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Sample records for predict extubation failure

  1. Predictors of Extubation Failure in Neurocritical Patients Identified by a Systematic Review and Meta-Analysis

    PubMed Central

    Huang, Kaibin; Lin, Zhenzhou; Qiao, Weiguang; Pan, Suyue

    2014-01-01

    Background Prediction of extubation failure, particularly in neurocritical patients, is unique and controversial. We conducted a systematic review and meta-analysis to identify the risk factors for extubation failure in these patients. Methods A literature search of databases (MEDLINE, EMBASE, the Cochrane Library, and Web of Science) was performed up to August of 2013 to identify trials that evaluated extubation failure predictors. Included trials were either prospective or retrospective cohort studies. Results Nine studies involving 928 participants were included. The systematic review and meta-analysis revealed that the following were predictive for extubation failure: pneumonia, atelectasis, mechanical ventilation of >24 h, a low Glasgow Coma Scale score (7–9T) (OR = 4.96, 95% CI = 1.61–15.26, P = 0.005), the inability to follow commands (OR = 2.07, 95% CI = 1.15–3.71, P = 0.02), especially the command to close the eyes, thick secretion, and no intact gag reflex. Meanwhile, the following were not predictive for extubation failure: sex, secretion volume, coughing upon suctioning, and the inability to follow one command among showing two fingers, wiggling the toes, or coughing on command. Additionally, some traditional weaning parameters were shown to poorly predict extubation failure in neurocritical patients. Conclusions Besides pneumonia, atelectasis, and the duration of mechanical ventilation, other factors that should be taken into consideration in the prediction of extubation failure when neurocritical patients are weaned from tracheal intubation include neurologic abilities (Glasgow Coma Scale score and following commands), the secretion texture, and the presence of a gag reflex. PMID:25486091

  2. Predictors of extubation failure and reintubation in newborn infants subjected to mechanical ventilation

    PubMed Central

    Costa, Ana Cristina de Oliveira; Schettino, Renata de Carvalho; Ferreira, Sandra Clecêncio

    2014-01-01

    Objective To identify risk factors for extubation failure and reintubation in newborn infants subjected to mechanical ventilation and to establish whether ventilation parameters and blood gas analysis behave as predictors of those outcomes. Methods Prospective study conducted at a neonatal intensive care unit from May to November 2011. A total of 176 infants of both genders subjected to mechanical ventilation were assessed after extubation. Extubation failure was defined as the need to resume mechanical ventilation within less than 72 hours. Reintubation was defined as the need to reintubate the infants any time after the first 72 hours. Results Based on the univariate analysis, the variables gestational age <28 weeks, birth weight <1,000g and low Apgar scores were associated with extubation failure and reintubation. Based on the multivariate analysis, the variables length of mechanical ventilation (days), potential of hydrogen (pH) and partial pressure of oxygen (pO2) remained associated with extubation failure, and the five-minute Apgar score and age at extubation were associated with reintubation. Conclusion Low five-minute Apgar scores, age at extubation, length of mechanical ventilation, acid-base disorders and hyperoxia exhibited associations with the investigated outcomes of extubation failure and reintubation. PMID:24770689

  3. Perioperative Predictors of Extubation Failure and the Effect on Clinical Outcome After Infratentorial Craniotomy

    PubMed Central

    Cai, Ye-Hua; Wang, Hai-Tang; Zhou, Jian-Xin

    2016-01-01

    Background The purpose of the study was to analyze the risk factors for failed extubation in subjects submitted to infratentorial craniotomy. Material/Methods Patients aged over 18 years who received infratentorial craniotomy for brain tumor resection were consecutively included in this study. Perioperative variables were collected and analyzed. Univariate analyses and multiple logistic regression were used to derive factors related to failed extubation. Patients had follow-up care until either out of hospital or death. Results Throughout the course of the study, 2118 patients were eligible and 94 (4.4%) suffered from extubation failure at some point during their hospital stay. Five factors were recognized as independent risk factors for postoperative failed extubation: craniotomy history, preoperative lower cranial nerve dysfunction, tumor size, tumor position, and maximum change in blood pressure (BP) during the operation. Failed extubation was related to a higher incidence rate of pneumonia, mortality, unfavorable Glasgow Outcome Scale score, longer stay in the neuro-intensive care unit (ICU) and hospitalization, and higher hospitalization costs compared with successful extubation. Conclusions History of craniotomy, preoperative lower cranial nerve dysfunction, tumor size, tumor position, and maximum change in BP during the operation were independent risk factors related to postoperative failed extubation in patients submitted to infratentorial craniotomy. Extubation failure raises the incidences of postoperative pneumonia, mortality, and higher hospitalization costs, and prolongs neuro-ICU and postoperative length of stay. PMID:27404044

  4. Perioperative Predictors of Extubation Failure and the Effect on Clinical Outcome After Infratentorial Craniotomy.

    PubMed

    Cai, Ye-Hua; Wang, Hai-Tang; Zhou, Jian-Xin

    2016-07-12

    BACKGROUND The purpose of the study was to analyze the risk factors for failed extubation in subjects submitted to infratentorial craniotomy. MATERIAL AND METHODS Patients aged over 18 years who received infratentorial craniotomy for brain tumor resection were consecutively included in this study. Perioperative variables were collected and analyzed. Univariate analyses and multiple logistic regression were used to derive factors related to failed extubation. Patients had follow-up care until either out of hospital or death. RESULTS Throughout the course of the study, 2118 patients were eligible and 94 (4.4%) suffered from extubation failure at some point during their hospital stay. Five factors were recognized as independent risk factors for postoperative failed extubation: craniotomy history, preoperative lower cranial nerve dysfunction, tumor size, tumor position, and maximum change in blood pressure (BP) during the operation. Failed extubation was related to a higher incidence rate of pneumonia, mortality, unfavorable Glasgow Outcome Scale score, longer stay in the neuro-intensive care unit (ICU) and hospitalization, and higher hospitalization costs compared with successful extubation. CONCLUSIONS History of craniotomy, preoperative lower cranial nerve dysfunction, tumor size, tumor position, and maximum change in BP during the operation were independent risk factors related to postoperative failed extubation in patients submitted to infratentorial craniotomy. Extubation failure raises the incidences of postoperative pneumonia, mortality, and higher hospitalization costs, and prolongs neuro-ICU and postoperative length of stay.

  5. Effects of mechanical insufflation-exsufflation in preventing respiratory failure after extubation: a randomized controlled trial

    PubMed Central

    2012-01-01

    Introduction Weaning protocols that include noninvasive ventilation (NIV) decrease re-intubation rates and ICU length of stay. However, impaired airway clearance is associated with NIV failure. Mechanical insufflation-exsufflation (MI-E) has been proven to be very effective in patients receiving NIV. We aimed to assess the efficacy of MI-E as part of an extubation protocol. Method Patients with mechanical ventilation (MV) for more than 48 hours with specific inclusion criteria, who successfully tolerated a spontaneous breathing trial (SBT), were randomly allocated before extubation, either for (A) a conventional extubation protocol (control group), or (B) the MI-E extubation protocol (study group). During the postextubation period (48 hours), group A patients received standard medical treatment (SMT), including NIV in case of specific indications, whereas group B received the same postextubation approach plus three daily sessions of mechanical in-exsufflation (MI-E). Reintubation rates, ICU length of stay, and NIV failure rates were analyzed. Results Seventy-five patients (26 women) with a mean age of 61.8 ± 17.3 years were randomized to a control group (n = 40; mean SAPS II, 47.8 ± 17.7) and to a study group (n = 35; mean SAPS II, 45.0 ± 15.0). MV time before enrollment was 9.4 ± 4.8 and 10.5 ± 4.1 days for the control and the study group, respectively. In the 48 hours after extubation, 20 control patients (50%) and 14 study patients (40%) used NIV. Study group patients had a significant lower reintubation rate than did controls; six patients (17%) versus 19 patients (48%), P < 0.05; respectively, and a significantly lower time under MV; 17.8 ± 6.4 versus 11.7 ± 3.5 days; P < 0.05; respectively. Considering only the subgroup of patients that used NIV, the reintubation rates related to NIV failure were significantly lower in the study group when compared with controls; two patients (6%) versus 13 (33%); P < 0.05, respectively. Mean ICU length of stay after

  6. Can Machine Learning Methods Predict Extubation Outcome in Premature Infants as well as Clinicians?

    PubMed Central

    Mueller, Martina; Almeida, Jonas S.; Stanislaus, Romesh; Wagner, Carol L.

    2014-01-01

    Rationale Though treatment of the prematurely born infant breathing with assistance of a mechanical ventilator has much advanced in the past decades, predicting extubation outcome at a given point in time remains challenging. Numerous studies have been conducted to identify predictors for extubation outcome; however, the rate of infants failing extubation attempts has not declined. Objective To develop a decision-support tool for the prediction of extubation outcome in premature infants using a set of machine learning algorithms Methods A dataset assembled from 486 premature infants on mechanical ventilation was used to develop predictive models using machine learning algorithms such as artificial neural networks (ANN), support vector machine (SVM), naïve Bayesian classifier (NBC), boosted decision trees (BDT), and multivariable logistic regression (MLR). Performance of all models was evaluated using area under the curve (AUC). Results For some of the models (ANN, MLR and NBC) results were satisfactory (AUC: 0.63–0.76); however, two algorithms (SVM and BDT) showed poor performance with AUCs of ~0.5. Conclusion Clinician's predictions still outperform machine learning due to the complexity of the data and contextual information that may not be captured in clinical data used as input for the development of the machine learning algorithms. Inclusion of preprocessing steps in future studies may improve the performance of prediction models. PMID:25419493

  7. Establishing predictors for successfully planned endotracheal extubation

    PubMed Central

    Lai, Chih-Cheng; Chen, Chin-Ming; Chiang, Shyh-Ren; Liu, Wei-Lun; Weng, Shih-Feng; Sung, Mei-I; Hsing, Shu-Chen; Cheng, Kuo-Chen

    2016-01-01

    Abstract The aim of this study was to establish predictors for successfully planned extubation, which can be followed by medical personnel. The patients who were admitted to the adult intensive care unit of a tertiary hospital and met the following criteria between January 2005 and December 2014 were collected retrospectively: intubation > 48 hours; and candidate for extubation. The patient characteristics, including disease severity, rapid shallow breath index (RSBI), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), cuff leak test (CLT) before extubation, and outcome, were recorded. The CLT was classified as 2+ with audible flow without a stethoscope, 1+ with audible flow using a stethoscope, and negative (N) with no audible flow, even with a stethoscope. Failure to extubate was defined as reintubation within 48 hours. In total, 6583 patients were enrolled and 403 patients (6.1%) had extubation failures. Male patients dominated the patient cohort (4261 [64.7%]). The mean age was 64.5±16.3 years. The overall in-hospital mortality rate was 11.3%. The extubation failure rate for females was greater than males (7.7% vs 5.3%, P < 0.001). The group of patients who failed extubation were older (66.7 ± 14.4 vs 64.3 ± 16.4, P = 0.002), had higher APACHE II scores (16.8 ± 7.6 vs 15.9 ± 7.8, P = 0.023), lower coma scales (10.3 ± 3.7 vs 10.8 ± 3.7, P = 0.07), a higher RSBI (69.9 ± 37.3 vs 58.6 ± 30.3, P < 0.001), a lower MIP, and MEP (−35.6 ± 15.3 vs −37.8 ± 14.6, P = 0.0001 and 49.6 ± 28.4 vs 58.6 ± 30.2, P < 0.001, respectively), and a higher mortality rate (25.6% vs 10.5%, P < 0.001) compared to the successful extubation group. Based on multivariate logistic regression, a CLT of 2+ (odds ratio [OR] = 2.07, P < 0.001), a MEP ≥ 55 cmH2O (OR = 1.73, P < 0.001), and a RSBI < 68 breath/min/ml (OR = 1.57, P < 0.001) were independent predictors for

  8. Effect of early application of biphasic positive airway pressure on the outcome of extubation in ventilator weaning.

    PubMed

    Jiang, J S; Kao, S J; Wang, S N

    1999-06-01

    Extubation failure is significantly associated with increased morbidity and mortality in mechanically ventilated patients. In respiratory distress after extubation, non-invasive positive pressure ventilation (NIPPV) has been suggested to avoid the complications of invasive mechanical ventilation. The purpose of this study was to evaluate the effect of early application of NIPPV on extubation outcome. We conducted a prospective study in 93 extubated patients with a mean age of 72.7 +/- 14.7 years (range, 24-93). Elective extubation was performed in 56 patients and unplanned extubation occurred in 37 patients. After extubation, patients randomly received either biphasic positive airway pressure (BIPAP) therapy (n = 47) or unassisted oxygen therapy (n = 46). Non-invasive positive pressure ventilation was delivered via face mask in BIPAP group. Of the 93 extubated patients, 73 (78.5%) were successfully extubated, and 20 (21.5%) had to be re-intubated. There were no significant differences in age, sex, pre-extubation blood gas data between re-intubated patients and those who were not re-intubated. While seven of the 46 patients in the unassisted oxygen therapy group required re-intubation, 13 of the 47 BIPAP-treated patients also required re-intubation. This difference was not statistically significant. The postextubation respiratory management, BIPAP or unassisted oxygen therapy, did not correlate with the extubation outcome, but the elective extubation had significantly better outcome than unplanned extubation. Patients with excessive bronchial secretions and intolerance to the equipment are poor candidates for NIPPV. We conclude that early application of BIPAP support did not predict a favourable extubation outcome. Our experience did not support the indiscriminate use of NIPPV to facilitate ventilator weaning.

  9. Predictive Factors for Efficacy and Safety of Prophylactic Theophylline for Extubation in Infants with Apnea of Prematurity

    PubMed Central

    Orita, Yuji; Mitarai, Fumi; Ishitsuka, Yoichi; Irikura, Mitsuru; Shimodozono, Yoshihiro; Douchi, Tsutomu; Takeda, Yasuo; Irie, Tetsumi

    2016-01-01

    Purpose This study aimed to evaluate predictive factors involved in efficacy and safety in Japanese infants who received theophylline therapy to prevent apnea of prematurity (AOP) after weaning from mechanical ventilation. Methods We retrospectively reviewed the medical records of infants who were administered intravenous aminophylline (theophylline ethylenediamine) for AOP at the neonatal intensive care unit, Kagoshima University Hospital, Japan, between January 2009 and June 2013. Results A total of 100 infants were evaluated as two separate groups in terms of efficacy and safety of theophylline. Sixty-seven (67.0%) infants had effective theophylline therapy. Multivariate logistic regression analysis showed that gestational age at birth was significant, with an odds ratio of 0.59 (p < 0.001). Receiver operating characteristic analysis showed that the cut-off value was 31.1 weeks old for predicting the efficacy of theophylline (specificity, 66.7%; sensitivity, 86.6%; p < 0.001; area under the curve, 0.750; 95% confidence interval, 0.45–0.74). Adverse reactions were identified in 21 (21.0%) infants. Multivariate logistic regression analysis showed that the number of days of theophylline administration from birth was associated with an increased risk of adverse reactions after theophylline administration (p = 0.01). Conclusions Physicians need to be aware of the possibility that theophylline fails to produce therapeutic effects for extubation in infants aged less than 31.1 weeks old, and adverse reactions can easily develop when theophylline is administered soon after birth. PMID:27388444

  10. 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.

  11. Detecting failure of climate predictions

    NASA Astrophysics Data System (ADS)

    Runge, Michael C.; Stroeve, Julienne C.; Barrett, Andrew P.; McDonald-Madden, Eve

    2016-09-01

    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 uncertainty. Such a decision-analytic focus uses the products of climate science as probabilistic predictions about the effects of management policies. 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.

  12. Predicting Electronic Failure from Smoke

    SciTech Connect

    Tanaka, T.J.

    1999-01-15

    Smoke can cause electronic equipment to fail through increased leakage currents and shorts. Sandia National Laboratories is studying the increased leakage currents caused by smoke with varying characteristics. The objective is to develop models to predict the failure of electronic equipment exposed to smoke. This requires the collection of data on the conductivity of smoke and knowledge of critical electrical systems that control high-consequence operations. We have found that conductivity is a function of the type of fuel, how it is burned, and smoke density. Video recordings of highly biased dc circuits exposed in a test chamber show that during a fire, smoke is attracted to high voltages and can build fragile carbon bridges that conduct leakage currents. The movement of air breaks the bridges, so the conductivity decreases after the fire is extinguished and the test chamber is vented. During the fire, however, electronic equipment may not operate correctly, leading to problems for critical operations dependent on electronic control. The potential for electronic failure is highly dependent on the type of electrical circuit, and Sandia National Laboratories plans to include electrical circuit modeling in the failure models.

  13. 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.

  14. Strain limit criteria to predict failure

    SciTech Connect

    Flanders, H.E.

    1995-12-31

    In recent years extensive effort has been expended to qualify existing structures for conditions that are beyond the original design basis. Determination of the component failure load is useful for this type of evaluation. This paper presents criteria based upon strain limits to predict the load at failure. The failure modes addressed are excessive plastic deformations, localized plastic strains, and structural instability. The effects of analytical method sophistication, as built configurations, material properties degradation, and stress state are addressed by the criteria.

  15. Uncertainties in container failure time predictions

    SciTech Connect

    Williford, R.E.

    1990-01-01

    Stochastic variations in the local chemical environment of a geologic waste repository can cause corresponding variations in container corrosion rates and failure times, and thus in radionuclide release rates. This paper addresses how well the future variations in repository chemistries must be known in order to predict container failure times that are bounded by a finite time period within the repository lifetime. Preliminary results indicate that a 5000 year scatter in predicted container failure times requires that repository chemistries be known to within {plus minus}10% over the repository lifetime. These are small uncertainties compared to current estimates. 9 refs., 3 figs.

  16. Prediction of Cascading Failures in Spatial Networks

    PubMed Central

    Shunkun, Yang; Dan, Lu

    2016-01-01

    Cascading overload failures are widely found in large-scale parallel systems and remain a major threat to system reliability; therefore, they are of great concern to maintainers and managers of different systems. Accurate cascading failure prediction can provide useful information to help control networks. However, for a large, gradually growing network with increasing complexity, it is often impractical to explore the behavior of a single node from the perspective of failure propagation. Fortunately, overload failures that propagate through a network exhibit certain spatial-temporal correlations, which allows the study of a group of nodes that share common spatial and temporal characteristics. Therefore, in this study, we seek to predict the failure rates of nodes in a given group using machine-learning methods. We simulated overload failure propagations in a weighted lattice network that start with a center attack and predicted the failure percentages of different groups of nodes that are separated by a given distance. The experimental results of a feedforward neural network (FNN), a recurrent neural network (RNN) and support vector regression (SVR) all show that these different models can accurately predict the similar behavior of nodes in a given group during cascading overload propagation. PMID:27093054

  17. Prediction of Cascading Failures in Spatial Networks.

    PubMed

    Shunkun, Yang; Jiaquan, Zhang; Dan, Lu

    2016-01-01

    Cascading overload failures are widely found in large-scale parallel systems and remain a major threat to system reliability; therefore, they are of great concern to maintainers and managers of different systems. Accurate cascading failure prediction can provide useful information to help control networks. However, for a large, gradually growing network with increasing complexity, it is often impractical to explore the behavior of a single node from the perspective of failure propagation. Fortunately, overload failures that propagate through a network exhibit certain spatial-temporal correlations, which allows the study of a group of nodes that share common spatial and temporal characteristics. Therefore, in this study, we seek to predict the failure rates of nodes in a given group using machine-learning methods. We simulated overload failure propagations in a weighted lattice network that start with a center attack and predicted the failure percentages of different groups of nodes that are separated by a given distance. The experimental results of a feedforward neural network (FNN), a recurrent neural network (RNN) and support vector regression (SVR) all show that these different models can accurately predict the similar behavior of nodes in a given group during cascading overload propagation.

  18. Multifactorial Risk Index for Predicting Postoperative Respiratory Failure in Men After Major Noncardiac Surgery

    PubMed Central

    Arozullah, Ahsan M.; Daley, Jennifer; Henderson, William G.; Khuri, Shukri F.

    2000-01-01

    Objective To develop and validate a preoperative risk index for predicting postoperative respiratory failure (PRF). Summary Background Data Respiratory failure is an important postoperative complication. Method Based on a prospective cohort study, cases from 44 Veterans Affairs Medical Centers (n = 81,719) were used to develop the models. Cases from 132 Veterans Affairs Medical Centers (n = 99,390) were used as a validation sample. PRF was defined as mechanical ventilation for more than 48 hours after surgery or reintubation and mechanical ventilation after postoperative extubation. Ventilator-dependent, comatose, do not resuscitate, and female patients were excluded. Results PRF developed in 2,746 patients (3.4%). The respiratory failure risk index was developed from a simplified logistic regression model and included abdominal aortic aneurysm repair, thoracic surgery, neurosurgery, upper abdominal surgery, peripheral vascular surgery, neck surgery, emergency surgery, albumin level less than 30 g/L, blood urea nitrogen level more than 30 mg/dL, dependent functional status, chronic obstructive pulmonary disease, and age. Conclusions The respiratory failure risk index is a validated model for identifying patients at risk for developing PRF and may be useful for guiding perioperative respiratory care. PMID:10903604

  19. Factors Predicting Meniscal Allograft Transplantation Failure

    PubMed Central

    Parkinson, Ben; Smith, Nicholas; Asplin, Laura; Thompson, Peter; Spalding, Tim

    2016-01-01

    Background: Meniscal allograft transplantation (MAT) is performed to improve symptoms and function in patients with a meniscal-deficient compartment of the knee. Numerous studies have shown a consistent improvement in patient-reported outcomes, but high failure rates have been reported by some studies. The typical patients undergoing MAT often have multiple other pathologies that require treatment at the time of surgery. The factors that predict failure of a meniscal allograft within this complex patient group are not clearly defined. Purpose: To determine predictors of MAT failure in a large series to refine the indications for surgery and better inform future patients. Study Design: Cohort study; Level of evidence, 3. Methods: All patients undergoing MAT at a single institution between May 2005 and May 2014 with a minimum of 1-year follow-up were prospectively evaluated and included in this study. Failure was defined as removal of the allograft, revision transplantation, or conversion to a joint replacement. Patients were grouped according to the articular cartilage status at the time of the index surgery: group 1, intact or partial-thickness chondral loss; group 2, full-thickness chondral loss 1 condyle; and group 3, full-thickness chondral loss both condyles. The Cox proportional hazards model was used to determine significant predictors of failure, independently of other factors. Kaplan-Meier survival curves were produced for overall survival and significant predictors of failure in the Cox proportional hazards model. Results: There were 125 consecutive MATs performed, with 1 patient lost to follow-up. The median follow-up was 3 years (range, 1-10 years). The 5-year graft survival for the entire cohort was 82% (group 1, 97%; group 2, 82%; group 3, 62%). The probability of failure in group 1 was 85% lower (95% CI, 13%-97%) than in group 3 at any time. The probability of failure with lateral allografts was 76% lower (95% CI, 16%-89%) than medial allografts at

  20. ESWL prediction of outcome and failure prevention.

    PubMed

    Vella, M; Caramia, M; Maltese, M; Melloni, D; Caramia, G

    2007-01-01

    Based on our own experiences and a review of the recent literature, this article evaluates recent developments in predicting outcomes and failures of shockwave lithotripsy when treating patients with urinary tract stones. After a detailed MEDLINE research, the authors identified several variables that influence and predict extracorporeal shockwave lithotripsy (ESWL) success. These variables may be categorized as stone variables, patient variables and operator variables. Only multivariate analysis on a large number of homogenous patients may offer an objective evaluation of the factors conditioning ESWL outcome.

  1. Progress in Predicting Rock-Slope Failures

    NASA Astrophysics Data System (ADS)

    Korup, O.

    2015-12-01

    Recent research on predicting landslides has seen a massive increase in statistical and computational methods that are largely adapted from the fields of machine learning and data mining. Judging from a sample of some 150 recent scientific papers, the gross majority of the reported success rates of these statistical methods are overwhelmingly high and promising at between 71% and 98%. Perhaps surprisingly, though, the death toll and damage from landslides has remained elevated in the early 21st century, so that reliably predicting the occurrence of rock-slope failures without overfitting our models remains challenging. Here I review some of the recent advances in this field, and show how novel results from landslide seismology and landslide sedimentology have promoted our ability of detecting large rock-slope failures in mountainous terrain. Several new detailed investigations of the internal nature of large rockslide deposits, for example, help to reduce the confusion potential with macroscopically similar moraine debris, or microscopically similar fault breccia. I further outline some of the limitations of empirical models that use rainfall intensity-duration thresholds for landslide early warning, and of multivariate methods concerned with mapping landslide susceptibility at the regional scale. I conclude by discussing the occurrence of 'black swans' such as long-runout rock-ice avalanches in size distributions of rock-slope failures, and their implications for quantitative hazard appraisals.

  2. [Predictors of extubation failure in neurosurgical patients].

    PubMed

    León-Gutiérrez, Marco Antonio; Tanus-Hajj, Janet; Sánchez-Hurtado, Luis Alejandro

    2016-01-01

    Introducción: la información con respecto a los factores que afectan el éxito de la extubación en pacientes neuroquirúrgicos es limitada; por lo tanto, es necesario determinar los factores que inciden en esta condición. Métodos: estudio prospectivo, longitudinal, observacional y comparativo en pacientes neuroquirúrgicos con criterios para la extubación. En aquellos que presentaron fracaso se analizó el número de aspiraciones endotraqueales en las 24 horas previas a la extubación, la presencia del reflejo de tos, los días de estancia y de ventilación mecánica. Resultados: se incluyeron 70 pacientes en el estudio, de los cuales el 11.4 % presentó fracaso de la extubación y los factores asociados fueron la realización de 6 aspiraciones de secreciones endotraqueales 24 horas previas a la extubación (con una razón de riesgo [RR] = 1.88, intervalo de confianza [IC] al 95 % = 1.14-3.09, p 0.01), 7 días de ventilación mecánica (RR = 1.31, IC 95 % = 1.08-1.57, p 0.005) y 7.5 días de estancia (RR = 1.24, IC 95 % = 1.05-1.47, p 0.01). Conclusión: hacer seis o más aspiraciones de secreciones endotraqueales durante las 24 horas previas a la extubación es un factor de riesgo para el fracaso de la extubación de pacientes neuroquirúrgicos.

  3. Association between the rapid shallow breathing index and extubation success in patients with traumatic brain injury

    PubMed Central

    dos Reis, Helena França Correia; Almeida, Mônica Lajana Oliveira; da Silva, Mário Ferreira; Moreira, Julião Oliveira; Rocha, Mário de Seixas

    2013-01-01

    Objective To investigate the association between the rapid shallow breathing index and successful extubation in patients with traumatic brain injury. Methods This study was a prospective study conducted in patients with traumatic brain injury of both genders who underwent mechanical ventilation for at least two days and who passed a spontaneous breathing trial. The minute volume and respiratory rate were measured using a ventilometer, and the data were used to calculate the rapid shallow breathing index (respiratory rate/tidal volume). The dependent variable was the extubation outcome: reintubation after up to 48 hours (extubation failure) or not (extubation success). The independent variable was the rapid shallow breathing index measured after a successful spontaneous breathing trial. Results The sample comprised 119 individuals, including 111 (93.3%) males. The average age of the sample was 35.0±12.9 years old. The average duration of mechanical ventilation was 8.1±3.6 days. A total of 104 (87.4%) participants achieved successful extubation. No association was found between the rapid shallow breathing index and extubation success. Conclusion The rapid shallow breathing index was not associated with successful extubation in patients with traumatic brain injury. PMID:24213084

  4. 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.

  5. 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.

  6. Failure strength prediction for adhesively bonded single lap joints

    NASA Astrophysics Data System (ADS)

    Rahman, Niat Mahmud

    For adhesively bonded joint, failure strength depends on many factors such as material properties (both adhesive and adherend), specimen geometries, test environments, surface preparation procedures, etc. Failure occurs inside constitutive materials or along joint interfaces. Based on location, adhesively bonded failure mode can be classified as adhesive failure mode, cohesive failure mode and adherend failure mode. Failure mode directly affects the failure strength of joint. For last eight decades, researchers have developed analytical, empirical or semi-empirical methods capable of predicting failure strength for adhesively bonded joints generating either cohesive failure or adherend failure. Applicability of most of the methods is limited to particular cases. In this research, different failure modes for single lap joints (SLJs) were generated experimentally using epoxy based paste adhesive. Based on experimental data and analytical study, simplified failure prediction methods were developed for each failure mode. For adhesive failure mode, it is observed that peel stress distributions concur along interface near crack initiation points. All SLJs for this test endured consistent surface treatments. Geometric parameters of the joints were varied to study their effect on failure strength. Peel stress distributions were calculated using finite analysis (FEA). Based on peel stress distribution near crack initiation point, a failure model is proposed. Numerous analytical, empirical and semi-empirical models are available for predicting failure strengths of SLJs generating cohesive failures. However, most of the methods in the literature failed to capture failure behavior of SLJs having thickness of adhesive layer as variable. Cohesive failure mode was generated experimentally using aluminum as adherend and epoxy adhesive considering thickness of adhesive layers as variable within SLJs. Comparative study was performed among various methods. It was observed that

  7. Predicting Computer System Failures Using Support Vector Machines

    SciTech Connect

    Fulp, Errin W.; Fink, Glenn A.; Haack, Jereme N.

    2008-12-07

    Mitigating the impact of computer failure is possible if accurate failure predictions are provided. Resources, applications, and services can be scheduled around predicted failure and limit the impact. Such strategies are especially important for multi-computer systems, such as compute clusters, that experience a higher rate failure due to the large number of components. However providing accurate predictions with sufficient lead time remains a challenging problem. This paper describes a new spectrum-kernel Support Vector Machine (SVM) approach to predict failure events based on system log files. These files contain messages that represent a change of system state. While a single message in the file may not be sufficient for predicting failure, a sequence or pattern of messages may be. The approach described in this paper will use a sliding window (sub-sequence) of messages to predict the likelihood of failure. The frequency representation of the message sub-sequences observed are then used as input to the SVM that associates the messages to a class of failed or non-failed system. Experimental results using actual system log files from a Linux-based compute cluster indicate the proposed SVM approach can predict hard disk failure with an accuracy of 76% one day in advance.

  8. 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.

  9. Prediction of Technological Failures in Nuclear Power Plant Operation

    SciTech Connect

    Salnykov, A. A.

    2015-01-15

    A method for predicting operating technological failures in nuclear power plants which makes it possible to reduce the unloading of the generator unit during the onset and development of an anomalous engineering state of the equipment by detecting a change in state earlier and taking suitable measures. With the circulating water supply loop of a nuclear power plant as an example, scenarios and algorithms for predicting technological failures in the operation of equipment long before their actual occurrence are discussed.

  10. Non invasive ventilation after extubation in paediatric patients: a preliminary study

    PubMed Central

    2010-01-01

    Background Non-invasive ventilation (NIV) may be useful after extubation in children. Our objective was to determine postextubation NIV characteristics and to identify risk factors of postextubation NIV failure. Methods A prospective observational study was conducted in an 8-bed pediatric intensive care unit (PICU). Following PICU protocol, NIV was applied to patients who had been mechanically ventilated for over 12 hours considered at high-risk of extubation failure -elective NIV (eNIV), immediately after extubation- or those who developed respiratory failure within 48 hours after extubation -rescue NIV (rNIV)-. Patients were categorized in subgroups according to their main underlying conditions. NIV was deemed successful when reintubation was avoided. Logistic regression analysis was performed in order to identify predictors of NIV failure. Results There were 41 episodes (rNIV in 20 episodes). Success rate was 50% in rNIV and 81% in eNIV (p = 0.037). We found significant differences in univariate analysis between success and failure groups in respiratory rate (RR) decrease at 6 hours, FiO2 at 1 hour and PO2/FiO2 ratio at 6 hours. Neurologic condition was found to be associated with NIV failure. Multiple logistic regression analysis identified no variable as independent NIV outcome predictor. Conclusions Our data suggest that postextubation NIV seems to be useful in avoiding reintubation in high-risk children when applied immediately after extubation. NIV was more likely to fail when ARF has already developed (rNIV), when RR at 6 hours did not decrease and if oxygen requirements increased. Neurologic patients seem to be at higher risk of reintubation despite NIV use. PMID:20444256

  11. Two-parameter Failure Model Improves Time-independent and Time-dependent Failure Predictions

    SciTech Connect

    Huddleston, R L

    2004-01-27

    A new analytical model for predicting failure under a generalized, triaxial stress state was developed by the author and initially reported in 1984. The model was validated for predicting failure under elevated-temperature creep-rupture conditions. Biaxial data for three alloy steels, Types 304 and 316 stainless steels and Inconel 600, demonstrated two to three orders of magnitude reduction in the scatter of predicted versus observed creep-rupture times as compared to the classical failure models of Mises, Tresca, and Rankine. In 1990, the new model was incorporated into American Society of Mechanical Engineers (ASME) Code Case N47-29 for design of components operating under creep-rupture conditions. The current report provides additional validation of the model for predicting failure under time-independent conditions and also outlines a methodology for predicting failure under cyclic, time-dependent, creep-fatigue conditions. The later extension of the methodology may have the potential to improve failure predictions there as well. These results are relevant to most design applications, but they have special relevance to high-performance design applications such as components for high-pressure equipment, nuclear reactors, and jet engines.

  12. Reflex cough PEF as a predictor of successful extubation in neurological patients*

    PubMed Central

    Kutchak, Fernanda Machado; Debesaitys, Andressa Maciel; Rieder, Marcelo de Mello; Meneguzzi, Carla; Skueresky, Amanda Soares; Alberto, Luiz; Bianchin, Marino Muxfeldt

    2015-01-01

    Abstract Objective: To evaluate the use of reflex cough PEF as a predictor of successful extubation in neurological patients who were candidates for weaning from mechanical ventilation. Methods: This was a cross-sectional study of 135 patients receiving mechanical ventilation for more than 24 h in the ICU of Cristo Redentor Hospital, in the city of Porto Alegre, Brazil. Reflex cough PEF, the rapid shallow breathing index, MIP, and MEP were measured, as were ventilatory, hemodynamic, and clinical parameters. Results: The mean age of the patients was 47.8 ± 17 years. The extubation failure rate was 33.3%. A reflex cough PEF of < 80 L/min showed a relative risk of 3.6 (95% CI: 2.0-6.7), and the final Glasgow Coma Scale score showed a relative risk of 0.64 (95% CI: 0.51-0.83). For every 1-point increase in a Glasgow Coma Scale score of 8, there was a 36% reduction in the risk of extubation failure. Conclusions: Reflex cough PEF and the Glasgow Coma Scale score are independent predictors of extubation failure in neurological patients admitted to the ICU. PMID:26398756

  13. Prediction failure of a wolf landscape model

    USGS Publications Warehouse

    Mech, L.D.

    2006-01-01

    I compared 101 wolf (Canis lupus) pack territories formed in Wisconsin during 1993-2004 to the logistic regression predictive model of Mladenoff et al. (1995, 1997, 1999). Of these, 60% were located in putative habitat suitabilities 50% remained unoccupied by known packs after 24 years of recolonization. This model was a poor predictor of wolf re-colonizing locations in Wisconsin, apparently because it failed to consider the adaptability of wolves. Such models should be used cautiously in wolf-management or restoration plans.

  14. Tensile failure of hybrid composites: measuring, predicting and understanding

    NASA Astrophysics Data System (ADS)

    Swolfs, Yentl; Verpoest, Ignaas; Gorbatikh, Larissa

    2016-07-01

    Fibre-hybrid composites are attracting an ever-increasing interest from academia and industry. It is therefore vital to develop a solid understanding of their basic mechanical properties. Measuring and predicting the tensile failure of hybrid composites however remains a challenging task. This paper describes how failure develops in unidirectional (UD) hybrid composites, and how this can be predicted using fibre break models. It also provides recommendations for experimental measurements of the hybrid effect, which is a synergetic increase of the failure strain of low elongation fibres when hybridised with higher elongation fibres. Finally, limitations of our understanding of the tensile failure of hybrid composites are discussed and recommendations for future research are proposed.

  15. Limitations of global morphometry in predicting trabecular bone failure.

    PubMed

    Stauber, Martin; Nazarian, Ara; Müller, Ralph

    2014-01-01

    Efforts in finding independent measures for accurate and reliable prediction of trabecular bone failure have led to the development of a number of morphometric indices characterizing trabecular bone microstructure. Generally, these indices assume a high homogeneity within the bone specimen. However, in the present study we found that the variance in bone volume fraction (BV/TV) in a single bone specimen can be relatively large (CV = 9.07% to 28.23%). To assess the limitations of morphometric indices in the prediction of bone failure for specimens in which the assumption of homogeneity is not met, we harvested 13 cadaveric samples from a single human spine. We tested these cylindrical samples using image-guided failure assessment (IGFA), a technique combining stepwise microcompression and time-lapsed micro-computed tomography (µCT). Additionally, we computed morphometric indices for the entire sample as well as for 10 equal subregions along the anatomical axis. We found that ultimate strength was equally well predicted by BV/TV of the entire sample (R(2)  = 0.55) and BV/TV of the weakest subregion (R(2)  = 0.57). Investigating three-dimensional animations of structural bone failure, we showed that two main failure mechanisms determine the competence of trabecular bone samples; in homogeneous, isotropic trabecular bone samples, competence is determined by a whole set of trabecular elements, whereas in inhomogeneous, anisotropic bone samples a single or a missing trabeculae may induce catastrophic failure. The latter failure mechanism cannot be described by conventional morphometry, indicating the need for novel morphometric indices also applicable to the prediction of failure in inhomogeneous bone samples. PMID:23761214

  16. Composite failure prediction of π-joint structures under bending

    NASA Astrophysics Data System (ADS)

    Huang, Hong-mei; Yuan, Shen-fang

    2012-03-01

    In this article, the composite -joint is investigated under bending loads. The "L" preform is the critical component regarding composite -joint failure. The study is presented in the failure detection of a carbon fiber composite -joint structure under bending loads using fiber Bragg grating (FBG) sensor. Firstly, based on the general finite element method (FEM) software, the 3-D finite element (FE) model of composite -joint is established, and the failure process and every lamina failure load of composite -joint are investigated by maximum stress criteria. Then, strain distributions along the length of FBG are extracted, and the reflection spectra of FBG are calculated according to the strain distribution. Finally, to verify the numerical results, a test scheme is performed and the experimental spectra of FBG are recorded. The experimental results indicate that the failure sequence and the corresponding critical loads of failure are consistent with the numerical predictions, and the computational error of failure load is less than 6.4%. Furthermore, it also verifies the feasibility of the damage detection system.

  17. Failure probability prediction of dielectric ceramics in multilayer capacitors

    SciTech Connect

    Wereszczak, A.A.; Breder, K.; Ferber, M.K.; Bridge, R.J.; Riester, L.; Kirkland, T.P.

    1998-11-01

    Dielectric ceramics in multilayer capacitors are subjected to manufacturing or service thermomechanical stresses which, if severe enough, will cause mechanical failure and perhaps subsequent loss of electrical function. Strength of monolithic ceramics is probabilistic in nature; however, probabilistic design of such electronic ceramic components generally has not been used by manufacturers and end-users of these components. To illustrate how probabilistic design may be utilized for small components, the present study demonstrates the applicability of an existing probabilistic life design computer code in the prediction of failure probability of a dielectric ceramic in an arbitrary multilayer capacitor. Issues involving the generation of representative strength and fatigue data for specimens at this small scale and the ultimate failure probability prediction of dielectric ceramics in multilayer capacitors are presented. Additionally, alternative means to generate a strength distribution as input for the probabilistic life design computer codes which are under consideration by the authors are discussed.

  18. 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.

  19. Predicting hospital failure with the financial flexibility index.

    PubMed

    Cleverley, W O

    1985-05-01

    In an environment of increasing financial risk, hospital managers are looking for ways to predict financial difficulties before they occur. One response is the financial flexibility index. This index, which uses 10 financial ratios, measures the inflow and outflow of funds to determine the financial flexibility of the institution and identify problem areas before financial failure occurs.

  20. Electrical impedance tomography to evaluate air distribution prior to extubation in very-low-birth-weight infants: a feasibility study

    PubMed Central

    de Souza Rossi, Felipe; Yagui, Ana Cristina Zanon; Haddad, Luciana Branco; Deutsch, Alice D'Agostini; Rebello, Celso Moura

    2013-01-01

    OBJECTIVES: Nasal continuous positive airway pressure is used as a standard of care after extubation in very-low-birth-weight infants. A pressure of 5 cmH2O is usually applied regardless of individual differences in lung compliance. Current methods for evaluation of lung compliance and air distribution in the lungs are thus imprecise for preterm infants. This study used electrical impedance tomography to determine the feasibility of evaluating the positive end-expiratory pressure level associated with a more homogeneous air distribution within the lungs before extubation. METHODS: Ventilation homogeneity was defined by electrical impedance tomography as the ratio of ventilation between dependent and non-dependent lung areas. The best ventilation homogeneity was achieved when this ratio was equal to 1. Just before extubation, decremental expiratory pressure levels were applied (8, 7, 6 and 5 cmH20; 3 minutes each step), and the pressure that determined the best ventilation homogeneity was defined as the best positive end-expiratory pressure. RESULTS: The best positive end-expiratory pressure value was 6.3±1.1 cmH20, and the mean continuous positive airway pressure applied after extubation was 5.2±0.4 cmH20 (p = 0.002). The extubation failure rate was 21.4%. X-Ray and blood gases after extubation were also checked. CONCLUSION: This study demonstrates that electrical impedance tomography can be safely and successfully used in patients ready for extubation to suggest the best ventilation homogeneity, which is influenced by the level of expiratory pressure applied. In this feasibility study, the best lung compliance was found with pressure levels higher than the continuous positive airway pressure levels that are usually applied for routine extubation. PMID:23644854

  1. Anticipating the future: Automatic prediction failures in schizophrenia

    PubMed Central

    Ford, Judith M.; Mathalon, Daniel H.

    2011-01-01

    People with schizophrenia often misperceive sensations and misinterpret experiences, perhaps contributing to psychotic symptoms. These misperceptions and misinterpretations might result from an inability to make valid predictions about expected sensations and experiences. Healthy normal people take advantage of neural mechanisms that allow them to make predictions unconsciously, facilitating processing of expected sensations and distinguishing the expected from the unexpected. In this paper, we focus on two types of automatic, unconscious mechanisms that allow us to predict our perceptions. The first involves predictions made via innate mechanisms basic to all species in the animal kingdom—the efference copy and corollary discharge mechanisms. They accompany our voluntary movements and allow us to suppress sensations resulting from our actions. We study this during talking, and show that auditory cortical response to the speech sounds during talking is reduced compared to when they are played back. This suppression is reduced in schizophrenia, suggesting a failure to predict the sensations resulting from talking. The second mechanism involves implicitly learning what to expect from the current context of events. We study this by observing the brain's response to an unexpected repetition of an event, when a change would have been predicted. That patients have a reduced response suggests they failed to predict that it was time for a change. Both types of predictions should happen automatically and effortlessly, allowing for economic processing of expected events and orientation to unexpected ones. These prediction failures characterize the diagnosis of schizophrenia rather than reflecting specific symptoms. PMID:21959054

  2. Failure prediction of thin beryllium sheets used in spacecraft structures

    NASA Technical Reports Server (NTRS)

    Roschke, Paul N.; Mascorro, Edward; Papados, Photios; Serna, Oscar R.

    1991-01-01

    The primary objective of this study is to develop a method for prediction of failure of thin beryllium sheets that undergo complex states of stress. Major components of the research include experimental evaluation of strength parameters for cross-rolled beryllium sheet, application of the Tsai-Wu failure criterion to plate bending problems, development of a high order failure criterion, application of the new criterion to a variety of structures, and incorporation of both failure criteria into a finite element code. A Tsai-Wu failure model for SR-200 sheet material is developed from available tensile data, experiments carried out by NASA on two circular plates, and compression and off-axis experiments performed in this study. The failure surface obtained from the resulting criterion forms an ellipsoid. By supplementing experimental data used in the the two-dimensional criterion and modifying previously suggested failure criteria, a multi-dimensional failure surface is proposed for thin beryllium structures. The new criterion for orthotropic material is represented by a failure surface in six-dimensional stress space. In order to determine coefficients of the governing equation, a number of uniaxial, biaxial, and triaxial experiments are required. Details of these experiments and a complementary ultrasonic investigation are described in detail. Finally, validity of the criterion and newly determined mechanical properties is established through experiments on structures composed of SR200 sheet material. These experiments include a plate-plug arrangement under a complex state of stress and a series of plates with an out-of-plane central point load. Both criteria have been incorporated into a general purpose finite element analysis code. Numerical simulation incrementally applied loads to a structural component that is being designed and checks each nodal point in the model for exceedance of a failure criterion. If stresses at all locations do not exceed the failure

  3. Failure prediction of thin beryllium sheets used in spacecraft structures

    NASA Technical Reports Server (NTRS)

    Roschke, Paul N.; Papados, Photios; Mascorro, Edward

    1991-01-01

    In an attempt to predict failure for cross-rolled beryllium sheet structures, high order macroscopic failure criteria are used. These require the knowledge of in-plane uniaxial and shear strengths. Test results are included for in-plane biaxial tension, uniaxial compression for two different material orientations, and shear. All beryllium specimens have the same chemical composition. In addition, all experimental work was performed in a controlled laboratory environment. Numerical simulation complements these tests. A brief bibliography supplements references listed in a previous report.

  4. Product component genealogy modeling and field-failure prediction

    DOE PAGESBeta

    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

  5. Progressive Failure And Life Prediction of Ceramic and Textile Composites

    NASA Technical Reports Server (NTRS)

    Xue, David Y.; Shi, Yucheng; Katikala, Madhu; Johnston, William M., Jr.; Card, Michael F.

    1998-01-01

    An engineering approach to predict the fatigue life and progressive failure of multilayered composite and textile laminates is presented. Analytical models which account for matrix cracking, statistical fiber failures and nonlinear stress-strain behavior have been developed for both composites and textiles. The analysis method is based on a combined micromechanics, fracture mechanics and failure statistics analysis. Experimentally derived empirical coefficients are used to account for the interface of fiber and matrix, fiber strength, and fiber-matrix stiffness reductions. Similar approaches were applied to textiles using Repeating Unit Cells. In composite fatigue analysis, Walker's equation is applied for matrix fatigue cracking and Heywood's formulation is used for fiber strength fatigue degradation. The analysis has been compared with experiment with good agreement. Comparisons were made with Graphite-Epoxy, C/SiC and Nicalon/CAS composite materials. For textile materials, comparisons were made with triaxial braided and plain weave materials under biaxial or uniaxial tension. Fatigue predictions were compared with test data obtained from plain weave C/SiC materials tested at AS&M. Computer codes were developed to perform the analysis. Composite Progressive Failure Analysis for Laminates is contained in the code CPFail. Micromechanics Analysis for Textile Composites is contained in the code MicroTex. Both codes were adapted to run as subroutines for the finite element code ABAQUS and CPFail-ABAQUS and MicroTex-ABAQUS. Graphic user interface (GUI) was developed to connect CPFail and MicroTex with ABAQUS.

  6. A predictive model for failure properties of thermoset resins

    NASA Technical Reports Server (NTRS)

    Caruthers, James M.; Bowles, Kenneth J.

    1989-01-01

    A predictive model for the three-dimensional failure behavior of engineering polymers has been developed in a recent NASA-sponsored research program. This model acknowledges the underlying molecular deformation mechanisms and thus accounts for the effects of different chemical compositions, crosslink density, functionality of the curing agent, etc., on the complete nonlinear stress-strain response including yield. The material parameters required by the model can be determined from test-tube quantities of a new resin in only a few days. Thus, we can obtain a first-order prediction of the applicability of a new resin for an advanced aerospace application without synthesizing the large quantities of material needed for failure testing. This technology will effect order-of-magnitude reductions in the time and expense required to develop new engineering polymers.

  7. On predicting and modeling material failure under impact loading

    SciTech Connect

    Lewis, M.W.

    1998-09-01

    A method for predicting and modeling material failure in solids subjected to impact loading is outlined. The method uses classical void growth models of Gurson and Tvergaard in a material point method (MPM). Because of material softening, material stability is lost. At this point, the character of the governing partial differential equations changes, and localization occurs. This localization results in mesh dependence for many problems of interest. For many problems, predicting the occurrence of material failure and its extent is necessary. To enable this modeling, it is proposed that a discontinuity be introduced into the displacement field. By including a dissipation-based force-displacement relationship, the mesh dependence of energy dissipation can be avoided. Additionally, the material point method provides a means of allowing large deformations without mesh distortion or introduction of error through remapping.

  8. Relational Neural Evolution Approach to Bank Failure Prediction

    SciTech Connect

    Abudu, Bolanle; Markose, Sheri

    2007-12-26

    Relational neural networks as a concept offers a unique opportunity for improving classification accuracy by exploiting relational structure in data. The premise is that a relational classification technique, which uses information implicit in relationships, should classify more accurately than techniques that only examine objects in isolation. In this paper, we study the use of relational neural networks for predicting bank failure. Alongside classical financial ratios normally used as predictor variables, we introduced new relational variables for the network. The relational neural network structure, specified as a combination of feed forward and recurrent neural networks, is determined by bank data through neuro-evolution. We discuss empirical results comparing performance of the relational approach to standard propositional methods used for bank failure prediction.

  9. Prediction of hospital failure: a post-PPS analysis.

    PubMed

    Gardiner, L R; Oswald, S L; Jahera, J S

    1996-01-01

    This study investigates the ability of discriminant analysis to provide accurate predictions of hospital failure. Using data from the period following the introduction of the Prospective Payment System, we developed discriminant functions for each of two hospital ownership categories: not-for-profit and proprietary. The resulting discriminant models contain six and seven variables, respectively. For each ownership category, the variables represent four major aspects of financial health (liquidity, leverage, profitability, and efficiency) plus county marketshare and length of stay. The proportion of closed hospitals misclassified as open one year before closure does not exceed 0.05 for either ownership type. Our results show that discriminant functions based on a small set of financial and nonfinancial variables provide the capability to predict hospital failure reliably for both not-for-profit and proprietary hospitals.

  10. Relational Neural Evolution Approach to Bank Failure Prediction

    NASA Astrophysics Data System (ADS)

    Abudu, Bolanle; Markose, Sheri

    2007-12-01

    Relational neural networks as a concept offers a unique opportunity for improving classification accuracy by exploiting relational structure in data. The premise is that a relational classification technique, which uses information implicit in relationships, should classify more accurately than techniques that only examine objects in isolation. In this paper, we study the use of relational neural networks for predicting bank failure. Alongside classical financial ratios normally used as predictor variables, we introduced new relational variables for the network. The relational neural network structure, specified as a combination of feed forward and recurrent neural networks, is determined by bank data through neuro-evolution. We discuss empirical results comparing performance of the relational approach to standard propositional methods used for bank failure prediction.

  11. Respiratory and hemodynamic outcomes following exchange extubation with laryngeal mask airway as compared to traditional awake extubation

    PubMed Central

    Suppiah, Ramanathan Kannan; Rajan, Sunil; Paul, Jerry; Kumar, Lakshmi

    2016-01-01

    Background: Traditional awake extubation leads to respiratory complications and hemodynamic response which are detrimental in neurosurgery, ENT surgery and patients with comorbidities. Aims: The primary objective was to compare the respiratory complications and hemodynamic stress response between traditional awake extubation of a endotracheal tube (ETT) and that following exchange extubation of ETT by using a laryngeal mask airway (LMA). Settings and Design: This prospective randomized study was conducted in a Tertiary Care Centre in 60 American Society of Anesthesiologists I and II patients coming for general surgery. Materials and Methods: Patients were randomized by permuted blocks into traditional awake extubation group and exchange extubation group. At the end of surgery in traditional group, awake extubation of ETT was done. In exchange group, 0.3 mg/kg propofol was administered, and the ETT was exchanged for a LMA. Awake extubation of LMA was then performed. Respiratory complications such as bucking, coughing, desaturation and the need for airway maneuvers and hemodynamic response were noted in both groups. Analysis Tools: Chi-square test, independent sample t- and paired t-tests were used as applicable. Results: Incidence of respiratory complication was 93.3% in traditional extubation while it was only 36.7% in exchange extubation group (P < 0.001). Hemodynamic response measured immediately at extubation in terms of heart rate, systolic blood pressure (BP), diastolic BP, mean arterial pressure, and rate pressure product were all significantly lesser in exchange group when compared to traditional extubation. Conclusion: Exchange extubation with LMA decreases respiratory complications and hemodynamic stress response when compared to traditional awake extubation. PMID:27212749

  12. Prediction of long-term failure in Kevlar 49 composites

    SciTech Connect

    Gerstle, F.P. Jr.

    1982-01-01

    Creep rupture data in Kevlar 49 epoxy usually exhibit considerable scatter: the coefficient of variation (CV) about the mean failure time at a given stress exceeds 100%. Quasi-static strength data, in contrast, shows little scatter: <4% CV for pressure vessels and <10% for impregnated strands. In this paper analysis of existing creep rupture data on Kevlar epoxy vessels at four storage pressures has produced an interesting and useful result. It was found that a significant portion of the scatter in failure times for pressure vessels is due to spool-to-spool variation in the eight spools of Kevlar fibers used to wind the vessels. The order rank of mean times to failure was consistent over a pressure range from 3400 to 4300 psi, 68 to 86% of short term burst. Also, the coefficient of variation about the mean failure time for each spool was less than that for the total sample. The statistical inference that the sample is nonhomogeneous was supported by a nonparametric check using the Kruskal-Wallis test, and by a parametric analysis of variance. The order rank found in long-term tests did not unequivocally agree with static strength ranks; several spool sets were distinctly high or low. The implication is that, while static strengths are not valid predictors of long-term behavior, short term creep rupture tests at high stress definitely are. The material difference which causes the spool-to-spool variations has not yet been identified for all eight spools. However, it appears that Kevlar behavior at lower pressures may be predicted through the use of curves fitted to the data for each spool. A power law relating failure time to pressure, t = t/sub 0/(p/p/sub 0/)/sup m/, was found to fit the data reasonably well. The implication is that, both in composite vessel design and in creep rupture experiments, the pressure (or stress) level be carefully controlled.

  13. What is the optimal rate of failed extubation?

    PubMed Central

    2012-01-01

    Failed extubation (FE), defined as reintubation 48 or 72 hours after planned extubation, occurs in a significant percentage of patients and is associated with a substantial burden of morbidity and mortality. This commentary reviews the literature describing FE rates and the clinical consequences of FE and proposes an 'optimal' rate of FE as well as avenues for future research. PMID:22356725

  14. Predicting Shear Failure of Dual-Phase Steels

    NASA Astrophysics Data System (ADS)

    Kim, Ji Hoon; Sung, Ji Hyun; Matlock, D. K.; Kim, Daeyong; Wagoner, R. H.

    2010-06-01

    Dual-phase (DP) steels are being used increasingly to make automotive panels because of their advantageous combinations of high ductility (for forming) and high strength (for service). However, their adoption has been limited because of failures during die tryout that are unpredicted by the usual methods of finite element modeling and forming limit diagrams. The failures, often called "shear failures" occur at regions of high curvature (low R/t) where sheet of thickness t is drawn over a tool radius R. Recent work revealed that the type of failure and the formability of DP steels depend not only on R/t, but also on strain rate, an effect derived from the propensity of these steels to locally heat in areas of high strain when strain rates are sufficiently high to limit heat transfer. The formability is reduced significantly by the thermal effect for rates greater than approximately 0.1/s. This result explains at least partially why forming limit diagrams, which are measured quasi-statically (and thus isothermally) do not reflect the behavior of DP steels formed industrially (at typical strain rates of approximately 10/s). In order to apply laboratory test results of draw-bend formability to industrial forming operations, the inputs to commercial finite element codes (constitutive equations, forming limits) must be adapted to the reality of the material (DP steel) and underlying physics (thermal effects on constitutive behavior). Toward this end, two procedures have been developed and tested, one numerical and one analytical. Together they predict similar forming limits and provide a path for understanding the applied formability of DP steels.

  15. Rational temporal predictions can underlie apparent failures to delay gratification

    PubMed Central

    McGuire, Joseph T.; Kable, Joseph W.

    2013-01-01

    An important category of seemingly maladaptive decisions involves failure to postpone gratification. A person pursuing a desirable long-run outcome may abandon it in favor of a short-run alternative that has been available all along. Here we present a theoretical framework in which this seemingly irrational behavior emerges from stable preferences and veridical judgments. Our account recognizes that decision makers generally face uncertainty regarding the time at which future outcomes will materialize. When timing is uncertain, the value of persistence depends crucially on the nature of a decision-maker’s prior temporal beliefs. Certain forms of temporal beliefs imply that a delay’s predicted remaining length increases as a function of time already waited. In this type of situation, the rational, utility-maximizing strategy is to persist for a limited amount of time and then give up. We show empirically that people’s explicit predictions of remaining delay lengths indeed increase as a function of elapsed time in several relevant domains, implying that temporal judgments offer a rational basis for limiting persistence. We then develop our framework into a simple working model and show how it accounts for individual differences in a laboratory task (the well-known “marshmallow test”). We conclude that delay-of-gratification failure, generally viewed as a manifestation of limited self-control capacity, can instead arise as an adaptive response to the perceived statistics of one’s environment. PMID:23458085

  16. Rational temporal predictions can underlie apparent failures to delay gratification.

    PubMed

    McGuire, Joseph T; Kable, Joseph W

    2013-04-01

    An important category of seemingly maladaptive decisions involves failure to postpone gratification. A person pursuing a desirable long-run outcome may abandon it in favor of a short-run alternative that has been available all along. Here we present a theoretical framework in which this seemingly irrational behavior emerges from stable preferences and veridical judgments. Our account recognizes that decision makers generally face uncertainty regarding the time at which future outcomes will materialize. When timing is uncertain, the value of persistence depends crucially on the nature of a decision maker's prior temporal beliefs. Certain forms of temporal beliefs imply that a delay's predicted remaining length increases as a function of time already waited. In this type of situation, the rational, utility-maximizing strategy is to persist for a limited amount of time and then give up. We show empirically that people's explicit predictions of remaining delay lengths indeed increase as a function of elapsed time in several relevant domains, implying that temporal judgments offer a rational basis for limiting persistence. We then develop our framework into a simple working model and show how it accounts for individual differences in a laboratory task (the well-known "marshmallow test"). We conclude that delay-of-gratification failure, generally viewed as a manifestation of limited self-control capacity, can instead arise as an adaptive response to the perceived statistics of one's environment.

  17. Out-of-bed extubation: a feasibility study

    PubMed Central

    Dexheimer Neto, Felippe Leopoldo; Vesz, Patrini Silveira; Cremonese, Rafael Viegas; Leães, Clarissa Garcia Soares; Raupp, Ana Carolina Tabajara; Rodrigues, Cristiano dos Santos; de Andrade, Juliana Mara Stormovski; Townsend, Raquel da Silva; Maccari, Juçara Gasparetto; Teixeira, Cassiano

    2014-01-01

    Objective In clinical intensive care practice, weaning from mechanical ventilation is accompanied by concurrent early patient mobilization. The aim of this study was to compare the success of extubation performed with patients seated in an armchair compared to extubation with patients in a supine position. Methods A retrospective study, observational and non-randomized was conducted in a mixed-gender, 23-bed intensive care unit. The primary study outcome was success of extubation, which was defined as the patient tolerating the removal of the endotracheal tube for at least 48 hours. The differences between the study groups were assessed using Student's t-test and chi-squared analysis. Results Ninety-one patients were included from December 2010 and June 2011. The study population had a mean age of 71 years ± 12 months, a mean APACHE II score of 21±7.6, and a mean length of mechanical ventilation of 2.6±2 days. Extubation was performed in 33 patients who were seated in an armchair (36%) and in 58 patients in a supine position (64%). There were no significant differences in age, mean APACHE II score or length of mechanical ventilation between the two groups, and a similar extubation success rate was observed (82%, seated group versus 85%, supine group, p>0.05). Furthermore, no significant differences were found between the two groups in terms of post-extubation distress, need for tracheostomy, duration of mechanical ventilation weaning, or intensive care unit stay. Conclusion Our results suggest that the clinical outcomes of patients extubated in a seated position are similar to those of patients extubated in a supine position. This new practice of seated extubation was not associated with adverse events and allowed extubation to occur simultaneously with early mobilization. PMID:25295820

  18. Predicting oligonucleotide-directed mutagenesis failures in protein engineering.

    PubMed

    Wassman, Christopher D; Tam, Phillip Y; Lathrop, Richard H; Weiss, Gregory A

    2004-01-01

    Protein engineering uses oligonucleotide-directed mutagenesis to modify DNA sequences through a two-step process of hybridization and enzymatic synthesis. Inefficient reactions confound attempts to introduce mutations, especially for the construction of vast combinatorial protein libraries. This paper applied computational approaches to the problem of inefficient mutagenesis. Several results implicated oligonucleotide annealing to non-target sites, termed 'cross-hybridization', as a significant contributor to mutagenesis reaction failures. Test oligonucleotides demonstrated control over reaction outcomes. A novel cross-hybridization score, quickly computable for any plasmid and oligonucleotide mixture, directly correlated with yields of deleterious mutagenesis side products. Cross-hybridization was confirmed conclusively by partial incorporation of an oligonucleotide at a predicted cross-hybridization site, and by modification of putative template secondary structure to control cross-hybridization. Even in low concentrations, cross-hybridizing species in mixtures poisoned reactions. These results provide a basis for improved mutagenesis efficiencies and increased diversities of cognate protein libraries.

  19. Infant with a Sudden, Large, Post-Extubation Subglottic Cyst

    PubMed Central

    Asha’ari, Zamzil Amin; Suhaimi, Yusof; Fadzil, Ahmad; Zihni, Muhammad

    2012-01-01

    Acquired subglottic cyst in infancy is almost always associated with episodes of early life intubation. Most cases typically presented late, usually days to months after extubation. We report a case of a subglottic cyst with different presentation than the norm. This case highlights that subglottic cyst can present acutely, and rapidly enlarging soon after the airway extubation. As the management of a large subglottic cyst can be challenging, a close observation for early diagnosis and intervention are recommended post extubation in the high-risk cases, such as in the premature infant. PMID:23613654

  20. Predictive modelling of fatigue failure in concentrated lubricated contacts.

    PubMed

    Evans, H P; Snidle, R W; Sharif, K J; Bryant, M J

    2012-01-01

    Reducing frictional losses in response to the energy agenda will require use of less viscous lubricants causing hydrodynamically-lubricated bearings to operate with thinner films leading to "mixed lubrication" conditions in which a degree of direct interaction occurs between surfaces protected only by boundary tribofilms. The paper considers the consequences of thinner films and mixed lubrication for concentrated contacts such as those occurring between the teeth of power transmission gears and in rolling element bearings. Surface fatigue in gears remains a serious problem in demanding applications, and its solution will become more pressing with the tendency towards thinner oils. The particular form of failure examined here is micropitting, which is identified as a fatigue phenomenon occurring at the scale of the surface roughness asperities. It has emerged recently as a systemic difficulty in the operation of large scale wind turbines where it occurs in both power transmission gears and their support bearings. Predictive physical modelling of these contacts requires a transient mixed lubrication analysis for conditions in which the predicted lubricant film thickness is of the same order or significantly less than the height of surface roughness features. Numerical solvers have therefore been developed which are able to deal with situations in which transient solid contacts occur between surface asperity features under realistic engineering conditions. Results of the analysis, which reveal the detailed time-varying behaviour of pressure and film clearance, have been used to predict fatigue and damage accumulation at the scale of surface asperity features with the aim of improving understanding of the micropitting phenomenon. The possible consequences on fatigue of residual stress fields resulting from plastic deformation of surface asperities is also considered.

  1. Predictive modelling of fatigue failure in concentrated lubricated contacts.

    PubMed

    Evans, H P; Snidle, R W; Sharif, K J; Bryant, M J

    2012-01-01

    Reducing frictional losses in response to the energy agenda will require use of less viscous lubricants causing hydrodynamically-lubricated bearings to operate with thinner films leading to "mixed lubrication" conditions in which a degree of direct interaction occurs between surfaces protected only by boundary tribofilms. The paper considers the consequences of thinner films and mixed lubrication for concentrated contacts such as those occurring between the teeth of power transmission gears and in rolling element bearings. Surface fatigue in gears remains a serious problem in demanding applications, and its solution will become more pressing with the tendency towards thinner oils. The particular form of failure examined here is micropitting, which is identified as a fatigue phenomenon occurring at the scale of the surface roughness asperities. It has emerged recently as a systemic difficulty in the operation of large scale wind turbines where it occurs in both power transmission gears and their support bearings. Predictive physical modelling of these contacts requires a transient mixed lubrication analysis for conditions in which the predicted lubricant film thickness is of the same order or significantly less than the height of surface roughness features. Numerical solvers have therefore been developed which are able to deal with situations in which transient solid contacts occur between surface asperity features under realistic engineering conditions. Results of the analysis, which reveal the detailed time-varying behaviour of pressure and film clearance, have been used to predict fatigue and damage accumulation at the scale of surface asperity features with the aim of improving understanding of the micropitting phenomenon. The possible consequences on fatigue of residual stress fields resulting from plastic deformation of surface asperities is also considered. PMID:23285624

  2. Flood Water Level Mapping and Prediction Due to Dam Failures

    NASA Astrophysics Data System (ADS)

    Musa, S.; Adnan, M. S.; Ahmad, N. A.; Ayob, S.

    2016-07-01

    Sembrong dam has undergone overflow failure. Flooding has been reported to hit the town, covering an area of up to Parit Raja, located in the district of Batu Pahat. This study aims to identify the areas that will be affected by flood in the event of a dam failure in Sembrong Dam, Kluang, Johor at a maximum level. To grasp the extent, the flood inundation maps have been generated by using the InfoWorks ICM and GIS software. By using these maps, information such as the depth and extent of floods can be identified the main ares flooded. The flood map was created starting with the collection of relevant data such as measuring the depth of the river and a maximum flow rate for Sembrong Dam. The data were obtained from the Drainage and Irrigation Department Malaysia and the Department of Survey and Mapping and HLA Associates Sdn. Bhd. Then, the data were analyzed according to the established Info Works ICM method. The results found that the flooded area were listed at Sri Lalang, Parit Sagil, Parit Sonto, Sri Paya, Parit Raja, Parit Sempadan, Talang Bunut, Asam Bubok, Tanjung Sembrong, Sungai Rambut and Parit Haji Talib. Flood depth obtained for the related area started from 0.5 m up to 1.2 m. As a conclusion, the flood emanating from this study include the area around the town of Ayer Hitam up to Parit Raja approximately of more than 20 km distance. This may give bad implication to residents around these areas. In future studies, other rivers such as Sungai Batu Pahat should be considered for this study to predict and reduce the yearly flood victims for this area.

  3. Variability of the breathing pattern before and after extubation.

    PubMed

    Krieger, B P; Chediak, A; Gazeroglu, H B; Bizousky, F P; Feinerman, D

    1988-04-01

    A stable breathing pattern during unassisted ventilation through an endotracheal tube (ETT) prior to extubation is an important factor in determining whether a patient can be successfully extubated. Proper interpretation of changes in the breathing pattern requires knowledge of the normal variability of the breathing pattern in critically ill, intubated patients. To establish these guidelines, 50 spontaneously breathing patients who were being weaned from mechanical ventilation were monitored with respiratory inductive plethysmography for one hour immediately prior to and following successful extubation. Immediately after extubation, respiratory rate (f), tidal volume (VT), minute ventilation, and mean inspiratory flow increased slightly. By 30 minutes postextubation, these parameters were similar to preextubation values. There was no significant change in variability of f or VT. Although the breathing pattern of these relatively stable, intensive care patients differed from values of normal ambulatory subjects, values were similar in the preextubation and postextubation periods.

  4. Immunophenotype predicts outcome in pediatric acute liver failure

    PubMed Central

    Bucuvalas, John; Filipovich, Lisa; Yazigi, Nada; Narkewicz, Michael R.; Ng, Vicky; Belle, Steven H.; Zhang, Song; Squires, Robert H.

    2012-01-01

    Objectives We sought to determine if markers of T cell immune activation, including soluble interleukin 2 receptor alpha (sIL2Rα) levels predict outcome in pediatric acute liver failure (PALF) and might target potential candidates for immunomodulatory therapy. Methods We analyzed markers of immune activation in 77 patients with PALF enrolled in a multi-national, multi-center study. The outcomes were survival with native liver, liver transplantation, and death without transplantation within 21 days after enrollment. Results Adjusting for multiple comparisons, only normalized serum sIL2Rα level differed significantly among the 3 outcomes, and was significantly higher in patients who died (p=0.02) or underwent liver transplantation (p=0.01) compared to those who survived with their native liver. The 37 patients with normal sIL2Rα levels all lived, 30 with their native liver. Of the 15 subjects with markedly high sIL2Rα (≥5000 IU/mL), 5 survived with their native liver, 2 died, and 8 underwent liver transplantation. Conclusions Evidence of immune activation is present in some patients who die or undergo liver transplantation. Patients with higher sIL2Rα levels were more likely to die or undergo liver transplantation within 21 days than those with lower levels. Identifying a subset of patients at risk for poor outcome may form the foundation for targeted clinical trials with immunomodulatory drugs. PMID:23111765

  5. The effect of coughing at extubation on oxygenation in the post-anaesthesia care unit.

    PubMed

    Lumb, A B; Bradshaw, K; Gamlin, F M C; Heard, J

    2015-04-01

    We prospectively studied 84 patients to investigate whether there is a relationship between coughing during emergence and tracheal extubation, and impaired oxygenation in the post-anaesthesia care unit. Our primary outcome measure was a change in the alveolar-arterial oxygen partial pressure gradient ((A-a)DO2 ) between time A (during general anaesthesia) and time B (1 h after extubation). Patients demonstrated a worsening of oxygenation with mean (SD) (A-a)DO2 increasing from 7.5 (5.2) kPa at time A to 13.9 (4.2) kPa at time B (p < 0.01). An overall linear regression model was not predictive for the observed change (adjusted R(2) = 0.01, p = 0.31) and nor were any of the individual predictors studied, including subjective cough score (p = 0.33), number of coughs (p = 0.95) and duration of coughing (p = 0.39). Despite the abnormal cough that occurs while tracheally intubated, we have been unable to demonstrate that coughing at extubation is associated with impaired oxygenation in the immediate postoperative period.

  6. Predicting subsequent task performance from goal motivation and goal failure

    PubMed Central

    Healy, Laura C.; Ntoumanis, Nikos; Stewart, Brandon D.; Duda, Joan L.

    2015-01-01

    Recent research has demonstrated that the cognitive processes associated with goal pursuit can continue to interfere with unrelated tasks when a goal is unfulfilled. Drawing from the self-regulation and goal-striving literatures, the present study explored the impact of goal failure on subsequent cognitive and physical task performance. Furthermore, we examined if the autonomous or controlled motivation underpinning goal striving moderates the responses to goal failure. Athletes (75 male, 59 female, Mage = 19.90 years, SDage = 3.50) completed a cycling trial with the goal of covering a given distance in 8 min. Prior to the trial, their motivation was primed using a video. During the trial they were provided with manipulated performance feedback, thus creating conditions of goal success or failure. No differences emerged in the responses to goal failure between the primed motivation or performance feedback conditions. We make recommendations for future research into how individuals can deal with failure in goal striving. PMID:26191029

  7. Predicting failure: acoustic emission of berlinite under compression.

    PubMed

    Nataf, Guillaume F; Castillo-Villa, Pedro O; Sellappan, Pathikumar; Kriven, Waltraud M; Vives, Eduard; Planes, Antoni; Salje, Ekhard K H

    2014-07-01

    Acoustic emission has been measured and statistical characteristics analyzed during the stress-induced collapse of porous berlinite, AlPO4, containing up to 50 vol% porosity. Stress collapse occurs in a series of individual events (avalanches), and each avalanche leads to a jerk in sample compression with corresponding acoustic emission (AE) signals. The distribution of AE avalanche energies can be approximately described by a power law p(E)dE = E(-ε)dE (ε ~ 1.8) over a large stress interval. We observed several collapse mechanisms whereby less porous minerals show the superposition of independent jerks, which were not related to the major collapse at the failure stress. In highly porous berlinite (40% and 50%) an increase of energy emission occurred near the failure point. In contrast, the less porous samples did not show such an increase in energy emission. Instead, in the near vicinity of the main failure point they showed a reduction in the energy exponent to ~ 1.4, which is consistent with the value reported for compressed porous systems displaying critical behavior. This suggests that a critical avalanche regime with a lack of precursor events occurs. In this case, all preceding large events were 'false alarms' and unrelated to the main failure event. Our results identify a method to use pico-seismicity detection of foreshocks to warn of mine collapse before the main failure (the collapse) occurs, which can be applied to highly porous materials only.

