Corneal graft reversal: Histopathologic report of two cases.

PubMed

Qahtani, Abdullah A; Alkatan, Hind M

2014-10-01

Graft reversal is a rare cause for failed PKP. In this case report we are presenting 2 graft failure cases in which the corneal grafts were reversed unintentionally. The onset of signs of graft failure, however was variable. We have included their clinical course and the histopathologic findings of the removed corneal grafts. A total of 6 cases including ours have been reported so far. The aim of this report is to attract the attention of corneal surgeons to an additional rare cause for failed penetrating keratoplasty (PKP) which is donor graft reversal.

Characterization and prediction of adverse events from intensive chronic heart failure management and effect on quality of life: results from the pro-B-type natriuretic peptide outpatient-tailored chronic heart failure therapy (PROTECT) study.

PubMed

Gandhi, Parul U; Szymonifka, Jackie; Motiwala, Shweta R; Belcher, Arianna M; Januzzi, James L; Gaggin, Hanna K

2015-01-01

Serious adverse events (SAEs) from heart failure (HF) therapy are frequent; however, techniques to identify at-risk patients are inadequate. Furthermore, the relationship between SAEs, quality of life (QOL), and cardiac structure are unknown. 151 symptomatic patients with systolic HF were followed for a mean of 10 months. In this post hoc analysis, treatment-related SAEs included acute renal failure, dizziness, hypo/hyperkalemia, hypotension, and syncope. At 1 year, 21 treatment-related SAEs occurred. No difference in SAEs existed between the N-terminal pro-B-type natriuretic peptide (NT-proBNP)-guided arm and the standard of care arm (P = .20). At baseline, patients who suffered SAEs were less likely to be receiving beta-blockers (85.7% vs 97.7%; P = .009) and had worse functional class and lower chloride levels. Patients who experienced SAEs had less improvement in their Minnesota Living With Heart Failure Questionnaire scores and had a trend toward reduced echocardiographic reverse remodeling over the follow-up period. Univariable and multivariable analyses were conducted to develop a risk score for SAE prediction; patients in the highest risk quartile had the shortest time to first cardiovascular event (P = 0.01). NT-proBNP-guided HF care is safe. Experiencing treatment-related SAEs is associated with worse QOL and potentially reduced reverse remodeling. A risk score to prospectively predict SAEs in aggressive HF management was developed. Copyright © 2015 Elsevier Inc. All rights reserved.

49 CFR 230.89 - Reverse gear.

Code of Federal Regulations, 2014 CFR

2014-10-01

... the main reservoir air pressure. The operating valve handle for such connection shall be conveniently... automatically prevent loss of pressure in event of failure of the main reservoir air pressure. (c) Power reverse... automatically prevent the loss of pressure in the event of a failure of main air pressure and have storage...

49 CFR 230.89 - Reverse gear.

Code of Federal Regulations, 2011 CFR

2011-10-01

... the main reservoir air pressure. The operating valve handle for such connection shall be conveniently... automatically prevent loss of pressure in event of failure of the main reservoir air pressure. (c) Power reverse... automatically prevent the loss of pressure in the event of a failure of main air pressure and have storage...

49 CFR 230.89 - Reverse gear.

Code of Federal Regulations, 2012 CFR

2012-10-01

... the main reservoir air pressure. The operating valve handle for such connection shall be conveniently... automatically prevent loss of pressure in event of failure of the main reservoir air pressure. (c) Power reverse... automatically prevent the loss of pressure in the event of a failure of main air pressure and have storage...

49 CFR 230.89 - Reverse gear.

Code of Federal Regulations, 2013 CFR

2013-10-01

... the main reservoir air pressure. The operating valve handle for such connection shall be conveniently... automatically prevent loss of pressure in event of failure of the main reservoir air pressure. (c) Power reverse... automatically prevent the loss of pressure in the event of a failure of main air pressure and have storage...

Chloroquine-induced cardiomyopathy: a reversible cause of heart failure.

PubMed

Yogasundaram, Haran; Hung, Whitney; Paterson, Ian D; Sergi, Consolato; Oudit, Gavin Y

2018-06-01

Chloroquine (CQ) and hydroxychloroquine (HCQ) are anti-rheumatic medications frequently used in the treatment of connective tissue disorders. We present the case of a 45-year-old woman with CQ-induced cardiomyopathy leading to severe heart failure. Electrocardiographic abnormalities included bifascicular block, while structural disease consisted of severe biventricular and biatrial hypertrophy. Appropriate diagnosis via endomyocardial biopsy led to cessation of CQ and subsequent dramatic improvement in symptoms and structural heart disease. Cardiac toxicity is an under-recognized adverse effect of CQ/HCQ leading to cardiomyopathy with concentric hypertrophy and conduction abnormalities, with the potential for significant morbidity and mortality. Predisposing factors for CQ/HCQ-induced cardiomyopathy have been proposed. CQ/HCQ cardiomyopathy is a phenocopy of Fabry disease, and α-galactosidase A polymorphism may account for some heterogeneity of disease presentation. © 2018 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

Left Ventricular Reverse Remodeling With Biventricular Versus Right Ventricular Pacing in Patients With Atrioventricular Block and Heart Failure in the BLOCK HF Trial.

PubMed

St John Sutton, Martin; Plappert, Ted; Adamson, Philip B; Li, Pei; Christman, Shelly A; Chung, Eugene S; Curtis, Anne B

2015-05-01

Biventricular pacing in heart failure (HF) improves survival, relieves symptoms, and attenuates left ventricular (LV) remodeling. However, little is known about biventricular pacing in HF patients with atrioventricular block because they are typically excluded from biventricular trials. The Biventricular versus Right Ventricular Pacing in Heart Failure Patients with Atrioventricular Block (BLOCK HF) trial randomized patients with atrioventricular block, New York Heart Association symptom classes I to III HF, and LV ejection fraction ≤50% to biventricular or right ventricular pacing. Doppler echocardiograms were obtained at randomization (after 30 to 60 days of right ventricular pacing postimplant) and every 6 months through 24 months. Data analysis comparing changes in 10 prespecified echo parameters over time was conducted using a Bayesian design. LV end systolic volume index was also evaluated as a predictor of mortality/morbidity. Of 691 randomized subjects, 624 had paired Doppler echocardiogram data for ≥1 analyses at 6, 12, 18, or 24 months. Biventricular pacing significantly reduced LV volume indices and intraventricular mechanical delay, and improved LV ejection fraction, consistent with LV reverse remodeling. These parameters showed little change with right ventricular pacing alone, indicating no systematic reverse remodeling with right ventricular pacing. LV end systolic volume index was predictive of mortality/morbidity; the estimated risk increased up to 1% for every 1 mL/m(2) increase in LV end systolic volume index. LV end systolic volume index is a significant predictor of mortality/morbidity in this population. Cardiac structure and function are improved with biventricular pacing for patients with atrioventricular block and LV systolic dysfunction. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00267098. © 2015 American Heart Association, Inc.

14 CFR 25.933 - Reversing systems.

Code of Federal Regulations, 2014 CFR

2014-01-01

... reversal in flight the engine will produce no more than flight idle thrust. In addition, it must be shown... kind of failure is extremely remote. (3) Each system must have means to prevent the engine from... alone, under the most critical reversing condition expected in operation. (b) For propeller reversing...

14 CFR 25.933 - Reversing systems.

Code of Federal Regulations, 2012 CFR

2012-01-01

... reversal in flight the engine will produce no more than flight idle thrust. In addition, it must be shown... kind of failure is extremely remote. (3) Each system must have means to prevent the engine from... alone, under the most critical reversing condition expected in operation. (b) For propeller reversing...

14 CFR 25.933 - Reversing systems.

Code of Federal Regulations, 2011 CFR

2011-01-01

... reversal in flight the engine will produce no more than flight idle thrust. In addition, it must be shown... kind of failure is extremely remote. (3) Each system must have means to prevent the engine from... alone, under the most critical reversing condition expected in operation. (b) For propeller reversing...

Two cases of malignant hypertension with reversible diffuse leukoencephalopathy exhibiting a reversible nocturnal blood pressure "riser" pattern.

PubMed

Eguchi, Kazuo; Kasahara, Kentaro; Nagashima, Akinori; Mor, Tadashi; Nii, Takanobu; Ibaraki, Kazuo; Kario, Kazuomi; Shimada, Kazuyuki

2002-05-01

We report two cases of malignant hypertension with reversible diffuse leukoencephalopathy demonstrating a nocturnal blood pressure (BP) rising pattern ("riser" pattern). Case 1 was a 54-year-old man diagnosed with malignant hypertension who presented with diffuse leukoencephalopathy and nocturnal BP rise during the acute phase. These abnormal findings diminished after treatment of hypertension. Case 2 was a 50-year-old woman diagnosed with malignant hypertension in association with leukoencephalopathy, heart failure and acute renal failure. She also presented with a "riser" pattern during the acute phase. In contrast to case 1, the leukoencephalopathy and "riser" pattern in case 2 were not improved even after 1 month of treatment. Following intensive antihypertensive treatment, renal failure was improved in case 1, but renal failure was not improved after 1 month in case 2. In conclusion, a possible explanation of this phenomenon is that a causative volume overload due to renal dysfunction produced the temporal leukoencephalopathy-like brain edema and "riser" pattern in these cases.

Reverse epidemiology beyond dialysis patients: chronic heart failure, geriatrics, rheumatoid arthritis, COPD, and AIDS.

PubMed

Horwich, Tamara B; Fonarow, Gregg C

2007-01-01

"Reverse epidemiology" refers to paradoxical and counterintuitive epidemiologic associations between survival outcomes and traditional cardiovascular risk factors such as obesity, high blood pressure, and high cholesterol. Reverse epidemiology has been well described in end stage renal disease, but also has been observed in chronic disease states, including chronic heart failure, rheumatoid arthritis, chronic obstructive pulmonary disease, and Acquired Immune Deficiency Syndrome, and in elderly populations. This review will highlight the recent medical literature on reverse epidemiology in these populations. Common pathophysiologic underpinnings in these chronic disease states may help explain the reversal of risk factors observed in these diverse populations. Furthermore, guidelines for the general population for optimal goals of weight, cholesterol levels, and blood pressure may not apply to special populations, including patients with chronic diseases or elderly persons.

Validation of Different Combination of Three Reversing Half-Hitches Alternating Posts (RHAPs) Effects on Arthroscopic Knot Integrity.

PubMed

Chong, Alexander Cm; Prohaska, Daniel J; Bye, Brian P

2017-05-01

With arthroscopic techniques being used, the importance of knot tying has been examined. Previous literature has examined the use of reversing half-hitches on alternating posts (RHAPs) on knot security. Separately, there has been research regarding different suture materials commonly used in the operating room. The specific aim of this study was to validate the effect of different stacked half-hitch configuration and different braided suture materials on arthroscopic knot integrity. Three different suture materials tied with five different RHAPs in arthroscopic knots were compared. A single load-to-failure test was performed and the mean ultimate clinical failure load was obtained. Significant knot holding strength improvement was found when one half-hitch was reversed as compared to baseline knot. When two of the half-hitches were reversed, there was a greater improvement with all knots having a mean ultimate clinical failure load greater than 150 newtons (N). Comparison of the suture materials demonstrated a higher mean ultimate clinical failure load when Force Fiber ® was used and at least one half-hitch was reversed. Knots tied with either Force Fiber ® or Orthocord ® showed 0% chance of knot slippage while knots tied with FiberWire ® or braided fishing line had about 10 and 30% knot slippage chances, respectively. A significant effect was observed in regards to both stacked half-hitch configuration and suture materials used on knot loop and knot security. Caution should be used with tying three RHAPs in arthroscopic surgery, particularly with a standard knot pusher and arthroscopic cannulas. The findings of this study indicated the importance of three RHAPs in performing arthroscopic knot tying and provided evidence regarding discrepancies of maximum clinical failure loads observed between orthopaedic surgeons, thereby leading to better surgical outcomes in the future.

Achieving cost-neutrality with long-acting reversible contraceptive methods.

PubMed

Trussell, James; Hassan, Fareen; Lowin, Julia; Law, Amy; Filonenko, Anna

2015-01-01

This analysis aimed to estimate the average annual cost of available reversible contraceptive methods in the United States. In line with literature suggesting long-acting reversible contraceptive (LARC) methods become increasingly cost-saving with extended duration of use, it aimed to also quantify minimum duration of use required for LARC methods to achieve cost-neutrality relative to other reversible contraceptive methods while taking into consideration discontinuation. A three-state economic model was developed to estimate relative costs of no method (chance), four short-acting reversible (SARC) methods (oral contraceptive, ring, patch and injection) and three LARC methods [implant, copper intrauterine device (IUD) and levonorgestrel intrauterine system (LNG-IUS) 20 mcg/24 h (total content 52 mg)]. The analysis was conducted over a 5-year time horizon in 1000 women aged 20-29 years. Method-specific failure and discontinuation rates were based on published literature. Costs associated with drug acquisition, administration and failure (defined as an unintended pregnancy) were considered. Key model outputs were annual average cost per method and minimum duration of LARC method usage to achieve cost-savings compared to SARC methods. The two least expensive methods were copper IUD ($304 per women, per year) and LNG-IUS 20 mcg/24 h ($308). Cost of SARC methods ranged between $432 (injection) and $730 (patch), per women, per year. A minimum of 2.1 years of LARC usage would result in cost-savings compared to SARC usage. This analysis finds that even if LARC methods are not used for their full durations of efficacy, they become cost-saving relative to SARC methods within 3 years of use. Previous economic arguments in support of using LARC methods have been criticized for not considering that LARC methods are not always used for their full duration of efficacy. This study calculated that cost-savings from LARC methods relative to SARC methods, with discontinuation rates considered, can be realized within 3 years. Copyright © 2014 Elsevier Inc. All rights reserved.

Achieving cost-neutrality with long-acting reversible contraceptive methods⋆

PubMed Central

Trussell, James; Hassan, Fareen; Lowin, Julia; Law, Amy; Filonenko, Anna

2014-01-01

Objectives This analysis aimed to estimate the average annual cost of available reversible contraceptive methods in the United States. In line with literature suggesting long-acting reversible contraceptive (LARC) methods become increasingly cost-saving with extended duration of use, it aimed to also quantify minimum duration of use required for LARC methods to achieve cost-neutrality relative to other reversible contraceptive methods while taking into consideration discontinuation. Study design A three-state economic model was developed to estimate relative costs of no method (chance), four short-acting reversible (SARC) methods (oral contraceptive, ring, patch and injection) and three LARC methods [implant, copper intrauterine device (IUD) and levonorgestrel intrauterine system (LNG-IUS) 20 mcg/24 h (total content 52 mg)]. The analysis was conducted over a 5-year time horizon in 1000 women aged 20–29 years. Method-specific failure and discontinuation rates were based on published literature. Costs associated with drug acquisition, administration and failure (defined as an unintended pregnancy) were considered. Key model outputs were annual average cost per method and minimum duration of LARC method usage to achieve cost-savings compared to SARC methods. Results The two least expensive methods were copper IUD ($304 per women, per year) and LNG-IUS 20 mcg/24 h ($308). Cost of SARC methods ranged between $432 (injection) and $730 (patch), per women, per year. A minimum of 2.1 years of LARC usage would result in cost-savings compared to SARC usage. Conclusions This analysis finds that even if LARC methods are not used for their full durations of efficacy, they become cost-saving relative to SARC methods within 3 years of use. Implications Previous economic arguments in support of using LARC methods have been criticized for not considering that LARC methods are not always used for their full duration of efficacy. This study calculated that cost-savings from LARC methods relative to SARC methods, with discontinuation rates considered, can be realized within 3 years. PMID:25282161

Biomechanical comparison of component position and hardware failure in the reverse shoulder prosthesis.

PubMed

Gutiérrez, Sergio; Greiwe, R Michael; Frankle, Mark A; Siegal, Steven; Lee, William E

2007-01-01

There has been renewed interest in reverse shoulder arthroplasty for the treatment of glenohumeral arthritis with concomitant rotator cuff deficiency. Failure of the prosthesis at the glenoid attachment site remains a concern. The purpose of this study was to examine glenoid component stability with regard to the angle of implantation. This investigation entailed a biomechanical analysis to evaluate forces and micromotion in glenoid components attached to 12 polyurethane blocks at -15 degrees, 0 degrees, and +15 degrees of superior and inferior tilt. The 15 degrees inferior tilt had the most uniform compressive forces and the least amount of tensile forces and micromotion when compared with the 0 degrees and 15 degrees superiorly tilted baseplate. Our results suggest that implantation with an inferior tilt will reduce the incidence of mechanical failure of the glenoid component in a reverse shoulder prosthesis.

Efficacy and Safety of Long-Acting Reversible Contraception

PubMed Central

Stoddard, Amy; McNicholas, Colleen; Peipert, Jeffrey F.

2013-01-01

Long-acting reversible contraception (LARC) includes intrauterine devices (IUDs) and the subdermal implant. These methods are the most effective reversible methods of contraception, and have the additional advantages of being long-lasting, convenient, well liked by users and cost effective. Compared with other user-dependent methods that increase the risk of noncompliance-related method failure, LARC methods can bring ‘typical use’ failure rates more in line with ‘perfect use’ failure rates. LARC methods are ‘forgettable’; they are not dependent on compliance with a pill-taking regimen, remembering to change a patch or ring, or coming back to the clinician for an injection. LARC method failure rates rival that of tubal sterilization at <1% for IUDs and the subdermal implant. For these reasons, we believe that IUDs and implants should be offered as first-line contraception for most women. This article provides a review of the LARC methods that are currently available in the US, including their effectiveness, advantages, disadvantages and contraindications. Additionally, we dispel myths and misconceptions regarding IUDs, and address the barriers to LARC use. PMID:21668037

Myxedema Coma with Reversible Cardiopulmonary Failure: a Rare Entity in 21St Century.

PubMed

Dhakal, Prajwal; Pant, Manisha; Acharya, Pranab Sharma; Dahal, Sumit; Bhatt, Vijaya Raj

2015-09-01

Myxedema coma, a rare entity in 21st century in developed nations, is a decompensated phase of hypothyroidism with high mortality rates. We describe a young woman with myxedema, who developed respiratory failure, congestive heart failure and significant pericardial effusion, some of the uncommon manifestations. Decreased cardiac contractility can result in cardiomyopathy and heart failure. As illustrated by this case, myxedema can also result in significant pericardial effusion due to increased vascular permeability. Myxedema can further be complicated by alveolar hypoventilation and respiratory failure secondary to the lack of central drive as well as respiratory muscle weakness. Prompt therapy with thyroid hormone replacement, glucocorticoid therapy, aggressive supportive care and management of the precipitating event can save lives and reverse the cardiopulmonary symptoms, as in our patient. Hence, physicians should have a high index of suspicion for myxedema coma in patients with unexplained cardiopulmonary failure. Our report is, therefore, aimed at bringing awareness about the rare but fatal manifestations of myxedema coma.

Reading tarot cards.

PubMed

Edmunds, L Henry

2004-02-01

In some patients acute myocardial infarction and/or infarct expansion induces progressive left ventricular dilatation that eventually leads to heart failure and death. The five year mortality after onset of heart failure is 50%. Chronically stretched viable myocardium adjacent to or remote from an expanding infarction initiates a myopathic process that leads to progressive myocyte apoptosis and adverse postinfarction remodeling. Revascularization of stunned or hibernating myocardium restores contractility and benefits patients in heart failure; however, revascularization does not restore contractility to myopathic, remodeling myocardium. Contemporary operations for heart failure temporarily reduce ventricular wall stress, but fail to reverse stretch induced myocyte apoptosis, which may not be reversible. Logically, prevention of this myopathic process after acute infarction seems required to extend survival. It follows that surgeons should operate before adverse postinfarction left ventricular remodeling occurs, using new operations, rather than afterwards.

A history of reverse total shoulder arthroplasty.

PubMed

Flatow, Evan L; Harrison, Alicia K

2011-09-01

Management of the cuff-deficient arthritic shoulder has long been challenging. Early unconstrained shoulder arthroplasty systems were associated with high complication and implant failure rates. The evolution toward the modern reverse shoulder arthroplasty includes many variables of constrained shoulder arthroplasty designs. This review explores the development of reverse shoulder arthroplasty, specifically describing (1) the evolution of reverse shoulder arthroplasty designs, (2) the biomechanical variations in the evolution of this arthroplasty, and (3) the current issues relevant to reverse shoulder arthroplasty today. Using a PubMed search, the literature was explored for articles addressing reverse shoulder arthroplasty, focusing on those papers with historical context. Results of the early designs were apparently poor, although they were not subjected to rigorous clinical research and usually reported only in secondary literature. We identified a trend of glenoid component failure in the early reverse designs. This trend was recognized and reported by authors as the reverse shoulder evolved. Authors reported greater pain relief and better function in reverse shoulder arthroplasty with the fundamental change of Grammont's design (moving the center of rotation medially and distally). However, current reports suggest lingering concerns and challenges with today's designs. The history of reverse shoulder arthroplasty involves the designs of many forward-thinking surgeons. Many of these highly constrained systems failed, although more recent designs have demonstrated improved longevity and implant performance. Reverse shoulder arthroplasty requires ongoing study, with challenges and controversies remaining around present-day designs.

The impact of HIV-1 reverse transcriptase polymorphisms on responses to first-line nonnucleoside reverse transcriptase inhibitor-based therapy in HIV-1-infected adults.

PubMed

Mackie, Nicola E; Dunn, David T; Dolling, David; Garvey, Lucy; Harrison, Linda; Fearnhill, Esther; Tilston, Peter; Sabin, Caroline; Geretti, Anna M

2013-09-10

HIV-1 genetic variability may influence antiretroviral therapy (ART) outcomes. The study aim was to determine the impact of polymorphisms in regions known to harbor major nonnucleoside reverse transcriptase inhibitor (NNRTI) resistance mutations (codons 90-108, 135-138, 179-190, 225-348) on virologic responses to first-line NNRTI-based ART. Reverse transcriptase sequences from ART-naive individuals who commenced efavirenz (EFV) or nevirapine (NVP) with at least two nucleos(t)ide reverse transcriptase inhibitors (NRTIs) without major drug resistance mutations were analyzed. The impact of polymorphisms on week 4 viral load decrease and time to virologic failure was measured over a median 97 weeks. Among 4528 patients, most were infected with HIV-1 subtype B (67%) and commenced EFV-based ART (84%). Overall, 2598 (57%) had at least one polymorphism, most frequently at codons 90, 98, 101, 103, 106, 135, 138, 179, and 238. Virologic failure rates were increased in patients with two (n = 597) or more than two (n = 72) polymorphisms [adjusted hazard ratio 1.43; 95% confidence interval (CI) 1.07-1.92; P = 0.016]. Polymorphisms associated with virologic failure occurred at codons 90 (mostly V90I), 98 (mostly A98S), and 103 (mostly K103R), with adjusted hazard ratios of 1.78 (1.15-2.73; P = 0.009), 1.55 (1.16-2.08; P = 0.003), and 1.75 (1.00-3.05: P = 0.049), respectively. Polymorphisms at codon 179, especially V179D/E/T, predicted reduced week 4 responses (P = 0.001) but not virologic failure. The occurrence of multiple polymorphisms, though uncommon, was associated with a small increase in the risk of NNRTI treatment failure; significant effects were seen with polymorphisms at codon 90, 98, and 103. The mechanisms underlying the slower suppression seen with V179D/E/T deserve further investigation.

