Sample records for regularized continuous failure

  1. 45 CFR 95.610 - Submission of advance planning documents.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... system failure and disaster recovery/business continuity procedures available or to be implemented; and... generally applies to large statewide system developments and/or major hardware acquisitions. States with large, independent counties requesting funding at the regular match rate for county systems are strongly...

  2. Statistical forecasting of repetitious dome failures during the waning eruption of Redoubt Volcano, Alaska, February-April 1990

    USGS Publications Warehouse

    Page, R.A.; Lahr, J.C.; Chouet, B.A.; Power, J.A.; Stephens, C.D.

    1994-01-01

    The waning phase of the 1989-1990 eruption of Redoubt Volcano in the Cook Inlet region of south-central Alaska comprised a quasi-regular pattern of repetitious dome growth and destruction that lasted from February 15 to late April 1990. The dome failures produced ash plumes hazardous to airline traffic. In response to this hazard, the Alaska Volcano Observatory sought to forecast these ash-producing events using two approaches. One approach built on early successes in issuing warnings before major eruptions on December 14, 1989 and January 2, 1990. These warnings were based largely on changes in seismic activity related to the occurrence of precursory swarms of long-period seismic events. The search for precursory swarms of long-period seismicity was continued through the waning phase of the eruption and led to warnings before tephra eruptions on March 23 and April 6. The observed regularity of dome failures after February 15 suggested that a statistical forecasting method based on a constant-rate failure model might also be successful. The first statistical forecast was issued on March 16 after seven events had occurred, at an average interval of 4.5 days. At this time, the interval between dome failures abruptly lengthened. Accordingly, the forecast was unsuccessful and further forecasting was suspended until the regularity of subsequent failures could be confirmed. Statistical forecasting resumed on April 12, after four dome failure episodes separated by an average of 7.8 days. One dome failure (April 15) was successfully forecast using a 70% confidence window, and a second event (April 21) was narrowly missed before the end of the activity. The cessation of dome failures after April 21 resulted in a concluding false alarm. Although forecasting success during the eruption was limited, retrospective analysis shows that early and consistent application of the statistical method using a constant-rate failure model and a 90% confidence window could have yielded five successful forecasts and two false alarms; no events would have been missed. On closer examination, the intervals between successive dome failures are not uniform but tend to increase with time. This increase attests to the continuous, slowly decreasing supply of magma to the surface vent during the waning phase of the eruption. The domes formed in a precarious position in a breach in the summit crater rim where they were susceptible to gravitational collapse. The instability of the February 15-April 21 domes relative to the earlier domes is attributed to reaming the lip of the vent by a laterally directed explosion during the major dome-destroying eruption of February 15, a process which would leave a less secure foundation for subsequent domes. ?? 1994.

  3. Personnel Recovery in Space

    DTIC Science & Technology

    2016-07-13

    adequate security testing , and segment their networks and systems into separate defended enclaves. Finally, cyber defenders should posi- tion themselves...explicitly tied to following security practices, and there should be consequences for security failures that are regularly tested via a continuing testing ...program. Users should be routinely tested and probed, and those who do not perform well should face escalating consequences. For example, cyber

  4. Evaluation of a continuous regimen of levonorgestrel/ethinyl estradiol: phase 3 study results.

    PubMed

    Archer, David F; Jensen, Jeffrey T; Johnson, Julia V; Borisute, Hannah; Grubb, Gary S; Constantine, Ginger D

    2006-12-01

    This study was conducted to evaluate the safety and efficacy of a continuous daily regimen of levonorgestrel (LNG) 90 microg/ethinyl estradiol (EE) 20 microg (continuous LNG/EE). Healthy women aged 18-49 years with regular menstrual cycles for 3 months enrolled in this single-treatment open-label study and took one pill of LNG 90 microg/EE 20 microg daily for 12 months. For the 2134 subjects enrolled, the Pearl Index method failure was 1.26, and user failure was 0.34. While on Pill Pack 13, 58.7% of subjects reported amenorrhea and 79.0% reported absence of bleeding. Overall, the number of bleeding and spotting days per pill pack declined progressively. Adverse events and discontinuations were comparable to those reported for cyclic oral contraceptive (OC) regimens, except for higher rates in those related to uterine bleeding. Continuous LNG/EE demonstrated a good safety profile and efficacy similar to cyclic OCs. The regimen continuously inhibited menses, increased the incidence of amenorrhea over time and, except for a subset of women, decreased the number of bleeding and spotting days.

  5. Correction of engineering servicing regularity of transporttechnological machines in operational process

    NASA Astrophysics Data System (ADS)

    Makarova, A. N.; Makarov, E. I.; Zakharov, N. S.

    2018-03-01

    In the article, the issue of correcting engineering servicing regularity on the basis of actual dependability data of cars in operation is considered. The purpose of the conducted research is to increase dependability of transport-technological machines by correcting engineering servicing regularity. The subject of the research is the mechanism of engineering servicing regularity influence on reliability measure. On the basis of the analysis of researches carried out before, a method of nonparametric estimation of car failure measure according to actual time-to-failure data was chosen. A possibility of describing the failure measure dependence on engineering servicing regularity by various mathematical models is considered. It is proven that the exponential model is the most appropriate for that purpose. The obtained results can be used as a separate method of engineering servicing regularity correction with certain operational conditions taken into account, as well as for the technical-economical and economical-stochastic methods improvement. Thus, on the basis of the conducted researches, a method of engineering servicing regularity correction of transport-technological machines in the operational process was developed. The use of that method will allow decreasing the number of failures.

  6. Application of micropolar plasticity to post failure analysis in geomechanics

    NASA Astrophysics Data System (ADS)

    Manzari, Majid T.

    2004-08-01

    A micropolar elastoplastic model for soils is formulated and a series of finite element analyses are employed to demonstrate the use of a micropolar continuum in overcoming the numerical difficulties encountered in application of finite element method in standard Cauchy-Boltzmann continuum. Three examples of failure analysis involving a deep excavation, shallow foundation, and a retaining wall are presented. In all these cases, it is observed that the length scale introduced in the polar continuum regularizes the incremental boundary value problem and allows the numerical simulation to be continued until a clear collapse mechanism is achieved. The issue of grain size effect is also discussed. Copyright

  7. [Comorbidities of heart failure: sleep apnea].

    PubMed

    Woehrle, H; Oldenburg, O; Stadler, S; Arzt, M

    2018-05-01

    Since sleep apnea often occurs in heart failure, physicians regularly need to decide whether further diagnostic procedures and/or treatment are required. Which types of sleep apnea occur in heart failure patients? When is treatment needed? Which treatments and treatment goals are appropriate? Clinical trials and guidelines as well as their implementation in clinical practice are discussed. At least 40% of patients with heart failure, both with reduced and preserved left ventricular ejection fraction (HFrEF and HFpEF, respectively), suffer from relevant sleep apnea. In heart failure patients both obstructive and central sleep apnea are associated with increased mortality. In HFrEF as well as in HFpEF patients with obstructive sleep apnea, treatment with continuous positive airway pressure (CPAP) achieves symptomatic and functional improvements. In patients with HFpEF, positive airway pressure treatment of central sleep apnea may be beneficial. In patients with HFrEF and left ventricular ejection fraction ≤45%, adaptive servoventilation is contraindicated. Sleep apnea is highly prevalent in heart failure patients and its treatment in specific patient groups can improve symptoms and functional outcomes. Thus, testing for sleep apnea is recommended.

  8. Effects on milk yield of milking interval regularity and teat cup attachment failures with robotic milking systems.

    PubMed

    Bach, Alex; Busto, Isabel

    2005-02-01

    A database consisting of 35291 milking records from 83 cows was built over a period of 10 months with the objectives of studying the effect of teat cup attachment failures and milking interval regularity on milk production with an automated milking system (AMS). The database collected records of lactation number, days in milk (DIM), milk production, interval between milkings (for both the entire udder and individual quarters in case of a teat cup attachment failure) and average and peak milk flows for each milking. The weekly coefficient of variation (CV) of milking intervals was used as a measure of milking regularity. DIM, milking intervals, and CV of milking intervals were divided into four categories coinciding with the four quartiles of their respective distributions. The data were analysed by analysis of variance with cow as a random effect and lactation number, DIM, the occurrence of a milking failure, and the intervals between milkings or the weekly CV of milking intervals as fixed effects. The incidence of attachment failures was 7.6% of total milkings. Milk production by quarters affected by a milking failure following the failure was numerically greater owing to the longer interval between milkings. When accounting for the effect of milking intervals, milk production by affected quarters following a milking failure was 26% lower than with regular milkings. However, the decrease in milk production by quarters affected by milking failures was more severe as DIM increased. Average and peak milk flows by quarters affected by a milking failure were lower than when milkings occurred normally. However, milk production recovered its former level within seven milkings following a milking failure. Uneven frequency (weekly CV of milking intervals >27%) decreased daily milk yield, and affected multiparous more negatively than primiparous cows.

  9. Transitional care programs improve outcomes for heart failure patients: an integrative review.

    PubMed

    Stamp, Kelly D; Machado, Monique A; Allen, Nancy A

    2014-01-01

    Individuals with heart failure are frequently rehospitalized owing to a lack of knowledge concerning how to perform their self-care and when to inform their healthcare provider of worsening symptoms. Because there are an overwhelming number of hospital readmissions for individuals with heart failure, efforts are underway to discover how they can be supported and educated during their hospitalization and subsequently followed by a nurse after discharge for continued education and support. The purpose of this integrative review was to critically examine the interventions, quality of life, and readmission rates of individuals with heart failure who are enrolled in a transitional care program. The second aim was to examine the cost-effectiveness of nurse-led transitional care programs. The results of this integrative review (n = 20) showed that transitional care programs for individuals with heart failure can increase a patient's quality of life and decrease the number of readmissions and the overall cost of care. The types of interventions that were most successful in decreasing readmissions used home visits alone or in combination with telephone calls. There is a need for nurse researchers to address gaps in transitional care for heart failure patients by performing studies with larger randomized clinical trials and measuring outcomes such as readmissions at regular intervals over the study period. The Patient Protection and Affordable Care Act will change reimbursement for heart failure readmissions and presents opportunities for healthcare teams to build transitional care programs for patients with conditions such as heart failure. This integrative review can be used to determine effective intervention strategies for transitional care programs and highlights the gaps in research. Healthcare teams that use these programs within their practice may increase continuity of care and quality of life and decrease readmissions and healthcare costs for individuals with heart failure.

  10. On the equivalence between traction- and stress-based approaches for the modeling of localized failure in solids

    NASA Astrophysics Data System (ADS)

    Wu, Jian-Ying; Cervera, Miguel

    2015-09-01

    This work investigates systematically traction- and stress-based approaches for the modeling of strong and regularized discontinuities induced by localized failure in solids. Two complementary methodologies, i.e., discontinuities localized in an elastic solid and strain localization of an inelastic softening solid, are addressed. In the former it is assumed a priori that the discontinuity forms with a continuous stress field and along the known orientation. A traction-based failure criterion is introduced to characterize the discontinuity and the orientation is determined from Mohr's maximization postulate. If the displacement jumps are retained as independent variables, the strong/regularized discontinuity approaches follow, requiring constitutive models for both the bulk and discontinuity. Elimination of the displacement jumps at the material point level results in the embedded/smeared discontinuity approaches in which an overall inelastic constitutive model fulfilling the static constraint suffices. The second methodology is then adopted to check whether the assumed strain localization can occur and identify its consequences on the resulting approaches. The kinematic constraint guaranteeing stress boundedness and continuity upon strain localization is established for general inelastic softening solids. Application to a unified stress-based elastoplastic damage model naturally yields all the ingredients of a localized model for the discontinuity (band), justifying the first methodology. Two dual but not necessarily equivalent approaches, i.e., the traction-based elastoplastic damage model and the stress-based projected discontinuity model, are identified. The former is equivalent to the embedded and smeared discontinuity approaches, whereas in the later the discontinuity orientation and associated failure criterion are determined consistently from the kinematic constraint rather than given a priori. The bi-directional connections and equivalence conditions between the traction- and stress-based approaches are classified. Closed-form results under plane stress condition are also given. A generic failure criterion of either elliptic, parabolic or hyperbolic type is analyzed in a unified manner, with the classical von Mises (J2), Drucker-Prager, Mohr-Coulomb and many other frequently employed criteria recovered as its particular cases.

  11. The Necessity of the Medial Temporal Lobe for Statistical Learning

    PubMed Central

    Schapiro, Anna C.; Gregory, Emma; Landau, Barbara; McCloskey, Michael; Turk-Browne, Nicholas B.

    2014-01-01

    The sensory input that we experience is highly patterned, and we are experts at detecting these regularities. Although the extraction of such regularities, or statistical learning (SL), is typically viewed as a cortical process, recent studies have implicated the medial temporal lobe (MTL), including the hippocampus. These studies have employed fMRI, leaving open the possibility that the MTL is involved but not necessary for SL. Here, we examined this issue in a case study of LSJ, a patient with complete bilateral hippocampal loss and broader MTL damage. In Experiments 1 and 2, LSJ and matched control participants were passively exposed to a continuous sequence of shapes, syllables, scenes, or tones containing temporal regularities in the co-occurrence of items. In a subsequent test phase, the control groups exhibited reliable SL in all conditions, successfully discriminating regularities from recombinations of the same items into novel foil sequences. LSJ, however, exhibited no SL, failing to discriminate regularities from foils. Experiment 3 ruled out more general explanations for this failure, such as inattention during exposure or difficulty following test instructions, by showing that LSJ could discriminate which individual items had been exposed. These findings provide converging support for the importance of the MTL in extracting temporal regularities. PMID:24456393

  12. Randomised controlled trial of specialist nurse intervention in heart failure

    PubMed Central

    Blue, Lynda; Lang, Elanor; McMurray, John J V; Davie, Andrew P; McDonagh, Theresa A; Murdoch, David R; Petrie, Mark C; Connolly, Eugene; Norrie, John; Round, Caroline E; Ford, Ian; Morrison, Caroline E

    2001-01-01

    Objectives To determine whether specialist nurse intervention improves outcome in patients with chronic heart failure. Design Randomised controlled trial. Setting Acute medical admissions unit in a teaching hospital. Participants 165 patients admitted with heart failure due to left ventricular systolic dysfunction. The intervention started before discharge and continued thereafter with home visits for up to 1 year. Main outcome measures Time to first event analysis of death from all causes or readmission to hospital with worsening heart failure. Results 31 patients (37%) in the intervention group died or were readmitted with heart failure compared with 45 (53%) in the usual care group (hazard ratio=0.61, 95% confidence interval 0.33 to 0.96).Compared with usual care, patients in the intervention group had fewer readmissions for any reason (86 v 114, P=0.018), fewer admissions for heart failure (19 v 45, P<0.001) and spent fewer days in hospital for heart failure (mean 3.43 v 7.46 days, P=0.0051). Conclusions Specially trained nurses can improve the outcome of patients admitted to hospital with heart failure. What is already known on this topicStudies have suggested that nurse intervention may reduce readmission in patients with heart failureWhat this study addsHome based intervention from nurses reduces readmissions for worsening heart failureRegular contact to review treatment and patient education are likely to contribute to this effect PMID:11576977

  13. Exercise training modalities in chronic heart failure: does high intensity aerobic interval training make the difference?

    PubMed

    Giallauria, Francesco; Smart, Neil Andrew; Cittadini, Antonio; Vigorito, Carlo

    2016-10-14

    Exercise training (ET) is strongly recommended in patients with chronic heart failure (CHF). Moderate-intensity aerobic continuous ET is the best established training modality in CHF patients. In the last decade, however, high-intensity interval exercise training (HIIT) has aroused considerable interest in cardiac rehabilitation community. Basically, HIIT consists of repeated bouts of high-intensity exercise alternated with recovery periods. In CHF patients, HIIT exerts larger improvements in exercise capacity compared to moderate-continuous ET. These results are intriguing, mostly considering that better functional capacity translates into an improvement of symptoms and quality of life. Notably, HIIT did not reveal major safety issues; although CHF patients should be clinically stable, have had recent exposure to at least regular moderate-intensity exercise, and appropriate supervision and monitoring during and after the exercise session are mandatory. The impact of HIIT on cardiac dimensions and function and on endothelial function remains uncertain. HIIT should not replace other training modalities in heart failure but should rather complement them. Combining and tailoring different ET modalities according to each patient's baseline clinical characteristics (i.e. exercise capacity, personal needs, preferences and goals) seem the most astute approach to exercise prescription.

  14. Do Learning Difficulties Differentiate Elementary Teachers' Attributional Patterns for Students' Academic Failure? A Comparison between Greek Regular and Special Education Teachers

    ERIC Educational Resources Information Center

    Vlachou, Anastasia; Eleftheriadou, Dimitra; Metallidou, Panayiota

    2014-01-01

    This study aimed to (a) investigate whether the presence of learning difficulties (LD) in primary school children differentiates Greek teachers' attributional patterns, emotional responses, expectations and evaluative feedback for the children's academic failures and (b) to examine possible differences between regular and special education…

  15. Perceived caring needs in patient-partner dyads affected by heart failure: a qualitative study.

    PubMed

    Liljeroos, Maria; Agren, Susanna; Jaarsma, Tiny; Strömberg, Anna

    2014-10-01

    To explore the perceived caring needs in patient-partner dyads affected by heart failure to develop an understanding of potential areas of support. Being affected by heart failure has a great impact on both the patient and the partner but until now contemporary care has remained patient focused. A qualitative study design was used. Eight focus group interviews were performed, which included nineteen patients diagnosed with heart failure and their cohabiting partner. Patients were aged between 55-89 years and partners' ages ranged from 48-87 years. Data were analysed using qualitative content analyses. The dyads perceived that caring needs could be summarised in two themes 'Dyads perceive a need for continuous guidance through the different phases of the illness trajectory' and 'Dyads perceive a need to share burden and support with each other and others'. The dyads described a need to learn more about heart failure to be able to manage everyday life. Regular outpatient clinic visits and access to telephone support were vital, and having someone who cared about the well-being of the partners was perceived as comforting. Both the patient and the partner need to be present at the clinic visits. Receiving the same information and being able to ask questions reduce insecurity. Meeting others in the same situation and sharing the burden in group sessions were proposed as an opportunity to support each other and others. There is a need to improve education and support for patient-partner dyads affected by heart failure. The result shows the importance to provide continuous healthcare contacts throughout the illness trajectory. Furthermore, partners should be included at follow-up, and support groups should be organised so that dyads can meet and support each other. © 2014 John Wiley & Sons Ltd.

  16. Quality of life improves in patients with chronic heart failure and Cheyne-Stokes respiration treated with adaptive servo-ventilation in a nurse-led heart failure clinic.

    PubMed

    Olseng, Margareth W; Olsen, Brita F; Hetland, Arild; Fagermoen, May S; Jacobsen, Morten

    2017-05-01

    The aim of this study was to investigate if quality of life improved in chronic heart failure patients with Cheyne-Stokes respiration treated with adaptive servo-ventilation in nurse-led heart failure clinic. Cheyne-Stokes respiration is associated with decreased quality of life in patients with chronic heart failure. Adaptive servo-ventilation is introduced to treat this sleep-disordered breathing. Randomised, controlled design. Fifty-one patients (ranging from 53-84 years), New York Heart Association III-IV and/or left ventricular ejection fraction ≤40% and Cheyne-Stokes respiration were randomised to an intervention group who received adaptive servo-ventilation or a control group. Minnesota Living with Heart Failure Questionnaire was used to assess quality of life at randomisation and after three months. Both groups were followed in the nurse-led heart failure clinic. Adaptive servo ventilation improved quality of life-scores both in a per protocol analysis and in an intention to treat analysis. Twenty-one patients dropped out of the study, nine in the control and 12 in the intervention group. Use of adaptive servo-ventilation improved quality of life in chronic heart failure patients with Cheyne-Stokes respiration. However, the drop-out rate was high. Chronic heart failure patients come regularly to the nurse-led heart failure clinic. The heart failure nurses' competency has to include knowledge of equipment to provide support and continuity of care to the patients. © 2016 John Wiley & Sons Ltd.

  17. [Side effects and risk profile of lithium: critical assessment of a systematic review and meta-analysis].

    PubMed

    Bschor, T; Bauer, M

    2013-07-01

    Lithium is the only drug that obtained the highest level of recommendation for maintenance therapy in the recent German S3 guidelines on bipolar disorders. In addition it is the only drug with proven efficacy for the prevention of manic as well as depressive episodes in studies with a non-enriched design. Therefore, it is highly welcomed that The Lancet recently published a systematic review and meta-analysis on the risks and side effects of lithium. This is the most comprehensive review on this topic so far.The glomerular filtration rate and maximum urinary concentration ability are slightly reduced under lithium. More patients suffered from renal failure compared to controls; however, renal failure remains a very rare event. The review confirmed the well known suppressive effects of lithium on the thyroid. An increase of serum calcium could be observed relatively frequently, therefore, regular control of serum calcium under lithium therapy is recommended. A relevant increase in body weight is more frequent under lithium than under placebo but less frequent than under olanzapine. No statistically significant increase could be found for hair loss, skin disorders or major congenital abnormalities.Lithium treatment is a safe therapy when clinicians follow the established recommendations. Data indicate that a risk for renal failure exists especially in patients without regular monitoring or with too high lithium serum levels. A (subclinical) hypothyroidism is not an indication to stop administration of lithium but is an indication for l-thyroxin substitution therapy. In pregnancy the risks of continuing lithium should be balanced against the risks of stopping lithium together with the patient.

  18. Local Regularity Analysis with Wavelet Transform in Gear Tooth Failure Detection

    NASA Astrophysics Data System (ADS)

    Nissilä, Juhani

    2017-09-01

    Diagnosing gear tooth and bearing failures in industrial power transition situations has been studied a lot but challenges still remain. This study aims to look at the problem from a more theoretical perspective. Our goal is to find out if the local regularity i.e. smoothness of the measured signal can be estimated from the vibrations of epicyclic gearboxes and if the regularity can be linked to the meshing events of the gear teeth. Previously it has been shown that the decreasing local regularity of the measured acceleration signals can reveal the inner race faults in slowly rotating bearings. The local regularity is estimated from the modulus maxima ridges of the signal's wavelet transform. In this study, the measurements come from the epicyclic gearboxes of the Kelukoski water power station (WPS). The very stable rotational speed of the WPS makes it possible to deduce that the gear mesh frequencies of the WPS and a frequency related to the rotation of the turbine blades are the most significant components in the spectra of the estimated local regularity signals.

  19. [Possibilities of dialysis therapy in irreversible renal failure in rheumatoid arthritis with secondary amyloidosis].

    PubMed

    Vachtenheim, J; Tocík, J; Novák, Z; Zeman, P

    1990-11-01

    The authors discuss their initial experience with the treatment of secondary amyloidosis in rheumatoid arthritis with irreversible renal failure in patients included in a regular dialyzation programme. The hitherto assembled 15-month experience justifies the inclusion of patients with this cause of irreversible renal failure in a dialyzation programme. The reverse is not only wrong from the medical aspect but is inhuman and interferes with the life of families of these patients. Although the procedure during a regular dialyzation programme of these patients with rheumatoid arthritis with secondary amyloidosis is more complicated, more pretentious and more responsible, it is our medical duty to carry this burden together with the patient.

  20. Factors associated with a continuous regular analgesic use - a population-based study of more than 45,000 Danish women and men 18-45 years of age.

    PubMed

    Hargreave, Marie; Andersen, Tina Veje; Nielsen, Ann; Munk, Christian; Liaw, Kai-Li; Kjaer, Susanne K

    2010-01-01

    Widespread use of and serious adverse effects associated with use of analgesics accentuates the need to consider factors related to analgesic use. The objective of this study was to describe continuous regular analgesics use and examine factors associated with a continuous regular analgesic use. The study was based on data from two surveys and included a random sample of women and men aged 18-45 years from the general Danish population. Information on analgesics use, self-rated health, demographic and lifestyle factors was collected using a self-administered questionnaire. A total of 28,000 women and 33 000 men were invited to participate and 22,199 women (response-rate 81.4%) and 23,080 men (response-rate 71.0%), respectively, were included in the study. Data were analyzed using multivariate logistic regression. We found that 27% of the women and 18% of the men reported a regular monthly use of at least seven analgesic tablets during the last year (continuous regular analgesics use). Besides poor self-rated health we found in both sexes that increasing age, poor self-rated fitness, and smoking were related to a continuous regular analgesics use. Nulliparity, low level of education, overweight/obesity, binge drinking, and abstinence were associated with a continuous regular analgesics use for women, while underweight and marital/cohabiting status were associated with a continuous regular analgesics use only for men. Regular monthly analgesic use during the last year was generally prevalent. Besides self-rated health, several socio-demographic and lifestyle factors were associated with a continuous regular analgesic use, although with some gender differences.

  1. [Update on the respiratory management of patients with chronic neuromuscular disease].

    PubMed

    Priou, P; Trzepizur, W; Meslier, N; Gagnadoux, F

    2017-12-01

    Neuromuscular diseases include a wide range of conditions that may involve potentially life-threatening respiratory complications (infection, respiratory failure). For patients with neuromuscular diseases, clinical assessment of respiratory function and regular pulmonary function tests are needed to screen for nocturnal respiratory disorders, weakness of the diaphragm and potential restrictive disorders and/or chronic hypercapnic respiratory insufficiency, possibly with couch deficiency. MANAGEMENT OF NOCTURNAL RESPIRATORY DISORDERS AND CHRONIC RESPIRATORY FAILURE: Nocturnal respiratory assistance is an important phase of care for nocturnal respiratory disorders and chronic respiratory failure. This may involve continuous positive airway pressure, adaptative servo-ventilation or non-invasive ventilation with a facial or nasal mask. As needed, diurnal assistance may be proposed by mouthpiece ventilation. Should non-invasive ventilation prove insufficient, or if significant swallowing disorders or recurrent bronchial obstruction develop, or in case of prolonged intubation, tracheotomy may be required. In case of lower airway infection with ineffective cough, physical therapy, associated with air stacking, intermittent positive pressure breathing or mechanical in-exsufflation may be proposed. Care for swallowing disorders, nutritional counseling (cachexia, obesity), vaccinations and therapeutic education are integral elements of patient-centered management aiming to prevent the negative impact of infection and to manage respiratory failure of chronic neuromuscular disease. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  2. Procedure to establish inspection intervals of regularity maintained in-service units subject to failure

    DOT National Transportation Integrated Search

    1996-05-01

    Procedures have been developed for determining the period between regular inspections that is required to ensure, with a : specified level of confidence, that no more than a certain percentage of the units of a population that is in service is : fail...

  3. Hepatic Encephalopathy: Early Diagnosis in Pediatric Patients With Cirrhosis

    PubMed Central

    DARA, Naghi; SAYYARI, Ali-Akbar; IMANZADEH, Farid

    2014-01-01

    Objective As acute liver failure (ALF) and chronic liver disease (cirrhosis) continue to increase in prevalence, we will see more cases of hepatic encephalopathy. Primary care physician are often the first to suspect it, since they are familiar with the patient’s usual physical and mental status. This serious complication typically occurs in patients with severe comorbidities and needs multidisciplinary evaluation and care. Hepatic encephalopathy should be considered in any patient with acute liver failure and cirrhosis who presents with neuropsychiatric manifestations, decrease level of consciousness (coma), change of personality, intellectual and behavioral deterioration, speech and motor dysfunction. Every cirrhotic patient may be at risk; potential precipitating factors should be addressed in regular clinic visits. The encephalopathy of liver disease may be prominent, or can be present in subtle forms, such as decline of school performance, emotional outbursts, or depression. “Subtle form” of hepatic encephalopathy may not be obvious on clinical examination, but can be detected by neurophysiologic and neuropsychiatric testing. PMID:24665321

  4. Emergency contraception - Potential for women's health

    PubMed Central

    Mittal, Suneeta

    2014-01-01

    Emergency contraception (EC) is a safe and effective method which is used to prevent unwanted pregnancy after unprotected sexual intercourse. Many of the unwanted pregnancies end in unsafe abortions. The search for an ideal contraceptive, which does not interfere with spontaneity or pleasure of the sexual act, yet effectively controls the fertility, is still continuing. Numerous contraceptive techniques are available, yet contraceptive coverage continues to be poor in India. Thus, even when not planning for a pregnancy, exposure to unprotected sex takes place often, necessitating the use of emergency contraception. This need may also arise due to failure of contraceptive method being used (condom rupture, diaphragm slippage, forgotten oral pills) or following sexual assault. Emergency contraception is an intervention that can prevent a large number of unwanted pregnancies resulting from failure of regular contraception or unplanned sexual activity, which in turn helps in reducing the maternal mortality and morbidity due to unsafe abortions. However, a concern has been expressed regarding repeated and indiscriminate usage of e-pill, currently the rational use of emergency contraception is being promoted as it is expected to make a significant dent in reducing the number of unwanted pregnancies and unsafe abortions. In fact, since the introduction of emergency contraception, the contribution of unsafe abortion towards maternal mortality has declined from 13 to 8 per cent. PMID:25673542

  5. Emergency contraception - potential for women's health.

    PubMed

    Mittal, Suneeta

    2014-11-01

    Emergency contraception (EC) is a safe and effective method which is used to prevent unwanted pregnancy after unprotected sexual intercourse. Many of the unwanted pregnancies end in unsafe abortions. The search for an ideal contraceptive, which does not interfere with spontaneity or pleasure of the sexual act, yet effectively controls the fertility, is still continuing. Numerous contraceptive techniques are available, yet contraceptive coverage continues to be poor in India. Thus, even when not planning for a pregnancy, exposure to unprotected sex takes place often, necessitating the use of emergency contraception. This need may also arise due to failure of contraceptive method being used (condom rupture, diaphragm slippage, forgotten oral pills) or following sexual assault. Emergency contraception is an intervention that can prevent a large number of unwanted pregnancies resulting from failure of regular contraception or unplanned sexual activity, which in turn helps in reducing the maternal mortality and morbidity due to unsafe abortions. However, a concern has been expressed regarding repeated and indiscriminate usage of e-pill, currently the rational use of emergency contraception is being promoted as it is expected to make a significant dent in reducing the number of unwanted pregnancies and unsafe abortions. In fact, since the introduction of emergency contraception, the contribution of unsafe abortion towards maternal mortality has declined from 13 to 8 per cent.

  6. Influence of influenza vaccination on recurrent hospitalization in patients with heart failure.

    PubMed

    Kaya, H; Beton, O; Acar, G; Temizhan, A; Cavusoğlu, Y; Guray, U; Zoghi, M; Ural, D; Ekmekci, A; Gungor, H; Sari, I; Oguz, D; Yucel, H; Zorlu, A; Yilmaz, M B

    2017-05-01

    The current study aimed to evaluate the influence of regular annual influenza vaccinations on cardiovascular (CV) death and heart failure-related hospitalizations (HFrH) in stable outpatients with heart failure with reduced ejection fraction. The Turkish research team-HF (TREAT-HF) is a network undertaking multicenter, observational cohort studies in HF. This study is a subgroup analysis of TREAT-HF outpatient cohorts who completed a questionnaire on influenza vaccination status and for whom follow-up data were available. A total of 656 patients with available follow-up data for CV death and HFrH including recurrent hospitalization were included in the study. Patients were classified into two groups: those who received regular influenza vaccination (40 %) and those who did not receive vaccination. During a mean follow-up of 15 ±6 months, 113 (18 %) patients had CV death and 471 (72 %) patients had at least one HFrH. The CV death rate was similar in both groups of patients (16 vs. 19 %, p = 0.37), whereas, HFrH and recurrent HFrH were significantly less frequently encountered in patients who received regular influenza vaccination than in those who did not receive vaccination (43 vs. 92 % and 16 vs. 66 %, p < 0.001, respectively). In a multivariate Cox proportional hazards model - in addition to a few clinical factors - vaccination status (HR = 0.30, 95 % CI = 0.17-0.51, p < 0.001) and graduation from university (HR = 0.35, 95 % CI = 0.17-0.72, p = 0.004) remained independently associated with the risk of recurrent HFrH. Regular influenza vaccination does not influence CV deaths; however, it decreases HFrH including recurrent episodes of HFrH in outpatients with heart failure with reduced ejection fraction.

  7. Characterization of the behavior of three definitions of prostate-specific antigen-based biochemical failure in relation to detection and follow-up biases: comparison with the American Society for Therapeutic Radiology and Oncology consensus definition.

    PubMed

    Williams, Scott G

    2006-03-01

    To examine the impact of detection biases on three prostate cancer biochemical failure (bF) definitions in comparison with the existing American Society for Therapeutic Radiology and Oncology Consensus Definition (ACD). Three alternative bF definitions were tested against the ACD: three rises in prostate-specific antigen (PSA) level without backdating, nadir plus 2 ng/mL, and a threshold PSA level of >3 ng/mL, according to data from 1050 men. The mean time between PSA tests (MTBT), regularity of collection, and calendar year of analysis were examined in each bF definition. The MTBT produced a statistically significant difference in the derived hazard ratio for identification of bF in all definitions. The influence of test regularity was statistically significant beyond the median level of regularity in all definitions. The year of analysis impacted greatly on the ACD, whereas the three alternative definitions exhibited minor follow-up duration variations by comparison. The alternative definitions had reliable follow-up when the crude median time to censoring was at least 1.6 times greater than that of failure. Detection biases will always be a significant issue in defining bF. A number of alternative failure definitions have more predictable interactions with these biases than the existing ACD.

  8. Application of Six Sigma methodology to a diagnostic imaging process.

    PubMed

    Taner, Mehmet Tolga; Sezen, Bulent; Atwat, Kamal M

    2012-01-01

    This paper aims to apply the Six Sigma methodology to improve workflow by eliminating the causes of failure in the medical imaging department of a private Turkish hospital. Implementation of the design, measure, analyse, improve and control (DMAIC) improvement cycle, workflow chart, fishbone diagrams and Pareto charts were employed, together with rigorous data collection in the department. The identification of root causes of repeat sessions and delays was followed by failure, mode and effect analysis, hazard analysis and decision tree analysis. The most frequent causes of failure were malfunction of the RIS/PACS system and improper positioning of patients. Subsequent to extensive training of professionals, the sigma level was increased from 3.5 to 4.2. The data were collected over only four months. Six Sigma's data measurement and process improvement methodology is the impetus for health care organisations to rethink their workflow and reduce malpractice. It involves measuring, recording and reporting data on a regular basis. This enables the administration to monitor workflow continuously. The improvements in the workflow under study, made by determining the failures and potential risks associated with radiologic care, will have a positive impact on society in terms of patient safety. Having eliminated repeat examinations, the risk of being exposed to more radiation was also minimised. This paper supports the need to apply Six Sigma and present an evaluation of the process in an imaging department.

  9. Optimizing Bariatric Surgery Multidisciplinary Follow-up: a Focus on Patient-Centered Care.

    PubMed

    Aarts, Mary-Anne; Sivapalan, Nardhana; Nikzad, Seyed-Ehsan; Serodio, Kristin; Sockalingam, Sanjeev; Conn, Lesley Gotlib

    2017-03-01

    Failure to follow-up post-bariatric surgery has been associated with higher postoperative complications, lower percentage weight loss and poorer nutrition. This study aimed to understand the patient follow-up experience in order to optimize follow-up care within a comprehensive bariatric surgery program. Qualitative telephone interviews were conducted in patients who underwent surgery through a publically funded multidisciplinary bariatric surgery program in 2011, in Ontario, Canada. Inductive thematic analysis was used. Of the 46 patients interviewed, 76.1 % were female, mean age was 50, and 10 were lost to follow-up within 1 year postsurgery. Therapeutic continuity was the most important element of follow-up care identified by patients and was most frequently established with the dietician, as this team member was highly sought and accessible. Patients who attended regularly (1) appreciated the specialized care, (2) favoured ongoing monitoring and support, (3) were committed to the program and (4) felt their family doctor had insufficient experience/knowledge to manage their follow-up care. Of the 36 people who attended the clinic regularly, 8 were not planning to return after 2 years due to (1) perceived diminishing usefulness, (2) system issues, (3) confidence that their family physician could continue their care or (4) higher priority personal/health issues. Patients lost to follow-up stated similar barriers. Patients believe the follow-up post-bariatric surgery is essential in providing the support required to maintain their diet and health. More personalized care focusing on continuity and relationships catering to individual patient needs balanced with local healthcare resources may redefine and reduce attrition rates.

  10. The Beliefs and Practices of Canadian Teachers about Including Students with Special Needs in their Regular Elementary Classrooms

    ERIC Educational Resources Information Center

    Jordan, Anne; Stanovich, Paula

    2004-01-01

    While considerable research has been directed at examining the effectiveness of placement for exceptional students, few studies have examined the instructional characteristics which contribute to the success or failure of these students included in regular classrooms (Swanson & Hoskyn, 1999; Swanson, Hoskyn & Lee, 1999). Over the last decade we…

  11. Cognitive Effects of Chess Instruction on Students at Risk for Academic Failure

    ERIC Educational Resources Information Center

    Hong, Saahoon; Bart, William M.

    2007-01-01

    Cognitive effects of chess instruction on students at risk for academic failure was examined. Thirty-eight students, from three elementary schools, participated in this study. The experimental group received a ninety-minute chess lesson once per week over a three-month period; and the control group students regularly attended school activities…

  12. 19 CFR 162.65 - Penalties for failure to manifest narcotic drugs or marihuana.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... or marihuana. 162.65 Section 162.65 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF... Substances, Narcotics, and Marihuana § 162.65 Penalties for failure to manifest narcotic drugs or marihuana. (a) Cargo or baggage containing unmanifested narcotic drugs or marihuana. When a package of regular...

  13. 19 CFR 162.65 - Penalties for failure to manifest narcotic drugs or marihuana.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... or marihuana. 162.65 Section 162.65 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF... Substances, Narcotics, and Marihuana § 162.65 Penalties for failure to manifest narcotic drugs or marihuana. (a) Cargo or baggage containing unmanifested narcotic drugs or marihuana. When a package of regular...

  14. Failure Analysis in Platelet Molded Composite Systems

    NASA Astrophysics Data System (ADS)

    Kravchenko, Sergii G.

    Long-fiber discontinuous composite systems in the form of chopped prepreg tapes provide an advanced, structural grade, molding compound allowing for fabrication of complex three-dimensional components. Understanding of process-structure-property relationship is essential for application of prerpeg platelet molded components, especially because of their possible irregular disordered heterogeneous morphology. Herein, a structure-property relationship was analyzed in the composite systems of many platelets. Regular and irregular morphologies were considered. Platelet-based systems with more ordered morphology possess superior mechanical performance. While regular morphologies allow for a careful inspection of failure mechanisms derived from the morphological characteristics, irregular morphologies are representative of the composite architectures resulting from uncontrolled deposition and molding with chopped prerpegs. Progressive failure analysis (PFA) was used to study the damaged deformation up to ultimate failure in a platelet-based composite system. Computational damage mechanics approaches were utilized to conduct the PFA. The developed computational models granted understanding of how the composite structure details, meaning the platelet geometry and system morphology (geometrical arrangement and orientation distribution of platelets), define the effective mechanical properties of a platelet-molded composite system, its stiffness, strength and variability in properties.

  15. The Art and Science of Using Diuretics in the Treatment of Heart Failure in Diverse Clinical Settings.

    PubMed

    Islam, Md Shahidul

    2018-01-01

    It is important to understand the rationale for appropriate use of different diuretics, alone or in combination, in different heart failure patients, under diverse clinical settings. Clinicians and nurses engaged in heart failure care, must be familiar with different diuretics, their appropriate doses, methods of administration, monitoring of the responses, and the side-effects. Inappropriate use of diuretics, both under-treatment and overtreatment, and poor follow-up can lead to failures, and adverse outcomes. Adequate treatment of congestion, with rather aggressive use of diuretics, is necessary, even if that may worsen renal function temporarily in some patients. Diuretic treatment should later be titrated down, by early recognition of the euvolemic sate, which can be assessed by clinical examination, measurement of the natriuretic peptides, and when possible, echocardiographic estimation of the left ventricular filling pressure. You need to treat patients, who are truly resistant to the loop diuretics, by administering the diuretics as intravenous bolus injection followed by continuous infusion, and/or by sequential nephron blockade by adding the thiazide diuretics. You need to use the diuretics based on a sound understanding of the pathophysiology of the disease process, the pharmacokinetics and pharmacodynamics of the diuretics, even when strong evidences for your choices might be lacking. Some patients may benefit from injection of loop diuretics together with hypertonic saline, and others from injection of loop diuretics with albumin. Patient education, and regular follow up of the treatment of heart failure patients, in out-patient settings are important for reducing the rates of complications, and for reducing the needs for urgent hospitalizations.

  16. Damage identification method for continuous girder bridges based on spatially-distributed long-gauge strain sensing under moving loads

    NASA Astrophysics Data System (ADS)

    Wu, Bitao; Wu, Gang; Yang, Caiqian; He, Yi

    2018-05-01

    A novel damage identification method for concrete continuous girder bridges based on spatially-distributed long-gauge strain sensing is presented in this paper. First, the variation regularity of the long-gauge strain influence line of continuous girder bridges which changes with the location of vehicles on the bridge is studied. According to this variation regularity, a calculation method for the distribution regularity of the area of long-gauge strain history is investigated. Second, a numerical simulation of damage identification based on the distribution regularity of the area of long-gauge strain history is conducted, and the results indicate that this method is effective for identifying damage and is not affected by the speed, axle number and weight of vehicles. Finally, a real bridge test on a highway is conducted, and the experimental results also show that this method is very effective for identifying damage in continuous girder bridges, and the local element stiffness distribution regularity can be revealed at the same time. This identified information is useful for maintaining of continuous girder bridges on highways.

  17. [MaRS Project

    NASA Technical Reports Server (NTRS)

    Aruljothi, Arunvenkatesh

    2016-01-01

    The Space Exploration Division of the Safety and Mission Assurances Directorate is responsible for reducing the risk to Human Space Flight Programs by providing system safety, reliability, and risk analysis. The Risk & Reliability Analysis branch plays a part in this by utilizing Probabilistic Risk Assessment (PRA) and Reliability and Maintainability (R&M) tools to identify possible types of failure and effective solutions. A continuous effort of this branch is MaRS, or Mass and Reliability System, a tool that was the focus of this internship. Future long duration space missions will have to find a balance between the mass and reliability of their spare parts. They will be unable take spares of everything and will have to determine what is most likely to require maintenance and spares. Currently there is no database that combines mass and reliability data of low level space-grade components. MaRS aims to be the first database to do this. The data in MaRS will be based on the hardware flown on the International Space Stations (ISS). The components on the ISS have a long history and are well documented, making them the perfect source. Currently, MaRS is a functioning excel workbook database; the backend is complete and only requires optimization. MaRS has been populated with all the assemblies and their components that are used on the ISS; the failures of these components are updated regularly. This project was a continuation on the efforts of previous intern groups. Once complete, R&M engineers working on future space flight missions will be able to quickly access failure and mass data on assemblies and components, allowing them to make important decisions and tradeoffs.