  8. Rational Temporal Predictions Can Underlie Apparent Failures to Delay Gratification

    ERIC Educational Resources Information Center

    McGuire, Joseph T.; Kable, Joseph W.

    2013-01-01

    An important category of seemingly maladaptive decisions involves failure to postpone gratification. A person pursuing a desirable long-run outcome may abandon it in favor of a short-run alternative that has been available all along. Here we present a theoretical framework in which this seemingly irrational behavior emerges from stable preferences…

  9. Experimental Verification of the Strain Non-Uniformity Index (SNI) based Failure Prediction

    NASA Astrophysics Data System (ADS)

    Dhumal, D. A.; Kulkarni, Pratik; Date, P. P.; Nandedkar, V. M.

    2016-08-01

    Formability of the sheet metal depends upon the uniformity of strain distribution, which depends on material properties, tooling and process parameters. Nakazima Test was conducted to study the strain distribution and establish the forming limits of AA 6016. The experimental conditions were simulated using AUTOFORM 5.2 Plus software and the failure predicted using the SNI based methodology. The failure predictions were correlated with the state of the experimentally deformed Nakazima samples, and also with the FLD based forming limits. The failure prediction from the SNI based methodology was found to correlate well with the state of the experimental Nakazima sample.

  10. Effect of various approximations on predicted progressive failure in plain weave composites

    NASA Technical Reports Server (NTRS)

    Whitcomb, John; Srirengan, Kanthikannan

    1995-01-01

    Three-dimensional finite element analysis was used to simulate progressive failure of a plain weave composite subjected to in-plane extension. The loading was parallel to one of the tow directions. The effects of various characteristics of the finite element model on predicted behavior were examined. The predicted behavior was found to be sensitive to quadrature order, mesh refinement, and the material degradation model. Also the sensitivity of the predictions to the tow waviness was studied. The predicted strength decreased considerably with increased waviness. More numerical studies and comparisons with experimental data are needed to establish reliable guidelines for accurate progressive failure prediction.

  11. 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.

  12. 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.

  13. Patient Characteristics Predicting Readmission Among Individuals Hospitalized for Heart Failure

    PubMed Central

    O'Connor, Melissa; Murtaugh, Christopher M.; Shah, Shivani; Barrón-Vaya, Yolanda; Bowles, Kathryn H.; Peng, Timothy R.; Zhu, Carolyn W.; Feldman, Penny H.

    2015-01-01

    Heart failure is difficult to manage and increasingly common with many individuals experiencing frequent hospitalizations. Little is known about patient factors consistently associated with hospital readmission. A literature review was conducted to identify heart failure patient characteristics, measured before discharge, that contribute to variation in hospital readmission rates. Database searches yielded 950 potential articles, of which 34 studies met inclusion criteria. Patient characteristics generally have a very modest effect on all-cause or heart failure–related readmission within 7 to 180 days of index hospital discharge. A range of cardiac diseases and other comorbidities only minimally increase readmission rates. No single patient characteristic stands out as a key contributor across multiple studies underscoring the challenge of developing successful interventions to reduce readmissions. Interventions may need to be general in design with the specific intervention depending on each patient's unique clinical profile. PMID:26180045

  14. Method of Testing and Predicting Failures of Electronic Mechanical Systems

    NASA Technical Reports Server (NTRS)

    Iverson, David L.; Patterson-Hine, Frances A.

    1996-01-01

    A method employing a knowledge base of human expertise comprising a reliability model analysis implemented for diagnostic routines is disclosed. The reliability analysis comprises digraph models that determine target events created by hardware failures human actions, and other factors affecting the system operation. The reliability analysis contains a wealth of human expertise information that is used to build automatic diagnostic routines and which provides a knowledge base that can be used to solve other artificial intelligence problems.

  15. Tongue weakness and somatosensory disturbance following oral endotracheal extubation.

    PubMed

    Su, Han; Hsiao, Tzu-Yu; Ku, Shih-Chi; Wang, Tyng-Guey; Lee, Jang-Jaer; Tzeng, Wen-Chii; Huang, Guan-Hua; Chen, Cheryl Chia-Hui

    2015-04-01

    The tongue plays important roles in mastication, swallowing, and speech, but its sensorimotor function might be affected by endotracheal intubation. The objective of this pilot study was to describe disturbances in the sensorimotor functions of the tongue over 14 days following oral endotracheal extubation. We examined 30 post-extubated patients who had prolonged (≥48 h) oral endotracheal intubation from six medical intensive care units. Another 36 patients were recruited and examined from dental and geriatric outpatient clinics served as a comparison group. Tongue strength was measured by the Iowa Oral Performance Instrument. Sensory disturbance of the tongue was measured by evaluating light touch sensation, oral stereognosis, and two-point discrimination with standardized protocols. Measurements were taken at three time points (within 48 h, and 7 and 14 days post-extubation) for patients with oral intubation but only once for the comparison group. The results show that independent of age, gender, tobacco used, and comorbidities, tongue strength was lower and its sensory functions were more impaired in patients who had oral intubation than in the comparison group. Sensory disturbances of the tongue gradually recovered, taking 14 days to be comparable with the comparison group, while weakness of the tongue persisted. In conclusion, patients with oral endotracheal intubation had weakness and somatosensory disturbances of the tongue lasting at least 14 days from extubation but whether is caused by intubation and whether is contributed to postextubation dysphagia should be further investigated.

  16. Real-time forecasting and predictability of catastrophic failure events: from rock failure to volcanoes and earthquakes

    NASA Astrophysics Data System (ADS)

    Main, I. G.; Bell, A. F.; Naylor, M.; Atkinson, M.; Filguera, R.; Meredith, P. G.; Brantut, N.

    2012-12-01

    Accurate prediction of catastrophic brittle failure in rocks and in the Earth presents a significant challenge on theoretical and practical grounds. The governing equations are not known precisely, but are known to produce highly non-linear behavior similar to those of near-critical dynamical systems, with a large and irreducible stochastic component due to material heterogeneity. In a laboratory setting mechanical, hydraulic and rock physical properties are known to change in systematic ways prior to catastrophic failure, often with significant non-Gaussian fluctuations about the mean signal at a given time, for example in the rate of remotely-sensed acoustic emissions. The effectiveness of such signals in real-time forecasting has never been tested before in a controlled laboratory setting, and previous work has often been qualitative in nature, and subject to retrospective selection bias, though it has often been invoked as a basis in forecasting natural hazard events such as volcanoes and earthquakes. Here we describe a collaborative experiment in real-time data assimilation to explore the limits of predictability of rock failure in a best-case scenario. Data are streamed from a remote rock deformation laboratory to a user-friendly portal, where several proposed physical/stochastic models can be analysed in parallel in real time, using a variety of statistical fitting techniques, including least squares regression, maximum likelihood fitting, Markov-chain Monte-Carlo and Bayesian analysis. The results are posted and regularly updated on the web site prior to catastrophic failure, to ensure a true and and verifiable prospective test of forecasting power. Preliminary tests on synthetic data with known non-Gaussian statistics shows how forecasting power is likely to evolve in the live experiments. In general the predicted failure time does converge on the real failure time, illustrating the bias associated with the 'benefit of hindsight' in retrospective analyses

  17. Developing a predictive risk model for first-line antiretroviral therapy failure in South Africa

    PubMed Central

    Rohr, Julia K; Ive, Prudence; Horsburgh, C Robert; Berhanu, Rebecca; Shearer, Kate; Maskew, Mhairi; Long, Lawrence; Sanne, Ian; Bassett, Jean; Ebrahim, Osman; Fox, Matthew P

    2016-01-01

    Introduction A substantial number of patients with HIV in South Africa have failed first-line antiretroviral therapy (ART). Although individual predictors of first-line ART failure have been identified, few studies in resource-limited settings have been large enough for predictive modelling. Understanding the absolute risk of first-line failure is useful for patient monitoring and for effectively targeting limited resources for second-line ART. We developed a predictive model to identify patients at the greatest risk of virologic failure on first-line ART, and to estimate the proportion of patients needing second-line ART over five years on treatment. Methods A cohort of patients aged ≥18 years from nine South African HIV clinics on first-line ART for at least six months were included. Viral load measurements and baseline predictors were obtained from medical records. We used stepwise selection of predictors in accelerated failure-time models to predict virologic failure on first-line ART (two consecutive viral load levels >1000 copies/mL). Multiple imputations were used to assign missing baseline variables. The final model was selected using internal-external cross-validation maximizing model calibration at five years on ART, and model discrimination, measured using Harrell's C-statistic. Model covariates were used to create a predictive score for risk group of ART failure. Results A total of 72,181 patients were included in the analysis, with an average of 21.5 months (IQR: 8.8–41.5) of follow-up time on first-line ART. The final predictive model had a Weibull distribution and the final predictors of virologic failure were men of all ages, young women, nevirapine use in first-line regimen, low baseline CD4 count, high mean corpuscular volume, low haemoglobin, history of TB and missed visits during the first six months on ART. About 24.4% of patients in the highest quintile and 9.4% of patients in the lowest quintile of risk were predicted to experience

  18. Developing a predictive risk model for first-line antiretroviral therapy failure in South Africa

    PubMed Central

    Rohr, Julia K; Ive, Prudence; Horsburgh, C Robert; Berhanu, Rebecca; Shearer, Kate; Maskew, Mhairi; Long, Lawrence; Sanne, Ian; Bassett, Jean; Ebrahim, Osman; Fox, Matthew P

    2016-01-01

    Introduction A substantial number of patients with HIV in South Africa have failed first-line antiretroviral therapy (ART). Although individual predictors of first-line ART failure have been identified, few studies in resource-limited settings have been large enough for predictive modelling. Understanding the absolute risk of first-line failure is useful for patient monitoring and for effectively targeting limited resources for second-line ART. We developed a predictive model to identify patients at the greatest risk of virologic failure on first-line ART, and to estimate the proportion of patients needing second-line ART over five years on treatment. Methods A cohort of patients aged ≥18 years from nine South African HIV clinics on first-line ART for at least six months were included. Viral load measurements and baseline predictors were obtained from medical records. We used stepwise selection of predictors in accelerated failure-time models to predict virologic failure on first-line ART (two consecutive viral load levels >1000 copies/mL). Multiple imputations were used to assign missing baseline variables. The final model was selected using internal-external cross-validation maximizing model calibration at five years on ART, and model discrimination, measured using Harrell's C-statistic. Model covariates were used to create a predictive score for risk group of ART failure. Results A total of 72,181 patients were included in the analysis, with an average of 21.5 months (IQR: 8.8–41.5) of follow-up time on first-line ART. The final predictive model had a Weibull distribution and the final predictors of virologic failure were men of all ages, young women, nevirapine use in first-line regimen, low baseline CD4 count, high mean corpuscular volume, low haemoglobin, history of TB and missed visits during the first six months on ART. About 24.4% of patients in the highest quintile and 9.4% of patients in the lowest quintile of risk were predicted to experience

  19. Multiscale Model Predicts Tissue-Level Failure From Collagen Fiber-Level Damage

    PubMed Central

    Hadi, Mohammad F.; Sander, Edward A.; Barocas, Victor H.

    2013-01-01

    Excessive tissue-level forces communicated to the microstructure and extracellular matrix of soft tissues can lead to damage and failure through poorly understood physical processes that are multiscale in nature. In this work, we propose a multiscale mechanical model for the failure of collagenous soft tissues that incorporates spatial heterogeneity in the microstructure and links the failure of discrete collagen fibers to the material response of the tissue. The model, which is based on experimental failure data derived from different collagen gel geometries, was able to predict the mechanical response and failure of type I collagen gels, and it demonstrated that a fiber-based rule (at the micrometer scale) for discrete failure can strongly shape the macroscale failure response of the gel (at the millimeter scale). The model may be a useful tool in predicting the macroscale failure conditions for soft tissues and engineered tissue analogs. In addition, the multiscale model provides a framework for the study of failure in complex fiber-based mechanical systems in general. PMID:22938372

  20. Predictive Indices of Reading Failure in Learning Disabled Children

    ERIC Educational Resources Information Center

    Newcomer, Phyllis L.; Magee, Patricia

    1977-01-01

    This study examined the extent to which learning disabled students scored poorly on a reading readiness test administered when they entered school, the incidence of undiagnosed oral language deficits among these learning disabled children, and the predictive relationships between reading readiness skills and components of oral language. (Author/MV)

  1. Multipulse laser-induced failure prediction for Mo metal mirrors

    NASA Astrophysics Data System (ADS)

    Becker, Michael F.; Ma, Chun C.; Walser, Rodger M.

    1991-06-01

    In combination with known thermomechanical fatigue data for Mo we have applied the Transient Photothermal Deflection (TPD) technique to develop a model f the N-on-i damage ofMo mirrors to predict their multipulse lifetimes. In laser-damage experiments to verify the model mechanically polished Mo mirrors were irradiated with 10 ns Nd:YAG laser pulses at 1064 nm at a 10 Hz rep rate. In the TPD experiments the approximately 600 jtm diameter Nd:YAG laser spot was probed off axis by a smaller HeNe laser beam whose deflection was detected by a fast bicell photodetector and amplifier. Digitized photodetector waveforms indicated that the surface angular deflection could be converted into surfae disp1zement. In addition thermal modelling of the vertical heat distribution enabled the peak surface-deflection signal to be converted into peak surfwe temperawre. The thermomechanical model was verified by both the experimental and model results. Conventional mechanical fatigue data for Mo were used to derive a predictive equation for the laser-accumulation lifetime of Mo mirrors. Experiments were performed with one to 1O'' pulses per site yielding laser-damage thresholds and accumulation curves. The accumulation behavior predicted from measurennts of mechanical fatigue was in excellent agreement with the measured behavior. It is possible that data on high-cycle ( mechanical fatigue can be used to predict the performance of optical surfaces at equally large values of N.

  2. Predicting the Failure Behavior of Textile Composite Laminates by Using a Multi-Scale Correlating Approach

    NASA Astrophysics Data System (ADS)

    Deng, Yan; Chen, Xiuhua; Wang, Hai

    2015-12-01

    This paper investigates the elastic and failure behavior of textile composite laminates by using an analytical multi-scale correlating approach. The analyses are performed under the four scale levels, i.e. the laminate scale, representative unit cell (RUC) scale, tow architecture scale and fiber/matrix scale levels. The correlation between different scales is derived based on the continuum mechanics and homogenization method from which the stress and strain fields in multiple scales can be obtained concurrently. Effective modulus and ultimate failure strengths of different textile composite (plain weave, twill weave and satin weave) laminates are predicted solely from the corresponding constituent properties, braid geometrical parameters and lay-up. The damage and failure mechanisms at the constituent level are also determined by the micromechanical failure criteria. All the predicted results compare favorably with available experimental data. Parametric studies are also performed to examine the effect of various mechanical and geometrical parameters on the resulting mechanical properties.

  3. A new method for failure prediction of SR-200 beryllium sheet structures

    NASA Technical Reports Server (NTRS)

    Papados, P. P.; Roschke, P. N.

    1994-01-01

    Contemporary applications of failure criteria frequently incorporate two-dimensional or simplified three-dimensional methodologies for prediction of stresses. Motivation behind the development of a new multi-dimensional failure criterion is due mainly to the lack of a sufficiently accurate mathematical tool that accounts for the behavior of brittle material with anisotropic properties. Such a criterion should be able to provide a reliable maximum load estimate so that design of the structure is not penalized in terms of excessive weight requirements. The failure criterion developed is represented by a fracture surface in a six-dimensional stress space. The criterion is applied for failure prediction of SR-200 beryllium sheet structures, a non-homogeneous orthotropic material used widely in space applications. Two experiments are used to verify the criterion.

  4. Methodology to predict the number of forced outages due to creep failure

    SciTech Connect

    Palermo, J.V. Jr.

    1996-12-31

    All alloy metals at a temperature above 950 degrees Fahrenheit experience creep damage. Creep failures in boiler tubes usually begin after 25 to 40 years of operation. Since creep damage is irreversible, the only remedy is to replace the tube sections. By predicting the number of failures per year, the utility can make the best economic decision concerning tube replacement. This paper describes a methodology to calculate the number of forced outages per yea due to creep failures. This methodology is particularly useful to utilities that have boilers that have at least 25 years of operation.

  5. Prediction of acute renal failure following soft-tissue injury using the venous bicarbonate concentration.

    PubMed

    Muckart, D J; Moodley, M; Naidu, A G; Reddy, A D; Meineke, K R

    1992-12-01

    Sixty-four patients with soft-tissue injuries were studied prospectively to determine whether an initial venous bicarbonate concentration (VBC) of less than 17 mmol/L would predict the development of myoglobin-induced acute renal failure. The VBC was > 17 mmol/L in 59 patients, seven of whom had myoglobinuria. All recovered without renal complications. The remaining five patients all had VBC < 17 mmol/L and four had myoglobinuria. Acute renal failure developed in four patients (p < 0.001). The VBC on hospital arrival was the most accurate predictor of these patients' risk for the development of acute renal failure following soft-tissue injury. PMID:1474620

  6. Dynamic Bayesian Networks to predict sequences of organ failures in patients admitted to ICU.

    PubMed

    Sandri, Micol; Berchialla, Paola; Baldi, Ileana; Gregori, Dario; De Blasi, Roberto Alberto

    2014-04-01

    Multi Organ Dysfunction Syndrome (MODS) represents a continuum of physiologic derangements and is the major cause of death in the Intensive Care Unit (ICU). Scoring systems for organ failure have become an integral part of critical care practice and play an important role in ICU-based research by tracking disease progression and facilitating patient stratification based on evaluation of illness severity during ICU stay. In this study a Dynamic Bayesian Network (DBN) was applied to model SOFA severity score changes in 79 adult critically ill patients consecutively admitted to the general ICU of the Sant'Andrea University hospital (Rome, Italy) from September 2010 to March 2011, with the aim to identify the most probable sequences of organs failures in the first week after the ICU admission. Approximately 56% of patients were admitted into the ICU with lung failure and about 27% of patients with heart failure. Results suggest that, given the first organ failure at the ICU admission, a sequence of organ failures can be predicted with a certain degree of probability. Sequences involving heart, lung, hematologic system and liver turned out to be the more likely to occur, with slightly different probabilities depending on the day of the week they occur. DBNs could be successfully applied for modeling temporal systems in critical care domain. Capability to predict sequences of likely organ failures makes DBNs a promising prognostic tool, intended to help physicians in undertaking therapeutic decisions in a patient-tailored approach.

  7. Endothelial Cell Density to Predict Endothelial Graft Failure After Penetrating Keratoplasty

    PubMed Central

    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

    Objective 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. Methods 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. Results 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/mm2 vs 2%(±3%) for the 137 participants with a 6-monthECDof 2500 cells/mm2 or higher. After 5 years’ follow-up, 40 of 277 participants (14%) with a clear graft had an ECD below 500 cells/mm2. Conclusions 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/mm2. PMID:20065219

  8. 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.

  9. 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.

  10. Feasibility of using adaptive logic networks to predict compressor unit failure

    SciTech Connect

    Armstrong, W.W.; Chungying Chu; Thomas, M.M.

    1995-12-31

    In this feasibility study, an adaptive logic network (ALN) was trained to predict failures of turbine-driven compressor units using a large database of measurements. No expert knowledge about compressor systems was involved. The predictions used only the statistical properties of the measurements and the indications of failure types. A fuzzy set was used to model measurements typical of normal operation. It was constrained by a requirement imposed during ALN training, that it should have a shape similar to a Gaussian density, more precisely, that its logarithm should be convex-up. Initial results obtained using this approach to knowledge discovery in the database were encouraging.

  11. High-level seismic response and failure prediction methods for piping

    SciTech Connect

    Severud, L.K.; Anderson, M.J.; Lindquist, M.R.; Wagner, S.E.; Weiner, E.O.

    1988-01-01

    Seismic response and failure analyses were performed for four piping systems that were shake-tested to high level nonlinear and inelastic response levels. Both pre- and post-test analyses were accomplished. A number of simplified elastic, elasto-plastic, and inelastic transient dynamic analysis methods were utilized. Descriptions of these methods, with their special structural parameters and comparisons of predictions using each method to test data, are provided. Reasonably useful, but conservative, methods were found for predicting the high-level inelastic response and the failure modes.

  12. [Complete fertilization failure following conventional IVF or ICSI: is it predictable? How to manage?].

    PubMed

    Durand, M; Sifer, C

    2013-12-01

    The occurrence of complete fertilization failure following conventional in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) is a rare event. Each of six physiological stages of the fertilisation can be failing. The cause of a fertilisation failure is either the spermatozoa, or the oocyte. The aim of this study was to determine if this event is predictable, and to define the later strategy. On all sperm tests available, it seems that only, tests of zona pellucida binding and acrosomique reaction are relatively predictive of a complete fertilization failure after IVF. No test allows at the moment to predict an oocyte contribution to unsuccessful fertilization. The strategy retained after a complete fertilization failure following the first attempt of IVF is to propose an ICSI; either to do an IVF if this event arises in the rank n+1, or when the number of inseminated oocytes was low. Concerning the ICSI, the low number of micro-injected oocyte is often in question; so the strategy retained following a first fertilization failure after ICSI is to perform a new ICSI attempt after optimization of the ovarian stimulation. When the cause is spermatic, it is indicated trying a modified ICSI with the use of pentoxifiline, or an intracytoplasmic morphologically selected sperm injection (IMSI), sometimes with assisted oocyte activation. In last solution, we can propose the ovum donation.

  13. Multiple immune deviations predictive for IVF failure as possible markers for IVIG therapy.

    PubMed

    Chernyshov, Viktor P; Dons'koi, Boris V; Sudoma, Iryna O; Goncharova, Yana O

    2016-08-01

    Recently we have shown that immune deviations (ID) may predict IVF failure. Benefit from IVIG therapy was observed in 115 women with repeated IVF failure according to proposed multiple ID that appeared unfavorable for implantation and live birth. Group of 123 women with repeated IVF failure without IVIG therapy was compared with former group. Immune phenotype and NK activity of peripheral blood lymphocytes were studied by flow cytometry. Potentially predictive for IVF failure ID included elevated expression of CD56, CD158a in T lymphocytes, decreased levels of CD4T lymphocytes, up-regulated expression of HLA DR in CD8+ T cells and NK cells, elevated number of NK cells and increased NK cytotoxicity, increased or decreased expression of CD158a and CD8 in NK cells. Three or more ID may predict implantation failure to a greater degree than one or two ID. In women receiving IVIG in subgroups with 0-1 and 2 ID, there was no increase in implantation rate (IR) and live birth rate (LBR) after IVIG in comparison with patients with the same number of ID but without IVIG correction. After IVIG therapy decreased IR and LBR were restored in women with three or more immune deviations. Multiple immune deviations indicate IVF patients who may benefit from IVIG therapy. IVIG seems to convert "unfavorable" immune phenotype to "favorable" one.

  14. Predicting age of ovarian failure after radiation to a field that includes the ovaries

    SciTech Connect

    Wallace, W. Hamish B. . E-mail: Hamish.Wallace@ed.ac.uk; Thomson, Angela B.; Saran, Frank; Kelsey, Tom W.

    2005-07-01

    Purpose: To predict the age at which ovarian failure is likely to develop after radiation to a field that includes the ovary in women treated for cancer. Methods and Materials: Modern computed tomography radiotherapy planning allows determination of the effective dose of radiation received by the ovaries. Together with our recent assessment of the radiosensitivity of the human oocyte, the effective surviving fraction of primordial oocytes can be determined and the age of ovarian failure, with 95% confidence limits, predicted for any given dose of radiotherapy. Results: The effective sterilizing dose (ESD: dose of fractionated radiotherapy [Gy] at which premature ovarian failure occurs immediately after treatment in 97.5% of patients) decreases with increasing age at treatment. ESD at birth is 20.3 Gy; at 10 years 18.4 Gy, at 20 years 16.5 Gy, and at 30 years 14.3 Gy. We have calculated 95% confidence limits for age at premature ovarian failure for estimated radiation doses to the ovary from 1 Gy to the ESD from birth to 50 years. Conclusions: We report the first model to reliably predict the age of ovarian failure after treatment with a known dose of radiotherapy. Clinical application of this model will enable physicians to counsel women on their reproductive potential following successful treatment.

  15. Prediction of Ductile Failure in the Stretch-Forming of AA2024 Sheets

    SciTech Connect

    Vallellano, C.; Guzman, C.; Garcia-Lomas, F. J.

    2007-05-17

    A number of ductile failure criteria are nowadays being used to predict the formability of aluminium alloy sheets. Generally speaking, integral criteria (e.g. those proposed by Cockcroft and Latham, Brozzo et al., Oyane et al Chaouadi et al., etc.) have been probed to work well when the principal strains are of opposite sign, i.e. in the left side of the Forming Limit Diagram (FLD). However, when tensile biaxial strains are present, as occurs in stretch-forming practice, their predictions are usually very poor and even non-conservatives. As an alternative, local criteria, such as the classical Tresca's and Bressan and Williams' criteria, have demonstrated a good capability to predict the failure in some automotive aluminum alloys under stretching. The present work analyses experimentally and numerically the failure in AA2024-T3 sheets subjected to biaxial stretching. A series of out-of-plane stretching tests have been simulated using ABAQUS. The experimental and the numerical FLD for different failure criteria are compared. The influence on the failure of the hydrostatic pressure and the normal stress to the fracture plane is also discussed.

  16. Predicting Outcomes of Hospitalization for Heart Failure Using Logistic Regression and Knowledge Discovery Methods

    PubMed Central

    Phillips, Kirk T.; Street, W. Nick

    2005-01-01

    The purpose of this study is to determine the best prediction of heart failure outcomes, resulting from two methods -- standard epidemiologic analysis with logistic regression and knowledge discovery with supervised learning/data mining. Heart failure was chosen for this study as it exhibits higher prevalence and cost of treatment than most other hospitalized diseases. The prevalence of heart failure has exceeded 4 million cases in the U.S.. Findings of this study should be useful for the design of quality improvement initiatives, as particular aspects of patient comorbidity and treatment are found to be associated with mortality. This is also a proof of concept study, considering the feasibility of emerging health informatics methods of data mining in conjunction with or in lieu of traditional logistic regression methods of prediction. Findings may also support the design of decision support systems and quality improvement programming for other diseases. PMID:16779367

  17. A New Method for Extubation: Comparison between Conventional and New Methods

    PubMed Central

    Yousefshahi, Fardin; Barkhordari, Khosro; Movafegh, Ali; Tavakoli, Vida; Paknejad, Omalbanin; Bina, Payvand; Yousefshahi, Hadi; Sheikh Fathollahi, Mahmood

    2012-01-01

    Background: Extubation is associated with the risk of complications such as accumulated secretion above the endotracheal tube cuff, eventual atelectasia following a reduction in pulmonary volumes because of a lack of physiological positive end expiratory pressure, and intra-tracheal suction. In order to reduce these complications, and, based on basic physiological principles, a new practical extubation method is presented in this article. Methods: The study was designed as a six-month prospective cross-sectional clinical trial. Two hundred fifty-seven patients undergoing coronary artery bypass grafting (CABG) were divided into two groups based on their scheduled surgery time. The first group underwent the conventional extubation method, while the other group was extubated according to a new described method. Arterial blood gas (ABG) analysis results before and after extubation were compared between the two groups to find the effect of the extubation method on the ABG parameters and the oxygenation profile. Results: In all time intervals, the partial pressure of oxygen in arterial blood / fraction of inspired oxygen (PaO2/FiO2) ratio in the new method group patients was improved compared to that in the conventional method; some differences, like PaO2/FiO2 four hours after extubation, were statistically significant, however (p value=0.0063). Conclusion: The new extubation method improved some respiratory parameters and thus attenuated oxygenation complications and amplified oxygenation after extubation. PMID:23304181

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

    NASA Technical Reports Server (NTRS)

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

    2006-01-01

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

  19. 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.

  20. A model for predicting embankment slope failures in clay-rich soils; A Louisiana example

    NASA Astrophysics Data System (ADS)

    Burns, S. F.

    2015-12-01

    A model for predicting embankment slope failures in clay-rich soils; A Louisiana example It is well known that smectite-rich soils significantly reduce the stability of slopes. The question is how much smectite in the soil causes slope failures. A study of over 100 sites in north and south Louisiana, USA, compared slopes that failed during a major El Nino winter (heavy rainfall) in 1982-1983 to similar slopes that did not fail. Soils in the slopes were tested for per cent clay, liquid limits, plasticity indices and semi-quantitative clay mineralogy. Slopes with the High Risk for failure (85-90% chance of failure in 8-15 years after construction) contained soils with a liquid limit > 54%, a plasticity index over 29%, and clay contents > 47%. Slopes with an Intermediate Risk (55-50% chance of failure in 8-15 years) contained soils with a liquid limit between 36-54%, plasticity index between 16-19%, and clay content between 32-47%. Slopes with a Low Risk chance of failure (< 5% chance of failure in 8-15 years after construction) contained soils with a liquid limit < 36%, a plasticity index < 16%, and a clay content < 32%. These data show that if one is constructing embankments and one wants to prevent slope failure of the 3:1 slopes, check the above soil characteristics before construction. If the soils fall into the Low Risk classification, construct the embankment normally. If the soils fall into the High Risk classification, one will need to use lime stabilization or heat treatments to prevent failures. Soils in the Intermediate Risk class will have to be evaluated on a case by case basis.

  1. Noninvasive Failure Load Prediction of Vertebrae with Simulated Lytic Defects and Biomaterial Augmentation.

    PubMed

    Giambini, Hugo; Fang, Zhong; Zeng, Heng; Camp, Jon J; Yaszemski, Michael J; Lu, Lichun

    2016-08-01

    The spine is the most common site for secondary bone metastases, and clinical management for fractures is based on size and geometry of the defect. About 75% of the bone needs to be damaged before lesions are detectable, so clinical tools should measure changes in both geometry and material properties. We have developed an automated, user-friendly, Spine Cancer Assessment (SCA) image-based analysis method that builds on a platform designed for clinical practice providing failure characteristics of vertebrae. The objectives of this study were to (1) validate SCA predictions with experimental failure load outcomes; (2) evaluate the planning capabilities for prophylactic vertebroplasty procedures; and (3) investigate the effect of computed tomography (CT) protocols on predicted failure loads. Twenty-one vertebrae were randomly divided into two groups: (1) simulated defect without treatment (negative control) [n = 9] and (2) with treatment [n = 12]. Defects were created and a polymeric biomaterial was injected into the vertebrae in the treated-defect group. Spines were scanned, reconstructed with two algorithms, and analyzed for fracture loads. To virtually plan for prophylactic intervention, vertebrae with empty lesions were simulated to be augmented with either poly(methyl methacrylate) (PMMA) or a novel bone replacement copolymer, poly(propylene fumarate-co-caprolactone) [P(PF-co-CL)]. Axial rigidities were calculated from the CT images. Failure loads, determined from the cross section with the lowest axial rigidity, were compared with experimental values. Predicted loads correlated well with experimental outcomes (R(2) = 0.73, p < 0.0001). Predictions from negative control specimens highly correlated with measured values (R(2) = 0.90, p < 0.0001). Although a similar correlation was obtained using both algorithms, the smooth reconstruction (B30) tended to underestimate predicted failure loads by ∼50% compared with the ∼10% underestimate

  2. Noninvasive Failure Load Prediction of Vertebrae with Simulated Lytic Defects and Biomaterial Augmentation.

    PubMed

    Giambini, Hugo; Fang, Zhong; Zeng, Heng; Camp, Jon J; Yaszemski, Michael J; Lu, Lichun

    2016-08-01

    The spine is the most common site for secondary bone metastases, and clinical management for fractures is based on size and geometry of the defect. About 75% of the bone needs to be damaged before lesions are detectable, so clinical tools should measure changes in both geometry and material properties. We have developed an automated, user-friendly, Spine Cancer Assessment (SCA) image-based analysis method that builds on a platform designed for clinical practice providing failure characteristics of vertebrae. The objectives of this study were to (1) validate SCA predictions with experimental failure load outcomes; (2) evaluate the planning capabilities for prophylactic vertebroplasty procedures; and (3) investigate the effect of computed tomography (CT) protocols on predicted failure loads. Twenty-one vertebrae were randomly divided into two groups: (1) simulated defect without treatment (negative control) [n = 9] and (2) with treatment [n = 12]. Defects were created and a polymeric biomaterial was injected into the vertebrae in the treated-defect group. Spines were scanned, reconstructed with two algorithms, and analyzed for fracture loads. To virtually plan for prophylactic intervention, vertebrae with empty lesions were simulated to be augmented with either poly(methyl methacrylate) (PMMA) or a novel bone replacement copolymer, poly(propylene fumarate-co-caprolactone) [P(PF-co-CL)]. Axial rigidities were calculated from the CT images. Failure loads, determined from the cross section with the lowest axial rigidity, were compared with experimental values. Predicted loads correlated well with experimental outcomes (R(2) = 0.73, p < 0.0001). Predictions from negative control specimens highly correlated with measured values (R(2) = 0.90, p < 0.0001). Although a similar correlation was obtained using both algorithms, the smooth reconstruction (B30) tended to underestimate predicted failure loads by ∼50% compared with the ∼10% underestimate

  3. Impact and Challenges of a Policy Change to Early Track Extubation in the Operating Room for Fontan.

    PubMed

    Kawaguchi, Atsushi; Liu, Qi; Coquet, Sean; Yasui, Yutaka; Cave, Dominic

    2016-08-01

    hemodynamic instability in the pre-policy-change era (6/39, 15.4 %) and excessive bleeding or respiratory etiologies in the post-policy-change era (10/88, 11.4 %). Significant reduction of PICU length of stay was achieved without any evidence of worsening of patient outcomes. RCA suggests watchful observations with respect to bleeding and respiratory etiologies are the key to prevent failure of extubation in the current practice. PMID:27160099

  4. 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. PMID:22182300

  5. Modeling Stress Strain Relationships and Predicting Failure Probabilities For Graphite Core Components

    SciTech Connect

    Duffy, Stephen

    2013-09-09

    This project will implement inelastic constitutive models that will yield the requisite stress-strain information necessary for graphite component design. Accurate knowledge of stress states (both elastic and inelastic) is required to assess how close a nuclear core component is to failure. Strain states are needed to assess deformations in order to ascertain serviceability issues relating to failure, e.g., whether too much shrinkage has taken place for the core to function properly. Failure probabilities, as opposed to safety factors, are required in order to capture the bariability in failure strength in tensile regimes. The current stress state is used to predict the probability of failure. Stochastic failure models will be developed that can accommodate possible material anisotropy. This work will also model material damage (i.e., degradation of mechanical properties) due to radiation exposure. The team will design tools for components fabricated from nuclear graphite. These tools must readily interact with finite element software--in particular, COMSOL, the software algorithm currently being utilized by the Idaho National Laboratory. For the eleastic response of graphite, the team will adopt anisotropic stress-strain relationships available in COMSO. Data from the literature will be utilized to characterize the appropriate elastic material constants.

  6. Major complications after angioplasty in patients with chronic renal failure: a comparison of predictive models.

    PubMed

    Lacson, R C; Ohno-Machado, L

    2000-01-01

    Novel modeling approaches were investigated to predict major complications in patients with chronic renal failure (CRF) or end-stage renal disease (ESRD) undergoing percutaneous transluminal coronary angioplasty (PTCA). The following hypotheses were explored: (1) Pre-angioplasty patient risk factors, demographic characteristics and procedural information may be used to predict major complications after PTCA; and (2) Rough sets and artificial neural nets (ANN) may be used to build models that are better than standard logistic regression models. Several variables were found to be predictive of major complications for patients with CRF or ESRD undergoing PTCA. The presence of shock at presentation portends poor outcome but congestive heart failure and prior history of myocardial infarction increases the risk tenfold and 25-fold, respectively. The discriminatory ability of the ANN model was better than both Rough Sets and Logistic Regression for the test set.

  7. Venovenous extracorporeal membrane oxygenation in adult respiratory failure: Scores for mortality prediction.

    PubMed

    Hsin, Chun-Hsien; Wu, Meng-Yu; Huang, Chung-Chi; Kao, Kuo-Chin; Lin, Pyng-Jing

    2016-06-01

    Despite a potentially effective therapy for adult respiratory failure, a general agreement on venovenous extracorporeal membrane oxygenation (VV-ECMO) has not been reached among institutions due to its invasiveness and high resource usage. To establish consensus on the timing of intervention, large ECMO organizations have published the respiratory extracorporeal membrane oxygenation survival prediction (RESP) score and the ECMOnet score, which allow users to predict hospital mortality for candidates with their pre-ECMO presentations. This study was aimed to test the predictive powers of these published scores in a medium-sized cohort enrolling adults treated with VV-ECMO for acute respiratory failure, and develop an institutional prediction model under the framework of the 3 scores if a superior predictive power could be achieved. This retrospective study included 107 adults who received VV-ECMO for severe acute respiratory failure (a PaO2/FiO2 ratio <70 mm Hg) in a tertiary referral center from 2007 to 2015. Essential demographic and clinical data were collected to calculate the RESP score, the ECMOnet score, and the sequential organ failure assessment (SOFA) score before VV-ECMO. The predictive power of hospital mortality of each score was presented as the area under receiver-operating characteristic curve (AUROC). The multivariate logistic regression was used to develop an institutional prediction model. The surviving to discharge rate was 55% (n = 59). All of the 3 published scores had a real but poor predictive power of hospital mortality in this study. The AUROCs of RESP score, ECMOnet score, and SOFA score were 0.662 (P = 0.004), 0.616 (P = 0.04), and 0.667 (P = 0.003), respectively. An institutional prediction model was established from these score parameters and presented as follows: hospital mortality (Y) = -3.173 + 0.208 × (pre-ECMO SOFA score) + 0.148 × (pre-ECMO mechanical ventilation day) + 1.021

  8. Predicting the Probability of Failure of Cementitious Sewer Pipes Using Stochastic Finite Element Method.

    PubMed

    Alani, Amir M; Faramarzi, Asaad

    2015-06-10

    In this paper, a stochastic finite element method (SFEM) is employed to investigate the probability of failure of cementitious buried sewer pipes subjected to combined effect of corrosion and stresses. A non-linear time-dependant model is used to determine the extent of concrete corrosion. Using the SFEM, the effects of different random variables, including loads, pipe material, and corrosion on the remaining safe life of the cementitious sewer pipes are explored. A numerical example is presented to demonstrate the merit of the proposed SFEM in evaluating the effects of the contributing parameters upon the probability of failure of cementitious sewer pipes. The developed SFEM offers many advantages over traditional probabilistic techniques since it does not use any empirical equations in order to determine failure of pipes. The results of the SFEM can help the concerning industry (e.g., water companies) to better plan their resources by providing accurate prediction for the remaining safe life of cementitious sewer pipes.

  9. Predicting Renal Failure Progression in Chronic Kidney Disease Using Integrated Intelligent Fuzzy Expert System

    PubMed Central

    Norouzi, Jamshid; Mirbagheri, Seyed Ahmad; Mazdeh, Mitra Mahdavi; Hosseini, Seyed Ahmad

    2016-01-01

    Background. Chronic kidney disease (CKD) is a covert disease. Accurate prediction of CKD progression over time is necessary for reducing its costs and mortality rates. The present study proposes an adaptive neurofuzzy inference system (ANFIS) for predicting the renal failure timeframe of CKD based on real clinical data. Methods. This study used 10-year clinical records of newly diagnosed CKD patients. The threshold value of 15 cc/kg/min/1.73 m2 of glomerular filtration rate (GFR) was used as the marker of renal failure. A Takagi-Sugeno type ANFIS model was used to predict GFR values. Variables of age, sex, weight, underlying diseases, diastolic blood pressure, creatinine, calcium, phosphorus, uric acid, and GFR were initially selected for the predicting model. Results. Weight, diastolic blood pressure, diabetes mellitus as underlying disease, and current GFR(t) showed significant correlation with GFRs and were selected as the inputs of model. The comparisons of the predicted values with the real data showed that the ANFIS model could accurately estimate GFR variations in all sequential periods (Normalized Mean Absolute Error lower than 5%). Conclusions. Despite the high uncertainties of human body and dynamic nature of CKD progression, our model can accurately predict the GFR variations at long future periods. PMID:27022406

  10. Prediction of bond failure of FRP layers and concrete interface using a finite element method

    NASA Astrophysics Data System (ADS)

    Britton, Holley L.

    Fiber reinforced polymers (FRPs) have become very popular for strengthening and reinforcing concrete civil structures such as columns, masonry walls, and bridges; for repairing deteriorating and damaged structures; and for strengthening wood structures. It has been proven through multiple experiments and analyses that bonding FRP sheets to the face of a concrete or a wooden structure can increase the structure's strength. However, in many instances, the structure strengthened with the FRP suffered a premature debonding failure between the FRP and the concrete substrate before the concrete element had reached its increased strength potential. A number of parameters that contribute to the debonding have been identified in the literature and several analytical models have been developed that attempt to predict the bond failure. The purpose of this research is to build a FRP strengthened reinforced concrete simply supported beam with finite element methods (FEMs) using ANSYS FEM software. The best approach for modeling the reinforced concrete beam with finite elements will be determined. A simple and efficient method for modeling the bond layer between the concrete and the FRP layers will also be determined. The finite element (FE) models will then be analyzed with nonlinear analyses and the results will be evaluated. The debond failure or fiber rupture mode of failure will be predicted based on the FEM results. The effects of the epoxy's parameters will be investigated. The validity of the models will be compared to various empirical model results and experimental results.

  11. A relation to predict the failure of materials and potential application to volcanic eruptions and landslides.

    PubMed

    Hao, Shengwang; Liu, Chao; Lu, Chunsheng; Elsworth, Derek

    2016-06-16

    A theoretical explanation of a time-to-failure relation is presented, with this relationship then used to describe the failure of materials. This provides the potential to predict timing (tf - t) immediately before failure by extrapolating the trajectory as it asymptotes to zero with no need to fit unknown exponents as previously proposed in critical power law behaviors. This generalized relation is verified by comparison with approaches to criticality for volcanic eruptions and creep failure. A new relation based on changes with stress is proposed as an alternative expression of Voight's relation, which is widely used to describe the accelerating precursory signals before material failure and broadly applied to volcanic eruptions, landslides and other phenomena. The new generalized relation reduces to Voight's relation if stress is limited to increase at a constant rate with time. This implies that the time-derivatives in Voight's analysis may be a subset of a more general expression connecting stress derivatives, and thus provides a potential method for forecasting these events.

  12. A relation to predict the failure of materials and potential application to volcanic eruptions and landslides

    PubMed Central

    Hao, Shengwang; Liu, Chao; Lu, Chunsheng; Elsworth, Derek

    2016-01-01

    A theoretical explanation of a time-to-failure relation is presented, with this relationship then used to describe the failure of materials. This provides the potential to predict timing (tf − t) immediately before failure by extrapolating the trajectory as it asymptotes to zero with no need to fit unknown exponents as previously proposed in critical power law behaviors. This generalized relation is verified by comparison with approaches to criticality for volcanic eruptions and creep failure. A new relation based on changes with stress is proposed as an alternative expression of Voight’s relation, which is widely used to describe the accelerating precursory signals before material failure and broadly applied to volcanic eruptions, landslides and other phenomena. The new generalized relation reduces to Voight’s relation if stress is limited to increase at a constant rate with time. This implies that the time-derivatives in Voight’s analysis may be a subset of a more general expression connecting stress derivatives, and thus provides a potential method for forecasting these events. PMID:27306851

  13. A relation to predict the failure of materials and potential application to volcanic eruptions and landslides

    NASA Astrophysics Data System (ADS)

    Hao, Shengwang; Liu, Chao; Lu, Chunsheng; Elsworth, Derek

    2016-06-01

    A theoretical explanation of a time-to-failure relation is presented, with this relationship then used to describe the failure of materials. This provides the potential to predict timing (tf ‑ t) immediately before failure by extrapolating the trajectory as it asymptotes to zero with no need to fit unknown exponents as previously proposed in critical power law behaviors. This generalized relation is verified by comparison with approaches to criticality for volcanic eruptions and creep failure. A new relation based on changes with stress is proposed as an alternative expression of Voight’s relation, which is widely used to describe the accelerating precursory signals before material failure and broadly applied to volcanic eruptions, landslides and other phenomena. The new generalized relation reduces to Voight’s relation if stress is limited to increase at a constant rate with time. This implies that the time-derivatives in Voight’s analysis may be a subset of a more general expression connecting stress derivatives, and thus provides a potential method for forecasting these events.

  14. A relation to predict the failure of materials and potential application to volcanic eruptions and landslides

    NASA Astrophysics Data System (ADS)

    Hao, Shengwang; Liu, Chao; Lu, Chunsheng; Elsworth, Derek

    2016-06-01

    A theoretical explanation of a time-to-failure relation is presented, with this relationship then used to describe the failure of materials. This provides the potential to predict timing (tf - t) immediately before failure by extrapolating the trajectory as it asymptotes to zero with no need to fit unknown exponents as previously proposed in critical power law behaviors. This generalized relation is verified by comparison with approaches to criticality for volcanic eruptions and creep failure. A new relation based on changes with stress is proposed as an alternative expression of Voight’s relation, which is widely used to describe the accelerating precursory signals before material failure and broadly applied to volcanic eruptions, landslides and other phenomena. The new generalized relation reduces to Voight’s relation if stress is limited to increase at a constant rate with time. This implies that the time-derivatives in Voight’s analysis may be a subset of a more general expression connecting stress derivatives, and thus provides a potential method for forecasting these events.

  15. A relation to predict the failure of materials and potential application to volcanic eruptions and landslides.

    PubMed

    Hao, Shengwang; Liu, Chao; Lu, Chunsheng; Elsworth, Derek

    2016-01-01

    A theoretical explanation of a time-to-failure relation is presented, with this relationship then used to describe the failure of materials. This provides the potential to predict timing (tf - t) immediately before failure by extrapolating the trajectory as it asymptotes to zero with no need to fit unknown exponents as previously proposed in critical power law behaviors. This generalized relation is verified by comparison with approaches to criticality for volcanic eruptions and creep failure. A new relation based on changes with stress is proposed as an alternative expression of Voight's relation, which is widely used to describe the accelerating precursory signals before material failure and broadly applied to volcanic eruptions, landslides and other phenomena. The new generalized relation reduces to Voight's relation if stress is limited to increase at a constant rate with time. This implies that the time-derivatives in Voight's analysis may be a subset of a more general expression connecting stress derivatives, and thus provides a potential method for forecasting these events. PMID:27306851

  16. Predicting the failure of a thin liquid film loaded with spherical particles.

    PubMed

    Morris, Gareth; Neethling, S J; Cilliers, Jan J

    2014-02-01

    A model is presented for predicting the failure of a thin liquid film stabilized by attached inert particles. A statistical analysis of roughly 3500 Surface Evolver1 simulations was used to identify the relationship between the packing density of the particles on the film, their contact angle distribution, and the capillary pressure required to rupture the film. The model presented allows a fast and simple method of calculating the range of pressures a thin film in a three-phase froth will fail at based upon three variables: the film loading, mean particle contact angle, and the standard distribution of contact angles round the mean. The predicted range of failure pressures can be used in simulations of bulk froth properties where bubble coalescence is an important factor governing the froth properties.

  17. A simple nonlocal damage model for predicting failure of notched laminates

    NASA Technical Reports Server (NTRS)

    Kennedy, T. C.; Nahan, M. F.

    1995-01-01

    The ability to predict failure loads in notched composite laminates is a requirement in a variety of structural design circumstances. A complicating factor is the development of a zone of damaged material around the notch tip. The objective of this study was to develop a computational technique that simulates progressive damage growth around a notch in a manner that allows the prediction of failure over a wide range of notch sizes. This was accomplished through the use of a relatively simple, nonlocal damage model that incorporates strain-softening. This model was implemented in a two-dimensional finite element program. Calculations were performed for two different laminates with various notch sizes under tensile loading, and the calculations were found to correlate well with experimental results.

  18. Benchmark 1 - Failure Prediction after Cup Drawing, Reverse Redrawing and Expansion Part A: Benchmark Description

    NASA Astrophysics Data System (ADS)

    Watson, Martin; Dick, Robert; Huang, Y. Helen; Lockley, Andrew; Cardoso, Rui; Santos, Abel

    2016-08-01

    This Benchmark is designed to predict the fracture of a food can after drawing, reverse redrawing and expansion. The aim is to assess different sheet metal forming difficulties such as plastic anisotropic earing and failure models (strain and stress based Forming Limit Diagrams) under complex nonlinear strain paths. To study these effects, two distinct materials, TH330 steel (unstoved) and AA5352 aluminum alloy are considered in this Benchmark. Problem description, material properties, and simulation reports with experimental data are summarized.

  19. Effect and clinical prediction of worsening renal function in acute decompensated heart failure.

    PubMed

    Breidthardt, Tobias; Socrates, Thenral; Noveanu, Markus; Klima, Theresia; Heinisch, Corinna; Reichlin, Tobias; Potocki, Mihael; Nowak, Albina; Tschung, Christopher; Arenja, Nisha; Bingisser, Roland; Mueller, Christian

    2011-03-01

    We aimed to establish the prevalence and effect of worsening renal function (WRF) on survival among patients with acute decompensated heart failure. Furthermore, we sought to establish a risk score for the prediction of WRF and externally validate the previously established Forman risk score. A total of 657 consecutive patients with acute decompensated heart failure presenting to the emergency department and undergoing serial creatinine measurements were enrolled. The potential of the clinical parameters at admission to predict WRF was assessed as the primary end point. The secondary end point was all-cause mortality at 360 days. Of the 657 patients, 136 (21%) developed WRF, and 220 patients had died during the first year. WRF was more common in the nonsurvivors (30% vs 41%, p = 0.03). Multivariate regression analysis found WRF to independently predict mortality (hazard ratio 1.92, p <0.01). In a single parameter model, previously diagnosed chronic kidney disease was the only independent predictor of WRF and achieved an area under the receiver operating characteristic curve of 0.60. After the inclusion of the blood gas analysis parameters into the model history of chronic kidney disease (hazard ratio 2.13, p = 0.03), outpatient diuretics (hazard ratio 5.75, p <0.01), and bicarbonate (hazard ratio 0.91, p <0.01) were all predictive of WRF. A risk score was developed using these predictors. On receiver operating characteristic curve analysis, the Forman and Basel prediction rules achieved an area under the curve of 0.65 and 0.71, respectively. In conclusion, WRF was common in patients with acute decompensated heart failure and was linked to significantly worse outcomes. However, the clinical parameters failed to adequately predict its occurrence, making a tailored therapy approach impossible.

  20. Hybrid neural intelligent system to predict business failure in small-to-medium-size enterprises.

    PubMed

    Borrajo, M Lourdes; Baruque, Bruno; Corchado, Emilio; Bajo, Javier; Corchado, Juan M

    2011-08-01

    During the last years there has been a growing need of developing innovative tools that can help small to medium sized enterprises to predict business failure as well as financial crisis. In this study we present a novel hybrid intelligent system aimed at monitoring the modus operandi of the companies and predicting possible failures. This system is implemented by means of a neural-based multi-agent system that models the different actors of the companies as agents. The core of the multi-agent system is a type of agent that incorporates a case-based reasoning system and automates the business control process and failure prediction. The stages of the case-based reasoning system are implemented by means of web services: the retrieval stage uses an innovative weighted voting summarization of self-organizing maps ensembles-based method and the reuse stage is implemented by means of a radial basis function neural network. An initial prototype was developed and the results obtained related to small and medium enterprises in a real scenario are presented. PMID:21809475

  1. Failure of Tube Models to Predict the Linear Rheology of Star/Linear Blends

    NASA Astrophysics Data System (ADS)

    Hall, Ryan; Desai, Priyanka; Kang, Beomgoo; Katzarova, Maria; Huang, Qifan; Lee, Sanghoon; Chang, Taihyun; Venerus, David; Mays, Jimmy; Schieber, Jay; Larson, Ronald

    We compare predictions of two of the most advanced versions of the tube model, namely the Hierarchical model by Wang et al. (J. Rheol. 54:223, 2010) and the BOB (branch-on-branch) model by Das et al. (J. Rheol. 50:207-234, 2006), against linear viscoelastic data on blends of monodisperse star and monodisperse linear polybutadiene polymers. The star was carefully synthesized/characterized by temperature gradient interaction chromatography, and rheological data in the high frequency region were obtained through time-temperature superposition. We found massive failures of both the Hierarchical and BOB models to predict the terminal relaxation behavior of the star/linear blends, despite their success in predicting the rheology of the pure star and pure linear. This failure occurred regardless of the choices made concerning constraint release, such as assuming arm retraction in fat or skinny tubes, or allowing for disentanglement relaxation to cut off the constraint release Rouse process at long times. The failures call into question whether constraint release can be described as a combination of constraint release Rouse processes and dynamic tube dilation within a canonical tube model of entanglement interactions.

  2. 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'. PMID:27242302

  3. Hybrid neural intelligent system to predict business failure in small-to-medium-size enterprises.

    PubMed

    Borrajo, M Lourdes; Baruque, Bruno; Corchado, Emilio; Bajo, Javier; Corchado, Juan M

    2011-08-01

    During the last years there has been a growing need of developing innovative tools that can help small to medium sized enterprises to predict business failure as well as financial crisis. In this study we present a novel hybrid intelligent system aimed at monitoring the modus operandi of the companies and predicting possible failures. This system is implemented by means of a neural-based multi-agent system that models the different actors of the companies as agents. The core of the multi-agent system is a type of agent that incorporates a case-based reasoning system and automates the business control process and failure prediction. The stages of the case-based reasoning system are implemented by means of web services: the retrieval stage uses an innovative weighted voting summarization of self-organizing maps ensembles-based method and the reuse stage is implemented by means of a radial basis function neural network. An initial prototype was developed and the results obtained related to small and medium enterprises in a real scenario are presented.

  4. 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'.

  5. Tension Strength, Failure Prediction and Damage Mechanisms in 2D Triaxial Braided Composites with Notch

    NASA Technical Reports Server (NTRS)

    Norman, Timothy L.; Anglin, Colin

    1995-01-01

    The unnotched and notched (open hole) tensile strength and failure mechanisms of two-dimensional (2D) triaxial braided composites were examined. The effect of notch size and notch position were investigated. Damage initiation and propagation in notched and unnotched coupons were also examined. Theory developed to predict the normal stress distribution near an open hole and failure for tape laminated composites was evaluated for its applicability to 2D triaxial braided textile composite materials. Four different fiber architectures were considered; braid angle, yarn and braider size, percentage of longitudinal yarns and braider angle varied. Tape laminates equivalent to textile composites were also constructed for comparison. Unnotched tape equivalents were stronger than braided textiles but exhibited greater notch sensitivity. Notched textiles and tape equivalents have roughly the same strength at large notch sizes. Two common damage mechanisms were found: braider yarn cracking and near notch longitudinal yarn splitting. Cracking was found to initiate in braider yarns in unnotched and notched coupons, and propagate in the direction of the braider yarns until failure. Damage initiation stress decreased with increasing braid angle. No significant differences in prediction of near notch strain between textile and tape equivalents could be detected for small braid angle, but the correlations were weak for textiles with large braid angle. Notch strength could not be predicted using existing anisotropic theory for braided textiles due to their insensitivity to notch.

  6. A Predictive Safety Management System Software Package Based on the Continuous Hazard Tracking and Failure Prediction Methodology

    NASA Technical Reports Server (NTRS)

    Quintana, Rolando

    2003-01-01

    The goal of this research was to integrate a previously validated and reliable safety model, called Continuous Hazard Tracking and Failure Prediction Methodology (CHTFPM), into a software application. This led to the development of a safety management information system (PSMIS). This means that the theory or principles of the CHTFPM were incorporated in a software package; hence, the PSMIS is referred to as CHTFPM management information system (CHTFPM MIS). The purpose of the PSMIS is to reduce the time and manpower required to perform predictive studies as well as to facilitate the handling of enormous quantities of information in this type of studies. The CHTFPM theory encompasses the philosophy of looking at the concept of safety engineering from a new perspective: from a proactive, than a reactive, viewpoint. That is, corrective measures are taken before a problem instead of after it happened. That is why the CHTFPM is a predictive safety because it foresees or anticipates accidents, system failures and unacceptable risks; therefore, corrective action can be taken in order to prevent all these unwanted issues. Consequently, safety and reliability of systems or processes can be further improved by taking proactive and timely corrective actions.

  7. Development of A Tabulated Thermo-Viscoplastic Material Model with Regularized Failure for Dynamic Ductile Failure Prediction of Structures under Impact Loading

    NASA Astrophysics Data System (ADS)

    Buyuk, Murat

    It is important to understand the dynamic failure behavior of structures subjected to impact loading in order to improve the survivability. Materials under impact are utterly affected by large deformations, high strain-rates, temperature softening and varying stress-states, which finally may lead to failure. It is shown that the impact characteristics are prone to change with several independent factors such as; impact speed, material thickness, and shape and orientation of the impacting object. Validated numerical simulations of impact tests reveal that the failure on ductile metals occur at certain locations of the failure locus that is constructed on a space as a function of all three stress invariants, which indicates that the failure depends profoundly on the state-of-stress. It is shown that existing material models are not always successful enough to cover the whole range of the failure locus and predict the failure. Therefore, it is a common practice to use different sets of material model parameters tuned or calibrated to cover a specific region of the failure loci in an ad hoc manner for practical reasons to match particular test results. Even in that case, specially tuned material properties are not capable of predicting these limited cases if differences in the mesh size and pattern need to be considered. In this dissertation a new, generic, thermo-elastic/viscoplastic material model with regularized failure is introduced. The new material model is implemented into a non-linear, explicit dynamics finite element code, LS-DYNA. A von Mises type isotropic, isochoric plasticity is utilized, where isotropic hardening, strain-rate hardening and temperature softening is considered. The model takes adiabatic heating and softening into account due to the plastic work. The constitutive relation is coupled with a new regularized accumulated failure law that is specifically developed to cover a large extent of the failure locus as a function of state

  8. Predicting Ductility and Failure Modes of TRIP Steels under Different Loading Conditions

    SciTech Connect

    Choi, Kyoo Sil; Liu, Wenning N.; Sun, Xin; Khaleel, Mohammad A.

    2010-06-12

    We study the ultimate ductility and failure modes of a TRIP (TRansformation-Induced Plasticity) 800 steel under different loading conditions with an advanced micromechanics-based finite element analysis. The representative volume element (RVE) for the TRIP800 under examination is developed based on an actual microstructure obtained from scanning electron microscopy (SEM). The evolution of retained austenite during deformation process and the mechanical properties of the constituent phases of the TRIP800 steel are obtained from the synchrotron-based in-situ high-energy X-ray diffraction (HEXRD) experiments and a self-consistent (SC) model. The ductile failure of the TRIP800 under different loading conditions is predicted in the form of plastic strain localization without any prescribed failure criteria for the individual phases. Comparisons of the computational results with experimental measurements suggest that the microstructure-based finite element analysis can well capture the overall macroscopic behavior of the TRIP800 steel under different loading conditions. The methodology described in this study may be extended for studying the ultimate ductile failure mechanisms of TRIP steels as well as the effects of the various processing parameters on the macroscopic behaviors of TRIP steels.

  9. No site unseen: predicting the failure to control problematic Internet use among young adults.

    PubMed

    Yamada, Tetsuhiro; Moshier, Samantha J; Otto, Michael W

    2016-11-01

    Problematic Internet use has been associated with the neglect of valued activities such as work, exercise, social activities, and relationships. In the present study, we expanded the understanding of problematic Internet use by identifying an important predictor of the inability to curb Internet use despite the desire to do so. Specifically, in a college student sample reporting a mean of 27.8 h of recreational Internet use in the past week, we investigated the role of distress intolerance (DI)-an individual difference variable that refers to the inability of an individual to tolerate emotional discomfort and to engage in goal-directed behavior when distressed-to predict the failure to meet personal restrictions on Internet use. Consistent with hypotheses, DI emerged as a significant predictor of the failure to meet self-control goals in both bivariate and multivariate models, indicating that DI offers unique prediction of self-control failure with problematic Internet use. Given that DI is a modifiable trait, these results encourage consideration of DI-focused early intervention strategies. PMID:27426432

  10. The Effect of Delamination on Damage Path and Failure Load Prediction for Notched Composite Laminates

    NASA Technical Reports Server (NTRS)

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

    2007-01-01

    The influence of delamination on the progressing damage path and initial failure load in composite laminates is investigated. Results are presented from a numerical and an experimental study of center-notched tensile-loaded coupons. The numerical study includes two approaches. The first approach considers only intralaminar (fiber breakage and matrix cracking) damage modes in calculating the progression of the damage path. In the second approach, the model is extended to consider the effect of interlaminar (delamination) damage modes in addition to the intralaminar damage modes. The intralaminar damage is modeled using progressive damage analysis (PDA) methodology implemented with the VUMAT subroutine in the ABAQUS finite element code. The interlaminar damage mode has been simulated using cohesive elements in ABAQUS. In the experimental study, 2-3 specimens each of two different stacking sequences of center-notched laminates are tensile loaded. The numerical results from the two different modeling approaches are compared with each other and the experimentally observed results for both laminate types. The comparisons reveal that the second modeling approach, where the delamination damage mode is included together with the intralaminar damage modes, better simulates the experimentally observed damage modes and damage paths, which were characterized by splitting failures perpendicular to the notch tips in one or more layers. Additionally, the inclusion of the delamination mode resulted in a better prediction of the loads at which the failure took place, which were higher than those predicted by the first modeling approach which did not include delaminations.

  11. Methods for predicting peak discharge of floods caused by failure of natural and constructed earthen dams

    USGS Publications Warehouse

    Walder, J.S.; O'Connor, J. E.

    1997-01-01

    Floods from failures of natural and constructed dams constitute a widespread hazard to people and property. Expeditious means of assessing flood hazards are necessary, particularly in the case of natural dams, which may form suddenly and unexpectedly. We revise statistical relations (derived from data for past constructed and natural dam failures) between peak discharge (Q(p)) and water volume released (V(0)) or drop in lake level (d) but assert that such relations, even when cast into a dimensionless form, are of limited utility because they fail to portray the effect of breach-formation rate. We then analyze a simple, physically based model of dam-breach formation to show that the hydrograph at the breach depends primarily on a dimensionless parameter ?? = kV0/g1/2d7/2, where k is the mean erosion rate of the breach and g is acceleration due to gravity. The functional relationship between Q(p) and ?? takes asymptotically distinct forms depending on whether ?? << 1 (relatively slow breach formation or small lake volume) or ?? >> 1 (relatively fast breach formation or large lake volume). Theoretical predictions agree well with data from dam failures for which k, and thus ??, can be estimated. The theory thus provides a rapid means of predicting the plausible range of values of peak discharge at the breach in an earthen dam as long as the impounded water volume and the water depth at the dam face can be estimated.

  12. No site unseen: predicting the failure to control problematic Internet use among young adults.

    PubMed

    Yamada, Tetsuhiro; Moshier, Samantha J; Otto, Michael W

    2016-11-01

    Problematic Internet use has been associated with the neglect of valued activities such as work, exercise, social activities, and relationships. In the present study, we expanded the understanding of problematic Internet use by identifying an important predictor of the inability to curb Internet use despite the desire to do so. Specifically, in a college student sample reporting a mean of 27.8 h of recreational Internet use in the past week, we investigated the role of distress intolerance (DI)-an individual difference variable that refers to the inability of an individual to tolerate emotional discomfort and to engage in goal-directed behavior when distressed-to predict the failure to meet personal restrictions on Internet use. Consistent with hypotheses, DI emerged as a significant predictor of the failure to meet self-control goals in both bivariate and multivariate models, indicating that DI offers unique prediction of self-control failure with problematic Internet use. Given that DI is a modifiable trait, these results encourage consideration of DI-focused early intervention strategies.

  13. An endometrial gene expression signature accurately predicts recurrent implantation failure after IVF

    PubMed Central

    Koot, Yvonne E. M.; van Hooff, Sander R.; Boomsma, Carolien M.; van Leenen, Dik; Groot Koerkamp, Marian J. A.; Goddijn, Mariëtte; Eijkemans, Marinus J. C.; Fauser, Bart C. J. M.; Holstege, Frank C. P.; Macklon, Nick S.

    2016-01-01

    The primary limiting factor for effective IVF treatment is successful embryo implantation. Recurrent implantation failure (RIF) is a condition whereby couples fail to achieve pregnancy despite consecutive embryo transfers. Here we describe the collection of gene expression profiles from mid-luteal phase endometrial biopsies (n = 115) from women experiencing RIF and healthy controls. Using a signature discovery set (n = 81) we identify a signature containing 303 genes predictive of RIF. Independent validation in 34 samples shows that the gene signature predicts RIF with 100% positive predictive value (PPV). The strength of the RIF associated expression signature also stratifies RIF patients into distinct groups with different subsequent implantation success rates. Exploration of the expression changes suggests that RIF is primarily associated with reduced cellular proliferation. The gene signature will be of value in counselling and guiding further treatment of women who fail to conceive upon IVF and suggests new avenues for developing intervention. PMID:26797113

  14. NASA Langley developments in response calculations needed for failure and life prediction

    NASA Technical Reports Server (NTRS)

    Housner, Jerrold M.

    1993-01-01

    NASA Langley developments in response calculations needed for failure and life predictions are discussed. Topics covered include: structural failure analysis in concurrent engineering; accuracy of independent regional modeling demonstrated on classical example; functional interface method accurately joins incompatible finite element models; interface method for insertion of local detail modeling extended to curve pressurized fuselage window panel; interface concept for joining structural regions; motivation for coupled 2D-3D analysis; compression panel with discontinuous stiffener coupled 2D-3D model and axial surface strains at the middle of the hat stiffener; use of adaptive refinement with multiple methods; adaptive mesh refinement; and studies on quantity effect of bow-type initial imperfections on reliability of stiffened panels.

  15. Application of Strain Non-Uniformity Index (SNI) Based Approach to Predict Failure in Sheet Metal Components

    NASA Astrophysics Data System (ADS)

    Date, P. P.; Jamadar, K. D.

    2016-08-01

    Industrial components are far too complex in shape and far too large in size compared to the laboratory scale test samples used to establish failure criteria like the forming limit diagram (FLD). These have been traditionally used to predict failure, but are found to often make wrong predictions due to their sensitivity to strain path, and forming conditions like temperature. The Strain Nonuniformity Index (SNI), a single parameter determined from the spatial strain distribution, may be used to predict failure and identify locations of failure or even imminent failure. This is possible regardless of temperature or even the method of forming (cold forming, hot forming, superplastic forming etc.). The paper presents a few results demonstrating successful applications of this novel SNI based technique.

  16. Risk Analysis of the Space Shuttle: Pre-Challenger Bayeisan Prediction of Failure

    SciTech Connect

    Dana L. Kelly

    2008-02-01

    Dalal et al performed a statistical analysis of field and nozzle O-ring data collected prior to the ill-fated launch of the Challenger in January 1986. The purpose of their analysis was to show how statistical analysis could be used to provide information to decisionmakers prior to the launch, information that could have been expected to lead to a decision to abort the launch due to the low temperatures (~30o F.) present at the launch pad on the morning of the scheduled launch. Dalal et al. performed a frequentist analysis of the O-ring data, and found that a logistic regression model provided a relatively good fit to the past data. In the second portion of their paper, Dalal et al. propagated parameter uncertainties through the fitted logistic regression model in order to estimate the probability of shuttle failure due to O-ring failure at the estimated launch temperature of ~30o F. Because their analysis was frequentist in nature, probability distributions representing epistemic uncertainty in the input parameters were not available, and the authors had to resort to an approximate approach based on bootstrap confidence intervals. In this paper, we will re-evaluate the analyses of Dalal et al. from a Bayesian perspective. Markov chain Monte Carlo (MCMC) sampling will be used to sample from the joint posterior distribution of the model parameters, and to sample from the posterior predictive distributions at the estimated launch temperature, a temperature that had not been observed in prior launches of the space shuttle. Uncertainties, which are represented by probability distributions in the Bayesian approach, are propagated through the model to obtain a probability distribution for O-ring failure, and subsequently for shuttle failure as a result of O-ring failure. No approximations are required in the Bayesian approach and the resulting distributions can be input to a decision analysis to obtain expected utility for the decision to launch.

  17. Predicting failure using conditioning on damage history: Demonstration on percolation and hierarchical fiber bundles

    SciTech Connect

    Andersen, J.V.; Sornette, D.

    2005-11-01

    We formulate the problem of probabilistic predictions of global failure in the simplest possible model based on site percolation and on one of the simplest models of time-dependent rupture, a hierarchical fiber bundle model. We show that conditioning the predictions on the knowledge of the current degree of damage (occupancy density p or number and size of cracks) and on some information on the largest cluster improves significantly the prediction accuracy, in particular by allowing one to identify those realizations which have anomalously low or large clusters (cracks). We quantify the prediction gains using two measures, the relative specific information gain (which is the variation of entropy obtained by adding new information) and the root mean square of the prediction errors over a large ensemble of realizations. The bulk of our simulations have been obtained with the two-dimensional site percolation model on a lattice of size LxL=20x20 and hold true for other lattice sizes. For the hierarchical fiber bundle model, conditioning the measures of damage on the information of the location and size of the largest crack extends significantly the critical region and the prediction skills. These examples illustrate how ongoing damage can be used as a revelation of both the realization-dependent preexisting heterogeneity and the damage scenario undertaken by each specific sample.

  18. A standardized model for predicting flap failure using indocyanine green dye

    NASA Astrophysics Data System (ADS)

    Zimmermann, Terence M.; Moore, Lindsay S.; Warram, Jason M.; Greene, Benjamin J.; Nakhmani, Arie; Korb, Melissa L.; Rosenthal, Eben L.

    2016-03-01

    Techniques that provide a non-invasive method for evaluation of intraoperative skin flap perfusion are currently available but underutilized. We hypothesize that intraoperative vascular imaging can be used to reliably assess skin flap perfusion and elucidate areas of future necrosis by means of a standardized critical perfusion threshold. Five animal groups (negative controls, n=4; positive controls, n=5; chemotherapy group, n=5; radiation group, n=5; chemoradiation group, n=5) underwent pre-flap treatments two weeks prior to undergoing random pattern dorsal fasciocutaneous flaps with a length to width ratio of 2:1 (3 x 1.5 cm). Flap perfusion was assessed via laser-assisted indocyanine green dye angiography and compared to standard clinical assessment for predictive accuracy of flap necrosis. For estimating flap-failure, clinical prediction achieved a sensitivity of 79.3% and a specificity of 90.5%. When average flap perfusion was more than three standard deviations below the average flap perfusion for the negative control group at the time of the flap procedure (144.3+/-17.05 absolute perfusion units), laser-assisted indocyanine green dye angiography achieved a sensitivity of 81.1% and a specificity of 97.3%. When absolute perfusion units were seven standard deviations below the average flap perfusion for the negative control group, specificity of necrosis prediction was 100%. Quantitative absolute perfusion units can improve specificity for intraoperative prediction of viable tissue. Using this strategy, a positive predictive threshold of flap failure can be standardized for clinical use.

  19. Numerical models for the prediction of failure for multilayer fusion Al-alloy sheets

    SciTech Connect

    Gorji, Maysam; Berisha, Bekim; Hora, Pavel; Timm, Jürgen

    2013-12-16

    Initiation and propagation of cracks in monolithic and multi-layer aluminum alloys, called “Fusion”, is investigated. 2D plane strain finite element simulations are performed to model deformation due to bending and to predict failure. For this purpose, fracture strains are measured based on microscopic pictures of Nakajima specimens. In addition to, micro-structure of materials is taken into account by introducing a random grain distribution over the sheet thickness as well as a random distribution of the measured yield curve. It is shown that the performed experiments and the introduced FE-Model are appropriate methods to highlight the advantages of the Fusion material, especially for bending processes.