Prevalence and Mutation Patterns of HIV Drug Resistance from 2010 to 2011 among ART-Failure Individuals in the Yunnan Province, China

PubMed Central

Guo, Wei; Zhuang, Daomin; Li, Lin; Liu, Yongjian; Bao, Zuoyi; Liu, Siyang; Wang, Xiaolin; Li, Tianyi; Yang, Shaomin; Li, Jingyun

2013-01-01

Background Assessing the prevalence of HIV-1 drug-resistance and the mutation patterns associated with resistance in the geographical regions implementing free antiretroviral therapy (ART) in China is necessary for preventing the spread of resistant strains and designing the regimens for the subsequent therapies with limited resources. Methods Plasma samples in different cities/prefectures were collected at Yunnan Provincial Hospital of Infectious Disease from January 2010 to December 2011. Genotyping of drug-resistant individuals was conducted using an in-house assay on plasma samples. Viral load, CD4 T cell counts and demographic data were obtained from medical records and an administered questionnaire. Results A total of 609 pol sequences (515 ART-failure and 94 therapy-naïve individuals) derived from 664 samples were obtained. The prevalence of drug-resistance was 45.1% in the ART-failure individuals. Of these, 26.8% harbored HIV strains dually resistant to nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors, and 14.8% harbored HIV strains resistant to only one drug category. Mutations such as M184V/I, K103N, V106A, Y181C and G190A were common among the ART-failure individuals, and the frequencies of M184V/I, K103N and V106A were 28.2%, 19.2%, and 22.1%, respectively. The percentages of individuals exhibiting intermediate or high-level resistance to 3TC, FTC, EFV and NVP drugs were 28.4%, 28.2%, 37.3%, and 37.5%, respectively. Factors such as ethnicity, transmission route, CD4 counts, viral load and the duration of ART were significantly correlated with development of drug resistance in the ART-failure individuals. Conclusions The high prevalence of HIV drug-resistance observed among the ART-failure individuals from 2010 to 2011 in Yunnan province should be of increasing concern in regions where the implementation of ART is widespread. Education about the risk factors associated with HIV drug resistance is important for preventing and controlling the spread of HIV drug-resistant strains. PMID:24009694

Does chlorination of seawater reverse osmosis membranes control biofouling?

PubMed

Khan, Muhammad Tariq; Hong, Pei-Ying; Nada, Nabil; Croue, Jean Philippe

2015-07-01

Biofouling is the major problem of reverse osmosis (RO) membranes used for desalting seawater (SW). The use of chlorine is a conventional and common practice to control/prevent biofouling. Unlike polyamide RO membranes, cellulose triacetate (CTA) RO membranes display a high chlorine tolerance. Due to this characteristic, CTA membranes are used in most of the RO plants located in the Middle East region where the elevated seawater temperature and water quality promote the risk of membrane biofouling. However, there is no detailed study on the investigation/characterization of CTA-RO membrane fouling. In this investigation, the fouling profile of a full-scale SWRO desalination plant operating with not only continuous chlorination of raw seawater but also intermittent chlorination of CTA-RO membranes was studied. Detailed water quality and membrane fouling analyses were conducted. Profiles of microbiological, inorganic, and organic constituents of analysed fouling layers were extensively discussed. Our results clearly identified biofilm development on these membranes. The incapability of chlorination on preventing biofilm formation on SWRO membranes could be assigned to its failure in effectively reaching throughout the different regions of the permeators. This failure could have occurred due to three main factors: plugging of membrane fibers, chlorine consumption by organics accumulated on the front side fibers, or chlorine adaptation of certain bacterial populations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Mesoscale Origin of the Enhanced Cycling-Stability of the Si-Conductive Polymer Anode for Li-ion Batteries

NASA Astrophysics Data System (ADS)

Gu, Meng; Xiao, Xing-Cheng; Liu, Gao; Thevuthasan, Suntharampillai; Baer, Donald R.; Zhang, Ji-Guang; Liu, Jun; Browning, Nigel D.; Wang, Chong-Min

2014-01-01

Electrode used in lithium-ion battery is invariably a composite of multifunctional components. The performance of the electrode is controlled by the interactive function of all components at mesoscale. Fundamental understanding of mesoscale phenomenon sets the basis for innovative designing of new materials. Here we report the achievement and origin of a significant performance enhancement of electrode for lithium ion batteries based on Si nanoparticles wrapped with conductive polymer. This new material is in marked contrast with conventional material, which exhibit fast capacity fade. In-situ TEM unveils that the enhanced cycling stability of the conductive polymer-Si composite is associated with mesoscale concordant function of Si nanoparticles and the conductive polymer. Reversible accommodation of the volume changes of Si by the conductive polymer allows good electrical contact between all the particles during the cycling process. In contrast, the failure of the conventional Si-electrode is probed to be the inadequate electrical contact.

Chimpanzees can point to smaller amounts of food to accumulate larger amounts but they still fail the reverse-reward contingency task.

PubMed

Beran, Michael J; James, Brielle T; Whitham, Will; Parrish, Audrey E

2016-10-01

The reverse-reward contingency task presents 2 food sets to an animal, and they are required to choose the smaller of the 2 sets in order to receive the larger food set. Intriguingly, the majority of species tested on the reverse-reward task fail to learn this contingency in the absence of large trial counts, correction trials, and punishment techniques. The unique difficulty of this seemingly simple task likely reflects a failure of inhibitory control which is required to point toward a smaller and less desirable reward rather than a larger and more desirable reward. This failure by chimpanzees and other primates to pass the reverse-reward task is striking given the self-control they exhibit in a variety of other paradigms. For example, chimpanzees have consistently demonstrated a high capacity for delay of gratification in order to maximize accumulating food rewards in which foods are added item-by-item to a growing set until the subject consumes the rewards. To study the mechanisms underlying success in the accumulation task and failure in the reverse-reward task, we presented chimpanzees with several combinations of these 2 tasks to determine when chimpanzees might succeed in pointing to smaller food sets over larger food sets and how the nature of the task might determine the animals' success or failure. Across experiments, 3 chimpanzees repeatedly failed to solve the reverse-reward task, whereas they accumulated nearly all food items across all instances of the accumulation self-control task, even when they had to point to small amounts of food to accumulate larger amounts. These data indicate that constraints of these 2 related but still different tasks of behavioral inhibition are dependent upon the animals' perceptions of the choice set, their sense of control over the contents of choice sets, and the nature of the task constraints. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Modification of a Volume-Overload Heart Failure Model to Track Myocardial Remodeling and Device-Related Reverse Remodeling

PubMed Central

Tuzun, Egemen; Bick, Roger; Kadipasaoglu, Cihan; Conger, Jeffrey L.; Poindexter, Brian J.; Gregoric, Igor D.; Frazier, O. H.; Towbin, Jeffrey A.; Radovancevic, Branislav

2011-01-01

Purpose. To provide an ovine model of ventricular remodeling and reverse remodeling by creating congestive heart failure (CHF) and then treating it by implanting a left ventricular assist device (LVAD). Methods. We induced volume-overload heart failure in 2 sheep; 20 weeks later, we implanted an LVAD and assessed recovery 11 weeks thereafter. We examined changes in histologic and hemodynamic data and levels of cellular markers of CHF. Results. After CHF induction, we found increases in LV end-diastolic pressure, LV systolic and diastolic dimensions, wall thickness, left atrial diameter, and atrial natriuretic protein (ANP) and endothelin-1 (ET-1) levels; β-adrenergic receptor (BAR) and dystrophin expression decreased markedly. Biopsies confirmed LV remodeling. After LVAD support, LV systolic and diastolic dimensions, wall thickness, and mass, and ANP and ET-1 levels decreased. Histopathologic and hemodynamic markers improved, and BAR and dystrophin expression normalized. Conclusions. We describe a successful sheep model for ventricular and reverse remodeling. PMID:22347659

Resetting the transcription factor network reverses terminal chronic hepatic failure

PubMed Central

Nishikawa, Taichiro; Bell, Aaron; Brooks, Jenna M.; Setoyama, Kentaro; Melis, Marta; Han, Bing; Fukumitsu, Ken; Handa, Kan; Tian, Jianmin; Kaestner, Klaus H.; Vodovotz, Yoram; Locker, Joseph; Soto-Gutierrez, Alejandro; Fox, Ira J.

2015-01-01

The cause of organ failure is enigmatic for many degenerative diseases, including end-stage liver disease. Here, using a CCl4-induced rat model of irreversible and fatal hepatic failure, which also exhibits terminal changes in the extracellular matrix, we demonstrated that chronic injury stably reprograms the critical balance of transcription factors and that diseased and dedifferentiated cells can be returned to normal function by re-expression of critical transcription factors, a process similar to the type of reprogramming that induces somatic cells to become pluripotent or to change their cell lineage. Forced re-expression of the transcription factor HNF4α induced expression of the other hepatocyte-expressed transcription factors; restored functionality in terminally diseased hepatocytes isolated from CCl4-treated rats; and rapidly reversed fatal liver failure in CCl4-treated animals by restoring diseased hepatocytes rather than replacing them with new hepatocytes or stem cells. Together, the results of our study indicate that disruption of the transcription factor network and cellular dedifferentiation likely mediate terminal liver failure and suggest reinstatement of this network has therapeutic potential for correcting organ failure without cell replacement. PMID:25774505

Pathophysiology of chronic heart failure.

PubMed

Francis, G S

2001-05-07

Heart failure is a changing paradigm. The hemodynamic model, which served our needs well from the 1950s through the early 1980s, has now been largely abandoned, except for the management of decompensated patients in the hospital. The pathophysiology is exceedingly complex and involves structural changes, such as loss of myofilaments, apoptosis and disorganization of the cytoskeleton, as well as disturbances in Ca(2+) homeostasis, alteration in receptor density, signal transduction, and collagen synthesis. A more contemporary working hypothesis is that heart failure is a progressive disorder of left ventricular remodeling, usually resulting from an index event, that culminates in a clinical syndrome characterized by impaired cardiac function and circulatory congestion. This change in the framework of our understanding of the pathophysiology of heart failure is predicated on the results of numerous clinical trials conducted during the past 20 years. New therapies are now evolving that are designed to inhibit neuroendocrine and cytokine activation, whereas drugs specifically designed to heighten cardiac contractility and "unload" the left ventricle have proven to be unhelpful in long-term management of patients with chronic heart failure. However, the hemodynamic model is still relevant for patients in the hospital with decompensated heart failure, where positive inotropic drugs and vasodilators are still widely used. The modern treatment of chronic heart failure is now largely based on the neurohormonal hypothesis, which states that neuroendocrine activation is important in the progression of heart failure and that inhibition of neurohormones is likely to have long-term benefit with regard to morbidity and mortality. Thus, the evolution of treatment for chronic heart failure as a result of clinical trials has provided much enlightenment for our understanding of the fundamental biology of the disorder, a reversal of the usual flow of information from basic science to clinical investigation.

Evaluation of neutrophil/leukocyte ratio and organ failure score as predictors of reversibility and survival following an acute-on-chronic liver failure event.

PubMed

Agiasotelli, Danai; Alexopoulou, Alexandra; Vasilieva, Larisa; Kalpakou, Georgia; Papadaki, Sotiria; Dourakis, Spyros P

2016-05-01

Acute-on-chronic liver failure (ACLF) is defined as an acute deterioration of liver disease with high mortality in patients with cirrhosis. The early mortality in ACLF is associated with organ failure and high leukocyte count. The time needed to reverse this condition and the factors affecting mortality after the early 30-day-period were evaluated. One hundred and ninety-seven consecutive patients with cirrhosis were included. Patients were prospectively followed up for 180 days. ACLF was diagnosed in 54.8% of the patients. Infection was the most common precipitating event in patients with ACLF. On multivariate analysis, only the neutrophil/leukocyte ratio and Chronic Liver Failure Consortium Organ Failure (CLIF-C OF) score were associated with mortality. Hazard ratios for mortality of patients with ACLF compared with those without at different time end-points post-enrollment revealed that the relative risk of death in the ACLF group was 8.54 during the first 30-day period and declined to 1.94 during the second period of observation. The time varying effect of neutrophil/leukocyte ratio and CLIF-C score was negative (1% and 18% decline in the hazard ratio per month) while that of Model for End-Stage Liver Disease (MELD) was positive (3% increase in the hazard ratio per month). The condition of ACLF was reversible in patients who survived. During the 30-180-day period following the acute event, the probability of death in ACLF became gradually similar to the non-ACLF group. The impact of inflammatory response and organ failure on survival is powerful during the first 30-day period and weakens thereafter while that of MELD increases. © 2015 The Japan Society of Hepatology.

Hypercalcemia with renal failure.

PubMed

Bhavani, Nisha; Praveen, Valiyaparambil Pavithran; Jayakumar, Rohinivilasam Vasukutty; Nair, Vasantha; Muraleedharan, Mangath; Kuma, Harish; Unnikrishnan, Ambika Gopalakrishnan; Menon, Vadayath Usha

2012-06-01

We report a cse of nephrocalcinosis with renal failure which on evaluation was found to have hypercalcemia. Further investigations showed an inappropriately normal intact parathormone (iPTH) and 1,25 dihydroxy-vitamin D level in the setting of renal failure. Probing for a cause of non-PTH mediated hypercalcemia led to the diagnosis of sarcoidosis. Treatment with glucocorticoids could partially reverse the renal failure and control the hypercalcemia. This case illustrates the importance of careful interpretation of laboratory parameters especially levels of iPTH and vitamin D metabolites in renal failure.

Efficacy and safety of sugammadex in the reversal of deep neuromuscular blockade induced by rocuronium in patients with end-stage renal disease: A comparative prospective clinical trial.

PubMed

de Souza, Camila M; Tardelli, Maria A; Tedesco, Helio; Garcia, Natalia N; Caparros, Mario P; Alvarez-Gomez, Jose A; de Oliveira Junior, Itamar S

2015-10-01

Renal failure affects the pharmacology of nondepolarizing neuromuscular blockers making recovery of neuromuscular function unpredictable. Sugammadex antagonises rocuronium-induced neuromuscular blockade by encapsulating rocuronium, creating a stable complex molecule that is mainly excreted by the kidneys. Previous studies suggest that sugammadex is effective in reversing moderate neuromuscular block in the presence of renal failure, but no data are available regarding reversal of profound neuromuscular block in patients with renal failure. The objective of this study is to compare the efficacy and safety of sugammadex in reversing profound neuromuscular block induced by rocuronium in patients with end-stage renal disease and those with normal renal function. A prospective clinical trial. Two university hospitals, from 1 October 2011 to 31 January 2012. Forty patients undergoing kidney transplant: 20 with renal failure [creatinine clearance (ClCr) <30 ml min] and 20 control patients (ClCr >90 ml min). Neuromuscular monitoring was performed by acceleromyography and train-of-four (TOF) stimulation. Profound neuromuscular block (posttetanic count, one to three responses) was maintained during surgery. Sugammadex 4 mg kg was administered on completion of skin closure. Recovery of the TOF ratio to 0.9 was recorded. Monitoring of neuromuscular function continued in the postanesthesia care unit for a further 2 h. The efficacy of sugammadex was evaluated by the time taken for the TOF ratio to recover to 0.9. The safety of sugammadex was assessed by monitoring for recurrence of neuromuscular block every 15 min for 2 h. Secondary variables were time to recovery of TOF ratio to 0.7 and 0.8. After sugammadex administration, the mean time for recovery of the TOF ratio to 0.9 was prolonged in the renal failure group (5.6 ± 3.6 min) compared with the control group (2.7 ± 1.3 min, P = 0.003). No adverse events or evidence of recurrence of neuromuscular block were observed. In patients with renal failure, sugammadex (4 mg kg) effectively and safely reversed profound rocuronium induced neuromuscular block, but the recovery was slower than healthy patients. Clinicaltrials.gov identifier NCT01785758.

Sensory nerves are frequently involved in the spectrum of fisher syndrome.

PubMed

Shahrizaila, Nortina; Goh, Khean J; Kokubun, Norito; Tan, Ai H; Tan, Cheng Y; Yuki, Nobuhiro

2014-04-01

Differing patterns of neurophysiological abnormalities have been reported in patients with Fisher syndrome. Fisher syndrome is rare, and few series have incorporated prospective serial studies to define the natural history of nerve conduction studies in Guillain-Barré syndrome. In an ongoing prospective study of Guillain-Barré syndrome patients, patients who presented with Fisher syndrome and its spectrum of illness were assessed through serial neurological examinations, nerve conduction studies, and serological testing of IgG against gangliosides and ganglioside complexes. Of the 36 Guillain-Barré syndrome patients identified within 2 years, 17 had features of Fisher syndrome. Serial nerve conduction studies detected significant abnormalities in sensory nerve action potential amplitude in 94% of patients associated with 2 patterns of recovery-non-demyelinating reversible distal conduction failure and axonal regeneration. Similar changes were seen in motor nerves of 5 patients. Patients with the Fisher syndrome spectrum of illness have significant sensory involvement, which may only be evident with serial neurophysiological studies. Copyright © 2013 Wiley Periodicals, Inc.

Effect of heart failure reversal treatment as add-on therapy in patients with chronic heart failure: A randomized, open-label study.

PubMed

Sane, Rohit; Aklujkar, Abhijeet; Patil, Atul; Mandole, Rahul

The present study was designed to evaluate effect of heart failure reversal therapy (HFRT) using herbal procedure (panchakarma) and allied therapies, as add-on to standard CHF treatment (SCT) in chronic heart failure (CHF) patients. This open-label, randomized study conducted in CHF patients (aged: 25-65 years, ejection fraction: 30-65%), had 3-phases: 1-week screening, 6-week treatment (randomized [1:1] to HFRT+SCT or SCT-alone) and follow-up (12-week). Twice weekly HFRT (60-75min) consisting of snehana (external oleation), swedana (passive heat therapy), hrudaydhara (concoction dripping treatment) and basti (enema) was administered. Primary endpoints included evaluation of change in metabolic equivalents of task (MET) and peak oxygen uptake (VO 2peak ) from baseline, at end of 6-week treatment and follow-up at week-18 (non-parametric rank ANCOVA analysis). Safety and quality of life (QoL) was assessed. Seventy CHF patients (n=35, each treatment-arm; mean [SD] age: 53.0 [8.6], 80% men) were enrolled in the study. All patients completed treatment phase. Add-on HFRT caused a significant increase in METs (least square mean difference [LSMD], 6-week: 1.536, p=0.0002; 18-week: -1.254, p=0.0089) and VO 2peak (LSMD, 6-week: -5.52, p=0.0002; 18-week: -4.517, p=0.0089) as compared with SCT-alone. Results were suggestive of improved functional capacity in patients with HFRT (QoL; Mean [SD] HFRT+SCT vs. SCT-alone; 6-week: -0.44 [0.34] vs. -0.06 [0.25], p<0.0001 and 18-week: -0.53 [0.35] vs. -0.29 [0.26], p=0.0013). Seven treatment-emergent adverse events (mild severity) were reported in HFRT-arm. Findings of this study highlight therapeutic efficacy of add-on HFRT vs. SCT-alone in CHF patients. The non-invasive HFRT showed no safety concerns. Copyright © 2016. Published by Elsevier B.V.

Comments on "Failures in detecting volcanic ash from a satellite-based technique"

USGS Publications Warehouse

Prata, F.; Bluth, G.; Rose, B.; Schneider, D.; Tupper, A.

2001-01-01

The recent paper by Simpson et al. [Remote Sens. Environ. 72 (2000) 191.] on failures to detect volcanic ash using the 'reverse' absorption technique provides a timely reminder of the danger that volcanic ash presents to aviation and the urgent need for some form of effective remote detection. The paper unfortunately suffers from a fundamental flaw in its methodology and numerous errors of fact and interpretation. For the moment, the 'reverse' absorption technique provides the best means for discriminating volcanic ash clouds from meteorological clouds. The purpose of our comment is not to defend any particular algorithm; rather, we point out some problems with Simpson et al.'s analysis and re-state the conditions under which the 'reverse' absorption algorithm is likely to succeed. ?? 2001 Elsevier Science Inc. All rights reserved.

The Failure of Progressive Paradigm Reversal

ERIC Educational Resources Information Center

Guthrie, Gerard

2017-01-01

The student-centred, progressive paradigm has not had sustained success in changing teacher-centred, formalistic practices in "developing" country classrooms. Does "Gestalt-switch" and paradigm reversal demonstrate that progressive theory has realigned with formalistic reality, or has it remained axiomatic in the research and…

Comparing the tensile strength of square and reversing half-hitch alternating post knots

PubMed Central

Wu, Vincent; Sykes, Edward A.; Mercer, Dale; Hopman, Wilma M.; Tang, Ephraim

2017-01-01

Background Square knots are the gold standard in hand-tie wound closure, but are difficult to reproduce in deep cavities, inadvertently resulting in slipknots. The reversing half-hitch alternating post (RHAP) knot has been suggested as an alternative owing to its nonslip nature and reproducibility in limited spaces. We explored whether the RHAP knot is noninferior to the square knot by assessing tensile strength. Methods We conducted 10 trials for each baseline and knot configuration, using 3–0 silk and 3–0 polyglactin 910 sutures. We compared tensile strength between knot configurations at the point of knot failure between slippage and breakage. Results Maximal failure strength (mean ± SD) in square knots was reached with 4-throw in both silk (30 ± 1.5 N) and polyglactin 910 (39 ± 12 N). For RHAP knots, maximal failure strength was reached at 5-throw for both silk (31 ± 1.5 N) and polyglactin 910 (41 ± 13 N). In both sutures, there were no strength differences between 3-throw square and 4-throw RHAP, between 4-throw square and 5-throw RHAP, or between 5-throw square and 6-throw RHAP knots. Polyglactin 910 sutures, in all knot configurations, were more prone to slippage than silk sutures (p < 0.001). Conclusion The difference in mean tensile strength could be attributed to the proportion of knot slippage versus breakage, which is material-dependent. Future studies can re-evaluate findings in monofilament sutures and objectively assess the reproducibility of square and RHAP knots in deep cavities. Our results indicate that RHAP knots composed of 1 extra throw provide equivalent strength to square knots and may be an alternative when performing hand-ties in limited cavities with either silk or polyglactin 910 sutures. PMID:28327276

Comparing the tensile strength of square and reversing half-hitch alternating post knots.

