger than the actual prediction which implies that (1) the predictions of total spring discharge at Comal and San Marcos Springs and head at Bexar County index well J-17 made with this model are not reliable, and (2) parameters that control these predictions are not informed well by the observation dataset during historymatching, even though the history-matching process yielded parameters to reproduce spring discharges and heads at these locations during the history-matching period. Furthermore, because spring discharges at these two springs and heads at Bexar County index well J-17 represent more of a cumulative effect of upstream conditions over a larger distance (and longer time), many more parameters (with their own uncertainties) are potentially controlling these predictions than the prediction of dissolved-solids concentration change at the prediction wells, and therefore contributing to a large posterior uncertainty.

Six Degree-of-Freedom Measurements of Human Mild Traumatic Brain Injury.

PubMed

Hernandez, Fidel; Wu, Lyndia C; Yip, Michael C; Laksari, Kaveh; Hoffman, Andrew R; Lopez, Jaime R; Grant, Gerald A; Kleiven, Svein; Camarillo, David B

2015-08-01

This preliminary study investigated whether direct measurement of head rotation improves prediction of mild traumatic brain injury (mTBI). Although many studies have implicated rotation as a primary cause of mTBI, regulatory safety standards use 3 degree-of-freedom (3DOF) translation-only kinematic criteria to predict injury. Direct 6DOF measurements of human head rotation (3DOF) and translation (3DOF) have not been previously available to examine whether additional DOFs improve injury prediction. We measured head impacts in American football, boxing, and mixed martial arts using 6DOF instrumented mouthguards, and predicted clinician-diagnosed injury using 12 existing kinematic criteria and 6 existing brain finite element (FE) criteria. Among 513 measured impacts were the first two 6DOF measurements of clinically diagnosed mTBI. For this dataset, 6DOF criteria were the most predictive of injury, more than 3DOF translation-only and 3DOF rotation-only criteria. Peak principal strain in the corpus callosum, a 6DOF FE criteria, was the strongest predictor, followed by two criteria that included rotation measurements, peak rotational acceleration magnitude and Head Impact Power (HIP). These results suggest head rotation measurements may improve injury prediction. However, more 6DOF data is needed to confirm this evaluation of existing injury criteria, and to develop new criteria that considers directional sensitivity to injury.

Screw-blade fixation systems in Pauwels three femoral neck fractures: a biomechanical evaluation.

PubMed

Knobe, Matthias; Altgassen, Simon; Maier, Klaus-Jürgen; Gradl-Dietsch, Gertraud; Kaczmarek, Chris; Nebelung, Sven; Klos, Kajetan; Kim, Bong-Sung; Gueorguiev, Boyko; Horst, Klemens; Buecking, Benjamin

2018-02-01

To reduce mechanical complications after osteosynthesis of femoral neck fractures, improved fixation techniques have been developed including blade or screw-anchor devices. This biomechanical study compares different fixation systems used for treatment of unstable femoral neck fractures with evaluation of failure mode, load to failure, stiffness, femoral head rotation, femoral neck shortening and femoral head migration. Standardized Pauwels type 3 fractures (AO/OTA 31-B2) with comminution were created in 18 biomechanical sawbones using a custom-made sawguide. Fractures were stabilized using either SHS-Screw, SHS-Blade or Rotationally Stable Screw-Anchor (RoSA). Femurs were positioned in 25 degrees adduction and ten degrees posterior flexion and were cyclically loaded with an axial sinusoidal loading pattern of 0.5 Hz, starting with 300 N, with an increase by 300 N every 2000 cycles until bone-implant failure occurred. Mean failure load for the Screw-Anchor fixation (RoSA) was 5100 N (IQR 750 N), 3900 N (IQR 75 N) for SHS-Blade and 3000 N (IQR 675 N; p = 0.002) for SHS-Screw. For SHS-Screw and SHS-Blade we observed fracture displacement with consecutive fracture collapse as the main reason for failure, whereas RoSA mainly showed a cut-out under high loadings. Mean stiffness at 1800 N was 826 (IQR 431) N/mm for SHS-Screw, 1328 (IQR 441) N/mm for SHS-Blade and 1953 (IQR 617) N/mm for RoSA (p = 0.003). With a load of 1800 N (SHS-Screw 12° vs. SHS-Blade 7° vs. RoSA 2°; p = 0.003) and with 2700 N (24° vs. 15° vs. 3°; p = 0.002) the RoSA implants demonstrated a higher rotational stability and had the lowest femoral neck shortening (p = 0.002), compared with the SHS groups. At the 2700 N load point, RoSA systems showed a lower axial (p = 0.019) and cranial (p = 0.031) femoral head migration compared to the SHS-Screw. In our study, the new Screw-Anchor fixation (RoSA) was superior to the comparable SHS implants regarding rotational stability and femoral neck shortening. Failure load, stiffness, femoral head migration, and resistance to fracture displacement were in RoSA implants higher than in SHS-Screws, but without significance in comparison to SHS-Blades.

Progressive Failure Analysis Methodology for Laminated Composite Structures

NASA Technical Reports Server (NTRS)

Sleight, David W.

1999-01-01

A progressive failure analysis method has been developed for predicting the failure of laminated composite structures under geometrically nonlinear deformations. The progressive failure analysis uses C(exp 1) shell elements based on classical lamination theory to calculate the in-plane stresses. Several failure criteria, including the maximum strain criterion, Hashin's criterion, and Christensen's criterion, are used to predict the failure mechanisms and several options are available to degrade the material properties after failures. The progressive failure analysis method is implemented in the COMET finite element analysis code and can predict the damage and response of laminated composite structures from initial loading to final failure. The different failure criteria and material degradation methods are compared and assessed by performing analyses of several laminated composite structures. Results from the progressive failure method indicate good correlation with the existing test data except in structural applications where interlaminar stresses are important which may cause failure mechanisms such as debonding or delaminations.

Failure prediction using machine learning and time series in optical network.

PubMed

Wang, Zhilong; Zhang, Min; Wang, Danshi; Song, Chuang; Liu, Min; Li, Jin; Lou, Liqi; Liu, Zhuo

2017-08-07

In this paper, we propose a performance monitoring and failure prediction method in optical networks based on machine learning. The primary algorithms of this method are the support vector machine (SVM) and double exponential smoothing (DES). With a focus on risk-aware models in optical networks, the proposed protection plan primarily investigates how to predict the risk of an equipment failure. To the best of our knowledge, this important problem has not yet been fully considered. Experimental results showed that the average prediction accuracy of our method was 95% when predicting the optical equipment failure state. This finding means that our method can forecast an equipment failure risk with high accuracy. Therefore, our proposed DES-SVM method can effectively improve traditional risk-aware models to protect services from possible failures and enhance the optical network stability.

Estimation of appropriate lubricating film thickness in ceramic-on-ceramic hip prostheses

NASA Astrophysics Data System (ADS)

Tauviqirrahman, M.; Muchammad, Bayuseno, A. P.; Ismail, R.; Saputra, E.; Jamari, J.

2016-04-01

Artificial hip prostheses, consisting of femoral head and acetabular cup are widely used and have affected the lives of many people.However, the primary issue associated with the long term performance of hip prostheses is loosening induced by excessive wear during daily activity. Therefore, an effective lubrication is necessary to significantly decrease the wear. To help understand the lubricating performance of such typical hip joint prostheses, in the present paper a hydrodynamic lubrication model based on Reynolds equationwas introduced. The material pairs of ceramic acetabular cup against ceramic femoral head was investegated.The main aim of this study is to investigate of the effect of loading on the formation of lubricating film thickness.The model of a ball-in-socket configuration was considered assuming that the cup was stationary while the ball was to rotate at a steady angular velocityvarying loads.Based on simulation result, it was found that to promote fluid film lubrication and prevent the contacting components leading to wear, the film thickness of lubricant should be determined carefully based on the load applied. This finding may have useful implication in predicting the failure of lubricating synovial fluid film and wear generation in hip prostheses.

The effect of in situ augmentation on implant anchorage in proximal humeral head fractures.

PubMed

Unger, Stefan; Erhart, Stefanie; Kralinger, Franz; Blauth, Michael; Schmoelz, Werner

2012-10-01

Fracture fixation in patients suffering from osteoporosis is difficult as sufficient implant anchorage is not always possible. One method to enhance implant anchorage is implant/screw augmentation with PMMA-cement. The present study investigated the feasibility of implant augmentation with PMMA-cement to enhance implant anchorage in the proximal humerus. A simulated three part humeral head fracture was stabilised with an angular stable plating system in 12 pairs of humeri using six head screws. In the augmentation group the proximal four screws were treated with four cannulated screws, each augmented with 0.5ml of PMMA-cement, whereas the contra lateral side served as a non-augmented control. Specimens were loaded in varus-bending or axial-rotation using a cyclic loading protocol with increasing load magnitude until failure of the osteosynthesis occurred. Augmented specimens showed a significant higher number of load cycles until failure than non-augment specimens (varus-bending: 8516 (SD 951.6) vs. 5583 (SD 2273.6), P=0.014; axial-rotation: 3316 (SD 348.8) vs. 2050 (SD 656.5), P=0.003). Non-augmented specimens showed a positive correlation of load cycles until failure and measured bone mineral density (varus-bending: r=0.893, P=0.016; axial-rotation: r=0.753, P=0.084), whereas no correlation was present in augmented specimens (varus-bending: r=0,258, P=0.621; axial-rotation r=0.127, P=0.810). These findings suggest that augmentation of cannulated screws is a feasible method to enhance implant/screw anchorage in the humeral head. The improvement of screw purchase is increasing with decreasing bone mineral density. Copyright © 2012 Elsevier Ltd. All rights reserved.

Prediction of postnatal outcomes in fetuses with isolated congenital diaphragmatic hernias using different lung-to-head ratio measurements.

PubMed

Kehl, Sven; Siemer, Jörn; Brunnemer, Suna; Weiss, Christel; Eckert, Sven; Schaible, Thomas; Sütterlin, Marc

2014-05-01

The purpose of this study was to compare different methods for measuring the fetal lung area-to-head circumference ratio and to investigate their prediction of postpartum survival and the need for neonatal extracorporeal membrane oxygenation (ECMO) therapy in fetuses with isolated congenital diaphragmatic hernias. This prospective study included 118 fetuses of at least 20 weeks' gestation with isolated left-sided congenital diaphragmatic hernias. The lung-to-head ratio was measured with 3 different methods (longest diameter, anteroposterior diameter, and tracing). To eliminate the influence of gestational age, the observed-to-expected lung-to-head ratio was calculated. Receiver operating characteristic (ROC) curves were calculated for the statistical prediction of survival and need for ECMO therapy by the observed-to-expected lung-to-head ratio measured with the different methods. For survival and ECMO necessity 118 and 102 cases (16 neonates were not eligible for ECMO) were assessed, respectively. For prediction of postpartum survival and ECMO necessity, the areas under the ROC curves and 95% confidence intervals showed very similar results for the 3 methods for prediction of survival (tracing, 0.8445 [0.7553-0.9336]; longest diameter, 0.8248 [0.7360-0.9136]; and anteroposterior diameter, 0.8002 [0.7075-0.8928]) and for ECMO necessity (tracing, 0.7344 [0.6297-0.8391]; longest diameter, 0.7128 [0.6027-0.8228]; and anteroposterior diameter, 0.7212 [0.6142-0.8281]). Comparisons between the areas under the ROC curves showed that the tracing method was superior to the anteroposterior diameter method in predicting postpartum survival (P = .0300). Lung-to-head ratio and observed-to-expected lung-to-head ratio measurements were shown to accurately predict postnatal survival and the need for ECMO therapy in fetuses with left-sided congenital diaphragmatic hernias. Tracing the limits of the lungs seems to be the favorable method for calculating the fetal lung area.

Sex Comparisons in Muscle Sympathetic Nerve Activity and Arterial Pressure Oscillations During Progressive Central Hypovolemia

DTIC Science & Technology

2015-01-01

Kenney, and P. Kenny. 1988. Cardiovascular responses to head -up tilt after an endurance exercise program. Aviat. Space Environ. Med. 59:107–112...the failure of compensatory mechanisms to maintain blood pressure, subsequently leading to cardiovascular decompensation and syncope. Several...the distribution of blood away from the upper body ( head and heart) to the abdomen and lower extremities, eliciting controlled, experimentally induced

Anterior longitudinal ligament injuries in whiplash may lead to cervical instability.

PubMed

Stemper, Brian D; Yoganandan, Narayan; Pintar, Frank A; Rao, Raj D

2006-07-01

Although whiplash injuries account for a significant annual cost to society, the exact mechanism of injury and affected tissues remain unknown. Previous investigations documented injuries to the cervical anterior longitudinal ligament in whiplash. The present investigation implemented a comprehensively validated computational model to quantify level-dependent distraction magnitudes of this structure in whiplash. Maximum ligament distractions approached failure levels, particularly in middle to lower cervical levels, and occurred during the initial phase of head-neck kinematics. In particular, the C5-C6 anterior longitudinal ligament sustained distraction magnitudes as high as 2.6mm during the retraction phase, corresponding to 56% of distraction necessary to result in ligament failure. Present results demonstrated that anterior structures in the lower cervical spine may be susceptible to injury through excess distraction during the retraction phase of whiplash, which likely occurs prior to head restraint contact. Susceptibility of these structures is likely due to non-physiologic loading placed on the cervical spinal column as the head translates posteriorly relative to the thorax. Injury to anterior spinal structures can result in clinical indications including cervical instability in extension, axial rotation, and lateral bending modes. Mitigation of whiplash injury may be achieved by minimizing head retraction during initial stages of whiplash.

Determination, mechanism and monitoring of knockdown resistance in permethrin-resistant human head lice, Pediculus humanus capitis

PubMed Central

Clark, J. Marshall

2009-01-01

Permethrin resistance has been reported worldwide and clinical failures to commercial pediculicides containing permethrin have likewise occurred. Permethrin resistance in head lice populations from the U.S. is widespread but is not yet uniform and the level of resistance is relatively low (~4–8 fold). Permethrin-resistant lice are cross-resistant to pyrethrins, PBO-synergized pyrethrins and to DDT. Nix®, when applied to human hair tufts following manufacture’s instructions, did not provide 100% control when assessed by the hair tuft bioassay in conjunction with the in vitro rearing system. Resistance to permethrin is due to knockdown resistance (kdr), which is the result of three point mutations within the α-subunit gene of the voltage-gated sodium channel that causes amino acid substitutions, leading to nerve insensitivity. A three-tiered resistance monitoring system has been established based on molecular resistance detection techniques. Quantitative sequencing (QS) has been developed to predict the kdr allele frequency in head lice at a population level. The speed, simplicity and accuracy of QS made it an ideal candidate for a routine primary resistance monitoring tool to screen a large number of louse populations as an alternative to conventional bioassay. As a secondary monitoring method, real-time PASA (rtPASA) has been devised for a more precise determination of low resistance allele frequencies. To obtain more detailed information on resistance allele zygosity, as well as allele frequency, serial invasive signal amplification reaction (SISAR) has been developed as an individual genotyping method. Our approach of using three tiers of molecular resistance detection should facilitate large-scale routine resistance monitoring of permethrin resistance in head lice using field-collected samples. PMID:20161186

Head Trauma as a Precipitating Factor for Late-onset Leigh Syndrome: a Case Report.

PubMed

Ashrafi, Farzad; Pakdaman, Hossein; Arabahmadi, Mehran; Behnam, Behdad

2017-01-01

Leigh syndrome is a severe progressive neurodegenerative disorder with different clinical presentationsthat usually becomes apparent in the first year of life and rarely in late childhood and elderly years. It is causedby failure of mitochondrial respiratory chain and often results in regression of both mental and motor skills and might even lead to death. In some of the inherited neurodegenerative diseases like Alexander disease, head trauma is reported as a trigger for onset of the disease. We present a late onset Leigh syndrome in a 14-year-old girl whose symptoms were initiating following head trauma.

Association Rule-based Predictive Model for Machine Failure in Industrial Internet of Things

NASA Astrophysics Data System (ADS)

Kwon, Jung-Hyok; Lee, Sol-Bee; Park, Jaehoon; Kim, Eui-Jik

2017-09-01

This paper proposes an association rule-based predictive model for machine failure in industrial Internet of things (IIoT), which can accurately predict the machine failure in real manufacturing environment by investigating the relationship between the cause and type of machine failure. To develop the predictive model, we consider three major steps: 1) binarization, 2) rule creation, 3) visualization. The binarization step translates item values in a dataset into one or zero, then the rule creation step creates association rules as IF-THEN structures using the Lattice model and Apriori algorithm. Finally, the created rules are visualized in various ways for users’ understanding. An experimental implementation was conducted using R Studio version 3.3.2. The results show that the proposed predictive model realistically predicts machine failure based on association rules.

Can Predictive Modeling Identify Head and Neck Oncology Patients at Risk for Readmission?

PubMed

Manning, Amy M; Casper, Keith A; Peter, Kay St; Wilson, Keith M; Mark, Jonathan R; Collar, Ryan M

2018-05-01

Objective Unplanned readmission within 30 days is a contributor to health care costs in the United States. The use of predictive modeling during hospitalization to identify patients at risk for readmission offers a novel approach to quality improvement and cost reduction. Study Design Two-phase study including retrospective analysis of prospectively collected data followed by prospective longitudinal study. Setting Tertiary academic medical center. Subjects and Methods Prospectively collected data for patients undergoing surgical treatment for head and neck cancer from January 2013 to January 2015 were used to build predictive models for readmission within 30 days of discharge using logistic regression, classification and regression tree (CART) analysis, and random forests. One model (logistic regression) was then placed prospectively into the discharge workflow from March 2016 to May 2016 to determine the model's ability to predict which patients would be readmitted within 30 days. Results In total, 174 admissions had descriptive data. Thirty-two were excluded due to incomplete data. Logistic regression, CART, and random forest predictive models were constructed using the remaining 142 admissions. When applied to 106 consecutive prospective head and neck oncology patients at the time of discharge, the logistic regression model predicted readmissions with a specificity of 94%, a sensitivity of 47%, a negative predictive value of 90%, and a positive predictive value of 62% (odds ratio, 14.9; 95% confidence interval, 4.02-55.45). Conclusion Prospectively collected head and neck cancer databases can be used to develop predictive models that can accurately predict which patients will be readmitted. This offers valuable support for quality improvement initiatives and readmission-related cost reduction in head and neck cancer care.

Postbuckling failure of composite plates with central holes. Interim Report, Feb. 1990 - Dec. 1991 Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Lee, H. H.; Hyer, M. W.

1992-01-01

The postbuckling failure of square composite plates with central holes is analyzed numerically and experimentally. The particular plates studies have stacking sequences of: (+ and - 45/0/90)(sub 2S); (+ and - 45/0(sub 2))(sub 2S); (+ and - 45/0(sub 6))(sub S); and (+ and - 45)(sub 4S). A simple plate geometry, one with a hole diameter to plate width ratio of 0.3 is compared. Failure load, failure mode, and failure location are predicted numerically by using the finite element method. Predictions are compared with experimental results. In numerical failure analysis the interlaminar shear stresses, as well as the inplane stresses are taken into account. An issue addressed in this study is the possible mode shape change of the plate during loading. It is predicted that the first three laminates fail due to excessive stresses in the fiber direction, and more importantly, that the load level is independent of whether the laminate is deformed in a one-half or two-half wave configuration. It is predicted that the fourth laminate fails due to excessive inplane shear stress. Interlaminar shear failure is not predicted for any laminates. For the first two laminates the experimental observations correlated well with the predictions. Experimentally, the third laminate failed along the side support due to interlaminar shear strength S(sub 23). The fourth experimental laminate failed due to inplane shear in the location predicted, however material softening resulted in a different failure load from predictions.

Lessons Learned from the Space Shuttle Engine Hydrogen Flow Control Valve Poppet Breakage

NASA Technical Reports Server (NTRS)

Martinez, Hugo E.; Damico, Stephen; Brewer, John

2011-01-01

The Main Propulsion System (MPS) uses three Flow Control Valves (FCV) to modulate the flow of pressurant hydrogen gas from the Space Shuttle Main Engines (SSME) to the hydrogen External Tank (ET). This maintains pressure in the ullage volume as the liquid level drops, preserving ET structural integrity and assuring the engines receive a sufficient amount of head pressure. On Space Transportation System (STS)-126 (2009), with only a handful of International Space Station (ISS) assembly flights from the end of the Shuttle program, a portion of a single FCV?s poppet head broke off at about a minute and a half after liftoff. The risk of the poppet head failure is that the increased flow area through the FCV could result in excessive gaseous hydrogen flow back to the external tank, which could result in overboard venting of hydrogen ullage pressure. If the hydrogen venting were to occur in first stage (i.e., lower atmosphere), a flammability hazard exists that could lead to catastrophic loss of crew and vehicle. Other failure risks included particle impact damage to MPS downstream hardware. Although the FCV design had been plagued by contamination-related sluggish valve response problems prior to a redesign at STS-80 (1996), contamination was ruled out as the cause of the STS-126 failure. Employing a combination of enhanced hardware inspection and a better understanding of the consequences of a poppet failure, safe flight rationale for subsequent flights (STS-119 and later) was achieved. This paper deals with the technical lessons learned during the investigation and mitigation of this problem at a time when assembly flights were each in the critical path to Space Station success.

Dkk1 and noggin cooperate in mammalian head induction

PubMed Central

del Barco Barrantes, Ivan; Davidson, Gary; Gröne, Hermann-Josef; Westphal, Heiner; Niehrs, Christof

2003-01-01

Growth factor antagonists play important roles in mediating the inductive effects of the Spemann organizer in amphibian embryos and its equivalents in other vertebrates. Dual inhibition of Wnt and BMP signals has been proposed to confer head organizer activity. We tested the requirement of this coinhibition in Xenopus and mice. In Xenopus, simultaneous reduction of the BMP antagonists chordin and noggin, and the Wnt antagonist dickkopf1 (dkk1) leads to anterior truncations. In mice, compound mutants for dkk1 and noggin display severe head defects, with deletion of all head structures anterior to the mid-hindbrain boundary. These defects arise as a result of a failure in anterior specification at the gastrula stage. The results provide genetic evidence for the dual inhibition model and indicate that dkk1 and noggin functionally cooperate in the head organizer. PMID:12952897

[Clinical experience with the supraclavicular flap to reconstruct head and neck defects].

PubMed

Zhang, Bin; Yan, Dangui; Zhang, Yabing; Zhang, Xiwei; Wan, Hanfeng

2015-06-01

To evaluate the efficacy of pedicled supraclavicular artery island flaps for head and neck reconstruction. Reconstructive surgeries for head and neck oncologic defects were performed with the pedicled supraclavicular artery island flaps in 10 patients from May 2013 to December 2014 and the cases were review. Among them, 6 were performed for hypopharyngeal cancer, 2 for oral tongue cancer, 1 for oral base cancer and 1 for cervical esophageal cancer. The size of the flaps was measured in (5-8) cm × (6-12) cm. Seven flaps survived, one flap failured and two flaps had partial necrosis. Donor sites were closed primarily without morbidity. The pedicled supraclavicular artery island flap is an easy harvesting and reliable for head and neck reconstruction, especially suitable for otolaryngo-head and neck surgeon and maxillofacial surgeon in the local hospital.

Prediction value of the Canadian CT head rule and the New Orleans criteria for positive head CT scan and acute neurosurgical procedures in minor head trauma: a multicenter external validation study.

PubMed

Bouida, Wahid; Marghli, Soudani; Souissi, Sami; Ksibi, Hichem; Methammem, Mehdi; Haguiga, Habib; Khedher, Sonia; Boubaker, Hamdi; Beltaief, Kaouthar; Grissa, Mohamed Habib; Trimech, Mohamed Naceur; Kerkeni, Wiem; Chebili, Nawfel; Halila, Imen; Rejeb, Imen; Boukef, Riadh; Rekik, Noureddine; Bouhaja, Bechir; Letaief, Mondher; Nouira, Semir

2013-05-01

The New Orleans Criteria and the Canadian CT Head Rule have been developed to decrease the number of normal computed tomography (CT) results in mild head injury. We compare the performance of both decision rules for identifying patients with intracranial traumatic lesions and those who require an urgent neurosurgical intervention after mild head injury. This was an observational cohort study performed between 2008 and 2011 on patients with mild head injury who were aged 10 years or older. We collected prospectively clinical head CT scan findings and outcome. Primary outcome was need for neurosurgical intervention, defined as either death or craniotomy, or the need of intubation within 15 days of the traumatic event. Secondary outcome was the presence of traumatic lesions on head CT scan. New Orleans Criteria and Canadian CT Head Rule decision rules were compared by using sensitivity specifications and positive and negative predictive value. We enrolled 1,582 patients. Neurosurgical intervention was performed in 34 patients (2.1%) and positive CT findings were demonstrated in 218 patients (13.8%). Sensitivity and specificity for need for neurosurgical intervention were 100% (95% confidence interval [CI] 90% to 100%) and 60% (95% CI 44% to 76%) for the Canadian CT Head Rule and 82% (95% CI 69% to 95%) and 26% (95% CI 24% to 28%) for the New Orleans Criteria. Negative predictive values for the above-mentioned clinical decision rules were 100% and 99% and positive values were 5% and 2%, respectively, for the Canadian CT Head Rule and New Orleans Criteria. Sensitivity and specificity for clinical significant head CT findings were 95% (95% CI 92% to 98%) and 65% (95% CI 62% to 68%) for the Canadian CT Head Rule and 86% (95% CI 81% to 91%) and 28% (95% CI 26% to 30%) for the New Orleans Criteria. A similar trend of results was found in the subgroup of patients with a Glasgow Coma Scale score of 15. For patients with mild head injury, the Canadian CT Head Rule had higher sensitivity than the New Orleans Criteria, with higher negative predictive value. The question of whether the use of the Canadian CT Head Rule would have a greater influence on head CT scan reduction requires confirmation in real clinical practice. Copyright © 2012 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Diagnosing and treating neurogenic orthostatic hypotension in primary care.

PubMed

Kuritzky, Louis; Espay, Alberto J; Gelblum, Jeffrey; Payne, Richard; Dietrich, Eric

2015-01-01

In response to a change in posture from supine or sitting to standing, autonomic reflexes normally maintain blood pressure (BP) by selective increases in arteriovenous resistance and by increased cardiac output, ensuring continued perfusion of the central nervous system. In neurogenic orthostatic hypotension (NOH), inadequate vasoconstriction and cardiac output cause BP to drop excessively, resulting in inadequate perfusion, with predictable symptoms such as dizziness, lightheadedness and falls. The condition may represent a central failure of baroreceptor signals to modulate cardiovascular function, a peripheral failure of norepinephrine release from cardiovascular sympathetic nerve endings, or both. Symptomatic patients may benefit from both non-pharmacologic and pharmacologic interventions. Among the latter, two pressor agents have been approved by the US Food and Drug Administration: the sympathomimetic prodrug midodrine, approved in 1996 for symptomatic orthostatic hypotension, and the norepinephrine prodrug droxidopa, approved in 2014, which is indicated for the treatment of symptomatic neurogenic orthostatic hypotension caused by primary autonomic failure (Parkinson's disease, multiple system atrophy and pure autonomic failure). A wide variety of off-label options also have been described (e.g. the synthetic mineralocorticoid fludrocortisone). Because pressor agents may promote supine hypertension, NOH management requires monitoring of supine BP and also lifestyle measures to minimize supine BP increases (e.g. head-of-bed elevation). However, NOH has been associated with cognitive impairment and increases a patient's risk of syncope and falls, with the potential for serious consequences. Hence, concerns about supine hypertension - for which the long-term prognosis in patients with NOH is yet to be established - must sometimes be balanced by the need to address a patient's immediate risks.

A computational parametric study on edge loading in ceramic-on-ceramic total hip joint replacements.

PubMed

Liu, Feng; Feng, Li; Wang, Junyuan

2018-07-01

Edge loading in ceramic-on-ceramic total hip joint replacement is an adverse condition that occurs as the result of a direct contact between the head and the cup rim. It has been associated with translational mismatch in the centres of rotation of the cup and head, and found to cause severe wear and early failure of the implants. Edge loading has been considered in particular in relation to dynamic separation of the cup and head centres during a gait cycle. Research has been carried out both experimentally and computationally to understand the mechanism including the influence of bearing component positioning on the occurrence and severity of edge loading. However, it is experimentally difficult to measure both the load magnitude and duration of edge loading as it occurs as a short impact within the tight space of hip joints. Computationally, a dynamic contact model, for example, developed using the MSC ADAMS software for a multi-body dynamics simulation can be particularly useful for calculating the loads and characterising the edge loading. The aim of the present study was to further develop the computational model, and improve the predictions of contact force and the understanding of mechanism in order to provide guidance on design and surgical factors to avoid or to reduce edge loading and wear. The results have shown that edge loading can be avoided for a low range of translational mismatch in the centres of rotation of the cup and head during gait at the level of approximately 1.0 mm for a cup at 45° inclination, keeping a correct cup inclination at 45° is important to reduce the edge loading severity, and edge loading can be avoided for a certain range of translational mismatch of the cup and head centres with an increased swing phase load. Copyright © 2018 Elsevier Ltd. All rights reserved.

Outcomes of mucosal melanoma of the head and neck.

PubMed

Frakes, Jessica M; Strom, Tobin J; Naghavi, Arash O; Trotti, Andy; Rao, Nikhil G; McCaffrey, Judith C; Otto, Kristen J; Padhya, Tapan; Caudell, Jimmy J

2016-04-01

Mucosal melanoma of the head and neck is a rare disease with limited data available on outcomes; therefore, we reviewed our institutional experience. An institutional database was queried and 38 patients with head and neck mucosal melanoma were identified. Charts were abstracted and local control (LC), progression-free survival (PFS) and overall survival (OS) were calculated. Most patients had T4 disease (86%), although nodes were positive in 11%. En bloc or endoscopic resection was performed on 93%. Adjuvant or definitive radiotherapy to a median dose of 60 Gy was utilized in 90%. Chemotherapy was given in 21%, and 16% received interferon. Three-year LC, PFS and OS were 90%, 48% and 59%, respectively. Median OS was 4.6 years. Site of first failure was distant in 52% of cases. With aggressive therapy median OS was 4.6 years in this cohort. Distant recurrence remains the primary mode of failure. It may be reasonable to include mucosal melanoma patients in trials of systemic agents along with high-risk cutaneous melanomas. © 2015 The Royal Australian and New Zealand College of Radiologists.

Optimum Design of a Ceramic Tensile Creep Specimen Using a Finite Element Method

PubMed Central

Wang, Z.; Chiang, C. K.; Chuang, T.-J.

1997-01-01

An optimization procedure for designing a ceramic tensile creep specimen to minimize stress concentration is carried out using a finite element method. The effect of pin loading and the specimen geometry are considered in the stress distribution calculations. A growing contact zone between the pin and the specimen has been incorporated into the problem solution scheme as the load is increased to its full value. The optimization procedures are performed for the specimen, and all design variables including pinhole location and pinhole diameter, head width, neck radius, and gauge length are determined based on a set of constraints imposed on the problem. In addition, for the purpose of assessing the possibility of delayed failure outside the gage section, power-law creep in the tensile specimen is considered in the analysis. Using a particular grade of advanced ceramics as an example, it is found that if the specimen is not designed properly, significant creep deformation and stress redistribution may occur in the head of the specimen resulting in undesirable (delayed) head failure of the specimen during the creep test. PMID:27805126

Viability of dental implants in head and neck irradiated patients: A systematic review.

PubMed

Zen Filho, Edson Virgílio; Tolentino, Elen de Souza; Santos, Paulo Sérgio Silva

2016-04-01

The purpose of this systematic review was to evaluate the safety of dental implants placed in irradiated bone and to discuss their viability when placed post-radiotherapy (RT). A systematic review was performed to answer the questions: "Are dental implants in irradiated bone viable?" and "What are the main factors that influence the loss of implants in irradiated patients?" The search strategy resulted in 8 publications. A total of 331 patients received 1237 implants, with an overall failure rate of 9.53%. The osseointegration success rates ranged between 62.5% and 100%. The optimal time interval between irradiation and dental implantation varied from 6 to 15 months. The interval time between RT and implant placement and the radiation doses are not associated with significant implant failure rates. The placement of implants in irradiated bone is viable, and head and neck RT should not be considered as a contraindication for dental rehabilitation with implants. © 2015 Wiley Periodicals, Inc. Head Neck 38: E2229-E2240, 2016. © 2015 Wiley Periodicals, Inc.

Using Anisotropic 3D Minkowski Functionals for Trabecular Bone Characterization and Biomechanical Strength Prediction in Proximal Femur Specimens

PubMed Central

Nagarajan, Mahesh B.; De, Titas; Lochmüller, Eva-Maria; Eckstein, Felix; Wismüller, Axel

2017-01-01

The ability of Anisotropic Minkowski Functionals (AMFs) to capture local anisotropy while evaluating topological properties of the underlying gray-level structures has been previously demonstrated. We evaluate the ability of this approach to characterize local structure properties of trabecular bone micro-architecture in ex vivo proximal femur specimens, as visualized on multi-detector CT, for purposes of biomechanical bone strength prediction. To this end, volumetric AMFs were computed locally for each voxel of volumes of interest (VOI) extracted from the femoral head of 146 specimens. The local anisotropy captured by such AMFs was quantified using a fractional anisotropy measure; the magnitude and direction of anisotropy at every pixel was stored in histograms that served as a feature vectors that characterized the VOIs. A linear multi-regression analysis algorithm was used to predict the failure load (FL) from the feature sets; the predicted FL was compared to the true FL determined through biomechanical testing. The prediction performance was measured by the root mean square error (RMSE) for each feature set. The best prediction performance was obtained from the fractional anisotropy histogram of AMF Euler Characteristic (RMSE = 1.01 ± 0.13), which was significantly better than MDCT-derived mean BMD (RMSE = 1.12 ± 0.16, p<0.05). We conclude that such anisotropic Minkowski Functionals can capture valuable information regarding regional trabecular bone quality and contribute to improved bone strength prediction, which is important for improving the clinical assessment of osteoporotic fracture risk. PMID:29170581

Head losses prediction and analysis in a bulb turbine draft tube under different operating conditions using unsteady simulations

NASA Astrophysics Data System (ADS)

Wilhelm, S.; Balarac, G.; Métais, O.; Ségoufin, C.

2016-11-01

Flow prediction in a bulb turbine draft tube is conducted for two operating points using Unsteady RANS (URANS) simulations and Large Eddy Simulations (LES). The inlet boundary condition of the draft tube calculation is a rotating two dimensional velocity profile exported from a RANS guide vane- runner calculation. Numerical results are compared with experimental data in order to validate the flow field and head losses prediction. Velocity profiles prediction is improved with LES in the center of the draft tube compared to URANS results. Moreover, more complex flow structures are obtained with LES. A local analysis of the predicted flow field using the energy balance in the draft tube is then introduced in order to detect the hydrodynamic instabilities responsible for head losses in the draft tube. In particular, the production of turbulent kinetic energy next to the draft tube wall and in the central vortex structure is found to be responsible for a large part of the mean kinetic energy dissipation in the draft tube and thus for head losses. This analysis is used in order to understand the differences in head losses for different operating points. The numerical methodology could then be improved thanks to an in-depth understanding of the local flow topology.

Survival of dental implants in native and grafted bone in irradiated head and neck cancer patients: a retrospective analysis.

PubMed

Buddula, Aravind; Assad, Daniel A; Salinas, Thomas J; Garces, Yolanda I

2011-01-01

To study the long-term survival of dental implants placed in native or grafted bone in irradiated bone in subjects who had received radiation for head and neck cancer. A retrospective chart review was conducted for all patients who received dental implants following radiation treatment for head and neck cancer between May 1, 1987 and July 1, 2008. Only patients irradiated with a radiation dose of 50 Gy or greater and those who received dental implants in the irradiated field after head and neck radiation were included in the study. The associations between implant survival and patient/implant characteristics were estimated by fitting univariate marginal Cox proportional hazards models. A total of 48 patients who had prior head and neck radiation had 271 dental implants placed during May 1987-July 2008. There was no statistically significant difference between implant failure in native and grafted bone (P=0.76). Survival of implants in grafted bone was 82.3% and 98.1% in maxilla and mandible, respectively, after 3 years. Survival of implants in native bone in maxilla and mandible was 79.8% and 100%, respectively, after 3 years. For implants placed in the native bone, there was a higher likelihood of failure in the maxilla compared to the mandible and there was also a tendency for implants placed in the posterior region to fail compared to those placed in the anterior region. There was no significant difference in survival when implants were placed in native or grafted bone in irradiated head and neck cancer patients. For implants placed in native bone, survival was significantly influenced by the location of the implant (maxilla or mandible, anterior or posterior).

New imaging of submarine landslides from the 1964 earthquake near Whittier, Alaska, and a comparison to failures in other Alaskan fjords

USGS Publications Warehouse

Haeussler, Peter J.; Parsons, Thomas E.; Finlayson, David P.; Hart, Patrick J.; Chaytor, Jason D.; Ryan, Holly F; Lee, Homa J.; Labay, Keith A.; Peterson, Andrew; Liberty, Lee

2014-01-01

The 1964 Alaska M w 9.2 earthquake triggered numerous submarine slope failures in fjords of southern Alaska. These failures generated local tsunamis, such as at Whittier, where they inundated the town within 4 min of the beginning of shaking. Run-up was up to 32 m, with 13 casualties. We collected new multibeam bathymetry and high-resolution sparker seismic data in Passage Canal, and we examined bathymetry changes before and after the earthquake. The data reveal the debris flow deposit from the 1964 landslides, which covers the western 5 km of the fjord bottom. Individual blocks in the flow are up to 145-m wide and 25-m tall. Bathymetry changes show the mass transfer deposits originated from the fjord head and Whittier Creek deltas and had a volume of about 42 million m3. The 1964 deposit has an average thickness of ∼5.4 m. Beyond the debris flow, the failures likely deposited a ∼4.6-m thick megaturbidite in a distal basin. We have studied the 1964 submarine landslides in three fjords. All involved failure of the fjord-head delta. All failures eroded basin-floor sediments and incorporated them as they travelled. All the failures deposited blocks, but their size and travel distances varied greatly. We find a correlation between maximum block size and maximum tsunami run-up regardless of the volume of the slides. Lastly, the fjord’s margins were influenced by increased supply of glacial sediments during the little ice age, which along with a long interseismic interval (∼900 years) may have caused the 1964 earthquake to produce particularly numerous and large submarine landslides.

Reliability analysis of C-130 turboprop engine components using artificial neural network

NASA Astrophysics Data System (ADS)

Qattan, Nizar A.

In this study, we predict the failure rate of Lockheed C-130 Engine Turbine. More than thirty years of local operational field data were used for failure rate prediction and validation. The Weibull regression model and the Artificial Neural Network model including (feed-forward back-propagation, radial basis neural network, and multilayer perceptron neural network model); will be utilized to perform this study. For this purpose, the thesis will be divided into five major parts. First part deals with Weibull regression model to predict the turbine general failure rate, and the rate of failures that require overhaul maintenance. The second part will cover the Artificial Neural Network (ANN) model utilizing the feed-forward back-propagation algorithm as a learning rule. The MATLAB package will be used in order to build and design a code to simulate the given data, the inputs to the neural network are the independent variables, the output is the general failure rate of the turbine, and the failures which required overhaul maintenance. In the third part we predict the general failure rate of the turbine and the failures which require overhaul maintenance, using radial basis neural network model on MATLAB tool box. In the fourth part we compare the predictions of the feed-forward back-propagation model, with that of Weibull regression model, and radial basis neural network model. The results show that the failure rate predicted by the feed-forward back-propagation artificial neural network model is closer in agreement with radial basis neural network model compared with the actual field-data, than the failure rate predicted by the Weibull model. By the end of the study, we forecast the general failure rate of the Lockheed C-130 Engine Turbine, the failures which required overhaul maintenance and six categorical failures using multilayer perceptron neural network (MLP) model on DTREG commercial software. The results also give an insight into the reliability of the engine turbine under actual operating conditions, which can be used by aircraft operators for assessing system and component failures and customizing the maintenance programs recommended by the manufacturer.

[Prediction of mortality in patients with acute hepatic failure].

PubMed

Eremeeva, L F; Berdnikov, A P; Musaeva, T S; Zabolotskikh, I B

2013-01-01

The article deals with a study of 243 patients (from 18 to 65 years old) with acute hepatic failure. Purpose of the study was to evaluate the predictive capability of severity scales APACHE III, SOFA, MODS, Child-Pugh and to identify mortality predictors in patients with acute hepatic failure. Results; The best predictive ability in patients with acute hepatic failure and multiple organ failure had APACHE III and SOFA scales. The strongest mortality predictors were: serum creatinine > 132 mmol/L, fibrinogen < 1.4 g/L, Na < 129 mmol/L.

Decreased alertness

MedlinePlus

... involves the brain Liver failure Thyroid conditions that cause low thyroid hormone levels or very high thyroid hormone levels Brain disorders or injury, such as: Dementia or Alzheimer disease Head trauma Seizure Stroke Infections that affect ...

Socket position determines hip resurfacing 10-year survivorship.

PubMed

Amstutz, Harlan C; Le Duff, Michel J; Johnson, Alicia J

2012-11-01

Modern metal-on-metal hip resurfacing arthroplasty designs have been used for over a decade. Risk factors for short-term failure include small component size, large femoral head defects, low body mass index, older age, high level of sporting activity, and component design, and it is established there is a surgeon learning curve. Owing to failures with early surgical techniques, we developed a second-generation technique to address those failures. However, it is unclear whether the techniques affected the long-term risk factors. We (1) determined survivorship for hips implanted with the second-generation cementing technique; (2) identified the risk factors for failure in these patients; and (3) determined the effect of the dominant risk factors on the observed modes of failure. We retrospectively reviewed the first 200 hips (178 patients) implanted using our second-generation surgical technique, which consisted of improvements in cleaning and drying the femoral head before and during cement application. There were 129 men and 49 women. Component orientation and contact patch to rim distance were measured. We recorded the following modes of failure: femoral neck fracture, femoral component loosening, acetabular component loosening, wear, dislocation, and sepsis. The minimum followup was 25 months (mean, 106.5 months; range, 25-138 months). Twelve hips were revised. Kaplan-Meier survivorship was 98.0% at 5 years and 94.3% at 10 years. The only variable associated with revision was acetabular component position. Contact patch to rim distance was lower in hips that dislocated, were revised for wear, or were revised for acetabular loosening. The dominant modes of failure were related to component wear or acetabular component loosening. Acetabular component orientation, a factor within the surgeon's control, determines the long-term success of our current hip resurfacing techniques. Current techniques have changed the modes of failure from aseptic femoral failure to wear or loosening of the acetabular component. Level III, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

A 4-year record of sitka spruce and western hemlock seed fall on the Cascade Head Experimental Forest.

Treesearch

Robert H. Ruth; Carl M. Berntsen

1955-01-01

Four years' measurement of seed fall in the spruce-hemlock type on the Cascade Head Experimental Forest indicates that an ample supply of seed is distributed over clear-cut areas under staggered-setting cutting. The largest tract sampled was 81 acres; in spite of a seed crop failure in 1950, it received an average of 243,000 viable spruce and hemlock seeds per...

[The acute phase, a time which determines the outcome of a patient with a head trauma].

PubMed

Jeauneaux, Olivier; Bony, Maylis; Giroud, Olivier; Chabert, Flavien; Pagnier, Daniel; Mansuy, Charlène; Quélin, Pauline; Lemperrière, Héloïse; Grodecœur, Caroline; Armonia, Cécile

2017-03-01

As soon as their prehospital care begins, patients with a serious head injury are given intensive care to offset the systemic failures observed and minimise secondary brain damage. In intensive care, monitoring is continuous and neuroprotection optimised. While the prognosis of the patient remains uncertain, their family are included and involved in their global care. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Quantifying effectiveness of failure prediction and response in HPC systems : methodology and example.

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

Mayo, Jackson R.; Chen, Frank Xiaoxiao; Pebay, Philippe Pierre

2010-06-01

Effective failure prediction and mitigation strategies in high-performance computing systems could provide huge gains in resilience of tightly coupled large-scale scientific codes. These gains would come from prediction-directed process migration and resource servicing, intelligent resource allocation, and checkpointing driven by failure predictors rather than at regular intervals based on nominal mean time to failure. Given probabilistic associations of outlier behavior in hardware-related metrics with eventual failure in hardware, system software, and/or applications, this paper explores approaches for quantifying the effects of prediction and mitigation strategies and demonstrates these using actual production system data. We describe context-relevant methodologies for determining themore » accuracy and cost-benefit of predictors. While many research studies have quantified the expected impact of growing system size, and the associated shortened mean time to failure (MTTF), on application performance in large-scale high-performance computing (HPC) platforms, there has been little if any work to quantify the possible gains from predicting system resource failures with significant but imperfect accuracy. This possibly stems from HPC system complexity and the fact that, to date, no one has established any good predictors of failure in these systems. Our work in the OVIS project aims to discover these predictors via a variety of data collection techniques and statistical analysis methods that yield probabilistic predictions. The question then is, 'How good or useful are these predictions?' We investigate methods for answering this question in a general setting, and illustrate them using a specific failure predictor discovered on a production system at Sandia.« less

The diagnostic accuracy of the natriuretic peptides in heart failure: systematic review and diagnostic meta-analysis in the acute care setting.

PubMed

Roberts, Emmert; Ludman, Andrew J; Dworzynski, Katharina; Al-Mohammad, Abdallah; Cowie, Martin R; McMurray, John J V; Mant, Jonathan

2015-03-04

To determine and compare the diagnostic accuracy of serum natriuretic peptide levels (B type natriuretic peptide, N terminal probrain natriuretic peptide (NTproBNP), and mid-regional proatrial natriuretic peptide (MRproANP)) in people presenting with acute heart failure to acute care settings using thresholds recommended in the 2012 European Society of Cardiology guidelines for heart failure. Systematic review and diagnostic meta-analysis. Medline, Embase, Cochrane central register of controlled trials, Cochrane database of systematic reviews, database of abstracts of reviews of effects, NHS economic evaluation database, and Health Technology Assessment up to 28 January 2014, using combinations of subject headings and terms relating to heart failure and natriuretic peptides. Eligible studies evaluated one or more natriuretic peptides (B type natriuretic peptide, NTproBNP, or MRproANP) in the diagnosis of acute heart failure against an acceptable reference standard in consecutive or randomly selected adults in an acute care setting. Studies were excluded if they did not present sufficient data to extract or calculate true positives, false positives, false negatives, and true negatives, or report age independent natriuretic peptide thresholds. Studies not available in English were also excluded. 37 unique study cohorts described in 42 study reports were included, with a total of 48 test evaluations reporting 15 263 test results. At the lower recommended thresholds of 100 ng/L for B type natriuretic peptide and 300 ng/L for NTproBNP, the natriuretic peptides have sensitivities of 0.95 (95% confidence interval 0.93 to 0.96) and 0.99 (0.97 to 1.00) and negative predictive values of 0.94 (0.90 to 0.96) and 0.98 (0.89 to 1.0), respectively, for a diagnosis of acute heart failure. At the lower recommended threshold of 120 pmol/L, MRproANP has a sensitivity ranging from 0.95 (range 0.90-0.98) to 0.97 (0.95-0.98) and a negative predictive value ranging from 0.90 (0.80-0.96) to 0.97 (0.96-0.98). At higher thresholds the sensitivity declined progressively and specificity remained variable across the range of values. There was no statistically significant difference in diagnostic accuracy between plasma B type natriuretic peptide and NTproBNP. At the rule-out thresholds recommended in the 2012 European Society of Cardiology guidelines for heart failure, plasma B type natriuretic peptide, NTproBNP, and MRproANP have excellent ability to exclude acute heart failure. Specificity is variable, and so imaging to confirm a diagnosis of heart failure is required. There is no statistical difference between the diagnostic accuracy of plasma B type natriuretic peptide and NTproBNP. Introduction of natriuretic peptide measurement in the investigation of patients with suspected acute heart failure has the potential to allow rapid and accurate exclusion of the diagnosis. © Roberts et al 2015.

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

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

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

1995-11-01

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

Electromigration model for the prediction of lifetime based on the failure unit statistics in aluminum metallization

NASA Astrophysics Data System (ADS)

Park, Jong Ho; Ahn, Byung Tae

2003-01-01

A failure model for electromigration based on the "failure unit model" was presented for the prediction of lifetime in metal lines.The failure unit model, which consists of failure units in parallel and series, can predict both the median time to failure (MTTF) and the deviation in the time to failure (DTTF) in Al metal lines. The model can describe them only qualitatively. In our model, both the probability function of the failure unit in single grain segments and polygrain segments are considered instead of in polygrain segments alone. Based on our model, we calculated MTTF, DTTF, and activation energy for different median grain sizes, grain size distributions, linewidths, line lengths, current densities, and temperatures. Comparisons between our results and published experimental data showed good agreements and our model could explain the previously unexplained phenomena. Our advanced failure unit model might be further applied to other electromigration characteristics of metal lines.

Neptune: towards understanding how Adams's upbringing enabled him to predict, then miss the discovery of the century

NASA Astrophysics Data System (ADS)

Sheen, B.

2013-03-01

The story of John Couch Adams the great Cornish astronomer of the nineteenth century is well known and this paper will not revisit old ground. However, many questions remain unanswered and in this paper I propose to indicate some of them as section headings, and seek to address them. In this way Adams's early life is examined, and its effect on his academic life during the time of the Neptune discovery. The row that followed discovery is high-lighted together with the equally contentious issue of the new planet's name. Although it is usually believed that Adams graciously accepted the failure of the Cambridge University Observatory to find his planet, examination of his later work which is often highly critical of French astronomers sheds a different light on that theory.

A Role for MST Neurons in Heading Estimation

NASA Technical Reports Server (NTRS)

Stone, L. S.; Perrone, J. A.

1994-01-01

A template model of human visual self-motion perception, which uses neurophysiologically realistic "heading detectors", is consistent with numerous human psychophysical results including the failure of humans to estimate their heading (direction of forward translation) accurately under certain visual conditions. We tested the model detectors with stimuli used by others in single-unit studies. The detectors showed emergent properties similar to those of MST neurons: (1) Sensitivity to non-preferred flow; Each detector is tuned to a specific combination of flow components and its response is systematically reduced by the addition of nonpreferred flow, and (2) Position invariance; The detectors maintain their apparent preference for particular flow components over large regions of their receptive fields. It has been argued that this latter property is incompatible with MST playing a role in heading perception. The model however demonstrates how neurons with the above response properties could still support accurate heading estimation within extrastriate cortical maps.

Evaluation of a Linear Cumulative Damage Failure Model for Epoxy Adhesive

NASA Technical Reports Server (NTRS)

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

2001-01-01

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

Predictions of heading date in bread wheat (Triticum aestivum L.) using QTL-based parameters of an ecophysiological model

PubMed Central

Bogard, Matthieu; Ravel, Catherine; Paux, Etienne; Bordes, Jacques; Balfourier, François; Chapman, Scott C.; Le Gouis, Jacques; Allard, Vincent

2014-01-01

Prediction of wheat phenology facilitates the selection of cultivars with specific adaptations to a particular environment. However, while QTL analysis for heading date can identify major genes controlling phenology, the results are limited to the environments and genotypes tested. Moreover, while ecophysiological models allow accurate predictions in new environments, they may require substantial phenotypic data to parameterize each genotype. Also, the model parameters are rarely related to all underlying genes, and all the possible allelic combinations that could be obtained by breeding cannot be tested with models. In this study, a QTL-based model is proposed to predict heading date in bread wheat (Triticum aestivum L.). Two parameters of an ecophysiological model (V sat and P base, representing genotype vernalization requirements and photoperiod sensitivity, respectively) were optimized for 210 genotypes grown in 10 contrasting location × sowing date combinations. Multiple linear regression models predicting V sat and P base with 11 and 12 associated genetic markers accounted for 71 and 68% of the variance of these parameters, respectively. QTL-based V sat and P base estimates were able to predict heading date of an independent validation data set (88 genotypes in six location × sowing date combinations) with a root mean square error of prediction of 5 to 8.6 days, explaining 48 to 63% of the variation for heading date. The QTL-based model proposed in this study may be used for agronomic purposes and to assist breeders in suggesting locally adapted ideotypes for wheat phenology. PMID:25148833

The function and failure of sensory predictions.

PubMed

Bansal, Sonia; Ford, Judith M; Spering, Miriam

2018-04-23

Humans and other primates are equipped with neural mechanisms that allow them to automatically make predictions about future events, facilitating processing of expected sensations and actions. Prediction-driven control and monitoring of perceptual and motor acts are vital to normal cognitive functioning. This review provides an overview of corollary discharge mechanisms involved in predictions across sensory modalities and discusses consequences of predictive coding for cognition and behavior. Converging evidence now links impairments in corollary discharge mechanisms to neuropsychiatric symptoms such as hallucinations and delusions. We review studies supporting a prediction-failure hypothesis of perceptual and cognitive disturbances. We also outline neural correlates underlying prediction function and failure, highlighting similarities across the visual, auditory, and somatosensory systems. In linking basic psychophysical and psychophysiological evidence of visual, auditory, and somatosensory prediction failures to neuropsychiatric symptoms, our review furthers our understanding of disease mechanisms. © 2018 New York Academy of Sciences.

Predictors of treatment failure in young patients undergoing in vitro fertilization.

PubMed

Jacobs, Marni B; Klonoff-Cohen, Hillary; Agarwal, Sanjay; Kritz-Silverstein, Donna; Lindsay, Suzanne; Garzo, V Gabriel

2016-08-01

The purpose of the study was to evaluate whether routinely collected clinical factors can predict in vitro fertilization (IVF) failure among young, "good prognosis" patients predominantly with secondary infertility who are less than 35 years of age. Using de-identified clinic records, 414 women <35 years undergoing their first autologous IVF cycle were identified. Logistic regression was used to identify patient-driven clinical factors routinely collected during fertility treatment that could be used to model predicted probability of cycle failure. One hundred ninety-seven patients with both primary and secondary infertility had a failed IVF cycle, and 217 with secondary infertility had a successful live birth. None of the women with primary infertility had a successful live birth. The significant predictors for IVF cycle failure among young patients were fewer previous live births, history of biochemical pregnancies or spontaneous abortions, lower baseline antral follicle count, higher total gonadotropin dose, unknown infertility diagnosis, and lack of at least one fair to good quality embryo. The full model showed good predictive value (c = 0.885) for estimating risk of cycle failure; at ≥80 % predicted probability of failure, sensitivity = 55.4 %, specificity = 97.5 %, positive predictive value = 95.4 %, and negative predictive value = 69.8 %. If this predictive model is validated in future studies, it could be beneficial for predicting IVF failure in good prognosis women under the age of 35 years.

Technical Complications during Veno-Venous Extracorporeal Membrane Oxygenation and Their Relevance Predicting a System-Exchange – Retrospective Analysis of 265 Cases

PubMed Central

Lubnow, Matthias; Philipp, Alois; Foltan, Maik; Bull Enger, Tone; Lunz, Dirk; Bein, Thomas; Haneya, Assad; Schmid, Christof; Riegger, Günter; Müller, Thomas; Lehle, Karla

2014-01-01

Objectives Technical complications are a known hazard in veno-venous extracorporeal membrane oxygenation (vvECMO). Identifying these complications and predictive factors indicating a developing system-exchange was the goal of the study. Methods Retrospective study on prospectively collected data of technical complications including 265 adult patients (Regensburg ECMO Registry, 2009-2013) with acute respiratory failure treated with vvECMO. Alterations in blood flow resistance, gas transfer capability, hemolysis, coagulation and hemostasis parameters were evaluated in conjunction with a system-exchange in all patients with at least one exchange (n = 83). Results Values presented as median (interquartile range). Patient age was 50(36–60) years, the SOFA score 11(8–14.3) and the Murray lung injury Score 3.33(3.3–3.7). Cumulative ECMO support time 3411 days, 9(6–15) days per patient. Mechanical failure of the blood pump (n = 5), MO (n = 2) or cannula (n = 1) accounted for 10% of the exchanges. Acute clot formation within the pump head (visible clots, increase in plasma free hemoglobin (frHb), serum lactate dehydrogenase (LDH), n = 13) and MO (increase in pressure drop across the MO, n = 16) required an urgent system-exchange, of which nearly 50% could be foreseen by measuring the parameters mentioned below. Reasons for an elective system-exchange were worsening of gas transfer capability (n = 10) and device-related coagulation disorders (n = 32), either local fibrinolysis in the MO due to clot formation (increased D-dimers [DD]), decreased platelet count; n = 24), or device-induced hyperfibrinolysis (increased DD, decreased fibrinogen [FG], decreased platelet count, diffuse bleeding tendency; n = 8), which could be reversed after system-exchange. Four MOs were exchanged due to suspicion of infection. Conclusions The majority of ECMO system-exchanges could be predicted by regular inspection of the complete ECMO circuit, evaluation of gas exchange, pressure drop across the MO and laboratory parameters (DD, FG, platelets, LDH, frHb). These parameters should be monitored in the daily routine to reduce the risk of unexpected ECMO failure. PMID:25464516

The predictive value of single-photon emission computed tomography/computed tomography for sentinel lymph node localization in head and neck cutaneous malignancy.

PubMed

Remenschneider, Aaron K; Dilger, Amanda E; Wang, Yingbing; Palmer, Edwin L; Scott, James A; Emerick, Kevin S

2015-04-01

Preoperative localization of sentinel lymph nodes in head and neck cutaneous malignancies can be aided by single-photon emission computed tomography/computed tomography (SPECT/CT); however, its true predictive value for identifying lymph nodes intraoperatively remains unquantified. This study aims to understand the sensitivity, specificity, and positive and negative predictive values of SPECT/CT in sentinel lymph node biopsy for cutaneous malignancies of the head and neck. Blinded retrospective imaging review with comparison to intraoperative gamma probe confirmed sentinel lymph nodes. A consecutive series of patients with a head and neck cutaneous malignancy underwent preoperative SPECT/CT followed by sentinel lymph node biopsy with a gamma probe. Two nuclear medicine physicians, blinded to clinical data, independently reviewed each SPECT/CT. Activity within radiographically defined nodal basins was recorded and compared to intraoperative gamma probe findings. Sensitivity, specificity, and negative and positive predictive values were calculated with subgroup stratification by primary tumor site. Ninety-two imaging reads were performed on 47 patients with cutaneous malignancy who underwent SPECT/CT followed by sentinel lymph node biopsy. Overall sensitivity was 73%, specificity 92%, positive predictive value 54%, and negative predictive value 96%. The predictive ability of SPECT/CT to identify the basin or an adjacent basin containing the single hottest node was 92%. SPECT/CT overestimated uptake by an average of one nodal basin. In the head and neck, SPECT/CT has higher reliability for primary lesions of the eyelid, scalp, and cheek. SPECT/CT has high sensitivity, specificity, and negative predictive value, but may overestimate relevant nodal basins in sentinel lymph node biopsy. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

Impact of creatine kinase correction on the predictive value of S-100B after mild traumatic brain injury.

PubMed

Bazarian, Jeffrey J; Beck, Christopher; Blyth, Brian; von Ahsen, Nicolas; Hasselblatt, Martin

2006-01-01

To validate a correction factor for the extracranial release of the astroglial protein, S-100B, based on concomitant creatine kinase (CK) levels. The CK- S-100B relationship in non-head injured marathon runners was used to derive a correction factor for the extracranial release of S-100B. This factor was then applied to a separate cohort of 96 mild traumatic brain injury (TBI) patients in whom both CK and S-100B levels were measured. Corrected S-100B was compared to uncorrected S-100B for the prediction of initial head CT, three-month headache and three-month post concussive syndrome (PCS). Corrected S-100B resulted in a statistically significant improvement in the prediction of 3-month headache (area under curve [AUC] 0.46 vs 0.52, p=0.02), but not PCS or initial head CT. Using a cutoff that maximizes sensitivity (> or = 90%), corrected S-100B improved the prediction of initial head CT scan (negative predictive value from 75% [95% CI, 2.6%, 67.0%] to 96% [95% CI: 83.5%, 99.8%]). Although S-100B is overall poorly predictive of outcome, a correction factor using CK is a valid means of accounting for extracranial release. By increasing the proportion of mild TBI patients correctly categorized as low risk for abnormal head CT, CK-corrected S100-B can further reduce the number of unnecessary brain CT scans performed after this injury.