  20. Predicting the time-temperature dependent axial failure of B/Al composites

    NASA Technical Reports Server (NTRS)

    Dicarlo, J. A.

    1980-01-01

    Theoretical and experimental studies are reviewed whose objective was to gain insight into and predict the effects of time, temperature, and stress on the axial failure modes of boron fibers and B/Al composites. Owing to the inelastic nature of boron fiber deformation, it proved possible to develop simple creep functions which can be used to describe accurately the creep and fracture stress of as-produced fibers. Analysis of damping and stress data for B/6061 Al composites indicates that fiber creep and the effects of creep of fiber fracture are measurably reduced by the composite fabrication process.

  1. Progressive failure methodologies for predicting residual strength and life of laminated composites

    NASA Technical Reports Server (NTRS)

    Harris, Charles E.; Allen, David H.; Obrien, T. Kevin

    1991-01-01

    Two progressive failure methodologies currently under development by the Mechanics of Materials Branch at NASA Langley Research Center are discussed. The damage tolerance/fail safety methodology developed by O'Brien is an engineering approach to ensuring adequate durability and damage tolerance by treating only delamination onset and the subsequent delamination accumulation through the laminate thickness. The continuum damage model developed by Allen and Harris employs continuum damage laws to predict laminate strength and life. The philosophy, mechanics framework, and current implementation status of each methodology are presented.

  2. Human Factors Predicting Failure and Success in Hospital Information System Implementations in Sub-Saharan Africa.

    PubMed

    Verbeke, Frank; Karara, Gustave; Nyssen, Marc

    2015-01-01

    From 2007 through 2014, the authors participated in the implementation of open source hospital information systems (HIS) in 19 hospitals in Rwanda, Burundi, DR Congo, Congo-Brazzaville, Gabon, and Mali. Most of these implementations were successful, but some failed. At the end of a seven-year implementation effort, a number of risk factors, facilitators, and pragmatic approaches related to the deployment of HIS in Sub-Saharan health facilities have been identified. Many of the problems encountered during the HIS implementation process were not related to technical issues but human, cultural, and environmental factors. This study retrospectively evaluates the predictive value of 14 project failure factors and 15 success factors in HIS implementation in the Sub-Saharan region. Nine of the failure factors were strongly correlated with project failure, three were moderately correlated, and one weakly correlated. Regression analysis also confirms that eight factors were strongly correlated with project success, four moderately correlated, and two weakly correlated. The study results may help estimate the expedience of future HIS projects. PMID:26262097

  3. Predicting the Probability of Failure of Cementitious Sewer Pipes Using Stochastic Finite Element Method.

    PubMed

    Alani, Amir M; Faramarzi, Asaad

    2015-06-01

    In this paper, a stochastic finite element method (SFEM) is employed to investigate the probability of failure of cementitious buried sewer pipes subjected to combined effect of corrosion and stresses. A non-linear time-dependant model is used to determine the extent of concrete corrosion. Using the SFEM, the effects of different random variables, including loads, pipe material, and corrosion on the remaining safe life of the cementitious sewer pipes are explored. A numerical example is presented to demonstrate the merit of the proposed SFEM in evaluating the effects of the contributing parameters upon the probability of failure of cementitious sewer pipes. The developed SFEM offers many advantages over traditional probabilistic techniques since it does not use any empirical equations in order to determine failure of pipes. The results of the SFEM can help the concerning industry (e.g., water companies) to better plan their resources by providing accurate prediction for the remaining safe life of cementitious sewer pipes. PMID:26068092

  4. Predicting the Probability of Failure of Cementitious Sewer Pipes Using Stochastic Finite Element Method

    PubMed Central

    Alani, Amir M.; Faramarzi, Asaad

    2015-01-01

    In this paper, a stochastic finite element method (SFEM) is employed to investigate the probability of failure of cementitious buried sewer pipes subjected to combined effect of corrosion and stresses. A non-linear time-dependant model is used to determine the extent of concrete corrosion. Using the SFEM, the effects of different random variables, including loads, pipe material, and corrosion on the remaining safe life of the cementitious sewer pipes are explored. A numerical example is presented to demonstrate the merit of the proposed SFEM in evaluating the effects of the contributing parameters upon the probability of failure of cementitious sewer pipes. The developed SFEM offers many advantages over traditional probabilistic techniques since it does not use any empirical equations in order to determine failure of pipes. The results of the SFEM can help the concerning industry (e.g., water companies) to better plan their resources by providing accurate prediction for the remaining safe life of cementitious sewer pipes. PMID:26068092

  5. Potential Impact of a Free Online HIV Treatment Response Prediction System for Reducing Virological Failures and Drug Costs after Antiretroviral Therapy Failure in a Resource-Limited Setting

    PubMed Central

    Revell, Andrew D.; Wang, Dechao; Pozniak, Anton; Montaner, Julio S.; Lane, H. Clifford; Larder, Brendan A.

    2013-01-01

    Objective. Antiretroviral drug selection in resource-limited settings is often dictated by strict protocols as part of a public health strategy. The objective of this retrospective study was to examine if the HIV-TRePS online treatment prediction tool could help reduce treatment failure and drug costs in such settings. Methods. The HIV-TRePS computational models were used to predict the probability of response to therapy for 206 cases of treatment change following failure in India. The models were used to identify alternative locally available 3-drug regimens, which were predicted to be effective. The costs of these regimens were compared to those actually used in the clinic. Results. The models predicted the responses to treatment of the cases with an accuracy of 0.64. The models identified alternative drug regimens that were predicted to result in improved virological response and lower costs than those used in the clinic in 85% of the cases. The average annual cost saving was $364 USD per year (41%). Conclusions. Computational models that do not require a genotype can predict and potentially avoid treatment failure and may reduce therapy costs. The use of such a system to guide therapeutic decision-making could confer health economic benefits in resource-limited settings. PMID:24175292

  6. Failure Mode Classification for Life Prediction Modeling of Solid-State Lighting

    SciTech Connect

    Sakalaukus, Peter Joseph

    2015-08-01

    light power” of the SSL luminaire. The use of the Arrhenius equation necessitates two different temperature conditions, 25°C and 45°C are suggested by TM28, to determine the SSL lamp specific activation energy. One principal issue with TM28 is the lack of additional stresses or parameters needed to characterize non-temperature dependent failure mechanisms. Another principal issue with TM28 is the assumption that lumen maintenance or lumen depreciation gives an adequate comparison between SSL luminaires. Additionally, TM28 has no process for the determination of acceleration factors or lifetime estimations. Currently, a literature gap exists for established accelerated test methods for SSL devices to assess quality, reliability and durability before being introduced into the marketplace. Furthermore, there is a need for Physics-of-Failure based approaches to understand the processes and mechanisms that induce failure for the assessment of SSL reliability in order to develop generalized acceleration factors that better represent SSL product lifetime. This and the deficiencies in TM28 validate the need behind the development of acceleration techniques to quantify SSL reliability under a variety of environmental conditions. The ability to assess damage accrual and investigate reliability of SSL components and systems is essential to understanding the life time of the SSL device itself. The methodologies developed in this work increases the understanding of SSL devices iv through the investigation of component and device reliability under a variety of accelerated test conditions. The approaches for suitable lifetime predictions through the development of novel generalized acceleration factors, as well as a prognostics and health management framework, will greatly reduce the time and effort needed to produce SSL acceleration factors for the development of lifetime predictions.

  7. Predicting the time-temperature dependent axial failure of B/A1 composites

    NASA Technical Reports Server (NTRS)

    Dicarlo, J. A.

    1980-01-01

    Experimental and theoretical studies were conducted in order to understand and predict the effects of time, temperature, and stress on the axial failure modes of boron fibers and B/A1 composites. Due to the anelastic nature of boron fiber deformation, it was possible to determine simple creep functions which can be employed to accurately describe creep and fracture stress of as-produced fibers. Analysis of damping and strength data for B/6061 A1 composites indicates that fiber creep effects of creep on fiber fracture are measurably reduced by the composite fabrication process. The creep function appropriate for fibers with B/Al composites was also determined. A fracture theory is presented for predicting the time-temperature dependence of the axial tensile strength for metal matrix composites in general and B/A1 composites in particular.

  8. Slope Failure Prediction and Early Warning Awareness Education for Reducing Landslides Casualty in Malaysia

    NASA Astrophysics Data System (ADS)

    Koay, S. P.; Tay, L. T.; Fukuoka, H.; Koyama, T.; Sakai, N.; Jamaludin, S. B.; Lateh, H.

    2015-12-01

    Northeast monsoon causes heavy rain in east coast of Peninsular Malaysia from November to March, every year. During this monsoon period, besides the happening of flood along east coast, landslides also causes millions of Malaysian Ringgit economical losses. Hence, it is essential to study the prediction of slope failure to prevent the casualty of landslides happening. In our study, we introduce prediction method of the accumulated rainfall affecting the stability of the slope. If the curve, in the graph, which is presented by rainfall intensity versus accumulated rainfall, crosses over the critical line, the condition of the slope is considered in high risk where the data are calculated and sent from rain gauge in the site via internet. If the possibility of slope failure is going high, the alert message will be sent out to the authorities for decision making on road block or setting the warning light at the road side. Besides road block and warning light, we propose to disseminate short message, to pre-registered mobile phone user, to notify the public for easing the traffic jam and avoiding unnecessary public panic. Prediction is not enough to prevent the casualty. Early warning awareness of the public is very important to reduce the casualty of landslides happening. IT technology does not only play a main role in disseminating information, early warning awareness education, by using IT technology, should be conducted, in schools, to give early warning awareness on natural hazard since childhood. Knowing the pass history on landslides occurrence will gain experience on the landslides happening. Landslides historical events with coordinate information are stored in database. The public can browse these historical events via internet. By referring to such historical landslides events, the public may know where did landslides happen before and the possibility of slope failure occurrence again is considered high. Simulation of rainfall induced slope failure mechanism

  9. Prospective development and validation of a model to predict heart failure hospitalisation

    PubMed Central

    Cubbon, R M; Woolston, A; Adams, B; Gale, C P; Gilthorpe, M S; Baxter, P D; Kearney, L C; Mercer, B; Rajwani, A; Batin, P D; Kahn, M; Sapsford, R J; Witte, K K; Kearney, M T

    2014-01-01

    Objective Acute heart failure syndrome (AHFS) is a major cause of hospitalisation and imparts a substantial burden on patients and healthcare systems. Tools to define risk of AHFS hospitalisation are lacking. Methods A prospective cohort study (n=628) of patients with stable chronic heart failure (CHF) secondary to left ventricular systolic dysfunction was used to derive an AHFS prediction model which was then assessed in a prospectively recruited validation cohort (n=462). Results Within the derivation cohort, 44 (7%) patients were hospitalised as a result of AHFS during 1 year of follow-up. Predictors of AHFS hospitalisation included furosemide equivalent dose, the presence of type 2 diabetes mellitus, AHFS hospitalisation within the previous year and pulmonary congestion on chest radiograph, all assessed at baseline. A multivariable model containing these four variables exhibited good calibration (Hosmer–Lemeshow p=0.38) and discrimination (C-statistic 0.77; 95% CI 0.71 to 0.84). Using a 2.5% risk cut-off for predicted AHFS, the model defined 38.5% of patients as low risk, with negative predictive value of 99.1%; this low risk cohort exhibited <1% excess all-cause mortality per annum when compared with contemporaneous actuarial data. Within the validation cohort, an identically applied model derived comparable performance parameters (C-statistic 0.81 (95% CI 0.74 to 0.87), Hosmer–Lemeshow p=0.15, negative predictive value 100%). Conclusions A prospectively derived and validated model using simply obtained clinical data can identify patients with CHF at low risk of hospitalisation due to AHFS in the year following assessment. This may guide the design of future strategies allocating resources to the management of CHF. PMID:24647052

  10. Post extubation negative pressure pulmonary edema due to posterior mediastinal cyst in an infant.

    PubMed

    Dubey, Prakash Kumar

    2014-01-01

    A 3-month-old male child underwent uneventful inguinal herniotomy under general anesthesia. After extubation, airway obstruction followed by pulmonary edema appeared for which the baby was reintubated and ventilated. The baby made a complete recovery and extubated after about 2 h. A post-operative computed tomography scan revealed a posterior mediastinal cystic mass abutting the tracheal bifurcation. Presumably, extrinsic compression by the mass on the tracheal bifurcation led to the development of negative pressure pulmonary edema.

  11. Application of a neural network as a potential aid in predicting NTF pump failure

    NASA Technical Reports Server (NTRS)

    Rogers, James L.; Hill, Jeffrey S.; Lamarsh, William J., II; Bradley, David E.

    1993-01-01

    The National Transonic Facility has three centrifugal multi-stage pumps to supply liquid nitrogen to the wind tunnel. Pump reliability is critical to facility operation and test capability. A highly desirable goal is to be able to detect a pump rotating component problem as early as possible during normal operation and avoid serious damage to other pump components. If a problem is detected before serious damage occurs, the repair cost and downtime could be reduced significantly. A neural network-based tool was developed for monitoring pump performance and aiding in predicting pump failure. Once trained, neural networks can rapidly process many combinations of input values other than those used for training to approximate previously unknown output values. This neural network was applied to establish relationships among the critical frequencies and aid in predicting failures. Training pairs were developed from frequency scans from typical tunnel operations. After training, various combinations of critical pump frequencies were propagated through the neural network. The approximated output was used to create a contour plot depicting the relationships of the input frequencies to the output pump frequency.

  12. Diagnostic prediction of renal failure from blood serum analysis by FTIR spectrometry and chemometrics

    NASA Astrophysics Data System (ADS)

    Khanmohammadi, Mohammdreza; Ghasemi, Keyvan; Garmarudi, Amir Bagheri; Ramin, Mehdi

    2015-02-01

    A new diagnostic approach based on Attenuated Total Reflectance-Fourier Transform Infrared (ATR-FTIR) spectrometry and classification algorithm has been introduced which provides a rapid, reliable, and easy way to perform blood test for the diagnosis of renal failure. Blood serum samples from 35 renal failure patients and 40 healthy persons were analyzed by ATR-FTIR spectrometry. The resulting data was processed by Quadratic Discriminant Analysis (QDA) and QDA combined with simple filtered method. Spectroscopic studies were performed in 900-2000 cm-1 spectral region with 3.85 cm-1 data space. Results showed 93.33% and 100% of accuracy for QDA and filter-QDA models, respectively. In the first step, 30 samples were applied to construct the model. In order to modify the capability of QDA in prediction of test samples, filter-based feature selection methods were applied. It was found that the filtered spectra coupled with QDA could correctly predict the test samples in most of the cases.

  13. Failure Predictions of Out-of-Autoclave Sandwich Joints with Delaminations under Flexure Loads

    NASA Technical Reports Server (NTRS)

    Nordendale, Nikolas; Goyal, Vinay; Lundgren, Eric; Patel, Dhruv; Farrokh, Babak; Jones, Justin; Fischetti, Grace; Segal, Kenneth

    2015-01-01

    An analysis and a test program was conducted to investigate the damage tolerance of composite sandwich joints. The joints contained a single circular delamination between the face-sheet and the doubler. The coupons were fabricated through out-of-autoclave (OOA) processes, a technology NASA is investigating for joining large composite sections. The four-point bend flexure test was used to induce compression loading into the side of the joint where the delamination was placed. The compression side was chosen since it tends to be one of the most critical loads in launch vehicles. Autoclave cure was used to manufacture the composite sandwich sections, while the doubler was co-bonded onto the sandwich face-sheet using an OOA process after sandwich panels were cured. A building block approach was adopted to characterize the mechanical properties of the joint material, including the fracture toughness between the doubler and facesheet. Twelve four-point-bend samples were tested, six in the sandwich core ribbon orientation and six in sandwich core cross-ribbon direction. Analysis predicted failure initiation and propagation at the pre-delaminated location, consistent with experimental observations. A building block approach using fracture analyses methods predicted failure loads in close agreement with tests. This investigation demonstrated a small strength reduction due to a flaw of significant size compared to the width of the sample. Therefore, concerns of bonding an OOA material to an in-autoclave material was mitigated for the geometries, materials, and load configurations considered.

  14. Failure Predictions of Out-of-Autoclave Sandwich Joints with Delaminations Under Flexure Loads

    NASA Technical Reports Server (NTRS)

    Nordendale, Nikolas; Goyal, Vinay; Lundgren, Eric; Patel, Dhruv; Farrokh, Babak; Jones, Justin; Fischetti, Grace; Segal, Kenneth

    2015-01-01

    An analysis and a test program was conducted to investigate the damage tolerance of composite sandwich joints. The joints contained a single circular delamination between the face-sheet and the doubler. The coupons were fabricated through out-of-autoclave (OOA) processes, a technology NASA is investigating for joining large composite sections. The four-point bend flexure test was used to induce compression loading into the side of the joint where the delamination was placed. The compression side was chosen since it tends to be one of the most critical loads in launch vehicles. Autoclave cure was used to manufacture the composite sandwich sections, while the doubler was co-bonded onto the sandwich face-sheet using an OOA process after sandwich panels were cured. A building block approach was adopted to characterize the mechanical properties of the joint material, including the fracture toughness between the doubler and face-sheet. Twelve four-point-bend samples were tested, six in the sandwich core ribbon orientation and six in sandwich core cross-ribbon direction. Analysis predicted failure initiation and propagation at the pre-delaminated location, consistent with experimental observations. Fracture analyses methods predicted failure loads in close agreement with tests. This investigation demonstrated a strength reduction of 10 percent due to a flaw of significant size compared to the width of the sample. Therefore, concerns of bonding an OOA material to an in-autoclave material was mitigated for the geometries, materials, and load configurations considered.

  15. Failure Predictions of Out-of-Autoclave Sandwich Joints with Delaminations Under Flexure Loads

    NASA Technical Reports Server (NTRS)

    Nordendale, Nikolas A.; Goyal, Vinay K.; Lundgren, Eric C.; Patel, Dhruv N.; Farrokh, Babak; Jones, Justin; Fischetti, Grace; Segal, Kenneth N.

    2015-01-01

    An analysis and a test program was conducted to investigate the damage tolerance of composite sandwich joints. The joints contained a single circular delamination between the face-sheet and the doubler. The coupons were fabricated through out-of-autoclave (OOA) processes, a technology NASA is investigating for joining large composite sections. The four-point bend flexure test was used to induce compression loading into the side of the joint where the delamination was placed. The compression side was chosen since it tends to be one of the most critical loads in launch vehicles. Autoclave cure was used to manufacture the composite sandwich sections, while the doubler was co-bonded onto the sandwich face-sheet using an OOA process after sandwich panels were cured. A building block approach was adopted to characterize the mechanical properties of the joint material, including the fracture toughness between the doubler and face-sheet. Twelve four-point-bend samples were tested, six in the sandwich core ribbon orientation and six in sandwich core cross-ribbon direction. Analysis predicted failure initiation and propagation at the pre-delaminated location, consistent with experimental observations. A building block approach using fracture analyses methods predicted failure loads in close agreement with tests. This investigation demonstrated a small strength reduction due to a flaw of significant size compared to the width of the sample. Therefore, concerns of bonding an OOA material to an in-autoclave material was mitigated for the geometries, materials, and load configurations considered.

  16. Multi-Marker Strategy in Heart Failure: Combination of ST2 and CRP Predicts Poor Outcome

    PubMed Central

    Dupuy, Anne Marie; Curinier, Corentin; Kuster, Nils; Huet, Fabien; Leclercq, Florence; Davy, Jean Marc; Cristol, Jean Paul; Roubille, François

    2016-01-01

    Natriuretic peptides (BNP and NT-proBNP) are recognized as gold-standard predictive markers in Heart Failure (HF). However, currently ST2 (member of the interleukin 1 receptor family) has emerged as marker of inflammation, fibrosis and cardiac stress. We evaluated ST2 and CRP as prognostic markers in 178 patients with chronic heart failure in comparison with other classical markers such as clinical established parameters but also biological markers: NT-proBNP, hs-cTnT alone or in combination. In multivariate analysis, subsequent addition of ST2 led to age, CRP and ST2 as the only remaining predictors of all-cause mortality (HR 1.03, HR 1.61 and HR 2.75, respectively) as well as of cardiovascular mortality (HR 1.00, HR 2.27 and HR 3.78, respectively). The combined increase of ST2 and CRP was significant for predicting worsened outcomes leading to identify a high risk subgroup that individual assessment of either marker. The same analysis was performed with ST2 in combination with Barcelona score. Overall, our findings extend previous data demonstrating that ST2 in combination with CRP as a valuable tool for identifying patients at risk of death. PMID:27311068

  17. Postoperative Prostate-Specific Antigen Velocity Independently Predicts for Failure of Salvage Radiotherapy After Prostatectomy

    SciTech Connect

    King, Christopher R. Presti, Joseph C.; Brooks, James D.; Gill, Harcharan; Spiotto, Michael T.

    2008-04-01

    Purpose: Identification of patients most likely to benefit from salvage radiotherapy (RT) using postoperative (postop) prostate-specific antigen (PSA) kinetics. Methods and Materials: From 1984 to 2004, 81 patients who fit the following criteria formed the study population: undetectable PSA after radical prostatectomy (RP); pathologically negative nodes; biochemical relapse defined as a persistently detectable PSA; salvage RT; and two or more postop PSAs available before salvage RT. Salvage RT included the whole pelvic nodes in 55 patients and 4 months of total androgen suppression in 56 patients. The median follow-up was >5 years. All relapses were defined as a persistently detectable PSA. Kaplan-Meier and Cox proportional hazards multivariable analysis were performed for all clinical, pathological, and treatment factors predicting for biochemical relapse-free survival (bRFS). Results: There were 37 biochemical relapses observed after salvage RT. The 5-year bRFS after salvage RT for patients with postop prostate-specific antigen velocity {<=}1 vs. >1 ng/ml/yr was 59% vs. 29%, p = 0.002. In multivariate analysis, only postop PSAV (p = 0.0036), pre-RT PSA level {<=}1 (p = 0.037) and interval-to-relapse >10 months (p = 0.012) remained significant, whereas pelvic RT, hormone therapy, and RT dose showed a trend (p = {approx}0.06). PSAV, but not prostate-specific antigen doubling time, predicted successful salvage RT, suggesting an association of zero-order kinetics with locally recurrent disease. Conclusions: Postoperative PSA velocity independently predicts for the failure of salvage RT and can be considered in addition to high-risk features when selecting patients in need of systemic therapy following biochemical failure after RP. For well-selected patients, salvage RT can achieve high cure rates.

  18. Neuroendocrine prediction of left ventricular function and heart failure after acute myocardial infarction

    PubMed Central

    Richards, A; Nicholls, M; Yandle, T; Ikram, H; Espiner, E; Turner, J; Buttimore, R; Lainchbury, J; Elliott, J; Frampton, C; Crozier, I; Smyth, D

    1999-01-01

    Objective—To determine the relations of plasma levels of brain natriuretic peptide (BNP), atrial natriuretic factor (ANF), N-terminal ANF (N-ANF), cyclic guanosine monophosphate (cGMP; the cardiac peptide second messenger), and plasma catecholamines to left ventricular function and to prognosis in patients admitted with acute myocardial infarction.
Design—Plasma hormones and ventricular function (radionuclide ventriculography) were measured 1-4 days after myocardial infarction in 220 patients admitted to a single coronary care unit. Radionuclide scanning was repeated 3-5 months after infarction. Clinical events were recorded over a mean period of 14 months.
Results—Both early and late left ventricular ejection fraction (LVEF) were most closely related to plasma BNP (r = −0.60, n = 220, p < 0.001; and r = −0.53, n = 192, p < 0.001, respectively), followed by ANF, N-ANF, cGMP, and the plasma catecholamines. Early plasma BNP concentrations less than twofold the upper limit of normal (20 pmol/l) had 100% negative predictive value for LVEF < 40% at 3-5 months after infarction. In multivariate analysis incorporating all the neurohormonal factors, only BNP remained independently predictive of LVEF < 40% (p < 0.005). Survival analysis by median levels of candidate predictors identified BNP as the most powerful discriminator for death (p < 0.0001). No early deaths (within 4 months) occurred in patients with plasma BNP concentrations below the group median (27 pmol/l), and over follow up only three of 26 deaths occurred in this subgroup. Of all episodes of left ventricular failure, 85% occurred in patients with plasma BNP above the median (p < 0.001). In multivariate analyses, BNP alone gave additional predictive information beyond sex, age, clinical history, LVEF, and plasma noradrenaline for both subsequent onset of LVF and death.
Conclusions—Plasma BNP measured within 1-4 days of acute myocardial infarction is a powerful

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

    DOE PAGESBeta

    Boyce, B. L.; Kramer, S. L. B.; Bosiljevac, T. R.; Corona, E.; Moore, J. A.; Elkhodary, K.; Simha, C. H. M.; Williams, B. W.; Cerrone, A. R.; Nonn, A.; et al

    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

  20. Genetic and immunological markers predict titanium implant failure: a retrospective study.

    PubMed

    Jacobi-Gresser, E; Huesker, K; Schütt, S

    2013-04-01

    This study evaluates diagnostic markers to predict titanium implant failure. Retrospectively, implant outcome was scored in 109 subjects who had undergone titanium implant surgery, IL1A -889 C/T (rs1800587), IL1B +3954 C/T (rs1143634), IL1RN +2018 T/C (rs419598) and TNFA -308 G/A (rs1800629) genotyping, in vitro IL-1β/TNF-α release assays and lymphocyte transformation tests during treatment. TNF-α and IL-1β release on titanium stimulation were significantly higher among patients with implant loss (TNF-α: 256.89 pg/ml vs. 81.4 pg/ml; p<0.0001; IL-1β: 159.96 pg/ml vs. 54.01 pg/ml; p<0.0001). The minor alleles of the studied polymorphisms showed increased prevalence in the implant failure group (IL1A: 61% vs. 42.6% in controls, IL1B: 53.7% vs. 39.7% in controls, TNFA: 46.3% vs. 30.9% in controls, IL1RN: 58.5% vs. 52.9% in controls). Increasing numbers of risk genotypes of the studied polymorphisms were associated with an increasing risk of implant loss, suggesting an additive effect. Multiple logistic regression analysis showed positive IL-1β/TNF-α release assay scores (p<0.0001, OR=12.01) and number of risk genotypes (p<0.046, OR=1.57-6.01) being significantly and independently associated with titanium implant failure. IL-1/IL1RN/TNFA genotyping and cytokine release assay scores provide prognostic markers for titanium implant outcome and may present new tools for individual risk assessment. PMID:22925444

  1. Model for end-stage liver disease predicts right ventricular failure in patients with left ventricular assist devices.

    PubMed

    Yost, Gardner L; Coyle, Laura; Bhat, Geetha; Tatooles, Antone J

    2016-03-01

    High rates of right ventricular failure continue to affect postoperative outcomes in patients implanted with left ventricular assist devices (LVADs). Development of right ventricular failure and implantation with right ventricular assist devices is known to be associated with significantly increased mortality. The model for end-stage liver disease (MELD) score is an effective means of evaluating liver dysfunction. We investigated the prognostic utility of postoperative MELD on post-LVAD implantation outcomes. MELD scores, demographic data, and outcomes including length of stay, survival, and postoperative right ventricular failure were collected for 256 patients implanted with continuous flow LVADs. Regression and Kaplan-Meier analyses were used to investigate the relationship between MELD and all outcomes. Increased MELD score was found to be an independent predictor of both right heart failure and necessity for RVAD implantation (OR 1.097, CI 1.040-1.158, p = 0.001; OR 1.121, CI 1.015, p = 0.024, respectively). Patients with RV failure and who underwent RVAD implantation had reduced postoperative survival compared to patients with RV dysfunction (no RV failure = 651.4 ± 609.8 days, RV failure = 392.6 ± 444.8 days, RVAD = 89.3 ± 72.8 days; p < 0.001). In conclusion, MELD can be used to reliably predict postoperative right heart failure and the necessity for RVAD implantation. Those patients with RV failure and RVADs experience significantly increased postoperative mortality compared to those without RV dysfunction. PMID:26187243

  2. PTCH1 expression at diagnosis predicts imatinib failure in chronic myeloid leukaemia patients in chronic phase.

    PubMed

    Alonso-Dominguez, Juan M; Grinfeld, Jacob; Alikian, Mary; Marin, David; Reid, Alistair; Daghistani, Mustafa; Hedgley, Corinne; O'Brien, Stephen; Clark, Richard E; Apperley, Jane; Foroni, Letizia; Gerrard, Gareth

    2015-01-01

    The tyrosine kinase inhibitor (TKI) imatinib has revolutionized the management of chronic myeloid leukaemia (CML). However, around 25% of patients fail to sustain an adequate response. We sought to identify gene-expression biomarkers that could be used to predict imatinib response. The expression of 29 genes, previously implicated in CML pathogenesis, were measured by TaqMan Low Density Array in 73 CML patient samples. Patients were divided into low and high expression for each gene and imatinib failure (IF), probability of achieving CCyR, progression free survival and CML related OS were compared by Kaplan-Meier and log-rank. Results were validated in a second cohort of 56 patients, with a further technical validation using custom gene-expression assays in a conventional RT-qPCR in a sub-cohort of 37 patients. Patients with low PTCH1 expression showed a worse clinical response for all variables in all cohorts. PTCH1 was the most significant predictor in the multivariate analysis compared with Sokal, age and EUTOS. PTCH1 expression assay showed the adequate sensitivity, specificity and predictive values to predict for IF. Given the different treatments available for CML, measuring PTCH1 expression at diagnosis may help establish who will benefit best from imatinib and who is better selected for second generation TKI. PMID:25250944

  3. Predicting success or failure of brace treatment for adolescents with idiopathic scoliosis.

    PubMed

    Chalmers, Eric; Westover, Lindsey; Jacob, Johith; Donauer, Andreas; Zhao, Vicky H; Parent, Eric C; Moreau, Marc J; Mahood, James K; Hedden, Douglas M; Lou, Edmond H M

    2015-10-01

    Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity. Brace treatment is a common non-surgical treatment, intended to prevent progression (worsening) of the condition during adolescence. Estimating a braced patient's risk of progression is an essential part of planning treatment, so method for predicting this risk would be a useful decision support tool for practitioners. This work attempts to discover whether failure of brace treatment (progression) can be predicted at the start of treatment. Records were obtained for 62 AIS patients who had completed brace treatment. Subjects were labeled as "progressive" if their condition had progressed despite brace treatment and "non-progressive" otherwise. Wrapper-based feature selection selected two useful predictor variables from a list of 14 clinical measurements taken from the records. A logistic regression model was trained to classify patients as "progressive" or "non-progressive" using these two variables. The logistic regression model's simplicity and interpretability should facilitate its clinical acceptance. The model was tested on data from an additional 28 patients and found to be 75 % accurate. This accuracy is sufficient to make the predictions clinically useful. It can be used online: http://www.ece.ualberta.ca/~dchalmer/SimpleBracePredictor.html . PMID:26002592

  4. Predicting success or failure of brace treatment for adolescents with idiopathic scoliosis.

    PubMed

    Chalmers, Eric; Westover, Lindsey; Jacob, Johith; Donauer, Andreas; Zhao, Vicky H; Parent, Eric C; Moreau, Marc J; Mahood, James K; Hedden, Douglas M; Lou, Edmond H M

    2015-10-01

    Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity. Brace treatment is a common non-surgical treatment, intended to prevent progression (worsening) of the condition during adolescence. Estimating a braced patient's risk of progression is an essential part of planning treatment, so method for predicting this risk would be a useful decision support tool for practitioners. This work attempts to discover whether failure of brace treatment (progression) can be predicted at the start of treatment. Records were obtained for 62 AIS patients who had completed brace treatment. Subjects were labeled as "progressive" if their condition had progressed despite brace treatment and "non-progressive" otherwise. Wrapper-based feature selection selected two useful predictor variables from a list of 14 clinical measurements taken from the records. A logistic regression model was trained to classify patients as "progressive" or "non-progressive" using these two variables. The logistic regression model's simplicity and interpretability should facilitate its clinical acceptance. The model was tested on data from an additional 28 patients and found to be 75 % accurate. This accuracy is sufficient to make the predictions clinically useful. It can be used online: http://www.ece.ualberta.ca/~dchalmer/SimpleBracePredictor.html .

  5. The EST Model for Predicting Progressive Damage and Failure of Open Hole Bending Specimens

    NASA Technical Reports Server (NTRS)

    Joseph, Ashith P. K.; Waas, Anthony M.; Pineda, Evan J.

    2016-01-01

    Progressive damage and failure in open hole composite laminate coupons subjected to flexural loading is modeled using Enhanced Schapery Theory (EST). Previous studies have demonstrated that EST can accurately predict the strength of open hole coupons under remote tensile and compressive loading states. This homogenized modeling approach uses single composite shell elements to represent the entire laminate in the thickness direction and significantly reduces computational cost. Therefore, when delaminations are not of concern or are active in the post-peak regime, the version of EST presented here is a good engineering tool for predicting deformation response. Standard coupon level tests provides all the input data needed for the model and they are interpreted in conjunction with finite element (FE) based simulations. Open hole bending test results of three different IM7/8552 carbon fiber composite layups agree well with EST predictions. The model is able to accurately capture the curvature change and deformation localization in the specimen at and during the post catastrophic load drop event.

  6. Predictors for an unsuccessful INtubation-SURfactant-Extubation procedure: a cohort study

    PubMed Central

    2014-01-01

    Background The INtubation-SURfactant-Extubation (INSURE) is a procedure that is increasingly being used to treat the respiratory distress syndrome in preterm infants. The objective of this study was to identify predictors for an unsuccessful INSURE procedure. Methods The neonates included were less than 32 weeks’ gestation, treated with surfactant in the neonatal intensive care unit, and born 1998–2010. INSURE was defined as surfactant administration during intubation for less than 2 hours without the need for mechanical ventilation. INSURE success was defined as no re-intubation within 72 hours after INSURE, and INSURE failure was defined as re-intubation within 72 hours after INSURE. An unsuccessful INSURE procedure was either INSURE failure or mechanical ventilation for more than 24 hours immediately after surfactant administration. All predictors were defined a priori and were present before surfactant administration. Multivariate logistic regression was performed. Results In total, 322 neonates were included: 31% (n = 100) had INSURE success, 10% (n = 33) had INSURE failure, 49% (n = 158) needed mechanical ventilation for more than 24 hours, and the remaining 10% (n = 31) needed mechanical ventilation for less than 24 hours. Predictors for INSURE failure were low gestational age and hemoglobin below 8.5 mmol/l. Predictors for mechanical ventilation for more than 24 hours were low gestational age, Apgar at 5 minutes below 7, oxygen need above 50%, CO2 pressure above 7 kPa (~53 mmHg), pH below 7.3, lactate above 2.5 mmol/l, need for inotropes, and surfactant administration shortly after birth, whereas preeclampsia reduced the risk. Conclusions We identified specific predictors associated with an unsuccessful INSURE procedure. Keeping high-risk neonates with one or several predictors intubated and treated with mechanical ventilation after surfactant may prevent a re-intubation procedure. PMID:24947477

  7. A state-based approach to trend recognition and failure prediction for the Space Station Freedom

    NASA Technical Reports Server (NTRS)

    Nelson, Kyle S.; Hadden, George D.

    1992-01-01

    A state-based reasoning approach to trend recognition and failure prediction for the Altitude Determination, and Control System (ADCS) of the Space Station Freedom (SSF) is described. The problem domain is characterized by features (e.g., trends and impending failures) that develop over a variety of time spans, anywhere from several minutes to several years. Our state-based reasoning approach, coupled with intelligent data screening, allows features to be tracked as they develop in a time-dependent manner. That is, each state machine has the ability to encode a time frame for the feature it detects. As features are detected, they are recorded and can be used as input to other state machines, creating a hierarchical feature recognition scheme. Furthermore, each machine can operate independently of the others, allowing simultaneous tracking of features. State-based reasoning was implemented in the trend recognition and the prognostic modules of a prototype Space Station Freedom Maintenance and Diagnostic System (SSFMDS) developed at Honeywell's Systems and Research Center.

  8. Perineural invasion on prostate needle biopsy does not predict biochemical failure following brachytherapy for prostate cancer

    SciTech Connect

    Weight, Christopher J.; Ciezki, Jay P.; Reddy, Chandana A.; Zhou Ming; Klein, Eric A.

    2006-06-01

    Purpose: To determine if the presence of perineural invasion (PNI) predicts biochemical recurrence in patients who underwent low-dose-rate brachytherapy for the treatment of localized prostate cancer. Methods and Materials: A retrospective case control matching study was performed. The records of 651 patients treated with brachytherapy between 1996 and 2003 were reviewed. Sixty-three of these patients developed biochemical failure. These sixty-three patients were then matched in a one-to-one ratio to patients without biochemical failure, controlling for biopsy Gleason score, clinical stage, initial prostate-specific antigen, age, and the use of androgen deprivation. The pathology of the entire cohort was then reviewed for evidence of perineural invasion on initial prostate biopsy specimens. The biochemical relapse free survival rates for these two groups were compared. Results: Cases and controls were well matched, and there were no significant differences between the two groups in age, Gleason grade, clinical stage, initial prostate-specific antigen, and the use of androgen deprivation. PNI was found in 19 (17%) patients. There was no significant difference in the rates of PNI between cases and controls, 19.6% and 14.3% respectively (p 0.45). PNI did not correlate with biochemical relapse free survival (p 0.40). Conclusion: Perineural invasion is not a significant predictor of biochemical recurrence in patients undergoing brachytherapy for prostate cancer.

  9. Failure Predictions for VHTR Core Components using a Probabilistic Contiuum Damage Mechanics Model

    SciTech Connect

    Fok, Alex

    2013-10-30

    The proposed work addresses the key research need for the development of constitutive models and overall failure models for graphite and high temperature structural materials, with the long-term goal being to maximize the design life of the Next Generation Nuclear Plant (NGNP). To this end, the capability of a Continuum Damage Mechanics (CDM) model, which has been used successfully for modeling fracture of virgin graphite, will be extended as a predictive and design tool for the core components of the very high- temperature reactor (VHTR). Specifically, irradiation and environmental effects pertinent to the VHTR will be incorporated into the model to allow fracture of graphite and ceramic components under in-reactor conditions to be modeled explicitly using the finite element method. The model uses a combined stress-based and fracture mechanics-based failure criterion, so it can simulate both the initiation and propagation of cracks. Modern imaging techniques, such as x-ray computed tomography and digital image correlation, will be used during material testing to help define the baseline material damage parameters. Monte Carlo analysis will be performed to address inherent variations in material properties, the aim being to reduce the arbitrariness and uncertainties associated with the current statistical approach. The results can potentially contribute to the current development of American Society of Mechanical Engineers (ASME) codes for the design and construction of VHTR core components.

  10. Failure Mechanisms and Life Prediction of Thermal and Environmental Barrier Coatings under Thermal Gradients

    NASA Technical Reports Server (NTRS)

    Zju, Dongming; Ghosn, Louis J.; Miller, Robert A.

    2008-01-01

    Ceramic thermal and environmental barrier coatings (TEBCs) will play an increasingly important role in gas turbine engines because of their ability to further raise engine temperatures. However, the issue of coating durability is of major concern under high-heat-flux conditions. In particular, the accelerated coating delamination crack growth under the engine high heat-flux conditions is not well understood. In this paper, a laser heat flux technique is used to investigate the coating delamination crack propagation under realistic temperature-stress gradients and thermal cyclic conditions. The coating delamination mechanisms are investigated under various thermal loading conditions, and are correlated with coating dynamic fatigue, sintering and interfacial adhesion test results. A coating life prediction framework may be realized by examining the crack initiation and propagation driving forces for coating failure under high-heat-flux test conditions.

  11. A Novel Method for the Prediction of Critical Inclusion Size Leading to Fatigue Failure

    NASA Astrophysics Data System (ADS)

    Saberifar, S.; Mashreghi, A. R.

    2012-06-01

    The fatigue behavior of two commercial 30MnVS6 steels with similar microstructure and mechanical properties containing inclusions of different sizes were studied in the 107 cycles fatigue regime. The scanning electron microscopy (SEM) investigations of the fracture surfaces revealed that the nonmetallic inclusions are the main sources of fatigue crack initiation. Calculated according to the Murakami's model, the stress intensity factors were found to be suitable for the assessment of fatigue behavior. In this article, a new method is proposed for the prediction of the critical inclusion size, using Murakami's model. According to this method, a critical stress intensity factor was determined for the estimation of the critical inclusion size causing the fatigue failure.

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

    SciTech Connect

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

    1998-03-01

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

  13. Predicting Biochemical Failure and Overall Survival Through Intratherapy PSA Changes During Definitive External Beam Radiotherapy

    SciTech Connect

    Soto, Daniel E.; Andridge, Rebecca R.; Taylor, Jeremy M.G.; McLaughlin, Patrick W.; Sandler, Howard M.; Pan, Charlie C.

    2008-12-01

    Purpose: To determine whether intratherapy prostate-specific antigen (itPSA) changes during radiotherapy (RT) predict prostate cancer outcomes. Methods and Materials: We retrospectively identified patients treated with definitive external beam RT without hormonal therapy who had at least two itPSA measurements. We calculated the adjusted ratio of rise (ARR) in itPSA relative to the pretreatment baseline PSA for each patient. This was defined as ln(maximal itPSA + 1)/ln(baseline PSA + 1). We stratified patients according to an ARR of <1 vs. >1.1. This corresponded to an approximately <30% vs. >30% increase in PSA during RT. Univariate and multivariate analyses were performed examining for biochemical failure-free survival (BFFS) and overall survival (OS). Results: At a median follow-up of 74 months, we identified 307 patients who met our criteria. Univariate analysis revealed that patients with an ARR of <1.1 (n = 182) had statistically significant inferior BFFS and OS compared with those with an ARR of >1.1 (n = 125). The median BFFS and OS for these two groups was 51 vs. 101 months (p = 0.001) and 96 vs. 128 months (p = 0.01), respectively. On multivariate analysis, the effect of ARR on the risk of biochemical failure for patients with an ARR of <1.1 was significant (p = 0.03) only during the first year after RT. In contrast, the effect of the ARR on OS remained significant for a full 5 years (p = 0.05). Conclusion: The results of our study have shown that an ARR of <1.1 predicts for inferior BFFS and OS in patients treated with RT alone. PSA measurement during RT is a novel clinical tool that could be used to identify patients who might warrant more aggressive therapeutic intervention.

  14. High-Sensitivity C-Reactive Protein Predicts Mortality and Technique Failure in Peritoneal Dialysis Patients

    PubMed Central

    Liu, Shou-Hsuan; Li, Yi-Jung; Wu, Hsin-Hsu; Lee, Cheng-Chia; Lin, Chan-Yu; Weng, Cheng-Hao; Chen, Yung-Chang; Chang, Ming-Yang; Hsu, Hsiang-Hao; Fang, Ji-Tseng; Hung, Cheng-Chieh; Yang, Chih-Wei; Tian, Ya-Chung

    2014-01-01

    Introduction An elevated level of serum C-reactive protein (CRP) is widely considered an indicator of an underlying inflammatory disease and a long-term prognostic predictor for dialysis patients. This cross-sectional cohort study was designed to assess the correlation between the level of high-sensitivity CRP (HS-CRP) and the outcome of peritoneal dialysis (PD) patients. Methods A total of 402 patients were stratified into 3 tertiles (lower, middle, upper) according to serum HS-CRP level and and followed up from October 2009 to September 2011. During follow-up, cardiovascular events, infection episodes, technique failure, and mortality rate were recorded. Results During the 24-month follow-up, 119 of 402 patients (29.6%) dropped out from PD, including 28 patients (7.0%) who died, 81 patients (20.1%) who switched to hemodialysis, and 10 patients (2.5%) who underwent kidney transplantation. The results of Kaplan–Meier analysis and log-rank test demonstrated a significant difference in the cumulative patient survival rate across the 3 tertiles (the lowest rate in upper tertile). On multivariate Cox regression analysis, only higher HS-CRP level, older age, the presence of diabetes mellitus (DM), lower serum albumin level, and the occurrence of cardiovascular events during follow-up were identified as independent predictors of mortality. Every 1 mg/L increase in HS-CRP level was independently predictive of a 1.4% increase in mortality. Multivariate Cox regression analysis also showed that higher HS-CRP level, the presence of DM, lower hemoglobin level, lower serum albumin level, higher dialysate/plasma creatinine ratio, and the occurrence of infective episodes and cardiovascular events during follow-up were independent predictors of technique failure. Conclusions The present study shows the importance of HS-CRP in the prediction of 2-year mortality and technique survival in PD patients independent of age, diabetes, hypoalbuminemia, and the occurrence of

  15. Predicting outcomes among patients with atrial fibrillation and heart failure receiving anticoagulation with warfarin.

    PubMed

    Kim, Eun-Jeong; Ozonoff, Al; Hylek, Elaine M; Berlowitz, Dan R; Ash, Aelene S; Miller, Donald R; Zhao, Shibei; Reisman, Joel I; Jasuja, Guneet K; Rose, Adam J

    2015-07-01

    Among patients receiving oral anticoagulation for atrial fibrillation (AF), heart failure (HF) is associated with poor anticoagulation control. However, it is not known which patients with heart failure are at greatest risk of adverse outcomes. We evaluated 62,156 Veterans Health Administration (VA) patients receiving warfarin for AF between 10/1/06-9/30/08 using merged VA-Medicare dataset. We predicted time in therapeutic range (TTR) and rates of adverse events by categorising patients into those with 0, 1, 2, or 3+ of five putative markers of HF severity such as aspartate aminotransferase (AST)> 80 U/l, alkaline phosphatase> 150 U/l, serum sodium< 130 mEq/l, any receipt of metolazone, and any inpatient admission for HF exacerbation. These risk categories predicted TTR: patients without HF (referent) had a mean TTR of 65.0 %, while HF patients with 0, 1, 2, 3 or more markers had mean TTRs of 62.2 %, 57.2 %, 53.5 %, and 50.7 %, respectively (p< 0.001). These categories also discriminated for major haemorrhage well; compared to patients without HF, HF patients with increasing severity had hazard ratios of 1.84, 3.06, 3.52 and 5.14 respectively (p< 0.001). However, although patients with HF had an elevated hazard for bleeding compared to those without HF, these categories did not effectively discriminate risk of ischaemic stroke across HF. In conclusion, we developed a HF severity model using easily available clinical characteristics that performed well to risk-stratify patients with HF who are receiving anticoagulation for AF with regard to major haemorrhage. PMID:25948532

  16. Diastolic Heart Failure Predicted by Left Atrial Expansion Index in Patients with Severe Diastolic Dysfunction

    PubMed Central

    Hsiao, Shih-Hung; Chiou, Kuan-Rau

    2016-01-01

    Background Left atrial (LA) echocardiographic parameters are increasingly used to predict clinically relevant cardiovascular events. The study aims to evaluate the LA expansion index (LAEI) for predicting diastolic heart failure (HF) in patients with severe left ventricular (LV) diastolic dysfunction. Methods This prospective study enrolled 162 patients (65% male) with preserved LV systolic function and severe diastolic dysfunction (132 grade 2 patients, 30 grade 3 patients). All patients had sinus rhythm at enrollment. The LAEI was calculated as (Volmax - Volmin) x 100% / Volmin, where Volmax was defined as maximal LA volume and Volmin was defined as minimal volume. The endpoint was hospitalization for HF withp reserved LV ejection fraction (HFpEF). Results The median follow-up duration was 2.9 years. Fifty-four patients had cardiovascular events, including 41 diastolic and 8 systolic HF hospitalizations. In these 54 patients, 13 in-hospital deaths and 5 sudden out-of-hospital deaths occurred. Multivariate analyses revealed that HFpEF was associated with LAEI.and atrial fibrillation during follow-up. For predicting HFpEF, the LAEI had a hazard ratio of 1.197per 10% decrease. In patients who had HFpEF events, the LAEI significantly (P< 0.0001) decreased from 69±18% to 39±11% during hospitalization. Although the LAEI improved during follow-up (53±13%), it did not return to baseline. Conclusions The LAEI predicts HFpEF in patients with severe diastolic dysfunction; it worsens during HFpEF events and partially recovers during followup. PMID:27622475

  17. The failure analysis and lifetime prediction for the solder joint of the magnetic head

    NASA Astrophysics Data System (ADS)

    Xiao, Xianghui; Peng, Minfang; Cardoso, Jaime S.; Tang, Rongjun; Zhou, YingLiang

    2015-02-01

    Micro-solder joint (MSJ) lifetime prediction methodology and failure analysis (FA) are to assess reliability by fatigue model with a series of theoretical calculations, numerical simulation and experimental method. Due to shortened time of solder joints on high-temperature, high-frequency sampling error that is not allowed in productions may exist in various models, including round-off error. Combining intermetallic compound (IMC) growth theory and the FA technology for the magnetic head in actual production, this thesis puts forward a new growth model to predict life expectancy for solder joint of the magnetic head. And the impact of IMC, generating from interface reaction between slider (magnetic head, usually be called slider) and bonding pad, on mechanical performance during aging process is analyzed in it. By further researching on FA of solder ball bonding, thesis chooses AuSn4 growth model that affects least to solder joint mechanical property to indicate that the IMC methodology is suitable to forecast the solder lifetime. And the diffusion constant under work condition 60 °C is 0.015354; the solder lifetime t is 14.46 years.

  18. Long-term Failure Prediction based on an ARP Model of Global Risk Network

    NASA Astrophysics Data System (ADS)

    Lin, Xin; Moussawi, Alaa; Szymanski, Boleslaw; Korniss, Gyorgy

    Risks that threaten modern societies form an intricately interconnected network. Hence, it is important to understand how risk materializations in distinct domains influence each other. In the paper, we study the global risks network defined by World Economic Forum experts in the form of Stochastic Block Model. We model risks as Alternating Renewal Processes with variable intensities driven by hidden values of exogenous and endogenous failure probabilities. Based on the expert assessments and historical status of each risk, we use Maximum Likelihood Evaluation to find the optimal model parameters and demonstrate that the model considering network effects significantly outperforms the others. In the talk, we discuss how the model can be used to provide quantitative means for measuring interdependencies and materialization of risks in the network. We also present recent results of long-term predictions in the form of predicated distributions of materializations over various time periods. Finally we show how the simulation of ARP's enables us to probe limits of the predictability of the system parameters from historical data and ability to recover hidden variable. Supported in part by DTRA, ARL NS-CTA.

  19. Symptom Variability, Not Severity, Predicts Rehospitalization and Mortality in Patients with Heart Failure

    PubMed Central

    Moser, Debra K.; Frazier, Susan K.; Worrall-Carter, Linda; Biddle, Martha J.; Chung, Misook L.; Lee, Kyoung Suk; Lennie, Terry A.

    2010-01-01

    Background Inability of heart failure (HF) patients to recognize worsening symptoms that herald an exacerbation is a common reason for HF readmissions. Aims To examine the relationship between patterns of HF symptom variability, and HF event-free survival. Methods Patients with HF (N = 71) rated HF symptoms daily for 30 days. Symptoms were rated on a 10 point scale anchored at the extreme ends by “worst symptom could be” and “best symptom could be”. Patients were followed for an average of 1 year to track HF and cardiac rehospitalizations and all-cause mortality. Results Cox regression comparing event-free survival between patients who had highly variable symptom ratings across the 30-days and those whose symptoms were less variable revealed worse event-free survival in patients with more variable symptoms of shortness of breath or edema. Symptom variability predicted event-free survival independently of severity of symptoms, ejection fraction, comorbidities, age and gender. Symptom severity did not predict rehospitalization or mortality. Conclusion Regardless of symptom severity, patients whose symptoms fluctuated in an improving and worsening pattern were at substantially greater risk for poorer event-free survival. These patients may become accustomed to this pattern such that they expect symptoms to improve and thus do not seek treatment with worsening symptoms. PMID:20637697

  20. Life Prediction and Classification of Failure Modes in Solid State Luminaires Using Bayesian Probabilistic Models

    SciTech Connect

    Lall, Pradeep; Wei, Junchao; Sakalaukus, Peter

    2014-05-27

    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. 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. It is expected that, the new test technique will allow the development of failure distributions without testing till L70 life for the manifestation of failure.

  1. Serum microRNA expression patterns that predict early treatment failure in prostate cancer patients

    PubMed Central

    Singh, Prashant K.; Preus, Leah; Hu, Qiang; Yan, Li; Long, Mark D.; Morrison, Carl D.; Nesline, Mary; Johnson, Candace S.; Koochekpour, Shahriar; Kohli, Manish; Liu, Song; Trump, Donald L.

    2014-01-01

    We aimed to identify microRNA (miRNA) expression patterns in the serum of prostate cancer (CaP) patients that predict the risk of early treatment failure following radical prostatectomy (RP). Microarray and Q-RT-PCR analyses identified 43 miRNAs as differentiating disease stages within 14 prostate cell lines and reflectedpublically available patient data. 34 of these miRNA were detectable in the serum of CaP patients. Association with time to biochemical progression was examined in a cohort of CaP patients following RP. A greater than two-fold increase in hazard of biochemical progression associated with altered expression of miR-103, miR-125b and miR-222 (p <.0008) in the serum of CaP patients. Prediction models based on penalized regression analyses showed that the levels of the miRNAs and PSA together were better at detecting false positives than models without miRNAs, for similar level of sensitivity. Analyses of publically available data revealed significant and reciprocal relationships between changes in CpG methylation and miRNA expression patterns suggesting a role for CpG methylation to regulate miRNA. Exploratory validation supported roles for miR-222 and miR-125b to predict progression risk in CaP. The current study established that expression patterns of serum-detectable miRNAs taken at the time of RP are prognostic for men who are at risk of experiencing subsequent early biochemical progression. These non-invasive approaches could be used to augment treatment decisions. PMID:24583788

  2. Oxygen Uptake Efficiency Plateau Best Predicts Early Death in Heart Failure

    PubMed Central

    Hansen, James E.; Stringer, William W.

    2012-01-01

    Background: The responses of oxygen uptake efficiency (ie, oxygen uptake/ventilation = V˙o2/V˙e) and its highest plateau (OUEP) during incremental cardiopulmonary exercise testing (CPET) in patients with chronic left heart failure (HF) have not been previously reported. We planned to test the hypothesis that OUEP during CPET is the best single predictor of early death in HF. Methods: We evaluated OUEP, slope of V˙o2 to log(V˙e) (oxygen uptake efficiency slope), oscillatory breathing, and all usual resting and CPET measurements in 508 patients with low-ejection-fraction (< 35%) HF. Each had further evaluations at other sites, including cardiac catheterization. Outcomes were 6-month all-reason mortality and morbidity (death or > 24 h cardiac hospitalization). Statistical analyses included area under curve of receiver operating characteristics, ORs, univariate and multivariate Cox regression, and Kaplan-Meier plots. Results: OUEP, which requires only moderate exercise, was often reduced in patients with HF. A low % predicted OUEP was the single best predictor of mortality (P < .0001), with an OR of 13.0 (P < .001). When combined with oscillatory breathing, the OR increased to 56.3, superior to all other resting or exercise parameters or combinations of parameters. Other statistical analyses and morbidity analysis confirmed those findings. Conclusions: OUEP is often reduced in patients with HF. Low % predicted OUEP (< 65% predicted) is the single best predictor of early death, better than any other CPET or other cardiovascular measurement. Paired with oscillatory breathing, it is even more powerful. PMID:22030802

  3. Urinary Angiotensinogen Level Predicts AKI in Acute Decompensated Heart Failure: A Prospective, Two-Stage Study

    PubMed Central

    Yang, Xiaobing; Chen, Chunbo; Tian, Jianwei; Zha, Yan; Xiong, Yuqin; Sun, Zhaolin; Chen, Pingyan; Li, Jun; Yang, Tiecheng; Ma, Changsheng; Liu, Huafeng

    2015-01-01

    A major challenge in prevention and early treatment of acute cardiorenal syndrome (CRS) is the lack of high-performance predictors. To test the hypothesis that urinary angiotensinogen (uAGT) is an early predictor for acute CRS and 1-year prognosis in patients with acute decompensated heart failure (ADHF), we performed a prospective, two-stage, multicenter cohort study in patients with ADHF. In stage I (test set), 317 patients were recruited from four centers. In stage II (validation set), 119 patients were enrolled from two other centers. Daily uAGT levels were analyzed consecutively. AKI was defined according to Kidney Disease Improving Global Outcomes (KDIGO) Clinical Practice Guidelines. In stage I, 104 (32.8%) patients developed AKI during hospitalization. Daily uAGT peaked on the first hospital day in patients who subsequently developed AKI. After multivariable adjustment, the highest quartile of uAGT on admission was associated with a 50-fold increased risk of AKI compared with the lowest quartile. For predicting AKI, uAGT (area under the receiver-operating characteristic curve [AUC]=0.84) outperformed urinary neutrophil gelatinase-associated lipocalin (AUC=0.78), the urinary albumin/creatinine ratio (AUC=0.71), and the clinical model (AUC=0.77). Survivors in stage I were followed prospectively for 1 year after hospital discharge. The uAGT level independently predicted the risk of 1-year mortality (adjusted odds ratio, 4.5; 95% confidence interval, 2.1 to 9.5) and rehospitalization (adjusted odds ratio, 3.6; 95% confidence interval, 1.6 to 5.7). The ability of uAGT in predicting AKI was validated in stage II (AUC=0.79). In conclusion, uAGT is a strong predictor for acute CRS and 1-year prognosis in ADHF. PMID:25722365

  4. Risk factors predictive of right ventricular failure after left ventricular assist device implantation.

    PubMed

    Drakos, Stavros G; Janicki, Lindsay; Horne, Benjamin D; Kfoury, Abdallah G; Reid, Bruce B; Clayson, Stephen; Horton, Kenneth; Haddad, Francois; Li, Dean Y; Renlund, Dale G; Fisher, Patrick W

    2010-04-01

    Right ventricular failure (RVF) after left ventricular assist device (LVAD) implantation appears to be associated with increased mortality. However, the determination of which patients are at greater risk of developing postoperative RVF remains controversial and relatively unknown. We sought to determine the preoperative risk factors for the development of RVF after LVAD implantation. The data were obtained for 175 consecutive patients who had received an LVAD. RVF was defined by the need for inhaled nitric oxide for >/=48 hours or intravenous inotropes for >14 days and/or right ventricular assist device implantation. An RVF risk score was developed from the beta coefficients of the independent variables from a multivariate logistic regression model predicting RVF. Destination therapy (DT) was identified as the indication for LVAD implantation in 42% of our patients. RVF after LVAD occurred in 44% of patients (n = 77). The mortality rates for patients with RVF were significantly greater at 30, 180, and 365 days after implantation compared to patients with no RVF. By multivariate logistic regression analysis, 3 preoperative factors were significantly associated with RVF after LVAD implantation: (1) a preoperative need for intra-aortic balloon counterpulsation, (2) increased pulmonary vascular resistance, and (3) DT. The developed RVF risk score effectively stratified the risk of RV failure and death after LVAD implantation. In conclusion, given the progressively growing need for DT, the developed RVF risk score, derived from a population with a large percentage of DT patients, might lead to improved patient selection and help stratify patients who could potentially benefit from early right ventricular assist device implantation. PMID:20346326

  5. Prediction factors for failure to seek treatment following traumatic dental injuries to primary teeth.

    PubMed

    Firmino, Ramon Targino; Siqueira, Maria Betânia Lins Dantas; Vieira-Andrade, Raquel Gonçalves; Gomes, Genara Brum; Martins, Carolina Castro; Paiva, Saul Martins; Granville-Garcia, Ana Flávia

    2014-01-01

    The objective of this study was to evaluate prediction factors for failure to seek treatment following a traumatic dental injury (TDI) to primary teeth among preschool children in the city of Campina Grande, Brazil. A cross-sectional study was carried out involving 277 children 3 to 5 years of age, with TDI, enrolled in public and private preschools. Parents filled out a form addressing demographic data and whether or not they had sought treatment. Clinical examinations were performed by three dentists who had undergone a calibration exercise (Kappa: 0.85 to 0.90) for the evaluation of TDI. Bivariate and multivariate Poisson regression models were constructed (α=5%). Enamel fracture was the most prevalent type of TDI (48.7%) and the upper central incisors were the most affected teeth (88.4%). The frequency of seeking dental treatment was low (9.7%). The following variables were associated with failure to seek treatment following TDI: a household income greater than one minimum wage (PR=1.170; 95%CI 1.018-1.341), parents/caregivers' perception of a child's oral health as poor (PR=1.100; 95%CI 1.026-1.176), and the non-perception of TDI by parents/caregivers (PR=1.250; 95%CI 1.142-1.360). In the present study, the frequency of seeking treatment following TDI was low, and parents/caregivers with a higher income, a poor perception of their child's oral health and a lack of awareness regarding the trauma were more likely to fail to seek treatment following TDI to primary teeth.

  6. Prediction factors for failure to seek treatment following traumatic dental injuries to primary teeth.

    PubMed

    Firmino, Ramon Targino; Siqueira, Maria Betânia Lins Dantas; Vieira-Andrade, Raquel Gonçalves; Gomes, Genara Brum; Martins, Carolina Castro; Paiva, Saul Martins; Granville-Garcia, Ana Flávia

    2014-01-01

    The objective of this study was to evaluate prediction factors for failure to seek treatment following a traumatic dental injury (TDI) to primary teeth among preschool children in the city of Campina Grande, Brazil. A cross-sectional study was carried out involving 277 children 3 to 5 years of age, with TDI, enrolled in public and private preschools. Parents filled out a form addressing demographic data and whether or not they had sought treatment. Clinical examinations were performed by three dentists who had undergone a calibration exercise (Kappa: 0.85 to 0.90) for the evaluation of TDI. Bivariate and multivariate Poisson regression models were constructed (α=5%). Enamel fracture was the most prevalent type of TDI (48.7%) and the upper central incisors were the most affected teeth (88.4%). The frequency of seeking dental treatment was low (9.7%). The following variables were associated with failure to seek treatment following TDI: a household income greater than one minimum wage (PR=1.170; 95%CI 1.018-1.341), parents/caregivers' perception of a child's oral health as poor (PR=1.100; 95%CI 1.026-1.176), and the non-perception of TDI by parents/caregivers (PR=1.250; 95%CI 1.142-1.360). In the present study, the frequency of seeking treatment following TDI was low, and parents/caregivers with a higher income, a poor perception of their child's oral health and a lack of awareness regarding the trauma were more likely to fail to seek treatment following TDI to primary teeth. PMID:24918361

  7. Pro: early extubation in the operating room following cardiac surgery in adults.

    PubMed

    Singh, Karen E; Baum, Victor C

    2012-12-01

    There is growing evidence that the general current approach in many centers of continued mechanical ventilation following cardiac surgery has evolved through historical experience rather than having a strong physiological basis in current practice. There is evidence going back several decades supporting very early (in the operating room [OR]) extubation in pediatric cardiac anesthesia. The authors provide evidence from numerous sources showing that extubation in the OR or shortly after arrival in the ICU is safe and cost-effective and is not prevented by the type of cardiac surgery or the use of cardiopulmonary bypass. They query if the paradigm should not be reversed and very early extubation be the routine unless contraindicated. Like any anesthetic technique, appropriate patient selection is called for, but this technique is widely appropriate. PMID:22798230

  8. A Statistical Approach to Predict the Failure Enthalpy and Reliability of Irradiated PWR Fuel Rods During Reactivity-Initiated Accidents

    SciTech Connect

    Nam, Cheol; Jeong, Yong-Hwan; Jung, Youn-Ho

    2001-11-15

    During the last decade, the failure behavior of high-burnup fuel rods under a reactivity-initiated accident (RIA) condition has been a serious concern since fuel rod failures at low enthalpy have been observed. This has resulted in the reassessment of existing licensing criteria and failure-mode study. To address the issue, a statistics-based methodology is suggested to predict failure probability of irradiated fuel rods under an RIA. Based on RIA simulation results in the literature, a failure enthalpy correlation for an irradiated fuel rod is constructed as a function of oxide thickness, fuel burnup, and pulse width. Using the failure enthalpy correlation, a new concept of ''equivalent enthalpy'' is introduced to reflect the effects of the three primary factors as well as peak fuel enthalpy into a single damage parameter. Moreover, the failure distribution function with equivalent enthalpy is derived, applying a two-parameter Weibull statistical model. Finally, the sensitivity analysis is carried out to estimate the effects of burnup, corrosion, peak fuel enthalpy, pulse width, and cladding materials used.

  9. Failure-plane angle in Bentheim sandstone subjected to true triaxial stresses: experimental results and theoretical prediction

    NASA Astrophysics Data System (ADS)

    Ma, Xiaodong; Rudnicki, John; Haimson, Bezalel

    2014-05-01

    We conducted true triaxial tests in the high-porosity (n = 24%), quartz-rich (95%), Bentheim sandstone. An important objective was to investigate the dependence of failure-plane angle θ (angle between the normal to the plane and σ1 direction) on the prevailing stress conditions. We employed two distinct loading paths, and seven σ3 magnitudes (between 0 and 150 MPa). In tests using the common loading path, σ2 and σ3 were fixed, while σ1 was raised monotonically to failure. In tests using the novel loading path (which facilitate comparison with theoretical predictions), σ3 was fixed, and the Lode angle, Θ (= tan-1 [(σ1 - 2σ2 + σ3) / 30.5(σ1 - σ3)]) was kept constant by raising σ1 and σ2 simultaneously at a set ratio b [= (σ2 -σ3)/(σ1 -σ3)] until failure occurred. Six stress ratios b (= 0, 1/6, 1/3, 1/2, 3/4, 1), i.e. six Θ (= tan-1 [(1-2b) / 30.5]) values from +π/6 (axisymmetric compression) to -π/6 (axisymmetric extension) were used. In axisymmetric common loading path tests, failure-plane angle θ generally declined as the applied σ3 = σ2 increased from about 80° at σ3 = σ2 = 0 MPa to 0° at σ3 = σ2 = 150 MPa (forming compaction bands). In tests where σ3 ≠ σ2, the resulting failure-plane strike was consistently parallel to σ2 direction. For low σ3, θ typically rose by up to 12° as σ2 rose from σ2 = σ3 to σ2 = σ1. However, the rise in θ with σ2 tended to diminish at higher σ3. A limiting case occurred at σ3 = 150 MPa, where failure plane remained at 0° , regardless of the rise in σ2. In the novel loading path tests, failure-plane angle θ declined monotonically for any given Lode angle Θ, from roughly 80° to 0° , as the mean stress at failure (σoct,f) rose from about 20 MPa to around 220 MPa; for a constant σoct,f, θ typically increased from 10° (at σoct,f = 20 MPa) to 30° (at σoct,f = 220 MPa) as Θ dropped from +π/6 (σ2 = σ3) to -π/6 (σ2 = σ1). We compared the measured θ with that predicted using

  10. 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.

  11. Right Ventricular Longitudinal Strain Measures Independently Predict Chronic Heart Failure Mortality.

    PubMed

    Iacoviello, Massimo; Citarelli, Gaetano; Antoncecchi, Valeria; Romito, Roberta; Monitillo, Francesco; Leone, Marta; Puzzovivo, Agata; Lattarulo, Maria Silvia; Rizzo, Caterina; Caldarola, Pasquale; Ciccone, Marco Matteo

    2016-07-01

    The assessment of right ventricular (RV) function still remains a challenge. Two-dimensional (2D) speckle tracking has recently been proposed to evaluate right ventricular function by analyzing myocardial deformation. The aim of this study was to evaluate the role of 2D systolic strain measures of RV in predicting mortality in patients with chronic heart failure (HF). We enrolled 332 outpatients in a stable clinical condition and in conventional therapy. A right ventricular-focused four-chamber view was analyzed by 2D speckle tracking to evaluate the global longitudinal strain of RV (RV-GLS) and the strain of RV free wall (RV-fwLS). During a mean follow-up of 36 ± 26 months, 64 patients died. Both RV-GLS and RV-fwLS were associated with all-cause mortality in univariate (HR: 1.16; 95% CI: 1.10-1.23; P < 0.001; C-index: 0.72; and HR: 1.10; 95% CI: 1.06-1.15; P < 0.001; C-index: 0.68, respectively) as well as multivariate analysis (HR: 1.13; 95% CI: 1.05-1.21; P:0.001; C-index: 0.85; and HR: 1.07; 95% CI: 1.02-1.12; P:0.004; C-index: 0.84, respectively). In conclusion, our findings demonstrate the role of RV 2D strain measures to independently predict mortality. These data highlight the clinical usefulness of this echocardiographic approach in the daily management of HF outpatients.

  12. DNA Methylation-Guided Prediction of Clinical Failure in High-Risk Prostate Cancer

    PubMed Central

    Joniau, Steven; Lerut, Evelyne; Laenen, Annouschka; Gevaert, Thomas; Gevaert, Olivier; Spahn, Martin; Kneitz, Burkhard; Gramme, Pierre; Helleputte, Thibault; Isebaert, Sofie; Haustermans, Karin; Bollen, Mathieu

    2015-01-01

    Background Prostate cancer (PCa) is a very heterogeneous disease with respect to clinical outcome. This study explored differential DNA methylation in a priori selected genes to diagnose PCa and predict clinical failure (CF) in high-risk patients. Methods A quantitative multiplex, methylation-specific PCR assay was developed to assess promoter methylation of the APC, CCND2, GSTP1, PTGS2 and RARB genes in formalin-fixed, paraffin-embedded tissue samples from 42 patients with benign prostatic hyperplasia and radical prostatectomy specimens of patients with high-risk PCa, encompassing training and validation cohorts of 147 and 71 patients, respectively. Log-rank tests, univariate and multivariate Cox models were used to investigate the prognostic value of the DNA methylation. Results Hypermethylation of APC, CCND2, GSTP1, PTGS2 and RARB was highly cancer-specific. However, only GSTP1 methylation was significantly associated with CF in both independent high-risk PCa cohorts. Importantly, trichotomization into low, moderate and high GSTP1 methylation level subgroups was highly predictive for CF. Patients with either a low or high GSTP1 methylation level, as compared to the moderate methylation groups, were at a higher risk for CF in both the training (Hazard ratio [HR], 3.65; 95% CI, 1.65 to 8.07) and validation sets (HR, 4.27; 95% CI, 1.03 to 17.72) as well as in the combined cohort (HR, 2.74; 95% CI, 1.42 to 5.27) in multivariate analysis. Conclusions Classification of primary high-risk tumors into three subtypes based on DNA methylation can be combined with clinico-pathological parameters for a more informative risk-stratification of these PCa patients. PMID:26086362

  13. Serum Uric Acid Predicts Declining of Circulating Proangiogenic Mononuclear Progenitor Cells in Chronic Heart Failure Patients

    PubMed Central

    Berezin, Alexander E.; Kremzer, Alexander A.; Samura, Tatyana A.; Berezina, Tatyana A.; Martovitskaya, Yulia V.