PubMed

Wu, Vincent; Sykes, Edward A; Mercer, Dale; Hopman, Wilma M; Tang, Ephraim

2017-06-01

Square knots are the gold standard in hand-tie wound closure, but are difficult to reproduce in deep cavities, inadvertently resulting in slipknots. The reversing half-hitch alternating post (RHAP) knot has been suggested as an alternative owing to its nonslip nature and reproducibility in limited spaces. We explored whether the RHAP knot is noninferior to the square knot by assessing tensile strength. We conducted 10 trials for each baseline and knot configuration, using 3-0 silk and 3-0 polyglactin 910 sutures. We compared tensile strength between knot configurations at the point of knot failure between slippage and breakage. Maximal failure strength (mean ± SD) in square knots was reached with 4-throw in both silk (30 ± 1.5 N) and polyglactin 910 (39 ± 12 N). For RHAP knots, maximal failure strength was reached at 5-throw for both silk (31 ± 1.5 N) and polyglactin 910 (41 ± 13 N). In both sutures, there were no strength differences between 3-throw square and 4-throw RHAP, between 4-throw square and 5-throw RHAP, or between 5-throw square and 6-throw RHAP knots. Polyglactin 910 sutures, in all knot configurations, were more prone to slippage than silk sutures ( p < 0.001). The difference in mean tensile strength could be attributed to the proportion of knot slippage versus breakage, which is material-dependent. Future studies can re-evaluate findings in monofilament sutures and objectively assess the reproducibility of square and RHAP knots in deep cavities. Our results indicate that RHAP knots composed of 1 extra throw provide equivalent strength to square knots and may be an alternative when performing hand-ties in limited cavities with either silk or polyglactin 910 sutures.

Drug Susceptibility and Resistance Mutations After First-Line Failure in Resource Limited Settings

PubMed Central

Wallis, Carole L.; Aga, Evgenia; Ribaudo, Heather; Saravanan, Shanmugam; Norton, Michael; Stevens, Wendy; Kumarasamy, Nagalingeswaran; Bartlett, John; Katzenstein, David

2014-01-01

Background. The development of drug resistance to nucleoside reverse transcriptase inhibitors (NRTIs) and nonnucleoside reverse transcriptase inhibitors (NNRTIs) has been associated with baseline human immunodeficiency virus (HIV)-1 RNA level (VL), CD4 cell counts (CD4), subtype, and treatment failure duration. This study describes drug resistance and levels of susceptibility after first-line virologic failure in individuals from Thailand, South Africa, India, Malawi, Tanzania. Methods. CD4 and VL were captured at AIDs Clinical Trial Group (ACTG) A5230 study entry, a study of lopinavir/ritonavir (LPV/r) monotherapy after first-line virologic failure on an NNRTI regimen. HIV drug-resistance mutation associations with subtype, site, study entry VL, and CD4 were evaluated using Fisher exact and Kruskall–Wallis tests. Results. Of the 207 individuals who were screened for A5230, sequence data were available for 148 individuals. Subtypes observed: subtype C (n = 97, 66%) AE (n = 27, 18%), A1 (n = 12, 8%), and D (n = 10, 7%). Of the 148 individuals, 93% (n = 138) and 96% (n = 142) had at least 1 reverse transcriptase (RT) mutation associated with NRTI and NNRTI resistance, respectively. The number of NRTI mutations was significantly associated with a higher study screening VL and lower study screening CD4 (P < .001). Differences in drug-resistance patterns in both NRTI and NNRTI were observed by site. Conclusions. The degree of NNRTI and NRTI resistance after first-line virologic failure was associated with higher VL at study entry. Thirty-two percent of individuals remained fully susceptible to etravirine and rilpivirine, protease inhibitor resistance was rare. Some level of susceptibility to NRTI remained; however, VL monitoring and earlier virologic failure detection may result in lower NRTI resistance. PMID:24795328

On the sensitivity of transtensional versus transpressional tectonic regimes to remote dynamic triggering by Coulomb failure

USGS Publications Warehouse

Hill, David P.

2015-01-01

 Accumulating evidence, although still strongly spatially aliased, indicates that although remote dynamic triggering of small-to-moderate (Mw<5) earthquakes can occur in all tectonic settings, transtensional stress regimes with normal and subsidiary strike-slip faulting seem to be more susceptible to dynamic triggering than transpressional regimes with reverse and subsidiary strike-slip faulting. Analysis of the triggering potential of Love- and Rayleigh-wave dynamic stresses incident on normal, reverse, and strike-slip faults assuming Andersonian faulting theory and simple Coulomb failure supports this apparent difference for rapid-onset triggering susceptibility.

p53 protects against genome instability following centriole duplication failure

PubMed Central

Lambrus, Bramwell G.; Uetake, Yumi; Clutario, Kevin M.; Daggubati, Vikas; Snyder, Michael; Sluder, Greenfield

2015-01-01

Centriole function has been difficult to study because of a lack of specific tools that allow persistent and reversible centriole depletion. Here we combined gene targeting with an auxin-inducible degradation system to achieve rapid, titratable, and reversible control of Polo-like kinase 4 (Plk4), a master regulator of centriole biogenesis. Depletion of Plk4 led to a failure of centriole duplication that produced an irreversible cell cycle arrest within a few divisions. This arrest was not a result of a prolonged mitosis, chromosome segregation errors, or cytokinesis failure. Depleting p53 allowed cells that fail centriole duplication to proliferate indefinitely. Washout of auxin and restoration of endogenous Plk4 levels in cells that lack centrioles led to the penetrant formation of de novo centrioles that gained the ability to organize microtubules and duplicate. In summary, we uncover a p53-dependent surveillance mechanism that protects against genome instability by preventing cell growth after centriole duplication failure. PMID:26150389

Quantifying Appropriate De-rating of SiC MOSFETs Subject to Cosmic Rays

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

Chatty, Kiran

Terrestrial Cosmic Radiation (TCR) is known to cause failures in high-voltage Si devices resulting in de-rating of the maximum reverse blocking voltage. In this work, a test setup was developed and unaccelerated TCR testing was performed on 1200V Si IGBTs, 1200V SiC MOSFETs and 1200V SiC Schottky diodes. Failures due to TCR were generated on 1200V Si IGBTs at reverse voltages from 900V to 1175V. Si IGBTs investigated in this work will need to be operated at a maximum voltage of 800V to achieve a Failure in Time (FIT) rate of 100. No failures were observed on 1200V SiC MOSFETsmore » and Schottky diodes after testing at 1200V for over 1.5 years demonstrating low FIT rates compared to Si IGBTs. 1200V SiC Schottky diodes were fabricated in this program and the packaged devices were used in the TCR testing.« less

[A patient with high creatinine levels but no renal failure: reversed autodialysis in a patient with a ruptured bladder].

PubMed

Raeymaeckers, Steven; Tosi, Maurizio; Van Bael, Kobe; Brussaard, Carola; De Mey, Johan

2016-01-01

In case of a ruptured bladder with urine leakage into the peritoneal cavity 'reversed autodialysis' can occur, in which urea and creatinine diffuse back into the bloodstream via the peritoneum. This causes clinical signs of pseudorenal failure, with raised concentrations of creatinine and urea. The urea/creatinine ratio does not change. A 34-year-old female patient experienced increasing abdominal pain 3 days after laparoscopic myomectomy. Acute renal failure was suspected because of increased serum concentrations of creatinine and urea, but no cause could be found. There was a build-up of fluid in the abdominal cavity, which proved to be urine originating from an iatrogenic rupture of the bladder. Serum levels normalised following repair of the rupture. If serum creatinine levels rise rapidly following abdominal surgery or blunt abdominal trauma the bladder should be examined for possible perforation, particularly if the abdominal dimension increases. A ruptured bladder leading to pseudorenal failure is an indication for rapid surgical intervention.

Design Safety Used in NASA's Human-rated Primary Lithium Batteries

NASA Technical Reports Server (NTRS)

Jeevarajan, J.

2013-01-01

Single cell tests were benign for external short, inadvertent charge and overdischarge into reversal up to 4.5 A. At lower current loads cells die (may be due to excessive dendrite formation) benignly. String level external short circuits lead to an unbalanced overdischarge, with one cell going into reversal. The result is catastrophic violent venting. Unbalanced string overdischarges at different currents causes catastrophic violent venting also. Heat-to-vent is very dramatic displaying violent venting Simulated internal short is also catastrophic and displays violent venting. Battery is not UL-rated; hence does not have dual-fault tolerance or tolerance to inherent cell tolerance to failures Battery Design for NASA JSC's human-rated application for use on ISS was changed to include two bypass diodes per cell to provide for two-failure tolerance to overdischarge into reversal (and external short) hazards.

'End-stage' heart failure therapy: potential lessons from congenital heart disease: from pulmonary artery banding and interatrial communication to parallel circulation.

PubMed

Schranz, Dietmar; Akintuerk, Hakan; Voelkel, Norbert F

2017-02-15

The final therapy of 'end-stage heart failure' is orthotopic heart, lung or heart-lung transplantation. However, these options are not available for many patients worldwide. Therefore, novel therapeutical strategies are needed. Based on pathophysiological insights regarding (1) the long-term impact of an obstructive pulmonary outflow tract in neonates with congenitally corrected transposition of the great arteries, (2) the importance of a restrictive versus a non-restrictive atrial septum in neonates born with a borderline left ventricle and (3) the significance of both, a patent foramen ovale and/or open ductus arteriosus for survival of newborns with persistent pulmonary hypertension, the current review introduces some therapeutical strategies that may be applicable to selected patients with heart failure. These strategies include (1) reversible pulmonary artery banding in left ventricular-dilated cardiomyopathy with preserved right ventricular function, (2) the creation of restrictive interatrial communication to treat diastolic (systolic) heart failure, (3) atrioseptostomy or reverse Potts shunt in pulmonary arterial hypertension and (4) return to a fetal, parallel circulation by combining atrioseptostomy and reversed Potts shunt with or without placement of a bilateral pulmonary artery banding. While still being experimental, it is hoped that the procedures presented in the current overview will inspire future novel therapeutic strategies that may be applicable to selected patients with heart failure. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The outcome of unstable proximal femoral fracture treated with reverse LISS plates.

PubMed

Lin, Shih-Jie; Huang, Kuo-Chin; Chuang, Po-Yao; Lee, Chien-Yin; Huang, Tsan-Wen; Lee, Mel S; Hsu, Robert Wen-Wei

2016-10-01

The Russel-Taylor type 2B fractures compromised the trochanteric region and medial buttress of proximal femur. This fracture pattern limits the choice of implants and raises the risk of adverse outcomes. We aimed to (i) determine the outcome of Russel-Taylor type 2B fractures treated using reverse less invasive stabilization system plates (LISS-DF) and to (ii) learn what factors affected outcomes after osteosynthesis with reverse LISS plates. A retrospective study SETTING: The study was conducted at a Level III trauma center in Taiwan. Twenty-five consecutive patients presenting with a Russel-Taylor type 2B fracture were enrolled. All cases were treated with reverse LISS plates. A Modified Radiographic Union Scale for Femur (RUSF), Radiographic parameters, functional scores, and complications were assessed. Union occurred in 21 cases at an average of 18.8 weeks. The average immediate postoperative neck-shaft angle was 130° (range: 122-135°) compared with 139° (range: 135-141°, p=0.05) on the contralateral side. Two cases had complications of proximal screws cutting out and two cases had broken implants. Finally, all 4 cases required repeated surgeries (16%). Malunion occurred in 4 patients and early mechanical failure (proximal screws cut out) occurred in 2. There was a significant difference in the purchase index of the proximal screws between cases with redisplacement and those without (26.4mm and 98.6mm, p=0.01). The use of reverse LISS plate appeared to be an alternative procedure for the specific pattern in the present study. We recommend using this reverse locking plate to treat unstable proximal femoral fractures with meticulous techniques of placing plates. Adequate purchase of the proximal locking screws might decrease the risks of complications. Copyright © 2016 Elsevier Ltd. All rights reserved.

Failure of a laminated composite under tension-compression fatigue loading

NASA Technical Reports Server (NTRS)

Rotem, A.; Nelson, H. G.

1989-01-01

The fatigue behavior of composite laminates under tension-compression loading is analyzed and compared with behavior under tension-tension and compression-compression loading. It is shown that for meaningful fatigue conditions, the tension-compression case is the dominant one. Both tension and compression failure modes can occur under the reversed loading, and failure is dependent on the specific lay-up of the laminate and the difference between the tensile static strength and the absolute value of the compressive static strength. The use of a fatigue failure envelope for determining the fatigue life and mode of failure is proposed and demonstrated.

Prerenal azotemia in congestive heart failure.

PubMed

Macedo, Etienne; Mehta, Ravindra

2010-01-01

Prerenal failure is used to designate a reversible form of acute renal dysfunction. However, the terminology encompasses different conditions that vary considerably. The Acute Kidney Injury Network group has recently standardized the acute kidney injury (AKI) definition and classification system; however, these criteria have not determined specific diagnostic criteria to classify prerenal conditions. The difference in the pathophysiology and manifestations of prerenal failure suggests that our current approach needs to be revaluated. Several mechanisms are recognized as contributory to development of a prerenal state associated with cardiac failure. Because of the broad differences in patients' reserve capacity and functional status, prerenal states may be triggered at different time points during the course of the disease. Prerenal state needs to be classified depending on the underlying capacity for compensation, the nature, timing of the insult and the adaptation to chronic comorbidities. Current diagnosis of prerenal conditions is relatively insensitive and would benefit from additional research to define and classify the condition. Identification of high-risk states and high-risk processes associated with the use of new biomarkers for AKI will provide new tools to distinguish between the prerenal and established AKI. Achieving a consensus definition for prerenal syndrome will allow physicians to describe treatments and interventions as well as conduct and compare epidemiological studies in order to better describe the implications of this syndrome. Copyright 2010 S. Karger AG, Basel.

Influence of Cyclic Straining on Fatigue, Deformation, and Fracture Behavior of High-Strength Alloy Steel

NASA Astrophysics Data System (ADS)

Manigandan, K.; Srivatsan, T. S.; Vasudevan, V. K.; Tammana, D.; Poorganji, B.

2016-01-01

In this paper, the results of a study on microstructural influences on mechanical behavior of the high-strength alloy steel Tenax™ 310 are presented and discussed. Under the influence of fully reversed strain cycling, the stress response of this alloy steel revealed softening from the onset of deformation. Cyclic strain resistance exhibited a linear trend for the variation of both elastic strain amplitude with reversals-to-failure, and plastic strain amplitude with reversals-to-failure. Fracture morphology was essentially the same at the macroscopic level over the entire range of cyclic strain amplitudes examined. However, at the fine microscopic level, this high-strength alloy steel revealed fracture to be mixed-mode with features reminiscent of "locally" ductile and brittle mechanisms. The macroscopic mechanisms governing stress response at the fine microscopic level, resultant fatigue life, and final fracture behavior are presented and discussed in light of the mutually interactive influences of intrinsic microstructural effects, deformation characteristics of the microstructural constituents during fully reversed strain cycling, cyclic strain amplitude, and resultant response stress.

Analyses of Transistor Punchthrough Failures

NASA Technical Reports Server (NTRS)

Nicolas, David P.

1999-01-01

The failure of two transistors in the Altitude Switch Assembly for the Solid Rocket Booster followed by two additional failures a year later presented a challenge to failure analysts. These devices had successfully worked for many years on numerous missions. There was no history of failures with this type of device. Extensive checks of the test procedures gave no indication for a source of the cause. The devices were manufactured more than twenty years ago and failure information on this lot date code was not readily available. External visual exam, radiography, PEID, and leak testing were performed with nominal results Electrical testing indicated nearly identical base-emitter and base-collector characteristics (both forward and reverse) with a low resistance short emitter to collector. These characteristics are indicative of a classic failure mechanism called punchthrough. In failure analysis punchthrough refers to an condition where a relatively low voltage pulse causes the device to conduct very hard producing localized areas of thermal runaway or "hot spots". At one or more of these hot spots, the excessive currents melt the silicon. Heavily doped emitter material diffuses through the base region to the collector forming a diffusion pipe shorting the emitter to base to collector. Upon cooling, an alloy junction forms between the pipe and the base region. Generally, the hot spot (punch-through site) is under the bond and no surface artifact is visible. The devices were delidded and the internal structures were examined microscopically. The gold emitter lead was melted on one device, but others had anomalies in the metallization around the in-tact emitter bonds. The SEM examination confirmed some anomalies to be cosmetic defects while other anomalies were artifacts of the punchthrough site. Subsequent to these analyses, the contractor determined that some irregular testing procedures occurred at the time of the failures heretofore unreported. These testing irregularities involved the use of a breakout box and were the likely cause of the failures. There was no evidence to suggest a generic failure mechanism was responsible for the failure of these transistors.

What plant hydraulics can tell us about responses to climate-change droughts.

PubMed

Sperry, John S; Love, David M

2015-07-01

Climate change exposes vegetation to unusual drought, causing declines in productivity and increased mortality. Drought responses are hard to anticipate because canopy transpiration and diffusive conductance (G) respond to drying soil and vapor pressure deficit (D) in complex ways. A growing database of hydraulic traits, combined with a parsimonious theory of tree water transport and its regulation, may improve predictions of at-risk vegetation. The theory uses the physics of flow through soil and xylem to quantify how canopy water supply declines with drought and ceases by hydraulic failure. This transpiration 'supply function' is used to predict a water 'loss function' by assuming that stomatal regulation exploits transport capacity while avoiding failure. Supply-loss theory incorporates root distribution, hydraulic redistribution, cavitation vulnerability, and cavitation reversal. The theory efficiently defines stomatal responses to D, drying soil, and hydraulic vulnerability. Driving the theory with climate predicts drought-induced loss of plant hydraulic conductance (k), canopy G, carbon assimilation, and productivity. Data lead to the 'chronic stress hypothesis' wherein > 60% loss of k increases mortality by multiple mechanisms. Supply-loss theory predicts the climatic conditions that push vegetation over this risk threshold. The theory's simplicity and predictive power encourage testing and application in large-scale modeling. © 2015 The Authors. New Phytologist © 2015 New Phytologist Trust.

A Failure Analysis Conducted on a Fractured AISI 5160 Steel Blade Which Separated from an Agricultural Rotary Cutter

NASA Astrophysics Data System (ADS)

Johnson, Alan A.; Storey, Randall J.

2011-07-01

One of the six blades of an agricultural rotary cutter used for cutting down small trees and bushes broke into two pieces while the blades were rotating. One piece was hurled from the cutter and struck a young farmer, who had been operating the machine, causing a near fatal leg injury. In the ensuing litigation against the manufacturers and marketer of the machine each litigant retained a metallurgist and other experts. The metallurgists jointly directed laboratory work on the broken blade conducted at an independent laboratory according to a protocol which they developed and which was approved by the court. As a result of the laboratory work the present authors, working for the Plaintiffs, concluded that failure of the blade occurred because it contained quench cracks introduced when it was manufactured. The Defendants' metallurgists concluded that the blade had been misassembled onto the machine and, as a result, had failed by fatigue. Eventually, the case was set for a jury trial in a Circuit Court in rural Kentucky. The jury found for the Plaintiffs and awarded them $5.9 million in damages. Part of this judgement was later reversed by the Kentucky Court of Appeals and the case was then settled without a second trial under terms which were not revealed.

Acute Liver Failure During Deferasirox Chelation: A Toxicity Worth Considering.

PubMed

Menaker, Nathan; Halligan, Katharine; Shur, Natasha; Paige, John; Hickling, Matthew; Nepo, Anne; Weintraub, Lauren

2017-04-01

This case report details a unique case of acute, reversible liver failure in a 12-year-old male with sickle cell anemia on chronic transfusion protocol and deferasirox chelation. There is substantial literature documenting deferasirox-induced renal injury, including Fanconi syndrome, but less documentation of hepatic toxicity and few reports of hepatic failure. The case highlights the importance of close monitoring of ferritin, bilirubin, and transaminases for patients on deferasirox.

Acute refractory hypoxemia after chest trauma reversed by high-frequency oscillatory ventilation: a case report

PubMed Central

2013-01-01

Introduction Polytrauma often results in significant hypoxemia secondary to direct lung contusion or indirectly through atelectasis, systemic inflammatory response, large volume fluid resuscitation and blood product transfusion. In addition to causing hypoxemia, atelectasis and acute lung injury can lead to right ventricular failure through an acute increase in pulmonary vascular resistance. Mechanical ventilation is often applied, accompanied with recruitment maneuvers and positive end-expiratory pressure in order to recruit alveoli and reverse atelectasis, while preventing excessive alveolar damage. This strategy should lead to the reversal of the hypoxemic condition and the detrimental heart–lung interaction that may occur. However, as described in this case report, hemodynamic instability and intractable alveolar atelectasis sometimes do not respond to conventional ventilation strategies. Case presentation We describe the case of a 21-year-old Caucasian man with severe chest trauma requiring surgical interventions, who developed refractory hypoxemia and overt right ventricular failure. After multiple failed attempts of recruitment using conventional ventilation, the patient was ventilated with high-frequency oscillatory ventilation. This mode of ventilation allowed the reversal of the hemodynamic effects of severe hypoxemia and of the acute cor pulmonale. We use this case report to describe the physiological advantages of high-frequency oscillatory ventilation in patients with chest trauma, and formulate the arguments to explain the positive effect observed in our patient. Conclusions High-frequency oscillatory ventilation can be used in the context of a blunt chest trauma accompanied by severe hypoxemia due to atelectasis. The positive effect is due to its capacity to recruit the collapsed alveoli and, as a result, the relief of increased pulmonary vascular resistance and subsequently the reversal of acute cor pulmonale. This approach may represent an alternative in case of failure of the conventional ventilation strategy. PMID:23855954

The public health approach to identify antiretroviral therapy failure: high-level nucleoside reverse transcriptase inhibitor resistance among Malawians failing first-line antiretroviral therapy

PubMed Central

Hosseinipour, Mina C.; van Oosterhout, Joep J.G.; Weigel, Ralf; Phiri, Sam; Kamwendo, Debbie; Parkin, Neil; Fiscus, Susan A.; Nelson, Julie A.E.; Eron, Joseph J.; Kumwenda, Johnstone

2010-01-01

Background Over 150 000 Malawians have started antiretroviral therapy (ART), in which first-line therapy is stavudine/lamivudine/nevirapine. We evaluated drug resistance patterns among patients failing first-line ART on the basis of clinical or immunological criteria in Lilongwe and Blantyre, Malawi. Methods Patients meeting the definition of ART failure (new or progressive stage 4 condition, CD4 cell count decline more than 30%, CD4 cell count less than that before treatment) from January 2006 to July 2007 were evaluated. Among those with HIV RNA of more than 1000 copies/ml, genotyping was performed. For complex genotype patterns, phenotyping was performed. Results Ninety-six confirmed ART failure patients were identified. Median (interquartile range) CD4 cell count, log10 HIV-1 RNA, and duration on ART were 68 cells/μl (23–174), 4.72 copies/ml (4.26–5.16), and 36.5 months (26.6–49.8), respectively. Ninety-three percent of samples had nonnucleoside reverse transcriptase inhibitor mutations, and 81% had the M184V mutation. The most frequent pattern included M184V and nonnucleoside reverse transcriptase inhibitor mutations along with at least one thymidine analog mutation (56%). Twenty-three percent of patients acquired the K70E or K65R mutations associated with tenofovir resistance; 17% of the patients had pan-nucleoside resistance that corresponded to K65R or K70E and additional resistance mutations, most commonly the 151 complex. Emergence of the K65R and K70E mutations was associated with CD4 cell count of less than 100 cells/μl (odds ratio 6.1) and inversely with the use of zidovudine (odds ratio 0.18). Phenotypic susceptibility data indicated that the nucleoside reverse transcriptase inhibitor backbone with the highest activity for subsequent therapy was zidovudine/lamivudine/tenofovir, followed by lamivudine/tenofovir, and then abacavir/didanosine. Conclusion When clinical and CD4 cell count criteria are used to monitor first-line ART failure, extensive nucleoside reverse transcriptase inhibitor and nonnucleoside reverse transcriptase inhibitor resistance emerges, with most patients having resistance profiles that markedly compromise the activity of second-line ART. PMID:19417582

Adjustable, physiological ventricular restraint improves left ventricular mechanics and reduces dilatation in an ovine model of chronic heart failure.