Preoperative radiation and free flap outcomes for head and neck reconstruction: a systematic review and meta-analysis.

PubMed

Herle, Pradyumna; Shukla, Lipi; Morrison, Wayne A; Shayan, Ramin

2015-03-01

There is a general consensus among reconstructive surgeons that preoperative radiotherapy is associated with a higher risk of flap failure and complications in head and neck surgery. Opinion is also divided regarding the effects of radiation dose on free flap outcomes and timing of preoperative radiation to minimize adverse outcomes. Our meta-analysis will attempt to address these issues. A systematic review of the literature was conducted in concordance to PRISMA protocol. Data were combined using STATA 12 and Open Meta-Analyst software programmes. Twenty-four studies were included comparing 2842 flaps performed in irradiated fields and 3491 flaps performed in non-irradiated fields. Meta-analysis yielded statistically significant risk ratios for flap failure (RR 1.48, P = 0.004), complications (RR 1.84, P < 0.001), reoperation (RR 2.06, P < 0.001) and fistula (RR 2.05, P < 0.001). Mean radiation dose demonstrated a trend towards increased risk of flap failure, but this was not statistically significant. On subgroup analysis, flaps with >60 Gy radiation had a non-statistically significant higher risk of flap failure (RR 1.61, P = 0.145). Preoperative radiation is associated with a statistically significant increased risk of flap complications, failure and fistula. Preoperative radiation in excess of 60 Gy after radiotherapy represents a potential risk factor for increased flap loss and should be avoided where possible. © 2014 Royal Australasian College of Surgeons.

Fukushima Daiichi Unit 1 Ex-Vessel Prediction: Core-Concrete Interaction

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

Robb, Kevin R.; Farmer, Mitchell T.; Francis, Matthew W.

Lower head failure and corium-concrete interaction were predicted to occur at Fukushima Daiichi Unit 1 (1F1) by several different system-level code analyses, including MELCOR v2.1 and MAAP5. Although these codes capture a wide range of accident phenomena, they do not contain detailed models for ex-vessel core melt behavior. However, specialized codes exist for the analysis of ex-vessel melt spreading (e.g., MELTSPREAD) and long-term debris coolability (e.g., CORQUENCH). On this basis, in this paper an analysis was carried out to further evaluate ex-vessel behavior for 1F1 using MELTSPREAD and CORQUENCH. Best-estimate melt pour conditions predicted by MELCOR v2.1 and MAAP5 weremore » used as input. MELTSPREAD was then used to predict the spatially dependent melt conditions and extent of spreading during relocation from the vessel. The results of the MELTSPREAD analysis are reported in a companion paper. This information was used as input for the long-term debris coolability analysis with CORQUENCH. For the MELCOR-based melt pour scenario, CORQUENCH predicted the melt would readily cool within 2.5 h after the pour, and the sumps would experience limited ablation (approximately 18 cm) under water-flooded conditions. Finally, for the MAAP-based melt pour scenarios, CORQUENCH predicted that the melt would cool in approximately 22.5 h, and the sumps would experience approximately 65 cm of concrete ablation under water-flooded conditions.« less

Fukushima Daiichi Unit 1 Ex-Vessel Prediction: Core-Concrete Interaction

DOE PAGES

Robb, Kevin R.; Farmer, Mitchell T.; Francis, Matthew W.

2016-10-31

Lower head failure and corium-concrete interaction were predicted to occur at Fukushima Daiichi Unit 1 (1F1) by several different system-level code analyses, including MELCOR v2.1 and MAAP5. Although these codes capture a wide range of accident phenomena, they do not contain detailed models for ex-vessel core melt behavior. However, specialized codes exist for the analysis of ex-vessel melt spreading (e.g., MELTSPREAD) and long-term debris coolability (e.g., CORQUENCH). On this basis, in this paper an analysis was carried out to further evaluate ex-vessel behavior for 1F1 using MELTSPREAD and CORQUENCH. Best-estimate melt pour conditions predicted by MELCOR v2.1 and MAAP5 weremore » used as input. MELTSPREAD was then used to predict the spatially dependent melt conditions and extent of spreading during relocation from the vessel. The results of the MELTSPREAD analysis are reported in a companion paper. This information was used as input for the long-term debris coolability analysis with CORQUENCH. For the MELCOR-based melt pour scenario, CORQUENCH predicted the melt would readily cool within 2.5 h after the pour, and the sumps would experience limited ablation (approximately 18 cm) under water-flooded conditions. Finally, for the MAAP-based melt pour scenarios, CORQUENCH predicted that the melt would cool in approximately 22.5 h, and the sumps would experience approximately 65 cm of concrete ablation under water-flooded conditions.« less

Femoral head epiphysis growth and development among Chinese children aged 0-5 years.

PubMed

Luo, Jiayou; Tang, Jin; Zhou, Libo; Zeng, Rong; Mou, Jinsong; Zhang, Lingli

2009-05-01

The aim of this study was to examine the pattern of femoral head epiphysis growth and development among Chinese children. Between January and December, 2007, we randomly sampled 1,450 healthy Chinese children (0-5 years old) from Hunan Provincial Children's Hospital in Changsha, Hunan, China. The diameter of femoral head epiphysis was measured by pelvic X-ray photography and processed by medical image processing software. The growth of femoral head epiphysis in girls was 2-3 months earlier than that in boys. The diameter of femoral head epiphysis increased with advancing age in both girls and boys, but the diameter of femoral head epiphysis in 2, 3, 4, 6, and 10-month-old girls was significantly larger than that in boys. Cubic regression equations between the diameter of femoral head epiphysis and age were created for boys and girls that could be used to predict the diameter of femoral head epiphysis. In conclusion, there was gender difference in femoral head epiphysis growth and development among Chinese children, and our prediction models will provide the guidance for early diagnosis of diseases related to the growth and development of the femoral head epiphysis.

An incurable itch: head lice.

PubMed

Smith, Christine H; Goldman, Ran D

2012-08-01

Head lice infestations continue to be seen frequently in many communities. Some of these children require multiple treatments before eradication. What are the current treatment recommendations for head lice? Head lice (Pediculus humanus capitis) infestations are common, particularly among school-aged children. In order to minimize louse resistance, insecticide usage, and social stigmatization, diagnosis and treatment should be limited to those with live lice on the scalp. Options for management are predominantly topical therapies or physical removal. Large studies comparing the efficacy of these treatments are lacking. Treatment should be repeated in approximately 7 days if topical insecticides are used or every 2 to 3 days for 2 weeks if wet combing is used. Lice resistance patterns vary widely geographically, and resistance is now the most common cause of treatment failure.

Radiotherapy after surgical resection for head and neck mucosal melanoma.

PubMed

Wu, Abraham J; Gomez, Jennifer; Zhung, Joanne E; Chan, Kelvin; Gomez, Daniel R; Wolden, Suzanne L; Zelefsky, Michael J; Wolchok, Jedd D; Carvajal, Richard D; Chapman, Paul B; Wong, Richard J; Shaha, Ashok R; Kraus, Dennis H; Shah, Jatin P; Lee, Nancy Y

2010-06-01

To present our single-institution experience with postoperative radiotherapy for mucosal melanoma of the head and neck. Between 1992 and 2007, 27 patients with mucosal melanoma of the head and neck underwent surgical resection followed by postoperative radiotherapy. Median age was 68 years (range: 45-89 years). Sites included were sinonasal in 24 patients, oral cavity in 2, and oropharynx in 1. All but 2 patients had stage I disease. Twenty-two patients received hypofractionated radiation. Radiation techniques were intensity-modulated radiation therapy in 13, 3-dimensional conformal in 4, and conventional in 10. The median follow-up for living patients was 45 months (range: 24-122 months). The 3- and 5-year estimates of local progression-free, loco-regional progression-free, distant metastasis-free, and overall survival were: 47% and 35%; 34% and 22%; 30% and 24%; and 40% and 33%, respectively. Median time to local failure and distant metastasis was 32 and 14 months, respectively. Acute toxicities included 19% with grade 2 or higher mucositis. No late complications related to the optic structures were seen. Modern radiotherapeutic techniques including intensity-modulated radiation therapy appear feasible and well-tolerated in the postoperative treatment of head and neck mucosal melanoma. Unusual or serious late complications have not been observed despite extensive use of hypofractionated regimens. However, rates of local and distant failure remain high.

Naturally Acquired Learned Helplessness: The Relationship of School Failure to Achievement Behavior, Attributions, and Self-Concept.

ERIC Educational Resources Information Center

Johnson, Dona S.

1981-01-01

Personality and behavioral consequences of learned helplessness were monitored in children experiencing failure in school. The predictive quality of learned helplessness theory was compared with that of value expectancy theories. Low self-concept was predicted significantly by school failure, internal attributions for failure, and external…

Anterior visceral endoderm SMAD4 signaling specifies anterior embryonic patterning and head induction in mice.

PubMed

Li, Cuiling; Li, Yi-Ping; Fu, Xin-Yuan; Deng, Chu-Xia

2010-09-27

SMAD4 serves as a common mediator for signaling of TGF-β superfamily. Previous studies illustrated that SMAD4-null mice die at embryonic day 6.5 (E6.5) due to failure of mesoderm induction and extraembryonic defects; however, functions of SMAD4 in each germ layer remain elusive. To investigate this, we disrupted SMAD4 in the visceral endoderm and epiblast, respectively, using a Cre-loxP mediated approach. We showed that mutant embryos lack of SMAD4 in the visceral endoderm (Smad4(Co/Co);TTR-Cre) died at E7.5-E9.5 without head-fold and anterior embryonic structures. We demonstrated that TGF-β regulates expression of several genes, such as Hex1, Cer1, and Lim1, in the anterior visceral endoderm (AVE), and the failure of anterior embryonic development in Smad4(Co/Co);TTR-Cre embryos is accompanied by diminished expression of these genes. Consistent with this finding, SMAD4-deficient embryoid bodies showed impaired responsiveness to TGF-β-induced gene expression and morphological changes. On the other hand, embryos carrying Cre-loxP mediated disruption of SMAD4 in the epiblasts exhibited relatively normal mesoderm and head-fold induction although they all displayed profound patterning defects in the later stages of gastrulation. Cumulatively, our data indicate that SMAD4 signaling in the epiblasts is dispensable for mesoderm induction although it remains critical for head patterning, which is significantly different from SMAD4 signaling in the AVE, where it specifies anterior embryonic patterning and head induction.

Anterior Visceral Endoderm SMAD4 Signaling Specifies Anterior Embryonic Patterning and Head Induction in Mice

PubMed Central

Li, Cuiling; Li, Yi-Ping; Fu, Xin-Yuan; Deng, Chu-Xia

2010-01-01

SMAD4 serves as a common mediator for signaling of TGF-β superfamily. Previous studies illustrated that SMAD4-null mice die at embryonic day 6.5 (E6.5) due to failure of mesoderm induction and extraembryonic defects; however, functions of SMAD4 in each germ layer remain elusive. To investigate this, we disrupted SMAD4 in the visceral endoderm and epiblast, respectively, using a Cre-loxP mediated approach. We showed that mutant embryos lack of SMAD4 in the visceral endoderm (Smad4Co/Co;TTR-Cre) died at E7.5-E9.5 without head-fold and anterior embryonic structures. We demonstrated that TGF-β regulates expression of several genes, such as Hex1, Cer1, and Lim1, in the anterior visceral endoderm (AVE), and the failure of anterior embryonic development in Smad4Co/Co;TTR-Cre embryos is accompanied by diminished expression of these genes. Consistent with this finding, SMAD4-deficient embryoid bodies showed impaired responsiveness to TGF-β-induced gene expression and morphological changes. On the other hand, embryos carrying Cre-loxP mediated disruption of SMAD4 in the epiblasts exhibited relatively normal mesoderm and head-fold induction although they all displayed profound patterning defects in the later stages of gastrulation. Cumulatively, our data indicate that SMAD4 signaling in the epiblasts is dispensable for mesoderm induction although it remains critical for head patterning, which is significantly different from SMAD4 signaling in the AVE, where it specifies anterior embryonic patterning and head induction. PMID:20941375

Reinforcement of composite laminate free edges with U-shaped caps

NASA Technical Reports Server (NTRS)

Howard, W. E.; Gossard, T., Jr.; Jones, R. M.

1986-01-01

Generalized plane strain finite element analysis is used to predict reduction of interlaminar normal stresses when a U-shaped cap is bonded to the edge of a laminate. Three-dimensional composite material failure criteria are used in a progressive laminate failure analysis to predict failure loads of laminates with different edge cap designs. In an experimental program, symmetric 11-layer graphite-epoxy laminates with a one-layer cap of Kevlar-epoxy cloth are shown to be 130 to 140 percent stronger than uncapped laminates under static tensile and tension-tension fatigue loading. In addition, the coefficient of variation of the static tensile failure load decreases from 24 to 8 percent when edge caps are added. The predicted failure load calculated with the finite element results is 10 percent lower than the actual failure load. For both capped and uncapped laminates, actual failure loads are much lower than those predicted using classical lamination theory stresses and a two-dimensional failure criterion. Possible applications of the free edge reinforcement concept are described, and future research is suggested.

XPF expression correlates with clinical outcome in squamous cell carcinoma of the head and neck

PubMed Central

Vaezi, Alec; Wang, XiaoZhe; Buch, Shama; Gooding, William; Wang, Lin; Seethala, Raja R.; Weaver, David T.; D’Andrea, Alan D.; Argiris, Athanassios; Romkes, Marjorie; Niedernhofer, Laura J.; Grandis, Jennifer R.

2011-01-01

Purpose Tumor-specific biomarkers that predict resistance to DNA damaging agents may improve therapeutic outcomes by guiding the selection of effective therapies and limiting morbidity related to ineffective approaches. XPF (ERCC4) is an essential component of several DNA repair pathways and XPF-deficient cells are exquisitely sensitive to DNA damaging agents. The purpose of this study was to determine whether XPF expression levels predict clinical response to DNA damaging agents in head and neck squamous cell carcinoma (HNSCC). Experimental Design Quantitative immunohistochemistry was used to measure XPF expression in tumors from a cohort of 80 patients with newly diagnosed HNSCC treated with radiation therapy with or without platinum-based chemotherapy; samples were collected prospectively. Genomic DNA isolated from blood samples was analyzed for nine single nucleotide polymorphisms in the XPF gene using a custom array. The primary endpoint was progression-free survival (PFS). Results XPF expression was higher in tumors from the oral cavity than from the other sites (p<0.01). High XPF expression correlated with early time to progression both by univariate (HR =1.87, p=0.03) and multivariate analysis (HR =1.83, p=0.05). The one year PFS for high expressers was 47% (95% CI = 31% – 62%) compared to 72% (95% CI = 55% – 83%) for low expressers. In addition, we identified four XPF single nucleotide polymorphisms (SNPs) that demonstrated marginal association with treatment failure. Conclusions Expression level of XPF in HNSCC tumors correlates with clinical response to DNA damaging agents. XPF has potential to guide next-generation personalized cancer therapy. PMID:21737503

Review on failure prediction techniques of composite single lap joint

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

Ab Ghani, A.F., E-mail: ahmadfuad@utem.edu.my; Rivai, Ahmad, E-mail: ahmadrivai@utem.edu.my

2016-03-29

Adhesive bonding is the most appropriate joining method in construction of composite structures. The use of reliable design and prediction technique will produce better performance of bonded joints. Several papers from recent papers and journals have been reviewed and synthesized to understand the current state of the art in this area. It is done by studying the most relevant analytical solutions for composite adherends with start of reviewing the most fundamental ones involving beam/plate theory. It is then extended to review single lap joint non linearity and failure prediction and finally on the failure prediction on composite single lap joint.more » The review also encompasses the finite element modelling part as tool to predict the elastic response of composite single lap joint and failure prediction numerically.« less

Comparison of the Walz Nomogram and Presence of Secondary Circulating Prostate Cells for Predicting Early Biochemical Failure after Radical Prostatectomy for Prostate Cancer in Chilean Men.

PubMed

Murray, Nigel P; Reyes, Eduardo; Orellana, Nelson; Fuentealba, Cynthia; Jacob, Omar

2015-01-01

To determine the utility of secondary circulating prostate cells for predicting early biochemical failure after radical prostatectomy for prostate cancer and compare the results with the Walz nomagram. A single centre, prospective study of men with prostate cancer treated with radical prostatectomy between 2004 and 2014 was conducted, with registration of clinical-pathological details, total serum PSA pre-surgery, Gleason score, extracapsular extension, positive surgical margins, infiltration of lymph nodes, seminal vesicles and pathological stage. Secondary circulating prostate cells were obtained using differential gel centrifugation and assessed using standard immunocytochemistry with anti-PSA. Biochemical failure was defined as a PSA >0.2ng/ml, predictive values werecalculated using the Walz nomagram and CPC detection. A total of 326 men participated, with a median follow up of 5 years; 64 had biochemical failure within two years. Extracapsular extension, positive surgical margins, pathological stage, Gleason score ≥ 8, infiltration of seminal vesicles and lymph nodes were all associated with higher risk of biochemical failure. The discriminative value for the nomogram and circulating prostate cells was high (AUC >0.80), predictive values were higher for circulating prostate cell detection, with a negative predictive value of 99%, sensitivity of 96% and specificity of 75%. The nomagram had good predictive power to identify men with a high risk of biochemical failure within two years. The presence of circulating prostate cells had the same predictive power, with a higher sensitivity and negative predictive value. The presence of secondary circulating prostate cells identifies a group of men with a high risk of early biochemical failure. Those negative for secondary CPCs have a very low risk of early biochemical failure.

Numerical investigations of rib fracture failure models in different dynamic loading conditions.

PubMed

Wang, Fang; Yang, Jikuang; Miller, Karol; Li, Guibing; Joldes, Grand R; Doyle, Barry; Wittek, Adam

2016-01-01

Rib fracture is one of the most common thoracic injuries in vehicle traffic accidents that can result in fatalities associated with seriously injured internal organs. A failure model is critical when modelling rib fracture to predict such injuries. Different rib failure models have been proposed in prediction of thorax injuries. However, the biofidelity of the fracture failure models when varying the loading conditions and the effects of a rib fracture failure model on prediction of thoracic injuries have been studied only to a limited extent. Therefore, this study aimed to investigate the effects of three rib failure models on prediction of thoracic injuries using a previously validated finite element model of the human thorax. The performance and biofidelity of each rib failure model were first evaluated by modelling rib responses to different loading conditions in two experimental configurations: (1) the three-point bending on the specimen taken from rib and (2) the anterior-posterior dynamic loading to an entire bony part of the rib. Furthermore, the simulation of the rib failure behaviour in the frontal impact to an entire thorax was conducted at varying velocities and the effects of the failure models were analysed with respect to the severity of rib cage damages. Simulation results demonstrated that the responses of the thorax model are similar to the general trends of the rib fracture responses reported in the experimental literature. However, they also indicated that the accuracy of the rib fracture prediction using a given failure model varies for different loading conditions.

Peridynamics for failure and residual strength prediction of fiber-reinforced composites

NASA Astrophysics Data System (ADS)

Colavito, Kyle

Peridynamics is a reformulation of classical continuum mechanics that utilizes integral equations in place of partial differential equations to remove the difficulty in handling discontinuities, such as cracks or interfaces, within a body. Damage is included within the constitutive model; initiation and propagation can occur without resorting to special crack growth criteria necessary in other commonly utilized approaches. Predicting damage and residual strengths of composite materials involves capturing complex, distinct and progressive failure modes. The peridynamic laminate theory correctly predicts the load redistribution in general laminate layups in the presence of complex failure modes through the use of multiple interaction types. This study presents two approaches to obtain the critical peridynamic failure parameters necessary to capture the residual strength of a composite structure. The validity of both approaches is first demonstrated by considering the residual strength of isotropic materials. The peridynamic theory is used to predict the crack growth and final failure load in both a diagonally loaded square plate with a center crack, as well as a four-point shear specimen subjected to asymmetric loading. This study also establishes the validity of each approach by considering composite laminate specimens in which each failure mode is isolated. Finally, the failure loads and final failure modes are predicted in a laminate with various hole diameters subjected to tensile and compressive loads.

Influence of Finite Element Size in Residual Strength Prediction of Composite Structures

NASA Technical Reports Server (NTRS)

Satyanarayana, Arunkumar; Bogert, Philip B.; Karayev, Kazbek Z.; Nordman, Paul S.; Razi, Hamid

2012-01-01

The sensitivity of failure load to the element size used in a progressive failure analysis (PFA) of carbon composite center notched laminates is evaluated. The sensitivity study employs a PFA methodology previously developed by the authors consisting of Hashin-Rotem intra-laminar fiber and matrix failure criteria and a complete stress degradation scheme for damage simulation. The approach is implemented with a user defined subroutine in the ABAQUS/Explicit finite element package. The effect of element size near the notch tips on residual strength predictions was assessed for a brittle failure mode with a parametric study that included three laminates of varying material system, thickness and stacking sequence. The study resulted in the selection of an element size of 0.09 in. X 0.09 in., which was later used for predicting crack paths and failure loads in sandwich panels and monolithic laminated panels. Comparison of predicted crack paths and failure loads for these panels agreed well with experimental observations. Additionally, the element size vs. normalized failure load relationship, determined in the parametric study, was used to evaluate strength-scaling factors for three different element sizes. The failure loads predicted with all three element sizes provided converged failure loads with respect to that corresponding with the 0.09 in. X 0.09 in. element size. Though preliminary in nature, the strength-scaling concept has the potential to greatly reduce the computational time required for PFA and can enable the analysis of large scale structural components where failure is dominated by fiber failure in tension.

The second Sandia Fracture Challenge. Predictions of ductile failure under quasi-static and moderate-rate dynamic loading

DOE PAGES

Boyce, B. L.; Kramer, S. L. B.; Bosiljevac, T. R.; ...

2016-03-14

Ductile failure of structural metals is relevant to a wide range of engineering scenarios. Computational methods are employed to anticipate the critical conditions of failure, yet they sometimes provide inaccurate and misleading predictions. Challenge scenarios, such as the one presented in the current work, provide an opportunity to assess the blind, quantitative predictive ability of simulation methods against a previously unseen failure problem. Instead of evaluating the predictions of a single simulation approach, the Sandia Fracture Challenge relied on numerous volunteer teams with expertise in computational mechanics to apply a broad range of computational methods, numerical algorithms, and constitutive modelsmore » to the challenge. This exercise is intended to evaluate the state of health of technologies available for failure prediction. In the first Sandia Fracture Challenge, a wide range of issues were raised in ductile failure modeling, including a lack of consistency in failure models, the importance of shear calibration data, and difficulties in quantifying the uncertainty of prediction [see Boyce et al. (Int J Fract 186:5–68, 2014) for details of these observations]. This second Sandia Fracture Challenge investigated the ductile rupture of a Ti–6Al–4V sheet under both quasi-static and modest-rate dynamic loading (failure in ~ 0.1 s). Like the previous challenge, the sheet had an unusual arrangement of notches and holes that added geometric complexity and fostered a competition between tensile- and shear-dominated failure modes. The teams were asked to predict the fracture path and quantitative far-field failure metrics such as the peak force and displacement to cause crack initiation. Fourteen teams contributed blind predictions, and the experimental outcomes were quantified in three independent test labs. In addition, shortcomings were revealed in this second challenge such as inconsistency in the application of appropriate boundary conditions, need for a thermomechanical treatment of the heat generation in the dynamic loading condition, and further difficulties in model calibration based on limited real-world engineering data. As with the prior challenge, this work not only documents the ‘state-of-the-art’ in computational failure prediction of ductile tearing scenarios, but also provides a detailed dataset for non-blind assessment of alternative methods.« less

The second Sandia Fracture Challenge. Predictions of ductile failure under quasi-static and moderate-rate dynamic loading

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

Boyce, B. L.; Kramer, S. L. B.; Bosiljevac, T. R.

Ductile failure of structural metals is relevant to a wide range of engineering scenarios. Computational methods are employed to anticipate the critical conditions of failure, yet they sometimes provide inaccurate and misleading predictions. Challenge scenarios, such as the one presented in the current work, provide an opportunity to assess the blind, quantitative predictive ability of simulation methods against a previously unseen failure problem. Instead of evaluating the predictions of a single simulation approach, the Sandia Fracture Challenge relied on numerous volunteer teams with expertise in computational mechanics to apply a broad range of computational methods, numerical algorithms, and constitutive modelsmore » to the challenge. This exercise is intended to evaluate the state of health of technologies available for failure prediction. In the first Sandia Fracture Challenge, a wide range of issues were raised in ductile failure modeling, including a lack of consistency in failure models, the importance of shear calibration data, and difficulties in quantifying the uncertainty of prediction [see Boyce et al. (Int J Fract 186:5–68, 2014) for details of these observations]. This second Sandia Fracture Challenge investigated the ductile rupture of a Ti–6Al–4V sheet under both quasi-static and modest-rate dynamic loading (failure in ~ 0.1 s). Like the previous challenge, the sheet had an unusual arrangement of notches and holes that added geometric complexity and fostered a competition between tensile- and shear-dominated failure modes. The teams were asked to predict the fracture path and quantitative far-field failure metrics such as the peak force and displacement to cause crack initiation. Fourteen teams contributed blind predictions, and the experimental outcomes were quantified in three independent test labs. In addition, shortcomings were revealed in this second challenge such as inconsistency in the application of appropriate boundary conditions, need for a thermomechanical treatment of the heat generation in the dynamic loading condition, and further difficulties in model calibration based on limited real-world engineering data. As with the prior challenge, this work not only documents the ‘state-of-the-art’ in computational failure prediction of ductile tearing scenarios, but also provides a detailed dataset for non-blind assessment of alternative methods.« less

Performance of immunological response in predicting virological failure.

PubMed

Ingole, Nayana; Mehta, Preeti; Pazare, Amar; Paranjpe, Supriya; Sarkate, Purva

2013-03-01

In HIV-infected individuals on antiretroviral therapy (ART), the decision on when to switch from first-line to second-line therapy is dictated by treatment failure, and this can be measured in three ways: clinically, immunologically, and virologically. While viral load (VL) decreases and CD4 cell increases typically occur together after starting ART, discordant responses may be seen. Hence the current study was designed to determine the immunological and virological response to ART and to evaluate the utility of immunological response to predict virological failure. All treatment-naive HIV-positive individuals aged >18 years who were eligible for ART were enrolled and assessed at baseline, 6 months, and 12 months clinically and by CD4 cell count and viral load estimations. The patients were categorized as showing concordant favorable (CF), immunological only (IO), virological only (VO), and concordant unfavorable responses (CU). The efficiency of immunological failure to predict virological failure was analyzed across various levels of virological failure (VL>50, >500, and >5,000 copies/ml). At 6 months, 87(79.81%), 7(5.5%), 13 (11.92%), and 2 (1.83%) patients and at 12 months 61(69.3%), 9(10.2%), 16 (18.2%), and 2 (2.3%) patients had CF, IO, VO, and CU responses, respectively. Immunological failure criteria had a very low sensitivity (11.1-40%) and positive predictive value (8.3-25%) to predict virological failure. Immunological criteria do not accurately predict virological failure resulting in significant misclassification of therapeutic responses. There is an urgent need for inclusion of viral load testing in the initiation and monitoring of ART.

Trunnionosis: Does Head Size Affect Fretting and Corrosion in Total Hip Arthroplasty?

PubMed

Del Balso, Christopher; Teeter, Matthew G; Tan, Sok Chuen; Howard, James L; Lanting, Brent A

2016-10-01

Wear and tribocorrosion at the modular head-neck taper interface may be a cause of failure in metal-on-polyethylene total hip arthroplasty (THA). The present investigation endeavored to elucidate the effect of femoral head diameter on fretting and corrosion in retrieved head-neck tapers. A retrieval analysis of THA prostheses in vivo for a minimum of 1 year was performed. Twenty-three femoral heads of 32-mm diameter were matched with 28-mm heads based on time in vivo and head length (-3 mm to +8 mm). All included implants featured a single taper design from a single manufacturer. Fretting and corrosion damage scoring was performed for each implant under stereomicroscopic visualization. Head diameter was observed to affect fretting (P = .01), with 32-mm femoral heads exhibiting greater total fretting scores than 28-mm heads. Fretting damage was greatest (P = .01) in the central concentric zone of the femoral head bore tapers, regardless of head diameter, length, or stem offset. No significant effect on total corrosion scores was observed for any head or stem variable. Retrieved implant total corrosion scores were positively correlated (ρ = 0.51, P < .001) with implantation time. Increased femoral head diameter in THA may produce greater fretting damage owing to and increased head-neck moment arm. There is no associated increase in corrosion with 28-mm and 32-mm heads of this taper design. The longer a THA prosthesis is implanted, the greater the risk of damage due to corrosion. Copyright © 2016 Elsevier Inc. All rights reserved.

Development of a child head analytical dynamic model considering cranial nonuniform thickness and curvature - Applying to children aged 0-1 years old.

PubMed

Li, Zhigang; Ji, Cheng; Wang, Lishu

2018-07-01

Although analytical models have been used to quickly predict head response under impact condition, the existing models generally took the head as regular shell with uniform thickness which cannot account for the actual head geometry with varied cranial thickness and curvature at different locations. The objective of this study is to develop and validate an analytical model incorporating actual cranial thickness and curvature for child aged 0-1YO and investigate their effects on child head dynamic responses at different head locations. To develop the new analytical model, the child head was simplified into an irregular fluid-filled shell with non-uniform thickness and the cranial thickness and curvature at different locations were automatically obtained from CT scans using a procedure developed in this study. The implicit equation of maximum impact force was derived as a function of elastic modulus, thickness and radius of curvature of cranium. The proposed analytical model are compared with cadaver test data of children aged 0-1 years old and it is shown to be accurate in predicting head injury metrics. According to this model, obvious difference in injury metrics were observed among subjects with the same age, but different cranial thickness and curvature; and the injury metrics at forehead location are significant higher than those at other locations due to large thickness it owns. The proposed model shows good biofidelity and can be used in quickly predicting the dynamics response at any location of head for child younger than 1 YO. Copyright © 2018 Elsevier B.V. All rights reserved.

Parameters Influencing Tracheostomy Decannulation in Patients Undergoing Rehabilitation after severe Acquired Brain Injury (sABI).

PubMed

Perin, Cecilia; Meroni, Roberto; Rega, Vincenzo; Braghetto, Giacomo; Cerri, Cesare Giuseppe

2017-10-01

Introduction  Tracheostomy weaning in patients who suffered a severe acquired brain injury is often a challenge and decannulation failures are not uncommon. Objective  Our study objective is to describe the decannulation failure rate in patients undergoing rehabilitation following a severe acquired brain injury (sABI); to describe the factors associated with a successful tube weaning. Methods  We conduct a retrospective analysis of charts, consecutively retrieved considering a 3-year window. Variables analyzed were: age, sex, body mass index (BMI), Glasgow Coma Scale (GCS), cause of hospitalization (stroke, trauma, cardiac arrest), date of the pathological event, gap between the index event and the first day of hospitalization, duration of Neurorehabilitation Ward hospitalization, comorbidities, chest morphological alteration, kind of tracheostomy tube used (overall dimension, cap, fenestration), SpO2, presentation and quantification of pulmonary secretion, maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP), respiratory frequency and pattern, cardiac frequency, presence of spontaneous cough, cough strength, and blood gas analysis. Results  We analyzed 45 tracheostomised sABI patients following stroke, trauma, or cardiac arrest. The weaning success percentage was higher in Head Trauma patients and in patients presenting positive spontaneous cough. Failures seem to be associated with presence of secretions and anoxic brain damage. GCS seemed not related to the decannulation outcome. Conclusions  Parameters that could be used as positive predictors of weaning are: mean expiratory pressure, presence of spontaneous cough, and cough strength. Provoked cough and GCS were not predictive of weaning success.

The effects of simulated bone loss on the implant-abutment assembly and likelihood of fracture: an in vitro study.

PubMed

Manzoor, Behzad; Suleiman, Mahmood; Palmer, Richard M

2013-01-01

The crestal bone level around a dental implant may influence its strength characteristics by offering protection against mechanical failures. Therefore, the present study investigated the effect of simulated bone loss on modes, loads, and cycles to failure in an in vitro model. Different amounts of bone loss were simulated: 0, 1.5, 3.0, and 4.5 mm from the implant head. Forty narrow-diameter (3.0-mm) implant-abutment assemblies were tested using compressive bending and cyclic fatigue testing. Weibull and accelerated life testing analysis were used to assess reliability and functional life. Statistical analyses were performed using the Fisher-Exact test and the Spearman ranked correlation. Compressive bending tests showed that the level of bone loss influenced the load-bearing capacity of implant-abutment assemblies. Fatigue testing showed that the modes, loads, and cycles to failure had a statistically significant relationship with the level of bone loss. All 16 samples with bone loss of 3.0 mm or more experienced horizontal implant body fractures. In contrast, 14 of 16 samples with 0 and 1.5 mm of bone loss showed abutment and screw fractures. Weibull and accelerated life testing analysis indicated a two-group distribution: the 0- and 1.5-mm bone loss samples had better functional life and reliability than the 3.0- and 4.5-mm samples. Progressive bone loss had a significant effect on modes, loads, and cycles to failure. In addition, bone loss influenced the functional life and reliability of the implant-abutment assemblies. Maintaining crestal bone levels is important in ensuring biomechanical sustainability and predictable long-term function of dental implant assemblies.

Multi-sector thermo-physiological head simulator for headgear research

NASA Astrophysics Data System (ADS)

Martinez, Natividad; Psikuta, Agnes; Corberán, José Miguel; Rossi, René M.; Annaheim, Simon

2017-02-01

A novel thermo-physiological human head simulator for headgear testing was developed by coupling a thermal head manikin with a thermo-physiological model. As the heat flux at head-site is directly measured by the head manikin, this method provides a realistic quantification of the heat transfer phenomena occurring in the headgear, such as moisture absorption-desorption cycles, condensation, or moisture migration across clothing layers. Before coupling, the opportunities of the head manikin for representing the human physiology were evaluated separately. The evaluation revealed reduced precision in forehead and face temperature predictions under extreme heterogeneous temperature distributions and no initial limitation for simulating temperature changes observed in the human physiology. The thermo-physiological model predicted higher sweat rates when applied for coupled than for pure virtual simulations. After coupling, the thermo-physiological human head simulator was validated using eight human experiments. It precisely predicted core, mean skin, and forehead temperatures with average rmsd values within the average experimental standard deviation (rmsd of 0.20 ± 0.15, 0.83 ± 0.34, and 1.04 ± 0.54 °C, respectively). However, in case of forehead, precision was lower for the exposures including activity than for the sedentary exposures. The representation of the human sweat evaporation could be affected by a reduced evaporation efficiency and the manikin sweat dynamics. The industry will benefit from this thermo-physiological human head simulator leading to the development of helmet designs with enhanced thermal comfort and, therefore, with higher acceptance by users.

Slope basins, headless canyons, and submarine palaeoseismology of the Cascadia accretionary complex

USGS Publications Warehouse

McAdoo, B.G.; Orange, D.L.; Screaton, Elizabeth; Lee, H.; Kayen, R.

1997-01-01

A combination of geomorphological, seismic reflection and geotechnical data constrains this study of sediment erosion and deposition at the toe of the Cascadia accretionary prism. We conducted a series of ALVIN dives in a region south of Astoria Canyon to examine the interrelationship of fluid flow and slope failure in a series of headless submarine canyons. Elevated head gradients at the inflection point of canyons have been inferred to assist in localized failures that feed sediment into a closed slope basin. Measured head gradients are an order of magnitude too low to cause seepage-induced slope failure alone; we therefore propose transient slope failure mechanisms. Intercanyon slopes are uniformly unscarred and smooth, although consolidation tests indicate that up to several metres of material may have been removed. A sheet-like failure would remove sediment uniformly, preserving the observed smooth intercanyon slope. Earthquake-induced liquefaction is a likely trigger for this type of sheet failure as the slope is too steep and short for sediment flow to organize itself into channels. Bathymetric and seismic reflection data suggest sediment in a trench slope basin between the second and third ridges from the prism's deformation is derived locally. A comparison of the amounts of material removed from the slopes and that in the basin shows that the amount of material removed from the slopes may slightly exceed the amount of material in the basin, implying that a small amount of sediment has escaped the basin, perhaps when the second ridge was too low to form a sufficient dam, or through a gap in the second ridge to the south. Regardless, almost 80% of the material shed off the slopes around the basin is deposited locally, whereas the remaining 20% is redeposited on the incoming section and will be re-accreted.

Aldehyde dehydrogenase 1 isoenzyme expression as a marker of cancer stem cells correlates to histopathological features in head and neck cancer: A meta-analysis

PubMed Central

Cai, Chengxuan; Kaufmann, Andreas M.; Albers, Andreas E.

2017-01-01

There is a lack of predictive biomarkers that can identify patients with head and neck squamous cell carcinoma (HNSCC) who will experience treatment failure and develop drug resistance, recurrence, and metastases. Cancer stem-like cells (CSC) were identified as a subset of cells within the tumor in a variety of solid tumors including HNSCC. CSC are considered the tumor-initiating population responsible for recurrence or metastasis and are associated with therapy resistance. This meta-analysis including fourteen studies with altogether 1258 patients updates and summarizes all relevant data on the impact of ALDH1+ CSC on the prognosis of HNSCC and its association with clinicopathological parameters. ALDH1 expression is highly correlated with tumor differentiation (G3 vs. G1+G2; odds ratio = 2.85. 95% CI: 1.72–4.73, P<0.0001) and decreased overall survival (relative risk = 1.77. 95% CI: 1.41–2.22, P<0.0001) if one out of seven studies was excluded because of heterogeneity. These findings provide insights into the understanding of more aggressive tumor phenotypes and also suggest that the prognostic value provided by HNSCC-subtyping by CSC frequency warrant further clinical investigation. PMID:29112953

Noncontact diffuse optical assessment of blood flow changes in head and neck free tissue transfer flaps

NASA Astrophysics Data System (ADS)

Huang, Chong; Radabaugh, Jeffrey P.; Aouad, Rony K.; Lin, Yu; Gal, Thomas J.; Patel, Amit B.; Valentino, Joseph; Shang, Yu; Yu, Guoqiang

2015-07-01

Knowledge of tissue blood flow (BF) changes after free tissue transfer may enable surgeons to predict the failure of flap thrombosis at an early stage. This study used our recently developed noncontact diffuse correlation spectroscopy to monitor dynamic BF changes in free flaps without getting in contact with the targeted tissue. Eight free flaps were elevated in patients with head and neck cancer; one of the flaps failed. Multiple BF measurements probing the transferred tissue were performed during and post the surgical operation. Postoperative BF values were normalized to the intraoperative baselines (assigning "1") for the calculation of relative BF change (rBF). The rBF changes over the seven successful flaps were 1.89±0.15, 2.26±0.13, and 2.43±0.13 (mean±standard error), respectively, on postoperative days 2, 4, and 7. These postoperative values were significantly higher than the intraoperative baseline values (p<0.001), indicating a gradual recovery of flap vascularity after the tissue transfer. By contrast, rBF changes observed from the unsuccessful flaps were 1.14 and 1.34, respectively, on postoperative days 2 and 4, indicating less flow recovery. Measurement of BF recovery after flap anastomosis holds the potential to act early to salvage ischemic flaps.

The hydrological response of a rocky head water basin to convective rainfalls

NASA Astrophysics Data System (ADS)

Gregoretti, Carlo; Bernard, Martino; Degetto, Massimo; Matteo, Berti; Alessandro, Simoni; Stefano, Lanzoni

2015-04-01

A sharp-crested weir is installed at the outlet (altitude 1770 m a.s.l) of a rocky channel incised on the walls of Dimai Peak in the area of Fiames (Cortina d'Ampezzo, Dolomites-North Eastern Italian Alps) at the purpose of measuring runoff discharges. The area of the headwater basin is just 0.032 km2 but sub-vertical cliffs are capable to generate notable discharge during severe rainstorms. Due to the severe environment only five runoff events were measured (two times the facility was destroyed by rock falls and avalanches; other times failure of sensors stopped the measurements). Hydrological response is characterized by peaked hydrographs with very high rising limb. A kinematic distributed hydrological model was used to simulate the response of the basin to the convective rainfalls with the help of two rain gauges placed upstream the basin head and downstream the outlet respectively. The hydrological model uses an hortonian simplified law for determining excess rainfall and satisfactorily simulates the measured hydrographs. Such measurements are important for the understanding the hydrological response of a rocky basin to a convective rainfall. Their modeling are important as well when focused on predicting both flash floods in mountain torrents and the triggering conditions and magnitude of runoff generated debris flows.

Noncontact diffuse optical assessment of blood flow changes in head and neck free tissue transfer flaps

PubMed Central

Huang, Chong; Radabaugh, Jeffrey P.; Aouad, Rony K.; Lin, Yu; Gal, Thomas J.; Patel, Amit B.; Valentino, Joseph; Shang, Yu; Yu, Guoqiang

2015-01-01

Abstract. Knowledge of tissue blood flow (BF) changes after free tissue transfer may enable surgeons to predict the failure of flap thrombosis at an early stage. This study used our recently developed noncontact diffuse correlation spectroscopy to monitor dynamic BF changes in free flaps without getting in contact with the targeted tissue. Eight free flaps were elevated in patients with head and neck cancer; one of the flaps failed. Multiple BF measurements probing the transferred tissue were performed during and post the surgical operation. Postoperative BF values were normalized to the intraoperative baselines (assigning “1”) for the calculation of relative BF change (rBF). The rBF changes over the seven successful flaps were 1.89±0.15, 2.26±0.13, and 2.43±0.13 (mean±standard error), respectively, on postoperative days 2, 4, and 7. These postoperative values were significantly higher than the intraoperative baseline values (p<0.001), indicating a gradual recovery of flap vascularity after the tissue transfer. By contrast, rBF changes observed from the unsuccessful flaps were 1.14 and 1.34, respectively, on postoperative days 2 and 4, indicating less flow recovery. Measurement of BF recovery after flap anastomosis holds the potential to act early to salvage ischemic flaps. PMID:26187444

Retrospective Cohort Analysis of Chest Injury Characteristics and Concurrent Injuries in Patients Admitted to Hospital in the Wenchuan and Lushan Earthquakes in Sichuan, China

PubMed Central

Yuan, Yong; Zhao, Yong-Fan

2014-01-01

Background The aim of this study was to compare retrospectively the characteristics of chest injuries and frequencies of other, concurrent injuries in patients after earthquakes of different seismic intensity. Methods We compared the cause, type, and body location of chest injuries as well as the frequencies of other, concurrent injuries in patients admitted to our hospital after the Wenchuan and Lushan earthquakes in Sichuan, China. We explored possible relationships between seismic intensity and the causes and types of injuries, and we assessed the ability of the Injury Severity Score, New Injury Severity Score, and Chest Injury Index to predict respiratory failure in chest injury patients. Results The incidence of chest injuries was 9.9% in the stronger Wenchuan earthquake and 22.2% in the less intensive Lushan earthquake. The most frequent cause of chest injuries in both earthquakes was being accidentally struck. Injuries due to falls were less prevalent in the stronger Wenchuan earthquake, while injuries due to burial were more prevalent. The distribution of types of chest injury did not vary significantly between the two earthquakes, with rib fractures and pulmonary contusions the most frequent types. Spinal and head injuries concurrent with chest injuries were more prevalent in the less violent Lushan earthquake. All three trauma scoring systems showed poor ability to predict respiratory failure in patients with earthquake-related chest injuries. Conclusions Previous studies may have underestimated the incidence of chest injury in violent earthquakes. The distributions of types of chest injury did not differ between these two earthquakes of different seismic intensity. Earthquake severity and interval between rescue and treatment may influence the prevalence and types of injuries that co-occur with the chest injury. Trauma evaluation scores on their own are inadequate predictors of respiratory failure in patients with earthquake-related chest injuries. PMID:24816485

Retrospective cohort analysis of chest injury characteristics and concurrent injuries in patients admitted to hospital in the Wenchuan and Lushan earthquakes in Sichuan, China.

PubMed

Zheng, Xi; Hu, Yang; Yuan, Yong; Zhao, Yong-Fan

2014-01-01

The aim of this study was to compare retrospectively the characteristics of chest injuries and frequencies of other, concurrent injuries in patients after earthquakes of different seismic intensity. We compared the cause, type, and body location of chest injuries as well as the frequencies of other, concurrent injuries in patients admitted to our hospital after the Wenchuan and Lushan earthquakes in Sichuan, China. We explored possible relationships between seismic intensity and the causes and types of injuries, and we assessed the ability of the Injury Severity Score, New Injury Severity Score, and Chest Injury Index to predict respiratory failure in chest injury patients. The incidence of chest injuries was 9.9% in the stronger Wenchuan earthquake and 22.2% in the less intensive Lushan earthquake. The most frequent cause of chest injuries in both earthquakes was being accidentally struck. Injuries due to falls were less prevalent in the stronger Wenchuan earthquake, while injuries due to burial were more prevalent. The distribution of types of chest injury did not vary significantly between the two earthquakes, with rib fractures and pulmonary contusions the most frequent types. Spinal and head injuries concurrent with chest injuries were more prevalent in the less violent Lushan earthquake. All three trauma scoring systems showed poor ability to predict respiratory failure in patients with earthquake-related chest injuries. Previous studies may have underestimated the incidence of chest injury in violent earthquakes. The distributions of types of chest injury did not differ between these two earthquakes of different seismic intensity. Earthquake severity and interval between rescue and treatment may influence the prevalence and types of injuries that co-occur with the chest injury. Trauma evaluation scores on their own are inadequate predictors of respiratory failure in patients with earthquake-related chest injuries.

Analysis of failed nuclear plant components

NASA Astrophysics Data System (ADS)

Diercks, D. R.

1993-12-01

Argonne National Laboratory has conducted analyses of failed components from nuclear power- gener-ating stations since 1974. The considerations involved in working with and analyzing radioactive compo-nents are reviewed here, and the decontamination of these components is discussed. Analyses of four failed components from nuclear plants are then described to illustrate the kinds of failures seen in serv-ice. The failures discussed are (1) intergranular stress- corrosion cracking of core spray injection piping in a boiling water reactor, (2) failure of canopy seal welds in adapter tube assemblies in the control rod drive head of a pressurized water reactor, (3) thermal fatigue of a recirculation pump shaft in a boiling water reactor, and (4) failure of pump seal wear rings by nickel leaching in a boiling water reactor.

Failure monitoring of E-glass/vinylester composites using fiber grating acoustic sensor

NASA Astrophysics Data System (ADS)

Azmi, A. I.; Raju; Peng, G. D.

2013-06-01

This paper reports an application of an optical fiber sensor in a continuous and in situ failure testing of an E-glass/vinylester top hat stiffener (THS). The sensor head was constructed from a compact phase-shifted fiber Bragg grating (PS-FBG). The narrow transmission channel of the PS-FBG is highly sensitive to small perturbation, hence suitable to be used in acoustic emission (AE) assessment technique. The progressive failure of THS was tested under transverse loading to experimentally simulate the actual loading in practice. Our experimental tests have demonstrated, in good agreement with the commercial piezoelectric sensors, that the important failures information of the THS was successfully recorded by the simple intensity-type PS-FBG sensor.

Measuring the migration of the components and polyethylene wear after total hip arthroplasty: beads and specialised radiographs are not necessary.

PubMed

Devane, P A; Horne, J G; Foley, G; Stanley, J

2017-10-01

This paper describes the methodology, validation and reliability of a new computer-assisted method which uses models of the patient's bones and the components to measure their migration and polyethylene wear from radiographs after total hip arthroplasty (THA). Models of the patient's acetabular and femoral component obtained from the manufacturer and models of the patient's pelvis and femur built from a single computed tomography (CT) scan, are used by a computer program to measure the migration of the components and the penetration of the femoral head from anteroposterior and lateral radiographs taken at follow-up visits. The program simulates the radiographic setup and matches the position and orientation of the models to outlines of the pelvis, the acetabular and femoral component, and femur on radiographs. Changes in position and orientation reflect the migration of the components and the penetration of the femoral head. Validation was performed using radiographs of phantoms simulating known migration and penetration, and the clinical feasibility of measuring migration was assessed in two patients. Migration of the acetabular and femoral components can be measured with limits of agreement (LOA) of 0.37 mm and 0.33 mm, respectively. Penetration of the femoral head can be measured with LOA of 0.161 mm. The migration of components and polyethylene wear can be measured without needing specialised radiographs. Accurate measurement may allow earlier prediction of failure after THA. Cite this article: Bone Joint J 2017;99-B:1290-7. ©2017 The British Editorial Society of Bone & Joint Surgery.

Low blood levels of sTWEAK are related to locoregional failure in head and neck cancer.

PubMed

Avilés-Jurado, Francesc Xavier; Terra, Ximena; Gómez, David; Flores, Joan Carles; Raventós, Antoni; Maymó-Masip, Elsa; León, Xavier; Serrano-Gonzalvo, Vicente; Vendrell, Joan; Figuerola, Enric; Chacón, Matilde R

2015-07-01

Identifying serum pre-treatment molecular markers that can predict response to therapy is of great interest in head and neck oncology and is required to develop personalized treatments that maximize survival while minimizing morbidity. The main aim was to investigate the potential prognostic significance of tumor necrosis factor-like weak inducer of apoptosis (TWEAK), and its receptors, fibroblast growth factor-inducible 14 (Fn14) and CD163, in head and neck squamous cell carcinoma (HNSCC). The study comprised 37 consecutive patients with pathologically confirmed, untreated HNSCC. Serum and tissue samples from these patients were available for study. We determined sTWEAK and sCD163 levels in serum from 37 HNSCC patients by ELISA. TWEAK, CD163, Fn14 and TNF-α gene expression were detected by real-time RT-PCR in 111 matched tissue samples (tumoral, adjacent and distal/normal mucosa). Our results showed a significant relationship between low sTWEAK levels and poor locoregional control of the disease. Kaplan-Meier curves indicated that the locoregional recurrence-free survival rate in patients with low sTWEAK circulating levels was significantly lower than in patients with high levels, and that high CD136/TWEAK expression ratio in tumors was also related to poor prognosis. sTWEAK pre-treatment serum levels might be used as prognostic non-invasive biomarkers for locoregional control in patients with HNSCC. Future investigations are warranted to determine the potential prognostic significance of this non-invasive biomarker in the rapid discrimination according to the locoregional control achieved in patients who received a non-surgical organ preservation treatment.

Wing-augmentation reduces femoral head cutting out of dynamic hip screw.

PubMed

Chen, Chih-Yu; Huang, Shu-Wei; Sun, Jui-Sheng; Lin, Shin-Yiing; Yu, Chih-Sheng; Pan, Hsu-Pin; Lin, Ping-Hung; Hsieh, Fan-Chun; Tsuang, Yang-Hwei; Lin, Feng-Huei; Yang, Rong-Sen; Cheng, Cheng-Kung

2017-06-01

The dynamic hip screw (DHS) is commonly used in the treatment of femoral intertrochanteric fracture with high satisfactory results. However, post-operative failure does occur and result in poor prognosis. The most common failure is femoral head varus collapse, followed by lag screw cut-out through the femoral head. In this study, a novel-designed DHS with two supplemental horizontal blades was used to improve the fixation stability. In this study, nine convention DHS and 9 Orthopaedic Device Research Center (ODRC) DHSs were tested in this study. Each implant was fixed into cellular polyurethane rigid foam as a surrogate of osteoporotic femoral head. Under biaxial rocking motion, all constructs were loaded to failure point (12mm axial displacement) or up to 20,000 cycles of 1.45kN peak magnitude were achieved, whichever occurred first. The migration kinematics was continuously monitored and recorded. The final tip-to-apex distance, rotational angle and varus deformation were also recorded. The results showed that the ODRC DHS sustained significantly more loading cycles and exhibited less axial migration in comparison to the conventional DHS. The ODRC DHS showed a significantly smaller bending strain and larger torsional strain compared to the conventional DHS. The changes in tip-to-apex distance (TAD), post-study varus angle, post-study rotational angle of the ODRC DHS were all significantly less than that of the conventional DHS (p < 0.05). We concluded that the ODRC DHS augmented with two horizontal wings would increase the bone-implant interface contact surface, dissipate the load to the screw itself, which improves the migration resistance and increases the anti-rotational implant effect. In conclusion, the proposed ODRC DHS demonstrated significantly better migration resistance and anti-rotational effect in comparison to the conventional DHS construct. Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.

Glasgow Coma Scale score, mortality, and functional outcome in head-injured patients.

PubMed

Udekwu, Pascal; Kromhout-Schiro, Sharon; Vaslef, Steven; Baker, Christopher; Oller, Dale

2004-05-01

Preresuscitation Glasgow Coma Scale (P-GCS) score is frequently obtained in injured patients and incorporated into mortality prediction. Data on functional outcome in head injury is sparse. A large group of patients with head injuries was analyzed to assess relationships between P-GCS score, mortality, and functional outcome as measured by the Functional Independence Measure (FIM). Records for patients with International Classification of Diseases, Ninth Revision diagnosis codes indicating head injury in a statewide trauma registry between 1994 and 2002 were selected. P-GCS score, mortality, and FIM score at hospital discharge were integrated and analyzed. Of 138,750 patients, 22,924 patients were used for the mortality study and 7,150 patients for the FIM study. A good correlation exists between P-GCS score and FIM, as determined by rank correlation coefficients, whereas mortality falls steeply between a P-GCS score of 3 and a P-GCS score of 7 followed by a shallow fall. Although P-GCS score is related to mortality in head-injured patients, its relationship is nonlinear, which casts doubt on its use as a continuous measure or an equivalent set of categorical measures incorporated into outcome prediction models. The average FIM scores indicate substantial likelihood of good outcomes in survivors with low P-GCS scores, further complicating the use of the P-GCS score in the prediction of poor outcome at the time of initial patient evaluation. Although the P-GCS score is related to functional outcome as measured by the FIM score and mortality in head injury, current mortality prediction models may need to be modified to account for the nonlinear relationship between P-GCS score and mortality. The P-GCS score is not a good clinical tool for outcome prediction in individual head-injured patients, given the variability in mortality rates and functional outcomes at all scores.

Traumatic dislocation of the S1 polyaxial pedicle screw head: a case report.

PubMed

Du Plessis, Pieter N B; Lau, Bernard P H; Hey, Hwee Weng Dennis

2017-03-01

Polyaxial screw head dislocation in the absence of a manufacture defect is extremely rare and represents a biomechanical overload of the screw, leading to early failure. A 58-year-old gentleman underwent instrumented fusion using polyaxial pedicle screws-titanium rod construct with interbody cage for spondylolytic spondylolisthesis at the L5/S1 level. He attempted to bend forward ten days after the surgery which resulted in a dislocation of the right S1 polyaxial screw head from the screw shank with recurrence of symptoms. He underwent revision surgery uneventfully. This case highlights the need to pay particular attention to the strength of fixation and the amount of release to avoid such a complication.

Hitherto unknown shear rupture mechanism as a source of instability in intact hard rocks at highly confined compression

NASA Astrophysics Data System (ADS)

Tarasov, Boris G.

2014-05-01

Today, frictional shear resistance along pre-existing faults is considered to be the lower limit on rock shear strength for confined conditions corresponding to the seismogenic layer. This paper introduces a recently identified shear rupture mechanism providing a paradoxical feature of hard rocks - the possibility of shear rupture propagation through the highly confined intact rock mass at shear stress levels significantly less than frictional strength. In the new mechanism, the rock failure associated with consecutive creation of small slabs (known as ‘domino-blocks') from the intact rock in the rupture tip is driven by a fan-shaped domino structure representing the rupture head. The fan-head combines such unique features as: extremely low shear resistance, self-sustaining stress intensification, and self-unbalancing conditions. Due to this the failure process caused by the mechanism is very dynamic and violent. This makes it impossible to directly observe and study the mechanism and can explain why the mechanism has not been detected before. This paper provides physical motivation for the mechanism, based upon side effects accompanying the failure process. Physical and mathematical models of the mechanism presented in the paper explain unique and paradoxical features of the mechanism. The new shear rupture mechanism allows a novel point of view for understanding the nature of spontaneous failure processes in hard rocks including earthquakes.

Head Start Program Quality: Examination of Classroom Quality and Parent Involvement in Predicting Children's Vocabulary, Literacy, and Mathematics Achievement Trajectories

ERIC Educational Resources Information Center

Wen, Xiaoli; Bulotsky-Shearer, Rebecca J.; Hahs-Vaughn, Debbie L.; Korfmacher, Jon

2012-01-01

Guided by a developmental-ecological framework and Head Start's two-generational approach, this study examined two dimensions of Head Start program quality, classroom quality and parent involvement and their unique and interactive contribution to children's vocabulary, literacy, and mathematics skills growth from the beginning of Head Start…

On the use and the performance of software reliability growth models

NASA Technical Reports Server (NTRS)

Keiller, Peter A.; Miller, Douglas R.

1991-01-01

We address the problem of predicting future failures for a piece of software. The number of failures occurring during a finite future time interval is predicted from the number failures observed during an initial period of usage by using software reliability growth models. Two different methods for using the models are considered: straightforward use of individual models, and dynamic selection among models based on goodness-of-fit and quality-of-prediction criteria. Performance is judged by the relative error of the predicted number of failures over future finite time intervals relative to the number of failures eventually observed during the intervals. Six of the former models and eight of the latter are evaluated, based on their performance on twenty data sets. Many open questions remain regarding the use and the performance of software reliability growth models.

Mortality prediction of head Abbreviated Injury Score and Glasgow Coma Scale: analysis of 7,764 head injuries.

PubMed

Demetriades, Demetrios; Kuncir, Eric; Murray, James; Velmahos, George C; Rhee, Peter; Chan, Linda

2004-08-01

We assessed the prognostic value and limitations of Glasgow Coma Scale (GCS) and head Abbreviated Injury Score (AIS) and correlated head AIS with GCS. We studied 7,764 patients with head injuries. Bivariate analysis was performed to examine the relationship of GCS, head AIS, age, gender, and mechanism of injury with mortality. Stepwise logistic regression analysis was used to identify the independent risk factors associated with mortality. The overall mortality in the group of head injury patients with no other major extracranial injuries and no hypotension on admission was 9.3%. Logistic regression analysis identified head AIS, GCS, age, and mechanism of injury as significant independent risk factors of death. The prognostic value of GCS and head AIS was significantly affected by the mechanism of injury and the age of the patient. Patients with similar GCS or head AIS but different mechanisms of injury or ages had significantly different outcomes. The adjusted odds ratio of death in penetrating trauma was 5.2 (3.9, 7.0), p < 0.0001, and in the age group > or = 55 years the adjusted odds ratio was 3.4 (2.6, 4.6), p < 0.0001. There was no correlation between head AIS and GCS (correlation coefficient -0.31). Mechanism of injury and age have a major effect in the predictive value of GCS and head AIS. There is no good correlation between GCS and head AIS.

Fall Risk Assessment Predicts Fall-Related Injury, Hip Fracture, and Head Injury in Older Adults.