    2014-01-01

    Introduction: Serum uric acid (SUA) is considered a marker for natural progression of chronic heart failure (CHF) mediated cardiovascular remodelling. CHF associates with declining of circulating mononuclear progenitor cells (MPCs). The objective of this study was to evaluate the interrelationship between SUA concentrations and proangiogenic MPCs in ischemic CHF patients. Methods: The study population was structured retrospectively after determining the coronary artery disease (CAD) by contrast-enhanced spiral computed tomography angiography in 126 subjects with symptomatic ischemic mild-to-severe CHF and 128 CAD subjects without CHF. Baseline biomarkers were measured in all patients. Cox proportional multivariate hazard ratio was calculated for predictors of MPCs declining in both CHF and non-CHF patient population predictors of MPCs declining in CHF subjects were examined in stepwise logistic regression. C-statistics, integrated discrimination indices (IDI) and net-reclassification improvement were utilized for prediction performance analyses. Results: Cox proportional adjusted hazard ratio analyses for CD14+CD309+ and CD14+CD309+Tie2+ MPCs by SUA has shown that the higher quartiles (Q3 and Q4) of SUA compared to the lower quartiles (Q1 and Q2) are associated with increased risks of depletion of both CD14+CD309+ and CD14+CD309+Tie2+ MPCs. The addition of Q4 SUA to the ABC model improved the relative IDI by 13.8% for depletion of CD14+CD309+ MPCs and by 14.5% for depletion of CD14+CD309+Tie2+ MPCs. Conclusion: Circulating levels of proangiogenic MPCs are declined progressively depending on the levels of SUA in the HF subjects with CHF. We suggest that even mild elevations of SUA might be used to predict of relative depletion of proangiogenic MPCs among chronic HF patients. PMID:25320662

  14. Early warning and clinical outcome prediction of acute-on-chronic hepatitis B liver failure

    PubMed Central

    Chen, En-Qiang; Zeng, Fan; Zhou, Ling-Yun; Tang, Hong

    2015-01-01

    Hepatitis B virus (HBV) associated acute-on-chronic liver failure (ACLF) is an increasingly recognized fatal liver disease encompassing a severe acute exacerbation of liver function in patients with chronic hepatitis B (CHB). Despite the introduction of an artificial liver support system and antiviral therapy, the short-term prognosis of HBV-ACLF is still extremely poor unless emergency liver transplantation is performed. In such a situation, stopping or slowing the progression of CHB to ACLF at an early stage is the most effective way of reducing the morbidity and mortality of HBV-ACLF. It is well-known that the occurrence and progression of HBV-ACLF is associated with many factors, and the outcomes of HBV-ACLF patients can be significantly improved if timely and appropriate interventions are provided. In this review, we highlight recent developments in early warning and clinical outcome prediction in patients with HBV-ACLF and provide an outlook for future research in this field. PMID:26576085

  15. Ambient seismic noise monitoring of a clay landslide: Toward failure prediction

    NASA Astrophysics Data System (ADS)

    Mainsant, Guénolé; Larose, Eric; Brönnimann, Cornelia; Jongmans, Denis; Michoud, Clément; Jaboyedoff, Michel

    2012-03-01

    Given that clay-rich landslides may become mobilized, leading to rapid mass movements (earthflows and debris flows), they pose critical problems in risk management worldwide. The most widely proposed mechanism leading to such flow-like movements is the increase in water pore pressure in the sliding mass, generating partial or complete liquefaction. This solid-to-liquid transition results in a dramatic reduction of mechanical rigidity in the liquefied zones, which could be detected by monitoring shear wave velocity variations. With this purpose in mind, the ambient seismic noise correlation technique has been applied to measure the variation in the seismic surface wave velocity in the Pont Bourquin landslide (Swiss Alps). This small but active composite earthslide-earthflow was equipped with continuously recording seismic sensors during spring and summer 2010. An earthslide of a few thousand cubic meters was triggered in mid-August 2010, after a rainy period. This article shows that the seismic velocity of the sliding material, measured from daily noise correlograms, decreased continuously and rapidly for several days prior to the catastrophic event. From a spectral analysis of the velocity decrease, it was possible to determine the location of the change at the base of the sliding layer. These results demonstrate that ambient seismic noise can be used to detect rigidity variations before failure and could potentially be used to predict landslides.

  16. Predicting time-to-failure in rock extrapolated from secondary creep

    NASA Astrophysics Data System (ADS)

    Hao, Sheng-Wang; Zhang, Bao-Ju; Tian, Ji-Feng; Elsworth, Derek

    2014-03-01

    Stress relaxation experiments are reported that culminate in energetic failure in rocks analogous to the loading cycle and subsequent localization or reactivation on brittle faults embedded in an elastic medium. Universally, rapid primary deformation arrests and transitions into a long secondary deformation phase that ultimately accelerates to catastrophic rupture. Primary deformation (u) conforms to Andrade's law as du/dt ~ (tc - t0)θ with a standard exponent of 2/3. In the long, and readily observable, secondary phase, the samples both deform and analogously shed load near linearly in time. This stress relaxation rate exhibits a robust power law dependency with time-to-rupture and exhibits the same 2/3 power law exponent observed in the primary phase. Similarly, the brittle strain energy released in the tertiary collapse scales with a normalized secondary stress relaxation rate. Together, these observations suggest a way to predict both the timing of rupture and its energetics from the observed stress (or strain) rate during the secondary relaxation stage.

  17. Prediction of the Chemoreflex Gain by Common Clinical Variables in Heart Failure

    PubMed Central

    Mirizzi, Gianluca; Giannoni, Alberto; Ripoli, Andrea; Iudice, Giovanni; Bramanti, Francesca; Emdin, Michele; Passino, Claudio

    2016-01-01

    Background Peripheral and central chemoreflex sensitivity, assessed by the hypoxic or hypercapnic ventilatory response (HVR and HCVR, respectively), is enhanced in heart failure (HF) patients, is involved in the pathophysiology of the disease, and is under investigation as a potential therapeutic target. Chemoreflex sensitivity assessment is however demanding and, therefore, not easily applicable in the clinical setting. We aimed at evaluating whether common clinical variables, broadly obtained by routine clinical and instrumental evaluation, could predict increased HVR and HCVR. Methods and results 191 patients with systolic HF (left ventricular ejection fraction—LVEF—<50%) underwent chemoreflex assessment by rebreathing technique to assess HVR and HCVR. All patients underwent clinical and neurohormonal evaluation, comprising: echocardiogram, cardiopulmonary exercise test (CPET), daytime cardiorespiratory monitoring for breathing pattern evaluation. Regarding HVR, multivariate penalized logistic regression, Bayesian Model Averaging (BMA) logistic regression and random forest analysis identified, as predictors, the presence of periodic breathing and increased slope of the relation between ventilation and carbon dioxide production (VE/VCO2) during exercise. Again, the above-mentioned statistical tools identified as HCVR predictors plasma levels of N-terminal fragment of proBNP and VE/VCO2 slope. Conclusions In HF patients, the simple assessment of breathing pattern, alongside with ventilatory efficiency during exercise and natriuretic peptides levels identifies a subset of patients presenting with increased chemoreflex sensitivity to either hypoxia or hypercapnia. PMID:27099934

  18. Single baseline serum creatinine measurements predict mortality in critically ill patients hospitalized for acute heart failure

    PubMed Central

    Schefold, Joerg C.; Hodoscek, Lea Majc; Blöchlinger, Stefan; Doehner, Wolfram; von Haehling, Stephan

    2015-01-01

    Abstract Background Acute heart failure (AHF) is a leading cause of death in critically ill patients and is often accompanied by significant renal dysfunction. Few data exist on the predictive value of measures of renal dysfunction in large cohorts of patients hospitalized for AHF. Methods Six hundred and eighteen patients hospitalized for AHF (300 male, aged 73.3 ± 10.3 years, 73% New York Heart Association Class 4, mean hospital length of stay 12.9 ± 7.7 days, 97% non‐ischaemic AHF) were included in a retrospective single‐centre data analysis. Echocardiographic data, serum creatinine/urea levels, estimated glomerular filtration rate (eGFR), and clinical/laboratory markers were recorded. Mean follow‐up time was 2.9 ± 2.1 years. All‐cause mortality was recorded, and univariate/multivariate analyses were performed. Results Normal renal function defined as eGFR > 90 mL/min/1.73 m2 was noted in only 3% of AHF patients at baseline. A significant correlation of left ventricular ejection fraction with serum creatinine levels and eGFR (all P < 0.002) was noted. All‐cause mortality rates were 12% (90 days) and 40% (at 2 years), respectively. In a multivariate model, increased age, higher New York Heart Association class at admission, higher total cholesterol levels, and lower eGFR independently predicted death. Patients with baseline eGFR < 30 mL/min/1.73 m2 had an exceptionally high risk of death (odds ratio 2.80, 95% confidence interval 1.52–5.15, P = 0.001). Conclusions In a large cohort of patients with mostly non‐ischaemic AHF, enhanced serum creatinine levels and reduced eGFR independently predict death. It appears that patients with eGFR < 30 mL/min/1.73 m2 have poorest survival rates. Our data add to mounting data indicating that impaired renal function is an important risk factor for non‐survival in patients hospitalized for AHF.

  19. Genomic Prostate Cancer Classifier Predicts Biochemical Failure and Metastases in Patients After Postoperative Radiation Therapy

    SciTech Connect

    Den, Robert B.; Feng, Felix Y.; Showalter, Timothy N.; Mishra, Mark V.; Trabulsi, Edouard J.; Lallas, Costas D.; Gomella, Leonard G.; Kelly, W. Kevin; Birbe, Ruth C.; McCue, Peter A.; Ghadessi, Mercedeh; Yousefi, Kasra; Davicioni, Elai; Knudsen, Karen E.; Dicker, Adam P.

    2014-08-01

    Purpose: To test the hypothesis that a genomic classifier (GC) would predict biochemical failure (BF) and distant metastasis (DM) in men receiving radiation therapy (RT) after radical prostatectomy (RP). Methods and Materials: Among patients who underwent post-RP RT, 139 were identified for pT3 or positive margin, who did not receive neoadjuvant hormones and had paraffin-embedded specimens. Ribonucleic acid was extracted from the highest Gleason grade focus and applied to a high-density-oligonucleotide microarray. Receiver operating characteristic, calibration, cumulative incidence, and Cox regression analyses were performed to assess GC performance for predicting BF and DM after post-RP RT in comparison with clinical nomograms. Results: The area under the receiver operating characteristic curve of the Stephenson model was 0.70 for both BF and DM, with addition of GC significantly improving area under the receiver operating characteristic curve to 0.78 and 0.80, respectively. Stratified by GC risk groups, 8-year cumulative incidence was 21%, 48%, and 81% for BF (P<.0001) and for DM was 0, 12%, and 17% (P=.032) for low, intermediate, and high GC, respectively. In multivariable analysis, patients with high GC had a hazard ratio of 8.1 and 14.3 for BF and DM. In patients with intermediate or high GC, those irradiated with undetectable prostate-specific antigen (PSA ≤0.2 ng/mL) had median BF survival of >8 years, compared with <4 years for patients with detectable PSA (>0.2 ng/mL) before initiation of RT. At 8 years, the DM cumulative incidence for patients with high GC and RT with undetectable PSA was 3%, compared with 23% with detectable PSA (P=.03). No outcome differences were observed for low GC between the treatment groups. Conclusion: The GC predicted BF and metastasis after post-RP irradiation. Patients with lower GC risk may benefit from delayed RT, as opposed to those with higher GC; however, this needs prospective validation. Genomic-based models

  20. Serum Procalcitonin and Peripheral Venous Lactate for Predicting Dengue Shock and/or Organ Failure: A Prospective Observational Study

    PubMed Central

    Thanachartwet, Vipa; Desakorn, Varunee; Sahassananda, Duangjai; Jittmittraphap, Akanitt; Oer-areemitr, Nittha; Osothsomboon, Sathaporn; Surabotsophon, Manoon; Wattanathum, Anan

    2016-01-01

    Background Currently, there are no biomarkers that can predict the incidence of dengue shock and/or organ failure, although the early identification of risk factors is important in determining appropriate management to reduce mortality. Therefore, we sought to determine the factors associated with dengue shock and/or organ failure and to evaluate the prognostic value of serum procalcitonin (PCT) and peripheral venous lactate (PVL) levels as biomarkers of dengue shock and/or organ failure. Methodology/Principal Findings A prospective observational study was conducted among adults hospitalized for confirmed viral dengue infection at the Hospital for Tropical Diseases in Bangkok, Thailand between October 2013 and July 2015. Data, including baseline characteristics, clinical parameters, laboratory findings, serum PCT and PVL levels, management, and outcomes, were recorded on pre-defined case report forms. Of 160 patients with dengue, 128 (80.0%) patients had dengue without shock or organ failure, whereas 32 (20.0%) patients developed dengue with shock and/or organ failure. Using a stepwise multivariate logistic regression analysis, PCT ≥0.7 ng/mL (odds ratio [OR]: 4.80; 95% confidence interval [CI]: 1.60–14.45; p = 0.005) and PVL ≥2.5 mmol/L (OR: 27.99, 95% CI: 8.47–92.53; p <0.001) were independently associated with dengue shock and/or organ failure. A combination of PCT ≥0.7 ng/mL and PVL ≥2.5 mmol/L provided good prognostic value for predicting dengue shock and/or organ failure, with an area under the receiver operating characteristics curve of 0.83 (95% CI: 0.74–0.92), a sensitivity of 81.2% (95% CI: 63.6–92.8%), and a specificity of 84.4% (95% CI: 76.9–90.2%). Dengue shock patients with non-clearance of PCT and PVL expired during hospitalization. Conclusions/Significance PCT ≥0.7 ng/mL and PVL ≥2.5 mmol/L were independently associated with dengue shock and/or organ failure. The combination of PCT and PVL levels could be used as prognostic

  1. Application of an interface failure model to predict fatigue crack growth in an implanted metallic femoral stem.

    PubMed

    Chen, J; Browne, M; Taylor, M; Gregson, P J

    2004-03-01

    A novel computational modelling technique has been developed for the prediction of crack growth in load bearing orthopaedic alloys subjected to fatigue loading. Elastic-plastic fracture mechanics has been used to define a three-dimensional fracture model, which explicitly models the opening, sliding and tearing process. This model consists of 3D nonlinear spring elements implemented in conjunction with a brittle material failure function, which is defined by the fracture energy for each nonlinear spring element. Thus, the fracture energy criterion is implicit in the brittle material failure function to search for crack initiation and crack development automatically. A degradation function is employed to reduce interfacial fracture properties corresponding to the number of cycles; thus fatigue lifetime can be predicted. Unlike other failure modelling methods, this model predicts the failure load, crack path and residual stiffness directly without assuming any pre-flaw condition. As an example, fatigue of a cobalt based alloy (CoCrMo) femoral stem is simulated. Experimental fatigue data was obtained from four point bending tests. The finite element model simulated a fully embedded implant with a constant point load. Comparison between the model and mechanical test results showed good agreement in fatigue crack growth rate.

  2. Predicting treatment failure in patients with community acquired pneumonia: a case-control study

    PubMed Central

    2014-01-01

    Introduction Treatment failure in community-acquired-pneumonia (CAP) patients is associated with a high mortality rate, and therefore are a matter of great concern in clinical management. Those patients have increased mortality and are a target population for randomized clinical trials. Methods A case–control study was performed in patients with CAP (non-failure cases vs. failure cases, discriminating by late and early failure). CRP, PCT, interleukin 1, 6, 8 and 10 and TNF were determined at days 1 and 3 of hospitalization. Results A total of 253 patients were included in this study where 83 patients presented treatment failure. Of these, 40 (48.2%) had early failure. A discriminative effect was found for a higher CURB-65 score among late failure patients (p = 0.004). A significant increase on day 1 of hospitalization in CRP (p < 0.001), PCT (p = 0.004), IL-6 (p < 0.001) and IL-8 (p = 0.02), and a decrease in IL-1 (p = 0.06) in patients with failure was observed compared with patients without failure. On day 3, only the increase in CRP (p < 0.001), PCT (p = 0.007) and IL-6 (p < 0.001) remained significant. Independent predictors for early failure were higher IL-6 levels on day 1 (OR = 1.78, IC = 1.2-2.6) and pleural effusion (OR = 2.25, IC = 1.0-5.3), and for late failure, higher PCT levels on day 3 (OR = 1.60, IC = 1.0-2.5), CURB-65 score ≥ 3 (OR = 1.43, IC = 1.0-2.0), and multilobar involvement (OR = 4.50, IC = 2.1-9.9). Conclusions There was a good correlation of IL-6 levels and CAP failure and IL-6 & PCT with late CAP failure. Pleural effusion and multilobar involvement were simple clinical predictors of early and late failure, respectively. Trial registration IRB Register: http://2009/5451. PMID:24996572

  3. Inappropriate fixation of an endotracheal tube causing cuff malfunction resulting in difficult extubation.

    PubMed

    Nag, Deb Sanjay; Samaddar, Devi Prasad

    2016-01-01

    We discuss a case of difficult extubation, due to inadequate deflation of the tracheal tube cuff, despite collapse of the pilot balloon, on its aspiration. This was caused by inadvertent kinking of the pilot balloon tubing due to inappropriate tape fixation of the endotracheal tube. PMID:27591469

  4. Utility of Socioeconomic Status in Predicting 30-Day Outcomes After Heart Failure Hospitalization

    PubMed Central

    Eapen, Zubin J.; McCoy, Lisa A.; Fonarow, Gregg C.; Yancy, Clyde W.; Miranda, Marie Lynn; Peterson, Eric D.; Califf, Robert M.; Hernandez, Adrian F.

    2015-01-01

    Background An individual's socioeconomic status (SES) is associated with health outcomes and mortality, yet it is unknown whether accounting for SES can improve risk-adjustment models for 30-day outcomes among Centers for Medicare & Medicaid Services (CMS) beneficiaries hospitalized with heart failure (HF). Methods and Results We linked clinical data on hospitalized HF patients in the Get With The Guidelines®-HF™ database (01/2005–12/2011) with CMS claims and county-level SES data from the 2012 Area Health Resources Files. We compared the discriminatory capabilities of multivariable models that adjusted for SES, patient, and/or hospital characteristics to determine whether county-level SES data improved prediction or changed hospital rankings for 30-day all-cause mortality and rehospitalization. After adjusting for patient and hospital characteristics, median household income (per $5,000 increase) was inversely associated with odds of 30-day mortality (OR 0.97, 95% CI 0.95–1.00, p=0.032), and the percentage of persons with at least a high school diploma (per 5 unit increase) was associated with lower odds of 30-day rehospitalization (OR 0.95, 95% CI 0.91–0.99).After adjustment for county-level SES data, relative to whites, Hispanic ethnicity (OR 0.70, 95% CI 0.58, 0.83) and black race (OR 0.57, 95% CI: 0.50–0.65) remained significantly associated with lower 30-day mortality, but had similar 30-day rehospitalization. County-level SES did not improve risk adjustment or change hospital rankings for 30-day mortality or rehospitalization. Conclusions County-level SES data are modestly associated with 30-day outcomes for CMS beneficiaries hospitalized with HF, but do not improve risk adjustment models based on patient characteristics alone. PMID:25747700

  5. Time shift in slope failure prediction between unimodal and bimodal modeling approaches

    NASA Astrophysics Data System (ADS)

    Ciervo, Fabio; Casini, Francesca; Nicolina Papa, Maria; Medina, Vicente

    2016-04-01

    within the Bishop stress theory framework (Ciervo et al., 2015). The proposed work tends to emphasize how a more accurate slope stability analysis that accounts dual-structure could be useful to reach a more accurate definition of the stability conditions. The effects in practical analysis may be significant. The highlighted discrepancies between the different approaches in describing the timing processes and strength contribution due to capillary forces may entail no negligible differences in slope stability predictions, especially in those cases where the possibility of a failure in unsaturated terrains is contemplated.

  6. The role of microstructure and phase distribution in the failure mechanisms and life prediction model for PSZ coatings

    NASA Technical Reports Server (NTRS)

    Sisson, R. D., Jr.; Sone, Ichiro; Biederman, R. R.

    1985-01-01

    Partially Stabilized Zirconia (PSZ) may become widely used for Thermal Barrier Coatings (TBC). Failure of these coatings can occur due to thermal fatigue in oxidizing atmospheres. The failure is due to the strains that develop due to thermal gradients, differences in thermal expansion coefficients, and oxidation of the bond coating. The role of microstructure and the cubic, tetragonal, and monoclinic phase distribution in the strain development and subsequent failure will be discussed. An X-ray diffraction technique for accurate determination of the fraction of each phase in PSZ will be applied to understanding the phase transformations and strain development. These results will be discussed in terms of developing a model for life prediction in PSZ coatings during thermal cycling.

  7. 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.

  8. Patency of Femoral Tunneled Hemodialysis Catheters and Factors Predictive of Patency Failure

    SciTech Connect

    Burton, Kirsteen R.; Guo, Lancia L. Q.; Tan, Kong T.; Simons, Martin E.; Sniderman, Kenneth W.; Kachura, John R.; Beecroft, John R.; Rajan, Dheeraj K.

    2012-12-15

    Purpose: To determine the patency rates of and factors associated with increased risk of patency failure in patients with femoral vein tunneled hemodialysis catheters. Methods: All femoral tunneled catheter insertions from 1996 to 2006 were reviewed, during which time 123 catheters were inserted. Of these, 66 were exchanges. Patients with femoral catheter failure versus those with femoral catheter patency were compared. Confounding factors, such as demographic and procedural factors, were incorporated and assessed using univariate and multivariable Cox proportional hazards regression analyses. Results: Mean catheter primary patency failure time was 96.3 days (SE 17.9 days). Primary patency at 30, 60, 90, and 180 days was 53.8%, 45.4%, 32.1%, and 27.1% respectively. Crude rates of risk of catheter failure did not suggest a benefit for patients receiving catheters introduced from one side versus the other, but more cephalad location of catheter tip was associated with improved patency. Multivariate analysis showed that patients whose catheters were on the left side (p = 0.009), were of increasing age at the time of insertion (p = 0.002) and that those who had diabetes (p = 0.001) were at significantly greater risk of catheter failure. The catheter infection rate was 1.4/1000 catheter days. Conclusion: Patients who were of a more advanced age and had diabetes were at greater risk of femoral catheter failure, whereas those who received femoral catheters from the right side were less at risk of catheter failure.

  9. Relationship between pre-extubation positive endexpiratory pressure and oxygenation after coronary artery bypass grafting

    PubMed Central

    Lima, Reijane Oliveira; Borges, Daniel Lago; Costa, Marina de Albuquerque Gonçalves; Baldez, Thiago Eduardo Pereira; Silva, Mayara Gabrielle Barbosa e; Sousa, Felipe André Silva; Soares, Milena de Oliveira; Pinto, Jivago Gentil Moreira

    2015-01-01

    Introduction After removal of endotracheal tube and artificial ventilation, ventilatory support should be continued, offering oxygen supply to ensure an arterial oxygen saturation close to physiological. Objective The aim of this study was to investigate the effects of positive-end expiratory pressure before extubation on the oxygenation indices of patients undergoing coronary artery bypass grafting. Methods A randomized clinical trial with seventy-eight patients undergoing coronary artery bypass grafting divided into three groups and ventilated with different positive-end expiratory pressure levels prior to extubation: Group A, 5 cmH2O (n=32); Group B, 8 cmH2O (n=26); and Group C, 10 cmH2O (n=20). Oxygenation index data were obtained from arterial blood gas samples collected at 1, 3, and 6 h after extubation. Patients with chronic pulmonary disease and those who underwent off-pump, emergency, or combined surgeries were excluded. For statistical analysis, we used Shapiro-Wilk, G, Kruskal-Wallis, and analysis of variance tests and set the level of significance at P<0.05. Results Groups were homogenous with regard to demographic, clinical, and surgical variables. There were no statistically significant differences between groups in the first 6 h after extubation with regard to oxygenation indices and oxygen therapy utilization. Conclusion In this sample of patients undergoing coronary artery bypass grafting, the use of different positive-end expiratory pressure levels before extubation did not affect gas exchange or oxygen therapy utilization in the first 6 h after endotracheal tube removal. PMID:27163418

  10. Mechanical assessment of local bone quality to predict failure of locked plating in a proximal humerus fracture model.

    PubMed

    Röderer, Götz; Brianza, Stefano; Schiuma, Damiano; Schwyn, Ronald; Scola, Alexander; Gueorguiev, Boyko; Gebhard, Florian; Tami, Andrea

    2013-09-01

    The importance of osteoporosis in proximal humerus fractures is well recognized. However, the local distribution of bone quality in the humeral head may also have a significant effect because it remains unclear in what quality of bone screws of standard implants purchase. The goal of this study was to investigate whether the failure of proximal humerus locked plating can be predicted by the DensiProbe (ARI, Davos, Switzerland). A 2-part fracture with metaphyseal impaction was simulated in 12 fresh-frozen human cadaveric humeri. Using the DensiProbe, local bone quality was determined in the humeral head in the course of 6 proximal screws of a standard locking plate (Philos; Synthes GmbH, Solothurn, Switzerland). Cyclic mechanical testing with increasing axial loading until failure was performed. Bone mineral density (BMD) significantly correlated with cycles until failure. Head migration significantly increased between 1000 and 2000 loading cycles and significantly correlated with BMD after 3000 cycles. DensiProbe peak torque in all screw positions and their respective mean torque correlated significantly with the BMD values. In 3 positions, the peak torque significantly correlated with cycles to failure; here BMD significantly influenced mechanical stability. The validity of the DensiProbe was proven by the correlation between its peak torque measurements and BMD. The correlation between the peak torque and cycles to failure revealed the potential of the DensiProbe to predict the failure of locked plating in vitro. This method provides information about local bone quality, potentially making it suitable for intraoperative use by allowing the surgeon to take measures to improve stability.

  11. Accuracy of finite element analyses of CT scans in predictions of vertebral failure patterns under axial compression and anterior flexion.

    PubMed

    Jackman, Timothy M; DelMonaco, Alex M; Morgan, Elise F

    2016-01-25

    Finite element (FE) models built from quantitative computed tomography (QCT) scans can provide patient-specific estimates of bone strength and fracture risk in the spine. While prior studies demonstrate accurate QCT-based FE predictions of vertebral stiffness and strength, the accuracy of the predicted failure patterns, i.e., the locations where failure occurs within the vertebra and the way in which the vertebra deforms as failure progresses, is less clear. This study used digital volume correlation (DVC) analyses of time-lapse micro-computed tomography (μCT) images acquired during mechanical testing (compression and anterior flexion) of thoracic spine segments (T7-T9, n=28) to measure displacements occurring throughout the T8 vertebral body at the ultimate point. These displacements were compared to those simulated by QCT-based FE analyses of T8. We hypothesized that the FE predictions would be more accurate when the boundary conditions are based on measurements of pressure distributions within intervertebral discs of similar level of disc degeneration vs. boundary conditions representing rigid platens. The FE simulations captured some of the general, qualitative features of the failure patterns; however, displacement errors ranged 12-279%. Contrary to our hypothesis, no differences in displacement errors were found when using boundary conditions representing measurements of disc pressure vs. rigid platens. The smallest displacement errors were obtained using boundary conditions that were measured directly by DVC at the T8 endplates. These findings indicate that further work is needed to develop methods of identifying physiological loading conditions for the vertebral body, for the purpose of achieving robust, patient-specific FE analyses of failure mechanisms.

  12. Prediction of flow-induced failures of braided flexible hoses and bellows

    NASA Technical Reports Server (NTRS)

    Sack, L. E.; Nelson, R. L.; Mason, D. R.; Cooper, R. A.

    1972-01-01

    Analytical techniques were developed to evaluate braided hoses and bellows for possibility of flow induced resonance. These techniques determine likelihood of high cycle fatigue failure when such resonance exists.

  13. Deformation, Failure, and Fatigue Life of SiC/Ti-15-3 Laminates Accurately Predicted by MAC/GMC

    NASA Technical Reports Server (NTRS)

    Bednarcyk, Brett A.; Arnold, Steven M.

    2002-01-01

    NASA Glenn Research Center's Micromechanics Analysis Code with Generalized Method of Cells (MAC/GMC) (ref.1) has been extended to enable fully coupled macro-micro deformation, failure, and fatigue life predictions for advanced metal matrix, ceramic matrix, and polymer matrix composites. Because of the multiaxial nature of the code's underlying micromechanics model, GMC--which allows the incorporation of complex local inelastic constitutive models--MAC/GMC finds its most important application in metal matrix composites, like the SiC/Ti-15-3 composite examined here. Furthermore, since GMC predicts the microscale fields within each constituent of the composite material, submodels for local effects such as fiber breakage, interfacial debonding, and matrix fatigue damage can and have been built into MAC/GMC. The present application of MAC/GMC highlights the combination of these features, which has enabled the accurate modeling of the deformation, failure, and life of titanium matrix composites.

  14. How well does B-type natriuretic peptide predict death and cardiac events in patients with heart failure: systematic review

    PubMed Central

    Doust, Jenny A; Pietrzak, Eva; Dobson, Annette; Glasziou, Paul

    2005-01-01

    Objective To assess how well B-type natriuretic peptide (BNP) predicts prognosis in patients with heart failure. Design Systematic review of studies assessing BNP for prognosis in patients with heart failure or asymptomatic patients. Data sources Electronic searches of Medline and Embase from January 1994 to March 2004 and reference lists of included studies. Study selection and data extraction We included all studies that estimated the relation between BNP measurement and the risk of death, cardiac death, sudden death, or cardiovascular event in patients with heart failure or asymptomatic patients, including initial values and changes in values in response to treatment. Multivariable models that included both BNP and left ventricular ejection fraction as predictors were used to compare the prognostic value of each variable. Two reviewers independently selected studies and extracted data. Data synthesis 19 studies used BNP to estimate the relative risk of death or cardiovascular events in heart failure patients and five studies in asymptomatic patients. In heart failure patients, each 100 pg/ml increase was associated with a 35% increase in the relative risk of death. BNP was used in 35 multivariable models of prognosis. In nine of the models, it was the only variable to reach significance—that is, other variables contained no prognostic information beyond that of BNP. Even allowing for the scale of the variables, it seems to be a strong indicator of risk. Conclusion Although systematic reviews of prognostic studies have inherent difficulties, including the possibility of publication bias, the results of the studies in this review show that BNP is a strong prognostic indicator for both asymptomatic patients and for patients with heart failure at all stages of disease. PMID:15774989

  15. Is there a way to predict failure after direct vision internal urethrotomy for single and short bulbar urethral strictures?

    PubMed Central

    Harraz, Ahmed M.; El-Assmy, Ahmed; Mahmoud, Osama; Elbakry, Amr A.; Tharwat, Mohamed; Omar, Helmy; Farg, Hashim; Laymon, Mahmoud; Mosbah, Ahmed

    2015-01-01

    Objective To identify patient and stricture characteristics predicting failure after direct vision internal urethrotomy (DVIU) for single and short (<2 cm) bulbar urethral strictures. Patients and methods We retrospectively analysed the records of adult patients who underwent DVIU between January 2002 and 2013. The patients’ demographics and stricture characteristics were analysed. The primary outcome was procedure failure, defined as the need for regular self-dilatation (RSD), redo DVIU or substitution urethroplasty. Predictors of failure were analysed. Results In all, 430 adult patients with a mean (SD) age of 50 (15) years were included. The main causes of stricture were idiopathic followed by iatrogenic in 51.6% and 26.3% of patients, respectively. Most patients presented with obstructive lower urinary tract symptoms (68.9%) and strictures were proximal bulbar, i.e. just close to the external urethral sphincter, in 35.3%. The median (range) follow-up duration was 29 (3–132) months. In all, 250 (58.1%) patients did not require any further instrumentation, while RSD was maintained in 116 (27%) patients, including 28 (6.5%) who required a redo DVIU or urethroplasty. In 64 (6.5%) patients, a redo DVIU or urethroplasty was performed. On multivariate analysis, older age at presentation [odds ratio (OR) 1.017; P = 0.03], obesity (OR 1.664; P = 0.015), and idiopathic strictures (OR 3.107; P = 0.035) were independent predictors of failure after DVIU. Conclusion The failure rate after DVIU accounted for 41.8% of our present cohort with older age at presentation, obesity, and idiopathic strictures independent predictors of failure after DVIU. This information is important in counselling patients before surgery. PMID:26609447

  16. A Novel MiRNA-Based Predictive Model for Biochemical Failure Following Post-Prostatectomy Salvage Radiation Therapy

    PubMed Central

    Stegmaier, Petra; Drendel, Vanessa; Mo, Xiaokui; Ling, Stella; Fabian, Denise; Manring, Isabel; Jilg, Cordula A.; Schultze-Seemann, Wolfgang; McNulty, Maureen; Zynger, Debra L.; Martin, Douglas; White, Julia; Werner, Martin; Grosu, Anca L.; Chakravarti, Arnab

    2015-01-01

    Purpose To develop a microRNA (miRNA)-based predictive model for prostate cancer patients of 1) time to biochemical recurrence after radical prostatectomy and 2) biochemical recurrence after salvage radiation therapy following documented biochemical disease progression post-radical prostatectomy. Methods Forty three patients who had undergone salvage radiation therapy following biochemical failure after radical prostatectomy with greater than 4 years of follow-up data were identified. Formalin-fixed, paraffin-embedded tissue blocks were collected for all patients and total RNA was isolated from 1mm cores enriched for tumor (>70%). Eight hundred miRNAs were analyzed simultaneously using the nCounter human miRNA v2 assay (NanoString Technologies; Seattle, WA). Univariate and multivariate Cox proportion hazards regression models as well as receiver operating characteristics were used to identify statistically significant miRNAs that were predictive of biochemical recurrence. Results Eighty eight miRNAs were identified to be significantly (p<0.05) associated with biochemical failure post-prostatectomy by multivariate analysis and clustered into two groups that correlated with early (≤ 36 months) versus late recurrence (>36 months). Nine miRNAs were identified to be significantly (p<0.05) associated by multivariate analysis with biochemical failure after salvage radiation therapy. A new predictive model for biochemical recurrence after salvage radiation therapy was developed; this model consisted of miR-4516 and miR-601 together with, Gleason score, and lymph node status. The area under the ROC curve (AUC) was improved to 0.83 compared to that of 0.66 for Gleason score and lymph node status alone. Conclusion miRNA signatures can distinguish patients who fail soon after radical prostatectomy versus late failures, giving insight into which patients may need adjuvant therapy. Notably, two novel miRNAs (miR-4516 and miR-601) were identified that significantly improve

  17. Predictive factors for renal failure and a control and treatment algorithm

    PubMed Central

    Cerqueira, Denise de Paula; Tavares, José Roberto; Machado, Regimar Carla

    2014-01-01

    Objectives to evaluate the renal function of patients in an intensive care unit, to identify the predisposing factors for the development of renal failure, and to develop an algorithm to help in the control of the disease. Method exploratory, descriptive, prospective study with a quantitative approach. Results a total of 30 patients (75.0%) were diagnosed with kidney failure and the main factors associated with this disease were: advanced age, systemic arterial hypertension, diabetes mellitus, lung diseases, and antibiotic use. Of these, 23 patients (76.6%) showed a reduction in creatinine clearance in the first 24 hours of hospitalization. Conclusion a decline in renal function was observed in a significant number of subjects, therefore, an algorithm was developed with the aim of helping in the control of renal failure in a practical and functional way. PMID:26107827

  18. On the development of life prediction methodologies for the failure of human teeth

    SciTech Connect

    Nalla, R.K.; Imbeni, V.; Kinney, J.H.; Marshall, S.J.; Ritchie, R.O.

    2002-09-18

    Human dentin is known to be susceptible to failure under cyclic loading. Surprisingly, there are few reports that quantify the effect of such loading, considering the fact that a typical tooth experiences a million or so loading cycles annually. In the present study, a systematic investigation is described of the effects of prolonged cyclic loading on human dentin in a simulated physiological environment. In vitro stress-life (S/N) data are discussed in the context of possible mechanisms of fatigue damage and failure.

  19. Seismic energy data analysis of Merapi volcano to test the eruption time prediction using materials failure forecast method (FFM)

    NASA Astrophysics Data System (ADS)

    Anggraeni, Novia Antika

    2015-04-01

    The test of eruption time prediction is an effort to prepare volcanic disaster mitigation, especially in the volcano's inhabited slope area, such as Merapi Volcano. The test can be conducted by observing the increase of volcanic activity, such as seismicity degree, deformation and SO2 gas emission. One of methods that can be used to predict the time of eruption is Materials Failure Forecast Method (FFM). Materials Failure Forecast Method (FFM) is a predictive method to determine the time of volcanic eruption which was introduced by Voight (1988). This method requires an increase in the rate of change, or acceleration of the observed volcanic activity parameters. The parameter used in this study is the seismic energy value of Merapi Volcano from 1990 - 2012. The data was plotted in form of graphs of seismic energy rate inverse versus time with FFM graphical technique approach uses simple linear regression. The data quality control used to increase the time precision employs the data correlation coefficient value of the seismic energy rate inverse versus time. From the results of graph analysis, the precision of prediction time toward the real time of eruption vary between -2.86 up to 5.49 days.

  20. Seismic energy data analysis of Merapi volcano to test the eruption time prediction using materials failure forecast method (FFM)

    SciTech Connect

    Anggraeni, Novia Antika

    2015-04-24

    The test of eruption time prediction is an effort to prepare volcanic disaster mitigation, especially in the volcano’s inhabited slope area, such as Merapi Volcano. The test can be conducted by observing the increase of volcanic activity, such as seismicity degree, deformation and SO2 gas emission. One of methods that can be used to predict the time of eruption is Materials Failure Forecast Method (FFM). Materials Failure Forecast Method (FFM) is a predictive method to determine the time of volcanic eruption which was introduced by Voight (1988). This method requires an increase in the rate of change, or acceleration of the observed volcanic activity parameters. The parameter used in this study is the seismic energy value of Merapi Volcano from 1990 – 2012. The data was plotted in form of graphs of seismic energy rate inverse versus time with FFM graphical technique approach uses simple linear regression. The data quality control used to increase the time precision employs the data correlation coefficient value of the seismic energy rate inverse versus time. From the results of graph analysis, the precision of prediction time toward the real time of eruption vary between −2.86 up to 5.49 days.

  1. An Evolutionary Algorithm for Feature Subset Selection in Hard Disk Drive Failure Prediction

    ERIC Educational Resources Information Center

    Bhasin, Harpreet

    2011-01-01

    Hard disk drives are used in everyday life to store critical data. Although they are reliable, failure of a hard disk drive can be catastrophic, especially in applications like medicine, banking, air traffic control systems, missile guidance systems, computer numerical controlled machines, and more. The use of Self-Monitoring, Analysis and…

  2. Predicting Success, Preventing Failure: An Investigation of the California High School Exit Exam

    ERIC Educational Resources Information Center

    Zau, Andrew C.; Betts, Julian R.

    2008-01-01

    Many educators, parents, and policymakers continue to call for reforms to the California High School Exit Exam (CAHSEE), citing concern about the 10 percent of California students who do not graduate because of their failure to pass the test. By law, current funding for tutoring those at risk of failing the CAHSEE is targeted at those in grade 12…

  3. Predictive failure analysis: planning for the worst so that it never happens!

    PubMed

    Hipple, Jack

    2008-01-01

    This article reviews an alternative approach to failure analysis involving a deliberate saboteurial approach rather than a checklist approach to disaster and emergency preparedness. This process is in the form of an algorithm that is easily applied to any planning situation. PMID:18091086

  4. Homocysteine as a predictive biomarker in early diagnosis of renal failure susceptibility and prognostic diagnosis for end stages renal disease.

    PubMed

    Amin, Hatem K; El-Sayed, Mohamed-I Kotb; Leheta, Ola F

    2016-09-01

    Glomerular filtration rate and/or creatinine are not accurate methods for renal failure prediction. This study tested homocysteine (Hcy) as a predictive and prognostic marker for end stage renal disease (ESRD). In total, 176 subjects were recruited and divided into: healthy normal group (108 subjects); mild-to-moderate impaired renal function group (21 patients); severe impaired renal function group (7 patients); and chronic renal failure group (40 patients) who were on regular hemodialysis. Blood samples were collected, and serum was separated for analysis of total Hcy, creatinine, high sensitive C-reactive protein (CRP), serum albumin, and calcium. Data showed that Hcy level was significantly increased from normal-to-mild impairment then significantly decreases from mild impairment until the patient reaches severe impairment while showing significant elevation in the last stage of chronic renal disease. Creatinine level was increased in all stages of kidney impairment in comparison with control. CRP level was showing significant elevation in the last stage. A significant decrease in both albumin and calcium was occurred in all stages of renal impairment. We conclude Hcy in combination with CRP, creatinine, albumin, and calcium can be used as a prognostic marker for ESRD and an early diagnostic marker for the risk of renal failure.

  5. Humane terminal extubation reconsidered: the role for preemptive analgesia and sedation.

    PubMed

    Billings, J Andrew

    2012-02-01

    Patient comfort is not assured by common practices for terminal extubation. Treatment guidelines suggest minimizing dosage of opioids and sedatives. Multiple lines of evidence indicate that clinicians are limited in their ability to recognize distress in such patients and tend to undermedicate patients in distress. Yet suffering of any significant degree should be unacceptable. For painful procedures, such as surgery, the analogous practice of postponing anesthesia until the patient evidences discomfort would never be tolerated. Waiting for signs of suffering before initiating excellent analgesia and sedation inexorably subjects patients to distress. Therefore, when death is inevitable and imminent after extubation, suffering should be anticipated, concerns about respiratory depression dismissed, and vigorous preemptive deep sedation or anesthesia provided.

  6. Rapid and reliable smooth extubation – Comparison of fentanyl with dexmedetomidine: A randomized, double-blind clinical trial

    PubMed Central

    Rani, P.; Hemanth Kumar, V. R.; Ravishankar, M.; Sivashanmugam, T.; Sripriya, R.; Trilogasundary, M.

    2016-01-01

    Background: Fentanyl and dexmedetomidine have been tried to attenuate airway and circulatory reflexes during emergence and extubation individually but have not been compared with respect to the level of sedation to evolve a reliable technique for rapid and smooth extubation. Aim: To compare the effects of fentanyl and dexmedetomidine in attenuating airway and circulatory reflexes during emergence and extubation of the endotracheal tube. Setting and Design: This double-blind, randomized, controlled study was done in patients undergoing surgery under general anesthesia belonging to the American Society of Anesthesiologists physical status 1 or 2. Methodology: All patients received a standardized anesthetic protocol. Patients were randomized to receive either fentanyl 1 μg/kg or dexmedetomidine 0.75 μg/kg. Fifteen minutes before expected last surgical suture, isoflurane was cutoff and equal amount of test solution was given when train-of-four ratio was 0.3. The degree of sedation, airway, and circulatory responses at the time of suction and extubation were analyzed. Statistical Analysis Used: Chi-square test for nonparametric data and t-test for parametric data. Results: Heart rate (HR) was comparable in both the groups until endotracheal extubation. Later, there was rise in HR in fentanyl group. There was stastisticaly significant drop in blood pressure at 5 min after test drug administration in both the groups. Airway response for suctioning and extubation was better in dexmedetomidine group and it was associated with better sedation score than fentanyl group. Conclusion: Single dose of 0.75 μg/kg dexmedetomidine given 15 min before extubation provides smooth extubation when compared to fentanyl. PMID:27746558

  7. A data-driven feature extraction framework for predicting the severity of condition of congestive heart failure patients.

    PubMed

    Sideris, Costas; Alshurafa, Nabil; Pourhomayoun, Mohammad; Shahmohammadi, Farhad; Samy, Lauren; Sarrafzadeh, Majid

    2015-01-01

    In this paper, we propose a novel methodology for utilizing disease diagnostic information to predict severity of condition for Congestive Heart Failure (CHF) patients. Our methodology relies on a novel, clustering-based, feature extraction framework using disease diagnostic information. To reduce the dimensionality we identify disease clusters using cooccurence frequencies. We then utilize these clusters as features to predict patient severity of condition. We build our clustering and feature extraction algorithm using the 2012 National Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP) which contains 7 million discharge records and ICD-9-CM codes. The proposed framework is tested on Ronald Reagan UCLA Medical Center Electronic Health Records (EHR) from 3041 patients. We compare our cluster-based feature set with another that incorporates the Charlson comorbidity score as a feature and demonstrate an accuracy improvement of up to 14% in the predictability of the severity of condition. PMID:26736808

  8. Risk Prediction Models of Locoregional Failure After Radical Cystectomy for Urothelial Carcinoma: External Validation in a Cohort of Korean Patients

    SciTech Connect

    Ku, Ja Hyeon; Kim, Myong; Jeong, Chang Wook; Kwak, Cheol; Kim, Hyeon Hoe

    2014-08-01

    Purpose: To evaluate the predictive accuracy and general applicability of the locoregional failure model in a different cohort of patients treated with radical cystectomy. Methods and Materials: A total of 398 patients were included in the analysis. Death and isolated distant metastasis were considered competing events, and patients without any events were censored at the time of last follow-up. The model included the 3 variables pT classification, the number of lymph nodes identified, and margin status, as follows: low risk (≤pT2), intermediate risk (≥pT3 with ≥10 nodes removed and negative margins), and high risk (≥pT3 with <10 nodes removed or positive margins). Results: The bootstrap-corrected concordance index of the model 5 years after radical cystectomy was 66.2%. When the risk stratification was applied to the validation cohort, the 5-year locoregional failure estimates were 8.3%, 21.2%, and 46.3% for the low-risk, intermediate-risk, and high-risk groups, respectively. The risk of locoregional failure differed significantly between the low-risk and intermediate-risk groups (subhazard ratio [SHR], 2.63; 95% confidence interval [CI], 1.35-5.11; P<.001) and between the low-risk and high-risk groups (SHR, 4.28; 95% CI, 2.17-8.45; P<.001). Although decision curves were appropriately affected by the incidence of the competing risk, decisions about the value of the models are not likely to be affected because the model remains of value over a wide range of threshold probabilities. Conclusions: The model is not completely accurate, but it demonstrates a modest level of discrimination, adequate calibration, and meaningful net benefit gain for prediction of locoregional failure after radical cystectomy.

  9. Secondary Circulating Prostate Cells Predict Biochemical Failure in Prostate Cancer Patients after Radical Prostatectomy and without Evidence of Disease

    PubMed Central

    Murray, Nigel P.; Reyes, Eduardo; Orellana, Nelson; Fuentealba, Cynthia; Bádinez, Leonardo; Olivares, Ruben; Porcell, José; Dueñas, Ricardo

    2013-01-01

    Introduction. Although 90% of prostate cancer is considered to be localized, 20%–30% of patients will experience biochemical failure (BF), defined as serum PSA >0.2 ng/mL, after radical prostatectomy (RP). The presence of circulating prostate cells (CPCs) in men without evidence of BF may be useful to predict patients at risk for BF. We describe the frequency of CPCs detected after RP, relation with clinicopathological parameters, and association with biochemical failure. Methods and Patients. Serial blood samples were taken during followup after RP, mononuclear cells were obtained by differential gel centrifugation, and CPCs identified using standard immunocytochemistry using anti-PSA monoclonal antibodies. Age, pathological stage (organ confined, nonorgan confined), pathological grade, margin status (positive, negative), extracapsular extension, perineural, vascular, and lymphatic infiltration (positive, negative) were compared with the presence/absence of CPCs and with and without biochemical failure. Kaplan Meier methods were used to compare the unadjusted biochemical failure free survival of patients with and without CPCs. Results. 114 men participated, and secondary CPCs were detected more frequently in patients with positive margins, extracapsular extension, and vascular and lymphatic infiltration and were associated with biochemical failure independent of these clinicopathological variables, and with a shorter time to BF. Conclusions. Secondary CPCs are an independent risk factor associated with increased BF in men with a PSA <0.2 ng/mL after radical prostatectomy, but do not determine if the recurrence is due to local or systemic disease. These results warrant larger studies to confirm the findings. PMID:23653529

  10. Texture feature analysis for prediction of postoperative liver failure prior to surgery

    NASA Astrophysics Data System (ADS)

    Simpson, Amber L.; Do, Richard K.; Parada, E. Patricia; Miga, Michael I.; Jarnagin, William R.

    2014-03-01

    Texture analysis of preoperative CT images of the liver is undertaken in this study. Standard texture features were extracted from portal-venous phase contrast-enhanced CT scans of 36 patients prior to major hepatic resection and correlated to postoperative liver failure. Differences between patients with and without postoperative liver failure were statistically significant for contrast (measure of local variation), correlation (linear dependency of gray levels on neighboring pixels), cluster prominence (asymmetry), and normalized inverse difference moment (local homogeneity). Though texture features have been used to diagnose and characterize lesions, to our knowledge, parenchymal statistical variation has not been quantified and studied. We demonstrate that texture analysis is a valuable tool for quantifying liver function prior to surgery, which may help to identify and change the preoperative management of patients at higher risk for overall morbidity.

  11. Comparative Study on Failure Prediction in Warm Forming Processes of Mg Alloy Sheet by the FEM and Ductile Fracture Criteria

    NASA Astrophysics Data System (ADS)

    Kim, Sang-Woo; Lee, Young-Seon

    2014-04-01

    An important concern in metal forming is whether the desired deformation can be accomplished without any failure of the material, even at elevated temperatures. This paper describes the utilization of ductile fracture criteria in conjunction with the finite element (FE) method for predicting the onset of fracture in warm metal working processes of magnesium alloy sheets. The uniaxial tensile tests of AZ31 alloy sheets with a thickness of 3 mm and FE simulations were performed to calculate the critical damage values for three kinds of ductile fracture criteria. The critical damage values for each criterion were expressed as the function of strain rate at various temperatures. In order to find out the best criterion for failure prediction, Erichsen cupping tests under isothermal conditions were carried out at various temperatures and punch velocities. Based on the plastic deformation histories obtained from FE analysis of the Erichsen cupping tests and the critical damage value curves, the initiation time and location of fracture were predicted under bi-axial tensile conditions. As a result, Cockcroft-Latham's criterion showed good agreement with the experiments.

  12. A comparative study of early and late extubation following transoral odontoidectomy and posterior fixation

    PubMed Central

    Marda, Manish; Pandia, Mihir Prakash; Rath, Girija Prasad; Kale, Shashank Sharad; Dash, Harihara

    2016-01-01

    Background and Aims: Elective ventilation is the usual practice after transoral odontoidectomy (TOO) and posterior fixation. This practice of elective ventilation is not based on any evidence. The primary objective of our study was to find out the difference in oxygenation and ventilation in patients extubated early compared to those extubated late after TOO and posterior fixation. The secondary objectives were to compare the length of Intensive Care Unit (ICU)/hospital stay and pulmonary complications between the two groups. Material and Methods: After TOO and posterior fixation, patients were either extubated in the operating room (Group E) or extubated next day (Group D). The oxygenation (PaO2:FiO2 ratio) and ventilation (PaCO2) of the two groups before surgery, at 30 min and at 6/12/24 and 48 h after extubation were compared. Complications, durations of ICU and hospital stay were noted. Results: The base-line PaO2:FiO2 and PaCO2 was comparable between the groups. No significant change in the PaO2:FiO2 was noted in the postoperative period in either group as compared to the preoperative values. Except for at 12 h after surgery, there was no significant difference between the two groups at various time intervals. No significant change in the PaCO2 level was seen during the study period in either group. PaCO2 measured at 30 min after surgery was more in Group E (37.5 ± 3.2 mmHg in Group E vs. 34.6 ± 2.9 mmHg in Group D), otherwise there was no significant difference between the two groups at various time intervals. One patient in Group E (7.1%) and two patients in Group D (13%) developed postoperative respiratory complication, but the difference was not statistically significant. The mean ICU stay (Group D = 42 ± 25 h vs. Group E = 25.1 ± 16.9 h) and mean hospital stay (Group D = 9.9 ± 4 days vs. Group E = 7.6 ± 2.2 days) were longer in Group D patients. Conclusion: Ventilation and oxygenation in the postoperative period in patients undergoing TOO and

  13. A Novel Risk Stratification to Predict Local-Regional Failures in Urothelial Carcinoma of the Bladder After Radical Cystectomy

    SciTech Connect

    Baumann, Brian C.; Guzzo, Thomas J.; He Jiwei; Keefe, Stephen M.; Tucker, Kai; Bekelman, Justin E.; Hwang, Wei-Ting; Vaughn, David J.; Malkowicz, S. Bruce; Christodouleas, John P.

    2013-01-01

    Purpose: Local-regional failures (LF) following radical cystectomy (RC) plus pelvic lymph node dissection (PLND) with or without chemotherapy for invasive urothelial bladder carcinoma are more common than previously reported. Adjuvant radiation therapy (RT) could reduce LF but currently has no defined role because of previously reported morbidity. Modern techniques with improved normal tissue sparing have rekindled interest in RT. We assessed the risk of LF and determined those factors that predict recurrence to facilitate patient selection for future adjuvant RT trials. Methods and Materials: From 1990-2008, 442 patients with urothelial bladder carcinoma at University of Pennsylvania were prospectively followed after RC plus PLND with or without chemotherapy with routine pelvic computed tomography (CT) or magnetic resonance imaging (MRI). One hundred thirty (29%) patients received chemotherapy. LF was any pelvic failure detected before or within 3 months of distant failure. Competing risk analyses identified factors predicting increased LF risk. Results: On univariate analysis, pathologic stage {>=}pT3, <10 nodes removed, positive margins, positive nodes, hydronephrosis, lymphovascular invasion, and mixed histology significantly predicted LF; node density was marginally predictive, but use of chemotherapy, number of positive nodes, type of surgical diversion, age, gender, race, smoking history, and body mass index were not. On multivariate analysis, only stage {>=}pT3 and <10 nodes removed were significant independent LF predictors with hazard ratios of 3.17 and 2.37, respectively (P<.01). Analysis identified 3 patient subgroups with significantly different LF risks: low-risk ({<=}pT2), intermediate-risk ({>=}pT3 and {>=}10 nodes removed), and high-risk ({>=}pT3 and <10 nodes) with 5-year LF rates of 8%, 23%, and 42%, respectively (P<.01). Conclusions: This series using routine CT and MRI surveillance to detect LF confirms that such failures are relatively common

  14. Hepatic Hemodynamics and Elevation of Liver Stiffness as Possible Predictive Markers of Late-onset Hepatic Failure.

    PubMed

    Kakisaka, Keisuke; Kuroda, Hidekatsu; Abe, Tamami; Suzuki, Yuji; Yoshida, Yuichi; Kataoka, Kojiro; Miyamoto, Yasuhiro; Ishida, Kazuyuki; Takikawa, Yasuhiro

    2016-01-01

    A 52-year-old Japanese woman admitted to our hospital for the treatment of liver dysfunction due to an undetermined cause developed disorientation on the 58th hospital day and was diagnosed with late-onset liver failure. Abdominal ultrasound examinations were performed several times from the admission. Before the disorientation appeared, the results of the examinations revealed that the portal flow decreased, after which the hepatic arterial flow increased and the degree of liver stiffness became elevated. Although the pathophysiology of these changes remains unclear, hemodynamic changes and elevation of liver stiffness might be predictive markers of severe liver tissue damage.

  15. Prediction of ppm level electrical failure by using physical variation analysis

    NASA Astrophysics Data System (ADS)

    Hou, Hsin-Ming; Kung, Ji-Fu; Hsu, Y.-B.; Yamazaki, Y.; Maruyama, Kotaro; Toyoshima, Yuya; Chen, Chu-en

    2016-03-01

    their spatial correlation distance. For local variations (LV) there is no correlation, whereas for global variations (GV) the correlation distance is very large [7]-[9]. This is the first time to certificate the validation of spatial distribution from the affordable bias contour big data fundamental infrastructures. And then apply statistical techniques to dig out the variation sources. The GV come from systematic issue, which could be compensated by adaptive LT condition or OPC correction. But LV comes from random issue, which being considered as intrinsic problem such as structure, material, tool capability… etc. In this paper studying, we can find out the advanced technology node SRAM contact CD local variation (LV) dominates in total variation, about 70%. It often plays significant in-line real time catching WP-DPMO role of the product yield loss, especially for wafer edge is the worst loss within wafer distribution and causes serious reliability concern. The major root cause of variations comes from the PR material induced burr defect (LV), the second one comes from GV enhanced wafer edge short opportunity, which being attributed to three factors, first one factor is wafer edge CD deliberated enlargement for yield improvement as shown in Fig. 10. Second factor is overlaps/AA shifts due to tool capability dealing with incoming wafer's war page issue and optical periphery layout dependent working pitch issue as shown in Fig. 9 (1)., the last factor comes from wafer edge burr enhanced by wafer edge larger Photo Resistance (PR) spin centrifugal force. After implementing KPIs such as GV related AA/CD indexes as shown in Fig. 9 (1) and 10, respectively, and LV related burr index as shown in Fig. 11., we can construct the parts per million (PPM) level short probability model via multi-variables regression, canonical correlation analysis and logistic transformation. The model provides prediction of PPM level electrical failure by using in-line real time physical

  16. Ambulatory heart rate range predicts mode-specific mortality and hospitalisation in chronic heart failure

    PubMed Central

    Cubbon, Richard M; Ruff, Naomi; Groves, David; Eleuteri, Antonio; Denby, Christine; Kearney, Lorraine; Ali, Noman; Walker, Andrew M N; Jamil, Haqeel; Gierula, John; Gale, Chris P; Batin, Phillip D; Nolan, James; Shah, Ajay M; Fox, Keith A A; Sapsford, Robert J; Witte, Klaus K; Kearney, Mark T

    2016-01-01

    Objective We aimed to define the prognostic value of the heart rate range during a 24 h period in patients with chronic heart failure (CHF). Methods Prospective observational cohort study of 791 patients with CHF associated with left ventricular systolic dysfunction. Mode-specific mortality and hospitalisation were linked with ambulatory heart rate range (AHRR; calculated as maximum minus minimum heart rate using 24 h Holter monitor data, including paced and non-sinus complexes) in univariate and multivariate analyses. Findings were then corroborated in a validation cohort of 408 patients with CHF with preserved or reduced left ventricular ejection fraction. Results After a mean 4.1 years of follow-up, increasing AHRR was associated with reduced risk of all-cause, sudden, non-cardiovascular and progressive heart failure death in univariate analyses. After accounting for characteristics that differed between groups above and below median AHRR using multivariate analysis, AHRR remained strongly associated with all-cause mortality (HR 0.991/bpm increase in AHRR (95% CI 0.999 to 0.982); p=0.046). AHRR was not associated with the risk of any non-elective hospitalisation, but was associated with heart-failure-related hospitalisation. AHRR was modestly associated with the SD of normal-to-normal beats (R2=0.2; p<0.001) and with peak exercise-test heart rate (R2=0.33; p<0.001). Analysis of the validation cohort revealed AHRR to be associated with all-cause and mode-specific death as described in the derivation cohort. Conclusions AHRR is a novel and readily available prognosticator in patients with CHF, which may reflect autonomic tone and exercise capacity. PMID:26674986

  17. Predicting the occurrence of mixed mode failure associated with hydraulic fracturing, part 2 water saturated tests

    SciTech Connect

    Bauer, Stephen J.; Broome, Scott Thomas; Choens, Charles; Barrow, Perry Carl

    2015-09-14

    Seven water-saturated triaxial extension experiments were conducted on four sedimentary rocks. This experimental condition was hypothesized more representative of that existing for downhole hydrofracture and thus it may improve our understanding of the phenomena. In all tests the pore pressure was 10 MPa and confirming pressure was adjusted to achieve tensile and transitional failure mode conditions. Using previous work in this LDRD for comparison, the law of effective stress is demonstrated in extension using this sample geometry. In three of the four lithologies, no apparent chemo-mechanical effect of water is apparent, and in the fourth lithology test results indicate some chemo-mechanical effect of water.

  18. A Comparison of Logistic Regression Model and Artificial Neural Networks in Predicting of Student’s Academic Failure

    PubMed Central

    Teshnizi, Saeed Hosseini; Ayatollahi, Sayyed Mohhamad Taghi

    2015-01-01

    Background and objective: Artificial Neural Networks (ANNs) have recently been applied in situations where an analysis based on the logistic regression (LR) is a standard statistical approach; direct comparisons of the results, however, are seldom attempted. In this study, we compared both logistic regression models and feed-forward neural networks on the academic failure data set. Methods: The data for this study included 18 questions about study situation of 275 undergraduate students selected randomly from among nursing and midwifery and paramedic schools of Hormozgan University of Medical Sciences in 2013. Logistic regression with forward method and feed forward Artificial Neural Network with 15 neurons in hidden layer were fitted to the dataset. The accuracy of the models in predicting academic failure was compared by using ROC (Receiver Operating Characteristic) and classification accuracy. Results: Among nine ANNs, the ANN with 15 neurons in hidden layer was a better ANN compared with LR. The Area Under Receiver Operating Characteristics (AUROC) of the LR model and ANN with 15 neurons in hidden layers, were estimated as 0.55 and 0.89, respectively and ANN was significantly greater than the LR. The LR and ANN models respectively classified 77.5% and 84.3% of the students correctly. Conclusion: Based on this dataset, it seems the classification of the students in two groups with and without academic failure by using ANN with 15 neurons in the hidden layer is better than the LR model. PMID:26635438

  19. Dynamic failure properties of the porcine medial collateral ligament-bone complex for predicting injury in automotive collisions.

    PubMed

    Peck, Louis; Billiar, Kristen; Ray, Malcolm

    2010-03-09

    The goal of this study was to model the dynamic failure properties of ligaments and their attachment sites to facilitate the development of more realistic dynamic finite element models of the human lower extremities for use in automotive collision simulations. Porcine medial collateral ligaments were chosen as a test model due to their similarities in size and geometry with human ligaments. Each porcine medial collateral ligament-bone complex (n = 12) was held in a custom test fixture placed in a drop tower to apply an axial impulsive impact load, applying strain rates ranging from 0.005 s(-1) to 145 s(-1). The data from the impact tests were analyzed using nonlinear regression to construct model equations for predicting the failure load of ligament-bone complexes subjected to specific strain rates as calculated from finite element knee, thigh, and hip impact simulations. The majority of the ligaments tested failed by tibial avulsion (75%) while the remaining ligaments failed via mid-substance tearing. The failure load ranged from 384 N to 1184 N and was found to increase with the applied strain rate and the product of ligament length and cross-sectional area. The findings of this study indicate the force required to rupture the porcine MCL increases with the applied bone-to-bone strain rate in the range expected from high speed frontal automotive collisions.

  20. Dynamic Failure Properties of the Porcine Medial Collateral Ligament-Bone Complex for Predicting Injury in Automotive Collisions

    PubMed Central

    Peck, Louis; Billiar, Kristen; Ray, Malcolm

    2010-01-01

    The goal of this study was to model the dynamic failure properties of ligaments and their attachment sites to facilitate the development of more realistic dynamic finite element models of the human lower extremities for use in automotive collision simulations. Porcine medial collateral ligaments were chosen as a test model due to their similarities in size and geometry with human ligaments. Each porcine medial collateral ligament-bone complex (n = 12) was held in a custom test fixture placed in a drop tower to apply an axial impulsive impact load, applying strain rates ranging from 0.005 s-1 to 145 s-1. The data from the impact tests were analyzed using nonlinear regression to construct model equations for predicting the failure load of ligament-bone complexes subjected to specific strain rates as calculated from finite element knee, thigh, and hip impact simulations. The majority of the ligaments tested failed by tibial avulsion (75%) while the remaining ligaments failed via mid-substance tearing. The failure load ranged from 384 N to 1184 N and was found to increase with the applied strain rate and the product of ligament length and cross-sectional area. The findings of this study indicate the force required to rupture the porcine MCL increases with the applied bone-to-bone strain rate in the range expected from high speed frontal automotive collisions. PMID:20461229

  1. 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.

  2. Predicting outflow induced by moraine failure in glacial lakes: the Lake Palcacocha case from an uncertainty perspective

    NASA Astrophysics Data System (ADS)

    Rivas, D. S.; Somos-Valenzuela, M. A.; McKinney, D. C.; Hodges, B. R.

    2014-09-01

    Moraine dam collapse is one of the causes of Glacier Lake Outburst Floods. Available models seek to predict both moraine breach formation and lake outflow. The models depend on hydraulic, erosion, and geotechnical parameters that are mostly unknown or uncertain. This paper estimates the outflow hydrograph caused by a potential collapse of the moraine dam of Lake Palcacocha in Peru and quantifies the uncertainty of the results. The overall aim is to provide a simple and robust method of calculation of the expected outflow hydrographs that is useful for risk assessment studies. To estimate the peak outflow and failure time of the hydrograph, we assessed several available empirical equations based on lake and moraine geometries; each equation has defined confidence intervals for peak flow predictions. Complete outflow hydrographs for each peak flow condition were modeled using a~hydraulic simulation model calibrated to meet the peak flows estimated with the empirical equations. Failure time and peak flow differences between the simulations and the corresponding empirical equations were used as error parameters. Along with an expected hydrograph, lower and upper bound hydrographs were calculated for Lake Palcacocha, representing the confidence interval of the results. The method has several advantages: first, it is simple and robust. Second, it evaluates the capability of empirical equations to reproduce the conditions of the lake and moraine dam. Third, this method accounts for uncertainty in the hydrographs estimations, which makes it appropriate for risk management studies.

  3. Predicting outflow induced by moraine failure in glacial lakes: the Lake Palcacocha case from an uncertainty perspective

    NASA Astrophysics Data System (ADS)

    Rivas, D. S.; Somos-Valenzuela, M. A.; Hodges, B. R.; McKinney, D. C.

    2015-06-01

    Moraine dam collapse is one of the causes of glacial lake outburst floods. Available models seek to predict both moraine breach formation and lake outflow. The models depend on hydraulic, erosion, and geotechnical parameters that are mostly unknown or uncertain. This paper estimates the outflow hydrograph caused by a potential erosive collapse of the moraine dam of Lake Palcacocha in Peru and quantifies the uncertainty of the results. The overall aim is to provide a simple yet hydraulically robust approach for calculating the expected outflow hydrographs that is useful for risk assessment studies. To estimate the peak outflow and failure time of the hydrograph, we assessed several available empirical equations based on lake and moraine geometries; each equation has defined confidence intervals for peak flow predictions. Complete outflow hydrographs for each peak flow condition were modeled using a hydraulic simulation model calibrated to match the peak flows estimated with the empirical equations. Failure time and peak flow differences between the simulations, and the corresponding empirical equations were used as error parameters. Along with an expected hydrograph, lower and upper bound hydrographs were calculated for Lake Palcacocha, representing the confidence interval of the results. The approach has several advantages: first, it is simple and robust. Second, it evaluates the capability of empirical equations to reproduce the conditions of the lake and moraine dam. Third, this approach accounts for uncertainty in the hydrographs estimations, which makes it appropriate for risk management studies.

  4. Modeling and Prediction of Thermal Cycle Induced Failure in Epoxy-Silica Composites

    NASA Astrophysics Data System (ADS)

    Kmita, Grzegorz; Nowak, Tomasz; Sekula, Robert

    2012-02-01

    Epoxy resins filled with dielectric mineral particles are frequently used as insulating materials in power industry applications. Due to their excellent dielectric properties and relatively good thermal performance (resistance, ageing and conductivity) their usability is common and extensive. However, the mechanical performance of the resins is influenced by several factors such as resistance to crack propagation, especially in low temperature applications. This phenomenon is normally linked with appearance of two phase systems where particle filled epoxy material interacts with metallic inserts having significantly different thermal expansion coefficients. This kind of epoxy-metal interface can produce relatively high stresses in the product structure during thermal cycle loading. The paper deals with mechanical problems of power industry products and introduces the methodology for numerical modeling of failure in silica filled epoxy systems subjected to severe temperature gradients. Various aspects of material behavior modeling are covered in this article, including polymerization process, viscoelastic stress relaxation as well as stochastic cracking.

  5. VISA: a computer code for predicting the probability of reactor pressure-vessel failure. [PWR

    SciTech Connect

    Stevens, D.L.; Simonen, F.A.; Strosnider, J. Jr.; Klecker, R.W.; Engel, D.W.; Johnson, K.I.

    1983-09-01

    The VISA (Vessel Integrity Simulation Analysis) code was developed as part of the NRC staff evaluation of pressurized thermal shock. VISA uses Monte Carlo simulation to evaluate the failure probability of a pressurized water reactor (PWR) pressure vessel subjected to a pressure and thermal transient specified by the user. Linear elastic fracture mechanics are used to model crack initiation and propagation. parameters for initial crack size, copper content, initial RT/sub NDT/, fluence, crack-initiation fracture toughness, and arrest fracture toughness are treated as random variables. This report documents the version of VISA used in the NRC staff report (Policy Issue from J.W. Dircks to NRC Commissioners, Enclosure A: NRC Staff Evaluation of Pressurized Thermal Shock, November 1982, SECY-82-465) and includes a user's guide for the code.

  6. Diffusional transport and predicting oxidative failure during cyclic oxidation of beta-NiAl alloys

    NASA Technical Reports Server (NTRS)

    Nesbitt, J. A.; Vinarcik, E. J.; Barrett, C. A.; Doychak, J.

    1992-01-01

    Nickel aluminides (NiAl) containing 40-50 at. percent Al and up to 0.1 at. percent Zr have been studied following cyclic oxidation at 1200, 1300, 1350 and 1400 C. The selective oxidation of aluminum resulted in the formation of protective Al2O3 scales on each alloy composition at each temperature. However, repeated cycling eventually resulted in the gradual formation of less protective NiAl2O4. The appearance of the NiAl2O4, signaling the end of the protective scale-forming capability of the alloy, was related to the presence of gamma-prime-(Ni3Al) which formed as a result of the loss of aluminum from the sample. A simple methodology is presented to predict the protective life of beta-NiAl alloys. This method predicts the oxidative lifetime due to aluminum depletion when the aluminum concentration decreases to a critical concentration. The time interval preceding NiAl2O4 formation (i.e., the lifetime based on protective Al2O3 formation) and predicted lifetimes are compared and discussed. Use of the method to predict the maximum use temperature for NiAl-Zr alloys is also discussed.

  7. Falling Off Track: How Teacher-Student Relationships Predict Early High School Failure Rates.

    ERIC Educational Resources Information Center

    Miller, Shazia Rafiullah

    This paper examines the relationship between the climate of teacher-student relations within a school and individual student's likelihood of freshman year success. Using administrative data from the Chicago Public Schools and survey data, researchers used hierarchical linear modeling to determine whether teacher-student climate predicts students'…

  8. Combined In-Plane and Through-the-Thickness Analysis for Failure Prediction of Bolted Composite Joints

    NASA Technical Reports Server (NTRS)

    Kradinov, V.; Madenci, E.; Ambur, D. R.

    2004-01-01

    Although two-dimensional methods provide accurate predictions of contact stresses and bolt load distribution in bolted composite joints with multiple bolts, they fail to capture the effect of thickness on the strength prediction. Typically, the plies close to the interface of laminates are expected to be the most highly loaded, due to bolt deformation, and they are usually the first to fail. This study presents an analysis method to account for the variation of stresses in the thickness direction by augmenting a two-dimensional analysis with a one-dimensional through the thickness analysis. The two-dimensional in-plane solution method based on the combined complex potential and variational formulation satisfies the equilibrium equations exactly, and satisfies the boundary conditions and constraints by minimizing the total potential. Under general loading conditions, this method addresses multiple bolt configurations without requiring symmetry conditions while accounting for the contact phenomenon and the interaction among the bolts explicitly. The through-the-thickness analysis is based on the model utilizing a beam on an elastic foundation. The bolt, represented as a short beam while accounting for bending and shear deformations, rests on springs, where the spring coefficients represent the resistance of the composite laminate to bolt deformation. The combined in-plane and through-the-thickness analysis produces the bolt/hole displacement in the thickness direction, as well as the stress state in each ply. The initial ply failure predicted by applying the average stress criterion is followed by a simple progressive failure. Application of the model is demonstrated by considering single- and double-lap joints of metal plates bolted to composite laminates.