PubMed

Ghanta, Ravi K; Rangaraj, Aravind; Umakanthan, Ramanan; Lee, Lawrence; Laurence, Rita G; Fox, John A; Bolman, R Morton; Cohn, Lawrence H; Chen, Frederick Y

2007-03-13

Ventricular restraint is a nontransplantation surgical treatment for heart failure. The effect of varying restraint level on left ventricular (LV) mechanics and remodeling is not known. We hypothesized that restraint level may affect therapy efficacy. We studied the immediate effect of varying restraint levels in an ovine heart failure model. We then studied the long-term effect of restraint applied over a 2-month period. Restraint level was quantified by use of fluid-filled epicardial balloons placed around the ventricles and measurement of balloon luminal pressure at end diastole. At 4 different restraint levels (0, 3, 5, and 8 mm Hg), transmural myocardial pressure (P(tm)) and indices of myocardial oxygen consumption (MVO2) were determined in control (n=5) and ovine heart failure (n=5). Ventricular restraint therapy decreased P(tm) and MVO2, and improved mechanical efficiency. An optimal physiological restraint level of 3 mm Hg was identified to maximize improvement without an adverse affect on systemic hemodynamics. At this optimal level, end-diastolic P(tm) and MVO2 indices decreased by 27% and 20%, respectively. The serial longitudinal effects of optimized ventricular restraint were then evaluated in ovine heart failure with (n=3) and without (n=3) restraint over 2 months. Optimized ventricular restraint prevented and reversed pathological LV dilatation (130+/-22 mL to 91+/-18 mL) and improved LV ejection fraction (27+/-3% to 43+/-5%). Measured restraint level decreased over time as the LV became smaller, and reverse remodeling slowed. Ventricular restraint level affects the degree of decrease in P(tm), the degree of decrease in MVO2, and the rate of LV reverse remodeling. Periodic physiological adjustments of restraint level may be required for optimal restraint therapy efficacy.

Lyapunov-Based Sensor Failure Detection And Recovery For The Reverse Water Gas Shift Process

NASA Technical Reports Server (NTRS)

Haralambous, Michael G.

2001-01-01

Livingstone, a model-based AI software system, is planned for use in the autonomous fault diagnosis, reconfiguration, and control of the oxygen-producing reverse water gas shift (RWGS) process test-bed located in the Applied Chemistry Laboratory at KSC. In this report the RWGS process is first briefly described and an overview of Livingstone is given. Next, a Lyapunov-based approach for detecting and recovering from sensor failures, differing significantly from that used by Livingstone, is presented. In this new method, models used are in terms of the defining differential equations of system components, thus differing from the qualitative, static models used by Livingstone. An easily computed scalar inequality constraint, expressed in terms of sensed system variables, is used to determine the existence of sensor failures. In the event of sensor failure, an observer/estimator is used for determining which sensors have failed. The theory underlying the new approach is developed. Finally, a recommendation is made to use the Lyapunov-based approach to complement the capability of Livingstone and to use this combination in the RWGS process.

LYAPUNOV-Based Sensor Failure Detection and Recovery for the Reverse Water Gas Shift Process

NASA Technical Reports Server (NTRS)

Haralambous, Michael G.

2002-01-01

Livingstone, a model-based AI software system, is planned for use in the autonomous fault diagnosis, reconfiguration, and control of the oxygen-producing reverse water gas shift (RWGS) process test-bed located in the Applied Chemistry Laboratory at KSC. In this report the RWGS process is first briefly described and an overview of Livingstone is given. Next, a Lyapunov-based approach for detecting and recovering from sensor failures, differing significantly from that used by Livingstone, is presented. In this new method, models used are in t e m of the defining differential equations of system components, thus differing from the qualitative, static models used by Livingstone. An easily computed scalar inequality constraint, expressed in terms of sensed system variables, is used to determine the existence of sensor failures. In the event of sensor failure, an observer/estimator is used for determining which sensors have failed. The theory underlying the new approach is developed. Finally, a recommendation is made to use the Lyapunov-based approach to complement the capability of Livingstone and to use this combination in the RWGS process.

Static Performance of Six Innovative Thrust Reverser Concepts for Subsonic Transport Applications: Summary of the NASA Langley Innovative Thrust Reverser Test Program

NASA Technical Reports Server (NTRS)

Asbury, Scott C.; Yetter, Jeffrey A.

2000-01-01

The NASA Langley Configuration Aerodynamics Branch has conducted an experimental investigation to study the static performance of innovative thrust reverser concepts applicable to high-bypass-ratio turbofan engines. Testing was conducted on a conventional separate-flow exhaust system configuration, a conventional cascade thrust reverser configuration, and six innovative thrust reverser configurations. The innovative thrust reverser configurations consisted of a cascade thrust reverser with porous fan-duct blocker, a blockerless thrust reverser, two core-mounted target thrust reversers, a multi-door crocodile thrust reverser, and a wing-mounted thrust reverser. Each of the innovative thrust reverser concepts offer potential weight savings and/or design simplifications over a conventional cascade thrust reverser design. Testing was conducted in the Jet-Exit Test Facility at NASA Langley Research Center using a 7.9%-scale exhaust system model with a fan-to-core bypass ratio of approximately 9.0. All tests were conducted with no external flow and cold, high-pressure air was used to simulate core and fan exhaust flows. Results show that the innovative thrust reverser concepts achieved thrust reverser performance levels which, when taking into account the potential for system simplification and reduced weight, may make them competitive with, or potentially more cost effective than current state-of-the-art thrust reverser systems.

Efficacy and safety of icotinib in Chinese patients with advanced non-small cell lung cancer after failure of chemotherapy.

PubMed

Shao, Lan; Zhang, Beibei; He, Chunxiao; Lin, Baochai; Song, Zhengbo; Lou, Guangyuan; Yu, Xinmin; Zhang, Yiping

2014-01-01

The preclinical experiments and several clinical studies showed icotinib, an oral epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, in Chinese patients with advanced non-small cell lung cancer (NSCLC) who failed previous chemotherapy. We performed a retrospective study of the efficacy and safety of icotinib monotherapy in a different and more recent sample of Chinese patients. The clinical data of 149 patients with advanced NSCLC who were admitted to Zhejiang Cancer Hospital from August 1, 2011 to July 31, 2012 were retrospectively analyzed. All patients were given icotinib treatment after the failure of previous chemotherapy. Univariate and multivariate analyses were conducted based on the Kaplan Meier method and Cox proportional hazards model. The objective response rate was 33/149 and disease control rate was 105/149. No complete response occurred. Median progression free survival (PFS) with icotinib treatment was 5.03 months (95% CI: 3.51 to 6.55). Median overall survival was 12.3 months (95% CI: 10.68 to 13.92). Multivariate analysis showed that the mutation of EGFR and one regimen of prior chemotherapy were significantly associated with longer PFS. At least one drug related adverse event was observed in 65.8% (98/149) of patients, but mostly grade 1 or 2 and reversible and none grade 4 toxicity. Icotinib monotherapy is an effective and well tolerated regimen for Chinese patients with NSCLC after the failure of chemotherapy. It is a promising agent and further study with icotinib in properly conducted trials with larger patient samples and other ethnic groups is warranted.

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

PubMed

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

2018-01-01

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

Deep sequencing analysis of HIV-1 reverse transcriptase at baseline and time of failure in patients receiving rilpivirine in the phase III studies ECHO and THRIVE.

PubMed

Van Eygen, Veerle; Thys, Kim; Van Hove, Carl; Rimsky, Laurence T; De Meyer, Sandra; Aerssens, Jeroen; Picchio, Gaston; Vingerhoets, Johan

2016-05-01

Minority variants (1.0-25.0%) were evaluated by deep sequencing (DS) at baseline and virological failure (VF) in a selection of antiretroviral treatment-naïve, HIV-1-infected patients from the rilpivirine ECHO/THRIVE phase III studies. Linkage between frequently emerging resistance-associated mutations (RAMs) was determined. DS (llIumina®) and population sequencing (PS) results were available at baseline for 47 VFs and time of failure for 48 VFs; and at baseline for 49 responders matched for baseline characteristics. Minority mutations were accurately detected at frequencies down to 1.2% of the HIV-1 quasispecies. No baseline minority rilpivirine RAMs were detected in VFs; one responder carried 1.9% F227C. Baseline minority mutations associated with resistance to other non-nucleoside reverse transcriptase inhibitors (NNRTIs) were detected in 8/47 VFs (17.0%) and 7/49 responders (14.3%). Baseline minority nucleoside/nucleotide reverse transcriptase inhibitor (NRTI) RAMs M184V and L210W were each detected in one VF (none in responders). At failure, two patients without NNRTI RAMs by PS carried minority rilpivirine RAMs K101E and/or E138K; and five additional patients carried other minority NNRTI RAMs V90I, V106I, V179I, V189I, and Y188H. Overall at failure, minority NNRTI RAMs and NRTI RAMs were found in 29/48 (60.4%) and 16/48 VFs (33.3%), respectively. Linkage analysis showed that E138K and K101E were usually not observed on the same viral genome. In conclusion, baseline minority rilpivirine RAMs and other NNRTI/NRTI RAMs were uncommon in the rilpivirine arm of the ECHO and THRIVE studies. DS at failure showed emerging NNRTI resistant minority variants in seven rilpivirine VFs who had no detectable NNRTI RAMs by PS. © 2015 Wiley Periodicals, Inc.

Optically probing torsional superelasticity in spider silks

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

Kumar, Bhupesh; Thakur, Ashish; Panda, Biswajit

2013-11-11

We investigate torsion mechanics of various spider silks using a sensitive optical technique. We find that spider silks are torsionally superelastic in that they can reversibly withstand great torsion strains of over 10{sup 2−3} rotations per cm before failure. Among various silks from a spider, we find the failure twist-strain is greatest in the sticky capture silk followed by dragline and egg-case silk. Our in situ laser-diffraction measurements reveal that torsional strains on the silks induce a nano-scale transverse compression in its diameter that is linear and reversible. These unique torsional properties of the silks could find applications in silk-basedmore » materials and devices.« less

Rapid evaluation of reverse-osmosis membranes

NASA Technical Reports Server (NTRS)

Hollahan, J. R.; Wydeven, T.

1972-01-01

Simultaneous reverse-osmosis tests conducted with centrifuges having multiple compartment heads are discussed. Equipment for retaining reverse-osmosis membrane is illustrated. Method of conducting tests is described.

Seismic performance of interior precast concrete beam-column connections with T-section steel inserts under cyclic loading

NASA Astrophysics Data System (ADS)

Ketiyot, Rattapon; Hansapinyo, Chayanon

2018-04-01

An experimental investigation was conducted to study the performance of precast beam-column concrete connections using T-section steel inserts into the concrete beam and joint core, under reversed cyclic loading. Six 2/3-scale interior beam-column subassemblies, one monolithic concrete specimen and five precast concrete specimens were tested. One precast specimen was a simple connection for a gravity load resistant design. Other precast specimens were developed with different attributes to improve their seismic performance. The test results showed that the performance of the monolithic specimen M1 represented ductile seismic behavior. Failure of columns and joints could be prevented, and the failure of the frame occurred at the flexural plastic hinge formation at the beam ends, close to the column faces. For the precast specimens, the splitting crack along the longitudinal lapped splice was a major failure. The precast P5 specimen with double steel T-section inserts showed better seismic performance compared to the other precast models. However, the dowel bars connected to the steel inserts were too short to develop a bond. The design of the precast concrete beams with lap splice is needed for longer lap lengths and should be done at the beam mid span or at the low flexural stress region.

Fatigue behavior of a cross-ply metal matrix composite at elevated temperature under strain controlled mode. Master`s thesis

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

Dennis, L.B.

1994-12-01

This research extends the existing knowledge of cross-ply metal matrix composites (MMC) to include fatigue behavior under strain-controlled fully reversed loading. This study investigated fatigue life, failure modes and damage mechanisms of the SCS-6/Ti-15-3, (O/9O)2s, MMC. The laminate was subjected to fully reversed fatigue at elevated temperature (427 deg C) at various strain levels. Stress, strain and modulus data were analyzed to characterize the macro-mechanical behavior of the composite. Microscopy and fractography were accomplished to identify and characterize the damage mechanisms at the microscopic level. Failure modes varied according to the maximum applied strain level showing either mixed mode (i.e.more » combination of both fiber and matrix dominated modes) or matrix dominated fatigue failures. As expected, higher strain loadings resulted in more ductility of the matrix at failure, evidenced by fracture surface features. For testing of the same composite laminate, the fatigue life under strain controlled mode slightly increased, compared to its load-controlled mode counterpart, using the effective strain range comparison basis. However, the respective fatigue life curves converged in the high cycle region, suggesting that the matrix dominated failure mode produces equivalent predicted fatigue lives for both control modes.« less

Refining success of cardiac resynchronization therapy using a simple score predicting the amount of reverse ventricular remodelling: results from the Markers and Response to CRT (MARC) study.

PubMed

Maass, Alexander H; Vernooy, Kevin; Wijers, Sofieke C; van 't Sant, Jetske; Cramer, Maarten J; Meine, Mathias; Allaart, Cornelis P; De Lange, Frederik J; Prinzen, Frits W; Gerritse, Bart; Erdtsieck, Erna; Scheerder, Coert O S; Hill, Michael R S; Scholten, Marcoen; Kloosterman, Mariëlle; Ter Horst, Iris A H; Voors, Adriaan A; Vos, Marc A; Rienstra, Michiel; Van Gelder, Isabelle C

2018-02-01

Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in systolic heart failure patients with ventricular conduction delay. Variability of individual response to CRT warrants improved patient selection. The Markers and Response to CRT (MARC) study was designed to investigate markers related to response to CRT. We prospectively studied the ability of 11 clinical, 11 electrocardiographic, 4 echocardiographic, and 16 blood biomarkers to predict CRT response in 240 patients. Response was measured by the reduction of indexed left ventricular end-systolic volume (LVESVi) at 6 months follow-up. Biomarkers were related to LVESVi change using log-linear regression on continuous scale. Covariates that were significant univariately were included in a multivariable model. The final model was utilized to compose a response score. Age was 67 ± 10 years, 63% were male, 46% had ischaemic aetiology, LV ejection fraction was 26 ± 8%, LVESVi was 75 ± 31 mL/m2, and QRS was 178 ± 23 ms. At 6 months LVESVi was reduced to 58 ± 31 mL/m2 (relative reduction of 22 ± 24%), 130 patients (61%) showed ≥ 15% LVESVi reduction. In univariate analysis 17 parameters were significantly associated with LVESVi change. In the final model age, QRSAREA (using vectorcardiography) and two echocardiographic markers (interventricular mechanical delay and apical rocking) remained significantly associated with the amount of reverse ventricular remodelling. This CAVIAR (CRT-Age-Vectorcardiographic QRSAREA -Interventricular Mechanical delay-Apical Rocking) response score also predicted clinical outcome assessed by heart failure hospitalizations and all-cause mortality. The CAVIAR response score predicts the amount of reverse remodelling after CRT and may be used to improve patient selection. Clinical Trials: NCT01519908. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

Pulmonary vasodilation in acute and chronic heart failure: empiricism and evidence.

PubMed

Guglin, Maya

2011-09-01

Pulmonary hypertension in heart failure is associated with exercise intolerance and adverse outcomes. With the availability of multiple drugs that cause pulmonary vasodilation and decrease pulmonary arterial pressure, pulmonary hypertension becomes an attractive therapeutic target. Out of several classes of medications, oral phosphodiesterase inhibitors emerge as the most promising in terms of symptomatic improvement, hemodynamic benefits, reverse cardiac remodeling, and functional capacity. Future trials will show whether the use of these drugs translates to decreased morbidity and mortality in heart failure.

Speech and Language Disorders in a Dialysis Encephalopathy Patient and the Effect of Desferrioxamine and Reverse-Osmosis Water Treatment.

ERIC Educational Resources Information Center

Lehtihalmes, Matti; And Others

Dialysis encephalopathy is a progressive neurological disorder occurring after long-term hemodialysis in some renal failure patients. Accumulation of aluminum in the brain is suspected as its cause, and the use of reverse osmosis of the dialysis water and administration of desferrioxamine to the patient have been successful in reducing the…

On the Specific Role of Microstructure in Governing Cyclic Fatigue, Deformation, and Fracture Behavior of a High-Strength Alloy Steel

NASA Astrophysics Data System (ADS)

Manigandan, K.; Srivatsan, T. S.

2015-06-01

In this paper, the results of an experimental study that focused on evaluating the conjoint influence of microstructure and test specimen orientation on fully reversed strain-controlled fatigue behavior of the high alloy steel X2M are presented and discussed. The cyclic stress response of this high-strength alloy steel revealed initial hardening during the first few cycles followed by gradual softening for most of fatigue life. Cyclic strain resistance exhibited a linear trend for the variation of elastic strain amplitude with reversals to failure, and plastic strain amplitude with reversals to failure. Fracture morphology was the same at the macroscopic level over the entire range of cyclic strain amplitudes examined. However, at the fine microscopic level, the alloy steel revealed fracture to be essentially ductile with features reminiscent of predominantly "locally" ductile and isolated brittle mechanisms. The mechanisms governing stress response at the fine microscopic level, fatigue life, and final fracture behavior are presented and discussed in light of the mutually interactive influences of intrinsic microstructural effects, deformation characteristics of the microstructural constituents during fully reversed strain cycling, cyclic strain amplitude, and resultant response stress.

Long-term efficacy of reverse pull headgear therapy.

PubMed

Wells, Andrew P; Sarver, David M; Proffit, William R

2006-11-01

To add to the data for long-term reverse pull headgear (RPHG) outcomes and further explore possible variables that could be predictors of long-term failure. Cephalometric radiographs of 41 Class III malocclusion children treated with RPHG (face mask) were evaluated before and immediately after treatment; at 5 years posttreatment; and, for 18 patients, at 10 years posttreatment. Patients were assigned to success or failure groups according to positive or negative overjet at the longest available recall. Seventy-five percent of the patients maintained positive overjet, whereas 25% outgrew the correction. In a stepwise discriminant analysis, a large mandible and vertical positioning of the maxilla and mandible so that mandibular growth would be projected more horizontally were the major indicators of unfavorable later mandibular growth. Patients who experienced downward-backward rotation of the mandible during RPHG treatment were more likely to be categorized in the failure group. The age at which treatment began had no effect on long-term success and failure for patients younger than 10 years, but the percentage of successful treatment decreased after that age. When RPHG treatment is used for all but the most obviously prognathic children to correct anterior cross-bite in the early mixed dentition, positive overjet is maintained long-term in 70%-75% of cases, whereas 25%-30% of cases relapse into reverse overjet mainly because of increased horizontally directed and often late mandibular growth. Up to age 10, the time at which RPHG treatment began does not appear to be a major factor in long-term success in maintaining positive overjet.

Prevalence of drug resistance and importance of viral load measurements in Honduran HIV-infected patients failing antiretroviral treatment.

PubMed

Murillo, Wendy; de Rivera, I L; Parham, L; Jovel, E; Palou, E; Karlsson, A C; Albert, J

2010-02-01

The Honduran HIV/AIDS Program began to scale up access to HIV therapy in 2002. Up to May 2008, more than 6000 patients received combination antiretroviral therapy (cART). As HIV drug resistance is the major obstacle for effective treatment, the purpose of this study was to assess the prevalence of antiretroviral drug resistance in Honduran HIV-1-infected individuals. We collected samples from 138 individuals (97 adults and 41 children) on cART with virological, immunological or clinical signs of treatment failure. HIV-1 pol sequences were obtained using an in-house method. Resistance mutations were identified according to the 2007 International AIDS Society (IAS)-USA list and predicted susceptibility to cART was scored using the ANRS algorithm. Resistance mutations were detected in 112 patients (81%), 74% in adults and 98% in children. Triple-, dual- and single-class drug resistance was documented in 27%, 43% and 11% of the study subjects, respectively. Multiple logistic regression showed that resistance was independently associated with type of treatment failure [virological failure (odds ratio (OR) = 1) vs. immunological failure (OR = 0.11; 95% confidence interval (CI) 0.030-0.43) vs. clinical failure (OR = 0.037; 95% CI 0.0063-0.22)], route of transmission (OR = 42.8; 95% CI 3.73-491), and years on therapy (OR = 1.81; 95% CI 1.11-2.93). The prevalence of antiretroviral resistance was high in Honduran HIV-infected patients with signs of treatment failure. A majority of study subjects showed dual- or triple-class resistance to nucleoside reverse transcriptase inhibitors, nonnucleoside reverse transcriptase inhibitors and protease inhibitors. Virologically defined treatment failure was a strong predictor of resistance, indicating that viral load testing is needed to correctly identify patients with treatment failure attributable to resistance.

Transmission failure in sympathetic nerves produced by hemicholinium

PubMed Central

Chang, V.; Rand, M. J.

1960-01-01

It has been shown by others that hemicholinium (α,α'-dimethylethanolamino-4,4'-biacetophenone) inhibits the synthesis of acetylcholine, an effect which is reversed by choline. Hemicholinium produces a failure of response to nerve stimulation in the following sympathetically innervated preparations: guinea-pig isolated vas deferens, rabbit isolated uterus, rabbit isolated colon, perfused rabbit ear, cat isolated atria and the piloerector muscles in the cat's tail. The blocking action of hemicholinium on the responses to postganglionic sympathetic stimulation resembles its blocking action against cholinergic nerve stimulation observed on rabbit isolated atria with vagus nerves, rabbit isolated vagina with pelvic nerves, and guinea-pig isolated diaphragm with phrenic nerve. The failure of transmission produced by hemicholinium in sympathetic nerves and in cholinergic nerves can be reversed by choline. It is suggested that if there were a cholinergic junction at sympathetic nerve endings the mechanism of the blocking action of hemicholinium at these endings could be explained by inhibition of acetylcholine synthesis. ImagesFIG. 13FIG. 14 PMID:13692344

Resistance Analyses of Integrase Strand Transfer Inhibitors within Phase 3 Clinical Trials of Treatment-Naive Patients

PubMed Central

White, Kirsten L.; Raffi, Francois; Miller, Michael D.