PubMed

Nilsson, Martin; Eriksson, Joel; Larsson, Berit; Odén, Anders; Johansson, Helena; Lorentzon, Mattias

2016-11-01

To investigate the role of a fall risk assessment, using the Downton Fall Risk Index (DFRI), in predicting fall-related injury, fall-related head injury and hip fracture, and death, in a large cohort of older women and men residing in Sweden. Cross sectional observational study. Sweden. Older adults (mean age 82.4 ± 7.8) who had a fall risk assessment using the DFRI at baseline (N = 128,596). Information on all fall-related injuries, all fall-related head injuries and hip fractures, and all-cause mortality was collected from the Swedish Patient Register and Cause of Death Register. The predictive role of DFRI was calculated using Poisson regression models with age, sex, height, weight, and comorbidities as covariates, taking time to outcome or end of study into account. During a median follow-up of 253 days (interquartile range 90-402 days) (>80,000 patient-years), 15,299 participants had a fall-related injury, 2,864 a head injury, and 2,557 a hip fracture, and 23,307 died. High fall risk (DFRI ≥3) independently predicted fall-related injury (hazard ratio (HR) = 1.43, 95% confidence interval (CI) = 1.39-1.49), hip fracture (HR = 1.51, 95% CI =1.38-1.66), head injury (HR = 1.12, 95% CI = 1.03-1.22), and all-cause mortality (HR = 1.39, 95% CI = 1.35-1.43). DFRI more strongly predicted head injury (HR = 1.29, 95% CI = 1.21-1.36 vs HR = 1.08, 95% CI = 1.04-1.11) and hip fracture (HR = 1.41, 95% CI = 1.30-1.53 vs HR = 1.08, 95% CI = 1.05-1.11) in 70-year old men than in 90-year old women (P < .001). Fall risk assessment using DFRI independently predicts fall-related injury, fall-related head injury and hip fracture, and all-cause mortality in older men and women, indicating its clinical usefulness to identify individuals who would benefit from interventions. © 2016 The Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.

Does working memory capacity predict cross-modally induced failures of awareness?

PubMed

Kreitz, Carina; Furley, Philip; Simons, Daniel J; Memmert, Daniel

2016-01-01

People often fail to notice unexpected stimuli when they are focusing attention on another task. Most studies of this phenomenon address visual failures induced by visual attention tasks (inattentional blindness). Yet, such failures also occur within audition (inattentional deafness), and people can even miss unexpected events in one sensory modality when focusing attention on tasks in another modality. Such cross-modal failures are revealing because they suggest the existence of a common, central resource limitation. And, such central limits might be predicted from individual differences in cognitive capacity. We replicated earlier evidence, establishing substantial rates of inattentional deafness during a visual task and inattentional blindness during an auditory task. However, neither individual working memory capacity nor the ability to perform the primary task predicted noticing in either modality. Thus, individual differences in cognitive capacity did not predict failures of awareness even though the failures presumably resulted from central resource limitations. Copyright © 2015 Elsevier Inc. All rights reserved.

Predictive modeling of dynamic fracture growth in brittle materials with machine learning

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

Moore, Bryan A.; Rougier, Esteban; O’Malley, Daniel

We use simulation data from a high delity Finite-Discrete Element Model to build an e cient Machine Learning (ML) approach to predict fracture growth and coalescence. Our goal is for the ML approach to be used as an emulator in place of the computationally intensive high delity models in an uncertainty quanti cation framework where thousands of forward runs are required. The failure of materials with various fracture con gurations (size, orientation and the number of initial cracks) are explored and used as data to train our ML model. This novel approach has shown promise in predicting spatial (path tomore » failure) and temporal (time to failure) aspects of brittle material failure. Predictions of where dominant fracture paths formed within a material were ~85% accurate and the time of material failure deviated from the actual failure time by an average of ~16%. Additionally, the ML model achieves a reduction in computational cost by multiple orders of magnitude.« less

Predictive modeling of dynamic fracture growth in brittle materials with machine learning

DOE PAGES

Moore, Bryan A.; Rougier, Esteban; O’Malley, Daniel; ...

2018-02-22

We use simulation data from a high delity Finite-Discrete Element Model to build an e cient Machine Learning (ML) approach to predict fracture growth and coalescence. Our goal is for the ML approach to be used as an emulator in place of the computationally intensive high delity models in an uncertainty quanti cation framework where thousands of forward runs are required. The failure of materials with various fracture con gurations (size, orientation and the number of initial cracks) are explored and used as data to train our ML model. This novel approach has shown promise in predicting spatial (path tomore » failure) and temporal (time to failure) aspects of brittle material failure. Predictions of where dominant fracture paths formed within a material were ~85% accurate and the time of material failure deviated from the actual failure time by an average of ~16%. Additionally, the ML model achieves a reduction in computational cost by multiple orders of magnitude.« less

Predicting Time Series Outputs and Time-to-Failure for an Aircraft Controller Using Bayesian Modeling

NASA Technical Reports Server (NTRS)

He, Yuning

2015-01-01

Safety of unmanned aerial systems (UAS) is paramount, but the large number of dynamically changing controller parameters makes it hard to determine if the system is currently stable, and the time before loss of control if not. We propose a hierarchical statistical model using Treed Gaussian Processes to predict (i) whether a flight will be stable (success) or become unstable (failure), (ii) the time-to-failure if unstable, and (iii) time series outputs for flight variables. We first classify the current flight input into success or failure types, and then use separate models for each class to predict the time-to-failure and time series outputs. As different inputs may cause failures at different times, we have to model variable length output curves. We use a basis representation for curves and learn the mappings from input to basis coefficients. We demonstrate the effectiveness of our prediction methods on a NASA neuro-adaptive flight control system.

Regenerative therapies increase survivorship of avascular necrosis of the femoral head: a systematic review and meta-analysis.

PubMed

Andriolo, Luca; Merli, Giulia; Tobar, Carlos; Altamura, Sante Alessandro; Kon, Elizaveta; Filardo, Giuseppe

2018-02-06

The aim of this study was to document the available evidence on the use of regenerative techniques for the treatment of femoral head osteonecrosis (or avascular necrosis of femoral head, AVN) and to understand their benefit compared to core decompression (CD) alone in avoiding failure and the need for total hip replacement (THR). The search was conducted on three medical electronic databases according to PRISMA guidelines. The studies reporting number and timing of failures were included in a meta-analysis calculating cumulative survivorship with a Kaplan-Mayer curve. Moreover, the results on failures in treatment groups reported in RCT were compared with those documented in control groups, in order to understand the benefit of biological therapies compared to CD for the treatment of AVN. Forty-eight studies were included in this systematic review, reporting results of different types of regenerative techniques: mesenchymal stem cell implantation in the osteonecrotic area, intra-arterial infiltration with mesenchymal stem cells, implantation of bioactive molecules, or platelet-rich plasma. Overall, reported results were good, with a cumulative survivorship of 80% after ten year follow-up, and better results when regenerative treatments were combined to CD compared to CD alone (89.9% vs 70.6%, p < 0.0001). Regenerative therapies offer good clinical results for the treatment of AVN. The combination of CD with regenerative techniques provides a significant improvement in terms of survivorship over time compared with CD alone. Further studies are needed to identify the best procedure and the most suitable patients to benefit from regenerative treatments for AVN.

Autoregulation of cerebral blood flow in orthostatic hypotension

NASA Technical Reports Server (NTRS)

Novak, V.; Novak, P.; Spies, J. M.; Low, P. A.

1998-01-01

BACKGROUND AND PURPOSE: We sought to evaluate cerebral autoregulation in patients with orthostatic hypotension (OH). METHODS: We studied 21 patients (aged 52 to 78 years) with neurogenic OH during 80 degrees head-up tilt. Blood flow velocities (BFV) from the middle cerebral artery were continuously monitored with transcranial Doppler sonography, as were heart rate, blood pressure (BP), cardiac output, stroke volume, CO2, total peripheral resistance, and cerebrovascular resistance. RESULTS: All OH patients had lower BP (P<.0001), BFV_diastolic (P<.05), CVR (P<.007), and TPR (P<.02) during head-up tilt than control subjects. In control subjects, no correlations between BFV and BP were found during head-up tilt, suggesting normal autoregulation. OH patients could be separated into those with normal or expanded autoregulation (OH_NA; n=16) and those with autoregulatory failure (OH_AF; n=5). The OH_NA group showed either no correlation between BFV and BP (n=8) or had a positive BFV/BP correlation (R2>.75) but with a flat slope. An expansion of the "autoregulated" range was seen in some patients. The OH_AF group was characterized by a profound fall in BFV in response to a small reduction in BP (mean deltaBP <40 mm Hg; R2>.75). CONCLUSIONS: The most common patterns of cerebral response to OH are autoregulatory failure with a flat flow-pressure relationship or intact autoregulation with an expanded autoregulated range. The least common pattern is autoregulatory failure with a steep flow-pressure relationship. Patients with patterns 1 and 2 have an enhanced capacity to cope with OH, while those with pattern 3 have reduced capacity.

Ex-Vessel Core Melt Modeling Comparison between MELTSPREAD-CORQUENCH and MELCOR 2.1

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

Robb, Kevin R.; Farmer, Mitchell; Francis, Matthew W.

System-level code analyses by both United States and international researchers predict major core melting, bottom head failure, and corium-concrete interaction for Fukushima Daiichi Unit 1 (1F1). Although system codes such as MELCOR and MAAP are capable of capturing a wide range of accident phenomena, they currently do not contain detailed models for evaluating some ex-vessel core melt behavior. However, specialized codes containing more detailed modeling are available for melt spreading such as MELTSPREAD as well as long-term molten corium-concrete interaction (MCCI) and debris coolability such as CORQUENCH. In a preceding study, Enhanced Ex-Vessel Analysis for Fukushima Daiichi Unit 1: Meltmore » Spreading and Core-Concrete Interaction Analyses with MELTSPREAD and CORQUENCH, the MELTSPREAD-CORQUENCH codes predicted the 1F1 core melt readily cooled in contrast to predictions by MELCOR. The user community has taken notice and is in the process of updating their systems codes; specifically MAAP and MELCOR, to improve and reduce conservatism in their ex-vessel core melt models. This report investigates why the MELCOR v2.1 code, compared to the MELTSPREAD and CORQUENCH 3.03 codes, yield differing predictions of ex-vessel melt progression. To accomplish this, the differences in the treatment of the ex-vessel melt with respect to melt spreading and long-term coolability are examined. The differences in modeling approaches are summarized, and a comparison of example code predictions is provided.« less

Fukushima Daiichi unit 1 uncertainty analysis--Preliminary selection of uncertain parameters and analysis methodology

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

Cardoni, Jeffrey N.; Kalinich, Donald A.

2014-02-01

Sandia National Laboratories (SNL) plans to conduct uncertainty analyses (UA) on the Fukushima Daiichi unit (1F1) plant with the MELCOR code. The model to be used was developed for a previous accident reconstruction investigation jointly sponsored by the US Department of Energy (DOE) and Nuclear Regulatory Commission (NRC). However, that study only examined a handful of various model inputs and boundary conditions, and the predictions yielded only fair agreement with plant data and current release estimates. The goal of this uncertainty study is to perform a focused evaluation of uncertainty in core melt progression behavior and its effect on keymore » figures-of-merit (e.g., hydrogen production, vessel lower head failure, etc.). In preparation for the SNL Fukushima UA work, a scoping study has been completed to identify important core melt progression parameters for the uncertainty analysis. The study also lays out a preliminary UA methodology.« less

Migration, Business Formation, and the Informal Economy in Urban Mexico

PubMed Central

Riosmena, Fernando

2013-01-01

Although the informal economy has grown rapidly in several developing nations, and migration and informality may be related to similar types of credit constraints and market failures, previous research has not systematically attempted to identify if migrant households are more likely to start informal and formal businesses alike and if this association varies across local contexts. We examine the relationship between prior U.S. migration and the creation of both formal and informal businesses in urban Mexico using several criteria to indirectly assess sector location. We use data from 56 communities from the Mexican Migration Project to estimate multilevel survival and nonmultilevel competing risk models predicting the likelihood of informal, formal, and no business formation. The recent return migration of the household head is strongly associated with informal business creation, particularly in economically dynamic areas. On the other hand, migrants are only marginally more likely to start formal businesses in highly economically dynamic sending areas. PMID:23721676

Cue-based decision making. A new framework for understanding the uninvolved food consumer.

PubMed

Hamlin, Robert P

2010-08-01

This article examines the processes that occur within the consumer's head as they make a choice between alternative market offers at a low level of involvement. It discusses recent research that indicates that the Theory of Planned Behaviour and its derivatives have restricted validity as a predictor of food consumers' evaluations and purchase patterns. This has significant implications as Planned Behaviour is the dominant paradigm within food industry research. The article demonstrates that Planned Behaviour has acquired this status more by default than by proven merit. The specific reasons for the failure of Planned Behaviour are discussed. An alternative paradigm, Cue-Based Decision Making is developed from an existing literature, and is proposed as a basis for increasing our understanding of the uninvolved food consumer in order to predict and influence their behaviour. 2010 Elsevier Ltd. All rights reserved.

Survivorship of standard versus modified posterior surgical approaches in metal-on-metal hip resurfacing.

PubMed

M Takamura, K; Maher, P; Nath, T; Su, E P

2014-05-01

Metal-on-metal hip resurfacing (MOMHR) is available as an alternative option for younger, more active patients. There are failure modes that are unique to MOMHR, which include loosening of the femoral head and fractures of the femoral neck. Previous studies have speculated that changes in the vascularity of the femoral head may contribute to these failure modes. This study compares the survivorship between the standard posterior approach (SPA) and modified posterior approach (MPA) in MOMHR. A retrospective clinical outcomes study was performed examining 351 hips (279 male, 72 female) replaced with Birmingham Hip Resurfacing (BHR, Smith and Nephew, Memphis, Tennessee) in 313 patients with a pre-operative diagnosis of osteoarthritis. The mean follow-up period for the SPA group was 2.8 years (0.1 to 6.1) and for the MPA, 2.2 years (0.03 to 5.2); this difference in follow-up period was statistically significant (p < 0.01). Survival analysis was completed using the Kaplan-Meier method. At four years, the Kaplan-Meier survival curve for the SPA was 97.2% and 99.4% for the MPA; this was statistically significant (log-rank; p = 0.036). There were eight failures in the SPA and two in the MPA. There was a 3.5% incidence of femoral head collapse or loosening in the SPA and 0.4% in the MPA, which represented a significant difference (p = 0.041). There was a 1.7% incidence of fractures of the femoral neck in the SPA and none in the MPA (p = 0.108). This study found a significant difference in survivorship at four years between the SPA and the MPA (p = 0.036). The clinical outcomes of this study suggest that preserving the vascularity of the femoral neck by using the MPA results in fewer vascular-related failures in MOMHRs. Cite this article: Bone Joint Res 2014;3:150-4. ©2014 The British Editorial Society of Bone & Joint Surgery.

Survivorship of standard versus modified posterior surgical approaches in metal-on-metal hip resurfacing

PubMed Central

M. Takamura, K.; Maher, P.; Nath, T.; Su, E. P.

2014-01-01

Objectives Metal-on-metal hip resurfacing (MOMHR) is available as an alternative option for younger, more active patients. There are failure modes that are unique to MOMHR, which include loosening of the femoral head and fractures of the femoral neck. Previous studies have speculated that changes in the vascularity of the femoral head may contribute to these failure modes. This study compares the survivorship between the standard posterior approach (SPA) and modified posterior approach (MPA) in MOMHR. Methods A retrospective clinical outcomes study was performed examining 351 hips (279 male, 72 female) replaced with Birmingham Hip Resurfacing (BHR, Smith and Nephew, Memphis, Tennessee) in 313 patients with a pre-operative diagnosis of osteoarthritis. The mean follow-up period for the SPA group was 2.8 years (0.1 to 6.1) and for the MPA, 2.2 years (0.03 to 5.2); this difference in follow-up period was statistically significant (p < 0.01). Survival analysis was completed using the Kaplan–Meier method. Results At four years, the Kaplan–Meier survival curve for the SPA was 97.2% and 99.4% for the MPA; this was statistically significant (log-rank; p = 0.036). There were eight failures in the SPA and two in the MPA. There was a 3.5% incidence of femoral head collapse or loosening in the SPA and 0.4% in the MPA, which represented a significant difference (p = 0.041). There was a 1.7% incidence of fractures of the femoral neck in the SPA and none in the MPA (p = 0.108). Conclusion This study found a significant difference in survivorship at four years between the SPA and the MPA (p = 0.036). The clinical outcomes of this study suggest that preserving the vascularity of the femoral neck by using the MPA results in fewer vascular-related failures in MOMHRs. Cite this article: Bone Joint Res 2014;3:150–4 PMID:24842931

SU-E-T-538: Evaluation of IMRT Dose Calculation Based on Pencil-Beam and AAA Algorithms.

PubMed

Yuan, Y; Duan, J; Popple, R; Brezovich, I

2012-06-01

To evaluate the accuracy of dose calculation for intensity modulated radiation therapy (IMRT) based on Pencil Beam (PB) and Analytical Anisotropic Algorithm (AAA) computation algorithms. IMRT plans of twelve patients with different treatment sites, including head/neck, lung and pelvis, were investigated. For each patient, dose calculation with PB and AAA algorithms using dose grid sizes of 0.5 mm, 0.25 mm, and 0.125 mm, were compared with composite-beam ion chamber and film measurements in patient specific QA. Discrepancies between the calculation and the measurement were evaluated by percentage error for ion chamber dose and γ〉l failure rate in gamma analysis (3%/3mm) for film dosimetry. For 9 patients, ion chamber dose calculated with AAA-algorithms is closer to ion chamber measurement than that calculated with PB algorithm with grid size of 2.5 mm, though all calculated ion chamber doses are within 3% of the measurements. For head/neck patients and other patients with large treatment volumes, γ〉l failure rate is significantly reduced (within 5%) with AAA-based treatment planning compared to generally more than 10% with PB-based treatment planning (grid size=2.5 mm). For lung and brain cancer patients with medium and small treatment volumes, γ〉l failure rates are typically within 5% for both AAA and PB-based treatment planning (grid size=2.5 mm). For both PB and AAA-based treatment planning, improvements of dose calculation accuracy with finer dose grids were observed in film dosimetry of 11 patients and in ion chamber measurements for 3 patients. AAA-based treatment planning provides more accurate dose calculation for head/neck patients and other patients with large treatment volumes. Compared with film dosimetry, a γ〉l failure rate within 5% can be achieved for AAA-based treatment planning. © 2012 American Association of Physicists in Medicine.

Adverse events and treatment failure leading to discontinuation of recently approved antipsychotic drugs in schizophrenia: A network meta-analysis.

PubMed

Tonin, Fernanda S; Piazza, Thais; Wiens, Astrid; Fernandez-Llimos, Fernando; Pontarolo, Roberto

2015-12-01

Objective:We aimed to gather evidence of the discontinuation rates owing to adverse events or treatment failure for four recently approved antipsychotics (asenapine, blonanserin, iloperidone, and lurasidone).Methods: A systematic review followed by pairwise meta-analysis and mixed treatment comparison meta analysis(MTC) was performed, including randomized controlled trials (RCTs) that compared the use of the above-mentioned drugs versus placebo in patients with schizophrenia. An electronic search was conducted in PubMed, Scopus, Science Direct, Scielo, the Cochrane Library, and International Pharmaceutical Abstracts(January 2015). The included trials were at least single blinded. The main outcome measures extracted were discontinuation owing to adverse events and discontinuation owing to treatment failure.Results: Fifteen RCTs were identified (n = 5400 participants) and 13 of them were amenable for use in our meta-analyses. No significant differences were observed between any of the four drugs and placebo as regards discontinuation owing to adverse events, whether in pairwise meta-analysis or in MTC. All drugs presented a better profile than placebo on discontinuation owing to treatment failure, both in pairwise meta-analysis and MTC. Asenapine was found to be the best therapy in terms of tolerability owing to failure,while lurasidone was the worst treatment in terms of adverse events. The evidence around blonanserin is weak.Conclusion: MTCs allowed the creation of two different rank orders of these four antipsychotic drugs in two outcome measures. This evidence-generating method allows direct and indirect comparisons, supporting approval and pricing decisions when lacking sufficient, direct, head-to-head trials.

Asymmetries and three-dimensional features of vestibular cross-coupled stimuli illuminated through modeling

PubMed Central

Holly, Jan E.; Masood, M. Arjumand; Bhandari, Chiran S.

2017-01-01

Head movements during sustained rotation can cause angular cross-coupling which leads to tumbling illusions. Even though angular vectors predict equal magnitude illusions for head movements in opposite directions, the magnitudes of the illusions are often surprisingly asymmetric, such as during leftward versus rightward yaw while horizontal in a centrifuge. This paper presents a comprehensive investigation of the angular-linear stimulus combinations from eight different published papers in which asymmetries were found. Interactions between all angular and linear vectors, including gravity, are taken into account to model the three-dimensional consequences of the stimuli. Three main results followed. First, for every pair of head yaw movements, an asymmetry was found in the stimulus itself when considered in a fully three-dimensional manner, and the direction of the asymmetry matched the subjectively reported magnitude asymmetry. Second, for pitch and roll head movements for which motion sickness was measured, the stimulus was found symmetric in every case except one, and motion sickness generally aligned with other factors such as the existence of a head rest. Third, three-dimensional modeling predicted subjective inconsistency in the direction of perceived rotation when linear and angular components were oppositely-directed, and predicted surplus illusory rotation in the direction of head movement. PMID:27814310

Analysis of Machine Learning Techniques for Heart Failure Readmissions.

PubMed

Mortazavi, Bobak J; Downing, Nicholas S; Bucholz, Emily M; Dharmarajan, Kumar; Manhapra, Ajay; Li, Shu-Xia; Negahban, Sahand N; Krumholz, Harlan M

2016-11-01

The current ability to predict readmissions in patients with heart failure is modest at best. It is unclear whether machine learning techniques that address higher dimensional, nonlinear relationships among variables would enhance prediction. We sought to compare the effectiveness of several machine learning algorithms for predicting readmissions. Using data from the Telemonitoring to Improve Heart Failure Outcomes trial, we compared the effectiveness of random forests, boosting, random forests combined hierarchically with support vector machines or logistic regression (LR), and Poisson regression against traditional LR to predict 30- and 180-day all-cause readmissions and readmissions because of heart failure. We randomly selected 50% of patients for a derivation set, and a validation set comprised the remaining patients, validated using 100 bootstrapped iterations. We compared C statistics for discrimination and distributions of observed outcomes in risk deciles for predictive range. In 30-day all-cause readmission prediction, the best performing machine learning model, random forests, provided a 17.8% improvement over LR (mean C statistics, 0.628 and 0.533, respectively). For readmissions because of heart failure, boosting improved the C statistic by 24.9% over LR (mean C statistic 0.678 and 0.543, respectively). For 30-day all-cause readmission, the observed readmission rates in the lowest and highest deciles of predicted risk with random forests (7.8% and 26.2%, respectively) showed a much wider separation than LR (14.2% and 16.4%, respectively). Machine learning methods improved the prediction of readmission after hospitalization for heart failure compared with LR and provided the greatest predictive range in observed readmission rates. © 2016 American Heart Association, Inc.

Hip replacement in femoral head osteonecrosis: current concepts

PubMed Central

Scaglione, Michelangelo; Fabbri, Luca; Celli, Fabio; Casella, Francesco; Guido, Giulio

2015-01-01

Summary Osteonecrosis of the femoral head is a destructive disease that usually affects young adults with high functional demands and can have devastating effects on hip joint. The treatment depends on extent and location of the necrosis lesion and on patient’s factors, that suggest disease progression, collapse probability and also implants survival. Non-idiopathic osteonecrosis patients had the worst outcome. There is not a gold standard treatment and frequently it is necessary a multidisciplinary approach. Preservation procedures of the femoral head are the first choice and can be attempted in younger patients without head collapse. Replacement procedure remains the main treatment after failure of preserving procedures and in the late-stage ONFH, involving collapse of the femoral head and degenerative changes to the acetabulum. Resurfacing procedure still has good results but the patient selection is a critical factor. Total hip arthroplasties had historically poor results in patients with osteonecrosis. More recently, reports have shown excellent results, but implant longevity and following revisions are still outstanding problems. PMID:27134633

Cancer stem cells in head and neck squamous cell carcinoma: a review.

PubMed

Satpute, Pranali Shirish; Hazarey, Vinay; Ahmed, Riyaz; Yadav, Lalita

2013-01-01

Research indicates that a small population of cancer cells is highly tumorigenic, endowed with the capacity for self-renewal, and has the ability to differentiate into cells that constitute the bulk of tumors. These cells are considered the "drivers" of the tumorigenic process in some tumor types, and have been named cancer stem cells (CSC). Epithelial-mesenchymal transition (EMT) appears to be involved in the process leading to the acquisition of stemness by epithelial tumor cells. Through this process, cells acquire an invasive phenotype that may contribute to tumor recurrence and metastasis. CSC have been identified in human head and neck squamous cell carcinomas (HNSCC) using markers such as CD133 and CD44 expression, and aldehyde dehydrogenase (ALDH) activity. Head and neck cancer stem cells reside primarily in perivascular niches in the invasive fronts where endothelial-cell initiated events contribute to their survival and function. Clinically, CSC enrichment has been shown to be enhanced in recurrent disease, treatment failure and metastasis. CSC represent a novel target of study given their slow growth and innate mechanisms conferring treatment resistance. Further understanding of their unique phenotype may reveal potential molecular targets to improve therapeutic and survival outcomes in patients with HNSCC. Here, we discuss the state-of-the-knowledge on the pathobiology of cancer stem cells, with a focus on the impact of these cells on head and neck tumor progression, metastasis and recurrence due to treatment failure.

Shorter, rough trunnion surfaces are associated with higher taper wear rates than longer, smooth trunnion surfaces in a contemporary large head metal-on-metal total hip arthroplasty system.

PubMed

Brock, Timothy M; Sidaginamale, Raghavendra; Rushton, Steven; Nargol, Antoni V F; Bowsher, John G; Savisaar, Christina; Joyce, Tom J; Deehan, David J; Lord, James K; Langton, David J

2015-12-01

Taper wear at the head-neck junction is a possible cause of early failure in large head metal-on-metal (LH-MoM) hip replacements. We hypothesized that: (i) taper wear may be more pronounced in certain product designs; and (ii) an increased abductor moment arm may be protective. The tapers of 104 explanted LH-MoM hip replacements revised for adverse reaction to metal debris (ARMD) from a single manufacturer were analyzed for linear and volumetric wear using a co-ordinate measuring machine. The mated stem was a shorter 12/14, threaded trunnion (n=72) or a longer, smooth 11/13 trunnion (n=32). The abductor moment arm was calculated from pre-revision radiographs. Independent predictors of linear and volumetric wear included taper angle, stem type, and the horizontal moment arm. Tapers mated with the threaded 12/14 trunnion had significantly higher rates of volumetric wear (0.402 mm3/yr vs. 0.123 mm3/yr [t=-2.145, p=0.035]). There was a trend to larger abductor moment arms being protective (p=0.055). Design variation appears to play an important role in taper-trunnion junction failure. We recommend that surgeons bear these findings in mind when considering the use of a short, threaded trunnion with a cobalt-chromium head. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Retrieval analysis of titanium nitride (TiN) coated prosthetic femoral heads articulating with polyethylene.

PubMed

Łapaj, Łukasz; Wendland, Justyna; Markuszewski, Jacek; Mróz, Adrian; Wiśniewski, Tomasz

2015-03-01

Data regarding in vivo performance of titanium nitride (TiN) coated prosthetic femoral heads is scarce, and available studies of older generations of implants demonstrated coating wear in vivo. That is why we conducted a retrieval analysis of 11 femoral heads (articulating in vivo for 1-56 months) with TiN film formed using physical vapor deposition (PVD), to verify if coating failure is a problem in contemporary implants. Retrieved implants were examined using scanning electron microscope, coating roughness was evaluated with a contact profilometer and adhesion was tested using a Rockwell HRC test according to VDI 3824 guideline. Although no gross failure of the TiN coating was observed in our retrievals, all implants had defects typical for PVD coatings, such as pinholes, small titanium droplets and blisters with delaminated coating. In some heads the coating was contaminated with small niobium (Nb) droplets uniformly scattered on the entire surface of the film. Presence of Nb contamination was associated with an increased number and area of other types of defects and poorer coating adhesion. In one component, subjected to multiple dislocations we found severe delamination and cracking of the coating, increased roughness and the presence of third bodies. Our results indicate, that although wear of the coating is lower than seen in older generations of implants, inconsistent quality of the TiN film among different implants indicates the need for strict monitoring of the manufacturing process. Copyright © 2015 Elsevier Ltd. All rights reserved.

Using variable importance measures to identify a small set of single nucleotide polymorphisms capable of predicting heading date in perennial ryegrass

USDA-ARS?s Scientific Manuscript database

Prior knowledge on heading date enables the selection of parents for synthetic cultivars that are well-matched with respect to heading date, which is necessary to ensure plants put together will successfully cross with each other. Heading date of individual plants can be determined directly, which h...

A Statistical Skull Geometry Model for Children 0-3 Years Old

PubMed Central

Li, Zhigang; Park, Byoung-Keon; Liu, Weiguo; Zhang, Jinhuan; Reed, Matthew P.; Rupp, Jonathan D.; Hoff, Carrie N.; Hu, Jingwen

2015-01-01

Head injury is the leading cause of fatality and long-term disability for children. Pediatric heads change rapidly in both size and shape during growth, especially for children under 3 years old (YO). To accurately assess the head injury risks for children, it is necessary to understand the geometry of the pediatric head and how morphologic features influence injury causation within the 0–3 YO population. In this study, head CT scans from fifty-six 0–3 YO children were used to develop a statistical model of pediatric skull geometry. Geometric features important for injury prediction, including skull size and shape, skull thickness and suture width, along with their variations among the sample population, were quantified through a series of image and statistical analyses. The size and shape of the pediatric skull change significantly with age and head circumference. The skull thickness and suture width vary with age, head circumference and location, which will have important effects on skull stiffness and injury prediction. The statistical geometry model developed in this study can provide a geometrical basis for future development of child anthropomorphic test devices and pediatric head finite element models. PMID:25992998

A statistical skull geometry model for children 0-3 years old.

PubMed

Li, Zhigang; Park, Byoung-Keon; Liu, Weiguo; Zhang, Jinhuan; Reed, Matthew P; Rupp, Jonathan D; Hoff, Carrie N; Hu, Jingwen

2015-01-01

Head injury is the leading cause of fatality and long-term disability for children. Pediatric heads change rapidly in both size and shape during growth, especially for children under 3 years old (YO). To accurately assess the head injury risks for children, it is necessary to understand the geometry of the pediatric head and how morphologic features influence injury causation within the 0-3 YO population. In this study, head CT scans from fifty-six 0-3 YO children were used to develop a statistical model of pediatric skull geometry. Geometric features important for injury prediction, including skull size and shape, skull thickness and suture width, along with their variations among the sample population, were quantified through a series of image and statistical analyses. The size and shape of the pediatric skull change significantly with age and head circumference. The skull thickness and suture width vary with age, head circumference and location, which will have important effects on skull stiffness and injury prediction. The statistical geometry model developed in this study can provide a geometrical basis for future development of child anthropomorphic test devices and pediatric head finite element models.

Multi-sector thermo-physiological head simulator for headgear research.

PubMed

Martinez, Natividad; Psikuta, Agnes; Corberán, José Miguel; Rossi, René M; Annaheim, Simon

2017-02-01

A novel thermo-physiological human head simulator for headgear testing was developed by coupling a thermal head manikin with a thermo-physiological model. As the heat flux at head-site is directly measured by the head manikin, this method provides a realistic quantification of the heat transfer phenomena occurring in the headgear, such as moisture absorption-desorption cycles, condensation, or moisture migration across clothing layers. Before coupling, the opportunities of the head manikin for representing the human physiology were evaluated separately. The evaluation revealed reduced precision in forehead and face temperature predictions under extreme heterogeneous temperature distributions and no initial limitation for simulating temperature changes observed in the human physiology. The thermo-physiological model predicted higher sweat rates when applied for coupled than for pure virtual simulations. After coupling, the thermo-physiological human head simulator was validated using eight human experiments. It precisely predicted core, mean skin, and forehead temperatures with average rmsd values within the average experimental standard deviation (rmsd of 0.20 ± 0.15, 0.83 ± 0.34, and 1.04 ± 0.54 °C, respectively). However, in case of forehead, precision was lower for the exposures including activity than for the sedentary exposures. The representation of the human sweat evaporation could be affected by a reduced evaporation efficiency and the manikin sweat dynamics. The industry will benefit from this thermo-physiological human head simulator leading to the development of helmet designs with enhanced thermal comfort and, therefore, with higher acceptance by users.

An investigation of gear mesh failure prediction techniques. M.S. Thesis - Cleveland State Univ.

NASA Technical Reports Server (NTRS)

Zakrajsek, James J.

1989-01-01

A study was performed in which several gear failure prediction methods were investigated and applied to experimental data from a gear fatigue test apparatus. The primary objective was to provide a baseline understanding of the prediction methods and to evaluate their diagnostic capabilities. The methods investigated use the signal average in both the time and frequency domain to detect gear failure. Data from eleven gear fatigue tests were recorded at periodic time intervals as the gears were run from initiation to failure. Four major failure modes, consisting of heavy wear, tooth breakage, single pits, and distributed pitting were observed among the failed gears. Results show that the prediction methods were able to detect only those gear failures which involved heavy wear or distributed pitting. None of the methods could predict fatigue cracks, which resulted in tooth breakage, or single pits. It is suspected that the fatigue cracks were not detected because of limitations in data acquisition rather than in methodology. Additionally, the frequency response between the gear shaft and the transducer was found to significantly affect the vibration signal. The specific frequencies affected were filtered out of the signal average prior to application of the methods.

Artificial gravity: head movements during short-radius centrifugation

NASA Technical Reports Server (NTRS)

Young, L. R.; Hecht, H.; Lyne, L. E.; Sienko, K. H.; Cheung, C. C.; Kavelaars, J.

2001-01-01

Short-radius centrifugation is a potential countermeasure to long-term weightlessness. Unfortunately, head movements in a rotating environment induce serious discomfort, non-compensatory vestibulo-ocular reflexes, and subjective illusions of body tilt. In two experiments we investigated the effects of pitch and yaw head movements in participants placed supine on a rotating bed with their head at the center of rotation, feet at the rim. The vast majority of participants experienced motion sickness, inappropriate vertical nystagmus and illusory tilt and roll as predicted by a semicircular canal model. However, a small but significant number of the 28 participants experienced tilt in the predicted plane but in the opposite direction. Heart rate was elevated following one-second duration head turns. Significant adaptation occurred following a series of head turns in the light. Vertical nystagmus, motion sickness and illusory tilt all decreased with adaptation. Consequences for artificial gravity produced by short-radius centrifuges as a countermeasure are discussed. Grant numbers: NCC 9-58. c 2001. Elsevier Science Ltd. All rights reserved.

Assessment of heart rate, acidosis, consciousness, oxygenation, and respiratory rate to predict noninvasive ventilation failure in hypoxemic patients.

PubMed

Duan, Jun; Han, Xiaoli; Bai, Linfu; Zhou, Lintong; Huang, Shicong

2017-02-01

To develop and validate a scale using variables easily obtained at the bedside for prediction of failure of noninvasive ventilation (NIV) in hypoxemic patients. The test cohort comprised 449 patients with hypoxemia who were receiving NIV. This cohort was used to develop a scale that considers heart rate, acidosis, consciousness, oxygenation, and respiratory rate (referred to as the HACOR scale) to predict NIV failure, defined as need for intubation after NIV intervention. The highest possible score was 25 points. To validate the scale, a separate group of 358 hypoxemic patients were enrolled in the validation cohort. The failure rate of NIV was 47.8 and 39.4% in the test and validation cohorts, respectively. In the test cohort, patients with NIV failure had higher HACOR scores at initiation and after 1, 12, 24, and 48 h of NIV than those with successful NIV. At 1 h of NIV the area under the receiver operating characteristic curve was 0.88, showing good predictive power for NIV failure. Using 5 points as the cutoff value, the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for NIV failure were 72.6, 90.2, 87.2, 78.1, and 81.8%, respectively. These results were confirmed in the validation cohort. Moreover, the diagnostic accuracy for NIV failure exceeded 80% in subgroups classified by diagnosis, age, or disease severity and also at 1, 12, 24, and 48 h of NIV. Among patients with NIV failure with a HACOR score of >5 at 1 h of NIV, hospital mortality was lower in those who received intubation at ≤12 h of NIV than in those intubated later [58/88 (66%) vs. 138/175 (79%); p = 0.03). The HACOR scale variables are easily obtained at the bedside. The scale appears to be an effective way of predicting NIV failure in hypoxemic patients. Early intubation in high-risk patients may reduce hospital mortality.

Reliability Analysis of the Gradual Degradation of Semiconductor Devices.

DTIC Science & Technology

1983-07-20

under the heading of linear models or linear statistical models . 3 ,4 We have not used this material in this report. Assuming catastrophic failure when...assuming a catastrophic model . In this treatment we first modify our system loss formula and then proceed to the actual analysis. II. ANALYSIS OF...Failure Time 1 Ti Ti 2 T2 T2 n Tn n and are easily analyzed by simple linear regression. Since we have assumed a log normal/Arrhenius activation

Predicting Failure Progression and Failure Loads in Composite Open-Hole Tension Coupons

NASA Technical Reports Server (NTRS)

Arunkumar, Satyanarayana; Przekop, Adam

2010-01-01

Failure types and failure loads in carbon-epoxy [45n/90n/-45n/0n]ms laminate coupons with central circular holes subjected to tensile load are simulated using progressive failure analysis (PFA) methodology. The progressive failure methodology is implemented using VUMAT subroutine within the ABAQUS(TradeMark)/Explicit nonlinear finite element code. The degradation model adopted in the present PFA methodology uses an instantaneous complete stress reduction (COSTR) approach to simulate damage at a material point when failure occurs. In-plane modeling parameters such as element size and shape are held constant in the finite element models, irrespective of laminate thickness and hole size, to predict failure loads and failure progression. Comparison to published test data indicates that this methodology accurately simulates brittle, pull-out and delamination failure types. The sensitivity of the failure progression and the failure load to analytical loading rates and solvers precision is demonstrated.

Computational Methods for Failure Analysis and Life Prediction

NASA Technical Reports Server (NTRS)

Noor, Ahmed K. (Compiler); Harris, Charles E. (Compiler); Housner, Jerrold M. (Compiler); Hopkins, Dale A. (Compiler)

1993-01-01

This conference publication contains the presentations and discussions from the joint UVA/NASA Workshop on Computational Methods for Failure Analysis and Life Prediction held at NASA Langley Research Center 14-15 Oct. 1992. The presentations focused on damage failure and life predictions of polymer-matrix composite structures. They covered some of the research activities at NASA Langley, NASA Lewis, Southwest Research Institute, industry, and universities. Both airframes and propulsion systems were considered.

[Spanish versions of the Simplified Motor Score and the Glasgow Coma Scale in out-of-hospital treatment of head injury in adults: a preliminary study of each scale's ability to predict adverse events].

PubMed

Roca, Guillem; Mayol, Sergi; García, Esteban; Casajuana, Edgar; Quintana, Salvador

2015-06-01

To determine the ability of the modified (Spanish) version of the Simplified Motor Score (mSMS) to predict adverse events during hospitalization and to compare its predictive ability to that of the Glasgow Coma Scale (GCS) in adults with head injuries treated outside the hospital. Observational study of retrospective cohorts including all patients over the age of 14 years attended for head injuries occurring within 24 hours of treatment by an advanced life-support unit staffed by nurses between May 1, 2013, and May 1, 2014. The mSMS was a translation of the English original, created through a process of discussions of direct and back translations to arrive at consensus. Out-of-hospital patient records were searched to find GCS and mSMS scores. To predict the ability of each scale to predict brain injuries, neurosurgery, intubation, and/or inhospital death, we calculated the area under the receiving operator characteristic curves (AUCs). Of the total of 115 head-injury patients attended, 64 met the inclusion criteria. The mean (SD) age was 47 (24) years. Twelve (18.8%) patients developed some form of adverse event during hospitalization; 91.6% had brain damage, 58.3% required intubation, 8.3% required surgery, and 41.6% died. The AUC for the GCS was 0.907 (95% CI, 0.81-1.00; P<.001); the AUC for the mSMS was 0.796 (95% CI, 0.64-0.95; P=.001). Although the ability of the mSMS to predict in-hospital adverse outcomes is good, it is inferior to the GCS in adults with head injuries attended outside the hospital.

Do behavioural self-blame and stigma predict positive health changes in survivors of lung or head and neck cancers?

PubMed

Lebel, Sophie; Feldstain, Andrea; McCallum, Megan; Beattie, Sara; Irish, Jonathan; Bezjak, Andrea; Devins, Gerald M

2013-01-01

Survivors of lung or head and neck cancers often change tobacco and alcohol consumption after diagnosis, but few studies have examined other positive health changes (PHCs) or their determinants in these groups. The present study aims to: (a) document PHCs in survivors of lung (n = 107) or head and neck cancers (n = 99) and (b) examine behavioural self-blame and stigma as determinants of PHCs. We hypothesised that: (a) survivors would make a variety of PHCs; (b) behavioural self-blame for the disease would positively predict making PHCs; and (c) stigma would negatively predict making PHCs. Respondents self-administered measures of PHC, behavioural self-blame, and stigma. Hierarchical multiple regression analysis tested the hypotheses. More than 65% of respondents reported making PHCs, the most common being changes in diet (25%), exercise (23%) and tobacco consumption (16.5%). Behavioural self-blame significantly predicted PHCs but stigma did not. However, both behavioural self-blame and stigma significantly predicted changes in tobacco consumption. Many survivors of lung or head and neck cancers engage in PHCs, but those who do not attribute the disease to their behaviour are less likely to do so. Attention to this problem and additional counselling may help people to adopt PHCs.

Does Quality of Radiation Therapy Predict Outcomes of Multicenter Cooperative Group Trials? A Literature Review

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

Fairchild, Alysa, E-mail: alysa.fairchild@albertahealthservices.ca; Straube, William; Laurie, Fran

2013-10-01

Central review of radiation therapy (RT) delivery within multicenter clinical trials was initiated in the early 1970s in the United States. Early quality assurance publications often focused on metrics related to process, logistics, and timing. Our objective was to review the available evidence supporting correlation of RT quality with clinical outcomes within cooperative group trials. A MEDLINE search was performed to identify multicenter studies that described central subjective assessment of RT protocol compliance (quality). Data abstracted included method of central review, definition of deviations, and clinical outcomes. Seventeen multicenter studies (1980-2012) were identified, plus one Patterns of Care Study. Diseasemore » sites were hematologic, head and neck, lung, breast, and pancreas. Between 0 and 97% of treatment plans received an overall grade of acceptable. In 7 trials, failure rates were significantly higher after inadequate versus adequate RT. Five of 9 and 2 of 5 trials reported significantly worse overall and progression-free survival after poor-quality RT, respectively. One reported a significant correlation, and 2 reported nonsignificant trends toward increased toxicity with noncompliant RT. Although more data are required, protocol-compliant RT may decrease failure rates and increase overall survival and likely contributes to the ability of collected data to answer the central trial question.« less

Does Quality of Radiotherapy Predict Outcomes of Multicentre Cooperative Group Trials? A Literature Review

PubMed Central

Fairchild, Alysa; Straube, William; Laurie, Fran; Followill, David

2013-01-01

Central review of radiotherapy (RT) delivery within multicentre clinical trials was initiated in the early 1970’s in the USA. Early quality assurance (QA) publications often focused on metrics related to process, logistics and timing. Our objective was to review the available evidence supporting correlation of RT quality with clinical outcomes within cooperative group trials. Medline search was performed to identify multicentre studies which described central subjective assessment of RT protocol compliance (quality). Data abstracted included method of central review, definition of deviations, and clinical outcomes. Seventeen multicentre studies (1980–2012) were identified, plus one Patterns of Care Study. Disease sites were hematologic, head and neck, lung, breast and pancreas. Between 0% and 97% of treatment plans received an overall grade of acceptable. In seven trials, failure rates were significantly higher after inadequate versus adequate RT. 5/9 and 2/5 trials reported significantly worse overall and progression-free survival after poor quality RT, respectively. One reported a significant correlation and two reported non-significant trends towards increased toxicity with non-compliant RT. Although more data are required, protocol-compliant RT may decrease failure rates and increase overall survival and likely contributes to the ability of collected data to answer the central trial question. PMID:23683829

Self-diagnosis of active head lice infestation by individuals from an impoverished community: high sensitivity and specificity.

PubMed

Pilger, Daniel; Khakban, Adak; Heukelbach, Jorg; Feldmeier, Hermann

2008-01-01

To compare sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of self-diagnosis for head lice infestation with visual inspection, we conducted a study in an urban slum in Brazil. Individuals were asked about active head lice infestation (self-diagnosis); we performed visual inspection and thereafter wet combing (gold standard). Of the 175 individuals included, 77 (44%) had an active head lice infestation. For self-diagnosis, sensitivity (80.5%), specificity (91.8%), PPV (88.6%) and NPV (85.7%) were high. Sensitivity of visual inspection was 35.1%. Public health professionals can use self-diagnosis as a diagnostic tool, to estimate accurately prevalence of pediculosis in a community, and to monitor ongoing intervention strategies.

Parent Involvement in Head Start and Children's Development: Indirect Effects Through Parenting.

PubMed

Ansari, Arya; Gershoff, Elizabeth

2016-04-01

The authors examined the extent to which parent involvement in Head Start programs predicted changes in both parent and child outcomes over time, using a nationally representative sample of 1,020 three-year-old children over 3 waves of the Family and Child Experiences Survey. Center policies that promote involvement predicted greater parent involvement, and parents who were more involved in Head Start centers demonstrated increased cognitive stimulation and decreased spanking and controlling behaviors. In turn, these changes in parenting behaviors were associated with gains in children's academic and behavioral skills. These findings suggest that Head Start programs should do even more to facilitate parent involvement because it can serve as an important means for promoting both parent and child outcomes.

Risk factors for work-related stress and health in head teachers.

PubMed

Phillips, Samantha J; Sen, Dil; McNamee, Roseanne

2008-12-01

Work-related stress (WRS) is known to cause ill-health and decreased productivity. Work in the education sector is thought to be particularly stressful. Few studies have considered risk factors for WRS and health in head teachers. To investigate health in head teachers in West Sussex. To determine personal risk factors most likely to predict cases of WRS and of poor health in head teachers. A cross-sectional study, in a population of 290 head teachers and principals of colleges of further education, using a validated questionnaire, 'a short stress evaluation tool' (ASSET) and additional questions derived from earlier studies. Results were compared with the ASSET database 'norm' groups: a general population of workers (GPN) group and a group of managers and professionals (MPN). 'Caseness' was defined as respondents who felt work was 'very or extremely stressful'. Head teachers had poor physical and mental health compared to the GPN group. Psychological well-being, particularly of females and primary head teachers was worse than a comparative group of managers and professionals. Teaching<5 h/week was a significant predictor of caseness and being female was the main risk factor for poor psychological well-being. Prevalence of self-reported stress in head teachers in West Sussex is high. Female head teachers had worse health outcomes. Our study identified possible personal risk factors predicting WRS and/or poor health in head teachers.

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

Puskar, Joseph David; Quintana, Michael A.; Sorensen, Neil Robert

A program is underway at Sandia National Laboratories to predict long-term reliability of photovoltaic (PV) systems. The vehicle for the reliability predictions is a Reliability Block Diagram (RBD), which models system behavior. Because this model is based mainly on field failure and repair times, it can be used to predict current reliability, but it cannot currently be used to accurately predict lifetime. In order to be truly predictive, physics-informed degradation processes and failure mechanisms need to be included in the model. This paper describes accelerated life testing of metal foil tapes used in thin-film PV modules, and how tape jointmore » degradation, a possible failure mode, can be incorporated into the model.« less

Design of Critical Components

NASA Technical Reports Server (NTRS)

Hendricks, Robert C.; Zaretsky, Erwin V.

2001-01-01

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

Tape recorder failure investigation

NASA Technical Reports Server (NTRS)

Higgins, M. D.; Loewenthal, S. H.; Carnahan, C. C.; Snyder, G. L.

1996-01-01

Two end-item tape recorders lost 4:1 mode data recording mode capability at less than half of their 1 6,000-cycle, 4-year operating life. Subsequent life tests on two spare recorders also experienced 4:1 mode data loss at 8,000 and 11,700 cycles. Tear down inspection after completion of the life tests showed that the tape had worn through the alfesil record and reproduce heads. An investigation was initiated to understand the cause of excessive tape head wear and the reasons why the 4:1 mode data rate, low-speed mode is more damaging than the 1:1 mode data rate, high-speed recording mode. The objective was to establish how operating conditions (tape speed, humidity, temperature, stop/start cycles) affects head life with the goal of extending head life on the remaining in-service tape recorders. Another interest was to explain why an earlier vendor life test showed capability beyond 16,000 cycles.

Tumour-infiltrating lymphocytes predict response to definitive chemoradiotherapy in head and neck cancer.

PubMed

Balermpas, P; Michel, Y; Wagenblast, J; Seitz, O; Weiss, C; Rödel, F; Rödel, C; Fokas, E

2014-01-21

We aimed to investigate the prognostic value of tumour-infiltrating lymphocytes' (TILs) expression in pretreatment specimens from patients with head and neck squamous cell carcinoma (HNSCC) treated with definitive chemoradiotherapy (CRT). The prevalence of CD3+, CD8+, CD4+ and FOXP3+ TILs was assessed using immunohistochemistry in tumour tissue obtained from 101 patients before CRT and was correlated with clinicopathological characteristics as well as local failure-free- (LFFS), distant metastases free- (DMFS), progression-free (PFS) and overall survival (OS). Survival curves were measured using the Kaplan-Meier method, and differences in survival between the groups were estimated using the log-rank test. Prognostic effects of TIL subset density were determined using the Cox regression analysis. With a mean follow-up of 25 months (range, 2.3-63 months), OS at 2 years was 57.4% for the entire cohort. Patients with high immunohistochemical CD3 and CD8 expression had significantly increased OS (P=0.024 and P=0.028), PFS (P=0.044 and P=0.047) and DMFS (P=0.021 and P=0.026) but not LFFS (P=0.90 and P=0.104) in multivariate analysis that included predictive clinicopathologic factors, such as age, sex, T-stage, N-stage, tumour grading and localisation. Neither CD4 nor FOXP3 expression showed significance for the clinical outcome. The lower N-stage was associated with improved OS in the multivariate analysis (P=0.049). The positive correlation between a high number of infiltrating CD3+ and CD8+ cells and clinical outcome indicates that TILs may have a beneficial role in HNSCC patients and may serve as a biomarker to identify patients likely to benefit from definitive CRT.

Relating Neuronal to Behavioral Performance: Variability of Optomotor Responses in the Blowfly

PubMed Central

Rosner, Ronny; Warzecha, Anne-Kathrin

2011-01-01

Behavioral responses of an animal vary even when they are elicited by the same stimulus. This variability is due to stochastic processes within the nervous system and to the changing internal states of the animal. To what extent does the variability of neuronal responses account for the overall variability at the behavioral level? To address this question we evaluate the neuronal variability at the output stage of the blowfly's (Calliphora vicina) visual system by recording from motion-sensitive interneurons mediating head optomotor responses. By means of a simple modelling approach representing the sensory-motor transformation, we predict head movements on the basis of the recorded responses of motion-sensitive neurons and compare the variability of the predicted head movements with that of the observed ones. Large gain changes of optomotor head movements have previously been shown to go along with changes in the animals' activity state. Our modelling approach substantiates that these gain changes are imposed downstream of the motion-sensitive neurons of the visual system. Moreover, since predicted head movements are clearly more reliable than those actually observed, we conclude that substantial variability is introduced downstream of the visual system. PMID:22066014

Continuum Damage Mechanics Models for the Analysis of Progressive Failure in Open-Hole Tension Laminates

NASA Technical Reports Server (NTRS)

Song, Kyonchan; Li, Yingyong; Rose, Cheryl A.

2011-01-01

The performance of a state-of-the-art continuum damage mechanics model for interlaminar damage, coupled with a cohesive zone model for delamination is examined for failure prediction of quasi-isotropic open-hole tension laminates. Limitations of continuum representations of intra-ply damage and the effect of mesh orientation on the analysis predictions are discussed. It is shown that accurate prediction of matrix crack paths and stress redistribution after cracking requires a mesh aligned with the fiber orientation. Based on these results, an aligned mesh is proposed for analysis of the open-hole tension specimens consisting of different meshes within the individual plies, such that the element edges are aligned with the ply fiber direction. The modeling approach is assessed by comparison of analysis predictions to experimental data for specimen configurations in which failure is dominated by complex interactions between matrix cracks and delaminations. It is shown that the different failure mechanisms observed in the tests are well predicted. In addition, the modeling approach is demonstrated to predict proper trends in the effect of scaling on strength and failure mechanisms of quasi-isotropic open-hole tension laminates.

A Progressive Damage Methodology for Residual Strength Predictions of Center-Crack Tension Composite Panels

NASA Technical Reports Server (NTRS)

Coats, Timothy William

1996-01-01

An investigation of translaminate fracture and a progressive damage methodology was conducted to evaluate and develop a residual strength prediction capability for laminated composites with through penetration notches. This is relevant to the damage tolerance of an aircraft fuselage that might suffer an in-flight accident such as an uncontained engine failure. An experimental characterization of several composite materials systems revealed an R-curve type of behavior. Fractographic examinations led to the postulate that this crack growth resistance could be due to fiber bridging, defined here as fractured fibers of one ply bridged by intact fibers of an adjacent ply. The progressive damage methodology is currently capable of predicting the initiation and growth of matrix cracks and fiber fracture. Using two difference fiber failure criteria, residual strength was predicted for different size panel widths and notch lengths. A ply discount fiber failure criterion yielded extremely conservative results while an elastic-perfectly plastic fiber failure criterion showed that the fiber bridging concept is valid for predicting residual strength for tensile dominated failure loads. Furthermore, the R-curves predicted by the model using the elastic-perfectly plastic fiber criterion compared very well with the experimental R-curves.

Traumatic dislocation of the S1 polyaxial pedicle screw head: a case report

PubMed Central

Du Plessis, Pieter N. B.; Lau, Bernard P. H.

2017-01-01

Polyaxial screw head dislocation in the absence of a manufacture defect is extremely rare and represents a biomechanical overload of the screw, leading to early failure. A 58-year-old gentleman underwent instrumented fusion using polyaxial pedicle screws-titanium rod construct with interbody cage for spondylolytic spondylolisthesis at the L5/S1 level. He attempted to bend forward ten days after the surgery which resulted in a dislocation of the right S1 polyaxial screw head from the screw shank with recurrence of symptoms. He underwent revision surgery uneventfully. This case highlights the need to pay particular attention to the strength of fixation and the amount of release to avoid such a complication. PMID:28435927

Poor postdischarge head growth is related to a 10% lower intelligence quotient in very preterm infants at the chronological age of five years.

PubMed

Neubauer, Vera; Fuchs, Teresa; Griesmaier, Elke; Kager, Katrin; Pupp-Peglow, Ulrike; Kiechl-Kohlendorfer, Ursula

2016-05-01

This study examined the relationship between head growth and cognitive outcome at the age of five years in preterm infants born at less than 32 weeks of gestation from 2003 to 2009, as previous research has mostly focused on outcomes in toddlers. The head circumference of 273 very preterm infants born in Tyrol, Austria, was measured at birth, discharge, the corrected ages of three, 12 and 24 months and the chronological age of five years. Suboptimal head size was defined as a head circumference of more than one standard deviation below the mean. Full-scale intelligence quotient (IQ) at five years was determined using Wechsler Preschool and Primary Scales of Intelligence, third edition. Infants with a suboptimal head size at the age of three months had a significantly lower median IQ than those with a normal head size (90 [20-122] versus 98 [20-138], p = 0.001) and from three months onwards they were more likely to exhibit cognitive delay. A suboptimal head size from the age of three months was consistently related to a 10% lower IQ, and this study adds further evidence that head growth failure, especially during the early postdischarge period, is related to impaired cognitive abilities. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Factors Influencing Progressive Failure Analysis Predictions for Laminated Composite Structure

NASA Technical Reports Server (NTRS)

Knight, Norman F., Jr.

2008-01-01

Progressive failure material modeling methods used for structural analysis including failure initiation and material degradation are presented. Different failure initiation criteria and material degradation models are described that define progressive failure formulations. These progressive failure formulations are implemented in a user-defined material model for use with a nonlinear finite element analysis tool. The failure initiation criteria include the maximum stress criteria, maximum strain criteria, the Tsai-Wu failure polynomial, and the Hashin criteria. The material degradation model is based on the ply-discounting approach where the local material constitutive coefficients are degraded. Applications and extensions of the progressive failure analysis material model address two-dimensional plate and shell finite elements and three-dimensional solid finite elements. Implementation details are described in the present paper. Parametric studies for laminated composite structures are discussed to illustrate the features of the progressive failure modeling methods that have been implemented and to demonstrate their influence on progressive failure analysis predictions.

Transvaginal ultrasonographic cervical measurement in predicting failed labor induction and cesarean delivery for failure to progress in nulliparous women.

PubMed

Park, Kyo Hoon

2007-08-01

The aim of this study was to evaluate the value of transvaginal sonographic cervical measurement in predicting failed labor induction and cesarean delivery for failure to progress in nulliparous women. One hundred and sixty-one women scheduled for labor induction underwent transvaginal ultrasonography and digital cervical examinations. Logistic regression demonstrated that cervical length and gestational age at induction, but not the Bishop score, significantly and independently predicted failed labor induction. According to the receiver operating characteristic curves analysis, the best cut-off value of cervical length for predicting failed labor induction was 28 mm, with a sensitivity of 62% and a specificity of 60%. In terms of the likelihood of a cesarean delivery for failure to progress as the outcome variable, logistic regression indicated that maternal height and birth weight, but not cervical length or Bishop score, were significantly and independently associated with an increased risk of cesarean delivery for failure to progress. Transvaginal sonographic measurements of cervical length thus independently predicted failed labor induction in nulliparous women. However, the relatively poor predictive performance of this test undermines its clinical usefulness as a predictor of failed labor induction. Moreover, cervical length appears to have a poor predictive value for the likelihood of a cesarean delivery for failure to progress.

Early failure mechanisms of constrained tripolar acetabular sockets used in revision total hip arthroplasty.

PubMed

Cooke, Christopher C; Hozack, William; Lavernia, Carlos; Sharkey, Peter; Shastri, Shani; Rothman, Richard H

2003-10-01

Fifty-eight patients received an Osteonics constrained acetabular implant for recurrent instability (46), girdlestone reimplant (8), correction of leg lengthening (3), and periprosthetic fracture (1). The constrained liner was inserted into a cementless shell (49), cemented into a pre-existing cementless shell (6), cemented into a cage (2), and cemented directly into the acetabular bone (1). Eight patients (13.8%) required reoperation for failure of the constrained implant. Type I failure (bone-prosthesis interface) occurred in 3 cases. Two cementless shells became loose, and in 1 patient, the constrained liner was cemented into an acetabular cage, which then failed by pivoting laterally about the superior fixation screws. Type II failure (liner locking mechanism) occurred in 2 cases. Type III failure (femoral head locking mechanism) occurred in 3 patients. Seven of the 8 failures occurred in patients with recurrent instability. Constrained liners are an effective method for treatment during revision total hip arthroplasty but should be used in select cases only.

[Necrotizing fasciitis in head and neck area].

PubMed

Sántha, Beáta; Sári, Katalin; Fülep, Zoltán; Patyi, Márta; Oberna, Ferenc

2017-03-01

Necrotizing fasciitis is a fulminant infection of the deeper layers of skin and subcutaneous tissues characterized by progressive soft tissue necrosis and high mortality. It rarely occurs in the head and neck area. The clinical picture includes non-specific but typical local and systemic symptoms. The treatment is a complex, multidisciplinary task which includes radical surgical exploration, debridement and drainage, empirically started and then targeted intravenous antibiotics and supportive therapy. Authors report a case of necrotizing fasciitis localized on the right side of the face which caused multi-organ failure and phlegmone of the neck.

Assessing performance and validating finite element simulations using probabilistic knowledge

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

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

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

Comparison of Damage Path Predictions for Composite Laminates by Explicit and Standard Finite Element Analysis Tools

NASA Technical Reports Server (NTRS)

Bogert, Philip B.; Satyanarayana, Arunkumar; Chunchu, Prasad B.