  9. Concurrent Anemia and Elevated C-Reactive Protein Predicts HIV Clinical Treatment Failure, Including Tuberculosis, After Antiretroviral Therapy Initiation

    PubMed Central

    Shivakoti, Rupak; Yang, Wei-Teng; Gupte, Nikhil; Berendes, Sima; Rosa, Alberto La; Cardoso, Sandra W.; Mwelase, Noluthando; Kanyama, Cecilia; Pillay, Sandy; Samaneka, Wadzanai; Riviere, Cynthia; Sugandhavesa, Patcharaphan; Santos, Brento; Poongulali, Selvamuthu; Tripathy, Srikanth; Bollinger, Robert C.; Currier, Judith S.; Tang, Alice M.; Semba, Richard D.; Christian, Parul; Campbell, Thomas B.; Gupta, Amita

    2015-01-01

    Background. Anemia is a known risk factor for clinical failure following antiretroviral therapy (ART). Notably, anemia and inflammation are interrelated, and recent studies have associated elevated C-reactive protein (CRP), an inflammation marker, with adverse human immunodeficiency virus (HIV) treatment outcomes, yet their joint effect is not known. The objective of this study was to assess prevalence and risk factors of anemia in HIV infection and to determine whether anemia and elevated CRP jointly predict clinical failure post-ART. Methods. A case-cohort study (N = 470 [236 cases, 234 controls]) was nested within a multinational randomized trial of ART efficacy (Prospective Evaluation of Antiretrovirals in Resource Limited Settings [PEARLS]). Cases were incident World Health Organization stage 3, 4, or death by 96 weeks of ART treatment (clinical failure). Multivariable logistic regression was used to determine risk factors for pre-ART (baseline) anemia (females: hemoglobin <12.0 g/dL; males: hemoglobin <13.0 g/dL). Association of anemia as well as concurrent baseline anemia and inflammation (CRP ≥10 mg/L) with clinical failure were assessed using multivariable Cox models. Results. Baseline anemia prevalence was 51% with 15% prevalence of concurrent anemia and inflammation. In analysis of clinical failure, multivariate-adjusted hazard ratios were 6.41 (95% confidence interval [CI], 2.82–14.57) for concurrent anemia and inflammation, 0.77 (95% CI, .37–1.58) for anemia without inflammation, and 0.45 (95% CI, .11–1.80) for inflammation without anemia compared to those without anemia and inflammation. Conclusions. ART-naive, HIV-infected individuals with concurrent anemia and inflammation are at particularly high risk of failing treatment, and understanding the pathogenesis could lead to new interventions. Reducing inflammation and anemia will likely improve HIV disease outcomes. Alternatively, concurrent anemia and inflammation could represent

  10. Developing EHR-driven heart failure risk prediction models using CPXR(Log) with the probabilistic loss function.

    PubMed

    Taslimitehrani, Vahid; Dong, Guozhu; Pereira, Naveen L; Panahiazar, Maryam; Pathak, Jyotishman

    2016-04-01

    Computerized survival prediction in healthcare identifying the risk of disease mortality, helps healthcare providers to effectively manage their patients by providing appropriate treatment options. In this study, we propose to apply a classification algorithm, Contrast Pattern Aided Logistic Regression (CPXR(Log)) with the probabilistic loss function, to develop and validate prognostic risk models to predict 1, 2, and 5year survival in heart failure (HF) using data from electronic health records (EHRs) at Mayo Clinic. The CPXR(Log) constructs a pattern aided logistic regression model defined by several patterns and corresponding local logistic regression models. One of the models generated by CPXR(Log) achieved an AUC and accuracy of 0.94 and 0.91, respectively, and significantly outperformed prognostic models reported in prior studies. Data extracted from EHRs allowed incorporation of patient co-morbidities into our models which helped improve the performance of the CPXR(Log) models (15.9% AUC improvement), although did not improve the accuracy of the models built by other classifiers. We also propose a probabilistic loss function to determine the large error and small error instances. The new loss function used in the algorithm outperforms other functions used in the previous studies by 1% improvement in the AUC. This study revealed that using EHR data to build prediction models can be very challenging using existing classification methods due to the high dimensionality and complexity of EHR data. The risk models developed by CPXR(Log) also reveal that HF is a highly heterogeneous disease, i.e., different subgroups of HF patients require different types of considerations with their diagnosis and treatment. Our risk models provided two valuable insights for application of predictive modeling techniques in biomedicine: Logistic risk models often make systematic prediction errors, and it is prudent to use subgroup based prediction models such as those given by CPXR

  11. Male-female conflict and genitalia: failure to confirm predictions in insects and spiders.

    PubMed

    Eberhard, William G

    2004-02-01

    Some recent models suggest a new role for evolutionary arms races between males and females in sexual selection. Female resistance to males is proposed to be driven by the direct advantage to the female of avoiding male-imposed reductions in the number of offspring she can produce, rather than by the indirect advantage of selecting among possible sires for her offspring, as in some traditional models of sexual selection by female choice. This article uses the massive but hitherto under-utilized taxonomic literature on genitalic evolution to test, in a two-step process, whether such new models of arms races between males and females have been responsible for rapid divergent evolution of male genitalia. The test revolves around the prediction that 'new arms races' are less likely to occur in species in which females are largely or completely protected from unwanted sexual attentions from males (e.g. species which mate in leks or in male swarms, in which males attract females from a distance, or in which females initiate contact by attracting males from a distance). The multiple possible mechanical functions of male genitalia are summarized, and functions of male genitalic structures in 43 species in 21 families of Diptera are compiled. Functions associated with intromission and insemination (e.g. seizing and positioning the female appropriately, pushing past possible barriers within the female, orienting within the female to achieve sperm transfer), which are unlikely to be involved in new arms races when females are protected, are shown to be common (> 50 % of documented cases). This information is then used to generate the new arms race prediction: differences in genitalic form among congeneric species in which females are protected should be less common than differences among congeneric species in which females are vulnerable to harassment by males. This prediction was tested using a sample of 361 genera of insects and spiders. The prediction clearly failed, even

  12. Predicting Honeybee Colony Failure: Using the BEEHAVE Model to Simulate Colony Responses to Pesticides.

    PubMed

    Rumkee, Jack C O; Becher, Matthias A; Thorbek, Pernille; Kennedy, Peter J; Osborne, Juliet L

    2015-11-01

    To simulate effects of pesticides on different honeybee (Apis mellifera L.) life stages, we used the BEEHAVE model to explore how increased mortalities of larvae, in-hive workers, and foragers, as well as reduced egg-laying rate, could impact colony dynamics over multiple years. Stresses were applied for 30 days, both as multiples of the modeled control mortality and as set percentage daily mortalities to assess the sensitivity of the modeled colony both to small fluctuations in mortality and periods of low to very high daily mortality. These stresses simulate stylized exposure of the different life stages to nectar and pollen contaminated with pesticide for 30 days. Increasing adult bee mortality had a much greater impact on colony survival than mortality of bee larvae or reduction in egg laying rate. Importantly, the seasonal timing of the imposed mortality affected the magnitude of the impact at colony level. In line with the LD50, we propose a new index of "lethal imposed stress": the LIS50 which indicates the level of stress on individuals that results in 50% colony mortality. This (or any LISx) is a comparative index for exploring the effects of different stressors at colony level in model simulations. While colony failure is not an acceptable protection goal, this index could be used to inform the setting of future regulatory protection goals.

  13. Predicting Honeybee Colony Failure: Using the BEEHAVE Model to Simulate Colony Responses to Pesticides

    PubMed Central

    2015-01-01

    To simulate effects of pesticides on different honeybee (Apis mellifera L.) life stages, we used the BEEHAVE model to explore how increased mortalities of larvae, in-hive workers, and foragers, as well as reduced egg-laying rate, could impact colony dynamics over multiple years. Stresses were applied for 30 days, both as multiples of the modeled control mortality and as set percentage daily mortalities to assess the sensitivity of the modeled colony both to small fluctuations in mortality and periods of low to very high daily mortality. These stresses simulate stylized exposure of the different life stages to nectar and pollen contaminated with pesticide for 30 days. Increasing adult bee mortality had a much greater impact on colony survival than mortality of bee larvae or reduction in egg laying rate. Importantly, the seasonal timing of the imposed mortality affected the magnitude of the impact at colony level. In line with the LD50, we propose a new index of “lethal imposed stress”: the LIS50 which indicates the level of stress on individuals that results in 50% colony mortality. This (or any LISx) is a comparative index for exploring the effects of different stressors at colony level in model simulations. While colony failure is not an acceptable protection goal, this index could be used to inform the setting of future regulatory protection goals. PMID:26444386

  14. Predicting success and failure in juvenile drug treatment court: a meta-analytic review.

    PubMed

    Stein, David M; Deberard, Scott; Homan, Kendra

    2013-02-01

    This meta-analysis summarizes 41 studies that examined associations between characteristics of adolescent participants in juvenile drug treatment court and outcomes (i.e., premature termination, recidivism). A summary of within- and post-program recidivism rates was calculated, as was a global estimate of the premature drop-out rate. One clear trend in the available studies was the dramatic difference in recidivism rates for adolescents who succeed in graduating from drug court, relative to those who do not. In addition, the review revealed that behavior patterns evidenced during drug court participation were most strongly associated with both the probability of graduating successfully from drug court and recidivism (e.g., few in-program arrests, citations, detentions, and referrals; greater length of time in program or amount of treatment; lower use of drug and alcohol use, few positive urine screens, greater school attendance). Unfortunately, non-white participants tend to have a lower probability of graduation from drug court and experience higher recidivism during and following the program. Available juvenile drug treatment court studies confirm a number of reputed adolescent risk factors associated with substance abuse, criminality, treatment failure, and recidivism among adolescents (e.g., higher levels of emotional and behavioral problems, higher levels and severity of pre-program substance abuse, male gender). Suggestions for improving the effects of juvenile drug treatment court based on key results of the meta-analysis are offered.

  15. Reduced cerebral blood flow and white matter hyperintensities predict poor sleep in heart failure

    PubMed Central

    2013-01-01

    Background Poor sleep is common in heart failure (HF), though mechanisms of sleep difficulties are not well understood. Adverse brain changes among regions important for sleep have been demonstrated in patients with HF. Cerebral hypoperfusion, a correlate of sleep quality, is also prevalent in HF and a likely contributor to white matter hyperintensities (WMH). However, no study to date has examined the effects of cerebral blood flow, WMH, and brain volume on sleep quality in HF. Methods Fifty-three HF patients completed the Pittsburgh Sleep Quality Index and underwent brain magnetic resonance imaging to quantify brain and WMH volume. Transcranial Doppler ultrasonography assessed cerebral blood flow velocity of the middle cerebral artery (CBF-V of the MCA). Results 75.5% of HF patients reported impaired sleep. Regression analyses adjusting for medical and demographic factors showed decreased CBF-V of the MCA and greater WMH volume were associated with poor sleep quality. No such pattern emerged on total brain or regional volume indices. Conclusions Decreased cerebral perfusion and greater WMH may contribute to sleep difficulties in HF. Future studies are needed to confirm these findings and clarify the effects of cerebral blood flow and WMH on sleep in healthy and patient samples. PMID:24171759

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

    SciTech Connect

    Liu, Chun; Macdonald, D.D.

    1993-05-01

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

  17. Feature selection and oversampling in analysis of clinical data for extubation readiness in extreme preterm infants.

    PubMed

    Gourdeau, Pascale; Kanbar, Lara; Shalish, Wissam; Sant'Anna, Guilherme; Kearney, Robert; Precup, Doina

    2015-08-01

    We present an approach for the analysis of clinical data from extremely preterm infants, in order to determine if they are ready to be removed from invasive endotracheal mechanical ventilation. The data includes over 100 clinical features, and the subject population is naturally quite small. To address this problem, we use feature selection, specifically mutual information, in order to choose a small subset of informative features. The other challenge we address is class imbalance, as there are many more babies that succeed extubation than those who fail. To handle this problem, we use SMOTE, an algorithm which creates synthetic examples of the minority class.

  18. Crisis Management of Accidental Extubation in a Prone-Positioned Patient with Klippel-Feil Syndrome.

    PubMed

    Spond, Matthew; Burns, Tyler; Rosenbaum, Thea; Lienhart, Kristen

    2016-06-15

    We present the case of an accidental extubation in a prone-positioned patient with a challenging airway because of Klippel-Feil syndrome and previous cervical spine fusions. The surgical procedure was well underway when this occurred, which added substantially to the difficulties produced by this event. We herein highlight the corrective steps we took in our case. We also recommend the need for a comprehensive preoperative briefing with all operating room personnel together with an action plan for how to prevent this particular scenario. PMID:27301052

  19. Prediction of Failure Due to Thermal Aging, Corrosion and Environmental Fracture in Amorphous and Titanium Alloys

    SciTech Connect

    Farmer, J C

    2003-04-15

    DARPA is exploring a number of advanced materials for military applications, including amorphous metals and titanium-based alloys. Equipment made from these materials can undergo degradation due to thermal aging, uniform corrosion, pitting, crevice corrosion, denting, stress corrosion cracking, corrosion fatigue, hydrogen induced cracking and microbial influenced corrosion. Amorphous alloys have exceptional resistance to corrosion, due in part to the absence of grain boundaries, but can undergo crystallization and other phase instabilities during heating and welding. Titanium alloys are extremely corrosion resistant due to the formation of a tenacious passive film of titanium oxide, but is prone to hydrogen absorption in crevices, and hydrogen induced cracking after hydrogen absorption. Accurate predictions of equipment reliability, necessary for strategic planning, requires integrated models that account for all relevant modes of attack, and that can make probabilistic predictions. Once developed, model parameters must be determined experimentally, and the validity of models must be established through careful laboratory and field tests. Such validation testing requires state-of-the-art surface analytical techniques, as well as electrochemical and fracture mechanics tests. The interaction between those processes that perturb the local environment on a surface and those that alter metallurgical condition must be integrated in predictive models. The material and environment come together to drive various modes of corrosive attack (Figure 1). Models must be supported through comprehensive materials testing capabilities. Such capabilities are available at LLNL and include: the Long Term Corrosion Test Facility (LTCTF) where large numbers of standard samples can be exposed to realistic test media at several temperature levels; a reverse DC machine that can be used to monitor the propagation of stress corrosion cracking (SCC) in situ; and banks of potentiostats with

  20. Perceived social support predicted quality of life in patients with heart failure, but the effect is mediated by depressive symptoms

    PubMed Central

    Chung, Misook L; Mosor, Debra K; Lennie, Terry A; Frazier, Susan K.

    2012-01-01

    Purpose Depressive symptoms and inadequate social support are well-known independent predictors of increased mortality and morbidity in heart failure (HF). However, it is unclear how depressive symptoms and social support interact to influence quality of life. Thus, the purpose of this study was to determine the nature of the relationships (direct, mediator, and moderator) among depressive symptoms, social support, and quality of life in patients with HF. Methods We performed a secondary data analysis that included 362 patients with HF who completed measures of depressive symptoms (the Beck Depression Inventory-II), perceived social support (the Multidimensional Scale of Perceived Social Support), and quality of life (the Minnesota Living with Heart Failure Questionnaire) instruments. The direct, mediator, and moderator effects of both depressive symptoms and social support on quality of life were tested using multiple regressions and 2×2 ANCOVA. Results Less social support and greater depressive symptoms independently predicted poorer quality of life. The relationship between social support and quality of life was mediated by depressive symptoms. Neither social support nor depressive symptoms moderated quality of life. Conclusion Promotion of social support will improve quality of life only when depressive symptoms are also effectively managed. PMID:23076798

  1. Fully Coupled Micro/Macro Deformation, Damage, and Failure Prediction for SiC/Ti-15-3 Laminates

    NASA Technical Reports Server (NTRS)

    Bednarcyk, Brett A.; Arnold, Steven M.; Lerch, Brad A.

    2001-01-01

    The deformation, failure, and low cycle fatigue life of SCS-6/Ti-15-3 composites are predicted using a coupled deformation and damage approach in the context of the analytical generalized method of cells (GMC) micromechanics model. The local effects of inelastic deformation, fiber breakage, fiber-matrix interfacial debonding, and fatigue damage are included as sub-models that operate on the micro scale for the individual composite phases. For the laminate analysis, lamination theory is employed as the global or structural scale model, while GMC is embedded to operate on the meso scale to simulate the behavior of the composite material within each laminate layer. While the analysis approach is quite complex and multifaceted, it is shown, through comparison with experimental data, to be quite accurate and realistic while remaining extremely efficient.

  2. Right ventricular failure predicted from right bundle branch block: cardiac magnetic resonance imaging validation

    PubMed Central

    Arora, Sameer; Ahmad, Ali; Sood, Mike; El Sergany, Amaar; Sacchi, Terrence; Saul, Barry; Gaglani, Rahul; Heitner, John

    2016-01-01

    Background Right ventricular (RV) failure has proven to be independently associated with adverse outcomes. Electrocardiographic parameters assessing RV function are largely unknown, making echocardiography the first line for RV function assessment. It is however, limited by geometrical assumptions and is inferior to cardiac magnetic resonance imaging (CMRI) which is widely regarded as the most accurate tool for assessing RV function. Methods We seek to determine the correlation of ECG parameters of right bundle branch block (RBBB) with RV ejection fraction (EF) and RV dimensions using the CMRI. QRS duration, R amplitude and R’ duration were obtained from precordial lead V1; S duration and amplitude were obtained from lead I and AVL. RV systolic dysfunction was defined as RV EF <40%. RV systolic dysfunction group (mean EF of 24±10%) were compared with normal RV systolic function group which acted as control (mean EF of 48±8%). CMRI and ECG parameters were compared between the two groups. Rank correlations and scatter diagrams between individual CMRI parameters and ECG parameters were done using medcalc for windows, version 12.5. Sensitivity, specificity and area under the curve (AUC) were calculated. Results RV systolic dysfunction group was found to have larger RV end systolic volumes (90±42 vs. 59±40 mL, P=0.02). ECG evaluation of RV dysfunction group revealed longer R’ duration (103±22 vs. 84±18 msec, P=0.005) as compared to the control group. The specificity of R’ duration >100 msec to detect RV systolic dysfunction was found to be 93%. R’ duration was found to have an inverse correlation with RV EF (r=−0.49, P=0.007). Conclusions Larger RV end systolic volumes seen with RV dysfunction can affect the latter part of right bundle branch leading to prolonged R’ duration. We here found prolonged R’ duration in lead V1 to have a highly specific inverse correlation to RV systolic function. ECG can be used as an inexpensive tool for RV function

  3. A physically-based method for predicting peak discharge of floods caused by failure of natural and constructed earthen dams

    USGS Publications Warehouse

    Walder, J.S.; O'Connor, J. E.; Costa, J.E.; ,

    1997-01-01

    We analyse a simple, physically-based model of breach formation in natural and constructed earthen dams to elucidate the principal factors controlling the flood hydrograph at the breach. Formation of the breach, which is assumed trapezoidal in cross-section, is parameterized by the mean rate of downcutting, k, the value of which is constrained by observations. A dimensionless formulation of the model leads to the prediction that the breach hydrograph depends upon lake shape, the ratio r of breach width to depth, the side slope ?? of the breach, and the parameter ?? = (V.D3)(k/???gD), where V = lake volume, D = lake depth, and g is the acceleration due to gravity. Calculations show that peak discharge Qp depends weakly on lake shape r and ??, but strongly on ??, which is the product of a dimensionless lake volume and a dimensionless erosion rate. Qp(??) takes asymptotically distinct forms depending on whether < ??? 1 or < ??? 1. Theoretical predictions agree well with data from dam failures for which k could be reasonably estimated. The analysis provides a rapid and in many cases graphical way to estimate plausible values of Qp at the breach.We analyze a simple, physically-based model of breach formation in natural and constructed earthen dams to elucidate the principal factors controlling the flood hydrograph at the breach. Formation of the breach, which is assumed trapezoidal in cross-section, is parameterized by the mean rate of downcutting, k, the value of which is constrained by observations. A dimensionless formulation of the model leads to the prediction that the breach hydrograph depends upon lake shape, the ratio r of breach width to depth, the side slope ?? of the breach, and the parameter ?? = (V/D3)(k/???gD), where V = lake volume, D = lake depth, and g is the acceleration due to gravity. Calculations show that peak discharge Qp depends weakly on lake shape r and ??, but strongly on ??, which is the product of a dimensionless lake volume and a

  4. Genomic signatures predict migration and spawning failure in wild Canadian salmon.

    PubMed

    Miller, Kristina M; Li, Shaorong; Kaukinen, Karia H; Ginther, Norma; Hammill, Edd; Curtis, Janelle M R; Patterson, David A; Sierocinski, Thomas; Donnison, Louise; Pavlidis, Paul; Hinch, Scott G; Hruska, Kimberly A; Cooke, Steven J; English, Karl K; Farrell, Anthony P

    2011-01-14

    Long-term population viability of Fraser River sockeye salmon (Oncorhynchus nerka) is threatened by unusually high levels of mortality as they swim to their spawning areas before they spawn. Functional genomic studies on biopsied gill tissue from tagged wild adults that were tracked through ocean and river environments revealed physiological profiles predictive of successful migration and spawning. We identified a common genomic profile that was correlated with survival in each study. In ocean-tagged fish, a mortality-related genomic signature was associated with a 13.5-fold greater chance of dying en route. In river-tagged fish, the same genomic signature was associated with a 50% increase in mortality before reaching the spawning grounds in one of three stocks tested. At the spawning grounds, the same signature was associated with 3.7-fold greater odds of dying without spawning. Functional analysis raises the possibility that the mortality-related signature reflects a viral infection.

  5. Cartilage Status at Time of Arthroscopy Predicts Failure in Patients With Hip Dysplasia.

    PubMed

    Dwyer, Maureen K; Lee, Jo-Ann; McCarthy, Joseph C

    2015-09-01

    The purpose of our study was to determine whether chondral damage at the time of arthroscopy predicted conversion to THA in patients with dysplasia. We identified 166 patients with dysplasia who underwent hip arthroscopy. Forty-seven went on to receive THA. The articular cartilage of three regions of the acetabulum and femoral head were assessed for signs of chondral damage (absent, mild, or severe]). A stepwise multivariable logistic regression analysis revealed mild damage on the posterior femoral head (P=0.001) and severe damage on the anterior acetabulum (P=0.007) made a significant contribution to the predictor. The presence of mild posterior femoral head chondral changes was indicative of more global cartilage damage in this series of patients. Our findings show that chondral damage on the posterior femoral head and anterior acetabulum is a strong predictor of ultimate conversion to THA in dysplastic patients. PMID:26059500

  6. Risk factors for post-extubation stridor in children: the role of orotracheal cannula

    PubMed Central

    Nascimento, Milena Siciliano; Prado, Cristiane; Troster, Eduardo Juan; Valério, Naiana; Alith, Marcela Batan; de Almeida, João Fernando Lourenço

    2015-01-01

    Objective To determine the risk factors associated with stridor, with special attention to the role of the cuffed orotracheal cannula. Methods Prospective analysis of all the intubated patients submitted to mechanical ventilator support from January 2008 to April 2011. The relevant factors for stridor collected were age, weight, size and type of airway tube, diagnosis, and duration of mechanical ventilation. The effects of variables on stridor were evaluated using uni- and multivariate logistic regression models. Results A total of 136 patients were included. Mean age was 1.4 year (3 days to 17 years). The mean duration of mechanical ventilation was 73.5 hours. Fifty-six patients (41.2%) presented with stridor after extubation. The total reintubation rate was 19.6% and 12.5 in patients with and without stridor, respectively. The duration of mechanical ventilation (>72 hours) was associated with a greater risk for stridor (odds ratio of 8.60; 95% confidence interval of 2.98-24.82; p<0.001). The presence of the cuffed orotracheal cannula was not associated with stridor (odds ratio of 98; 95% confidence interval of 0.46-2.06; p=0.953). Conclusion The main risk factor for stridor after extubation in our population was duration of mechanical ventilation. The presence of the cuffed orotracheal cannula was not associated with increased risk for stridor, reinforcing the use of the cuffed orotracheal cannula in children with respiratory distress. PMID:26061076

  7. Why achievement motivation predicts success in business but failure in politics: the importance of personal control.

    PubMed

    Winter, David G

    2010-12-01

    Several decades of research have established that implicit achievement motivation (n Achievement) is associated with success in business, particularly in entrepreneurial or sales roles. However, several political psychology studies have shown that achievement motivation is not associated with success in politics; rather, implicit power motivation often predicts political success. Having versus lacking control may be a key difference between business and politics. Case studies suggest that achievement-motivated U.S. presidents and other world leaders often become frustrated and thereby fail because of lack of control, whereas power-motivated presidents develop ways to work with this inherent feature of politics. A reevaluation of previous research suggests that, in fact, relationships between achievement motivation and business success only occur when control is high. The theme of control is also prominent in the development of achievement motivation. Cross-national data are also consistent with this analysis: In democratic industrialized countries, national levels of achievement motivation are associated with strong executive control. In countries with low opportunity for education (thus fewer opportunities to develop a sense of personal control), achievement motivation is associated with internal violence. Many of these manifestations of frustrated achievement motivation in politics resemble authoritarianism. This conclusion is tested by data from a longitudinal study of 113 male college students, showing that high initial achievement motivation combined with frustrated desires for control is related to increases in authoritarianism (F-scale scores) during the college years. Implications for the psychology of leadership and practical politics are discussed.

  8. Prediction of diffusion assisted hydrogen embrittlement failure in high strength martensitic steels

    NASA Astrophysics Data System (ADS)

    Wu, Q.; Zikry, M. A.

    2015-12-01

    A stress assisted hydrogen diffusion transport model, a dislocation-density-based multiple-slip crystalline plasticity formulation, and an overlapping fracture method were used to investigate hydrogen diffusion and embrittlement in lath martensitic steels with distributions of M23C6 carbide precipitates. The formulation accounts for variant morphologies based on orientation relationships (ORs) that are uniquely inherent to lath martensitic microstructures. The interrelated effects of martensitic block and packet boundaries and carbide precipitates on hydrogen diffusion, hydrogen assisted crack nucleation and growth, are analyzed to characterize the competition between cleavage fracture and hydrogen diffusion assisted fracture along preferential microstructural fracture planes. Stresses along the three cleavage planes and the six hydrogen embrittlement fracture planes are monitored, such that crack nucleation and growth can nucleate along energetically favorable planes. High pressure gradients result in the accumulation of hydrogen, which embrittles martensite, and results in crack nucleation and growth along {110} planes. Cleavage fracture occurs along {100} planes when there is no significant hydrogen diffusion. The predictions indicate that hydrogen diffusion can suppress the emission and accumulation of dislocation density, and lead to fracture with low plastic strains.

  9. Chronic Liver Failure-Sequential Organ Failure Assessment is better than the Asia-Pacific Association for the Study of Liver criteria for defining acute-on-chronic liver failure and predicting outcome

    PubMed Central

    Dhiman, Radha K; Agrawal, Swastik; Gupta, Tarana; Duseja, Ajay; Chawla, Yogesh

    2014-01-01

    AIM: To compare the utility of the Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) and Asia-Pacific Association for the Study of Liver (APASL) definitions of acute-on-chronic liver failure (ACLF) in predicting short-term prognosis of patients with ACLF. METHODS: Consecutive patients of cirrhosis with acute decompensation were prospectively included. They were grouped into ACLF and no ACLF groups as per CLIF-SOFA and APASL criteria. Patients were followed up for 3 mo from inclusion or mortality whichever was earlier. Mortality at 28-d and 90-d was compared between no ACLF and ACLF groups as per both criteria. Mortality was also compared between different grades of ACLF as per CLIF-SOFA criteria. Prognostic scores like CLIF-SOFA, Acute Physiology and Chronic Health Evaluation (APACHE)-II, Child-Pugh and Model for End-Stage Liver Disease (MELD) scores were evaluated for their ability to predict 28-d mortality using area under receiver operating curves (AUROC). RESULTS: Of 50 patients, 38 had ACLF as per CLIF-SOFA and 19 as per APASL criteria. Males (86%) were predominant, alcoholic liver disease (68%) was the most common etiology of cirrhosis, sepsis (66%) was the most common cause of acute decompensation while infection (66%) was the most common precipitant of acute decompensation. The 28-d mortality in no ACLF and ACLF groups was 8.3% and 47.4% (P = 0.018) as per CLIF-SOFA and 39% and 37% (P = 0.895) as per APASL criteria. The 28-d mortality in patients with no ACLF (n = 12), ACLF grade 1 (n = 11), ACLF grade 2 (n = 14) and ACLF grade 3 (n = 13) as per CLIF-SOFA criteria was 8.3%, 18.2%, 42.9% and 76.9% (χ2 for trend, P = 0.002) and 90-d mortality was 16.7%, 27.3%, 78.6% and 100% (χ2 for trend, P < 0.0001) respectively. Patients with prior decompensation had similar 28-d and 90-d mortality (39.3% and 53.6%) as patients without prior decompensation (36.4% and 63.6%) (P = NS). AUROCs for 28-d mortality were 0.795, 0.787, 0.739 and 0.710 for

  10. A physically-based method for predicting peak discharge of floods caused by failure of natural and constructed earthen dams

    USGS Publications Warehouse

    Walder, J.S.

    1997-01-01

    We analyse a simple, physically-based model of breach formation in natural and constructed earthen dams to elucidate the principal factors controlling the flood hydrograph at the breach. Formation of the breach, which is assumed trapezoidal in cross-section, is parameterized by the mean rate of downcutting, k, the value of which is constrained by observations. A dimensionless formulation of the model leads to the prediction that the breach hydrograph depends upon lake shape, the ratio r of breach width to depth, the side slope ?? of the breach, and the parameter ?? = (V/ D3)(k/???gD), where V = lake volume, D = lake depth, and g is the acceleration due to gravity. Calculations show that peak discharge Qp depends weakly on lake shape r and ??, but strongly on ??, which is the product of a dimensionless lake volume and a dimensionless erosion rate. Qp(??) takes asymptotically distinct forms depending on whether ?? > 1. Theoretical predictions agree well with data from dam failures for which k could be reasonably estimated. The analysis provides a rapid and in many cases graphical way to estimate plausible values of Qp at the breach.

  11. The predicted relative risk of premature ovarian failure for three radiotherapy modalities in a girl receiving craniospinal irradiation

    NASA Astrophysics Data System (ADS)

    Pérez-Andújar, A.; Newhauser, W. D.; Taddei, P. J.; Mahajan, A.; Howell, R. M.

    2013-05-01

    In girls and young women, irradiation of the ovaries can reduce the number of viable ovarian primordial follicles, which may lead to premature ovarian failure (POF) and subsequently to sterility. One strategy to minimize this late effect is to reduce the radiation dose to the ovaries. A primary means of reducing dose is to choose a radiotherapy technique that avoids irradiating nearby normal tissue; however, the relative risk of POF (RRPOF) due to the various therapeutic options has not been assessed. This study compared the predicted RRPOF after craniospinal proton radiotherapy, conventional photon radiotherapy (CRT) and intensity-modulated photon radiotherapy (IMRT). We calculated the equivalent dose delivered to the ovaries of an 11-year-old girl from therapeutic and stray radiation. We then predicted the percentage of ovarian primordial follicles killed by radiation and used this as a measure of the RRPOF; we also calculated the ratio of the relative risk of POF (RRRPOF) among the three radiotherapies. Proton radiotherapy had a lower RRPOF than either of the other two types. We also tested the sensitivity of the RRRPOF between photon and proton therapies to the anatomic position of the ovaries, i.e., proximity to the treatment field (2 ≤ RRRPOF ≤ 10). We found that CRT and IMRT have higher risks of POF than passive-scattering proton radiotherapy (PRT) does, regardless of uncertainties in the ovarian location. Overall, PRT represents a lower RRPOF over the two other modalities.

  12. The stress response predicts migration failure but not migration rate in a semelparous fish.

    PubMed

    Cook, Katrina V; Crossin, Glenn T; Patterson, David A; Hinch, Scott G; Gilmour, Kathleen M; Cooke, Steven J

    2014-06-01

    Recent findings from iteroparous species suggest that glucocorticoid secretion following acute stress can mediate behavior and survival strategies, ultimately influencing fitness. However, these correlates of the stress response may not exist in semelparous animals given the inability to maximize fitness by delaying reproduction. We measured baseline and stress-induced cortisol concentrations in semelparous sockeye salmon (Oncorhynchus nerka) following exposure to an acute stressor at the mouth of the Fraser River in British Columbia. The homing fish were then radio-tagged and tracked throughout their in-river migration. Findings reveal that the stress response (i.e. change from baseline to stress-induced cortisol) was predictive of mortality; fish failing to leave the release site had a significantly greater stress response (mean±SE=1004.0±75.3ng/mL) compared to fish capable of successfully migrating beyond one of the most difficult areas of passage over 100 river kilometers upstream (mean±SE=780.7±66.7ng/mL). However, there were no associations between swimming behaviors, both immediately following release and to last point of detection, and the stress response. This study also introduced an unique method of tagging migrating salmon that allows for rapid capture and sampling and thus provides the first assessment of true baseline cortisol concentrations at river-entry for migrating Pacific salmon in the wild. Results show the stress response to be linked to survival in a semelparous species and therefore set the stage for further exploration into how the evolutionary theories underlying relationships between stress responsiveness and fitness may differ between semelparous and iteroparous species. PMID:24769043

  13. Metabolic Response on Post-therapy FDG-PET Predicts Patterns of Failure After Radiotherapy for Cervical Cancer

    SciTech Connect

    Schwarz, Julie K.; Siegel, Barry A.; Dehdashti, Farrokh; Grigsby, Perry W.

    2012-05-01

    Purpose: To determine the patterns of failure in patients with cervical cancer treated with definitive radiotherapy and evaluated for metabolic response with early posttherapy {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG-PET). Methods and Materials: The records of 238 patients with cervical cancer were reviewed. All patients were treated with a combination of external radiotherapy and intracavitary brachytherapy. Two hundred and nineteen patients (92%) received concurrent chemotherapy. All patients underwent pretreatment FDG-PET, and posttherapy FDG-PET was performed within 8-16 weeks of the completion of radiotherapy. Posttherapy FDG-PET results were categorized as complete metabolic response (CMR), partial metabolic response (PMR), and progressive disease (PD). Failure patterns were categorized as none, isolated local failure (central pelvis {+-} pelvic lymph nodes), distant failure, or combined local plus distant failure. Results: Of the 91 patients (38%) who had a recurrence, 22 had isolated local failures, and 69 had distant failures (49 distant failures and 20 combined local plus distant failures). Of the 173 patients with a CMR, 40 (23%) experienced treatment failure. All 25 patients with PD experienced treatment failure, which was distant in 24 patients (96%). Among the 40 patients with PMR, no failure has been observed for 14 patients (35%). Of the 26 failures within the PMR group, 15 (58%) were limited to the pelvis. Differences in the patterns of failure between the three groups (CMR, PMR, PD) were statistically significant (chi-square test; p < 0.0001). Conclusions: The majority of failures after definitive radiotherapy for cervical cancer include distant failures, even in the setting of concurrent chemotherapy. PMR within the cervix or lymph nodes is more commonly associated with isolated local recurrence.

  14. On prediction of the strength levels and failure patterns of human vertebrae using quantitative computed tomography (QCT)-based finite element method.

    PubMed

    Mirzaei, Majid; Zeinali, Ahad; Razmjoo, Arash; Nazemi, Majid

    2009-08-01

    This paper presents an effective patient-specific approach for prediction of failure initiation and growth in human vertebra using the general framework of the quantitative computed tomography (QCT)-based finite element method (FEM). The studies were carried out on 13 vertebrae (lumbar and thoracic), excised from 3 cadavers with the average age of 42 years old. Initially, 4 samples were QCT scanned and the images were directly converted into voxel-based 3D finite element models for linear and nonlinear analyses. The equivalent plastic strains obtained from the nonlinear analyses were used to predict the occurrence of local failures and development of the failure patterns. In the linear analyses, the strain energy density measure was used to identify the critical elements and predict the failure patterns. Subsequently, the samples were destructively tested in uniaxial compression and the experimental load-displacement diagrams were obtained. The plain radiographic images of the tested samples were also examined for observation of the failure patterns. In continuation, the presence of osteolytic defects in vertebrae was simulated by creation of artificial cavities within 9 remaining samples using a computer numerical control (CNC) milling machine. The same protocol was followed for scanning, modeling, and destructive testing of these samples. A strong correlation was found between the predicted and measured strengths. Finally, a typical vertebroplasty treatment was simulated by injection of low-viscosity bone cement within 3 compressed samples. The failure patterns and the associated load levels for these samples were also predicted using the QCT voxel-based FEM. PMID:19457486

  15. Serum activin A and B levels predict outcome in patients with acute respiratory failure: a prospective cohort study

    PubMed Central

    2013-01-01

    Introduction 30 day mortality in patients with Acute Respiratory Failure (ARF) is approximately 30%, defined as patients requiring ventilator support for more than 6 hours. Novel biomarkers are needed to predict patient outcomes and to guide potential future therapies. The activins A and B, members of the Transforming Growth Factor β family of proteins, and their binding protein, follistatin, have recently been shown to be important regulators of inflammation and fibrosis but no substantial data are available concerning their roles in ARF. Our objectives were to evaluate whether the serum levels of activin A, B and follistatin are elevated in 518 patients with ARF from the FINNALI study compared the concentrations in 138 normal subjects that form a reference range. Methods Specific assays for activin A, B and follistatin were used and the results analyzed according to diagnostic groups as well as according to standard measures in intensive care. Multivariable logistic regression was used to create a model to predict death at 90 days and 12 months from the onset of the ARF. Results Serum activin A and B were significantly elevated in most patients and in most of the diagnostic groups. Patients who had activin A and/or B concentrations above the reference maximum were significantly more likely to die in the 12 months following admission [either activin A or B above reference maximum: Positive Likelihood Ratio [LR+] 1.65 [95% CI 1.28-2.12, P = 0.00013]; both activin A and B above reference maximum: LR + 2.78 [95% CI 1.96-3.95, P < 0.00001]. The predictive model at 12 months had an overall accuracy of 80.2% [95% CI 76.6-83.3%]. Conclusions The measurement of activin A and B levels in these patients with ARF would have assisted in predicting those at greatest risk of death. Given the existing data from animal studies linking high activin A levels to significant inflammatory challenges, the results from this study suggest that approaches to modulate

  16. Usefulness of C-Reactive Protein Plasma Levels to Predict Exercise Intolerance in Patients With Chronic Systolic Heart Failure.

    PubMed

    Canada, Justin McNair; Fronk, Daniel Taylor; Cei, Laura Freeman; Carbone, Salvatore; Erdle, Claudia Oddi; Abouzaki, Nayef Antar; Melchior, Ryan David; Thomas, Christopher Scott; Christopher, Sanah; Turlington, Jeremy Shane; Trankle, Cory Ross; Thurber, Clinton Joseph; Evans, Ronald Kenneth; Dixon, Dave L; Van Tassell, Benjamin Wallace; Arena, Ross; Abbate, Antonio

    2016-01-01

    Patients with heart failure (HF) have evidence of chronic systemic inflammation. Whether inflammation contributes to the exercise intolerance in patients with HF is, however, not well established. We hypothesized that the levels of C-reactive protein (CRP), an established inflammatory biomarker, predict impaired cardiopulmonary exercise performance, in patients with chronic systolic HF. We measured CRP using high-sensitivity particle-enhanced immunonephelometry in 16 patients with ischemic heart disease (previous myocardial infarction) and chronic systolic HF, defined as a left ventricular ejection fraction ≤ 50% and New York Heart Association class II-III symptoms. All subjects with CRP >2 mg/L, reflecting systemic inflammation, underwent cardiopulmonary exercise testing using a symptom-limited ramp protocol. CRP levels predicted shorter exercise times (R = -0.65, p = 0.006), lower oxygen consumption (VO2) at the anaerobic threshold (R = -0.66, p = 0.005), and lower peak VO2 (R = -0.70, p = 0.002), reflecting worse cardiovascular performance. CRP levels also significantly correlated with an elevated ventilation/carbon dioxide production slope (R = +0.64, p = 0.008), a reduced oxygen uptake efficiency slope (R = -0.55, p = 0.026), and reduced end-tidal CO2 level at rest and with exercise (R = -0.759, p = 0.001 and R = -0.739, p = 0.001, respectively), reflecting impaired gas exchange. In conclusion, the intensity of systemic inflammation, measured as CRP plasma levels, is associated with cardiopulmonary exercise performance, in patients with ischemic heart disease and chronic systolic HF. These data provide the rationale for targeted anti-inflammatory treatments in HF. PMID:26546248

  17. Sequential organ failure assessment scoring and prediction of patient's outcome in Intensive Care Unit of a tertiary care hospital

    PubMed Central

    Jain, Aditi; Palta, Sanjeev; Saroa, Richa; Palta, Anshu; Sama, Sonu; Gombar, Satinder

    2016-01-01

    Background and Aims: The objective was to determine the accuracy of sequential organ failure assessment (SOFA) score in predicting outcome of patients in Intensive Care Unit (ICU). Material and Methods: Forty-four consecutive patients between 15 and 80 years admitted to ICU over 8 weeks period were studied prospectively. Three patients were excluded. SOFA score was determined 24 h postadmission to ICU and subsequently every 48 h for the first 10 days. Patients were followed till discharge/death/transfer from the ICU. Initial SOFA score, highest and mean SOFA scores were calculated and correlated with mortality and duration of stay in ICU. Results: The mortality rate was 39% and the mean duration of stay in the ICU was 9 days. The maximum score in survivors (3.92 ± 2.17) was significantly lower than nonsurvivors (8.9 ± 3.45). The initial SOFA score had a strong statistical correlation with mortality. Cardiovascular score on day 1 and 3, respiratory score on day 7, and coagulation profile on day 3 correlated significantly with the outcome. Duration of the stay did not correlate with the survival (P = 0.461). Conclusion: SOFA score is a simple, but effective prognostic indicator and evaluator for patient progress in ICU. Day 1 SOFA can triage the patients into risk categories. For further management, mean and maximum score help determine the severity of illness and can act as a guide for the intensity of therapy required for each patient. PMID:27625487

  18. Prediction of Hospital Acute Myocardial Infarction and Heart Failure 30-Day Mortality Rates Using Publicly Reported Performance Measures

    PubMed Central

    Aaronson, David S.; Bardach, Naomi S.; Lin, Grace A.; Chattopadhyay, Arpita; Goldman, L. Elizabeth; Dudley, R. Adams

    2014-01-01

    Objective To identify an approach to summarizing publicly reported hospital performance data for acute myocardial infarction (AMI) or heart failure (HF) that best predicts current year hospital mortality rates. Setting A total of 1,868 U.S. hospitals reporting process and outcome measures for AMI and HF to the Centers for Medicare and Medicaid Services (CMS) from July 2005 to June 2006 (Year 0) and July 2006 to June 2007 (Year 1). Design Observational cohort study measuring the percentage variation in Year 1 hospital 30-day risk-adjusted mortality rate explained by denominator-based weighted composite scores summarizing hospital Year 0 performance. Data Collection Data were prospectively collected from hospitalcompare.gov. Results Percentage variation in Year 1 mortality was best explained by mortality rate alone in Year 0 over other composites including process performance. If only Year 0 mortality rates were reported, and consumers using hospitals in the highest decile of mortality instead chose hospitals in the lowest decile of mortality rate, the number of deaths at 30 days that potentially could have been avoided was 1.31 per 100 patients for AMI and 2.12 for HF (p < .001). Conclusion Public reports focused on 30-day risk-adjusted mortality rate may more directly address policymakers’ goals of facilitating consumer identification of hospitals with better outcomes. PMID:22093186

  19. Increased Platelet-to-Lymphocyte Ratios and Low Relative Lymphocyte Counts Predict Appropriate Shocks in Heart Failure Patients with ICDs

    PubMed Central

    Balci, Kevser Gülcihan; Balci, Mustafa Mücahit; Arslan, Ugur; Açar, Burak; Maden, Orhan; Selcuk, Hatice; Selcuk, Timur

    2016-01-01

    Background Platelet-to-lymphocyte ratio (PLR) and relative lymphocyte count (L%) are commonly available tests that can be obtained from complete blood count. The aim of this study was to investigate the association between appropriate defibrillator therapy and PLR, and whether decreased lymphocyte count may predict appropriate implantable cardioverter defibrillator (ICD) shocks in heart failure (HF) patients. Methods A total of 147 patients with ischemic or non-ischemic HF who underwent ICD implantation for primary prevention were enrolled in this study. Peripheral venous blood samples were drawn on the same day as ICD implantation. White blood cell counts with differentials, red blood cell indices, and platelet counts were calculated with an automated blood cell counter. All patients were evaluated according to the presence of appropriate ICD therapy. Results Baseline ejection fraction was significantly lower in the appropriate shock received group (p = 0.040). Median PLR was significantly higher and L% was significantly lower in the appropriate shock received group (p < 0.001). In both ischemic and non-ischemic HF groups, median L% was significantly lower in the appropriate shock received group (p < 0.001; p = 0.006, respectively). In multivariable logistic regression analysis, only L% showed a strong association with appropriate shock therapy (p < 0.001). Conclusions Higher PLRs are related to appropriate shocks in patients that received ICD with lower EF. Furthermore, decreased L% is independently associated with appropriate shocks in HF. PMID:27713602

  20. Symptomatology and Coping Resources Predict Self-Care Behaviors in Middle to Older Age Patients with Heart Failure

    PubMed Central

    Graven, Lucinda J.; Grant, Joan S.; Gordon, Glenna

    2015-01-01

    Background. Symptoms of heart failure (HF) and coping resources, such as social support and social problem-solving, may influence self-care behaviors. Research regarding the influence of HF symptomatology characteristics and components of social support and social problem-solving on self-care is limited. Objective. To identify predictors of HF self-care behaviors using characteristics of HF symptomatology, components of social support and social problem-solving, and demographic and clinical factors. Methods. Using a cross-sectional, correlational predictive design, a convenience sample (N = 201) of outpatients with HF answered self-report surveys. Multiple linear regression with stepwise variable selection was conducted. Results. Six predictors of HF self-care were identified: race, symptom frequency, symptom-related interference with enjoyment of life, New York Heart Association Class HF, rational problem-solving style, and social network (β = 34.265, R2 = 0.19, P = 0.001). Conclusions. Assessing the influence of race on self-care behaviors in middle to older age patients with HF is important. Clinical assessment that focuses on symptom frequency, symptom-related interference with enjoyment of life, and HF Class might also impact self-care behaviors in this population. Rational problem-solving skills used and evaluation of the size of and satisfaction with one's social network may be appropriate when assessing self-care. PMID:26618000

  1. Symptomatology and Coping Resources Predict Self-Care Behaviors in Middle to Older Age Patients with Heart Failure.

    PubMed

    Graven, Lucinda J; Grant, Joan S; Gordon, Glenna

    2015-01-01

    Background. Symptoms of heart failure (HF) and coping resources, such as social support and social problem-solving, may influence self-care behaviors. Research regarding the influence of HF symptomatology characteristics and components of social support and social problem-solving on self-care is limited. Objective. To identify predictors of HF self-care behaviors using characteristics of HF symptomatology, components of social support and social problem-solving, and demographic and clinical factors. Methods. Using a cross-sectional, correlational predictive design, a convenience sample (N = 201) of outpatients with HF answered self-report surveys. Multiple linear regression with stepwise variable selection was conducted. Results. Six predictors of HF self-care were identified: race, symptom frequency, symptom-related interference with enjoyment of life, New York Heart Association Class HF, rational problem-solving style, and social network (β = 34.265, R (2) = 0.19, P = 0.001). Conclusions. Assessing the influence of race on self-care behaviors in middle to older age patients with HF is important. Clinical assessment that focuses on symptom frequency, symptom-related interference with enjoyment of life, and HF Class might also impact self-care behaviors in this population. Rational problem-solving skills used and evaluation of the size of and satisfaction with one's social network may be appropriate when assessing self-care.

  2. Comparative assessment of ProSeal™ laryngeal mask airway intervention versus standard technique of endotracheal extubation for attenuation of pressor response in controlled hypertensive patients

    PubMed Central

    Singh, Raj Pal; Gulabani, Michell; Kaur, Mohandeep; Sood, Rajesh

    2016-01-01

    Background and Aims: Swapping of the endotracheal tube with laryngeal mask airway (LMA) before emergence from anaesthesia is one of the methods employed for attenuation of pressor response at extubation. We decided to compare the placement of ProSeal™ LMA (PLMA) before endotracheal extubation versus conventional endotracheal extubation in controlled hypertensive patients scheduled for elective surgeries under general anaesthesia. Methods: Sixty consenting adult patients were randomly allocated to two groups of thirty each; Group E in whom extubation was performed using standard technique and Group P in whom PLMA was inserted before endotracheal extubation (Bailey manoeuvre). The primary outcome parameter was heart rate (HR). The secondary outcomes were systolic, diastolic and mean blood pressure (MBP), electrocardiogram, oxygen saturation and end-tidal carbon dioxide. Two-tailed paired Student's t-test was used for comparison between the two study groups. The value of P < 0.05 was considered as statistically significant. Results: The patient characteristics, demographic data and surgical procedures were comparable in the two groups. A statistically significant decrease was observed in HR in Group P as compared to Group E. Secondary outcomes such as systolic, diastolic and MBP depicted a statistically insignificant difference. Conclusion: Bailey manoeuvre was not effective method to be completely relied upon during extubation when compared to standard extubation. PMID:27512160

  3. Role of galectin-3 and plasma B type-natriuretic peptide in predicting prognosis in discharged chronic heart failure patients

    PubMed Central

    Feola, Mauro; Testa, Marzia; Leto, Laura; Cardone, Marco; Sola, Mario; Rosso, Gian Luca

    2016-01-01

    Abstract Galectin-3 demonstrated to be a robust independent marker of cardiovascular mid-term (18-month) outcome in heart failure (HF) patients. The objective of this study was to analyze the value of a predischarged determination of plasma galectin-3 alone and with plasma brain natriuretic peptide (BNP) in predicting mid-term outcome in frequent-flyers (FF) HF (≥2 hospitalization for HF/year)/dead patients discharged after an acute decompensated HF (ADHF) episode. All FF chronic HF subjects discharged alive after an ADHF were enrolled. All patients underwent a determination of BNP and galectin-3, a 6-minute walk test, and an echocardiogram within 48 hours upon hospital discharge. Death by any cause, cardiac transplantation, and worsening HF requiring readmission to hospital were considered cardiovascular events. Eighty-three patients (67 males, age 73.2 ± 8.6 years old) were analyzed (mean follow-up 11.6 ± 5.2 months; range 4–22 months). During the follow-up 38 events (45.7%) were scheduled: (13 cardiac deaths, 35 rehospitalizations for ADHF). According to medical history, in 33 patients (39.8%) a definition of FF HF patients was performed (range 2–4 hospitalization/year). HF patients who suffered an event (FF or death) demonstrated more impaired ventricular function (P = 0.037), higher plasma BNP (P = 0.005), and Gal-3 at predischarge evaluation (P = 0.027). Choosing adequate cut-off points (BNP ≥ 500 pg/mL and Gal-3 ≥ 17.6 ng/mL), the Kaplan–Meier curves depicted the powerful stratification using BNP + Gal-3 in predicting clinical course at mid-term follow-up (log rank 5.65; P = 0.017). Adding Gal-3 to BNP, a single predischarge strategy testing seemed to obtain a satisfactorily predictive value in alive HF patients discharged after an ADHF episode. PMID:27368017

  4. 1,25-Dihydroxyvitamin D to PTH(1–84) Ratios Strongly Predict Cardiovascular Death in Heart Failure

    PubMed Central

    Gruson, Damien; Ferracin, Benjamin; Ahn, Sylvie A.; Zierold, Claudia; Blocki, Frank; Hawkins, Douglas M.; Bonelli, Fabrizio; Rousseau, Michel F.

    2015-01-01

    Objectives Vitamin D deficiency and hyperparathyroidism are common in patients with heart failure (HF). There is a growing body of evidence supporting the role of vitamin D and parathyroid hormone (PTH) in cardiac remodeling and worsening of HF. Lack of reliable automated testing of 1,25-dihydroxyvitamin D (1,25(OH)2D), the biologically active metabolite of vitamin D, has limited its contribution to the prognostic assessment of HF. Here, the association of 1,25(OH)2D and PTH(1–84) levels was evaluated for prediction of cardiovascular death in chronic HF patients. Methods We conducted a single center prospective cohort including 170 chronic HF patients (females n = 36; males n = 134; NYHA II-IV; mean age: 67 years; etiology: ischemic n = 119, dilated cardiomyopathy n = 51; mean LVEF: 23%). The primary outcome was cardiovascular death. Results Serum levels of 1,25(OH)2D decreased markedly with increased HF severity. Medians were 33.3 pg/mL for NYHA-II patients, 23.4 pg/mL for NYHA-III, and 14.0 pg/mL for NYHA-IV patients (p<0.001). Most patients had levels of 25(OH)D below 30ng/mL, and stratification by NYHA functional class did not show significant differences (p = 0.249). The 1,25(OH)2D to PTH(1–84) ratio and the (1,25(OH)2D)2 to PTH(1–84) ratio were found to be the most significantly related to HF severity. After a median follow-up of 4.1 years, 106 out of 170 patients reached the primary endpoint. Cox proportional hazard modeling revealed 1,25(OH)2D and the 1,25(OH)2D to PTH(1–84) ratios to be strongly predictive of outcomes. Conclusions 1,25(OH)2D and its ratios to PTH(1–84) strongly and independently predict cardiovascular mortality in chronic HF. PMID:26308451

  5. Spectral transfer function analysis of respiratory hemodynamic fluctuations predicts end-diastolic stiffness in preserved ejection fraction heart failure.

    PubMed

    Abdellatif, Mahmoud; Leite, Sara; Alaa, Mohamed; Oliveira-Pinto, José; Tavares-Silva, Marta; Fontoura, Dulce; Falcão-Pires, Inês; Leite-Moreira, Adelino F; Lourenço, André P

    2016-01-01

    Preserved ejection fraction heart failure (HFpEF) diagnosis remains controversial, and invasive left ventricular (LV) hemodynamic evaluation and/or exercise testing is advocated by many. The stiffer HFpEF myocardium may show impaired stroke volume (SV) variation induced by fluctuating LV filling pressure during ventilation. Our aim was to investigate spectral transfer function (STF) gain from end-diastolic pressure (EDP) to indexed SV (SVi) in experimental HFpEF. Eighteen-week-old Wistar-Kyoto (WKY) and ZSF1 lean (ZSF1 Ln) and obese rats (ZSF1 Ob) randomly underwent LV open-chest (OC, n = 8 each group) or closed-chest hemodynamic evaluation (CC, n = 6 each group) under halogenate anesthesia and positive-pressure ventilation at constant inspiratory pressure. Beat-to-beat fluctuations in hemodynamic parameters during ventilation were assessed by STF. End-diastolic stiffness (βi) and end-systolic elastance (Eesi) for indexed volumes were obtained by inferior vena cava occlusion in OC (multibeat) or single-beat method estimates in CC. ZSF1 Ob showed higher EDP spectrum (P < 0.001), higher STF gain between end-diastolic volume and EDP, and impaired STF gain between EDP and SVi compared with both hypertensive ZSF1 Ln and normotensive WKY controls (P < 0.001). Likewise βi was only higher in ZSF1 Ob while Eesi was raised in both ZSF1 groups. On multivariate analysis βi and not Eesi correlated with impaired STF gain from EDP to SVi (P < 0.001), and receiver-operating characteristics analysis showed an area under curve of 0.89 for higher βi prediction (P < 0.001). Results support further clinical testing of STF analysis from right heart catheterization-derived EDP surrogates to noninvasively determined SV as screening/diagnostic tool to assess myocardial stiffness in HFpEF.

  6. Metabolic rates of ATP transfer through creatine kinase (CK Flux) predict clinical heart failure events and death.

    PubMed

    Bottomley, Paul A; Panjrath, Gurusher S; Lai, Shenghan; Hirsch, Glenn A; Wu, Katherine; Najjar, Samer S; Steinberg, Angela; Gerstenblith, Gary; Weiss, Robert G

    2013-12-11

    Morbidity and mortality from heart failure (HF) are high, and current risk stratification approaches for predicting HF progression are imperfect. Adenosine triphosphate (ATP) is required for normal cardiac contraction, and abnormalities in creatine kinase (CK) energy metabolism, the primary myocardial energy reserve reaction, have been observed in experimental and clinical HF. However, the prognostic value of abnormalities in ATP production rates through CK in human HF has not been investigated. Fifty-eight HF patients with nonischemic cardiomyopathy underwent ³¹P magnetic resonance spectroscopy (MRS) to quantify cardiac high-energy phosphates and the rate of ATP synthesis through CK (CK flux) and were prospectively followed for a median of 4.7 years. Multiple-event analysis (MEA) was performed for HF-related events including all-cause and cardiac death, HF hospitalization, cardiac transplantation, and ventricular-assist device placement. Among baseline demographic, clinical, and metabolic parameters, MEA identified four independent predictors of HF events: New York Heart Association (NYHA) class, left ventricular ejection fraction (LVEF), African-American race, and CK flux. Reduced myocardial CK flux was a significant predictor of HF outcomes, even after correction for NYHA class, LVEF, and race. For each increase in CK flux of 1 μmol g⁻¹ s⁻¹, risk of HF-related composite outcomes decreased by 32 to 39%. These findings suggest that reduced CK flux may be a potential HF treatment target. Newer imaging strategies, including noninvasive ³¹P MRS that detect altered ATP kinetics, could thus complement risk stratification in HF and add value in conditions involving other tissues with high energy demands, including skeletal muscle and brain.

  7. Heart Failure

    MedlinePlus

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

  8. Numerical Predictions of Damage and Failure in Carbon Fiber Reinforced Laminates Using a Thermodynamically-Based Work Potential Theory

    NASA Technical Reports Server (NTRS)

    Pineda, Evan Jorge; Waas, Anthony M.

    2013-01-01

    A thermodynamically-based work potential theory for modeling progressive damage and failure in fiber-reinforced laminates is presented. The current, multiple-internal state variable (ISV) formulation, referred to as enhanced Schapery theory (EST), utilizes separate ISVs for modeling the effects of damage and failure. Consistent characteristic lengths are introduced into the formulation to govern the evolution of the failure ISVs. Using the stationarity of the total work potential with respect to each ISV, a set of thermodynamically consistent evolution equations for the ISVs are derived. The theory is implemented into a commercial finite element code. The model is verified against experimental results from two laminated, T800/3900-2 panels containing a central notch and different fiber-orientation stacking sequences. Global load versus displacement, global load versus local strain gage data, and macroscopic failure paths obtained from the models are compared against the experimental results.

  9. Safety profile of fast-track extubation in pediatric congenital heart disease surgery patients in a tertiary care hospital of a developing country: An observational prospective study

    PubMed Central

    Akhtar, Mohammad Irfan; Hamid, Mohammad; Minai, Fauzia; Wali, Amina Rehmat; Anwar-ul-Haq; Aman-Ullah, Muneer; Ahsan, Khalid

    2014-01-01

    Background and Aims: Early extubation after cardiac operations is an important aspect of fast-track cardiac anesthesia. In order to reduce or eliminate the adverse effects of prolonged ventilation in pediatric congenital heart disease (CHD) surgical patients, the concept of early extubation has been analyzed at our tertiary care hospital. The current study was carried out to record the data to validate the importance and safety of fast-track extubation (FTE) with evidence. Materials and Methods: A total of 71 patients, including male and female aged 6 months to 18 years belonging to risk adjustment for congenital heart surgery-1 category 1, 2, and 3 were included in this study. All patients were anesthetized with a standardized technique and surgery performed by the same surgeon. At the end of operation, the included patients were assessed for FTE and standard extubation criteria were used for decision making. Results: Of the total 71 patients included in the study, 26 patients (36.62%) were extubated in the operating room, 29 (40.85%) were extubated within 6 h of arrival in cardiovascular intensive care unit and 16 (22.54%) were unable to get extubated within 6 h due to multiple reasons. Hence, overall success rate was 77.47%. The reasons for delayed extubation were significant bleeding in 5 (31.3%) cases, hemodynamic instability (low cardiac output syndrome) in 4 (25%) cases, respiratory complication in 2 (12.5%), bleeding plus hemodynamic instability in 2 (12.5) cases, hemodynamic instability, and respiratory complication in 2 (12.5%) cases and triad of hemodynamic instability, bleeding and respiratory complication in 1 (6.5%) case. There was no reintubation in the FTE cases. Conclusion: On the basis of the current study results, it is recommended to use FTE in pediatric CHD surgical patients safely with multidisciplinary approach. PMID:25190943

  10. Pre-existing Arterial Micro-Calcification Predicts Primary Unassisted Arteriovenous Fistula Failure in Incident Hemodialysis Patients.

    PubMed

    Choi, Su Jin; Yoon, Hye Eun; Kim, Young Soo; Yoon, Sun Ae; Yang, Chul Woo; Kim, Yong-Soo; Park, Sun Cheol; Kim, Young Ok

    2015-01-01

    Vascular access micro-calcification is a risk factor for cardiovascular morbidity and mortality in hemodialysis (HD) patients but its influence on vascular access patency is still undetermined. Our study aimed to determine the impact of arterial micro-calcification (AMiC) on the patency of vascular access in HD patients. One-hundred fourteen HD patients receiving arteriovenous fistula (AVF) operation were included in this study. During the operation, we obtained partial arterial specimen and performed pathological examination by von Kossa stain to identify AMiC. We compared primary unassisted AVF failure within 1 year between positive and negative AMiC groups, and performed Cox regression analysis for evaluating risk factor of AVF failure. The incidence of AMiC was 37.7% and AVF failure occurred in 45 patients (39.5%). The AVF failure rate within 1 year was greater in the positive AMiC group than those in the negative AMiC group (53.5% vs. 31.0%, p = 0.02). Kaplan-Meier analysis showed that the positive AMiC group had a lower AVF patency rate than the negative AMiC group (p = 0.02). The presence of AMiC was an independent risk factor for AVF failure. In conclusion, preexisting AMiC of the vascular access is associated with primary unassisted AVF failure in incident HD patients.

  11. The importance of ultrasound in the strategy of a difficult airway extubation, after a prolonged facial and cervical area surgery.

    PubMed

    Carbonell Soto, M M; San Juan Álvarez, M; López López, B; Rodríguez Bertos, C; Sainz Azara, C

    2016-10-01

    On many occasions we are faced with complex and long-lasting surgeries affecting the cervicofacial region, seriously compromising the time of extubation and presenting before us a high-risk position. To avoid this, we will plan our activities bearing in mind all the possible complications and the different alternative plans, considering the ultrasound as a useful diagnostic method in the daily management of the airway.

  12. A prospective randomized control study comparing classic laryngeal mask airway with Guedel's airway for tracheal tube exchange and smooth extubation

    PubMed Central

    Jain, Shruti; Nazir, Nazia; Khan, Rashid M.; Ahmed, Syed M.

    2016-01-01

    Introduction: Extubation in deep plane of anesthesia followed by Guedel's oropharyngeal airway (OPA™) insertion is a routine method to avoid hemodynamic changes associated with tracheal extubation. Exchange of endotracheal tube (ETT) with Classic laryngeal mask airway (LMA™) prior to emergence from anesthesia also serves similar purpose. We had compared the hemodynamic changes involved during this ETT/LMA™ and ETT/OPA™ exchange technique. Material and Methods: This was a randomized prospective study on ASA I and 2 patients undergoing elective surgery under general anesthesia. These patients were randomly divided into two groups i.e. OPA group and LMA group of 50 patients each. Hemodynamic parameters i.e. systolic blood pressure (SBP) and heart rate (HR) were recorded during exchange of ETT with OPA™ or LMA™. Coughing / bucking during removal of OPA™ and LMA™, and presence of post operative sore throat for both the groups were also graded and recorded. Data within the groups have been analyzed using paired “t” test while those between the groups were analyzed using unpaired “t” test. Chi square test was used to analyze grades of coughing and post operative sore throat. Results: In both groups, hemodynamic parameters rose significantly as OPA™/LMA™ was placed (P < 0.05) and then started declining. Hemodynamic parameters continued to fall in LMA group after extubation. However in OPA group, hemodynamic parameters continued to rise even after extubation and declined only when OPA™ was removed. There was no statistical significant difference between the LMA and OPA group in respect to coughing and post operative sore throat. Conclusion: LMA™ is superior to OPA™ for exchange of ETT as it provides greater hemodynamic stability. PMID:27746550

  13. Extubation versus tracheostomy in withdrawal of treatment-ethical, clinical, and legal perspectives.

    PubMed

    Chotirmall, Sanjay Haresh; Flynn, Maura G; Donegan, Ciaran F; Smith, David; O'Neill, Shane J; McElvaney, Noel Gerard

    2010-06-01

    The provision of life-sustaining ventilation, such as tracheostomy to critically ill patients, is commonly performed. However, the utilization of tracheostomy or extubation after a withdrawal of treatment decision is debated. There is a dearth of practical information available to aid clinical decision making because withdrawal of treatment is a challenging scenario for all concerned. This is further complicated by medicolegal and ethical considerations. Care of the "hopelessly ill" patient should be based on daily evaluation and comfort making it impossible to fit into general algorithms. Although respect for autonomy is important in healthcare, it is limited for patients in an unconscious state. Beneficence remains the basis for withdrawing treatment in futile cases and underpins the "doctrine of double effect." This article presents a relevant clinical case of hypoxic brain injury where a question of withdrawal of treatment arose and examines the ethical, clinical, and medicolegal considerations inherent in such cases, including beneficence, nonmaleficence, and the "sanctity of life doctrine." In addition, the considerations of prognosis for recovery, patient autonomy, patient quality of life, and patient family involvement, which are central to decision making, are addressed. The varying legal frameworks that exist internationally regarding treatment withdrawal are also described. Good ethics needs sound facts, and despite the lack of legal foundation in several countries, withdrawal of treatment remains practiced, and the principles described within this article aim to aid clinician decision making during such complex and multifaceted end-of-life decisions. PMID:19850443

  14. Factors predictive of treatment failure in staphylococcal prosthetic vascular graft infections: a prospective observational cohort study: impact of rifampin

    PubMed Central

    2014-01-01

    Background There exists considerable debate concerning management of prosthetic vascular graft infection (PVGI), especially in terms of antimicrobial treatment. This report studies factors associated with treatment failure in a cohort of patients with staphylococcal PVGI, along with the impact of rifampin (RIF). Methods All data on patients with PVGI between 2006 and 2010 were reviewed. Cure was defined as the absence of evidence of infection during the entire post-treatment follow-up for a minimum of one year. Failure was defined as any other outcome. Results 84 patients (72 M/12 F, median age 64.5 ± 11 y) with diabetes mellitus (n = 25), obesity (n = 48), coronary artery disease (n = 48), renal failure (n = 24) or COPD (n = 22) were treated for PVGI (median follow-up was 470 ± 469 d). PVGI was primarily intracavitary (n = 47). Staphylococcus aureus (n = 65; including 17 methicillin-resistant S. aureus) and coagulase-negative Staphylocococcus (n = 22) were identified. Surgical treatment was performed in 71 patients. In univariate analysis, significant risk factors associated with failure were renal failure (p = 0.04), aortic aneurysm (p = 0.03), fever (p = 0.009), aneurysm disruption (p = 0.02), septic shock in the peri-operative period (p = 0.005) and antibiotic treatment containing RIF (p = 0.03). In multivariate analysis, 2 variables were independently associated with failure:septic shock [OR 4.98: CI 95% 1.45-16.99; p=0.01] and antibiotic containing rifampin [OR: 0.32: CI95% 0.10-0.96; p=0.04]. Conclusion Results of the present study suggest that fever, septic shock and non-use of antibiotic treatment containing RIF are associated with poor outcome. PMID:24775563

  15. Testing failure surface prediction methods and deposit reconstruction for the landslides cluster occurring during Talas Typhoon (Japan)

    NASA Astrophysics Data System (ADS)

    Jaboyedoff, Michel; Chigira, Masahiro; Arai, Noriyuki; Derron, Marc-Henri; Rudaz, Benjamin; Tsou, Ching-Ying

    2016-04-01

    Talas Typhoon hit Japan from 2 to 5 September 2011. It induced more than 70 deep-seated landslides in Kii peninsula. The hi-resolution topography of these landslides have been acquired by aerial 1 m LiDAR digital elevation models (DEM) before (pre-DEM) and after (post-DEM) the events (data from Nara prefectural Government and the Kinki Regional development Bureau of Ministry of Land, Infrastructure, Transportation, and Tourism). This extraordinary opportunity allows us to test methods to construct failure surface geometries, buried valley topographies and/or to rebuild deposits surfaces. We tested the sloping base local level method (SLBL) on 5 deep seated landslides which occurred during Typhoon Talas (Akatani, Kitamata, Nagatono, Shimizu and Akatani-East; see Chigira et al., 2013). The SLBL corresponds to a quadratic surface with a constant second derivative in all x-y directions. This curvature can be based on the knowledge of the length of the landslide and its maximum thickness. We used mainly hillshade DEM, slope maps and Coltop schemes to define the limits of landslides and to interpret their structures. Different attempts were performed to reconstruct the failure surface and deposits depending on a priori knowledge. Basically the morphological features extracted from the pre-DEM were used to delineate the limits of the landslides. The curvature of the failure surface was obtained by "expert" interpretations. The failure surfaces obtained using SLBL are in good agreement with the failure surface observed on the post-DEM. The results are improved when (1) they are adjusted to obtain similar estimate of the volume deduced by Chigira et al. (2013), and when (2) the contours of the landslides used comes from an interpretation of both post and pre-DEM. In order to obtain the expansion coefficient some of these landslide, the missing volume of the deposits (by river erosion) were calculated using inverse SLBL. The coefficient of expansion ranges from 13% to 30

  16. Prediction of Hip Failure Load: In Vitro Study of 80 Femurs Using Three Imaging Methods and Finite Element Models-The European Fracture Study (EFFECT).

    PubMed

    Pottecher, Pierre; Engelke, Klaus; Duchemin, Laure; Museyko, Oleg; Moser, Thomas; Mitton, David; Vicaut, Eric; Adams, Judith; Skalli, Wafa; Laredo, Jean Denis; Bousson, Valérie

    2016-09-01

    Purpose To evaluate the performance of three imaging methods (radiography, dual-energy x-ray absorptiometry [DXA], and quantitative computed tomography [CT]) and that of a numerical analysis with finite element modeling (FEM) in the prediction of failure load of the proximal femur and to identify the best densitometric or geometric predictors of hip failure load. Materials and Methods Institutional review board approval was obtained. A total of 40 pairs of excised cadaver femurs (mean patient age at time of death, 82 years ± 12 [standard deviation]) were examined with (a) radiography to measure geometric parameters (lengths, angles, and cortical thicknesses), (b) DXA (reference standard) to determine areal bone mineral densities (BMDs), and (c) quantitative CT with dedicated three-dimensional analysis software to determine volumetric BMDs and geometric parameters (neck axis length, cortical thicknesses, volumes, and moments of inertia), and (d) quantitative CT-based FEM to calculate a numerical value of failure load. The 80 femurs were fractured via mechanical testing, with random assignment of one femur from each pair to the single-limb stance configuration (hereafter, stance configuration) and assignment of the paired femur to the sideways fall configuration (hereafter, side configuration). Descriptive statistics, univariate correlations, and stepwise regression models were obtained for each imaging method and for FEM to enable us to predict failure load in both configurations. Results Statistics reported are for stance and side configurations, respectively. For radiography, the strongest correlation with mechanical failure load was obtained by using a geometric parameter combined with a cortical thickness (r(2) = 0.66, P < .001; r(2) = 0.65, P < .001). For DXA, the strongest correlation with mechanical failure load was obtained by using total BMD (r(2) = 0.73, P < .001) and trochanteric BMD (r(2) = 0.80, P < .001). For quantitative CT, in both configurations

  17. Response Prediction and Influence of Tolvaptan in Chronic Heart Failure Patients Considering the Interaction of the Renin-Angiotensin-Aldosterone System and Arginine Vasopressin.

    PubMed

    Kadota, Muneyuki; Ise, Takayuki; Yagi, Shusuke; Iwase, Takashi; Akaike, Masashi; Ueno, Rie; Kawabata, Yutaka; Hara, Tomoya; Ogasawara, Kozue; Bando, Mika; Bando, Sachiko; Matsuura, Tomomi; Yamaguchi, Koji; Yamada, Hirotsugu; Soeki, Takeshi; Wakatsuki, Tetsuzo; Sata, Masataka

    2016-07-27

    The renin-angiotensin-aldosterone system (RAAS) and arginine vasopressin (AVP) regulate body fluids. Although conventional diuretics have been used for treating heart failure, they activate RAAS and exacerbate renal function. Tolvaptan, a newly developed vasopressin-2 receptor antagonist, elicits aquaresis and improves volume overload in heart failure patients, however, the predictors of tolvaptan effectiveness and the influence on the RAAS and renal function according to tolvaptan therapy are not established. We evaluated 26 chronic heart failure patients receiving therapy with 15 mg/day tolvaptan and examined their laboratory and urinary data before and after tolvaptan therapy. A response to tolvaptan was defined as a body weight decrease by more than 2 kg in a week and a urine volume increase by 500 mL/ day compared with that before tolvaptan administration. Body weight, urine volume, and brain natriuretic peptide levels significantly improved (P < 0.05), without any worsening of renal function represented by serum creatinine, sodium, and potassium. Moreover, no significant changes were observed in the plasma renin activity and plasma aldosterone concentration (PAC). In the responder group, urine osmolality before tolvaptan administration was significantly higher (P < 0.05) but declined significantly after tolvaptan administration (P < 0.05). The AVP/PAC ratio before administration was positively correlated with the efficacy of tolvaptan. Tolvaptan treatment could prevent RAAS activation in chronic heart failure patients. Moreover, monitoring the AVP/PAC ratio may be useful in predicting the tolvaptan response. PMID:27357439

  18. Prediction and Control of Network Cascade: Example of Power Grid or Networking Adaptability from WMD Disruption and Cascading Failures

    SciTech Connect

    Chertkov, Michael

    2012-07-24

    The goal of the DTRA project is to develop a mathematical framework that will provide the fundamental understanding of network survivability, algorithms for detecting/inferring pre-cursors of abnormal network behaviors, and methods for network adaptability and self-healing from cascading failures.