2014-01-01

The integrase (IN) strand transfer inhibitors (INSTIs), raltegravir (RAL), elvitegravir (EVG) and dolutegravir (DTG), comprise the newest drug class approved for the treatment of HIV-1 infection, which joins the existing classes of reverse transcriptase, protease and binding/entry inhibitors. The efficacy of first-line regimens has attained remarkably high levels, reaching undetectable viral loads in 90% of patients by Week 48; however, there remain patients who require a change in regimen due to adverse events, virologic failure with emergent resistance or other issues of patient management. Large, randomized clinical trials conducted in antiretroviral treatment-naive individuals are required for drug approval in this population in the US, EU and other countries, with the primary endpoint for virologic success at Week 48. However, there are differences in the definition of virologic failure and the evaluation of drug resistance among the trials. This review focuses on the methodology and tabulation of resistance to INSTIs in phase 3 clinical trials of first-line regimens and discusses case studies of resistance. PMID:25054884

Catch-Up Growth Assessment in Long-Term Physically Neglected and Emotionally Abused Preschool Age Male Children.

ERIC Educational Resources Information Center

Olivan, Gonzalo

2003-01-01

A longitudinal study examined 20 neglected and emotionally abused boys (ages 30-42 months) who entered foster residential care and remained a year after initial placement. At placement, children showed a mild form of chronic malnutrition with growth failure. Growth failure was reversible after the first year of stay. (Contains references.)…

Metabolic Stress and Compromised Identity of Pancreatic Beta Cells

PubMed Central

Swisa, Avital; Glaser, Benjamin; Dor, Yuval

2017-01-01

Beta cell failure is a central feature of type 2 diabetes (T2D), but the molecular underpinnings of the process remain only partly understood. It has been suggested that beta cell failure in T2D involves massive cell death. Other studies ascribe beta cell failure to cell exhaustion, due to chronic oxidative or endoplasmic reticulum stress leading to cellular dysfunction. More recently it was proposed that beta cells in T2D may lose their differentiated identity, possibly even gaining features of other islet cell types. The loss of beta cell identity appears to be driven by glucotoxicity inhibiting the activity of key beta cell transcription factors including Pdx1, Nkx6.1, MafA and Pax6, thereby silencing beta cell genes and derepressing alternative islet cell genes. The loss of beta cell identity is at least partly reversible upon normalization of glycemia, with implications for the reversibility of T2D, although it is not known if beta cell failure reaches eventually a point of no return. In this review we discuss current evidence for metabolism-driven compromised beta cell identity, key knowledge gaps and opportunities for utility in the treatment of T2D. PMID:28270834

Metabolic Stress and Compromised Identity of Pancreatic Beta Cells.

PubMed

Swisa, Avital; Glaser, Benjamin; Dor, Yuval

2017-01-01

Beta cell failure is a central feature of type 2 diabetes (T2D), but the molecular underpinnings of the process remain only partly understood. It has been suggested that beta cell failure in T2D involves massive cell death. Other studies ascribe beta cell failure to cell exhaustion, due to chronic oxidative or endoplasmic reticulum stress leading to cellular dysfunction. More recently it was proposed that beta cells in T2D may lose their differentiated identity, possibly even gaining features of other islet cell types. The loss of beta cell identity appears to be driven by glucotoxicity inhibiting the activity of key beta cell transcription factors including Pdx1, Nkx6.1, MafA and Pax6, thereby silencing beta cell genes and derepressing alternative islet cell genes. The loss of beta cell identity is at least partly reversible upon normalization of glycemia, with implications for the reversibility of T2D, although it is not known if beta cell failure reaches eventually a point of no return. In this review we discuss current evidence for metabolism-driven compromised beta cell identity, key knowledge gaps and opportunities for utility in the treatment of T2D.

[Post-partum posterior reversible encephalopathy syndrome].

PubMed

Aaen, Anne Albers; Jeppesen, Jørgen; Obaid, Hayder; Bülow, Hans Henrik

2015-11-23

Posterior reversible encephalopathy syndrome (PRES) is a complex clinical condition with vasogenic subcortical oedema caused by hypertension. Oedema is often seen on magnetic resonance imaging. The wide clinical spectrum ranges from headaches to vision loss and even death. Early diagnosis and treatment is important for the reversibility of the condition. In this case report we emphasize the importance of blood pressure control in a post-partum woman, who had a rather complicated pregnancy. The symptoms of PRES were not recognized immediately because of failure to use and acknowledge a blood pressure test.

Accelerated graft dysfunction in heart transplant patients with persistent atrioventricular conduction block.

PubMed

Lee, William; Tay, Andre; Walker, Bruce D; Kuchar, Dennis L; Hayward, Christopher S; Spratt, Phillip; Subbiah, Rajesh N

2016-12-01

Bradyarrhythmia following heart transplantation is common-∼7.5-24% of patients require permanent pacemaker (PPM) implantation. While overall mortality is similar to their non-paced counterparts, the effects of chronic right ventricular pacing (CRVP) in heart transplant patients have not been studied. We aim to examine the effects of CRVP on heart failure and mortality in heart transplant patients. Records of heart transplant recipients requiring PPM at St Vincent's Hospital, Sydney, Australia between January 1990 and January 2015 were examined. Patient's without a right ventricular (RV) pacing lead or a follow-up time of <1 year were excluded. Patients with pre-existing abnormal left ventricular function (<50%) were analysed separately. Patients were grouped by pacing dependence (100% pacing dependent vs. non-pacing dependent). The primary endpoint was clinical or echocardiographic heart failure (<35%) in the first 5 years post-PPM. Thirty-three of 709 heart transplant recipients were studied. Two patients had complete RV pacing dependence, and the remaining 31 patients had varying degrees of pacing requirement, with an underlying ventricular escape rhythm. The primary endpoint occurred significantly more in the pacing-dependent group; 2 (100%) compared with 2 (6%) of the non pacing dependent group (P < 0.0001 by log-rank analysis, HR = 24.58). Non-pacing-dependent patients had reversible causes for heart failure, unrelated to pacing. In comparison, there was no other cause of heart failure in the pacing-dependent group. Permanent atrioventricular block is rare in the heart transplant population. We have demonstrated CRVP as a potential cause of accelerated graft failure in pacing-dependent heart transplant patients. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

[Surgical Regeneration Therapy Using Myoblast Sheets for Severe Heart Failure].

PubMed

Sawa, Yoshiki

2017-01-01

Heart failure is a life-threatening disorder worldwide, and the current end-stage therapies for severe heart failure are replacement therapies such as ventricular-assist devices and heart transplantation. Although these therapies have been reported to be useful, there are many issues in terms of the durability, complications, limited donors, adverse effect of continuous administration of immunosuppressive agents, and high costs involved. Recently, regenerative therapy based on genetic, cellular, or tissue engineering techniques has gained attention as a new therapy to overcome the challenges encountered in transplantation medicine. We focused on skeletal myoblasts as the source of progenitor cells for autologous cell transplantation and the cell-sheet technique for site-specific implantation. In vitro studies have reported that myoblast sheets secrete cytoprotective and angiogenic cytokines such as hepatocyte growth factor (HGF). Additionally, in vivo studies using large and small animal models of heart failure, we have shown that myoblast sheets could improve diastolic and systolic performance and enhance angiogenesis and antifibrosis as well as the expression of several cytokines including HGF and vascular endothelial growth factor(VEGF) in the tissues at the transplanted site. Based on the results of these studies, we performed clinical trials using autologous myoblast sheets in ischemic cardiomyopathy (ICM) and dilated cardiomyopathy patients. Some patients showed left ventricular reverse remodeling and improved symptoms and exercise tolerance. Recently, multiple medical institutions including our institution successfully conducted an exploratory, uncontrolled, open-label phase II study in subjects with ICM to validate the efficacy and safety of autologous myoblast sheets. Moreover, as a novel cell source for regenerative medicine, our recent studies demonstrated that induced pluripotent stem cell-derived cardiomyocyte sheets showed electrical and microstructural homogeneity with heart tissue in vitro and in vivo, thus establishing proof of concept in small and large animal models of heart failure.

Significance of change in serum bilirubin in predicting left ventricular reverse remodeling and outcomes in heart failure patients with cardiac resynchronization therapy.

PubMed

Hosoda, Junya; Ishikawa, Toshiyuki; Matsumoto, Katsumi; Iguchi, Kohei; Matsushita, Hirooki; Ogino, Yutaka; Taguchi, Yuka; Sugano, Teruyasu; Ishigami, Tomoaki; Kimura, Kazuo; Tamura, Kouichi

2017-11-01

Research on the correlation of serum bilirubin level with cardiac function as well as outcomes in heart failure patients with cardiac resynchronization therapy (CRT) has not yet been reported. The aim of this study was to analyze the relationship between change in serum bilirubin level and left ventricular reverse remodeling, and also to clarify the impact of bilirubin change on clinical outcomes in CRT patients. We evaluated 105 consecutive patients who underwent CRT. Patients who had no serum total-bilirubin data at both baseline and 3-9 months' follow-up or had died less than 3 months after CRT implantation were excluded. Accordingly, a total of 69 patients were included in the present analysis. The patients were divided into two groups: decreased bilirubin group (serum total-bilirubin level at follow-up≤that at baseline; n=48) and increased bilirubin group (serum total-bilirubin level at follow-up>that at baseline; n=21). Mean follow-up period was 39.3 months. In the decreased bilirubin group, mean left ventricular end-systolic diameter decreased from 54.5mm to 50.2mm (p=0.001) and mean left ventricular ejection fraction increased significantly from 29.8% to 37.0% (p=0.001). In the increased bilirubin group, there was no significant change in echocardiographic parameters from baseline to follow-up. In Kaplan-Meyer analysis, cardiac mortality combined with heart failure hospitalization in the increased bilirubin group was significantly higher than that in the decreased bilirubin group (log-rank p=0.018). Multivariate Cox regression analysis revealed that increased bilirubin was an independent predictor of cardiac mortality combined with heart failure hospitalization (OR=2.66, p=0.023). The change in serum bilirubin is useful for assessment of left ventricular reverse remodeling and prediction of outcomes in heart failure patients with CRT. Copyright © 2017 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Blood urea nitrogen/creatinine ratio identifies a high-risk but potentially reversible form of renal dysfunction in patients with decompensated heart failure.

PubMed

Brisco, Meredith A; Coca, Steven G; Chen, Jennifer; Owens, Anjali Tiku; McCauley, Brian D; Kimmel, Stephen E; Testani, Jeffrey M

2013-03-01

Identifying reversible renal dysfunction (RD) in the setting of heart failure is challenging. The goal of this study was to evaluate whether elevated admission blood urea nitrogen/creatinine ratio (BUN/Cr) could identify decompensated heart failure patients likely to experience improvement in renal function (IRF) with treatment. Consecutive hospitalizations with a discharge diagnosis of heart failure were reviewed. IRF was defined as ≥20% increase and worsening renal function as ≥20% decrease in estimated glomerular filtration rate. IRF occurred in 31% of the 896 patients meeting eligibility criteria. Higher admission BUN/Cr was associated with in-hospital IRF (odds ratio, 1.5 per 10 increase; 95% confidence interval [CI], 1.3-1.8; P<0.001), an association persisting after adjustment for baseline characteristics (odds ratio, 1.4; 95% CI, 1.1-1.8; P=0.004). However, higher admission BUN/Cr was also associated with post-discharge worsening renal function (odds ratio, 1.4; 95% CI, 1.1-1.8; P=0.011). Notably, in patients with an elevated admission BUN/Cr, the risk of death associated with RD (estimated glomerular filtration rate <45) was substantial (hazard ratio, 2.2; 95% CI, 1.6-3.1; P<0.001). However, in patients with a normal admission BUN/Cr, RD was not associated with increased mortality (hazard ratio, 1.2; 95% CI, 0.67-2.0; P=0.59; p interaction=0.03). An elevated admission BUN/Cr identifies decompensated patients with heart failure likely to experience IRF with treatment, providing proof of concept that reversible RD may be a discernible entity. However, this improvement seems to be largely transient, and RD, in the setting of an elevated BUN/Cr, remains strongly associated with death. Further research is warranted to develop strategies for the optimal detection and treatment of these high-risk patients.

Blood Urea Nitrogen/Creatinine Ratio Identifies a High-Risk but Potentially Reversible Form of Renal Dysfunction in Patients With Decompensated Heart Failure

PubMed Central

Brisco, Meredith A.; Coca, Steven G.; Chen, Jennifer; Owens, Anjali Tiku; McCauley, Brian D.; Kimmel, Stephen E.; Testani, Jeffrey M.

2014-01-01

Background Identifying reversible renal dysfunction (RD) in the setting of heart failure is challenging. The goal of this study was to evaluate whether elevated admission blood urea nitrogen/creatinine ratio (BUN/Cr) could identify decompensated heart failure patients likely to experience improvement in renal function (IRF) with treatment. Methods and Results Consecutive hospitalizations with a discharge diagnosis of heart failure were reviewed. IRF was defined as ≥20% increase and worsening renal function as ≥20% decrease in estimated glomerular filtration rate. IRF occurred in 31% of the 896 patients meeting eligibility criteria. Higher admission BUN/Cr was associated with inhospital IRF (odds ratio, 1.5 per 10 increase; 95% confidence interval [CI], 1.3–1.8; P<0.001), an association persisting after adjustment for baseline characteristics (odds ratio, 1.4; 95% CI, 1.1–1.8; P=0.004). However, higher admission BUN/Cr was also associated with post-discharge worsening renal function (odds ratio, 1.4; 95% CI, 1.1–1.8; P=0.011). Notably, in patients with an elevated admission BUN/Cr, the risk of death associated with RD (estimated glomerular filtration rate <45) was substantial (hazard ratio, 2.2; 95% CI, 1.6–3.1; P<0.001). However, in patients with a normal admission BUN/Cr, RD was not associated with increased mortality (hazard ratio, 1.2; 95% CI, 0.67–2.0; P=0.59; p interaction=0.03). Conclusions An elevated admission BUN/Cr identifies decompensated patients with heart failure likely to experience IRF with treatment, providing proof of concept that reversible RD may be a discernible entity. However, this improvement seems to be largely transient, and RD, in the setting of an elevated BUN/Cr, remains strongly associated with death. Further research is warranted to develop strategies for the optimal detection and treatment of these high-risk patients. PMID:23325460

Tantalum capacitor behavior under fast transient overvoltages. [circuit protection against lightning

NASA Technical Reports Server (NTRS)

Zill, J. A.; Castle, K. D.

1974-01-01

Tantalum capacitors were tested to determine failure time when subjected to short-duration, high-voltage surges caused by lightning strikes. Lightning is of concern to NASA because of possible damage to critical spacecraft circuits. The test was designed to determine the minimum time for tantalum capacitor failure and the amount of overvoltage a capacitor could survive, without permanent damage, in 100 microseconds. All tested exhibited good recovery from the transient one-shot pulses with no failure at any voltage, forward or reverse, in less than 25 microseconds.

CESAR: conventional ventilatory support vs extracorporeal membrane oxygenation for severe adult respiratory failure.

PubMed

Peek, Giles J; Clemens, Felicity; Elbourne, Diana; Firmin, Richard; Hardy, Pollyanna; Hibbert, Clare; Killer, Hilliary; Mugford, Miranda; Thalanany, Mariamma; Tiruvoipati, Ravin; Truesdale, Ann; Wilson, Andrew

2006-12-23

An estimated 350 adults develop severe, but potentially reversible respiratory failure in the UK annually. Current management uses intermittent positive pressure ventilation, but barotrauma, volutrauma and oxygen toxicity can prevent lung recovery. An alternative treatment, extracorporeal membrane oxygenation, uses cardio-pulmonary bypass technology to temporarily provide gas exchange, allowing ventilator settings to be reduced. While extracorporeal membrane oxygenation is proven to result in improved outcome when compared to conventional ventilation in neonates with severe respiratory failure, there is currently no good evidence from randomised controlled trials to compare these managements for important clinical outcomes in adults, although evidence from case series is promising. The aim of the randomised controlled trial of Conventional ventilatory support vs extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR) is to assess whether, for patients with severe, but potentially reversible, respiratory failure, extracorporeal membrane oxygenation will increase the rate of survival without severe disability ('confined to bed' and 'unable to wash or dress') by six months post-randomisation, and be cost effective from the viewpoints of the NHS and society, compared to conventional ventilatory support. Following assent from a relative, adults (18-65 years) with severe, but potentially reversible, respiratory failure (Murray score >/= 3.0 or hypercapnea with pH < 7.2) will be randomised for consideration of extracorporeal membrane oxygenation at Glenfield Hospital, Leicester or continuing conventional care in a centre providing a high standard of conventional treatment. The central randomisation service will minimise by type of conventional treatment centre, age, duration of high pressure ventilation, hypoxia/hypercapnea, diagnosis and number of organs failed, to ensure balance in key prognostic variables. Extracorporeal membrane oxygenation will not be available for patients meeting entry criteria outside the trial. 180 patients will be recruited to have 80% power to be able to detect a one third reduction in the primary outcome from 65% at 5% level of statistical significance (2-sided test). Secondary outcomes include patient morbidity and health status at 6 months. Analysis will be based on intention to treat. A concurrent economic evaluation will also be performed to compare the costs and outcomes of both treatments.

Left ventricular assist device and drug therapy for the reversal of heart failure.

PubMed

Birks, Emma J; Tansley, Patrick D; Hardy, James; George, Robert S; Bowles, Christopher T; Burke, Margaret; Banner, Nicholas R; Khaghani, Asghar; Yacoub, Magdi H

2006-11-02

In patients with severe heart failure, prolonged unloading of the myocardium with the use of a left ventricular assist device has been reported to lead to myocardial recovery in small numbers of patients for varying periods of time. Increasing the frequency and durability of myocardial recovery could reduce or postpone the need for subsequent heart transplantation. We enrolled 15 patients with severe heart failure due to nonischemic cardiomyopathy and with no histologic evidence of active myocarditis. All had markedly reduced cardiac output and were receiving inotropes. The patients underwent implantation of left ventricular assist devices and were treated with lisinopril, carvedilol, spironolactone, and losartan to enhance reverse remodeling. Once regression of left ventricular enlargement had been achieved, the beta2-adrenergic-receptor agonist clenbuterol was administered to prevent myocardial atrophy. Eleven of the 15 patients had sufficient myocardial recovery to undergo explantation of the left ventricular assist device a mean (+/-SD) of 320+/-186 days after implantation of the device. One patient died of intractable arrhythmias 24 hours after explantation; another died of carcinoma of the lung 27 months after explantation. The cumulative rate of freedom from recurrent heart failure among the surviving patients was 100% and 88.9% 1 and 4 years after explantation, respectively. The quality of life as assessed by the Minnesota Living with Heart Failure Questionnaire score at 3 years was nearly normal. Fifty-nine months after explantation, the mean left ventricular ejection fraction was 64+/-12%, the mean left ventricular end-diastolic diameter was 59.4+/-12.1 mm, the mean left ventricular end-systolic diameter was 42.5+/-13.2 mm, and the mean maximal oxygen uptake with exercise was 26.3+/-6.0 ml per kilogram of body weight per minute. In this single-center study, we found that sustained reversal of severe heart failure secondary to nonischemic cardiomyopathy could be achieved in selected patients with the use of a left ventricular assist device and a specific pharmacologic regimen. Copyright 2006 Massachusetts Medical Society.

Rescue therapy by switching to total face mask after failure of face mask-delivered noninvasive ventilation in do-not-intubate patients in acute respiratory failure.

PubMed

Lemyze, Malcolm; Mallat, Jihad; Nigeon, Olivier; Barrailler, Stéphanie; Pepy, Florent; Gasan, Gaëlle; Vangrunderbeeck, Nicolas; Grosset, Philippe; Tronchon, Laurent; Thevenin, Didier

2013-02-01

To evaluate the impact of switching to total face mask in cases where face mask-delivered noninvasive mechanical ventilation has already failed in do-not-intubate patients in acute respiratory failure. Prospective observational study in an ICU and a respiratory stepdown unit over a 12-month study period. Switching to total face mask, which covers the entire face, when noninvasive mechanical ventilation using facial mask (oronasal mask) failed to reverse acute respiratory failure. Seventy-four patients with a do-not-intubate order and treated by noninvasive mechanical ventilation for acute respiratory failure. Failure of face mask-delivered noninvasive mechanical ventilation was associated with a three-fold increase in in-hospital mortality (36% vs. 10.5%; p = 0.009). Nevertheless, 23 out of 36 patients (64%) in whom face mask-delivered noninvasive mechanical ventilation failed to reverse acute respiratory failure and, therefore, switched to total face mask survived hospital discharge. Reasons for switching from facial mask to total face mask included refractory hypercapnic acute respiratory failure (n = 24, 66.7%), painful skin breakdown or facial mask intolerance (n = 11, 30%), and refractory hypoxemia (n = 1, 2.7%). In the 24 patients switched from facial mask to total face mask because of refractory hypercapnia, encephalopathy score (3 [3-4] vs. 2 [2-3]; p < 0.0001), PaCO2 (87 ± 25 mm Hg vs. 70 ± 17 mm Hg; p < 0.0001), and pH (7.24 ± 0.1 vs. 7.32 ± 0.09; p < 0.0001) significantly improved after 2 hrs of total face mask-delivered noninvasive ventilation. Patients switched early to total face mask (in the first 12 hrs) developed less pressure sores (n = 5, 24% vs. n = 13, 87%; p = 0.0002), despite greater length of noninvasive mechanical ventilation within the first 48 hrs (44 hrs vs. 34 hrs; p = 0.05) and less protective dressings (n = 2, 9.5% vs. n = 8, 53.3%; p = 0.007). The optimal cutoff value for face mask-delivered noninvasive mechanical ventilation duration in predicting facial pressure sores was 11 hrs (area under the receiver operating characteristic curve, 0.86 ± 0.04; 95% confidence interval 0.76-0.93; p < 0.0001; sensitivity, 84%; specificity, 71%). In patients in hypercapnic acute respiratory failure, for whom escalation to intubation is deemed inappropriate, switching to total face mask can be proposed as a last resort therapy when face mask-delivered noninvasive mechanical ventilation has already failed to reverse acute respiratory failure. This strategy is particularly adapted to provide prolonged periods of continuous noninvasive mechanical ventilation while preventing facial pressure sores.

Axonal Guillain-Barré syndrome: concepts and controversies.

PubMed

Kuwabara, Satoshi; Yuki, Nobuhiro

2013-12-01

Acute motor axonal neuropathy (AMAN) is a pure motor axonal subtype of Guillain-Barré syndrome (GBS) that was identified in the late 1990s. In Asia and Central and South America, it is the major subtype of GBS, seen in 30-65% of patients. AMAN progresses more rapidly and has an earlier peak than demyelinating GBS; tendon reflexes are relatively preserved or even exaggerated, and autonomic dysfunction is rare. One of the main causes is molecular mimicry of human gangliosides by Campylobacter jejuni lipo-oligosaccharides. In addition to axonal degeneration, electrophysiology shows rapidly reversible nerve conduction blockade or slowing, presumably due to pathological changes at the nodes or paranodes. Autoantibodies that bind to GM1 or GD1a gangliosides at the nodes of Ranvier activate complement and disrupt sodium-channel clusters and axoglial junctions, which leads to nerve conduction failure and muscle weakness. Improved understanding of the disease mechanism and pathophysiology might lead to new treatment options and improve the outlook for patients with AMAN. Copyright © 2013 Elsevier Ltd. All rights reserved.