2006-01-01

Splitting, ultimate failure load and the damage path in center notched composite specimens subjected to in-plane tension loading are predicted using progressive failure analysis methodology. A 2-D Hashin-Rotem failure criterion is used in determining intra-laminar fiber and matrix failures. This progressive failure methodology has been implemented in the Abaqus/Explicit and Abaqus/Standard finite element codes through user written subroutines "VUMAT" and "USDFLD" respectively. A 2-D finite element model is used for predicting the intra-laminar damages. Analysis results obtained from the Abaqus/Explicit and Abaqus/Standard code show good agreement with experimental results. The importance of modeling delamination in progressive failure analysis methodology is recognized for future studies. The use of an explicit integration dynamics code for simple specimen geometry and static loading establishes a foundation for future analyses where complex loading and nonlinear dynamic interactions of damage and structure will necessitate it.

Narrowing the scope of failure prediction using targeted fault load injection

NASA Astrophysics Data System (ADS)

Jordan, Paul L.; Peterson, Gilbert L.; Lin, Alan C.; Mendenhall, Michael J.; Sellers, Andrew J.

2018-05-01

As society becomes more dependent upon computer systems to perform increasingly critical tasks, ensuring that those systems do not fail becomes increasingly important. Many organizations depend heavily on desktop computers for day-to-day operations. Unfortunately, the software that runs on these computers is written by humans and, as such, is still subject to human error and consequent failure. A natural solution is to use statistical machine learning to predict failure. However, since failure is still a relatively rare event, obtaining labelled training data to train these models is not a trivial task. This work presents new simulated fault-inducing loads that extend the focus of traditional fault injection techniques to predict failure in the Microsoft enterprise authentication service and Apache web server. These new fault loads were successful in creating failure conditions that were identifiable using statistical learning methods, with fewer irrelevant faults being created.

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

Daniel, Isaac M.

To facilitate and accelerate the process of introducing, evaluating and adopting of new material systems, it is important to develop/establish comprehensive and effective procedures of characterization, modeling and failure prediction of structural laminates based on the properties of the constituent materials, e. g., fibers, matrix, and the single ply or lamina. A new failure theory, the Northwestern (NU-Daniel) theory, has been proposed for predicting lamina yielding and failure under multi-axial states of stress including strain rate effects. It is primarily applicable to matrix-dominated interfiber/interlaminar failures. It is based on micromechanical failure mechanisms but is expressed in terms of easily measuredmore » macroscopic lamina stiffness and strength properties. It is presented in the form of a master failure envelope incorporating strain rate effects. The theory was further adapted and extended to the prediction of in situ first ply yielding and failure (FPY and FPF) and progressive failure of multi-directional laminates under static and dynamic loadings. The significance of this theory is that it allows for rapid screening of new composite materials without very extensive testing and offers easily implemented design tools.« less

Incidence and risk factors of ventilator associated pneumonia in a tertiary care hospital.

PubMed

Charles, Mv Pravin; Easow, Joshy M; Joseph, Noyal M; Ravishankar, M; Kumar, Shailesh; Umadevi, Sivaraman

2013-01-01

Ventilator associated pneumonia (VAP) is a type of nosocomial pneumonia associated with increased morbidity and mortality. Knowledge about the incidence and risk factors is necessary to implement preventive measures to reduce mortality in these patients. A prospective study was conducted at a tertiary care teaching hospital for a period of 20 months from November 2009 to July 2011. Patients who were on mechanical ventilation (MV) for more than 48 hours were monitored at frequent intervals for development of VAP using clinical and microbiological criteria until discharge or death. Of the 76 patients, 18 (23.7%) developed VAP during their ICU stay. The incidence of VAP was 53.25 per 1,000 ventilator days. About 94% of VAP cases occurred within the first week of MV. Early-onset and late-onset VAP was observed in 72.2% and 27.8%, respectively. Univariate analysis showed chronic lung failure, H2 blockers usage, and supine head position were significant risk factors for VAP. Logistic regression revealed supine head position as an independent risk factor for VAP. VAP occurred in a sizeable number of patients on MV. Chronic lung failure, H2 blockers usage, and supine head position were the risk factors associated with VAP. Awareness about these risk factors can be used to inform simple and effective preventive measures.

Experimental and predicted cavitation performance of an 80.6 deg helical inducer in high temperature water

NASA Technical Reports Server (NTRS)

Kovich, G.

1972-01-01

The cavitating performance of a stainless steel 80.6 degree flat-plate helical inducer was investigated in water over a range of liquid temperatures and flow coefficients. A semi-empirical prediction method was used to compare predicted values of required net positive suction head in water with experimental values obtained in water. Good agreement was obtained between predicted and experimental data in water. The required net positive suction head in water decreased with increasing temperature and increased with flow coefficient, similar to that observed for a like inducer in liquid hydrogen.

Changing head model extent affects finite element predictions of transcranial direct current stimulation distributions

NASA Astrophysics Data System (ADS)

Indahlastari, Aprinda; Chauhan, Munish; Schwartz, Benjamin; Sadleir, Rosalind J.

2016-12-01

Objective. In this study, we determined efficient head model sizes relative to predicted current densities in transcranial direct current stimulation (tDCS). Approach. Efficiency measures were defined based on a finite element (FE) simulations performed using nine human head models derived from a single MRI data set, having extents varying from 60%-100% of the original axial range. Eleven tissue types, including anisotropic white matter, and three electrode montages (T7-T8, F3-right supraorbital, Cz-Oz) were used in the models. Main results. Reducing head volume extent from 100% to 60%, that is, varying the model’s axial range from between the apex and C3 vertebra to one encompassing only apex to the superior cerebellum, was found to decrease the total modeling time by up to half. Differences between current density predictions in each model were quantified by using a relative difference measure (RDM). Our simulation results showed that {RDM} was the least affected (a maximum of 10% error) for head volumes modeled from the apex to the base of the skull (60%-75% volume). Significance. This finding suggested that the bone could act as a bioelectricity boundary and thus performing FE simulations of tDCS on the human head with models extending beyond the inferior skull may not be necessary in most cases to obtain reasonable precision in current density results.

The Head Tracks and Gaze Predicts: How the World’s Best Batters Hit a Ball

PubMed Central

Mann, David L.; Spratford, Wayne; Abernethy, Bruce

2013-01-01

Hitters in fast ball-sports do not align their gaze with the ball throughout ball-flight; rather, they use predictive eye movement strategies that contribute towards their level of interceptive skill. Existing studies claim that (i) baseball and cricket batters cannot track the ball because it moves too quickly to be tracked by the eyes, and that consequently (ii) batters do not – and possibly cannot – watch the ball at the moment they hit it. However, to date no studies have examined the gaze of truly elite batters. We examined the eye and head movements of two of the world’s best cricket batters and found both claims do not apply to these batters. Remarkably, the batters coupled the rotation of their head to the movement of the ball, ensuring the ball remained in a consistent direction relative to their head. To this end, the ball could be followed if the batters simply moved their head and kept their eyes still. Instead of doing so, we show the elite batters used distinctive eye movement strategies, usually relying on two predictive saccades to anticipate (i) the location of ball-bounce, and (ii) the location of bat-ball contact, ensuring they could direct their gaze towards the ball as they hit it. These specific head and eye movement strategies play important functional roles in contributing towards interceptive expertise. PMID:23516460

Validation of concussion risk curves for collegiate football players derived from HITS data.

PubMed

Funk, James R; Rowson, Steven; Daniel, Ray W; Duma, Stefan M

2012-01-01

For several years, Virginia Tech and other schools have measured the frequency and severity of head impacts sustained by collegiate American football players in real time using the Head Impact Telemetry (HIT) System of helmet-mounted accelerometers. In this study, data from 37,128 head impacts collected at Virginia Tech during games from 2006 to 2010 were analyzed. Peak head acceleration exceeded 100 g in 516 impacts, and the Head Injury Criterion (HIC) exceeded 200 in 468 impacts. Four instrumented players in the dataset sustained a concussion. These data were used to develop risk curves for concussion as a function of peak head acceleration and HIC. The validity of this biomechanical approach was assessed using epidemiological data on concussion incidence from other sources. Two specific aspects of concussion incidence were addressed: the variation by player position, and the frequency of repeat concussions. The HIT System data indicated that linemen sustained the highest overall number of head impacts, while skill positions sustained a higher number of more severe head impacts (peak acceleration > 100 g or HIC > 200). When weighted using injury risk curves, the HIT System data predicted a higher incidence of concussion in skill positions compared to linemen at rates that were in strong agreement with the epidemiological literature (Pearson's r = 0.72-0.87). The predicted rates of repeat concussions (21-39% over one season and 33-50% over five seasons) were somewhat higher than the ranges reported in the epidemiological literature. These analyses demonstrate that simple biomechanical parameters that can be measured by the HIT System possess a high level of power for predicting concussion.

An Analytical Calculation of Frictional and Bending Moments at the Head-Neck Interface of Hip Joint Implants during Different Physiological Activities.

PubMed

Farhoudi, Hamidreza; Oskouei, Reza H; Pasha Zanoosi, Ali A; Jones, Claire F; Taylor, Mark

2016-12-05

This study predicts the frictional moments at the head-cup interface and frictional torques and bending moments acting on the head-neck interface of a modular total hip replacement across a range of activities of daily living. The predicted moment and torque profiles are based on the kinematics of four patients and the implant characteristics of a metal-on-metal implant. Depending on the body weight and type of activity, the moments and torques had significant variations in both magnitude and direction over the activity cycles. For the nine investigated activities, the maximum magnitude of the frictional moment ranged from 2.6 to 7.1 Nm. The maximum magnitude of the torque acting on the head-neck interface ranged from 2.3 to 5.7 Nm. The bending moment acting on the head-neck interface varied from 7 to 21.6 Nm. One-leg-standing had the widest range of frictional torque on the head-neck interface (11 Nm) while normal walking had the smallest range (6.1 Nm). The widest range, together with the maximum magnitude of torque, bending moment, and frictional moment, occurred during one-leg-standing of the lightest patient. Most of the simulated activities resulted in frictional torques that were near the previously reported oxide layer depassivation threshold torque. The predicted bending moments were also found at a level believed to contribute to the oxide layer depassivation. The calculated magnitudes and directions of the moments, applied directly to the head-neck taper junction, provide realistic mechanical loading data for in vitro and computational studies on the mechanical behaviour and multi-axial fretting at the head-neck interface.

An Analytical Calculation of Frictional and Bending Moments at the Head-Neck Interface of Hip Joint Implants during Different Physiological Activities

PubMed Central

Farhoudi, Hamidreza; Oskouei, Reza H.; Pasha Zanoosi, Ali A.; Jones, Claire F.; Taylor, Mark

2016-01-01

This study predicts the frictional moments at the head-cup interface and frictional torques and bending moments acting on the head-neck interface of a modular total hip replacement across a range of activities of daily living. The predicted moment and torque profiles are based on the kinematics of four patients and the implant characteristics of a metal-on-metal implant. Depending on the body weight and type of activity, the moments and torques had significant variations in both magnitude and direction over the activity cycles. For the nine investigated activities, the maximum magnitude of the frictional moment ranged from 2.6 to 7.1 Nm. The maximum magnitude of the torque acting on the head-neck interface ranged from 2.3 to 5.7 Nm. The bending moment acting on the head-neck interface varied from 7 to 21.6 Nm. One-leg-standing had the widest range of frictional torque on the head-neck interface (11 Nm) while normal walking had the smallest range (6.1 Nm). The widest range, together with the maximum magnitude of torque, bending moment, and frictional moment, occurred during one-leg-standing of the lightest patient. Most of the simulated activities resulted in frictional torques that were near the previously reported oxide layer depassivation threshold torque. The predicted bending moments were also found at a level believed to contribute to the oxide layer depassivation. The calculated magnitudes and directions of the moments, applied directly to the head-neck taper junction, provide realistic mechanical loading data for in vitro and computational studies on the mechanical behaviour and multi-axial fretting at the head-neck interface. PMID:28774104

Can Functional Movement Assessment Predict Football Head Impact Biomechanics?

PubMed

Ford, Julia M; Campbell, Kody R; Ford, Cassie B; Boyd, Kenneth E; Padua, Darin A; Mihalik, Jason P

2018-06-01

The purposes of this study was to determine functional movement assessments' ability to predict head impact biomechanics in college football players and to determine whether head impact biomechanics could explain preseason to postseason changes in functional movement performance. Participants (N = 44; mass, 109.0 ± 20.8 kg; age, 20.0 ± 1.3 yr) underwent two preseason and postseason functional movement assessment screenings: 1) Fusionetics Movement Efficiency Test and 2) Landing Error Scoring System (LESS). Fusionetics is scored 0 to 100, and participants were categorized into the following movement quality groups as previously published: good (≥75), moderate (50-75), and poor (<50). The LESS is scored 0 to 17, and participants were categorized into the following previously published movement quality groups: good (≤5 errors), moderate (6-7 errors), and poor (>7 errors). The Head Impact Telemetry (HIT) System measured head impact frequency and magnitude (linear acceleration and rotational acceleration). An encoder with six single-axis accelerometers was inserted between the padding of a commercially available Riddell football helmet. We used random intercepts general linear-mixed models to analyze our data. There were no effects of preseason movement assessment group on the two Head Impact Telemetry System impact outcomes: linear acceleration and rotational acceleration. Head impact frequency did not significantly predict preseason to postseason score changes obtained from the Fusionetics (F1,36 = 0.22, P = 0.643, R = 0.006) or the LESS (F1,36 < 0.01, P = 0.988, R < 0.001) assessments. Previous research has demonstrated an association between concussion and musculoskeletal injury, as well as functional movement assessment performance and musculoskeletal injury. The functional movement assessments chosen may not be sensitive enough to detect neurological and neuromuscular differences within the sample and subtle changes after sustaining head impacts.

Alternative metrics for real-ear-to-coupler difference average values in children.

PubMed

Blumsack, Judith T; Clark-Lewis, Sandra; Watts, Kelli M; Wilson, Martha W; Ross, Margaret E; Soles, Lindsey; Ennis, Cydney

2014-10-01

Ideally, individual real-ear-to-coupler difference (RECD) measurements are obtained for pediatric hearing instrument-fitting purposes. When RECD measurements cannot be obtained, age-related average RECDs based on typically developing North American children are used. Evidence suggests that these values may not be appropriate for populations of children with retarded growth patterns. The purpose of this study was to determine if another metric, such as head circumference, height, or weight, can be used for prediction of RECDs in children. Design was a correlational study. For all participants, RECD values in both ears, head circumference, height, and weight were measured. The sample consisted of 68 North American children (ages 3-11 yr). Height, weight, head circumference, and RECDs were measured and were analyzed for both ears at 500, 750, 1000, 1500, 2000, 3000, 4000, and 6000 Hz. A backward elimination multiple-regression analysis was used to determine if age, height, weight, and/or head circumference are significant predictors of RECDs. For the left ear, head circumference was retained as the only statistically significant variable in the final model. For the right ear, head circumference was retained as the only statistically significant independent variable at all frequencies except at 2000 and 4000 Hz. At these latter frequencies, weight was retained as the only statistically significant independent variable after all other variables were eliminated. Head circumference can be considered as a metric for RECD prediction in children when individual measurements cannot be obtained. In developing countries where equipment is often unavailable and stunted growth can reduce the value of using age as a metric, head circumference can be considered as an alternative metric in the prediction of RECDs. American Academy of Audiology.

Yield and failure criteria for composite materials under static and dynamic loading

DOE PAGES

Daniel, Isaac M.

2015-12-23

To facilitate and accelerate the process of introducing, evaluating and adopting of new material systems, it is important to develop/establish comprehensive and effective procedures of characterization, modeling and failure prediction of structural laminates based on the properties of the constituent materials, e. g., fibers, matrix, and the single ply or lamina. A new failure theory, the Northwestern (NU-Daniel) theory, has been proposed for predicting lamina yielding and failure under multi-axial states of stress including strain rate effects. It is primarily applicable to matrix-dominated interfiber/interlaminar failures. It is based on micromechanical failure mechanisms but is expressed in terms of easily measuredmore » macroscopic lamina stiffness and strength properties. It is presented in the form of a master failure envelope incorporating strain rate effects. The theory was further adapted and extended to the prediction of in situ first ply yielding and failure (FPY and FPF) and progressive failure of multi-directional laminates under static and dynamic loadings. The significance of this theory is that it allows for rapid screening of new composite materials without very extensive testing and offers easily implemented design tools.« less

Comparison of the Canadian CT head rule and the New Orleans criteria in patients with minor head injury in a Spanish hospital.

PubMed

Valle Alonso, Joaquín; Fonseca Del Pozo, Francisco Javier; Vaquero Álvarez, Manuel; Lopera Lopera, Elisa; Garcia Segura, Marisol; García Arévalo, Ricardo

2016-12-16

To compare two scales for assessment of patients with mild head injury. The Canadian CT Head Rule (CCHR) and New Orleans Criteria (NOC) according to their diagnostic accuracy in patients attending an emergency department, and to determine the most important predictive values. Cross-sectional study in a first-level Hospital in the period of January 2011 to January 2013. Patients with mild head injury criteria were included. All the patients underwent a computed tomography (CT) of the head as part of internal protocol and the CCHR and NOC criteria were recorded for each patient. We consider the main variable the presence of traumatic lesions on CT and, as secondary variables, neurosurgical intervention and post-concussion syndrome. Sensitivity, specificity, predictive values and validity index (VI) of the CCHR and the NO criteria in the subgroup of patients with a Glasgow Coma Scale (GCS) score of 15 points were compared. A total of 217 patients, of whom 197 had a GCS score of 15 points were evaluated. Both rules showed 100% sensitivity when a significant injury was presented in the CT, the CCHR 100% (95% CI: 97.4%-100%) and the NO criteria 100% (95% CI: 97.4%-100%); but the CCHR achieved higher values of specificity 25.3% (95% CI: 18.6%-32%), positive predictive value (PPV) and VI. The two rules showed a 100% sensitivity regarding neurosurgical intervention; however the CCHR with high-risk criteria showed better specificity, PPV and VI 55.2 (95% CI: 8.3%-62.2%) compared to the NO criteria 7.6 (95% CI: 3.8%-11.5%). With regard to post-concussion syndrome criteria NO criteria showed better sensitivity 100% (95% CI: 96.2%-100%) and predictive values, but lower specificity and VI compared with the CCHR 76.9% (95% CI: 50.2%-100%). Our study demonstrates the high sensitivity of the CCHR and the NO criteria in patients with mild head injury, both to detect a significant clinical lesion on CT or the need for neurosurgical intervention and better specificity of CCHR compared with NO criteria. The adoption of clinical prediction rules, especially the CCHR, to request a CT scan in patients with mild head injury should be recommended in the emergency department. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Phase III randomized trial of induction chemotherapy in patients with N2 or N3 locally advanced head and neck cancer.

PubMed

Cohen, Ezra E W; Karrison, Theodore G; Kocherginsky, Masha; Mueller, Jeffrey; Egan, Robyn; Huang, Chao H; Brockstein, Bruce E; Agulnik, Mark B; Mittal, Bharat B; Yunus, Furhan; Samant, Sandeep; Raez, Luis E; Mehra, Ranee; Kumar, Priya; Ondrey, Frank; Marchand, Patrice; Braegas, Bettina; Seiwert, Tanguy Y; Villaflor, Victoria M; Haraf, Daniel J; Vokes, Everett E

2014-09-01

Induction chemotherapy (IC) before radiotherapy lowers distant failure (DF) rates in locally advanced squamous cell carcinoma of the head and neck (SCCHN). The goal of this phase III trial was to determine whether IC before chemoradiotherapy (CRT) further improves survival compared with CRT alone in patients with N2 or N3 disease. Treatment-naive patients with nonmetastatic N2 or N3 SCCHN were randomly assigned to CRT alone (CRT arm; docetaxel, fluorouracil, and hydroxyurea plus radiotherapy 0.15 Gy twice per day every other week) versus two 21-day cycles of IC (docetaxel 75 mg/m(2) on day 1, cisplatin 75 mg/m(2) on day 1, and fluorouracil 750 mg/m(2) on days 1 to 5) followed by the same CRT regimen (IC + CRT arm). The primary end point was overall survival (OS). Secondary end points included DF-free survival, failure pattern, and recurrence-free survival (RFS). A total of 285 patients were randomly assigned. The most common grade 3 to 4 toxicities during IC were febrile neutropenia (11%) and mucositis (9%); during CRT (both arms combined), they were mucositis (49%), dermatitis (21%), and leukopenia (18%). Serious adverse events were more common in the IC arm (47% v 28%; P = .002). With a minimum follow-up of 30 months, there were no statistically significant differences in OS (hazard ratio, 0.91; 95% CI, 0.59 to 1.41), RFS, or DF-free survival. IC did not translate into improved OS compared with CRT alone. However, the study was underpowered because it did not meet the planned accrual target, and OS was higher than predicted in both arms. IC cannot be recommended routinely in patients with N2 or N3 locally advanced SCCHN. © 2014 by American Society of Clinical Oncology.

Phase III Randomized Trial of Induction Chemotherapy in Patients With N2 or N3 Locally Advanced Head and Neck Cancer

PubMed Central

Cohen, Ezra E.W.; Karrison, Theodore G.; Kocherginsky, Masha; Mueller, Jeffrey; Egan, Robyn; Huang, Chao H.; Brockstein, Bruce E.; Agulnik, Mark B.; Mittal, Bharat B.; Yunus, Furhan; Samant, Sandeep; Raez, Luis E.; Mehra, Ranee; Kumar, Priya; Ondrey, Frank; Marchand, Patrice; Braegas, Bettina; Seiwert, Tanguy Y.; Villaflor, Victoria M.; Haraf, Daniel J.; Vokes, Everett E.

2014-01-01

Purpose Induction chemotherapy (IC) before radiotherapy lowers distant failure (DF) rates in locally advanced squamous cell carcinoma of the head and neck (SCCHN). The goal of this phase III trial was to determine whether IC before chemoradiotherapy (CRT) further improves survival compared with CRT alone in patients with N2 or N3 disease. Patients and Methods Treatment-naive patients with nonmetastatic N2 or N3 SCCHN were randomly assigned to CRT alone (CRT arm; docetaxel, fluorouracil, and hydroxyurea plus radiotherapy 0.15 Gy twice per day every other week) versus two 21-day cycles of IC (docetaxel 75 mg/m2 on day 1, cisplatin 75 mg/m2 on day 1, and fluorouracil 750 mg/m2 on days 1 to 5) followed by the same CRT regimen (IC + CRT arm). The primary end point was overall survival (OS). Secondary end points included DF-free survival, failure pattern, and recurrence-free survival (RFS). Results A total of 285 patients were randomly assigned. The most common grade 3 to 4 toxicities during IC were febrile neutropenia (11%) and mucositis (9%); during CRT (both arms combined), they were mucositis (49%), dermatitis (21%), and leukopenia (18%). Serious adverse events were more common in the IC arm (47% v 28%; P = .002). With a minimum follow-up of 30 months, there were no statistically significant differences in OS (hazard ratio, 0.91; 95% CI, 0.59 to 1.41), RFS, or DF-free survival. Conclusion IC did not translate into improved OS compared with CRT alone. However, the study was underpowered because it did not meet the planned accrual target, and OS was higher than predicted in both arms. IC cannot be recommended routinely in patients with N2 or N3 locally advanced SCCHN. PMID:25049329

Mechanical torque measurement for in vivo quantification of bone strength in the proximal femur.

PubMed

Mueller, Marc Andreas; Hengg, Clemens; Hirschmann, Michael; Schmid, Denise; Sprecher, Christoph; Audigé, Laurent; Suhm, Norbert

2012-10-01

Bone strength determines fracture risk and fixation strength of osteosynthesis implants. In vivo, bone strength is currently measured indirectly by quantifying bone mineral density (BMD) which is however only one determinant of the bone's biomechanical competence besides the bone's macro- and micro-architecture and tissue related parameters. We have developed a measurement principle (DensiProbe™ Hip) for direct, mechanical quantification of bone strength within the proximal femur upon hip fracture fixation. Previous cadaver tests indicated a close correlation between DensiProbe™ Hip measurements, 3D micro-CT analysis and biomechanical indicators of bone strength. The goal of this study was to correlate DensiProbe™ Hip measurements with areal bone mineral density (BMD). Forty-three hip fracture patients were included in this study. Intraoperatively, DensiProbe™ Hip was inserted to the subsequent hip screw tip position within the femoral head. Peak torque to breakaway of local cancellous bone was registered. Thirty-seven patients underwent areal BMD measurements of the contralateral proximal femur. Failure of fixation was assessed radio graphically 6 and 12 weeks postoperatively. Peak torque and femoral neck BMD showed significant correlations (R=0.60, P=0.0001). In regression analysis, areal BMD explained 46% of femoral neck BMD variance in a quadratic relationship. Throughout the 12-week follow-up period, no failure of fixation was observed. DensiProbe™ Hip may capture variations of bone strength beyond areal BMD which are currently difficult to measure in vivo. A multicenter study will clarify if peak torque predicts fixation failure. Copyright © 2012 Elsevier Ltd. All rights reserved.

A comparison of skin graft success in the head & neck with and without the use of a pressure dressing.

PubMed

Dhillon, M; Carter, C P; Morrison, J; Hislop, W S; Currie, W J R

2015-06-01

The success of skin grafting is dependent on the interplay between many factors including nutrient uptake and vascular in-growth. To allow this, it is important that the graft is immobile and traditionally a 'pressure dressing' has been placed over the graft to improve outcome and graft 'take'. We present the findings of our comparative study of full-thickness skin grafts performed in the head, neck and face region over a period of 24 months. We felt that there was an unacceptably high infection rate and graft failure using pressure dressings. Data was collected retrospectively from the case notes on 70 patients who had undergone full-thickness skin grafting to the head, neck and face over a 2 year period. Thirty-five patients underwent grafting with pressure dressing and 35 without. The group with the pressure dressing had the same 'bolster' specification-type dressing and those without had their graft 'quilted' in and chloramphenicol ointment applied topically. Success was determined by the percentage 'take' of the grafts and absence of infection i.e. purulence. Infection in those with a pressure dressing stood at 26 % in contrast to those without, at 9 %. Without a pressure dressing we observed no total graft failures, compared to 6 % in those with a pressure dressing. The results confirmed the perception that there was a higher infection and graft failure rate where a pressure dressing was applied; however, this was not a statistically significant difference and a randomised control trial with a larger sample size would be required to validate the results.

Systematic analysis of video data from different human-robot interaction studies: a categorization of social signals during error situations.

PubMed

Giuliani, Manuel; Mirnig, Nicole; Stollnberger, Gerald; Stadler, Susanne; Buchner, Roland; Tscheligi, Manfred

2015-01-01

Human-robot interactions are often affected by error situations that are caused by either the robot or the human. Therefore, robots would profit from the ability to recognize when error situations occur. We investigated the verbal and non-verbal social signals that humans show when error situations occur in human-robot interaction experiments. For that, we analyzed 201 videos of five human-robot interaction user studies with varying tasks from four independent projects. The analysis shows that there are two types of error situations: social norm violations and technical failures. Social norm violations are situations in which the robot does not adhere to the underlying social script of the interaction. Technical failures are caused by technical shortcomings of the robot. The results of the video analysis show that the study participants use many head movements and very few gestures, but they often smile, when in an error situation with the robot. Another result is that the participants sometimes stop moving at the beginning of error situations. We also found that the participants talked more in the case of social norm violations and less during technical failures. Finally, the participants use fewer non-verbal social signals (for example smiling, nodding, and head shaking), when they are interacting with the robot alone and no experimenter or other human is present. The results suggest that participants do not see the robot as a social interaction partner with comparable communication skills. Our findings have implications for builders and evaluators of human-robot interaction systems. The builders need to consider including modules for recognition and classification of head movements to the robot input channels. The evaluators need to make sure that the presence of an experimenter does not skew the results of their user studies.

Phase II Trial of Hyperfractionated Intensity-Modulated Radiation Therapy and Concurrent Weekly Cisplatin for Stage III and IVa Head-and-Neck Cancer

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

Maguire, Patrick D., E-mail: pmaguire@nhroc.co; Papagikos, Michael; Hamann, Sue

2011-03-15

Purpose: To investigate a novel chemoradiation regimen designed to maximize locoregional control (LRC) and minimize toxicity for patients with advanced head-and-neck squamous cell carcinoma (HNSCC). Methods and Materials: Patients received hyperfractionated intensity modulated radiation therapy (HIMRT) in 1.25-Gy fractions b.i.d. to 70 Gy to high-risk planning target volume (PTV). Intermediate and low-risk PTVs received 60 Gy and 50 Gy, at 1.07, and 0.89 Gy per fraction, respectively. Concurrent cisplatin 33 mg/m{sup 2}/week was started Week 1. Patients completed the Quality of Life Radiation Therapy Instrument pretreatment (PRE), at end of treatment (EOT), and at 1, 3, 6, 9, and 12more » months. Overall survival (OS), progression-free (PFS), LRC, and toxicities were assessed. Results: Of 39 patients, 30 (77%) were alive without disease at median follow-up of 37.5 months. Actuarial 3-year OS, PFS, and LRC were 80%, 82%, and 87%, respectively. No failures occurred in the electively irradiated neck and there were no isolated neck failures. Head and neck QOL was significantly worse in 18 of 35 patients (51%): mean 7.8 PRE vs. 3.9 EOT. By month 1, H and N QOL returned near baseline (mean 6.2, SD = 1.7). The most common acute Grade 3+ toxicities were mucositis (38%), fatigue (28%), dysphagia (28%), and leukopenia (26%). Conclusions: Hyperfractionated IMRT with low-dose weekly cisplatin resulted in good LRC with acceptable toxicity and QOL. Lack of elective nodal failures despite very low dose per fraction has led to an attempt to further minimize toxicity by reducing elective nodal doses in our subsequent protocol.« less

Systematic analysis of video data from different human–robot interaction studies: a categorization of social signals during error situations

PubMed Central

Giuliani, Manuel; Mirnig, Nicole; Stollnberger, Gerald; Stadler, Susanne; Buchner, Roland; Tscheligi, Manfred

2015-01-01

Human–robot interactions are often affected by error situations that are caused by either the robot or the human. Therefore, robots would profit from the ability to recognize when error situations occur. We investigated the verbal and non-verbal social signals that humans show when error situations occur in human–robot interaction experiments. For that, we analyzed 201 videos of five human–robot interaction user studies with varying tasks from four independent projects. The analysis shows that there are two types of error situations: social norm violations and technical failures. Social norm violations are situations in which the robot does not adhere to the underlying social script of the interaction. Technical failures are caused by technical shortcomings of the robot. The results of the video analysis show that the study participants use many head movements and very few gestures, but they often smile, when in an error situation with the robot. Another result is that the participants sometimes stop moving at the beginning of error situations. We also found that the participants talked more in the case of social norm violations and less during technical failures. Finally, the participants use fewer non-verbal social signals (for example smiling, nodding, and head shaking), when they are interacting with the robot alone and no experimenter or other human is present. The results suggest that participants do not see the robot as a social interaction partner with comparable communication skills. Our findings have implications for builders and evaluators of human–robot interaction systems. The builders need to consider including modules for recognition and classification of head movements to the robot input channels. The evaluators need to make sure that the presence of an experimenter does not skew the results of their user studies. PMID:26217266

Computer-Assisted Sperm Analysis (CASA) parameters and their evolution during preparation as predictors of pregnancy in intrauterine insemination with frozen-thawed donor semen cycles.

PubMed

Fréour, Thomas; Jean, Miguel; Mirallié, Sophie; Dubourdieu, Sophie; Barrière, Paul

2010-04-01

To study the potential of CASA parameters in frozen-thawed donor semen before and after preparation on silica gradient as predictors of pregnancy in IUI with donor semen cycles. CASA parameters were measured in thawed donor semen before and after preparation on a silica gradient in 132 couples undergoing 168 IUI cycles with donor semen. The evolution of these parameters throughout this process was calculated. The relationship with cycle outcome was then studied. Clinical pregnancy rate was 18.4% per cycle. CASA parameters on donor semen before or after preparation were not significantly different between pregnancy and failure groups. However, amplitude of lateral head displacement (ALH) of spermatozoa improved in all cycles where pregnancy occurred, thus predicting pregnancy with a sensitivity of 100% and a specificity of 20%. Even if CASA parameters do not seem to predict pregnancy in IUI with donor semen cycles, their evolution during the preparation process should be evaluated, especially for ALH. However, the link between ALH improvement during preparation process and pregnancy remains to be explored. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

Preference bias of head orientation in choosing between two non-durables.

PubMed

Funaya, Hiroyuki; Shibata, Tomohiro

2015-01-01

The goal of this study is to investigate how customers' gaze, head and body orientations reflect their choices. Although the relationship between human choice and gaze behavior has been well-studied, other behaviors such as head and body are unknown. We conducted a two-alternatives-forced-choice task to examine (1) whether preference bias, i.e., a positional bias in gaze, head and body toward the item that was later chosen, exists in choice, (2) when preference bias is observed and when prediction of the resulting choice becomes possible (3) whether human choice is affected when the body orientations are manipulated. We used real non-durable products (cheap snacks and clothing) on a shopping shelf. The results showed that there was a significant preference bias in head orientation at the beginning 1 s when the subjects stood straight toward the shelf, and that the head orientation was more biased toward the selected item than the gaze and the center of pressure at the ending 1 s. Manipulating body orientation did not affect the result of choice. The preference bias detected by observing the head orientation would be useful in marketing science for predicting customers' choice.

Parent Involvement in Head Start and Children’s Development: Indirect Effects Through Parenting

PubMed Central

Ansari, Arya; Gershoff, Elizabeth

2015-01-01

The authors examined the extent to which parent involvement in Head Start programs predicted changes in both parent and child outcomes over time, using a nationally representative sample of 1,020 three-year-old children over 3 waves of the Family and Child Experiences Survey. Center policies that promote involvement predicted greater parent involvement, and parents who were more involved in Head Start centers demonstrated increased cognitive stimulation and decreased spanking and controlling behaviors. In turn, these changes in parenting behaviors were associated with gains in children’s academic and behavioral skills. These findings suggest that Head Start programs should do even more to facilitate parent involvement because it can serve as an important means for promoting both parent and child outcomes. PMID:27022200

Failure mode analysis to predict product reliability.

NASA Technical Reports Server (NTRS)

Zemanick, P. P.

1972-01-01

The failure mode analysis (FMA) is described as a design tool to predict and improve product reliability. The objectives of the failure mode analysis are presented as they influence component design, configuration selection, the product test program, the quality assurance plan, and engineering analysis priorities. The detailed mechanics of performing a failure mode analysis are discussed, including one suggested format. Some practical difficulties of implementation are indicated, drawn from experience with preparing FMAs on the nuclear rocket engine program.

Structure of myosin filaments from relaxed Lethocerus flight muscle by cryo-EM at 6 Å resolution

PubMed Central

Hu, Zhongjun; Taylor, Dianne W.; Reedy, Michael K.; Edwards, Robert J.; Taylor, Kenneth A.

2016-01-01

We describe a cryo–electron microscopy three-dimensional image reconstruction of relaxed myosin II–containing thick filaments from the flight muscle of the giant water bug Lethocerus indicus. The relaxed thick filament structure is a key element of muscle physiology because it facilitates the reextension process following contraction. Conversely, the myosin heads must disrupt their relaxed arrangement to drive contraction. Previous models predicted that Lethocerus myosin was unique in having an intermolecular head-head interaction, as opposed to the intramolecular head-head interaction observed in all other species. In contrast to the predicted model, we find an intramolecular head-head interaction, which is similar to that of other thick filaments but oriented in a distinctly different way. The arrangement of myosin’s long α-helical coiled-coil rod domain has been hypothesized as either curved layers or helical subfilaments. Our reconstruction is the first report having sufficient resolution to track the rod α helices in their native environment at resolutions ~5.5 Å, and it shows that the layer arrangement is correct for Lethocerus. Threading separate paths through the forest of myosin coiled coils are four nonmyosin peptides. We suggest that the unusual position of the heads and the rod arrangement separated by nonmyosin peptides are adaptations for mechanical signal transduction whereby applied tension disrupts the myosin heads as a component of stretch activation. PMID:27704041

Utilizing multiple scale models to improve predictions of extra-axial hemorrhage in the immature piglet.

PubMed

Scott, Gregory G; Margulies, Susan S; Coats, Brittany

2016-10-01

Traumatic brain injury (TBI) is a leading cause of death and disability in the USA. To help understand and better predict TBI, researchers have developed complex finite element (FE) models of the head which incorporate many biological structures such as scalp, skull, meninges, brain (with gray/white matter differentiation), and vasculature. However, most models drastically simplify the membranes and substructures between the pia and arachnoid membranes. We hypothesize that substructures in the pia-arachnoid complex (PAC) contribute substantially to brain deformation following head rotation, and that when included in FE models accuracy of extra-axial hemorrhage prediction improves. To test these hypotheses, microscale FE models of the PAC were developed to span the variability of PAC substructure anatomy and regional density. The constitutive response of these models were then integrated into an existing macroscale FE model of the immature piglet brain to identify changes in cortical stress distribution and predictions of extra-axial hemorrhage (EAH). Incorporating regional variability of PAC substructures substantially altered the distribution of principal stress on the cortical surface of the brain compared to a uniform representation of the PAC. Simulations of 24 non-impact rapid head rotations in an immature piglet animal model resulted in improved accuracy of EAH prediction (to 94 % sensitivity, 100 % specificity), as well as a high accuracy in regional hemorrhage prediction (to 82-100 % sensitivity, 100 % specificity). We conclude that including a biofidelic PAC substructure variability in FE models of the head is essential for improved predictions of hemorrhage at the brain/skull interface.

Derivation and experimental verification of clock synchronization theory

NASA Technical Reports Server (NTRS)

Palumbo, Daniel L.

1994-01-01

The objective of this work is to validate mathematically derived clock synchronization theories and their associated algorithms through experiment. Two theories are considered, the Interactive Convergence Clock Synchronization Algorithm and the Mid-Point Algorithm. Special clock circuitry was designed and built so that several operating conditions and failure modes (including malicious failures) could be tested. Both theories are shown to predict conservative upper bounds (i.e., measured values of clock skew were always less than the theory prediction). Insight gained during experimentation led to alternative derivations of the theories. These new theories accurately predict the clock system's behavior. It is found that a 100% penalty is paid to tolerate worst case failures. It is also shown that under optimal conditions (with minimum error and no failures) the clock skew can be as much as 3 clock ticks. Clock skew grows to 6 clock ticks when failures are present. Finally, it is concluded that one cannot rely solely on test procedures or theoretical analysis to predict worst case conditions. conditions.

Experimental validation of clock synchronization algorithms

NASA Technical Reports Server (NTRS)

Palumbo, Daniel L.; Graham, R. Lynn

1992-01-01

The objective of this work is to validate mathematically derived clock synchronization theories and their associated algorithms through experiment. Two theories are considered, the Interactive Convergence Clock Synchronization Algorithm and the Midpoint Algorithm. Special clock circuitry was designed and built so that several operating conditions and failure modes (including malicious failures) could be tested. Both theories are shown to predict conservative upper bounds (i.e., measured values of clock skew were always less than the theory prediction). Insight gained during experimentation led to alternative derivations of the theories. These new theories accurately predict the behavior of the clock system. It is found that a 100 percent penalty is paid to tolerate worst-case failures. It is also shown that under optimal conditions (with minimum error and no failures) the clock skew can be as much as three clock ticks. Clock skew grows to six clock ticks when failures are present. Finally, it is concluded that one cannot rely solely on test procedures or theoretical analysis to predict worst-case conditions.

Severe hepatic trauma: nonoperative management, definitive repair, or damage control surgery?

PubMed

Leppäniemi, Ari K; Mentula, Panu J; Streng, Mari H; Koivikko, Mika P; Handolin, Lauri E

2011-12-01

Management of severe liver injuries has evolved to include the options for nonoperative management and damage control surgery. The present study analyzes the criteria for choosing between nonoperative management and early surgery, and definitive repair versus damage control strategy during early surgery. In a retrospective analysis of 144 patients with severe (AAST grade III-V) liver injuries (94% blunt trauma), early laparotomy was performed in 50 patients. Initial management was nonoperative in 94 blunt trauma patients with 8 failures. Uni- and multivariate analyses were used to calculate predictor odds ratios (OR) with 95% confidence intervals (CI). Factors associated with early laparotomy in blunt trauma included shock on admission, associated grade IV-V splenic injury, grade IV-V head injury, and grade V liver injury. Only shock was an independent predictor (OR, 26.1; 95% CI, 8.9-77.1; P < 0.001). The presence of a grade IV-V splenic injury predicted damage control strategy (OR infinite; P = 0.021). Failed nonoperative management was associated with grade IV-V splenic injury (OR, 14.00; 95% CI, 1.67-117.55), and shock (OR, 6.82; 95% CI, 1.49-31.29). The hospital mortality rate was 15%; 8 of 21 deaths were liver-related. Shock (OR, 9.3; 95% CI, 2.4-35.8; P = 0.001) and severe head injury (OR, 9.25; 95% CI, 3.0-28.9; P = 0.000) were independent predictors for mortality. In patients with severe liver injury, associated severe splenic injury favors early laparotomy and damage control strategy. Patients who arrive in shock or have an associated severe splenic injury should not be managed nonoperatively. In addition to severe head injury, uncontrollable bleeding from the liver injury is still a major cause of early death.

Pulling smarties out of a bag: a Headed Records analysis of children's recall of their own past beliefs.

PubMed

Barreau, S; Morton, J

1999-11-09

The work reported provides an information processing account of young children's performance on the Smarties task (Perner, J., Leekam, S.R., & Wimmer, H. 1987, Three-year-olds' difficulty with false belief: the case for a conceptual deficit. British Journal of Developmental Psychology, 5, 125-137). In this task, a 3-year-old is shown a Smarties tube and asked about the supposed contents. The true contents, pencils, is then revealed, and the majority of 3-year-olds cannot recall their initial belief that the tube contained Smarties. The theoretical analysis, based on the Headed Records framework (Morton, J., Hammersley, R.J., & Bekerian, D.A. 1985, Headed records: a model for memory and its failures, Cognition, 20, 1-23), focuses on the computational conditions that are required to resolve the Smarties task; on the possible limitations in the developing memory system that may lead to a computational breakdown; and on ways of bypassing such limitations to ensure correct resolution. The design, motivated by this analysis, is a variation on Perner's Smarties task. Instead of revealing the tube's contents immediately after establishing the child's beliefs about it, these contents were then transferred to a bag and a (false) belief about the bag's contents established. Only then were the true contents of the bag revealed. The same procedure (different contents) was carried out a week later. As predicted children's performance was better (a) in the 'tube' condition; and (b) on the second test. Consistent with the proposed analysis, the data show that when the computational demands imposed by the original task are reduced, young children can and do remember what they had thought about the contents of the tube even after its true contents are revealed.

What Predicts Children's Fixed and Growth Intelligence Mind-Sets? Not Their Parents' Views of Intelligence but Their Parents' Views of Failure.

PubMed

Haimovitz, Kyla; Dweck, Carol S

2016-06-01

Children's intelligence mind-sets (i.e., their beliefs about whether intelligence is fixed or malleable) robustly influence their motivation and learning. Yet, surprisingly, research has not linked parents' intelligence mind-sets to their children's. We tested the hypothesis that a different belief of parents-their failure mind-sets-may be more visible to children and therefore more prominent in shaping their beliefs. In Study 1, we found that parents can view failure as debilitating or enhancing, and that these failure mind-sets predict parenting practices and, in turn, children's intelligence mind-sets. Study 2 probed more deeply into how parents display failure mind-sets. In Study 3a, we found that children can indeed accurately perceive their parents' failure mind-sets but not their parents' intelligence mind-sets. Study 3b showed that children's perceptions of their parents' failure mind-sets also predicted their own intelligence mind-sets. Finally, Study 4 showed a causal effect of parents' failure mind-sets on their responses to their children's hypothetical failure. Overall, parents who see failure as debilitating focus on their children's performance and ability rather than on their children's learning, and their children, in turn, tend to believe that intelligence is fixed rather than malleable. © The Author(s) 2016.

Fear of failure and student athletes' interpersonal antisocial behaviour in education and sport.

PubMed

Sagar, Sam S; Boardley, Ian D; Kavussanu, Maria

2011-09-01

BACKGROUND. The link between fear of failure and students' antisocial behaviour has received scant research attention despite associations between fear of failure, hostility, and aggression. Also, the effect of sport experience on antisocial behaviour has not been considered outside of the sport context in adult populations. Further, to date, sex differences have not been considered in fear of failure research. AIMS. To examine whether (a) fear of failure and sport experience predict antisocial behaviour in the university and sport contexts in student athletes, and whether this prediction is the same in males and females; and (b) sex differences exist in antisocial behaviour and fear of failure. SAMPLE. British university student athletes (n= 176 male; n= 155 female; M(age) = 20.11 years). METHOD. Participants completed questionnaires assessing fear of failure, sport experience, and antisocial behaviour in both contexts. RESULTS. (a) Fear of failure and sport experience positively predicted antisocial behaviour in university and sport and the strength of these predictions did not differ between males and females; (b) females reported higher levels of fear of devaluing one's self-estimate than males whereas males reported higher levels of fear of important others losing interest than females. Males engaged more frequently than females in antisocial behaviour in both contexts. CONCLUSIONS. Fear of failure and sport experience may be important considerations when trying to understand antisocial behaviour in student athletes in education and sport; moreover, the potential effect of overall fear of failure and of sport experience on this frequency does not differ by sex. The findings make an important contribution to the fear of failure and morality literatures. ©2010 The British Psychological Society.

Development and testing of texture discriminators for the analysis of trabecular bone in proximal femur radiographs

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

Huber, M. B.; Carballido-Gamio, J.; Fritscher, K.

2009-11-15

Purpose: Texture analysis of femur radiographs may serve as a potential low cost technique to predict osteoporotic fracture risk and has received considerable attention in the past years. A further application of this technique may be the measurement of the quality of specific bone compartments to provide useful information for treatment of bone fractures. Two challenges of texture analysis are the selection of the best suitable texture measure and reproducible placement of regions of interest (ROIs). The goal of this in vitro study was to automatically place ROIs in radiographs of proximal femur specimens and to calculate correlations between variousmore » different texture analysis methods and the femurs' anchorage strength. Methods: Radiographs were obtained from 14 femoral specimens and bone mineral density (BMD) was measured in the femoral neck. Biomechanical testing was performed to assess the anchorage strength in terms of failure load, breakaway torque, and number of cycles. Images were segmented using a framework that is based on the usage of level sets and statistical in-shape models. Five ROIs were automatically placed in the head, upper and lower neck, trochanteric, and shaft compartment in an atlas subject. All other subjects were registered rigidly, affinely, and nonlinearly, and the resulting transformation was used to map the five ROIs onto the individual femora. Results: In each ROI, texture features were extracted using gray level co-occurence matrices (GLCM), third-order GLCM, morphological gradients (MGs), Minkowski dimensions (MDs), Minkowski functionals (MFs), Gaussian Markov random fields, and scaling index method (SIM). Coefficients of determination for each texture feature with parameters of anchorage strength were computed. In a stepwise multiregression analysis, the most predictive parameters were identified in different models. Texture features were highly correlated with anchorage strength estimated by the failure load of up to R{sup 2}=0.61 (MF and MG features, p<0.01) and were partially independent of BMD. The correlations were dependent on the choice of the ROI and the texture measure. The best predictive multiregression model for failure load R{sub adj}{sup 2}=0.86 (p<0.001) included a set of recently developed texture methods (MF and SIM) but excluded bone mineral density and commonly used texture measures. Conclusions: The results suggest that texture information contained in trabecular bone structure visualized on radiographs may predict whether an implant anchorage can be used and may determine the local bone quality from preoperative radiographs.« less

Cybersickness Onset With Reflexive Head Movements During Land and Shipboard Head-Mounted Display Flight Simulation

DTIC Science & Technology

2010-09-09

provoked a predictable OKCR coronal head tilt (p < 0.001) whenever aircraft angle of bank (AOB) increased (Fig. 2). With 90º of simulated AOB, land... head pitch were –3.3 ± 3.8 to 6.8 ± 5.9 on land, and –4.0º ± 5.6 to 7.6º ± 9.7 at sea (Fig. 3). 7 Combined Coronal OKCR ( Head Tilt ) Data for...Land OKCR Figure 2: Coronal OKCR ( head tilt ) vs. angle of bank, during both land based and shipboard HMD/VR flight simulation. Combined

Optimal estimation of spatially variable recharge and transmissivity fields under steady-state groundwater flow. Part 2. Case study

NASA Astrophysics Data System (ADS)

Graham, Wendy D.; Neff, Christina R.

1994-05-01

The first-order analytical solution of the inverse problem for estimating spatially variable recharge and transmissivity under steady-state groundwater flow, developed in Part 1 is applied to the Upper Floridan Aquifer in NE Florida. Parameters characterizing the statistical structure of the log-transmissivity and head fields are estimated from 152 measurements of transmissivity and 146 measurements of hydraulic head available in the study region. Optimal estimates of the recharge, transmissivity and head fields are produced throughout the study region by conditioning on the nearest 10 available transmissivity measurements and the nearest 10 available head measurements. Head observations are shown to provide valuable information for estimating both the transmissivity and the recharge fields. Accurate numerical groundwater model predictions of the aquifer flow system are obtained using the optimal transmissivity and recharge fields as input parameters, and the optimal head field to define boundary conditions. For this case study, both the transmissivity field and the uncertainty of the transmissivity field prediction are poorly estimated, when the effects of random recharge are neglected.

A micromechanics-based strength prediction methodology for notched metal matrix composites

NASA Technical Reports Server (NTRS)

Bigelow, C. A.

1992-01-01

An analytical micromechanics based strength prediction methodology was developed to predict failure of notched metal matrix composites. The stress-strain behavior and notched strength of two metal matrix composites, boron/aluminum (B/Al) and silicon-carbide/titanium (SCS-6/Ti-15-3), were predicted. The prediction methodology combines analytical techniques ranging from a three dimensional finite element analysis of a notched specimen to a micromechanical model of a single fiber. In the B/Al laminates, a fiber failure criteria based on the axial and shear stress in the fiber accurately predicted laminate failure for a variety of layups and notch-length to specimen-width ratios with both circular holes and sharp notches when matrix plasticity was included in the analysis. For the SCS-6/Ti-15-3 laminates, a fiber failure based on the axial stress in the fiber correlated well with experimental results for static and post fatigue residual strengths when fiber matrix debonding and matrix cracking were included in the analysis. The micromechanics based strength prediction methodology offers a direct approach to strength prediction by modeling behavior and damage on a constituent level, thus, explicitly including matrix nonlinearity, fiber matrix debonding, and matrix cracking.

A micromechanics-based strength prediction methodology for notched metal-matrix composites

NASA Technical Reports Server (NTRS)

Bigelow, C. A.

1993-01-01

An analytical micromechanics-based strength prediction methodology was developed to predict failure of notched metal matrix composites. The stress-strain behavior and notched strength of two metal matrix composites, boron/aluminum (B/Al) and silicon-carbide/titanium (SCS-6/Ti-15-3), were predicted. The prediction methodology combines analytical techniques ranging from a three-dimensional finite element analysis of a notched specimen to a micromechanical model of a single fiber. In the B/Al laminates, a fiber failure criteria based on the axial and shear stress in the fiber accurately predicted laminate failure for a variety of layups and notch-length to specimen-width ratios with both circular holes and sharp notches when matrix plasticity was included in the analysis. For the SCS-6/Ti-15-3 laminates, a fiber failure based on the axial stress in the fiber correlated well with experimental results for static and postfatigue residual strengths when fiber matrix debonding and matrix cracking were included in the analysis. The micromechanics-based strength prediction methodology offers a direct approach to strength prediction by modeling behavior and damage on a constituent level, thus, explicitly including matrix nonlinearity, fiber matrix debonding, and matrix cracking.

Failure analysis of thick composite cylinders under external pressure

NASA Technical Reports Server (NTRS)

Caiazzo, A.; Rosen, B. W.

1992-01-01

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

Across-canyon movement of earthquake-induced sediment gravity flow offshore southwestern Taiwan.

NASA Astrophysics Data System (ADS)

Chen, Yen-Ting; Su, Chih-Chieh; Lu, Yi-Wei; Cheng, Yiya

2017-04-01

Caused by the origin of oblique collision between the Eurasian and Philippine Sea Plate, Taiwan Island inevitably faces the destiny to be continuously influenced by frequent and severe earthquake activities. Thus, earthquake-induced sediment gravity flows are common marine geo-hazards in the submarine region of Taiwan. The Pingtung Doublet earthquakes occurred in Dec. 2006 offshore Fangliao Township and two submarine cables were broken at the Fangliao Submarine Canyon (FLSC) head, simultaneously. On the eastern side of the FLSC head, chirp sonar profiles and high-resolution bathymetry data revealed linear seafloor failures along the northwest direction and merged into the FLSC. Moreover, cores taken from the seafloor failure area and in the FLSC also observed thick debrite and turbidite layers at core tops. Nevertheless, in the western side of the FLSC head, local fishermen reported disturbed water just after the Pingtung Doublet earthquakes. Hence series of cores and chirp sonar data were collected at the western side of the FLSC, trying to figure out the linkage of Pingtung Doublet earthquakes induced gravity flow deposits on both sides of the FLSC. The analysis results suggest that the deposits of disturbed water at the western side of FLSC head was caused by the finer suspended sediments separated from the main body at the top of the gravity flow. Our results point out besides the traditional well-known downward transportation in the canyon, the across-canyon movement may also leave stratigraphic records and help us to establish a more complete transportation process of a sediment gravity flow.

Head and Neck Cancer: An Overview

PubMed Central

Stepnick, David; Gilpin, David

2010-01-01

Ablative surgery for malignancies of the upper aerodigestive tract is the most common reason why the reconstructive surgeon is called upon to reconstruct adult head and neck defects. An understanding of the pathophysiology and treatment of head and neck malignancy is vital to the reconstructive surgeon so that restoration of both form and function can be achieved. It is important to understand the behavior of cancers of each head and neck subsite, as staging and ultimately the treatment of tumors from each subsite is different. Historically, the standard treatment of head and neck cancer was surgery and/or primary radiation therapy with surgical salvage for failure. Beginning in the 1980s, advances in chemotherapy and concurrent delivery with radiation offered new options to standard surgical therapy. Over the past two decades, the concept of organ preservation using chemotherapy together with radiation therapy has been definitively established. Yet, even with the strides made over these two decades with chemoradiation, surgical treatment of head and neck cancer and reconstruction thereof will be an important treatment option for the foreseeable future. Therefore, the relationship between the extirpative and reconstructive surgeon is vital, and a clear understanding of the biology and behavior of head and neck malignancy is crucial to successful patient outcomes. PMID:22550431

Baseline Hemodynamics and Response to Contrast Media During Diagnostic Cardiac Catheterization Predict Adverse Events in Heart Failure Patients.

PubMed

Denardo, Scott J; Vock, David M; Schmalfuss, Carsten M; Young, Gregory D; Tcheng, James E; O'Connor, Christopher M

2016-07-01

Contrast media administered during cardiac catheterization can affect hemodynamic variables. However, little is documented about the effects of contrast on hemodynamics in heart failure patients or the prognostic value of baseline and changes in hemodynamics for predicting subsequent adverse events. In this prospective study of 150 heart failure patients, we measured hemodynamics at baseline and after administration of iodixanol or iopamidol contrast. One-year Kaplan-Meier estimates of adverse event-free survival (death, heart failure hospitalization, and rehospitalization) were generated, grouping patients by baseline measures of pulmonary capillary wedge pressure (PCWP) and cardiac index (CI), and by changes in those measures after contrast administration. We used Cox proportional hazards modeling to assess sequentially adding baseline PCWP and change in CI to 5 validated risk models (Seattle Heart Failure Score, ESCAPE [Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness], CHARM [Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity], CORONA [Controlled Rosuvastatin Multinational Trial in Heart Failure], and MAGGIC [Meta-Analysis Global Group in Chronic Heart Failure]). Median contrast volume was 109 mL. Both contrast media caused similarly small but statistically significant changes in most hemodynamic variables. There were 39 adverse events (26.0%). Adverse event rates increased using the composite metric of baseline PCWP and change in CI (P<0.01); elevated baseline PCWP and decreased CI after contrast correlated with the poorest prognosis. Adding both baseline PCWP and change in CI to the 5 risk models universally improved their predictive value (P≤0.02). In heart failure patients, the administration of contrast causes small but significant changes in hemodynamics. Calculating baseline PCWP with change in CI after contrast predicts adverse events and increases the predictive value of existing models. Patients with elevated baseline PCWP and decreased CI after contrast merit greatest concern. © 2016 American Heart Association, Inc.

Use of a Dual Mobility Socket to Manage Total Hip Arthroplasty Instability

PubMed Central

Pibarot, Vincent; Vaz, Gualter; Chevillotte, Christophe; Béjui-Hugues, Jacques

2008-01-01

Unconstrained tripolar hip implants provide an additional bearing using a mobile polyethylene component between the prosthetic head and the outer metal shell. Such a design increases the effective head diameter and therefore is an attractive option in challenging situations of unstable total hip arthroplasties. We report our experience with 54 patients treated using this dual mobility implant in such situations. We ascertained its ability to restore and maintain stability, and examined component loosening and component failure. At a minimum followup of 2.2 years (mean, 4 years; range, 2.2–6.8 years), one hip had redislocated 2 months postoperatively and was managed successfully without reoperation by closed reduction with no additional dislocation. Two patients required revision of the implant because of dislocation at the inner bearing. Technical errors were responsible for these failures. Three patients had reoperations for deep infections. The postoperative radiographs at latest followup showed very satisfactory osseointegration of the acetabular component because no radiolucent line or osteolysis was reported. Use of this unconstrained tripolar design was successful in restoring and maintaining hip stability. We observed encouraging results at short-term followup regarding potential for loosening or mechanical failures. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18780135

Jakub Penson and his studies on acute renal failure during typhus epidemics in Warsaw Ghetto.

PubMed

Rutkowski, Boleslaw

2004-01-01

In the Warsaw Ghetto established by the German Nazis as a special district for Polish Jews in 1940 there were two typhus epidemics. Many patients affected by this disease (1500 during the first and 6500 during second epidemic) were treated at The Department of Infectious Disease of Czyste Hospital headed by Dr Jakub Penson--a Polish physician of Jewish origin. A heroic group of 20 physicians not only treated patients in these tragic circumstances, but also performed in defiance of Nazi prohibition, scientific studies on the clinical course of typhus with special attention on hyperazotemia and renal complication. The results of their observations were presented in 1941-42 during clinical meetings in Czyste Hospital and later published by Penson in 1946 in the Polish Physicians Weekly. Among other clinical statements a description of acute renal failure of extrarenal origin, caused by dehydration and toxic influence of primary disease seems the most important one. It has to be taken into account that acute renal failure appearing during Crush Syndrome was described by Bywaters in 1941. Jakub Penson survived the German Nazi occupation and later become a head of the Internal Medicine Department in Gdansk Medical University and one of the precursors of clinical nephrology in Poland.

Very High Cycle Fatigue Failure Analysis and Life Prediction of Cr-Ni-W Gear Steel Based on Crack Initiation and Growth Behaviors.