  18. Validation of self assessment patient knowledge questionnaire for heart failure patients.

    PubMed

    Lainscak, Mitja; Keber, Irena

    2005-12-01

    Several studies showed insufficient knowledge and poor compliance to non-pharmacological management in heart failure patients. Only a limited number of validated tools are available to assess their knowledge. The aim of the study was to test our 10-item Patient knowledge questionnaire. The Patient knowledge questionnaire was administered to 42 heart failure patients from Heart failure clinic and to 40 heart failure patients receiving usual care. Construct validity (Pearson correlation coefficient), internal consistency (Cronbach alpha), reproducibility (Wilcoxon signed rank test), and reliability (chi-square test and Student's t-test for independent samples) were assessed. Overall score of the Patient knowledge questionnaire had the strongest correlation to the question about regular weighing (r=0.69) and the weakest to the question about presence of heart disease (r=0.33). There was a strong correlation between question about fluid retention and questions assessing regular weighing, (r=0.86), weight of one litre of water (r=0.86), and salt restriction (r=0.57). The Cronbach alpha was 0.74 and could be improved by exclusion of questions about clear explanation (Chronbach alpha 0.75), importance of fruit, soup, and vegetables (Chronbach alpha 0.75), and self adjustment of diuretic (Chronbach alpha 0.81). During reproducibility testing 91% to 98% of questions were answered equally. Patients from Heart failure clinic scored significantly better than patients receiving usual care (7.9 (1.3) vs. 5.7 (2.2), p<0.001). Patient knowledge questionnaire is a valid and reliable tool to measure knowledge of heart failure patients.

  19. European LeukemiaNet recommendations for the management of chronic myeloid leukemia: 2013

    PubMed Central

    Deininger, Michael W.; Rosti, Gianantonio; Hochhaus, Andreas; Soverini, Simona; Apperley, Jane F.; Cervantes, Francisco; Clark, Richard E.; Cortes, Jorge E.; Guilhot, François; Hjorth-Hansen, Henrik; Hughes, Timothy P.; Kantarjian, Hagop M.; Kim, Dong-Wook; Larson, Richard A.; Lipton, Jeffrey H.; Mahon, François-Xavier; Martinelli, Giovanni; Mayer, Jiri; Müller, Martin C.; Niederwieser, Dietger; Pane, Fabrizio; Radich, Jerald P.; Rousselot, Philippe; Saglio, Giuseppe; Saußele, Susanne; Schiffer, Charles; Silver, Richard; Simonsson, Bengt; Steegmann, Juan-Luis; Goldman, John M.; Hehlmann, Rüdiger

    2013-01-01

    Advances in chronic myeloid leukemia treatment, particularly regarding tyrosine kinase inhibitors, mandate regular updating of concepts and management. A European LeukemiaNet expert panel reviewed prior and new studies to update recommendations made in 2009. We recommend as initial treatment imatinib, nilotinib, or dasatinib. Response is assessed with standardized real quantitative polymerase chain reaction and/or cytogenetics at 3, 6, and 12 months. BCR-ABL1 transcript levels ≤10% at 3 months, <1% at 6 months, and ≤0.1% from 12 months onward define optimal response, whereas >10% at 6 months and >1% from 12 months onward define failure, mandating a change in treatment. Similarly, partial cytogenetic response (PCyR) at 3 months and complete cytogenetic response (CCyR) from 6 months onward define optimal response, whereas no CyR (Philadelphia chromosome–positive [Ph+] >95%) at 3 months, less than PCyR at 6 months, and less than CCyR from 12 months onward define failure. Between optimal and failure, there is an intermediate warning zone requiring more frequent monitoring. Similar definitions are provided for response to second-line therapy. Specific recommendations are made for patients in the accelerated and blastic phases, and for allogeneic stem cell transplantation. Optimal responders should continue therapy indefinitely, with careful surveillance, or they can be enrolled in controlled studies of treatment discontinuation once a deeper molecular response is achieved. PMID:23803709

  20. A comparison of remedial, failure, and successful secondary school students across self-perception and past and present school performance variables.

    PubMed

    Zarb, J M

    1984-01-01

    Three groups of Grades 9-10 adolescents were compared across a combination of self-perception and school performance variables (past and present). The three groups studied were (1) students in remedial math and English classes (Remedials), (2) unsuccessful regular-stream students failing three or more subjects (Failures), and (3) successful regular-stream students failing no more than one course (Controls). The sample of 96 students was predominantly female, and subjects were enrolled in a general nonuniversity preparatory program at a commercial high school in an inner-city working-class district. Five sets of measures were used: Self-Perception Measures (Peer, Family, and Academic Self-Concept scales, as well as self-report measures of Study Habits and Educational Aspirations), Current, Past and Follow-up School Performance Measures (academic and nonacademic), and Attribution Measures (student and teacher attributions of reason for failure). Results indicated significant differences between the three groups on several variables. Compared with the Controls, both Remedials and Failures had lower Academic Self-Concepts and lower Reading Levels, but only the Remedials had significantly lower levels of Intellectual Functioning, in addition to lower Math Achievement Levels than the Controls. The Failure group was significantly lower than the other two groups on Family Self-Concept, Attendance, and Overall Grade Percentage (both at the initial and follow-up periods), and they had records showing a higher frequency of elementary school Behavior Problems. Thus it was suggested that school failure was related to emotional difficulties to a significantly greater degree for the Failure group as compared to the Remedial group, which was characterized by more straightforward academic and intellectual deficits. Finally, Failures and Remedials and their teachers tended to attribute the student's failure in particular courses fairly equally to either the student's difficulty in grasping the subject matter, or to insufficient effort, whereas those Controls who were failing a course tended to blame their failure on "Teacher Problems."

  1. [Analysis of on medication rules for Qi-deficiency and blood-stasis syndrome of chronic heart failure based on data mining technology].

    PubMed

    Wang, Qian; Yao, Geng-Zhen; Pan, Guang-Ming; Huang, Jing-Yi; An, Yi-Pei; Zou, Xu

    2017-01-01

    To analyze the medication features and the regularity of prescriptions of traditional Chinese medicine in treating patients with Qi-deficiency and blood-stasis syndrome of chronic heart failure based on modern literature. In this article, CNKI Chinese academic journal database, Wanfang Chinese academic journal database and VIP Chinese periodical database were all searched from January 2000 to December 2015 for the relevant literature on traditional Chinese medicine treatment for Qi-deficiency and blood-stasis syndrome of chronic heart failure. Then a normalized database was established for further data mining and analysis. Subsequently, the medication features and the regularity of prescriptions were mined by using traditional Chinese medicine inheritance support system(V2.5), association rules, improved mutual information algorithm, complex system entropy clustering and other mining methods. Finally, a total of 171 articles were included, involving 171 prescriptions, 140 kinds of herbs, with a total frequency of 1 772 for the herbs. As a result, 19 core prescriptions and 7 new prescriptions were mined. The most frequently used herbs included Huangqi(Astragali Radix), Danshen(Salviae Miltiorrhizae Radix et Rhizoma), Fuling(Poria), Renshen(Ginseng Radix et Rhizoma), Tinglizi(Semen Lepidii), Baizhu(Atractylodis Macrocephalae Rhizoma), and Guizhi(Cinnamomum Ramulus). The core prescriptions were composed of Huangqi(Astragali Radix), Danshen(Salviae Miltiorrhizae Radix et Rhizoma) and Fuling(Poria), etc. The high frequent herbs and core prescriptions not only highlight the medication features of Qi-invigorating and blood-circulating therapy, but also reflect the regularity of prescriptions of blood-circulating, Yang-warming, and urination-promoting therapy based on syndrome differentiation. Moreover, the mining of the new prescriptions provide new reference and inspiration for clinical treatment of various accompanying symptoms of chronic heart failure. In conclusion, this article provides new reference for traditional Chinese medicine in the treatment of chronic heart failure. Copyright© by the Chinese Pharmaceutical Association.

  2. A regularized auxiliary particle filtering approach for system state estimation and battery life prediction

    NASA Astrophysics Data System (ADS)

    Liu, Jie; Wang, Wilson; Ma, Fai

    2011-07-01

    System current state estimation (or condition monitoring) and future state prediction (or failure prognostics) constitute the core elements of condition-based maintenance programs. For complex systems whose internal state variables are either inaccessible to sensors or hard to measure under normal operational conditions, inference has to be made from indirect measurements using approaches such as Bayesian learning. In recent years, the auxiliary particle filter (APF) has gained popularity in Bayesian state estimation; the APF technique, however, has some potential limitations in real-world applications. For example, the diversity of the particles may deteriorate when the process noise is small, and the variance of the importance weights could become extremely large when the likelihood varies dramatically over the prior. To tackle these problems, a regularized auxiliary particle filter (RAPF) is developed in this paper for system state estimation and forecasting. This RAPF aims to improve the performance of the APF through two innovative steps: (1) regularize the approximating empirical density and redraw samples from a continuous distribution so as to diversify the particles; and (2) smooth out the rather diffused proposals by a rejection/resampling approach so as to improve the robustness of particle filtering. The effectiveness of the proposed RAPF technique is evaluated through simulations of a nonlinear/non-Gaussian benchmark model for state estimation. It is also implemented for a real application in the remaining useful life (RUL) prediction of lithium-ion batteries.

  3. Effect of reducing interns' weekly work hours on sleep and attentional failures.

    PubMed

    Lockley, Steven W; Cronin, John W; Evans, Erin E; Cade, Brian E; Lee, Clark J; Landrigan, Christopher P; Rothschild, Jeffrey M; Katz, Joel T; Lilly, Craig M; Stone, Peter H; Aeschbach, Daniel; Czeisler, Charles A

    2004-10-28

    Knowledge of the physiological effects of extended (24 hours or more) work shifts in postgraduate medical training is limited. We aimed to quantify work hours, sleep, and attentional failures among first-year residents (postgraduate year 1) during a traditional rotation schedule that included extended work shifts and during an intervention schedule that limited scheduled work hours to 16 or fewer consecutive hours. Twenty interns were studied during two three-week rotations in intensive care units, each during both the traditional and the intervention schedule. Subjects completed daily sleep logs that were validated with regular weekly episodes (72 to 96 hours) of continuous polysomnography (r=0.94) and work logs that were validated by means of direct observation by study staff (r=0.98). Seventeen of 20 interns worked more than 80 hours per week during the traditional schedule (mean, 84.9; range, 74.2 to 92.1). All interns worked less than 80 hours per week during the intervention schedule (mean, 65.4; range, 57.6 to 76.3). On average, interns worked 19.5 hours per week less (P<0.001), slept 5.8 hours per week more (P<0.001), slept more in the 24 hours preceding each working hour (P<0.001), and had less than half the rate of attentional failures while working during on-call nights (P=0.02) on the intervention schedule as compared with the traditional schedule. Eliminating interns' extended work shifts in an intensive care unit significantly increased sleep and decreased attentional failures during night work hours. Copyright 2004 Massachusetts Medical Society.

  4. A Case Study on the Strata Movement Mechanism and Surface Deformation Regulation in Chengchao Underground Iron Mine

    NASA Astrophysics Data System (ADS)

    Cheng, Guanwen; Chen, Congxin; Ma, Tianhui; Liu, Hongyuan; Tang, Chunan

    2017-04-01

    The regular pattern of surface deformation and the mechanism of underground strata movement, especially in iron mines constructed with the block caving method, have a great influence on infrastructure on the surface, so they are an important topic for research. Based on the engineering geology conditions and the surface deformation and fracture features in Chengchao Iron Mine, the mechanism of strata movement and the regular pattern of surface deformation in the footwall were studied by the geomechanical method, and the following conclusions can be drawn: I. The surface deformation process is divided into two stages over time, i.e., the chimney caving development stage and the post-chimney deformation stage. Currently, the surface deformation in Chengchao Iron Mine is at the post-chimney deformation stage. II. At the post-chimney deformation stage, the surface deformation and geological hazards in Chengchao Iron Mine are primarily controlled by the NWW-trending joints, with the phenomenon of toppling deformation and failure on the surface. Based on the surface deformation characteristics in Chengchao Iron Mine, the surface deformation area can be divided into the following four zones: the fracture extension zone, the fracture closure zone, the fracture formation zone and the deformation accumulation zone. The zones on the surface can be determined by the surface deformation characteristics. III. The cantilever beams near the chimney caving area, caused by the NWW-trending joints, have been subjected to toppling failure. This causes the different deformation and failure mechanisms in different locations of the deep rock mass. The deep rock can be divided into four zones, i.e., the fracture zone, fracture transition zone, deformation zone and undisturbed zone, according to the different deformation and failure mechanisms. The zones in the deep rock are the reason for the zones on the surface, so they can be determined by the zones on the surface. Through these findings, the degree of damage to the infrastructure in different locations can be determined based on the surface deformation zones. As the mining continues deeper, the development regulation of the zones on the surface and in deep rock mass can be further studied based on the zones in the deep rock.

  5. Application of Six Sigma methodology to a cataract surgery unit.

    PubMed

    Taner, Mehmet Tolga

    2013-01-01

    The article's aim is to focus on the application of Six Sigma to minimise intraoperative and post-operative complications rates in a Turkish public hospital cataract surgery unit. Implementing define-measure-analyse-improve and control (DMAIC) involves process mapping, fishbone diagrams and rigorous data-collection. Failure mode and effect analysis (FMEA), pareto diagrams, control charts and process capability analysis are applied to redress cataract surgery failure root causes. Inefficient skills of assistant surgeons and technicians, low quality of IOLs used, wrong IOL placement, unsystematic sterilisation of surgery rooms and devices, and the unprioritising network system are found to be the critical drivers of intraoperative-operative and post-operative complications. Sigma level was increased from 2.60 to 3.75 subsequent to extensive training of assistant surgeons, ophthalmologists and technicians, better quality IOLs, systematic sterilisation and air-filtering, and the implementation of a more sophisticated network system. This article shows that Six Sigma measurement and process improvement can become the impetus for cataract unit staff to rethink their process and reduce malpractices. Measuring, recording and reporting data regularly helps them to continuously monitor their overall process and deliver safer treatments. This is the first Six Sigma ophthalmology study in Turkey.

  6. Graph Laplacian Regularization for Image Denoising: Analysis in the Continuous Domain.

    PubMed

    Pang, Jiahao; Cheung, Gene

    2017-04-01

    Inverse imaging problems are inherently underdetermined, and hence, it is important to employ appropriate image priors for regularization. One recent popular prior-the graph Laplacian regularizer-assumes that the target pixel patch is smooth with respect to an appropriately chosen graph. However, the mechanisms and implications of imposing the graph Laplacian regularizer on the original inverse problem are not well understood. To address this problem, in this paper, we interpret neighborhood graphs of pixel patches as discrete counterparts of Riemannian manifolds and perform analysis in the continuous domain, providing insights into several fundamental aspects of graph Laplacian regularization for image denoising. Specifically, we first show the convergence of the graph Laplacian regularizer to a continuous-domain functional, integrating a norm measured in a locally adaptive metric space. Focusing on image denoising, we derive an optimal metric space assuming non-local self-similarity of pixel patches, leading to an optimal graph Laplacian regularizer for denoising in the discrete domain. We then interpret graph Laplacian regularization as an anisotropic diffusion scheme to explain its behavior during iterations, e.g., its tendency to promote piecewise smooth signals under certain settings. To verify our analysis, an iterative image denoising algorithm is developed. Experimental results show that our algorithm performs competitively with state-of-the-art denoising methods, such as BM3D for natural images, and outperforms them significantly for piecewise smooth images.

  7. Pre-configured polyhedron based protection against multi-link failures in optical mesh networks.

    PubMed

    Huang, Shanguo; Guo, Bingli; Li, Xin; Zhang, Jie; Zhao, Yongli; Gu, Wanyi

    2014-02-10

    This paper focuses on random multi-link failures protection in optical mesh networks, instead of single, the dual or sequential failures of previous studies. Spare resource efficiency and failure robustness are major concerns in link protection strategy designing and a k-regular and k-edge connected structure is proved to be one of the optimal solutions for link protection network. Based on this, a novel pre-configured polyhedron based protection structure is proposed, and it could provide protection for both simultaneous and sequential random link failures with improved spare resource efficiency. Its performance is evaluated in terms of spare resource consumption, recovery rate and average recovery path length, as well as compared with ring based and subgraph protection under probabilistic link failure scenarios. Results show the proposed novel link protection approach has better performance than previous works.

  8. 76 FR 21774 - Wisconsin; Major Disaster and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-18

    ... protective measures, including snow assistance, under the Public Assistance program for any continuous 48... warranted. This assistance excludes regular time costs for the sub-grantees' regular employees. Consistent..., under the Public Assistance program for any continuous 48-hour period during or proximate to the...

  9. European health policy challenges.

    PubMed

    Maynard, Alan

    2005-09-01

    Few countries are immune to the international health care 'virus' of reform, with many countries regularly re-cycling changes that shift costs and benefits in ways that are arbitrary, inefficient and offer short term political palliation. Much of this activity has little evidence base and reveals lack of clarity in defining public policy goals, establishing trade-offs and aligning incentive structures with these objectives. Well established failures in health care delivery systems such as variations in medical practice and continuing absence of systematic outcome measurement, have persisted for decades as nations grapple inefficiently with recurring problems of expenditure inflation and waiting times. The lack of emphasis on evidence to inform the efficient management of chronic disease and the reduction of health inequalities is a product of perverse incentives and managerial inertia that maintains the incomes of powerful interest groups. Copyright (c) 2005 John Wiley & Sons, Ltd.

  10. Military nephrology—what a civilian doctor should know

    PubMed Central

    2011-01-01

    This article provides some background on military nephrology in the UK. The primary objective of the Defence Medical Services is the maintenance of operational capability of military personnel. This includes exclusion of nephrological diseases that might reduce renal reserve to a critical level under field conditions, increasing susceptibility to trauma, burns, infection and adverse environmental conditions and increasing the need for renal support. Renal failure potentially compromises not only the patient but also his comrades through reduced staffing and inability to execute the military mission. Safety of weapon systems for which the patient is responsible may be reduced. At forward locations, need for evacuation may put aircraft or vehicles and their crew with medical attendants at unnecessary risk. Regular follow-up and continuity of care are difficult owing to the demands of military life that include frequent postings and deployments. PMID:25984145

  11. Structural and mechanical defects of materials of offshore and onshore main gas pipelines after long-term operation

    NASA Astrophysics Data System (ADS)

    Maruschak, Pavlo; Panin, Sergey; Danyliuk, Iryna; Poberezhnyi, Lyubomyr; Pyrig, Taras; Bishchak, Roman; Vlasov, Ilya

    2015-10-01

    The study has established the main regularities of a fatigue failure of offshore gas steel pipes installed using S-lay and J-lay methods.We have numerically analyzed the influence of preliminary deformation on the fatigue life of 09Mn2Si steel at different amplitudes of cyclic loading. The results have revealed the regularities of formation and development of a fatigue crack in 17Mn1Si steel after 40 years of underground operation. The quantitative analysis describes the regularities of occurrence and growth of fatigue cracks in the presence of a stress concentration.

  12. 75 FR 11903 - Nebraska; Major Disaster and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-12

    ... protective measures, including snow assistance, under the Public Assistance program for any continuous 48... warranted. This assistance excludes regular time costs for the sub-grantees' regular employees. Consistent... Assistance program for any continuous 48-hour period during or proximate to the incident period. All counties...

  13. 75 FR 9425 - New Jersey; Major Disaster and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-02

    ... protective measures, including snow assistance, under the Public Assistance program for any continuous 48... warranted. This assistance excludes regular time costs for the sub-grantees' regular employees. Consistent... Assistance program for any continuous 48-hour period during or proximate to the incident period. All counties...

  14. Method of Individual Forecasting of Technical State of Logging Machines

    NASA Astrophysics Data System (ADS)

    Kozlov, V. G.; Gulevsky, V. A.; Skrypnikov, A. V.; Logoyda, V. S.; Menzhulova, A. S.

    2018-03-01

    Development of the model that evaluates the possibility of failure requires the knowledge of changes’ regularities of technical condition parameters of the machines in use. To study the regularities, the need to develop stochastic models that take into account physical essence of the processes of destruction of structural elements of the machines, the technology of their production, degradation and the stochastic properties of the parameters of the technical state and the conditions and modes of operation arose.

  15. Disease management programs for heart failure: not just for the 'sick' heart failure population.

    PubMed

    McDonald, Ken; Conlon, Carmel; Ledwidge, Mark

    2007-02-01

    The development of disease management programs has been a major advance in heart failure care, bringing about significant improvements for the heart failure population, with reduction in readmission, better use of guideline therapy and improved survival. However, at present, the majority of such programs focus their attention only on the sicker segment of this population, with little application of this important service to the broader heart failure population, where potentially benefits may be even more impressive. This has led to an imbalance in the care of patients with heart failure, where aspects of management such as regular structured review and education are preferentially given to the group at the later stages of the natural history of the syndrome. This paper argues for a far wider application of the disease management program concept in heart failure care so as to bring the benefits of specialist care, patient education and follow-up to patients at an earlier stage in the natural history of heart failure.

  16. 34 CFR 691.8 - Enrollment status for students taking regular and correspondence courses.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 4 2011-07-01 2011-07-01 false Enrollment status for students taking regular and correspondence courses. 691.8 Section 691.8 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) ACADEMIC COMPETITIVENESS...

  17. 34 CFR 691.8 - Enrollment status for students taking regular and correspondence courses.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 4 2014-07-01 2014-07-01 false Enrollment status for students taking regular and correspondence courses. 691.8 Section 691.8 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) ACADEMIC COMPETITIVENESS...

  18. 34 CFR 691.8 - Enrollment status for students taking regular and correspondence courses.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 4 2012-07-01 2012-07-01 false Enrollment status for students taking regular and correspondence courses. 691.8 Section 691.8 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) ACADEMIC COMPETITIVENESS...

  19. 34 CFR 691.8 - Enrollment status for students taking regular and correspondence courses.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 4 2013-07-01 2013-07-01 false Enrollment status for students taking regular and correspondence courses. 691.8 Section 691.8 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) ACADEMIC COMPETITIVENESS...

  20. 26 CFR 1.547-5 - Deduction denied in case of fraud or wilful failure to file timely return.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... failure to file timely return. 1.547-5 Section 1.547-5 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Personal Holding Companies § 1.547-5 Deduction denied in case of fraud or wilful failure to file timely return. No deduction...

  1. 26 CFR 1.547-5 - Deduction denied in case of fraud or wilful failure to file timely return.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... failure to file timely return. 1.547-5 Section 1.547-5 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Personal Holding Companies § 1.547-5 Deduction denied in case of fraud or wilful failure to file timely return. No deduction...

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

    PubMed

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

    2006-01-01

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

  3. 26 CFR 1.6038A-6 - Failure to furnish information.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 13 2012-04-01 2012-04-01 false Failure to furnish information. 1.6038A-6... TAX (CONTINUED) INCOME TAXES (CONTINUED) Information Returns § 1.6038A-6 Failure to furnish... by § 1.6038A-3, and by reason of that failure, the summons is quashed in a proceeding under section...

  4. 26 CFR 1.6038A-6 - Failure to furnish information.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 13 2011-04-01 2011-04-01 false Failure to furnish information. 1.6038A-6... TAX (CONTINUED) INCOME TAXES (CONTINUED) Information Returns § 1.6038A-6 Failure to furnish... by § 1.6038A-3, and by reason of that failure, the summons is quashed in a proceeding under section...

  5. 26 CFR 1.6038A-6 - Failure to furnish information.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 13 2013-04-01 2013-04-01 false Failure to furnish information. 1.6038A-6... TAX (CONTINUED) INCOME TAXES (CONTINUED) Information Returns § 1.6038A-6 Failure to furnish... by § 1.6038A-3, and by reason of that failure, the summons is quashed in a proceeding under section...

  6. What Can We Apply to Manage Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Acute Respiratory Failure?

    PubMed

    Kim, Deog Kyeom; Lee, Jungsil; Park, Ju Hee; Yoo, Kwang Ha

    2018-04-01

    Acute exacerbation(s) of chronic obstructive pulmonary disease (AECOPD) tend to be critical and debilitating events leading to poorer outcomes in relation to chronic obstructive pulmonary disease (COPD) treatment modalities, and contribute to a higher and earlier mortality rate in COPD patients. Besides pro-active preventative measures intended to obviate acquisition of AECOPD, early recovery from severe AECOPD is an important issue in determining the long-term prognosis of patients diagnosed with COPD. Updated GOLD guidelines and recently published American Thoracic Society/European Respiratory Society clinical recommendations emphasize the importance of use of pharmacologic treatment including bronchodilators, systemic steroids and/or antibiotics. As a non-pharmacologic strategy to combat the effects of AECOPD, noninvasive ventilation (NIV) is recommended as the treatment of choice as this therapy is thought to be most effective in reducing intubation risk in patients diagnosed with AECOPD with acute respiratory failure. Recently, a few adjunctive modalities, including NIV with helmet and helium-oxygen mixture, have been tried in cases of AECOPD with respiratory failure. As yet, insufficient documentation exists to permit recommendation of this therapy without qualification. Although there are too few findings, as yet, to allow for regular andr routine application of those modalities in AECOPD, there is anecdotal evidence to indicate both mechanical and physiological benefits connected with this therapy. High-flow nasal cannula oxygen therapy is another supportive strategy which serves to improve the symptoms of hypoxic respiratory failure. The therapy also produced improvement in ventilatory variables, and it may be successfully applied in cases of hypercapnic respiratory failure. Extracorporeal carbon dioxide removal has been successfully attempted in cases of adult respiratory distress syndrome, with protective hypercapnic ventilatory strategy. Nowadays, it is reported that it was also effective in reducing intubation in AECOPD with hypercapnic respiratory failure. Despite the apparent need for more supporting evidence, efforts to improve efficacy of NIV have continued unabated. It is anticipated that these efforts will, over time, serve toprogressively decrease the risk of intubation and invasive mechanical ventilation in cases of AECOPD with acute respiratory failure. Copyright©2018. The Korean Academy of Tuberculosis and Respiratory Diseases.

  7. 47 CFR 87.189 - Requirements for public correspondence equipment and operations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES AVIATION SERVICES Aircraft Stations § 87.189 Requirements for... continuous watch must be maintained on the frequencies used for safety and regularity of flight while public... interfere with message pertaining to safety of life and property or regularity of flight, or when ordered by...

  8. Effects of methylphenidate and expectancy on children with ADHD: behavior, academic performance, and attributions in a summer treatment program and regular classroom settings.

    PubMed

    Pelham, William E; Hoza, Betsy; Pillow, David R; Gnagy, Elizabeth M; Kipp, Heidi L; Greiner, Andrew R; Waschbusch, Daniel A; Trane, Sarah T; Greenhouse, Joel; Wolfson, Lara; Fitzpatrick, Erin

    2002-04-01

    Pharmacological and expectancy effects of 0.3 mg/kg methylphenidate on the behavior and attributions of boys with attention-deficit/hyperactivity disorder were evaluated. In a within-subject, balanced-placebo design, 136 boys received 4 medication-expectancy conditions. Attributions for success and failure on a daily report card were gathered. Assessments took place within the setting of a summer treatment program and were repeated in boys' regular classrooms. Expectancy did not affect the boys' behavior; only active medication improved their behavior. Boys attributed their success to their effort and ability and attributed failure to task difficulty and the pill, regardless of medication and expectancy. Results were generally equivalent across the two settings; where there were differences, beneficial effects of medication were more apparent in the school setting. The findings were unaffected by individual-difference factors.

  9. Regularized finite element modeling of progressive failure in soils within nonlocal softening plasticity

    NASA Astrophysics Data System (ADS)

    Huang, Maosong; Qu, Xie; Lü, Xilin

    2017-11-01

    By solving a nonlinear complementarity problem for the consistency condition, an improved implicit stress return iterative algorithm for a generalized over-nonlocal strain softening plasticity was proposed, and the consistent tangent matrix was obtained. The proposed algorithm was embodied into existing finite element codes, and it enables the nonlocal regularization of ill-posed boundary value problem caused by the pressure independent and dependent strain softening plasticity. The algorithm was verified by the numerical modeling of strain localization in a plane strain compression test. The results showed that a fast convergence can be achieved and the mesh-dependency caused by strain softening can be effectively eliminated. The influences of hardening modulus and material characteristic length on the simulation were obtained. The proposed algorithm was further used in the simulations of the bearing capacity of a strip footing; the results are mesh-independent, and the progressive failure process of the soil was well captured.

  10. Application of Quality Management Tools for Evaluating the Failure Frequency of Cutter-Loader and Plough Mining Systems

    NASA Astrophysics Data System (ADS)

    Biały, Witold

    2017-06-01

    Failure frequency in the mining process, with a focus on the mining machine, has been presented and illustrated by the example of two coal-mines. Two mining systems have been subjected to analysis: a cutter-loader and a plough system. In order to reduce costs generated by failures, maintenance teams should regularly make sure that the machines are used and operated in a rational and effective way. Such activities will allow downtimes to be reduced, and, in consequence, will increase the effectiveness of a mining plant. The evaluation of mining machines' failure frequency contained in this study has been based on one of the traditional quality management tools - the Pareto chart.

  11. Lifetime evaluation of large format CMOS mixed signal infrared devices

    NASA Astrophysics Data System (ADS)

    Linder, A.; Glines, Eddie

    2015-09-01

    New large scale foundry processes continue to produce reliable products. These new large scale devices continue to use industry best practice to screen for failure mechanisms and validate their long lifetime. The Failure-in-Time analysis in conjunction with foundry qualification information can be used to evaluate large format device lifetimes. This analysis is a helpful tool when zero failure life tests are typical. The reliability of the device is estimated by applying the failure rate to the use conditions. JEDEC publications continue to be the industry accepted methods.

  12. The Potential That Electronic Nicotine Delivery Systems Can be a Disruptive Technology: Results From a National Survey.

    PubMed

    Pechacek, Terry F; Nayak, Pratibha; Gregory, Kyle R; Weaver, Scott R; Eriksen, Michael P

    2016-10-01

    This study evaluates the reasons for use and acceptance of Electronic Nicotine Delivery Systems (ENDS) among current and former cigarette smokers to assess if ENDS may become a satisfying alternative to cigarettes. Data are from a national probability sample of 5717 US adults, surveyed June-November 2014. The survey contained questions on awareness, usage, and reasons for use of traditional and novel tobacco products. The analytic sample was current and former smokers who ever used ENDS (n = 729) and was divided into four mutually exclusive categories. Among the 585 current smokers, 337 were no longer using ENDS ("E-Cig Rejecters"), and 248 were continuing to use both ENDS and cigarettes ("E-Cig Dual Users"). Among 144 former cigarette smokers, 101 were non-recent users of ENDS ("Quit All Products"), and 43 were continuing to use ENDS exclusively ("Switchers"). Former smokers (the "Switchers") report finding ENDS a satisfying alternative to regular cigarettes, with only 15.8% (95% confidence interval [CI] 4.4-27.1) rating ENDS as less enjoyable than regular cigarettes. However, greater than fivefold more current smokers did not find them satisfying and stopped using them (77.3%; 95% CI 72.1-82.4 of "E-Cig Rejecters" rated ENDS as less enjoyable). Being less harmful was the most highly rated reason for continuing to use ENDS among "Switchers." Most (80.9%) "Switchers" reported that ENDS helped them quit cigarettes. Since many current smokers who have tried ENDS reject them as a satisfying alternative to regular cigarettes, ENDS will not replace regular cigarettes unless they improve. Since about one-half of recent former smokers are trying ENDS with about one-fourth continuing to use them, and many reporting that these products have helped them quit regular cigarettes, the potential impact of ENDS on population quit rates deserves continued surveillance. However, since most current smokers who have tried ENDS reject them as a satisfying alternative to regular cigarettes, the potential of ENDS becoming a disruptive technology replacing regular cigarettes remains uncertain. ENDS need to improve as a satisfying alternative or the attractiveness and appeal of the regular cigarette must be degraded to increase the potential of ENDS replacing regular cigarettes. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.

  13. The Potential That Electronic Nicotine Delivery Systems Can be a Disruptive Technology: Results From a National Survey

    PubMed Central

    Nayak, Pratibha; Gregory, Kyle R.; Weaver, Scott R.; Eriksen, Michael P.

    2016-01-01

    Introduction: This study evaluates the reasons for use and acceptance of Electronic Nicotine Delivery Systems (ENDS) among current and former cigarette smokers to assess if ENDS may become a satisfying alternative to cigarettes. Methods: Data are from a national probability sample of 5717 US adults, surveyed June–November 2014. The survey contained questions on awareness, usage, and reasons for use of traditional and novel tobacco products. The analytic sample was current and former smokers who ever used ENDS (n = 729) and was divided into four mutually exclusive categories. Among the 585 current smokers, 337 were no longer using ENDS (“E-Cig Rejecters”), and 248 were continuing to use both ENDS and cigarettes (“E-Cig Dual Users”). Among 144 former cigarette smokers, 101 were non-recent users of ENDS (“Quit All Products”), and 43 were continuing to use ENDS exclusively (“Switchers”). Results: Former smokers (the “Switchers”) report finding ENDS a satisfying alternative to regular cigarettes, with only 15.8% (95% confidence interval [CI] 4.4–27.1) rating ENDS as less enjoyable than regular cigarettes. However, greater than fivefold more current smokers did not find them satisfying and stopped using them (77.3%; 95% CI 72.1–82.4 of “E-Cig Rejecters” rated ENDS as less enjoyable). Being less harmful was the most highly rated reason for continuing to use ENDS among “Switchers.” Most (80.9%) “Switchers” reported that ENDS helped them quit cigarettes. Conclusion: Since many current smokers who have tried ENDS reject them as a satisfying alternative to regular cigarettes, ENDS will not replace regular cigarettes unless they improve. Implications: Since about one-half of recent former smokers are trying ENDS with about one-fourth continuing to use them, and many reporting that these products have helped them quit regular cigarettes, the potential impact of ENDS on population quit rates deserves continued surveillance. However, since most current smokers who have tried ENDS reject them as a satisfying alternative to regular cigarettes, the potential of ENDS becoming a disruptive technology replacing regular cigarettes remains uncertain. ENDS need to improve as a satisfying alternative or the attractiveness and appeal of the regular cigarette must be degraded to increase the potential of ENDS replacing regular cigarettes. PMID:27142201

  14. Follow-up study for a disease management program for chronic heart failure 24 months after program commencement.

    PubMed

    Otsu, Haruka; Moriyama, Michiko

    2012-12-01

    There are few studies dealing with comprehensive chronic heart failure (CHF) disease management programs, which are based on self-management, in Japan. We developed and conducted a comprehensive educational program for CHF for 6 months that aimed to improve self-management and prevent the deterioration of outpatients with CHF. Our follow-up research focused on whether performance of self-management in the intervention group continued for 24 months after commencement. Participants were selected from patients who went for follow-up visits to one Japanese clinic, which specialized in cardiovascular internal medicine, that were diagnosed with CHF. During the first follow-up period, 7 to 12 months after program commencement, 47 participants in the intervention group and 47 participants in the control group were analyzed. During the second follow-up period, 13 to 24 months after program commencement, 41 participants in the intervention group were analyzed. Participants in the intervention group acquired self-management skills and activities and these continued up to 24 months after the program commencement. As a result, no deterioration in symptoms related to CHF was demonstrated. Meanwhile, quitting smoking and drinking depended on individual preference and it was difficult to improve. The educational program was effective in the long term and the program is significant for use in busy medical situations that do not offer sufficient follow-up support for patients. Regular intervention and ways that produce longer-lasting effects should be further developed. © 2011 The Authors. Japan Journal of Nursing Science © 2011 Japan Academy of Nursing Science.

  15. A practical review for cardiac rehabilitation professionals of continuous-flow left ventricular assist devices: historical and current perspectives.

    PubMed

    Compostella, Leonida; Russo, Nicola; Setzu, Tiziana; Bottio, Tomaso; Compostella, Caterina; Tarzia, Vincenzo; Livi, Ugolino; Gerosa, Gino; Iliceto, Sabino; Bellotto, Fabio

    2015-01-01

    An increasing number of patients with end-stage heart failure are being treated with continuous-flow left ventricular assist devices (cf-LVADs). These patients provide new challenges to the staff in exercise-based cardiac rehabilitation (CR) programs. Even though experience remains limited, it seems that patients supported by cf-LVADs may safely engage in typical rehabilitative activities, provided that some attention is paid to specific aspects, such as the presence of a short external drive line. In spite of initial physical deconditioning, CR allows progressive improvement of symptoms such as fatigue and dyspnea. Intensity of rehabilitative activities should ideally be based on measured aerobic capacity and increased appropriately over time. Regular, long-term exercise training results in improved physical fitness and survival rates. Appropriate adjustment of cf-LVAD settings, together with maintenance of adequate blood volume, provides maximal output, while avoiding suction effects. Ventricular arrhythmias, although not necessarily constituting an immediate life-threatening situation, deserve treatment as they could lead to an increased rate of hospitalization and poorer quality of life. Atrial fibrillation may worsen symptoms of right ventricular failure and reduce exercise tolerance. Blood pressure measurements are possible in cf-LVAD patients only using a Doppler technique, and a mean blood pressure ≤80 mmHg is considered "ideal." Some patients may present with orthostatic intolerance, related to autonomic dysfunction. While exercise training constitutes the basic rehabilitative tool, a comprehensive intervention that includes psychological and social support could better meet the complex needs of patients in which cf-LVAD may offer prolonged survival.

  16. Hemodynamic deterioration precedes onset of ventricular tachyarrhythmia after Heartmate II implantation.

    PubMed

    Yaksh, Ameeta; Kik, Charles; Knops, Paul; Zwiers, Korinne; van Ettinger, Maarten J B; Manintveld, Olivier C; de Wijs, Marcel C J; van der Kemp, Peter; Bogers, Ad J J C; de Groot, Natasja M S

    2016-07-08

    Early postoperative ventricular tachyarrhythmia (PoVT) after left ventricular assist device (LVAD) implantation are common and associated with higher mortality-rates. At present, there is no data on initiation of these PoVT and the role of alterations in cardiac hemodynamics. A LVAD was implanted in a patient with end-stage heart failure due to a ischemic cardiomyopathy. Alterations in cardiac rhythm and hemodynamics preceding PoVT-episodes during the first five postoperative days were examined by using continuous recordings of cardiac rhythm and various hemodynamic parameters. All PoVT (N=120) were monomorphic, most often preceded by short-long-short-sequences or regular SR and initiated by ventricular runs. Prior to PoVT, mean arterial pressure decreased; heart rate and ST-segments deviations increased. PoVT are caused by different underlying electrophysiological mechanisms. Yet, they are all monomorphic and preceded by hemodynamic deterioration due to myocardial ischemia.

  17. [Modern therapy of chronic myeloid leukemia: an example for paradigma shift in hemato-oncology].

    PubMed

    Leitner, A A; Hehlmann, R

    2011-02-01

    Chronic myeloid leukemia (CML) is exceptional amongst neoplasias since its underlying pathomechanism has been elucidated, and potent well tolerated targeted drugs, the tyrosine kinase inhibitors (TKI), are available for treatment. They convincingly improve prognosis while retaining good quality of life. Aims of therapy are complete remissions as well as prolongation of life and cure. Imatinib 400 mg per day is current standard therapy. There are hints for a better outcome with a higher initial imatinib dose or with combination therapy. Even after achievement of complete molecular response continuous therapy might be necessary in most cases. In case of imatinib intolerance or failure, the second generation TKI dasatinib and nilotinib and allogeneic stem cell transplantation are available. The use of second generation TKI as first line treatment might further improve prognosis. The therapeutic response should be regularly monitored according to international recommendations.

  18. WE-H-BRC-01: Failure Mode and Effects Analysis of Skin Electronic Brachytherapy Using Esteya Unit

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

    Ibanez-Rosello, B; Bautista-Ballesteros, J; Bonaque, J

    Purpose: A failure mode and effect analysis (FMEA) of skin lesions treatment process using Esteya™ device (Elekta Brachyterapy, Veenendaal, The Netherlands) was performed, with the aim of increasing the quality of the treatment and reducing the likelihood of unwanted events. Methods: A multidisciplinary team with experience in the treatment process met to establish the process map, which outlines the flow of various stages for such patients undergoing skin treatment. Potential failure modes (FM) were identified and the value of severity (S), frequency of occurrence (O), and lack of detectability (D) of the proposed FM were scored individually, each on amore » scale of 1 to 10 following TG-100 guidelines of the AAPM. These failure modes were ranked according to our risk priority number (RPN) and S scores. The efficiency of existing quality management tools was analyzed through a reassessment of the O and D made by consensus. Results: 149 FM were identified, 43 of which had RPN ≥ 100 and 30 had S ≥ 7. After introduction of the tools of quality management, only 3 FM had RPN ≥ 100 and 22 FM had RPN ≥ 50. These 22 FM were thoroughly analyzed and new tools for quality management were proposed. The most common cause of highest RPN FM was associated with the heavy patient workload and the continuous and accurate applicator-patient skin contact during the treatment. To overcome this second item, a regular quality control and setup review by a second individual before each treatment session was proposed. Conclusion: FMEA revealed some of the FM potentials that were not predicted during the initial implementation of the quality management tools. This exercise was useful in identifying the need of periodic update of the FMEA process as new potential failures can be identified.« less

  19. Electrical failure debug using interlayer profiling method

    NASA Astrophysics Data System (ADS)

    Yang, Thomas; Shen, Yang; Zhang, Yifan; Sweis, Jason; Lai, Ya-Chieh

    2017-03-01

    It is very well known that as technology nodes move to smaller sizes, the number of design rules increases while design structures become more regular and the process manufacturing steps have increased as well. Normal inspection tools can only monitor hard failures on a single layer. For electrical failures that happen due to inter layers misalignments, we can only detect them through testing. This paper will present a working flow for using pattern analysis interlayer profiling techniques to turn multiple layer physical info into group linked parameter values. Using this data analysis flow combined with an electrical model allows us to find critical regions on a layout for yield learning.