  19. Why GPA Isn't Predictive: Student Perceptions of Success or Failure in an Associate Degree Nursing Program

    ERIC Educational Resources Information Center

    Sall, James

    2009-01-01

    The purpose of this research was to identify the factors that students attending a Midwestern community college perceived contributed to their academic success or failure in an Associate Degree nursing program. A review of student academic records revealed that many students with weak academic records were successful while students with strong…

  20. Drug Concentration Thresholds Predictive of Therapy Failure and Death in Children With Tuberculosis: Bread Crumb Trails in Random Forests

    PubMed Central

    Swaminathan, Soumya; Pasipanodya, Jotam G.; Ramachandran, Geetha; Hemanth Kumar, A. K.; Srivastava, Shashikant; Deshpande, Devyani; Nuermberger, Eric; Gumbo, Tawanda

    2016-01-01

    Background. The role of drug concentrations in clinical outcomes in children with tuberculosis is unclear. Target concentrations for dose optimization are unknown. Methods. Plasma drug concentrations measured in Indian children with tuberculosis were modeled using compartmental pharmacokinetic analyses. The children were followed until end of therapy to ascertain therapy failure or death. An ensemble of artificial intelligence algorithms, including random forests, was used to identify predictors of clinical outcome from among 30 clinical, laboratory, and pharmacokinetic variables. Results. Among the 143 children with known outcomes, there was high between-child variability of isoniazid, rifampin, and pyrazinamide concentrations: 110 (77%) completed therapy, 24 (17%) failed therapy, and 9 (6%) died. The main predictors of therapy failure or death were a pyrazinamide peak concentration <38.10 mg/L and rifampin peak concentration <3.01 mg/L. The relative risk of these poor outcomes below these peak concentration thresholds was 3.64 (95% confidence interval [CI], 2.28–5.83). Isoniazid had concentration-dependent antagonism with rifampin and pyrazinamide, with an adjusted odds ratio for therapy failure of 3.00 (95% CI, 2.08–4.33) in antagonism concentration range. In regard to death alone as an outcome, the same drug concentrations, plus z scores (indicators of malnutrition), and age <3 years, were highly ranked predictors. In children <3 years old, isoniazid 0- to 24-hour area under the concentration-time curve <11.95 mg/L × hour and/or rifampin peak <3.10 mg/L were the best predictors of therapy failure, with relative risk of 3.43 (95% CI, .99–11.82). Conclusions. We have identified new antibiotic target concentrations, which are potential biomarkers associated with treatment failure and death in children with tuberculosis. PMID:27742636

  1. Effect of bispectral index versus end-tidal anesthetic gas concentration-guided protocol on time to tracheal extubation for halothane-based general anesthesia

    PubMed Central

    Jain, Neena; Mathur, Pooja Rawat; Khan, Shoyeb; Khare, Arvind; Mathur, Veena; Sethi, Surendra

    2016-01-01

    Background and Aims: Early extubation is a desirable goal after general anesthesia. Very few studies have compared the effect of bispectral index (BIS) monitoring versus standard end-tidal anesthetic gas (ETAG) concentration monitoring on tracheal extubation time for halothane-based anesthesia. The aim of this study was to compare the effect of BIS versus ETAG-guided anesthesia on time to tracheal extubation for halothane-based anesthesia in general surgical setting. Methods: This was a randomized, controlled double-blind study. Sixty patients with the American Society of Anesthesiologists physical status Class 1 or 2, receiving halothane-based general anesthesia were randomized to BIS-guided (n = 30) and ETAG-guided anesthesia (n = 30). Time to tracheal extubation was measured. In BIS group, BIS value was kept between 40 and 60 while in ETAG group; ETAG value was kept between 0.7 and 1.3 minimum alveolar concentration. The two groups were compared using Student's t-test, and P < 0.05 was considered statistically significant. Data were processed and analyzed using SPSS version 17 software. Results: Mean time to tracheal extubation was significantly longer in BIS group (9.63 ± 3.02 min) as compared to ETAG group (5.29 ± 1.51 min), mean difference 4.34 min with 95% confidence interval (3.106, 5.982) (P < 0.05). Conclusion: In our study, the extubation time was significantly longer in BIS-guided anesthesia as compared to ETAG-guided anesthesia. ETAG monitoring promotes earlier extubation of patients as compared to BIS monitoring during halothane anesthesia. PMID:27746557

  2. Usefulness of Cardiac Sympathetic Nerve Imaging Using (123)Iodine-Metaiodobenzylguanidine Scintigraphy for Predicting Sudden Cardiac Death in Patients With Heart Failure.

    PubMed

    Kasama, Shu; Toyama, Takuji; Kurabayashi, Masahiko

    2016-01-01

    The autonomic nervous system plays an important role in the human heart. Activation of the cardiac sympathetic nervous system is a cardinal pathophysiological abnormality associated with the failing human heart. Myocardial imaging using (123)I-metaiodobenzylguanidine (MIBG), an analog of norepinephrine, can be used to investigate the activity of norepinephrine, the predominant neurotransmitter of the sympathetic nervous system. Many clinical trials have demonstrated that (123)I-MIBG scintigraphic parameters predict cardiac adverse events, especially sudden cardiac death, in patients with heart failure. In this review, we summarize results from published studies that have focused on the use of cardiac sympathetic nerve imaging using (123)I-MIBG scintigraphy for risk stratification of sudden cardiac death in patients with heart failure.

  3. Posttransplant Hyponatremia Predicts Graft Failure and Mortality in Kidney Transplantation Recipients: A Multicenter Cohort Study in Korea

    PubMed Central

    Han, Miyeun; Park, Jae Yoon; An, Jung Nam; Park, Seokwoo; Park, Su-Kil; Han, Duck-Jong; Na, Ki Young; Oh, Yun Kyu; Lim, Chun Soo; Kim, Yon Su

    2016-01-01

    Although hyponatremia is related to poorer outcomes in several clinical settings, its significance remains unresolved in kidney transplantation. Data on 1,786 patients who received kidney transplantations between January 2000 and December 2011 were analyzed. The patients were divided into two groups according to the corrected sodium values for serum glucose 3 months after their transplantations (<135 mmol/L vs. ≥135 mmol/L). Subsequently, the hazard ratios (HRs) for biopsy-proven acute rejection, graft failure, and all-cause mortality were calculated after adjustments for several immunological and non-immunological covariates. 4.0% of patients had hyponatremia. Patients with hyponatremia had higher risks for graft failure and all-cause mortality than did the counterpart normonatremia group; the adjusted HRs for graft failure and mortality were 3.21 (1.47–6.99) and 3.03 (1.21–7.54), respectively. These relationships remained consistent irrespective of heart function. However, hyponatremia was not associated with the risk of acute rejection. The present study addressed the association between hyponatremia and graft and patient outcomes in kidney transplant recipients. Based on the study results, our recommendation is to monitor serum sodium levels after kidney transplantations. PMID:27214138

  4. pRIFLE (Pediatric Risk, Injury, Failure, Loss, End Stage Renal Disease) score identifies Acute Kidney Injury and predicts mortality in critically ill children : a prospective study

    PubMed Central

    Soler, Yadira A.; Nieves-Plaza, Mariely; Prieto, Mónica; García-De Jesús, Ricardo; Suárez-Rivera, Marta

    2014-01-01

    Objectives 1) To determine whether pRIFLE (Pediatric Risk, Injury, Failure, Loss, End Stage Renal Disease) criteria serves to characterize the pattern of Acute Kidney Injury (AKI) in critically ill pediatric patients; and 2) to identify if pRIFLE score will predict morbidity and mortality in our patient´s cohort. Design Prospective Cohort. Setting Multidisciplinary, tertiary care, 10- bed PICU. Patients 266 patients admitted to PICU from November 2009 to November 2010. Interventions None. Measurements and Main Results The incidence of AKI in the PICU was 27.4%, of which 83.5% presented within 72hrs of admission to the PICU. Patients with AKI were younger, weighed less, were more likely to be on in fluid overload ≥10%, and were more likely to be on inotropic support, diuretics or amino glycosides. No difference in gender, use of other nephrotoxins, or mechanical ventilation was observed. Fluid overload ≥10% was an independent predictor of morbidity and mortality. In multivariate analysis, AKI-Injury and Failure categories, as defined by pRIFLE, predicted mortality, hospital length of stay, and PICU length of stay. Conclusions In this cohort of critically ill pediatric patients, AKI identified by pRIFLE and fluid overload ≥ 10% predicted increased morbidity and mortality. Implementation of pRIFLE scoring and close monitoring of fluid overload upon admission may help develop early interventions to prevent and treat AKI in critically ill children. PMID:23439463

  5. Effect of peri-operative intravenous infusion of lignocaine on haemodynamic responses to intubation, extubation and post-operative analgesia

    PubMed Central

    Jain, Shruti; Khan, Rashid M

    2015-01-01

    Background and Aims: Lignocaine in intravenous (IV) bolus dose has been used for minimising haemodynamic changes associated with intubation and extubation. Furthermore, IV infusion has been used for post-operative analgesia. We investigated whether IV peri-operative lignocaine (bolus and infusion) would be able to produce both the effects simultaneously in elective laparoscopic cholecystectomies. Methods: In this randomised prospective study, 60 patients undergoing elective laparoscopic cholecystectomy were randomly divided into two groups of 30 each. In Group A, patients received 6 ml normal saline as bolus over 10 min followed by 6 ml/h infusion whereas in Group B, patients received preservative free 2% lignocaine 1.5 mg/kg IV bolus (made to a volume of 6 ml with normal saline) administered over a period of 10 min and thereafter an infusion at a rate of 1.5 mg/kg/h (pre-diluted in normal saline made to a volume of 6 ml/h. P < 0.05 was considered as significant. Results: The rise in pulse rate (PR) and mean arterial pressure (MAP) were less in Group B as compared to the Group A (P < 0.05) during intubation as well as during extubation. Furthermore, the Group B had significant longer mean pain-free post-operative period of 5½ h as compared to 54.43 min in the Group A (P < 0.05). Conclusion: Administration of lignocaine infusion attenuates the rise in PR as well as MAP during the peri-intubation and peri-extubation period. Furthermore, infusion of lignocaine significantly increases the mean pain-free period post-operatively. PMID:26195829

  6. Prognostic value of 13C-phenylalanine breath test on predicting survival in patients with chronic liver failure

    PubMed Central

    Gallardo-Wong, I; Morán, S; Rodríguez-Leal, G; Castañeda-Romero, B; Mera, R; Poo, J; Uribe, M; Dehesa, M

    2007-01-01

    AIM: To evaluate the prognostic value of percentage of 13C-phenylalanine oxidation (13C-PheOx) obtained by 13C-phenylalanine breath test (13C-PheBT) on the survival of patients with chronic liver failure. METHODS: The hepatic function was determined by standard liver blood tests and the percentage of 13C-PheOx in 118 chronic liver failure patients. The follow-up period was of 64 mo. Survival analysis was performed by the Kaplan-Meier method and variables that were significant (P < 0.10) in univariate analysis and subsequently introduced in a multivariate analysis according to the hazard model proposed by Cox. RESULTS: Forty-one patients died due to progressive liver failure during the follow-up period. The probability of survival at 12, 24, 36, 48 and 64 mo was 0.88, 0.78, 0.66, 0.57 and 0.19, respectively. Multivariate analysis demonstrated that Child-Pugh classes, age, creatinine and the percentage of 13C-PheOx (HR 0.338, 95% CI: 0.150-0.762, P = 0.009) were independent predictors of survival. When Child-Pugh classes were replaced by all the parameters of the score, only albumin, bilirubin, creatinine, age and the percentage of 13C-PheOx (HR 0.449, 95% CI: 0.206-0.979, P = 0.034) were found to be independent predictors of survival. CONCLUSION: Percentage of 13C-PheOx obtained by 13C-PheBT is a strong predictor of survival in patients with chronic liver disease. PMID:17729409

  7. Effluent Free Radicals are Associated with Residual Renal Function and Predict Technique Failure in Peritoneal Dialysis Patients

    PubMed Central

    Morinaga, Hiroshi; Sugiyama, Hitoshi; Inoue, Tatsuyuki; Takiue, Keiichi; Kikumoto, Yoko; Kitagawa, Masashi; Akagi, Shigeru; Nakao, Kazushi; Maeshima, Yohei; Miyazaki, Ikuko; Asanuma, Masato; Hiramatsu, Makoto; Makino, Hirofumi

    2012-01-01

    ♦ Objective: Residual renal function (RRF) is associated with low oxidative stress in peritoneal dialysis (PD). In the present study, we investigated the relationship between the impact of oxidative stress on RRF and patient outcomes during PD. ♦ Methods: Levels of free radicals (FRs) in effluent from the overnight dwell in 45 outpatients were determined by electron spin resonance spectrometry. The FR levels, clinical parameters, and the level of 8-hydroxy-2′-deoxyguanosine were evaluated at study start. The effects of effluent FR level on technique and patient survival were analyzed in a prospective cohort followed for 24 months. ♦ Results: Levels of effluent FRs showed significant negative correlations with daily urine volume and residual renal Kt/V, and positive correlations with plasma β2-microglobulin and effluent 8-hydroxy-2′-deoxyguanosine. A highly significant difference in technique survival (p < 0.05), but not patient survival, was observed for patients grouped by effluent FR quartile. The effluent FR level was independently associated with technique failure after adjusting for patient age, history of cardiovascular disease, and presence of diabetes mellitus (p < 0.001). The level of effluent FRs was associated with death-censored technique failure in both univariate (p < 0.001) and multivariate (p < 0.01) hazard models. Compared with patients remaining on PD, those withdrawn from the modality had significantly higher levels of effluent FRs (p < 0.005). ♦ Conclusions: Elevated effluent FRs are associated with RRF and technique failure in stable PD patients. These findings highlight the importance of oxidative stress as an unfavorable prognostic factor in PD and emphasize that steps should be taken to minimize oxidative stress in these patients. PMID:22215657

  8. Predictive Factors for the Effect of Treatment by Noninvasive Ventilation in Patients with Respiratory Failure as a Result of Acute Exacerbation of the Chronic Obstructive Pulmonary Disease

    PubMed Central

    Pejkovska, Sava; Kaeva, Biserka Jovkovska; Goseva, Zlatica; Arsovski, Zoran; Janeva, Jelena Jovanovska; Zeynel, Sead

    2015-01-01

    BACKGROUND: Noninvasive mechanical ventilation (NIV) applies ventilator support through the patient’s upper airway using a mask. AIM: The aim of the study is to define factors that will point out an increased risk of NIV failure in patients with exacerbation of Chronic Obstructive Pulmonary Disease (COPD). PATIENTS AND METHODS: Patients over the age of 40, treated with NIV, were prospectively recruited. After data processing, the patients were divided into two groups: 1) successful NIV treatment group; 2) failed NIV treatment group. RESULTS: On admission arterial pH and Glasgow coma scale (GCS) levels were lower (pH: p < 0.05, GCS: p < 0.05), and Acute Physiology and Chronic Health Evaluation II (APACHE) score and PaCO2 were higher (p < 0.05) in the NIV failure group. Arterial pH was lower (p < 0.05) and PaCO2 and respiratory rate were higher (p < 0.05) after 1h, and arterial pH was lower (p < 0.05) and PaCO2 (p < 0.05), respiratory and heart rate were higher (p < 0.05) after 4h in the NIV failure group. CONCLUSION: Measurement and monitoring of certain parameters may be of value in terms of predicting the effectiveness of NIV treatment. PMID:27275303

  9. Pre-cue fronto-occipital alpha phase and distributed cortical oscillations predict failures of cognitive control.

    PubMed

    Hamm, Jordan P; Dyckman, Kara A; McDowell, Jennifer E; Clementz, Brett A

    2012-05-16

    Cognitive control is required for correct performance on antisaccade tasks, including the ability to inhibit an externally driven ocular motor response (a saccade to a peripheral stimulus) in favor of an internally driven ocular motor goal (a saccade directed away from a peripheral stimulus). Healthy humans occasionally produce errors during antisaccade tasks, but the mechanisms associated with such failures of cognitive control are uncertain. Most research on cognitive control failures focuses on poststimulus processing, although a growing body of literature highlights a role of intrinsic brain activity in perceptual and cognitive performance. The current investigation used dense array electroencephalography and distributed source analyses to examine brain oscillations across a wide frequency bandwidth in the period before antisaccade cue onset. Results highlight four important aspects of ongoing and preparatory brain activations that differentiate error from correct antisaccade trials: (1) ongoing oscillatory beta (20-30 Hz) power in anterior cingulate before trial initiation (lower for error trials); (2) instantaneous phase of ongoing alpha/theta (7 Hz) in frontal and occipital cortices immediately before trial initiation (opposite between trial types); (3) gamma power (35-60 Hz) in posterior parietal cortex 100 ms before cue onset (greater for error trials); and (4) phase locking of alpha (5-12 Hz) in parietal and occipital cortices immediately before cue onset (lower for error trials). These findings extend recently reported effects of pre-trial alpha phase on perception to cognitive control processes and help identify the cortical generators of such phase effects.

  10. Deterministic and probabilistic prediction of the distribution of inter-fiber failure test data of prestrained CFRP tubes composed of thin layers and loaded by radial pressure

    SciTech Connect

    Cuntze, R.G.

    1993-12-31

    The limit of usability of a CFRP (Carbon Fiber Reinforced Plastics) structure is often determined by initiation of Inter Fiber Failure (IFF) indicated by interfibre/matrix cracking. It will be shown how this crack initiation threshold can be delayed. The process used is prestraining in analogy to that of prestressed concrete inducing advantageous compression built in stresses/strains transverse to the fibres. As a certain structural example cylindrical tube specimens were wound, prestrained by hydraulic pressurization, and then loaded while monitoring acoustic emission. Crack counting followed the sectioning of the tube. The theoretical investigations aimed at both a deterministic and a probabilistic prediction of the IFF test results. Basis for the prediction are firstly all design parameters, mainly the material properties of the layers, secondly the classical laminate theory and an IFF-criterion and finally a program for probabilistic computations to treat the large set of the stochastic design parameters respectively uncertain basic variables. Included in the IFF-criterion applied had to be the so called Thin-layer Effect representing the decreasing sensitivity of an embedded layer to IFF with the decrease of it`s thickness. The probabilistic prediction of the test data distribution is compared with as well the deterministically predicted single value for the test mean as the corresponding measured test data distribution. They show a very satisfying agreement. The increase in crack-threshold level is shifted from {var_epsilon}{sub hoop} {approx} 0.75% (0% prestrain) to a higher design strain of 1.0% (0.4% prestrain). In case of 0.8% prestrain the design strain even becomes much higher then the operational strain of {approx} 1.15%. This value is normally defined is tensile failure strain e{sub {parallel}}{sup t} {approx} 1.7% in case of T8OO/epoxide composite divided by the usual design factor j{sub u} = 1.5.

  11. The study of homology between tumor progression genes and members of retroviridae as a tool to predict target-directed therapy failure.

    PubMed

    Fernandes, Janaina

    2015-01-01

    Oncogenes are the primary candidates for target-directed therapy, given that they are involved directly in the progression and resistance of tumors. However, the appearance of point mutations can hinder the treatment of patients with these new molecules, raising costs and the need to development new analogs that target the novel mutations. Based on an analysis of homologies, the present study discusses the possibility of predicting the failure of a protein as a pharmacological target, due to its similarities with retrovirus sequences, which have extremely high mutation rates. This analysis was based on the molecular evidence available in the literature, and widely-used and well-established PSI-BLAST, with two iterations and maximum of 500 aligned sequences. The possibility of predicting which newly-discovered genes involved in tumor progression would likely result in the failure of targeted therapy, using free, simple and automated bioinformatics tools, could provide substantial savings in the time and financial resources needed for long-term drug development.

  12. The study of homology between tumor progression genes and members of retroviridae as a tool to predict target-directed therapy failure

    PubMed Central

    Fernandes, Janaina

    2015-01-01

    Oncogenes are the primary candidates for target-directed therapy, given that they are involved directly in the progression and resistance of tumors. However, the appearance of point mutations can hinder the treatment of patients with these new molecules, raising costs and the need to development new analogs that target the novel mutations. Based on an analysis of homologies, the present study discusses the possibility of predicting the failure of a protein as a pharmacological target, due to its similarities with retrovirus sequences, which have extremely high mutation rates. This analysis was based on the molecular evidence available in the literature, and widely-used and well-established PSI-BLAST, with two iterations and maximum of 500 aligned sequences. The possibility of predicting which newly-discovered genes involved in tumor progression would likely result in the failure of targeted therapy, using free, simple and automated bioinformatics tools, could provide substantial savings in the time and financial resources needed for long-term drug development. PMID:25983693

  13. Scoring systems predict the prognosis of acute-on-chronic hepatitis B liver failure: an evidence-based review.

    PubMed

    Wu, Fa-Ling; Shi, Ke-Qing; Chen, Yong-Ping; Braddock, Martin; Zou, Hai; Zheng, Ming-Hua

    2014-08-01

    Acute-on-chronic hepatitis B liver failure is a devastating condition that is associated with mortality rates of over 50% and is consequent to acute exacerbation of chronic hepatitis B in patients with previously diagnosed or undiagnosed chronic liver disease. Liver transplantation is the definitive treatment to lower mortality rate, but there is a great imbalance between donation and potential recipients. An early and accurate prognostic system based on the integration of laboratory indicators, clinical events and some mathematic logistic equations is needed to optimize treatment for patients. As parts of the scoring systems, the MELD was the most common and the donor-MELD was the most innovative for patients on the waiting list for liver transplantation. This review aims to highlight the various features and prognostic capabilities of these scoring systems. PMID:24762209

  14. Effect of Residual Stresses and Prediction of Possible Failure Mechanisms on Thermal Barrier Coating System by Finite Element Method

    NASA Astrophysics Data System (ADS)

    Ranjbar-Far, M.; Absi, J.; Mariaux, G.; Shahidi, S.

    2010-09-01

    This work is focused on the effect of the residual stresses resulting from the coating process and thermal cycling on the failure mechanisms within the thermal barrier coating (TBC) system. To reach this objective, we studied the effect of the substrate preheating and cooling rate on the coating process conditions. A new thermomechanical finite element model (FEM) considering a nonhomogeneous temperature distribution has been developed. In the results, we observed a critical stress corresponding to a low substrate temperature and high cooling rate during spraying of the top-coat material. Moreover, the analysis of the stress distribution after service shows that more critical stresses are obtained in the case where residual stresses are taken into account.

  15. Cephalometric variables predicting the long-term success or failure of combined rapid maxillary expansion and facial mask therapy.

    PubMed

    Baccetti, Tiziano; Franchi, Lorenzo; McNamara, James A

    2004-07-01

    The aim of this study was to select a model of cephalometric variables to predict the results of early treatment of Class III malocclusion with rapid maxillary expansion and facemask therapy followed by comprehensive treatment with fixed appliances. Lateral cephalograms of 42 patients (20 boys, 22 girls) with Class III malocclusion were analyzed at the start of treatment (mean age 8 years 6 months +/- 2 years, at stage I in cervical vertebral maturation). All patients were reevaluated after a mean period of 6 years 6 months (at stage IV or V in cervical vertebral maturation) that included active treatment plus retention. At this time, the sample was divided into 2 groups according to occlusal criteria: a successful group (30 patients) and an unsuccessful group (12 patients). Discriminant analysis was applied to select pretreatment predictive variables of long-term treatment outcome. Stepwise variable selection of the cephalometric measurements at the first observation identified 3 predictive variables. Orthopedic treatment of Class III malocclusion might be unfavorable over the long term when a patient's pretreatment cephalometric records exhibit a long mandibular ramus (ie, increased posterior facial height), an acute cranial base angle, and a steep mandibular plane angle. On the basis of the equation generated by the multivariate statistical method, the outcome of interceptive orthopedic treatment for each new patient with Class III malocclusion can be predicted with a probability error of 16.7%.

  16. N-terminal pro b-type natriuretic peptide (NT-pro-BNP) –based score can predict in-hospital mortality in patients with heart failure

    PubMed Central

    Huang, Ya-Ting; Tseng, Yuan-Teng; Chu, Tung-Wei; Chen, John; Lai, Min-Yu; Tang, Woung-Ru; Shiao, Chih-Chung

    2016-01-01

    Serum N-terminal pro b-type natriuretic peptide (NT-pro-BNP) testing is recommended in the patients with heart failure (HF). We hypothesized that NT-pro-BNP, in combination with other clinical factors in terms of a novel NT-pro BNP-based score, may provide even better predictive power for in-hospital mortality among patients with HF. A retrospective study enrolled adult patients with hospitalization-requiring HF who fulfilled the predefined criteria during the period from January 2011 to December 2013. We proposed a novel scoring system consisting of several independent predictors including NT-pro-BNP for predicting in-hospital mortality, and then compared the prognosis-predictive power of the novel NT-pro BNP-based score with other prognosis-predictive scores. A total of 269 patients were enrolled in the current study. Factors such as “serum NT-pro-BNP level above 8100 mg/dl,” “age above 79 years,” “without taking angiotensin converting enzyme inhibitors/angiotensin receptor blocker,” “without taking beta-blocker,” “without taking loop diuretics,” “with mechanical ventilator support,” “with non-invasive ventilator support,” “with vasopressors use,” and “experience of cardio-pulmonary resuscitation” were found as independent predictors. A novel NT-pro BNP-based score composed of these risk factors was proposed with excellent predictability for in-hospital mortality. The proposed novel NT-pro BNP-based score was extremely effective in predicting in-hospital mortality in HF patients. PMID:27411951

  17. N-terminal pro b-type natriuretic peptide (NT-pro-BNP) -based score can predict in-hospital mortality in patients with heart failure.

    PubMed

    Huang, Ya-Ting; Tseng, Yuan-Teng; Chu, Tung-Wei; Chen, John; Lai, Min-Yu; Tang, Woung-Ru; Shiao, Chih-Chung

    2016-01-01

    Serum N-terminal pro b-type natriuretic peptide (NT-pro-BNP) testing is recommended in the patients with heart failure (HF). We hypothesized that NT-pro-BNP, in combination with other clinical factors in terms of a novel NT-pro BNP-based score, may provide even better predictive power for in-hospital mortality among patients with HF. A retrospective study enrolled adult patients with hospitalization-requiring HF who fulfilled the predefined criteria during the period from January 2011 to December 2013. We proposed a novel scoring system consisting of several independent predictors including NT-pro-BNP for predicting in-hospital mortality, and then compared the prognosis-predictive power of the novel NT-pro BNP-based score with other prognosis-predictive scores. A total of 269 patients were enrolled in the current study. Factors such as "serum NT-pro-BNP level above 8100 mg/dl," "age above 79 years," "without taking angiotensin converting enzyme inhibitors/angiotensin receptor blocker," "without taking beta-blocker," "without taking loop diuretics," "with mechanical ventilator support," "with non-invasive ventilator support," "with vasopressors use," and "experience of cardio-pulmonary resuscitation" were found as independent predictors. A novel NT-pro BNP-based score composed of these risk factors was proposed with excellent predictability for in-hospital mortality. The proposed novel NT-pro BNP-based score was extremely effective in predicting in-hospital mortality in HF patients. PMID:27411951

  18. Minimizing the cost of translocation failure with decision-tree models that predict species' behavioral response in translocation sites.

    PubMed

    Ebrahimi, Mehregan; Ebrahimie, Esmaeil; Bull, C Michael

    2015-08-01

    The high number of failures is one reason why translocation is often not recommended. Considering how behavior changes during translocations may improve translocation success. To derive decision-tree models for species' translocation, we used data on the short-term responses of an endangered Australian skink in 5 simulated translocations with different release conditions. We used 4 different decision-tree algorithms (decision tree, decision-tree parallel, decision stump, and random forest) with 4 different criteria (gain ratio, information gain, gini index, and accuracy) to investigate how environmental and behavioral parameters may affect the success of a translocation. We assumed behavioral changes that increased dispersal away from a release site would reduce translocation success. The trees became more complex when we included all behavioral parameters as attributes, but these trees yielded more detailed information about why and how dispersal occurred. According to these complex trees, there were positive associations between some behavioral parameters, such as fight and dispersal, that showed there was a higher chance, for example, of dispersal among lizards that fought than among those that did not fight. Decision trees based on parameters related to release conditions were easier to understand and could be used by managers to make translocation decisions under different circumstances.

  19. Donor preoperative oxygen delivery and post-extubation hypoxia impact donation after circulatory death hypoxic cholangiopathy

    PubMed Central

    Chirichella, Thomas J; Dunham, C Michael; Zimmerman, Michael A; Phelan, Elise M; Mandell, M Susan; Conzen, Kendra D; Kelley, Stephen E; Nydam, Trevor L; Bak, Thomas E; Kam, Igal; Wachs, Michael E

    2016-01-01

    .10). HC was independently associated with age, multi-pressor/red-cell transfusion status, arterial oxygen content, hypoxia score, and mean arterial pressure (r2 = 0.6197). The transplantation rate was greater for the later period with more liberal donor selection [era 2 (7.1/year)], compared to our early experience [era 1 (2.5/year)]. HC occurred in 63.0% during era 2 and in 29.4% during era 1 (P = 0.03). Era 2 donors had longer times for extubation-to-asystole (14.4 ± 4.7 m vs 9.3 ± 4.5 m, P = 0.001), ischemia (13.9 ± 5.9 m vs 9.7 ± 5.6 m, P = 0.03), and hypoxemia (16.0 ± 5.1 m vs 11.1 ± 6.7 m, P = 0.013) and a higher hypoxia score > 2.0 rate (73.1% vs 28.6%, P = 0.006). CONCLUSION: Easily measured donor indices, including a hypoxia score, provide an objective measure of DCD liver transplantation risk for recipient HC. Donor selection criteria influence HC rates. PMID:27022221

  20. Computational models can predict response to HIV therapy without a genotype and may reduce treatment failure in different resource-limited settings

    PubMed Central

    Revell, A. D.; Wang, D.; Wood, R.; Morrow, C.; Tempelman, H.; Hamers, R. L.; Alvarez-Uria, G.; Streinu-Cercel, A.; Ene, L.; Wensing, A. M. J.; DeWolf, F.; Nelson, M.; Montaner, J. S.; Lane, H. C.; Larder, B. A.

    2013-01-01

    Objectives Genotypic HIV drug-resistance testing is typically 60%–65% predictive of response to combination antiretroviral therapy (ART) and is valuable for guiding treatment changes. Genotyping is unavailable in many resource-limited settings (RLSs). We aimed to develop models that can predict response to ART without a genotype and evaluated their potential as a treatment support tool in RLSs. Methods Random forest models were trained to predict the probability of response to ART (≤400 copies HIV RNA/mL) using the following data from 14 891 treatment change episodes (TCEs) after virological failure, from well-resourced countries: viral load and CD4 count prior to treatment change, treatment history, drugs in the new regimen, time to follow-up and follow-up viral load. Models were assessed by cross-validation during development, with an independent set of 800 cases from well-resourced countries, plus 231 cases from Southern Africa, 206 from India and 375 from Romania. The area under the receiver operating characteristic curve (AUC) was the main outcome measure. Results The models achieved an AUC of 0.74–0.81 during cross-validation and 0.76–0.77 with the 800 test TCEs. They achieved AUCs of 0.58–0.65 (Southern Africa), 0.63 (India) and 0.70 (Romania). Models were more accurate for data from the well-resourced countries than for cases from Southern Africa and India (P < 0.001), but not Romania. The models identified alternative, available drug regimens predicted to result in virological response for 94% of virological failures in Southern Africa, 99% of those in India and 93% of those in Romania. Conclusions We developed computational models that predict virological response to ART without a genotype with comparable accuracy to genotyping with rule-based interpretation. These models have the potential to help optimize antiretroviral therapy for patients in RLSs where genotyping is not generally available. PMID:23485767

  1. On colloid retention in saturated porous media in the presence of energy barriers: The failure of α, and opportunities to predict η

    NASA Astrophysics Data System (ADS)

    Johnson, William P.; Tong, Meiping; Li, Xiqing

    2007-12-01

    This contribution reviews recent findings that illuminate the processes governing colloid retention in porous media under environmentally relevant conditions. In the environment, colloids act as conveyors of contaminants, or even as contaminants themselves; however, despite decades of research, we are unable to accurately predict the retention of colloids in granular aquifer media under environmental conditions, where repulsion exists between colloids and surfaces. This failure cannot be blamed solely on the complexities of the subsurface, since colloid filtration theory (CFT) works well in the absence of colloid-collector repulsion despite its idealization of porous media as consisting of spherical grains completely surrounded by fluid envelopes. Rather, the failure of CFT stems from failure to incorporate the correct mechanisms of retention when repulsion exists. Recent observations implicate wedging in grain-to-grain contacts and retention in secondary energy minima as dominant mechanisms of colloid retention in the presence of an energy barrier. Mechanistic simulations in unit cells containing grain-to-grain contacts corroborate these mechanisms of colloid retention. The resulting concept for colloid retention in the presence of an energy barrier involves translation of colloids across the collector surfaces until they become wedged within grain-to-grain contacts, or are retained via secondary energy minima (without attachment) in zones where the balance of fluid drag, diffusion, gravitational, and colloid-collector interaction forces allow retention. The above findings highlight the pore domain geometry as a dominant governor of colloid retention in so far as the geometry gives rise to grain-to-grain contacts and zones of relatively low fluid drag.

  2. Generalized energy failure criterion.

    PubMed

    Qu, R T; Zhang, Z J; Zhang, P; Liu, Z Q; Zhang, Z F

    2016-01-01

    Discovering a generalized criterion that can predict the mechanical failure of various different structural materials is one of ultimate goals for scientists in both material and mechanics communities. Since the first study on the failure criterion of materials by Galileo, about three centuries have passed. Now we eventually find the "generalized energy criterion", as presented here, which appears to be one universal law for various different kinds of materials. The validity of the energy criterion for quantitatively predicting the failure is experimentally confirmed using a metallic glass. The generalized energy criterion reveals the competition and interaction between shear and cleavage, the two fundamental inherent failure mechanisms, and thus provides new physical insights into the failure prediction of materials and structural components. PMID:26996781

  3. Generalized energy failure criterion

    PubMed Central

    Qu, R. T.; Zhang, Z. J.; Zhang, P.; Liu, Z. Q.; Zhang, Z. F.

    2016-01-01

    Discovering a generalized criterion that can predict the mechanical failure of various different structural materials is one of ultimate goals for scientists in both material and mechanics communities. Since the first study on the failure criterion of materials by Galileo, about three centuries have passed. Now we eventually find the “generalized energy criterion”, as presented here, which appears to be one universal law for various different kinds of materials. The validity of the energy criterion for quantitatively predicting the failure is experimentally confirmed using a metallic glass. The generalized energy criterion reveals the competition and interaction between shear and cleavage, the two fundamental inherent failure mechanisms, and thus provides new physical insights into the failure prediction of materials and structural components. PMID:26996781

  4. The clustering-based case-based reasoning for imbalanced business failure prediction: a hybrid approach through integrating unsupervised process with supervised process

    NASA Astrophysics Data System (ADS)

    Li, Hui; Yu, Jun-Ling; Yu, Le-An; Sun, Jie

    2014-05-01

    Case-based reasoning (CBR) is one of the main forecasting methods in business forecasting, which performs well in prediction and holds the ability of giving explanations for the results. In business failure prediction (BFP), the number of failed enterprises is relatively small, compared with the number of non-failed ones. However, the loss is huge when an enterprise fails. Therefore, it is necessary to develop methods (trained on imbalanced samples) which forecast well for this small proportion of failed enterprises and performs accurately on total accuracy meanwhile. Commonly used methods constructed on the assumption of balanced samples do not perform well in predicting minority samples on imbalanced samples consisting of the minority/failed enterprises and the majority/non-failed ones. This article develops a new method called clustering-based CBR (CBCBR), which integrates clustering analysis, an unsupervised process, with CBR, a supervised process, to enhance the efficiency of retrieving information from both minority and majority in CBR. In CBCBR, various case classes are firstly generated through hierarchical clustering inside stored experienced cases, and class centres are calculated out by integrating cases information in the same clustered class. When predicting the label of a target case, its nearest clustered case class is firstly retrieved by ranking similarities between the target case and each clustered case class centre. Then, nearest neighbours of the target case in the determined clustered case class are retrieved. Finally, labels of the nearest experienced cases are used in prediction. In the empirical experiment with two imbalanced samples from China, the performance of CBCBR was compared with the classical CBR, a support vector machine, a logistic regression and a multi-variant discriminate analysis. The results show that compared with the other four methods, CBCBR performed significantly better in terms of sensitivity for identifying the

  5. Combination of Urinary Sodium/Creatinine Ratio and Plasma Brain Natriuretic Peptide Level Predicts Successful Tolvaptan Therapy in Patients With Heart Failure and Volume Overload.

    PubMed

    Sato, Yuichi; Dohi, Kaoru; Watanabe, Kiyotaka; Tanimura, Muneyoshi; Takeuchi, Tetsushiro; Sugiura, Emiyo; Sugimoto, Tadafumi; Kumagai, Naoto; Ogura, Toru; Nakamori, Shiro; Fujimoto, Naoki; Yamada, Norikazu; Ito, Masaaki

    2016-01-01

    To evaluate the short-term clinical and hemodynamic effects of tolvaptan therapy and to identify predictors of the therapeutic outcomes, we retrospectively recruited 60 consecutive hospitalized heart failure (HF) patients (70 ± 11 years) with volume overload. The subjects were divided into two groups on the basis of the changes in HF symptom scores and hemodynamic status assessed by right heart catheterization after tolvaptan therapy (median: 7 days). The majority of patients were successfully treated (group 1). However, 22% of patients (group 2) were unsuccessfully treated, in whom 1) the HF symptom score worsened or 2) there was a stationary HF symptom score ≥ 6 points, and mean PCWP > 18 mmHg and mean RAP > 10 mmHg, after tolvaptan therapy. HF symptom scores, hemodynamic parameters, and plasma brain natriuretic peptide (BNP) level improved in group 1, but all of these parameters remained unchanged in group 2. Lower urine sodium/creatinine ratio (UNa/UCr) and higher BNP level at baseline were independently associated with unsuccessful tolvaptan therapy, and UNa/UCr best predicts unsuccessful tolvaptan therapy with a cut-off value of 46.5 mEq/g·Cr (AUC 0.847, 95% CI: 0.718-0.976, sensitivity 77%, specificity 81%, P < 0.01). Double-positive results of UNa/UCr < 46.5 mEq/g·Cr and plasma BNP level > 778 pg/mL predicted unsuccessful tolvaptan therapy with high diagnostic accuracy (sensitivity 54%, specificity 100%, positive predictive value 100%, negative predictive value 89%, and accuracy 90%). In summary, short-term tolvaptan therapy ameliorated HF symptoms and provided hemodynamic improvement in the majority of patients, and UNa/UCr and BNP level strongly predicted the therapeutic outcomes. PMID:26973271

  6. Early Indication of Decompensated Heart Failure in Patients on Home-Telemonitoring: A Comparison of Prediction Algorithms Based on Daily Weight and Noninvasive Transthoracic Bio-impedance

    PubMed Central

    Bonomi, Alberto G; Goode, Kevin M; Reiter, Harald; Habetha, Joerg; Amft, Oliver; Cleland, John GF

    2016-01-01

    Background Heart Failure (HF) is a common reason for hospitalization. Admissions might be prevented by early detection of and intervention for decompensation. Conventionally, changes in weight, a possible measure of fluid accumulation, have been used to detect deterioration. Transthoracic impedance may be a more sensitive and accurate measure of fluid accumulation. Objective In this study, we review previously proposed predictive algorithms using body weight and noninvasive transthoracic bio-impedance (NITTI) to predict HF decompensations. Methods We monitored 91 patients with chronic HF for an average of 10 months using a weight scale and a wearable bio-impedance vest. Three algorithms were tested using either simple rule-of-thumb differences (RoT), moving averages (MACD), or cumulative sums (CUSUM). Results Algorithms using NITTI in the 2 weeks preceding decompensation predicted events (P<.001); however, using weight alone did not. Cross-validation showed that NITTI improved sensitivity of all algorithms tested and that trend algorithms provided the best performance for either measurement (Weight-MACD: 33%, NITTI-CUSUM: 60%) in contrast to the simpler rules-of-thumb (Weight-RoT: 20%, NITTI-RoT: 33%) as proposed in HF guidelines. Conclusions NITTI measurements decrease before decompensations, and combined with trend algorithms, improve the detection of HF decompensation over current guideline rules; however, many alerts are not associated with clinically overt decompensation. PMID:26892844

  7. Prediction of hospital readmission for heart failure: development of a simple risk score based on administrative data

    PubMed

    Philbin; DiSalvo

    1999-09-01

    OBJECTIVES: The purpose of this study was to develop a convenient and inexpensive method for identifying and individual's risk for hospital readmission for congestive heart failure (CHF) using information derived exclusively from administrative data sources and available at the time of an index hospital discharge. BACKGROUND: Rates of readmission are higher after hospitalization for CHF. The significant determinants of rehospitalization are debated. METHODS: Administrative information on all 1995 hospital discharges in New York State which were assigned International Classification of Diseases--9--Clinical Modification codes indicative of CHF in the principal diagnosis position were obtained. The following were compared among hospital survivors who did and did not experience readmission: demographics, comorbid illness, hospital type and location, processes of care, length of stay and hospital charges. RESULTS: A total of 42,731 black or white patients were identified. The subgroup of 9,112 (21.3%) who were readmitted were distinguished by a greater proportion of blacks, a higher prevalence of Medicare and Medicaid insurance, more comorbid illnesses and the use of telemetry monitoring during their index hospitalization. Patients treated at rural hospitals, those discharged to skilled nursing facilities and those having echocardiograms or cardiac catheterization were less likely to be readmitted. Using multiple regression methods, a simple methodology was devised that segregated patients into low, intermediate and high risk for readmission. CONCLUSIONS: Patient characteristics, hospital features, processes of care and clinical outcomes may be used to estimate the risk of hospital readmission for CHF. However, some of the variation in rehospitalization risk remains unexplained and may be the result of discretionary behavior by physicians and patients.

  8. Kidney Failure

    MedlinePlus

    ... if You Have Kidney Disease Kidney Failure Expand Dialysis Kidney Transplant Preparing for Kidney Failure Treatment Choosing Not to Treat with Dialysis or Transplant Paying for Kidney Failure Treatment Contact ...

  9. WAIS-IV Digit Span variables: are they valuable for use in predicting TOMM and MSVT failure?

    PubMed

    Whitney, Kriscinda A; Shepard, Polly H; Davis, Jeremy J

    2013-01-01

    The Digit Span (DS) task in the Wechsler Adult Intelligence Scale-Fourth Edition differs substantially from earlier versions of the measure, with one of the major changes being the addition of a sequencing component. In the present investigation, the usefulness of the new sequencing task and other DS variables (i.e., DS Age-Scaled Score, DS Forward Total, DS Backward Total, and Reliable DS) was investigated with regard to the ability of these variables to predict negative response bias. Negative response bias was first defined and examined using below-cutoff performance on the Test of Memory Malingering (TOMM) (N = 99). Then, for comparison purposes, negative response bias was examined using below-cutoff performance on the Medical Symptom Validity Test (MSVT; N = 95). Study participants included primarily middle-aged outpatients at a Veterans Affairs medical center. Findings from this retrospective analysis showed that, regardless of whether the TOMM or the MSVT was used as the negative response bias criterion, of all the DS variables examined, DS Sequencing Total showed the best classification accuracy. Yet, due to its relatively low positive and negative predictive power, DS Sequencing Total is not recommended for use in isolation to identify negative response bias.

  10. Prediction of failure behavior of a welded pressure vessel containing flaws during a hydrogen-charged burst test

    SciTech Connect

    Bhuyan, G.S.; Sperling, E.J.; Shen, G.; Yin, H.; Rana, M.D.

    1996-12-01

    An industry-government collaborative program was carried out with an aim to promoting the acceptance of fracture mechanics based fitness-for-service assessment methodology for a service-damaged pressure vessel. A collaborative round robin exercise was carried out to predict the fracture behavior of a vessel containing hydrogen damage, fabrication related lack-of-fusion defects, an artificially induced fatigue crack and a localized thinned area. The fracture assessment procedures used include the US ASME Material Property Council`s PREFIS Program based on the British Standard (BS) Published Document (PD) 6493, ASME Section XI and The Central Electricity Generating Board (CEGB) R6 approach; The welding Institute (TWI) CRACKWISE program (based on BS PD6493 Level 2 approach), a variant of the R6 approach, J-tearing instability approaches, various J-estimation schemes, LEFM approach and simplified stress analysis. Assessments were compared with the results obtained from a hydrogen charged burst test of the vessel. Predictions, based on the J-tearing approach, compared well with the actual burst test results. Actual burst pressure was about five times the operating pressure.

  11. Prediction of failure behavior of a welded pressure vessel containing flaws during a hydrogen-charged burst test

    SciTech Connect

    Bhuyan, G.S.; Sperling, E.J.; Shen, G.; Yin, H.; Rana, M.D.

    1999-08-01

    An industry-government collaborative program was carried out with an aim to promoting the acceptance of fracture mechanics-based fitness-for-service assessment methodology for a service-damaged pressure vessel. A collaborative round robin exercise was carried out to predict the fracture behavior of a vessel containing hydrogen damage, fabrication-related lack-of-fusion defects, an artificially induced fatigue crack, and a localized thinned area. The fracture assessment procedures used include the US ASME Material Property Council`s PREFIS Program based on the British Standard (BS) Published Document (PD) 6493, ASME Section XI and The Central Electricity Generating Board (CEGB) R6 approach, The Welding Institute (TWI) CRACKWISE program (based on BS PD6493 Level 2 approach), a variant of the R6 approach, J-tearing instability approaches, various J-estimation schemes, LEFM approach, and simplified stress analysis. Assessments were compared with the results obtained from a hydrogen-charged burst test of the vessel. Predictions, based on the J-tearing approach, compared well with the actual burst test results. Actual burst pressure was about five times the operating pressure.

  12. Red cell distribution width predicts short- and long-term outcomes of acute congestive heart failure more effectively than hemoglobin.

    PubMed

    Dai, Yuxiang; Konishi, Hakuoh; Takagi, Atsutoshi; Miyauchi, Katsumi; Daida, Hiroyuki

    2014-08-01

    The present study compared short- and long-term prognostic values of red blood cell distribution width (RDW) with those of hemoglobin (Hgb) among patients with acute congestive heart failure (CHF) in a cardiac care unit. The cross-sectional study examined data from 521 patients with acute CHF who were admitted to a cardiac care unit and followed up for 24 months (median). Mean Hgb levels in patients who succumbed (DIH) or remained alive (AIH) were 11.0±1.8 and 11.8±2.6 g/l (P>0.05), respectively. Median values of RDW were 16.2% and 14.4%, respectively (P<0.0001). During the 24-month follow-up, mean levels of Hgb in groups with and without endpoints were 11.4±2.5 and 12.5±2.4 g/dl (P<0.0001), respectively. Median RDW values were 14.9 and 13.8%, respectively (P<0.0001). Logistic regression analysis showed that in-hospital mortality was significantly associated with RDW (P=0.044), New York Heart Association (NYHA) functional class IV (P=0.0037), estimated glomerular filtration rate (eGFR) (P=0.042) and C-reactive protein (P=0.0044), but not with Hgb (P=0.10). The multivariate Cox proportional hazard model selected RDW [hazard ratio (HR), 2.19; P<0.0001], left ventricular ejection fraction (HR 0.81, P=0.0016), age (10-year increase; HR 1.19, P=0.0017) and NYHA functional classes III/IV (HR 1.52, P=0.0029) as independent predictors of long-term outcomes after adjustment, but not Hgb (HR 1.01, P=0.86). Higher RDW values in acute CHF patients at admission were associated with worse short- and long-term outcomes and RDW values were more prognostically relevant than Hgb levels. PMID:25009627

  13. Neural Network Prediction of Failure of Damaged Composite Pressure Vessels from Strain Field Data Acquired by a Computer Vision Method

    NASA Technical Reports Server (NTRS)

    Russell, Samuel S.; Lansing, Matthew D.

    1997-01-01

    This effort used a new and novel method of acquiring strains called Sub-pixel Digital Video Image Correlation (SDVIC) on impact damaged Kevlar/epoxy filament wound pressure vessels during a proof test. To predict the burst pressure, the hoop strain field distribution around the impact location from three vessels was used to train a neural network. The network was then tested on additional pressure vessels. Several variations on the network were tried. The best results were obtained using a single hidden layer. SDVIC is a fill-field non-contact computer vision technique which provides in-plane deformation and strain data over a load differential. This method was used to determine hoop and axial displacements, hoop and axial linear strains, the in-plane shear strains and rotations in the regions surrounding impact sites in filament wound pressure vessels (FWPV) during proof loading by internal pressurization. The relationship between these deformation measurement values and the remaining life of the pressure vessels, however, requires a complex theoretical model or numerical simulation. Both of these techniques are time consuming and complicated. Previous results using neural network methods had been successful in predicting the burst pressure for graphite/epoxy pressure vessels based upon acoustic emission (AE) measurements in similar tests. The neural network associates the character of the AE amplitude distribution, which depends upon the extent of impact damage, with the burst pressure. Similarly, higher amounts of impact damage are theorized to cause a higher amount of strain concentration in the damage effected zone at a given pressure and result in lower burst pressures. This relationship suggests that a neural network might be able to find an empirical relationship between the SDVIC strain field data and the burst pressure, analogous to the AE method, with greater speed and simplicity than theoretical or finite element modeling. The process of testing SDVIC

  14. Micromechanics analysis of space simulated thermal stresses in composites. I - Theory and unidirectional laminates. II - Multidirectional laminates and failure predictions

    NASA Technical Reports Server (NTRS)

    Bowles, David E.; Griffin, O. H., Jr.

    1991-01-01

    A micromechanics analysis is used to study the effects of constituent properties on thermally induced stresses in continuous fiber reinforced composites. A finite element formulation is described, and results are presented for unidirectional carbon/epoxy laminates. It is shown that significant stresses develop in composites exposed to thermal excursions typical of spacecraft operating environments and that the fiber thermoelastic properties have a minimal effect on the magnitude of these stresses. The finite element micromechanics analysis is then extended to the study of multidirectional laminates using a simple global/local formulation. Damage initiation predictions are compared with experimental data, and factors controlling the initiation of damage are identified. Ways of improving the durability of composites are discussed.

  15. Predicting ex vivo failure loads in human metatarsals using bone strength indices derived from volumetric quantitative computed tomography.

    PubMed

    Gutekunst, David J; Patel, Tarpit K; Smith, Kirk E; Commean, Paul K; Silva, Matthew J; Sinacore, David R

    2013-02-22

    We investigated the capacity of bone quantity and bone geometric strength indices to predict ultimate force in the human second metatarsal (Met2) and third metatarsal (Met3). Intact lower extremity cadaver samples were measured using clinical, volumetric quantitative computed tomography (vQCT) with positioning and parameters applicable to in vivo scanning. During processing, raw voxel data (0.4mm isotropic voxels) were converted from Hounsfield units to apparent bone mineral density (BMD) using hydroxyapatite calibration phantoms to allow direct volumetric assessment of whole-bone and subregional metatarsal BMD. Voxel data were realigned to produce cross-sectional slices perpendicular to the longitudinal axes of the metatarsals. Average mid-diaphyseal BMD, bone thickness, and buckling ratio were measured using an optimized threshold to distinguish bone from non-bone material. Minimum and maximum moments of inertia and section moduli were measured in the mid-diaphysis region using both a binary threshold for areal, unit-density measures and a novel technique for density-weighted measures. BMD and geometric strength indices were strongly correlated to ultimate force measured by ex vivo 3-point bending. Geometric indices were more highly correlated to ultimate force than was BMD; bone thickness and density-weighted minimum section modulus had the highest individual correlations to ultimate force. Density-weighted geometric indices explained more variance than their binary analogs. Multiple regression analyses defined models that predicted 85-89% of variance in ultimate force in Met2 and Met3 using bone thickness and minimum section modulus in the mid-diaphysis. These results have implications for future in vivo imaging to non-invasively assess bone strength and metatarsal fracture risk.

  16. Acute kidney injury with hypoxic respiratory failure

    PubMed Central

    Neubert, Zachary; Hoffmann, Paul; Owshalimpur, David

    2014-01-01

    A 27-year-old Caucasian man was transferred from a remote clinic with acute kidney injury for the prior 7–10 days preceded by gastroenteritis. His kidney biopsy showed non-specific mesangiopathic glomerular changes, minimal tubulointerstitial disease without sclerosis, crescents, nor evidence of vasculitis. On his third hospital day, he developed acute hypoxic respiratory failure requiring intubation and mechanical ventilation. Pulmonary renal syndromes ranked highest on his differential diagnosis. He was extubated after 2 days of mechanical ventilation and after pulse dose steroids. His lung biopsy showed pulmonary capillaritis. Our case describes a patient with clinically appearing renopulmonary syndrome, but found to have pulmonary capillaritis, a rare form of lung disease that may also cause acute kidney injury. PMID:25246473

  17. Feasibility and safety of on table extubation after corrective surgical repair of tetralogy of Fallot in a developing country: a case series.

    PubMed

    Akhtar, Mohammad Irfan; Hamid, Mohammad; Minai, Fauzia; Rehman, Naveed

    2015-01-01

    Fast-track extubation is an established safe practice in pediatric congenital heart disease (CHD) surgical patients. On table extubation (OTE) in acyanotic CHD surgical patients is well established with validated safety profile. This practice is not yet reported in tetralogy of Fallot (TOF) cardiac surgical repair patients in developing countries. Evidence suggests that TOF total correction patients should be extubated early, as positive pressure ventilation has a negative impact on right ventricular function and the overall increase in post-TOF repair complications such as low cardiac output state and arrhythmias. The objective of the case series was to determine the safety and feasibility of OTE in elective TOF total correction cardiac surgical patients with an integrated team approach. To the best of our knowledge, this is the first reported case series. A total of 8 elective male and female TOF patients were included. Standard anesthetic, surgical and perfusion techniques were used in these procedures. All patients were extubated in the operating room safely without any complications with the exception of one patient who continued to bleed for 3 h of postextubation at 2-3 ml/kg/h which was managed with transfusion of fresh frozen plasma at 15 mL/kg, packed red blood cells 10 mL/kg and bolus of transamine at 20 mg/kg. Apart from better surgical and bypass techniques, the most important factor leading to successful OTE was an excellent analgesia. On the basis of the case series, it is suggested to extubate selected TOF cardiac surgery repair patients on table safely with integrated multidisciplinary approach. PMID:25849700

  18. Associations Between Prolonged Intubation and Developing Post-extubation Dysphagia and Aspiration Pneumonia in Non-neurologic Critically Ill Patients

    PubMed Central

    Kim, Min Jung; Park, Young Sook; Song, You Hong

    2015-01-01

    Objective To identify the associations between the duration of endotracheal intubation and developing post-extubational supraglottic and infraglottic aspiration (PEA) and subsequent aspiration pneumonia. Methods This was a retrospective observational study from January 2009 to November 2014 of all adult patients who had non-neurologic critical illness, required endotracheal intubation and were referred for videofluoroscopic swallowing study. Demographic information, intensive care unit (ICU) admission diagnosis, severity of critical illness, duration of endotracheal intubation, length of stay in ICU, presence of PEA and severity of dysphagia were reviewed. Results Seventy-four patients were enrolled and their PEA frequency was 59%. Patients with PEA had significantly longer endotracheal intubation durations than did those without (median [interquartile range]: 15 [9-21] vs. 10 [6-15] days; p=0.02). In multivariate logistic regression analysis, the endotracheal intubation duration was significantly associated with PEA (odds ratio, 1.09; 95% confidence interval [CI], 1.01-1.18; p=0.04). Spearman correlation analysis of intubation duration and dysphagia severity showed a positive linear association (r=0.282, p=0.02). The areas under the receiver operating characteristic curves (AUCs) of endotracheal intubation duration for developing PEA and aspiration pneumonia were 0.665 (95% CI, 0.542-0.788; p=0.02) and 0.727 (95% CI, 0.614-0.840; p=0.001), respectively. Conclusion In non-neurologic critically ill patients, the duration of endotracheal intubation was independently associated with PEA development. Additionally, the duration was positively correlated with dysphagia severity and may be helpful for identifying patients who require a swallowing evaluation after extubation. PMID:26605174

  19. Evaluation of the role of maternal serum high-sensitivity C-reactive protein in predicting early pregnancy failure.

    PubMed

    Jauniaux, Eric; Gulbis, Béatrice; Jamil, Amna; Jurkovic, Davor

    2015-03-01

    Maternal serum high-sensitivity C-reactive protein (HSCRP) was evaluated in predicting spontaneous abortion in spontaneous pregnancies presenting with threatened spontaneous abortion. Seventy-one cases of threatened spontaneous abortion (group A) and 71 asymptomatic controls (group B), matched for gestational and maternal age, body mass index and smoking status, were included. Maternal serum samples were evaluated for HCG, progesterone, pregnancy-associated plasma protein-A (PAPP-A) and HSCRP using standard bio-assays. No difference was observed in ultrasound measurements, and median progesterone maternal serum level was significantly lower (P < 0.05) in group A compared with group B. In group A, the median of all ultrasound and maternal serum parameters was significantly lower (P < 0.01) compared with group B. The median gestational sac diameter, volume and median HSCRP and PAPP-A levels were significantly increased (P < 0.05) in group A, with a normal outcome compared with group B, probably owing to the inflammatory reaction associated with intrauterine bleeding. In group A patients destined to abortion, the gestational sac development and corresponding protein synthesis fell before the fetal heart activity stopped; in spontaneous pregnancies, maternal serum HSCRP did not provide additional information for the management of threatened spontaneous abortion but warrants further research in assisted reproduction pregnancies. PMID:25596909

  20. Examining the potential for gender bias in the prediction of symptom validity test failure by MMPI-2 symptom validity scale scores.

    PubMed

    Lee, Tayla T C; Graham, John R; Sellbom, Martin; Gervais, Roger O

    2012-09-01

    Using a sample of individuals undergoing medico-legal evaluations (690 men, 519 women), the present study extended past research on potential gender biases for scores of the Symptom Validity (FBS) scale of the Minnesota Multiphasic Personality Inventory-2 by examining score- and item-level differences between men and women and determining the extent to which FBS scores were able to correctly identify men and women who were divided into credible responders (n = 837) and noncredible responders (n = 372) on the basis of performance on symptom validity tests. Results indicated that women had slightly higher raw FBS scores than men (d = .29), and significant differences between men and women in item endorsement were demonstrated for 14 FBS items. Step-down hierarchical logistic regression procedures indicated predictive bias (χ²Δ = 23.72, p < .001). Follow-up analyses indicated intercept bias (χ²Δ = 23.51, p < .001) but not slope bias (χ²Δ = 0.22, p = .64). However, using the test publisher's recommended FBS cutoff scores (Ben-Porath, Graham, & Tellegen, 2009), classification accuracies were similar for women and men (T > 80, h = -.02; T > 100, h = -.22, respectively). On the basis of these results, we conclude there is no evidence of clinically meaningful bias in predictions of symptom validity test failure made using FBS scores for men and women. PMID:22309000

  1. A predictive analytics approach to reducing 30-day avoidable readmissions among patients with heart failure, acute myocardial infarction, pneumonia, or COPD.

    PubMed

    Shams, Issac; Ajorlou, Saeede; Yang, Kai

    2015-03-01

    Hospital readmission has become a critical metric of quality and cost of healthcare. Medicare anticipates that nearly $17 billion is paid out on the 20 % of patients who are readmitted within 30 days of discharge. Although several interventions such as transition care management have been practiced in recent years, the effectiveness and sustainability depends on how well they can identify patients at high risk of rehospitalization. Based on the literature, most current risk prediction models fail to reach an acceptable accuracy level; none of them considers patient's history of readmission and impacts of patient attribute changes over time; and they often do not discriminate between planned and unnecessary readmissions. Tackling such drawbacks, we develop a new readmission metric based on administrative data that can identify potentially avoidable readmissions from all other types of readmission. We further propose a tree-based classification method to estimate the predicted probability of readmission that can directly incorporate patient's history of readmission and risk factors changes over time. The proposed methods are validated with 2011-12 Veterans Health Administration data from inpatients hospitalized for heart failure, acute myocardial infarction, pneumonia, or chronic obstructive pulmonary disease in the State of Michigan. Results shows improved discrimination power compared to the literature (c-statistics >80 %) and good calibration.

  2. Failure to attain stretched penile length after intracavernosal injection of a vasodilator agent is predictive of veno-occlusive dysfunction on penile duplex Doppler ultrasonography.

    PubMed

    Yafi, F A; Libby, R P; McCaslin, I R; Sangkum, P; Sikka, S C; Hellstrom, W J G

    2015-09-01

    Penile duplex Doppler ultrasound (PDDU) assesses the etiology of erectile dysfunction. Peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) are common PDDU parameters. We assessed whether stretched penile length (SPL) in the flaccid state and measured penile length at peak erection after intracavernosal injection (ICI) of a vasodilator during PDDU correlated with the etiology of erectile dysfunction. We performed a retrospective review of 93 patients who underwent PDDU for erectile dysfunction. Normal and stretched penile length were measured, both at a flaccid state prior to ICI and at peak erection during PDDU. Collected data included patient demographics, vascular, and anatomic parameters. The mean age was 52 years. SPL was equivalent to peak penile length after ICI in 60 patients (65%, group 1) and did not match in 33 (35%, group 2). There were no significant differences between the two groups in terms of flaccid, stretched, and post-ICI erect penile lengths, IIEF score, PSV, percent rigidity or tumescence, and vasodilator dose used. Patients in group 2 had less of a change in penile length from flaccid to erect state (36% vs. 44%, p = 0.02), higher EDV (12.0 vs. 8.5, p = 0.041), lower RI (0.6 vs. 1.0, p = 0.046), and more veno-occlusive dysfunction (82% vs. 53%, p = 0.001). On multivariate analysis, failure to reach maximum SPL at peak ICI erection (OR 2.255, CI 1.191-4.271, p = 0.0126), EDV (OR 1.281, CI 1.115-1.471, p < 0.001) and RI (OR 0.694, CI 0.573-0.723, p = 0.009) predicted veno-occlusive dysfunction. Failure to reach maximal SPL during PDDU using ICI with a vasodilator agent predicted veno-occlusive dysfunction, which is independent of both penile rigidity and tumescence. This measurement could serve as another diagnostic tool for predicting veno-occlusive dysfunction when PDDU is not readily available. Limitations include the subjective nature of penile measurements and different PGE1 doses used.

  3. End-Tidal CO2 Tension Is Predictive of Effective Nocturnal Oxygen Therapy in Patients with Chronic Heart Failure and Central Sleep Apnea.

    PubMed

    Sugimura, Koichiro; Shinozaki, Tsuyoshi; Fukui, Shigefumi; Ogawa, Hiromasa; Shimokawa, Hiroaki

    2016-01-01

    Central sleep apnea (CSA) is characterized by recurring cycles of crescendo-decrescendo ventilation during sleep, and enhances sympathetic nerve activity. Thus CSA has a prognostic impact in patients with chronic heart failure (CHF). Although nocturnal oxygen (O2) therapy decreases frequency of CSA and improves functional exercise capacity, it is also known that some non-responders to the therapy exist. We thus aimed to identify predictors of responders to nocturnal O2 therapy in CHF patients with CSA. In 12 CHF patients with CSA hospitalized at our department, sleep study was performed at 2 consecutive nights. Patients nasally inhaled O2 at either the first or second night in a randomized manner. To predict the percentage reduction in apnea-hypopnea index (%ΔAHI) in response to the nocturnal O2 therapy, we performed multiple regression analysis with a stepwise method with variables including age, brain-natriuretic peptide, circulation time, baseline AHI, hypercapnic ventilatory response and end-tidal carbon dioxide tension (PETCO2). Nocturnal O2 therapy significantly decreased AHI (from 32 ± 13 /h to 12 ± 10 /h, P < 0.0001). Among the possible predictors, PETCO2 was the only variable that is predictive of % changes in AHI. Receiver operating characteristics analysis determined 4.25% as the optimal cutoff PETCO2 level to identify responder to nocturnal O2 therapy (> 50% reduction of AHI), with 88.9% of sensitivity and 66.7% of specificity. In conclusion, PETCO2 is useful to predict the efficacy of O2 therapy in CHF patients with CSA, providing important information to the current nocturnal O2 therapy.

  4. A model to predict 3-month mortality risk of acute-on-chronic hepatitis B liver failure using artificial neural network.

    PubMed

    Zheng, M-H; Shi, K-Q; Lin, X-F; Xiao, D-D; Chen, L-L; Liu, W-Y; Fan, Y-C; Chen, Y-P

    2013-04-01

    Model for end-stage liver disease (MELD) scoring was initiated using traditional statistical technique by assuming a linear relationship between clinical features, but most phenomena in a clinical situation are not linearly related. The aim of this study was to predict 3-month mortality risk of acute-on-chronic hepatitis B liver failure (ACHBLF) on an individual patient level using an artificial neural network (ANN) system. The ANN model was built using data from 402 consecutive patients with ACHBLF. It was trained to predict 3-month mortality by the data of 280 patients and validated by the remaining 122 patients. The area under the curve of receiver operating characteristic (AUROC) was calculated for ANN and MELD-based scoring systems. The following variables age (P < 0.001), prothrombin activity (P < 0.001), serum sodium (P < 0.001), total bilirubin (P = 0.015), hepatitis B e antigen positivity rate (P < 0.001) and haemoglobin (P < 0.001) were significantly related to the prognosis of ACHBLF and were selected to build the ANN. The ANN performed significantly better than MELD-based scoring systems both in the training cohort (AUROC = 0.869 vs 0.667, 0.591, 0.643, 0.571 and 0.577; P < 0.001, respectively) and in the validation cohort (AUROC = 0.765 vs 0.599, 0.563, 0.601, 0.521 and 0.540; P ≤ 0.006, respectively). Thus, the ANN model was shown to be more accurate in predicting 3-month mortality of ACHBLF than MELD-based scoring systems. PMID:23490369

  5. Usefulness of Combining Galectin-3 and BIVA Assessments in Predicting Short- and Long-Term Events in Patients Admitted for Acute Heart Failure

    PubMed Central

    De Berardinis, Benedetta; Magrini, Laura; Zampini, Giorgio; Zancla, Benedetta; Salerno, Gerardo; Cardelli, Patrizia; Di Stasio, Enrico; Gaggin, Hanna K.; Belcher, Arianna; Parry, Blair A.; Nagurney, John T.; Januzzi, James L.; Di Somma, Salvatore

    2014-01-01

    Introduction. Acute heart failure (AHF) is associated with a higher risk for the occurrence of rehospitalization and death. Galectin-3 (GAL3) is elevated in AHF patients and is an indicator in predicting short-term mortality. The total body water using bioimpedance vector analysis (BIVA) is able to identify mortality within AHF patients. The aim of this study was to evaluate the short- and long-term predictive value of GAL3, BIVA, and the combination of both in AHF patients in Emergency Department (ED). Methods. 205 ED patients with AHF were evaluated by testing for B type natriuretic peptide (BNP) and GAL3. The primary endpoint was death and rehospitalization at 30, 60, 90, and 180 days and 12 and 18 months. AHF patients were evaluated at the moment of ED arrival with clinical judgment and GAL3 and BIVA measurement. Results. GAL3 level was significantly higher in patients >71 years old, and with eGFR < 30 cc/min. The area under the curve (AUC) of GAL3 + BIVA, GAL3 and BIVA for death and rehospitalization both when considered in total and when considered serially for the follow-up period showed that the combination has a better prognostic value. Kaplan-Meier survival curve for GAL3 values >17.8 ng/mL shows significant survival difference. At multivariate Cox regression analysis GAL3 is an independent variable to predict death + rehospitalization with a value of 32.24 ng/mL at 30 days (P < 0.005). Conclusion. In patients admitted for AHF an early assessment of GAL3 and BIVA seems to be useful in identifying patients at high risk for death and rehospitalization at short and long term. Combining the biomarker and the device could be of great utility since they monitor the severity of two pathophysiological different mechanisms: heart fibrosis and fluid overload. PMID:25101304

  6. Interval to Biochemical Failure Predicts Clinical Outcomes in Patients With High-Risk Prostate Cancer Treated by Combined-Modality Radiation Therapy

    SciTech Connect

    Shilkrut, Mark; McLaughlin, P. William; Merrick, Gregory S.; Vainshtein, Jeffrey M.; Feng, Felix Y.; Hamstra, Daniel A.