PubMed

Deng, Hailong; Li, Wei; Sakai, Tatsuo; Sun, Zhenduo

2015-12-02

The unexpected failures of structural materials in very high cycle fatigue (VHCF) regime have been a critical issue in modern engineering design. In this study, the VHCF property of a Cr-Ni-W gear steel was experimentally investigated under axial loading with the stress ratio of R = -1, and a life prediction model associated with crack initiation and growth behaviors was proposed. Results show that the Cr-Ni-W gear steel exhibits the constantly decreasing S-N property without traditional fatigue limit, and the fatigue strength corresponding to 10⁸ cycles is around 485 MPa. The inclusion-fine granular area (FGA)-fisheye induced failure becomes the main failure mechanism in the VHCF regime, and the local stress around the inclusion play a key role. By using the finite element analysis of representative volume element, the local stress tends to increase with the increase of elastic modulus difference between inclusion and matrix. The predicted crack initiation life occupies the majority of total fatigue life, while the predicted crack growth life is only accounts for a tiny fraction. In view of the good agreement between the predicted and experimental results, the proposed VHCF life prediction model involving crack initiation and growth can be acceptable for inclusion-FGA-fisheye induced failure.

Spatio-temporal propagation of cascading overload failures in spatially embedded networks

NASA Astrophysics Data System (ADS)

Zhao, Jichang; Li, Daqing; Sanhedrai, Hillel; Cohen, Reuven; Havlin, Shlomo

2016-01-01

Different from the direct contact in epidemics spread, overload failures propagate through hidden functional dependencies. Many studies focused on the critical conditions and catastrophic consequences of cascading failures. However, to understand the network vulnerability and mitigate the cascading overload failures, the knowledge of how the failures propagate in time and space is essential but still missing. Here we study the spatio-temporal propagation behaviour of cascading overload failures analytically and numerically on spatially embedded networks. The cascading overload failures are found to spread radially from the centre of the initial failure with an approximately constant velocity. The propagation velocity decreases with increasing tolerance, and can be well predicted by our theoretical framework with one single correction for all the tolerance values. This propagation velocity is found similar in various model networks and real network structures. Our findings may help to predict the dynamics of cascading overload failures in realistic systems.

Spatio-temporal propagation of cascading overload failures in spatially embedded networks

PubMed Central

Zhao, Jichang; Li, Daqing; Sanhedrai, Hillel; Cohen, Reuven; Havlin, Shlomo

2016-01-01

Different from the direct contact in epidemics spread, overload failures propagate through hidden functional dependencies. Many studies focused on the critical conditions and catastrophic consequences of cascading failures. However, to understand the network vulnerability and mitigate the cascading overload failures, the knowledge of how the failures propagate in time and space is essential but still missing. Here we study the spatio-temporal propagation behaviour of cascading overload failures analytically and numerically on spatially embedded networks. The cascading overload failures are found to spread radially from the centre of the initial failure with an approximately constant velocity. The propagation velocity decreases with increasing tolerance, and can be well predicted by our theoretical framework with one single correction for all the tolerance values. This propagation velocity is found similar in various model networks and real network structures. Our findings may help to predict the dynamics of cascading overload failures in realistic systems. PMID:26754065

Point-shear wave elastography predicts liver hypertrophy after portal vein embolization and postoperative liver failure.

PubMed

Hocquelet, A; Frulio, N; Gallo, G; Laurent, C; Papadopoulos, P; Salut, C; Denys, A; Trillaud, H

2018-06-01

To correlate point-shear wave elastography (SWE) with liver hypertrophy after right portal vein embolization (RPVE) and to determine its usefulness in predicting postoperative liver failure in patients undergoing partial liver resection. Point-SWE was performed the day before RPVE in 56 patients (41 men) with a median age of 66 years. The percentage (%) of future remnant liver (FRL) volume increase was defined as: %FRL post -%FRL pre %FRL pre ×100 and assessed on computed tomography performed 4 weeks after RPVE. Median (range) %FRL pre and %FRL post was respectively, 31.5% (12-48%) and 41% (23-61%) (P<0.001), with a median %FRL volume increase of 25.6% (-8; 123%). SWE correlated with %FRL volume increase (P=-0.510; P<0.001). SWV (P=0.003) and %FRL pre (P<0.001) were associated with %FRL volume increase at multivariate regression analysis. Forty-three patients (77%) were operated. Postoperative liver failure occurred in 14 patients (32.5%). Median SWE was different between the group with (1.68m/s) and without liver failure (1.07m/s) (P=0.018). The AUROC of SWE predicting liver failure was 0.724 with a best cut-off of 1.31m/s, corresponding to a sensitivity of 21%, specificity of 96%, positive predictive value 75% and negative predictive value of 72%. SWE was the single independent preoperative variable associated with liver failure. SWE assessed by point-SWE is a simple and useful tool to predict the FRL volume increase and postoperative liver failure in a population of patients with liver tumor. Copyright © 2018 Société française de radiologie. Published by Elsevier Masson SAS. All rights reserved.

Player and Game Characteristics and Head Impacts in Female Youth Ice Hockey Players.

PubMed

Reed, Nick; Taha, Tim; Greenwald, Richard; Keightley, Michelle

2017-08-01

  Despite the growing popularity of ice hockey among female youth and interest in the biomechanics of head impacts in sport, the head impacts sustained by this population have yet to be characterized.   To describe the number of, biomechanical characteristics of, and exposure to head impacts of female youth ice hockey players during competition and to investigate the influences of player and game characteristics on head impacts.   Cohort study.   Twenty-seven female youth ice hockey players (mean age = 12.5 ± 0.52 years) wore instrumented ice hockey helmets during 66 ice hockey games over a 3-year period. Data specific to player, game, and biomechanical head impact characteristics were recorded. A multiple regression analysis identified factors most associated with head impacts of greater frequency and severity.   A total of 436 total head impacts were sustained during 6924 minutes of active ice hockey participation (0.9 ± 0.6 impacts per player per game; range, 0-2.1). A higher body mass index (BMI) significantly predicted a higher number of head impacts sustained per game (P = .008). Linear acceleration of head impacts was greater in older players and those who played the forward position, had a greater BMI, and spent more time on the ice (P = .008), whereas greater rotational acceleration was present in older players who had a greater BMI and played the forward position (P = .008). During tournament games, increased ice time predicted increased severity of head impacts (P = .03).   This study reveals for the first time that head impacts are occurring in female youth ice hockey players, albeit at a lower rate and severity than in male youth ice hockey players, despite the lack of intentional body checking.

An incurable itch

PubMed Central

Smith, Christine H.; Goldman, Ran D.

2012-01-01

Abstract Question Head lice infestations continue to be seen frequently in many communities. Some of these children require multiple treatments before eradication. What are the current treatment recommendations for head lice? Answer Head lice (Pediculus humanus capitis) infestations are common, particularly among school-aged children. In order to minimize louse resistance, insecticide usage, and social stigmatization, diagnosis and treatment should be limited to those with live lice on the scalp. Options for management are predominantly topical therapies or physical removal. Large studies comparing the efficacy of these treatments are lacking. Treatment should be repeated in approximately 7 days if topical insecticides are used or every 2 to 3 days for 2 weeks if wet combing is used. Lice resistance patterns vary widely geographically, and resistance is now the most common cause of treatment failure. PMID:22893334

Pitfalls and Precautions When Using Predicted Failure Data for Quantitative Analysis of Safety Risk for Human Rated Launch Vehicles

NASA Technical Reports Server (NTRS)

Hatfield, Glen S.; Hark, Frank; Stott, James

2016-01-01

Launch vehicle reliability analysis is largely dependent upon using predicted failure rates from data sources such as MIL-HDBK-217F. Reliability prediction methodologies based on component data do not take into account risks attributable to manufacturing, assembly, and process controls. These sources often dominate component level reliability or risk of failure probability. While consequences of failure is often understood in assessing risk, using predicted values in a risk model to estimate the probability of occurrence will likely underestimate the risk. Managers and decision makers often use the probability of occurrence in determining whether to accept the risk or require a design modification. Due to the absence of system level test and operational data inherent in aerospace applications, the actual risk threshold for acceptance may not be appropriately characterized for decision making purposes. This paper will establish a method and approach to identify the pitfalls and precautions of accepting risk based solely upon predicted failure data. This approach will provide a set of guidelines that may be useful to arrive at a more realistic quantification of risk prior to acceptance by a program.

A micro-architectural evaluation of osteoporotic human femoral heads to guide implant placement in proximal femoral fractures.

PubMed

Jenkins, Paul J; Ramaesh, Rishikesan; Pankaj, Pankaj; Patton, James T; Howie, Colin R; Goffin, Jérôme M; Merwe, Andrew van der; Wallace, Robert J; Porter, Daniel E; Simpson, A Hamish

2013-10-01

The micro-architecture of bone has been increasingly recognized as an important determinant of bone strength. Successful operative stabilization of fractures depends on bone strength. We evaluated the osseous micro-architecture and strength of the osteoporotic human femoral head. 6 femoral heads, obtained during arthroplasty surgery for femoral neck fracture, underwent micro-computed tomography (microCT) scanning at 30 μm, and bone volume ratio (BV/TV), trabecular thickness, structural model index, connection density, and degree of anisotropy for volumes of interest throughout the head were derived. A further 15 femoral heads underwent mechanical testing of compressive failure stress of cubes of trabecular bone from different regions of the head. The greatest density and trabecular thickness was found in the central core that extended from the medial calcar to the physeal scar. This region also correlated with the greatest degree of anisotropy and proportion of plate-like trabeculae. In the epiphyseal region, the trabeculae were organized radially from the physeal scar. The weakest area was found at the apex and peripheral areas of the head. The strongest region was at the center of the head. The center of the femoral head contained the strongest trabecular bone, with the thickest, most dense trabeculae. The apical region was weaker. From an anatomical and mechanical point of view, implants that achieve fixation in or below this central core may achieve the most stable fixation during fracture healing.

Product component genealogy modeling and field-failure prediction

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

King, Caleb; Hong, Yili; Meeker, William Q.

Many industrial products consist of multiple components that are necessary for system operation. There is an abundance of literature on modeling the lifetime of such components through competing risks models. During the life-cycle of a product, it is common for there to be incremental design changes to improve reliability, to reduce costs, or due to changes in availability of certain part numbers. These changes can affect product reliability but are often ignored in system lifetime modeling. By incorporating this information about changes in part numbers over time (information that is readily available in most production databases), better accuracy can bemore » achieved in predicting time to failure, thus yielding more accurate field-failure predictions. This paper presents methods for estimating parameters and predictions for this generational model and a comparison with existing methods through the use of simulation. Our results indicate that the generational model has important practical advantages and outperforms the existing methods in predicting field failures.« less

Product component genealogy modeling and field-failure prediction

DOE PAGES

King, Caleb; Hong, Yili; Meeker, William Q.

2016-04-13

Many industrial products consist of multiple components that are necessary for system operation. There is an abundance of literature on modeling the lifetime of such components through competing risks models. During the life-cycle of a product, it is common for there to be incremental design changes to improve reliability, to reduce costs, or due to changes in availability of certain part numbers. These changes can affect product reliability but are often ignored in system lifetime modeling. By incorporating this information about changes in part numbers over time (information that is readily available in most production databases), better accuracy can bemore » achieved in predicting time to failure, thus yielding more accurate field-failure predictions. This paper presents methods for estimating parameters and predictions for this generational model and a comparison with existing methods through the use of simulation. Our results indicate that the generational model has important practical advantages and outperforms the existing methods in predicting field failures.« less

78 FR 29279 - Safety Standard for Carriages and Strollers

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-20

... incorporate automatic or assisted folding and unfolding mechanisms. B. Market Description The majority of... resulted in a bone fracture and head concussion. Parking brake problems related to parking brake failure or assembly resulted in 132 incidents, including eight injuries. Incidents typically occurred when the parking...

45 CFR 1305.10 - Compliance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Compliance. 1305.10 Section 1305.10 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH..., RECRUITMENT, SELECTION, ENROLLMENT AND ATTENDANCE IN HEAD START § 1305.10 Compliance. A grantee's failure to...

45 CFR 1305.10 - Compliance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Compliance. 1305.10 Section 1305.10 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH..., RECRUITMENT, SELECTION, ENROLLMENT AND ATTENDANCE IN HEAD START § 1305.10 Compliance. A grantee's failure to...

Risk factors for the treatment outcome of retreated pulmonary tuberculosis patients in China: an optimized prediction model.

PubMed

Wang, X-M; Yin, S-H; Du, J; Du, M-L; Wang, P-Y; Wu, J; Horbinski, C M; Wu, M-J; Zheng, H-Q; Xu, X-Q; Shu, W; Zhang, Y-J

2017-07-01

Retreatment of tuberculosis (TB) often fails in China, yet the risk factors associated with the failure remain unclear. To identify risk factors for the treatment failure of retreated pulmonary tuberculosis (PTB) patients, we analyzed the data of 395 retreated PTB patients who received retreatment between July 2009 and July 2011 in China. PTB patients were categorized into 'success' and 'failure' groups by their treatment outcome. Univariable and multivariable logistic regression were used to evaluate the association between treatment outcome and socio-demographic as well as clinical factors. We also created an optimized risk score model to evaluate the predictive values of these risk factors on treatment failure. Of 395 patients, 99 (25·1%) were diagnosed as retreatment failure. Our results showed that risk factors associated with treatment failure included drug resistance, low education level, low body mass index (6 months), standard treatment regimen, retreatment type, positive culture result after 2 months of treatment, and the place where the first medicine was taken. An Optimized Framingham risk model was then used to calculate the risk scores of these factors. Place where first medicine was taken (temporary living places) received a score of 6, which was highest among all the factors. The predicted probability of treatment failure increases as risk score increases. Ten out of 359 patients had a risk score >9, which corresponded to an estimated probability of treatment failure >70%. In conclusion, we have identified multiple clinical and socio-demographic factors that are associated with treatment failure of retreated PTB patients. We also created an optimized risk score model that was effective in predicting the retreatment failure. These results provide novel insights for the prognosis and improvement of treatment for retreated PTB patients.

A Review of Statistical Failure Time Models with Application of a Discrete Hazard Based Model to 1Cr1Mo-0.25V Steel for Turbine Rotors and Shafts

PubMed Central

2017-01-01

Producing predictions of the probabilistic risks of operating materials for given lengths of time at stated operating conditions requires the assimilation of existing deterministic creep life prediction models (that only predict the average failure time) with statistical models that capture the random component of creep. To date, these approaches have rarely been combined to achieve this objective. The first half of this paper therefore provides a summary review of some statistical models to help bridge the gap between these two approaches. The second half of the paper illustrates one possible assimilation using 1Cr1Mo-0.25V steel. The Wilshire equation for creep life prediction is integrated into a discrete hazard based statistical model—the former being chosen because of its novelty and proven capability in accurately predicting average failure times and the latter being chosen because of its flexibility in modelling the failure time distribution. Using this model it was found that, for example, if this material had been in operation for around 15 years at 823 K and 130 MPa, the chances of failure in the next year is around 35%. However, if this material had been in operation for around 25 years, the chance of failure in the next year rises dramatically to around 80%. PMID:29039773

On the State of Stress and Failure Prediction Near Planetary Surface Loads

NASA Astrophysics Data System (ADS)

Schultz, R. A.

1996-03-01

The state of stress surrounding planetary surface loads has been used extensively to predict failure of surface rocks and to invert this information for effective elastic thickness. As demonstrated previously, however, several factors can be important including an explicit comparison between model stresses and rock strength as well as the magnitude of calculated stress. As re-emphasized below, failure to take stress magnitudes into account can lead to erroneous predictions of near-surface faulting. This abstract results from discussions on graben formation at Fall 1995 AGU.

Severe Pediatric Head Injury During the Iraq and Afghanistan Conflicts.

PubMed

Klimo, Paul; Ragel, Brian T; Jones, G Morgan; McCafferty, Randall

2015-07-01

Much has been written about injuries sustained by US and coalition soldiers during the Global War on Terrorism campaigns. However, injuries to civilians, including children, have been less well documented. To describe the epidemiologic features and outcomes associated with isolated severe head injury in children during Operations Enduring Freedom and Iraqi Freedom (OEF and OIF). A retrospective review of children (<18 years old) in the Joint Theater Trauma Registry with isolated head injury (defined as an Abbreviated Injury Score Severity Code >3) and treated at a US combat support hospital in Iraq or Afghanistan (2004-2012). The primary outcome was in-hospital mortality. We identified 647 children with severe isolated head injuries: 337 from OEF, 268 from OIF, and 42 nontheater specific. Most were boys (76%; median age = 8 years). Penetrating injuries were most common (60.6%). Overall, 330 (51%) children underwent a craniotomy/craniectomy; 156 (24.1%) succumbed to their injuries. Admission Glasgow Coma Score was predictive of survival among the entire cohort and each of the individual conflicts. Male sex also significantly increased the odds of survival for the entire group and OEF, but not for OIF. Closed-head injury improved the predictive ability of our model but did not reach statistical significance as an independent factor. This is the largest study of combat-related isolated head injuries in children. Admission Glasgow Coma Score and male sex were found to be predictive of survival. Assets to comprehensively care for the pediatric patient should be established early in future conflicts.

Who Drops out of Early Head Start Home Visiting Programs?

ERIC Educational Resources Information Center

Roggman, Lori A.; Cook, Gina A.; Peterson, Carla A.; Raikes, Helen H.

2008-01-01

Research Findings: Early Head Start home-based programs provide services through weekly home visits to families with children up to age 3, but families vary in how long they remain enrolled. In this study of 564 families in home-based Early Head Start programs, "dropping out" was predicted by specific variations in home visits and certain family…

Ultrasonographic fetal head position to predict mode of delivery: a systematic review and bivariate meta-analysis.

PubMed

Verhoeven, C J M; Rückert, M E P F; Opmeer, B C; Pajkrt, E; Mol, B W J

2012-07-01

We performed a systematic review to determine whether sonographic assessment of occipital position of the fetal head can contribute to the prediction of the mode of delivery. We performed a systematic literature search of electronic databases from inception to May 2011. Two reviewers independently extracted data from the included studies. We used a bivariate model to estimate point estimates for sensitivity and specificity curves for the outcome Cesarean delivery. Eligible studies were cohort studies or cross-sectional studies that reported on both the position of the fetal head, as assessed by ultrasound, before or at the beginning of active labor as well as the outcome of labor in women at term. We included 11 primary articles reporting on 5053 women, of whom 898 had a Cesarean section. All studies indicated disappointing values for sensitivity and specificity in the prediction of Cesarean section. Summary point estimates of sensitivity and specificity were 0.39 (95% CI, 0.32-0.48) and 0.71 (95% CI, 0.67-0.74), respectively. Sonographic assessment of occipital position of the fetal head before delivery should not be used in the prediction of mode of delivery. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.

Multiple Fatigue Failure Behaviors and Long-Life Prediction Approach of Carburized Cr-Ni Steel with Variable Stress Ratio

PubMed Central

Deng, Hailong; Li, Wei; Zhao, Hongqiao; Sakai, Tatsuo

2017-01-01

Axial loading tests with stress ratios R of −1, 0 and 0.3 were performed to examine the fatigue failure behavior of a carburized Cr-Ni steel in the long-life regime from 104 to 108 cycles. Results show that this steel represents continuously descending S-N characteristics with interior inclusion-induced failure under R = −1, whereas it shows duplex S-N characteristics with surface defect-induced failure and interior inclusion-induced failure under R = 0 and 0.3. The increasing tension eliminates the effect of compressive residual stress and promotes crack initiation from the surface or interior defects in the carburized layer. The FGA (fine granular area) formation greatly depends on the number of loading cycles, but can be inhibited by decreasing the compressive stress. Based on the evaluation of the stress intensity factor at the crack tip, the surface and interior failures in the short life regime can be characterized by the crack growth process, while the interior failure with the FGA in the long life regime can be characterized by the crack initiation process. In view of the good agreement between predicted and experimental results, the proposed approach can be well utilized to predict fatigue lives associated with interior inclusion-FGA-fisheye induced failure, interior inclusion-fisheye induced failure, and surface defect induced failure. PMID:28906454

Effect of an adhesive resin luting agent on the dowel-head retention of three different core materials.

PubMed

Aksoy, Gokhan; Cotert, H Serdar; Korkut, Levent

2005-05-01

A dowel-and-core restoration may fail due to failure at either the dowel-tooth or dowel head-core material interface. Long-term clinical success of a dowel-and-core restoration depends on retention of both the dowel to the tooth and the dowel head to the core material. Thus, strengthening of the dowel head-core interface is important. This study evaluated the retention between a prefabricated dowel and 3 different core materials with or without a dual-polymerized adhesive resin luting agent. Sixty prefabricated dowels (Gold Plated Anchorage Post) were divided into 3 groups (n=20) consisting of 1 of 3 core materials, amalgam (Standalloy F), light-polymerized resin composite (Clearfil Ray), or glass ionomer (Chelon-Silver). Each core group was divided into 2 subgroups (n=10), and a dual-polymerized adhesive resin luting agent (Panavia F) was applied to the dowel heads of 1 of these subgroups before application of the core material. The manufacturing procedure was standardized by using a plastic index (4.5-mm internal diameter and 5-mm height) and a custom-made dowel holder, which held the dowel head. Prepared specimens were stored in water at room temperature for 3 months and then loaded to fracture in a universal testing machine with a crosshead speed of 0.05 mm/min until failure. Bond strengths were recorded (MPa). Data were analyzed with 2-way analysis of variance (ANOVA) in a 2 x 3 factorial randomized design (alpha=.05). Afterward, core material differences were computed with 1-way ANOVA for both of the bonded and nonbonded groups. Post hoc multiple comparisons were made with the Dunnett C multiple range test. Dowel-head retention values (MPa) of the tested core materials (mean +/- SD) from the highest to the lowest were as follows: bonded amalgam core, 296.1 +/- 108; bonded composite core, 284.3 +/- 38.3; nonbonded composite core, 177.0 +/- 53.7; nonbonded amalgam core, 128.5 +/- 35.0; bonded glass-ionomer core (GIC), 128.0 +/- 24.5; nonbonded GIC, 61.8 +/- 13.3. Two-way ANOVA revealed significant differences between the core material groups and between the bonded and nonbonded groups (P <.001). The interaction between the core material and bond variables was also significant (P =.018). One-way ANOVA revealed statistically significant differences between the bonded (P <.001) and also between the nonbonded core material groups (P <.001). Post hoc multiple comparisons showed that the dowel-head retention of the GIC was significantly weaker than the post-head retention for amalgam and resin composite, whether bonded or not. Within the limitations of this study, the adhesive resin luting agent tested appeared to have a significant strengthening effect on the dowel-head retention of the core materials.

Head injury trends and helmet use in skiers and snowboarders in Western Canada, 2008-2009 to 2012-2013: an ecological study.

PubMed

Dickson, T J; Trathen, S; Terwiel, F A; Waddington, G; Adams, R

2017-02-01

This research explored associations between helmet use and head injuries in snowsports by investigating reported snowsport injuries in Western Canada from 2008-2009 to 2012-2013. The key finding was that increased helmet use (from 69% to 80%) was not associated with a reduction in reported head injuries. Over the study period, the average rate of reported head injuries was 0.2/1000 skier visits, with a statistically significant variation (P < 0.001). The line of best fit showed an non-significant upward trend (P = 0.13). Lacerations were the only subcategory of head injuries that decreased significantly with helmet use. A higher proportion of people who reported a head injury were wearing a helmet than for injuries other than to the head. Skiers were more likely to report a head injury when wearing a helmet than snowboarders (P < 0.001 cf. P = 0.22). There were significant differences in characteristics of helmet and non-helmet wearers. Helmet wearers were more likely to be: young adults (P < 0.001); beginner/novices (P = 0.004); and snowboarders (P < 0.001), but helmet wearing was not associated with gender (P = 0.191). Further research is needed to explore the possible reasons for the failure of helmets to reduce head injuries, for example, increased reporting of head injuries and increased risk-taking combined with over-rating of the helmets' protection. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Risk prediction models for graft failure in kidney transplantation: a systematic review.

PubMed

Kaboré, Rémi; Haller, Maria C; Harambat, Jérôme; Heinze, Georg; Leffondré, Karen

2017-04-01

Risk prediction models are useful for identifying kidney recipients at high risk of graft failure, thus optimizing clinical care. Our objective was to systematically review the models that have been recently developed and validated to predict graft failure in kidney transplantation recipients. We used PubMed and Scopus to search for English, German and French language articles published in 2005-15. We selected studies that developed and validated a new risk prediction model for graft failure after kidney transplantation, or validated an existing model with or without updating the model. Data on recipient characteristics and predictors, as well as modelling and validation methods were extracted. In total, 39 articles met the inclusion criteria. Of these, 34 developed and validated a new risk prediction model and 5 validated an existing one with or without updating the model. The most frequently predicted outcome was graft failure, defined as dialysis, re-transplantation or death with functioning graft. Most studies used the Cox model. There was substantial variability in predictors used. In total, 25 studies used predictors measured at transplantation only, and 14 studies used predictors also measured after transplantation. Discrimination performance was reported in 87% of studies, while calibration was reported in 56%. Performance indicators were estimated using both internal and external validation in 13 studies, and using external validation only in 6 studies. Several prediction models for kidney graft failure in adults have been published. Our study highlights the need to better account for competing risks when applicable in such studies, and to adequately account for post-transplant measures of predictors in studies aiming at improving monitoring of kidney transplant recipients. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Method and apparatus for faulty memory utilization

DOEpatents

Cher, Chen-Yong; Andrade Costa, Carlos H.; Park, Yoonho; Rosenburg, Bryan S.; Ryu, Kyung D.

2016-04-19

A method for faulty memory utilization in a memory system includes: obtaining information regarding memory health status of at least one memory page in the memory system; determining an error tolerance of the memory page when the information regarding memory health status indicates that a failure is predicted to occur in an area of the memory system affecting the memory page; initiating a migration of data stored in the memory page when it is determined that the data stored in the memory page is non-error-tolerant; notifying at least one application regarding a predicted operating system failure and/or a predicted application failure when it is determined that data stored in the memory page is non-error-tolerant and cannot be migrated; and notifying at least one application regarding the memory failure predicted to occur when it is determined that data stored in the memory page is error-tolerant.

Role of muscle pulleys in producing eye position-dependence in the angular vestibuloocular reflex: a model-based study

NASA Technical Reports Server (NTRS)

Thurtell, M. J.; Kunin, M.; Raphan, T.; Wall, C. C. (Principal Investigator)

2000-01-01

It is well established that the head and eye velocity axes do not always align during compensatory vestibular slow phases. It has been shown that the eye velocity axis systematically tilts away from the head velocity axis in a manner that is dependent on eye-in-head position. The mechanisms responsible for producing these axis tilts are unclear. In this model-based study, we aimed to determine whether muscle pulleys could be involved in bringing about these phenomena. The model presented incorporates semicircular canals, central vestibular pathways, and an ocular motor plant with pulleys. The pulleys were modeled so that they brought about a rotation of the torque axes of the extraocular muscles that was a fraction of the angle of eye deviation from primary position. The degree to which the pulleys rotated the torque axes was altered by means of a pulley coefficient. Model input was head velocity and initial eye position data from passive and active yaw head impulses with fixation at 0 degrees, 20 degrees up and 20 degrees down, obtained from a previous experiment. The optimal pulley coefficient required to fit the data was determined by calculating the mean square error between data and model predictions of torsional eye velocity. For active head impulses, the optimal pulley coefficient varied considerably between subjects. The median optimal pulley coefficient was found to be 0.5, the pulley coefficient required for producing saccades that perfectly obey Listing's law when using a two-dimensional saccadic pulse signal. The model predicted the direction of the axis tilts observed in response to passive head impulses from 50 ms after onset. During passive head impulses, the median optimal pulley coefficient was found to be 0.21, when roll gain was fixed at 0.7. The model did not accurately predict the alignment of the eye and head velocity axes that was observed early in the response to passive head impulses. We found that this alignment could be well predicted if the roll gain of the angular vestibuloocular reflex was modified during the initial period of the response, while pulley coefficient was maintained at 0.5. Hence a roll gain modification allows stabilization of the retinal image without requiring a change in the pulley effect. Our results therefore indicate that the eye position-dependent velocity axis tilts could arise due to the effects of the pulleys and that a roll gain modification in the central vestibular structures may be responsible for countering the pulley effect.

Generation of Accurate Lateral Boundary Conditions for a Surface-Water Groundwater Interaction Model

NASA Astrophysics Data System (ADS)

Khambhammettu, P.; Tsou, M.; Panday, S. M.; Kool, J.; Wei, X.

2010-12-01

The 106 mile long Peace River in Florida flows south from Lakeland to Charlotte Harbor and has a drainage basin of approximately 2,350 square miles. A long-term decline in stream flows and groundwater potentiometric levels has been observed in the region. Long-term trends in rainfall, along with effects of land use changes on runoff, surface-water storage, recharge and evapotranspiration patterns, and increased groundwater and surface-water withdrawals have contributed to this decline. The South West Florida Water Management District (SWFWMD) has funded the development of the Peace River Integrated Model (PRIM) to assess the effects of land use, water use, and climatic changes on stream flows and to evaluate the effectiveness of various management alternatives for restoring stream flows. The PRIM was developed using MODHMS, a fully integrated surface-water groundwater flow and transport simulator developed by HydroGeoLogic, Inc. The development of the lateral boundary conditions (groundwater inflow and outflow) for the PRIM in both historical and predictive contexts is discussed in this presentation. Monthly-varying specified heads were used to define the lateral boundary conditions for the PRIM. These head values were derived from the coarser Southern District Groundwater Model (SDM). However, there were discrepancies between the simulated SDM heads and measured heads: the likely causes being spatial (use of a coarser grid) and temporal (monthly average pumping rates and recharge rates) approximations in the regional SDM. Finer re-calibration of the SDM was not feasible, therefore, an innovative approach was adopted to remove the discrepancies. In this approach, point discrepancies/residuals between the observed and simulated heads were kriged with an appropriate variogram to generate a residual surface. This surface was then added to the simulated head surface of the SDM to generate a corrected head surface. This approach preserves the trends associated with groundwater pumping / recharge in the SDM and adds the kriged residual surface as variations back to the trend. The variations could be from the scale effects of grid resolution and from the temporal averaging of stresses (pumping, recharge, etc.,). The validity of the approach is demonstrated by visual and statistical comparison of the observed and simulated heads before and after correction. For predictive simulations, an Artificial Neural Network was trained to predict heads at monitoring wells based on precipitation and pumping. These predicted head values could then be used as surrogate observations for correcting the results of the regional SDM. In summary, an appropriate approach to link a regional groundwater model to a detailed surface-water groundwater interaction model is demonstrated with an example.

Modeling of BN Lifetime Prediction of a System Based on Integrated Multi-Level Information

PubMed Central

Wang, Xiaohong; Wang, Lizhi

2017-01-01

Predicting system lifetime is important to ensure safe and reliable operation of products, which requires integrated modeling based on multi-level, multi-sensor information. However, lifetime characteristics of equipment in a system are different and failure mechanisms are inter-coupled, which leads to complex logical correlations and the lack of a uniform lifetime measure. Based on a Bayesian network (BN), a lifetime prediction method for systems that combine multi-level sensor information is proposed. The method considers the correlation between accidental failures and degradation failure mechanisms, and achieves system modeling and lifetime prediction under complex logic correlations. This method is applied in the lifetime prediction of a multi-level solar-powered unmanned system, and the predicted results can provide guidance for the improvement of system reliability and for the maintenance and protection of the system. PMID:28926930

Modeling of BN Lifetime Prediction of a System Based on Integrated Multi-Level Information.

PubMed

Wang, Jingbin; Wang, Xiaohong; Wang, Lizhi

2017-09-15

Predicting system lifetime is important to ensure safe and reliable operation of products, which requires integrated modeling based on multi-level, multi-sensor information. However, lifetime characteristics of equipment in a system are different and failure mechanisms are inter-coupled, which leads to complex logical correlations and the lack of a uniform lifetime measure. Based on a Bayesian network (BN), a lifetime prediction method for systems that combine multi-level sensor information is proposed. The method considers the correlation between accidental failures and degradation failure mechanisms, and achieves system modeling and lifetime prediction under complex logic correlations. This method is applied in the lifetime prediction of a multi-level solar-powered unmanned system, and the predicted results can provide guidance for the improvement of system reliability and for the maintenance and protection of the system.

Prediction of failure pressure and leak rate of stress corrosion.

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

Majumdar, S.; Kasza, K.; Park, J. Y.

2002-06-24

An ''equivalent rectangular crack'' approach was employed to predict rupture pressures and leak rates through laboratory generated stress corrosion cracks and steam generator tubes removed from the McGuire Nuclear Station. Specimen flaws were sized by post-test fractography in addition to a pre-test advanced eddy current technique. The predicted and observed test data on rupture and leak rate are compared. In general, the test failure pressures and leak rates are closer to those predicted on the basis of fractography than on nondestructive evaluation (NDE). However, the predictions based on NDE results are encouraging, particularly because they have the potential to determinemore » a more detailed geometry of ligamented cracks, from which failure pressure and leak rate can be more accurately predicted. One test specimen displayed a time-dependent increase of leak rate under constant pressure.« less

Neuropsychological impairment as a consequence of football (soccer) play and football heading: preliminary analyses and report on university footballers.

PubMed

Rutherford, A; Stephens, R; Potter, D; Fernie, G

2005-04-01

Previous research has claimed neuropsychological impairment occurs as a result of professional and amateur football play, and, specifically, football heading. However, much of this research exhibits substantial methodological problems. By investigating less committed amateur level footballers, the current study sought to gain some insight into the developmental history of any neuropsychological consequences of football play. University football, rugby and noncontact sports players were compared on a range of biographical and neuropsychological test variables. While playing their chosen sports, rugby players sustained many more head injuries than footballers and noncontact sportsmen, but footballers did not sustain significantly more head injuries than noncontact sportsmen. The number of head injuries sustained predicted Trails B and TAP Divided Attention latencies in a positive fashion. After controlling for the number of head injuries sustained, sport group effects were detected with TAP Divided Attention accuracy scores, with footballers exhibiting poorest performance. After controlling for the number of head injuries sustained, the total amount of heading done by footballers predicted the number of Wisconsin Card Sorting category shifts in a negative fashion. Nevertheless, over interpretation of all of these results should be resisted because of the exploratory nature of the analyses and the possibility that the sport groups may differ in ways other than just the nature of their sports activities.

Factors Influencing Helmet Use, Head Injury, and Hospitalization Among Children Involved in Skateboarding and Snowboarding Accidents.

PubMed

Sadeghian, Homa; Nguyen, Brian; Huynh, Nhan; Rouch, Joshua; Lee, Steven L; Bazargan-Hejazi, Shahrzad

2017-01-01

Up to 75% of skateboarders and snowboarders admitted to the hospital sustain head injuries. It is unclear why not all children and teenagers wear helmets while snowboarding and skateboarding given the protection they afford. To report on the prevalence of, and factors associated with, skateboarding and snowboarding in injured children and to explore factors that influence helmet use, head injury, and hospitalization in this sample. A cross-sectional study of skateboard- and snowboard-associated injuries from 2003 to 2012 among individuals younger than age 18 years using National Electronic Injury Surveillance System (NEISS) data from approximately 100 hospitals. Helmet use, head injury, and hospitalization. Of 1742 patients in the study, 852 (48.9%) and 890 (51.1%) were skateboarders and snowboarders, respectively. Overall, 907 (52.1%) did not use helmets, and 704 (40.4%) sustained head injuries. Multiple logistic regression analysis showed that age, race/ethnicity, location of boarding, and engaging in skateboarding influenced helmet use. Sex, race/ethnicity, helmet use, and skateboarding predicted head injury. Age, sex, skateboarding, and head injury predicted hospital admission. Statistically significant differences exist in helmet use, head injury, and hospitalization rates between skateboarders and snowboarders. Our findings suggest that injury prevention and outreach programs are needed to increase helmet use and reduce the risk of head injury and hospitalization in skateboarders and other at-risk groups. Further studies are needed to clarify the association between race/ethnicity and helmet use among skateboarders and snowboarders.

The 2006 Pingtung Earthquake Doublet Triggered Seafloor Liquefaction: Revisiting the Evidence with Ultra-High-Resolution Seafloor Mapping

NASA Astrophysics Data System (ADS)

Su, C. C.; Chen, T. T.; Paull, C. K.; Gwiazda, R.; Chen, Y. H.; Lundsten, E. M.; Caress, D. W.; Hsu, H. H.; Liu, C. S.

2017-12-01

Since Heezen and Ewing's (1952) classic work on the 1929 Grand Banks earthquake, the damage of submarine cables have provided critical information on the nature of seafloor mass movements or sediment density flows. However, the understanding of the local conditions that lead to particular seafloor failures earthquakes trigger is still unclear. The Decemeber 26, 2006 Pingtung earthquake doublet which occurred offshore of Fangliao Township, southwestern Taiwan damaged 14 submarine cables between Gaoping slope to the northern terminus of the Manila Trench. Local fisherman reported disturbed waters at the head of the Fangliao submarine canyon, which lead to conjectures that eruptions of mud volcanoes which are common off the southwestern Taiwan. Geophysical survey were conducted to evaluate this area which revealed a series of faults, liquefied strata, pockmarks and acoustically transparent sediments with doming structures which may relate to the submarine groundwater discharge. Moreover, shipboard multi-beam bathymetric survey which was conducted at the east of Fangliao submarine canyon head shows over 10 km2 area with maximum depth around 40 m of seafloor subsidence after Pingtung earthquake. The north end of the subsidence is connected to the Fangliao submarine canyon where the first cable failed after Pingtung earthquake. The evidences suggests the earthquake triggered widespeard liquefaction and generated debris flows within Fangliao submarine canyon. In May 2017, an IONTU-MBARI Joint Survey Cruise (OR1-1163) was conducted on using MBARI Mapping AUV and miniROV to revisit the area where the cable damaged after Pingtung earthquake. From newly collected ultra-high-resolution (1-m lateral resolution) bathymetry data, the stair-stepped morphology is observed at the edge of canyon. The comet-shaped depressions are located along the main headwall of the seafloor failure. The new detailed bathymetry reveal details which suggest Fangliao submarine canyon head is preconditioned to failure. Submarine groundwater discharge from the Pingtung Plain and the southern tip of the Central Mountains is inferred to generate elevated pore pressures leaving the area susceptible to liquefaction and failure when triggered by earthquakes.

Simulations of the failure scenarios of the crab cavities for the nominal scheme of the LHC

NASA Astrophysics Data System (ADS)

Yee, B.; Calaga, R.; Zimmermann, F.; Lopez, R.

2012-02-01

The Crab Cavity (CC) represents a possible solution to the problem of the reduction in luminosity due to the impact angle of two colliding beams. The CC is a Radio Frequency (RF) superconducting cavity which applies a transversal kick into a bunch of particles producing a rotation in order to have a head-on collision to improve the luminosity. For this reason people at the Beams Department-Accelerators & Beams Physics of CERN (BE-ABP) have studied the implementation of the CC scheme at the LHC. It is essential to study the failure scenarios and the damage that can be produced to the lattice devices. We have performed simulations of these failures for the nominal scheme.

Artificial neural network approach to predict surgical site infection after free-flap reconstruction in patients receiving surgery for head and neck cancer.

PubMed

Kuo, Pao-Jen; Wu, Shao-Chun; Chien, Peng-Chen; Chang, Shu-Shya; Rau, Cheng-Shyuan; Tai, Hsueh-Ling; Peng, Shu-Hui; Lin, Yi-Chun; Chen, Yi-Chun; Hsieh, Hsiao-Yun; Hsieh, Ching-Hua

2018-03-02

The aim of this study was to develop an effective surgical site infection (SSI) prediction model in patients receiving free-flap reconstruction after surgery for head and neck cancer using artificial neural network (ANN), and to compare its predictive power with that of conventional logistic regression (LR). There were 1,836 patients with 1,854 free-flap reconstructions and 438 postoperative SSIs in the dataset for analysis. They were randomly assigned tin ratio of 7:3 into a training set and a test set. Based on comprehensive characteristics of patients and diseases in the absence or presence of operative data, prediction of SSI was performed at two time points (pre-operatively and post-operatively) with a feed-forward ANN and the LR models. In addition to the calculated accuracy, sensitivity, and specificity, the predictive performance of ANN and LR were assessed based on area under the curve (AUC) measures of receiver operator characteristic curves and Brier score. ANN had a significantly higher AUC (0.892) of post-operative prediction and AUC (0.808) of pre-operative prediction than LR (both P <0.0001). In addition, there was significant higher AUC of post-operative prediction than pre-operative prediction by ANN (p<0.0001). With the highest AUC and the lowest Brier score (0.090), the post-operative prediction by ANN had the highest overall predictive performance. The post-operative prediction by ANN had the highest overall performance in predicting SSI after free-flap reconstruction in patients receiving surgery for head and neck cancer.

If It Is Stored in My Memory I Will Surely Retrieve It: Anatomy of a Metacognitive Belief

ERIC Educational Resources Information Center

Kornell, Nate

2015-01-01

Retrieval failures--moments when a memory will not come to mind--are a universal human experience. Yet many laypeople believe human memory is a reliable storage system in which a stored memory should be accessible. I predicted that people would see retrieval failures as aberrations and predict that fewer retrieval failures would happen in the…

Prediction of Brittle Failure for TBM Tunnels in Anisotropic Rock: A Case Study from Northern Norway

NASA Astrophysics Data System (ADS)

Dammyr, Øyvind

2016-06-01

Prediction of spalling and rock burst is especially important for hard rock TBM tunneling, because failure can have larger impact than in a drill and blast tunnel and ultimately threaten excavation feasibility. The majority of research on brittle failure has focused on rock types with isotropic behavior. This paper gives a review of existing theory and its application before a 3.5-m-diameter TBM tunnel in foliated granitic gneiss is used as a case to study brittle failure characteristics of anisotropic rock. Important aspects that should be considered in order to predict brittle failure in anisotropic rock are highlighted. Foliation is responsible for considerable strength anisotropy and is believed to influence the preferred side of v-shaped notch development in the investigated tunnel. Prediction methods such as the semi- empirical criterion, the Hoek- Brown brittle parameters, and the non-linear damage initiation and spalling limit method give reliable results; but only as long as the angle between compression axis and foliation in uniaxial compressive tests is relevant, dependent on the relation between tunnel trend/plunge, strike/dip of foliation, and tunnel boundary stresses. It is further demonstrated that local in situ stress variations, for example, due to the presence of discontinuities, can have profound impact on failure predictions. Other carefully documented case studies into the brittle failure nature of rock, in particular anisotropic rock, are encouraged in order to expand the existing and relatively small database. This will be valuable for future TBM planning and construction stages in highly stressed brittle anisotropic rock.

Prediction of Composite Laminate Strength Properties Using a Refined Zigzag Plate Element

NASA Technical Reports Server (NTRS)

Barut, Atila; Madenci, Erdogan; Tessler, Alexander

2013-01-01

This study presents an approach that uses the refined zigzag element, RZE(exp2,2) in conjunction with progressive failure criteria to predict the ultimate strength of composite laminates based on only ply-level strength properties. The methodology involves four major steps: (1) Determination of accurate stress and strain fields under complex loading conditions using RZE(exp2,2)-based finite element analysis, (2) Determination of failure locations and failure modes using the commonly accepted Hashin's failure criteria, (3) Recursive degradation of the material stiffness, and (4) Non-linear incremental finite element analysis to obtain stress redistribution until global failure. The validity of this approach is established by considering the published test data and predictions for (1) strength of laminates under various off-axis loading, (2) strength of laminates with a hole under compression, and (3) strength of laminates with a hole under tension.

A quantitative model of honey bee colony population dynamics.

PubMed

Khoury, David S; Myerscough, Mary R; Barron, Andrew B

2011-04-18

Since 2006 the rate of honey bee colony failure has increased significantly. As an aid to testing hypotheses for the causes of colony failure we have developed a compartment model of honey bee colony population dynamics to explore the impact of different death rates of forager bees on colony growth and development. The model predicts a critical threshold forager death rate beneath which colonies regulate a stable population size. If death rates are sustained higher than this threshold rapid population decline is predicted and colony failure is inevitable. The model also predicts that high forager death rates draw hive bees into the foraging population at much younger ages than normal, which acts to accelerate colony failure. The model suggests that colony failure can be understood in terms of observed principles of honey bee population dynamics, and provides a theoretical framework for experimental investigation of the problem.

Submarine landslides in the Santa Barbara Channel as potential tsunami sources

USGS Publications Warehouse

Greene, H. Gary; Murai, L.Y.; Watts, P.; Maher, N.A.; Fisher, M.A.; Paull, C.E.; Eichhubl, P.

2006-01-01

Recent investigations using the Monterey Bay Aquarium Research Institutes (MBARI) Remotely Operated Vehicles (ROVs) "Ventana" and "Tiburon" and interpretation of MBARI's EM 300 30 kHz multibeam bathymetric data show that the northern flank of the Santa Barbara Basin has experienced massive slope failures. Of particular concern is the large (130 km2) Goleta landslide complex located off Coal Oil Point near the town of Goleta, that measures 14.6-km long extending from a depth of 90 m to nearly 574 m deep and is 10.5 km wide. We estimate that approximately 1.75 km3 has been displaced by this slide during the Holocene. This feature is a complex compound submarine landslide that contains both surfical slump blocks and mud flows in three distinct segments. Each segment is composed of a distinct head scarp, down-dropped head block and a slide debris lobe. The debris lobes exhibit hummocky topography in the central areas that appear to result from compression during down slope movement. The toes of the western and eastern lobes are well defined in the multibeam image, whereas the toe of the central lobe is less distinct. Continuous seismic reflection profiles show that many buried slide debris lobes exist and comparison of the deformed reflectors with ODP Drill Site 149, Hole 893 suggest that at least 200 000 years of failure have occurred in the area (Fisher et al., 2005a). Based on our interpretation of the multibeam bathymetry and seismic reflection profiles we modeled the potential tsunami that may have been produced from one of the three surfical lobes of the Goleta slide. This model shows that a 10 m high wave could have run ashore along the cliffs of the Goleta shoreline. Several other smaller (2 km2 and 4 km2) slides are located on the northern flank of the Santa Barbara Basin, both to the west and east of Goleta slide and on the Concepcion fan along the western flank of the basin. One slide, named the Gaviota slide, is 3.8 km2, 2.6 km long and 1.7 km wide. A distinct narrow scar extends from near the eastern head wall of this slide for over 2 km eastward toward the Goleta slide and may represent either an incipient failure or a remnant of a previous failure. Push cores collected within the main head scar of this slide consisted of hydrogen sulfide bearing mud, possibly suggesting active fluid seepage and a vibra-core penetrated ???50 cm of recent sediment overlying colluvium or landslide debris confirming the age of ???300 years as proposed by Lee et al. (2004). However, no seeps or indications of recent movement were observed during our ROV investigation within this narrow head scar indicating that seafloor in the scar is draped with mud. ?? 2006 Author(s). This work is licensed under a Creative Commons License.

Endothelial cell density to predict endothelial graft failure after penetrating keratoplasty.

PubMed

Lass, Jonathan H; Sugar, Alan; Benetz, Beth Ann; Beck, Roy W; Dontchev, Mariya; Gal, Robin L; Kollman, Craig; Gross, Robert; Heck, Ellen; Holland, Edward J; Mannis, Mark J; Raber, Irving; Stark, Walter; Stulting, R Doyle

2010-01-01

To determine whether preoperative and/or postoperative central endothelial cell density (ECD) and its rate of decline postoperatively are predictive of graft failure caused by endothelial decompensation following penetrating keratoplasty to treat a moderate-risk condition, principally, Fuchs dystrophy or pseudophakic corneal edema. In a subset of Cornea Donor Study participants, a central reading center determined preoperative and postoperative ECD from available specular images for 17 grafts that failed because of endothelial decompensation and 483 grafts that did not fail. Preoperative ECD was not predictive of graft failure caused by endothelial decompensation (P = .91). However, the 6-month ECD was predictive of subsequent failure (P < .001). Among those that had not failed within the first 6 months, the 5-year cumulative incidence (+/-95% confidence interval) of failure was 13% (+/-12%) for the 33 participants with a 6-month ECD of less than 1700 cells/mm(2) vs 2% (+/-3%) for the 137 participants with a 6-month ECD of 2500 cells/mm(2) or higher. After 5 years' follow-up, 40 of 277 participants (14%) with a clear graft had an ECD below 500 cells/mm(2). Preoperative ECD is unrelated to graft failure from endothelial decompensation, whereas there is a strong correlation of ECD at 6 months with graft failure from endothelial decompensation. A graft can remain clear after 5 years even when the ECD is below 500 cells/mm(2).

Patient characteristics as predictors of clinical outcome of distraction in treatment of severe ankle osteoarthritis.

PubMed

Marijnissen, A C A; Hoekstra, M C L; Pré, B C du; van Roermund, P M; van Melkebeek, J; Amendola, A; Maathuis, P; Lafeber, F P J G; Welsing, P M J

2014-01-01

Osteoarthritis (OA) is a slowly progressive joint disease. Joint distraction can be a treatment of choice in case of severe OA. Prediction of failure will facilitate implementation of joint distraction in clinical practice. Patients with severe ankle OA, who underwent joint distraction were included. Survival analysis was performed over 12 years (n = 25 after 12 years). Regression analyses were used to predict failures and clinical benefit at 2 years after joint distraction (n = 111). Survival analysis showed that 44% of the patients failed, 17% within 2 years and 37% within 5 years after joint distraction (n = 48 after 5 years). Survival analysis in subgroups showed that the percentage failure was only different in women (30% after 2 years) versus men (after 11 years still no 30% failure). In the multivariate analyses female gender was predictive for failure 2 years after joint distraction. Gender and functional disability at baseline predicted more pain. Functional disability and pain at baseline were associated with more functional disability. Joint distraction shows a long-term clinical beneficial outcome. However, failure rate is considerable over the years. Female patients have a higher chance of failure during follow-up. Unfortunately, not all potential predictors could be investigated and other clinically significant predictors were not found. © 2013 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Electrical stimulation of rhesus monkey nucleus reticularis gigantocellularis. II. Effects on metrics and kinematics of ongoing gaze shifts to visual targets.

PubMed

Freedman, Edward G; Quessy, Stephan

2004-06-01

Saccade kinematics are altered by ongoing head movements. The hypothesis that a head movement command signal, proportional to head velocity, transiently reduces the gain of the saccadic burst generator (Freedman 2001, Biol Cybern 84:453-462) can account for this observation. Using electrical stimulation of the rhesus monkey nucleus reticularis gigantocellularis (NRG) to alter the head contribution to ongoing gaze shifts, two critical predictions of this gaze control hypothesis were tested. First, this hypothesis predicts that activation of the head command pathway will cause a transient reduction in the gain of the saccadic burst generator. This should alter saccade kinematics by initially reducing velocity without altering saccade amplitude. Second, because this hypothesis does not assume that gaze amplitude is controlled via feedback, the added head contribution (produced by NRG stimulation on the side ipsilateral to the direction of an ongoing gaze shift) should lead to hypermetric gaze shifts. At every stimulation site tested, saccade kinematics were systematically altered in a way that was consistent with transient reduction of the gain of the saccadic burst generator. In addition, gaze shifts produced during NRG stimulation were hypermetric compared with control movements. For example, when targets were briefly flashed 30 degrees from an initial fixation location, gaze shifts during NRG stimulation were on average 140% larger than control movements. These data are consistent with the predictions of the tested hypothesis, and may be problematic for gaze control models that rely on feedback control of gaze amplitude, as well as for models that do not posit an interaction between head commands and the saccade burst generator.

Effect of gamma-hydroxybutyric acid on tissue Na+,K- ATPase levels after experimental head trauma.

PubMed

Yosunkaya, A; Ustün, M E; Bariskaner, H; Tavlan, A; Gürbilek, M

2004-05-01

A failure of the Na(+),K(+)-ATPase activity (which is essential for ion flux across the cell membranes) occurs in many pathological conditions and may lead to cell dysfunction or even cell death. By altering the concentration of specific opioid peptides, gamma-hydroxybutyric acid (GHB) may change ion flux across cell membranes and produce the 'channel arrest' which we assumed will inhibit the failure of Na+,K(+)-ATPase activity and therefore lead to energy conservation and cell protection. Therefore we planned this study to see the effects of GHB at two different doses on Na(+),K(+)-ATPase activity in an experimental head trauma model. Forty New Zealand rabbits were divided equally into four groups: group I was the sham-operated group, group II (untreated group), group III received head trauma and intravenous (i.v.) 500 mg/kg GHB and group IV received head trauma and i.v. 50 mg/kg GHB. Head trauma was delivered by performing a craniectomy over the right hemisphere and dropping a weight of 10 g from a height of 80 cm. The non-traumatized (left) side was named as 'a' and the traumatized (right) side as 'b'. One hour after the trauma in groups II and III and craniotomy in group I, brain cortices were resected from both sides and in group I only from the right side was the tissue Na-K-ATPase activity determined. The mean +/- SD of Na(+),K(+)-ATPase levels of each group are as follows: group I - 5.97 +/- 0.55; group IIa - 3.90 +/- 1.08; group IIb - 3.58 +/- 0.90; group IIIa - 5.53 +/- 0.60; group IIIb - 5.33 +/- 0.88; group IVa - 5.05 +/- 0.72; group IVb - 4.93 +/- 0.67. The Na(+),K(+)-ATPase levels of group IIa, IIb, IVa and IVb were significantly different from group S (P < 0.05). There were also significant differences between group IIa and groups IIIa and IVa; group IIb and groups IIIb and IVb (P < 0.05). We conclude that GHB is effective in suppressing the decrease in Na(+),K(+)-ATPase levels in brain tissue at two different dose schedules after head trauma.

Humboldt slide - A large shear-dominated retrogressive slope failure

USGS Publications Warehouse

Gardner, J.V.; Prior, D.B.; Field, M.E.

1999-01-01

Humboldt Slide is a large, complex slide zone located on the northern California continental margin. Its three-dimensional architecture has been imaged by a combination of multibeam bathymetry, Huntec Deep-Tow seismic profiling, and sidescan sonar. The slide is interpreted to be Late Pleistocene to early Holocene in age and was caused by a combination of factors. The area of the slide is a local depocenter with high accumulation rates of organic-rich sediment; there has been local steepening of slopes by tectonic uplifts; and the entire area is one of high seismicity. Overall, the failure occurred by retrogressive, shear-dominated, minimum movement apparently as a sequence of events. Failure initially occurred by subsidence extension at the middle of the feature, followed by upslope retrogressive failure and downslope compression, and finally by translational sliding at the top of the slide. Degassing, as evidenced by abundant pockmarks, may have inhibited downslope translation. The slide may still be active, as suggested by offsets in Holocene hemipelagic sediment draped over some of the shear surfaces. Crown cracks occur above the present head of the failure and may represent the next generation of failure.

Injury pattern as an indication of seat belt failure in ejected vehicle occupants.

PubMed

Freeman, Michael D; Eriksson, Anders; Leith, Wendy

2014-09-01

Prior authors have suggested that when occupant ejection occurs in association with a seat belt failure, entanglement of the outboard upper extremity (OUE) with the retracting shoulder belt will invariably occur, leaving injury pattern evidence of belt use. In the present investigation, the authors assessed this theory using data accessed from the NASS-CDS for ejected front seat occupants of passenger vehicles. Logistic regression models were used to assess the associations between seat belt failure status and injuries. Injury types associated with seat belt failure were significant OUE and head injuries (OR = 3.87, [95% CI 1.2, 13.0] and 3.1, [95% CI 1.0, 9.7], respectively). The two injury types were found to be a predictor of seat belt use and subsequent failure only if combined with a high (≥0.8) precrash probability of belt use. The injury pattern associated with a seat belt failure-related ejection has limited use in the forensic investigation of crash-related ejections. © 2014 American Academy of Forensic Sciences.

Probabilistic framework for product design optimization and risk management

NASA Astrophysics Data System (ADS)

Keski-Rahkonen, J. K.

2018-05-01

Probabilistic methods have gradually gained ground within engineering practices but currently it is still the industry standard to use deterministic safety margin approaches to dimensioning components and qualitative methods to manage product risks. These methods are suitable for baseline design work but quantitative risk management and product reliability optimization require more advanced predictive approaches. Ample research has been published on how to predict failure probabilities for mechanical components and furthermore to optimize reliability through life cycle cost analysis. This paper reviews the literature for existing methods and tries to harness their best features and simplify the process to be applicable in practical engineering work. Recommended process applies Monte Carlo method on top of load-resistance models to estimate failure probabilities. Furthermore, it adds on existing literature by introducing a practical framework to use probabilistic models in quantitative risk management and product life cycle costs optimization. The main focus is on mechanical failure modes due to the well-developed methods used to predict these types of failures. However, the same framework can be applied on any type of failure mode as long as predictive models can be developed.

Postural Control in Bilateral Vestibular Failure: Its Relation to Visual, Proprioceptive, Vestibular, and Cognitive Input.

PubMed

Sprenger, Andreas; Wojak, Jann F; Jandl, Nico M; Helmchen, Christoph

2017-01-01

Patients with bilateral vestibular failure (BVF) suffer from postural and gait unsteadiness with an increased risk of falls. The aim of this study was to elucidate the differential role of otolith, semicircular canal (SSC), visual, proprioceptive, and cognitive influences on the postural stability of BVF patients. Center-of-pressure displacements were recorded by posturography under six conditions: target visibility; tonic head positions in the pitch plane; horizontal head shaking; sensory deprivation; dual task; and tandem stance. Between-group analysis revealed larger postural sway in BVF patients on eye closure; but with the eyes open, BVF did not differ from healthy controls (HCs). Head tilts and horizontal head shaking increased sway but did not differ between groups. In the dual task condition, BVF patients maintained posture indistinguishable from controls. On foam and tandem stance, postural sway was larger in BVF, even with the eyes open. The best predictor for the severity of bilateral vestibulopathy was standing on foam with eyes closed. Postural control of our BVF was indistinguishable from HCs once visual and proprioceptive feedback is provided. This distinguishes them from patients with vestibulo-cerebellar disorders or functional dizziness. It confirms previous reports and explains that postural unsteadiness of BVF patients can be missed easily if not examined by conditions of visual and/or proprioceptive deprivation. In fact, the best predictor for vestibular hypofunction (VOR gain) was examining patients standing on foam with the eyes closed. Postural sway in that condition increased with the severity of vestibular impairment but not with disease duration. In the absence of visual control, impaired otolith input destabilizes BVF with head retroflexion. Stimulating deficient SSC does not distinguish patients from controls possibly reflecting a shift of intersensory weighing toward proprioceptive-guided postural control. Accordingly, proprioceptive deprivation heavily destabilizes BVF, even when visual control is provided.

Postural Control in Bilateral Vestibular Failure: Its Relation to Visual, Proprioceptive, Vestibular, and Cognitive Input

PubMed Central

Sprenger, Andreas; Wojak, Jann F.; Jandl, Nico M.; Helmchen, Christoph

2017-01-01

Patients with bilateral vestibular failure (BVF) suffer from postural and gait unsteadiness with an increased risk of falls. The aim of this study was to elucidate the differential role of otolith, semicircular canal (SSC), visual, proprioceptive, and cognitive influences on the postural stability of BVF patients. Center-of-pressure displacements were recorded by posturography under six conditions: target visibility; tonic head positions in the pitch plane; horizontal head shaking; sensory deprivation; dual task; and tandem stance. Between-group analysis revealed larger postural sway in BVF patients on eye closure; but with the eyes open, BVF did not differ from healthy controls (HCs). Head tilts and horizontal head shaking increased sway but did not differ between groups. In the dual task condition, BVF patients maintained posture indistinguishable from controls. On foam and tandem stance, postural sway was larger in BVF, even with the eyes open. The best predictor for the severity of bilateral vestibulopathy was standing on foam with eyes closed. Postural control of our BVF was indistinguishable from HCs once visual and proprioceptive feedback is provided. This distinguishes them from patients with vestibulo-cerebellar disorders or functional dizziness. It confirms previous reports and explains that postural unsteadiness of BVF patients can be missed easily if not examined by conditions of visual and/or proprioceptive deprivation. In fact, the best predictor for vestibular hypofunction (VOR gain) was examining patients standing on foam with the eyes closed. Postural sway in that condition increased with the severity of vestibular impairment but not with disease duration. In the absence of visual control, impaired otolith input destabilizes BVF with head retroflexion. Stimulating deficient SSC does not distinguish patients from controls possibly reflecting a shift of intersensory weighing toward proprioceptive-guided postural control. Accordingly, proprioceptive deprivation heavily destabilizes BVF, even when visual control is provided. PMID:28919878

Predictive factors of tumor control and survival after radiosurgery for local failures of nasopharyngeal carcinoma.