  20. Left ventricular assist device management in patients chronically supported for advanced heart failure.

    PubMed

    Cowger, Jennifer; Romano, Matthew A; Stulak, John; Pagani, Francis D; Aaronson, Keith D

    2011-03-01

    This review summarizes management strategies to reduce morbidity and mortality in heart failure patients supported chronically with implantable left ventricular assist devices (LVADs). As the population of patients supported with long-term LVADs has grown, patient selection, operative technique, and patient management strategies have been refined, leading to improved outcomes. This review summarizes recent findings on LVAD candidate selection, and discusses outpatient strategies to optimize device performance and heart failure management. It also reviews important device complications that warrant close outpatient monitoring. Managing patients on chronic LVAD support requires regular patient follow-up, multidisciplinary care teams, and frequent laboratory and echocardiographic surveillance to ensure optimal outcomes.

  1. 26 CFR 1.6049-7 - Returns of information with respect to REMIC regular interests and collateralized debt obligations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 13 2010-04-01 2010-04-01 false Returns of information with respect to REMIC regular interests and collateralized debt obligations. 1.6049-7 Section 1.6049-7 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Information...

  2. ADAPTIVE FINITE ELEMENT MODELING TECHNIQUES FOR THE POISSON-BOLTZMANN EQUATION

    PubMed Central

    HOLST, MICHAEL; MCCAMMON, JAMES ANDREW; YU, ZEYUN; ZHOU, YOUNGCHENG; ZHU, YUNRONG

    2011-01-01

    We consider the design of an effective and reliable adaptive finite element method (AFEM) for the nonlinear Poisson-Boltzmann equation (PBE). We first examine the two-term regularization technique for the continuous problem recently proposed by Chen, Holst, and Xu based on the removal of the singular electrostatic potential inside biomolecules; this technique made possible the development of the first complete solution and approximation theory for the Poisson-Boltzmann equation, the first provably convergent discretization, and also allowed for the development of a provably convergent AFEM. However, in practical implementation, this two-term regularization exhibits numerical instability. Therefore, we examine a variation of this regularization technique which can be shown to be less susceptible to such instability. We establish a priori estimates and other basic results for the continuous regularized problem, as well as for Galerkin finite element approximations. We show that the new approach produces regularized continuous and discrete problems with the same mathematical advantages of the original regularization. We then design an AFEM scheme for the new regularized problem, and show that the resulting AFEM scheme is accurate and reliable, by proving a contraction result for the error. This result, which is one of the first results of this type for nonlinear elliptic problems, is based on using continuous and discrete a priori L∞ estimates to establish quasi-orthogonality. To provide a high-quality geometric model as input to the AFEM algorithm, we also describe a class of feature-preserving adaptive mesh generation algorithms designed specifically for constructing meshes of biomolecular structures, based on the intrinsic local structure tensor of the molecular surface. All of the algorithms described in the article are implemented in the Finite Element Toolkit (FETK), developed and maintained at UCSD. The stability advantages of the new regularization scheme are demonstrated with FETK through comparisons with the original regularization approach for a model problem. The convergence and accuracy of the overall AFEM algorithm is also illustrated by numerical approximation of electrostatic solvation energy for an insulin protein. PMID:21949541

  3. 32 CFR 724.211 - Regularity of government affairs.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false Regularity of government affairs. 724.211 Section 724.211 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NAVAL DISCHARGE REVIEW BOARD Authority/Policy for Departmental Discharge Review § 724.211 Regularity of government...

  4. Medicare program; changes to the Medicare claims appeal procedures; continuation of effectiveness and extension of timeline for publication of final rule. Interim final rule with comment period; continuation of effectiveness and extension of timeline for publication of final rule.

    PubMed

    2009-02-27

    This notice announces the continuation of effectiveness of a Medicare interim final rule with comment period and the extension of the timeline for publication of the final rule. This notice is issued in accordance with section 1871(a)(3)(C) of the Social Security Act (the Act), which allows an interim final rule to remain in effect after the expiration of the timeline specified in section 1871(a)(3)(B) of the Act (the "regular timeline") or, if applicable, at the end of each succeeding 1-year extension to the regular timeline, if prior to the expiration of the timeline, the Secretary publishes in the Federal Register a notice of continuation and explains why the regular timeline or any subsequent extension was not complied with.

  5. Performance characteristics of a batch service queueing system with functioning server failure and multiple vacations

    NASA Astrophysics Data System (ADS)

    Niranjan, S. P.; Chandrasekaran, V. M.; Indhira, K.

    2018-04-01

    This paper examines bulk arrival and batch service queueing system with functioning server failure and multiple vacations. Customers are arriving into the system in bulk according to Poisson process with rate λ. Arriving customers are served in batches with minimum of ‘a’ and maximum of ‘b’ number of customers according to general bulk service rule. In the service completion epoch if the queue length is less than ‘a’ then the server leaves for vacation (secondary job) of random length. After a vacation completion, if the queue length is still less than ‘a’ then the server leaves for another vacation. The server keeps on going vacation until the queue length reaches the value ‘a’. The server is not stable at all the times. Sometimes it may fails during functioning of customers. Though the server fails service process will not be interrupted.It will be continued for the current batch of customers with lower service rate than the regular service rate. The server will be repaired after the service completion with lower service rate. The probability generating function of the queue size at an arbitrary time epoch will be obtained for the modelled queueing system by using supplementary variable technique. Moreover various performance characteristics will also be derived with suitable numerical illustrations.

  6. Efficient Meshfree Large Deformation Simulation of Rainfall Induced Soil Slope Failure

    NASA Astrophysics Data System (ADS)

    Wang, Dongdong; Li, Ling

    2010-05-01

    An efficient Lagrangian Galerkin meshfree framework is presented for large deformation simulation of rainfall-induced soil slope failure. Detailed coupled soil-rainfall seepage equations are given for the proposed formulation. This nonlinear meshfree formulation is featured by the Lagrangian stabilized conforming nodal integration method where the low cost nature of nodal integration approach is kept and at the same time the numerical stability is maintained. The initiation and evolution of progressive failure in the soil slope is modeled by the coupled constitutive equations of isotropic damage and Drucker-Prager pressure-dependent plasticity. The gradient smoothing in the stabilized conforming integration also serves as a non-local regularization of material instability and consequently the present method is capable of effectively capture the shear band failure. The efficacy of the present method is demonstrated by simulating the rainfall-induced failure of two typical soil slopes.

  7. Predicting survival in critical patients by use of body temperature regularity measurement based on approximate entropy.

    PubMed

    Cuesta, D; Varela, M; Miró, P; Galdós, P; Abásolo, D; Hornero, R; Aboy, M

    2007-07-01

    Body temperature is a classical diagnostic tool for a number of diseases. However, it is usually employed as a plain binary classification function (febrile or not febrile), and therefore its diagnostic power has not been fully developed. In this paper, we describe how body temperature regularity can be used for diagnosis. Our proposed methodology is based on obtaining accurate long-term temperature recordings at high sampling frequencies and analyzing the temperature signal using a regularity metric (approximate entropy). In this study, we assessed our methodology using temperature registers acquired from patients with multiple organ failure admitted to an intensive care unit. Our results indicate there is a correlation between the patient's condition and the regularity of the body temperature. This finding enabled us to design a classifier for two outcomes (survival or death) and test it on a dataset including 36 subjects. The classifier achieved an accuracy of 72%.

  8. 47 CFR 54.713 - Contributors' failure to report or to contribute.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 3 2011-10-01 2011-10-01 false Contributors' failure to report or to contribute. 54.713 Section 54.713 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Administration § 54.713 Contributors' failure to report or to contribute. (a) A contributor that fails to...

  9. 47 CFR 54.713 - Contributors' failure to report or to contribute.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 3 2014-10-01 2014-10-01 false Contributors' failure to report or to contribute. 54.713 Section 54.713 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Administration § 54.713 Contributors' failure to report or to contribute. (a) A contributor that fails to...

  10. 47 CFR 54.713 - Contributors' failure to report or to contribute.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 3 2013-10-01 2013-10-01 false Contributors' failure to report or to contribute. 54.713 Section 54.713 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Administration § 54.713 Contributors' failure to report or to contribute. (a) A contributor that fails to...

  11. 47 CFR 54.713 - Contributors' failure to report or to contribute.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Contributors' failure to report or to contribute. 54.713 Section 54.713 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Administration § 54.713 Contributors' failure to report or to contribute. (a) A contributor that fails to...

  12. 47 CFR 54.713 - Contributors' failure to report or to contribute.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 3 2012-10-01 2012-10-01 false Contributors' failure to report or to contribute. 54.713 Section 54.713 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Administration § 54.713 Contributors' failure to report or to contribute. (a) A contributor that fails to...

  13. [Frozen shoulder. Diagnosis and therapy].

    PubMed

    Schultheis, A; Reichwein, F; Nebelung, W

    2008-11-01

    The condition of shoulder stiffness is often called adhesive capsulitis or frozen shoulder. It is regarded as a distinct clinical entity showing a benign and regular course. The major clinical feature is significant reduction in both active and passive range of motion (ROM) accompanied by stage-dependent pain, allowing for a clinical diagnosis. There are primary and secondary forms, the former having an unknown etiology and increased occurrence in patients with metabolic disorders and the latter being seen with prior injury or operation. Three stages, each lasting 4-6 months, mark the clinical course. The progression of the disease is self-limiting and may occasionally resolve in partial restitution. In the first stage ("freezing"), the shoulder continuously loses passive motion and causes worsening pain. Continuing stiffness and improvements in pain and inflammation are characteristic of the second stage ("frozen"). In the third stage ("thawing"), restriction of shoulder motion decreases, and ROM increases. Treatment should be adjusted to these stages. Recommendations include analgesics and joint injections in the first stage and physiotherapy in combination with manual therapy in the second and third stages. In cases of failure, passive exercise under interscalene block, manipulation under general anesthesia, or arthroscopic arthrolysis should be considered.

  14. Determinants of compliance with nasal continuous positive airway pressure treatment applied in a community setting.

    PubMed

    Ball, E M.; Banks, M B.

    2001-05-01

    Objectives: To assess determinants of nasal continuous positive airway pressure (CPAP) compliance when applied in a community setting.Background: One-third of obstructive sleep apnea patients eventually refuse CPAP therapy. Treatment outcomes may be improved by identifying predictors of CPAP failure, including whether management by primary care physicians without sleep consultation affects results.Methods: Polysomnogram, chart review, and questionnaire results for regular CPAP users (n=123) were compared with those returning the CPAP machine (n=26).Results: Polysomnographic data and the presence of multiple sleep disorders were only modestly predictive of CPAP compliance. Striking differences in questionnaire responses separated CPAP users from non-users, who reported less satisfaction with all phases of their diagnosis and management. Rates of CPAP use were not significantly different between patients managed solely by their primary care physician or by a sleep consultant.Conclusions: Polysomnographic findings are unlikely to identify eventual CPAP non-compliers in a cost-effective fashion. Improvements in sleep apnea management may result from addressing the role of personality factors and multiple sleep disorders in determining compliance. In this practice setting, management by primary care physicians did not significantly degrade CPAP compliance.

  15. The Rising Frequency of IT Blackouts Indicates the Increasing Relevance of IT Emergency Concepts to Ensure Patient Safety

    PubMed Central

    Sax, U.; Lipprandt, M.

    2016-01-01

    Summary Introduction As many medical workflows depend vastly on IT support, great demands are placed on the availability and accuracy of the applications involved. The cases of IT failure through ransomware at the beginning of 2016 are impressive examples of the dependence of clinical processes on IT. Although IT risk management attempts to reduce the risk of IT blackouts, the probability of partial/total data loss, or even worse, data falsification, is not zero. The objective of this paper is to present the state of the art with respect to strategies, processes, and governance to deal with the failure of IT systems. Methods This article is conducted as a narrative review. Results Worst case scenarios are needed, dealing with methods as to how to survive the downtime of clinical systems, for example through alternative workflows. These workflows have to be trained regularly. We categorize the most important types of IT system failure, assess the usefulness of classic counter measures, and state that most risk management approaches fall short on exactly this matter. Conclusion To ensure that continuous, evidence-based improvements to the recommendations for IT emergency concepts are made, it is essential that IT blackouts and IT disasters are reported, analyzed, and critically discussed. This requires changing from a culture of shame and blame to one of error and safety in healthcare IT. This change is finding its way into other disciplines in medicine. In addition, systematically planned and analyzed simulations of IT disaster may assist in IT emergency concept development. PMID:27830241

  16. The Rising Frequency of IT Blackouts Indicates the Increasing Relevance of IT Emergency Concepts to Ensure Patient Safety.

    PubMed

    Sax, Ulrich; Lipprandt, M; Röhrig, R

    2016-11-10

    As many medical workflows depend vastly on IT support, great demands are placed on the availability and accuracy of the applications involved. The cases of IT failure through ransomware at the beginning of 2016 are impressive examples of the dependence of clinical processes on IT. Although IT risk management attempts to reduce the risk of IT blackouts, the probability of partial/total data loss, or even worse, data falsification, is not zero. The objective of this paper is to present the state of the art with respect to strategies, processes, and governance to deal with the failure of IT systems. This article is conducted as a narrative review. Worst case scenarios are needed, dealing with methods as to how to survive the downtime of clinical systems, for example through alternative workflows. These workflows have to be trained regularly. We categorize the most important types of IT system failure, assess the usefulness of classic counter measures, and state that most risk management approaches fall short on exactly this matter. To ensure that continuous, evidence-based improvements to the recommendations for IT emergency concepts are made, it is essential that IT blackouts and IT disasters are reported, analyzed, and critically discussed. This requires changing from a culture of shame and blame to one of error and safety in healthcare IT. This change is finding its way into other disciplines in medicine. In addition, systematically planned and analyzed simulations of IT disaster may assist in IT emergency concept development.

  17. Multiorgan failure following mass wasp stings.

    PubMed

    Lin, Cheng-Jui; Wu, Chih-Jen; Chen, Han-Hsiang; Lin, Hsin-Chang

    2011-05-01

    Wasp bites usually bring temporary discomfort and pain, but on occasion, they can cause serious infections and fatal allergic reactions. We report on a patient who experienced massive wasp stings and developed multiple organ failure, including acute kidney, hepatic failure, and circulatory collapse 4 days later. He was treated with aggressive fluid resuscitation, inotropic agent, intravenous injection of steroids, broad-spectrum antibiotics, and hemodialysis. After intensive treatment, his liver function recovered one month later. Recovery of renal function was delayed, and the patient needed temporary regular hemodialysis. The pathology of kidney biopsy showed acute tubulointerstitial nephritis. This case shows that toxic reactions following massive wasp attacks may happen several days after the fact and result in severe, multiorgan system dysfunction.

  18. Subcortical processing of speech regularities underlies reading and music aptitude in children.

    PubMed

    Strait, Dana L; Hornickel, Jane; Kraus, Nina

    2011-10-17

    Neural sensitivity to acoustic regularities supports fundamental human behaviors such as hearing in noise and reading. Although the failure to encode acoustic regularities in ongoing speech has been associated with language and literacy deficits, how auditory expertise, such as the expertise that is associated with musical skill, relates to the brainstem processing of speech regularities is unknown. An association between musical skill and neural sensitivity to acoustic regularities would not be surprising given the importance of repetition and regularity in music. Here, we aimed to define relationships between the subcortical processing of speech regularities, music aptitude, and reading abilities in children with and without reading impairment. We hypothesized that, in combination with auditory cognitive abilities, neural sensitivity to regularities in ongoing speech provides a common biological mechanism underlying the development of music and reading abilities. We assessed auditory working memory and attention, music aptitude, reading ability, and neural sensitivity to acoustic regularities in 42 school-aged children with a wide range of reading ability. Neural sensitivity to acoustic regularities was assessed by recording brainstem responses to the same speech sound presented in predictable and variable speech streams. Through correlation analyses and structural equation modeling, we reveal that music aptitude and literacy both relate to the extent of subcortical adaptation to regularities in ongoing speech as well as with auditory working memory and attention. Relationships between music and speech processing are specifically driven by performance on a musical rhythm task, underscoring the importance of rhythmic regularity for both language and music. These data indicate common brain mechanisms underlying reading and music abilities that relate to how the nervous system responds to regularities in auditory input. Definition of common biological underpinnings for music and reading supports the usefulness of music for promoting child literacy, with the potential to improve reading remediation.

  19. Regular wine consumption in chronic heart failure: impact on outcomes, quality of life, and circulating biomarkers.

    PubMed

    Cosmi, Franco; Di Giulio, Paola; Masson, Serge; Finzi, Andrea; Marfisi, Rosa Maria; Cosmi, Deborah; Scarano, Marco; Tognoni, Gianni; Maggioni, Aldo P; Porcu, Maurizio; Boni, Silvana; Cutrupi, Giovanni; Tavazzi, Luigi; Latini, Roberto

    2015-05-01

    Moderate, regular alcohol consumption is generally associated with a lower risk of cardiovascular events but data in patients with chronic heart failure are scarce. We evaluated the relations between wine consumption, health status, circulating biomarkers, and clinical outcomes in a large Italian population of patients with chronic heart failure enrolled in a multicenter clinical trial. A brief questionnaire on dietary habits was administered at baseline to 6973 patients enrolled in the Gruppo Italiano per lo Studio della Sopravvivenza nell'Insufficienza Cardiaca-Heart Failure (GISSI-HF) trial. The relations between wine consumption, fatal and nonfatal clinical end points, quality of life, symptoms of depression, and circulating biomarkers of cardiac function and inflammation (in subsets of patients) were evaluated with simple and multivariable-adjusted statistical models. Almost 56% of the patients reported drinking at least 1 glass of wine per day. After adjustment, clinical outcomes were not significantly different in the predefined 4 groups of wine consumption. However, patients with more frequent wine consumption had a significantly better perception of health status (Kansas City Cardiomyopathy Questionnaire score, adjusted P<0.0001), less frequent symptoms of depression (Geriatric Depression Scale, adjusted P=0.01), and lower plasma levels of biomarkers of vascular inflammation (osteoprotegerin and C-terminal proendothelin-1, adjusted P<0.0001, and pentraxin-3, P=0.01) after adjusting for possible confounders. We show for the first time in a large cohort of patients with chronic heart failure that moderate wine consumption is associated with a better perceived and objective health status, lower prevalence of depression, and less vascular inflammation, but does not translate into more favorable clinical 4-year outcomes. URL: http://www.clinicaltrials.gov. Unique identifier: NCT0033633. © 2015 American Heart Association, Inc.

  20. Regular intermittent bolus provides similar incidence of maternal fever compared with continuous infusion during epidural labor analgesia.

    PubMed

    Feng, Shan-Wu; Xu, Shi-Qin; Ma, Li; Li, Cai-Juan; Wang, Xian; Yuan, Hong-Mei; Wang, Fu-Zhou; Shen, Xiao-Feng; Ding, Zheng-Nian

    2014-10-01

    To compare the effects of regular intermittent bolus versus continuous infusion for epidural labor analgesia on maternal temperature and serum interleukin-6 (IL-6) level. This randomized trial was performed in Nanjing Maternity and Child Health Care Hospital, Nanjing, Jiangsu Province, China between October 2012 and February 2014. Either regular intermittent bolus (RIB, n=66) or continuous infusion (CI, n=66) was used for epidural labor analgesia. A bolus dose (10 ml of 0.08% ropivacaine + 0.4 ug·ml-1 sufentanil) was manually administrated once an hour in the RIB group, whereas the same solution was continuously infused at a constant rate of 10 ml·h-1 in the CI group. Maternal tympanic temperature and serum IL-6 level were measured hourly from baseline to one hour post partum. The incidences of fever (>/=38 degree celsius ) were calculated. The incidence of maternal fever was similar between the 2 groups. There was a rising trend in mean temperature over time in both groups, but no statistical difference was detected between the groups at respective time points; maternal serum IL-6 showed similar changes. Compared with continuous infusion, regular intermittent bolus presents with the same incidence of maternal fever for epidural labor analgesia. Interleukin-6 elevation could be involved in mean maternal temperature increase. 

  1. Spelling Impairments in Italian Dyslexic Children with and without a History of Early Language Delay. Are There Any Differences?

    PubMed

    Angelelli, Paola; Marinelli, Chiara V; Iaia, Marika; Putzolu, Anna; Gasperini, Filippo; Brizzolara, Daniela; Chilosi, Anna M

    2016-01-01

    Language delay is considered a frequent antecedent of literacy problems and both may be linked to phonological impairment. However, while several studies have examined the relationship between language delay and reading impairment, relatively few have focused on spelling. In this study, spelling performance of 28 children with developmental dyslexia (DD), 14 children with a history of language delay (LD), and 14 children without (NoLD) and 28 control participants were examined. Spelling was investigated by a writing to dictation task that included orthographically regular stimuli (word and non-words), as well as words with unpredictable transcription. Results indicated that all dyslexic participants underperformed compared to controls on both regular and unpredictable transcription stimuli, but LD performance was generally the worst. Moreover, spelling impairment assumed different characteristics in LD and NoLD children. LD children were more sensitive to acoustic-to-phonological variables, showing relevant failure especially on stimuli containing geminate consonants but also on polysyllabic stimuli and those containing non-continuant consonants. Error analysis confirmed these results, with LD children producing a higher rate of phonological errors respect to NoLD children and controls. Results were coherent with the hypothesis that among dyslexic children, those with previous language delay have more severe spelling deficit, suffering from defective orthographic lexical acquisition together with long-lasting phonological difficulties.

  2. Spelling Impairments in Italian Dyslexic Children with and without a History of Early Language Delay. Are There Any Differences?

    PubMed Central

    Angelelli, Paola; Marinelli, Chiara V.; Iaia, Marika; Putzolu, Anna; Gasperini, Filippo; Brizzolara, Daniela; Chilosi, Anna M.

    2016-01-01

    Language delay is considered a frequent antecedent of literacy problems and both may be linked to phonological impairment. However, while several studies have examined the relationship between language delay and reading impairment, relatively few have focused on spelling. In this study, spelling performance of 28 children with developmental dyslexia (DD), 14 children with a history of language delay (LD), and 14 children without (NoLD) and 28 control participants were examined. Spelling was investigated by a writing to dictation task that included orthographically regular stimuli (word and non-words), as well as words with unpredictable transcription. Results indicated that all dyslexic participants underperformed compared to controls on both regular and unpredictable transcription stimuli, but LD performance was generally the worst. Moreover, spelling impairment assumed different characteristics in LD and NoLD children. LD children were more sensitive to acoustic-to-phonological variables, showing relevant failure especially on stimuli containing geminate consonants but also on polysyllabic stimuli and those containing non-continuant consonants. Error analysis confirmed these results, with LD children producing a higher rate of phonological errors respect to NoLD children and controls. Results were coherent with the hypothesis that among dyslexic children, those with previous language delay have more severe spelling deficit, suffering from defective orthographic lexical acquisition together with long-lasting phonological difficulties. PMID:27148135

  3. System Proposal for Mass Transit Service Quality Control Based on GPS Data

    PubMed Central

    Padrón, Gabino; Cristóbal, Teresa; Alayón, Francisco; Quesada-Arencibia, Alexis; García, Carmelo R.

    2017-01-01

    Quality is an essential aspect of public transport. In the case of regular public passenger transport by road, punctuality and regularity are criteria used to assess quality of service. Calculating metrics related to these criteria continuously over time and comprehensively across the entire transport network requires the handling of large amounts of data. This article describes a system for continuously and comprehensively monitoring punctuality and regularity. The system uses location data acquired continuously in the vehicles and automatically transferred for analysis. These data are processed intelligently by elements that are commonly used by transport operators: GPS-based tracking system, onboard computer and wireless networks for mobile data communications. The system was tested on a transport company, for which we measured the punctuality of one of the routes that it operates; the results are presented in this article. PMID:28621745

  4. System Proposal for Mass Transit Service Quality Control Based on GPS Data.

    PubMed

    Padrón, Gabino; Cristóbal, Teresa; Alayón, Francisco; Quesada-Arencibia, Alexis; García, Carmelo R

    2017-06-16

    Quality is an essential aspect of public transport. In the case of regular public passenger transport by road, punctuality and regularity are criteria used to assess quality of service. Calculating metrics related to these criteria continuously over time and comprehensively across the entire transport network requires the handling of large amounts of data. This article describes a system for continuously and comprehensively monitoring punctuality and regularity. The system uses location data acquired continuously in the vehicles and automatically transferred for analysis. These data are processed intelligently by elements that are commonly used by transport operators: GPS-based tracking system, onboard computer and wireless networks for mobile data communications. The system was tested on a transport company, for which we measured the punctuality of one of the routes that it operates; the results are presented in this article.

  5. 29 CFR 778.209 - Method of inclusion of bonus in regular rate.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 3 2012-07-01 2012-07-01 false Method of inclusion of bonus in regular rate. 778.209 Section 778.209 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF... COMPENSATION Payments That May Be Excluded From the âRegular Rateâ Bonuses § 778.209 Method of inclusion of...

  6. 29 CFR 778.209 - Method of inclusion of bonus in regular rate.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 3 2013-07-01 2013-07-01 false Method of inclusion of bonus in regular rate. 778.209 Section 778.209 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF... COMPENSATION Payments That May Be Excluded From the âRegular Rateâ Bonuses § 778.209 Method of inclusion of...

  7. 29 CFR 778.209 - Method of inclusion of bonus in regular rate.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 3 2014-07-01 2014-07-01 false Method of inclusion of bonus in regular rate. 778.209 Section 778.209 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF... COMPENSATION Payments That May Be Excluded From the âRegular Rateâ Bonuses § 778.209 Method of inclusion of...

  8. 29 CFR 778.209 - Method of inclusion of bonus in regular rate.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Method of inclusion of bonus in regular rate. 778.209 Section 778.209 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF... COMPENSATION Payments That May Be Excluded From the âRegular Rateâ Bonuses § 778.209 Method of inclusion of...

  9. 29 CFR 778.209 - Method of inclusion of bonus in regular rate.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 3 2011-07-01 2011-07-01 false Method of inclusion of bonus in regular rate. 778.209 Section 778.209 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF... COMPENSATION Payments That May Be Excluded From the âRegular Rateâ Bonuses § 778.209 Method of inclusion of...

  10. 49 CFR 193.2515 - Investigations of failures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ....2515 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY LIQUEFIED NATURAL GAS FACILITIES: FEDERAL SAFETY STANDARDS Operations § 193.2515 Investigations of failures. (a) Each...

  11. Heart Truth for Women: If You Have Heart Disease

    MedlinePlus

    ... failure and a damaged heart muscle. My experience with heart disease started with typical symptoms. It took me some time to get my strength back, but now I exercise regularly and eat healthy foods. To ... counseling, and training. This part of rehab helps you understand your ...

  12. Experimental tests and numerical analyses of steel truss bridge gusset connections.

    DOT National Transportation Integrated Search

    2012-11-01

    Gusset plates connect individual steel truss bridge members together at a node. In 10% of the 200,000 steel bridges in US in 2008, failure of a : single truss or connection could lead to collapse. Regular inspection and load rating are essential for ...

  13. A preliminary evaluation of a reusable digital sterilization indicator prototype.

    PubMed

    Puttaiah, R; Griggs, J; D'Onofrio, M

    2014-09-01

    Sterilization of critical and semicritical instruments used in patient care must undergo a terminal process of sterilization. Use of chemical and physical indicators are important in providing information on the sterilizer's performance during each cycle. Regular and periodic monitoring of sterilizers using biological indicators is necessary in periodically validating performance of sterilizers. Data loggers or independent digital parametric indicators are innovative devices that provide more information than various classes chemical indicators. In this study we evaluated a prototype of an independent digital parametric indicator's use in autoclaves. The purpose of this study was to evaluate the performance of an independent digital indicator/data logger prototype (DS1922F) that could be used for multiple cycles within an autoclave.MG Materials and methods: Three batches of the DS1922F (150 samples) were used in this study that was conducted in a series. The first batch was challenged with 300 sterilization cycles within an autoclave and the data loggers evaluated to study failures and the reason for failure, make corrections and improve the prototype design. After changes made based on studying the first batch, the second batch of the prototype (150 samples) were challenged once again with 300 sterilization cycles within an autoclave and failure studied again in further improvement of the prototype. The final batch (3rd batch) of the prototype (150 samples) was challenged again but with 600 cycles to see how long they would last. Kaplan-Meier survival analysis analyses of all three batches was conducted (α = 0.05) and failed samples qualitatively studied in understanding the variables involved in the failure of the prototype, and in improving quality. Each tested batch provided crucial information on device failure and helped in improvement of the prototype. Mean lifetime survival of the final batch (Batch 3) of prototype was 498 (480, 516) sterilization cycles in an autoclave. In this study, the final batch of the DS1922F prototype data logger was found to be robust in withstanding the challenge of 600 autoclave cycles, with a mean lifetime of more than 450 cycles, multiple times more than prescribed number of cycles. Instrument reprocessing is among the important aspects of infection control. While stringent procedures are followed in instrument reprocessing within the clinic in assuring patient safety, regular use of sterilization process indicators and periodic biological validation of the sterilizer's performance is necessary. Chemical indicators for use in Autoclaves provide information on whether the particular cycle's parameters were achieved but do not provide at what specific point in time or temperature the failure occurred. Data loggers and associated reader software as the tested prototype in this evaluation (DS1922F), are designed to provide continuous information on time and temperature of the prescribed cycle. Data loggers provide immediate information on the process as opposed to Biological Indicators that take from days to a week in obtaining a confirmatory result. Further, many countries do not have the sterilization monitoring service infrastructure to meet the demands of the end users. In the absence of sterilization monitoring services, use of digital data loggers for each sterilization cycle is more pragmatic.

  14. Continuous infusion or bolus injection of loop diuretics for congestive heart failure?

    PubMed

    Zepeda, Patricio; Rain, Carmen; Sepúlveda, Paola

    2016-04-22

    Loop diuretics are widely used in acute heart failure. However, there is controversy about the superiority of continuous infusion over bolus administration. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified four systematic reviews including 11 pertinent randomized controlled trials overall. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded continuous administration of loop diuretics probably reduces mortality and length of stay compared to intermittent administration in patients with acute heart failure.

  15. An Appropriate Population for Acute Inpatient Rehabilitation? A Case Series of Three Patients With Advanced Heart Failure on Continuous Inotropic Support.

    PubMed

    McCormick, Zachary L; Chu, Samuel K; Goodman, Daniel; Oswald, Matthew; Reger, Christopher; Sliwa, James

    2015-06-01

    The number of individuals with heart failure and the treatment modalities available to manage heart failure are increasing. Continuous inotropic support is a treatment modality used in cases of severe heart failure. Although most patients initiated on continuous inotropic support are discharged home, those with greater functional compromise, comorbid conditions that cause disability, or other significant medical complexity may be referred to acute inpatient rehabilitation. The feasibility and benefits of acute inpatient rehabilitation in this population, however, has yet to be investigated. We report the functional progress and medical complications of 3 patients on continuous inotropic support who participated in acute inpatient rehabilitation. The patients demonstrated varying levels of success, highlighting a need for evidence-based, preadmission screening criteria for this population. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  16. 26 CFR 1.857-4 - Tax imposed by reason of the failure to meet certain source-of-income requirements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Real Estate Investment Trusts § 1.857-4 Tax imposed by reason of the failure to meet certain source-of-income requirements. Section 857... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Tax imposed by reason of the failure to meet...

  17. Mining Clinicians' Electronic Documentation to Identify Heart Failure Patients with Ineffective Self-Management: A Pilot Text-Mining Study.

    PubMed

    Topaz, Maxim; Radhakrishnan, Kavita; Lei, Victor; Zhou, Li

    2016-01-01

    Effective self-management can decrease up to 50% of heart failure hospitalizations. Unfortunately, self-management by patients with heart failure remains poor. This pilot study aimed to explore the use of text-mining to identify heart failure patients with ineffective self-management. We first built a comprehensive self-management vocabulary based on the literature and clinical notes review. We then randomly selected 545 heart failure patients treated within Partners Healthcare hospitals (Boston, MA, USA) and conducted a regular expression search with the compiled vocabulary within 43,107 interdisciplinary clinical notes of these patients. We found that 38.2% (n = 208) patients had documentation of ineffective heart failure self-management in the domains of poor diet adherence (28.4%), missed medical encounters (26.4%) poor medication adherence (20.2%) and non-specified self-management issues (e.g., "compliance issues", 34.6%). We showed the feasibility of using text-mining to identify patients with ineffective self-management. More natural language processing algorithms are needed to help busy clinicians identify these patients.

  18. A New Challenge for Compression Algorithms: Genetic Sequences.

    ERIC Educational Resources Information Center

    Grumbach, Stephane; Tahi, Fariza

    1994-01-01

    Analyzes the properties of genetic sequences that cause the failure of classical algorithms used for data compression. A lossless algorithm, which compresses the information contained in DNA and RNA sequences by detecting regularities such as palindromes, is presented. This algorithm combines substitutional and statistical methods and appears to…

  19. Pyrrolizidine alkaloids: Potential role in the etiology of cancers, pulmonary hypertension, congenital anomalies, and liver disease

    USDA-ARS?s Scientific Manuscript database

    Large outbreaks of acute food-related poisoning, characterized by hepatic sinusoidal obstruction syndrome, hemorrhagic necrosis, and rapid liver failure, occur on a regular basis in some countries. They are caused by 1,2-dehydropyrrolizidine alkaloids contaminating locally grown grain. Similar acute...

  20. Heart Failure with Recovered EF and Heart Failure with Mid-Range EF: Current Recommendations and Controversies.

    PubMed

    Unkovic, Peter; Basuray, Anupam

    2018-04-03

    This review explores key features and potential management controversies in two emerging populations in heart failure: heart failure with recovered ejection fraction (HF-recovered EF) and heart failure with mid-range ejection fraction (HFmrEF). While HF-recovered EF patients have better outcomes than heart failure with reduced ejection fraction (HFrEF), they continue to have symptoms, persistent biomarker elevations, and abnormal outcomes suggesting a continued disease process. HFmrEF patients appear to have features of HFrEF and heart failure with preserved ejection fraction (HFpEF), but have a high prevalence of ischemic heart disease and may represent a transitory phase between the HFrEF and HFpEF. Management strategies have insufficient data to warrant standardization at this time. HF-recovered EF and HFmrEF represent new populations with unmet needs and expose the pitfalls of an EF basis for heart failure classification.

  1. [Relationship between breast milk composition and weight growth velocity of infants fed with exclusive breast milk].

    PubMed

    Huang, Li-Li; Xiong, Fei; Yang, Fan

    2016-10-01

    To study the effect of breast milk composition on weight growth velocity of infants fed with exclusive breast milk. One hundred and thirty-eight full-term singleton infants who received regular follow-up visits and fed with exclusive breast milk and their mothers were recruited. Body height, weight and head circumference of these infants were measured at regular visits. Z scores were used to evaluate growth velocity. The subjects were classified into a failure to thrive group (ΔZ scores≤-0.67), a poor growth group (-0.67<ΔZ scores<0) and a normal control group (ΔZ scores≥0). The samples of mature breast milk were collected for composition analysis. The differences in the levels of the protein, fats, energy, carbohydrates and minerals in breast milk were compared among the three groups. ΔZ scores for weight in the failure to thrive and poor growth groups were lower than in the normal control group (P<0.05). There was no significant difference in the levels of protein, fats and energy in breast milk among the failure to thrive, poor growth and normal control groups. However, the levels of carbohydrates and minerals in both the failure to thrive and poor growth groups were lower than in the normal control group (P<0.05). Weight growth velocity of infants can be affected by the composition of breast milk to a certain degree in a short period. In order to maintain a good weight growth velocity of infants, mothers should have a balanced diet to improve the quality of breast milk.

  2. Verified clinical failure with cefotaxime 1g for treatment of gonorrhoea in the Netherlands: a case report.

    PubMed

    van Dam, Alje P; van Ogtrop, Marc L; Golparian, Daniel; Mehrtens, Jan; de Vries, Henry J C; Unemo, Magnus

    2014-11-01

    We describe the first case of treatment failure of gonorrhoea with a third generation cephalosporin, cefotaxime 1g intramuscularly, in the Netherlands. The case was from a high-frequency transmitting population (men having sex with men) and was caused by the internationally spreading multidrug-resistant gonococcal NG-MAST ST1407 clone. The patient was clinically cured after treatment with ceftriaxone 500 mg intramuscularly and this is the only third generation cephalosporin that should be used for first-line empiric treatment of gonorrhoea. Increased awareness of failures with third generation cephalosporins, enhanced monitoring and appropriate verification of treatment failures including more frequent test-of-cures, and strict adherence to regularly updated treatment guidelines are essential globally. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  3. Premature ovarian failure 3 years after menarche in a 16-year-old girl following human papillomavirus vaccination.

    PubMed

    Little, Deirdre Therese; Ward, Harvey Rodrick Grenville

    2012-09-30

    Premature ovarian failure in a well adolescent is a rare event. Its occurrence raises important questions about causation, which may signal other systemic concerns. This patient presented with amenorrhoea after identifying a change from her regular cycle to irregular and scant periods following vaccinations against human papillomavirus. She declined the oral contraceptives initially prescribed for amenorrhoea. The diagnostic tasks were to determine the reason for her secondary amenorrhoea and then to investigate for possible causes of the premature ovarian failure identified. Although the cause is unknown in 90% of cases, the remaining chief identifiable causes of this condition were excluded. Premature ovarian failure was then notified as a possible adverse event following this vaccination. The young woman was counselled regarding preservation of bone density, reproductive implications and relevant follow-up. This event could hold potential implications for population health and prompts further inquiry.

  4. Expert system for identification of simultaneous and sequential reactor fuel failures with gas tagging

    DOEpatents

    Gross, Kenny C.

    1994-01-01

    Failure of a fuel element in a nuclear reactor core is determined by a gas tagging failure detection system and method. Failures are catalogued and characterized after the event so that samples of the reactor's cover gas are taken at regular intervals and analyzed by mass spectroscopy. Employing a first set of systematic heuristic rules which are applied in a transformed node space allows the number of node combinations which must be processed within a barycentric algorithm to be substantially reduced. A second set of heuristic rules treats the tag nodes of the most recent one or two leakers as "background" gases, further reducing the number of trial node combinations. Lastly, a "fuzzy" set theory formalism minimizes experimental uncertainties in the identification of the most likely volumes of tag gases. This approach allows for the identification of virtually any number of sequential leaks and up to five simultaneous gas leaks from fuel elements.

  5. 49 CFR 192.617 - Investigation of failures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY TRANSPORTATION OF NATURAL AND OTHER GAS BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Operations § 192.617 Investigation of failures. Each...

  6. Multiorgan failure and antiphospholipid antibodies: the catastrophic antiphospholipid (Asherson's) syndrome.

    PubMed

    Asherson, Ronald A

    2005-01-01

    A review of 250 patients with the catastrophic antiphospholipid (Asherson's) syndrome (CAPS) taken from the web site organized by the Europhospholipid Group (http://www.med.ub.es/MIMMUN/FORUM/CAPS.HTM) is presented in this paper. A short historical overview of the antiphospholipid syndrome (APS) is followed by a description of the "triggering" factors, associated autoimmune diseases, clinical presentation, presumed pathogenesis, prognosis, mode of death and suggested therapies. Triggering factors are present in approximately 50% of patients and consist predominantly of infections, trauma, including minor surgical procedures such as biopsies, obstetric-related multiorgan failure and malignancy-associated CAPS. The patients present mainly with multiorgan failure resulting from predominantly small vessel occlusions affecting mainly intra-abdominal organs such as bowel, liver, pancreas, and adrenals, although large vessel occlusions do occur and comprise mainly deep vein thromboses (DVT) of the veins of the lower limbs and arterial occlusions causing strokes and peripheral gangrene. They do not however dominate the clinical picture. The condition differs considerably from the simple/classic APS in several respects, viz. the rapid development of multiorgan failure following the above-mentioned identifiable precipitating factors, the involvement of unusual organs such as bowel, reproductive organs, and bone marrow, complicating features of disseminated intravascular coagulation in 20% of cases, the acute (adult) respiratory distress syndrome (ARDS) in one third of patients, and severe thrombocytopenia; these not being encountered in the simple/classic APS. Treatment consisting of regular and repeated plasma exchanges using fresh frozen plasma, and IV immunoglobulins in addition to parenteral steroids and anticoagulation are necessary to improve the survival in a condition where the mortality is still of the order of 50%. Treatment may have to be continued for several weeks. Parenteral antibiotics may be indicated where an underlying infection is suspected. Antifungal therapy may also be indicated with prolonged treatment and the use of the monoclonal anti-CD20 molecule, Rituximab, has proven useful in those patients where thrombocytopenia poses a major risk of hemorrhage.

  7. Multi-Hazard Assessment of Scour Damaged Bridges with UAS-Based Measurements

    NASA Astrophysics Data System (ADS)

    Özcan, O.; Ozcan, O.

    2017-12-01

    Flood and stream induced scour occurring in bridge piers constructed on rivers is one of the mostly observed failure reasons in bridges. Scour induced failure risk in bridges and determination of the alterations in bridge safety under seismic effects has the ultimate importance. Thus, for the determination of bridge safety under the scour effects, the scour amount under bridge piers should be designated realistically and should be tracked and updated continuously. Hereby, the scour induced failures in bridge foundation systems will be prevented and bridge substructure design will be conducted safely. In this study, in order to measure the amount of scour in bridge load bearing system (pile foundations and pile abutments) and to attain very high definition 3 dimensional models of river flood plain for the flood analysis, unmanned aircraft system (UAS) based measurement methods were implemented. UAS based measurement systems provide new and practical approach and bring high precision and reliable solutions considering recent measurement systems. For this purpose, the reinforced concrete (RC) bridge that is located on Antalya Boğaçayı River, Turkey and that failed in 2003 due to flood-induced scour was selected as the case study. The amount of scour occurred in bridge piers and piles was determined realistically and the behavior of bridge piers under scour effects was investigated. Future flood effects and the resultant amount of scour was determined with HEC-RAS software by using digital surface models that were obtained at regular intervals using UAS for the riverbed. In the light of the attained scour measurements and expected scour after a probable flood event, the behavior of scour damaged RC bridge was investigated by pushover and time history analyses under lateral and vertical seismic loadings. In the analyses, the load and displacement capacity of bridge was observed to diminish significantly under expected scour. Thus, the deterioration in multi hazard performance of the bridge was monitored significantly in the light of updated bridge load bearing system capacity. Regarding the case study, UAS based and continuously updated bridge multi hazard risk detection system was established that can be used for bridges located on riverbed.