    2013-07-15

    Purpose: To validate the prognostic value of interval to biochemical failure (IBF) in patients with high-risk prostate cancer (HiRPCa) treated with combined-modality radiation therapy (CMRT) with or without androgen deprivation therapy (ADT). Methods and Materials: We conducted a retrospective review of HiRPCa (prostate-specific antigen >20 ng/mL, Gleason score [GS] 8-10, or clinical T stage T3-T4) treated with either dose-escalated external beam radiation therapy (EBRT) or CMRT. Interval to biochemical failure was classified as ≤18 or >18 months from the end of all therapy to the date of biochemical failure (BF). Kaplan-Meier methods and Cox proportional hazards regression were used to evaluate the prognostic value of IBF ≤18 months for distant metastasis (DM) and prostate cancer-specific mortality (PCSM). Results: Of 958 patients with a median follow-up of 63.2 months, 175 patients experienced BF. In those with BF, there were no differences in pretreatment clinical characteristics between the EBRT and CMRT groups, except for a higher proportion of patients with GS 8-10 in the CMRT group (70% vs 52%, P=.02). Median IBF after all therapy was 24.0 months (interquartile range 9.6-46.0) in the EBRT group and 18.9 months (interquartile range 9.2-34.5) in the CMRT group (P=.055). On univariate analysis, IBF ≤18 months was associated with increased risk of DM and PCSM in the entire cohort and the individual EBRT and CMRT groups. On multivariate analysis, only GS 9-10 and IBF ≤18 months, but not the radiation therapy regimen or ADT use, predicted DM (hazard ratio [HR] 3.7, P<.01, 95% confidence interval [CI] 1.4-10.3 for GS 9-10; HR 3.9, P<.0001, 95% CI 2.4-6.5 for IBF ≤18 months) and PCSM (HR 14.8, P<.009, 95% CI 2.0-110 for GS 9-10; HR 4.4, P<.0001, 95% CI 2.4-8.1 for IBF ≤18 months). Conclusions: Short IBF was highly prognostic for higher DM and PCSM in patients with HiRPCa. The prognostic value of IBF for DM and PCSM was not affected by the radiation

  7. Predictive value of cell-surface markers in infections in critically ill patients: protocol for an observational study (ImmuNe FailurE in Critical Therapy (INFECT) Study)

    PubMed Central

    Shankar-Hari, Manu; Weir, Christopher J; Rennie, Jillian; Antonelli, Jean; Rossi, Adriano G; Warner, Noel; Keenan, Jim; Wang, Alice; Brown, K Alun; Lewis, Sion; Mare, Tracey; Simpson, A John; Hulme, Gillian; Dimmick, Ian; Walsh, Timothy S

    2016-01-01

    Introduction Critically ill patients are at high risk of nosocomial infections, with between 20% and 40% of patients admitted to the intensive care unit (ICU) acquiring infections. These infections result in increased antibiotic use, and are associated with morbidity and mortality. Although critical illness is classically associated with hyperinflammation, the high rates of nosocomial infection argue for an importance of effect of impaired immunity. Our group recently demonstrated that a combination of 3 measures of immune cell function (namely neutrophil CD88, monocyte HLA-DR and % regulatory T cells) identified a patient population with a 2.4–5-fold greater risk for susceptibility to nosocomial infections. Methods and analysis This is a prospective, observational study to determine whether previously identified markers of susceptibility to nosocomial infection can be validated in a multicentre population, as well as testing several novel markers which may improve the risk of nosocomial infection prediction. Blood samples from critically ill patients (those admitted to the ICU for at least 48 hours and requiring mechanical ventilation alone or support of 2 or more organ systems) are taken and undergo whole blood staining for a range of immune cell surface markers. These samples undergo analysis on a standardised flow cytometry platform. Patients are followed up to determine whether they develop nosocomial infection. Infections need to meet strict prespecified criteria based on international guidelines; where these criteria are not met, an adjudication panel of experienced intensivists is asked to rule on the presence of infection. Secondary outcomes will be death from severe infection (sepsis) and change in organ failure. Ethics and dissemination Ethical approval including the involvement of adults lacking capacity has been obtained from respective English and Scottish Ethics Committees. Results will be disseminated through presentations at scientific meetings

  8. One-year mortality, quality of life and predicted life-time cost-utility in critically ill patients with acute respiratory failure

    PubMed Central

    2010-01-01

    Introduction High daily intensive care unit (ICU) costs are associated with the use of mechanical ventilation (MV) to treat acute respiratory failure (ARF), and assessment of quality of life (QOL) after critical illness and cost-effectiveness analyses are warranted. Methods Nationwide, prospective multicentre observational study in 25 Finnish ICUs. During an eight-week study period 958 consecutive adult ICU patients were treated with ventilatory support over 6 hours. Of those 958, 619 (64.6%) survived one year, of whom 288 (46.5%) answered the quality of life questionnaire (EQ-5D). We calculated EQ-5D index and predicted lifetime quality-adjusted life years (QALYs) gained using the age- and sex-matched life expectancy for survivors after one year. For expired patients the exact lifetime was used. We divided all hospital costs for all ARF patients by the number of hospital survivors, and by all predicted lifetime QALYs. We also adjusted for those who died before one year and for those with missing QOL to be able to estimate the total QALYs. Results One-year mortality was 35% (95% CI 32 to 38%). For the 288 respondents median [IQR] EQ-5D index after one year was lower than that of the age- and sex-matched general population 0.70 [0.45 to 0.89] vs. 0.84 [0.81 to 0.88]. For these 288, the mean (SD) predicted lifetime QALYs was 15.4 (13.3). After adjustment for missing QOL the mean predicted lifetime (SD) QALYs was 11.3 (13.0) for all the 958 ARF patients. The mean estimated costs were 20.739 € per hospital survivor, and mean predicted lifetime cost-utility for all ARF patients was 1391 € per QALY. Conclusions Despite lower health-related QOL compared to reference values, our result suggests that cost per hospital survivor and lifetime cost-utility remain reasonable regardless of age, disease severity, and type or duration of ventilation support in patients with ARF. PMID:20384998

  9. Detecting servo failures with software

    NASA Technical Reports Server (NTRS)

    Lew, D.; Quam, R.

    1979-01-01

    Program detects hardware failure in servosystems by comparing actual servo valve position with predictions of software model. In addition, system will also pick up most computer input/output failures. Process presents faster and more reliable results than previous failure detection methods.

  10. Respiratory Failure in Acute Organophosphorus Pesticide Self-Poisoning

    PubMed Central

    Eddleston, Michael; Mohamed, Fahim; Davies, James OJ; Eyer, Peter; Worek, Franz; Sheriff, MH Rezvi; Buckley, Nick A

    2006-01-01

    Background: Acute organophosphorus (OP) pesticide poisoning is a major clinical problem in the developing world. Textbooks ascribe most deaths to respiratory failure occurring in one of two distinct clinical syndromes - acute cholinergic respiratory failure or the intermediate syndrome. The delayed failure appears to be due to respiratory muscle weakness, but its pathophysiology is not yet clear. Aim: To describe the clinical patterns of OP-induced respiratory failure and to determine whether the two syndromes are clinically distinct. Design: Prospective cohort study of 376 patients with confirmed OP poisoning. Methods: Patients were observed throughout their admission to three Sri Lankan hospitals. Exposure was confirmed by butyrylcholinesterase and blood OP assays. Results: Ninety of 376 patients (24%) required intubation, 52 (58%) within 2 hrs of admission while unconscious with cholinergic features. Twenty-nine (32%) were well on admission but then required intubation after 24 hrs while conscious and without cholinergic features. These two syndromes were not clinically distinct and had much overlap. In particular, some patients who required intubation on arrival subsequently recovered conscious but could not be extubated, requiring ventilation for up to 6 days. Discussion: Respiratory failure did not occur as two discrete clinical syndromes within distinct time frames. Instead, the pattern of failure was variable and overlapped in some patients. There seemed to be two underlying mechanisms - an early acute mixed central and peripheral respiratory failure, and a late peripheral respiratory failure - rather than two defined clinical syndromes. PMID:16861715

  11. A Single Quantifiable Viral Load Is Predictive of Virological Failure in Human Immunodeficiency Virus (HIV)-Infected Patients on Combination Antiretroviral Therapy: The Austrian HIV Cohort Study

    PubMed Central

    Leierer, Gisela; Grabmeier-Pfistershammer, Katharina; Steuer, Andrea; Sarcletti, Mario; Geit, Maria; Haas, Bernhard; Taylor, Ninon; Kanatschnig, Manfred; Rappold, Michaela; Ledergerber, Bruno; Zangerle, Robert

    2016-01-01

    Background. Viral loads (VLs) detectable at low levels are not uncommon in patients on combination antiretroviral therapy (cART). We investigated whether a single quantifiable VL predicted virological failure (VF). Methods. We analyzed patients receiving standard regimens with at least 1 VL measurement below the limit of quantification (BLQ) in their treatment history. The first VL measurement after 6 months of unmodified cART served as baseline VL for the subsequent analyses of the time to reach single VL levels of ≥200, ≥400, and ≥1000 copies/mL. Roche TaqMan 2.0 was used to quantify human immunodeficiency virus-1 ribonucleic acid. Factors associated with VF were determined by Cox proportional hazards models. Results. Of 1614 patients included in the study, 68, 44, and 34 experienced VF ≥200, ≥400, and ≥1000 copies/mL, respectively. In multivariable analyses, compared with patients who were BLQ, a detectable VL ≤ 50 and VL 51–199 copies/mL predicted VF ≥ 200 copies/mL (hazards ratio [HR] = 2.19, 95% confidence interval [CI] = 1.06–4.55 and HR = 4.21, 95% CI = 2.15–8.22, respectively). In those with VL 51–199 copies/mL, a trend for an increased risk of VF ≥400 and VF ≥1000 copies/mL could be found (HR = 2.13, 95% CI = 0.84–5.39 and HR = 2.52, 95% CI = 0.96–6.60, respectively). Conclusions. These findings support closer monitoring and adherence counseling for patients with a single measurement of quantifiable VL <200 copies/mL. PMID:27419163

  12. Respiratory Failure

    MedlinePlus

    Respiratory failure happens when not enough oxygen passes from your lungs into your blood. Your body's organs, ... brain, need oxygen-rich blood to work well. Respiratory failure also can happen if your lungs can' ...

  13. The Usefulness of the Delta Neutrophil Index for Predicting Superimposed Pneumonia in Patients with Acute Decompensated Heart Failure in the Emergency Department

    PubMed Central

    Lee, Jong Wook; Kwon, Woocheol; Lee, Seok Jeong; Kang, Kyung Sik; Kim, Hyung Il; Kim, Oh Hyun; Cha, Kyoung-Chul; Kim, Hyun; Hwang, Sung Oh

    2016-01-01

    Background Although respiratory infections, such as pneumonia, have long been recognized as precipitators of exacerbation in patients with acute decompensated heart failure (ADHF), identifying signs of concomitant pneumonia in ADHF is a clinical diagnostic challenge. We evaluated the predictive value of the delta neutrophil index (DNI), a new indicator for immature granulocytes, for diagnosing superimposed pneumonia in patients presenting with ADHF in the emergency department (ED). Methods This was a retrospective and observational study of consecutive patients (>18 years old) diagnosed with an ADHF in the ED over a 7-month period. Patients were categorized into either the ADHF group or the ADHF with pneumonia group. DNI, serum white blood cell (WBC), C-reactive protein (CRP), and β-natriuretic peptide (BNP) were measured upon ED arrival. Results The ADHF with pneumonia group included 30 patients (20.4%). Median initial DNI, WBC, and CRP were significantly higher in the ADHF with pneumonia group [0% vs. 1.8%, p<0.001, 8,200 cells/mL vs. 10,470 cells/mL, p<0.001, and 0.56 mg/dL vs. 6.10 mg/dL, p<0.001]. Multiple logistic regression analyses showed that only initial DNI significantly predicted the presence of superimposed pneumonia in patients with ADHF. In the receiver operating characteristic curves for initial DNI, WBC, and CRP for differentiating superimposed pneumonia in ADHF patients, the area under curve (AUC) of DNI (0.916 [95% confidence interval 0.859–0.955]) was good. AUC of DNI was significantly higher than AUC of CRP and WBC [0.828 and 0.715] (DNI vs. CRP, p = 0.047 and DNI vs. WBC, p<0.001). Conclusions Initial DNI, which was measured upon ED arrival, was significantly higher in the ADHF with pneumonia group than in the ADHF group. The initial DNI’s ability of prediction for ADHF with superimposed pneumonia in the ED was good and it was better than those of serum WBC and CRP. Therefore, DNI may serve as a convenient and useful marker for early

  14. Failure of Viral Shells

    NASA Astrophysics Data System (ADS)

    Klug, William S.; Bruinsma, Robijn F.; Michel, Jean-Philippe; Knobler, Charles M.; Ivanovska, Irena L.; Schmidt, Christoph F.; Wuite, Gijs J. L.

    2006-12-01

    We report a combined theoretical and experimental study of the structural failure of viral shells under mechanical stress. We find that discontinuities in the force-indentation curve associated with failure should appear when the so-called Föppl von Kármán (FvK) number exceeds a critical value. A nanoindentation study of a viral shell subject to a soft-mode instability, where the stiffness of the shell decreases with increasing pH, confirms the predicted onset of failure as a function of the FvK number.

  15. The failure of earthquake failure models

    USGS Publications Warehouse

    Gomberg, J.

    2001-01-01

    In this study I show that simple heuristic models and numerical calculations suggest that an entire class of commonly invoked models of earthquake failure processes cannot explain triggering of seismicity by transient or "dynamic" stress changes, such as stress changes associated with passing seismic waves. The models of this class have the common feature that the physical property characterizing failure increases at an accelerating rate when a fault is loaded (stressed) at a constant rate. Examples include models that invoke rate state friction or subcritical crack growth, in which the properties characterizing failure are slip or crack length, respectively. Failure occurs when the rate at which these grow accelerates to values exceeding some critical threshold. These accelerating failure models do not predict the finite durations of dynamically triggered earthquake sequences (e.g., at aftershock or remote distances). Some of the failure models belonging to this class have been used to explain static stress triggering of aftershocks. This may imply that the physical processes underlying dynamic triggering differs or that currently applied models of static triggering require modification. If the former is the case, we might appeal to physical mechanisms relying on oscillatory deformations such as compaction of saturated fault gouge leading to pore pressure increase, or cyclic fatigue. However, if dynamic and static triggering mechanisms differ, one still needs to ask why static triggering models that neglect these dynamic mechanisms appear to explain many observations. If the static and dynamic triggering mechanisms are the same, perhaps assumptions about accelerating failure and/or that triggering advances the failure times of a population of inevitable earthquakes are incorrect.

  16. Predicting survival in heart failure case and control subjects by use of fully automated methods for deriving nonlinear and conventional indices of heart rate dynamics

    NASA Technical Reports Server (NTRS)

    Ho, K. K.; Moody, G. B.; Peng, C. K.; Mietus, J. E.; Larson, M. G.; Levy, D.; Goldberger, A. L.

    1997-01-01

    BACKGROUND: Despite much recent interest in quantification of heart rate variability (HRV), the prognostic value of conventional measures of HRV and of newer indices based on nonlinear dynamics is not universally accepted. METHODS AND RESULTS: We have designed algorithms for analyzing ambulatory ECG recordings and measuring HRV without human intervention, using robust methods for obtaining time-domain measures (mean and SD of heart rate), frequency-domain measures (power in the bands of 0.001 to 0.01 Hz [VLF], 0.01 to 0.15 Hz [LF], and 0.15 to 0.5 Hz [HF] and total spectral power [TP] over all three of these bands), and measures based on nonlinear dynamics (approximate entropy [ApEn], a measure of complexity, and detrended fluctuation analysis [DFA], a measure of long-term correlations). The study population consisted of chronic congestive heart failure (CHF) case patients and sex- and age-matched control subjects in the Framingham Heart Study. After exclusion of technically inadequate studies and those with atrial fibrillation, we used these algorithms to study HRV in 2-hour ambulatory ECG recordings of 69 participants (mean age, 71.7+/-8.1 years). By use of separate Cox proportional-hazards models, the conventional measures SD (P<.01), LF (P<.01), VLF (P<.05), and TP (P<.01) and the nonlinear measure DFA (P<.05) were predictors of survival over a mean follow-up period of 1.9 years; other measures, including ApEn (P>.3), were not. In multivariable models, DFA was of borderline predictive significance (P=.06) after adjustment for the diagnosis of CHF and SD. CONCLUSIONS: These results demonstrate that HRV analysis of ambulatory ECG recordings based on fully automated methods can have prognostic value in a population-based study and that nonlinear HRV indices may contribute prognostic value to complement traditional HRV measures.

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

    PubMed

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

    2014-01-01

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

  18. A Thermodynamically-Based Mesh Objective Work Potential Theory for Predicting Intralaminar Progressive Damage and Failure in Fiber-Reinforced Laminates

    NASA Technical Reports Server (NTRS)

    Pineda, Evan J.; Waas, Anthony M.

    2012-01-01

    A thermodynamically-based work potential theory for modeling progressive damage and failure in fiber-reinforced laminates is presented. The current, multiple-internal state variable (ISV) formulation, enhanced Schapery theory (EST), utilizes separate ISVs for modeling the effects of damage and failure. Damage is considered to be the effect of any structural changes in a material that manifest as pre-peak non-linearity in the stress versus strain response. Conversely, failure is taken to be the effect of the evolution of any mechanisms that results in post-peak strain softening. It is assumed that matrix microdamage is the dominant damage mechanism in continuous fiber-reinforced polymer matrix laminates, and its evolution is controlled with a single ISV. Three additional ISVs are introduced to account for failure due to mode I transverse cracking, mode II transverse cracking, and mode I axial failure. Typically, failure evolution (i.e., post-peak strain softening) results in pathologically mesh dependent solutions within a finite element method (FEM) setting. Therefore, consistent character element lengths are introduced into the formulation of the evolution of the three failure ISVs. Using the stationarity of the total work potential with respect to each ISV, a set of thermodynamically consistent evolution equations for the ISVs is derived. The theory is implemented into commercial FEM software. Objectivity of total energy dissipated during the failure process, with regards to refinements in the FEM mesh, is demonstrated. The model is also verified against experimental results from two laminated, T800/3900-2 panels containing a central notch and different fiber-orientation stacking sequences. Global load versus displacement, global load versus local strain gage data, and macroscopic failure paths obtained from the models are compared to the experiments.

  19. Risk Analysis and Prediction of Floor Failure Mechanisms at Longwall Face in Parvadeh-I Coal Mine using Rock Engineering System (RES)

    NASA Astrophysics Data System (ADS)

    Aghababaei, Sajjad; Saeedi, Gholamreza; Jalalifar, Hossein

    2016-05-01

    The floor failure at longwall face decreases productivity and safety, increases operation costs, and causes other serious problems. In Parvadeh-I coal mine, the timber is used to prevent the puncture of powered support base into the floor. In this paper, a rock engineering system (RES)-based model is presented to evaluate the risk of floor failure mechanisms at the longwall face of E 2 and W 1 panels. The presented model is used to determine the most probable floor failure mechanism, effective factors, damaged regions and remedial actions. From the analyzed results, it is found that soft floor failure is dominant in the floor failure mechanism at Parvadeh-I coal mine. The average of vulnerability index (VI) for soft, buckling and compressive floor failure mechanisms was estimated equal to 52, 43 and 30 for both panels, respectively. By determining the critical VI for soft floor failure mechanism equal to 54, the percentage of regions with VIs beyond the critical VI in E 2 and W 1 panels is equal to 65.5 and 30, respectively. The percentage of damaged regions showed that the excess amount of used timber to prevent the puncture of weak floor below the powered support base is equal to 4,180,739 kg. RES outputs and analyzed results showed that setting and yielding load of powered supports, length of face, existent water at face, geometry of powered supports, changing the cutting pattern at longwall face and limiting the panels to damaged regions with supercritical VIs could be considered to control the soft floor failure in this mine. The results of this research could be used as a useful tool to identify the damaged regions prior to mining operation at longwall panel for the same conditions.

  20. Neutrophil to lymphocyte ratio predicts persistent organ failure and in-hospital mortality in an Asian Chinese population of acute pancreatitis.

    PubMed

    Zhang, Yushun; Wu, Wei; Dong, Liming; Yang, Chong; Fan, Ping; Wu, Heshui

    2016-09-01

    Neutrophil to lymphocyte ratio (NLR) has frequently been reported as a significant indicator of systemic inflammation in various medical conditions. The association underlying NLR and outcomes in patients with acute pancreatitis (AP) has not been evaluated after the publication of revised Atlanta classification.This was a single-center retrospective diagnostic accuracy study and a cohort outcome study. From 2009 to 2015, Asian Chinese patients with a diagnosis of AP presented within 72 hours from symptom onset and underwent neutrophil, lymphocyte assessment at presentation were included in this study. The outcomes were the occurrence of persistent organ failure (POF), intensive care unit (ICU) stay >7 days, and in-hospital mortality. The relationships of baseline neutrophil, lymphocyte count, and NLR with outcomes were assessed with multivariate Cox regression model.A total of 974 consecutive AP patients were clinically eligible. The mean neutrophils, lymphocytes, and NLR for the entire population were 10.23 ± 4.76  × 10/L, 1.05 ± 0.49  × 10/L, and 12.88 ± 11.25. Overall, 223 (22.9%) of the patients developed with POF, 202 (20.7%) spent more than 7 days in ICU, and 58 (6.0%) died during hospitalization. The NLR had a superior predictive performance than neutrophils and lymphocytes. Using an NLR cutoff of 11, the area under the curves (AUC) were 0.76 for POF, 0.74 for longer ICU stay, and 0.79 for death during hospitalization. After multivariate analysis, NLR ≥ 11 was further identified as an independent prognostic factor (hazard ratio [HR] 1.37, 95% confidence interval [CI] 1.00-1.89; HR 1.44, 95% CI 1.03-2.00; HR 2.75, 95% CI 1.12-6.76; all P value < 0.05). Following stratification according to quartiles of NLR, positive trends for the association across increasing NLR quartiles and the 3 outcomes were observed (P values for trends across quartiles were 0.007, 0.016, and 0.028, respectively). The adjusted HRs for highest

  1. Insulin Resistance Predicts Retreatment Failure in an Efficacy Study of Peginterferon-α-2a and Ribavirin in HIV/HCV Co-infected Patients

    PubMed Central

    Vachon, Marie-Louise C.; Factor, Stephanie H.; Branch, Andrea D.; Fiel, Maria-Isabel; Rodriguez-Torres, Maribel; Bräu, Norbert; Sterling, Richard K.; Slim, Jihad; Talal, Andrew H.; Dieterich, Douglas T.; Sulkowski, Mark S.

    2010-01-01

    Background and Aims Few studies evaluated the efficacy of HCV re-treatment and the predictors of response in HIV/HCV co-infected patients. The role of insulin resistance as a predictor of response in this population is unknown. To evaluate safety and efficacy of pegylated interferon-α-2a and ribavirin in re-treatment of HIV/HCV co-infected patients, predictors of sustained virological response including insulin resistance, and the relationship between insulin resistance and liver histology. Methods This prospective, multi-centered study included HIV/HCV co-infected patients with prior interferon-based treatment failure. Patients received pegylated interferon-α-2a and ribavirin for 48 weeks. Serum HCV RNA was measured 24 weeks post treatment to assess sustained virological response. Insulin resistance was defined as HOMA-IR >2. Correlations between baseline insulin resistance and steatosis and/or cirrhosis were determined. Results Sustained virological response was achieved by 14/96 (15%) patients. Of those with HOMA-IR <2, 35% (6/17) achieved sustained virological response vs 14% (15/36) of those with HOMA-IR between 2–4 and 7% (3/41) of those with HOMA-IR >4 (p=0.01). In multivariable analysis, insulin resistance and log10 HCV RNA were negatively associated with sustained virological response [AOR 0.17; 95%CI 0.05–0.64, p=0.009, and AOR 0.36; 95%CI 0.14–0.93, p=0.04, respectively). Steatosis and cirrhosis correlated with insulin resistance (p=0.02 and 0.03, respectively) but neither independently predicted sustained virological response. Discontinuations due to severe adverse events occurred in 8% and 2 patients died of unrelated cause. Conclusions In HIV/HCV co-infected patients undergoing re-treatment, sustained virological response rate is low; those without insulin resistance are significantly more likely to achieve sustained virological response. PMID:20974502

  2. Pre-Antiretroviral Therapy Serum Selenium Concentrations Predict WHO Stages 3, 4 or Death but not Virologic Failure Post-Antiretroviral Therapy

    PubMed Central

    Shivakoti, Rupak; Gupte, Nikhil; Yang, Wei-Teng; Mwelase, Noluthando; Kanyama, Cecilia; Tang, Alice M.; Pillay, Sandy; Samaneka, Wadzanai; Riviere, Cynthia; Berendes, Sima; Lama, Javier R.; Cardoso, Sandra W.; Sugandhavesa, Patcharaphan; Semba, Richard D.; Christian, Parul; Campbell, Thomas B.; Gupta, Amita

    2014-01-01

    A case-cohort study, within a multi-country trial of antiretroviral therapy (ART) efficacy (Prospective Evaluation of Antiretrovirals in Resource Limited Settings (PEARLS)), was conducted to determine if pre-ART serum selenium deficiency is independently associated with human immunodeficiency virus (HIV) disease progression after ART initiation. Cases were HIV-1 infected adults with either clinical failure (incident World Health Organization (WHO) stage 3, 4 or death by 96 weeks) or virologic failure by 24 months. Risk factors for serum selenium deficiency (<85 μg/L) pre-ART and its association with outcomes were examined. Median serum selenium concentration was 82.04 μg/L (Interquartile range (IQR): 57.28–99.89) and serum selenium deficiency was 53%, varying widely by country from 0% to 100%. In multivariable models, risk factors for serum selenium deficiency were country, previous tuberculosis, anemia, and elevated C-reactive protein. Serum selenium deficiency was not associated with either clinical failure or virologic failure in multivariable models. However, relative to people in the third quartile (74.86–95.10 μg/L) of serum selenium, we observed increased hazards (adjusted hazards ratio (HR): 3.50; 95% confidence intervals (CI): 1.30–9.42) of clinical failure but not virologic failure for people in the highest quartile. If future studies confirm this relationship of high serum selenium with increased clinical failure, a cautious approach to selenium supplementation might be needed, especially in HIV-infected populations with sufficient or unknown levels of selenium. PMID:25401501

  3. Pre-antiretroviral therapy serum selenium concentrations predict WHO stages 3, 4 or death but not virologic failure post-antiretroviral therapy.

    PubMed

    Shivakoti, Rupak; Gupte, Nikhil; Yang, Wei-Teng; Mwelase, Noluthando; Kanyama, Cecilia; Tang, Alice M; Pillay, Sandy; Samaneka, Wadzanai; Riviere, Cynthia; Berendes, Sima; Lama, Javier R; Cardoso, Sandra W; Sugandhavesa, Patcharaphan; Semba, Richard D; Christian, Parul; Campbell, Thomas B; Gupta, Amita

    2014-11-01

    A case-cohort study, within a multi-country trial of antiretroviral therapy (ART) efficacy (Prospective Evaluation of Antiretrovirals in Resource Limited Settings (PEARLS)), was conducted to determine if pre-ART serum selenium deficiency is independently associated with human immunodeficiency virus (HIV) disease progression after ART initiation. Cases were HIV-1 infected adults with either clinical failure (incident World Health Organization (WHO) stage 3, 4 or death by 96 weeks) or virologic failure by 24 months. Risk factors for serum selenium deficiency (<85 μg/L) pre-ART and its association with outcomes were examined. Median serum selenium concentration was 82.04 μg/L (Interquartile range (IQR): 57.28-99.89) and serum selenium deficiency was 53%, varying widely by country from 0% to 100%. In multivariable models, risk factors for serum selenium deficiency were country, previous tuberculosis, anemia, and elevated C-reactive protein. Serum selenium deficiency was not associated with either clinical failure or virologic failure in multivariable models. However, relative to people in the third quartile (74.86-95.10 μg/L) of serum selenium, we observed increased hazards (adjusted hazards ratio (HR): 3.50; 95% confidence intervals (CI): 1.30-9.42) of clinical failure but not virologic failure for people in the highest quartile. If future studies confirm this relationship of high serum selenium with increased clinical failure, a cautious approach to selenium supplementation might be needed, especially in HIV-infected populations with sufficient or unknown levels of selenium. PMID:25401501

  4. Pre-antiretroviral therapy serum selenium concentrations predict WHO stages 3, 4 or death but not virologic failure post-antiretroviral therapy.

    PubMed

    Shivakoti, Rupak; Gupte, Nikhil; Yang, Wei-Teng; Mwelase, Noluthando; Kanyama, Cecilia; Tang, Alice M; Pillay, Sandy; Samaneka, Wadzanai; Riviere, Cynthia; Berendes, Sima; Lama, Javier R; Cardoso, Sandra W; Sugandhavesa, Patcharaphan; Semba, Richard D; Christian, Parul; Campbell, Thomas B; Gupta, Amita

    2014-11-01

    A case-cohort study, within a multi-country trial of antiretroviral therapy (ART) efficacy (Prospective Evaluation of Antiretrovirals in Resource Limited Settings (PEARLS)), was conducted to determine if pre-ART serum selenium deficiency is independently associated with human immunodeficiency virus (HIV) disease progression after ART initiation. Cases were HIV-1 infected adults with either clinical failure (incident World Health Organization (WHO) stage 3, 4 or death by 96 weeks) or virologic failure by 24 months. Risk factors for serum selenium deficiency (<85 μg/L) pre-ART and its association with outcomes were examined. Median serum selenium concentration was 82.04 μg/L (Interquartile range (IQR): 57.28-99.89) and serum selenium deficiency was 53%, varying widely by country from 0% to 100%. In multivariable models, risk factors for serum selenium deficiency were country, previous tuberculosis, anemia, and elevated C-reactive protein. Serum selenium deficiency was not associated with either clinical failure or virologic failure in multivariable models. However, relative to people in the third quartile (74.86-95.10 μg/L) of serum selenium, we observed increased hazards (adjusted hazards ratio (HR): 3.50; 95% confidence intervals (CI): 1.30-9.42) of clinical failure but not virologic failure for people in the highest quartile. If future studies confirm this relationship of high serum selenium with increased clinical failure, a cautious approach to selenium supplementation might be needed, especially in HIV-infected populations with sufficient or unknown levels of selenium.

  5. A simple approach to modeling ductile failure.

    SciTech Connect

    Wellman, Gerald William

    2012-06-01

    Sandia National Laboratories has the need to predict the behavior of structures after the occurrence of an initial failure. In some cases determining the extent of failure, beyond initiation, is required, while in a few cases the initial failure is a design feature used to tailor the subsequent load paths. In either case, the ability to numerically simulate the initiation and propagation of failures is a highly desired capability. This document describes one approach to the simulation of failure initiation and propagation.

  6. Testicular failure

    MedlinePlus

    ... LH . Your doctor may also order a semen analysis to examine the number of healthy sperm you are producing. Sometimes, an ultrasound of the testes will be ordered. Testicular failure and low testosterone level may be hard to ...

  7. Identifying Clients Predisposed To Failure

    ERIC Educational Resources Information Center

    Carnes, G. D.

    1973-01-01

    Studies are reviewed that report the prediction of rehabilitation failure from personality measures. Related research is discussed that suggest the dynamics underlying a key concept, the "hypochondriacally organized personality" which is identifiable from the Rorschach anatomy response percentage. (Author)

  8. Comparison of Ranson, Glasgow, MOSS, SIRS, BISAP, APACHE-II, CTSI Scores, IL-6, CRP, and Procalcitonin in Predicting Severity, Organ Failure, Pancreatic Necrosis, and Mortality in Acute Pancreatitis.

    PubMed

    Khanna, Ajay K; Meher, Susanta; Prakash, Shashi; Tiwary, Satyendra Kumar; Singh, Usha; Srivastava, Arvind; Dixit, V K

    2013-01-01

    Background. Multifactorial scorings, radiological scores, and biochemical markers may help in early prediction of severity, pancreatic necrosis, and mortality in patients with acute pancreatitis (AP). Methods. BISAP, APACHE-II, MOSS, and SIRS scores were calculated using data within 24 hrs of admission, whereas Ranson and Glasgow scores after 48 hrs of admission; CTSI was calculated on day 4 whereas IL-6 and CRP values at end of study. Predictive accuracy of scoring systems, sensitivity, specificity, and positive and negative predictive values of various markers in prediction of severe acute pancreatitis, organ failure, pancreatic necrosis, admission to intensive care units and mortality were calculated. Results. Of 72 patients, 31 patients had organ failure and local complication classified as severe acute pancreatitis, 17 had pancreatic necrosis, and 9 died (12.5%). Area under curves for Ranson, Glasgow, MOSS, SIRS, APACHE-II, BISAP, CTSI, IL-6, and CRP in predicting SAP were 0.85, 0.75, 0.73, 0.73, 0.88, 0.80, 0.90, and 0.91, respectively, for pancreatic necrosis 0.70, 0.64, 0.61, 0.61, 0.68, 0.61, 0.75, 0.86, and 0.90, respectively, and for mortality 0.84, 0.83, 0.77, 0.76, 0.86, 0.83, 0.57, 0.80, and 0.75, respectively. Conclusion. CRP and IL-6 have shown a promising result in early detection of severity and pancreatic necrosis whereas APACHE-II and Ranson score in predicting AP related mortality in this study.

  9. Does Lymphovascular Invasion Predict Regional Nodal Failure in Breast Cancer Patients With Zero to Three Positive Lymph Nodes Treated With Conserving Surgery and Radiotherapy? Implications for Regional Radiation

    SciTech Connect

    Boutrus, Rimoun; Abi-Raad, Rita; Niemierko, Andrzej; Brachtel, Elena F.; Rizk, Levi; Kelada, Alexandra; Taghian, Alphonse G.

    2010-11-01

    Purpose: To examine the relationship between lymphovascular invasion (LVI) and regional nodal failure (RNF) in breast cancer patients with zero to three positive nodes treated with breast-conservation therapy (BCT). Methods and Materials: The records of 1,257 breast cancer patients with zero to three positive lymph nodes were reviewed. All patients were treated with BCT at Massachusetts General Hospital from 1980 to December 2003. Lymphovascular invasion was diagnosed by hematoxylin and eosin-stained sections and in some cases supported by immunohistochemical stains. Regional nodal failure was defined as recurrence in the ipsilateral supraclavicular, axillary, or internal mammary lymph nodes. Regional nodal failure was diagnosed by clinical and/or radiologic examination. Results: The median follow-up was 8 years (range, 0.1-21 years). Lymphovascular invasion was present in 211 patients (17%). In univariate analysis, patients with LVI had a higher rate of RNF (3.32% vs. 1.15%; p = 0.02). In multivariate analysis, only tumor size, grade, and local failure were significant predictors of RNF (p = 0.049, 0.013, and 0.0001, respectively), whereas LVI did not show a significant relationship with RNF (hazard ratio = 2.07; 95% CI, 0.8-5.5; p = 0.143). The presence of LVI in the T2/3 population did not increase the risk of RNF over that for those with no LVI (p = 0.15). In addition, patients with Grade 3 tumors and positive LVI did not have a higher risk of RNF than those without LVI (p = 0.96). Conclusion: These results suggest that LVI can not be used as a sole indicator for regional nodal irradiation in breast cancer patients with zero to three positive lymph nodes treated with BCT.

  10. Heart failure.

    PubMed

    2014-12-15

    Essential facts Heart failure affects about 900,000 people in the UK. The condition can affect people of all ages, but it is more common in older people, with more than half of all patients over the age of 75. It is caused by the heart failing to pump enough blood around the body at the right pressure, usually because the heart muscle has become too weak or stiff to work properly. Acute heart failure, which occurs when symptoms develop quickly, is the leading cause of hospital admission in people over 65. PMID:25492766

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

    PubMed Central

    McCurdy, BR

    2012-01-01

    group, but the results were only significant in 1 study (13% vs. 23.1%, P = 0.29; and 6.4% vs. 34.6%; P < 0.001). GRADE: very low Other Outcomes One of the studies followed patients for 12 months. At the end of follow-up, patients in the NPPV group had a significantly lower rate of needing de novo oxygen supplementation at home. In addition, the IMV group experienced significant increases in functional limitations due to COPD, while no increase was seen in the NPPV group. Finally, no significant differences were observed for hospital readmissions, ICU readmissions, and patients with an open tracheotomy, between the NPPV and IMV groups. NPPV for Weaning COPD Patients From IMV A total of 80 participants were included in the 2 RCTs; the sample sizes of the studies were 30 and 50 patients. The mean age of the participants ranged from 58 to 69 years of age. Based on either the GOLD COPD stage criteria or the mean percent predicted FEV1, both studies included patients with very severe COPD. Both studies also included patients with very severe respiratory failure (mean pH of the study populations was less than 7.23). Chronic obstructive pulmonary disease patients receiving IMV were enrolled in the study if they failed a T-piece weaning trial (spontaneous breathing test), so they could not be directly extubated from IMV. Both studies were conducted in the ICU. Patients in the NPPV group received weaning using either BiPAP or pressure support ventilation NPPV through a face mask, and patients in the IMV weaning group received pressure support ventilation. In both cases, weaning was achieved by tapering the ventilation level. The individual quality of the studies ranged. Common methodological problems included unclear randomization methods and allocation concealment, lack of blinding, and small sample size. Mortality Both studies reported mortality as an outcome. The pooled results showed a significant reduction in ICU mortality in the NPPV group compared with the IMV group (RR

  12. Heart Failure

    MedlinePlus

    ... of breath Common causes of heart failure are coronary artery disease, high blood pressure and diabetes. It is more common in people who are 65 years old or older, African Americans, people who are ... treatments fail. NIH: National Heart, Lung, and Blood Institute

  13. Early Failure of Frontline Rituximab-containing Chemoimmunotherapy in Diffuse Large B-Cell Lymphoma does not Predict Futility of Autologous Hematopoietic Cell Transplantation

    PubMed Central

    Hamadani, Mehdi; Hari, Parameswaran N.; Zhang, Ying; Carreras, Jeanette; Akpek, Görgün; Aljurf, Mahmoud D.; Ayala, Ernesto; Bachanova, Veronika; Chen, Andy I.; Chen, Yi-Bin; Costa, Luciano J.; Fenske, Timothy S.; Freytes, César O.; Ganguly, Siddhartha; Hertzberg, Mark S.; Holmberg, Leona A.; Inwards, David J.; Kamble, Rammurti T.; Kanfer, Edward J.; Lazarus, Hillard M.; Marks, David I.; Nishihori, Taiga; Olsson, Richard; Reddy, Nishitha M.; Rizzieri, David A.; Savani, Bipin N.; Solh, Melhem; Vose, Julie M.; Wirk, Baldeep; Maloney, David G.; Smith, Sonali M.; Montoto, Silvia; Saber, Wael

    2014-01-01

    The poor prognosis of diffuse large B-cell lymphoma (DLBCL) patients relapsing within 1-year of initial diagnosis after first-line rituximab-based chemoimmunotherapy has created controversy about the role of autologous transplantation (auto-HCT) in this setting. We compared auto-HCT outcomes of chemosensitive DLBCL patients between 2000 and 2011 in two cohorts based on time to relapse from diagnosis. The early rituximab failure (ERF) cohort consisted of patients with primary refractory disease or those with first relapse within 1-year of initial diagnosis. The ERF cohort was compared with those relapsing >1-year after initial diagnosis (Late Rituximab Failure [LRF] cohort). ERF and LRF cohorts included 300 and 216 patients, respectively. Non-relapse mortality (NRM), progression/relapse, progression-free survival (PFS) and overall survival (OS) of ERF vs. LRF cohorts at 3-years were 9% (95%CI 6–13) vs. 9% (95%CI 5–13), 47% (95%CI 41–52) vs. 39% (95%CI 33–46), 44% (95%CI 38–50) vs. 52% (95%CI 45–59) and 50% (95 CI 44–56) vs. 67% (95%CI 60–74), respectively. On multivariate analysis, ERF was not associated with higher NRM (relative risk (RR) 1.31, p=0.34). ERF cohort had a higher risk of treatment failure (progression/relapse or death) (RR 2.08, p<0.001) and overall mortality (RR 3.75, p<0.001) within the first 9 months post auto-HCT. Beyond this period, PFS and OS were not significantly different between ERF and LRF cohorts. Auto-HCT provides durable disease control to a sizeable subset of DLBCL despite ERF (3-year PFS 44%), and remains the standard-of-care in chemosensitive DLBCL regardless of the timing of disease relapse. PMID:25008330

  14. Heart failure in South America.

    PubMed

    Bocchi, Edimar Alcides

    2013-05-01

    Continued assessment of temporal trends in mortality and epidemiology of specific heart failure in South America is needed to provide a scientific basis for rational allocation of the limited health care resources, and strategies to reduce risk and predict the future burden of heart failure. The epidemiology of heart failure in South America was reviewed. Heart failure is the main cause of hospitalization based on available data from approximately 50% of the South American population. The main etiologies of heart failure are ischemic, idiopathic dilated cardiomyopathy, valvular, hypertensive and chagasic etiologies. In endemic areas, Chagas heart disease may be responsible by 41% of the HF cases. Also, heart failure presents high mortality especially in patients with Chagas etiology. Heart failure and etiologies associated with heart failure may be responsible for 6.3% of causes of deaths. Rheumatic fever is the leading cause of valvular heart disease. However, a tendency to reduction of HF mortality due to Chagas heart disease from 1985 to 2006, and reduction in mortality due to HF from 1999 to 2005 were observed in selected states in Brazil. The findings have important public health implications because the allocation of health care resources, and strategies to reduce risk of heart failure should also consider the control of neglected Chagas disease and rheumatic fever in South American countries.

  15. Heart Failure in South America

    PubMed Central

    Bocchi, Edimar Alcides

    2013-01-01

    Continued assessment of temporal trends in mortality and epidemiology of specific heart failure in South America is needed to provide a scientific basis for rational allocation of the limited health care resources, and strategies to reduce risk and predict the future burden of heart failure. The epidemiology of heart failure in South America was reviewed. Heart failure is the main cause of hospitalization based on available data from approximately 50% of the South American population. The main etiologies of heart failure are ischemic, idiopathic dilated cardiomyopathy, valvular, hypertensive and chagasic etiologies. In endemic areas, Chagas heart disease may be responsible by 41% of the HF cases. Also, heart failure presents high mortality especially in patients with Chagas etiology. Heart failure and etiologies associated with heart failure may be responsible for 6.3% of causes of deaths. Rheumatic fever is the leading cause of valvular heart disease. However, a tendency to reduction of HF mortality due to Chagas heart disease from 1985 to 2006, and reduction in mortality due to HF from 1999 to 2005 were observed in selected states in Brazil. The findings have important public health implications because the allocation of health care resources, and strategies to reduce risk of heart failure should also consider the control of neglected Chagas disease and rheumatic fever in South American countries. PMID:23597301

  16. Strategies of learning from failure.

    PubMed

    Edmondson, Amy C

    2011-04-01

    Many executives believe that all failure is bad (although it usually provides Lessons) and that Learning from it is pretty straightforward. The author, a professor at Harvard Business School, thinks both beliefs are misguided. In organizational life, she says, some failures are inevitable and some are even good. And successful learning from failure is not simple: It requires context-specific strategies. But first leaders must understand how the blame game gets in the way and work to create an organizational culture in which employees feel safe admitting or reporting on failure. Failures fall into three categories: preventable ones in predictable operations, which usually involve deviations from spec; unavoidable ones in complex systems, which may arise from unique combinations of needs, people, and problems; and intelligent ones at the frontier, where "good" failures occur quickly and on a small scale, providing the most valuable information. Strong leadership can build a learning culture-one in which failures large and small are consistently reported and deeply analyzed, and opportunities to experiment are proactively sought. Executives commonly and understandably worry that taking a sympathetic stance toward failure will create an "anything goes" work environment. They should instead recognize that failure is inevitable in today's complex work organizations.

  17. 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.

  18. Evaluation of global longitudinal strain of left ventricle and regional longitudinal strain in the region of left ventricular leads predicts the response to cardiac resynchronization therapy in patients with ischemic heart failure.

    PubMed

    Ma, Chun-Yan; Liu, Shuang; Yang, Jun; Tang, Li; Zhang, Li-Ming; Li, Nan; Yu, Bo

    2014-09-01

    Myocardium viability in ischemic heart failure (HF) may affect the effect of cardiac resynchronization therapy (CRT). We hypothesized that longitudinal strain of 2D-STE, which reflects myocardium viability, can predict the response to CRT in patients with ischemic HF. 2D-STE was performed in 42 patients with HF, 1 week before and 1 year after CRT. GLS, RLS, and the LV synchrony index (SI), defined as the difference in timing to peak radial strain between LV anterior septal and posterior wall in LV short axis view, were calculated. A decrease in the LV end-systolic volume (LVESV) value of ≥ 15 % 1 year after CRT was defined as response to CRT. Twenty-nine patients responded to CRT (CRT-R group), while 13 patients did not respond and were assigned as CRT-NR group. Pre-CRT RLS and GLS were higher, while SI is lower, in CRT-R patients compared with CRT-NR group (p < 0.001). The ROC curve revealed that RLS of -11.5 % predicted response to CRT with sensitivity of 80.0 % and specificity of 77.9 % (AUC = 0.84, p < 0.001). Further, GLS of -13 % predicted response to CRT with sensitivity of 73.0 % and specificity of 73.4 % (AUC = 0.79, p < 0.001). In conclusion, LV dyssynchrony, GLS, and RLS calculated by 2D-STE can predict long-term response to CRT in patients with ischemic HF.

  19. Prediction of Long-Term Survival in Patients with End-Stage Heart Failure Secondary to Ischemic Heart Disease: Surgical Correction and Volumetric Analysis

    PubMed Central

    Yoshida, Minoru; Hoshino, Joji; Kondo, Taichi; Isomura, Tadashi

    2015-01-01

    Purpose: Ischemic heart disease (IHD) may result in lethal conditions such as ischemic cardiomyopathy (ICM) and mitral regurgitation (MR). Methods: We hypothesized preoperative LV volume would be highly associated with long-term survival in such patients. We retrospectively evaluated effects of LV end-systolic volume index (LVESVI) on survival. Results: Patients were divided into two groups according to LVESVI; Group S (n = 19, <100 ml/m2), and L (n = 55, >100 ml/m2). There were 74 patients (male 61, female 13; 61 ± 10 y.o.). There was no statistical significance in preoperative parameters, including ejection fraction (EF), severity of MR, severity of tricuspid regurgitation (TR), and right ventricular systolic pressure (RVSP). After operation, LVESVI and severity of MR were statistically reduced in both groups. However, EF, severity of TR and RVSP were not statistically alleviated in both groups. In Group S, 5- and 10-year survival rates were 93% and 48%. In Group L, 5- and 10-year survival rates were 50% and 29%. There was a statistical difference in long-term survival between two groups. Conclusions: Preoperative LV volume would be one of the risk factors for long-term survival in patients with congestive heart failure secondary to IHD. Careful follow-up and optimal treatment should be recommended before LV dimension becomes too large. PMID:26073141

  20. Early measurement of CD34+ cells in peripheral blood after cyclophosphamide and granulocyte colony-stimulating factor treatment predicts later CD34+ mobilisation failure and is a possible criterion for guiding “on demand” use of plerixafor

    PubMed Central

    Milone, Giuseppe; Tripepi, Giovanni; Martino, Massimo; Ancora, Flavia; Bartolozzi, Benedetta; Spadaro, Andrea; Nozzoli, Chiara; La Fauci, Alessia; Amico, Irene; Leotta, Salvatore; Poidomani, Massimo; Irrera, Giuseppe; Iacopino, Pasquale; Saccardi, Riccardo; Guidi, Stefano; Bosi, Alberto

    2013-01-01

    Background Early identification of predictive factors of failure to mobilise CD34+ cells could enable rational use of plerixafor during first mobilisation, avoiding the need for a second mobilisation course. However, “on demand” administration of plerixafor needs to be driven by established parameters to avoid inappropriate use. Materials and methods To address this issue, we studied the value of the peripheral blood CD34+ count, measured early (on days +10, +11, +12 and +13), in predicting the mobilisation outcome in the ensuing days. We retrospectively collected data from three Italian centres on 233 patients affected by multiple myeloma or lymphoma who underwent a first or second attempt at mobilisation with cyclophosphamide 4 g/m2 and granulocyte colony-stimulating factor. To assess the diagnostic value of peripheral blood white blood cell and CD34+ cell counts with respect to “mobilisation failure”, we considered failed mobilisation as “disease” and the CD34+ cell count in peripheral blood, on a specific day, as a “diagnostic test”. For various thresholds, we measured sensitivity, false positive rate, specificity and positive predictive value (PPV) as well as the area under the receiver-operating characteristic curves (AUC). Results A CD34+ cell count <10×106/L on day 13 had high sensitivity (1.00) and high specificity (1.00) for predicting subsequent mobilisation failure, with an AUC of 1.0. However, good prediction was also obtained using a lower threshold (CD34+ cell count: <6×106/L) at an earlier time (day 12). The PPV of the day 13 threshold was 1.00 while that of the day 12 one was 0.87. Discussion We propose that patients with <6×106/L CD34+ cells in peripheral blood on day 12 and <10×106/L on day 13 following mobilisation with cyclophosphamide 4 g/m2 and granulocyte colony-stimulating factor are candidates for “on demand” use of plerixafor, making the administration of this expensive agent more efficient and avoiding its

  1. Biomarkers in acute heart failure.

    PubMed

    Mallick, Aditi; Januzzi, James L

    2015-06-01

    The care of patients with acutely decompensated heart failure is being reshaped by the availability and understanding of several novel and emerging heart failure biomarkers. The gold standard biomarkers in heart failure are B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide, which play an important role in the diagnosis, prognosis, and management of acute decompensated heart failure. Novel biomarkers that are increasingly involved in the processes of myocardial injury, neurohormonal activation, and ventricular remodeling are showing promise in improving diagnosis and prognosis among patients with acute decompensated heart failure. These include midregional proatrial natriuretic peptide, soluble ST2, galectin-3, highly-sensitive troponin, and midregional proadrenomedullin. There has also been an emergence of biomarkers for evaluation of acute decompensated heart failure that assist in the differential diagnosis of dyspnea, such as procalcitonin (for identification of acute pneumonia), as well as markers that predict complications of acute decompensated heart failure, such as renal injury markers. In this article, we will review the pathophysiology and usefulness of established and emerging biomarkers for the clinical diagnosis, prognosis, and management of acute decompensated heart failure.

  2. Usefulness of right ventricular fractional area change to predict death, heart failure, and stroke following myocardial infarction (from the VALIANT ECHO Study).

    PubMed

    Anavekar, Nagesh S; Skali, Hicham; Bourgoun, Mikhail; Ghali, Jalal K; Kober, Lars; Maggioni, Aldo P; McMurray, John J V; Velazquez, Eric; Califf, Robert; Pfeffer, Marc A; Solomon, Scott D

    2008-03-01

    Severe right ventricular dysfunction independent of left ventricular ejection fraction increased the risk of heart failure (HF) and death after myocardial infarction (MI). The association between right ventricular function and other clinical outcomes after MI was less clear. Two-dimensional echocardiograms were obtained in 605 patients with left ventricular dysfunction and/or clinical/radiologic evidence of HF from the VALIANT echocardiographic substudy (mean 5.0 +/- 2.5 days after MI). Clinical outcomes included all-cause mortality, cardiovascular (CV) death, sudden death, HF, and stroke. Baseline right ventricular function was measured in 522 patients using right ventricular fractional area change (RVFAC) and was related to clinical outcomes. Mean RVFAC was 41.9 +/- 4.3% (range 19.2% to 53.1%). The incidence of clinical events increased with decreasing RVFAC. After adjusting for 11 covariates, including age, ejection fraction, and Killip's classification, decreased RVFAC was independently associated with increased risk of all-cause mortality (hazard ratio [HR] 1.61, 95% confidence interval [CI] 1.31 to 1.98), CV death (HR 1.62, 95% CI 1.30 to 2.01), sudden death (HR 1.79, 95% CI 1.26 to 2.54), HF (HR 1.48, 95% CI 1.17 to 1.86), and stroke (HR 2.95, 95% CI 1.76 to 4.95), but not recurrent MI. Each 5% decrease in baseline RVFAC was associated with a 1.53 (95% CI 1.24 to 1.88) increased risk of fatal and nonfatal CV outcomes. In conclusion, decreased right ventricular systolic function is a major risk factor for death, sudden death, HF, and stroke after MI. PMID:18308007

  3. Do uterine natural killer cell numbers in peri-implantation endometrium predict hypertensive disorder in pregnancy in women with a history of reproductive failure?

    PubMed

    Wong, Alice Wai Yee; Archer, Bethan; Mariee, Najat; Li, Tin Chiu; Laird, Susan M

    2014-12-01

    The aim of this study was to investigate whether or not increased uterine natural killer (uNK) cell numbers in the peri-implantation endometrium are associated with an increased risk of hypertensive disorders in a subsequent pregnancy. This is a retrospective study including 80 women with a history of unexplained recurrent miscarriage or recurrent implantation failure. Precisely timed endometrial biopsies were obtained from women 7-9 days after the luteinising hormone surge. uNK cells were immunostained for CD56+ and expressed as a percentage of total stromal cells. Patients were defined as having a high uNK cell count if the percentage of total stromal cells was more than 13.9%. Five out of 29 (17.2%) women in the high uNK cell count group and 5 out of 51 (9.8%) women in the normal uNK cell count group developed gestational hypertension. Pre-eclampsia was diagnosed in 2 (6.9%) patients in the high uNK cell count group and 1 (2.0%) patient from the normal uNK cell count group. There was no significant difference in the incidence of either gestational hypertension (P=0.483) and pre-eclampsia (P=0.296) between groups. The overall incidence of hypertensive disease in women with high uNK cell count (24.1%) was two times higher than women with normal uNK cell count (11.8%), but it was not statistically significant (P=0.208). An increased uNK cells count in the peri-implantation period in a cycle prior to conception did not appear to significantly increase the likelihood of hypertensive disease of pregnancy.

  4. Lifetime and failure strain prediction for material subjected to non-stationary tensile loading conditions: applications to Zircaloy - 4. [Monkman-Grant relationship

    SciTech Connect

    Bocek, M.

    1982-01-01

    The life fraction rule (LFR) is used to calculate the lifetime of materials subjected to stress and temperature ramp loading. The solutions for the individual nonstationary temperature and stress loading conditions can be applied to predict also the lifetime of structures loaded by superimposed ramps solely on the basis of normal 'iso'-stress rupture data. The concept is applied to tensional stress and temperature cycling as well. As compared with the peculiarities of the problem, the agreement between experiments and calculations is encouraging. 16 refs.

  5. WE-G-BRD-09: Prediction of Local Control/Failure by Using Feature Histogram Selection in Follow-Up T2-Weighted MR Image in Spinal Tumors After Stereotactic Body Radiation Therapy

    SciTech Connect

    Zhou, J; Harb, J; Jawad, M; Yee, S; Schulze, D; Liang, J; Grills D, Yan

    2014-06-15

    Purpose: In follow-up T2-weighted MR images of spinal tumor patients treated with stereotactic body radiation therapy (SBRT), high intensity features embedded in dark surroundings may suggest a local failure (LF). We investigated image intensity histogram in imaging features to predict LF and local control (LC). Methods: Sixty-seven spinal tumors were treated with SBRT at our institution with scheduled follow-up MR T2-weighted (TR 3200–6600ms; TE 75-132ms) imaging. The LF group included 10 tumors with 8.7 months median follow-up, while the LC group had 11 tumors with 24.1 months median follow-up. The follow-up images were fused to the planning CT. Image intensity histograms of the GTV were calculated. Voxels in greater than 90% (V90), 80% (V80), and peak (Vpeak) of the histogram were grouped into sub-ROIs to determine the best feature histogram. The intensity of each sub-ROI was evaluated using the mean T2-weighted signal ratio (intensity in sub-ROI / intensity in normal vertebrae). An ROC curve in predicting LF for each sub-ROI was calculated to determine the best feature histogram parameter for LF prediction. Results: Mean T2-weighted signal ratio in the LF group was significantly higher than that in the LC group for all sub-ROIs (1.1±0.4 vs. 0.7±0.2, 1.2±0.4 vs. 0.8±0.2, 1.4±0.5 vs. 0.8±0.2, for V90, V80, and Vpeak, p=0.02, 0.02, and 0.002, respectively). The corresponding areas-under-curve (AUC) of ROC were 0.78, 0.80, and 0.87, p=0.02, 0.03, 0.004, respectively. No correlation was found between T2-weighted signal ratio in Vpeak and follow-up time (Pearson's ρ=0.15). Conclusion: Increased T2-weighted signal can be used to identify local failure while decreased signal indicates local control after spinal SBRT. By choosing the best histogram parameter (here the Vpeak), the AUC of the ROC can be substantially improved, which implies reliable prediction of LC and LF. These results are being further studied and validated with large multi-institutional data.

  6. Postbuckling failure of composite plates with holes

    NASA Technical Reports Server (NTRS)

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

    1992-01-01

    This paper summarizes a study focused on understanding the failure mechanisms present in a plate with a centrally located circular hole loaded inplane into the postbuckling range of deflections. The study was numerical and experimental in nature and had as a goal the a priori prediction of failure using existing failure data from several sources, together with a stress analysis. The maximum stress failure criterion was used to predict failure and both intra- and interlaminar stresses were considered. Four laminates were considered. The phenomenon of modal interaction, or the jumping from one deformed configuration to another, is discussed. With this jumping, the plate configuration may change from one half-wave in the loading direction to two half-waves in the loading direction. The study concludes that the failure in (+/-45/0/90)2s and (+/-45/2(2))2s laminates is due to fiber compression failure and is predictable. The failure load is, for the most part, independent of response configuration. The (+/-45/0/(6))s laminate fails due to interlaminar shear along the simple support, while the response and failure of the (+/-45)4s laminate is governed to a large degree by material nonlinearities and progressive failure.

  7. Application of a model of plastic porous materials including void shape effects to the prediction of ductile failure under shear-dominated loadings

    NASA Astrophysics Data System (ADS)

    Morin, Léo; Leblond, Jean-Baptiste; Tvergaard, Viggo

    2016-09-01

    An extension of Gurson's famous model (Gurson, 1977) of porous plastic solids, incorporating void shape effects, has recently been proposed by Madou and Leblond (Madou and Leblond, 2012a, 2012b, 2013; Madou et al., 2013). In this extension the voids are no longer modelled as spherical but ellipsoidal with three different axes, and changes of the magnitude and orientation of these axes are accounted for. The aim of this paper is to show that the new model is able to predict softening due essentially to such changes, in the absence of significant void growth. This is done in two steps. First, a numerical implementation of the model is proposed and incorporated into the SYSTUS® and ABAQUS® finite element programmes (through some freely available UMAT (Leblond, 2015) in the second case). Second, the implementation in SYSTUS® is used to simulate previous "numerical experiments" of Tvergaard and coworkers (Tvergaard, 2008, 2009, 2012, 2015a; Dahl et al., 2012; Nielsen et al., 2012) involving the shear loading of elementary porous cells, where softening due to changes of the void shape and orientation was very apparent. It is found that with a simple, heuristic modelling of the phenomenon of mesoscopic strain localization, the model is indeed able to reproduce the results of these numerical experiments, in contrast to Gurson's model disregarding void shape effects.

  8. Mesh convergence differences based on failure mechanisms

    SciTech Connect

    Pilat, K.R.; Revelli, V.D.

    1994-04-01

    Material properties affect the deformation and failure modes in structural parts. When performing finite element analyses to compare response for different materials, different levels of mesh discretization may be necessary for each analyses because the failure mode changes, even through the part geometry and loading remain the same. Take, for example, strain localization, a material dependent phenomenon. When localization occurs, the mesh needs to be much finer to capture the steep strain gradients in the region of localization than in a case where localization does not occur. Although this requirement is almost intuitive once stated, it is often not used in practice because the effects are less pronounced when failure is not present, and also because failure modes are difficult to anticipate. The lack of availability of constitutive models for failure prediction is also a contributing factor. This paper describes a recent study regarding the effect of mesh refinement on failure prediction in a part modeled with two different materials.

  9. Light water reactor lower head failure analysis

    SciTech Connect

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

    1993-10-01

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

  10. Everyday attention failures: an individual differences investigation.

    PubMed

    Unsworth, Nash; McMillan, Brittany D; Brewer, Gene A; Spillers, Gregory J

    2012-11-01

    The present study examined individual differences in everyday attention failures. Undergraduate students completed various cognitive ability measures in the laboratory and recorded everyday attention failures in a diary over the course of a week. The majority of attention failures were failures of distraction or mind wandering in educational contexts (in class or while studying). Latent variable techniques were used to perform analyses, and the results suggested that individual differences in working memory capacity and attention control were related to some but not all everyday attention failures. Furthermore, everyday attention failures predicted SAT scores and partially accounted for the relation between cognitive abilities and SAT scores. These results provide important evidence for individual differences in everyday attention failures as well as for the ecological validity of laboratory measures of working memory capacity and attention control.

  11. Wind Turbine Failures - Tackling current Problems in Failure Data Analysis

    NASA Astrophysics Data System (ADS)

    Reder, M. D.; Gonzalez, E.; Melero, J. J.

    2016-09-01

    The wind industry has been growing significantly over the past decades, resulting in a remarkable increase in installed wind power capacity. Turbine technologies are rapidly evolving in terms of complexity and size, and there is an urgent need for cost effective operation and maintenance (O&M) strategies. Especially unplanned downtime represents one of the main cost drivers of a modern wind farm. Here, reliability and failure prediction models can enable operators to apply preventive O&M strategies rather than corrective actions. In order to develop these models, the failure rates and downtimes of wind turbine (WT) components have to be understood profoundly. This paper is focused on tackling three of the main issues related to WT failure analyses. These are, the non-uniform data treatment, the scarcity of available failure analyses, and the lack of investigation on alternative data sources. For this, a modernised form of an existing WT taxonomy is introduced. Additionally, an extensive analysis of historical failure and downtime data of more than 4300 turbines is presented. Finally, the possibilities to encounter the lack of available failure data by complementing historical databases with Supervisory Control and Data Acquisition (SCADA) alarms are evaluated.

  12. Acute kidney failure

    MedlinePlus

    Kidney failure; Renal failure; Renal failure - acute; ARF; Kidney injury - acute ... There are many possible causes of kidney damage. They include: ... cholesterol (cholesterol emboli) Decreased blood flow due to very ...

  13. What Is Heart Failure?

    MedlinePlus

    ... page from the NHLBI on Twitter. What Is Heart Failure? Heart failure is a condition in which the heart can' ... force. Some people have both problems. The term "heart failure" doesn't mean that your heart has stopped ...

  14. Heart failure - medicines

    MedlinePlus

    CHF - medicines; Congestive heart failure - medicines; Cardiomyopathy - medicines; HF - medicines ... You will need to take most of your heart failure medicines every day. Some medicines are taken ...

  15. Heart failure prognostic model.

    PubMed

    Axente, L; Sinescu, C; Bazacliu, G

    2011-05-15

    Heart failure (HF) is a common, costly, disabling and deadly syndrome. Heart failure is a progressive disease characterized by high prevalence in society, significantly reducing physical and mental health, frequent hospitalization and high mortality (50% of the patients survive up to 4 years after the diagnosis, the annual mortality varying from 5% to 75%). The purpose of this study is to develop a prognostic model with easily obtainable variables for patients with heart failure. METHODS AND RESULTS. Our lot included 101 non-consecutive hospitalized patients with heart failure diagnosis. It included 49.5% women having the average age of 71.23 years (starting from 40 up to 91 years old) and the roughly estimated period for monitoring was 35.1 months (5-65 months). Survival data were available for all patients and the median survival duration was of 44.0 months. A large number of variables (demographic, etiologic, co morbidity, clinical, echocardiograph, ECG, laboratory and medication) were evaluated. We performed a complex statistical analysis, studying: survival curve, cumulative hazard, hazard function, lifetime distribution and density function, meaning residual life time, Ln S (t) vs. t and Ln(H) t vs. Ln (t). The Cox multiple regression model was used in order to determine the major factors that allow the forecasting survival and their regression coefficients: age (0.0369), systolic blood pressure (-0.0219), potassium (0.0570), sex (-0.3124) and the acute myocardial infarction (0.2662). DISCUSSION. Our model easily incorporates obtainable variables that may be available in any hospital, accurately predicting survival of the heart failure patients and enables risk stratification in a few hours after the patients' presentation. Our model is derived from a sample of patients hospitalized in an emergency department of cardiology, some with major life-altering co morbidities. The benefit of being aware of the prognosis of these patients with high risk is extremely

  16. The Impact of Worsening Heart Failure in the United States.

    PubMed

    Cooper, Lauren B; DeVore, Adam D; Michael Felker, G

    2015-10-01

    In-hospital worsening heart failure represents a clinical scenario wherein a patient hospitalized for acute heart failure experiences a worsening of their condition, requiring escalation of therapy. Worsening heart failure is associated with worse in-hospital and postdischarge outcomes. Worsening heart failure is increasingly being used as an endpoint or combined endpoint in clinical trials, as it is unique to episodes of acute heart failure and captures an important event during the inpatient course. While prediction models have been developed to identify worsening heart failure, there are no known FDA-approved medications associated with decreased worsening heart failure. Continued study is warranted.

  17. Distributive shock, cardiac arrhythmias and multiple organ failure following surgery of a fourth ventricular epidermoid.

    PubMed

    Bercker, Sven; Meixensberger, Jürgen; Laudi, Sven; Renner, Christof

    2016-03-31

    A 33-years-old male patient presented with cardiac arrhythmias, acute shock and multiple organ dysfunction after the surgical removal of a massive epidermoid posterior to the brainstem. The patient initially presented with paraesthesia along the right C6 dermatome due to a big tumour at the brain stem. Surgical removal was performed without adverse events and he was transferred to our intensive care unit (ICU) immediately after the operation. Though initially showing a stable postsurgical course he developed cardiac arrhythmias and a state of acute distributive shock with consecutive multi organ failure. Extensive diagnostic measures could not identify a specific cause for this rapid deterioration. However, under carefully monitored symptomatic therapy the patient improved quickly, was extubated 72 h after admission and discharged from the ICU 6 days later. The follow-up did not show any persisting neurological deficits and no evidence of a residual tumour in the MRI-study.

  18. Intentional replantation to prevent predictable endodontic failures.

    PubMed

    Nosonowitz, D M; Stanley, H R

    1984-04-01

    A clinical approach to intentional replantation with indications and contradictions is presented. A histopathologic analysis of a tooth that was replanted and then removed 22 years later is illustrated.

  19. Steam generator tube failures

    SciTech Connect

    MacDonald, P.E.; Shah, V.N.; Ward, L.W.; Ellison, P.G.

    1996-04-01

    A review and summary of the available information on steam generator tubing failures and the impact of these failures on plant safety is presented. The following topics are covered: pressurized water reactor (PWR), Canadian deuterium uranium (CANDU) reactor, and Russian water moderated, water cooled energy reactor (VVER) steam generator degradation, PWR steam generator tube ruptures, the thermal-hydraulic response of a PWR plant with a faulted steam generator, the risk significance of steam generator tube rupture accidents, tubing inspection requirements and fitness-for-service criteria in various countries, and defect detection reliability and sizing accuracy. A significant number of steam generator tubes are defective and are removed from service or repaired each year. This wide spread damage has been caused by many diverse degradation mechanisms, some of which are difficult to detect and predict. In addition, spontaneous tube ruptures have occurred at the rate of about one every 2 years over the last 20 years, and incipient tube ruptures (tube failures usually identified with leak detection monitors just before rupture) have been occurring at the rate of about one per year. These ruptures have caused complex plant transients which have not always been easy for the reactor operators to control. Our analysis shows that if more than 15 tubes rupture during a main steam line break, the system response could lead to core melting. Although spontaneous and induced steam generator tube ruptures are small contributors to the total core damage frequency calculated in probabilistic risk assessments, they are risk significant because the radionuclides are likely to bypass the reactor containment building. The frequency of steam generator tube ruptures can be significantly reduced through appropriate and timely inspections and repairs or removal from service.

  20. Advanced Heart Failure

    MedlinePlus

    ... High Blood Pressure Tools & Resources Stroke More Advanced Heart Failure Updated:Oct 8,2015 When heart failure (HF) ... content was last reviewed on 04/06/2015. Heart Failure • Home • About Heart Failure • Causes and Risks for ...

  1. Copeptin in Heart Failure.

    PubMed

    Balling, Louise; Gustafsson, Finn

    2016-01-01

    Heart failure (HF) is one of the most common causes of hospitalization and mortality in the modern Western world and an increasing proportion of the population will be affected by HF in the future. Although HF management has improved quality of life and prognosis, mortality remains very high despite therapeutic options. Medical management consists of a neurohormonal blockade of an overly activated neurohormonal axis. No single marker has been able to predict or monitor HF with respect to disease progression, hospitalization, or mortality. New methods for diagnosis, monitoring therapy, and prognosis are warranted. Copeptin, a precursor of pre-provasopressin, is a new biomarker in HF with promising potential. Copeptin has been found to be elevated in both acute and chronic HF and is associated with prognosis. Copeptin, in combination with other biomarkers, could be a useful marker in the monitoring of disease severity and as a predictor of prognosis and survival in HF. PMID:26975969

  2. Acute Decompensated Heart Failure Update

    PubMed Central

    Teerlink, John R; Alburikan, Khalid; Metra, Marco; Rodgers, Jo E

    2015-01-01

    Acute decompensated heart failure (ADHF) continues to increase in prevalence and is associated with substantial mortality and morbidity including frequent hospitalizations. The American Heart Association is predicting that more than eight million Americans will have heart failure by 2030 and that the total direct costs associated with the disease will rise from $21 billion in 2012 to $70 billion in 2030. The increase in the prevalence and cost of HF is primarily the result of shifting demographics and a growing population. Although many large, randomized, controlled clinical trials have been conducted in patients with chronic heart failure, it was not until recently that a growing number of studies began to address the management of ADHF. It is the intent of this review to update the clinician regarding the evaluation and optimal management of ADHF. PMID:24251454

  3. Failure analyses of composite bolted joints

    NASA Technical Reports Server (NTRS)

    Wilson, D. W.; Gillespie, J. W.; York, J. L.; Pipes, R. B.

    1980-01-01

    The complex failure behavior exhibited by bolted joints of graphite epoxy (Hercules AS/3501) was investigated for the net tension, bearing and shearout failure modes using combined analytical and experimental techniques. Plane stress, linear elastic, finite element methods were employed to determine the two dimensional state of stress resulting from a loaded hole in a finite width, semiinfinite strip. The stresses predicted by the finite element method were verified by experiment to lend credence to the analysis. The influence of joint geometric parameters on the state of stress and resultant strength of the joint was also studied. The resulting functional relationships found to exist between bolted joint strength and the geometric parameters, were applied in the formulation of semiempirical strength models for the basic failure modes. A point stress failure criterion was successfully applied as the failure criterion for the net tension and shearout failure modes.

  4. Failure Assessment Diagram for Brazed 304 Stainless Steel Joints

    NASA Technical Reports Server (NTRS)

    Flom, Yory

    2011-01-01

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

  5. 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.

  6. Post Buckling Progressive Failure Analysis of Composite Laminated Stiffened Panels

    NASA Astrophysics Data System (ADS)

    Anyfantis, Konstantinos N.; Tsouvalis, Nicholas G.

    2012-06-01

    The present work deals with the numerical prediction of the post buckling progressive and final failure response of stiffened composite panels based on structural nonlinear finite element methods. For this purpose, a progressive failure model (PFM) is developed and applied to predict the behaviour of an experimentally tested blade-stiffened panel found in the literature. Failure initiation and propagation is calculated, owing to the accumulation of the intralaminar failure modes induced in fibre reinforced composite materials. Hashin failure criteria have been employed in order to address the fiber and matrix failure modes in compression and tension. On the other hand, the Tsai-Wu failure criterion has been utilized for addressing shear failure. Failure detection is followed with the introduction of corresponding material degradation rules depending on the individual failure mechanisms. Failure initiation and failure propagation as well as the post buckling ultimate attained load have been numerically evaluated. Final failure behaviour of the simulated stiffened panel is due to sudden global failure, as concluded from comparisons between numerical and experimental results being in good agreement.

  7. 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.

  8. Contraceptive failure in China.

    PubMed

    Wang, Duolao

    2002-09-01

    This study examines patterns and differentials of contraceptive failure rates by method and characteristics of users, using the Chinese Two-per-Thousand Fertility Survey data. The results show that contraceptive failure rates for modern methods including sterilization are some of the highest in the world. The first year failure rates are 4.2% for male sterilization, 0.7% for female sterilization, 10.3% for IUD, 14.5% for pill, and 19.0% for condom. There are also some differentials in contraceptive failure rates by users' sociodemographic and fertility characteristics. Contraceptive failure rate declines with women's age for all reversible methods. Rural women have higher sterilization, IUD, and condom contraceptive failure rates than urban women. Women with two or more children have a higher failure rate for sterilization methods but have lower failure rates for other methods.

  9. In Support of Failure

    ERIC Educational Resources Information Center

    Carr, Allison

    2013-01-01

    In this essay, I propose a concerted effort to begin devising a theory and pedagogy of failure. I review the discourse of failure in Western culture as well as in composition pedagogy, ultimately suggesting that failure is not simply a judgement or indication of rank but is a relational, affect-bearing concept with tremendous relevance to…

  10. Ammonia tank failure

    SciTech Connect

    Sweat, M.E.

    1983-04-01

    An ammonia tank failure at Hawkeye Chemical of Clinton, Iowa is discussed. The tank was a double-wall, 27,000 metric-ton tank built in 1968 and commissioned in December 1969. The paper presented covers the cause of the failure, repair, and procedural changes made to prevent recurrence of the failure. (JMT)

  11. Forecasting the failure of heterogeneous magmas

    NASA Astrophysics Data System (ADS)

    Vasseur, J.; Wadsworth, F. B.; Lavallée, Y.; Bell, A. F.; Main, I. G.; Dingwell, D. B.