PubMed

Chua, Daniel T T; Sham, Jonathan S T; Hung, Kwan-Ngai; Leung, Lucullus H T; Au, Gordon K H

2006-12-01

Stereotactic radiosurgery has been employed as a salvage treatment of local failures of nasopharyngeal carcinoma (NPC). To identify patients that would benefit from radiosurgery, we reviewed our data with emphasis on factors that predicted treatment outcome. A total of 48 patients with local failures of NPC were treated by stereotactic radiosurgery between March 1996 and February 2005. Radiosurgery was administered using a modified linear accelerator with single or multiple isocenters to deliver a median dose of 12.5 Gy to the target periphery. Median follow-up was 54 months. Five-year local failure-free probability after radiosurgery was 47.2% and 5-year overall survival rate was 46.9%. Neuroendocrine complications occurred in 27% of patients but there were no treatment-related deaths. Time interval from primary radiotherapy, retreatment T stage, prior local failures and tumor volume were significant predictive factors of local control and/or survival whereas age was of marginal significance in predicting survival. A radiosurgery prognostic scoring system was designed based on these predictive factors. Five-year local failure-free probabilities in patients with good, intermediate and poor prognostic scores were 100%, 42.5%, and 9.6%. The corresponding five-year overall survival rates were 100%, 51.1%, and 0%. Important factors that predicted tumor control and survival after radiosurgery were identified. Patients with good prognostic score should be treated by radiosurgery in view of the excellent results. Patients with intermediate prognostic score may also be treated by radiosurgery but those with poor prognostic score should receive other salvage treatments.

[Treatment of beginning juvenile detachment of the femoral head, taking growth of the femoral neck into account (author's transl)].

PubMed

Engelhardt, P

1979-10-01

Prevention of further detachment is the primary aim in the immediate treatment of beginning juvenile detachment of the femoral head. Screwing of the epiphysis of the head, first introduced by M. E. Mueller (1965), has proved successful. Besides providing immediate mechanical stability, this method, however, results in premature ossification of the joint of the femoral neck. Epiphysiodesis has a particularly unfavourable effect in early childhood, because it inhibits proper growth of the leg and development of the mechanism of the hip joint on account of the shortened femoral neck. Spiking of the epiphysis with Krischner screw wires guarantees safe fixation of the epiphyseal head on the one hand, and sufficient freedom of femoral neck growth on the other. Surgical treatment requires knowledge of the changed hip joint anatomy of the child. Preoperative planning via drawing to determine the length and position of the implantate on the basis of standardised x-ray films, will help to prevent operative failures.

Head and neck mucosal melanoma: experience with 42 patients, with emphasis on the role of postoperative radiotherapy.

PubMed

Meleti, Marco; Leemans, C René; de Bree, Remco; Vescovi, Paolo; Sesenna, Enrico; van der Waal, Isaäc

2008-12-01

Treatment of head and neck mucosal melanoma remains a challenge. Surgery has traditionally been the main therapeutic approach. The role of postoperative radiotherapy has never been clearly established. The experience with a group of 42 patients (16 males, 26 females) with a primary head and neck mucosal melanoma is reported. Eleven of 19 patients (57.9%) receiving surgery alone developed a regional lymphatic metastasis. For patients receiving postoperative radiotherapy (19 patients), regional metastatic spread occurred in 4 patients (21%). Percentages of local failure were 57.9% (11/19) and 26.3% (5/19) for patients treated with surgery alone and for those treated with surgery and radiotherapy, respectively. Distant metastases occurred in 10 of 19 patients (52.6%) receiving surgery alone and in 9 of 19 patients (47.3%) receiving both therapies. The present evaluation confirms a poor prognosis for patients with head and neck mucosal melanoma, independent of the treatment modality. (c) 2008 Wiley Periodicals, Inc.

78 FR 48828 - Airworthiness Directives; Continental Motors, Inc. Reciprocating Engines

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-12

... cylinder. We identified two independent failure modes resulting in the cylinder head separations; however... cylinders to be $82,620,000. Our cost estimate is exclusive of possible warranty coverage. Authority for... any other maintenance event, or were installed when the engine was modified and are currently...

22 CFR 35.39 - Appeal to authority head.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Foreign Relations DEPARTMENT OF STATE CLAIMS AND STOLEN PROPERTY PROGRAM FRAUD CIVIL REMEDIES § 35.39... that was not raised before the ALJ unless a demonstration is any objection that was not raised before the ALJ unless a demonstration is made of extraordinary circumstances causing the failure to raise the...

22 CFR 35.39 - Appeal to authority head.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Foreign Relations DEPARTMENT OF STATE CLAIMS AND STOLEN PROPERTY PROGRAM FRAUD CIVIL REMEDIES § 35.39... that was not raised before the ALJ unless a demonstration is any objection that was not raised before the ALJ unless a demonstration is made of extraordinary circumstances causing the failure to raise the...

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

ERIC Educational Resources Information Center

Weinberg, Bella Hass

1996-01-01

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

36 CFR 800.7 - Failure to resolve adverse effects.

Code of Federal Regulations, 2010 CFR

2010-07-01

... into account the Council's comments in reaching a final decision on the undertaking. Section 110(l) of the act directs that the head of the agency shall document this decision and may not delegate his or... comments. Upon request of the Council, the agency official shall provide additional existing information...

The Confrontation with Nazism at Rutgers: Academic Bureaucracy and Moral Failure.

ERIC Educational Resources Information Center

Greenberg, Michael; Zenchelsky, Seymour

1990-01-01

Argues that Rutgers University administrators participated in obfuscating the political nature of the 1935 dismissal of Lienhard Bergel, a German-born professor, whose anti-Nazi views alienated him from Friedrich Hauptmann, department head, also German-born, and avowedly pro-Nazi. Analyzes Hauptmann's central role and hearings testimony. Charges…

The Soviet Withdrawal from Afghanistan: Strategic Context

DTIC Science & Technology

2013-12-10

degree along Khalq-Parcham lines. The arrests exploded into a series of violent and bloody events called the Saur Revolution. The Saur Revolution...he made a promise to protect him. Yuri Andropov, the head of the KGB, was “mortified by his department’s failure to keep control of events” and...

"Heading up the Street": Localised Opportunities for Shared Constructions of Knowledge

ERIC Educational Resources Information Center

Lee, Carol D.; Majors, Yolanda J.

2003-01-01

Success and failure in school is contingent upon one's ability to regulate and situate identities, utilise culturally-developed semiotic tools and negotiate models of meaning in shared social activity. However, many language minority students lack such success, struggling with conflicts between their primary-and community-based identities, and…

Personal and Interpersonal Aspects of Effective Team-Oriented Headship in the Primary School.

ERIC Educational Resources Information Center

Johnston, John; Pickersgill, Susan

1992-01-01

Examines elementary principals' perceptions of themselves as stretched to the limit, undervalued, undersupported, and underresourced. Heads tend to interpret the majority of organizational problems as a reflection of their personal failure. A team-oriented approach to headship would ameliorate this situation by creating more efficient work…

Recurrence in Region of Spared Parotid Gland After Definitive Intensity-Modulated Radiotherapy for Head and Neck Cancer

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

Cannon, Donald M.; Lee, Nancy Y.

2008-03-01

Purpose: To discuss the implications of three examples of periparotid recurrence after definitive intensity-modulated radiotherapy (IMRT) for head and neck cancer (HNC). Methods and Materials: We present 3 patients with HNC who underwent definitive IMRT with concurrent chemotherapy and later had treatment failure in or near a spared parotid gland. Two patients had bilateral multilevel nodal disease, and all had Level II nodal disease ipsilateral to the site of recurrence. The patients were treated using dose-painting IMRT with a dose of 70 Gy to the gross tumor volume and 59.4 Gy or 54 Gy to the high-risk or low-risk clinicalmore » tumor volume, respectively. The parotid glands were spared bilaterally. The patients had not undergone any surgical treatment for HNC before radiotherapy. Results: All patients had treatment failure in the region of a spared parotid gland. Failure in the 2 patients with bilateral multilevel nodal involvement occurred in the periparotid lymph nodes. The third patient developed a dermal metastasis near the tail of a spared parotid gland. On pretreatment imaging, the 2 patients with nodal failure had small nonspecific periparotid nodules that showed no hypermetabolic activity on positron emission tomography. Conclusion: For HNC patients receiving definitive IMRT, nonspecific positron emission tomography-negative periparotid nodules on pretreatment imaging should raise the index of suspicion for subclinical disease in the presence of multilevel or Level II nodal metastases. Additional evaluation of such nodules might be indicated before sparing the ipsilateral parotid gland.« less

Analysis of Discrete-Source Damage Progression in a Tensile Stiffened Composite Panel

NASA Technical Reports Server (NTRS)

Wang, John T.; Lotts, Christine G.; Sleight, David W.

1999-01-01

This paper demonstrates the progressive failure analysis capability in NASA Langley s COMET-AR finite element analysis code on a large-scale built-up composite structure. A large-scale five stringer composite panel with a 7-in. long discrete source damage was analyzed from initial loading to final failure including the geometric and material nonlinearities. Predictions using different mesh sizes, different saw cut modeling approaches, and different failure criteria were performed and assessed. All failure predictions have a reasonably good correlation with the test result.

Predicting the need for CT imaging in children with minor head injury using an ensemble of Naive Bayes classifiers.

PubMed

Klement, William; Wilk, Szymon; Michalowski, Wojtek; Farion, Ken J; Osmond, Martin H; Verter, Vedat

2012-03-01

Using an automatic data-driven approach, this paper develops a prediction model that achieves more balanced performance (in terms of sensitivity and specificity) than the Canadian Assessment of Tomography for Childhood Head Injury (CATCH) rule, when predicting the need for computed tomography (CT) imaging of children after a minor head injury. CT is widely considered an effective tool for evaluating patients with minor head trauma who have potentially suffered serious intracranial injury. However, its use poses possible harmful effects, particularly for children, due to exposure to radiation. Safety concerns, along with issues of cost and practice variability, have led to calls for the development of effective methods to decide when CT imaging is needed. Clinical decision rules represent such methods and are normally derived from the analysis of large prospectively collected patient data sets. The CATCH rule was created by a group of Canadian pediatric emergency physicians to support the decision of referring children with minor head injury to CT imaging. The goal of the CATCH rule was to maximize the sensitivity of predictions of potential intracranial lesion while keeping specificity at a reasonable level. After extensive analysis of the CATCH data set, characterized by severe class imbalance, and after a thorough evaluation of several data mining methods, we derived an ensemble of multiple Naive Bayes classifiers as the prediction model for CT imaging decisions. In the first phase of the experiment we compared the proposed ensemble model to other ensemble models employing rule-, tree- and instance-based member classifiers. Our prediction model demonstrated the best performance in terms of AUC, G-mean and sensitivity measures. In the second phase, using a bootstrapping experiment similar to that reported by the CATCH investigators, we showed that the proposed ensemble model achieved a more balanced predictive performance than the CATCH rule with an average sensitivity of 82.8% and an average specificity of 74.4% (vs. 98.1% and 50.0% for the CATCH rule respectively). Automatically derived prediction models cannot replace a physician's acumen. However, they help establish reference performance indicators for the purpose of developing clinical decision rules so the trade-off between prediction sensitivity and specificity is better understood. Copyright © 2011 Elsevier B.V. All rights reserved.

Innovative Design to Prevent Reversal of Roller Blood Pump Rotation in the Event of Electromechanical Failure: An Easy Solution to a Devastating Problem

PubMed Central

Skoletsky, Jennifer S.; White, Brian T.; Austin, Jon W.

2007-01-01

Abstract: Despite the advanced technologies of battery back-up for heart-lung consoles and the availability of system-wide generators, electromechanical failure is still occurring. Several heartlung machine manufacturers still provide unsafe handcranking devices to use in the case of an emergency while using a roller blood pump. A new design has been engineered to eliminate safety and quality issues for the perfusionist and the patient when the need for handcranking presents itself. A ratchet-style handcranking device was fabricated by means of a steel plate with adjustable pins. The adjustable pins allow for use with different models of the Cobe, Stockert, and Jostra heart-lung consoles, which contain roller pumps with 180° roller heads. Additional modifications such as a 1:2 transmission and fluorescent markers are also used in the design. This innovative design is an improvement in safety compared with the current handcrank provided by Cobe, Stockert, and Jostra. With this modified handcranking device, accidental reverse rotation of the roller pump head cannot occur. Fluorescent markers will improve visualization of the pump head in low-light situations. The ergonomic design improves efficiency by reducing fatigue. Most importantly, a “safe” safety device will replace the current design provided by these manufacturers, thus improving the quality of care by health care providers. PMID:17672191

Failure Pressure and Leak Rate of Steam Generator Tubes With Stress Corrosion Cracks

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

Majumdar, S.; Kasza, K.; Park, J.Y.

2002-07-01

This paper illustrates the use of an 'equivalent rectangular crack' approach to predict leak rates through laboratory generated stress corrosion cracks. A comparison between predicted and observed test data on rupture and leak rate from laboratory generated stress corrosion cracks are provided. Specimen flaws were sized by post-test fractography in addition to pre-test advanced eddy current technique. The test failure pressures and leak rates are shown to be closer to those predicted on the basis of fractography than on NDE. However, the predictions based on NDE results are encouraging, particularly because they have the potential to determine a more detailedmore » geometry of ligamentous cracks from which more accurate predictions of failure pressure and leak rate can be made in the future. (authors)« less

Study on compensation algorithm of head skew in hard disk drives

NASA Astrophysics Data System (ADS)

Xiao, Yong; Ge, Xiaoyu; Sun, Jingna; Wang, Xiaoyan

2011-10-01

In hard disk drives (HDDs), head skew among multiple heads is pre-calibrated during manufacturing process. In real applications with high capacity of storage, the head stack may be tilted due to environmental change, resulting in additional head skew errors from outer diameter (OD) to inner diameter (ID). In case these errors are below the preset threshold for power on recalibration, the current strategy may not be aware, and drive performance under severe environment will be degraded. In this paper, in-the-field compensation of small DC head skew variation across stroke is proposed, where a zone table has been equipped. Test results demonstrating its effectiveness to reduce observer error and to enhance drive performance via accurate prediction of DC head skew are provided.

Epidemiology and risk factors of multiple-organ failure after multiple trauma: an analysis of 31,154 patients from the TraumaRegister DGU.

PubMed

Fröhlich, Matthias; Lefering, Rolf; Probst, Christian; Paffrath, Thomas; Schneider, Marco M; Maegele, Marc; Sakka, Samir G; Bouillon, Bertil; Wafaisade, Arasch

2014-04-01

In the severely injured who survive the early posttraumatic phase, multiple-organ failure (MOF) is the main cause of morbidity and mortality. An enhanced prediction of MOF might influence individual monitoring and therapy of severely injured patients. We performed a retrospective analysis of a nationwide prospective database, the TraumaRegister DGU of the German Trauma Society. Patients with complete data sets (2002-2011) and a relevant trauma load (Injury Severity Score [ISS] ≥ 16), who were admitted to an intensive care unit, were included. Of a total of 31,154 patients enclosed in this study, 10,201 (32.7%) developed an MOF according to the Sequential Organ Failure Assessment score. During the study period, mortality of all patients decreased from 18.1% in 2002 to 15.3% in 2011 (p < 0.001). Meanwhile, MOF occurred significantly more often (24.6% in 2002 vs. 31.5% in 2011, p < 0.001), but mortality of MOF patients decreased (42.6% vs. 33.3%, p < 0.001). MOF patients who died survived 2 days less (11 days in 2002 vs. 8.9 days in 2011, p < 0.001). Independent risk factors for the development of MOF following severe trauma were age, ISS, head Abbreviated Injury Scale (AIS) score of 3 or higher, thoracic AIS score of 3 or higher, male sex, Glasgow Coma Scale (GCS) score of 8 or less, mass transfusion, base excess of less than -3, systolic blood pressure less than 90 mm Hg at admission, and coagulopathy. Over one decade, we observed an ongoing decrease of mortality after multiple trauma, accompanied by decreasing mortality in the subgroup with MOF. However, incidence of MOF in the severely injured increased significantly. Thus, MOF after multiple trauma remains a challenge in intensive care. The risk factors from multivariate analysis could be instrumental in anticipating the early development of MOF. Furthermore, a reliable prediction model might be supportive for patient enrolment in trauma studies, in which MOF marks the primary end point. Epidemiologic study, level III.

An Experimental Study of Incremental Surface Loading of an Elastic Plate: Application to Volcano Tectonics

NASA Technical Reports Server (NTRS)

Williams, K. K.; Zuber, M. T.

1995-01-01

Models of surface fractures due to volcanic loading an elastic plate are commonly used to constrain thickness of planetary lithospheres, but discrepancies exist in predictions of the style of initial failure and in the nature of subsequent fracture evolution. In this study, we perform an experiment to determine the mode of initial failure due to the incremental addition of a conical load to the surface of an elastic plate and compare the location of initial failure with that predicted by elastic theory. In all experiments, the mode of initial failure was tension cracking at the surface of the plate, with cracks oriented circumferential to the load. The cracks nucleated at a distance from load center that corresponds the maximum radial stress predicted by analytical solutions, so a tensile failure criterion is appropriate for predictions of initial failure. With continued loading of the plate, migration of tensional cracks was observed. In the same azimuthal direction as the initial crack, subsequent cracks formed at a smaller radial distance than the initial crack. When forming in a different azimuthal direction, the subsequent cracks formed at a distance greater than the radial distance of the initial crack. The observed fracture pattern may explain the distribution of extensional structures in annular bands around many large scale, circular volcanic features.

Accelerated fatigue durability of a high performance composite

NASA Technical Reports Server (NTRS)

Rotem, A.

1982-01-01

The fatigue behavior of multidirectional graphite-epoxy laminates was analyzed theoretically and experimentally in an effort to establish an accelerated testing methodology. Analysis of the failure mechanism in fatigue of the laminates led to the determination of the failure mode governing fracture. The nonlinear, cyclic-dependent shear modulus was used to calculate the changing stress field in the laminate during the fatigue loading. Fatigue tests were performed at three different temperatures: 25 C, 74 C, and 114 C. The prediction of the S-N curves was made based on the artificial static strength artificial static strength at a reference temperature and the fatigue functions associated with them. The prediction of an S-N curve at other temperatures was performed using shifting factors determined for the specific failure mode. For multidirectional laminates, different S-N curves at different temperatures could be predicted using these shifting factors. Different S-N curves at different temperatures occur only when the fatigue failure mode is matrix dominated. It was found that whenever the fatigue failure mode is fiber dominated, temperature, over the range investigated, had no influence on the fatigue life. These results permit the prediction of long-time, low temperature fatigue behavior from data obtained in short time, high temperature testing, for laminates governed by a matrix failure mode.

Automatic Tube Compensation versus Pressure Support Ventilation and Extubation Outcome in Children: A Randomized Controlled Study

PubMed Central

El-beleidy, Ahmed Saad El-din; Khattab, Asser Abd EL-Hamied; El-Sherbini, Seham Awad; Al-gebaly, Hebatalla Fadel

2013-01-01

Background. Automatic tube compensation (ATC) has been developed to overcome the imposed work of breathing due to artificial airways during spontaneous breathing trials (SBTs). Objectives. This study aimed to assess extubation outcome after an SBT (spontaneous breathing trial) with ATC compared with pressure support ventilation (PSV) and to determine the risk factors for extubation failure. Methods. Patients ready for extubation were randomly assigned to two-hour spontaneous breathing trial with either ATC or pressure support ventilation. Results. In the ATC group (n = 17), 11 (65%) patients passed the SBT with subsequent extubation failure (9%). While in PSV group (n = 19), 10 (53%) patients passed the SBT with subsequent extubation failure (10%). This represented a positive predictive value for ATC of 91% and PSV of 90% (P = 0.52). Five (83%) of the patients who failed the SBT in ATC group were reintubated. This represented a higher negative predictive value for ATC of 83% than for PSV which was 56%. None of the assessed risk factors were independently associated with extubation failure including failed trial. Conclusion. ATC was equivalent to PSV in predicting patients with successful extubation. A trial failure in ATC group is associated with but does not definitely predict extubation failure. PMID:23533800

Is it possible to predict office hysteroscopy failure?

PubMed

Cobellis, Luigi; Castaldi, Maria Antonietta; Giordano, Valentino; De Franciscis, Pasquale; Signoriello, Giuseppe; Colacurci, Nicola

2014-10-01

The purpose of this study was to develop a clinical tool, the HFI (Hysteroscopy Failure Index), which gives criteria to predict hysteroscopic examination failure. This was a retrospective diagnostic test study, aimed to validate the HFI, set at the Department of Gynaecology, Obstetric and Reproductive Science of the Second University of Naples, Italy. The HFI was applied to our database of 995 consecutive women, who underwent office based to assess abnormal uterine bleeding (AUB), infertility, cervical polyps, and abnormal sonographic patterns (postmenopausal endometrial thickness of more than 5mm, endometrial hyperechogenic spots, irregular endometrial line, suspect of uterine septa). Demographic characteristics, previous surgery, recurrent infections, sonographic data, Estro-Progestins, IUD and menopausal status were collected. Receiver operating characteristic (ROC) curve analysis was used to assess the ability of the model to identify patients who were correctly identified (true positives) divided by the total number of failed hysteroscopies (true positives+false negatives). Positive and Negative Likelihood Ratios with 95%CI were calculated. The HFI score is able to predict office hysteroscopy failure in 76% of cases. Moreover, the Positive likelihood ratio was 11.37 (95% CI: 8.49-15.21), and the Negative likelihood ratio was 0.33 (95% CI: 0.27-0.41). Hysteroscopy failure index was able to retrospectively predict office hysteroscopy failure. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Biomarkers of head and neck cancer, tools or a gordian knot?

PubMed

Lampri, Evangeli S; Chondrogiannis, Georgios; Ioachim, Elli; Varouktsi, Anna; Mitselou, Antigoni; Galani, Aggeliki; Briassoulis, Evangelos; Kanavaros, Panagiotis; Galani, Vasiliki

2015-01-01

Head and neck tumors comprise a wide spectrum of heterogeneous neoplasms for which biomarkers are needed to aid in earlier diagnosis, risk assessment and therapy response. Personalized medicine based on predictive markers linked to drug response, it is hoped, will lead to improvements in outcomes and avoidance of unnecessary treatment in carcinoma of the head and neck. Because of the heterogeneity of head and neck tumors, the integration of multiple selected markers in association with the histopathologic features is advocated for risk assessment. Validation of each biomarker in the context of clinical trials will be required before a specific marker can be incorporated into daily practice. Furthermore, we will give evidence that some proteins implicated in cell-cell interaction, such as CD44 may be involved in the multiple mechanism of the development and progression of laryngeal lesions and may help to predict the risk of transformation of the benign or precancerous lesions to cancer.

Predictors of incident heart failure in patients after an acute coronary syndrome: The LIPID heart failure risk-prediction model.

PubMed

Driscoll, Andrea; Barnes, Elizabeth H; Blankenberg, Stefan; Colquhoun, David M; Hunt, David; Nestel, Paul J; Stewart, Ralph A; West, Malcolm J; White, Harvey D; Simes, John; Tonkin, Andrew

2017-12-01

Coronary heart disease is a major cause of heart failure. Availability of risk-prediction models that include both clinical parameters and biomarkers is limited. We aimed to develop such a model for prediction of incident heart failure. A multivariable risk-factor model was developed for prediction of first occurrence of heart failure death or hospitalization. A simplified risk score was derived that enabled subjects to be grouped into categories of 5-year risk varying from <5% to >20%. Among 7101 patients from the LIPID study (84% male), with median age 61years (interquartile range 55-67years), 558 (8%) died or were hospitalized because of heart failure. Older age, history of claudication or diabetes mellitus, body mass index>30kg/m 2 , LDL-cholesterol >2.5mmol/L, heart rate>70 beats/min, white blood cell count, and the nature of the qualifying acute coronary syndrome (myocardial infarction or unstable angina) were associated with an increase in heart failure events. Coronary revascularization was associated with a lower event rate. Incident heart failure increased with higher concentrations of B-type natriuretic peptide >50ng/L, cystatin C>0.93nmol/L, D-dimer >273nmol/L, high-sensitivity C-reactive protein >4.8nmol/L, and sensitive troponin I>0.018μg/L. Addition of biomarkers to the clinical risk model improved the model's C statistic from 0.73 to 0.77. The net reclassification improvement incorporating biomarkers into the clinical model using categories of 5-year risk was 23%. Adding a multibiomarker panel to conventional parameters markedly improved discrimination and risk classification for future heart failure events. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Model-Biased, Data-Driven Adaptive Failure Prediction

NASA Technical Reports Server (NTRS)

Leen, Todd K.

2004-01-01

This final report, which contains a research summary and a viewgraph presentation, addresses clustering and data simulation techniques for failure prediction. The researchers applied their techniques to both helicopter gearbox anomaly detection and segmentation of Earth Observing System (EOS) satellite imagery.

Predicting the failure of retrograde ureteral stent insertion for managing malignant ureteral obstruction in outpatients

PubMed Central

WANG, JIN-YOU; ZHANG, HAI-LIANG; ZHU, YAO; QIN, XIAO-JIAN; DAI, BO; YE, DING-WEI

2016-01-01

Malignant ureteral obstruction (MUO) is an unpropitious sign that is commonly observed in patients with advanced incurable cancer. The present study aimed to evaluate predictive factors for the failure of retrograde ureteral stent insertion in the management of MUO in outpatients. A total of 164 patients with MUO were retrospectively assessed in this study. Clinical factors, including age, gender, type of malignancy, level of obstruction, cause of obstruction, pre-operative creatinine level, degree of hydronephrosis, condition of the contralateral ureter, prior radiotherapy, Eastern Cooperative Oncology Group performance status (ECOG PS), bladder wall invasion and technical failure, were recorded for each case. Univariate and multivariate logistic regression analyses were used to investigate the risk factors for predicting the failure of retrograde ureteral stent insertion. In total, 38 out of 164 patients experienced bilateral obstruction, therefore, a total of 202 ureteral units were available for data analysis. The rate of insertion failure in MUO was 34.65%. Multivariate analyses identified ECOG PS, degree of hydronephrosis and bladder wall invasion as independent predictors for insertion failure. Overall, the present study found that rate of retrograde ureteral stent insertion failure is high in outpatients with MUO, and that ECOG PS, degree of hydronephrosis and bladder invasion are potential independent predictors of insertion failure. PMID:26870299

Multiple drilling combined with simvastatin versus multiple drilling alone for the treatment of avascular osteonecrosis of the femoral head: 3-year follow-up study.

PubMed

Yin, Han; Yuan, Zhenfeng; Wang, Dawei

2016-08-15

Multiple small drilling for core decompression is widely used to preserve the femoral head in patients with avascular necrosis of the femoral head (ANFH). Nevertheless, the clinical outcome remains controversial. Simvastatin has been demonstrated to promote bone formation and reduce bone adsorption. The purpose of this study was to determine whether simvastatin enhanced the effect of multiple decompressions in preventing progression of ANFH and to identify independent risk factors associated with poor results. We retrospectively analyzed 58 hips in 36 patients, with a follow-up of 36 months. 20 patients (32 hips) underwent multiple drilling combined with simvastatin treatment (SIM group); 16 patients (26 hips) underwent multiple drilling alone (MD group). We defined clinical failure as a requirement for subsequent hip surgery or Harris Hip Score < 75. New occurrence of collapse or increased collapse > 2 mm on plain radiographs was defined as radiological failure. Successful clinical results were achieved in 27 of 32 hips (84 %) in the SIM group compared with 15 of 26 hips (58 %) in the MD group (OR = 0.2, CI (0.1, 0.6.), P = 0.032). Successful radiological results were achieved in 27 of 32 hips (84 %) in the SIM group and in 16 of 26 hips (61.5 %) in the MD group (P = 0.048). Body mass index, disease stage and location of lesion were independent prognostic factors for overall survival. We believe that simvastatin could enhance the effects of multiple decompressions in preventing progression of ANFH and reducing the risk of femoral head collapse.

Midterm results of osteochondral allograft transplantation to the humeral head.

PubMed

Riff, Andrew J; Yanke, Adam B; Shin, Jason J; Romeo, Anthony A; Cole, Brian J

2017-07-01

This study evaluated clinical outcomes of osteochondral allograft (OCA) transplantation for humeral head osteochondral defects. We hypothesized that patients with isolated humeral head disease would achieve favorable results and that patients with bipolar disease would experience inferior outcomes. We identified patients who underwent humeral head OCA transplantation. Subjective questionnaire data were obtained preoperatively and at a minimum of 2 years postoperatively. Radiographs were evaluated for graft incorporation. Failure was defined by conversion to shoulder arthroplasty, American Shoulder and Elbow Surgeons score <50, or dissatisfaction with the surgical result. Twenty patients (65% male) met inclusion criteria. Patients were an average age of 24.8 ± 8.1 years. Eleven patients underwent concomitant glenoid surgery (microfracture or meniscal allograft resurfacing). Follow-up was available for 18 patients (90%) at mean of 67 months. All grafts incorporated except 2. Four patients underwent shoulder arthroplasty at mean of 25 months postoperatively (all after pain pump chondrolysis). Eleven of the 20 patients were satisfied (all dissatisfied patients underwent glenoid surgery). Significant improvements (P < .001) were seen for the visual analog scale (from 6.1 to 1.5), Simple Shoulder Test (from 32 to 73), American Shoulder and Elbow Surgeons score (from 39 to 76), and the physical component of the 12-Item Short Form Survey (from 38 to 48). Pain pump patients who did not progress to arthroplasty experienced inferior satisfaction (40% vs. 87.5%, P = .04) and a trend toward inferior outcomes compared with the rest of the cohort. OCA transplantation is a viable option for young patients with isolated humeral chondral injury. Patients with bipolar disease or a history of intra-articular pain pump have increased failure and decreased subjective outcomes. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Second generation locked plating for complex proximal humerus fractures in very elderly patients.

PubMed

Gavaskar, Ashok S; Karthik B, Bhupesh; Tummala, Naveen C; Srinivasan, Parthasarathy; Gopalan, Hitesh

2016-11-01

Humeral head sacrificing procedures are more favored in elderly patients with complex proximal humerus fractures because of high incidence of failures and complications with osteosynthesis. The purpose of this study is to assess the outcome of second generation locked plating techniques in 3 and 4 part fractures in active elderly patients >70years with an emphasis on function and complications. 29 patients with displaced 3 and 4 part proximal humerus fractures were treated using the principles of second-generation proximal humerus locked plating. Fixed angle locked plating (PHILOS) using the anterolateral deltoid spilt approach augmented with traction cuff sutures was performed. Minimum of 7 locking head screws including 2 calcar screws were used. In cases with a comminuted medial calcar, an endosteal fibular strut was used. Subchondral metaphyseal bone voids were filled with injectable calcium phosphate cement. Radiological outcome (union, head - shaft angle, tuberosity reduction), functional outcome assessment (Constant and ASES scores) and complications (loss of reduction, nonunion and osteonecrosis) were assessed. The fracture united in 24 of the 26 patients available for follow up at a mean of 27 months (12-40 months). 3 patients developed complications that required arthroplasty (fixation failure in 2 patients and osteonecrosis in 1 patient). Follow up age adjusted Constant (63.1±11.9) and ASES scores (62.58±7.5) showed the extent of functional improvement post surgery. Patients with fractures having a non-comminuted medial calcar and valgus displacement of the humeral head had better functional scores and fewer complications. Osteosynthesis with second generation locked plating techniques provide satisfactory outcome in very elderly patients with complex proximal humerus fractures with minimal complications. Copyright © 2016 Elsevier Ltd. All rights reserved.

Characteristics and analysis of scientific articles submitted to the European Annals of Otorhinolaryngology, Head and Neck Diseases.

PubMed

Laccourreye, O; Bonfils, P; Denoyelle, F; Garrel, R; Jankowski, R; Karkas, A; Makeieff, M; Righini, C; Vincent, C; Martin, C

2015-09-01

To evaluate characteristics, suggested modifications and reasons for rejection in scientific articles submitted for publication in the European Annals of Otorhinolaryngology, Head and Neck Diseases. A prospective study analyzed the flaws noted by reviewers in 52 scientific articles submitted to the European Annals of Otorhinolaryngology, Head and Neck Diseases between August 31, 2014 and February 28, 2015. Fifteen flaws concerning content and 7 concerning form were identified. In more than 25% of submissions, major flaws were noted: purely descriptive paper; lack of contribution to existing state of knowledge; failure to define a clear study objective and/or analyze the impact of major variables; poorly structured Materials and methods section, lacking description of study population, objective and/or variables; lack of or inappropriate statistical analysis; Introduction verbose and/or misrepresenting the literature; excessively heterogeneous and/or poorly described study population; imprecise discussion, straying from the point, overstating the significance of results and/or introducing new results not mentioned in the Results section; description of the study population placed in the Results section instead of under Materials and methods; serious mistakes of syntax, spelling and/or tense; and failure to follow the Instructions to Authors. After review, 21.1% of articles were published, 65.3% rejected and 13.4% non-resubmitted within 3 months of review. On univariate analysis, the only variable increasing the percentage of articles accepted was the topic not being devoted to head and neck surgery (P=0.03). These results document the excessive flaw rate still to be found in manuscripts and demonstrate the continuing need for authors to master and implement the rules of scientific medical writing. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Assessment of oral ivermectin versus shampoo in the treatment of pediculosis (head lice infestation) in rural areas of Sine-Saloum, Senegal.

PubMed

Leulmi, Hamza; Diatta, Georges; Sokhna, Cheikh; Rolain, Jean-Marc; Raoult, Didier

2016-12-01

Reports of treatment failure and the emergence of resistance to topical head lice treatments have become increasingly common, driving the need for continued development of new therapeutic options for pediculosis. Ivermectin has been proposed as a potential alternative for the treatment of pediculosis but has not been sufficiently evaluated. In this study, the effectiveness of oral ivermectin versus shampoo in the treatment of pediculosis in Senegal was compared. The study was conducted in two neighbouring villages of Sine-Saloum, Senegal: Dielmo (ivermectin trial group; 201 female participants) and Ndiop (shampoo trial group; 239 female participants). In the ivermectin group, patients received two doses of oral ivermectin (400 µg/kg body weight; Mectizan ® ) 7 days apart. In contrast, the shampoo group received a shampoo treatment based on d-phenothrin (0.23%; Hégor ® ). At the beginning of the study, 70 (34.8%) of 201 participants in the ivermectin group were infested by head lice versus 145 (60.7%) of 239 participants in the shampoo group. At Day 15 post-treatment, the efficacy of the treatment against head lice reached 41/53 (77.4%) in the ivermectin group (53 patients were tested in this group) versus 42/130 (32.3%) in the shampoo group (130 patients were tested in this group) (P <10 -7 ). However, 4 (7.5%) of the 53 females in the ivermectin group exhibited probable ivermectin treatment failure, suggesting the emergence of ivermectin-resistant lice. This study demonstrates that oral ivermectin is highly effective for the treatment of pediculosis compared with shampoo, but also suggests that ivermectin resistance may emerge during treatment. Copyright © 2016 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

Prediction of mode of death in heart failure: the Seattle Heart Failure Model.

PubMed

Mozaffarian, Dariush; Anker, Stefan D; Anand, Inder; Linker, David T; Sullivan, Mark D; Cleland, John G F; Carson, Peter E; Maggioni, Aldo P; Mann, Douglas L; Pitt, Bertram; Poole-Wilson, Philip A; Levy, Wayne C

2007-07-24

Prognosis and mode of death in heart failure patients are highly variable in that some patients die suddenly (often from ventricular arrhythmia) and others die of progressive failure of cardiac function (pump failure). Prediction of mode of death may facilitate decisions about specific medications or devices. We used the Seattle Heart Failure Model (SHFM), a validated prediction model for total mortality in heart failure, to assess the mode of death in 10,538 ambulatory patients with New York Heart Association class II to IV heart failure and predominantly systolic dysfunction enrolled in 6 randomized trials or registries. During 16,735 person-years of follow-up, 2014 deaths occurred, which included 1014 sudden deaths and 684 pump-failure deaths. Compared with a SHFM score of 0, patients with a score of 1 had a 50% higher risk of sudden death, patients with a score of 2 had a nearly 3-fold higher risk, and patients with a score of 3 or 4 had a nearly 7-fold higher risk (P<0.001 for all comparisons; 1-year area under the receiver operating curve, 0.68). Stratification of risk of pump-failure death was even more pronounced, with a 4-fold higher risk with a score of 1, a 15-fold higher risk with a score of 2, a 38-fold higher risk with a score of 3, and an 88-fold higher risk with a score of 4 (P<0.001 for all comparisons; 1-year area under the receiver operating curve, 0.85). The proportion of deaths caused by sudden death versus pump-failure death decreased from a ratio of 7:1 with a SHFM score of 0 to a ratio of 1:2 with a SHFM score of 4 (P trend <0.001). The SHFM score provides information about the likely mode of death among ambulatory heart failure patients. Investigation is warranted to determine whether such information might predict responses to or cost-effectiveness of specific medications or devices in heart failure patients.

Meso-Scale Progressive Damage Behavior Characterization of Triaxial Braided Composites under Quasi-Static Tensile Load

NASA Astrophysics Data System (ADS)

Ren, Yiru; Zhang, Songjun; Jiang, Hongyong; Xiang, Jinwu

2018-04-01

Based on continuum damage mechanics (CDM), a sophisticated 3D meso-scale finite element (FE) model is proposed to characterize the progressive damage behavior of 2D Triaxial Braided Composites (2DTBC) with 60° braiding angle under quasi-static tensile load. The modified Von Mises strength criterion and 3D Hashin failure criterion are used to predict the damage initiation of the pure matrix and fiber tows. A combining interface damage and friction constitutive model is applied to predict the interface damage behavior. Murakami-Ohno stiffness degradation scheme is employed to predict the damage evolution process of each constituent. Coupling with the ordinary and translational symmetry boundary conditions, the tensile elastic response including tensile strength and failure strain of 2DTBC are in good agreement with the available experiment data. The numerical results show that the main failure modes of the composites under axial tensile load are pure matrix cracking, fiber and matrix tension failure in bias fiber tows, matrix tension failure in axial fiber tows and interface debonding; the main failure modes of the composites subjected to transverse tensile load are free-edge effect, matrix tension failure in bias fiber tows and interface debonding.

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

Lall, Pradeep; Wei, Junchao; Sakalaukus, Peter

A new method has been developed for assessment of the onset of degradation in solid state luminaires to classify failure mechanisms by using metrics beyond lumen degradation that are currently used for identification of failure. Luminous Flux output, Correlated Color Temperature Data on Philips LED Lamps has been gathered under 85°C/85%RH till lamp failure. Failure modes of the test population of the lamps have been studied to understand the failure mechanisms in 85°C/85%RH accelerated test. Results indicate that the dominant failure mechanism is the discoloration of the LED encapsulant inside the lamps which is the likely cause for the luminousmore » flux degradation and the color shift. The acquired data has been used in conjunction with Bayesian Probabilistic Models to identify luminaires with onset of degradation much prior to failure through identification of decision boundaries between lamps with accrued damage and lamps beyond the failure threshold in the feature space. In addition luminaires with different failure modes have been classified separately from healthy pristine luminaires. The α-λ plots have been used to evaluate the robustness of the proposed methodology. Results show that the predicted degradation for the lamps tracks the true degradation observed during 85°C/85%RH during accelerated life test fairly closely within the ±20% confidence bounds. Correlation of model prediction with experimental results indicates that the presented methodology allows the early identification of the onset of failure much prior to development of complete failure distributions and can be used for assessing the damage state of SSLs in fairly large deployments. It is expected that, the new prediction technique will allow the development of failure distributions without testing till L70 life for the manifestation of failure.« less

Oral ivermectin for the treatment of head lice infestation.

PubMed

Sanchezruiz, Wendy L; Nuzum, Donald S; Kouzi, Samir A

2018-05-22

Published literature describing the use of oral ivermectin for the treatment of head lice infestation is reviewed. In the United States and globally, head lice infestation, or pediculosis capitis, remains a public health issue with both social and medical implications. Treatment with oral or topical medications is typically required for head lice eradication. Resistance to traditional topical therapies for head lice infestation is increasing, creating a need for consideration of additional treatment options. A growing body of data describing the potential role of oral ivermectin for the treatment or prevention of head lice infestation is available. A literature search identified 5 clinical trials that evaluated safety and/or effectiveness outcomes of oral ivermectin use as an alternative to malathion, other topical prescription medications, and traditional, nonprescription remedies; those studies were conducted in various parts of the world (e.g., Australia, Brazil, Mexico, Egypt) and likely involved varying types and degrees of lice resistance. Clinical research findings to date, while not consistently robust, suggest that oral ivermectin is comparable or superior in effectiveness to other topical treatment options for head lice infestation while being well tolerated and favorably perceived by patients and caretakers. Oral ivermectin is an option for the treatment of head lice infestation, especially in individuals who have experienced a treatment failure. Published evidence from clinical trials indicates that oral ivermectin is as effective as currently available topical treatments. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Migration, business formation, and the informal economy in urban Mexico.

PubMed

Sheehan, Connor M; Riosmena, Fernando

2013-07-01

Although the informal economy has grown rapidly in several developing nations, and migration and informality may be related to similar types of credit constraints and market failures, previous research has not systematically attempted to identify if migrant households are more likely to start informal and formal businesses alike and if this association varies across local contexts. We examine the relationship between prior US migration and the creation of both formal and informal businesses in urban Mexico using several criteria to indirectly assess sector location. We use data from 56 communities from the Mexican Migration Project to estimate multilevel survival and nonmultilevel competing risk models predicting the likelihood of informal, formal, and no business formation. The recent return migration of the household head is strongly associated with informal business creation, particularly in economically dynamic areas. On the other hand, migrants are only marginally more likely to start formal businesses in highly economically dynamic sending areas. Published by Elsevier Inc.

A quantitative framework for whole-body coordination reveals specific deficits in freely walking ataxic mice

PubMed Central

Machado, Ana S; Darmohray, Dana M; Fayad, João; Marques, Hugo G; Carey, Megan R

2015-01-01

The coordination of movement across the body is a fundamental, yet poorly understood aspect of motor control. Mutant mice with cerebellar circuit defects exhibit characteristic impairments in locomotor coordination; however, the fundamental features of this gait ataxia have not been effectively isolated. Here we describe a novel system (LocoMouse) for analyzing limb, head, and tail kinematics of freely walking mice. Analysis of visibly ataxic Purkinje cell degeneration (pcd) mice reveals that while differences in the forward motion of individual paws are fully accounted for by changes in walking speed and body size, more complex 3D trajectories and, especially, inter-limb and whole-body coordination are specifically impaired. Moreover, the coordination deficits in pcd are consistent with a failure to predict and compensate for the consequences of movement across the body. These results isolate specific impairments in whole-body coordination in mice and provide a quantitative framework for understanding cerebellar contributions to coordinated locomotion. DOI: http://dx.doi.org/10.7554/eLife.07892.001 PMID:26433022

Limited improvement of incorporating primary circulating prostate cells with the CAPRA score to predict biochemical failure-free outcome of radical prostatectomy for prostate cancer.

PubMed

Murray, Nigel P; Aedo, Socrates; Fuentealba, Cynthia; Jacob, Omar; Reyes, Eduardo; Novoa, Camilo; Orellana, Sebastian; Orellana, Nelson

2016-10-01

To establish a prediction model for early biochemical failure based on the Cancer of the Prostate Risk Assessment (CAPRA) score, the presence or absence of primary circulating prostate cells (CPC) and the number of primary CPC (nCPC)/8ml blood sample is detected before surgery. A prospective single-center study of men who underwent radical prostatectomy as monotherapy for prostate cancer. Clinical-pathological findings were used to calculate the CAPRA score. Before surgery blood was taken for CPC detection, mononuclear cells were obtained using differential gel centrifugation, and CPCs identified using immunocytochemistry. A CPC was defined as a cell expressing prostate-specific antigen and P504S, and the presence or absence of CPCs and the number of cells detected/8ml blood sample was registered. Patients were followed up for up to 5 years; biochemical failure was defined as a prostate-specific antigen>0.2ng/ml. The validity of the CAPRA score was calibrated using partial validation, and the fractional polynomial Cox proportional hazard regression was used to build 3 models, which underwent a decision analysis curve to determine the predictive value of the 3 models with respect to biochemical failure. A total of 267 men participated, mean age 65.80 years, and after 5 years of follow-up the biochemical-free survival was 67.42%. The model using CAPRA score showed a hazards ratio (HR) of 5.76 between low and high-risk groups, that of CPC with a HR of 26.84 between positive and negative groups, and the combined model showed a HR of 4.16 for CAPRA score and 19.93 for CPC. Using the continuous variable nCPC, there was no improvement in the predictive value of the model compared with the model using a positive-negative result of CPC detection. The combined CAPRA-nCPC model showed an improvement of the predictive performance for biochemical failure using the Harrell׳s C concordance test and a net benefit on DCA in comparison with either model used separately. The use of primary CPC as a predictive factor based on their presence or absence did not predict aggressive disease or biochemical failure. Although the use of a combined CAPRA-nCPC model improves the prediction of biochemical failure in patients undergoing radical prostatectomy for prostate cancer, this is minimal. The use of the presence or absence of primary CPCs alone did not predict aggressive disease or biochemical failure. Copyright © 2016 Elsevier Inc. All rights reserved.

A Multi-channel Semicircular Canal Neural Prosthesis Using Electrical Stimulation to Restore 3D Vestibular Sensation

PubMed Central

Della Santina, Charles C.; Migliaccio, Americo A.; Patel, Amit H.

2009-01-01

Bilateral loss of vestibular sensation can be disabling. Those afflicted suffer illusory visual field movement during head movements, chronic disequilibrium and postural instability due to failure of vestibulo-ocular and vestibulo-spinal reflexes. A neural prosthesis that emulates the normal transduction of head rotation by semicircular canals could significantly improve quality of life for these patients. Like the 3 semicircular canals in a normal ear, such a device should at least transduce 3 orthogonal (or linearly separable) components of head rotation into activity on corresponding ampullary branches of the vestibular nerve. We describe the design, circuit performance and in vivo application of a head-mounted, semi-implantable multi-channel vestibular prosthesis that encodes head movement in 3 dimensions as pulse-frequency-modulated electrical stimulation of 3 or more ampullary nerves. In chinchillas treated with intratympanic gentamicin to ablate vestibular sensation bilaterally, prosthetic stimuli elicited a partly compensatory angular vestibulo-ocular reflex in multiple planes. Minimizing misalignment between the axis of eye and head rotation, apparently caused by current spread beyond each electrode’s targeted nerve branch, emerged as a key challenge. Increasing stimulation selectivity via improvements in electrode design, surgical technique and stimulus protocol will likely be required to restore AVOR function over the full range of normal behavior. PMID:17554821

A Comparative Study of Classification and Regression Algorithms for Modelling Students' Academic Performance

ERIC Educational Resources Information Center

Strecht, Pedro; Cruz, Luís; Soares, Carlos; Mendes-Moreira, João; Abreu, Rui

2015-01-01

Predicting the success or failure of a student in a course or program is a problem that has recently been addressed using data mining techniques. In this paper we evaluate some of the most popular classification and regression algorithms on this problem. We address two problems: prediction of approval/failure and prediction of grade. The former is…

The Role of Predictability in Saccadic Eye Responses in the Suppression Head Impulse Test of Horizontal Semicircular Canal Function.

PubMed

Rey-Martinez, Jorge; Yanes, Joaquin; Esteban, Jonathan; Sanz, Ricardo; Martin-Sanz, Eduardo

2017-01-01

In the suppression head impulse paradigm (SHIMP) vHIT protocol, the participant is instructed to follow with his gaze a mobile target generated by a laser placed on the participant's head. Recent studies have reported that the refixation saccade latencies are in relation with the time evolution of the vestibular dysfunction in both (standard and SHIMP) procedures. We hypothesized that some central mechanisms like head impulse prediction could be one of the causes for the differences in the saccadic eye responses. A prospective cohort non-randomized study was designed. For the SHIMP protocol, recorded with the ICS Impulse ver. 4.0 ® (Otometrics A/S, Taastrup, Denmark) vHIT device, three different algorithms were performed: "predictable," "less predictable," and "unpredictable" depending on the target's predictability. A mathematical method was developed to analyze the SHIMP responses. The method was implemented as an additional tool to the MATLAB open source script for the extended analysis of the vHIT responses named HITCal. In cohort 1, 52 participants were included in "predictable" SHIMP protocol. In cohort 2, 60 patients were included for the "less predictable" and 35 patients for the "unpredictable" SHIMP protocol. The participants made more early saccades when instructed to perform the "predictable" paradigm compared with the "less predictable" paradigm ( p  < 0.001). The less predictable protocol did not reveal any significant difference when compared with the unpredictable protocol ( p  = 0.189). For the latency of the first saccade, there was statistical difference between the "unpredictable" and "predictable" protocols ( p  < 0.001) and between the "less predictable" and "predictable" protocols ( p  < 0.001). Finally, we did not find any relationship between the horizontal vestibulo-ocular reflex (hVOR) gain and the latency of the saccades. We developed a specific method to analyze and detect early SHIMP saccades. Our findings offer evidence regarding the influence of predictability on the latency of the SHIMP saccadic responses, suggesting that early saccades are probably caused by a conditioned response of the participant. The lack of relationship between the hVOR gain and the latency of the saccades suggests that the predictive behavior that caused the early eye saccades are independent of the vestibular function.

Predicting the mechanical behaviour of Kevlar/epoxy and carbon/epoxy filament-wound tubes

NASA Astrophysics Data System (ADS)

Cazeneuve, C.; Joguet, P.; Maile, J. C.; Oytana, C.

1992-11-01

The axial, hoop and shear moduli and failure conditions of carbon/epoxy and Kevlar/epoxy filament-wound tubes have been determined through respective applications of internal pressure, tension and torsion. The introduction in the laminated plate theory of a gradual reduction in individual moduli makes it possible to overcome the limitations of the theory and enables accurate predictions to be made of the linear and non-linear stress/strain curves of 90 deg +/- 0/90 deg tubes. The existence of a dominant layer in the failure of the multilayered tubes has been shown experimentally. When associated with a failure criterion applied to the dominant layer, the new model permits the prediction of tube failure. Agreement between calculated and experimental data is better than 5 percent.

Implicit and Explicit Attitudes Predict Smoking Cessation: Moderating Effects of Experienced Failure to Control Smoking and Plans to Quit

PubMed Central

Chassin, Laurie; Presson, Clark C.; Sherman, Steven J.; Seo, Dong-Chul; Macy, Jon

2010-01-01

The current study tested implicit and explicit attitudes as prospective predictors of smoking cessation in a Midwestern community sample of smokers. Results showed that the effects of attitudes significantly varied with levels of experienced failure to control smoking and plans to quit. Explicit attitudes significantly predicted later cessation among those with low (but not high or average) levels of experienced failure to control smoking. Conversely, however, implicit attitudes significantly predicted later cessation among those with high levels of experienced failure to control smoking, but only if they had a plan to quit. Because smoking cessation involves both controlled and automatic processes, interventions may need to consider attitude change interventions that focus on both implicit and explicit attitudes. PMID:21198227

Bridging the gap between marker-assisted and genomic selection of heading time and plant height in hybrid wheat.

PubMed

Zhao, Y; Mette, M F; Gowda, M; Longin, C F H; Reif, J C

2014-06-01

Based on data from field trials with a large collection of 135 elite winter wheat inbred lines and 1604 F1 hybrids derived from them, we compared the accuracy of prediction of marker-assisted selection and current genomic selection approaches for the model traits heading time and plant height in a cross-validation approach. For heading time, the high accuracy seen with marker-assisted selection severely dropped with genomic selection approaches RR-BLUP (ridge regression best linear unbiased prediction) and BayesCπ, whereas for plant height, accuracy was low with marker-assisted selection as well as RR-BLUP and BayesCπ. Differences in the linkage disequilibrium structure of the functional and single-nucleotide polymorphism markers relevant for the two traits were identified in a simulation study as a likely explanation for the different trends in accuracies of prediction. A new genomic selection approach, weighted best linear unbiased prediction (W-BLUP), designed to treat the effects of known functional markers more appropriately, proved to increase the accuracy of prediction for both traits and thus closes the gap between marker-assisted and genomic selection.

Bridging the gap between marker-assisted and genomic selection of heading time and plant height in hybrid wheat

PubMed Central

Zhao, Y; Mette, M F; Gowda, M; Longin, C F H; Reif, J C

2014-01-01

Based on data from field trials with a large collection of 135 elite winter wheat inbred lines and 1604 F1 hybrids derived from them, we compared the accuracy of prediction of marker-assisted selection and current genomic selection approaches for the model traits heading time and plant height in a cross-validation approach. For heading time, the high accuracy seen with marker-assisted selection severely dropped with genomic selection approaches RR-BLUP (ridge regression best linear unbiased prediction) and BayesCπ, whereas for plant height, accuracy was low with marker-assisted selection as well as RR-BLUP and BayesCπ. Differences in the linkage disequilibrium structure of the functional and single-nucleotide polymorphism markers relevant for the two traits were identified in a simulation study as a likely explanation for the different trends in accuracies of prediction. A new genomic selection approach, weighted best linear unbiased prediction (W-BLUP), designed to treat the effects of known functional markers more appropriately, proved to increase the accuracy of prediction for both traits and thus closes the gap between marker-assisted and genomic selection. PMID:24518889

Modeling gravity-dependent plasticity of the angular vestibuloocular reflex with a physiologically based neural network.

PubMed

Xiang, Yongqing; Yakushin, Sergei B; Cohen, Bernard; Raphan, Theodore

2006-12-01

A neural network model was developed to explain the gravity-dependent properties of gain adaptation of the angular vestibuloocular reflex (aVOR). Gain changes are maximal at the head orientation where the gain is adapted and decrease as the head is tilted away from that position and can be described by the sum of gravity-independent and gravity-dependent components. The adaptation process was modeled by modifying the weights and bias values of a three-dimensional physiologically based neural network of canal-otolith-convergent neurons that drive the aVOR. Model parameters were trained using experimental vertical aVOR gain values. The learning rule aimed to reduce the error between eye velocities obtained from experimental gain values and model output in the position of adaptation. Although the model was trained only at specific head positions, the model predicted the experimental data at all head positions in three dimensions. Altering the relative learning rates of the weights and bias improved the model-data fits. Model predictions in three dimensions compared favorably with those of a double-sinusoid function, which is a fit that minimized the mean square error at every head position and served as the standard by which we compared the model predictions. The model supports the hypothesis that gravity-dependent adaptation of the aVOR is realized in three dimensions by a direct otolith input to canal-otolith neurons, whose canal sensitivities are adapted by the visual-vestibular mismatch. The adaptation is tuned by how the weights from otolith input to the canal-otolith-convergent neurons are adapted for a given head orientation.

Long Term Survivorship of a Severely Notched Femoral Stem after Replacing the Fractured Ceramic head with a Cobalt-Chromium Head

PubMed Central

Panagopoulos, Andreas; Tatani, Irini; Megas, Panagiotis

2016-01-01

Background: Although ceramic head fracture occurs infrequently today, in the event of a fracture, the resulting revision surgery can prove very challenging, since the ceramic particles lodge into the surrounding soft tissue and can cause rapid implant failure Case Presentation: A case of long term survivorship of a severed notched femoral stem after replacing the fractured femoral head with a cobalt-chromium one is reported in a 40-year old woman with hip dysplasia who underwent an uncomplicated total hip arthroplasty. The incident of ceramic femoral head fracture occurred 14 months postoperatively without reporting any significant trauma. Intraoperative findings at revision were a multifragmented femoral head and a damaged polyethylene insert along with diffuse metallosis and excessive wear of the cone of the stem. Both the stem and the acetabular component were stable. After removal of ceramic fragments, metallotic tissue excision and careful lavage of the joint, the inlay was replaced by a similar one and a cobalt-chromium femoral head was placed to the existing notched taper of the firmly incorporated stem. At the 13th year follow up examination, the patient had no pain, used no walking aids, and had normal activity with no signs of wearing or loosening in the plain x-rays. Conclusion: Despite current recommendations of using ceramic femoral heads in cases of fracture or to revise the severely damaged stems we were able to provide a long term survivorship up to 13 years postoperatively of a cobalt-chromium femoral head applied to a severe damaged stem. PMID:28217203

Long Term Survivorship of a Severely Notched Femoral Stem after Replacing the Fractured Ceramic head with a Cobalt-Chromium Head.

PubMed

Panagopoulos, Andreas; Tatani, Irini; Megas, Panagiotis

2016-01-01

Although ceramic head fracture occurs infrequently today, in the event of a fracture, the resulting revision surgery can prove very challenging, since the ceramic particles lodge into the surrounding soft tissue and can cause rapid implant failure. A case of long term survivorship of a severed notched femoral stem after replacing the fractured femoral head with a cobalt-chromium one is reported in a 40-year old woman with hip dysplasia who underwent an uncomplicated total hip arthroplasty. The incident of ceramic femoral head fracture occurred 14 months postoperatively without reporting any significant trauma. Intraoperative findings at revision were a multifragmented femoral head and a damaged polyethylene insert along with diffuse metallosis and excessive wear of the cone of the stem. Both the stem and the acetabular component were stable. After removal of ceramic fragments, metallotic tissue excision and careful lavage of the joint, the inlay was replaced by a similar one and a cobalt-chromium femoral head was placed to the existing notched taper of the firmly incorporated stem. At the 13 th year follow up examination, the patient had no pain, used no walking aids, and had normal activity with no signs of wearing or loosening in the plain x-rays. Despite current recommendations of using ceramic femoral heads in cases of fracture or to revise the severely damaged stems we were able to provide a long term survivorship up to 13 years postoperatively of a cobalt-chromium femoral head applied to a severe damaged stem.

Metallic ureteral stents in malignant ureteral obstruction: clinical factors predicting stent failure.

PubMed

Chow, Po-Ming; Hsu, Jui-Shan; Huang, Chao-Yuan; Wang, Shuo-Meng; Lee, Yuan-Ju; Huang, Kuo-How; Yu, Hong-Jheng; Pu, Yeong-Shiau; Liang, Po-Chin

2014-06-01

To provide clinical outcomes of the Resonance metallic ureteral stent in patients with malignant ureteral obstruction, as well as clinical factors predicting stent failure. Cancer patients who have received Resonance stents from July 2009 to March 2012 for ureteral obstruction were included for chart review. Stent failure was detected by clinical symptoms, image studies, and renal function tests. Survival analysis for stent duration was used to estimate patency rate and factors predicting stent failure. A total of 117 stents were inserted successfully into 94 ureteral units in 79 patients. There were no major complications. These stents underwent survival analysis and proportional hazard regression. The median duration for the stents was 5.77 months. In multivariate analysis, age (P=0.043), preoperative serum creatinine level (P=0.0174), and cancer type (P=0.0494) were significant factors associated with stent failure. Cancer treatment before and after stent insertion had no effect on stent duration. Resonance stents are effective and safe in relieving malignant ureteral obstructions. Old age and high serum creatinine level are predictors for stent failure. Stents in patients with lower gastrointestinal cancers have longer functional duration.

Sonographical predictive markers of failure of induction of labour in term pregnancy.