  8. High-Intensity Interval Training in Patients With Heart Failure With Reduced Ejection Fraction

    PubMed Central

    Halle, Martin; Conraads, Viviane; Støylen, Asbjørn; Dalen, Håvard; Delagardelle, Charles; Larsen, Alf-Inge; Hole, Torstein; Mezzani, Alessandro; Van Craenenbroeck, Emeline M.; Videm, Vibeke; Beckers, Paul; Christle, Jeffrey W.; Winzer, Ephraim; Mangner, Norman; Woitek, Felix; Höllriegel, Robert; Pressler, Axel; Monk-Hansen, Tea; Snoer, Martin; Feiereisen, Patrick; Valborgland, Torstein; Kjekshus, John; Hambrecht, Rainer; Gielen, Stephan; Karlsen, Trine; Prescott, Eva; Linke, Axel

    2017-01-01

    Background: Small studies have suggested that high-intensity interval training (HIIT) is superior to moderate continuous training (MCT) in reversing cardiac remodeling and increasing aerobic capacity in patients with heart failure with reduced ejection fraction. The present multicenter trial compared 12 weeks of supervised interventions of HIIT, MCT, or a recommendation of regular exercise (RRE). Methods: Two hundred sixty-one patients with left ventricular ejection fraction ≤35% and New York Heart Association class II to III were randomly assigned to HIIT at 90% to 95% of maximal heart rate, MCT at 60% to 70% of maximal heart rate, or RRE. Thereafter, patients were encouraged to continue exercising on their own. Clinical assessments were performed at baseline, after the intervention, and at follow-up after 52 weeks. Primary end point was a between-group comparison of change in left ventricular end-diastolic diameter from baseline to 12 weeks. Results: Groups did not differ in age (median, 60 years), sex (19% women), ischemic pathogenesis (59%), or medication. Change in left ventricular end-diastolic diameter from baseline to 12 weeks was not different between HIIT and MCT (P=0.45); left ventricular end-diastolic diameter changes compared with RRE were −2.8 mm (−5.2 to −0.4 mm; P=0.02) in HIIT and −1.2 mm (−3.6 to 1.2 mm; P=0.34) in MCT. There was also no difference between HIIT and MCT in peak oxygen uptake (P=0.70), but both were superior to RRE. However, none of these changes was maintained at follow-up after 52 weeks. Serious adverse events were not statistically different during supervised intervention or at follow-up at 52 weeks (HIIT, 39%; MCT, 25%; RRE, 34%; P=0.16). Training records showed that 51% of patients exercised below prescribed target during supervised HIIT and 80% above target in MCT. Conclusions: HIIT was not superior to MCT in changing left ventricular remodeling or aerobic capacity, and its feasibility remains unresolved in patients with heart failure. Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00917046. PMID:28082387

  9. High-Intensity Interval Training in Patients With Heart Failure With Reduced Ejection Fraction.

    PubMed

    Ellingsen, Øyvind; Halle, Martin; Conraads, Viviane; Støylen, Asbjørn; Dalen, Håvard; Delagardelle, Charles; Larsen, Alf-Inge; Hole, Torstein; Mezzani, Alessandro; Van Craenenbroeck, Emeline M; Videm, Vibeke; Beckers, Paul; Christle, Jeffrey W; Winzer, Ephraim; Mangner, Norman; Woitek, Felix; Höllriegel, Robert; Pressler, Axel; Monk-Hansen, Tea; Snoer, Martin; Feiereisen, Patrick; Valborgland, Torstein; Kjekshus, John; Hambrecht, Rainer; Gielen, Stephan; Karlsen, Trine; Prescott, Eva; Linke, Axel

    2017-02-28

    Small studies have suggested that high-intensity interval training (HIIT) is superior to moderate continuous training (MCT) in reversing cardiac remodeling and increasing aerobic capacity in patients with heart failure with reduced ejection fraction. The present multicenter trial compared 12 weeks of supervised interventions of HIIT, MCT, or a recommendation of regular exercise (RRE). Two hundred sixty-one patients with left ventricular ejection fraction ≤35% and New York Heart Association class II to III were randomly assigned to HIIT at 90% to 95% of maximal heart rate, MCT at 60% to 70% of maximal heart rate, or RRE. Thereafter, patients were encouraged to continue exercising on their own. Clinical assessments were performed at baseline, after the intervention, and at follow-up after 52 weeks. Primary end point was a between-group comparison of change in left ventricular end-diastolic diameter from baseline to 12 weeks. Groups did not differ in age (median, 60 years), sex (19% women), ischemic pathogenesis (59%), or medication. Change in left ventricular end-diastolic diameter from baseline to 12 weeks was not different between HIIT and MCT ( P =0.45); left ventricular end-diastolic diameter changes compared with RRE were -2.8 mm (-5.2 to -0.4 mm; P =0.02) in HIIT and -1.2 mm (-3.6 to 1.2 mm; P =0.34) in MCT. There was also no difference between HIIT and MCT in peak oxygen uptake ( P =0.70), but both were superior to RRE. However, none of these changes was maintained at follow-up after 52 weeks. Serious adverse events were not statistically different during supervised intervention or at follow-up at 52 weeks (HIIT, 39%; MCT, 25%; RRE, 34%; P =0.16). Training records showed that 51% of patients exercised below prescribed target during supervised HIIT and 80% above target in MCT. HIIT was not superior to MCT in changing left ventricular remodeling or aerobic capacity, and its feasibility remains unresolved in patients with heart failure. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00917046. © 2017 The Authors.

  10. Creating an educationally minded schedule: one approach to minimize the impact of duty hour standards on intern continuity clinic experience.

    PubMed

    DeBlasio, Dominick; Kerrey, M Kathleen; Sucharew, Heidi; Klein, Melissa

    2014-11-01

    To determine if implementing an educationally minded schedule utilizing consecutive night shifts can moderate the impact of the 2011 duty hour standards on education and patient continuity of care in longitudinal primary care experience (continuity clinic). A 14-month pre-post study was performed in continuity clinic with one supervising physician group and two intern groups. Surveys to assess attitudes and education were distributed to the supervising physicians and interns before and after the changes in duty hour standards. Intern groups' schedules were reviewed for the number of regular and alternative day clinic (i.e. primary care experience on a different weekday) sessions and patient continuity of care. Fifteen supervising physicians and 51 interns participated (25 in 2011, 26 in 2012). Intern groups' comfort when discussing patient issues, educational needs and teamwork perception did not differ. Supervising physicians' understanding of learning needs and provision of feedback did not differ between groups. Supervising physicians indicated a greater ability to provide feedback and understand learning needs during regular continuity clinic sessions compared with alternative day clinics (all p < 0.05). No significant difference was detected between intern groups in the number of regularly scheduled continuity clinics, alternative day clinics or patient continuity of care. The 2011 duty hour standards required significant alterations to intern schedules, but educationally minded scheduling limited impact on education and patient continuity in care.

  11. Platform-Switching for Cemented Versus Screwed Fixed Dental Prostheses: Reliability and Failure Modes: An In Vitro Study.

    PubMed

    Anchieta, Rodolfo Brunieira; Machado, Lucas Silveira; Hirata, Ronaldo; Bonfante, Estevam Augusto; Coelho, Paulo G

    2016-08-01

    The aim of this study was to evaluate the probability of survival of cemented and screwed three-unit implant-supported fixed dental prostheses (ISFDP) using different implant-abutment horizontal matching configurations (regular vs switching platforms). One hundred and sixty-eight implants with internal hexagon connection (4 mm diameter, 10 mm length, Emfils; Colosso Evolution System, Itú, SP, Brazil) were selected for this study according to the horizontal implant-abutment matching configuration (regular or switching) and retention method and divided in four groups (n = 21 per group) as follows: 1) regular platform cemented (IRC); 2) or screw-retained (IRS); 3) switched-platform cemented (ISC); or 4) screw-retained (ISS). Regular and platform-switched abutments (Colosso evolution, 4 mm and 3.3 mm, respectively) were torqued, and 84 three-unit metal bridges were fabricated (first molar pontic). Implants were embedded in polymethyl-methacrylate resin and subjected to step-stress accelerated life testing in water. Weibull distribution was used to determine the probability of survival for a mission of 100,000 cycles at 400 N (90% two-sided confidence intervals). Polarized light and scanning electron microscopes were used for fractographic analysis. The β values of 0.50, 1.19, 1.25, and 1.95 for groups IRC, IRS, ISC, and ISS respectively, indicated that fatigue accelerated the failure for all groups, except IRC. The cement-retained groups presented significantly higher probability of survival (IRC - 98%, ISC - 59%) than screw-retained groups (IRS - 23% and ISS - 0%). Screw-retained FDPs exclusively failed by abutment-screw fractures, whereas cement-retained presented implant/screw/abutment fractures. The probability of survival of cement-retained ISFDP was higher than screw-retained, irrespective of implant-abutment horizontal configuration. © 2015 Wiley Periodicals, Inc.

  12. Adoption of electronic health records and barriers

    PubMed Central

    Palabindala, Venkataraman; Pamarthy, Amaleswari; Jonnalagadda, Nageshwar Reddy

    2016-01-01

    Electronic health records (EHR) are not a new idea in the U.S. medical system, but surprisingly there has been very slow adoption of fully integrated EHR systems in practice in both primary care settings and within hospitals. For those who have invested in EHR, physicians report high levels of satisfaction and confidence in the reliability of their system. There is also consensus that EHR can improve patient care, promote safe practice, and enhance communication between patients and multiple providers, reducing the risk of error. As EHR implementation continues in hospitals, administrative and physician leadership must actively investigate all of the potential risks for medical error, system failure, and legal responsibility before moving forward. Ensuring that physicians are aware of their responsibilities in relation to their charting practices and the depth of information available within an EHR system is crucial for minimizing the risk of malpractice and lawsuit. Hospitals must commit to regular system upgrading and corresponding training for all users to reduce the risk of error and adverse events. PMID:27802857

  13. Incipient fault diagnosis of power transformers using optical spectro-photometric technique

    NASA Astrophysics Data System (ADS)

    Hussain, K.; Karmakar, Subrata

    2015-06-01

    Power transformers are the vital equipment in the network of power generation, transmission and distribution. Mineral oil in oil-filled transformers plays very important role as far as electrical insulation for the winding and cooling of the transformer is concerned. As transformers are always under the influence of electrical and thermal stresses, incipient faults like partial discharge, sparking and arcing take place. As a result, mineral oil deteriorates there by premature failure of the transformer occurs causing huge losses in terms of revenue and assets. Therefore, the transformer health condition has to be monitored continuously. The Dissolved Gas Analysis (DGA) is being extensively used for this purpose, but it has some drawbacks like it needs carrier gas, regular instrument calibration, etc. To overcome these drawbacks, Ultraviolet (UV) -Visible and Fourier Transform Infrared (FTIR) Spectro-photometric techniques are used as diagnostic tools for investigating the degraded transformer oil affected by electrical, mechanical and thermal stresses. The technique has several advantages over the conventional DGA technique.

  14. J.-L. Lions' problem concerning maximal regularity of equations governed by non-autonomous forms

    NASA Astrophysics Data System (ADS)

    Fackler, Stephan

    2017-05-01

    An old problem due to J.-L. Lions going back to the 1960s asks whether the abstract Cauchy problem associated to non-autonomous forms has maximal regularity if the time dependence is merely assumed to be continuous or even measurable. We give a negative answer to this question and discuss the minimal regularity needed for positive results.

  15. Factors associated with occupation changes after pregnancy/delivery: result from Japan Environment & Children's pilot study.

    PubMed

    Suga, Reiko; Tsuji, Mayumi; Tanaka, Rie; Shibata, Eiji; Tanaka, Masayuki; Senju, Ayako; Araki, Shunsuke; Morokuma, Seiichi; Sanefuji, Masafumi; Oda, Masako; Mise, Nathan; Baba, Yosuke; Hayama-Terada, Mina; Kusuhara, Koichi; Mitsubuchi, Hiroshi; Katoh, Takahiko; Kawamoto, Toshihiro

    2018-06-05

    In Japan, although the number of females who continue to work after marriage has recently increased, the proportion of those working while parenting their infants is still not clearly increasing, indicating that it is still difficult for them to continue working after delivery. The present study aimed to clarify factors influencing females' continuation of work, using data obtained by continuously following up the same subjects and focusing on occupation changes, family environments, and the type of employment after pregnancy or delivery. Based on the results of the questionnaire survey, which was conducted involving 164 participants at 4 universities, as part of the Japan Environment and Children's Pilot Study (JECS Pilot Study) led by the Ministry of Environment and the National Institute for Environmental Studies, the occupational status was compared between the detection of pregnancy (weeks 0 to 7) and 1 year after delivery. compared with changed their occupations significantly more frequently (OR = 5.07, 95% CI = 2.57-10.01, P < 0.001). Furthermore, on examining in detail, occupation changes were particularly marked among (OR = 12.48, 95% CI = 4.43-35.15, P < 0.001). This tendency was especially shown among  > (OR = 10.36, 95% CI = 1.59-67.38, P = 0.014) and <  > (OR = 15.15, 95% CI = 2.55-90.17, P = 0.003). Analysis revealed that the type of employment, rather than the category of occupation, was associated with the continuation of work after pregnancy or delivery more closely, as compared with continued to work less frequently. Furthermore, on comparison of the category of occupation among ,  > and <  > were shown to be more likely to continue to be engaged in the same occupation after pregnancy or delivery. These differences may be related to availability of the child-care leave program and other support resources, therefore, it may be important to establish social systems that enable all females, to use these support resources if they wish, and actively work, while delivering and parenting their children.

  16. Subcortical processing of speech regularities underlies reading and music aptitude in children

    PubMed Central

    2011-01-01

    Background Neural sensitivity to acoustic regularities supports fundamental human behaviors such as hearing in noise and reading. Although the failure to encode acoustic regularities in ongoing speech has been associated with language and literacy deficits, how auditory expertise, such as the expertise that is associated with musical skill, relates to the brainstem processing of speech regularities is unknown. An association between musical skill and neural sensitivity to acoustic regularities would not be surprising given the importance of repetition and regularity in music. Here, we aimed to define relationships between the subcortical processing of speech regularities, music aptitude, and reading abilities in children with and without reading impairment. We hypothesized that, in combination with auditory cognitive abilities, neural sensitivity to regularities in ongoing speech provides a common biological mechanism underlying the development of music and reading abilities. Methods We assessed auditory working memory and attention, music aptitude, reading ability, and neural sensitivity to acoustic regularities in 42 school-aged children with a wide range of reading ability. Neural sensitivity to acoustic regularities was assessed by recording brainstem responses to the same speech sound presented in predictable and variable speech streams. Results Through correlation analyses and structural equation modeling, we reveal that music aptitude and literacy both relate to the extent of subcortical adaptation to regularities in ongoing speech as well as with auditory working memory and attention. Relationships between music and speech processing are specifically driven by performance on a musical rhythm task, underscoring the importance of rhythmic regularity for both language and music. Conclusions These data indicate common brain mechanisms underlying reading and music abilities that relate to how the nervous system responds to regularities in auditory input. Definition of common biological underpinnings for music and reading supports the usefulness of music for promoting child literacy, with the potential to improve reading remediation. PMID:22005291

  17. How Do You Feel after a Program Failure? TECHNIQUES.

    ERIC Educational Resources Information Center

    Keller, M. Jean; Mills, Helen H.

    1983-01-01

    Program failure has been demonstrated to have both detrimental and enhancing effects upon individuals. Two detrimental reactions to program failures are those of self-doubt and embarrassment. The focus of adult and continuing educators should not be on condemning each other for failure, but on exploring program failure, how it personally affects…

  18. A prospective study of frequency and characteristics of cough during ACE inhibitor treatment.

    PubMed

    Sato, Atsuhisa; Fukuda, Seiichi

    2015-01-01

    Angiotensin converting enzyme (ACE) inhibitors are reportedly effective, and positively indicated in patients with chronic heart failure with decreased contractility, after myocardial infarction, after cerebrovascular disorders, and in those with chronic kidney disease. However, the biggest challenge to continuous use of ACE inhibitors is the adverse reaction of cough. Accordingly, in the present study, we investigated the present state and characteristics of ACE inhibitor-induced cough in patients with essential hypertension currently being treated with an ACE inhibitor for an average of 18 months, who could be regularly checked for cough. Subjects in this study were 176 patients overall (mean age 67 ± 11 years old), 90 men and 86 women. The adverse reaction of cough was observed in 20% of patients, and more frequently in women than in men. However, in 26 of the patients with cough, the cough either resolved naturally or completely disappeared while the treatment continued, after which patients could continue taking the medication. Specifically, ACE inhibitor treatment was eventually discontinued due to cough in 5.1% of patients. Cough occurred less frequently with concomitant calcium antagonists or diuretics than with ACE inhibitor monotherapy. Cough as an adverse reaction occurred at a low frequency when medication was taken at bedtime. We considered a number of measures to counteract cough, then in addition to starting the ACE inhibitor treatment as early as possible, it is important to devise ways for the ACE inhibitor treatment to be continued for as long as possible, through the adept use of these measures.

  19. A SUGGESTED GUIDANCE PROGRAM FOR COMBATING SCHOOL "DROP-OUTS."

    ERIC Educational Resources Information Center

    Boys Club of New York, NY.

    THE PROBLEM OF SCHOOL DROPOUTS WAS CAUSED BY CONSISTENT FAILURE TO ACHIEVE IN REGULAR SCHOOL WORK, GRADE RETENTION, READING802RETARDATI RETARDATION, AND POOR SELF-IMAGE. THE CLUB'S STAFF WOULD HELP SOLVE THIS PROBLEM THROUGH TEACHING, DIRECTING, AND COUNSELING BOYS IN THE AREAS OF HEALTH, COMPATIBILITY, RESPECT, STAYING IN SCHOOL, PLANNING…

  20. Sleep and wake phase of heart beat dynamics by artificial insymmetrised patterns

    NASA Astrophysics Data System (ADS)

    Dudkowska, A.; Makowiec, D.

    2004-05-01

    In order to determine differences between healthy patients and patients with congestive heart failure we apply the artificial insymmetrised pattern (AIP) method. The AIP method by exploring a human eye ability to extract regularities and read symmetries in a dot pattern, serves a tool for qualitative discrimination of heart rate states.

  1. Resilience Does Not Predict Academic Performance in Gross Anatomy

    ERIC Educational Resources Information Center

    Elizondo-Omana, Rodrigo Enrique; Garcia-Rodriguez, Maria de los Angeles; Hinojosa-Amaya, Jose Miguel; Villarreal-Silva, Eliud Enrique; Avilan, Rosa Ivette Guzman; Cruz, Juan Jose Bazaldua; Guzman-Lopez, Santos

    2010-01-01

    Few studies have evaluated resilience in an academic environment as it relates to academic success or failure. This work sought to assess resilience in regular and remedial students of gross anatomy during the first and second semesters of medical school and to correlate this personal trait with academic performance. Two groups of students were…

  2. Evaluation of a Smoking Cessation Program in the U.S. Navy: Implications for Long Term Success and Failure

    DTIC Science & Technology

    1989-05-03

    attempted. In addition, the program participants indicated the brand of cigarette smoked and whether the brand was light or regular, menthol or...light cigarettes than any other group. Preference for non- menthol (versus menthol ) cigarettes was clear for all the groups and most pronounced for Navy...Regular 1220 73.8 30 55.6 I 78 78.8 69 61.6 1298 75.1 99 59.6I II Menthol I 48 16.2 26 25.7 I 26 25.7 31 27.9 74 18.6 57 26.9.I I °I Non- Menthol 1248

  3. Right ventricular strain in heart failure: Clinical perspective.

    PubMed

    Tadic, Marijana; Pieske-Kraigher, Elisabeth; Cuspidi, Cesare; Morris, Daniel A; Burkhardt, Franziska; Baudisch, Ana; Haßfeld, Sabine; Tschöpe, Carsten; Pieske, Burket

    2017-10-01

    The number of studies demonstrating the importance of right ventricular remodelling in a wide range of cardiovascular diseases has increased in the past two decades. Speckle-tracking imaging provides new variables that give comprehensive information about right ventricular function and mechanics. In this review, we summarize current knowledge of right ventricular mechanics in heart failure with reduced ejection fraction and preserved ejection fraction. We searched PubMed, MEDLINE, Ovid and Embase databases for studies published from January 2000 to December 2016 in the English language using the following keywords: "right ventricle"; "strain"; "speckle tracking"; "heart failure with reduced ejection fraction"; and "heart failure with preserved ejection fraction". Investigations showed that right ventricular dysfunction is associated with higher cardiovascular and overall mortality in patients with heart failure, irrespective of ejection fraction. The number of studies investigating right ventricular strain in patients with heart failure with reduced ejection fraction is constantly increasing, whereas data on right ventricular mechanics in patients with heart failure with preserved ejection fraction are limited. Given the high feasibility, accuracy and clinical implications of right ventricular strain in the population with heart failure, it is of great importance to try to include the evaluation of right ventricular strain as a regular part of each echocardiographic examination in patients with heart failure. However, further investigations are necessary to establish right ventricular strain as a standard variable for decision-making. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  4. 32 CFR 732.12 - Eligibility.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NONNAVAL MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.12 Eligibility. (a) Regular members. To be eligible for non-Federal medical, dental, or emergency maternity care at Government expense, Regular active...

  5. 32 CFR 732.12 - Eligibility.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NONNAVAL MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.12 Eligibility. (a) Regular members. To be eligible for non-Federal medical, dental, or emergency maternity care at Government expense, Regular active...

  6. 32 CFR 732.12 - Eligibility.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NONNAVAL MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.12 Eligibility. (a) Regular members. To be eligible for non-Federal medical, dental, or emergency maternity care at Government expense, Regular active...

  7. 32 CFR 732.12 - Eligibility.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NONNAVAL MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.12 Eligibility. (a) Regular members. To be eligible for non-Federal medical, dental, or emergency maternity care at Government expense, Regular active...

  8. 32 CFR 732.12 - Eligibility.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NONNAVAL MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.12 Eligibility. (a) Regular members. To be eligible for non-Federal medical, dental, or emergency maternity care at Government expense, Regular active...

  9. 7 CFR 993.165 - Disposition of reserve prunes.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing... regular commercial trade channels, (2) any foreign government or any agency thereof, except any which normally is serviced through regular commercial trade channels, (3) any foreign country with an average of...

  10. 47 CFR 76.614 - Cable television system regular monitoring.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 4 2011-10-01 2011-10-01 false Cable television system regular monitoring. 76.614 Section 76.614 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Technical Standards § 76.614 Cable television...

  11. 49 CFR 191.12 - Distribution Systems: Mechanical Fitting Failure Reports

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Distribution Systems: Mechanical Fitting Failure Reports 191.12 Section 191.12 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY TRANSPORTATION OF NATURAL AND OTHER...

  12. 5 CFR 890.1021 - Determining length of debarment based on failure to furnish information needed to resolve claims.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... failure to furnish information needed to resolve claims. 890.1021 Section 890.1021 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Administrative Sanctions Imposed Against Health Care Providers Permissive...

  13. 5 CFR 890.1021 - Determining length of debarment based on failure to furnish information needed to resolve claims.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... failure to furnish information needed to resolve claims. 890.1021 Section 890.1021 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Administrative Sanctions Imposed Against Health Care Providers Permissive...

  14. 5 CFR 890.1021 - Determining length of debarment based on failure to furnish information needed to resolve claims.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... failure to furnish information needed to resolve claims. 890.1021 Section 890.1021 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Administrative Sanctions Imposed Against Health Care Providers Permissive...

  15. 5 CFR 890.1021 - Determining length of debarment based on failure to furnish information needed to resolve claims.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... failure to furnish information needed to resolve claims. 890.1021 Section 890.1021 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Administrative Sanctions Imposed Against Health Care Providers Permissive...

  16. 5 CFR 890.1021 - Determining length of debarment based on failure to furnish information needed to resolve claims.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... failure to furnish information needed to resolve claims. 890.1021 Section 890.1021 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Administrative Sanctions Imposed Against Health Care Providers Permissive...

  17. 49 CFR 630.5 - Failure to report data.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Failure to report data. 630.5 Section 630.5 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION NATIONAL TRANSIT DATABASE § 630.5 Failure to report data. Failure to report data...

  18. 49 CFR 630.5 - Failure to report data.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Failure to report data. 630.5 Section 630.5 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION NATIONAL TRANSIT DATABASE § 630.5 Failure to report data. Failure to report data...

  19. 49 CFR 630.5 - Failure to report data.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Failure to report data. 630.5 Section 630.5 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION NATIONAL TRANSIT DATABASE § 630.5 Failure to report data. Failure to report data...

  20. 49 CFR 630.5 - Failure to report data.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Failure to report data. 630.5 Section 630.5 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION NATIONAL TRANSIT DATABASE § 630.5 Failure to report data. Failure to report data...

  1. 49 CFR 630.5 - Failure to report data.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Failure to report data. 630.5 Section 630.5 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION NATIONAL TRANSIT DATABASE § 630.5 Failure to report data. Failure to report data...

  2. The effect of a clinical pharmacist discharge service on medication discrepancies in patients with heart failure

    PubMed Central

    Lenderink, Albert W.; Widdershoven, Jos W. M. G.; van den Bemt, Patricia M. L. A.

    2010-01-01

    Objective Heart failure patients are regularly admitted to hospital and frequently use multiple medication. Besides intentional changes in pharmacotherapy, unintentional changes may occur during hospitalisation. The aim of this study was to investigate the effect of a clinical pharmacist discharge service on medication discrepancies and prescription errors in patients with heart failure. Setting A general teaching hospital in Tilburg, the Netherlands. Method An open randomized intervention study was performed comparing an intervention group, with a control group receiving regular care by doctors and nurses. The clinical pharmacist discharge service consisted of review of discharge medication, communicating prescribing errors with the cardiologist, giving patients information, preparation of a written overview of the discharge medication and communication to both the community pharmacist and the general practitioner about this medication. Within 6 weeks after discharge all patients were routinely scheduled to visit the outpatient clinic and medication discrepancies were measured. Main outcome measure The primary endpoint was the frequency of prescription errors in the discharge medication and medication discrepancies after discharge combined. Results Forty-four patients were included in the control group and 41 in the intervention group. Sixty-eight percent of patients in the control group had at least one discrepancy or prescription error against 39% in the intervention group (RR 0.57 (95% CI 0.37–0.88)). The percentage of medications with a discrepancy or prescription error in the control group was 14.6% and in the intervention group it was 6.1% (RR 0.42 (95% CI 0.27–0.66)). Conclusion This clinical pharmacist discharge service significantly reduces the risk of discrepancies and prescription errors in medication of patients with heart failure in the 1st month after discharge. PMID:20809276

  3. Senior military officers' educational concerns, motivators and barriers for healthful eating and regular exercise.

    PubMed

    Sigrist, Lori D; Anderson, Jennifer E; Auld, Garry W

    2005-10-01

    The increasing trend of overweight in the military, the high cost of health care associated with overweight, and the failure to meet some Healthy People 2000 objectives related to diet identify the need for more appropriate nutrition and fitness education for military personnel. The purpose of this study was to assess senior military officers' concerns on various health topics, educational preferences for nutrition and health topics, eating habits, and barriers and motivators for eating healthfully and exercising regularly. The survey was completed by 52 resident students at the U.S. Army War College. Fitness, weight, and blood cholesterol were top health concerns, and respondents wanted to know more about eating healthfully on the run. The primary barrier to eating healthfully and exercising regularly was lack of time, whereas health and appearance were top motivators. Health interventions for this population should include their topics of concern and should address perceived barriers and motivators.

  4. Recent advances in heart failure.

    PubMed

    Kassi, Mahwash; Hannawi, Bashar; Trachtenberg, Barry

    2018-03-01

    Acute heart failure continues to be a challenge as there is limited benefit of numerous agents that have been tested. Cardiac resynchronization therapy remains standard of care, yet timing and need for implantable cardiac defibrillator has been brought into question with the recent randomized trials. Several recent advances have been made towards management of heart failure both in drug and device therapy. The purpose of this review is to provide an update on the most important recent studies on heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). Two new drugs have been added to the armamentarium for HFrEF; ivabradine and angiotensin receptor-neprilysin inhibitors (ARNIs). Initial data from a new left ventricular assist device (LVAD) pump, the HeartMate 3 (HM III), have demonstrated no reports of pump thrombosis at 6 months, but stroke and right ventricle failure continue to be a challenge with comparable rates compared with the HeartMate II. Several large studies in HFpEF failed to show improvement in outcomes and management continues to be geared towards lifestyle modification and symptom relief. Newer therapies and devices have met with great success, yet there are several therapies that provide no benefit and even harm. A careful review of the recent literature remains instrumental to the effective management of patients with heart failure.

  5. 29 CFR 541.701 - Customarily and regularly.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Customarily and regularly. 541.701 Section 541.701 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR REGULATIONS DEFINING AND DELIMITING THE EXEMPTIONS FOR EXECUTIVE, ADMINISTRATIVE, PROFESSIONAL, COMPUTER AND OUTSIDE SALES EMPLOYEES...

  6. 75 FR 25873 - West Virginia; Major Disaster and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-10

    ... provide emergency protective measures, including snow assistance, under the Public Assistance program for... assistance, as warranted. This assistance excludes regular time costs for the sub-grantees' regular employees..., (Category B), including snow assistance, under the Public Assistance program for any continuous 48-hour...

  7. 76 FR 19116 - Illinois; Major Disaster and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-06

    ... Counties for Public Assistance. Bureau, Calhoun, Carroll, Cass, Cook, DeKalb, DuPage, Fulton, Hancock... protective measures, including snow assistance, under the Public Assistance program for any continuous 48... warranted. This assistance excludes regular time costs for the sub-grantees' regular employees. Consistent...

  8. Continuous vs. blocks of physiotherapy for motor development in children with cerebral palsy and similar syndromes: A prospective randomized study.

    PubMed

    Brunner, Anne-Louise; Rutz, Erich; Juenemann, Stephanie; Brunner, Reinald

    2014-12-01

    To determine whether physiotherapy is more effective when applied in blocks or continuously in children with cerebral palsy (CP). A prospective randomized cross-over design study compared the effect of regular physiotherapy (baseline) with blocks of physiotherapy alternating with no physiotherapy over one year. Thirty-nine institutionalized children with CP and clinically similar syndromes (6-16 years old, Gross Motor Function Classification Scale II-IV) were included. During the first scholastic year, group A received regular physiotherapy, group B blocks of physiotherapy and vice versa in the second year. The Gross Motor Function Measure 66 (GMFM-66) was the outcome measure. Thirteen children in each group completed the study. GMFM-66 improved (p < 0.05) over the study period in both groups in total; changes (p < 0.05) were seen only in dimension D (group B) and E (both groups) during regular therapy. Physiotherapy may be more effective when provided regularly rather than in blocks.

  9. Is Time of the Essence? The Impact of Time of Hospital Presentation in Acute Heart Failure: Insights From ASCEND-HF Trial.

    PubMed

    Cerbin, Lukasz P; Ambrosy, Andrew P; Greene, Stephen J; Armstrong, Paul W; Butler, Javed; Coles, Adrian; DeVore, Adam D; Ezekowitz, Justin A; Hernandez, Adrian F; Metra, Marco; Starling, Randall C; Tang, Wilson; Teerlink, John R; Voors, Adriaan A; Wu, Angie; O'Connor, Christopher M; Mentz, Robert J

    2018-04-01

    As the largest acute heart failure (AHF) trial conducted to date, the global ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure) trial database presented an opportunity to systematically describe the relationship among time of hospital presentation, clinical profile, inpatient management, and outcomes among patients admitted with AHF. Time of hospital presentation has been shown to impact outcomes among patients hospitalized with many conditions. However, the association among time of presentation and patient characteristics, management, and clinical outcomes among patients hospitalized with AHF has not been well characterized. A post hoc analysis of the ASCEND-HF trial was performed, which enrolled 7,141 patients hospitalized for AHF. Patients were divided based on when they presented to the hospital; regular hours were defined as 9 am to 5 pm, Monday through Friday, and off hours were defined as 5 pm to 9 am, Monday through Friday and weekends. Clinical characteristics and outcomes were compared by time of presentation. Overall, 3,298 patients (46%) presented during off hours. Off-hour patients were more likely to have orthopnea (80% vs. 74%, respectively) and rales (56% vs. 49%, respectively) than regular-hour patients. Off-hour patients were more likely to receive intravenous (IV) nitroglycerin (18% vs. 11%, respectively) and IV loop diuretics (92% vs. 86%, respectively) as initial therapy and reported greater relief from dyspnea at 24 h (odds ratio [OR]: 1.14; 95% confidence interval [CI]: 1.04 to 1.24; p = 0.01) than regular-hour patients. After adjustment, off-hour presentation was associated with significantly lower 30-day mortality (OR: 0.74; 95% CI: 0.57 to 0.96; p = 0.03) and 180-day mortality (hazard ratio [HR]: 0.82; 95% CI: 0.72 to 0.94; p = 0.01) but similar 30-day rehospitalization rates (p = 0.40). In this AHF trial, patients admitted during off hours exhibited a distinct clinical profile, experienced greater dyspnea relief, and had lower post-discharge mortality than regular-hour patients. These findings have implications for future AHF trials. Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  10. Pregnancy after azathioprine therapy for ulcerative colitis in a woman with autoimmune premature ovarian failure and Addison's disease: HLA haplotype characterization.

    PubMed

    Ferraù, Francesco; Gangemi, Sebastiano; Vita, Giuseppe; Trimarchi, Francesco; Cannavò, Salvatore

    2011-06-01

    To present a case of fertility restored by azathioprine treatment in a woman with autoimmune premature ovarian failure, Addison's disease, and ulcerative colitis, and to study the genetic background of the three autoimmune diseases. Case report. Endocrinology and Immunology Units of an university hospital. A 30-year-old woman with autoimmune premature ovarian failure, Addison's disease, and ulcerative colitis. Azathioprine has been administered as immunosuppressive treatment. We performed analysis of human leukocyte antigens expression on lymphocytes and genomic haplotype of the patient. The human leukocyte antigen haplotype of the patient was consistent with the haplotypes predisposing for the three autoimmune diseases, as reported in the literature. The administration of azathioprine restored regular menses and allowed uneventful pregnancy. This is the first clinical evidence of association of immunosuppressive azathioprine treatment and restored ovarian function and fertility in a woman with autoimmune premature ovarian failure. In this patient, the haplotype was associated with susceptibility to autoimmune premature ovarian failure, Addison's disease, and ulcerative colitis. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  11. Survival and failure modes: platform-switching for internal and external hexagon cemented fixed dental prostheses.

    PubMed

    Anchieta, Rodolfo B; Machado, Lucas S; Hirata, Ronaldo; Coelho, Paulo G; Bonfante, Estevam A

    2016-10-01

    This study evaluated the probability of survival (reliability) of platform-switched fixed dental prostheses (FDPs) cemented on different implant-abutment connection designs. Eighty-four-three-unit FDPs (molar pontic) were cemented on abutments connected to two implants of external or internal hexagon connection. Four groups (n = 21 each) were established: external hexagon connection and regular platform (ERC); external hexagon connection and switched platform (ESC); internal hexagon and regular platform (IRC); and internal hexagon and switched platform (ISC). Prostheses were subjected to step-stress accelerated life testing in water. Weibull curves and probability of survival for a mission of 100,000 cycles at 400 N (two-sided 90% CI) were calculated. The beta values of 0.22, 0.48, 0.50, and 1.25 for groups ERC, ESC, IRC, and ISC, respectively, indicated a limited role of fatigue in damage accumulation, except for group ISC. Survival decreased for both platform-switched groups (ESC: 74%, and ISC: 59%) compared with the regular matching platform counterparts (ERC: 95%, and IRC: 98%). Characteristic strength was higher only for ERC compared with ESC, but not different between internal connections. Failures chiefly involved the abutment screw. Platform switching decreased the probability of survival of FDPs on both external and internal connections. The absence in loss of characteristic strength observed in internal hexagon connections favor their use compared with platform-switched external hexagon connections. © 2016 Eur J Oral Sci.

  12. 49 CFR 510.12 - Remedies for failure to comply with compulsory process.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 6 2010-10-01 2010-10-01 false Remedies for failure to comply with compulsory process. 510.12 Section 510.12 Transportation Other Regulations Relating to Transportation (Continued... § 510.12 Remedies for failure to comply with compulsory process. Any failure to comply with compulsory...

  13. 24 CFR 3286.703 - Failure to comply.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 5 2012-04-01 2012-04-01 false Failure to comply. 3286.703 Section 3286.703 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued....703 Failure to comply. (a) Penalties and injunctive relief. Failure to comply with the requirements of...

  14. 24 CFR 3286.703 - Failure to comply.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 5 2014-04-01 2014-04-01 false Failure to comply. 3286.703 Section 3286.703 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued....703 Failure to comply. (a) Penalties and injunctive relief. Failure to comply with the requirements of...

  15. 24 CFR 3286.703 - Failure to comply.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 5 2013-04-01 2013-04-01 false Failure to comply. 3286.703 Section 3286.703 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued....703 Failure to comply. (a) Penalties and injunctive relief. Failure to comply with the requirements of...

  16. 24 CFR 3286.703 - Failure to comply.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 5 2011-04-01 2011-04-01 false Failure to comply. 3286.703 Section 3286.703 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued....703 Failure to comply. (a) Penalties and injunctive relief. Failure to comply with the requirements of...

  17. New therapy, new challenges: The effects of long-term continuous flow left ventricular assist device on inflammation.

    PubMed

    Grosman-Rimon, Liza; Billia, Filio; Fuks, Avi; Jacobs, Ira; A McDonald, Michael; Cherney, David Z; Rao, Vivek

    2016-07-15

    Surgically implanted continuous flow left ventricular assist devices (CF-LVADs) are currently used in patients with end-stage heart failure (HF). However, CF-LVAD therapy introduces a new set of complications and adverse events in these patients. Major adverse events with the CF-LVAD include right heart failure, vascular dysfunction, stroke, hepatic failure, and multi-organ failure, complications that may have inflammation as a common etiology. Our aim was to review the current evidence showing a relationship between these adverse events and elevated levels of inflammatory biomarkers in CF-LVAD recipients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. 75 FR 9426 - Maryland; Major Disaster and Related Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-02

    ... measures (Category B) under the Public Assistance program in the designated areas. You are further authorized to provide snow assistance under the Public Assistance program for any continuous 48-hour period... assistance excludes regular time costs for the sub-grantees' regular employees. Consistent with the...

  19. 16 CFR 803.2 - Instructions applicable to Notification and Report Form.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... comprised of entities separately engaged in wholesale magazine distribution, auto rental and book publishing... business. (c) In response to items 5, 7, and 8 of the Notification and Report Form— (1) Information shall... in § 803.10(c)(1) by 5 p.m. on the next regular business day. Failure to make the documents available...

  20. 16 CFR 803.2 - Instructions applicable to Notification and Report Form.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... comprised of entities separately engaged in wholesale magazine distribution, auto rental and book publishing... business. (c) In response to items 5, 7, and 8 of the Notification and Report Form— (1) Information shall... in § 803.10(c)(1) by 5 p.m. on the next regular business day. Failure to make the documents available...

  1. 16 CFR 803.2 - Instructions applicable to Notification and Report Form.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... comprised of entities separately engaged in wholesale magazine distribution, auto rental and book publishing... business. (c) In response to items 5, 7, and 8 of the Notification and Report Form—Information need not be... in § 803.10(c)(1) by 5 p.m. on the next regular business day. Failure to make the documents available...

  2. 16 CFR 803.2 - Instructions applicable to Notification and Report Form.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... comprised of entities separately engaged in wholesale magazine distribution, auto rental and book publishing... business. (c) In response to items 5, 7, and 8 of the Notification and Report Form—Information need not be... in § 803.10(c)(1) by 5 p.m. on the next regular business day. Failure to make the documents available...

  3. 16 CFR 803.2 - Instructions applicable to Notification and Report Form.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... comprised of entities separately engaged in wholesale magazine distribution, auto rental and book publishing... business. (c) In response to items 5, 7, and 8 of the Notification and Report Form—Information need not be... in § 803.10(c)(1) by 5 p.m. on the next regular business day. Failure to make the documents available...

  4. Success for All in Acre, Israel: Effects on Hebrew and Arabic Reading and Writing. (First Year).

    ERIC Educational Resources Information Center

    Hertz-Lazarowitz, Rachel; Schaedel, Bruria

    A study investigated the effectiveness of the Success for All (SFA) program developed at Johns Hopkins University. The program emphasizes prevention of failure, personal tutoring, family-school program, and regular evaluation of student progress. In 1996, the program involved schools in northern Israel--Arabic and Jewish, religious and secular.…

  5. 29 CFR 778.220 - “Show-up” or “reporting” pay.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... scheduled work on any day will receive a minimum of 4 hours' work or pay. The employee thus receives not... failure to provide expected work during regular hours. One of the primary purposes of such an arrangement... that an employee entitled to overtime pay after 40 hours a week whose workweek begins on Monday and who...

  6. Making The Case: A Fact Sheet on Children and Youth on Out-of-School Time

    ERIC Educational Resources Information Center

    Wellesley Centers for Women, 2006

    2006-01-01

    Research on school-age children (those between the ages of 5 and 12) indicates that an estimated 4 million regularly spend time without adult supervision. There is growing evidence that quality out-of-school opportunities matter, complementing environments created by schools and families and providing important "nutrients" that deter failure and…

  7. Exercise and College Students: How Regular Exercise Contributes to Approach Motivation via Self-Efficacy

    ERIC Educational Resources Information Center

    Weinkauff Duranso, Christine M.