Assessing the autopsy.

PubMed

Nemetz, P N; Ludwig, J; Kurland, L T

1987-08-01

This study outlines the role of autopsies in medical practice and health policy, details the nature and reason for declining rates, including those in Rochester, Minnesota, and suggests possible remedial measures to halt or reverse this trend. It is concluded that one of the principal impediments to reversing the declining rate of autopsies is what is referred to in Economics as "market failure." In particular, the nature of the spatial and temporal distribution of costs and benefits has precluded the existence of an incentive structure which can lead to a realization of the major net social benefits from the autopsy. Ultimately, it is only the explicit recognition by the medical profession, government agencies, corporate insurers, and the general public of the nature and significance of this market failure and foregone benefits which can lead to remediation.

Assessing the autopsy.

PubMed Central

Nemetz, P. N.; Ludwig, J.; Kurland, L. T.

1987-01-01

This study outlines the role of autopsies in medical practice and health policy, details the nature and reason for declining rates, including those in Rochester, Minnesota, and suggests possible remedial measures to halt or reverse this trend. It is concluded that one of the principal impediments to reversing the declining rate of autopsies is what is referred to in Economics as "market failure." In particular, the nature of the spatial and temporal distribution of costs and benefits has precluded the existence of an incentive structure which can lead to a realization of the major net social benefits from the autopsy. Ultimately, it is only the explicit recognition by the medical profession, government agencies, corporate insurers, and the general public of the nature and significance of this market failure and foregone benefits which can lead to remediation. PMID:3113257

Impact of Cardiac Progenitor Cells on Heart Failure and Survival in Single Ventricle Congenital Heart Disease.

PubMed

Sano, Toshikazu; Ousaka, Daiki; Goto, Takuya; Ishigami, Shuta; Hirai, Kenta; Kasahara, Shingo; Ohtsuki, Shinichi; Sano, Shunji; Oh, Hidemasa

2018-03-30

Intracoronary administration of cardiosphere-derived cells (CDCs) in patients with single ventricles resulted in a short-term improvement in cardiac function. To test the hypothesis that CDC infusion is associated with improved cardiac function and reduced mortality in patients with heart failure. We evaluated the effectiveness of CDCs using an integrated cohort study in 101 patients with single ventricles, including 41 patients who received CDC infusion and 60 controls treated with staged palliation alone. Heart failure with preserved ejection fraction (EF) or reduced EF was stratified by the cardiac function after surgical reconstruction. The main outcome measure was to evaluate the magnitude of improvement in cardiac function and all-cause mortality at 2 years. Animal studies were conducted to clarify the underlying mechanisms of heart failure with preserved EF and heart failure with reduced EF phenotypes. At 2 years, CDC infusion increased ventricular function (stage 2: +8.4±10.0% versus +1.6±6.4%, P =0.03; stage 3: +7.9±7.5% versus -1.1±5.5%, P <0.001) compared with controls. In all available follow-up data, survival did not differ between the 2 groups (log-rank P =0.225), whereas overall patients treated by CDCs had lower incidences of late failure ( P =0.022), adverse events ( P =0.013), and catheter intervention ( P =0.005) compared with controls. CDC infusion was associated with a lower risk of adverse events (hazard ratio, 0.411; 95% CI, 0.179-0.942; P =0.036). Notably, CDC infusion reduced mortality ( P =0.038) and late complications ( P <0.05) in patients with heart failure with reduced EF but not with heart failure with preserved EF. CDC-treated rats significantly reversed myocardial fibrosis with differential collagen deposition and inflammatory responses between the heart failure phenotypes. CDC administration in patients with single ventricles showed favorable effects on ventricular function and was associated with reduced late complications except for all-cause mortality after staged procedures. Patients with heart failure with reduced EF but not heart failure with preserved EF treated by CDCs resulted in significant improvement in clinical outcome. URL: http://www.clinicaltrials.gov. Unique identifiers: NCT01273857 and NCT01829750. © 2018 American Heart Association, Inc.

Reverse leakage current characteristics of InGaN/GaN multiple quantum well ultraviolet/blue/green light-emitting diodes

NASA Astrophysics Data System (ADS)

Zhou, Shengjun; Lv, Jiajiang; Wu, Yini; Zhang, Yuan; Zheng, Chenju; Liu, Sheng

2018-05-01

We investigated the reverse leakage current characteristics of InGaN/GaN multiple quantum well (MQW) near-ultraviolet (NUV)/blue/green light-emitting diodes (LEDs). Experimental results showed that the NUV LED has the smallest reverse leakage current whereas the green LED has the largest. The reason is that the number of defects increases with increasing nominal indium content in InGaN/GaN MQWs. The mechanism of the reverse leakage current was analyzed by temperature-dependent current–voltage measurement and capacitance–voltage measurement. The reverse leakage currents of NUV/blue/green LEDs show similar conduction mechanisms: at low temperatures, the reverse leakage current of these LEDs is attributed to variable-range hopping (VRH) conduction; at high temperatures, the reverse leakage current of these LEDs is attributed to nearest-neighbor hopping (NNH) conduction, which is enhanced by the Poole–Frenkel effect.

Adjusting for reverse causation to estimate the effect of obesity on mortality after incident heart failure in the Atherosclerosis Risk in Communities (ARIC) study.

PubMed

Shakiba, Maryam; Soori, Hamid; Mansournia, Mohammad Ali; Nazari, Seyed Saeed Hashemi; Salimi, Yahya

2016-01-01

The lower mortality rate of obese patients with heart failure (HF) has been partly attributed to reverse causation bias due to weight loss caused by disease. Using data about weight both before and after HF, this study aimed to adjust for reverse causation and examine the association of obesity both before and after HF with mortality. Using the Atherosclerosis Risk in Communities (ARIC) study, 308 patients with data available from before and after the incidence of HF were included. Pre-morbid and post-morbid obesity were defined based on body mass index measurements at least three months before and after incident HF. The associations of pre-morbid and post-morbid obesity and weight change with survival after HF were evaluated using a Cox proportional hazard model. Pre-morbid obesity was associated with higher mortality (hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.04 to 2.49) but post-morbid obesity was associated with increased survival (HR, 0.57; 95% CI, 0.37 to 0.88). Adjusting for weight change due to disease as a confounder of the obesity-mortality relationship resulted in the absence of any significant associations between post-morbid obesity and mortality. This study demonstrated that controlling for reverse causality by adjusting for the confounder of weight change may remove or reverse the protective effect of obesity on mortality among patients with incident HF.

Coupled Electro-Thermal Simulations of Single Event Burnout in Power Diodes

NASA Astrophysics Data System (ADS)

Albadri, A. M.; Schrimpf, R. D.; Walker, D. G.; Mahajan, S. V.

2005-12-01

Power diodes may undergo destructive failures when they are struck by high-energy particles during the off state (high reverse-bias voltage). This paper describes the failure mechanism using a coupled electro-thermal model. The specific case of a 3500-V diode is considered and it is shown that the temperatures reached when high voltages are applied are sufficient to cause damage to the constituent materials of the diode. The voltages at which failure occurs (e.g., 2700 V for a 17-MeV carbon ion) are consistent with previously reported data. The simulation results indicate that the catastrophic failures result from local heating caused by avalanche multiplication of ion-generated carriers.

Acute-on-chronic and Decompensated Chronic Liver Failure: Definitions, Epidemiology, and Prognostication.

PubMed

Olson, Jody C

2016-07-01

Chronic liver disease is the fifth leading cause of death worldwide and represents a major burden for the health care community. Cirrhosis is a progressive disease resulting in end-stage liver failure, which in the absence of liver transplantation is fatal. Acute-on-chronic liver failure carries high short-term mortality but is potentially reversible. Viral hepatitis, alcohol, and nonalcoholic fatty liver disease remain the principal causes of liver disease. Though treatments exist for hepatitis B and C, they remain unavailable to many with these diseases. This article reviews the epidemiology of advanced liver disease and the concept of acute-on-chronic liver failure. Copyright © 2016 Elsevier Inc. All rights reserved.

Design Methodology for Bonded-Bolted Composite Joints. Volume I. Analysis Derivations and Illustrative Solutions

DTIC Science & Technology

1982-02-01

EXPERIMENTAL EVIDENCE ...... ....... ....... ....... ... 27 2.6 LOAD REDISTRIBUTION DUE TO DISBONDS IN ADHESIVE IN STEPPED-LAP JOINTS...SINGLE FASTENER " . ;39 3.4 LOAD SHARING BETWEEN MULTIRUW FASTENERS.."."..-.."." ൴ 3.5 FAILURE CRITERIA AT FASTENER HOLES . . ... 3.6 EXPERIMENTAL ...PLASTIC C. PERFECTLY ELASTIC THROUGHOUT A. ULL PLSTC SEAR TRS•WITHOUT $1IGN REVERSAL WITHOUT S:IG13 REVERSAL IOR FULLY NEGATIVE QUIVALENT ) (OR FULLY

Strain-controlled thermal conductivity in ferroic twinned films

PubMed Central

Li, Suzhi; Ding, Xiangdong; Ren, Jie; Moya, Xavier; Li, Ju; Sun, Jun; Salje, Ekhard K. H.

2014-01-01

Large reversible changes of thermal conductivity are induced by mechanical stress, and the corresponding device is a key element for phononics applications. We show that the thermal conductivity κ of ferroic twinned thin films can be reversibly controlled by strain. Nonequilibrium molecular dynamics simulations reveal that thermal conductivity decreases linearly with the number of twin boundaries perpendicular to the direction of heat flow. Our demonstration of large and reversible changes in thermal conductivity driven by strain may inspire the design of controllable thermal switches for thermal logic gates and all-solid-state cooling devices. PMID:25224749

Replicative stress and alterations in cell cycle checkpoint controls following acetaminophen hepatotoxicity restrict liver regeneration.

PubMed

Viswanathan, Preeti; Sharma, Yogeshwar; Gupta, Priya; Gupta, Sanjeev

2018-03-05

Acetaminophen hepatotoxicity is a leading cause of hepatic failure with impairments in liver regeneration producing significant mortality. Multiple intracellular events, including oxidative stress, mitochondrial damage, inflammation, etc., signify acetaminophen toxicity, although how these may alter cell cycle controls has been unknown and was studied for its significance in liver regeneration. Assays were performed in HuH-7 human hepatocellular carcinoma cells, primary human hepatocytes and tissue samples from people with acetaminophen-induced acute liver failure. Cellular oxidative stress, DNA damage and cell proliferation events were investigated by mitochondrial membrane potential assays, flow cytometry, fluorescence staining, comet assays and spotted arrays for protein expression after acetaminophen exposures. In experimental groups with acetaminophen toxicity, impaired mitochondrial viability and substantial DNA damage were observed with rapid loss of cells in S and G2/M and cell cycle restrictions or even exit in the remainder. This resulted from altered expression of the DNA damage regulator, ATM and downstream transducers, which imposed G1/S checkpoint arrest, delayed entry into S and restricted G2 transit. Tissues from people with acute liver failure confirmed hepatic DNA damage and cell cycle-related lesions, including restrictions of hepatocytes in aneuploid states. Remarkably, treatment of cells with a cytoprotective cytokine reversed acetaminophen-induced restrictions to restore cycling. Cell cycle lesions following mitochondrial and DNA damage led to failure of hepatic regeneration in acetaminophen toxicity but their reversibility offers molecular targets for treating acute liver failure. © 2018 John Wiley & Sons Ltd.

Isothermal Fatigue, Damage Accumulation, and Life Prediction of a Woven PMC

NASA Technical Reports Server (NTRS)

Gyekenyesi, Andrew L.

1998-01-01

This dissertation focuses on the characterization of the fully reversed fatigue behavior exhibited by a carbon fiber/polyimide resin, woven laminate at room and elevated temperatures. Nondestructive video edge view microscopy and destructive sectioning techniques were used to study the microscopic damage mechanisms that evolved. The residual elastic stiffness was monitored and recorded throughout the fatigue life of the coupon. In addition, residual compressive strength tests were conducted on fatigue coupons with various degrees of damage as quantified by stiffness reduction. Experimental results indicated that the monotonic tensile properties were only minimally influenced by temperature, while the monotonic compressive and fully reversed fatigue properties displayed noticeable reductions due to the elevated temperature. The stiffness degradation, as a function of cycles, consisted of three stages; a short-lived high degradation period, a constant degradation rate segment composing the majority of the life, and a final stage demonstrating an increasing rate of degradation up to failure. Concerning the residual compressive strength tests at room and elevated temperatures, the elevated temperature coupons appeared much more sensitive to damage. At elevated temperatures, coupons experienced a much larger loss in compressive strength when compared to room temperature coupons with equivalent damage. The fatigue damage accumulation law proposed for the model incorporates a scalar representation for damage, but admits a multiaxial, anisotropic evolutionary law. The model predicts the current damage (as quantified by residual stiffness) and remnant life of a composite that has undergone a known load at temperature. The damage/life model is dependent on the applied multiaxial stress state as well as temperature. Comparisons between the model and data showed good predictive capabilities concerning stiffness degradation and cycles to failure.

Microstructure-sensitive plasticity and fatigue modeling of extruded 6061 aluminum alloys

NASA Astrophysics Data System (ADS)

McCullough, Robert Ross

In this study, the development of fatigue failure and stress anisotropy in light weight ductile metal alloys, specifically Al-Mg-Si aluminum alloys, was investigated. The experiments were carried out on an extruded 6061 aluminum alloy. Reverse loading experiments were performed up to a prestrain of 5% in both tension-followed-by-compression and compression-followed-by-tension. The development of isotropic and kinematic hardening and subsequent anisotropy was indicated by the observation of the Bauschinger effect phenomenon. Experimental results show that 6061 aluminum alloy exhibited a slight increase in the kinematic hardening versus applied prestrain. However, the ratio of kinematic-to-isotropic hardening remained near unity. An internal state variable (ISV) plasticity and damage model was used to capture the evolution of the anisotropy for the as-received T6 and partially annealed conditions. Following the stress anisotropy experiments, the same extruded 6061 aluminum alloy was tested under fully reversing, strain-controlled low cycle fatigue at up to 2.5% strain amplitudes and two heat treatment conditions. Observations were made of the development of striation fields up to the point of nucleation at cracked and clustered precipitants and free surfaces through localized precipitant slip band development. A finite element enabled micro-mechanics study of fatigue damage development of local strain field in the presence of hard phases was conducted. Both the FEA and experimental data sets were utilized in the implementation of a multi-stage fatigue model in order to predict the microstructure response, including fatigue nucleation and propagation contributions on the total fatigue life in AA6061. Good correlation between experimental and predicted results in the number of cycles to final failure was observed. The AA6061 material maintained relatively consistent low cycle fatigue performance despite two different heat treatments.

Understanding nonresponders of cardiac resynchronization therapy--current and future perspectives.

PubMed

Yu, Cheuk-Man; Wing-Hong Fung, Jeffrey; Zhang, Qing; Sanderson, John E

2005-10-01

Cardiac resynchronization therapy (CRT) is now an established nonpharmacologic therapy for advanced heart failure with electromechanical delay. Despite compelling evidence of the benefits of CRT, one troubling issue is the lack of a favorable response in about one-third of patients. Currently, there is no unifying definition of responders, and published data were based on acute hemodynamic changes, chronic left ventricular reverse remodeling, as well as the intermediate or long-term clinical response. The lack of improvement with CRT can be due to many factors including the placement of the left ventricular pacing lead in an inappropriate location, the absence of electrical conduction delay or mechanical dyssynchrony despite wide QRS complexes, and possibly failure to optimize the CRT settings after device implantation. In acute hemodynamic studies, placing the left ventricular leads at the free wall region has been suggested to generate the best pulse pressure and positive dp/dt. The degree of mechanical dyssynchrony has recently been assessed noninvasively in CRT patients by echocardiography and in particular by tissue Doppler imaging. These studies suggested that responders of left ventricular reverse remodeling or systolic function had more severe systolic dyssynchrony. However, further studies are needed to examine the clinical utility of these parameters when applied to the standardized anatomic or functional endpoints. Optimization of atrioventricular and interventricular pacing intervals may also reduce the number of nonresponders, though newer methods, especially interventricular pacing intervals, are still under clinical investigation. With the adjunctive use of imaging technology, physicians are able to characterize the response to CRT objectively, and cardiac imaging is an important clinical tool for determining more precisely the presence and degree of mechanical dyssynchrony.

Tenofovir-based regimens associated with less drug resistance in HIV-1-infected Nigerians failing first-line antiretroviral therapy.

PubMed

Etiebet, Mary-Ann A; Shepherd, James; Nowak, Rebecca G; Charurat, Man; Chang, Harry; Ajayi, Samuel; Elegba, Olufunmilayo; Ndembi, Nicaise; Abimiku, Alashle; Carr, Jean K; Eyzaguirre, Lindsay M; Blattner, William A

2013-02-20

In resource-limited settings, HIV-1 drug resistance testing to guide antiretroviral therapy (ART) selection is unavailable. We retrospectively conducted genotypic analysis on archived samples from Nigerian patients who received targeted viral load testing to confirm treatment failure and report their drug resistance mutation patterns. Stored plasma from 349 adult patients on non-nucleoside reverse transcriptase inhibitor (NNRTI) regimens was assayed for HIV-1 RNA viral load, and samples with more than 1000 copies/ml were sequenced in the pol gene. Analysis for resistance mutations utilized the IAS-US 2011 Drug Resistance Mutation list. One hundred and seventy-five samples were genotyped; the majority of the subtypes were G (42.9%) and CRF02_AG (33.7%). Patients were on ART for a median of 27 months. 90% had the M184V/I mutation, 62% had at least one thymidine analog mutation, and 14% had the K65R mutation. 97% had an NNRTI resistance mutation and 47% had at least two etravirine-associated mutations. In multivariate analysis tenofovir-based regimens were less likely to have at least three nucleoside reverse transcriptase inhibitor (NRTI) mutations after adjusting for subtype, previous ART, CD4, and HIV viral load [P < 0.001, odds ratio (OR) 0.04]. 70% of patients on tenofovir-based regimens had at least two susceptible NRTIs to include in a second-line regimen compared with 40% on zidovudine-based regimens (P = 0.04, OR = 3.4). At recognition of treatment failure, patients on tenofovir-based first-line regimens had fewer NRTI drug-resistant mutations and more active NRTI drugs available for second-line regimens. These findings can inform strategies for ART regimen sequencing to optimize long-term HIV treatment outcomes in low-resource settings.

Ventilatory support in critically ill hematology patients with respiratory failure

PubMed Central

2012-01-01

Introduction Hematology patients admitted to the ICU frequently experience respiratory failure and require mechanical ventilation. Noninvasive mechanical ventilation (NIMV) may decrease the risk of intubation, but NIMV failure poses its own risks. Methods To establish the impact of ventilatory management and NIMV failure on outcome, data from a prospective, multicenter, observational study were analyzed. All hematology patients admitted to one of the 34 participating ICUs in a 17-month period were followed up. Data on demographics, diagnosis, severity, organ failure, and supportive therapies were recorded. A logistic regression analysis was done to evaluate the risk factors associated with death and NIVM failure. Results Of 450 patients, 300 required ventilatory support. A diagnosis of congestive heart failure and the initial use of NIMV significantly improved survival, whereas APACHE II score, allogeneic transplantation, and NIMV failure increased the risk of death. The risk factors associated with NIMV success were age, congestive heart failure, and bacteremia. Patients with NIMV failure experienced a more severe respiratory impairment than did those electively intubated. Conclusions NIMV improves the outcome of hematology patients with respiratory insufficiency, but NIMV failure may have the opposite effect. A careful selection of patients with rapidly reversible causes of respiratory failure may increase NIMV success. PMID:22827955

A Proposal of Operational Risk Management Method Using FMEA for Drug Manufacturing Computerized System

NASA Astrophysics Data System (ADS)

Takahashi, Masakazu; Nanba, Reiji; Fukue, Yoshinori

This paper proposes operational Risk Management (RM) method using Failure Mode and Effects Analysis (FMEA) for drug manufacturing computerlized system (DMCS). The quality of drug must not be influenced by failures and operational mistakes of DMCS. To avoid such situation, DMCS has to be conducted enough risk assessment and taken precautions. We propose operational RM method using FMEA for DMCS. To propose the method, we gathered and compared the FMEA results of DMCS, and develop a list that contains failure modes, failures and countermeasures. To apply this list, we can conduct RM in design phase, find failures, and conduct countermeasures efficiently. Additionally, we can find some failures that have not been found yet.

The paradox of left ventricular assist device unloading and myocardial recovery in end-stage dilated cardiomyopathy: implications for heart failure in the elderly.

PubMed

Butler, Craig R; Jugdutt, Bodh I

2012-09-01

Dilated cardiomyopathy (DCM) is a common debilitating condition with limited therapeutic options besides heart transplantation or palliation. It is characterized by maladaptive remodeling of cardiomyocytes, extracellular collagen matrix (ECCM) and left ventricular (LV) geometry which contributes to further dysfunction. LV assist devices (LVADs) can reverse adverse remodeling in end-stage DCM. However, there is a disconnect between the benefits of prolonged unloading with LVAD at molecular and cellular levels and the low rate of bridge to recovery (BTR). Potential explanations for this paradox include insufficient reverse ECCM remodeling and/or excessive reverse cardiomyocyte remodeling with atrophy. LVAD therapy is associated with decreased collagen turnover and cross-linking and increased tissue angiotensin II (AngII), whereas LVAD combined with angiotensin-converting enzyme inhibition results in decreased tissue AngII and collagen cross-linking, normalizes LV end-diastolic pressure volume relationships and is associated with modestly higher rates of BTR. Much remains to be learned about ventricular reverse remodeling after LVAD. This can be facilitated through systematic collection and comparison of recovered and unrecovered myocardium. Importantly, vigilant monitoring for ventricular recovery among LVAD patients is needed, particularly in older patients receiving LVAD for destination therapy. In addition, prospective multicenter trials are needed to clarify the potential benefit of concomitant heart failure therapy with selective β2 agonism on ventricular recovery.