PubMed

Brik, Maia; Mateos, Silvia; Fernandez-Buhigas, Irene; Garbayo, Paloma; Costa, Gloria; Santacruz, Belen

2017-02-01

Predictive markers of failure of induction of labour in term pregnancy were evaluated. A prospective study including 245 women attending induction of labour was performed. The inclusion criteria were singleton pregnancies, gestational age 37-42 weeks and the main outcomes were failure of induction, induction to delivery interval and mode of delivery. Women with a longer cervical length prior to induction (CLpi) had a higher rate of failure of induction (30.9 ± 6.8 vs. 23.9 ± 9.3, p < .001). BMI was higher and maternal height was lower in the group of caesarean section compared to vaginal delivery (33.1 ± 8 vs. 29.3 ± 4.6, 160 ± 5 vs. 164 ± 5, p < .001, respectively). A shorter CLpi correlated with a shorter induction to delivery interval (R Pearson .237, p < .001). In the regression analysis, for failure of induction the only independent predictor was the CL prior to induction. Therefore, the CLpi is an independent factor for prediction of failure of induction of labour.

A new yield and failure theory for composite materials under static and dynamic loading

DOE PAGES

Daniel, Isaac M.; Daniel, Sam M.; Fenner, Joel S.

2017-09-12

In order to facilitate and accelerate the process of introducing, evaluating and adopting new material systems, it is important to develop/establish comprehensive and effective procedures of characterization, modeling and failure prediction of composite structures based on the properties of the constituent materials, e. g., fibers, matrix, and the single ply or lamina. A new yield/failure theory is proposed for predicting lamina yielding and failure under multi-axial states of stress including strain rate effects. It is based on the equivalent stress concept derived from energy principles and is expressed in terms of a single criterion. It is presented in the formmore » of master yield and failure envelopes incorporating strain rate effects. The theory can be further adapted and extended to the prediction of in situ first ply yielding and failure (FPY and FPF) and progressive damage of multi-directional laminates under static and dynamic loadings. The significance of this theory is that it allows for rapid screening of new composite materials without extensive testing and offers easily implemented design tools.« less

A new yield and failure theory for composite materials under static and dynamic loading

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

Daniel, Isaac M.; Daniel, Sam M.; Fenner, Joel S.

In order to facilitate and accelerate the process of introducing, evaluating and adopting new material systems, it is important to develop/establish comprehensive and effective procedures of characterization, modeling and failure prediction of composite structures based on the properties of the constituent materials, e. g., fibers, matrix, and the single ply or lamina. A new yield/failure theory is proposed for predicting lamina yielding and failure under multi-axial states of stress including strain rate effects. It is based on the equivalent stress concept derived from energy principles and is expressed in terms of a single criterion. It is presented in the formmore » of master yield and failure envelopes incorporating strain rate effects. The theory can be further adapted and extended to the prediction of in situ first ply yielding and failure (FPY and FPF) and progressive damage of multi-directional laminates under static and dynamic loadings. The significance of this theory is that it allows for rapid screening of new composite materials without extensive testing and offers easily implemented design tools.« less

Identifying the necessary and sufficient number of risk factors for predicting academic failure.

PubMed

Lucio, Robert; Hunt, Elizabeth; Bornovalova, Marina

2012-03-01

Identifying the point at which individuals become at risk for academic failure (grade point average [GPA] < 2.0) involves an understanding of which and how many factors contribute to poor outcomes. School-related factors appear to be among the many factors that significantly impact academic success or failure. This study focused on 12 school-related factors. Using a thorough 5-step process, we identified which unique risk factors place one at risk for academic failure. Academic engagement, academic expectations, academic self-efficacy, homework completion, school relevance, school safety, teacher relationships (positive relationship), grade retention, school mobility, and school misbehaviors (negative relationship) were uniquely related to GPA even after controlling for all relevant covariates. Next, a receiver operating characteristic curve was used to determine a cutoff point for determining how many risk factors predict academic failure (GPA < 2.0). Results yielded a cutoff point of 2 risk factors for predicting academic failure, which provides a way for early identification of individuals who are at risk. Further implications of these findings are discussed. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Multiaxial Temperature- and Time-Dependent Failure Model

NASA Technical Reports Server (NTRS)

Richardson, David; McLennan, Michael; Anderson, Gregory; Macon, David; Batista-Rodriquez, Alicia

2003-01-01

A temperature- and time-dependent mathematical model predicts the conditions for failure of a material subjected to multiaxial stress. The model was initially applied to a filled epoxy below its glass-transition temperature, and is expected to be applicable to other materials, at least below their glass-transition temperatures. The model is justified simply by the fact that it closely approximates the experimentally observed failure behavior of this material: The multiaxiality of the model has been confirmed (see figure) and the model has been shown to be applicable at temperatures from -20 to 115 F (-29 to 46 C) and to predict tensile failures of constant-load and constant-load-rate specimens with failure times ranging from minutes to months..

Pitfalls and Precautions When Using Predicted Failure Data for Quantitative Analysis of Safety Risk for Human Rated Launch Vehicles

NASA Technical Reports Server (NTRS)

Hatfield, Glen S.; Hark, Frank; Stott, James

2016-01-01

Launch vehicle reliability analysis is largely dependent upon using predicted failure rates from data sources such as MIL-HDBK-217F. Reliability prediction methodologies based on component data do not take into account system integration risks such as those attributable to manufacturing and assembly. These sources often dominate component level risk. While consequence of failure is often understood, using predicted values in a risk model to estimate the probability of occurrence may underestimate the actual risk. Managers and decision makers use the probability of occurrence to influence the determination whether to accept the risk or require a design modification. The actual risk threshold for acceptance may not be fully understood due to the absence of system level test data or operational data. This paper will establish a method and approach to identify the pitfalls and precautions of accepting risk based solely upon predicted failure data. This approach will provide a set of guidelines that may be useful to arrive at a more realistic quantification of risk prior to acceptance by a program.

Impact of the Occlusion Duration on the Performance of J-CTO Score in Predicting Failure of Percutaneous Coronary Intervention for Chronic Total Occlusion.

PubMed

de Castro-Filho, Antonio; Lamas, Edgar Stroppa; Meneguz-Moreno, Rafael A; Staico, Rodolfo; Siqueira, Dimytri; Costa, Ricardo A; Braga, Sergio N; Costa, J Ribamar; Chamié, Daniel; Abizaid, Alexandre

2017-06-01

The present study examined the association between Multicenter CTO Registry in Japan (J-CTO) score in predicting failure of percutaneous coronary intervention (PCI) correlating with the estimated duration of chronic total occlusion (CTO). The J-CTO score does not incorporate estimated duration of the occlusion. This was an observational retrospective study that involved all consecutive procedures performed at a single tertiary-care cardiology center between January 2009 and December 2014. A total of 174 patients, median age 59.5 years (interquartile range [IQR], 53-65 years), undergoing CTO-PCI were included. The median estimated occlusion duration was 7.5 months (IQR, 4.0-12.0 months). The lesions were classified as easy (score = 0), intermediate (score = 1), difficult (score = 2), and very difficult (score ≥3) in 51.1%, 33.9%, 9.2%, and 5.7% of the patients, respectively. Failure rate significantly increased with higher J-CTO score (7.9%, 20.3%, 50.0%, and 70.0% in groups with J-CTO scores of 0, 1, 2, and ≥3, respectively; P<.001). There was no significant difference in success rate according to estimated duration of occlusion (P=.63). Indeed, J-CTO score predicted failure of CTO-PCI independently of the estimated occlusion duration (P=.24). Areas under receiver-operating characteristic curves were computed and it was observed that for each occlusion time period, the discriminatory capacity of the J-CTO score in predicting CTO-PCI failure was good, with a C-statistic >0.70. The estimated duration of occlusion had no influence on the J-CTO score performance in predicting failure of PCI in CTO lesions. The probability of failure was mainly determined by grade of lesion complexity.

DEPEND - A design environment for prediction and evaluation of system dependability

NASA Technical Reports Server (NTRS)

Goswami, Kumar K.; Iyer, Ravishankar K.

1990-01-01

The development of DEPEND, an integrated simulation environment for the design and dependability analysis of fault-tolerant systems, is described. DEPEND models both hardware and software components at a functional level, and allows automatic failure injection to assess system performance and reliability. It relieves the user of the work needed to inject failures, maintain statistics, and output reports. The automatic failure injection scheme is geared toward evaluating a system under high stress (workload) conditions. The failures that are injected can affect both hardware and software components. To illustrate the capability of the simulator, a distributed system which employs a prediction-based, dynamic load-balancing heuristic is evaluated. Experiments were conducted to determine the impact of failures on system performance and to identify the failures to which the system is especially susceptible.

Factors Influencing Helmet Use, Head Injury, and Hospitalization Among Children Involved in Skateboarding and Snowboarding Accidents

PubMed Central

Sadeghian, Homa; Nguyen, Brian; Huynh, Nhan; Rouch, Joshua; Lee, Steven L; Bazargan-Hejazi, Shahrzad

2017-01-01

Context Up to 75% of skateboarders and snowboarders admitted to the hospital sustain head injuries. It is unclear why not all children and teenagers wear helmets while snowboarding and skateboarding given the protection they afford. Objectives To report on the prevalence of, and factors associated with, skateboarding and snowboarding in injured children and to explore factors that influence helmet use, head injury, and hospitalization in this sample. Design A cross-sectional study of skateboard- and snowboard-associated injuries from 2003 to 2012 among individuals younger than age 18 years using National Electronic Injury Surveillance System (NEISS) data from approximately 100 hospitals. Main Outcome Measures: Helmet use, head injury, and hospitalization. Results Of 1742 patients in the study, 852 (48.9%) and 890 (51.1%) were skateboarders and snowboarders, respectively. Overall, 907 (52.1%) did not use helmets, and 704 (40.4%) sustained head injuries. Multiple logistic regression analysis showed that age, race/ethnicity, location of boarding, and engaging in skateboarding influenced helmet use. Sex, race/ethnicity, helmet use, and skateboarding predicted head injury. Age, sex, skateboarding, and head injury predicted hospital admission. Conclusion Statistically significant differences exist in helmet use, head injury, and hospitalization rates between skateboarders and snowboarders. Our findings suggest that injury prevention and outreach programs are needed to increase helmet use and reduce the risk of head injury and hospitalization in skateboarders and other at-risk groups. Further studies are needed to clarify the association between race/ethnicity and helmet use among skateboarders and snowboarders. PMID:28406787

[Unclear altered mental state and respiratory insufficiency following multiple injuries: fat embolism syndrome].

PubMed

Schott, M; Thürmer, G; Jantzen, J-P

2008-01-01

Fat embolism syndrome is associated with respiratory failure, hypoxia, petechial rash, pyrexia and altered mental state. Signs and symptoms usually begin within 12-72 h after trauma. The pathophysiology, differential diagnosis and therapeutic options of fat embolism syndrome are described and the case of a 29-year-old motorcyclist with fractures of the lower extremities, coma and respiratory failure 24-36 h after an accident is reported. Based on the clinical signs and course, fat embolism syndrome was suspected which was substantiated by ophthalmic fundoscopy and magnetic resonance imaging of the head.

Artificial neural network approach to predict surgical site infection after free-flap reconstruction in patients receiving surgery for head and neck cancer

PubMed Central

Kuo, Pao-Jen; Wu, Shao-Chun; Chien, Peng-Chen; Chang, Shu-Shya; Rau, Cheng-Shyuan; Tai, Hsueh-Ling; Peng, Shu-Hui; Lin, Yi-Chun; Chen, Yi-Chun; Hsieh, Hsiao-Yun; Hsieh, Ching-Hua

2018-01-01

Background The aim of this study was to develop an effective surgical site infection (SSI) prediction model in patients receiving free-flap reconstruction after surgery for head and neck cancer using artificial neural network (ANN), and to compare its predictive power with that of conventional logistic regression (LR). Materials and methods There were 1,836 patients with 1,854 free-flap reconstructions and 438 postoperative SSIs in the dataset for analysis. They were randomly assigned tin ratio of 7:3 into a training set and a test set. Based on comprehensive characteristics of patients and diseases in the absence or presence of operative data, prediction of SSI was performed at two time points (pre-operatively and post-operatively) with a feed-forward ANN and the LR models. In addition to the calculated accuracy, sensitivity, and specificity, the predictive performance of ANN and LR were assessed based on area under the curve (AUC) measures of receiver operator characteristic curves and Brier score. Results ANN had a significantly higher AUC (0.892) of post-operative prediction and AUC (0.808) of pre-operative prediction than LR (both P<0.0001). In addition, there was significant higher AUC of post-operative prediction than pre-operative prediction by ANN (p<0.0001). With the highest AUC and the lowest Brier score (0.090), the post-operative prediction by ANN had the highest overall predictive performance. Conclusion The post-operative prediction by ANN had the highest overall performance in predicting SSI after free-flap reconstruction in patients receiving surgery for head and neck cancer. PMID:29568393

Experimental Test of Spatial Updating Models for Monkey Eye-Head Gaze Shifts

PubMed Central

Van Grootel, Tom J.; Van der Willigen, Robert F.; Van Opstal, A. John

2012-01-01

How the brain maintains an accurate and stable representation of visual target locations despite the occurrence of saccadic gaze shifts is a classical problem in oculomotor research. Here we test and dissociate the predictions of different conceptual models for head-unrestrained gaze-localization behavior of macaque monkeys. We adopted the double-step paradigm with rapid eye-head gaze shifts to measure localization accuracy in response to flashed visual stimuli in darkness. We presented the second target flash either before (static), or during (dynamic) the first gaze displacement. In the dynamic case the brief visual flash induced a small retinal streak of up to about 20 deg at an unpredictable moment and retinal location during the eye-head gaze shift, which provides serious challenges for the gaze-control system. However, for both stimulus conditions, monkeys localized the flashed targets with accurate gaze shifts, which rules out several models of visuomotor control. First, these findings exclude the possibility that gaze-shift programming relies on retinal inputs only. Instead, they support the notion that accurate eye-head motor feedback updates the gaze-saccade coordinates. Second, in dynamic trials the visuomotor system cannot rely on the coordinates of the planned first eye-head saccade either, which rules out remapping on the basis of a predictive corollary gaze-displacement signal. Finally, because gaze-related head movements were also goal-directed, requiring continuous access to eye-in-head position, we propose that our results best support a dynamic feedback scheme for spatial updating in which visuomotor control incorporates accurate signals about instantaneous eye- and head positions rather than relative eye- and head displacements. PMID:23118883

Shoulder instability in the setting of bipolar (glenoid and humeral head) bone loss: the glenoid track concept.

PubMed

Trivedi, Suraj; Pomerantz, Michael L; Gross, Daniel; Golijanan, Petar; Provencher, Matthew T

2014-08-01

An assortment of variables has been used in predicting anterior shoulder instability resulting from pathologic engagement of Hill-Sachs lesions on the glenoid. The glenoid track is a unique biomechanical model that relates both Hill-Sachs and bony Bankart lesions to predict shoulder engagement. We examined the glenoid track concept to determine if it provides a model that unifies glenoid rim and humeral head bone loss in predicting engagement. In this review we addressed two questions: (1) How are humeral head and glenoid rim bony defects and their interactions quantified? (2) Why is the concept of the glenoid track important? We performed a systematic review of the literature using PubMed (MEDLINE) and OVID for biomechanical studies and peer-reviewed articles published until March 2013. Twenty-four studies fit the inclusion criteria. These were subdivided into four anatomic studies, four studies quantifying glenohumeral bone loss, nine studies biomechanically defining shoulder engagement, six studies analyzing current treatment models, and one clinical study to be included in the final review. Data demonstrate pathologic engagement is dependent on the medial margin of the Hill-Sachs lesion traveling outside the glenoid track. The width of the glenoid track decreases accordingly if there is a glenoid defect, making engagement more likely. Most treatment models focus on widening the glenoid track before addressing Hill-Sachs lesions. The glenoid track uses both glenoid and humeral head bone loss to predict subsequent risk of humeral head engagement and possible dislocation. The glenoid track shows us that restoring the track to its natural width should be among the surgeon's first priority in restoring shoulder stability. Humeral head lesions, also known as Hill-Sachs lesions, are surgically addressed when they cause clinical symptoms. Symptoms arise when the medial margin of the defect engages the glenoid track.

Thermal barrier coating life prediction model

NASA Technical Reports Server (NTRS)

Pilsner, B. H.; Hillery, R. V.; Mcknight, R. L.; Cook, T. S.; Kim, K. S.; Duderstadt, E. C.

1986-01-01

The objectives of this program are to determine the predominant modes of degradation of a plasma sprayed thermal barrier coating system, and then to develop and verify life prediction models accounting for these degradation modes. The program is divided into two phases, each consisting of several tasks. The work in Phase 1 is aimed at identifying the relative importance of the various failure modes, and developing and verifying life prediction model(s) for the predominant model for a thermal barrier coating system. Two possible predominant failure mechanisms being evaluated are bond coat oxidation and bond coat creep. The work in Phase 2 will develop design-capable, causal, life prediction models for thermomechanical and thermochemical failure modes, and for the exceptional conditions of foreign object damage and erosion.

Improved Fiber-Optic-Coupled Pressure And Vibration Sensors

NASA Technical Reports Server (NTRS)

Zuckerwar, Allan J.; Cuomo, Frank W.

1994-01-01

Improved fiber-optic coupler enables use of single optical fiber to carry light to and from sensor head. Eliminates problem of alignment of multiple fibers in sensor head and simplifies calibration by making performance both more predictable and more stable. Sensitivities increased, sizes reduced. Provides increased margin for design of compact sensor heads not required to contain amplifier circuits and withstand high operating temperatures.

Autonomous Motion Planning Using a Predictive Temporal Method

DTIC Science & Technology

2009-01-01

interception test. ......150 5-20 Target and solution path heading angles for target interception test. ..............................151 10 LIST...environment as a series of distances and angles . Regardless of the technique, this knowledge of the surrounding area is crucial for the issue of...to, the rather simplistic vector driver algorithms which compute the angle between the current vehicle heading and the heading to the goal and

Performance of Subsurface Tube Drainage System in Saline Soils: A Case Study

NASA Astrophysics Data System (ADS)

Pali, A. K.

2015-06-01

In order to improve the saline and water logged soils caused due to groundwater table rise, installation of subsurface drainage system is considered as one of the best remedies. However, the design of the drainage system has to be accurate so that the field performance results conform to the designed results. In this investigation, the field performance of subsurface tube drainage system installed at the study area was evaluated. The performance was evaluated on the basis of comparison of the designed value of water table drop as 30 cm after 2 days of drainage and predicted and field measured hydraulic heads for a consecutive drainage period of 14 days. The investigation revealed that the actual drop of water table after 2 days of drainage was 25 cm, about 17 % less than the designed value of 30 cm after 2 days of drainage. The comparison of hydraulic heads predicted by Van Schilfgaarde equation of unsteady drainage with the field-measured hydraulic heads showed that the deviation of predicted hydraulic heads varied within a range of ±8 % indicating high acceptability of Van Schlifgaarde equation for designing subsurface drainage system in saline and water logged soils resembling to that of the study area.

Some practical observations on the accelerated testing of Nickel-Cadmium Cells

NASA Technical Reports Server (NTRS)

Mcdermott, P. P.

1979-01-01

A large scale test of 6.0 Ah Nickel-Cadmium Cells conducted at the Naval Weapons Support Center, Crane, Indiana has demonstrated a methodology for predicting battery life based on failure data from cells cycled in an accelerated mode. After examining eight variables used to accelerate failure, it was determined that temperature and depth of discharge were the most reliable and efficient parameters for use in accelerating failure and for predicting life.

Probability of failure prediction for step-stress fatigue under sine or random stress

NASA Technical Reports Server (NTRS)

Lambert, R. G.

1979-01-01

A previously proposed cumulative fatigue damage law is extended to predict the probability of failure or fatigue life for structural materials with S-N fatigue curves represented as a scatterband of failure points. The proposed law applies to structures subjected to sinusoidal or random stresses and includes the effect of initial crack (i.e., flaw) sizes. The corrected cycle ratio damage function is shown to have physical significance.

Using methods from the data mining and machine learning literature for disease classification and prediction: A case study examining classification of heart failure sub-types

PubMed Central

Austin, Peter C.; Tu, Jack V.; Ho, Jennifer E.; Levy, Daniel; Lee, Douglas S.

2014-01-01

Objective Physicians classify patients into those with or without a specific disease. Furthermore, there is often interest in classifying patients according to disease etiology or subtype. Classification trees are frequently used to classify patients according to the presence or absence of a disease. However, classification trees can suffer from limited accuracy. In the data-mining and machine learning literature, alternate classification schemes have been developed. These include bootstrap aggregation (bagging), boosting, random forests, and support vector machines. Study design and Setting We compared the performance of these classification methods with those of conventional classification trees to classify patients with heart failure according to the following sub-types: heart failure with preserved ejection fraction (HFPEF) vs. heart failure with reduced ejection fraction (HFREF). We also compared the ability of these methods to predict the probability of the presence of HFPEF with that of conventional logistic regression. Results We found that modern, flexible tree-based methods from the data mining literature offer substantial improvement in prediction and classification of heart failure sub-type compared to conventional classification and regression trees. However, conventional logistic regression had superior performance for predicting the probability of the presence of HFPEF compared to the methods proposed in the data mining literature. Conclusion The use of tree-based methods offers superior performance over conventional classification and regression trees for predicting and classifying heart failure subtypes in a population-based sample of patients from Ontario. However, these methods do not offer substantial improvements over logistic regression for predicting the presence of HFPEF. PMID:23384592

Sensitivity, Specificity, Predictive Values, and Accuracy of Three Diagnostic Tests to Predict Inferior Alveolar Nerve Blockade Failure in Symptomatic Irreversible Pulpitis

PubMed Central

Rodríguez-Wong, Laura; Noguera-González, Danny; Esparza-Villalpando, Vicente; Montero-Aguilar, Mauricio

2017-01-01

Introduction The inferior alveolar nerve block (IANB) is the most common anesthetic technique used on mandibular teeth during root canal treatment. Its success in the presence of preoperative inflammation is still controversial. The aim of this study was to evaluate the sensitivity, specificity, predictive values, and accuracy of three diagnostic tests used to predict IANB failure in symptomatic irreversible pulpitis (SIP). Methodology A cross-sectional study was carried out on the mandibular molars of 53 patients with SIP. All patients received a single cartridge of mepivacaine 2% with 1 : 100000 epinephrine using the IANB technique. Three diagnostic clinical tests were performed to detect anesthetic failure. Anesthetic failure was defined as a positive painful response to any of the three tests. Sensitivity, specificity, predictive values, accuracy, and ROC curves were calculated and compared and significant differences were analyzed. Results IANB failure was determined in 71.7% of the patients. The sensitivity scores for the three tests (lip numbness, the cold stimuli test, and responsiveness during endodontic access) were 0.03, 0.35, and 0.55, respectively, and the specificity score was determined as 1 for all of the tests. Clinically, none of the evaluated tests demonstrated a high enough accuracy (0.30, 0.53, and 0.68 for lip numbness, the cold stimuli test, and responsiveness during endodontic access, resp.). A comparison of the areas under the curve in the ROC analyses showed statistically significant differences between the three tests (p < 0.05). Conclusion None of the analyzed tests demonstrated a high enough accuracy to be considered a reliable diagnostic tool for the prediction of anesthetic failure. PMID:28694714

A Bayesian network approach for modeling local failure in lung cancer

NASA Astrophysics Data System (ADS)

Oh, Jung Hun; Craft, Jeffrey; Lozi, Rawan Al; Vaidya, Manushka; Meng, Yifan; Deasy, Joseph O.; Bradley, Jeffrey D.; El Naqa, Issam

2011-03-01

Locally advanced non-small cell lung cancer (NSCLC) patients suffer from a high local failure rate following radiotherapy. Despite many efforts to develop new dose-volume models for early detection of tumor local failure, there was no reported significant improvement in their application prospectively. Based on recent studies of biomarker proteins' role in hypoxia and inflammation in predicting tumor response to radiotherapy, we hypothesize that combining physical and biological factors with a suitable framework could improve the overall prediction. To test this hypothesis, we propose a graphical Bayesian network framework for predicting local failure in lung cancer. The proposed approach was tested using two different datasets of locally advanced NSCLC patients treated with radiotherapy. The first dataset was collected retrospectively, which comprises clinical and dosimetric variables only. The second dataset was collected prospectively in which in addition to clinical and dosimetric information, blood was drawn from the patients at various time points to extract candidate biomarkers as well. Our preliminary results show that the proposed method can be used as an efficient method to develop predictive models of local failure in these patients and to interpret relationships among the different variables in the models. We also demonstrate the potential use of heterogeneous physical and biological variables to improve the model prediction. With the first dataset, we achieved better performance compared with competing Bayesian-based classifiers. With the second dataset, the combined model had a slightly higher performance compared to individual physical and biological models, with the biological variables making the largest contribution. Our preliminary results highlight the potential of the proposed integrated approach for predicting post-radiotherapy local failure in NSCLC patients.

Will New Metal Heads Restore Mechanical Integrity of Corroded Trunnions?

PubMed

Derasari, Aditya; Gold, Jonathan E; Ismaily, Sabir; Noble, Philip C; Incavo, Stephen J

2017-04-01

Metal wear and corrosion from modular junctions in total hip arthroplasty can lead to further unwanted surgery. Trunnion tribocorrosion is recognized as an important contributor to failure. This study was performed to determine if new metal heads restore mechanical integrity of the original modular junction after impaction on corroded trunnions, and assess which variables affect stability of the new interface created at revision total hip arthroplasty. Twenty-two trunnions, cobalt-chromium (CoCr) and titanium alloy (TiAIV), (CoCr, n = 12; TiAIV, n = 10) and new metal heads were used, 10 trunnions in pristine condition and 12 with corrosion damage. Test states were performed using an MTS Machine and included the following: 1, Assembly; 2, Disassembly; 3, Assembly; 4, Toggling; and 5, Disassembly. During loading, three-dimensional motion of the head-trunnion junction was measured using a custom jig. There were no statistical differences in the tested mechanical properties between corroded and pristine trunnions implanted with a new metal femoral head. Average micromotion of the head versus trunnion interface was greatest at the start of loading, stabilizing after approximately 50 loading cycles at an average of 30.6 ± 3.2 μm. Corrosion at the trunnion does not disrupt mechanical integrity of the junction when a CoCr head is replaced with a CoCr trunnion. However, increased interface motion of a new metal head on a corroded titanium trunnion requires additional study. The evaluation of ball head size on mechanical integrity of trunnions would also be a potential subject of future investigation, as increasing the ball head size at the time of revision is not uncommon in revisions today. Copyright © 2016 Elsevier Inc. All rights reserved.

Implantable cardiac resynchronization therapy devices to monitor heart failure clinical status.

PubMed

Fung, Jeffrey Wing-Hong; Yu, Cheuk-Man

2007-03-01

Cardiac resynchronization therapy is a standard therapy for selected patients with heart failure. With advances in technology and storage capacity, the device acts as a convenient platform to provide valuable information about heart failure status in these high-risk patients. Unlike other modalities of investigation which may only allow one-off evaluation, heart failure status can be monitored by device diagnostics including heart rate variability, activity status, and intrathoracic impedance in a continuous basis. These parameters do not just provide long-term prognostic information but also may be useful to predict upcoming heart failure exacerbation. Prompt and early intervention may abort decompensation, prevent hospitalization, improve quality of life, and reduce health care cost. Moreover, this information may be applied to titrate the dosage of medication and monitor response to heart failure treatment. This review will focus on the prognostic and predictive values of heart failure status monitoring provided by these devices.

Evaluation of critical nuclear power plant electrical cable response to severe thermal fire conditions

NASA Astrophysics Data System (ADS)

Taylor, Gabriel James

The failure of electrical cables exposed to severe thermal fire conditions are a safety concern for operating commercial nuclear power plants (NPPs). The Nuclear Regulatory Commission (NRC) has promoted the use of risk-informed and performance-based methods for fire protection which resulted in a need to develop realistic methods to quantify the risk of fire to NPP safety. Recent electrical cable testing has been conducted to provide empirical data on the failure modes and likelihood of fire-induced damage. This thesis evaluated numerous aspects of the data. Circuit characteristics affecting fire-induced electrical cable failure modes have been evaluated. In addition, thermal failure temperatures corresponding to cable functional failures have been evaluated to develop realistic single point thermal failure thresholds and probability distributions for specific cable insulation types. Finally, the data was used to evaluate the prediction capabilities of a one-dimension conductive heat transfer model used to predict cable failure.

A Role for MST Neurons in Heading Estimation

NASA Technical Reports Server (NTRS)

Stone, Leland Scott; Perrone, J. A.; Wade, Charles E. (Technical Monitor)

1994-01-01

A template model of human visual self-motion perception (Perrone, JOSA, 1992; Perrone & Stone, Vis. Res., in press), which uses neurophysiologically realistic "heading detectors", is consistent with numerous human psychophysical results (Warren & Hannon, Nature, 1988; Stone & Perrone, Neuro. Abstr., 1991) including the failure of humans to estimate their heading (direction of forward translation) accurately under certain visual conditions (Royden et al., Nature, 1992). We tested the model detectors with stimuli used by others in- single-unit studies. The detectors showed emergent properties similar to those of MST neurons: 1) Sensitivity to non-preferred flow. Each detector is tuned to a specific combination of flow components and its response is systematically reduced by the addition of nonpreferred flow (Orban et al., PNAS, 1992), and 2) Position invariance. The detectors maintain their apparent preference for particular flow components over large regions of their receptive fields (e.g. Duffy & Wurtz, J. Neurophys., 1991; Graziano et al., J. Neurosci., 1994). It has been argued that this latter property is incompatible with MST playing a role in heading perception. The model however demonstrates how neurons with the above response properties could still support accurate heading estimation within extrastriate cortical maps.

The Inclusion of Arbitrary Load Histories in the Strength Decay Model for Stress Rupture

NASA Technical Reports Server (NTRS)

Reeder, James R.

2014-01-01

Stress rupture is a failure mechanism where failures can occur after a period of time, even though the material has seen no increase in load. Carbon/epoxy composite materials have demonstrated the stress rupture failure mechanism. In a previous work, a model was proposed for stress rupture of composite overwrap pressure vessels (COPVs) and similar composite structures based on strength degradation. However, the original model was limited to constant load periods (holds) at constant load. The model was expanded in this paper to address arbitrary loading histories and specifically the inclusions of ramp loadings up to holds and back down. The broadening of the model allows for failures on loading to be treated as any other failure that may occur during testing instead of having to be treated as a special case. The inclusion of ramps can also influence the length of the "safe period" following proof loading that was previously predicted by the model. No stress rupture failures are predicted in a safe period because time is required for strength to decay from above the proof level to the lower level of loading. Although the model can predict failures during the ramp periods, no closed-form solution for the failure times could be derived. Therefore, two suggested solution techniques were proposed. Finally, the model was used to design an experiment that could detect the difference between the strength decay model and a commonly used model for stress rupture. Although these types of models are necessary to help guide experiments for stress rupture, only experimental evidence will determine how well the model may predict actual material response. If the model can be shown to be accurate, current proof loading requirements may result in predicted safe periods as long as 10(13) years. COPVs design requirements for stress rupture may then be relaxed, allowing more efficient designs, while still maintaining an acceptable level of safety.

Multiple regression analysis of anthropometric measurements influencing the cephalic index of male Japanese university students.

PubMed

Hossain, Md Golam; Saw, Aik; Alam, Rashidul; Ohtsuki, Fumio; Kamarul, Tunku

2013-09-01

Cephalic index (CI), the ratio of head breadth to head length, is widely used to categorise human populations. The aim of this study was to access the impact of anthropometric measurements on the CI of male Japanese university students. This study included 1,215 male university students from Tokyo and Kyoto, selected using convenient sampling. Multiple regression analysis was used to determine the effect of anthropometric measurements on CI. The variance inflation factor (VIF) showed no evidence of a multicollinearity problem among independent variables. The coefficients of the regression line demonstrated a significant positive relationship between CI and minimum frontal breadth (p < 0.01), bizygomatic breadth (p < 0.01) and head height (p < 0.05), and a negative relationship between CI and morphological facial height (p < 0.01) and head circumference (p < 0.01). Moreover, the coefficient and odds ratio of logistic regression analysis showed a greater likelihood for minimum frontal breadth (p < 0.01) and bizygomatic breadth (p < 0.01) to predict round-headedness, and morphological facial height (p < 0.05) and head circumference (p < 0.01) to predict long-headedness. Stepwise regression analysis revealed bizygomatic breadth, head circumference, minimum frontal breadth, head height and morphological facial height to be the best predictor craniofacial measurements with respect to CI. The results suggest that most of the variables considered in this study appear to influence the CI of adult male Japanese students.

Prediction of failure in notched carbon-fibre-reinforced-polymer laminates under multi-axial loading.

PubMed

Tan, J L Y; Deshpande, V S; Fleck, N A

2016-07-13

A damage-based finite-element model is used to predict the fracture behaviour of centre-notched quasi-isotropic carbon-fibre-reinforced-polymer laminates under multi-axial loading. Damage within each ply is associated with fibre tension, fibre compression, matrix tension and matrix compression. Inter-ply delamination is modelled by cohesive interfaces using a traction-separation law. Failure envelopes for a notch and a circular hole are predicted for in-plane multi-axial loading and are in good agreement with the observed failure envelopes from a parallel experimental study. The ply-by-ply (and inter-ply) damage evolution and the critical mechanisms of ultimate failure also agree with the observed damage evolution. It is demonstrated that accurate predictions of notched compressive strength are obtained upon employing the band broadening stress for microbuckling, highlighting the importance of this damage mode in compression. This article is part of the themed issue 'Multiscale modelling of the structural integrity of composite materials'. © 2016 The Author(s).

Early Shear Failure Prediction in Incremental Sheet Forming Process Using FEM and ANN

NASA Astrophysics Data System (ADS)

Moayedfar, Majid; Hanaei, Hengameh; Majdi Rani, Ahmad; Musa, Mohd Azam Bin; Sadegh Momeni, Mohammad

2018-03-01

The application of incremental sheet forming process as a rapid forming technique is rising in variety of industries such as aerospace, automotive and biomechanical purposes. However, the sheet failure is a big challenge in this process which leads wasting lots of materials. Hence, this study tried to propose a method to predict the early sheet failure in this process using mathematical solution. For the feasibility of the study, design of experiment with the respond surface method is employed to extract a set of experiments data for the simulation. The significant forming parameters were recognized and their integration was used for prediction system. Then, the results were inserted to the artificial neural network as input parameters to predict a vast range of applicable parameters avoiding sheet failure in ISF. The value of accuracy R2 ∼0.93 was obtained and the maximum sheet stretch in the depth of 25mm were recorded. The figures generate from the trend of interaction between effective parameters were provided for future studies.

LS-DYNA Simulation of Hemispherical-punch Stamping Process Using an Efficient Algorithm for Continuum Damage Based Elastoplastic Constitutive Equation

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

Salajegheh, Nima; Abedrabbo, Nader; Pourboghrat, Farhang

An efficient integration algorithm for continuum damage based elastoplastic constitutive equations is implemented in LS-DYNA. The isotropic damage parameter is defined as the ratio of the damaged surface area over the total cross section area of the representative volume element. This parameter is incorporated into the integration algorithm as an internal variable. The developed damage model is then implemented in the FEM code LS-DYNA as user material subroutine (UMAT). Pure stretch experiments of a hemispherical punch are carried out for copper sheets and the results are compared against the predictions of the implemented damage model. Evaluation of damage parameters ismore » carried out and the optimized values that correctly predicted the failure in the sheet are reported. Prediction of failure in the numerical analysis is performed through element deletion using the critical damage value. The set of failure parameters which accurately predict the failure behavior in copper sheets compared to experimental data is reported as well.« less

Residual Strength Predictions with Crack Buckling

NASA Technical Reports Server (NTRS)

Dawicke, D. S.; Gullerud, A. S.; Dodds, R. H., Jr.; Hampton, R. W.

1999-01-01

Fracture tests were conducted on middle crack tension, M(T), and compact tension, C(T), specimens of varying widths, constructed from 0.063 inch thick sheets of 2024-T3 aluminum alloy. Guide plates were used to restrict out-of-plane displacements in about half of the tests. Analyses using the three-dimensional, elastic-plastic finite element code WARP3D simulated the tests with and without guide plates using a critical CTOA fracture criterion. The experimental results indicate that crack buckling reduced the failure loads by up to 40%. Using a critical CTOA value of 5.5 deg., the WARP3D analyses predicted the failure loads for the tests with guide plates within +/- 10% of the experimentally measured values. For the M(T) tests without guide plates, the WARP3D analyses predicted the failure loads for the 12 and 24 inch tests within 10%, while over predicting the failure loads for the 40 inch wide tests by about 20%.

Predictions of structural integrity of steam generator tubes under normal operating, accident, an severe accident conditions

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

Majumdar, S.

1997-02-01

Available models for predicting failure of flawed and unflawed steam generator tubes under normal operating, accident, and severe accident conditions are reviewed. Tests conducted in the past, though limited, tended to show that the earlier flow-stress model for part-through-wall axial cracks overestimated the damaging influence of deep cracks. This observation was confirmed by further tests at high temperatures, as well as by finite-element analysis. A modified correlation for deep cracks can correct this shortcoming of the model. Recent tests have shown that lateral restraint can significantly increase the failure pressure of tubes with unsymmetrical circumferential cracks. This observation was confirmedmore » by finite-element analysis. The rate-independent flow stress models that are successful at low temperatures cannot predict the rate-sensitive failure behavior of steam generator tubes at high temperatures. Therefore, a creep rupture model for predicting failure was developed and validated by tests under various temperature and pressure loadings that can occur during postulated severe accidents.« less

A model for the progressive failure of laminated composite structural components

NASA Technical Reports Server (NTRS)

Allen, D. H.; Lo, D. C.

1991-01-01

Laminated continuous fiber polymeric composites are capable of sustaining substantial load induced microstructural damage prior to component failure. Because this damage eventually leads to catastrophic failure, it is essential to capture the mechanics of progressive damage in any cogent life prediction model. For the past several years the authors have been developing one solution approach to this problem. In this approach the mechanics of matrix cracking and delamination are accounted for via locally averaged internal variables which account for the kinematics of microcracking. Damage progression is predicted by using phenomenologically based damage evolution laws which depend on the load history. The result is a nonlinear and path dependent constitutive model which has previously been implemented to a finite element computer code for analysis of structural components. Using an appropriate failure model, this algorithm can be used to predict component life. In this paper the model will be utilized to demonstrate the ability to predict the load path dependence of the damage and stresses in plates subjected to fatigue loading.

Deliberate Excellence

ERIC Educational Resources Information Center

Weast, Jerry D.

2010-01-01

Every autumn, 50 million children load their backpacks and head off to public school. Most children embark on the adventure of a new school year with a mix of anxiety and anticipation. Many excuses are offered for the failures of public education. Still, on their very first day of school, kindergartners and new teachers alike arrive with the…

Serving the Needs of At-Risk Refugee Youth: A Program Evaluation

ERIC Educational Resources Information Center

McBrien, J. Lynn

2006-01-01

Refugee students, although frequently subsumed under the "immigrant" heading, often suffer from effects of significant trauma that can make them more vulnerable than children of voluntary immigrant families. This study evaluated a program created specifically for refugee youth at-risk for academic failure and "social death." The program goals…

Effects of Pharmacologic and Immunologic Intervention on the Pseudomonas Porcine Model of ARDS

DTIC Science & Technology

1991-07-01

report, although it is Pancreatiti sShock now generally accepted that patients rarely Fat Embolism die from respiratory failure due to ARDS, but...34 was also noted to be present in soldiers who had sustained non-thoracic trauma such as abdominal wounds, fractures of long bones !nd head injuries

16 CFR 1508.11 - Requirements for cutouts.

Code of Federal Regulations, 2011 CFR

2011-01-01

... shall comply with the following test requirements: (a) Place the neck of the headform probe shown in... point of contact. The head portion of the probe shall be on the outer side of the panel. With the neck... at all points that could result in a failure), and the front of the probe pointing downwards, draw...

Outcomes after primary chemoradiotherapy for N3 (>6 cm) head and neck squamous cell carcinoma after an FDG-PET--guided neck management policy.

PubMed

Adams, Gerard; Porceddu, Sandro V; Pryor, David I; Panizza, Benedict; Foote, Matthew; Rowan, Ann; Burmeister, Bryan

2014-08-01

The purpose of this study was to assess whether a positron emission tomography (PET)-directed policy remains appropriate for managing neck nodes (N3; >6 cm) in head and neck squamous cell carcinoma (HNSCC). All patients with N3 (>6 cm) HNSCC treated with definitive chemoradiotherapy (CRT) at our institution between 2005 and 2012 were included in the analysis. Patients underwent PET assessment before and 12 weeks after CRT. Neck dissections were performed for PET-avid residual nodal abnormalities after complete response at the primary site. Rate of isolated nodal failure (INF) was the primary outcome. Median follow-up from diagnosis for 33 patients was 30 months (range, 6-76 months). INF occurred in 2 patients (6%) with neck dissections performed in 4 cases (12%). First failure was predominantly distant metastatic (10; 30%). The rate of INF remains low when following a PET-directed neck management policy after definitive CRT for N3 (>6 cm) HNSCC. Copyright © 2013 Wiley Periodicals, Inc.

Cavitating flow during water hammer using a generalized interface vaporous cavitation model

NASA Astrophysics Data System (ADS)

Sadafi, Mohamadhosein; Riasi, Alireza; Nourbakhsh, Seyed Ahmad

2012-10-01

In a transient flow simulation, column separation may occur when the calculated pressure head decreases to the saturated vapor pressure head in a computational grid. Abrupt valve closure or pump failure can result in a fast transient flow with column separation, potentially causing problems such as pipe failure, hydraulic equipment damage, cavitation or corrosion. This paper reports a numerical study of water hammer with column separation in a simple reservoir-pipeline-valve system and pumping station. The governing equations for two-phase transient flow in pipes are solved based on the method of characteristics (MOC) using a generalized interface vaporous cavitating model (GIVCM). The numerical results were compared with the experimental data for validation purposes, and the comparison indicated that the GIVCM describes the experimental results more accurately than the discrete vapor cavity model (DVCM). In particular, the GIVCM correlated better with the experimental data than the DVCM in terms of timing and pressure magnitude. The effects of geometric and hydraulic parameters on flow behavior in a pumping station with column separation were also investigated in this study.

Effects of body position on the carbon monoxide diffusing capacity in patients with chronic heart failure: relation to hemodynamic changes.

PubMed

Faggiano, P; D'Aloia, A; Simoni, P; Gualeni, A; Foglio, K; Ambrosino, N; Giordano, A

1998-01-01

Pulmonary diffusion has been found to be reduced in patients with congestive heart failure. The effects of postural changes on the diffusing capacity had been evaluated in healthy subjects, but not in patients with heart failure. The aim of this study was to evaluate the posture-induced changes in diffusing capacity in patients with chronic heart failure and their relation to the hemodynamic profile. The pulmonary carbon monoxide diffusing capacity (DLCO) was measured in the supine position, with 20 degrees passive head elevation, and in the sitting position, both postures maintained for 10 min, in a group of 32 male patients with mild to moderate chronic heart failure due to left ventricular systolic dysfunction (ejection fraction <35%). On a separate day, in the absence of any changes in clinical status and therapy, the hemodynamic parameters were measured by right-heart catheterization. The sequence of postures was assigned randomly. The mean values of DLCO were slightly reduced and did not differ in the two positions (20.3 +/- 5.7 vs. 19.4 +/- 5.6 ml/min/mm Hg, 77 +/- 23 vs. 75 +/- 20% of predicted, respectively). The patients were then subdivided according to changes in DLCO from the supine to the sitting position: DLCO increased (+23%) in 9 patients (28%, group 1), decreased (-17.5%) in 17 patients (53%, group 2), and remained within the coefficient of reproducibility ( +/- 5 %) in 6 patients (group 3). As compared with group 2, group 1 patients showed a significant increase in mean pulmonary artery pressure (+7 vs. -15%, p < 0.01) and pulmonary capillary wedge pressure (+8 vs. -22%, p < 0.005) from the supine to the sitting position, while the cardiac index showed a smaller - but not significant - decrease in group 1 (-5 vs. -12%). The percent changes in DLCO significantly correlated with changes in pulmonary capillary wedge (r = 0.54, p < 0.0005) and mean pulmonary artery (r = 0.47, p < 0.005) pressures. In chronic heart failure postural changes may induce different responses in diffusing capacity. To a greater extent than in healthy subjects, the most common response is a decrease in DLCO in the sitting as compared with the supine position. The DLCO changes correlate with variations in pulmonary circulation pressure, probably due to changes in pulmonary vascular recruitment and pulmonary capillary blood volume.

Time prediction of failure a type of lamps by using general composite hazard rate model

NASA Astrophysics Data System (ADS)

Riaman; Lesmana, E.; Subartini, B.; Supian, S.

2018-03-01

This paper discusses the basic survival model estimates to obtain the average predictive value of lamp failure time. This estimate is for the parametric model, General Composite Hazard Level Model. The random time variable model used is the exponential distribution model, as the basis, which has a constant hazard function. In this case, we discuss an example of survival model estimation for a composite hazard function, using an exponential model as its basis. To estimate this model is done by estimating model parameters, through the construction of survival function and empirical cumulative function. The model obtained, will then be used to predict the average failure time of the model, for the type of lamp. By grouping the data into several intervals and the average value of failure at each interval, then calculate the average failure time of a model based on each interval, the p value obtained from the tes result is 0.3296.

Failure Models and Criteria for FRP Under In-Plane or Three-Dimensional Stress States Including Shear Non-Linearity

NASA Technical Reports Server (NTRS)

Pinho, Silvestre T.; Davila, C. G.; Camanho, P. P.; Iannucci, L.; Robinson, P.

2005-01-01

A set of three-dimensional failure criteria for laminated fiber-reinforced composites, denoted LaRC04, is proposed. The criteria are based on physical models for each failure mode and take into consideration non-linear matrix shear behaviour. The model for matrix compressive failure is based on the Mohr-Coulomb criterion and it predicts the fracture angle. Fiber kinking is triggered by an initial fiber misalignment angle and by the rotation of the fibers during compressive loading. The plane of fiber kinking is predicted by the model. LaRC04 consists of 6 expressions that can be used directly for design purposes. Several applications involving a broad range of load combinations are presented and compared to experimental data and other existing criteria. Predictions using LaRC04 correlate well with the experimental data, arguably better than most existing criteria. The good correlation seems to be attributable to the physical soundness of the underlying failure models.

Improvement of Progressive Damage Model to Predicting Crashworthy Composite Corrugated Plate

NASA Astrophysics Data System (ADS)

Ren, Yiru; Jiang, Hongyong; Ji, Wenyuan; Zhang, Hanyu; Xiang, Jinwu; Yuan, Fuh-Gwo

2018-02-01

To predict the crashworthy composite corrugated plate, different single and stacked shell models are evaluated and compared, and a stacked shell progressive damage model combined with continuum damage mechanics is proposed and investigated. To simulate and predict the failure behavior, both of the intra- and inter- laminar failure behavior are considered. The tiebreak contact method, 1D spot weld element and cohesive element are adopted in stacked shell model, and a surface-based cohesive behavior is used to capture delamination in the proposed model. The impact load and failure behavior of purposed and conventional progressive damage models are demonstrated. Results show that the single shell could simulate the impact load curve without the delamination simulation ability. The general stacked shell model could simulate the interlaminar failure behavior. The improved stacked shell model with continuum damage mechanics and cohesive element not only agree well with the impact load, but also capture the fiber, matrix debonding, and interlaminar failure of composite structure.

Predicting Military Recruiter Effectiveness: A Literature Review

DTIC Science & Technology

1987-04-01

employing commanding officer nominations and/or supervisor ratings as criteria for success in recruiting. Wollack and KiDnis (1960). Commanding officer...ratings can be used to predict field recruiter performance. The authors attribute the failure to predict field recruiter performance to the...Time to Complete -12 -27 -5 -09 5. MC 431 Completion/ Failure 08 Studies 1. Cross-validities obtained via rMonte Carlo procedure by Borman, Toquam

Nonlinear-regression flow model of the Gulf Coast aquifer systems in the south-central United States

USGS Publications Warehouse

Kuiper, L.K.

1994-01-01

A multiple-regression methodology was used to help answer questions concerning model reliability, and to calibrate a time-dependent variable-density ground-water flow model of the gulf coast aquifer systems in the south-central United States. More than 40 regression models with 2 to 31 regressions parameters are used and detailed results are presented for 12 of the models. More than 3,000 values for grid-element volume-averaged head and hydraulic conductivity are used for the regression model observations. Calculated prediction interval half widths, though perhaps inaccurate due to a lack of normality of the residuals, are the smallest for models with only four regression parameters. In addition, the root-mean weighted residual decreases very little with an increase in the number of regression parameters. The various models showed considerable overlap between the prediction inter- vals for shallow head and hydraulic conductivity. Approximate 95-percent prediction interval half widths for volume-averaged freshwater head exceed 108 feet; for volume-averaged base 10 logarithm hydraulic conductivity, they exceed 0.89. All of the models are unreliable for the prediction of head and ground-water flow in the deeper parts of the aquifer systems, including the amount of flow coming from the underlying geopressured zone. Truncating the domain of solution of one model to exclude that part of the system having a ground-water density greater than 1.005 grams per cubic centimeter or to exclude that part of the systems below a depth of 3,000 feet, and setting the density to that of freshwater does not appreciably change the results for head and ground-water flow, except for locations close to the truncation surface.

PREDICE score as a predictor of 90 days mortality in patients with heart failure

NASA Astrophysics Data System (ADS)

Purba, D. P. S.; Hasan, R.

2018-03-01

Hospitalization in chronic heart failure patients associated with high mortality and morbidity rate. The 90 days post-discharge period following hospitalization in heart failure patients is known as the vulnerable phase, it carries the high risk of poor outcomes. Identification of high-risk individuals by using prognostic evaluation was intended to do a closer follow up and more intensive to decreasing the morbidity and mortality rate of heart failure.To determine whether PREDICE score could predict mortality within 90 days in patients with heart failure, an observational cohort study in patients with heart failure who were hospitalized due to worsening chronic heart failure. Patients were in following-up for up to 90 days after initial evaluation with the primary endpoint is death.We found a difference of the significantstatistical between PREDICE score in survival and mortality group (p=0.001) of 84% (95% CI: 60.9% - 97.4%).In conclusion, PREDICE score has a good ability to predict mortality within 90 days in patients with heart failure.

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.

Application of multi attribute failure mode analysis of milk production using analytical hierarchy process method

NASA Astrophysics Data System (ADS)

Rucitra, A. L.

2018-03-01

Pusat Koperasi Induk Susu (PKIS) Sekar Tanjung, East Java is one of the modern dairy industries producing Ultra High Temperature (UHT) milk. A problem that often occurs in the production process in PKIS Sekar Tanjung is a mismatch between the production process and the predetermined standard. The purpose of applying Analytical Hierarchy Process (AHP) was to identify the most potential cause of failure in the milk production process. Multi Attribute Failure Mode Analysis (MAFMA) method was used to eliminate or reduce the possibility of failure when viewed from the failure causes. This method integrates the severity, occurrence, detection, and expected cost criteria obtained from depth interview with the head of the production department as an expert. The AHP approach was used to formulate the priority ranking of the cause of failure in the milk production process. At level 1, the severity has the highest weight of 0.41 or 41% compared to other criteria. While at level 2, identifying failure in the UHT milk production process, the most potential cause was the average mixing temperature of more than 70 °C which was higher than the standard temperature (≤70 ° C). This failure cause has a contributes weight of 0.47 or 47% of all criteria Therefore, this study suggested the company to control the mixing temperature to minimise or eliminate the failure in this process.

Effect of telephone health coaching (Birmingham OwnHealth) on hospital use and associated costs: cohort study with matched controls.

PubMed

Steventon, Adam; Tunkel, Sarah; Blunt, Ian; Bardsley, Martin

2013-08-06

To test the effect of a telephone health coaching service (Birmingham OwnHealth) on hospital use and associated costs. Analysis of person level administrative data. Difference-in-difference analysis was done relative to matched controls. Community based intervention operating in a large English city with industry. 2698 patients recruited from local general practices before 2009 with heart failure, coronary heart disease, diabetes, or chronic obstructive pulmonary disease; and a history of inpatient or outpatient hospital use. These individuals were matched on a 1:1 basis to control patients from similar areas of England with respect to demographics, diagnoses of health conditions, previous hospital use, and a predictive risk score. Telephone health coaching involved a personalised care plan and a series of outbound calls usually scheduled monthly. Median length of time enrolled on the service was 25.5 months. Control participants received usual healthcare in their areas, which did not include telephone health coaching. Number of emergency hospital admissions per head over 12 months after enrolment. Secondary metrics calculated over 12 months were: hospital bed days, elective hospital admissions, outpatient attendances, and secondary care costs. In relation to diagnoses of health conditions and other baseline variables, matched controls and intervention patients were similar before the date of enrolment. After this point, emergency admissions increased more quickly among intervention participants than matched controls (difference 0.05 admissions per head, 95% confidence interval 0.00 to 0.09, P=0.046). Outpatient attendances also increased more quickly in the intervention group (difference 0.37 attendances per head, 0.16 to 0.58, P<0.001), as did secondary care costs (difference £175 per head, £22 to £328, P=0.025). Checks showed that we were unlikely to have missed reductions in emergency admissions because of unobserved differences between intervention and matched control groups. The Birmingham OwnHealth telephone health coaching intervention did not lead to the expected reductions in hospital admissions or secondary care costs over 12 months, and could have led to increases.

When High-Capacity Readers Slow Down and Low-Capacity Readers Speed Up: Working Memory and Locality Effects.

PubMed

Nicenboim, Bruno; Logačev, Pavel; Gattei, Carolina; Vasishth, Shravan

2016-01-01

We examined the effects of argument-head distance in SVO and SOV languages (Spanish and German), while taking into account readers' working memory capacity and controlling for expectation (Levy, 2008) and other factors. We predicted only locality effects, that is, a slowdown produced by increased dependency distance (Gibson, 2000; Lewis and Vasishth, 2005). Furthermore, we expected stronger locality effects for readers with low working memory capacity. Contrary to our predictions, low-capacity readers showed faster reading with increased distance, while high-capacity readers showed locality effects. We suggest that while the locality effects are compatible with memory-based explanations, the speedup of low-capacity readers can be explained by an increased probability of retrieval failure. We present a computational model based on ACT-R built under the previous assumptions, which is able to give a qualitative account for the present data and can be tested in future research. Our results suggest that in some cases, interpreting longer RTs as indexing increased processing difficulty and shorter RTs as facilitation may be too simplistic: The same increase in processing difficulty may lead to slowdowns in high-capacity readers and speedups in low-capacity ones. Ignoring individual level capacity differences when investigating locality effects may lead to misleading conclusions.

Cetuximab for treating non-small cell lung cancer.

PubMed

Mazzarella, Luca; Guida, Alessandro; Curigliano, Giuseppe

2018-04-01

Epidermal Growth Factor Receptor (EGFR)-dependent signaling plays a crucial role in epithelial cancer biology, and dictated the development of several targeting agents. The mouse-human chimeric antibody Cetuximab was among the first to be developed. After about two decades of clinical research it has gained a significant place in the management of advanced colorectal and head and neck cancers, whereas its development in non small cell lung cancer (NSCLC) has not led to a place in routine clinical practice, because of marginal clinical benefit despite statistically significant Phase III trials. Recent data from ongoing trials suggest that more careful selection based on molecular markers may identify good responders. Areas covered: In this article, the authors review the literature concerning basic science studies identifying EGFR as a therapeutic target, pharmacological development of Cetuximab, its pharmacodynamics and pharmacokinetics, and clinical trials on Cetuximab in NSCLC, focusing on recent findings on putative predictive biomarkers. Expert opinion: Cetuximab currently has no role in NSCLC treatment outside of research settings. We argue that failure to identify a predictive biomarker early on has hampered its chances to enter routine practice. Although recent research suggests benefit in highly selected patient subsets, its potential impact is severely dampened by lack of regulatory body approval and the emergence of competitors for the same niches.

[How to intervene and prevent stunting of children from homes belonging to the Sisbén in Caldas].

PubMed

Benjumea, María Victoria; Parra, José Hernán; Jaramillo, Juan Felipe

2017-12-01

Growth retardation or chronic malnutrition (low height for age) indicates a failure in the natural genetic potential that allows us to growth. To estimate predictive models of growth retardation in households with children younger than five years in the department of Caldas and registered in the identification system of potential beneficiaries of social programs (Sistema de Identificación de Potenciales Beneficiarios de Programas Sociales, Sisbén). We conducted an analytical study in all households (N=56,987) included in the Sisbén III database with the presence of children younger than five years (N=33,244). The variables under study were demographic and socioeconomic characteristics, health service access, housing, poverty, education, job market, and growth retardation. The multivariate analysis was done in two phases: first, an exploratory analysis of households using hierarchical classification (cluster), then estimation of a nonlinear predictive model (probit) with growth retardation as the dependent variable. The largest proportion of growth retardation in children younger than five years was found in southcentral Caldas, in urban centers, and households with monthly income lower than USD$ 65. Poverty in Caldas women-headed households with children younger than five years registered in the Sisbén was the main predictor of growth retardation.

When High-Capacity Readers Slow Down and Low-Capacity Readers Speed Up: Working Memory and Locality Effects

PubMed Central

Nicenboim, Bruno; Logačev, Pavel; Gattei, Carolina; Vasishth, Shravan

2016-01-01

We examined the effects of argument-head distance in SVO and SOV languages (Spanish and German), while taking into account readers' working memory capacity and controlling for expectation (Levy, 2008) and other factors. We predicted only locality effects, that is, a slowdown produced by increased dependency distance (Gibson, 2000; Lewis and Vasishth, 2005). Furthermore, we expected stronger locality effects for readers with low working memory capacity. Contrary to our predictions, low-capacity readers showed faster reading with increased distance, while high-capacity readers showed locality effects. We suggest that while the locality effects are compatible with memory-based explanations, the speedup of low-capacity readers can be explained by an increased probability of retrieval failure. We present a computational model based on ACT-R built under the previous assumptions, which is able to give a qualitative account for the present data and can be tested in future research. Our results suggest that in some cases, interpreting longer RTs as indexing increased processing difficulty and shorter RTs as facilitation may be too simplistic: The same increase in processing difficulty may lead to slowdowns in high-capacity readers and speedups in low-capacity ones. Ignoring individual level capacity differences when investigating locality effects may lead to misleading conclusions. PMID:27014113

Numerical simulation of flow in a high head Francis turbine with prediction of efficiency, rotor stator interaction and vortex structures in the draft tube

NASA Astrophysics Data System (ADS)

Jošt, D.; Škerlavaj, A.; Morgut, M.; Mežnar, P.; Nobile, E.

2015-01-01

The paper presents numerical simulations of flow in a model of a high head Francis turbine and comparison of results to the measurements. Numerical simulations were done by two CFD (Computational Fluid Dynamics) codes, Ansys CFX and OpenFOAM. Steady-state simulations were performed by k-epsilon and SST model, while for transient simulations the SAS SST ZLES model was used. With proper grid refinement in distributor and runner and with taking into account losses in labyrinth seals very accurate prediction of torque on the shaft, head and efficiency was obtained. Calculated axial and circumferential velocity components on two planes in the draft tube matched well with experimental results.

Child Care Enrollment Decisions Among Dual Language Learner Families: The Role of Spanish Language Instruction in the Child Care Setting

PubMed Central

Miller, Elizabeth B.

2016-01-01

Data from the Head Start Impact Study (N = 1,141) and the Head Start Family and Child Experiences Survey, 2009 Cohort (N = 825) were used to describe child care enrollment decisions among Spanish-speaking Dual Language Learner (DLL) families. In particular, logistic regression models tested which child, family, and institutional characteristics predicted enrollment in early care and education (ECE) settings that used Spanish for instruction versus enrollment in settings that did not use Spanish. Results showed that whether the child’s first language was exclusively Spanish and whether other DLL families previously attended the ECE arrangement strongly predicted whether that child enrolled. Policy implications for Head Start-eligible Spanish-speaking DLLs are discussed. PMID:26900255

Implicit and explicit attitudes predict smoking cessation: moderating effects of experienced failure to control smoking and plans to quit.