    2017-01-01

    There is evidence that participating in physical exercise reduces stress and the risk of many physical maladies. Exercise is also correlated with higher levels of approach motivation, or a tendency to approach challenge as an opportunity for growth or improvement instead of an opportunity for failure. To date, most research on this relationship…

  8. Heart failure presenting as myxedema coma: case report and review article.

    PubMed

    Chaudhari, Dhara; Gangadharan, Venkat; Forrest, Terry

    2013-05-01

    Hypothyroidism is a common medical problem easily treated when diagnosed but requiring regular follow-up and patient medication compliance. At times, this diagnosis can go untreated resulting in the development of severe consequences such as Myxedema Coma. Of all the clinical symptoms, cardiovascular manifestations tend to be especially severe and often life threatening.

  9. Heart failure presenting as myxedema coma: case report and review article.

    PubMed

    Chaudhari, Dhara; Gangadharan, Venkat; Forrest, Terry

    2014-02-01

    Hypothyroidism is a common medical problem easily treated when diagnosed but requiring regular follow-up and patient medication compliance. At times, this diagnosis can go untreated resulting in the development of severe consequences such as Myxedema Coma. Of all the clinical symptoms, cardiovascular manifestations tend to be especially severe and often life threatening.

  10. Evidence: Educational Evaluation and the Metaphors of Law.

    ERIC Educational Resources Information Center

    Wolf, Robert L.

    A suit was filed in 1972 in California by an 18 year old high school graduate who asserted that he remained functionally illiterate after 13 years of regular attendance in the San Francisco public schools. Claiming personal injury as a consequence of the failure of school professionals to exercise reasonable care in the discharge of their duties,…

  11. Implicit Learning of Non-Linguistic and Linguistic Regularities in Children with Dyslexia

    ERIC Educational Resources Information Center

    Nigro, Luciana; Jiménez-Fernández, Gracia; Simpson, Ian C.; Defior, Sylvia

    2016-01-01

    One of the hallmarks of dyslexia is the failure to automatise written patterns despite repeated exposure to print. Although many explanations have been proposed to explain this problem, researchers have recently begun to explore the possibility that an underlying implicit learning deficit may play a role in dyslexia. This hypothesis has been…

  12. Tree Owner's Manual for the Northeastern Midwestern United States

    Treesearch

    Jill Johnson; Gary Johnson; Maureen McDonough; Lisa Burban; Janette Monear

    2008-01-01

    One common issue facing our urban forests is the fact that trees are dying prematurely. Many are planted improperly, setting them up for failure. Many do not receive regular maintenance. And few are adequately protected during construction projects. To help remedy this issue, the Forest Service has created this Tree Owner's Manual. Just like the owner...

  13. Digital Engagement: Learning Experiences of Alternative High School Students within a Technology Integrated Triad Model

    ERIC Educational Resources Information Center

    Gurung, Binod

    2013-01-01

    Alternative high school students are the at-risk students of educational failure lacking behavioral, emotional, and cognitive engagement with school and the schoolwork. They are also generally considered as the at-risk computer users, who use technology for development of skills and drill and practice when compared to their regular counterparts,…

  14. The Impotence of Being Important – Reflections on Leadership

    PubMed Central

    Couper, Ian Douglas

    2007-01-01

    An observed doctor-patient encounter, in which impotence and importance were confused, led me to a reflection on leadership. A sense of importance can be destructive in leadership, leading to failure to perform, or impotence. Understanding the dangers of self-importance, I am challenged to ensure that I regularly reflect on my leadership style. PMID:17548855

  15. Gerontechnologies for Older Patients with Heart Failure: What is the Role of Smartphones, Tablets, and Remote Monitoring Devices in Improving Symptom Monitoring and Self-Care Management?

    PubMed

    Masterson Creber, Ruth M; Hickey, Kathleen T; Maurer, Mathew S

    2016-10-01

    Older adults with heart failure have multiple chronic conditions and a large number and range of symptoms. A fundamental component of heart failure self-care management is regular symptom monitoring. Symptom monitoring can be facilitated by cost-effective, easily accessible technologies that are integrated into patients' lives. Technologies that are tailored to older adults by incorporating gerontological design principles are called gerontechnologies. Gerontechnology is an interdisciplinary academic and professional field that combines gerontology and technology with the goals of improving prevention, care, and enhancing the quality of life for older adults. The purpose of this article is to discuss the role of gerontechnologies, specifically the use of mobile applications available on smartphones and tablets as well as remote monitoring systems, for outpatient disease management among older adults with heart failure. While largely unproven, these rapidly developing technologies have great potential to improve outcomes among older persons.

  16. Expert system for identification of simultaneous and sequential reactor fuel failures with gas tagging

    DOEpatents

    Gross, K.C.

    1994-07-26

    Failure of a fuel element in a nuclear reactor core is determined by a gas tagging failure detection system and method. Failures are catalogued and characterized after the event so that samples of the reactor's cover gas are taken at regular intervals and analyzed by mass spectroscopy. Employing a first set of systematic heuristic rules which are applied in a transformed node space allows the number of node combinations which must be processed within a barycentric algorithm to be substantially reduced. A second set of heuristic rules treats the tag nodes of the most recent one or two leakers as background'' gases, further reducing the number of trial node combinations. Lastly, a fuzzy'' set theory formalism minimizes experimental uncertainties in the identification of the most likely volumes of tag gases. This approach allows for the identification of virtually any number of sequential leaks and up to five simultaneous gas leaks from fuel elements. 14 figs.

  17. Improving the quality of the order-writing process for inpatient orders and outpatient prescriptions.

    PubMed

    Meyer, T A

    2000-12-15

    Because many preventable medication errors occur at the ordering stage, a program for improving the quality of writing inpatient orders and outpatient prescriptions at one institution was developed. To determine whether potential problems existed in the order-writing process for inpatients, all physician orders for a seven-day period in 1997 were reviewed (n = 3740). More than 10% of all orders had illegible handwriting or were written with a felt-tip pen, which makes NCR copies difficult to read. Other potential errors were also identified. Following educational programs for physicians and residents focusing on the importance of writing orders clearly, physician orders were reviewed for a 24-hour period (n = 654). The use of felt-tip pens decreased to 1.37% of all orders, and no orders had illegible handwriting. A similar quality improvement approach was used to evaluate the outpatient prescription-writing process. A review of all new prescriptions for a consecutive seven-day period at a local hospital-owned community pharmacy (n = 1425) revealed that about 15% of the prescriptions had illegible handwriting and roughly 10% were incomplete. Additional data were gathered through a survey sent to 71 outside provider pharmacies requesting information on problems related to prescriptions written by physicians from the institution; 66% responded. Failure to print prescriber name (96%), illegible signature (94%), failure to include DEA number (89%), and illegible handwriting other than signature (69%) were reported as the main problems. Each physician was given a self-inking name stamp to use when writing prescriptions. In addition, educational programs covering examples of poorly written prescriptions and the legal requirements of a prescription were held for physicians and residents. A follow-up survey showed that 72% of pharmacies saw stamps being used; when stamps were not used, however, illegible signatures continued to be a problem. Follow-up reviews of outpatient prescriptions indicate improvements in handwriting and completeness, but continuing educational efforts are needed. The quality of order writing for inpatients and outpatients continues to be monitored on a regular basis. Ongoing educational programs, follow-up reminders, and feedback to physicians have greatly improved the prescription-writing habits of physicians.

  18. Remote monitoring of heart failure: benefits for therapeutic decision making.

    PubMed

    Martirosyan, Mihran; Caliskan, Kadir; Theuns, Dominic A M J; Szili-Torok, Tamas

    2017-07-01

    Chronic heart failure is a cardiovascular disorder with high prevalence and incidence worldwide. The course of heart failure is characterized by periods of stability and instability. Decompensation of heart failure is associated with frequent and prolonged hospitalizations and it worsens the prognosis for the disease and increases cardiovascular mortality among affected patients. It is therefore important to monitor these patients carefully to reveal changes in their condition. Remote monitoring has been designed to facilitate an early detection of adverse events and to minimize regular follow-up visits for heart failure patients. Several new devices have been developed and introduced to the daily practice of cardiology departments worldwide. Areas covered: Currently, special tools and techniques are available to perform remote monitoring. Concurrently there are a number of modern cardiac implantable electronic devices that incorporate a remote monitoring function. All the techniques that have a remote monitoring function are discussed in this paper in detail. All the major studies on this subject have been selected for review of the recent data on remote monitoring of HF patients and demonstrate the role of remote monitoring in the therapeutic decision making for heart failure patients. Expert commentary: Remote monitoring represents a novel intensified follow-up strategy of heart failure management. Overall, theoretically, remote monitoring may play a crucial role in the early detection of heart failure progression and may improve the outcome of patients.

  19. Acute-on-chronic liver failure due to thiamazole in a patient with hyperthyroidism and trilogy of Fallot: case report

    PubMed Central

    2010-01-01

    Background Thiamazole is a widely used antithyroid agent that has been approved for the treatment of hyperthyroidism. Although thiamazole-induced hepatotoxicity is a main side effect, it may progress to liver failure in a very few cases. Case Presentation We described a 24-year-old patient with hyperthyroidism and trilogy of Fallot, who developed liver failure due to thiamazole. Liver biopsy showed intrahepatic cholestasis, mild inflammatory infiltrates, as well as significant fibrosis, indicating both acute and chronic liver injuries. Although a series of potent therapies were given, the patient deceased due to severe liver decompensation. Conclusions This case suggests that thiamazole-induced hepatotoxicity in the setting of advanced fibrosis increases the risk of poor outcome. Regular liver function monitoring during thiamazole therapy is therefore important. PMID:20707932

  20. A Regularizer Approach for RBF Networks Under the Concurrent Weight Failure Situation.

    PubMed

    Leung, Chi-Sing; Wan, Wai Yan; Feng, Ruibin

    2017-06-01

    Many existing results on fault-tolerant algorithms focus on the single fault source situation, where a trained network is affected by one kind of weight failure. In fact, a trained network may be affected by multiple kinds of weight failure. This paper first studies how the open weight fault and the multiplicative weight noise degrade the performance of radial basis function (RBF) networks. Afterward, we define the objective function for training fault-tolerant RBF networks. Based on the objective function, we then develop two learning algorithms, one batch mode and one online mode. Besides, the convergent conditions of our online algorithm are investigated. Finally, we develop a formula to estimate the test set error of faulty networks trained from our approach. This formula helps us to optimize some tuning parameters, such as RBF width.

  1. Temporary ovarian failure in thyroid cancer patients after thyroid remnant ablation with radioactive iodine

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

    Raymond, J.P.; Izembart, M.; Marliac, V.

    We studied ovarian function retrospectively in 66 women who had regular menstrual cycles before undergoing complete thyroidectomy for differentiated thyroid cancer and subsequent thyroid remnant ablation with /sup 131/I. Eighteen women developed temporary amenorrhea accompanied by increased serum gonadotropin concentrations during the first year after /sup 131/I therapy. No correlation was found between the radioactive iodine dose absorbed, thyroid uptake before treatment, oral contraceptive use, or thyroid autoimmunity. Only age was a determining factor, with the older women being the most affected. We conclude that radioiodine ablation therapy is followed by transient ovarian failure, especially in older women.

  2. Continuous infusion or bolus injection of loop diuretics for patients admitted for severe acute heart failure: is one strategy better than the other?

    PubMed

    Caetano, Francisca; Mota, Paula; Almeida, Inês; Fernandes, Andreia; Botelho, Ana; Leitão Marques, António

    2015-02-01

    Intravenous loop diuretics are an essential part of acute heart failure management; however, data to guide their use is sparse. Our aim was to compare continuous intravenous infusion of loop diuretics with intravenous bolus administration in terms of efficacy and adverse events in patients admitted with severe acute heart failure. Over a period of three years, 110 patients were admitted to our cardiac intensive care unit with acute heart failure. Clinical, laboratory and prognostic parameters were compared according to the diuretic strategy used and mortality and readmission for acute heart failure during follow-up were analyzed. Previous medical history was similar in the two groups. At admission, the continuous infusion group met criteria for worse prognosis: lower systolic blood pressure (p=0.011), more severe renal injury (p=0.008), lower left ventricular ejection fraction (p=0.016) and higher incidence of restrictive pattern of diastolic dysfunction (p=0.032). They were more often treated with vasopressors (p=0.003), inotropes (p=0.010), renal support therapy (p=0.003) and non-invasive ventilation (p<0.001). They had longer hospitalizations (p=0.014) and a higher incidence of cardiorenal syndrome (p=0.009); however, at discharge, there were no differences in renal function between the groups. In-hospital mortality was similar, and during follow-up there were no differences in mortality or readmission for acute heart failure. Continuous infusion was preferred in patients presenting with worse clinical status, in whom renal dysfunction was transiently worse. However, in-hospital mortality and creatinine at discharge were similar. Continuous infusion thus appears to counteract the initial dire prognosis of more unstable patients. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  3. 47 CFR 64.1507 - Prohibition on disconnection or interruption of service for failure to remit pay-per-call and...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... service for failure to remit pay-per-call and similar service charges. 64.1507 Section 64.1507 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) MISCELLANEOUS RULES RELATING TO COMMON CARRIERS Interstate Pay-Per-Call and Other Information Services § 64.1507...

  4. 12 CFR 263.21 - Failure to appear.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 3 2011-01-01 2011-01-01 false Failure to appear. 263.21 Section 263.21 Banks and Banking FEDERAL RESERVE SYSTEM (CONTINUED) BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM RULES OF PRACTICE FOR HEARINGS Uniform Rules of Practice and Procedure § 263.21 Failure to appear. Failure...

  5. The pharmacotherapy of the HeartMate II, a continuous flow left ventricular assist device, in patients with advanced heart failure: integration of disease, device, and drug.

    PubMed

    Jennings, Douglas L; Chambers, Rachel M; Schillig, Jessica M

    2010-10-01

    Advanced heart failure continues to be a significant cause of morbidity and mortality in the US. Patients with advanced heart failure have a poor prognosis without cardiac transplantation. The use of left ventricular assist devices (LVADs) as destination therapy for these patients is therefore expected to increase in the coming years as technology advances. The HeartMate II, a continuous flow implantable device, is currently the only LVAD that has been approved by the Food and Drug Administration for destination therapy in patients with advanced heart failure. The pharmacotherapy associated with this device is very complex and, therefore, the need for expertly trained clinical pharmacists to care for this expanding patient population will also likely increase. Unfortunately, most pharmacists are unfamiliar with the effect of LVADs on the physiology and pharmacotherapy of a patient's heart failure. The purpose of this article is to give clinical pharmacists an introduction to the most common pharmacotherapeutic issues for patients with LVADs and present practical solutions for managing common drug therapy problems.

  6. Development of the Synarcual in the Elephant Sharks (Holocephali; Chondrichthyes): Implications for Vertebral Formation and Fusion.

    PubMed

    Johanson, Zerina; Boisvert, Catherine; Maksimenko, Anton; Currie, Peter; Trinajstic, Kate

    2015-01-01

    The synarcual is a structure incorporating multiple elements of two or more anterior vertebrae of the axial skeleton, forming immediately posterior to the cranium. It has been convergently acquired in the fossil group 'Placodermi', in Chondrichthyes (Holocephali, Batoidea), within the teleost group Syngnathiformes, and to varying degrees in a range of mammalian taxa. In addition, cervical vertebral fusion presents as an abnormal pathology in a variety of human disorders. Vertebrae develop from axially arranged somites, so that fusion could result from a failure of somite segmentation early in development, or from later heterotopic development of intervertebral bone or cartilage. Examination of early developmental stages indicates that in the Batoidea and the 'Placodermi', individual vertebrae developed normally and only later become incorporated into the synarcual, implying regular somite segmentation and vertebral development. Here we show that in the holocephalan Callorhinchus milii, uniform and regular vertebral segmentation also occurs, with anterior individual vertebra developing separately with subsequent fusion into a synarcual. Vertebral elements forming directly behind the synarcual continue to be incorporated into the synarcual through growth. This appears to be a common pattern through the Vertebrata. Research into human disorders, presenting as cervical fusion at birth, focuses on gene misexpression studies in humans and other mammals such as the mouse. However, in chondrichthyans, vertebral fusion represents the normal morphology, moreover, taxa such Leucoraja (Batoidea) and Callorhinchus (Holocephali) are increasingly used as laboratory animals, and the Callorhinchus genome has been sequenced and is available for study. Our observations on synarcual development in three major groups of early jawed vertebrates indicate that fusion involves heterotopic cartilage and perichondral bone/mineralised cartilage developing outside the regular skeleton. We suggest that chondrichthyans have potential as ideal extant models for identifying the genes involved in these processes, for application to human skeletal heterotopic disorders.

  7. Development of the Synarcual in the Elephant Sharks (Holocephali; Chondrichthyes): Implications for Vertebral Formation and Fusion

    PubMed Central

    Johanson, Zerina; Boisvert, Catherine; Maksimenko, Anton; Currie, Peter; Trinajstic, Kate

    2015-01-01

    The synarcual is a structure incorporating multiple elements of two or more anterior vertebrae of the axial skeleton, forming immediately posterior to the cranium. It has been convergently acquired in the fossil group ‘Placodermi’, in Chondrichthyes (Holocephali, Batoidea), within the teleost group Syngnathiformes, and to varying degrees in a range of mammalian taxa. In addition, cervical vertebral fusion presents as an abnormal pathology in a variety of human disorders. Vertebrae develop from axially arranged somites, so that fusion could result from a failure of somite segmentation early in development, or from later heterotopic development of intervertebral bone or cartilage. Examination of early developmental stages indicates that in the Batoidea and the ‘Placodermi’, individual vertebrae developed normally and only later become incorporated into the synarcual, implying regular somite segmentation and vertebral development. Here we show that in the holocephalan Callorhinchus milii, uniform and regular vertebral segmentation also occurs, with anterior individual vertebra developing separately with subsequent fusion into a synarcual. Vertebral elements forming directly behind the synarcual continue to be incorporated into the synarcual through growth. This appears to be a common pattern through the Vertebrata. Research into human disorders, presenting as cervical fusion at birth, focuses on gene misexpression studies in humans and other mammals such as the mouse. However, in chondrichthyans, vertebral fusion represents the normal morphology, moreover, taxa such Leucoraja (Batoidea) and Callorhinchus (Holocephali) are increasingly used as laboratory animals, and the Callorhinchus genome has been sequenced and is available for study. Our observations on synarcual development in three major groups of early jawed vertebrates indicate that fusion involves heterotopic cartilage and perichondral bone/mineralised cartilage developing outside the regular skeleton. We suggest that chondrichthyans have potential as ideal extant models for identifying the genes involved in these processes, for application to human skeletal heterotopic disorders. PMID:26339918

  8. 30 CFR 100.3 - Determination of penalty amount; regular assessment.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... criteria are: (i) The appropriateness of the penalty to the size of the business of the operator charged; (ii) The operator's history of previous violations; (iii) Whether the operator was negligent; (iv) The... ability to continue in business. (2) A regular assessment is determined by first assigning the appropriate...

  9. 32 CFR 724.223 - NDRB support and augmentation by regular and reserve activities.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false NDRB support and augmentation by regular and reserve activities. 724.223 Section 724.223 National Defense Department of Defense (Continued) DEPARTMENT... can be undertaken without interference with mission accomplishment. The NDRB shall coordinate requests...

  10. 32 CFR 724.223 - NDRB support and augmentation by regular and reserve activities.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false NDRB support and augmentation by regular and reserve activities. 724.223 Section 724.223 National Defense Department of Defense (Continued) DEPARTMENT... can be undertaken without interference with mission accomplishment. The NDRB shall coordinate requests...

  11. 32 CFR 724.223 - NDRB support and augmentation by regular and reserve activities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false NDRB support and augmentation by regular and reserve activities. 724.223 Section 724.223 National Defense Department of Defense (Continued) DEPARTMENT... can be undertaken without interference with mission accomplishment. The NDRB shall coordinate requests...

  12. 32 CFR 724.223 - NDRB support and augmentation by regular and reserve activities.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false NDRB support and augmentation by regular and reserve activities. 724.223 Section 724.223 National Defense Department of Defense (Continued) DEPARTMENT... can be undertaken without interference with mission accomplishment. The NDRB shall coordinate requests...

  13. 32 CFR 724.223 - NDRB support and augmentation by regular and reserve activities.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false NDRB support and augmentation by regular and reserve activities. 724.223 Section 724.223 National Defense Department of Defense (Continued) DEPARTMENT... can be undertaken without interference with mission accomplishment. The NDRB shall coordinate requests...

  14. Long term SAR interferometry monitoring for assessing changing levels of slope instability hazards

    NASA Astrophysics Data System (ADS)

    Wasowski, J.; Ferretti, A.

    The population growth with increasing impact of man on the environment and urbanisation of areas susceptible to slope failures coupled with the ongoing change in climate patterns will require a shift in the approaches to landslide hazard reduction Indeed there is evidence that landslide activity and related socio-economic loss are increasing in both rich and less developed countries throughout the world Because of this and because the urbanisation of hillside and mountain slopes prone to failure will likely continue in the future the protection of new and pre-existing developed areas via traditional engineering stabilisation works and in situ monitoring is not considered economically feasible Furthermore in most cases the ground control systems are installed post-factum and for short term monitoring and hence their role in preventing disasters is limited Considering the global dimension of the slope instability problem a sustainable road to landslide hazard reduction seems to be via exploitation of EO systems with focus on early detection long term monitoring and early warning Thanks to the wide-area coverage regular schedule and improving resolution of space-borne sensors the EO can foster the auspicious shift from a culture of repair to a culture of awarness and prevention Under this scenario the space-borne synthetic aperture radar differential interferometry DInSAR is attractive because of its capability to provide both wide-area and spatially dense information on surface displacements Since the presence of movements represents a direct evidence of

  15. 49 CFR 193.2515 - Investigations of failures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false Investigations of failures. 193.2515 Section 193.2515 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS... GAS FACILITIES: FEDERAL SAFETY STANDARDS Operations § 193.2515 Investigations of failures. (a) Each...

  16. 49 CFR 193.2515 - Investigations of failures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Investigations of failures. 193.2515 Section 193.2515 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS... GAS FACILITIES: FEDERAL SAFETY STANDARDS Operations § 193.2515 Investigations of failures. (a) Each...

  17. 49 CFR 193.2515 - Investigations of failures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Investigations of failures. 193.2515 Section 193.2515 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS... GAS FACILITIES: FEDERAL SAFETY STANDARDS Operations § 193.2515 Investigations of failures. (a) Each...

  18. 49 CFR 193.2515 - Investigations of failures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 3 2014-10-01 2014-10-01 false Investigations of failures. 193.2515 Section 193.2515 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS... GAS FACILITIES: FEDERAL SAFETY STANDARDS Operations § 193.2515 Investigations of failures. (a) Each...

  19. 78 FR 61408 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-03

    ... continues for a period of 30 consecutive business days. Upon such failure, the Company shall be notified.... Compliance can be achieved by meeting the applicable standard for a minimum of 10 consecutive business days... the deficiency continues for a period of 30 consecutive business days. Upon such failure, the Company...

  20. 12 CFR 263.21 - Failure to appear.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 4 2014-01-01 2014-01-01 false Failure to appear. 263.21 Section 263.21 Banks... (CONTINUED) RULES OF PRACTICE FOR HEARINGS Uniform Rules of Practice and Procedure § 263.21 Failure to appear. Failure of a respondent to appear in person at the hearing or by a duly authorized counsel constitutes a...

  1. 12 CFR 263.21 - Failure to appear.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 4 2013-01-01 2013-01-01 false Failure to appear. 263.21 Section 263.21 Banks... (CONTINUED) RULES OF PRACTICE FOR HEARINGS Uniform Rules of Practice and Procedure § 263.21 Failure to appear. Failure of a respondent to appear in person at the hearing or by a duly authorized counsel constitutes a...

  2. A regularity condition and temporal asymptotics for chemotaxis-fluid equations

    NASA Astrophysics Data System (ADS)

    Chae, Myeongju; Kang, Kyungkeun; Lee, Jihoon; Lee, Ki-Ahm

    2018-02-01

    We consider two dimensional chemotaxis equations coupled to the Navier-Stokes equations. We present a new localized regularity criterion that is localized in a neighborhood at each point. Secondly, we establish temporal decays of the regular solutions under the assumption that the initial mass of biological cell density is sufficiently small. Both results are improvements of previously known results given in Chae et al (2013 Discrete Continuous Dyn. Syst. A 33 2271-97) and Chae et al (2014 Commun. PDE 39 1205-35)

  3. Influence of continuous haemofiltration-related hypothermia on haemodynamic variables and gas exchange in septic patients.

    PubMed

    Matamis, D; Tsagourias, M; Koletsos, K; Riggos, D; Mavromatidis, K; Sombolos, K; Bursztein, S

    1994-07-01

    To investigate the influence of continuous haemofiltration (CHF) on haemodynamics, gas exchange and core temperature in critically ill septic patients with acute renal failure. In 20 patients (17 male, 3 female) ultrafiltration rate, core temperature, gas exchange and haemodynamic variables were measured at regular intervals during the first 48 h of haemofiltration. Baseline data were compared to those obtained 30 min after initiating CHF and also to those during hypothermia (if observed). Haemodynamic variables remained remarkably constant throughout the study period. In patients with a relatively low ultrafiltration rate (855 +/- 278 ml/h) temperature did not change, while in patients with a high ultrafiltration rate (1468 +/- 293 ml/h) core temperature significantly decreased from 37.6 +/- 0.9 degrees C to 34.8 +/- 0.8 degrees C (p < 0.001). There was a statistically significant correlation between temperature decrease and ultrafiltration rate (r = -0.68, Y = 1.8-0.003 X, p < 0.01). Hypothermic patients also showed a mean decrease in VO2 from 141 +/- 22 ml/min/m2 to 112 +/- 22 ml/min/m2 (p < 0.01) with a concomitant increase in PaO2 from 103 +/- 37 mmHg to 140 +/- 42 mmHg (p < 0.001) and in PvO2 from 35 +/- 4 mmHg to 41 +/- 5 mmHg (p < 0.001). 1) Continuous haemofiltration does not cause significant alternations in haemodynamic variables. 2) Hypothermia frequently occurs in patients undergoing continuous haemofiltration with high ultrafiltration rates. These hypothermic patients show a reduction in VO2 leading to an increase in PvO2 and PaO2. This mild hypothermia in these circumstances has no evident deleterious effects.

  4. 42 CFR 61.13 - Duration and continuation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Duration and continuation. 61.13 Section 61.13 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING FELLOWSHIPS Regular Fellowships § 61.13 Duration and continuation. An award period may be any...

  5. 42 CFR 61.13 - Duration and continuation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Duration and continuation. 61.13 Section 61.13 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING FELLOWSHIPS Regular Fellowships § 61.13 Duration and continuation. An award period may be any...

  6. 42 CFR 61.13 - Duration and continuation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Duration and continuation. 61.13 Section 61.13 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING FELLOWSHIPS Regular Fellowships § 61.13 Duration and continuation. An award period may be any...

  7. 42 CFR 61.13 - Duration and continuation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Duration and continuation. 61.13 Section 61.13 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING FELLOWSHIPS Regular Fellowships § 61.13 Duration and continuation. An award period may be any...

  8. 42 CFR 61.13 - Duration and continuation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Duration and continuation. 61.13 Section 61.13 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING FELLOWSHIPS Regular Fellowships § 61.13 Duration and continuation. An award period may be any...

  9. Influences of personality traits and continuation intentions on physical activity participation within the theory of planned behaviour.

    PubMed

    Chatzisarantis, Nikos L D; Hagger, Martin S

    2008-01-01

    Previous research has suggested that the theory of planned behaviour is insufficient in capturing all the antecedents of physical activity participation and that continuation intentions or personality traits may improve the predictive validity of the model. The present study examined the combined effects of continuation intentions and personality traits on health behaviour within the theory of planned behaviour. To examine these effects, 180 university students (N = 180, Male = 87, Female = 93, Age = 19.14 years, SD = 0.94) completed self-report measures of the theory of planned behaviour, personality traits and continuation intentions. After 5 weeks, perceived achievement of behavioural outcomes and actual participation in physical activities were assessed. Results supported discriminant validity between continuation intentions, conscientiousness and extroversion and indicated that perceived achievement of behavioural outcomes and continuation intentions of failure predicted physical activity participation after controlling for personality effects, past behaviour and other variables in the theory of planned behaviour. In addition, results indicated that conscientiousness moderated the effects of continuation intentions of failure on physical activity such that continuation intentions of failure predicted physical activity participation among conscientious and not among less conscientious individuals. These findings suggest that the effects of continuation intentions on health behaviour are contingent on personality characteristics.

  10. Continuous noninvasive ventilation delivered by a novel total face mask: a case series report.

    PubMed

    Belchior, Inês; Gonçalves, Miguel R; Winck, João Carlos

    2012-03-01

    Noninvasive ventilation (NIV) has been widely used to decrease the complications associated with tracheal intubation in mechanically ventilated patients. However, nasal ulcerations may occur when conventional masks are used for continuous ventilation. A total face mask, which has no contact with the more sensitive areas of the face, is a possible option. We describe 3 patients with acute respiratory failure due to amyotrophic lateral sclerosis, who developed nasal bridge skin necrosis during continuous NIV, and one patient with post-extubation respiratory failure due to a high spinal cord injury, who had facial trauma with contraindication for conventional mask use. The total face mask was very well tolerated by all the patients, and permitted safe and efficient continuous NIV for several days until the acute respiratory failure episode resolved. None of the patients required endotracheal intubation during the acute episode.

  11. The anxiety of Taiwanese women with or without continuity treatment after previous in vitro fertilisation failure.

    PubMed

    Su, Tsann-Juu; Tzeng, Ya-Ling; Kuo, Pi-Chao

    2011-08-01

    To compare the anxiety levels of Taiwanese women who continued with in vitro fertilisation treatment and those who discontinued treatment post-in vitro fertilisation failure. In vitro fertilisation is perceived as the last resort of infertility treatment. The impact of unsuccessful in vitro fertilisation treatment on psychological function has been documented; however, research comparing the levels of anxiety of women who cease and those who continue in vitro fertilisation post-failure is scant. A cross-sectional comparative study design was used. Fifty-eight women in whom in vitro fertilisation had failed within the previous year were recruited to this study from a medical centre in northern Taiwan; 34 women continued treatment and 24 discontinued treatment. The State-Trait Anxiety Inventory was used to assess their levels of anxiety. Women in the group who continued treatment exhibited higher state and trait anxiety (TA) than women in the group who discontinued treatment (p < 0·005). The number and frequency of in vitro fertilisation cycles were significantly higher in the group who continued treatment than in those who did not. A strong positive correlation between state and TA (r = 0·8, p < 0·01) existed in both groups. Both groups exhibited considerable levels of anxiety; however, the women who continued in vitro fertilisation treatment had higher levels of anxiety than those who discontinued treatment. The level of anxiety of women who decide to continue in vitro fertilisation treatment should be assessed as early as possible and counselling services provided to women who experience in vitro fertilisation failure should concentrate more on relieving psychological distress. One year after discontinuing treatment, some women still experience considerable anxiety; therefore, the care and assistance provided to these women need to be continually evaluated. © 2011 Blackwell Publishing Ltd.

  12. Drop-Out Rates among American Indian and Alaska Native Students: Beyond Cultural Discontinuity. ERIC Digest.

    ERIC Educational Resources Information Center

    St. Germaine, Richard

    American Indian and Alaska Native (AI/AN) students regularly face obstacles during the transition to high school and have the highest dropout rate of all U.S. racial and ethnic groups. Educational theorists and researchers have various explanations for this high failure rate, each with its own prescriptions. These explanations include: (1) deficit…

  13. Examining the Potential of Critical and Kaupapa Maori Approaches to Leading Education Reform in New Zealand's English-Medium Secondary Schools

    ERIC Educational Resources Information Center

    Berryman, Mere; Egan, Margaret; Ford, Therese

    2017-01-01

    This paper discusses expectations, policies and practices that currently underpin education within the New Zealand context. It acknowledges the ongoing failure of this policy framework to positively influence reform for Indigenous Maori students in regular, state-funded schools and highlights the need for extensive change in the positioning and…

  14. A Dense Corpus Study of Past Tense and Plural Overregularization in English.

    ERIC Educational Resources Information Center

    Maslen, Robert J.C.; Theakson, Anna L.; Lieven, Elena V.M.; Tomasello, Michael

    2004-01-01

    In the "blocking-and-retrieval-failure" account of overregularization (OR; G. F. Marcus, 1995; G. F. Marcus et al., 1992), the claim that a symbolic rule generates regular inflection is founded on pervasively low past tense OR rates and the lack of a substantive difference between past tense and plural OR rates. Evidence of extended periods of OR…

  15. California Master Plan for Migrant Education, 1976 Edition (Plan Maestro de California para Educacion Migrante, Edicion de 1976).

    ERIC Educational Resources Information Center

    California State Dept. of Education, Sacramento. Div. of Compensatory Education.

    Based on the national migrant education plan, California's master plan aims to mobilize the necessary State and Federal resources, and to unify and assist the efforts of local educational agencies to end the migrant child's failure in school. The plan includes provisions for: instructional activities on a regular and extended year basis designed…

  16. On the buckling of an elastic holey column

    PubMed Central

    Hazel, A. L.; Pihler-Puzović, D.

    2017-01-01

    We report the results of a numerical and theoretical study of buckling in elastic columns containing a line of holes. Buckling is a common failure mode of elastic columns under compression, found over scales ranging from metres in buildings and aircraft to tens of nanometers in DNA. This failure usually occurs through lateral buckling, described for slender columns by Euler’s theory. When the column is perforated with a regular line of holes, a new buckling mode arises, in which adjacent holes collapse in orthogonal directions. In this paper, we firstly elucidate how this alternate hole buckling mode coexists and interacts with classical Euler buckling modes, using finite-element numerical calculations with bifurcation tracking. We show how the preferred buckling mode is selected by the geometry, and discuss the roles of localized (hole-scale) and global (column-scale) buckling. Secondly, we develop a novel predictive model for the buckling of columns perforated with large holes. This model is derived without arbitrary fitting parameters, and quantitatively predicts the critical strain for buckling. We extend the model to sheets perforated with a regular array of circular holes and use it to provide quantitative predictions of their buckling. PMID:29225498

  17. 49 CFR 220.38 - Communication equipment failure.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Communication equipment failure. 220.38 Section 220.38 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD... § 220.38 Communication equipment failure. (a) Any radio or wireless communication device found not to be...

  18. 49 CFR 220.38 - Communication equipment failure.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Communication equipment failure. 220.38 Section 220.38 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD... § 220.38 Communication equipment failure. (a) Any radio or wireless communication device found not to be...

  19. NIV by an interdisciplinary respiratory care team in severe respiratory failure in the emergency department limited to day time hours.

    PubMed

    Horvath, Christian Michael; Brutsche, Martin Hugo; Schoch, Otto Dagobert; Schillig, Bernarde; Baty, Florent; vonOw, Dieter; Rüdiger, Jochen Julius

    2017-12-01

    Non-invasive ventilatory support is frequently used in patients with severe respiratory failure (SRF), but is often limited to intensive care units (ICU). We hypothesized that an instantaneous short course of NIV (up to 2 h), limited to regular working hours as an additional therapy on the emergency department (ED) would be feasible and could improve patient´s dyspnoea measured by respiratory rate and Borg visual dyspnea scale. NIV was set up by an interdisciplinary respiratory care team. Outside these predefined hours NIV was performed in the ICU. This is an observational cohort study over 1 year in the ED in a non-university hospital. Fifty-one % of medical emergencies arrived during regular working hours (5475 of 10,718 patients). In total, 63 patients were treated with instantaneous NIV. Door to NIV in the ED was 56 (31-97) min, door to ICU outside regular working hours was 84 (57-166) min. Within 1 h of NIV, the respiratory rate decreased from 30/min (25-35) to 19/min (14-24, p < 0.001), the Borg dyspnoea scale improved from 7 (5-8) to 2 (0-3, p < 0.001). In hypercapnic patients, the blood-pH increased from 7.29 (7.24-7.33) to 7.35 (7.29-7.40) and the pCO 2 dropped from 8.82 (8.13-10.15) to 7.45 (6.60-8.75) kPa. In patients with SRF of varying origin, instantaneous NIV in the ED during regular working hours was feasible in a non-university hospital setting, and rapidly and significantly alleviated dyspnoea and reduced respiratory rate. This approach proved to be useful as a bridge to the ICU as well as an efficient palliative dyspnoea treatment.

  20. Preliminary Examination of Cervical Health Practices and Knowledge among University-Aged Females

    ERIC Educational Resources Information Center

    Fletcher, Paula C.; Bryden, Pamela J.

    2005-01-01

    Cervical cancer is relatively preventable through regular cervical examinations and by engaging in healthy practices concerning lifestyle behaviors, like safe sexual intercourse. Despite the benefits that regular pap tests provide, screening tests continue to be under used by women, with younger women being one of the most negligent groups. Since…

  1. 34 CFR 645.12 - How are regular Upward Bound projects organized?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false How are regular Upward Bound projects organized? 645.12 Section 645.12 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION UPWARD BOUND PROGRAM What Kinds of Projects and Services Does...

  2. Elastic and failure response of imperfect three-dimensional metallic lattices: the role of geometric defects induced by Selective Laser Melting

    NASA Astrophysics Data System (ADS)

    Liu, Lu; Kamm, Paul; García-Moreno, Francisco; Banhart, John; Pasini, Damiano

    2017-10-01

    This paper examines three-dimensional metallic lattices with regular octet and rhombicuboctahedron units fabricated with geometric imperfections via Selective Laser Sintering. We use X-ray computed tomography to capture morphology, location, and distribution of process-induced defects with the aim of studying their role in the elastic response, damage initiation, and failure evolution under quasi-static compression. Testing results from in-situ compression tomography show that each lattice exhibits a distinct failure mechanism that is governed not only by cell topology but also by geometric defects induced by additive manufacturing. Extracted from X-ray tomography images, the statistical distributions of three sets of defects, namely strut waviness, strut thickness variation, and strut oversizing, are used to develop numerical models of statistically representative lattices with imperfect geometry. Elastic and failure responses are predicted within 10% agreement from the experimental data. In addition, a computational study is presented to shed light into the relationship between the amplitude of selected defects and the reduction of elastic properties compared to their nominal values. The evolution of failure mechanisms is also explained with respect to strut oversizing, a parameter that can critically cause failure mode transitions that are not visible in defect-free lattices.

  3. Operating manual for the miniservo-control tester

    USGS Publications Warehouse

    Rapp, W.L.

    1986-01-01

    Ever since the implementation of servo-control units (regular and minimodels) with manometers at U. S. Geological Survey streamflow stations, the need for an effective and efficient servo-control unit tester has been paramount among field personnel. In numerous cases, servo-control unit failures were blamed on battery failures and vice versa. There was no valid instrument to definitively identify cause of failure, let alone properly diagnose the servo-control/manometer system. In 1983, two servo-control unit testers were developed and fabricated. One was mechanical in fabrication, operation, and serviceability; the other was electronic. The testers were extensively used and evaluated in Maine, Ohio, Kansas, and Louisiana under a wide range of environmental conditions. The consensus to integrate the best aspects of both testers into one instrument allowed the Survey to finally solve its long-time need for an effective, efficient servo-control unit tester. (USGS)

  4. 7 CFR 281.7 - Indian tribal organization failure.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 4 2011-01-01 2011-01-01 false Indian tribal organization failure. 281.7 Section 281.7 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE... ON INDIAN RESERVATIONS § 281.7 Indian tribal organization failure. When Performance Reporting System...

  5. 7 CFR 281.7 - Indian tribal organization failure.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 4 2013-01-01 2013-01-01 false Indian tribal organization failure. 281.7 Section 281.7 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE... ON INDIAN RESERVATIONS § 281.7 Indian tribal organization failure. When Performance Reporting System...

  6. 7 CFR 281.7 - Indian tribal organization failure.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 4 2012-01-01 2012-01-01 false Indian tribal organization failure. 281.7 Section 281.7 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE... ON INDIAN RESERVATIONS § 281.7 Indian tribal organization failure. When Performance Reporting System...

  7. 49 CFR 630.7 - Failure to respond to questions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Failure to respond to questions. 630.7 Section 630.7 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION NATIONAL TRANSIT DATABASE § 630.7 Failure to respond to questions...

  8. 49 CFR 630.7 - Failure to respond to questions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Failure to respond to questions. 630.7 Section 630.7 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION NATIONAL TRANSIT DATABASE § 630.7 Failure to respond to questions...

  9. 49 CFR 630.7 - Failure to respond to questions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Failure to respond to questions. 630.7 Section 630.7 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION NATIONAL TRANSIT DATABASE § 630.7 Failure to respond to questions...

  10. 49 CFR 630.7 - Failure to respond to questions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Failure to respond to questions. 630.7 Section 630.7 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION NATIONAL TRANSIT DATABASE § 630.7 Failure to respond to questions...

  11. 49 CFR 630.7 - Failure to respond to questions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Failure to respond to questions. 630.7 Section 630.7 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION NATIONAL TRANSIT DATABASE § 630.7 Failure to respond to questions...

  12. 7 CFR 922.24 - Failure to nominate.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 8 2013-01-01 2013-01-01 false Failure to nominate. 922.24 Section 922.24 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... IN WASHINGTON Order Regulating Handling Administrative Body § 922.24 Failure to nominate. If...

  13. 7 CFR 932.31 - Failure to nominate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Failure to nominate. 932.31 Section 932.31 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Olive Administrative Committee § 932.31 Failure to nominate. If nominations for any...

  14. 14 CFR 65.19 - Retesting after failure.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false Retesting after failure. 65.19 Section 65.19 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRMEN CERTIFICATION: AIRMEN OTHER THAN FLIGHT CREWMEMBERS General § 65.19 Retesting after failure. An...

  15. 7 CFR 953.20 - Failure to nominate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Failure to nominate. 953.20 Section 953.20 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... STATES Order Regulating Handling Administrative Committee § 953.20 Failure to nominate. If nominations...

  16. 7 CFR 923.24 - Failure to nominate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Failure to nominate. 923.24 Section 923.24 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... COUNTIES IN WASHINGTON Order Regulating Handling Administrative Body § 923.24 Failure to nominate. If...

  17. 7 CFR 953.20 - Failure to nominate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Failure to nominate. 953.20 Section 953.20 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... STATES Order Regulating Handling Administrative Committee § 953.20 Failure to nominate. If nominations...