Reverse right ventricular structural and extracellular matrix remodeling by estrogen in severe pulmonary hypertension

PubMed Central

Nadadur, Rangarajan D.; Umar, Soban; Wong, Gabriel; Eghbali, Mansour; Iorga, Andrea; Matori, Humann; Partow-Navid, Rod

2012-01-01

Chronic pulmonary hypertension (PH) leads to right-ventricular failure (RVF) characterized by RV remodeling. Ventricular remodeling is emerging as an important process during heart failure and recovery. Remodeling in RVF induced by PH is not fully understood. Recently we discovered that estrogen (E2) therapy can rescue severe preexisting PH. Here, we focused on whether E2 (42.5 μg·kg−1·day−1, 10 days) can reverse adverse RV structural and extracellular matrix (ECM) remodeling induced by PH using monocrotaline (MCT, 60 mg/kg). RV fibrosis was evident in RVF males. Intact females developed less severe RV remodeling compared with males and ovariectomized (OVX) females. Novel ECM-degrading disintegrin-metalloproteinases ADAM15 and ADAM17 transcripts were elevated ∼2-fold in all RVF animals. E2 therapy reversed RV remodeling in all groups. In vitro, E2 directly inhibited ANG II-induced expression of fibrosis markers as well as the metalloproteinases in cultured cardiac fibroblasts. Estrogen receptor-β agonist diarylpropionitrile (DPN) but not estrogen receptor-α agonist 4,4′,4″-(4-propyl-[1H]-pyrazole-1,3,5-triyl)trisphenol (PPT) was as effective as E2 in inhibiting expression of these genes. Expression of ECM-interacting cardiac fetal-gene osteopontin (OPN) also increased ∼9-fold in RVF males. Intact females were partially protected from OPN upregulation (∼2-fold) but OVX females were not. E2 reversed OPN upregulation in all groups. Upregulation of OPN was also reversed in vitro by E2. Plasma OPN was elevated in RVF (∼1.5-fold) and decreased to control levels in the E2 group. RVF resulted in elevated Akt phosphorylation, but not ERK, in the RV, and E2 therapy restored Akt phosphorylation. In conclusion, E2 therapy reverses adverse RV remodeling associated with PH by reversing fibrosis and upregulation of novel ECM enzymes ADAM15, ADAM17, and OPN. These effects are likely mediated through estrogen receptor-β. PMID:22628376

A novel dynamic mechanical testing technique for reverse shoulder replacements.

PubMed

Dabirrahmani, Danè; Bokor, Desmond; Appleyard, Richard

2014-04-01

In vitro mechanical testing of orthopedic implants provides information regarding their mechanical performance under simulated biomechanical conditions. Current in vitro component stability testing methods for reverse shoulder implants are based on anatomical shoulder designs, which do not capture the dynamic nature of these loads. With glenoid component loosening as one of the most prevalent modes of failure in reverse shoulder replacements, it is important to establish a testing protocol with a more realistic loading regime. This paper introduces a novel method of mechanically testing reverse shoulder implants, using more realistic load magnitudes and vectors, than is currently practiced. Using a custom made jig setup within an Instron mechanical testing system, it is possible to simulate the change in magnitude and direction of the joint load during arm abduction. This method is a step towards a more realistic testing protocol for measuring reverse shoulder implant stability.

Brittle Creep of Tournemire Shale: Orientation, Temperature and Pressure Dependences

NASA Astrophysics Data System (ADS)

Geng, Zhi; Bonnelye, Audrey; Dick, Pierre; David, Christian; Chen, Mian; Schubnel, Alexandre

2017-04-01

Time and temperature dependent rock deformation has both scientific and socio-economic implications for natural hazards, the oil and gas industry and nuclear waste disposal. During the past decades, most studies on brittle creep have focused on igneous rocks and porous sedimentary rocks. To our knowledge, only few studies have been carried out on the brittle creep behavior of shale. Here, we conducted a series of creep experiments on shale specimens coming from the French Institute for Nuclear Safety (IRSN) underground research laboratory located in Tournemire, France. Conventional tri-axial experiments were carried under two different temperatures (26˚ C, 75˚ C) and confining pressures (10 MPa, 80 MPa), for three orientations (σ1 along, perpendicular and 45˚ to bedding). Following the methodology developed by Heap et al. [2008], differential stress was first increased to ˜ 60% of the short term peak strength (10-7/s, Bonnelye et al. 2016), and then in steps of 5 to 10 MPa every 24 hours until brittle failure was achieved. In these long-term experiments (approximately 10 days), stress and strains were recorded continuously, while ultrasonic acoustic velocities were recorded every 1˜15 minutes, enabling us to monitor the evolution of elastic wave speed anisotropy. Temporal evolution of anisotropy was illustrated by inverting acoustic velocities to Thomsen parameters. Finally, samples were investigated post-mortem using scanning electron microscopy. Our results seem to contradict our traditional understanding of loading rate dependent brittle failure. Indeed, the brittle creep failure stress of our Tournemire shale samples was systematically observed ˜50% higher than its short-term peak strength, with larger final axial strain accumulated. At higher temperatures, the creep failure strength of our samples was slightly reduced and deformation was characterized with faster 'steady-state' creep axial strain rates at each steps, and larger final axial strain accumulated. At each creep step, ultrasonic wave velocities first decreased, and then increased gradually. The magnitude of elastic wave velocity variations showed an important orientation and temperature dependence. Velocities measured perpendicular to bedding showed increased variation, variation that was enhanced at higher temperature and higher pressure. The case of complete elastic anisotropy reversal was even observed for sample deformed perpendicular to bedding, with a reduction amount of axial strain needed to reach anisotropy reversal at higher temperature. Our data were indicative of competition between crack growth, sealing/healing, and possibly mineral rotation or anisotropic compaction during creep. SEM investigation confirmed evidence of time dependent pressure solution and crack sealing/healing. Our research not only has practical engineering consequence but, more importantly, can provide valuable insights into the underlying mechanisms of creep in complex media like shale. In particular, our study highlights that the short-term peak strength has little meaning in shale material, which can over-consolidate importantly by 'plastic' flow. In addition, we showed that elastic anisotropy can switch and even reverse over relatively short time periods (<10 days) and for relatively small amount of plastic deformation (<5%).

Thrust reverser design studies for an over-the-wing STOL transport

NASA Technical Reports Server (NTRS)

Ammer, R. C.; Sowers, H. D.

1977-01-01

Aerodynamic and acoustics analytical studies were conducted to evaluate three thrust reverser designs for potential use on commercial over-the-wing STOL transports. The concepts were: (1) integral D nozzle/target reverser, (2) integral D nozzle/top arc cascade reverser, and (3) post exit target reverser integral with wing. Aerodynamic flowpaths and kinematic arrangements for each concept were established to provide a 50% thrust reversal capability. Analytical aircraft stopping distance/noise trade studies conducted concurrently with flow path design showed that these high efficiency reverser concepts are employed at substantially reduced power settings to meet noise goals of 100 PNdB on a 152.4 m sideline and still meet 609.6 m landing runway length requirements. From an overall installation standpoint, only the integral D nozzle/target reverser concept was found to penalize nacelle cruise performance; for this concept a larger nacelle diameter was required to match engine cycle effective area demand in reverse thrust.

HIV-1 drug resistance genotyping from antiretroviral therapy (ART) naïve and first-line treatment failures in Djiboutian patients

PubMed Central

2012-01-01

Abstract In this study we report the prevalence of antiretroviral drug resistant HIV-1 genotypes of virus isolated from Djiboutian patients who failed first-line antiretroviral therapy (ART) and from ART naïve patients. Patients and methods A total of 35 blood samples from 16 patients who showed first-line ART failure (>1000 viral genome copies/ml) and 19 ART-naïve patients were collected in Djibouti from October 2009 to December 2009. Both the protease (PR) and reverse transcriptase (RT) genes were amplified and sequenced using National Agency for AIDS Research (ANRS) protocols. The Stanford HIV database algorithm was used for interpretation of resistance data and genotyping. Results Among the 16 patients with first-line ART failure, nine (56.2%) showed reverse transcriptase inhibitor-resistant HIV-1 strains: two (12.5%) were resistant to nucleoside (NRTI), one (6.25%) to non-nucleoside (NNRTI) reverse transcriptase inhibitors, and six (37.5%) to both. Analysis of the DNA sequencing data indicated that the most common mutations conferring drug resistance were M184V (38%) for NRTI and K103N (25%) for NNRTI. Only NRTI primary mutations K101Q, K103N and the PI minor mutation L10V were found in ART naïve individuals. No protease inhibitor resistant strains were detected. In our study, we found no detectable resistance in ∼ 44% of all patients who experienced therapeutic failure which was explained by low compliance, co-infection with tuberculosis and malnutrition. Genotyping revealed that 65.7% of samples were infected with subtype C, 20% with CRF02_AG, 8.5% with B, 2.9% with CRF02_AG/C and 2.9% with K/C. Conclusion The results of this first study about drug resistance mutations in first-line ART failures show the importance of performing drug resistance mutation test which guides the choice of a second-line regimen. This will improve the management of HIV-infected Djiboutian patients. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2051206212753973 PMID:23044036

HIV-1 drug resistance genotyping from antiretroviral therapy (ART) naïve and first-line treatment failures in Djiboutian patients.

PubMed

Elmi Abar, Aden; Jlizi, Asma; Darar, Houssein Youssouf; Kacem, Mohamed Ali Ben Hadj; Slim, Amine

2012-10-08

In this study we report the prevalence of antiretroviral drug resistant HIV-1 genotypes of virus isolated from Djiboutian patients who failed first-line antiretroviral therapy (ART) and from ART naïve patients. A total of 35 blood samples from 16 patients who showed first-line ART failure (>1000 viral genome copies/ml) and 19 ART-naïve patients were collected in Djibouti from October 2009 to December 2009. Both the protease (PR) and reverse transcriptase (RT) genes were amplified and sequenced using National Agency for AIDS Research (ANRS) protocols. The Stanford HIV database algorithm was used for interpretation of resistance data and genotyping. Among the 16 patients with first-line ART failure, nine (56.2%) showed reverse transcriptase inhibitor-resistant HIV-1 strains: two (12.5%) were resistant to nucleoside (NRTI), one (6.25%) to non-nucleoside (NNRTI) reverse transcriptase inhibitors, and six (37.5%) to both. Analysis of the DNA sequencing data indicated that the most common mutations conferring drug resistance were M184V (38%) for NRTI and K103N (25%) for NNRTI. Only NRTI primary mutations K101Q, K103N and the PI minor mutation L10V were found in ART naïve individuals. No protease inhibitor resistant strains were detected. In our study, we found no detectable resistance in ∼ 44% of all patients who experienced therapeutic failure which was explained by low compliance, co-infection with tuberculosis and malnutrition. Genotyping revealed that 65.7% of samples were infected with subtype C, 20% with CRF02_AG, 8.5% with B, 2.9% with CRF02_AG/C and 2.9% with K/C. The results of this first study about drug resistance mutations in first-line ART failures show the importance of performing drug resistance mutation test which guides the choice of a second-line regimen. This will improve the management of HIV-infected Djiboutian patients. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2051206212753973.

Effect of Thermal Shock During Legionella Bacteria Removal on the Corrosion Properties of Zinc-Coated Steel Pipes

NASA Astrophysics Data System (ADS)

Orlikowski, Juliusz; Ryl, Jacek; Jazdzewska, Agata; Krakowiak, Stefan

2016-07-01

The purpose of this investigation was to conduct the failure analysis of a water-supply system made from zinc-coated steel. The observed corrosion process had an intense and complex character. The brownish deposits and perforations were present after 2-3 years of exploitation. The electrochemical study based on the Tafel polarization, corrosion potential monitoring, and electrochemical impedance spectroscopy together with microscopic analysis via SEM and EDX were performed in order to identify the cause of such intense corrosion. The performed measurements allowed us to determine that thermal shock was the source of polarity-reversal phenomenon. This process had begun the corrosion of steel which later led to the formation of deposits and perforations in the pipes. The work includes appropriate action in order to efficiently identify the described corrosion threat.

The criterion for time symmetry of probabilistic theories and the reversibility of quantum mechanics

NASA Astrophysics Data System (ADS)

Holster, A. T.

2003-10-01

Physicists routinely claim that the fundamental laws of physics are 'time symmetric' or 'time reversal invariant' or 'reversible'. In particular, it is claimed that the theory of quantum mechanics is time symmetric. But it is shown in this paper that the orthodox analysis suffers from a fatal conceptual error, because the logical criterion for judging the time symmetry of probabilistic theories has been incorrectly formulated. The correct criterion requires symmetry between future-directed laws and past-directed laws. This criterion is formulated and proved in detail. The orthodox claim that quantum mechanics is reversible is re-evaluated. The property demonstrated in the orthodox analysis is shown to be quite distinct from time reversal invariance. The view of Satosi Watanabe that quantum mechanics is time asymmetric is verified, as well as his view that this feature does not merely show a de facto or 'contingent' asymmetry, as commonly supposed, but implies a genuine failure of time reversal invariance of the laws of quantum mechanics. The laws of quantum mechanics would be incompatible with a time-reversed version of our universe.

76 FR 72952 - Guidance for Industry on Nonclinical Evaluation of Late Radiation Toxicity of Therapeutic...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-28

... effects of therapeutic radiopharmaceutical agents. This guidance is not intended to address late radiation... and is often self-limiting and reversible. In contrast, late radiation toxicity (e.g., renal failure...

Next generation sequencing identifies abnormal Y chromosome and candidate causal variants in premature ovarian failure patients.

PubMed

Lee, Yujung; Kim, Changshin; Park, YoungJoon; Pyun, Jung-A; Kwack, KyuBum

2016-12-01

Premature ovarian failure (POF) is characterized by heterogeneous genetic causes such as chromosomal abnormalities and variants in causal genes. Recently, development of techniques made next generation sequencing (NGS) possible to detect genome wide variants including chromosomal abnormalities. Among 37 Korean POF patients, XY karyotype with distal part deletions of Y chromosome, Yp11.32-31 and Yp12 end part, was observed in two patients through NGS. Six deleterious variants in POF genes were also detected which might explain the pathogenesis of POF with abnormalities in the sex chromosomes. Additionally, the two POF patients had no mutation in SRY but three non-synonymous variants were detected in genes regarding sex reversal. These findings suggest candidate causes of POF and sex reversal and show the propriety of NGS to approach the heterogeneous pathogenesis of POF. Copyright © 2016 Elsevier Inc. All rights reserved.

Myocardial recovery during mechanical circulatory support: long-term outcome and elective ventricular assist device implantation to promote recovery as a treatment goal.

PubMed

Dandel, Michael; Hetzer, Roland

2015-01-01

Even after incomplete myocardial recovery during mechanical circulatory support, long-term survival rates after ventricular assist device (VAD) explantation can be better than those expected after heart transplantation even for patients with chronic non-ischemic cardiomyopathy as the underlying cause for VAD implantation. The elective therapeutic use of ventricular assist devices for heart failure reversal in its early stage is a future goal. It may be possible to achieve it by developing tools to predict heart failure reversibility even before ventricular assist device implantation and increasing the number of weaning candidates by improvement of adjunctive therapies to optimize unloading-promoted recovery.  Special attention is focused on the long-term stability of cardiac remission after VAD removal, the clinical relevance unloading-promoted myocardial recovery and on the current knowledge about a potential prediction of myocardial recovery during long-term VAD support already before VAD implantation.

[Comparative studies of the quality of the esophageal voice following laryngectomy: the insufflation test and reverse speech audiometry].

PubMed

Böhme, G; Clasen, B

1989-09-01

We carried out a transnasal insufflation test according to Blom and Singer on 27 laryngectomy patients as well as a speech communications test with the help of reverse speech audiometry, i.e. the post laryngectomy telephone test according to Zenner and Pfrang. The combined evaluation of both tests provided basic information on the quality of the esophagus voice and functionability of the speech organs. Both tests can be carried out quickly and easily and allow a differentiated statement to be made on the application possibilities of a esophagus voice, electronic speech aids and voice prothesis. Three groups could be identified from our results: 1. Insufflation test and reverse speech test provided conformable good or very good results. The esophagus voice was well understood. 2. Complete failure in the insufflation and telephone tests calls for further examinations to exclude any spasm, stricture, divertical and scarred membrane stenosis as well as tumor relapse in the region of the pharyngo-esophageal segments. 3. Organic causes must be looked for in the area of the nozzle as well as cranial nerve failure and social-determined causes in the case of normal insufflation and considerably reduced speech communication in the telephone test.

Design features and results from fatigue reliability research machines.

NASA Technical Reports Server (NTRS)

Lalli, V. R.; Kececioglu, D.; Mcconnell, J. B.

1971-01-01

The design, fabrication, development, operation, calibration and results from reversed bending combined with steady torque fatigue research machines are presented. Fifteen-centimeter long, notched, SAE 4340 steel specimens are subjected to various combinations of these stresses and cycled to failure. Failure occurs when the crack in the notch passes through the specimen automatically shutting down the test machine. These cycles-to-failure data are statistically analyzed to develop a probabilistic S-N diagram. These diagrams have many uses; a rotating component design example given in the literature shows that minimum size and weight for a specified number of cycles and reliability can be calculated using these diagrams.

Viral Suppression and HIV Drug Resistance at 6 Months Among Women in Malawi's Option B+ Program: Results From the PURE Malawi Study.

PubMed

Hosseinipour, Mina; Nelson, Julie A E; Trapence, Clement; Rutstein, Sarah E; Kasende, Florence; Kayoyo, Virginia; Kaunda-Khangamwa, Blessings; Compliment, Kara; Stanley, Christopher; Cataldo, Fabian; van Lettow, Monique; Rosenberg, Nora E; Tweya, Hannock; Gugsa, Salem; Sampathkumar, Veena; Schouten, Erik; Eliya, Michael; Chimbwandira, Frank; Chiwaula, Levison; Kapito-Tembo, Atupele; Phiri, Sam

2017-06-01

In 2011, Malawi launched Option B+, a program of universal antiretroviral therapy (ART) treatment for pregnant and lactating women to optimize maternal health and prevent pediatric HIV infection. For optimal outcomes, women need to achieve HIVRNA suppression. We report 6-month HIVRNA suppression and HIV drug resistance in the PURE study. PURE study was a cluster-randomized controlled trial evaluating 3 strategies for promoting uptake and retention; arm 1: Standard of Care, arm 2: Facility Peer Support, and arm 3: Community Peer support. Pregnant and breastfeeding mothers were enrolled and followed according to Malawi ART guidelines. Dried blood spots for HIVRNA testing were collected at 6 months. Samples with ART failure (HIVRNA ≥1000 copies/ml) had resistance testing. We calculated odds ratios for ART failure using generalized estimating equations with a logit link and binomial distribution. We enrolled 1269 women across 21 sites in Southern and Central Malawi. Most enrolled while pregnant (86%) and were WHO stage 1 (95%). At 6 months, 950/1269 (75%) were retained; 833/950 (88%) had HIVRNA testing conducted, and 699/833 (84%) were suppressed. Among those with HIVRNA ≥1000 copies/ml with successful amplification (N = 55, 41% of all viral loads > 1000 copies/ml), confirmed HIV resistance was found in 35% (19/55), primarily to the nonnucleoside reverse transcriptase inhibitor class of drugs. ART failure was associated with treatment default but not study arm, age, WHO stage, or breastfeeding status. Virologic suppression at 6 months was <90% target, but the observed confirmed resistance rates suggest that adherence support should be the primary approach for early failure in option B+.

Uraemic hyperparathyroidism causes a reversible inflammatory process of aortic valve calcification in rats

PubMed Central

Shuvy, Mony; Abedat, Suzan; Beeri, Ronen; Danenberg, Haim D.; Planer, David; Ben-Dov, Iddo Z.; Meir, Karen; Sosna, Jacob; Lotan, Chaim

2008-01-01

Aims Renal failure is associated with aortic valve calcification (AVC). Our aim was to develop an animal model for exploring the pathophysiology and reversibility of AVC, utilizing rats with diet-induced kidney disease. Methods and results Sprague–Dawley rats (n = 23) were fed a phosphate-enriched, uraemia-inducing diet for 7 weeks followed by a normal diet for 2 weeks (‘diet group’). These rats were compared with normal controls (n = 10) and with uraemic controls fed with phosphate-depleted diet (‘low-phosphate group’, n = 10). Clinical investigations included serum creatinine, phosphate and parathyroid hormone (PTH) levels, echocardiography, and multislice computed tomography. Pathological examinations of the valves included histological characterization, Von Kossa staining, and antigen and gene expression analyses. Eight diet group rats were further assessed for reversibility of valve calcification following normalization of their kidney function. At 4 weeks, all diet group rats developed renal failure and hyperparathyroidism. At week 9, renal failure resolved with improvement in the hyperparathyroid state. Echocardiography demonstrated valve calcifications only in diet group rats. Tomographic calcium scores were significantly higher in the diet group compared with controls. Von Kossa stain in diet group valves revealed calcium deposits, positive staining for osteopontin, and CD68. Gene expression analyses revealed overexpression of osteoblast genes and nuclear factor κB activation. Valve calcification resolved after diet cessation in parallel with normalization of PTH levels. Resolution was associated with down-regulation of inflammation and osteoblastic features. Low-phosphate group rats developed kidney dysfunction similar to that of the diet group but with normal levels of PTH. Calcium scores and histology showed only minimal valve calcification. Conclusion We developed an animal model for AVC. The process is related to disturbed mineral metabolism. It is associated with inflammation and osteoblastic features. Furthermore, the process is reversible upon normalization of the mineral homeostasis. Thus, our model constitutes a convenient platform for studying AVC and potential remedies. PMID:18390899

Uraemic hyperparathyroidism causes a reversible inflammatory process of aortic valve calcification in rats.

PubMed

Shuvy, Mony; Abedat, Suzan; Beeri, Ronen; Danenberg, Haim D; Planer, David; Ben-Dov, Iddo Z; Meir, Karen; Sosna, Jacob; Lotan, Chaim

2008-08-01

Renal failure is associated with aortic valve calcification (AVC). Our aim was to develop an animal model for exploring the pathophysiology and reversibility of AVC, utilizing rats with diet-induced kidney disease. Sprague-Dawley rats (n = 23) were fed a phosphate-enriched, uraemia-inducing diet for 7 weeks followed by a normal diet for 2 weeks ('diet group'). These rats were compared with normal controls (n = 10) and with uraemic controls fed with phosphate-depleted diet ('low-phosphate group', n = 10). Clinical investigations included serum creatinine, phosphate and parathyroid hormone (PTH) levels, echocardiography, and multislice computed tomography. Pathological examinations of the valves included histological characterization, Von Kossa staining, and antigen and gene expression analyses. Eight diet group rats were further assessed for reversibility of valve calcification following normalization of their kidney function. At 4 weeks, all diet group rats developed renal failure and hyperparathyroidism. At week 9, renal failure resolved with improvement in the hyperparathyroid state. Echocardiography demonstrated valve calcifications only in diet group rats. Tomographic calcium scores were significantly higher in the diet group compared with controls. Von Kossa stain in diet group valves revealed calcium deposits, positive staining for osteopontin, and CD68. Gene expression analyses revealed overexpression of osteoblast genes and nuclear factor kappaB activation. Valve calcification resolved after diet cessation in parallel with normalization of PTH levels. Resolution was associated with down-regulation of inflammation and osteoblastic features. Low-phosphate group rats developed kidney dysfunction similar to that of the diet group but with normal levels of PTH. Calcium scores and histology showed only minimal valve calcification. We developed an animal model for AVC. The process is related to disturbed mineral metabolism. It is associated with inflammation and osteoblastic features. Furthermore, the process is reversible upon normalization of the mineral homeostasis. Thus, our model constitutes a convenient platform for studying AVC and potential remedies.

A Prospective Study on Cardiovascular Dysfunction in Patients with Hyperthyroidism and Its Reversal After Surgical Cure.