PubMed

Chassin, Laurie; Presson, Clark C; Sherman, Steven J; Seo, Dong-Chul; Macy, Jonathan T

2010-12-01

The current study tested implicit and explicit attitudes as prospective predictors of smoking cessation in a Midwestern community sample of smokers. Results showed that the effects of attitudes significantly varied with levels of experienced failure to control smoking and plans to quit. Explicit attitudes significantly predicted later cessation among those with low (but not high or average) levels of experienced failure to control smoking. Conversely, however, implicit attitudes significantly predicted later cessation among those with high levels of experienced failure to control smoking, but only if they had a plan to quit. Because smoking cessation involves both controlled and automatic processes, interventions may need to consider attitude change interventions that focus on both implicit and explicit attitudes. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Clinical significance of the neutrophil-lymphocyte ratio as an early predictive marker for adverse outcomes in patients with acute pancreatitis

PubMed Central

Jeon, Tae Joo; Park, Ji Young

2017-01-01

AIM To investigated the prognostic value of the neutrophil-lymphocyte ratio (NLR) in patients with acute pancreatitis and determined an optimal cut-off value for the prediction of adverse outcomes in these patients. METHODS We retrospectively analyzed 490 patients with acute pancreatitis diagnosed between March 2007 and December 2012. NLRs were calculated at admission and 24, 48, and 72 h after admission. Patients were grouped according to acute pancreatitis severity and organ failure occurrence, and a comparative analysis was performed to compare the NLR between groups. RESULTS Among the 490 patients, 70 had severe acute pancreatitis with 31 experiencing organ failure. The severe acute pancreatitis group had a significantly higher NLR than the mild acute pancreatitis group on all 4 d (median, 6.14, 6.71, 5.70, and 4.00 vs 4.74, 4.47, 3.20, and 3.30, respectively, P < 0.05). The organ failure group had a significantly higher NLR than the group without organ failure on all 4 d (median, 7.09, 6.72, 6.27, and 6.24 vs 4.85, 4.49, 3.35, and 2.34, respectively, P < 0.05). The optimal cut-off value for baseline NLR was 4.76 in predicting severity and 4.88 in predicting organ failure in acute pancreatitis. CONCLUSION Elevated baseline NLR correlates with severe acute pancreatitis and organ failure. PMID:28638228

Clinical significance of the neutrophil-lymphocyte ratio as an early predictive marker for adverse outcomes in patients with acute pancreatitis.

PubMed

Jeon, Tae Joo; Park, Ji Young

2017-06-07

To investigated the prognostic value of the neutrophil-lymphocyte ratio (NLR) in patients with acute pancreatitis and determined an optimal cut-off value for the prediction of adverse outcomes in these patients. We retrospectively analyzed 490 patients with acute pancreatitis diagnosed between March 2007 and December 2012. NLRs were calculated at admission and 24, 48, and 72 h after admission. Patients were grouped according to acute pancreatitis severity and organ failure occurrence, and a comparative analysis was performed to compare the NLR between groups. Among the 490 patients, 70 had severe acute pancreatitis with 31 experiencing organ failure. The severe acute pancreatitis group had a significantly higher NLR than the mild acute pancreatitis group on all 4 d (median, 6.14, 6.71, 5.70, and 4.00 vs 4.74, 4.47, 3.20, and 3.30, respectively, P < 0.05). The organ failure group had a significantly higher NLR than the group without organ failure on all 4 d (median, 7.09, 6.72, 6.27, and 6.24 vs 4.85, 4.49, 3.35, and 2.34, respectively, P < 0.05). The optimal cut-off value for baseline NLR was 4.76 in predicting severity and 4.88 in predicting organ failure in acute pancreatitis. Elevated baseline NLR correlates with severe acute pancreatitis and organ failure.

Micromechanics of failure waves in glass. 2: Modeling

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

Espinosa, H.D.; Xu, Y.; Brar, N.S.

1997-08-01

In an attempt to elucidate the failure mechanism responsible for the so-called failure waves in glass, numerical simulations of plate and rod impact experiments, with a multiple-plane model, have been performed. These simulations show that the failure wave phenomenon can be modeled by the nucleation and growth of penny-shaped shear defects from the specimen surface to its interior. Lateral stress increase, reduction of spall strength,and progressive attenuation of axial stress behind the failure front are properly predicted by the multiple-plane model. Numerical simulations of high-strain-rate pressure-shear experiments indicate that the model predicts reasonably well the shear resistance of the materialmore » at strain rates as high as 1 {times} 10{sup 6}/s. The agreement is believed to be the result of the model capability in simulating damage-induced anisotropy. By examining the kinetics of the failure process in plate experiments, the authors show that the progressive glass spallation in the vicinity of the failure front and the rate of increase in lateral stress are more consistent with a representation of inelasticity based on shear-activated flow surfaces, inhomogeneous flow, and microcracking, rather than pure microcracking. In the former mechanism, microcracks are likely formed at a later time at the intersection of flow surfaces, in the case of rod-on-rod impact, stress and radial velocity histories predicted by the microcracking model are in agreement with the experimental measurements. Stress attenuation, pulse duration, and release structure are properly simulated. It is shown that failure wave speeds in excess to 3,600 m/s are required for adequate prediction in rod radial expansion.« less

Percutaneous radiofrequency ablation of hepatic tumours: factors affecting technical failure of artificial ascites formation using an angiosheath.

PubMed

Kang, T W; Lee, M W; Hye, M J; Song, K D; Lim, S; Rhim, H; Lim, H K; Cha, D I

2014-12-01

To evaluate the technical feasibility of artificial ascites formation using an angiosheath before percutaneous radiofrequency ablation (RFA) for hepatic tumours and to determine predictive factors affecting the technical failure of artificial ascites formation. This retrospective study was approved by the institutional review board. One hundred and thirteen patients underwent percutaneous RFA of hepatic tumours after trying to make artificial ascites using an angiosheath to avoid collateral thermal damage. The technical success rate of making artificial ascites using an angiosheath and conversion rate to other techniques after initial failure of making artificial ascites were evaluated. The technical success rate for RFA was assessed. In addition, potential factors associated with technical failure including previous history of transcatheter arterial chemoembolization (TACE) or RFA, type of abdominal surgery, and adjacent perihepatic structures were reviewed. Predictive factors for the technical failure of artificial ascites formation were analysed using multivariate analysis. The technical success rates of artificial ascites formation by angiosheath and that of RFA were 84.1% (95/113) and 97.3% (110/113), respectively. The conversion rate to other techniques after the failure of artificial ascites formation using an angiosheath was 15.9% (18/113). Previous hepatic resection was the sole independent predictive factor affecting the technical failure of artificial ascites formation (p<0.001, odds ratio = 29.03, 95% confidence interval: 4.56-184.69). Making artificial ascites for RFA of hepatic tumours using an angiosheath was technically feasible in most cases. However, history of hepatic resection was a significant predictive factor affecting the technical failure of artificial ascites formation. Copyright © 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Aberrant GSTP1 promoter methylation predicts short-term prognosis in acute-on-chronic hepatitis B liver failure.

PubMed

Gao, S; Sun, F-K; Fan, Y-C; Shi, C-H; Zhang, Z-H; Wang, L-Y; Wang, K

2015-08-01

Glutathione-S-transferase P1 (GSTP1) methylation has been demonstrated to be associated with oxidative stress induced liver damage in acute-on-chronic hepatitis B liver failure (ACHBLF). To evaluate the methylation level of GSTP1 promoter in acute-on-chronic hepatitis B liver failure and determine its predictive value for prognosis. One hundred and five patients with acute-on-chronic hepatitis B liver failure, 86 with chronic hepatitis B (CHB) and 30 healthy controls (HC) were retrospectively enrolled. GSTP1 methylation level in peripheral mononuclear cells (PBMC) was detected by MethyLight. Clinical and laboratory parameters were obtained. GSTP1 methylation levels were significantly higher in patients with acute-on-chronic hepatitis B liver failure (median 16.84%, interquartile range 1.83-59.05%) than those with CHB (median 1.25%, interquartile range 0.48-2.47%; P < 0.01) and HC (median 0.80%, interquartile range 0.67-1.27%; P < 0.01). In acute-on-chronic hepatitis B liver failure group, nonsurvivors showed significantly higher GSTP1 methylation levels (P < 0.05) than survivors. GSTP1 methylation level was significantly correlated with total bilirubin (r = 0.29, P < 0.01), prothrombin time activity (r = -0.24, P = 0.01) and model for end-stage liver disease (MELD) score (r = 0.26, P = 0.01). When used to predict 1- or 2-month mortality of acute-on-chronic hepatitis B liver failure, GSTP1 methylation showed significantly better predictive value than MELD score [area under the receiver operating characteristic curve (AUC) 0.89 vs. 0.72, P < 0.01; AUC 0.83 vs. 0.70, P < 0.05 respectively]. Meanwhile, patients with GSTP1 methylation levels above the cut-off points showed significantly poorer survival than those below (P < 0.05). Aberrant GSTP1 promoter methylation exists in acute-on-chronic hepatitis B liver failure and shows high predictive value for short-term mortality. It might serve as a potential prognostic marker for acute-on-chronic hepatitis B liver failure. © 2015 John Wiley & Sons Ltd.

Effects of Barometric Fluctuations on Well Water-Level Measurements and Aquifer Test Data

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

Spane, Frank A.

1999-12-16

This report examines the effects of barometric fluctuations on well water-level measurements and evaluates adjustment and removal methods for determining areal aquifer head conditions and aquifer test analysis. Two examples of Hanford Site unconfined aquifer tests are examined that demonstrate baro-metric response analysis and illustrate the predictive/removal capabilities of various methods for well water-level and aquifer total head values. Good predictive/removal characteristics were demonstrated with best corrective results provided by multiple-regression deconvolution methods.

Effect of acetabular cup abduction angle on wear of ultrahigh-molecular-weight polyethylene in hip simulator testing.

PubMed

Korduba, Laryssa A; Essner, Aaron; Pivec, Robert; Lancin, Perry; Mont, Michael A; Wang, Aiguo; Delanois, Ronald E

2014-10-01

The effect of acetabular component positioning on the wear rates of metal-on-polyethylene articulations has not been extensively studied. Placement of acetabular cups at abduction angles of more than 40° has been noted as a possible reason for early failure caused by increased wear. We conducted a study to evaluate the effects of different acetabular cup abduction angles on polyethylene wear rate, wear area, contact pressure, and contact area. Our in vitro study used a hip joint simulator and finite element analysis to assess the effects of cup orientation at 4 angles (0°, 40°, 50°, 70°) on wear and contact properties. Polyethylene bearings with 28-mm cobalt-chrome femoral heads were cycled in an environment mimicking in vivo joint fluid to determine the volumetric wear rate after 10 million cycles. Contact pressure and contact area for each cup abduction angle were assessed using finite element analysis. Results were correlated with cup abduction angles to determine if there were any differences among the 4 groups. The inverse relationship between volumetric wear rate and acetabular cup inclination angle demonstrated less wear with steeper cup angles. The largest abduction angle (70°) had the lowest contact area, largest contact pressure, and smallest head coverage. Conversely, the smallest abduction angle (0°) had the most wear and most head coverage. Polyethylene wear after total hip arthroplasty is a major cause of osteolysis and aseptic loosening, which may lead to premature implant failure. Several studies have found that high wear rates for cups oriented at steep angles contributed to their failure. Our data demonstrated that larger cup abduction angles were associated with lower, not higher, wear. However, this potentially "protective" effect is likely counteracted by other complications of steep cup angles, including impingement, instability, and edge loading. These factors may be more relevant in explaining why implants fail at a higher rate if cups are oriented at more than 40° of abduction.

Tell me who you are and I tell you how you feel: expected emotional reactions to success and failure are influenced by knowledge about a person's personality.

PubMed

Hareli, Shlomo; Sharabi, Moshe; Hess, Ursula

2011-08-01

The present research investigated the influence of knowledge about a person's modesty or arrogance on people's expectations regarding that person's emotional reactions to success and failure. Arrogance and modesty reflect the extent to which someone is likely to publicize their ability. Accordingly, we predicted that observers' expectations regarding a person's tendency to publicize their ability should inform expectations about the person's emotional reactions to success and failure. In two vignette studies, observers predicted the emotional state of a protagonist, as well as the probability that s/he will actually express that emotion and share the experience with others. For success, participants predicted a protagonist's pride, happiness, schadenfreude, and embarrassment if praised for a positive outcome. For failure, participants predicted anger, shame, guilt, sadness, and fear reactions. Across studies, personality information explained more variance than did gender or status. Results showed that the expectations for an arrogant person matched modal expectations for success, whereas for failure the expectations for the modest individual were closest to the modal expectations. Specifically, both modest and arrogant individuals were expected to suppress emotions that do not fit their self-presentational styles rather than to exaggerate expressions that do. This paper adds to our understanding of the information that people use to predict others' emotional reactions.

Adolescent cocaine self-administration induces habit behavior in adulthood: sex differences and structural consequences

PubMed Central

DePoy, L M; Allen, A G; Gourley, S L

2016-01-01

Adolescent cocaine use increases the likelihood of drug abuse and addiction in adulthood, and etiological factors may include a cocaine-induced bias towards so-called ‘reward-seeking' habits. To determine whether adolescent cocaine exposure indeed impacts decision-making strategies in adulthood, we trained adolescent mice to orally self-administer cocaine. In adulthood, males with a history of escalating self-administration developed a bias towards habit-based behaviors. In contrast, escalating females did not develop habit biases; rather, low response rates were associated with later behavioral inflexibility, independent of cocaine dose. We focused the rest of our report on understanding how individual differences in young-adolescent females predicted long-term behavioral outcomes. Low, ‘stable' cocaine-reinforced response rates during adolescence were associated with cocaine-conditioned object preference and enlarged dendritic spine head size in the medial (prelimbic) prefrontal cortex in adulthood. Meanwhile, cocaine resilience was associated with enlarged spine heads in deep-layer orbitofrontal cortex. Re-exposure to the cocaine-associated context in adulthood energized responding in ‘stable responders', which could then be reduced by the GABAB agonist baclofen and the putative tyrosine receptor kinase B (trkB) agonist, 7,8-dihydroxyflavone. Together, our findings highlight resilience to cocaine-induced habits in females relative to males when intake escalates. However, failures in instrumental conditioning in adolescent females may precipitate reward-seeking behaviors in adulthood, particularly in the context of cocaine exposure. PMID:27576164

Free testosterone levels in umbilical-cord blood predict infant head circumference in females.

PubMed

Whitehouse, Andrew J O; Maybery, Murray T; Hart, Roger; Sloboda, Deborah M; Stanley, Fiona J; Newnham, John P; Hickey, Martha

2010-03-01

Fetal androgens influence fetal growth as well as postnatal neurocognitive ability. However, to our knowledge, no published study has prospectively examined the impact of early-life androgens on infant brain growth. We report the association between circulating fetal androgen levels, measured from umbilical-cord blood at birth, and a proxy measure of brain growth: head circumference. Participants were 82 unselected female infants from a large representative birth cohort (mean gestational age 39.4 wks, SD 1.7). Umbilical-cord blood was obtained at birth and analysed for androgen concentrations (total testosterone, androstenedione, dehyrdroepiandrosterone, and its sulphated metabolite). Head circumference and two other measures of growth - weight (mean 3311.4 g, SD 461.3) and length - were measured within 3 days of birth and again at approximately 1 year of age (mean age 13.1 mo, SD 1.1). Multivariate linear regressions found an inverse association between levels of free testosterone and growth in head circumference (correlation=-.24), even when adjusting for sociodemographic/obstetric covariates and head size at birth. Growth in weight and length could not be predicted by free testosterone concentration. This is the first report of an association between prenatal androgen levels and postnatal growth in head circumference. These findings suggest that early-life androgens may impact brain development during infancy.

Limiting Radiotherapy to the Contralateral Retropharyngeal and High Level II Lymph Nodes in Head and Neck Squamous Cell Carcinoma is Safe and Improves Quality of Life

PubMed Central

Spencer, Christopher R.; Gay, Hiram A.; Haughey, Bruce H.; Nussenbaum, Brian; Adkins, Douglas R.; Wildes, Tanya M.; DeWees, Todd A.; Lewis, James S.; Thorstad, Wade L.

2014-01-01

Background Radiation treatment volumes in head and neck squamous cell carcinoma (HNSCC) are controversial. Here we report the outcomes, failures, and quality of life (QOL) of patients treated using intensity modulated radiation therapy (IMRT) that eliminated treatment of contralateral retropharyngeal lymph nodes (RPLN) in the clinically uninvolved neck. Methods A prospective institutional database identified patients with primary oral cavity, oropharynx, hypopharynx, larynx and unknown primary HNSCC treated using IMRT. There were three temporal groups (G1-3). G1 received comprehensive neck IMRT with parotid sparing, G2 eliminated the contralateral high level II (HLII) lymph nodes, and G3 further eliminated the contralateral RPLN in the clinically uninvolved neck. Patterns of failure and survival analyses were completed and QOL data measured by the MD Anderson Dysphagia Inventory (MDADI) was compared in a subset of patients from G1 and G3. Results There were 748 patients identified. Of the 488 patients treated in G2 or G3, 406 had a clinically uninvolved contralateral neck. There were no failures in the spared RPLNs (95% CI; 0-1.3%) or high contralateral neck (95% CI; 0-0.7%). QOL data was compared between 44 patients in G1 and 51 patients in G3. QOL improved both globally and in all domains assessed for G3 in which reduced radiotherapy volumes were used (p < 0.007). Conclusions For patients with locally advanced HNSCC, eliminating coverage to the contralateral HLII and contralateral RPLN in the clinically uninvolved side of the neck is associated with minimal risk of failure in these regions and significantly improved patient-reported QOL. PMID:25143048

Extended Aging Theories for Predictions of Safe Operational Life of Critical Airborne Structural Components

NASA Technical Reports Server (NTRS)

Ko, William L.; Chen, Tony

2006-01-01

The previously developed Ko closed-form aging theory has been reformulated into a more compact mathematical form for easier application. A new equivalent loading theory and empirical loading theories have also been developed and incorporated into the revised Ko aging theory for the prediction of a safe operational life of airborne failure-critical structural components. The new set of aging and loading theories were applied to predict the safe number of flights for the B-52B aircraft to carry a launch vehicle, the structural life of critical components consumed by load excursion to proof load value, and the ground-sitting life of B-52B pylon failure-critical structural components. A special life prediction method was developed for the preflight predictions of operational life of failure-critical structural components of the B-52H pylon system, for which no flight data are available.

Progressive Failure Analysis of Composite Stiffened Panels

NASA Technical Reports Server (NTRS)

Bednarcyk, Brett A.; Yarrington, Phillip W.; Collier, Craig S.; Arnold, Steven M.

2006-01-01

A new progressive failure analysis capability for stiffened composite panels has been developed based on the combination of the HyperSizer stiffened panel design/analysis/optimization software with the Micromechanics Analysis Code with Generalized Method of Cells (MAC/GMC). MAC/GMC discretizes a composite material s microstructure into a number of subvolumes and solves for the stress and strain state in each while providing the homogenized composite properties as well. As a result, local failure criteria may be employed to predict local subvolume failure and the effects of these local failures on the overall composite response. When combined with HyperSizer, MAC/GMC is employed to represent the ply level composite material response within the laminates that constitute a stiffened panel. The effects of local subvolume failures can then be tracked as loading on the stiffened panel progresses. Sample progressive failure results are presented at both the composite laminate and the composite stiffened panel levels. Deformation and failure model predictions are compared with experimental data from the World Wide Failure Exercise for AS4/3501-6 graphite/epoxy laminates.

Effects of electrical stimulation in the treatment of osteonecrosis of the femoral head.

PubMed

Fornell, Salvador; Ribera, Juan; Mella, Mario; Carranza, Andrés; Serrano-Toledano, David; Domecq, Gabriel

2017-10-16

The aim of this study was to examine whether the use of an internal electrostimulator could improve the results obtained with core decompression alone in the treatment of osteonecrosis of the femoral head. We performed a retrospective study of 41 patients (55 hips) treated for osteonecrosis of the femoral head between 2005 and 2014. Mean follow-up time was 56 (12-108) months. We recorded 3 parameters: time to recurrence of pain, time to conversion to arthroplasty and time to radiographic failure. Survival was estimated using the Kaplan-Meier method. The equality of the survival distributions was determined by the Log rank test. Implanted electrostimulator was a factor that increased the survival of hips in a pre-op Steinberg stage of II or below, while it remained unchanged if the stage was III or higher. The addition of an internal electrostimulator provides increased survival compared to core decompression alone at stages below III.

Antithrombin III is associated with acute liver failure in patients with end-stage heart failure undergoing mechanical circulatory support.

PubMed

Hoefer, Judith; Ulmer, Hanno; Kilo, Juliane; Margreiter, Raimund; Grimm, Michael; Mair, Peter; Ruttmann, Elfriede

2017-06-01

There are few data on the role of liver dysfunction in patients with end-stage heart failure supported by mechanical circulatory support. The aim of our study was to investigate predictors for acute liver failure in patients with end-stage heart failure undergoing mechanical circulatory support. A consecutive 164 patients with heart failure with New York Heart Association class IV undergoing mechanical circulatory support were investigated for acute liver failure using the King's College criteria. Clinical characteristics of heart failure together with hemodynamic and laboratory values were analyzed by logistic regression. A total of 45 patients (27.4%) with heart failure developed subsequent acute liver failure with a hospital mortality of 88.9%. Duration of heart failure, cause, cardiopulmonary resuscitation, use of vasopressors, central venous pressure, pulmonary capillary wedge pressure, pulmonary pulsatility index, cardiac index, and transaminases were not significantly associated with acute liver failure. Repeated decompensation, atrial fibrillation (P < .001) and the use of inotropes (P = .007), mean arterial (P = .005) and pulmonary pressures (P = .042), cholinesterase, international normalized ratio, bilirubin, lactate, and pH (P < .001) were predictive of acute liver failure in univariate analysis only. In multivariable analysis, decreased antithrombin III was the strongest single measurement indicating acute liver failure (relative risk per %, 0.84; 95% confidence interval, 0.77-0.93; P = .001) and remained an independent predictor when adjustment for the Model for End-Stage Liver Disease score was performed (relative risk per %, 0.89; 95% confidence interval, 0.80-0.99; P = .031). Antithrombin III less than 59.5% was identified as a cutoff value to predict acute liver failure with a corresponding sensitivity of 81% and specificity of 87%. In addition to the Model for End-Stage Liver Disease score, decreased antithrombin III activity tends to be superior in predicting acute liver failure compared with traditionally thought predictors. Antithrombin III measurement may help to identify patients more precisely who are developing acute liver failure during mechanical circulatory support. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Pretherapeutic Functional Imaging Allows Prediction of Head Tremor Arrest After Thalamotomy for Essential Tremor: The Role of Altered Interconnectivity Between Thalamolimbic and Supplementary Motor Circuits.

PubMed

Tuleasca, Constantin; Régis, Jean; Najdenovska, Elena; Witjas, Tatiana; Girard, Nadine; Champoudry, Jérôme; Faouzi, Mohamed; Thiran, Jean-Philippe; Cuadra, Meritxell Bach; Levivier, Marc; Van De Ville, Dimitri

2018-04-01

To correlate pretherapeutic resting-state functional magnetic resonance imaging (rs-fMRI) measures with pretherapeutic head tremor presence and/or further improvement 1 year after stereotactic radiosurgical thalamotomy (SRS-T) for essential tremor (ET). We prospectively collected head tremor scores (range, 0-3) and rs-fMRI data for a cohort of 17 consecutive ET patients in pretherapeutic and 1 year after SRS-T states. We additionally acquired rs-fMRI data for a healthy control (HC) group (n = 12). Group-level independent component analysis (n = 17 for pretherapeutic rs-fMRI) was applied to decompose neuroimaging data into 20 large-scale brain networks using a standard approach. Through spatial regression, we projected 1 year after SRS-T and HC rs-fMRI time points, on the same 20 brain networks. Pretherapeutic interconnectivity (IC) strength between the network including bilateral thalamus and limbic system with left supplementary motor area predicted head tremor improvement at 1 year after SRS-T (family-wise corrected P < 0.001, cluster size K c  = 146). For the statistically significant cluster, IC strength was strongest in HCs (mean, 4.6; median, 3.8) compared with pre- (mean, 0.1; median, 0.2) or posttherapeutic (mean, -0.2; median, 0.09) states. Baseline measures of IC between bilateral thalamus and limbic system with left supplementary motor area may predict head tremor arrest after thalamotomy. However, procedures such as SRS-T, for this particular clinical feature, do not align patients to HCs in terms of functional brain connectivity. We postulate that supplementary motor area is modulating head tremor appearance, by abnormal connectivity with the thalamolimbic system. Copyright © 2018 Elsevier Inc. All rights reserved.

Modes of failure of Osteonics constrained tripolar implants: a retrospective analysis of forty-three failed implants.

PubMed

Guyen, Olivier; Lewallen, David G; Cabanela, Miguel E

2008-07-01

The Osteonics constrained tripolar implant has been one of the most commonly used options to manage recurrent instability after total hip arthroplasty. Mechanical failures were expected and have been reported. The purpose of this retrospective review was to identify the observed modes of failure of this device. Forty-three failed Osteonics constrained tripolar implants were revised at our institution between September 1997 and April 2005. All revisions related to the constrained acetabular component only were considered as failures. All of the devices had been inserted for recurrent or intraoperative instability during revision procedures. Seven different methods of implantation were used. Operative reports and radiographs were reviewed to identify the modes of failure. The average time to failure of the forty-three implants was 28.4 months. A total of five modes of failure were observed: failure at the bone-implant interface (type I), which occurred in eleven hips; failure at the mechanisms holding the constrained liner to the metal shell (type II), in six hips; failure of the retaining mechanism of the bipolar component (type III), in ten hips; dislocation of the prosthetic head at the inner bearing of the bipolar component (type IV), in three hips; and infection (type V), in twelve hips. The mode of failure remained unknown in one hip that had been revised at another institution. The Osteonics constrained tripolar total hip arthroplasty implant is a complex device involving many parts. We showed that failure of this device can occur at most of its interfaces. It would therefore appear logical to limit its application to salvage situations.

The role of the donor liaison officer at PlusLife (Perth Bone and Tissue Bank Inc.), Western Australia.

PubMed

Smythe, Claire; White, Nicola; Winter, Joyleen; Cowie, Anne

2015-06-01

Femoral head donation at the time of hip replacement surgery provides a much needed resource of bone allograft to orthopaedic surgeons. Prior to 2005, potential femoral head donors were identified and consented in the hospital setting on the day of surgery. This resulted in over 40 % of donations failing post operatively suggesting that more effort could be given to pre-operative screening resulting in substantial savings in the cost associated with collection and testing of donors who were subsequently failed. The Donor Liaison role was implemented in 2005 to coordinate a Femoral Head Donation program maximising the number of successful donations through pre-operative screening. This study reviews the effectiveness of pre-operative screening of potential femoral head donors at PlusLife from 2002-2012. A retrospective audit of the database was undertaken 2002-2012 and medical/social reasons for pre-operative and postoperative failures were collated into 4 main categories to enable comparison: malignancy, autoimmune conditions, variant Creutzfeldt Jakob disease risk and general medical/social reasons. The number of femoral heads failed post operatively has decreased significantly from 26 % in 2003 to 6 % in 2012. A cost of $121,000 was expended on femoral heads failed post operatively in 2004, as compared to $20,350 in 2012. Donors excluded due to the 4 main categories (medical/social history) were identified pre-operatively in over 80 % of all cases. Preoperative screening of femoral head donors through a coordinated Femoral Head Donation Program is a safe and cost effective method.

Predictive factors for the failure of endoscopic stent-in-stent self-expandable metallic stent placement to treat malignant hilar biliary obstruction

PubMed Central

Sugimoto, Mitsuru; Takagi, Tadayuki; Suzuki, Rei; Konno, Naoki; Asama, Hiroyuki; Watanabe, Ko; Nakamura, Jun; Kikuchi, Hitomi; Waragai, Yuichi; Takasumi, Mika; Sato, Yuki; Hikichi, Takuto; Ohira, Hiromasa

2017-01-01

AIM To investigate the factors predictive of failure when placing a second biliary self-expandable metallic stents (SEMSs). METHODS This study evaluated 65 patients with an unresectable malignant hilar biliary obstruction who were examined in our hospital. Sixty-two of these patients were recruited to the study and divided into two groups: the success group, which consisted of patients in whom a stent-in-stent SEMS had been placed successfully, and the failure group, which consisted of patients in whom the stent-in-stent SEMS had not been placed successfully. We compared the characteristics of the patients, the stricture state of their biliary ducts, and the implemented endoscopic retrograde cholangiopancreatography (ERCP) procedures between the two groups. RESULTS The angle between the target biliary duct stricture and the first implanted SEMS was significantly larger in the failure group than in the success group. There were significantly fewer wire or dilation devices (ERCP catheter, dilator, or balloon catheter) passing the first SEMS cell in the failure group than in the success group. The cut-off value of the angle predicting stent-in-stent SEMS placement failure was 49.7 degrees according to the ROC curve (sensitivity 91.7%, specificity 61.2%). Furthermore, the angle was significantly smaller in patients with wire or dilation devices passing the first SEMS cell than in patients without wire or dilation devices passing the first SEMS cell. CONCLUSION A large angle was identified as a predictive factor for failure of stent-in-stent SEMS placement. PMID:28974893

Predictive factors for the failure of endoscopic stent-in-stent self-expandable metallic stent placement to treat malignant hilar biliary obstruction.

PubMed

Sugimoto, Mitsuru; Takagi, Tadayuki; Suzuki, Rei; Konno, Naoki; Asama, Hiroyuki; Watanabe, Ko; Nakamura, Jun; Kikuchi, Hitomi; Waragai, Yuichi; Takasumi, Mika; Sato, Yuki; Hikichi, Takuto; Ohira, Hiromasa

2017-09-14

To investigate the factors predictive of failure when placing a second biliary self-expandable metallic stents (SEMSs). This study evaluated 65 patients with an unresectable malignant hilar biliary obstruction who were examined in our hospital. Sixty-two of these patients were recruited to the study and divided into two groups: the success group, which consisted of patients in whom a stent-in-stent SEMS had been placed successfully, and the failure group, which consisted of patients in whom the stent-in-stent SEMS had not been placed successfully. We compared the characteristics of the patients, the stricture state of their biliary ducts, and the implemented endoscopic retrograde cholangiopancreatography (ERCP) procedures between the two groups. The angle between the target biliary duct stricture and the first implanted SEMS was significantly larger in the failure group than in the success group. There were significantly fewer wire or dilation devices (ERCP catheter, dilator, or balloon catheter) passing the first SEMS cell in the failure group than in the success group. The cut-off value of the angle predicting stent-in-stent SEMS placement failure was 49.7 degrees according to the ROC curve (sensitivity 91.7%, specificity 61.2%). Furthermore, the angle was significantly smaller in patients with wire or dilation devices passing the first SEMS cell than in patients without wire or dilation devices passing the first SEMS cell. A large angle was identified as a predictive factor for failure of stent-in-stent SEMS placement.

Biomarkers of Myocardial Stress and Fibrosis as Predictors of Mode of Death in Patients with Chronic Heart Failure

PubMed Central

Ahmad, Tariq; Fiuzat, Mona; Neely, Ben; Neely, Megan; Pencina, Michael J.; Kraus, William E.; Zannad, Faiez; Whellan, David J.; Donahue, Mark; Piña, Ileana L.; Adams, Kirkwood; Kitzman, Dalane W.; O’Connor, Christopher M.; Felker, G. Michael

2014-01-01

Objective To determine whether biomarkers of myocardial stress and fibrosis improve prediction of mode of death in patients with chronic heart failure. Background The two most common modes of death in patients with chronic heart failure are pump failure and sudden cardiac death. Prediction of mode of death may facilitate treatment decisions. The relationship between NT-proBNP, galectin-3, and ST2, biomarkers that reflect different pathogenic pathways in heart failure (myocardial stress and fibrosis), and mode of death is unknown. Methods HF-ACTION was a randomized controlled trial of exercise training vs. usual care in patients with chronic heart failure due to left ventricular systolic dysfunction (LVEF<35%). An independent clinical events committee prospectively adjudicated mode of death. NT-proBNP, galectin-3, and ST2 levels were assessed at baseline in 813 subjects. Associations between biomarkers and mode of death were assessed using cause-specific Cox-proportional hazards modeling, and interaction testing was used to measure differential association between biomarkers and pump failure versus sudden cardiac death. Discrimination and risk reclassification metrics were used to assess the added value of galectin-3 and ST2 in predicting mode of death risk beyond a clinical model that included NT-proBNP. Results After a median follow up of 2.5 years, there were 155 deaths: 49 from pump failure 42 from sudden cardiac death, and 64 from other causes. Elevations in all biomarkers were associated with increased risk of both pump failure and sudden cardiac death in both adjusted and unadjusted analyses. In each case, increases in the biomarker had a stronger association with pump failure than sudden cardiac death but this relationship was attenuated after adjustment for clinical risk factors. Clinical variables along with NT-proBNP levels were stronger predictors of pump failure (C statistic: 0.87) than sudden cardiac death (C statistic: 0.73). Addition of ST2 and galectin-3 led to improved net risk classification of 11% for sudden cardiac death, but not pump failure. Conclusions Clinical predictors along with NT-proBNP levels were strong predictors of pump failure risk, with insignificant incremental contributions of ST2 and galectin-3. Predictability of sudden cardiac death risk was less robust and enhanced by information provided by novel biomarkers. PMID:24952693

Preventing abusive head trauma resulting from a failure of normal interaction between infants and their caregivers.

PubMed

Barr, Ronald G

2012-10-16

Head trauma from abuse, including shaken baby syndrome, is a devastating and potentially lethal form of infant physical abuse first recognized in the early 1970s. What has been less recognized is the role of the early increase in crying in otherwise normal infants in the first few months of life as a trigger for the abuse. In part, this is because infant crying, especially prolonged unsoothable crying, has been interpreted clinically as something wrong with the infant, the infant's caregiver, or the interactions between them. Here, we review an alternative developmental interpretation, namely, that the early increase in crying is a typical behavioral development in normal infants and usually does not reflect anything wrong or abnormal. We also review evidence indicating that this normal crying pattern is the most common trigger for abusive head trauma (AHT). Together, these findings point to a conceptualization of AHT as the consequence of a failure in an otherwise common, iterative, and developmentally normal infant-caregiver interaction. They also imply that there is a window of opportunity for prevention of AHT, and potentially other forms of infant abuse, through a public health primary universal prevention strategy aimed at changing knowledge and behaviors of caregivers and society in general concerning normal development of infants and the significance of early increased infant crying. If effective, there may be important implications for prevention of infant abuse nationally and internationally.

Preventing abusive head trauma resulting from a failure of normal interaction between infants and their caregivers

PubMed Central

Barr, Ronald G.

2012-01-01

Head trauma from abuse, including shaken baby syndrome, is a devastating and potentially lethal form of infant physical abuse first recognized in the early 1970s. What has been less recognized is the role of the early increase in crying in otherwise normal infants in the first few months of life as a trigger for the abuse. In part, this is because infant crying, especially prolonged unsoothable crying, has been interpreted clinically as something wrong with the infant, the infant’s caregiver, or the interactions between them. Here, we review an alternative developmental interpretation, namely, that the early increase in crying is a typical behavioral development in normal infants and usually does not reflect anything wrong or abnormal. We also review evidence indicating that this normal crying pattern is the most common trigger for abusive head trauma (AHT). Together, these findings point to a conceptualization of AHT as the consequence of a failure in an otherwise common, iterative, and developmentally normal infant–caregiver interaction. They also imply that there is a window of opportunity for prevention of AHT, and potentially other forms of infant abuse, through a public health primary universal prevention strategy aimed at changing knowledge and behaviors of caregivers and society in general concerning normal development of infants and the significance of early increased infant crying. If effective, there may be important implications for prevention of infant abuse nationally and internationally. PMID:23045677

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

NASA Technical Reports Server (NTRS)

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

2002-01-01

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

Study protocol. IDUS - Instrumental delivery & ultrasound: a multi-centre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery.

PubMed

Murphy, Deirdre J; Burke, Gerard; Montgomery, Alan A; Ramphul, Meenakshi

2012-09-13

Instrumental deliveries are commonly performed in the United Kingdom and Ireland, with rates of 12 - 17% in most centres. Knowing the exact position of the fetal head is a pre-requisite for safe instrumental delivery. Traditionally, diagnosis of the fetal head position is made on transvaginal digital examination by delineating the suture lines of the fetal skull and the fontanelles. However, the accuracy of transvaginal digital examination can be unreliable and varies between 20% and 75%. Failure to identify the correct fetal head position increases the likelihood of failed instrumental delivery with the additional morbidity of sequential use of instruments or second stage caesarean section. The use of ultrasound in determining the position of the fetal head has been explored but is not part of routine clinical practice. A multi-centre randomised controlled trial is proposed. The study will take place in two large maternity units in Ireland with a combined annual birth rate of 13,500 deliveries. It will involve 450 nulliparous women undergoing instrumental delivery after 37 weeks gestation. The main outcome measure will be incorrect diagnosis of the fetal head position. A study involving 450 women will have 80% power to detect a 10% difference in the incidence of inaccurate diagnosis of the fetal head position with two-sided 5% alpha. It is both important and timely to evaluate the use of ultrasound to diagnose the fetal head position prior to instrumental delivery before routine use can be advocated. The overall aim is to reduce the incidence of incorrect diagnosis of the fetal head position prior to instrumental delivery and improve the safety of instrumental deliveries. Current Controlled Trials ISRCTN72230496.

Learning toward practical head pose estimation

NASA Astrophysics Data System (ADS)

Sang, Gaoli; He, Feixiang; Zhu, Rong; Xuan, Shibin

2017-08-01

Head pose is useful information for many face-related tasks, such as face recognition, behavior analysis, human-computer interfaces, etc. Existing head pose estimation methods usually assume that the face images have been well aligned or that sufficient and precise training data are available. In practical applications, however, these assumptions are very likely to be invalid. This paper first investigates the impact of the failure of these assumptions, i.e., misalignment of face images, uncertainty and undersampling of training data, on head pose estimation accuracy of state-of-the-art methods. A learning-based approach is then designed to enhance the robustness of head pose estimation to these factors. To cope with misalignment, instead of using hand-crafted features, it seeks suitable features by learning from a set of training data with a deep convolutional neural network (DCNN), such that the training data can be best classified into the correct head pose categories. To handle uncertainty and undersampling, it employs multivariate labeling distributions (MLDs) with dense sampling intervals to represent the head pose attributes of face images. The correlation between the features and the dense MLD representations of face images is approximated by a maximum entropy model, whose parameters are optimized on the given training data. To estimate the head pose of a face image, its MLD representation is first computed according to the model based on the features extracted from the image by the trained DCNN, and its head pose is then assumed to be the one corresponding to the peak in its MLD. Evaluation experiments on the Pointing'04, FacePix, Multi-PIE, and CASIA-PEAL databases prove the effectiveness and efficiency of the proposed method.

[Ex vivo microCT analysis of possible microfractures of the femoral head during implantation of a cementless hip resurfacing femoral component].

PubMed

Lerch, M; Olender, G; von der Höh, N; Thorey, F; von Lewinski, G; Meyer-Lindenberg, A; Windhagen, H; Hurschler, C

2009-01-01

Microfractures of the femoral head during implantation of the femoral components are suspected to be a cause of fractures at the implant/neck junction which represent a common failure mode in hip resurfacing arthroplasty. Callus formation observed in femoral head retrievals suggests the occurrence of microfractures inside the femoral head, which might be inadvertently caused by the surgeon during implantation. The aim of this biomechanical study was to analyse whether or not the implantation of a cementless femoral component hip resurfacing system causes microfractures in the femoral head. After the preparation of 20 paired human cadaveric femoral heads, the cementless femoral component ESKA Typ BS (ESKA Implants GmbH & Co., Lübeck) was implanted on 9 specimens with an impaction device that generates 4.5 kN impaction force. On 9 specimens the femoral component was implanted by hand. One head was used as a fracture model, 1 specimen served as control without manipulation. The femoral component used for impaction was equipped with hinges to enable its removal without further interfering with the bone stock. Specimens were scanned with a microCT device before and after impaction and the microCT datasets before and after impaction were compared to identify possible microfractures. Twenty strikes per hand or with the impaction device provided sufficient implant seating. Neither the macroscopic examination nor the 2-dimensional microCT analysis revealed any fractures of the femoral heads after impaction. At least macroscopically and in the 2-dimensional microCT analysis, implantation of the cementless hip resurfacing femoral component ESKA Typ BS with 4.5 kN or by hand does not seem to cause fractures of the femoral head. Georg Thieme Verlag KG Stuttgart, New York.

Acute liver failure and self-medication.

PubMed

de Oliveira, André Vitorio Câmara; Rocha, Frederico Theobaldo Ramos; Abreu, Sílvio Romero de Oliveira

2014-01-01

Not responsible self-medication refers to drug use in high doses without rational indication and often associated with alcohol abuse. It can lead to liver damage and drug interactions, and may cause liver failure. To warn about how the practice of self-medication can be responsible for acute liver failure. Were used the Medline via PubMed, Cochrane Library, SciELO and Lilacs, and additional information on institutional sites of interest crossing the headings acute liver failure [tiab] AND acetaminophen [tiab]; self-medication [tiab] AND acetaminophen [tiab]; acute liver failure [tiab] AND dietary supplements [tiab]; self-medication [tiab] AND liver failure [tiab] and self-medication [tiab] AND green tea [tiab]. In Lilacs and SciELO used the descriptor self medication in Portuguese and Spanish. From total surveyed were selected 27 articles and five sites specifically related to the purpose of this review. Legislation and supervision disabled and information inaccessible to people, favors the emergence of cases of liver failure drug in many countries. In the list of released drugs that deserve more attention and care, are some herbal medicines used for the purpose of weight loss, and acetaminophen. It is recommended that institutes of health intensify supervision and better orient their populations on drug seemingly harmless, limiting the sale of products or requiring a prescription for release them.

Prediction of scuffing failure based on competitive kinetics of oxide formation and removal: Application to lubricated sliding of AISI 52100 steel on steel

NASA Astrophysics Data System (ADS)

Cutiongco, Eric C.; Chung, Yip-Wah

1994-07-01

A method for predicting scuffing failure based on the competitive kinetics of oxide formation and removal has been developed and applied to the sliding of AISI 52100 steel on steel with poly-alpha-olefin as the lubricant. Oxide formation rates were determining using static oxidation tests on coupons of 52100 steel covered with poly-alpha-olefin at temperatures of 140 C to 250 C. Oxide removal rates were determined at different combinations of initial average nominal contact pressures (950 MPa to 1578 MPa) and sliding velocities (0.4 m/s to 1.8 m/s) using a ball-on-disk vacuum tribotester. The nominal asperity flash temperatures generated during the wear tests were calculated and the temperatures corresponding to the intersection of the the Arrhenius plots of oxide formation and removal rates were determined and taken as the critical failure temperatures. The pressure-velocity failure transition diagram was constructed by plotting the critical failure temperatures along isotherms of average nominal asperity flash temperatures calculated at different combinations of contact stress and sliding speed. The predicted failure transition curve agreed well with experimental scuffing data.

Injuries among powered two-wheeler users in eight European countries: a descriptive analysis of hospital discharge data.

PubMed

Forman, Jason L; Lopez-Valdes, Francisco J; Pollack, Keshia; Heredero-Ordoyo, Rafael; Molinero, Aquilino; Mansilla, Alberto; Fildes, Brian; Segui-Gomez, Maria

2012-11-01

Powered two-wheelers (PTWs--mopeds, motorcycles, and scooters) remain the most dangerous form of travel on today's roads. This study used hospital discharge data from eight European countries to examine the frequencies and patterns of injury among PTW users (age≥14 years), the predicted incidence of the loss of functional ability, and the mechanisms of the head injuries observed (all in light of increased helmet use). Of 977,557 injured patients discharged in 2004, 12,994 were identified as having been injured in PTW collisions. Lower extremity injuries accounted for 26% (25.6-26.7, 95% C.I.) of the total injuries, followed by upper extremity injuries (20.7%: 20.3-21.2), traumatic brain injuries (TBI) (18.5%: 18-19), and thoracic injuries (8.2%: 7.8-8.5). Approximately 80% of the lower extremity injury cases were expected to exhibit some functional disability one year following discharge (predicted Functional Capacity Index, pFCI-AIS98<100), compared to 47% of the upper extremity injury cases and 24% of the TBI cases. Although it occurred less frequently, patients that were expected to experience some functional limitation from TBI were predicted to fair worse on average (lose more functional ability) than patients expected to have functional limitations from extremity injuries. Cerebral concussion was the most common head injury observed (occurring in 56% of head injury cases), with most concussion cases (78%) exhibiting no other head injury. Among the AIS3+ head injuries that could be mapped to an injury mechanism, 48% of these were associated with a translational-impact mechanism, and 37% were associated with a rotational mechanism. The observation of high rates of expected long-term disability suggests that future efforts aim to mitigate lower and upper extremity injuries among PTW users. Likewise, the high rates of concussion and head injuries associated with a rotational mechanism provide goals for the next phase of PTW user head protection. Copyright © 2011 Elsevier Ltd. All rights reserved.

Detecting failure of climate predictions

USGS Publications Warehouse

Runge, Michael C.; Stroeve, Julienne C.; Barrett, Andrew P.; McDonald-Madden, Eve

2016-01-01

The practical consequences of climate change challenge society to formulate responses that are more suited to achieving long-term objectives, even if those responses have to be made in the face of uncertainty1, 2. Such a decision-analytic focus uses the products of climate science as probabilistic predictions about the effects of management policies3. Here we present methods to detect when climate predictions are failing to capture the system dynamics. For a single model, we measure goodness of fit based on the empirical distribution function, and define failure when the distribution of observed values significantly diverges from the modelled distribution. For a set of models, the same statistic can be used to provide relative weights for the individual models, and we define failure when there is no linear weighting of the ensemble models that produces a satisfactory match to the observations. Early detection of failure of a set of predictions is important for improving model predictions and the decisions based on them. We show that these methods would have detected a range shift in northern pintail 20 years before it was actually discovered, and are increasingly giving more weight to those climate models that forecast a September ice-free Arctic by 2055.

You can't pay me to quit: the failure of financial incentives for smoking cessation in head and neck cancer patients.

PubMed

Ghosh, A; Philiponis, G; Bewley, A; Ransom, E R; Mirza, N

2016-03-01

A prospective randomised study was conducted at a tertiary care hospital to evaluate the effects of financial incentives for smoking cessation targeted at a high-risk population. Patients with a past history of head and neck cancer were voluntarily enrolled over a two-year period. They were randomised to a cash incentives or no incentive group. Subjects were offered enrolment in smoking cessation courses. Smoking by-product levels were assessed at 30 days, 3 months and 6 months. Subjects in the incentive group received $150 if smoking cessation was confirmed. Over 2 years, 114 patients with an established diagnosis of head and neck cancer were offered enrolment. Twenty-four enrolled and 14 attended the smoking cessation classes. Only two successfully quit smoking at six months. Both these patients were in the financially incentivised group and received $150 at each test visit. Providing a financial incentive for smoking cessation to a population already carrying a diagnosis of head and neck cancer in order to promote a positive behaviour change was unsuccessful.

Comparison of International Guidelines on Mucosal Melanoma of the Head and Neck: A Comprehensive Review of the Role of Radiation Therapy.

PubMed

Pittaka, Maria; Kardamakis, Dimitrios; Spyropoulou, Despina

2016-01-01

Mucosal melanomas of the head and neck are rare pathological entities that correlate with poor prognosis due to their high propensity for local failure and distant metastases. The exact role of radiation therapy in the management of mucosal melanoma patients has not yet been fully proven, even though in everyday clinical practice these patients are referred for radiotherapy, in an effort to improve locoregional control. The guidelines of various societies on the role of radiation therapy for the treatment of mucosal melanoma of the head and neck region are very limited. We reviewed and analyzed the guidelines developed in the U.S.A. (National Comprehensive Cancer Network), Canada (Cancer Care Ontario and Canadian Medical Association), Europe (European Society for Medical Oncology and European Society for Radiotherapy and Oncology) and Australia and New Zealand (Cancer Council Australia) and isolated evidence for the management of mucosal melanomas of the head and neck region with radiation therapy worldwide. Copyright © 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Influence of diabetes mellitus on postoperative complications and failure in head and neck free flap reconstruction: a systematic review and meta-analysis.

PubMed

Rosado, Pablo; Cheng, Hsu-Tang; Wu, Chao-Min; Wei, Fu-Chan

2015-04-01

We performed a systematic review and meta-analysis to determine whether diabetic patients have an increased rate of postoperative complications compared to nondiabetic patients after head and neck free flap reconstruction. A systematic review of PubMed Database between 1966 and 2012 was performed. RevMan 5.0 was used for meta-analysis. A retrospective medical chart review of 7890 patients to identify those who had a failed microsurgical reconstruction of the head and neck region at Chang Gung Memorial Hospital was also carried out. The result revealed that patients with diabetes mellitus have a 1.76 increased risk of complications (odds ratio [OR] = 1.76; 95% confidence interval [CI] = 1.11-2.79) with minimal heterogeneity (I( 2)  = 22%; p = .28). The prevalence of diabetes mellitus in patients with failed free flaps for head and neck reconstruction is 15%. The incidence of diabetes mellitus in these patients with failed free flaps is 2.3 times higher than in the general population. © 2014 Wiley Periodicals, Inc.

A biomechanical evaluation of a cannulated compressive screw for use in fractures of the scaphoid.

PubMed

Rankin, G; Kuschner, S H; Orlando, C; McKellop, H; Brien, W W; Sherman, R

1991-11-01

The compressive force generated by a 3.5 mm ASIF cannulated cancellous screw with a 5 mm head was compared with that generated by a standard 3.5 mm ASIF screw (6 mm head), a 2.7 mm ASIF screw (5 mm head), and a Herbert screw. The screws were evaluated in the laboratory with the use of a custom-designed load washer (transducer) to the maximum compressive force generated by each screw until failure, either by thread stripping or by head migration into the specimen. Testing was done on paired cadaver scaphoids. To minimize the variability that occurs with human bone, and because of the cost and difficulty of obtaining human tissue specimens, a study was also done on polyurethane foam simulated bones. The 3.5 cannulated screw generated greater compressive forces than the Herbert screw but less compression than the 2.7 mm and 3.5 mm ASIF cortical screws. The 3.5 mm cannulated screw offers more rigid internal fixation for scaphoid fractures than the Herbert screw and gives the added advantage of placement over a guide wire.

DE 1 RIMS operational characteristics

NASA Technical Reports Server (NTRS)

Olsen, R. C.; Comfort, R. H.; Chandler, M. O.; Moore, T. E.; Waite, J. H., Jr.; Reasoner, D. L.; Biddle, A. P.

1985-01-01

The Retarding Ion Mass Spectrometer (RIMS) on the Dynamics Explorer 1 spacecraft observes both the thermal and superthermal (50 eV) ions of the ionosphere and inner magnetosphere. It is capable of measuring the detailed species distribution function of these ions in many cases. It was equipped with an integral electrometer to permit in-flight calibration of the detector sensitivities and variations thereof. A guide to understanding the RIMS data set is given. The reduction process from count rates to physical quantities is discussed in some detail. The procedure used to establish in-flight calibration is described, and results of a comparison with densities from plasma wave measurements are provided. Finally, a discussion is provided of various anomalies in the data set, including changes of channeltron efficiency with time, spin modulation of the axial sensor heads, apparent potential differences between the sensor heads, and failures of the radial head retarding potential sweep and of the -Z axial head aperture plane bias. Studies of the RIMS data set should be conducted only with a thorough awareness of the material presented here, or in collaboration with one of the scientists actively involved with RIMS data analysis.

Impact of pre-operative body mass index in head and neck cancer patients undergoing microvascular reconstruction.

PubMed

Hyun, D-J; Joo, Y-H; Kim, M-S

2017-11-01

To analyse the relationship of pre-operative body mass index with surgical complications and oncological outcomes in patients undergoing microvascular reconstruction for head and neck squamous cell cancer. A retrospective review was conducted of 259 patients who underwent microvascular free flap reconstruction after head and neck ablative surgery. Mean body mass index was 22.48 kg/m2. There were no correlations between body mass index and: flap failure (p = 0.739), flap ischaemia (p = 0.644), pharyngocutaneous fistula (p = 0.141) or wound infection (p = 0.224). The five-year disease-specific survival rate was 63 per cent. On univariate analysis, the five-year disease-specific survival rate was significantly correlated with pre-operative body mass index, based on Kaplan-Meier survival curves (p = 0.028). The five-year disease-specific survival rates in underweight, normal weight, overweight and obese groups were 47 per cent, 55 per cent, 65 per cent and 80 per cent, respectively. Pre-operative body mass index was a useful predictor for recurrence and survival in patients who underwent microvascular reconstruction for head and neck squamous cell cancer.

Vagal Nerve Stimulator Malfunction with Change in Neck Position: Case Report and Literature Review.

PubMed

D'Agostino, Erin; Makler, Vyacheslav; Bauer, David F

2018-06-01

Vagal nerve stimulation is a safe and well-tolerated treatment for drug-resistant epilepsy. Complications and failure of the device can result from lead fracture, device malfunction, disconnection, or battery displacement and can result in a variety of symptoms. We present an interesting case of stimulator malfunction with increased impedance change seen only with a change in head position. The patient is a 25-year-old male with a vagal nerve stimulator (VNs) placed for medically refractory epilepsy who presented with neck pain and an electrical pulling sensation in his neck whenever he turned his head to the right. Initial interrogation of the VNs showed normal impedance. Subsequent interrogation with the patient's head turned found increased impedance only when the head was turned to the right. The patient had successful removal and replacement of the device with resolution of his preoperative complaints. Partial lead fracture was seen at explant. VNs malfunction can present in atypical ways. Positional maneuvers may help with its timely diagnosis. Copyright © 2018 Elsevier Inc. All rights reserved.

Materials for a Stirling engine heater head

NASA Technical Reports Server (NTRS)

Noble, J. E.; Lehmann, G. A.; Emigh, S. G.

1990-01-01

Work done on the 25-kW advanced Stirling conversion system (ASCS) terrestrial solar program in establishing criteria and selecting materials for the engine heater head and heater tubes is described. Various mechanisms contributing to incompatibility between materials are identified and discussed. Large thermal gradients, coupled with requirements for long life (60,000 h at temperature) and a large number of heatup and cooldown cycles (20,000) drive the design from a structural standpoint. The pressurized cylinder is checked for creep rupture, localized yielding, reverse plasticity, creep and fatigue damage, and creep ratcheting, in addition to the basic requirements for bust and proof pressure. In general, creep rupture and creep and fatigue interaction are the dominant factors in the design. A wide range of materials for the heater head and tubes was evaluated. Factors involved in the assessment were strength and effect on engine efficiency, reliability, and cost. A preliminary selection of Inconel 713LC for the heater head is based on acceptable structural properties but driven mainly by low cost. The criteria for failure, the structural analysis, and the material characteristics with basis for selection are discussed.

Does contact by a family nurse practitioner decrease early school absence?

PubMed

Kerr, Jill; Price, Marva; Kotch, Jonathan; Willis, Stephanie; Fisher, Michael; Silva, Susan

2012-02-01

Chronic early school absence (preschool through third grade) is associated with school failure. The presence of school nurses may lead to fewer absences, and nurse practitioners in school-based health centers (SBHCs) can facilitate a healthier population resulting in improved attendance. Efforts to get students back to school are unexplored in nursing literature. This article describes a nursing intervention to decrease early school absence in two elementary schools K-3 (N = 449) and a Head Start program (N = 130). The Head Start Family Nurse Practitioner (FNP) contacted families of chronically and excessively absent students by telephone, clinic visit at school, or home visit. The aggregate percentage attendance was evaluated by grades (preschool to third grade), schools (Head Start, Elementary Schools 1 and 2), and grades and schools and compared with publicly available school district aggregate data. There were statistically significant increases in attendance from Year 1 to Year 2 at p < .05 at the elementary level but not at the Head Start level. Student demographics, types of contacts, absence reasons (including sick child), and medical diagnoses are described.

Interpretation of Post-operative Distal Humerus Radiographs After Internal Fixation: Prediction of Later Loss of Fixation.

PubMed

Claessen, Femke M A P; Stoop, Nicky; Doornberg, Job N; Guitton, Thierry G; van den Bekerom, Michel P J; Ring, David

2016-10-01

Stable fixation of distal humerus fracture fragments is necessary for adequate healing and maintenance of reduction. The purpose of this study was to measure the reliability and accuracy of interpretation of postoperative radiographs to predict which implants will loosen or break after operative treatment of bicolumnar distal humerus fractures. We also addressed agreement among surgeons regarding which fracture fixation will loosen or break and the influence of years in independent practice, location of practice, and so forth. A total of 232 orthopedic residents and surgeons from around the world evaluated 24 anteroposterior and lateral radiographs of distal humerus fractures on a Web-based platform to predict which implants would loosen or break. Agreement among observers was measured using the multi-rater kappa measure. The sensitivity of prediction of failure of fixation of distal humerus fracture on radiographs was 63%, specificity was 53%, positive predictive value was 36%, the negative predictive value was 78%, and accuracy was 56%. There was fair interobserver agreement (κ = 0.27) regarding predictions of failure of fixation of distal humerus fracture on radiographs. Interobserver variability did not change when assessed for the various subgroups. When experienced and skilled surgeons perform fixation of type C distal humerus fracture, the immediate postoperative radiograph is not predictive of fixation failure. Reoperation based on the probability of failure might not be advisable. Diagnostic III. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Predicting failure of hematopoietic stem cell mobilization before it starts: the predicted poor mobilizer (pPM) score.

PubMed

Olivieri, Jacopo; Attolico, Immacolata; Nuccorini, Roberta; Pascale, Sara Pasquina; Chiarucci, Martina; Poiani, Monica; Corradini, Paolo; Farina, Lucia; Gaidano, Gianluca; Nassi, Luca; Sica, Simona; Piccirillo, Nicola; Pioltelli, Pietro Enrico; Martino, Massimo; Moscato, Tiziana; Pini, Massimo; Zallio, Francesco; Ciceri, Fabio; Marktel, Sarah; Mengarelli, Andrea; Musto, Pellegrino; Capria, Saveria; Merli, Francesco; Codeluppi, Katia; Mele, Giuseppe; Lanza, Francesco; Specchia, Giorgina; Pastore, Domenico; Milone, Giuseppe; Saraceni, Francesco; Di Nardo, Elvira; Perseghin, Paolo; Olivieri, Attilio

2018-04-01

Predicting mobilization failure before it starts may enable patient-tailored strategies. Although consensus criteria for predicted PM (pPM) are available, their predictive performance has never been measured on real data. We retrospectively collected and analyzed 1318 mobilization procedures performed for MM and lymphoma patients in the plerixafor era. In our sample, 180/1318 (13.7%) were PM. The score resulting from published pPM criteria had sufficient performance for predicting PM, as measured by AUC (0.67, 95%CI: 0.63-0.72). We developed a new prediction model from multivariate analysis whose score (pPM-score) resulted in better AUC (0.80, 95%CI: 0.76-0.84, p < 0001). pPM-score included as risk factors: increasing age, diagnosis of NHL, positive bone marrow biopsy or cytopenias before mobilization, previous mobilization failure, priming strategy with G-CSF alone, or without upfront plerixafor. A simplified version of pPM-score was categorized using a cut-off to maximize positive likelihood ratio (15.7, 95%CI: 9.9-24.8); specificity was 98% (95%CI: 97-98.7%), sensitivity 31.7% (95%CI: 24.9-39%); positive predictive value in our sample was 71.3% (95%CI: 60-80.8%). Simplified pPM-score can "rule in" patients at very high risk for PM before starting mobilization, allowing changes in clinical management, such as choice of alternative priming strategies, to avoid highly likely mobilization failure.