  18. 7 CFR 932.31 - Failure to nominate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Failure to nominate. 932.31 Section 932.31 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Regulating Handling Olive Administrative Committee § 932.31 Failure to nominate. If nominations for any...

  19. 14 CFR 65.19 - Retesting after failure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false Retesting after failure. 65.19 Section 65.19 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRMEN CERTIFICATION: AIRMEN OTHER THAN FLIGHT CREWMEMBERS General § 65.19 Retesting after failure. An...

  20. 7 CFR 927.25 - Failure to nominate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Failure to nominate. 927.25 Section 927.25 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Order Regulating Handling Administrative Bodies § 927.25 Failure to nominate. In the event nominations...

  1. 7 CFR 922.24 - Failure to nominate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Failure to nominate. 922.24 Section 922.24 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... IN WASHINGTON Order Regulating Handling Administrative Body § 922.24 Failure to nominate. If...

  2. 7 CFR 932.31 - Failure to nominate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Failure to nominate. 932.31 Section 932.31 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Olive Administrative Committee § 932.31 Failure to nominate. If nominations for any...

  3. 7 CFR 953.20 - Failure to nominate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Failure to nominate. 953.20 Section 953.20 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... STATES Order Regulating Handling Administrative Committee § 953.20 Failure to nominate. If nominations...

  4. 7 CFR 917.26 - Failure to nominate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Failure to nominate. 917.26 Section 917.26 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... CALIFORNIA Order Regulating Handling Administrative Bodies § 917.26 Failure to nominate. If nominations are...

  5. 7 CFR 927.25 - Failure to nominate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Failure to nominate. 927.25 Section 927.25 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Order Regulating Handling Administrative Bodies § 927.25 Failure to nominate. In the event nominations...

  6. 7 CFR 917.26 - Failure to nominate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Failure to nominate. 917.26 Section 917.26 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... CALIFORNIA Order Regulating Handling Administrative Bodies § 917.26 Failure to nominate. If nominations are...

  7. 14 CFR 65.19 - Retesting after failure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Retesting after failure. 65.19 Section 65.19 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRMEN CERTIFICATION: AIRMEN OTHER THAN FLIGHT CREWMEMBERS General § 65.19 Retesting after failure. An...

  8. 14 CFR 65.19 - Retesting after failure.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Retesting after failure. 65.19 Section 65.19 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRMEN CERTIFICATION: AIRMEN OTHER THAN FLIGHT CREWMEMBERS General § 65.19 Retesting after failure. An...

  9. 7 CFR 927.25 - Failure to nominate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Failure to nominate. 927.25 Section 927.25 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Order Regulating Handling Administrative Bodies § 927.25 Failure to nominate. In the event nominations...

  10. 7 CFR 923.24 - Failure to nominate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Failure to nominate. 923.24 Section 923.24 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... COUNTIES IN WASHINGTON Order Regulating Handling Administrative Body § 923.24 Failure to nominate. If...

  11. 7 CFR 922.24 - Failure to nominate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Failure to nominate. 922.24 Section 922.24 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... IN WASHINGTON Order Regulating Handling Administrative Body § 922.24 Failure to nominate. If...

  12. 7 CFR 923.24 - Failure to nominate.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 8 2013-01-01 2013-01-01 false Failure to nominate. 923.24 Section 923.24 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... COUNTIES IN WASHINGTON Order Regulating Handling Administrative Body § 923.24 Failure to nominate. If...

  13. 7 CFR 917.26 - Failure to nominate.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 8 2013-01-01 2013-01-01 false Failure to nominate. 917.26 Section 917.26 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... CALIFORNIA Order Regulating Handling Administrative Bodies § 917.26 Failure to nominate. If nominations are...

  14. 7 CFR 922.24 - Failure to nominate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Failure to nominate. 922.24 Section 922.24 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... IN WASHINGTON Order Regulating Handling Administrative Body § 922.24 Failure to nominate. If...

  15. 7 CFR 917.26 - Failure to nominate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Failure to nominate. 917.26 Section 917.26 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... CALIFORNIA Order Regulating Handling Administrative Bodies § 917.26 Failure to nominate. If nominations are...

  16. 7 CFR 932.31 - Failure to nominate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Failure to nominate. 932.31 Section 932.31 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Olive Administrative Committee § 932.31 Failure to nominate. If nominations for any...

  17. 7 CFR 923.24 - Failure to nominate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Failure to nominate. 923.24 Section 923.24 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... COUNTIES IN WASHINGTON Order Regulating Handling Administrative Body § 923.24 Failure to nominate. If...

  18. 7 CFR 923.24 - Failure to nominate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Failure to nominate. 923.24 Section 923.24 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... COUNTIES IN WASHINGTON Order Regulating Handling Administrative Body § 923.24 Failure to nominate. If...

  19. 7 CFR 917.26 - Failure to nominate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Failure to nominate. 917.26 Section 917.26 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... CALIFORNIA Order Regulating Handling Administrative Bodies § 917.26 Failure to nominate. If nominations are...

  20. 7 CFR 932.31 - Failure to nominate.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 8 2013-01-01 2013-01-01 false Failure to nominate. 932.31 Section 932.31 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Regulating Handling Olive Administrative Committee § 932.31 Failure to nominate. If nominations for any...

  1. 7 CFR 927.25 - Failure to nominate.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 8 2013-01-01 2013-01-01 false Failure to nominate. 927.25 Section 927.25 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Order Regulating Handling Administrative Bodies § 927.25 Failure to nominate. In the event nominations...

  2. 7 CFR 922.24 - Failure to nominate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Failure to nominate. 922.24 Section 922.24 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... IN WASHINGTON Order Regulating Handling Administrative Body § 922.24 Failure to nominate. If...

  3. 7 CFR 927.25 - Failure to nominate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Failure to nominate. 927.25 Section 927.25 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Order Regulating Handling Administrative Bodies § 927.25 Failure to nominate. In the event nominations...

  4. 49 CFR 661.17 - Failure to comply with certification.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Failure to comply with certification. 661.17 Section 661.17 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION BUY AMERICA REQUIREMENTS § 661.17 Failure to comply with...

  5. 49 CFR 661.17 - Failure to comply with certification.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Failure to comply with certification. 661.17 Section 661.17 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION BUY AMERICA REQUIREMENTS § 661.17 Failure to comply with...

  6. 49 CFR 661.17 - Failure to comply with certification.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Failure to comply with certification. 661.17 Section 661.17 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION BUY AMERICA REQUIREMENTS § 661.17 Failure to comply with...

  7. 49 CFR 661.17 - Failure to comply with certification.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Failure to comply with certification. 661.17 Section 661.17 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION BUY AMERICA REQUIREMENTS § 661.17 Failure to comply with...

  8. 49 CFR 661.17 - Failure to comply with certification.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Failure to comply with certification. 661.17 Section 661.17 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION BUY AMERICA REQUIREMENTS § 661.17 Failure to comply with...

  9. Population movement and malaria persistence in Rameswaram Island.

    PubMed

    Rajagopalan, P K; Jambulingam, P; Sabesan, S; Krishnamoorthy, K; Rajendran, S; Gunasekaran, K; Kumar, N P; Prothero, R M

    1986-01-01

    The role of population movement on the persistent transmission of malaria in Rameswaram Island was studied. Majority of the inhabitants of the island are fishermen, who engage in perennial fishing. They move from one coastal place to the other for fishing and stay in temporary camps depending on season and fish availability. Such seasonal fishing camps attract fishermen from the mainland coastal villages also. The parasitological and entomological studies carried out in these places reveal that some of the camps are highly vulnerable to the movement of individuals with malaria infection and highly receptive. Rameswaram being a holy place, receives pilgrims from all over India and Nepal. Plasmodium falciparum cases recorded from the pilgrims of North India indicate the danger of the possible introduction of chloroquine-resistant parasite in the island. Also, a large number of passengers in transit from various countries, many of which are at risk of malaria transmission, stay in the island before or after visiting Sri Lanka. Such population movements being a continuous and regular feature are significant and result in failures in the operational programmes.

  10. Damage tolerance of woven graphite-epoxy buffer strip panels

    NASA Technical Reports Server (NTRS)

    Kennedy, John M.

    1990-01-01

    Graphite-epoxy panels with S glass buffer strips were tested in tension and shear to measure their residual strengths with crack-like damage. The buffer strips were regularly spaced narrow strips of continuous S glass. Panels were made with a uniweave graphite cloth where the S glass buffer material was woven directly into the cloth. Panels were made with different width and thickness buffer strips. The panels were loaded to failure while remote strain, strain at the end of the slit, and crack opening displacement were monitoring. The notched region and nearby buffer strips were radiographed periodically to reveal crack growth and damage. Except for panels with short slits, the buffer strips arrested the propagating crack. The strength (or failing strain) of the panels was significantly higher than the strength of all-graphite panels with the same length slit. Panels with wide, thick buffer strips were stronger than panels with thin, narrow buffer strips. A shear-lag model predicted the failing strength of tension panels with wide buffer strips accurately, but over-estimated the strength of the shear panels and the tension panels with narrow buffer strips.

  11. Preventing Continuous Positive Airway Pressure Failure: Evidence-Based and Physiologically Sound Practices from Delivery Room to the Neonatal Intensive Care Unit.

    PubMed

    Wright, Clyde J; Sherlock, Laurie G; Sahni, Rakesh; Polin, Richard A

    2018-06-01

    Routine use of continuous positive airway pressure (CPAP) to support preterm infants with respiratory distress is an evidenced-based strategy to decrease incidence of bronchopulmonary dysplasia. However, rates of CPAP failure remain unacceptably high in very premature neonates, who are at high risk for developing bronchopulmonary dysplasia. Using the GRADE framework to assess the quality of available evidence, this article reviews strategies aimed at decreasing CPAP failure, starting with delivery room interventions and followed through to system-based efforts in the neonatal intensive care unit. Despite best efforts, some very premature neonates fail CPAP. Also reviewed are predictors of CPAP failure in this vulnerable population. Copyright © 2018 Elsevier Inc. All rights reserved.

  12. Percolation of a general network of networks.

    PubMed

    Gao, Jianxi; Buldyrev, Sergey V; Stanley, H Eugene; Xu, Xiaoming; Havlin, Shlomo

    2013-12-01

    Percolation theory is an approach to study the vulnerability of a system. We develop an analytical framework and analyze the percolation properties of a network composed of interdependent networks (NetONet). Typically, percolation of a single network shows that the damage in the network due to a failure is a continuous function of the size of the failure, i.e., the fraction of failed nodes. In sharp contrast, in NetONet, due to the cascading failures, the percolation transition may be discontinuous and even a single node failure may lead to an abrupt collapse of the system. We demonstrate our general framework for a NetONet composed of n classic Erdős-Rényi (ER) networks, where each network depends on the same number m of other networks, i.e., for a random regular network (RR) formed of interdependent ER networks. The dependency between nodes of different networks is taken as one-to-one correspondence, i.e., a node in one network can depend only on one node in the other network (no-feedback condition). In contrast to a treelike NetONet in which the size of the largest connected cluster (mutual component) depends on n, the loops in the RR NetONet cause the largest connected cluster to depend only on m and the topology of each network but not on n. We also analyzed the extremely vulnerable feedback condition of coupling, where the coupling between nodes of different networks is not one-to-one correspondence. In the case of NetONet formed of ER networks, percolation only exhibits two phases, a second order phase transition and collapse, and no first order percolation transition regime is found in the case of the no-feedback condition. In the case of NetONet composed of RR networks, there exists a first order phase transition when the coupling strength q (fraction of interdependency links) is large and a second order phase transition when q is small. Our insight on the resilience of coupled networks might help in designing robust interdependent systems.

  13. 42 CFR 414.806 - Penalties associated with the failure to submit timely and accurate ASP data.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Penalties associated with the failure to submit timely and accurate ASP data. 414.806 Section 414.806 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES...

  14. 42 CFR 414.806 - Penalties associated with the failure to submit timely and accurate ASP data.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Penalties associated with the failure to submit timely and accurate ASP data. 414.806 Section 414.806 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES...

  15. 42 CFR 414.806 - Penalties associated with the failure to submit timely and accurate ASP data.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Penalties associated with the failure to submit timely and accurate ASP data. 414.806 Section 414.806 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES...

  16. Regularized Chapman-Enskog expansion for scalar conservation laws

    NASA Technical Reports Server (NTRS)

    Schochet, Steven; Tadmor, Eitan

    1990-01-01

    Rosenau has recently proposed a regularized version of the Chapman-Enskog expansion of hydrodynamics. This regularized expansion resembles the usual Navier-Stokes viscosity terms at law wave-numbers, but unlike the latter, it has the advantage of being a bounded macroscopic approximation to the linearized collision operator. The behavior of Rosenau regularization of the Chapman-Enskog expansion (RCE) is studied in the context of scalar conservation laws. It is shown that thie RCE model retains the essential properties of the usual viscosity approximation, e.g., existence of traveling waves, monotonicity, upper-Lipschitz continuity..., and at the same time, it sharpens the standard viscous shock layers. It is proved that the regularized RCE approximation converges to the underlying inviscid entropy solution as its mean-free-path epsilon approaches 0, and the convergence rate is estimated.

  17. [A rare case of Graves' disease in a patient on regular haemodialysis].

    PubMed

    Boubaker, Karima; Ounissi, Mondher; Khiari, Karima; Harzallah, Amel; Abbes, Monia; El Younsi, Fethi; Ben Abdellah, Taieb; Ben Maïz, Hedi; Kaaroud, Hayet; Kheder, Adel

    2010-07-01

    Abnormal thyroid hormone production and metabolism are relatively common in chronic renal failure and in regular haemodialysis. Graves' disease is a very unusual condition and is difficult to identify. We report a case of Graves' disease in a patient on regular hemodialysis. A 26-year-old man undergoing regular hemodialysis from unknown chronic nephropathy since four years. The patient suffered from unexplained slimming and aggressiveness. On admission, he had an irritability, tremor of the extremities, arterial hypertension not controlled by the medical treatment, discrete asynergy oculo-palpebral, glare of the glance and protrusion of the ocular spheres. The thyroid was non palpable. Biological tests demonstrated hyperthyroidism. Thyroid-stimulating hormone receptor antibodies were positive. Thyroid echography and scintiscanning showed vascular and hyperfonctionnel character of the thyroid. The patient was treated radically by radioactive iodine 131 therapy after medical preparation by antithyroid agent. He developed hypothyroidism treated by substitutive treatment. The diagnosis of Graves' disease must be evoked even in the absence of specific symptoms in haemodialysis patients. In front of clinical symptoms, since the conventional treatment is effective and inoffensive. Copyright 2010 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

  18. Experimental/clinical evaluation of EIT image reconstruction with l1 data and image norms

    NASA Astrophysics Data System (ADS)

    Mamatjan, Yasin; Borsic, Andrea; Gürsoy, Doga; Adler, Andy

    2013-04-01

    Electrical impedance tomography (EIT) image reconstruction is ill-posed, and the spatial resolution of reconstructed images is low due to the diffuse propagation of current and limited number of independent measurements. Generally, image reconstruction is formulated using a regularized scheme in which l2 norms are preferred for both the data misfit and image prior terms due to computational convenience which result in smooth solutions. However, recent work on a Primal Dual-Interior Point Method (PDIPM) framework showed its effectiveness in dealing with the minimization problem. l1 norms on data and regularization terms in EIT image reconstruction address both problems of reconstruction with sharp edges and dealing with measurement errors. We aim for a clinical and experimental evaluation of the PDIPM method by selecting scenarios (human lung and dog breathing) with known electrode errors, which require a rigorous regularization and cause the failure of reconstructions with l2 norm. Results demonstrate the applicability of PDIPM algorithms, especially l1 data and regularization norms for clinical applications of EIT showing that l1 solution is not only more robust to measurement errors in clinical setting, but also provides high contrast resolution on organ boundaries.

  19. 49 CFR 192.617 - Investigation of failures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY TRANSPORTATION OF NATURAL AND OTHER GAS... operator shall establish procedures for analyzing accidents and failures, including the selection of...

  20. 40 CFR 82.161 - Technician certification.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... (CONTINUED) PROTECTION OF STRATOSPHERIC OZONE Recycling and Emissions Reduction § 82.161 Technician... proper procedures for recovering and/or recycling refrigerant. Failure to demonstrate or failure to...

  1. 40 CFR 82.161 - Technician certification.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... (CONTINUED) PROTECTION OF STRATOSPHERIC OZONE Recycling and Emissions Reduction § 82.161 Technician... proper procedures for recovering and/or recycling refrigerant. Failure to demonstrate or failure to...

  2. 40 CFR 82.161 - Technician certification.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... (CONTINUED) PROTECTION OF STRATOSPHERIC OZONE Recycling and Emissions Reduction § 82.161 Technician... proper procedures for recovering and/or recycling refrigerant. Failure to demonstrate or failure to...

  3. 40 CFR 82.161 - Technician certification.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... (CONTINUED) PROTECTION OF STRATOSPHERIC OZONE Recycling and Emissions Reduction § 82.161 Technician... proper procedures for recovering and/or recycling refrigerant. Failure to demonstrate or failure to...

  4. 40 CFR 82.161 - Technician certification.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... (CONTINUED) PROTECTION OF STRATOSPHERIC OZONE Recycling and Emissions Reduction § 82.161 Technician... proper procedures for recovering and/or recycling refrigerant. Failure to demonstrate or failure to...

  5. On-Orbit Performance of the Helioseismic and Magnetic Imager Instrument onboard the Solar Dynamics Observatory

    NASA Astrophysics Data System (ADS)

    Hoeksema, J. T.; Baldner, C. S.; Bush, R. I.; Schou, J.; Scherrer, P. H.

    2018-03-01

    The Helioseismic and Magnetic Imager (HMI) instrument is a major component of NASA's Solar Dynamics Observatory (SDO) spacecraft. Since commencement of full regular science operations on 1 May 2010, HMI has operated with remarkable continuity, e.g. during the more than five years of the SDO prime mission that ended 30 September 2015, HMI collected 98.4% of all possible 45-second velocity maps; minimizing gaps in these full-disk Dopplergrams is crucial for helioseismology. HMI velocity, intensity, and magnetic-field measurements are used in numerous investigations, so understanding the quality of the data is important. This article describes the calibration measurements used to track the performance of the HMI instrument, and it details trends in important instrument parameters during the prime mission. Regular calibration sequences provide information used to improve and update the calibration of HMI data. The set-point temperature of the instrument front window and optical bench is adjusted regularly to maintain instrument focus, and changes in the temperature-control scheme have been made to improve stability in the observable quantities. The exposure time has been changed to compensate for a 20% decrease in instrument throughput. Measurements of the performance of the shutter and tuning mechanisms show that they are aging as expected and continue to perform according to specification. Parameters of the tunable optical-filter elements are regularly adjusted to account for drifts in the central wavelength. Frequent measurements of changing CCD-camera characteristics, such as gain and flat field, are used to calibrate the observations. Infrequent expected events such as eclipses, transits, and spacecraft off-points interrupt regular instrument operations and provide the opportunity to perform additional calibration. Onboard instrument anomalies are rare and seem to occur quite uniformly in time. The instrument continues to perform very well.

  6. 7 CFR 1219.34 - Failure to nominate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 10 2012-01-01 2012-01-01 false Failure to nominate. 1219.34 Section 1219.34 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING....34 Failure to nominate. In any case in which producers or importers fail to nominate individuals for...

  7. 7 CFR 915.24 - Failure to nominate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Failure to nominate. 915.24 Section 915.24 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Regulating Handling Administrative Body § 915.24 Failure to nominate. If nominations are not made within the...

  8. 7 CFR 915.24 - Failure to nominate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Failure to nominate. 915.24 Section 915.24 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Administrative Body § 915.24 Failure to nominate. If nominations are not made within the...

  9. 14 CFR 63.41 - Retesting after failure.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Retesting after failure. 63.41 Section 63.41 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED... failure. An applicant for a flight engineer certificate who fails a written test or practical test for...

  10. 7 CFR 905.27 - Failure to nominate.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 8 2013-01-01 2013-01-01 false Failure to nominate. 905.27 Section 905.27 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... TANGELOS GROWN IN FLORIDA Order Regulating Handling Administrative Bodies § 905.27 Failure to nominate. In...

  11. 14 CFR 63.41 - Retesting after failure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Retesting after failure. 63.41 Section 63.41 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED... failure. An applicant for a flight engineer certificate who fails a written test or practical test for...

  12. 7 CFR 1219.34 - Failure to nominate.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 10 2013-01-01 2013-01-01 false Failure to nominate. 1219.34 Section 1219.34 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING....34 Failure to nominate. In any case in which producers or importers fail to nominate individuals for...

  13. 7 CFR 905.27 - Failure to nominate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Failure to nominate. 905.27 Section 905.27 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... TANGELOS GROWN IN FLORIDA Order Regulating Handling Administrative Bodies § 905.27 Failure to nominate. In...

  14. 7 CFR 915.24 - Failure to nominate.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 8 2013-01-01 2013-01-01 false Failure to nominate. 915.24 Section 915.24 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Regulating Handling Administrative Body § 915.24 Failure to nominate. If nominations are not made within the...

  15. 7 CFR 906.24 - Failure to nominate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Failure to nominate. 906.24 Section 906.24 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... RIO GRANDE VALLEY IN TEXAS Order Regulating Handling Committee § 906.24 Failure to nominate. If...

  16. 29 CFR 1601.25 - Failure of conciliation; notice.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 4 2012-07-01 2012-07-01 false Failure of conciliation; notice. 1601.25 Section 1601.25 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURAL... Employment Practices § 1601.25 Failure of conciliation; notice. Where the Commission is unable to obtain...

  17. 14 CFR 63.59 - Retesting after failure.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Retesting after failure. 63.59 Section 63.59 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED... failure. (a) An applicant for a flight navigator certificate who fails a written or practical test for...

  18. 14 CFR 63.41 - Retesting after failure.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false Retesting after failure. 63.41 Section 63.41 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED... failure. An applicant for a flight engineer certificate who fails a written test or practical test for...

  19. 7 CFR 906.24 - Failure to nominate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Failure to nominate. 906.24 Section 906.24 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... RIO GRANDE VALLEY IN TEXAS Order Regulating Handling Committee § 906.24 Failure to nominate. If...

  20. 7 CFR 906.24 - Failure to nominate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Failure to nominate. 906.24 Section 906.24 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... RIO GRANDE VALLEY IN TEXAS Order Regulating Handling Committee § 906.24 Failure to nominate. If...

  1. 7 CFR 948.57 - Failure to nominate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Failure to nominate. 948.57 Section 948.57 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Order Regulating Handling Committees § 948.57 Failure to nominate. If nominations are not made pursuant...

  2. 7 CFR 948.57 - Failure to nominate.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 8 2013-01-01 2013-01-01 false Failure to nominate. 948.57 Section 948.57 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Order Regulating Handling Committees § 948.57 Failure to nominate. If nominations are not made pursuant...

  3. 7 CFR 948.57 - Failure to nominate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Failure to nominate. 948.57 Section 948.57 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Order Regulating Handling Committees § 948.57 Failure to nominate. If nominations are not made pursuant...

  4. 14 CFR 63.41 - Retesting after failure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false Retesting after failure. 63.41 Section 63.41 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED... failure. An applicant for a flight engineer certificate who fails a written test or practical test for...

  5. 29 CFR 1601.25 - Failure of conciliation; notice.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 4 2013-07-01 2013-07-01 false Failure of conciliation; notice. 1601.25 Section 1601.25 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURAL... Employment Practices § 1601.25 Failure of conciliation; notice. Where the Commission is unable to obtain...

  6. 7 CFR 1219.34 - Failure to nominate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Failure to nominate. 1219.34 Section 1219.34 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING....34 Failure to nominate. In any case in which producers or importers fail to nominate individuals for...

  7. 7 CFR 916.24 - Failure to nominate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Failure to nominate. 916.24 Section 916.24 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Administrative Body § 916.24 Failure to nominate. If nominations are not made within the...

  8. 7 CFR 916.24 - Failure to nominate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Failure to nominate. 916.24 Section 916.24 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Administrative Body § 916.24 Failure to nominate. If nominations are not made within the...

  9. 7 CFR 905.27 - Failure to nominate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Failure to nominate. 905.27 Section 905.27 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... TANGELOS GROWN IN FLORIDA Order Regulating Handling Administrative Bodies § 905.27 Failure to nominate. In...

  10. 14 CFR 63.59 - Retesting after failure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Retesting after failure. 63.59 Section 63.59 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED... failure. (a) An applicant for a flight navigator certificate who fails a written or practical test for...

  11. 29 CFR 1601.25 - Failure of conciliation; notice.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 4 2014-07-01 2014-07-01 false Failure of conciliation; notice. 1601.25 Section 1601.25 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURAL... Employment Practices § 1601.25 Failure of conciliation; notice. Where the Commission is unable to obtain...

  12. 7 CFR 948.57 - Failure to nominate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Failure to nominate. 948.57 Section 948.57 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Order Regulating Handling Committees § 948.57 Failure to nominate. If nominations are not made pursuant...

  13. 7 CFR 948.57 - Failure to nominate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Failure to nominate. 948.57 Section 948.57 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Order Regulating Handling Committees § 948.57 Failure to nominate. If nominations are not made pursuant...

  14. 14 CFR 63.59 - Retesting after failure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false Retesting after failure. 63.59 Section 63.59 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED... failure. (a) An applicant for a flight navigator certificate who fails a written or practical test for...

  15. 14 CFR 63.59 - Retesting after failure.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false Retesting after failure. 63.59 Section 63.59 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED... failure. (a) An applicant for a flight navigator certificate who fails a written or practical test for...

  16. 7 CFR 905.27 - Failure to nominate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Failure to nominate. 905.27 Section 905.27 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... TANGELOS GROWN IN FLORIDA Order Regulating Handling Administrative Bodies § 905.27 Failure to nominate. In...

  17. 7 CFR 906.24 - Failure to nominate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Failure to nominate. 906.24 Section 906.24 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... RIO GRANDE VALLEY IN TEXAS Order Regulating Handling Committee § 906.24 Failure to nominate. If...

  18. 7 CFR 1219.34 - Failure to nominate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 10 2014-01-01 2014-01-01 false Failure to nominate. 1219.34 Section 1219.34 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING....34 Failure to nominate. In any case in which producers or importers fail to nominate individuals for...

  19. 7 CFR 906.24 - Failure to nominate.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 8 2013-01-01 2013-01-01 false Failure to nominate. 906.24 Section 906.24 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... RIO GRANDE VALLEY IN TEXAS Order Regulating Handling Committee § 906.24 Failure to nominate. If...

  20. 7 CFR 915.24 - Failure to nominate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Failure to nominate. 915.24 Section 915.24 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Administrative Body § 915.24 Failure to nominate. If nominations are not made within the...

  1. DDD pacemaker for severe heart failure-alternate to CRT.

    PubMed

    Krishnamani, N C

    Patients with severe systolic Heart Failure continue to have poor quality of life and increased mortality in spite of optimal medical management. Cardiac Resynchronization Therapy [CRT] is promising modality in patients with systolic heart failure and electrocardiographic [ECG] evidence of left bundle branch block [LBBB]. Cost issues continue to elude many deserving cases of this therapy in our society. Relatively cost effective Dual chamber pacing [DDD] with right atrial and isolated left ventricular pacing [RA-LV] can be a good alternative. Copyright © 2016 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

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

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

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

    2010-06-01

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

  3. 12 CFR 261b.8 - Meetings closed to public observation under regular procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Meetings closed to public observation under regular procedures. 261b.8 Section 261b.8 Banks and Banking FEDERAL RESERVE SYSTEM (CONTINUED) BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM RULES REGARDING PUBLIC OBSERVATION OF MEETINGS § 261b.8 Meetings...

  4. U.N. Convention Against Torture (CAT): Overview and Application to Interrogation Techniques

    DTIC Science & Technology

    2008-01-25

    torture”); Al- Saher v. I.N.S., 268 F.3d 1143 (9th Cir. 2001) (finding that regular, severe beatings and cigarette burns inflicted upon an Iraqi alien by...continued) be of sufficient severity to constitute torture. See Al- Saher , 268 F.3d at 1143 (regular, severe beatings and cigarette burns

  5. Successes and Difficulties in the Individual Inclusion of Children with Autism Spectrum Disorder (ASD) in the Eyes of Their Coordinators

    ERIC Educational Resources Information Center

    Eldar, Eitan; Talmor, Rachel; Wolf-Zukerman, Tali

    2010-01-01

    This study examined the inclusion of children with Autism Spectrum Disorder (ASD) in regular classes and analysed the factors related to its success and failure. Thirty-seven inclusion coordinators participated in the study and conveyed their view about their own experience. The qualitative methodology used in this study was comprised of regular…

  6. Combined antegrade and retrograde esophageal dilation for head and neck cancer-related complete esophageal stenosis.

    PubMed

    Goguen, Laura A; Norris, Charles M; Jaklitsch, Michael T; Sullivan, Christopher A; Posner, Marshall R; Haddad, Robert I; Tishler, Roy B; Burke, Elaine; Annino, Donald J

    2010-02-01

    Assess the safety and efficacy of combined antegrade and retrograde esophageal dilation (CARD) for complete esophageal stenosis following head and neck cancer (HNC) treatment. Review HNC dysphagia management. Retrospective review of all patients undergoing CARD following HNC treatment between May 2001 and September 2008. Forty-five patients were identified for review. Parameters assessed included: ability to obtain intraoperative esophageal patency, complications, number of dilations required, diet, and gastric tube (GT) status. Factors associated with dilation failure were analyzed. Intraoperative esophageal patency was obtained in 91% of patients. Median number of all dilations per patient was three. Median number of CARDs per patient was one. Resumption of oral intake occurred in 36/45 (80%). Diet results included: regular or soft diet 32/45 (71%), GT removal 27/45 (60%), and GT dependence with nothing by mouth 9/45 (20%). Laryngeal and pharyngeal stenosis, radionecrosis, tracheotomy dependence, and elongated stenosis were associated with dilation failure. Complications occurred in 18/63 (29%) CARD procedures: eight pneumomediastinum, seven GT site problems, two esophageal perforations, and one pharyngeal infection. All complications resolved spontaneously or with minimal interventions. CARD was safe and effective. Intraoperative patency was achieved in 91% of patients. Eighty percent resumed oral intake. The majority of patients had their GTs removed and resumed a soft or regular diet. Dilation failure was associated with laryngeal, pharyngeal, and excessively long esophageal stenosis, often resulting from radionecrosis. Complications were minor. CARD should be considered before relegating patients with complete esophageal stenosis to chronic GT dependence or subjecting them to laryngopharyngo esophagectomy.

  7. Lessons learned from 150 continuous-flow left ventricular assist devices: a single institutional 7 year experience.

    PubMed

    Tsiouris, Athanasios; Paone, Gaetano; Nemeh, Hassan W; Brewer, Robert J; Borgi, Jamil; Hodari, Arielle; Morgan, Jeffrey A

    2015-01-01

    Continuous-flow (CF) left ventricular assist devices (LVADs) have become the standard of care for patients with advanced heart failure refractory to optimal medical therapy. The goal of this study was to review our 7 year single institutional experience with CF LVADs. Mean age was 50.4 + 12.5 (17-69) years for bridge-to-transplantation (BTT) patients and 57.6 + 10.4 (31-81) years for destination therapy (DT) patients (p < 0.001). Overall, 38 patients (26%) were female and 58 (41%) were African American. Etiology of heart failure was ischemic in 54 patients (37%) and nonischemic in 93 patients (63%). Overall survival at 30 days, 6 months, 12 months, and 2 years was 93%, 89%, 84%, and 81%, respectively. Gastrointestinal bleeding (GIB) was the most common complication (24%), followed by stroke (18%), right ventricular (RV) failure (18%), ventilator-dependent respiratory failure (10%), reoperation for bleeding (10%), and driveline infection (9%). These data demonstrate excellent survival with low mortality for both BTT and DT patients on long-term LVAD support. However, for LVAD therapy to become the gold standard for long-term treatment of end-stage heart failure and a plausible alternative to heart transplantation, we need to continue to improve the incidence of frequent postoperative complications, such as RV failure, driveline infections, strokes, and GIB.

  8. 14 CFR 61.49 - Retesting after failure.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Retesting after failure. 61.49 Section 61.49 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED... failure. (a) An applicant for a knowledge or practical test who fails that test may reapply for the test...

  9. 14 CFR 61.49 - Retesting after failure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Retesting after failure. 61.49 Section 61.49 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED... failure. (a) An applicant for a knowledge or practical test who fails that test may reapply for the test...

  10. 19 CFR 143.6 - Failure to maintain performance standards.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 2 2011-04-01 2011-04-01 false Failure to maintain performance standards. 143.6 Section 143.6 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) SPECIAL ENTRY PROCEDURES Automated Broker Interface § 143.6 Failure to...

  11. 7 CFR 718.304 - Failure to fully comply.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Failure to fully comply. 718.304 Section 718.304 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF... MULTIPLE PROGRAMS Equitable Relief From Ineligibility § 718.304 Failure to fully comply. (a) Under a...

  12. 7 CFR 718.304 - Failure to fully comply.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 7 2011-01-01 2011-01-01 false Failure to fully comply. 718.304 Section 718.304 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF... MULTIPLE PROGRAMS Equitable Relief From Ineligibility § 718.304 Failure to fully comply. (a) Under a...

  13. 28 CFR 51.40 - Failure to complete submissions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Failure to complete submissions. 51.40 Section 51.40 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PROCEDURES FOR THE ADMINISTRATION OF SECTION 5 OF THE VOTING RIGHTS ACT OF 1965, AS AMENDED Processing of Submissions § 51.40 Failure...

  14. 28 CFR 51.40 - Failure to complete submissions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Failure to complete submissions. 51.40 Section 51.40 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PROCEDURES FOR THE ADMINISTRATION OF SECTION 5 OF THE VOTING RIGHTS ACT OF 1965, AS AMENDED Processing of Submissions § 51.40 Failure...

  15. 7 CFR 930.25 - Failure to nominate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Failure to nominate. 930.25 Section 930.25 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Administrative Body § 930.25 Failure to nominate. If nominations are not made within the time and in the manner...

  16. 31 CFR 340.11 - Failure to complete transaction.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 2 2012-07-01 2012-07-01 false Failure to complete transaction. 340.11 Section 340.11 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... TREASURY BONDS THROUGH COMPETITIVE BIDDING § 340.11 Failure to complete transaction. If any successful...

  17. 38 CFR 21.3103 - Failure to cooperate.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Failure to cooperate. 21.3103 Section 21.3103 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED.... Chapter 35 Counseling § 21.3103 Failure to cooperate. VA will not act further on an eligible person's...

  18. 7 CFR 959.28 - Failure to nominate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Failure to nominate. 959.28 Section 959.28 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Committee § 959.28 Failure to nominate. If nominations are not made within the time and...

  19. 31 CFR 340.11 - Failure to complete transaction.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Failure to complete transaction. 340.11 Section 340.11 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... TREASURY BONDS THROUGH COMPETITIVE BIDDING § 340.11 Failure to complete transaction. If any successful...

  20. 7 CFR 959.28 - Failure to nominate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Failure to nominate. 959.28 Section 959.28 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Committee § 959.28 Failure to nominate. If nominations are not made within the time and...

  1. 7 CFR 930.25 - Failure to nominate.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 8 2013-01-01 2013-01-01 false Failure to nominate. 930.25 Section 930.25 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Administrative Body § 930.25 Failure to nominate. If nominations are not made within the time and in the manner...

  2. 7 CFR 945.26 - Failure to nominate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Failure to nominate. 945.26 Section 945.26 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... § 945.26 Failure to nominate. If nominations are not made within the time and in the manner specified by...

  3. 38 CFR 21.3103 - Failure to cooperate.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Failure to cooperate. 21.3103 Section 21.3103 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED.... Chapter 35 Counseling § 21.3103 Failure to cooperate. VA will not act further on an eligible person's...

  4. 45 CFR 1614.7 - Failure to comply.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 4 2014-10-01 2014-10-01 false Failure to comply. 1614.7 Section 1614.7 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION PRIVATE ATTORNEY INVOLVEMENT § 1614.7 Failure to comply. (a) If a recipient fails to comply with the expenditure required by...

  5. 38 CFR 21.3103 - Failure to cooperate.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Failure to cooperate. 21.3103 Section 21.3103 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED.... Chapter 35 Counseling § 21.3103 Failure to cooperate. VA will not act further on an eligible person's...

  6. 45 CFR 1614.7 - Failure to comply.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 4 2013-10-01 2013-10-01 false Failure to comply. 1614.7 Section 1614.7 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION PRIVATE ATTORNEY INVOLVEMENT § 1614.7 Failure to comply. (a) If a recipient fails to comply with the expenditure required by...

  7. 45 CFR 1614.7 - Failure to comply.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 4 2012-10-01 2012-10-01 false Failure to comply. 1614.7 Section 1614.7 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION PRIVATE ATTORNEY INVOLVEMENT § 1614.7 Failure to comply. (a) If a recipient fails to comply with the expenditure required by...

  8. 7 CFR 930.25 - Failure to nominate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Failure to nominate. 930.25 Section 930.25 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Administrative Body § 930.25 Failure to nominate. If nominations are not made within the time and in the manner...

  9. 31 CFR 340.11 - Failure to complete transaction.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 2 2013-07-01 2013-07-01 false Failure to complete transaction. 340.11 Section 340.11 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... TREASURY BONDS THROUGH COMPETITIVE BIDDING § 340.11 Failure to complete transaction. If any successful...

  10. 19 CFR 148.18 - Failure to declare.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 2 2013-04-01 2013-04-01 false Failure to declare. 148.18 Section 148.18 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) PERSONAL DECLARATIONS AND EXEMPTIONS Declarations § 148.18 Failure to declare. (a) Penalty...

  11. 26 CFR 301.7269-1 - Failure to produce records.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 18 2013-04-01 2013-04-01 false Failure to produce records. 301.7269-1 Section 301.7269-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) PROCEDURE AND ADMINISTRATION PROCEDURE AND ADMINISTRATION Other Offenses § 301.7269-1 Failure to produce records...

  12. 7 CFR 945.26 - Failure to nominate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Failure to nominate. 945.26 Section 945.26 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... § 945.26 Failure to nominate. If nominations are not made within the time and in the manner specified by...

  13. 26 CFR 301.7269-1 - Failure to produce records.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 18 2011-04-01 2011-04-01 false Failure to produce records. 301.7269-1 Section 301.7269-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) PROCEDURE AND ADMINISTRATION PROCEDURE AND ADMINISTRATION Other Offenses § 301.7269-1 Failure to produce records...

  14. 19 CFR 148.18 - Failure to declare.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 2 2011-04-01 2011-04-01 false Failure to declare. 148.18 Section 148.18 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) PERSONAL DECLARATIONS AND EXEMPTIONS Declarations § 148.18 Failure to declare. (a) Penalty...

  15. 7 CFR 966.28 - Failure to nominate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Failure to nominate. 966.28 Section 966.28 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Regulating Handling Committee § 966.28 Failure to nominate. If nominations are not made within the time and...

  16. 31 CFR 340.11 - Failure to complete transaction.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Failure to complete transaction. 340.11 Section 340.11 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... TREASURY BONDS THROUGH COMPETITIVE BIDDING § 340.11 Failure to complete transaction. If any successful...

  17. 7 CFR 958.29 - Failure to nominate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Failure to nominate. 958.29 Section 958.29 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Failure to nominate. If nominations are not made within the time and in the manner specified by the...

  18. 28 CFR 51.40 - Failure to complete submissions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Failure to complete submissions. 51.40 Section 51.40 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PROCEDURES FOR THE ADMINISTRATION OF SECTION 5 OF THE VOTING RIGHTS ACT OF 1965, AS AMENDED Processing of Submissions § 51.40 Failure...

  19. 40 CFR 700.49 - Failure to remit fees.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 31 2011-07-01 2011-07-01 false Failure to remit fees. 700.49 Section 700.49 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT GENERAL Fees § 700.49 Failure to remit fees. EPA will not consider a section 5 notice to be...

  20. 40 CFR 700.49 - Failure to remit fees.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Failure to remit fees. 700.49 Section 700.49 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT GENERAL Fees § 700.49 Failure to remit fees. EPA will not consider a section 5 notice to be...

  1. 7 CFR 930.25 - Failure to nominate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Failure to nominate. 930.25 Section 930.25 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Administrative Body § 930.25 Failure to nominate. If nominations are not made within the time and in the manner...

  2. 26 CFR 301.7269-1 - Failure to produce records.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Failure to produce records. 301.7269-1 Section 301.7269-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) PROCEDURE AND ADMINISTRATION PROCEDURE AND ADMINISTRATION Other Offenses § 301.7269-1 Failure to produce records...

  3. 7 CFR 924.24 - Failure to nominate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Failure to nominate. 924.24 Section 924.24 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements....24 Failure to nominate. If nominations are not made within the time and in the manner prescribed in...

  4. 28 CFR 51.40 - Failure to complete submissions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Failure to complete submissions. 51.40 Section 51.40 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PROCEDURES FOR THE ADMINISTRATION OF SECTION 5 OF THE VOTING RIGHTS ACT OF 1965, AS AMENDED Processing of Submissions § 51.40 Failure...

  5. 7 CFR 930.25 - Failure to nominate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Failure to nominate. 930.25 Section 930.25 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Administrative Body § 930.25 Failure to nominate. If nominations are not made within the time and in the manner...

  6. 19 CFR 148.18 - Failure to declare.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 2 2014-04-01 2014-04-01 false Failure to declare. 148.18 Section 148.18 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) PERSONAL DECLARATIONS AND EXEMPTIONS Declarations § 148.18 Failure to declare. (a) Penalty...

  7. 28 CFR 51.40 - Failure to complete submissions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Failure to complete submissions. 51.40 Section 51.40 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PROCEDURES FOR THE ADMINISTRATION OF SECTION 5 OF THE VOTING RIGHTS ACT OF 1965, AS AMENDED Processing of Submissions § 51.40 Failure...

  8. 19 CFR 148.18 - Failure to declare.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Failure to declare. 148.18 Section 148.18 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) PERSONAL DECLARATIONS AND EXEMPTIONS Declarations § 148.18 Failure to declare. (a) Penalty...