    2015-12-01

    Eruption prediction is a long-sought-after goal of volcanology. Yet applying existing techniques retrospectively (hindcasting), we fail to predict events more often than we success. As much of the seismicity associated with intermediate to silicic volcanic eruptions comes from the brittle response of the ascending magma itself, we clearly require a good understanding of the parameters that control the ability to forecast magma failure itself. Here, we present suites of controlled experiments at magmatic temperatures using a range of synthetic magmas to investigate the control of microstructures on the efficacy of forecast models for material failure. We find that the failure of magmas with very little microstructural heterogeneity - such as melts - is very challenging to predict; whereas, the failure of very heterogeneous magmas is always well-predicted. To shed further light on this issue, we provide a scaling law based on the relationship between the microstructural heterogeneity in a magma and the error in the prediction of its failure time. We propose this method be used to elucidate the variable success rate of predicting volcanic predictions. We discuss this scaling in the context of the birth, life and death of structural heterogeneity during magma ascent with specific emphasis on obsidian-forming eruptions such as Chaitèn, 2008. During such eruptions, the repetitive creation and destruction of fractures filled with granular magma, which are thought to be the in situ remnants of seismogenic fracturing itself, are expressions of the life-cycle of heterogeneity in an otherwise coherent, melt-rich magma. We conclude that the next generation of failure forecast tools available to monitoring teams should incorporate some acknowledgment of the magma microstructure and not be solely based on the geophysical signals prior to eruption.

  12. Failure Assessment Diagram for Titanium Brazed Joints

    NASA Technical Reports Server (NTRS)

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

    2011-01-01

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

  13. Diuretics as pathogenetic treatment for heart failure

    PubMed Central

    Guglin, Maya

    2011-01-01

    Increased intracardiac filling pressure or congestion causes symptoms and leads to hospital admissions in patients with heart failure, regardless of their systolic function. A history of hospital admission, in turn, predicts further hospitalizations and morbidity, and a higher number of hospitalizations determine higher mortality. Congestion is therefore the driving force of the natural history of heart failure. Congestion is the syndrome shared by heart failure with preserved and reduced systolic function. These two conditions have almost identical morbidity, mortality, and survival because the outcomes are driven by congestion. A small difference in favor of heart failure with preserved systolic function comes from decreased ejection fraction and left ventricular remodeling which is only present in heart failure with decreased systolic function. The magnitude of this difference reflects the contribution of decreased systolic function and ventricular remodeling to the progression of heart failure. The only treatment available for congestion is fluid removal via diuretics, ultrafiltration, or dialysis. It is the only treatment that works equally well for heart failure with reduced and preserved systolic function because it affects congestion, the main pathogenetic feature of the disease. Diuretics are pathogenetic therapy for heart failure. PMID:21403798

  14. Duralumin - Defects and Failures

    NASA Technical Reports Server (NTRS)

    Nelson, WM

    1927-01-01

    It is proposed in this paper to identify some of the defects and failures in duralumin most frequently encountered by the aircraft industry with a view to indicate their importance. The defects and failures in duralumin may be classified into the following groups: 1) defects produced during manufacture; 2) defects produced during fabrication; 3) corrosion and erosion; and 4) fatigue failures. Only the first two will be covered in this report.

  15. Seasonal factors influencing the failure of buried water reticulation pipes.

    PubMed

    Gould, S J F; Boulaire, F A; Burn, S; Zhao, X L; Kodikara, J K

    2011-01-01

    While the use of environmental factors in the analysis and prediction of failures of buried reticulation pipes in cold environments has been the focus of extensive work, the same cannot be said for failures occurring on pipes in other (non-freezing) environments. A novel analysis of pipe failures in such an environment is the subject of this paper. An exploratory statistical analysis was undertaken, identifying a peak in failure rates during mid to late summer. This peak was found to correspond to a peak in the rate of circumferential failures, whilst the rate of longitudinal failures remained constant. Investigation into the effect of climate on failure rates revealed that the peak in failure rates occurs due to differential soil movement as the result of shrinkage in expansive soils. PMID:22049766

  16. The Predictable Failure of Educational Reform: Can We Change Course before It's Too Late? The Jossey-Bass Education Series and the Jossey-Bass Social and Behavioral Science Series.

    ERIC Educational Resources Information Center

    Sarason, Seymour B.

    Schools have been intractable to change and the attainment of goals set by reformers. A major failure has been the inability of reformers to confront this intractability. As a result, each new wave of reform learns nothing from earlier efforts and comes up with recommendations that have failed in the past. Nine chapters explore why reform efforts…

  17. Post-hepatectomy liver failure

    PubMed Central

    Kauffmann, Rondi

    2014-01-01

    Hepatectomies are among some of the most complex operative interventions performed. Mortality rates after major hepatectomy are as high as 30%, with post-hepatic liver failure (PHLF) representing the major source of morbidity and mortality. We present a review of PHLF, including the current definition, predictive factors, pre-operative risk assessment, techniques to prevent PHLF, identification and management. Despite great improvements in morbidity and mortality, liver surgery continues to demand excellent clinical judgement in selecting patients for surgery. Appropriate choice of pre-operative techniques to improve the functional liver remnant (FLR), fastidious surgical technique, and excellent post-operative management are essential to optimize patient outcomes. PMID:25392835

  18. Failure to Achieve a PSA Level {<=}1 ng/mL After Neoadjuvant LHRHA Therapy Predicts for Lower Biochemical Control Rate and Overall Survival in Localized Prostate Cancer Treated With Radiotherapy

    SciTech Connect

    Mitchell, Darren M. McAleese, Jonathan; Park, Richard M.; Stewart, David P.; Stranex, Stephen; Eakin, Ruth L.; Houston, Russell F.; O'Sullivan, Joe M.

    2007-12-01

    Purpose: To investigate whether failure to suppress the prostate-specific antigen (PSA) level to {<=}1 ng/mL after {>=}2 months of neoadjuvant luteinizing hormone-releasing hormone agonist therapy in patients scheduled to undergo external beam radiotherapy for localized prostate carcinoma is associated with reduced biochemical failure-free survival. Methods and Materials: A retrospective case note review of consecutive patients with intermediate- or high-risk localized prostate cancer treated between January 2001 and December 2002 with neoadjuvant hormonal deprivation therapy, followed by concurrent hormonal therapy and radiotherapy was performed. Patient data were divided for analysis according to whether the PSA level in Week 1 of radiotherapy was {<=}1.0 ng/mL. Biochemical failure was determined using the American Society for Therapeutic Radiology and Oncology (Phoenix) definition. Results: A total of 119 patients were identified. The PSA level after neoadjuvant hormonal deprivation therapy was {<=}1 ng/mL in 67 patients and >1 ng/mL in 52. At a median follow-up of 49 months, the 4-year actuarial biochemical failure-free survival rate was 84% vs. 60% (p = 0.0016) in favor of the patients with a PSA level after neoadjuvant hormonal deprivation therapy of {<=}1 ng/mL. The overall survival rate was 94% vs. 77.5% (p = 0.0045), and the disease-specific survival rate at 4 years was 98.5% vs. 82.5%. Conclusions: The results of our study have shown that patients with a PSA level >1 ng/mL at the beginning of external beam radiotherapy after {>=}2 months of neoadjuvant luteinizing hormone-releasing hormone agonist therapy have a significantly greater rate of biochemical failure and lower survival rate compared with those with a PSA level of {<=}1 ng/mL. Patients without adequate PSA suppression should be considered a higher risk group and considered for dose escalation or the use of novel treatments.

  19. Ampoule Failure System

    NASA Technical Reports Server (NTRS)

    Watring, Dale A. (Inventor); Johnson, Martin L. (Inventor)

    1996-01-01

    An ampoule failure system for use in material processing furnaces comprising a containment cartridge and an ampoule failure sensor. The containment cartridge contains an ampoule of toxic material therein and is positioned within a furnace for processing. An ampoule failure probe is positioned in the containment cartridge adjacent the ampoule for detecting a potential harmful release of toxic material therefrom during processing. The failure probe is spaced a predetermined distance from the ampoule and is chemically chosen so as to undergo a timely chemical reaction with the toxic material upon the harmful release thereof. The ampoule failure system further comprises a data acquisition system which is positioned externally of the furnace and is electrically connected to the ampoule failure probe so as to form a communicating electrical circuit. The data acquisition system includes an automatic shutdown device for shutting down the furnace upon the harmful release of toxic material. It also includes a resistance measuring device for measuring the resistance of the failure probe during processing. The chemical reaction causes a step increase in resistance of the failure probe whereupon the automatic shutdown device will responsively shut down the furnace.

  20. Immune mediated liver failure

    PubMed Central

    Wang, Xiaojing; Ning, Qin

    2014-01-01

    Liver failure is a clinical syndrome of various etiologies, manifesting as jaundice, encephalopathy, coagulopathy and circulatory dysfunction, which result in subsequent multiorgan failure. Clinically, liver failure is classified into four categories: acute, subacute, acute-on-chronic and chronic liver failure. Massive hepatocyte death is considered to be the core event in the development of liver failure, which occurs when the extent of hepatocyte death is beyond the liver regenerative capacity. Direct damage and immune-mediated liver injury are two major factors involved in this process. Increasing evidence has suggested the essential role of immune-mediated liver injury in the pathogenesis of liver failure. Here, we review the evolved concepts concerning the mechanisms of immune-mediated liver injury in liver failure from human and animal studies. Both innate and adaptive immunity, especially the interaction of various immune cells and molecules as well as death receptor signaling system are discussed. In addition, we highlight the concept of “immune coagulation”, which has been shown to be related to the disease progression and liver injury exacerbation in HBV related acute-on-chronic liver failure. PMID:26417328

  1. Physicists and failure

    NASA Astrophysics Data System (ADS)

    Raheem, Ruby; zilch, Mortimer

    2015-08-01

    In reply to a post on the physicsworld.com blog about the central role of failure in physics (“Success, failure and women in physics”, 10 June, http://ow.ly/O8kvR; see also “Failing better,” Editorial, July p15).

  2. Modeling Pathologies of Diastolic and Systolic Heart Failure.

    PubMed

    Genet, M; Lee, L C; Baillargeon, B; Guccione, J M; Kuhl, E

    2016-01-01

    Chronic heart failure is a medical condition that involves structural and functional changes of the heart and a progressive reduction in cardiac output. Heart failure is classified into two categories: diastolic heart failure, a thickening of the ventricular wall associated with impaired filling; and systolic heart failure, a dilation of the ventricles associated with reduced pump function. In theory, the pathophysiology of heart failure is well understood. In practice, however, heart failure is highly sensitive to cardiac microstructure, geometry, and loading. This makes it virtually impossible to predict the time line of heart failure for a diseased individual. Here we show that computational modeling allows us to integrate knowledge from different scales to create an individualized model for cardiac growth and remodeling during chronic heart failure. Our model naturally connects molecular events of parallel and serial sarcomere deposition with cellular phenomena of myofibrillogenesis and sarcomerogenesis to whole organ function. Our simulations predict chronic alterations in wall thickness, chamber size, and cardiac geometry, which agree favorably with the clinical observations in patients with diastolic and systolic heart failure. In contrast to existing single- or bi-ventricular models, our new four-chamber model can also predict characteristic secondary effects including papillary muscle dislocation, annular dilation, regurgitant flow, and outflow obstruction. Our prototype study suggests that computational modeling provides a patient-specific window into the progression of heart failure with a view towards personalized treatment planning. PMID:26043672

  3. Acute Decompensated Heart Failure

    PubMed Central

    Joseph, Susan M.; Cedars, Ari M.; Ewald, Gregory A.; Geltman, Edward M.; Mann, Douglas L.

    2009-01-01

    Hospitalizations for acute decompensated heart failure are increasing in the United States. Moreover, the prevalence of heart failure is increasing consequent to an increased number of older individuals, as well as to improvement in therapies for coronary artery disease and sudden cardiac death that have enabled patients to live longer with cardiovascular disease. The main treatment goals in the hospitalized patient with heart failure are to restore euvolemia and to minimize adverse events. Common in-hospital treatments include intravenous diuretics, vasodilators, and inotropic agents. Novel pharmaceutical agents have shown promise in the treatment of acute decompensated heart failure and may simplify the treatment and reduce the morbidity associated with the disease. This review summarizes the contemporary management of patients with acute decompensated heart failure. PMID:20069075

  4. Heterogeneity: The key to failure forecasting

    PubMed Central

    Vasseur, Jérémie; Wadsworth, Fabian B.; Lavallée, Yan; Bell, Andrew F.; Main, Ian G.; Dingwell, Donald B.

    2015-01-01

    Elastic waves are generated when brittle materials are subjected to increasing strain. Their number and energy increase non-linearly, ending in a system-sized catastrophic failure event. Accelerating rates of geophysical signals (e.g., seismicity and deformation) preceding large-scale dynamic failure can serve as proxies for damage accumulation in the Failure Forecast Method (FFM). Here we test the hypothesis that the style and mechanisms of deformation, and the accuracy of the FFM, are both tightly controlled by the degree of microstructural heterogeneity of the material under stress. We generate a suite of synthetic samples with variable heterogeneity, controlled by the gas volume fraction. We experimentally demonstrate that the accuracy of failure prediction increases drastically with the degree of material heterogeneity. These results have significant implications in a broad range of material-based disciplines for which failure forecasting is of central importance. In particular, the FFM has been used with only variable success to forecast failure scenarios both in the field (volcanic eruptions and landslides) and in the laboratory (rock and magma failure). Our results show that this variability may be explained, and the reliability and accuracy of forecast quantified significantly improved, by accounting for material heterogeneity as a first-order control on forecasting power. PMID:26307196

  5. Heterogeneity: The key to failure forecasting.

    PubMed

    Vasseur, Jérémie; Wadsworth, Fabian B; Lavallée, Yan; Bell, Andrew F; Main, Ian G; Dingwell, Donald B

    2015-08-26

    Elastic waves are generated when brittle materials are subjected to increasing strain. Their number and energy increase non-linearly, ending in a system-sized catastrophic failure event. Accelerating rates of geophysical signals (e.g., seismicity and deformation) preceding large-scale dynamic failure can serve as proxies for damage accumulation in the Failure Forecast Method (FFM). Here we test the hypothesis that the style and mechanisms of deformation, and the accuracy of the FFM, are both tightly controlled by the degree of microstructural heterogeneity of the material under stress. We generate a suite of synthetic samples with variable heterogeneity, controlled by the gas volume fraction. We experimentally demonstrate that the accuracy of failure prediction increases drastically with the degree of material heterogeneity. These results have significant implications in a broad range of material-based disciplines for which failure forecasting is of central importance. In particular, the FFM has been used with only variable success to forecast failure scenarios both in the field (volcanic eruptions and landslides) and in the laboratory (rock and magma failure). Our results show that this variability may be explained, and the reliability and accuracy of forecast quantified significantly improved, by accounting for material heterogeneity as a first-order control on forecasting power.

  6. Heterogeneity: The key to failure forecasting.

    PubMed

    Vasseur, Jérémie; Wadsworth, Fabian B; Lavallée, Yan; Bell, Andrew F; Main, Ian G; Dingwell, Donald B

    2015-01-01

    Elastic waves are generated when brittle materials are subjected to increasing strain. Their number and energy increase non-linearly, ending in a system-sized catastrophic failure event. Accelerating rates of geophysical signals (e.g., seismicity and deformation) preceding large-scale dynamic failure can serve as proxies for damage accumulation in the Failure Forecast Method (FFM). Here we test the hypothesis that the style and mechanisms of deformation, and the accuracy of the FFM, are both tightly controlled by the degree of microstructural heterogeneity of the material under stress. We generate a suite of synthetic samples with variable heterogeneity, controlled by the gas volume fraction. We experimentally demonstrate that the accuracy of failure prediction increases drastically with the degree of material heterogeneity. These results have significant implications in a broad range of material-based disciplines for which failure forecasting is of central importance. In particular, the FFM has been used with only variable success to forecast failure scenarios both in the field (volcanic eruptions and landslides) and in the laboratory (rock and magma failure). Our results show that this variability may be explained, and the reliability and accuracy of forecast quantified significantly improved, by accounting for material heterogeneity as a first-order control on forecasting power. PMID:26307196

  7. Modelling early failures in Space Station Freedom

    NASA Technical Reports Server (NTRS)

    Navard, Sharon E.

    1993-01-01

    A major problem encountered in planning for Space Station Freedom is the amount of maintenance that will be required. To predict the failure rates of components and systems aboard Space Station Freedom, the logical approach is to use data obtained from previously flown spacecraft. In order to determine the mechanisms that are driving the failures, models can be proposed, and then checked to see if they adequately fit the observed failure data obtained from a large variety of satellites. For this particular study, failure data and truncation times were available for satellites launched between 1976 and 1984; no data past 1984 was available. The study was limited to electrical subsystems and assemblies, which were studied to determine if they followed a model resulting from a mixture of exponential distributions.

  8. Compression failure of angle-ply laminates

    NASA Technical Reports Server (NTRS)

    Peel, Larry D.; Hyer, Michael W.; Shuart, Mark J.

    1991-01-01

    The present work deals with modes and mechanisms of failure in compression of angle-ply laminates. Experimental results were obtained from 42 angle-ply IM7/8551-7a specimens with a lay-up of ((plus or minus theta)/(plus or minus theta)) sub 6s where theta, the off-axis angle, ranged from 0 degrees to 90 degrees. The results showed four failure modes, these modes being a function of off-axis angle. Failure modes include fiber compression, inplane transverse tension, inplane shear, and inplane transverse compression. Excessive interlaminar shear strain was also considered as an important mode of failure. At low off-axis angles, experimentally observed values were considerably lower than published strengths. It was determined that laminate imperfections in the form of layer waviness could be a major factor in reducing compression strength. Previously developed linear buckling and geometrically nonlinear theories were used, with modifications and enhancements, to examine the influence of layer waviness on compression response. The wavy layer is described by a wave amplitude and a wave length. Linear elastic stress-strain response is assumed. The geometrically nonlinear theory, in conjunction with the maximum stress failure criterion, was used to predict compression failure and failure modes for the angle-ply laminates. A range of wave length and amplitudes were used. It was found that for 0 less than or equal to theta less than or equal to 15 degrees failure was most likely due to fiber compression. For 15 degrees less than theta less than or equal to 35 degrees, failure was most likely due to inplane transverse tension. For 35 degrees less than theta less than or equal to 70 degrees, failure was most likely due to inplane shear. For theta less than 70 degrees, failure was most likely due to inplane transverse compression. The fiber compression and transverse tension failure modes depended more heavily on wave length than on wave amplitude. Thus using a single

  9. Micromechanics-Based Progressive Failure Analysis of Composite Laminates Using Different Constituent Failure Theories

    NASA Technical Reports Server (NTRS)

    Moncada, Albert M.; Chattopadhyay, Aditi; Bednarcyk, Brett A.; Arnold, Steven M.

    2008-01-01

    Predicting failure in a composite can be done with ply level mechanisms and/or micro level mechanisms. This paper uses the Generalized Method of Cells and High-Fidelity Generalized Method of Cells micromechanics theories, coupled with classical lamination theory, as implemented within NASA's Micromechanics Analysis Code with Generalized Method of Cells. The code is able to implement different failure theories on the level of both the fiber and the matrix constituents within a laminate. A comparison is made among maximum stress, maximum strain, Tsai-Hill, and Tsai-Wu failure theories. To verify the failure theories the Worldwide Failure Exercise (WWFE) experiments have been used. The WWFE is a comprehensive study that covers a wide range of polymer matrix composite laminates. The numerical results indicate good correlation with the experimental results for most of the composite layups, but also point to the need for more accurate resin damage progression models.

  10. Elevated serum cardiac markers predict coronary artery disease in patients with a history of heart failure who present with chest pain: insights from the i*trACS registry.

    PubMed

    Glauser, Jonathan; Erickson, James; Bhatt, Deepak; Lindsell, Christopher; Gibler, Brian; Hoekstra, James; Pollack, Charles; Hollander, Judd; Peacock, W Franklin

    2007-01-01

    The significance of a history of heart failure (HF) in patients presenting with acute coronary syndromes and elevated cardiac markers is unclear. The authors performed an analysis of patients enrolled in the Internet Tracking Registry of Acute Coronary Syndromes (i*trACS). Cardiac marker measurement and cardiac catheterization were performed in 1174 patients. Of these, 116 (9.9%) had heart failure (HF). Coronary artery disease (CAD) was found in 61 (52.6%) patients in the HF group and 581 (54.9%) in the group without HF. In the non-HF cohort, positive markers occurred in 306 patients, in whom 217 (70.9%) had CAD at catheterization. In the HF subset, 24 patients had positive biomarkers and 15 (62.5%) had CAD. A history of HF did not lessen the likelihood of CAD as evidenced by angiography and does not diminish the utility of cardiac markers in diagnosing acute coronary syndromes.

  11. Buckling failures in insect exoskeletons.

    PubMed

    Parle, Eoin; Herbaj, Simona; Sheils, Fiona; Larmon, Hannah; Taylor, David

    2016-02-01

    Thin walled tubes are often used for load-bearing structures, in nature and in engineering, because they offer good resistance to bending and torsion at relatively low weight. However, when loaded in bending they are prone to failure by buckling. It is difficult to predict the loading conditions which cause buckling, especially for tubes whose cross sections are not simple shapes. Insights into buckling prevention might be gained by studying this phenomenon in the exoskeletons of insects and other arthropods. We investigated the leg segments (tibiae) of five different insects: the locust (Schistocerca gergaria), American cockroach (Periplaneta americana), death's head cockroach (Blaberus discoidalis), stick insect (Parapachymorpha zomproi) and bumblebee (Bombus terrestris audax). These were tested to failure in cantilever bending and modelled using finite element analysis (FEA). The tibiae of the locust and the cockroaches were found to be approximately circular in shape. Their buckling loads were well predicted by linear elastic FEA, and also by one of the analytical solutions available in the literature for elastic buckling. The legs of the stick insect are also circular in cross section but have several prominent longitudinal ridges. We hypothesised that these ridges might protect the legs against buckling but we found that this was not the case: the loads necessary for elastic buckling were not reached in practice because yield occurred in the material, causing plastic buckling. The legs of bees have a non-circular cross section due to a pollen-carrying feature (the corbicula). We found that this did not significantly affect their resistance to buckling. Our results imply that buckling is the dominant failure mode in the tibia of insects; it likely to be a significant consideration for other arthropods and any organisms with stiff exoskeletons. The interactions displayed here between material properties and cross sectional geometry may provide insights for the

  12. A failure modes, mechanisms, and effects analysis (FMMEA) of lithium-ion batteries

    NASA Astrophysics Data System (ADS)

    Hendricks, Christopher; Williard, Nick; Mathew, Sony; Pecht, Michael

    2015-11-01

    Lithium-ion batteries are popular energy storage devices for a wide variety of applications. As batteries have transitioned from being used in portable electronics to being used in longer lifetime and more safety-critical applications, such as electric vehicles (EVs) and aircraft, the cost of failure has become more significant both in terms of liability as well as the cost of replacement. Failure modes, mechanisms, and effects analysis (FMMEA) provides a rigorous framework to define the ways in which lithium-ion batteries can fail, how failures can be detected, what processes cause the failures, and how to model failures for failure prediction. This enables a physics-of-failure (PoF) approach to battery life prediction that takes into account life cycle conditions, multiple failure mechanisms, and their effects on battery health and safety. This paper presents an FMMEA of battery failure and describes how this process enables improved battery failure mitigation control strategies.

  13. Progressive failure of structures

    NASA Technical Reports Server (NTRS)

    Khozeimeh, K.; Toridis, G. T. G.; Zanganeh, S. E.

    1978-01-01

    A procedure is presented for determining the nonlinear behavior of structures subjected to extreme loading and the possibility of development of potential for progressive failure. The methodology takes into account the effect of both material and geometric nonlinearities. At a given stage of analysis, the individual components of the structure are checked against predetermined failure criteria. Subsequently, the failing components are removed and the modified structure is analyzed for overall failure. Examples, obtained from a computer program based on the proposed procedure, showing the applicability of the method are presented.

  14. Damage mechanics - failure modes

    SciTech Connect

    Krajcinovic, D.; Vujosevic, M.

    1996-12-31

    The present study summarizes the results of the DOE sponsored research program focused on the brittle failure of solids with disordered microstructure. The failure is related to the stochastic processes on the microstructural scale; namely, the nucleation and growth of microcracks. The intrinsic failure modes, such as the percolation, localization and creep rupture, are studied by emphasizing the effect of the micro-structural disorder. A rich spectrum of physical phenomena and new concepts that emerges from this research demonstrates the reasons behind the limitations of traditional, deterministic, and local continuum models.

  15. Failure of underground concrete structures subjected to blast loadings

    NASA Technical Reports Server (NTRS)

    Ross, C. A.; Nash, P. T.; Griner, G. R.

    1979-01-01

    The response and failure of two edges of free reinforced concrete slabs subjected to intermediate blast loadings are examined. The failure of the reinforced concrete structures is defined as a condition where actual separation or fracture of the reinforcing elements has occurred. Approximate theoretical methods using stationary and moving plastic hinge mechanisms with linearly varying and time dependent loadings are developed. Equations developed to predict deflection and failure of reinforced concrete beams are presented and compared with the experimental results.

  16. Predicting success in weaning from mechanical ventilation.

    PubMed

    Meade, M; Guyatt, G; Cook, D; Griffith, L; Sinuff, T; Kergl, C; Mancebo, J; Esteban, A; Epstein, S

    2001-12-01

    We identified 65 observational studies of weaning predictors that had been reported in 70 publications. After grouping predictors with similar names but different thresholds, the following predictors met our relevance criteria: heterogeneous populations, 51; COPD patients, 21; and cardiovascular ICU patients, 45. Many variables were of no use in predicting the results of weaning. Moreover, few variables had been studied in > 50 patients or had results presented to generate estimates of predictive power. For stepwise reductions in mechanical support, the most promising predictors were a rapid shallow breathing index (RSBI) < 65 breaths/min/L (measured using the ventilator settings that were in effect at the time that the prediction was made) and a pressure time product < 275 cm H2O/L/s. The pooled likelihood ratios (LRs) were 1.1 (95% confidence interval [CI], 0.95 to 1.28) for a respiratory rate [RR] of < 38 breaths/min and 0.32 (95% CI, 0.06 to 1.71) for an RR of > 38 breaths/min, which indicate that an RR of < 38 breaths/min leaves the probability of successful weaning virtually unchanged but that a value of > 38 breaths/min leads to a small reduction in the probability of success in weaning the level of mechanical support. For trials of unassisted breathing, the most promising weaning predictors include the following: RR; RSBI; a product of RSBI and occlusion pressure < 450 cm H2O breaths/min/L; maximal inspiratory pressure (PImax) < 20 cm H2O; and a knowledge-based system for adjusting pressure support. Pooled results for the power of a positive test result for both RR and RSBI were limited (highest LR, 2.23), while the power of a negative test result was substantial (ie, LR, 0.09 to 0.23). Summary data suggest a similar predictive power for RR and RSBI. In the prediction of successful extubation, an RR of < 38 breaths/min (sensitivity, 88%; specificity, 47%), an RSBI < 100 or 105 breaths/min/L (sensitivity, 65 to 96%; specificity, 0 to 73%), PImax, and APACHE

  17. Hyperkalemia in Heart Failure.

    PubMed

    Sarwar, Chaudhry M S; Papadimitriou, Lampros; Pitt, Bertram; Piña, Ileana; Zannad, Faiez; Anker, Stefan D; Gheorghiade, Mihai; Butler, Javed

    2016-10-01

    Disorders of potassium homeostasis can potentiate the already elevated risk of arrhythmia in heart failure. Heart failure patients have a high prevalence of chronic kidney disease, which further heightens the risk of hyperkalemia, especially when renin-angiotensin-aldosterone system inhibitors are used. Acute treatment for hyperkalemia may not be tolerated in the long term. Recent data for patiromer and sodium zirconium cyclosilicate, used to treat and prevent high serum potassium levels on a more chronic basis, have sparked interest in the treatment of hyperkalemia, as well as the potential use of renin-angiotensin-aldosterone system inhibitors in patients who were previously unable to take these drugs or tolerated only low doses. This review discusses the epidemiology, pathophysiology, and outcomes of hyperkalemia in heart failure; provides an overview of traditional and novel ways to approach management of hyperkalemia; and discusses the need for further research to optimally treat heart failure.

  18. Hyperkalemia in Heart Failure.

    PubMed

    Sarwar, Chaudhry M S; Papadimitriou, Lampros; Pitt, Bertram; Piña, Ileana; Zannad, Faiez; Anker, Stefan D; Gheorghiade, Mihai; Butler, Javed

    2016-10-01

    Disorders of potassium homeostasis can potentiate the already elevated risk of arrhythmia in heart failure. Heart failure patients have a high prevalence of chronic kidney disease, which further heightens the risk of hyperkalemia, especially when renin-angiotensin-aldosterone system inhibitors are used. Acute treatment for hyperkalemia may not be tolerated in the long term. Recent data for patiromer and sodium zirconium cyclosilicate, used to treat and prevent high serum potassium levels on a more chronic basis, have sparked interest in the treatment of hyperkalemia, as well as the potential use of renin-angiotensin-aldosterone system inhibitors in patients who were previously unable to take these drugs or tolerated only low doses. This review discusses the epidemiology, pathophysiology, and outcomes of hyperkalemia in heart failure; provides an overview of traditional and novel ways to approach management of hyperkalemia; and discusses the need for further research to optimally treat heart failure. PMID:27687200

  19. What Causes Heart Failure?

    MedlinePlus

    ... the heart, leading to heart failure. High Blood Pressure Blood pressure is the force of blood pushing against the ... weaken your heart and lead to plaque buildup. Blood pressure is considered high if it stays at or ...

  20. Heart failure - tests

    MedlinePlus

    CHF - tests; Congestive heart failure - tests; Cardiomyopathy - tests; HF - tests ... An echocardiogram (Echo) is a test that uses sound waves to create a moving picture of the heart. The picture is much more detailed than a plain ...

  1. Types of Heart Failure

    MedlinePlus

    ... to be made. Here we delve into the importance of shared decision making. This content was last ... heart failure. Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Low Blood Pressure ...

  2. Classes of Heart Failure

    MedlinePlus

    ... to be made. Here we delve into the importance of shared decision making. HF Resources For Life ... heart failure. Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Low Blood Pressure ...

  3. Common Cause Failure Modeling

    NASA Technical Reports Server (NTRS)

    Hark, Frank; Britton, Paul; Ring, Robert; Novack, Steven

    2015-01-01

    Space Launch System (SLS) Agenda: Objective; Key Definitions; Calculating Common Cause; Examples; Defense against Common Cause; Impact of varied Common Cause Failure (CCF) and abortability; Response Surface for various CCF Beta; Takeaways.

  4. Kidney (Renal) Failure

    MedlinePlus

    ... renal function using ureteral stenting, nephrostomy, surgery or dialysis. What is kidney (renal) failure? How is kidney ... as a urinary stent or kidney stone removal. Dialysis , including hemodialysis and peritoneal dialysis: These procedures remove ...

  5. What Causes Respiratory Failure?

    MedlinePlus

    ... easily move oxygen into your blood and remove carbon dioxide from your blood (gas exchange). This can cause a low oxygen level or high carbon dioxide level, or both, in your blood. Respiratory failure ...

  6. Genesis Failure Investigation Report

    NASA Technical Reports Server (NTRS)

    Klein, John

    2004-01-01

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

  7. The influence of gouge defects on failure pressure of steel pipes

    NASA Astrophysics Data System (ADS)

    Alang, N. A.; Razak, N. A.; Zulfadli, M. R.

    2013-12-01

    Failure pressure of API X42 steel pipes with gouge defects was estimated through a nonlinear finite element (FE) analysis. The effect of gouge length on failure pressure of different pipe diameters was investigated. Stress modified critical strain (SMCS) model was applied as in predicting the failure of the pipe. The model uses strain based criteria to predict the failure. For validation of the model, the FE results were compared to experimental data in literature showing overall good agreement. The results show that the gouge length has significant influence on failure pressure. A smaller pipe diameter gives highest value of failure pressure.

  8. Decompensated heart failure

    PubMed Central

    Mangini, Sandrigo; Pires, Philippe Vieira; Braga, Fabiana Goulart Marcondes; Bacal, Fernando

    2013-01-01

    ABSTRACT Heart failure is a disease with high incidence and prevalence in the population. The costs with hospitalization for decompensated heart failure reach approximately 60% of the total cost with heart failure treatment, and mortality during hospitalization varies according to the studied population, and could achieve values of 10%. In patients with decompensated heart failure, history and physical examination are of great value for the diagnosis of the syndrome, and also can help the physician to identify the beginning of symptoms, and give information about etiology, causes and prognosis of the disease. The initial objective of decompensated heart failure treatment is the hemodynamic and symptomatic improvement preservation and/or improvement of renal function, prevention of myocardial damage, modulation of the neurohormonal and/or inflammatory activation and control of comorbidities that can cause or contribute to progression of the syndrome. According to the clinical-hemodynamic profile, it is possible to establish a rational for the treatment of decompensated heart failure, individualizing the proceedings to be held, leading to reduction in the period of hospitalization and consequently reducing overall mortality. PMID:24136770

  9. Troponins in heart failure.

    PubMed

    Omland, T; Røsjø, H; Giannitsis, E; Agewall, S

    2015-03-30

    The signs and symptoms of heart failure are frequently unspecific and correlate poorly with objective indices of cardiac function. Objective assessment of cardiac function by echocardiography or other imaging modalities also correlate poorly with symptomatic status and functional capacity. Accordingly, there is a need for circulating biomarkers that can provide incremental diagnostic and prognostic information to the existing armamentarium of tests. The introduction of more sensitive assays that allow determination of very low circulating concentrations of the myofibrillar proteins cardiac troponin I and T has not only resulted in improved diagnostic accuracy in the setting of acute coronary syndromes. The high sensitivity assays have also shown that cardiac troponins are frequently found chronically circulating in a variety of acute and chronic, cardiac and non-cardiac disease conditions, including acute heart failure and chronic symptomatic and asymptomatic left ventricular dysfunction. Cardiac troponin I and T provide may provide clinically useful prognostic information both concerning the future risk of developing heart failure in asymptomatic subjects and the risk of fatal events and hospital admissions in those with already established heart failure This review summarizes current literature on the clinical performance and utility of cardiac troponin measurements as diagnostic and prognostic tools in patients with symptomatic heart failure, as well as in those with asymptomatic left ventricular dysfunction, and clinical phenotypes at high risk for developing heart failure, including stable coronary artery disease, left ventricular hypertrophy, and aortic stenosis.

  10. Pathophysiology of Heart Failure.

    PubMed

    Tanai, Edit; Frantz, Stefan

    2015-12-15

    Heart failure is considered an epidemic disease in the modern world affecting approximately 1% to 2% of adult population. It presents a multifactorial, systemic disease, in which--after cardiac injury--structural, neurohumoral, cellular, and molecular mechanisms are activated and act as a network to maintain physiological functioning. These coordinated, complex processes lead to excessive volume overload, increased sympathetic activity, circulation redistribution, and result in different, parallel developing clinical signs and symptoms. These signs and symptoms sum up to an unspecific clinical picture; thus invasive and noninvasive diagnostic tools are used to get an accurate diagnosis and to specify the underlying cause. The most important, outcome determining factor in heart failure is its constant progression. Constant optimizing of pharmatherapeutical regimes, novel targets, and fine regulation of these processes try to keep these compensatory mechanisms in a physiological range. Beside pharmacological therapy, interventional and surgical therapy options give new chances in the management of heart failure. For the optimization and establishment of these and novel therapeutical approaches, complete and comprehensive understanding of the underlying mechanisms is essentially needed. Besides diagnosis and treatment, efforts should be made for better prevention in heart failure by treatment of risk factors, or identifying and following risk groups. This summary of the pathophysiology of heart failure tries to give a compact overview of basic mechanisms and of the novel unfolding, progressive theory of heart failure to contribute to a more comprehensive knowledge of the disease.

  11. Pathophysiology of Heart Failure.

    PubMed

    Tanai, Edit; Frantz, Stefan

    2015-01-01

    Heart failure is considered an epidemic disease in the modern world affecting approximately 1% to 2% of adult population. It presents a multifactorial, systemic disease, in which--after cardiac injury--structural, neurohumoral, cellular, and molecular mechanisms are activated and act as a network to maintain physiological functioning. These coordinated, complex processes lead to excessive volume overload, increased sympathetic activity, circulation redistribution, and result in different, parallel developing clinical signs and symptoms. These signs and symptoms sum up to an unspecific clinical picture; thus invasive and noninvasive diagnostic tools are used to get an accurate diagnosis and to specify the underlying cause. The most important, outcome determining factor in heart failure is its constant progression. Constant optimizing of pharmatherapeutical regimes, novel targets, and fine regulation of these processes try to keep these compensatory mechanisms in a physiological range. Beside pharmacological therapy, interventional and surgical therapy options give new chances in the management of heart failure. For the optimization and establishment of these and novel therapeutical approaches, complete and comprehensive understanding of the underlying mechanisms is essentially needed. Besides diagnosis and treatment, efforts should be made for better prevention in heart failure by treatment of risk factors, or identifying and following risk groups. This summary of the pathophysiology of heart failure tries to give a compact overview of basic mechanisms and of the novel unfolding, progressive theory of heart failure to contribute to a more comprehensive knowledge of the disease. PMID:26756631

  12. In-hospital worsening heart failure.

    PubMed

    Butler, Javed; Gheorghiade, Mihai; Kelkar, Anita; Fonarow, Gregg C; Anker, Stefan; Greene, Stephen J; Papadimitriou, Lampros; Collins, Sean; Ruschitzka, Frank; Yancy, Clyde W; Teerlink, John R; Adams, Kirkwood; Cotter, Gadi; Ponikowski, Piotr; Felker, G Michael; Metra, Marco; Filippatos, Gerasimos

    2015-11-01

    Acute worsening heart failure (WHF) is seen in a sizable portion of patients hospitalized for heart failure, and is increasingly being recognized as an entity that is associated with an adverse in-hospital course. WHF is generally defined as worsening heart failure symptoms and signs requiring an intensification of therapy, and is reported to be seen in anywhere from 5% to 42% of heart failure admissions. It is difficult to ascertain the exact epidemiology of WHF due to varying definitions used in the literature. Studies indicate that WHF cannot be precisely predicted on the basis of baseline variables assessed at the time of admission. Recent data suggest that some experimental therapies may reduce the risk of development of WHF among hospitalized heart failure patients, and this is associated with a reduction in risk of subsequent post-discharge cardiovascular mortality. In this respect, WHF holds promise as a endpoint for acute heart failure clinical trials to better elucidate the benefit of targeted novel therapies. Better understanding of the pathophysiology and a consensus on the definition of WHF will further improve our epidemiological and clinical understanding of this entity.

  13. Bench-to-bedside review: weaning failure--should we rest the respiratory muscles with controlled mechanical ventilation?

    PubMed

    Vassilakopoulos, Theodoros; Zakynthinos, Spyros; Roussos, Charis

    2006-02-01

    The use of controlled mechanical ventilation (CMV) in patients who experience weaning failure after a spontaneous breathing trial or after extubation is a strategy based on the premise that respiratory muscle fatigue (requiring rest to recover) is the cause of weaning failure. Recent evidence, however, does not support the existence of low frequency fatigue (the type of fatigue that is long-lasting) in patients who fail to wean despite the excessive respiratory muscle load. This is because physicians have adopted criteria for the definition of spontaneous breathing trial failure and thus termination of unassisted breathing, which lead them to put patients back on the ventilator before the development of low frequency respiratory muscle fatigue. Thus, no reason exists to completely unload the respiratory muscles with CMV for low frequency fatigue reversal if weaning is terminated based on widely accepted predefined criteria. This is important, since experimental evidence suggests that CMV can induce dysfunction of the diaphragm, resulting in decreased diaphragmatic force generating capacity, which has been called ventilator-induced diaphragmatic dysfunction (VIDD). The mechanisms of VIDD are not fully elucidated, but include muscle atrophy, oxidative stress and structural injury. Partial modes of ventilatory support should be used whenever possible, since these modes attenuate the deleterious effects of mechanical ventilation on respiratory muscles. When CMV is used, concurrent administration of antioxidants (which decrease oxidative stress and thus attenuate VIDD) seems justified, since antioxidants may be beneficial (and are certainly not harmful) in critical care patients.

  14. Mechanistic fracture criteria for the failure of human cortical bone

    SciTech Connect

    Nalla, Ravi K.; Kinney, John H.; Ritchie, Robert O.

    2002-12-13

    A mechanistic understanding of fracture in human bone is critical to predicting fracture risk associated with age and disease. Despite extensive work, a mechanistic framework for describing how the underlying microstructure affects the failure mode in bone is lacking.

  15. 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.

  16. Common Cause Failure Modeling

    NASA Technical Reports Server (NTRS)

    Hark, Frank; Britton, Paul; Ring, Rob; Novack, Steven D.

    2015-01-01

    Common Cause Failures (CCFs) are a known and documented phenomenon that defeats system redundancy. CCFS are a set of dependent type of failures that can be caused by: system environments; manufacturing; transportation; storage; maintenance; and assembly, as examples. Since there are many factors that contribute to CCFs, the effects can be reduced, but they are difficult to eliminate entirely. Furthermore, failure databases sometimes fail to differentiate between independent and CCF (dependent) failure and data is limited, especially for launch vehicles. The Probabilistic Risk Assessment (PRA) of NASA's Safety and Mission Assurance Directorate at Marshall Space Flight Center (MFSC) is using generic data from the Nuclear Regulatory Commission's database of common cause failures at nuclear power plants to estimate CCF due to the lack of a more appropriate data source. There remains uncertainty in the actual magnitude of the common cause risk estimates for different systems at this stage of the design. Given the limited data about launch vehicle CCF and that launch vehicles are a highly redundant system by design, it is important to make design decisions to account for a range of values for independent and CCFs. When investigating the design of the one-out-of-two component redundant system for launch vehicles, a response surface was constructed to represent the impact of the independent failure rate versus a common cause beta factor effect on a system's failure probability. This presentation will define a CCF and review estimation calculations. It gives a summary of reduction methodologies and a review of examples of historical CCFs. Finally, it presents the response surface and discusses the results of the different CCFs on the reliability of a one-out-of-two system.

  17. Common Cause Failure Modeling

    NASA Technical Reports Server (NTRS)

    Hark, Frank; Britton, Paul; Ring, Rob; Novack, Steven D.

    2016-01-01

    Common Cause Failures (CCFs) are a known and documented phenomenon that defeats system redundancy. CCFS are a set of dependent type of failures that can be caused by: system environments; manufacturing; transportation; storage; maintenance; and assembly, as examples. Since there are many factors that contribute to CCFs, the effects can be reduced, but they are difficult to eliminate entirely. Furthermore, failure databases sometimes fail to differentiate between independent and CCF (dependent) failure and data is limited, especially for launch vehicles. The Probabilistic Risk Assessment (PRA) of NASA's Safety and Mission Assurance Directorate at Marshal Space Flight Center (MFSC) is using generic data from the Nuclear Regulatory Commission's database of common cause failures at nuclear power plants to estimate CCF due to the lack of a more appropriate data source. There remains uncertainty in the actual magnitude of the common cause risk estimates for different systems at this stage of the design. Given the limited data about launch vehicle CCF and that launch vehicles are a highly redundant system by design, it is important to make design decisions to account for a range of values for independent and CCFs. When investigating the design of the one-out-of-two component redundant system for launch vehicles, a response surface was constructed to represent the impact of the independent failure rate versus a common cause beta factor effect on a system's failure probability. This presentation will define a CCF and review estimation calculations. It gives a summary of reduction methodologies and a review of examples of historical CCFs. Finally, it presents the response surface and discusses the results of the different CCFs on the reliability of a one-out-of-two system.

  18. Basic failure mechanisms in advanced composites

    NASA Technical Reports Server (NTRS)

    Mullin, J. V.; Mazzio, V. F.; Mehan, R. L.

    1972-01-01

    Failure mechanisms in carbon-epoxy composites are identified as a basis for more reliable prediction of the performance of these materials. The approach involves both the study of local fracture events in model specimens containing small groups of filaments and fractographic examination of high fiber content engineering composites. Emphasis is placed on the correlation of model specimen observations with gross fracture modes. The effects of fiber surface treatment, resin modification and fiber content are studied and acoustic emission methods are applied. Some effort is devoted to analysis of the failure process in composite/metal specimens.

  19. Development of a clinical prediction rule to improve peripheral intravenous cannulae first attempt success in the emergency department and reduce post insertion failure rates: the Vascular Access Decisions in the Emergency Room (VADER) study protocol

    PubMed Central

    Carr, Peter J; Rippey, James C R; Cooke, Marie L; Bharat, Chrianna; Murray, Kevin; Higgins, Niall S; Foale, Aileen; Rickard, Claire M

    2016-01-01

    Introduction Peripheral intravenous cannula (PIVC) insertion is one of the most common clinical interventions performed in emergency care worldwide. However, factors associated with successful PIVC placement and maintenance are not well understood. This study seeks to determine the predictors of first time PIVC insertion success in emergency department (ED) and identify the rationale for removal of the ED inserted PIVC in patients admitted to the hospital ward. Reducing failed insertion attempts and improving peripheral intravenous cannulation practice could lead to better staff and patient experiences, as well as improving hospital efficiency. Methods and analysis We propose an observational cohort study of PIVC insertions in a patient population presenting to ED, with follow-up observation of the PIVC in subsequent admissions to the hospital ward. We will collect specific PIVC observational data such as; clinician factors, patient factors, device information and clinical practice variables. Trained researchers will gather ED PIVC insertion data to identify predictors of insertion success. In those admitted from the ED, we will determine the dwell time of the ED-inserted PIVC. Multivariate regression analyses will be used to identify factors associated with insertions success and PIVC failure and standard statistical validation techniques will be used to create and assess the effectiveness of a clinical predication rule. Ethics and dissemination The findings of our study will provide new evidence to improve insertion success rates in the ED setting and identify strategies to reduce premature device failure for patients admitted to hospital wards. Results will unravel a complexity of factors that contribute to unsuccessful PIVC attempts such as patient and clinician factors along with the products, technologies and infusates used. Trial registration number ACTRN12615000588594; Pre-results. PMID:26868942

  20. Regional Lymph Node Uptake of [18F]Fluorodeoxyglucose After Definitive Chemoradiation Therapy Predicts Local-Regional Failure of Locally Advanced Non-Small Cell Lung Cancer: Results of ACRIN 6668/RTOG 0235

    PubMed Central

    Markovina, Stephanie; Duan, Fenghai; Snyder, Bradley S.; Siegel, Barry A.; Machtay, Mitchell; Bradley, Jeffrey

    2015-01-01

    Purpose/Objective(s) ACRIN 6668/RTOG 0235 demonstrated that standardized uptake value (SUV) on post-treatment [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) correlates with survival in locally advanced non-small cell lung cancer (NSCLC). This secondary analysis determines if SUV of regional lymph nodes (RLNs) on post-treatment FDG-PET correlates with patient outcomes. Methods and Materials Included for analysis were patients treated with concurrent chemoradiation therapy using radiation doses ≥60 Gy, with identifiable FDG-avid RLNs (distinct from primary tumor) on pre-treatment FDG-PET, and post-treatment FDG-PET data. ACRIN Core Laboratory SUV measurements were used. Event time was calculated from the date of post-treatment FDG-PET. Local-regional failure was defined as failure within the treated RT volume and reported by the treating institution. Statistical analyses included Wilcoxon signed-rank test, Kaplan-Meier curves (log rank test), and Cox proportional hazards regression modeling. Results Of 234 trial-eligible patients, 139 (59%) had uptake in both primary tumor and RLNs on pre-treatment FDG-PET, and had SUV data from post-treatment FDG-PET. Maximum SUV was greater for primary tumor than for RLNs before treatment (p<0.001), but not different post-treatment (p=0.320). Post-treatment SUV of RLNs was not associated with overall survival. However, elevated post-treatment SUV of RLNs, both the absolute value and the percent residual activity compared to the pre-treatment SUV, were associated with inferior local-regional control (p<0.001). Conclusions High residual metabolic activity in RLNs on post-treatment FDG-PET is associated with worse local-regional control. Based on these data, future trials evaluating a radiotherapy boost should consider inclusion of both primary tumor and FDG-avid RLNs in the boost volume to maximize local-regional control. PMID:26461002

  1. Prediction of drug-resistance using genotypic and docking analysis among anti-retroviral therapy naïve and first-line treatment failures in Salem, Tamil Nadu, India.

    PubMed

    Dharmalingam, Thirunavukkarasu; Udhaya, V; Umaarasu, T; Elangovan, V; Rajesh, S V; Shanmugam, Gnanendra

    2015-01-01

    The emergence of drug resistance among HIV-positive patients undergoing Anti- Retroviral Therapy (ART) with poor adherence to the HAART is a major concern in India. As the HIV accumulates the key mutations, the drug resistance occurs, that pose challenges to the ART regimens currently being used. Thus, the present study was carried out among the ART- naïve patients attending ART Centre at Salem district, Tamil Nadu, India. The mutations that concern the drug resistance were discriminated by determining the viral load before and after 6 months. The drug resistance was analyzed by HIV genotyping from the patients possessing a viral load of >1000 copies/mL after 6 months of ART. The mutations pertaining to drug resistance were analyzed by the online Stanford HIV Database. The 3D structures of the RT were modeled and the drugs used in the first-line regimens were docked to explore the effect of mutations on the binding pattern of the drugs. Among the 250 patients, the viral load data were obtained for 213 patients. The study found 23 patients with both virological and immunological failures and HIV drug mutations were also revealed by genotyping. The mutations of I135R/T/V/X, L178 I/M, M184V/I, D67N, K70R, and K103N were the most common among these 23 patients. The present study revealed that the NACO recommended first-line ART regimen is efficient in most of the patients attending ART center. The emergence of drug resistance of HIV variant is common even under the best circumstance of ART. This study reveals that there is a necessity for the implementation of improved and economically systematic attempt that allows the clinicians to make a rational choice of therapy regimen to overcome the first-line therapy failures among the ART- naive.

  2. Weld failure detection

    DOEpatents

    Pennell, William E.; Sutton, Jr., Harry G.

    1981-01-01

    Method and apparatus for detecting failure in a welded connection, particrly applicable to not readily accessible welds such as those joining components within the reactor vessel of a nuclear reactor system. A preselected tag gas is sealed within a chamber which extends through selected portions of the base metal and weld deposit. In the event of a failure, such as development of a crack extending from the chamber to an outer surface, the tag gas is released. The environment about the welded area is directed to an analyzer which, in the event of presence of the tag gas, evidences the failure. A trigger gas can be included with the tag gas to actuate the analyzer.

  3. BIOASSAY VESSEL FAILURE ANALYSIS

    SciTech Connect

    Vormelker, P

    2008-09-22

    Two high-pressure bioassay vessels failed at the Savannah River Site during a microwave heating process for biosample testing. Improper installation of the thermal shield in the first failure caused the vessel to burst during microwave heating. The second vessel failure is attributed to overpressurization during a test run. Vessel failure appeared to initiate in the mold parting line, the thinnest cross-section of the octagonal vessel. No material flaws were found in the vessel that would impair its structural performance. Content weight should be minimized to reduce operating temperature and pressure. Outer vessel life is dependent on actual temperature exposure. Since thermal aging of the vessels can be detrimental to their performance, it was recommended that the vessels be used for a limited number of cycles to be determined by additional testing.

  4. Judicial failure to thrive.

    PubMed

    Stern, H P; Casey, P H

    1984-06-01

    The case of a toddler who developed nonorganic failure to thrive during the course of a custody determination is reported. The child demonstrated physical, emotional, and developmental aspects of failure to thrive. These signs correlated with custody ordered by the judge, during which time the child's care was alternated between parents. The symptoms resolved when the child was in the hospital and when provided stable care by his grandmother. With the increasing frequency of divorce, failure to thrive resulting from judicial decisions will probably increase. Physicians should monitor these children carefully in order to prevent serious psychosocial complications. The judicial system should expedite custody decisions, availing itself of information in child development. PMID:6736261

  5. Floods from tailings dam failures.

    PubMed

    Rico, M; Benito, G; Díez-Herrero, A

    2008-06-15

    This paper compiles the available information on historic tailings dam failures with the purpose to establish simple correlations between tailings ponds geometric parameters (e.g., dam height, tailings volume) and the hydraulic characteristics of floods resulting from released tailings. Following the collapse of a mining waste dam, only a part of tailings and polluted water stored at the dam is released, and this outflow volume is difficult to estimate prior the incident. In this study, tailings' volume stored at the time of failure was shown to have a good correlation (r2=0.86) with the tailings outflow volume, and the volume of spilled tailings was correlated with its run-out distance (r2=0.57). An envelope curve was drawn encompassing the majority of data points indicating the potential maximum downstream distance affected by a tailings' spill. The application of the described regression equations for prediction purposes needs to be treated with caution and with support of on-site measurement and observations. However, they may provide a universal baseline approximation on tailing outflow characteristics (even if detailed dam information is unavailable), which is of a great importance for risk analysis purposes.

  6. Common Cause Failure Modes

    NASA Technical Reports Server (NTRS)

    Wetherholt, Jon; Heimann, Timothy J.; Anderson, Brenda

    2011-01-01

    High technology industries with high failure costs commonly use redundancy as a means to reduce risk. Redundant systems, whether similar or dissimilar, are susceptible to Common Cause Failures (CCF). CCF is not always considered in the design effort and, therefore, can be a major threat to success. There are several aspects to CCF which must be understood to perform an analysis which will find hidden issues that may negate redundancy. This paper will provide definition, types, a list of possible causes and some examples of CCF. Requirements and designs from NASA projects will be used in the paper as examples.

  7. Failure detection and identification

    NASA Technical Reports Server (NTRS)

    Massoumnia, Mohammad-Ali; Verghese, George C.; Willsky, Alan S.

    1989-01-01

    Using the geometric concept of an unobservability subspace, a solution is given to the problem of detecting and identifying control system component failures in linear, time-invariant systems. Conditions are developed for the existence of a causal, linear, time-invariant processor that can detect and uniquely identify a component failure, first for the case where components can fail simultaneously, and then for the case where they fail only one at a time. Explicit design algorithms are provided when these conditions are satisfied. In addition to time-domain solvability conditions, frequency-domain interpretations of the results are given, and connections are drawn with results already available in the literature.

  8. SCADA alarms processing for wind turbine component failure detection

    NASA Astrophysics Data System (ADS)

    Gonzalez, E.; Reder, M.; Melero, J. J.

    2016-09-01

    Wind turbine failure and downtime can often compromise the profitability of a wind farm due to their high impact on the operation and maintenance (O&M) costs. Early detection of failures can facilitate the changeover from corrective maintenance towards a predictive approach. This paper presents a cost-effective methodology to combine various alarm analysis techniques, using data from the Supervisory Control and Data Acquisition (SCADA) system, in order to detect component failures. The approach categorises the alarms according to a reviewed taxonomy, turning overwhelming data into valuable information to assess component status. Then, different alarms analysis techniques are applied for two purposes: the evaluation of the SCADA alarm system capability to detect failures, and the investigation of the relation between components faults being followed by failure occurrences in others. Various case studies are presented and discussed. The study highlights the relationship between faulty behaviour in different components and between failures and adverse environmental conditions.

  9. Reconfigurable control of aircraft undergoing sensor and actuator failures

    NASA Astrophysics Data System (ADS)

    Bajpai, Gaurav

    2001-07-01

    Significant number of fatal aircraft accidents in recent years have been linked to component failures. With the predicted increase in air traffic these numbers are likely to increase. With reduction of fatal accidents as motivation, this dissertation investigates design of fault tolerant control systems for aircrafts undergoing sensor and/or actuator failures. Given that the nominal controller may perform inadequately in the event of sensors and/or actuator failure, the feasible approach for such a control scheme is to predesign various controllers anticipating these failures and then switching to an appropriate controller when the failure occurs. This is enabled by the available redundancy in sensing and actuation and allows the system to perform adequately even when these failures occur. The predesign of controllers for sensor and actuator failures is considered. Sensor failures are easily accommodated if certain detectability conditions are met. However, the predesign for actuator failures is not trivial as the position at which the actuators fail is not known a priori. It is shown that this problem can be tackled by reducing it to the classical control problem of disturbance decoupling, in which, the functional control enables the steady state output of dynamical system to reject any disturbance due to the failed actuators. For linear systems, conditions for existence of a controller capable of accommodating these failures can be understood in geometric terms and calculations are linked to solvability of coupled matrix equations. Although control design for aircrafts is done using linear techniques, failures can cause excursions into nonlinear regimes due to ensuing changes in the flight conditions. This dissertation also uses the recent results in the nonlinear regulator theory to address actuator failures in nonlinear systems. The utility of design techniques is illustrated using flight control examples with failures. The symbolic computational tools are

  10. Living with Heart Failure

    MedlinePlus

    ... should be. This includes advice on daily activities, work, leisure time, sex, and exercise. Your level of activity will depend on the stage of your heart failure (how severe it is). Keep all of your ... to get tests and lab work. Your doctor needs the results of these tests ...

  11. Failure Free Reading.

    ERIC Educational Resources Information Center

    Education Commission of the States, Denver, CO.

    This paper provides an overview of Failure Free Reading, a program with the primary goal of providing a basic understanding of the reading process to students in grades K-12 with pronounced reading difficulty and move them into traditional reading programs. The program is targeted to and most effective with at-risk and English as a Second Language…

  12. Designing for Productive Failure

    ERIC Educational Resources Information Center

    Kapur, Manu; Bielaczyc, Katerine

    2012-01-01

    In this article, we describe the design principles undergirding "productive failure" (PF; M. Kapur, 2008). We then report findings from an ongoing program of research on PF in mathematical problem solving in 3 Singapore public schools with significantly different mathematical ability profiles, ranging from average to lower ability. In the 1st…

  13. Premature Ovarian Failure

    MedlinePlus

    Premature ovarian failure (POF) is when a woman's ovaries stop working before she is 40. POF is different from premature menopause. With premature menopause, ... be a disease, surgery, chemotherapy, or radiation. With POF, some women still have occasional periods. They may ...

  14. Preventing Early Learning Failure.

    ERIC Educational Resources Information Center

    Sornson, Bob, Ed.

    Noting that thousands of young children with the capacity to experience school success do not because they are unprepared for school learning activities, have experienced physical or emotional setbacks that cause them to be at risk for early learning failure, have never experienced limits on their behavior, or have mild sensory or motor deficits,…

  15. Explaining Jewish Student Failure.

    ERIC Educational Resources Information Center

    Schoem, David

    1982-01-01

    Ethnographic study of a suburban Jewish afternoon school suggests that students' failure to meet school behavior and learning standards occurred because they did not value or understand the rewards made available to them through the school and because their means of achieving status mobility had shifted away from the Jewish school. (Author/GC)

  16. Learning from Failures.

    ERIC Educational Resources Information Center

    Saffran, Murray

    1991-01-01

    Describes mistakes made in trying to change the Nutrition and Digestion section of a medical biochemistry course. Author tried to make the section student taught and reports nine mistakes including the following: ignoring active opposition of colleagues, failure to assess the receptivity of the class to a new form of teaching, and overestimating…

  17. A Comparison of the Haider Tube-Guard® Endotracheal Tube Holder Versus Adhesive Tape to Determine if This Novel Device Can Reduce Endotracheal Tube Movement and Prevent Unplanned Extubation

    PubMed Central

    Buckley, Jack C.; Brown, Adam P.; Shin, John S.; Rogers, Kirsten M.

    2016-01-01

    a high extubation risk (endotracheal tube movement >4 cm) when the endotracheal tube was secured with tape versus 0% (0/30) when secured with the Haider Tube-Guard (P = 0.004). Six patients with taped endotracheal tubes required the traction to be aborted before 15 N of force was achieved to prevent potential extubation as the tape either separated from the face or stretched to allow excessive endotracheal tube movement. None of the patients appeared to sustain any injury from the Haider Tube-Guard device. CONCLUSIONS: The Haider Tube-Guard significantly reduced the mobility of the endotracheal tube when compared with adhesive tape and was well tolerated in our observations. PMID:26983051

  18. From yield to fracture, failure initiation captured by molecular simulation

    NASA Astrophysics Data System (ADS)

    Brochard, Laurent; Tejada, Ignacio G.; Sab, Karam

    2016-10-01

    While failure of cracked bodies with strong stress concentrations is described by an energy criterion (fracture mechanics), failure of flawless bodies with uniform stresses is captured by a criterion on stress (yielding). In-between those two cases, the problem of failure initiation from flaws that moderately concentrate stresses is debated. In this paper, we propose an investigation of the process of failure initiation at the atomic scale by means of molecular simulations. We first discuss the appropriate scaling conditions to capture initiation, since system sizes that can be simulated by molecular mechanics are strongly limited. Then, we perform a series of molecular simulations of failure of a 2D model material, which exhibits strength and toughness properties that are suitable to capture initiation with systems of reasonable sizes. Transition from fracture failure to yield failure is well characterized. Interestingly, in some specific cases, failure exceeds yield failure which is in contradiction with most initiation theories. This occurs when stress are highly concentrated while little mechanical energy is stored in the material. This observation calls for a theory of initiation which requires that both stress and energy are necessary conditions of failure. Such an approach was proposed by Leguillon (2002). We show that the predictions of this theory are consistent with the molecular simulation results.

  19. 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…

  20. A combined experimental and finite element study to predict the failure mechanisms in SiC coated carbon/carbon composites at room and elevated temperatures under flexural loading

    NASA Technical Reports Server (NTRS)

    Mahfuz, Hassan; Das, Partha S.; Xue, Dongwei; Krishnagopalan, Jaya; Jeelani, Shaik

    1993-01-01

    Response of quasi-isotropic laminates of SiC coated Carbon/Carbon (C/C) composites have been investigated under flexural loading at various temperatures. Variation of load-deflection behavior with temperatures are studied. Increase in flexural strength and stiffness are observed with the rise in temperature. Extensive analyses through Optical Microscope (OM) and Non-Destructive Evaluation (NDE) have been performed to understand the failure mechanisms. Damage zone is found only within the neighborhood of the loading plane. Isoparametric layered shell elements developed on the basis of the first order shear deformation theory have been used to model the thin laminates of C/C under flexural loading. Large deformation behavior has been considered in the finite element analysis to account for the non-linearities encountered during the actual test. Data generated using finite element analysis are presented to corroborate the experimental findings, and a comparison in respect of displacement and stress-strain behavior are given to check the accuracy of the finite element analysis. Reasonable correlation between the experimental and finite element results have been established.

  1. Predicting service life margins

    NASA Technical Reports Server (NTRS)

    Egan, G. F.

    1971-01-01

    Margins are developed for equipment susceptible to malfunction due to excessive time or operation cycles, and for identifying limited life equipment so monitoring and replacing is accomplished before hardware failure. Method applies to hardware where design service is established and where reasonable expected usage prediction is made.

  2. Compression failure of angle-ply laminates

    NASA Technical Reports Server (NTRS)

    Peel, L. D.; Hyer, M. W.; Shuart, M. J.

    1992-01-01

    Test results from the compression loading of (+ or - Theta/ - or + Theta)(sub 6s) angle-ply IM7-8551-7a specimens, 0 less than or = Theta less than or = 90 degs, are presented. The observed failure strengths and modes are discussed, and typical stress-strain relations shown. Using classical lamination theory and the maximum stress criterion, an attempt is made to predict failure stress as a function of Theta. This attempt results in poor correlation with test results and thus a more advanced model is used. The model, which is based on a geometrically nonlinear theory, and which was taken from previous work, includes the influence of observed layer waviness. The waviness is described by the wave length and the wave amplitude. The theory is briefly described and results from the theory are correlated with test results. It is shown that by using levels of waviness observed in the specimens, the correlation between predictions and observations is good.

  3. Satellite Failure Risk Due to Hypervelocity Impacts

    NASA Astrophysics Data System (ADS)

    Flegel, S.; Wiedemann, C.; Gelhaus, J.; Dietze, C.; Vorsmann, P.; Alwes, D.

    2009-03-01

    The increasing accumulation of space debris objects on earth orbits represents a risk for spaceflight missions. Particle impacts on satellites can lead to serious damages or even to the loss of a mission. In this paper the risk for historical and future satellite missions is analyzed separately. For historical satellite missions, the risk analysis is combined with cost estimations. Altogether 3893 satellites were examined and their analysis results evaluated. The failure probability of selected future satellite missions due to hypervelocity impacts from space debris is estimated for the years 2005 and 2055. The future evolution of the spatial density is predicted for a business-as-usual scenario which is based on the launch activity in the years preceding 2005. The predicted evolution of the space debris environment is discussed in terms of object sources and orbit altitudes. The analysis shows that an increase in the failure probability of satellites is likely.

  4. Modelling of failure of structural textile composites

    NASA Astrophysics Data System (ADS)

    Svensson, N.; Gilchrist, M. D.

    This paper summarizes extensive experimental work regarding the manufacture, mechanical characterization and modelling of textile thermoplastic composites produced by means of commingled yarns. These composites are believed to have a high potential for applications in structural automotive components. However, methods need to be developed for faster manufacturing and reliable prediction of the component mechanical performance and failure. A practical approach of finite element modelling of the stiffness and strength behaviour of these composites is briefly discussed.

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

    PubMed

    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.

  6. 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

  7. Satellite failures revisited

    NASA Astrophysics Data System (ADS)

    Balcerak, Ernie

    2012-12-01

    In January 1994, the two geostationary satellites known as Anik-E1 and Anik-E2, operated by Telesat Canada, failed one after the other within 9 hours, leaving many northern Canadian communities without television and data services. The outage, which shut down much of the country's broadcast television for hours and cost Telesat Canada more than $15 million, generated significant media attention. Lam et al. used publicly available records to revisit the event; they looked at failure details, media coverage, recovery effort, and cost. They also used satellite and ground data to determine the precise causes of those satellite failures. The researchers traced the entire space weather event from conditions on the Sun through the interplanetary medium to the particle environment in geostationary orbit.

  8. Methods for Assessing Honeycomb Sandwich Panel Wrinkling Failures

    NASA Technical Reports Server (NTRS)

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

    2012-01-01

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

  9. Traumatic Tension Pneumothorax as a Cause of ICD Failure: A Case Report and Review of the Literature

    PubMed Central

    2014-01-01

    Background. Tension pneumothorax can infrequently cause ventricular arrhythmias and increase the threshold of defibrillation. It should be suspected whenever there is difficulty in defibrillation for a ventricular arrhythmia. Purpose. To report a case of traumatic tension pneumothorax leading to ventricular tachycardia and causing defibrillator failure. Case. A 65-year-old African-American female was brought in to our emergency department complaining of dyspnea after being forced down by cops. She had history of mitral valve replacement for severe mitral regurgitation and biventricular implantable cardioverter defibrillator inserted for nonischemic cardiomyopathy. Shortly after arrival, she developed sustained ventricular tachycardia, causing repetitive unsuccessful ICD shocks. She was intubated and ventricular tachycardia resolved with amiodarone. Chest radiograph revealed large left sided tension pneumothorax which was promptly drained. The patient was treated for congestive heart failure; she was extubated on the third day of admission, and the chest tube was removed. Conclusion. Prompt recognition of tension pneumothorax is essential, by maintaining a high index of suspicion in patients with an increased defibrillation threshold causing ineffective defibrillations. PMID:25400953

  10. Traumatic Tension Pneumothorax as a Cause of ICD Failure: A Case Report and Review of the Literature.

    PubMed

    Ul Haq, Ehtesham; Omar, Bassam

    2014-01-01

    Background. Tension pneumothorax can infrequently cause ventricular arrhythmias and increase the threshold of defibrillation. It should be suspected whenever there is difficulty in defibrillation for a ventricular arrhythmia. Purpose. To report a case of traumatic tension pneumothorax leading to ventricular tachycardia and causing defibrillator failure. Case. A 65-year-old African-American female was brought in to our emergency department complaining of dyspnea after being forced down by cops. She had history of mitral valve replacement for severe mitral regurgitation and biventricular implantable cardioverter defibrillator inserted for nonischemic cardiomyopathy. Shortly after arrival, she developed sustained ventricular tachycardia, causing repetitive unsuccessful ICD shocks. She was intubated and ventricular tachycardia resolved with amiodarone. Chest radiograph revealed large left sided tension pneumothorax which was promptly drained. The patient was treated for congestive heart failure; she was extubated on the third day of admission, and the chest tube was removed. Conclusion. Prompt recognition of tension pneumothorax is essential, by maintaining a high index of suspicion in patients with an increased defibrillation threshold causing ineffective defibrillations. PMID:25400953

  11. Diastolic heart failure.

    PubMed

    Gary, Rebecca; Davis, Leslie

    2008-01-01

    Diastolic heart failure (DHF) is estimated to occur in 40% to 50% of patients with heart failure. Evidence suggests that DHF is primarily a cardiogeriatric syndrome that increases from approximately 1% at age 50 years to 10% or more at 80 years. DHF is also more likely to occur in older women who are hypertensive or diabetic. Although survival is better in patients with DHF compared with systolic heart failure, mortality rates for patients with DHF are four times higher than those for healthy, community-dwelling older adults. The increase in DHF is anticipated to continue during the next several decades largely because of the aging of the population; increase in risk factors associated with hypertension, diabetes, and obesity; and ongoing technologic advances in the treatment of cardiovascular disease. Few clinical trials have evaluated therapy in this population, so evidence about the effectiveness of treatment strategies for DHF is limited. Future research should target novel interventions that specifically target patients with DHF who are typically older and female, and experience exertional intolerance and have a considerably reduced quality of life.

  12. 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.

  13. Heart Failure Society of America

    MedlinePlus

    ... Review Course in Advanced Heart Failure and Transplant Cardiology is now available OnDemand! Monday, August 29, 2016! ... than expected, and the FDA... European Society of Cardiology – Heart Failure 2017 October 11, 2016 ESC: Heart ...

  14. Failure Analysis for Improved Reliability

    NASA Technical Reports Server (NTRS)

    Sood, Bhanu

    2016-01-01

    Outline: Section 1 - What is reliability and root cause? Section 2 - Overview of failure mechanisms. Section 3 - Failure analysis techniques (1. Non destructive analysis techniques, 2. Destructive Analysis, 3. Materials Characterization). Section 4 - Summary and Closure

  15. Temporal-varying failures of nodes in networks

    NASA Astrophysics Data System (ADS)

    Knight, Georgie; Cristadoro, Giampaolo; Altmann, Eduardo G.

    2015-08-01

    We consider networks in which random walkers are removed because of the failure of specific nodes. We interpret the rate of loss as a measure of the importance of nodes, a notion we denote as failure centrality. We show that the degree of the node is not sufficient to determine this measure and that, in a first approximation, the shortest loops through the node have to be taken into account. We propose approximations of the failure centrality which are valid for temporal-varying failures, and we dwell on the possibility of externally changing the relative importance of nodes in a given network by exploiting the interference between the loops of a node and the cycles of the temporal pattern of failures. In the limit of long failure cycles we show analytically that the escape in a node is larger than the one estimated from a stochastic failure with the same failure probability. We test our general formalism in two real-world networks (air-transportation and e-mail users) and show how communities lead to deviations from predictions for failures in hubs.

  16. Fault failure with moderate earthquakes

    USGS Publications Warehouse

    Johnston, M.J.S.; Linde, A.T.; Gladwin, M.T.; Borcherdt, R.D.

    1987-01-01

    High resolution strain and tilt recordings were made in the near-field of, and prior to, the May 1983 Coalinga earthquake (ML = 6.7, ?? = 51 km), the August 4, 1985, Kettleman Hills earthquake (ML = 5.5, ?? = 34 km), the April 1984 Morgan Hill earthquake (ML = 6.1, ?? = 55 km), the November 1984 Round Valley earthquake (ML = 5.8, ?? = 54 km), the January 14, 1978, Izu, Japan earthquake (ML = 7.0, ?? = 28 km), and several other smaller magnitude earthquakes. These recordings were made with near-surface instruments (resolution 10-8), with borehole dilatometers (resolution 10-10) and a 3-component borehole strainmeter (resolution 10-9). While observed coseismic offsets are generally in good agreement with expectations from elastic dislocation theory, and while post-seismic deformation continued, in some cases, with a moment comparable to that of the main shock, preseismic strain or tilt perturbations from hours to seconds (or less) before the main shock are not apparent above the present resolution. Precursory slip for these events, if any occurred, must have had a moment less than a few percent of that of the main event. To the extent that these recor