  9. 31 CFR 340.11 - Failure to complete transaction.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance: Treasury 2 2014-07-01 2014-07-01 false Failure to complete transaction. 340.11 Section 340.11 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... TREASURY BONDS THROUGH COMPETITIVE BIDDING § 340.11 Failure to complete transaction. If any successful...

  10. 7 CFR 958.29 - Failure to nominate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Failure to nominate. 958.29 Section 958.29 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Failure to nominate. If nominations are not made within the time and in the manner specified by the...

  11. 40 CFR 700.49 - Failure to remit fees.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 32 2012-07-01 2012-07-01 false Failure to remit fees. 700.49 Section 700.49 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT GENERAL Fees § 700.49 Failure to remit fees. EPA will not consider a section 5 notice to be...

  12. 7 CFR 958.29 - Failure to nominate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Failure to nominate. 958.29 Section 958.29 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Failure to nominate. If nominations are not made within the time and in the manner specified by the...

  13. 7 CFR 945.26 - Failure to nominate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Failure to nominate. 945.26 Section 945.26 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... § 945.26 Failure to nominate. If nominations are not made within the time and in the manner specified by...

  14. 40 CFR 700.49 - Failure to remit fees.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 31 2014-07-01 2014-07-01 false Failure to remit fees. 700.49 Section 700.49 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT GENERAL Fees § 700.49 Failure to remit fees. EPA will not consider a section 5 notice to be...

  15. 7 CFR 966.28 - Failure to nominate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Failure to nominate. 966.28 Section 966.28 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Committee § 966.28 Failure to nominate. If nominations are not made within the time and...

  16. 40 CFR 700.49 - Failure to remit fees.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 32 2013-07-01 2013-07-01 false Failure to remit fees. 700.49 Section 700.49 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT GENERAL Fees § 700.49 Failure to remit fees. EPA will not consider a section 5 notice to be...

  17. 45 CFR 1614.7 - Failure to comply.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Failure to comply. 1614.7 Section 1614.7 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION PRIVATE ATTORNEY INVOLVEMENT § 1614.7 Failure to comply. (a) If a recipient fails to comply with the expenditure required by...

  18. 19 CFR 148.18 - Failure to declare.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 2 2012-04-01 2012-04-01 false Failure to declare. 148.18 Section 148.18 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) PERSONAL DECLARATIONS AND EXEMPTIONS Declarations § 148.18 Failure to declare. (a) Penalty...

  19. 7 CFR 945.26 - Failure to nominate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Failure to nominate. 945.26 Section 945.26 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... § 945.26 Failure to nominate. If nominations are not made within the time and in the manner specified by...

  20. 7 CFR 945.26 - Failure to nominate.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 8 2013-01-01 2013-01-01 false Failure to nominate. 945.26 Section 945.26 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... § 945.26 Failure to nominate. If nominations are not made within the time and in the manner specified by...

  1. 45 CFR 1614.7 - Failure to comply.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Failure to comply. 1614.7 Section 1614.7 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION PRIVATE ATTORNEY INVOLVEMENT § 1614.7 Failure to comply. (a) If a recipient fails to comply with the expenditure required by...

  2. 38 CFR 21.3103 - Failure to cooperate.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Failure to cooperate. 21.3103 Section 21.3103 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED.... Chapter 35 Counseling § 21.3103 Failure to cooperate. VA will not act further on an eligible person's...

  3. 7 CFR 959.28 - Failure to nominate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Failure to nominate. 959.28 Section 959.28 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Regulating Handling Committee § 959.28 Failure to nominate. If nominations are not made within the time and...

  4. 7 CFR 924.24 - Failure to nominate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Failure to nominate. 924.24 Section 924.24 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements....24 Failure to nominate. If nominations are not made within the time and in the manner prescribed in...

  5. Treatment of Hyperkalemia in Heart Failure.

    PubMed

    DeFilippis, Ersilia M; Desai, Akshay S

    2017-08-01

    The aim of this paper is to discuss strategies for prevention and management of hyperkalemia in patients with heart failure, including the role of novel therapies. Renin-angiotensin-aldosterone system (RAAS) antagonists, including angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), and mineralocorticoid receptor antagonists (MRA) decrease mortality and morbidity in heart failure but increase the risk of hyperkalemia, especially when used in combination. Prevention of hyperkalemia and its associated complications requires careful patient selection, counseling regarding dietary potassium intake, awareness of drug interactions, and regular laboratory surveillance. Recent data suggests that the risk of hyperkalemia may be further moderated through the use of combined angiotensin-neprilysin inhibitors, novel MRAs, and novel potassium binding agents. Clinicians should be mindful of the risk of hyperkalemia when prescribing RAAS inhibitors to patients with heart failure. In patients at highest risk, such as those with diabetes, the elderly, and advanced chronic kidney disease, more intensive laboratory surveillance of potassium and creatinine may be required. Novel therapies hold promise for reducing the risk of hyperkalemia and enhancing the tolerability of RAAS antagonists.

  6. Compounds from multilayer plastic bags cause reproductive failures in artificial insemination.

    PubMed

    Nerin, C; Ubeda, J L; Alfaro, P; Dahmani, Y; Aznar, M; Canellas, E; Ausejo, R

    2014-05-09

    High levels of reproductive failure were detected in some Spanish sow farms in the Spring of 2010. Regular returns to estrus and variable reductions in litter size were observed. The problem started suddenly and did not appear to be related to the quality of the ejaculates, disease, alterations of body condition or any other apparent reasons. Subsequent studies determined that the problem was the origin of the plastic bags used for semen storage. Chemical analysis of the suspicious bags identified unexpected compounds such as BADGE, a cyclic lactone and an unknown phthalate that leached into the semen at concentrations of 0.2 to 2.5 mg/L. Spermatozoa preserved in these bags passed all of the routine quality control tests, and no differences were observed between storage in the control and suspicious bags (p > 0.05). In vitro fecundation tests and endocrine profiler panel analysis (EPP) did not show any alterations, whereas the in vivo tests confirmed the described failure. This is the first described relationship between reproductive failure and toxic compounds released from plastic bags.

  7. Compounds from multilayer plastic bags cause reproductive failures in artificial insemination

    NASA Astrophysics Data System (ADS)

    Nerin, C.; Ubeda, J. L.; Alfaro, P.; Dahmani, Y.; Aznar, M.; Canellas, E.; Ausejo, R.

    2014-05-01

    High levels of reproductive failure were detected in some Spanish sow farms in the Spring of 2010. Regular returns to estrus and variable reductions in litter size were observed. The problem started suddenly and did not appear to be related to the quality of the ejaculates, disease, alterations of body condition or any other apparent reasons. Subsequent studies determined that the problem was the origin of the plastic bags used for semen storage. Chemical analysis of the suspicious bags identified unexpected compounds such as BADGE, a cyclic lactone and an unknown phthalate that leached into the semen at concentrations of 0.2 to 2.5 mg/L. Spermatozoa preserved in these bags passed all of the routine quality control tests, and no differences were observed between storage in the control and suspicious bags (p > 0.05). In vitro fecundation tests and endocrine profiler panel analysis (EPP) did not show any alterations, whereas the in vivo tests confirmed the described failure. This is the first described relationship between reproductive failure and toxic compounds released from plastic bags.

  8. Compounds from multilayer plastic bags cause reproductive failures in artificial insemination

    PubMed Central

    Nerin, C.; Ubeda, J. L.; Alfaro, P.; Dahmani, Y.; Aznar, M.; Canellas, E.; Ausejo, R.

    2014-01-01

    High levels of reproductive failure were detected in some Spanish sow farms in the Spring of 2010. Regular returns to estrus and variable reductions in litter size were observed. The problem started suddenly and did not appear to be related to the quality of the ejaculates, disease, alterations of body condition or any other apparent reasons. Subsequent studies determined that the problem was the origin of the plastic bags used for semen storage. Chemical analysis of the suspicious bags identified unexpected compounds such as BADGE, a cyclic lactone and an unknown phthalate that leached into the semen at concentrations of 0.2 to 2.5 mg/L. Spermatozoa preserved in these bags passed all of the routine quality control tests, and no differences were observed between storage in the control and suspicious bags (p > 0.05). In vitro fecundation tests and endocrine profiler panel analysis (EPP) did not show any alterations, whereas the in vivo tests confirmed the described failure. This is the first described relationship between reproductive failure and toxic compounds released from plastic bags. PMID:24810330

  9. 26 CFR 1.860G-1 - Definition of regular and residual interests.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Real Estate Investment Trusts § 1.860G-1... or the amount of income from permitted investments (as defined in § 1.860G-2(g)); or (B) The timing... interest is affected by defaults on qualified mortgages and permitted investments, unanticipated expenses...

  10. 26 CFR 1.860G-1 - Definition of regular and residual interests.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Real Estate Investment Trusts § 1.860G-1... or the amount of income from permitted investments (as defined in § 1.860G-2(g)); or (B) The timing... interest is affected by defaults on qualified mortgages and permitted investments, unanticipated expenses...

  11. 26 CFR 1.860G-1 - Definition of regular and residual interests.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Real Estate Investment Trusts § 1.860G-1... or the amount of income from permitted investments (as defined in § 1.860G-2(g)); or (B) The timing... interest is affected by defaults on qualified mortgages and permitted investments, unanticipated expenses...

  12. 26 CFR 1.860G-1 - Definition of regular and residual interests.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Real Estate Investment Trusts § 1.860G-1... or the amount of income from permitted investments (as defined in § 1.860G-2(g)); or (B) The timing... interest is affected by defaults on qualified mortgages and permitted investments, unanticipated expenses...

  13. Radiometric calibration status of Landsat-7 and Landsat-5

    USGS Publications Warehouse

    Barsi, J.A.; Markham, B.L.; Helder, D.L.; Chander, G.

    2007-01-01

    Launched in April 1999, Landsat-7 ETM+ continues to acquire data globally. The Scan Line Corrector in failure in 2003 has affected ground coverage and the recent switch to Bumper Mode operations in April 2007 has degraded the internal geometric accuracy of the data, but the radiometry has been unaffected. The best of the three on-board calibrators for the reflective bands, the Full Aperture Solar Calibrator, has indicated slow changes in the ETM+, but this is believed to be due to contamination on the panel rather then instrument degradation. The Internal Calibrator lamp 2, though it has not been used regularly throughout the whole mission, indicates smaller changes than the FASC since 2003. The changes indicated by lamp 2 are only statistically significant in band 1, circa 0.3% per year, and may be lamp as opposed to instrument degradations. Regular observations of desert targets in the Saharan and Arabian deserts indicate the no change in the ETM+ reflective band response, though the uncertainty is larger and does not preclude the small changes indicated by lamp 2. The thermal band continues to be stable and well-calibrated since an offset error was corrected in late-2000. Launched in 1984, Landsat-5 TM also continues to acquire global data; though without the benefit of an on-board recorder, data can only be acquired where a ground station is within range. Historically, the calibration of the TM reflective bands has used an onboard calibration system with multiple lamps. The calibration procedure for the TM reflective bands was updated in 2003 based on the best estimate at the time, using only one of the three lamps and a cross-calibration with Landsat-7 ETM+. Since then, the Saharan desert sites have been used to validate this calibration model. Problems were found with the lamp based model of up to 13% in band 1. Using the Saharan data, a new model was developed and implemented in the US processing system in April 2007. The TM thermal band was found to have a calibration offset error of 0.092 W/m 2 sr ??m (0.68K at 300K) based on vicarious calibration data between 1999 and 2006. The offset error was corrected in the US processing system on April 2007 for all data acquired since April 1999.

  14. Fatigue damage accumulation in various metal matrix composites

    NASA Technical Reports Server (NTRS)

    Johnson, W. S.

    1987-01-01

    The purpose of this paper is to review some of the latest understanding of the fatigue behavior of continuous fiber reinforced metal matrix composites. The emphasis is on the development of an understanding of different fatigue damage mechanisms and why and how they occur. The fatigue failure modes in continuous fiber reinforced metal matrix composites are controlled by the three constituents of the system: fiber, matrix, and fiber/matrix interface. The relative strains to fatigue failure of the fiber and matrix will determine the failure mode. Several examples of matrix, fiber, and self-similar damage growth dominated fatigue damage are given for several metal matrix composite systems. Composite analysis, failure modes, and damage modeling are discussed. Boron/aluminum, silicon-carbide/aluminum, FP/aluminum, and borsic/titanium metal matrix composites are discussed.

  15. Failure factors in non-life insurance companies in United Kingdom

    NASA Astrophysics Data System (ADS)

    Samsudin, Humaida Banu

    2013-04-01

    Failure in insurance company is a condition of financial distress where a company has difficulty paying off its financial obligations to its creditors. This study continues the research from the study in identifying the determinants for run-off non-life insurance companies in United Kingdom. The analysis continues to identify other variables that could lead companies to financial distress that is macroeconomic factors (GDP rates, inflation rates and interest rates); total companies failed a year before and average size for failed companies'. The result from the analysis indicates that inflation rates, interest rates, total companies failed a year before and average sizes for failed companies are the best predictors. An early detection of failure can prevent companies from bankruptcy and allow management to take action to reduce the failure costs.

  16. A Job Pause Service under LAM/MPI+BLCR for Transparent Fault Tolerance

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

    Wang, Chao; Mueller, Frank; Engelmann, Christian

    2007-01-01

    Checkpoint/restart (C/R) has become a requirement for long-running jobs in large-scale clusters due to a meantime- to-failure (MTTF) in the order of hours. After a failure, C/R mechanisms generally require a complete restart of an MPI job from the last checkpoint. A complete restart, however, is unnecessary since all but one node are typically still alive. Furthermore, a restart may result in lengthy job requeuing even though the original job had not exceeded its time quantum. In this paper, we overcome these shortcomings. Instead of job restart, we have developed a transparent mechanism for job pause within LAM/MPI+BLCR. This mechanismmore » allows live nodes to remain active and roll back to the last checkpoint while failed nodes are dynamically replaced by spares before resuming from the last checkpoint. Our methodology includes LAM/MPI enhancements in support of scalable group communicationwith fluctuating number of nodes, reuse of network connections, transparent coordinated checkpoint scheduling and a BLCR enhancement for job pause. Experiments in a cluster with the NAS Parallel Benchmark suite show that our overhead for job pause is comparable to that of a complete job restart. A minimal overhead of 5.6% is only incurred in case migration takes place while the regular checkpoint overhead remains unchanged. Yet, our approach alleviates the need to reboot the LAM run-time environment, which accounts for considerable overhead resulting in net savings of our scheme in the experiments. Our solution further provides full transparency and automation with the additional benefit of reusing existing resources. Executing continues after failures within the scheduled job, i.e., the application staging overhead is not incurred again in contrast to a restart. Our scheme offers additional potential for savings through incremental checkpointing and proactive diskless live migration, which we are currently working on.« less

  17. Benefits of regular walking exercise in advanced pre-dialysis chronic kidney disease.

    PubMed

    Kosmadakis, George C; John, Stephen G; Clapp, Emma L; Viana, Joao L; Smith, Alice C; Bishop, Nicolette C; Bevington, Alan; Owen, Paul J; McIntyre, Christopher W; Feehally, John

    2012-03-01

    There is increasing evidence of the benefit of regular physical exercise in a number of long-term conditions including chronic kidney disease (CKD). In CKD, this evidence has mostly come from studies in end stage patients receiving regular dialysis. There is little evidence in pre-dialysis patients with CKD Stages 4 and 5. A prospective study compared the benefits of 6 months regular walking in 40 pre-dialysis patients with CKD Stages 4 and 5. Twenty of them were the exercising group and were compared to 20 patients who were continuing with usual physical activity. In addition, the 40 patients were randomized to receive additional oral sodium bicarbonate (target venous bicarbonate 29 mmol/L) or continue with previous sodium bicarbonate treatment (target 24 mmol/L). Improvements noted after 1 month were sustained to 6 months in the 18 of 20 who completed the exercise study. These included improvements in exercise tolerance (reduced exertion to achieve the same activity), weight loss, improved cardiovascular reactivity, avoiding an increase in blood pressure medication and improvements in quality of health and life and uraemic symptom scores assessed by questionnaire. Sodium bicarbonate supplementation did not produce any significant alterations. This study provides further support for the broad benefits of aerobic physical exercise in CKD. More studies are needed to understand the mechanisms of these benefits, to study whether resistance exercise will add to the benefit and to evaluate strategies to promote sustained lifestyle changes, that could ensure continued increase in habitual daily physical activity levels.

  18. 5 CFR 890.302 - Coverage of family members.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Section 890.302 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Enrollment § 890.302 Coverage of family...) Evidence of goods or services which show regular and substantial contributions of considerable value; (v...

  19. Comparing Algorithms for Graph Isomorphism Using Discrete- and Continuous-Time Quantum Random Walks

    DOE PAGES

    Rudinger, Kenneth; Gamble, John King; Bach, Eric; ...

    2013-07-01

    Berry and Wang [Phys. Rev. A 83, 042317 (2011)] show numerically that a discrete-time quan- tum random walk of two noninteracting particles is able to distinguish some non-isomorphic strongly regular graphs from the same family. Here we analytically demonstrate how it is possible for these walks to distinguish such graphs, while continuous-time quantum walks of two noninteracting parti- cles cannot. We show analytically and numerically that even single-particle discrete-time quantum random walks can distinguish some strongly regular graphs, though not as many as two-particle noninteracting discrete-time walks. Additionally, we demonstrate how, given the same quantum random walk, subtle di erencesmore » in the graph certi cate construction algorithm can nontrivially im- pact the walk's distinguishing power. We also show that no continuous-time walk of a xed number of particles can distinguish all strongly regular graphs when used in conjunction with any of the graph certi cates we consider. We extend this constraint to discrete-time walks of xed numbers of noninteracting particles for one kind of graph certi cate; it remains an open question as to whether or not this constraint applies to the other graph certi cates we consider.« less

  20. Existence and Regularity of Invariant Measures for the Three Dimensional Stochastic Primitive Equations

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

    Glatt-Holtz, Nathan, E-mail: negh@vt.edu; Kukavica, Igor, E-mail: kukavica@usc.edu; Ziane, Mohammed, E-mail: ziane@usc.edu

    2014-05-15

    We establish the continuity of the Markovian semigroup associated with strong solutions of the stochastic 3D Primitive Equations, and prove the existence of an invariant measure. The proof is based on new moment bounds for strong solutions. The invariant measure is supported on strong solutions and is furthermore shown to have higher regularity properties.

  1. Well-posedness of characteristic symmetric hyperbolic systems

    NASA Astrophysics Data System (ADS)

    Secchi, Paolo

    1996-06-01

    We consider the initial-boundary-value problem for quasi-linear symmetric hyperbolic systems with characteristic boundary of constant multiplicity. We show the well-posedness in Hadamard's sense (i.e., existence, uniqueness and continuous dependence of solutions on the data) of regular solutions in suitable functions spaces which take into account the loss of regularity in the normal direction to the characteristic boundary.

  2. 29 CFR 778.326 - Reduction of regular overtime workweek without reduction of take-home pay.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... working long hours. In arrangements of this type, no additional financial pressure would fall upon the... take-home pay. 778.326 Section 778.326 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR... was hired at an hourly rate of $5 an hour and regularly worked 50 hours, earning $275 as his total...

  3. Attachment in the doctor-patient relationship in general practice: a qualitative study.

    PubMed

    Frederiksen, Heidi Bøgelund; Kragstrup, Jakob; Dehlholm-Lambertsen, Birgitte

    2010-09-01

    To explore why interpersonal continuity with a regular doctor is valuable to patients. A qualitative study based on 22 interviews with patients, 12 who saw their regular general practitioner (GP) and 10 who saw an unfamiliar GP. The patients were selected after an observed consultation and sampled purposively according to reason for encounter, age, and sex. The research question was answered by means of psychological theory. A need for attachment was a central issue for the understanding of the value of interpersonal continuity for patients. The patients explained that they preferred to create a personal relationship with their GP and the majority expressed a degree of vulnerability in the doctor-patient relationship. The more sick or worried they were the more vulnerable and the more in need of a regular GP. Furthermore, patients stated that it was difficult for them to change GP even if they had a poor relationship. Attachment theory may provide an explanation for patients' need to see a regular GP. The vulnerability of being a patient creates a need for attachment to a caregiver. This need is fundamental and is activated in adults when they are sick or scared.

  4. Impulsivity and related neuropsychological features in regular and addictive first person shooter gaming.

    PubMed

    Metcalf, Olivia; Pammer, Kristen

    2014-03-01

    Putative cyber addictions are of significant interest. There remains little experimental research into excessive use of first person shooter (FPS) games, despite their global popularity. Moreover, the role between excessive gaming and impulsivity remains unclear, with previous research showing conflicting findings. The current study investigated performances on a number of neuropsychological tasks (go/no-go, continuous performance task, Iowa gambling task) and a trait measure of impulsivity for a group of regular FPS gamers (n=25), addicted FPS gamers (n=22), and controls (n=22). Gamers were classified using the Addiction-Engagement Questionnaire. Addicted FPS gamers had significantly higher levels of trait impulsivity on the Barratt Impulsiveness Scale compared to controls. Addicted FPS gamers also had significantly higher levels of disinhibition in a go/no-go task and inattention in a continuous performance task compared to controls, whereas the regular FPS gamers had better decision making on the Iowa gambling task compared to controls. The results indicate impulsivity is associated with FPS gaming addiction, comparable to pathological gambling. The relationship between impulsivity and excessive gaming may be unique to the FPS genre. Furthermore, regular FPS gaming may improve decision making ability.

  5. 15 CFR 904.212 - Failure to prosecute or defend.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... (Continued) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE GENERAL REGULATIONS CIVIL PROCEDURES Hearing and Appeal Procedures General § 904.212 Failure to prosecute or defend. (a) Whenever the...

  6. 15 CFR 904.212 - Failure to prosecute or defend.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... (Continued) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE GENERAL REGULATIONS CIVIL PROCEDURES Hearing and Appeal Procedures General § 904.212 Failure to prosecute or defend. (a) Whenever the...

  7. An Analysis of Learned Helplessness: Continuous Changes in Performance, Strategy, and Achievement Cognitions Following Failure

    ERIC Educational Resources Information Center

    Diener, Carol I.; Dweck, Carol S.

    1978-01-01

    Two studies examined the cognitive-motivational differences between helpless and mastery-oriented children by analyzing the effects of failure feedback on problem solving strategies during testing and identifying semantic differences in children's verbalizations following failure on task. Subjects were fifth graders of both sexes. (CM)

  8. 45 CFR 1355.36 - Withholding Federal funds due to failure to achieve substantial conformity or failure to...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Withholding Federal funds due to failure to... Section 1355.36 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN... FAMILIES, FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND FAMILY SERVICES GENERAL...

  9. 45 CFR 1355.36 - Withholding Federal funds due to failure to achieve substantial conformity or failure to...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 4 2012-10-01 2012-10-01 false Withholding Federal funds due to failure to... Section 1355.36 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN... FAMILIES, FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND FAMILY SERVICES GENERAL...

  10. 45 CFR 1355.36 - Withholding Federal funds due to failure to achieve substantial conformity or failure to...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 4 2014-10-01 2014-10-01 false Withholding Federal funds due to failure to... Section 1355.36 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN... FAMILIES, FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND FAMILY SERVICES GENERAL...

  11. Inequality of Educational Opportunities: School Failure Trends in Spain (1977-2012)

    ERIC Educational Resources Information Center

    Fernández-Mellizo, María; Martínez-García, José Saturnino

    2016-01-01

    School failure is substantive in Spain. The percentage of students that do not achieve the compulsory education diploma is around 20%. School failure is higher for students from lower socio-economic backgrounds. Students who "fail" cannot continue to post-compulsory education and, sooner or later, they have to leave formal education. The…

  12. 43 CFR 3163.4 - Failure to pay.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Failure to pay. 3163.4 Section 3163.4 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT..., Assessments, and Penalties § 3163.4 Failure to pay. If any person fails to pay an assessment or a civil...

  13. 43 CFR 3106.7-1 - Failure to qualify.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Failure to qualify. 3106.7-1 Section 3106.7-1 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND..., Sublease or Otherwise § 3106.7-1 Failure to qualify. No transfer of record title or of operating rights...

  14. 43 CFR 3106.7-1 - Failure to qualify.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Failure to qualify. 3106.7-1 Section 3106.7-1 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND..., Sublease or Otherwise § 3106.7-1 Failure to qualify. No transfer of record title or of operating rights...

  15. 43 CFR 3163.4 - Failure to pay.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Failure to pay. 3163.4 Section 3163.4 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT..., Assessments, and Penalties § 3163.4 Failure to pay. If any person fails to pay an assessment or a civil...

  16. 43 CFR 3106.7-1 - Failure to qualify.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Failure to qualify. 3106.7-1 Section 3106.7-1 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND..., Sublease or Otherwise § 3106.7-1 Failure to qualify. No transfer of record title or of operating rights...

  17. 43 CFR 3163.4 - Failure to pay.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Failure to pay. 3163.4 Section 3163.4 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT..., Assessments, and Penalties § 3163.4 Failure to pay. If any person fails to pay an assessment or a civil...

  18. 26 CFR 31.3406(d)-2 - Payee certification failure.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 15 2014-04-01 2014-04-01 false Payee certification failure. 31.3406(d)-2 Section 31.3406(d)-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED... SOURCE Collection of Income Tax at Source § 31.3406(d)-2 Payee certification failure. (a) Requirement to...

  19. 26 CFR 31.3406(d)-2 - Payee certification failure.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 15 2011-04-01 2011-04-01 false Payee certification failure. 31.3406(d)-2 Section 31.3406(d)-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED... SOURCE Collection of Income Tax at Source § 31.3406(d)-2 Payee certification failure. (a) Requirement to...

  20. 26 CFR 31.3406(d)-2 - Payee certification failure.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 15 2010-04-01 2010-04-01 false Payee certification failure. 31.3406(d)-2 Section 31.3406(d)-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED... SOURCE Collection of Income Tax at Source § 31.3406(d)-2 Payee certification failure. (a) Requirement to...

  1. 43 CFR 3163.4 - Failure to pay.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Failure to pay. 3163.4 Section 3163.4 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT..., Assessments, and Penalties § 3163.4 Failure to pay. If any person fails to pay an assessment or a civil...

  2. 43 CFR 3106.7-1 - Failure to qualify.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Failure to qualify. 3106.7-1 Section 3106.7-1 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND..., Sublease or Otherwise § 3106.7-1 Failure to qualify. No transfer of record title or of operating rights...

  3. 26 CFR 31.3406(d)-2 - Payee certification failure.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 15 2012-04-01 2012-04-01 false Payee certification failure. 31.3406(d)-2 Section 31.3406(d)-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED... SOURCE Collection of Income Tax at Source § 31.3406(d)-2 Payee certification failure. (a) Requirement to...

  4. 26 CFR 31.3406(d)-2 - Payee certification failure.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 15 2013-04-01 2013-04-01 false Payee certification failure. 31.3406(d)-2 Section 31.3406(d)-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED... SOURCE Collection of Income Tax at Source § 31.3406(d)-2 Payee certification failure. (a) Requirement to...

  5. Comparison of Subcutaneous Regular Insulin and Lispro Insulin in Diabetics Receiving Continuous Nutrition

    PubMed Central

    Stull, Mamie C.; Strilka, Richard J.; Clemens, Michael S.; Armen, Scott B.

    2015-01-01

    Background: Optimal management of non–critically ill patients with diabetes maintained on continuous enteral feeding (CEN) is poorly defined. Subcutaneous (SQ) lispro and SQ regular insulin were compared in a simulated type 1 and type 2 diabetic patient receiving CEN. Method: A glucose-insulin feedback mathematical model was employed to simulate type 1 and type 2 diabetic patients on CEN. Each patient received 25 SQ injections of regular insulin or insulin lispro, ranging from 0-6 U. Primary endpoints were the change in mean glucose concentration (MGC) and change in glucose variability (GV); hypoglycemic episodes were also reported. The model was first validated against patient data. Results: Both SQ insulin preparations linearly decreased MGC, however, SQ regular insulin decreased GV whereas SQ lispro tended to increase GV. Hourly glucose concentration measurements were needed to capture the increase in GV. In the type 2 diabetic patient, “rebound hyperglycemia” occurred after SQ lispro was rapidly metabolized. Although neither SQ insulin preparation caused hypoglycemia, SQ lispro significantly lowered MGC compared to SQ regular insulin. Thus, it may be more likely to cause hypoglycemia. Analyses of the detailed glucose concentration versus time data suggest that the inferior performance of lispro resulted from its shorter duration of action. Finally, the effects of both insulin preparations persisted beyond their duration of actions in the type 2 diabetic patient. Conclusions: Subcutaneous regular insulin may be the short-acting insulin preparation of choice for this subset of diabetic patients. Clinical trial is required before a definitive recommendation can be made. PMID:26134836

  6. Comparison of Subcutaneous Regular Insulin and Lispro Insulin in Diabetics Receiving Continuous Nutrition: A Numerical Study.

    PubMed

    Stull, Mamie C; Strilka, Richard J; Clemens, Michael S; Armen, Scott B

    2015-06-30

    Optimal management of non-critically ill patients with diabetes maintained on continuous enteral feeding (CEN) is poorly defined. Subcutaneous (SQ) lispro and SQ regular insulin were compared in a simulated type 1 and type 2 diabetic patient receiving CEN. A glucose-insulin feedback mathematical model was employed to simulate type 1 and type 2 diabetic patients on CEN. Each patient received 25 SQ injections of regular insulin or insulin lispro, ranging from 0-6 U. Primary endpoints were the change in mean glucose concentration (MGC) and change in glucose variability (GV); hypoglycemic episodes were also reported. The model was first validated against patient data. Both SQ insulin preparations linearly decreased MGC, however, SQ regular insulin decreased GV whereas SQ lispro tended to increase GV. Hourly glucose concentration measurements were needed to capture the increase in GV. In the type 2 diabetic patient, "rebound hyperglycemia" occurred after SQ lispro was rapidly metabolized. Although neither SQ insulin preparation caused hypoglycemia, SQ lispro significantly lowered MGC compared to SQ regular insulin. Thus, it may be more likely to cause hypoglycemia. Analyses of the detailed glucose concentration versus time data suggest that the inferior performance of lispro resulted from its shorter duration of action. Finally, the effects of both insulin preparations persisted beyond their duration of actions in the type 2 diabetic patient. Subcutaneous regular insulin may be the short-acting insulin preparation of choice for this subset of diabetic patients. Clinical trial is required before a definitive recommendation can be made. © 2015 Diabetes Technology Society.

  7. Antimicrobial treatment failures in patients with community-acquired pneumonia: causes and prognostic implications.

    PubMed

    Arancibia, F; Ewig, S; Martinez, J A; Ruiz, M; Bauer, T; Marcos, M A; Mensa, J; Torres, A

    2000-07-01

    The aim of the study was to determine the causes and prognostic implications of antimicrobial treatment failures in patients with nonresponding and progressive life-threatening, community-acquired pneumonia. Forty-nine patients hospitalized with a presumptive diagnosis of community-acquired pneumonia during a 16-mo period, failure to respond to antimicrobial treatment, and documented repeated microbial investigation >/= 72 h after initiation of in-hospital antimicrobial treatment were recorded. A definite etiology of treatment failure could be established in 32 of 49 (65%) patients, and nine additional patients (18%) had a probable etiology. Treatment failures were mainly infectious in origin and included primary, persistent, and nosocomial infections (n = 10 [19%], 13 [24%], and 11 [20%] of causes, respectively). Definite but not probable persistent infections were mostly due to microbial resistance to the administered initial empiric antimicrobial treatment. Nosocomial infections were particularly frequent in patients with progressive pneumonia. Definite persistent infections and nosocomial infections had the highest associated mortality rates (75 and 88%, respectively). Nosocomial pneumonia was the only cause of treatment failure independently associated with death in multivariate analysis (RR, 16.7; 95% CI, 1.4 to 194.9; p = 0.03). We conclude that the detection of microbial resistance and the diagnosis of nosocomial pneumonia are the two major challenges in hospitalized patients with community-acquired pneumonia who do not respond to initial antimicrobial treatment. In order to establish these potentially life-threatening etiologies, a regular microbial reinvestigation seems mandatory for all patients presenting with antimicrobial treatment failures.

  8. Heart failure.

    PubMed

    Metra, Marco; Teerlink, John R

    2017-10-28

    Heart failure is common in adults, accounting for substantial morbidity and mortality worldwide. Its prevalence is increasing because of ageing of the population and improved treatment of acute cardiovascular events, despite the efficacy of many therapies for patients with heart failure with reduced ejection fraction, such as angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), β blockers, and mineralocorticoid receptor antagonists, and advanced device therapies. Combined angiotensin receptor blocker neprilysin inhibitors (ARNIs) have been associated with improvements in hospital admissions and mortality from heart failure compared with enalapril, and guidelines now recommend substitution of ACE inhibitors or ARBs with ARNIs in appropriate patients. Improved safety of left ventricular assist devices means that these are becoming more commonly used in patients with severe symptoms. Antidiabetic therapies might further improve outcomes in patients with heart failure. New drugs with novel mechanisms of action, such as cardiac myosin activators, are under investigation for patients with heart failure with reduced left ventricular ejection fraction. Heart failure with preserved ejection fraction is a heterogeneous disorder that remains incompletely understood and will continue to increase in prevalence with the ageing population. Although some data suggest that spironolactone might improve outcomes in these patients, no therapy has conclusively shown a significant effect. Hopefully, future studies will address these unmet needs for patients with heart failure. Admissions for acute heart failure continue to increase but, to date, no new therapies have improved clinical outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Multifunctional Flexible Composites Based on Continuous Carbon Nanotube Fiber

    DTIC Science & Technology

    2014-07-28

    fibers [1] The mechanical and electrical behavior of carbon nanotube fibers spun continuously from an aerogel is discussed. These fibers exhibit moderate...loading, demonstrates their potential for sensing applications in advanced composite materials. Insight into the failure behavior of the aerogel -spun...nanotube fibers is reported-the aerogel -spun fibers are observed to undergo mild to severe kinking due to tensile failure. This kinking is attributed to

  10. Successfully treated necrotizing fasciitis using extracorporeal life support combined with hemoadsorption device and continuous renal replacement therapy.

    PubMed

    Eid, Maroua; Fouquet, Olivier; Darreau, Cédric; Pierrot, Marc; Kouatchet, Achille; Mercat, Alain; Baufreton, Christophe

    2018-03-01

    Necrotizing fasciitis represents a life-threatening infectious condition that causes spreading necrotisis of superficial fascia and subcutaneous cellular tissues. We describe the case of a patient diagnosed with septic and toxic shocks leading to multiple organ failure successfully treated with a combination of extracorporeal life support, continuous renal replacement therapy, and a hemoadsorption device. A 41-year-old patient presented with necrotizing fasciitis and multi-organ failure. Initial extracorporeal life support therapy was implanted, compensating for systolic failure. Due to acute renal failure that persisted in time, continuous renal replacement therapy was added. Despite these treatments and as a last attempt to control the septic condition, a CytoSorb ® hemoadsorption device was installed in parallel to the extracorporeal life support circuit and two sessions were run. During the days following CytoSorb ® treatment, hemodynamic stabilization was observed, as well as normalization of lactic acidosis and blood parameters. This case describes the successful use of CytoSorb ® with continuous renal replacement therapy and extracorporeal life support in a combined way to overcome a critical phase of septic shock in a young adult patient. This combination of treatments turned out to be efficient for this patient in the context of necrotizing fasciitis.

  11. Pre-use anesthesia machine check; certified anesthesia technician based quality improvement audit.

    PubMed

    Al Suhaibani, Mazen; Al Malki, Assaf; Al Dosary, Saad; Al Barmawi, Hanan; Pogoku, Mahdhav

    2014-01-01

    Quality assurance of providing a work ready machine in multiple theatre operating rooms in a tertiary modern medical center in Riyadh. The aim of the following study is to keep high quality environment for workers and patients in surgical operating rooms. Technicians based audit by using key performance indicators to assure inspection, passing test of machine worthiness for use daily and in between cases and in case of unexpected failure to provide quick replacement by ready to use another anesthetic machine. The anesthetic machines in all operating rooms are daily and continuously inspected and passed as ready by technicians and verified by anesthesiologist consultant or assistant consultant. The daily records of each machines were collected then inspected for data analysis by quality improvement committee department for descriptive analysis and report the degree of staff compliance to daily inspection as "met" items. Replaced machine during use and overall compliance. Distractive statistic using Microsoft Excel 2003 tables and graphs of sums and percentages of item studied in this audit. Audit obtained highest compliance percentage and low rate of replacement of machine which indicate unexpected machine state of use and quick machine switch. The authors are able to conclude that following regular inspection and running self-check recommended by the manufacturers can contribute to abort any possibility of hazard of anesthesia machine failure during operation. Furthermore in case of unexpected reason to replace the anesthesia machine in quick maneuver contributes to high assured operative utilization of man machine inter-phase in modern surgical operating rooms.

  12. A comparative approach to assess drivers of success in mammalian conservation recovery programs.

    PubMed

    Crees, Jennifer J; Collins, Amy C; Stephenson, P J; Meredith, Helen M R; Young, Richard P; Howe, Caroline; Price, Mark R Stanley; Turvey, Samuel T

    2016-08-01

    The outcomes of species recovery programs have been mixed; high-profile population recoveries contrast with species-level extinctions. Each conservation intervention has its own challenges, but to inform more effective management it is imperative to assess whether correlates of wider recovery program success or failure can be identified. To contribute to evidence-based improvement of future conservation strategies, we conducted a global quantitative analysis of 48 mammalian recovery programs. We reviewed available scientific literature and conducted semistructured interviews with conservation professionals involved in different recovery programs to investigate ecological, management, and political factors associated with population recoveries or declines. Identifying and removing threats was significantly associated with increasing population trend and decreasing conservation dependence, emphasizing that populations are likely to continue to be compromised in the absence of effective threat mitigation and supporting the need for threat monitoring and adaptive management in response to new and potential threats. Lack of habitat and small population size were cited as limiting factors in 56% and 42% of recovery programs, respectively, and both were statistically associated with increased longer term dependence on conservation intervention, demonstrating the importance of increasing population numbers quickly and restoring and protecting habitat. Poor stakeholder coordination and management were also regularly cited by respondents as key weaknesses in recovery programs, indicating the importance of effective leadership and shared goals and management plans. Project outcomes were not influenced by biological or ecological variables such as body mass or habitat, which suggests that these insights into correlates of conservation success and failure are likely to be generalizable across mammals. © 2016 Society for Conservation Biology.

  13. Four quadrant transversus abdominis plane block and continuous transversus abdominis plane analgesia: a 3-year prospective audit in 124 patients.

    PubMed

    Niraj, G; Kelkar, Aditi; Hart, Elaine; Kaushik, Vipul; Fleet, Danny; Jameson, John

    2015-11-01

    Transversus abdominis plane (TAP) blocks have been reported to be an effective method of providing analgesia after abdominal surgery. To perform a prospective audit on the effectiveness of a novel technique of providing continuous transversus abdominis plane (TAP) analgesia in patients undergoing emergency and elective abdominal surgery. Prospective single center audit over a 3-year period. University hospital. One hundred twenty-four American Society of Anesthesiologists I to IV adult patients presenting for elective as well as emergency abdominal surgery in whom epidural analgesia was contraindicated or refused. Four quadrant TAP blocks and continuous TAP analgesia. Numerical rating scale pain scores at rest and on coughing, nausea scores, satisfaction scores, complications, frequency of analgesia failure, therapeutic failure with continuous TAP analgesia and opioid consumption. One hundred twenty-four patients who received continuous TAP analgesia were audited. This included 34 patients for elective open surgery, 36 patients for emergency laparotomy, and 54 patients who underwent elective laparoscopic colorectal surgery. Surgical incision was within the dermatomal limit of the block in 70% of the patients (88/124). Therapeutic failure with the technique was 10%. Frequency of analgesic failure over the 48-hour period was none in 39% and below 5 episodes in 57%. Four quadrant transversus abdominis plane blocks and continuous TAP analgesia is an effective technique for providing postoperative analgesia after abdominal surgery. It has the potential to be used as a sole analgesic technique when the surgical incision is within its dermatomal limit. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Cascading failures in ac electricity grids.

    PubMed

    Rohden, Martin; Jung, Daniel; Tamrakar, Samyak; Kettemann, Stefan

    2016-09-01

    Sudden failure of a single transmission element in a power grid can induce a domino effect of cascading failures, which can lead to the isolation of a large number of consumers or even to the failure of the entire grid. Here we present results of the simulation of cascading failures in power grids, using an alternating current (AC) model. We first apply this model to a regular square grid topology. For a random placement of consumers and generators on the grid, the probability to find more than a certain number of unsupplied consumers decays as a power law and obeys a scaling law with respect to system size. Varying the transmitted power threshold above which a transmission line fails does not seem to change the power-law exponent q≈1.6. Furthermore, we study the influence of the placement of generators and consumers on the number of affected consumers and demonstrate that large clusters of generators and consumers are especially vulnerable to cascading failures. As a real-world topology, we consider the German high-voltage transmission grid. Applying the dynamic AC model and considering a random placement of consumers, we find that the probability to disconnect more than a certain number of consumers depends strongly on the threshold. For large thresholds the decay is clearly exponential, while for small ones the decay is slow, indicating a power-law decay.

  15. Nurses' strategies to address self-care aspects related to medication adherence and symptom recognition in heart failure patients: an in-depth look.

    PubMed

    Jaarsma, Tiny; Nikolova-Simons, Mariana; van der Wal, Martje H L

    2012-01-01

    Despite an increasing body of knowledge on self-care in heart failure patients, the need for effective interventions remains. We sought to deepen the understanding of interventions that heart failure nurses use in clinical practice to improve patient adherence to medication and symptom monitoring. A qualitative study with a directed content analysis was performed, using data from a selected sample of Dutch-speaking heart failure nurses who completed booklets with two vignettes involving medication adherence and symptom recognition. Nurses regularly assess and reassess patients before they decide on an intervention. They evaluate basic/factual information and barriers in a patient's behavior, and try to find room for improvement in a patient's behavior. Interventions that heart failure nurses use to improve adherence to medication and symptom monitoring were grouped into the themes of increasing knowledge, increasing motivation, and providing patients with practical tools. Nurses also described using technology-based tools, increased social support, alternative communication, partnership approaches, and coordination of care to improve adherence to medications and symptom monitoring. Despite a strong focus on educational strategies, nurses also reported other strategies to increase patient adherence. Nurses use several strategies to improve patient adherence that are not incorporated into guidelines. These interventions need to be evaluated for further applications in improving heart failure management. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. A Randomized Trial of Heart Failure Disease Management in Skilled Nursing Facilities: Design and Rationale

    PubMed Central

    Boxer, Rebecca S.; Dolansky, Mary A.; Bodnar, Christine A.; Singer, Mendel E.; Albert, Jeffery M.; Gravenstein, Stefan

    2013-01-01

    Background Heart failure disease management can improve health outcomes for older community dwelling patients with heart failure. Heart failure disease management has not been studied in skilled nursing facilities, a major site of transitional care for older adults. Methods and Anticipated Results The objective of this trial is to investigate if a heart failure disease management program (HF-DMP) in skilled nursing facilities (SNF) will decrease all-cause rehospitalizations for the first 60 days post SNF admission. The trial is a randomized cluster trial to be conducted in 12 for-profit SNF in the greater Cleveland area. The study population is inclusive of patients with heart failure regardless of ejection fraction but excludes those patients on dialysis and with a life expectancy of 6 months or less. The HF-DMP includes 7 elements considered standard of care for patients with heart failure: documentation of left ventricular function, tracking of weight and symptoms, medication titration, discharge instructions, 7 day follow up appointment post SNF discharge, patient education. The HF-DMP is conducted by a research nurse tasked with adhering to each element of the program and regularly audited to maintain fidelity of the program. Additional outcomes include health status, self-care management, and discharge destination. Conclusion The SNF-Connect Trial is the first trial of its kind to assess if a HF-DMP will improve outcomes for patients in SNFs. This trial will provide evidence on the effectiveness of HF-DMP to improve outcomes for older frail heart failure patients undergoing post-acute rehabilitation. PMID:23871475

  17. A practical guide to failure mode and effects analysis in health care: making the most of the team and its meetings.

    PubMed

    Ashley, Laura; Armitage, Gerry; Neary, Maria; Hollingsworth, Gillian

    2010-08-01

    Failure Mode and Effects Analysis (FMEA) is a proactive risk assessment tool used to identify potential vulnerabilities in complex, high-risk processes and to generate remedial actions before the processes result in adverse events. FMEA is increasingly used to proactively assess and improve the safety of complex health care processes such as drug administration and blood transfusion. A central feature of FMEA is that it is undertaken by a multidisciplinary team, and because it entails numerous analytical steps, it takes a series of several meetings. Composing a team of busy health care professionals with the appropriate knowledge, skill mix, and logistical availability for regular meetings is, however, a serious challenge. Despite this, information and advice on FMEA team assembly and meetings scheduling are scarce and diffuse and often presented without the accompanying rationale. Assemble an eight-member team composed of clinically active health care staff, from every profession involved in delivery of the process-and who regularly perform it; staff from a range of seniority levels; outsider(s) to the process-and perhaps even to health care; a leader (and facilitator); and researchers. Plan for 10-15 hours of team meeting time for first-time, narrowly defined FMEAs, scheduled as four to six meetings lasting 2 to 3 hours each, spaced weekly to biweekly. Meet in a venue that seats the team around one table and is off the hospital floor but within its grounds. FMEA, generally acknowledged to be a useful addition to the patient safety toolkit, is a meticulous and time- and resource-intensive methodology, and its successful completion is highly dependent on the team members' aptitude and on the facility's and team members' commitment to hold regular, productive meetings.

  18. Adding statistical regularity results in a global slowdown in visual search.

    PubMed

    Vaskevich, Anna; Luria, Roy

    2018-05-01

    Current statistical learning theories predict that embedding implicit regularities within a task should further improve online performance, beyond general practice. We challenged this assumption by contrasting performance in a visual search task containing either a consistent-mapping (regularity) condition, a random-mapping condition, or both conditions, mixed. Surprisingly, performance in a random visual search, without any regularity, was better than performance in a mixed design search that contained a beneficial regularity. This result was replicated using different stimuli and different regularities, suggesting that mixing consistent and random conditions leads to an overall slowing down of performance. Relying on the predictive-processing framework, we suggest that this global detrimental effect depends on the validity of the regularity: when its predictive value is low, as it is in the case of a mixed design, reliance on all prior information is reduced, resulting in a general slowdown. Our results suggest that our cognitive system does not maximize speed, but rather continues to gather and implement statistical information at the expense of a possible slowdown in performance. Copyright © 2018 Elsevier B.V. All rights reserved.

  19. Influence of Career Information on Choice of Degree Programme among Regular and Self-Sponsored Students in Public Universities, Kenya

    ERIC Educational Resources Information Center

    Gacohi, Jane Njeri; Sindabi, Aggrey M.; Chepchieng, Micah C.

    2017-01-01

    Choosing a degree programme to study in the university is a critical career task that is a major turning point in a student's life which not only is a start to workplace readiness, but also establishes the student in a career path that opens as well as closes life opportunities. Failure to achieve this task may cause dissatisfaction within the…

  20. High Stakes: Children, Testing, and Failure in American Schools. A Year in the Life of One Rural School and Its Children.

    ERIC Educational Resources Information Center

    Johnson, Dale D.; Johnson, Bonnie

    This book connects the educational conditions created by high-stakes testing to the students and teachers who are influenced or victimized by the currents driving this movement. The authors left their positions as teacher-educators and taught grades 3 and 4 for 1 year as regular teachers in one of America's most impoverished schools. Redbud…

  1. Compression deformation behavior of Ti-6Al-4V alloy with cellular structures fabricated by electron beam melting.

    PubMed

    Cheng, X Y; Li, S J; Murr, L E; Zhang, Z B; Hao, Y L; Yang, R; Medina, F; Wicker, R B

    2012-12-01

    Ti-6Al-4V alloy with two kinds of open cellular structures of stochastic foam and reticulated mesh was fabricated by additive manufacturing (AM) using electron beam melting (EBM), and microstructure and mechanical properties of these samples with high porosity in the range of 62%∼92% were investigated. Optical observations found that the cell struts and ligaments consist of primary α' martensite. These cellular structures have comparable compressive strength (4∼113 MPa) and elastic modulus (0.2∼6.3 GPa) to those of trabecular and cortical bone. The regular mesh structures exhibit higher specific strength than other reported metallic foams under the condition of identical specific stiffness. During the compression, these EBM samples have a brittle response and undergo catastrophic failure after forming crush band at their peak loading. These bands have identical angle of ∼45° with compression axis for the regular reticulated meshes and such failure phenomenon was explained by considering the cell structure. Relative strength and density follow a linear relation as described by the well-known Gibson-Ashby model but its exponential factor is ∼2.2, which is relative higher than the idea value of 1.5 derived from the model. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Poor symptom and performance validity in regularly referred Hospital outpatients: Link with standard clinical measures, and role of incentives.

    PubMed

    Dandachi-FitzGerald, Brechje; van Twillert, Björn; van de Sande, Peter; van Os, Yindee; Ponds, Rudolf W H M

    2016-05-30

    We investigated the frequency of symptom validity test (SVT) failure and its clinical correlates in a large, heterogeneous sample of hospital outpatients referred for psychological assessment for clinical purposes. We studied patients (N=469), who were regularly referred for assessment to the psychology departments of five hospitals. Background characteristics, including information about incentives, were obtained with a checklist completed by the clinician. As a measure of over-reporting, the Structured Inventory of Malingered Symptomatology (SIMS) was administered to all patients. The Amsterdam Short-Term Memory test (ASTM), a cognitive underperformance measure, was only administered to patients who were referred for a neuropsychological assessment. Symptom over-reporting occurred in a minority of patients, ranging from 12% to 19% in the main diagnostic patient groups. Patients with morbid obesity had a low rate of over-reporting (1%). The SIMS was positively associated with levels of self-reported psychological symptoms. Cognitive underperformance occurred in 29.3% of the neuropsychological assessments. The ASTM was negatively associated with memory test performance. We found no association between SVT failure and financial incentives. Our results support the recommendation to routinely evaluate symptom validity in clinical assessments of hospital patients. The dynamics behind invalid symptom reporting need to be further elucidated. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. Impression cytology changes and corneoconjunctival calcification in patients with chronic renal failure.

    PubMed

    Bakaris, Sevgi; Ozdemir, Murat; Isik, Ismet Onder; Buyukbese, Mehmet Akif; Ozdemir, Gokhan

    2005-01-01

    To evaluate the relationship between corneoconjunctival calcification and conjunctival squamous metaplasia in patients with chronic renal failure (CRP). We studied impression cytology in 45 CRF patients on regular hemodialysis and 30 age- and sex-matched controls. Specimens were obtainedfrom the temporal bulbar conjunctiva using cellulose acetate filter paper. The samples were fixed in a mixture of 70% ethyl alcohol, 37% formaldehyde and glacial acetic acid and then stained with a combination of periodic acid- Schiff and Gill's modified Papanicolaou stain and graded by a masked observer. Corneoconjunctival calcification was graded by the Porter-Crombie classification. Of 45 study patients, 4 (9%) disclosed grade 0, 23 (51%) grade 1, 14 (31%) grade 2 and 4 grade 3 (9%) impression cytology changes. There was a statistically significant difference between the patient and control groups (p < 0.001). Calcium deposits were more frequent and extensive in CRF patients than in controls (p = 0.01). There was no correlation between impression cytology and calcium deposit grades (p = 0.128). However the presence of conjunctival inflammation correlated with the existence of extensive squamous metaplasia (p < 0.001). The severity of conjunctival changes in CRF patients on regular hemodialysis are not related to calcium deposition but to acute conjunctival inflammation.

  4. Climate change and the global pattern of moraine-dammed glacial lake outburst floods

    NASA Astrophysics Data System (ADS)

    Harrison, Stephan; Kargel, Jeffrey S.; Huggel, Christian; Reynolds, John; Shugar, Dan H.; Betts, Richard A.; Emmer, Adam; Glasser, Neil; Haritashya, Umesh K.; Klimeš, Jan; Reinhardt, Liam; Schaub, Yvonne; Wiltshire, Andy; Regmi, Dhananjay; Vilímek, Vít

    2018-04-01

    Despite recent research identifying a clear anthropogenic impact on glacier recession, the effect of recent climate change on glacier-related hazards is at present unclear. Here we present the first global spatio-temporal assessment of glacial lake outburst floods (GLOFs) focusing explicitly on lake drainage following moraine dam failure. These floods occur as mountain glaciers recede and downwaste. GLOFs can have an enormous impact on downstream communities and infrastructure. Our assessment of GLOFs associated with the rapid drainage of moraine-dammed lakes provides insights into the historical trends of GLOFs and their distributions under current and future global climate change. We observe a clear global increase in GLOF frequency and their regularity around 1930, which likely represents a lagged response to post-Little Ice Age warming. Notably, we also show that GLOF frequency and regularity - rather unexpectedly - have declined in recent decades even during a time of rapid glacier recession. Although previous studies have suggested that GLOFs will increase in response to climate warming and glacier recession, our global results demonstrate that this has not yet clearly happened. From an assessment of the timing of climate forcing, lag times in glacier recession, lake formation and moraine-dam failure, we predict increased GLOF frequencies during the next decades and into the 22nd century.

  5. Managing Endings in a Longitudinal Study: Respect for Persons

    NASA Astrophysics Data System (ADS)

    Reiss, Michael J.

    2005-03-01

    In this paper I describe and discuss the way that a book I had written on a five-year longitudinal study of school science teaching was received by the pupils and teachers it featured. By and large the pupils' reception was positive. However, one group of teachers was deeply hurt by the book. I trace this mainly to my failure to consider adequately their fears of the consequences of the book's publication and possibly to my failure to consider with them the psychological significance of my withdrawing from the school after five years of regular study. I hope that there are lessons not only for myself but also for others considering longitudinal and ethnographic research in science education and more broadly.

  6. Cliophysics: Socio-Political Reliability Theory, Polity Duration and African Political (In)stabilities

    PubMed Central

    Cherif, Alhaji; Barley, Kamal

    2010-01-01

    Quantification of historical sociological processes have recently gained attention among theoreticians in the effort of providing a solid theoretical understanding of the behaviors and regularities present in socio-political dynamics. Here we present a reliability theory of polity processes with emphases on individual political dynamics of African countries. We found that the structural properties of polity failure rates successfully capture the risk of political vulnerability and instabilities in which , , , and of the countries with monotonically increasing, unimodal, U-shaped and monotonically decreasing polity failure rates, respectively, have high level of state fragility indices. The quasi-U-shape relationship between average polity duration and regime types corroborates historical precedents and explains the stability of the autocracies and democracies. PMID:21206911

  7. A Robust Damage-Reporting Strategy for Polymeric Materials Enabled by Aggregation-Induced Emission.

    PubMed

    Robb, Maxwell J; Li, Wenle; Gergely, Ryan C R; Matthews, Christopher C; White, Scott R; Sottos, Nancy R; Moore, Jeffrey S

    2016-09-28

    Microscopic damage inevitably leads to failure in polymers and composite materials, but it is difficult to detect without the aid of specialized equipment. The ability to enhance the detection of small-scale damage prior to catastrophic material failure is important for improving the safety and reliability of critical engineering components, while simultaneously reducing life cycle costs associated with regular maintenance and inspection. Here, we demonstrate a simple, robust, and sensitive fluorescence-based approach for autonomous detection of damage in polymeric materials and composites enabled by aggregation-induced emission (AIE). This simple, yet powerful system relies on a single active component, and the general mechanism delivers outstanding performance in a wide variety of materials with diverse chemical and mechanical properties.

  8. [Management of chronic heart failure - a systematic review of guidelines in the context of the DMP revision].

    PubMed

    Kötter, Thomas; Bartel, Carmen; Schramm, Susanne; Lange, Petra; Höfer, Eva; Hänsel, Michaela; Waffenschmidt, Siw; Waldt, Susanne Ein; Hoffmann-Eßer, Wiebke; Rüther, Alric; Lühmann, Dagmar; Scherer, Martin

    2013-01-01

    Disease Management Programmes (DMPs) are structured treatment programmes for chronic diseases. The DMP requirements are primarily derived from evidence-based guidelines. DMPs are regularly revised to ensure that they reflect current best practice and medical knowledge. The aim of this study was to assess the need for updating the German DMP module on heart failure by comparing it to relevant guidelines and identifying recommendations that should be revised. We systematically searched for clinical guidelines on heart failure published in German, English or French, and extracted relevant guideline recommendations. All included guidelines were assessed for methodological quality. To identify revision needs in the DMP, we performed a synoptic analysis of the extracted guideline recommendations and DMP requirements. 27 guidelines were included. The extracted recommendations covered all aspects of the management of heart failure. The comparison of guideline recommendations with DMP requirements showed that, overall, guideline recommendations were more detailed than DMP requirements, and that the guidelines covered topics not included in the DMP module. The DMP module is largely consistent with current guidelines on heart failure. We did not identify any need for significant revision of the DMP requirements. However, some specific recommendations of the DMP module could benefit from revision. Copyright © 2013. Published by Elsevier GmbH.

  9. Numerical simulation of the fatigue behavior of additive manufactured titanium porous lattice structures.

    PubMed

    Zargarian, A; Esfahanian, M; Kadkhodapour, J; Ziaei-Rad, S

    2016-03-01

    In this paper, the effects of cell geometry and relative density on the high-cycle fatigue behavior of Titanium scaffolds produced by selective laser melting and electron beam melting techniques were numerically investigated by finite element analysis. The regular titanium lattice samples with three different unit cell geometries, namely, diamond, rhombic dodecahedron and truncated cuboctahedron, and the relative density range of 0.1-0.3 were analyzed under uniaxial cyclic compressive loading. A failure event based algorithm was employed to simulate fatigue failure in the cellular material. Stress-life approach was used to model fatigue failure of both bulk (struts) and cellular material. The predicted fatigue life and the damage pattern of all three structures were found to be in good agreement with the experimental fatigue investigations published in the literature. The results also showed that the relationship between fatigue strength and cycles to failure obeyed the power law. The coefficient of power function was shown to depend on relative density, geometry and fatigue properties of the bulk material while the exponent was only dependent on the fatigue behavior of the bulk material. The results also indicated the failure surface at an angle of 45° to the loading direction. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Clinical and psychological telemonitoring and telecare of high risk heart failure patients.

    PubMed

    Villani, Alessandra; Malfatto, Gabriella; Compare, Angelo; Della Rosa, Francesco; Bellardita, Lara; Branzi, Giovanna; Molinari, Enrico; Parati, Gianfranco

    2014-12-01

    We conducted a trial of telemonitoring and telecare for patients with chronic heart failure leaving hospital after being treated for clinical instability. Eighty patients were randomized before hospital discharge to a usual care group (n=40: follow-up at the outpatient clinic) or to an integrated management group (n=40: patients learned to use a handheld PDA and kept in touch daily with the monitoring centre). At enrolment, the groups were similar for all clinical variables. At one-year follow-up, integrated management patients showed better adherence, reduced anxiety and depression, and lower NYHA class and plasma levels of BNP with respect to the usual care patients (e.g. NYHA class 2.1 vs 2.4, P<0.02). Mortality and hospital re-admissions for congestive heart failure were also reduced in integrated management patients (P<0.05). Integrated management was more expensive than usual care, although the cost of adverse events was 42% lower. In heart failure patients at high risk of relapse, the regular acquisition of simple clinical information and the possibility for the patient to contact the clinical staff improved drug titration, produced better psychological status and quality of life, and reduced hospitalizations for heart failure. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  11. A study of Mariner 10 flight experiences and some flight piece part failure rate computations

    NASA Technical Reports Server (NTRS)

    Paul, F. A.

    1976-01-01

    The problems and failures encountered in Mariner flight are discussed and the data available through a quantitative accounting of all electronic piece parts on the spacecraft are summarized. It also shows computed failure rates for electronic piece parts. It is intended that these computed data be used in the continued updating of the failure rate base used for trade-off studies and predictions for future JPL space missions.

  12. Colloidal domain lithography for regularly arranged artificial magnetic out-of-plane monodomains in Au/Co/Au layers.

    PubMed

    Kuświk, Piotr; Ehresmann, Arno; Tekielak, Maria; Szymański, Bogdan; Sveklo, Iosif; Mazalski, Piotr; Engel, Dieter; Kisielewski, Jan; Lengemann, Daniel; Urbaniak, Maciej; Schmidt, Christoph; Maziewski, Andrzej; Stobiecki, Feliks

    2011-03-04

    Regularly arranged magnetic out-of-plane patterns in continuous and flat films are promising for applications in data storage technology (bit patterned media) or transport of individual magnetic particles. Whereas topographic magnetic structures are fabricated by standard lithographical techniques, the fabrication of regularly arranged artificial domains in topographically flat films is difficult, since the free energy minimization determines the existence, shape, and regularity of domains. Here we show that keV He(+) ion bombardment of Au/Co/Au layer systems through a colloidal mask of hexagonally arranged spherical polystyrene beads enables magnetic patterning of regularly arranged cylindrical magnetic monodomains with out-of-plane magnetization embedded in a ferromagnetic matrix with easy-plane anisotropy. This colloidal domain lithography creates artificial domains via periodic lateral anisotropy variations induced by periodic defect density modulations. Magnetization reversal of the layer system observed by magnetic force microscopy shows individual disc switching indicating monodomain states.

  13. Continuous Intravenous Milrinone Therapy in Pediatric Outpatients.

    PubMed

    Curley, Michelle; Liebers, Jill; Maynard, Roy

    Milrinone is a phosphodiesterase 3 inhibitor with both positive inotropic and vasodilator properties. Administered as a continuous infusion, milrinone is indicated for the short-term treatment of patients with acute decompensated heart failure. Despite limited data supporting long-term milrinone therapy in adults with congestive heart failure, children managed as outpatients may benefit from continuous milrinone as a treatment for cardiac dysfunction, as a destination therapy for cardiac transplant, or as palliative therapy for cardiomyopathy. The aim of this article is to review the medical literature and describe a home infusion company's experience with pediatric outpatient milrinone therapy.

  14. Continuous Intravenous Milrinone Therapy in Pediatric Outpatients

    PubMed Central

    Curley, Michelle; Liebers, Jill

    2017-01-01

    Milrinone is a phosphodiesterase 3 inhibitor with both positive inotropic and vasodilator properties. Administered as a continuous infusion, milrinone is indicated for the short-term treatment of patients with acute decompensated heart failure. Despite limited data supporting long-term milrinone therapy in adults with congestive heart failure, children managed as outpatients may benefit from continuous milrinone as a treatment for cardiac dysfunction, as a destination therapy for cardiac transplant, or as palliative therapy for cardiomyopathy. The aim of this article is to review the medical literature and describe a home infusion company's experience with pediatric outpatient milrinone therapy. PMID:28248808

  15. 19 CFR 162.93 - Failure to issue notice of seizure.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Failure to issue notice of seizure. 162.93 Section... OF THE TREASURY (CONTINUED) INSPECTION, SEARCH, AND SEIZURE Civil Asset Forfeiture Reform Act § 162.93 Failure to issue notice of seizure. If Customs does not send notice of a seizure of property in...

  16. 29 CFR 1602.43 - Commission's remedy for school systems' or districts' failure to file report.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...' failure to file report. Any school system or district failing or refusing to file report EEO-5 when... 29 Labor 4 2013-07-01 2013-07-01 false Commission's remedy for school systems' or districts' failure to file report. 1602.43 Section 1602.43 Labor Regulations Relating to Labor (Continued) EQUAL...

  17. 29 CFR 1602.43 - Commission's remedy for school systems' or districts' failure to file report.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...' failure to file report. Any school system or district failing or refusing to file report EEO-5 when... 29 Labor 4 2011-07-01 2011-07-01 false Commission's remedy for school systems' or districts' failure to file report. 1602.43 Section 1602.43 Labor Regulations Relating to Labor (Continued) EQUAL...

  18. 29 CFR 1602.43 - Commission's remedy for school systems' or districts' failure to file report.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...' failure to file report. Any school system or district failing or refusing to file report EEO-5 when... 29 Labor 4 2012-07-01 2012-07-01 false Commission's remedy for school systems' or districts' failure to file report. 1602.43 Section 1602.43 Labor Regulations Relating to Labor (Continued) EQUAL...

  19. 29 CFR 1602.43 - Commission's remedy for school systems' or districts' failure to file report.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...' failure to file report. Any school system or district failing or refusing to file report EEO-5 when... 29 Labor 4 2014-07-01 2014-07-01 false Commission's remedy for school systems' or districts' failure to file report. 1602.43 Section 1602.43 Labor Regulations Relating to Labor (Continued) EQUAL...

  20. 29 CFR 1602.43 - Commission's remedy for school systems' or districts' failure to file report.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...' failure to file report. Any school system or district failing or refusing to file report EEO-5 when... 29 Labor 4 2010-07-01 2010-07-01 false Commission's remedy for school systems' or districts' failure to file report. 1602.43 Section 1602.43 Labor Regulations Relating to Labor (Continued) EQUAL...

  1. 43 CFR 4170.1-2 - Failure to use.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Failure to use. 4170.1-2 Section 4170.1-2 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT... § 4170.1-2 Failure to use. If a permittee or lessee has, for 2 consecutive grazing fee years, failed to...

  2. 43 CFR 4170.1-2 - Failure to use.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Failure to use. 4170.1-2 Section 4170.1-2 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT... § 4170.1-2 Failure to use. If a permittee or lessee has, for 2 consecutive grazing fee years, failed to...

  3. 43 CFR 4170.1-2 - Failure to use.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Failure to use. 4170.1-2 Section 4170.1-2 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT... § 4170.1-2 Failure to use. If a permittee or lessee has, for 2 consecutive grazing fee years, failed to...

  4. 43 CFR 4170.1-2 - Failure to use.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Failure to use. 4170.1-2 Section 4170.1-2 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT... § 4170.1-2 Failure to use. If a permittee or lessee has, for 2 consecutive grazing fee years, failed to...

  5. The Type A behavior pattern and adherence to a regular running program by adult males ages 25 to 39 years.

    PubMed

    Pargman, D; Green, L

    1990-06-01

    This study examined the relationship between the Type A behavior pattern and adherence to a regular running program. Type A runners among 149 men of 25 to 39 yr. age reported significantly higher self-motivation than the Type B runners. Research should continue to examine motivational patterns associated with long-term adherence to physical exercise.

  6. School Psychologists' Continuing Professional Development Preferences and Practices

    ERIC Educational Resources Information Center

    Armistead, Leigh D.; Castillo, Jose M.; Curtis, Michael J.; Chappel, Ashley; Cunningham, Jennifer

    2013-01-01

    This study investigated school psychologists' continuing professional development (CPD) activities, topics, needs, motivations, financial expenditures, and opinions, as well as relationships between select demographic characteristics and certain CPD practices and preferences. A survey was mailed to 1,000 randomly selected Regular Members of…

  7. Investigating Main and High-Speed Shaft Bearing Reliability through Uptower Testing

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

    Keller, Jonathan A

    The most prevalent failure modes in wind turbine drivetrains are main bearing failures stemming from micropitting, white etching or axial cracks in gearbox bearings, and generator bearing failures. These failures are neither well understood nor accounted for in design standards; consequently, the mitigation strategies being developed and fielded may only partially address the physics of failure and can take years to assess. The U.S. Department of Energy continues to support research programs to investigate the influence of rolling element sliding on the formation of bearing axial cracks and main bearing micropitting.

  8. VERA Geodetic Activities

    NASA Technical Reports Server (NTRS)

    Jike, Takaaki; Tamura, Yoshiaki; Shizugami, Makoto

    2013-01-01

    This report briefly describes the geodetic activities of VERA in the year 2012. The regular geodetic observations are carried out both in K- and S/X-bands. The frequency of regular observations is three times a month-twice for the VERA internal observations in K-band. The networks of the S/X sessions are JADE of GSI and IVS-T2. The raw data of the T2 and JADE sessions are electronically transferred to the Bonn, Haystack, and GSI correlators via Internet. Gravimetric observations are carried out at the VERA stations. An SG was installed at Mizusawa and placed in the vicinity of the VERA antenna in order to monitor vertical displacement at the end of 2008, and the observations continued throughout the year. Also at the VERA-Ishigakijima station, continuous operation of the SG started in 2012. The crustal movements generated by the 2011 earthquake off the Pacific coast of Tohoku continued during 2012, and displacement of the VERA-Mizusawa position by post-seismic creeping continued.

  9. A New Continuous-Time Equality-Constrained Optimization to Avoid Singularity.

    PubMed

    Quan, Quan; Cai, Kai-Yuan

    2016-02-01

    In equality-constrained optimization, a standard regularity assumption is often associated with feasible point methods, namely, that the gradients of constraints are linearly independent. In practice, the regularity assumption may be violated. In order to avoid such a singularity, a new projection matrix is proposed based on which a feasible point method to continuous-time, equality-constrained optimization is developed. First, the equality constraint is transformed into a continuous-time dynamical system with solutions that always satisfy the equality constraint. Second, a new projection matrix without singularity is proposed to realize the transformation. An update (or say a controller) is subsequently designed to decrease the objective function along the solutions of the transformed continuous-time dynamical system. The invariance principle is then applied to analyze the behavior of the solution. Furthermore, the proposed method is modified to address cases in which solutions do not satisfy the equality constraint. Finally, the proposed optimization approach is applied to three examples to demonstrate its effectiveness.

  10. Vitamin C for preventing and treating the common cold.

    PubMed

    Hemilä, Harri; Chalker, Elizabeth

    2013-01-31

    Vitamin C (ascorbic acid) for preventing and treating the common cold has been a subject of controversy for 70 years. To find out whether vitamin C reduces the incidence, the duration or severity of the common cold when used either as a continuous regular supplementation every day or as a therapy at the onset of cold symptoms. We searched CENTRAL 2012, Issue 11, MEDLINE (1966 to November week 3, 2012), EMBASE (1990 to November 2012), CINAHL (January 2010 to November 2012), LILACS (January 2010 to November 2012) and Web of Science (January 2010 to November 2012). We also searched the U.S. National Institutes of Health trials register and WHO ICTRP on 29 November 2012. We excluded trials which used less than 0.2 g per day of vitamin C and trials without a placebo comparison. We restricted our review to placebo-controlled trials. Two review authors independently extracted data. We assessed 'incidence' of colds during regular supplementation as the proportion of participants experiencing one or more colds during the study period. 'Duration' was the mean number of days of illness of cold episodes. Twenty-nine trial comparisons involving 11,306 participants contributed to the meta-analysis on the risk ratio (RR) of developing a cold whilst taking vitamin C regularly over the study period. In the general community trials involving 10,708 participants, the pooled RR was 0.97 (95% confidence interval (CI) 0.94 to 1.00). Five trials involving a total of 598 marathon runners, skiers and soldiers on subarctic exercises yielded a pooled RR of 0.48 (95% CI 0.35 to 0.64).Thirty-one comparisons examined the effect of regular vitamin C on common cold duration (9745 episodes). In adults the duration of colds was reduced by 8% (3% to 12%) and in children by 14% (7% to 21%). In children, 1 to 2 g/day vitamin C shortened colds by 18%. The severity of colds was also reduced by regular vitamin C administration.Seven comparisons examined the effect of therapeutic vitamin C (3249 episodes). No consistent effect of vitamin C was seen on the duration or severity of colds in the therapeutic trials.The majority of included trials were randomised, double-blind trials. The exclusion of trials that were either not randomised or not double-blind had no effect on the conclusions. The failure of vitamin C supplementation to reduce the incidence of colds in the general population indicates that routine vitamin C supplementation is not justified, yet vitamin C may be useful for people exposed to brief periods of severe physical exercise. Regular supplementation trials have shown that vitamin C reduces the duration of colds, but this was not replicated in the few therapeutic trials that have been carried out. Nevertheless, given the consistent effect of vitamin C on the duration and severity of colds in the regular supplementation studies, and the low cost and safety, it may be worthwhile for common cold patients to test on an individual basis whether therapeutic vitamin C is beneficial for them. Further therapeutic RCTs are warranted.

  11. [Implementation of a palliative care concept in a geriatric acute care hospital].

    PubMed

    Hagg-Grün, U; Lukas, A; Sommer, B-N; Klaiber, H-R; Nikolaus, T

    2010-12-01

    To integrate palliative care patients into an acute geriatric ward requires extensive and continuous education and preparation of all participating professionals. It can be a lengthy process to integrate palliative care concepts despite cooperation of the hospital administration. The group of patients to be integrated differs from the patients of regular geriatric wards because of a higher percentage of relatively young oncologic patients and they differ from a regular palliative ward because about 50% are non-oncologic patients, while the average age is much higher than in normal palliative care. It is possible to integrate specialized palliative care into a regular geriatric ward. Patients admitted without palliative intention will benefit the most from ward-integrated palliative care if the treatment aim turns this way. Ward-integrated palliative care can be an integral part of treating geriatric patients in addition to acute geriatric medicine, rehabilitation, and prevention. It can also provide caretakers and patients with the benefits from continuity of treatment and care.

  12. 26 CFR 301.7231-1 - Failure to obtain license for collection of foreign items.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... TREASURY (CONTINUED) PROCEDURE AND ADMINISTRATION PROCEDURE AND ADMINISTRATION Crimes, Other Offenses, and Forfeitures Crimes § 301.7231-1 Failure to obtain license for collection of foreign items. For provisions...

  13. The effects of gum arabic oral treatment on the metabolic profile of chronic renal failure patients under regular haemodialysis in Central Sudan.

    PubMed

    Ali, Adil Ahmed; Ali, Khalid Eltom; Fadlalla, Abd Eigani; Khalid, Khalid Eltahir

    2008-01-10

    This study aimed at assessing the effect of gum arabic (Acacia senegal) oral treatment on the metabolic profile of chronic renal failure (CRF) patients. A total of 36 CRF patients (under regular haemodialysis) and 10 normal subjects participated in this study. The patients were randomly allocated into three groups-group A: 12 CRF patients under low-protein diet (LPD) (<40 g day(-1)) and gum arabic (50 g day(-1)) treatment; group B: 14 CRF patients under LPD and gum arabic, iron (ferrous sulphate, 200 mg day(-1)) and folic acid (5 mg day(-1)) treatment; group C (control group): 10 CRF patients under LPD and iron and folic acid treatment and group D: 10 normal volunteers (on normal diet) under daily dose of 50 g gum arabic. Each of the above treatments was continued for three consecutive months. Blood samples were collected from each subject before treatment and twice per month "pre-dialysis" for 3 months. Biochemical parameters measured were: serum urea, serum creatinine, serum uric acid, serum calcium and serum phosphorus. By the end of the 3 months of treatment, serum urea levels significantly decreased by 31.2 and 44.18% for group A and B, respectively, compared with the baseline (0.01 < p < 0.001) and control group (p < 0.05). Serum creatinine levels significantly decreased in the groups of gum users (A, B and D) by 9.94, 12.65 and 11.7%, respectively, compared with the control group (p < 0.001). There was a significant decrease (p < 0.05) in serum uric acid levels by 14 and 19.9% for group A and B, respectively, compared with the baseline. Serum calcium levels increased by 12.64, 15.75 and 8.75% for group A, B and D, respectively, and these increases were significantly different (0.05 < p < 0.001) from baseline and control group for groups A and B. Serum phosphorus levels significantly decreased by 22.54% for group A, 17.69% for group B and 7.71% for group D, compared with the baseline (0.05 < p < 0.001). From this study, we conclude that oral administration of gum arabic could conceivably alleviate adverse effects of CRF.

  14. Nasal Jet-CPAP (variable flow) versus Bubble-CPAP in preterm infants with respiratory distress: an open label, randomized controlled trial.

    PubMed

    Bhatti, A; Khan, J; Murki, S; Sundaram, V; Saini, S S; Kumar, P

    2015-11-01

    To compare the failure rates between Jet continuous positive airway pressure device (J-CPAP-variable flow) and Bubble continuous positive airway device (B-CPAP) in preterm infants with respiratory distress. Preterm newborns <34 weeks gestation with onset of respiratory distress within 6 h of life were randomized to receive J-CPAP (a variable flow device) or B-CPAP (continuous flow device). A standardized protocol was followed for titration, weaning and removal of CPAP. Pressure was monitored close to the nares in both the devices every 6 hours and settings were adjusted to provide desired CPAP. The primary outcome was CPAP failure rate within 72 h of life. Secondary outcomes were CPAP failure within 7 days of life, need for surfactant post-randomization, time to CPAP failure, duration of CPAP and complications of prematurity. An intention to treat analysis was done. One-hundred seventy neonates were randomized, 80 to J-CPAP and 90 to B-CPAP. CPAP failure rates within 72 h were similar in infants who received J-CPAP and in those who received B-CPAP (29 versus 21%; relative risks 1.4 (0.8 to 2.3), P=0.25). Mean (95% confidence intervals) time to CPAP failure was 59 h (54 to 64) in the Jet CPAP group in comparison with 65 h (62 to 68) in the Bubble CPAP group (log rank P=0.19). All other secondary outcomes were similar between the two groups. In preterm infants with respiratory distress starting within 6 h of life, CPAP failure rates were similar with Jet CPAP and Bubble CPAP.

  15. Refining the Use of Nasal High-Flow Therapy as Primary Respiratory Support for Preterm Infants.

    PubMed

    Manley, Brett J; Roberts, Calum T; Frøisland, Dag H; Doyle, Lex W; Davis, Peter G; Owen, Louise S

    2018-05-01

    To identify clinical and demographic variables that predict nasal high-flow (nHF) treatment failure when used as a primary respiratory support for preterm infants. This secondary analysis used data from a multicenter, randomized, controlled trial comparing nHF with continuous positive airway pressure as primary respiratory support in preterm infants 28-36 completed weeks of gestation. Treatment success or failure with nHF was determined using treatment failure criteria within the first 72 hours after randomization. Infants in whom nHF treatment failed received continuous positive airway pressure, and were then intubated if failure criteria were again met. There were 278 preterm infants included, with a mean gestational age (GA) of 32.0 ± 2.1 weeks and a birth weight of 1737 ± 580 g; of these, nHF treatment failed in 71 infants (25.5%). Treatment failure was moderately predicted by a lower GA and higher prerandomization fraction of inspired oxygen (FiO 2 ): area under a receiver operating characteristic curve of 0.76 (95% CI, 0.70-0.83). Nasal HF treatment success was more likely in infants born at ≥30 weeks GA and with prerandomization FiO 2 <0.30. In preterm infants ≥28 weeks' GA enrolled in a randomized, controlled trial, lower GA and higher FiO 2 before randomization predicted early nHF treatment failure. Infants were more likely to be successfully treated with nHF from soon after birth if they were born at ≥30 weeks GA and had a prerandomization FiO 2 <0.30. However, even in this select population, continuous positive airway pressure remains superior to nHF as early respiratory support in preventing treatment failure. Australian New Zealand Clinical Trials Registry: ACTRN12613000303741. Copyright © 2018 Elsevier Inc. All rights reserved.

  16. Cheyne-Stokes respiration in patients with congestive heart failure.

    PubMed

    Brack, Thomas

    2003-12-13

    Cheyne-Stokes Respiration (CSR) is a breathing pattern characterised by rhythmic oscillation of tidal volume with regularly recurring periods of hyperpnoea, hypopnoea and apnoea. CSR is no longer solely regarded as a symptom of severe congestive heart failure (CHF), but has been recognised as an independent risk factor for worsening heart failure and reduced survival in patients with CHF. CSR is associated with frequent awakening that fragment sleep and with concomitant sympathetic activation both of which may worsen CHF. Cheyne-Stokes Respiration is very common in patients with severe CHF and its prevalence may have been underestimated in the past due to technical limitations that precluded respiratory monitoring outside sleep laboratories. Since treatment of CSR appears to be beneficial and safe, patients at risk should be promptly diagnosed and treated. Treatment of CSR has been demonstrated to improve left ventricular ejection fraction and potentially prolongs survival in patients with severe CHF. This article briefly summarises the current knowledge of the patho-physiology, prevalence and therapy of Cheyne-Stokes respiration.

  17. The hot (invisible?) hand: can time sequence patterns of success/failure in sports be modeled as repeated random independent trials?

    PubMed

    Yaari, Gur; Eisenmann, Shmuel

    2011-01-01

    The long lasting debate initiated by Gilovich, Vallone and Tversky in [Formula: see text] is revisited: does a "hot hand" phenomenon exist in sports? Hereby we come back to one of the cases analyzed by the original study, but with a much larger data set: all free throws taken during five regular seasons ([Formula: see text]) of the National Basketball Association (NBA). Evidence supporting the existence of the "hot hand" phenomenon is provided. However, while statistical traces of this phenomenon are observed in the data, an open question still remains: are these non random patterns a result of "success breeds success" and "failure breeds failure" mechanisms or simply "better" and "worse" periods? Although free throws data is not adequate to answer this question in a definite way, we speculate based on it, that the latter is the dominant cause behind the appearance of the "hot hand" phenomenon in the data.

  18. [Iron Deficiency in Chronic Heart Failure: Diagnostic Algorithm and Present-Day Therapeutic Options].

    PubMed

    Doehner, Wolfram; Blankenberg, Stefan; Erdmann, Erland; Ertl, Georg; Hasenfuß, Gerd; Landmesser, Ulf; Pieske, Burkert; Schieffer, Bernhard; Schunkert, Heribert; von Haehling, Stephan; Zeiher, Andreas; Anker, Stefan D

    2017-05-01

    Iron deficiency (ID) occurs in up to 50% of patients with heart failure (HF). Even without presence of anaemia ID contributes to more severe symptoms, increased hospitalization and mortality. A number of randomized controlled trials demonstrated the clinical benefit of replenishment of iron stores with improvement of symptoms and fewer hospitalizations. Assessment of iron status should therefore become routine assessment in newly diagnosed and in symptomatic patients with HF. ID can be identified with simple and straightforward diagnostic steps. Assessment of Ferritin (indicating iron stores) and transferrin saturation (TSAT, indication capability to mobilise internal iron stores) are sufficient to detect ID. In this review a plain diagnostic algorithm for ID is suggested. Confounding factors for diagnosis and adequate treatment of ID in HF are discussed. A regular workup for iron deficiency parameters may benefit patients with heart failure by providing symptomatic improvements and fewer hospitalizations. © Georg Thieme Verlag KG Stuttgart · New York.

  19. [Specific aspects and care of lung involvement in adults with cystic fibrosis].

    PubMed

    Pin, I; Grenet, D; Scheid, P; Domblides, P; Stern, M; Hubert, D

    2000-08-01

    Respiratory impairment is present in almost all adult cystic fibrosis patients and makes the prognosis. Viscous, infected and abundant secretions, inflammation and bronchial oedema, bronchoconstriction and respiratory muscle fatigue lead to airway obstruction, bronchiectasis and respiratory failure. The disease is preferentially located in the upper lobes. Exacerbations of the disease are due to bronchial infections and are often responsible for drops of the respiratory function. Regular spirometric surveillance is fundamental for the prognosis and the assessment of the effects of the treatment. Among adult patients chronic colonisation with mucoid and often multiresistant strains of Pseudomonas Aeruginosa are common. It is treated with i.v. high doses antibiotic courses and nebulized antibiotics between i.v. courses. Respiratory failure may require long term oxygen and non invasive mechanical ventilation. Systemic hypervascularization around the bronchiectasis may lead to moderate to severe hemoptysis, which may require embolization. Pneumothorax are associated with poor prognosis and are treated by pleural drainage and if failure by thoracoscopy.

  20. [The cavernosometry].

    PubMed

    Mantovani, F; Mastromarino, G; Fenice, O; Canclini, L; Patelli, E; Colombo, F; Vecchio, D; Austoni, E

    1994-09-01

    The recent clinical and experimental research innovations in Andrology make possible the following classification of impotence: "Failure to initiate" "Failure to store" "Failure to fill" The last aspect, including veno-occlusive dysfunction, is continuously reevaluated by andrologic studies. The main diagnostic procedure of this complex problem, in constant evolution, is represented by cavernometry. Recently, but with full success, we are utilizing direct radioisotopic penogram in video sexy stimulation: in preselection function but probably in future with substitutive function of the more invasive and traditional cavernometry. In spite of this methodologic progress the findings of cavernometry are in continuous discussion as in tumultuous evolution, in anatomo-physiological environment, is the intracavernous district that, for many aspects, necessity of ulterior histochemical, pharmacodynamic and neurophysiological acknowledgements.

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