PubMed

Muthukumar, Sankaran; Sadacharan, Dhalapathy; Ravikumar, Krishnan; Mohanapriya, Gajarajan; Hussain, Zahir; Suresh, R V

2016-03-01

Cardiovascular dysfunction (CVD) is a major cause of mortality and morbidity in hyperthyroidism. CVD and its reversibility after total thyroidectomy (TT) are not adequately addressed. This prospective case-control study evaluates the effect of hyperthyroidism on myocardium and its reversibility after TT. Surgical candidates of new onset hyperthyroidism, Group A (n = 41, age < 60 years) was evaluated with 2D Echocardiography, serum n-terminal probrain natriuretic peptide (NT-proBNP) at the time of diagnosis (Point A), after achieving euthyroidism (Point B) with antithyroid drugs, and 3 months after TT (Point C). 20 patients with nontoxic benign thyroid nodules undergoing TT served as controls (Group B). Both groups were age and sex matched. Group A (n = 41) comprises Graves disease (n = 22) and Toxic Multinodular goiter (n = 19). At point A, CVD was evident in 26/41(63.4%), pulmonary hypertension (PHT) in 24/41(58.5%)--mild in 17/41(41.4%) and moderate in 7/41(17%)--dilated cardiomyopathy (DCM) in 8/41(19.5%), heart failure in 4/41(9.7%), and NT-proBNP elevated in 28/41(68.3%). At point B, recovery was observed in PHT 19/26(73.1%), DCM 4/8(50%), heart failure 4/4(100%), NT-proBNP in 3/28(10.7%). At Point C, further improvement occurred in PHT 23/24(95.8%), DCM 7/8(87.5%), heart failure 4/4(100%), and NT-proBNP in 24/28(85.7%). Pulmonary hypertension is completely reversible at 3 months after TT and is the most common cardiac event in Hyperthyroidism. Various parameters of CVD improved consistently after surgical cure. NT-proBNP levels correlated well with the severity and duration of CVD and hence can be an objective tool in monitoring of hyperthyroid cardiac dysfunction.

Phenotype, Genotype, and Drug Resistance in Subtype C HIV-1 Infection.

PubMed

Derache, Anne; Wallis, Carole L; Vardhanabhuti, Saran; Bartlett, John; Kumarasamy, Nagalingeswaran; Katzenstein, David

2016-01-15

Virologic failure in subtype C is characterized by high resistance to first-line antiretroviral (ARV) drugs, including efavirenz, nevirapine, and lamivudine, with nucleoside resistance including type 2 thymidine analog mutations, K65R, a T69del, and M184V. However, genotypic algorithms predicting resistance are mainly based on subtype B viruses and may under- or overestimate drug resistance in non-B subtypes. To explore potential treatment strategies after first-line failure, we compared genotypic and phenotypic susceptibility of subtype C human immunodeficiency virus 1 (HIV-1) following first-line ARV failure. AIDS Clinical Trials Group 5230 evaluated patients failing an initial nonnucleoside reverse-transcriptase inhibitor (NNRTI) regimen in Africa and Asia, comparing the genotypic drug resistance and phenotypic profile from the PhenoSense (Monogram). Site-directed mutagenesis studies of K65R and T69del assessed the phenotypic impact of these mutations. Genotypic algorithms overestimated resistance to etravirine and rilpivirine, misclassifying 28% and 32%, respectively. Despite K65R with the T69del in 9 samples, tenofovir retained activity in >60%. Reversion of the K65R increased susceptibility to tenofovir and other nucleosides, while reversion of the T69del showed increased resistance to zidovudine, with little impact on other NRTI. Although genotype and phenotype were largely concordant for first-line drugs, estimates of genotypic resistance to etravirine and rilpivirine may misclassify subtype C isolates compared to phenotype. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Sepsis and acute respiratory distress syndrome requiring extracorporeal life support in an adolescent with mild cystic fibrosis.

PubMed

Faricy, Lauren Elizabeth; Church, Gwynne

2017-01-01

Outcomes for invasive mechanical ventilation and extracorporeal membrane oxygenation (ECMO) to treat acute respiratory failure in patients with mild cystic fibrosis (CF) lung disease are not known. We present a case of the successful use of ECMO to treat acute respiratory failure secondary to staphylococcal sepsis in an adolescent CF patient with previously normal lung function. Her post-ECMO course was notable for severe airflow obstruction, hypoxemia, deconditioning, and growth failure. She had significantly improved at six months follow-up, though she continued to have moderate airflow obstruction on pulmonary function testing. This case illustrates that ECMO and prolonged intubation can prolong life in CF patients with mild lung disease who present with potentially reversible acute respiratory failure, though they are associated with significant morbidity.

Distinguishing starvation from cachexia.

PubMed

Thomas, David R

2002-11-01

The poor response to hypercaloric feeding in ill adults may be caused by failure to distinguish cachexia from starvation (Table 1). The chief difference between starvation and cachexia is that refeeding reverses starvation but is less effective for cachexia. The ineffectiveness of refeeding in treating cachexia may explain some of the poor results from direct nutritional interventions in clinical trials. Simple starvation should respond to voluntary or involuntary hypercaloric feedings. The failure to demonstrate a more positive response may be caused by underlying cachexic states.

Fatigue criterion for the design of rotating shafts under combined stress

NASA Technical Reports Server (NTRS)

Loewenthal, S. H.

1977-01-01

A revised approach to the design of transmission shafting which considers the flexure fatigue characteristics of the shaft material under combined cyclic bending and static torsion stress is presented. A fatigue failure relation, corroborated by published combined stress test data, is presented which shows an elliptical variation of reversed bending endurance strength with static torsional stress. From this elliptical failure relations, a design formula for computing the diameter of rotating solid shafts under the most common condition of loading is developed.

Associations of Intimate Partner Violence with Unintended Pregnancy and Pre-Pregnancy Contraceptive Use in South Asia

PubMed Central

Raj, Anita; McDougal, Lotus

2015-01-01

Objective To assess associations of intimate partner violence (IPV) with pregnancy intendedness and pre-pregnancy contraceptive use among pregnant women in South Asia. Study Design Cross-sectional analyses were conducted using most recent Demographic and Health Surveys (DHS) from Bangladesh, India and Nepal for married, pregnant women aged 15–49 years who responded to IPV assessments specific to current marriage (N=4738). Adjusted logistic and multinomial regression analyses were conducted with pooled data to assess associations of IPV ever (sexual only, physical only, sexual plus physical, none) with the outcomes of pregnancy intendedness (wanted, mistimed or unwanted) and pre-pregnancy contraceptive use (no, traditional, or modern), for the current pregnancy. Results IPV was not associated with a mistimed or unwanted pregnancy. Sexual IPV was associated with pre-pregnancy modern contraceptive use (aOR=2.32, 95% CI=1.24, 4.36); sexual plus physical IPV was associated with pre-pregnancy traditional contraceptive use (aOR=1.85, 95% CI=1.12, 3.07). Post-hoc analysis of reasons for pre-pregnancy contraceptive discontinuation revealed that women with a history of IPV, particularly sexual IPV, had higher prevalence of contraceptive failure (sexual only: 37.3%, sexual plus physical: 30.9%, physical only: 22.6%, no IPV: 13.6%). Conclusion Pregnant women who experienced sexual IPV from husbands were more likely to use contraceptives pre-pregnancy but had no reduced risk unintended pregnancy, possibly due to higher rates of pre-pregnancy contraceptive failure among those with this history. These findings suggest that victims of sexual IPV are able to acquire and use family planning services, but require more support to sustain effective contraceptive use. Implications Family planning services are reaching women affected by sexual IPV, and programs should be sensitive to this concern and the heightened vulnerability to contraceptive failure these women face. Long-acting reversible contraception could be beneficial by allowing women to have greater reproductive control in situations of compromised sexual autonomy. PMID:25769441

Associations of intimate partner violence with unintended pregnancy and pre-pregnancy contraceptive use in South Asia.

PubMed

Raj, Anita; McDougal, Lotus

2015-06-01

To assess associations of intimate partner violence (IPV) with pregnancy intendedness and pre-pregnancy contraceptive use among pregnant women in South Asia. Cross-sectional analyses were conducted using the most recent Demographic and Health Surveys from Bangladesh, India and Nepal for married, pregnant women aged 15-49 years who responded to IPV assessments specific to current marriage (N=4738). Adjusted logistic and multinomial regression analyses were conducted with pooled data to assess associations of IPV ever (sexual only, physical only, sexual plus physical or none) with the outcomes of pregnancy intendedness (wanted, mistimed or unwanted) and pre-pregnancy contraceptive use (no, traditional or modern) for the current pregnancy. IPV was not associated with a mistimed or unwanted pregnancy. Sexual IPV was associated with pre-pregnancy modern contraceptive use (aOR=2.32, 95% CI=1.24, 4.36); sexual plus physical IPV was associated with pre-pregnancy traditional contraceptive use (aOR=1.85, 95% CI=1.12, 3.07). Post hoc analysis of reasons for pre-pregnancy contraceptive discontinuation revealed that women with a history of IPV, particularly sexual IPV, had higher prevalence of contraceptive failure (sexual only, 37.3%; sexual plus physical, 30.9%; physical only, 22.6%; no IPV, 13.6%). Pregnant women who experienced sexual IPV from husbands were more likely to use contraceptives pre-pregnancy but had no reduced risk unintended pregnancy, possibly due to higher rates of pre-pregnancy contraceptive failure among those with this history. These findings suggest that victims of sexual IPV are able to acquire and use family planning services but require more support to sustain effective contraceptive use. Family planning services are reaching women affected by sexual IPV, and programs should be sensitive to this concern and the heightened vulnerability to contraceptive failure these women face. Long-acting reversible contraception could be beneficial by allowing women to have greater reproductive control in situations of compromised sexual autonomy. Copyright © 2015 Elsevier Inc. All rights reserved.

Phrenic Nerve Conduction Study in the Early Stage of Guillain-Barre Syndrome as a Predictor of Respiratory Failure.

PubMed

Sen, Barun Kumar; Pandit, Alak

2018-01-01

Guillain-Barré syndrome (GBS) has unpredictable clinical course with severe complication of respiratory failure. To identify clinical profiles and electrophysiological study particularly non-invasive Phrenic nerve conduction study in patients of early GBS to predict respiratory failure. 64 adult (age≥18yrs) patients of early GBS (onset ≤ 14 days) during the study period from January 2014 to October 2015 were evaluated by clinical profiles of age, gender, antecedent infection, time to peak disability, single breath counts, cranial nerve involvement, autonomic dysfunction and non-invasive Phrenic nerve conduction study. Patients with predisposition factors of polyneuropathy like diabetes mellitus, hypothyroidism, vitamin deficiency, renal failure were excluded. Among 64 patients abnormal phrenic nerve conduction study was seen in 65.62% cases (42/64) and 45.23% (19/42) of them developed respiratory failure. Phrenic nerve sum latency, amplitude, duration and area were abnormal in those who developed respiratory failure and they had sum of phrenic nerve latency >28 msec, sum of CMAP amplitude <300 μV, sum of CMAP duration >50 msec and sum of area < 4 mVmS. None with normal phrenic nerve study developed respiratory failure. It was found that age, gender, preceding infection, autonomic involvement and types of GB syndrome had no influence on development of respiratory failure (p>0.05). Rapid disease progression to peak disability, more severe disease, shorter single breath counts and cranial nerve involvement were seen more often in patients with respiratory failure. Abnormal Phrenic nerve conduction study in the early Guillain-Barré syndrome might be of great value independently in predicting impending respiratory failure.

Phrenic Nerve Conduction Study in the Early Stage of Guillain–Barre Syndrome as a Predictor of Respiratory Failure

PubMed Central

Sen, Barun Kumar; Pandit, Alak

2018-01-01

Background: Guillain-Barré syndrome (GBS) has unpredictable clinical course with severe complication of respiratory failure. Objective: To identify clinical profiles and electrophysiological study particularly non-invasive Phrenic nerve conduction study in patients of early GBS to predict respiratory failure. Methods: 64 adult (age≥18yrs) patients of early GBS (onset ≤ 14 days) during the study period from January 2014 to October 2015 were evaluated by clinical profiles of age, gender, antecedent infection, time to peak disability, single breath counts, cranial nerve involvement, autonomic dysfunction and non-invasive Phrenic nerve conduction study. Patients with predisposition factors of polyneuropathy like diabetes mellitus, hypothyroidism, vitamin deficiency, renal failure were excluded. Results: Among 64 patients abnormal phrenic nerve conduction study was seen in 65.62% cases (42/64) and 45.23% (19/42) of them developed respiratory failure. Phrenic nerve sum latency, amplitude, duration and area were abnormal in those who developed respiratory failure and they had sum of phrenic nerve latency >28 msec, sum of CMAP amplitude <300 μV, sum of CMAP duration >50 msec and sum of area < 4 mVmS. None with normal phrenic nerve study developed respiratory failure. It was found that age, gender, preceding infection, autonomic involvement and types of GB syndrome had no influence on development of respiratory failure (p>0.05). Rapid disease progression to peak disability, more severe disease, shorter single breath counts and cranial nerve involvement were seen more often in patients with respiratory failure. Conclusion: Abnormal Phrenic nerve conduction study in the early Guillain-Barré syndrome might be of great value independently in predicting impending respiratory failure. PMID:29720799

POLICY CONUNDRUM: RESTORING WILD SALMON TO THE PACIFIC NORTHWEST

EPA Science Inventory

Restoring wild salmon runs to the Pacific Northwest is technically challenging, politically nasty, and socially divisive. Past restoration efforts have been largely unsuccessful. Society's failure to reverse the continuing decline of wild salmon has the characteristics of a pol...

END-DIASTOLIC FLOW REVERSAL LIMITS THE EFFICACY OF PEDIATRIC INTRAAORTIC BALLOON PUMP COUNTERPULSATION

PubMed Central

Bartoli, Carlo R.; Rogers, Benjamin D.; Ionan, Constantine E.; Koenig, Steven C.; Pantalos, George M.

2013-01-01

OBJECTIVE Counterpulsation with an intraaortic balloon pump (IABP) has not achieved the same successes or clinical use in pediatric patients as in adults. In a pediatric animal model, IABP efficacy was investigated to determine whether IABP timing with a high-fidelity blood pressure signal may improve counterpulsation therapy versus a low-fidelity signal. METHODS In Yorkshire piglets (n=19, 13.0±0.5 kg) with coronary ligation-induced acute ischemic left ventricular failure, pediatric IABPs (5 or 7cc) were placed in the descending thoracic aorta. Inflation and deflation were timed with traditional criteria from low-fidelity (fluid-filled) and high-fidelity (micromanometer) blood pressure signals during 1:1 support. Aortic, carotid, and coronary hemodynamics were measured with pressure and flow transducers. Myocardial oxygen consumption was calculated from coronary sinus and arterial blood samples. Left ventricular myocardial blood flow and end-organ blood flow were measured with microspheres. RESULTS Despite significant suprasystolic diastolic augmentation and afterload reduction at heart rates of 105±3bmp, left ventricular myocardial blood flow, myocardial oxygen consumption, the myocardial oxygen supply/demand relationship, cardiac output, and end-organ blood flow did not change. Statistically significant end-diastolic coronary, carotid, and aortic flow reversal occurred with IABP deflation. Inflation and deflation timed with a high-fidelity versus low-fidelity signal did not attenuate systemic flow reversal or improve the myocardial oxygen supply/demand relationship. CONCLUSIONS Systemic end-diastolic flow reversal limited counterpulsation efficacy in a pediatric model of acute left ventricular failure. Adjustment of IABP inflation and deflation timing with traditional criteria and a high-fidelity blood pressure waveform did not improve IABP efficacy or attenuate flow reversal. End-diastolic flow reversal may limit the efficacy of IABP counterpulsation therapy in pediatric patients with traditional timing criteria. Investigation of alternative deflation timing strategies is warranted. PMID:24139614

End-diastolic flow reversal limits the efficacy of pediatric intra-aortic balloon pump counterpulsation.

PubMed

Bartoli, Carlo R; Rogers, Benjamin D; Ionan, Constantine E; Pantalos, George M

2014-05-01

Counterpulsation with an intra-aortic balloon pump (IABP) has not achieved the same success or clinical use in pediatric patients as in adults. In a pediatric animal model, IABP efficacy was investigated to determine whether IABP timing with a high-fidelity blood pressure signal may improve counterpulsation therapy versus a low-fidelity signal. In Yorkshire piglets (n = 19; weight, 13.0 ± 0.5 kg) with coronary ligation-induced acute ischemic left ventricular failure, pediatric IABPs (5 or 7 mL) were placed in the descending thoracic aorta. Inflation and deflation were timed with traditional criteria from low-fidelity (fluid-filled) and high-fidelity (micromanometer) blood pressure signals during 1:1 support. Aortic, carotid, and coronary hemodynamics were measured with pressure and flow transducers. Myocardial oxygen consumption was calculated from coronary sinus and arterial blood samples. Left ventricular myocardial blood flow and end-organ blood flow were measured with microspheres. Despite significant suprasystolic diastolic augmentation and afterload reduction at heart rates of 105 ± 3 beats per minute, left ventricular myocardial blood flow, myocardial oxygen consumption, the myocardial oxygen supply/demand relationship, cardiac output, and end-organ blood flow did not change. Statistically significant end-diastolic coronary, carotid, and aortic flow reversal occurred with IABP deflation. Inflation and deflation timed with a high-fidelity versus low-fidelity signal did not attenuate systemic flow reversal or improve the myocardial oxygen supply/demand relationship. Systemic end-diastolic flow reversal limited counterpulsation efficacy in a pediatric model of acute left ventricular failure. Adjustment of IABP inflation and deflation timing with traditional criteria and a high-fidelity blood pressure waveform did not improve IABP efficacy or attenuate flow reversal. End-diastolic flow reversal may limit the efficacy of IABP counterpulsation therapy in pediatric patients with traditional timing criteria. Investigation of alternative deflation timing strategies is warranted. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

[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.

Combined bending-torsion fatigue reliability of AISI 4340 steel shafting with K sub t = 2.34. [stress concentration factor

NASA Technical Reports Server (NTRS)

Kececioglu, D.; Chester, L. B.; Dodge, T. M.

1974-01-01

Results generated by three, unique fatigue reliability research machines which can apply reversed bending loads combined with steady torque are presented. Six-inch long, AISI 4340 steel, grooved specimens with a stress concentration factor of 2.34 and R sub C 35/40 hardness were subjected to various combinations of these loads and cycled to failure. The generated cycles-to-failure and stress-to-failure data are statistically analyzed to develop distributional S-N and Goodman diagrams. Various failure theories are investigated to determine which one represents the data best. The effect of the groove and of the various combined bending-torsion loads on the S-N and Goodman diagrams are determined. Three design applications are presented. The third one illustrates the weight savings that may be achieved by designing for reliability.

WILD SALMON RESTORATION IN THE PACIFIC NORTHWEST: FORECASTING THE TWENTY-FIRST CENTURY

EPA Science Inventory

Restoring wild salmon runs to the Pacific Northwest is technically challenging, politically nasty, and socially divisive. Past restoration efforst have been largely unsuccessful. Society's failure to reverse the continuing decline of wild salmon has the characteristics of a pol...

Manifestations of Lyme carditis.

PubMed

Kostić, Tomislav; Momčilović, Stefan; Perišić, Zoran D; Apostolović, Svetlana R; Cvetković, Jovana; Jovanović, Andriana; Barać, Aleksandra; Šalinger-Martinović, Sonja; Tasić-Otašević, Suzana

2017-04-01

The first data of Lyme carditis, a relatively rare manifestation of Lyme disease, were published in eighties of the last century. Clinical manifestations include syncope, light-headedness, fainting, shortness of breath, palpitations, and/or chest pain. Atrioventricular (AV) electrical block of varying severity presents the most common conduction disorder in Lyme carditis. Although is usually mild, AV block can fluctuates rapidly and progress from a prolonged P-R interval to a His-Purkinje block within minutes to hours and days. Rarely, Lyme disease may be the cause of endocarditis, while some studies and reports, based on serological and/or molecular investigations, have suggested possible influence of Borrelia burgdorferi on degenerative cardiac valvular disease. Myocarditis, pericarditis, pancarditis, dilated cardiomyopathy, and heart failure have also been described as possible manifestations of Lyme carditis. The clinical course of Lyme carditis is generally mild, short term, and in most cases, completely reversible after adequate antibiotic treatment. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Verification of the Multi-Axial, Temperature and Time Dependent (MATT) Failure Criterion

NASA Technical Reports Server (NTRS)

Richardson, David E.; Macon, David J.

2005-01-01

An extensive test and analytical effort has been completed by the Space Shuttle's Reusable Solid Rocket Motor (KSKM) nozzle program to characterize the failure behavior of two epoxy adhesives (TIGA 321 and EA946). As part of this effort, a general failure model, the "Multi-Axial, Temperature, and Time Dependent" or MATT failure criterion was developed. In the initial development of this failure criterion, tests were conducted to provide validation of the theory under a wide range of test conditions. The purpose of this paper is to present additional verification of the MATT failure criterion, under new loading conditions for the adhesives TIGA 321 and EA946. In many cases, the loading conditions involve an extrapolation from the conditions under which the material models were originally developed. Testing was conducted using three loading conditions: multi-axial tension, torsional shear, and non-uniform tension in a bondline condition. Tests were conducted at constant and cyclic loading rates ranging over four orders of magnitude. Tests were conducted under environmental conditions of primary interest to the RSRM program. The temperature range was not extreme, but the loading ranges were extreme (varying by four orders of magnitude). It should be noted that the testing was conducted at temperatures below the glass transition temperature of the TIGA 321 adhesive. However for the EA946, the testing was conducted at temperatures that bracketed the glass transition temperature.

In vitro and in situ characterization of arthroscopic loop security and knot security of braided polyblend sutures: a biomechanical study.

PubMed

Armstrong, Lucas C; Chong, Alexander; Livermore, Ryan W; Prohaska, Daniel J; Doyon, Amanda N; Wooley, Paul H

2015-04-01

We conducted a study to evaluate biomechanical performance during destructive testing of several different suture materials in various arthroscopic knot configurations under both in vitro and in situ conditions. Surgeons of different levels of experience tied the knots. Three different arthroscopic knots (static surgeon's, Weston, Tennessee slider) with 3 reverse half-hitches on alternating posts were tested using Fiberwire, ForceFiber, Orthocord, and Ultrabraid suture materials under both in vitro and in situ (blood plasma at 37°C) conditions. Three surgeons of different experience levels tied the knots on a post 30 mm in circumference. A single load-to-failure test was performed. There were no significant in vitro-in situ differences for Ultrabraid in the different knot configurations or with the different experience levels. Surgeon B (intermediate experience) showed no significant differences between test conditions for any knot configuration or suture material. With Tennessee slider knots, surgeon C (least experience) showed significantly lower clinical failure load under both test conditions and had a higher percentage of complete knot slippage. Surgeon B had no knot slippage with use of Fiberwire. Both the aqueous environment and the surgeon's familiarity with certain knots have an effect on knot security.

Left Ventricular Architecture, Long-Term Reverse Remodeling, and Clinical Outcome in Mild Heart Failure With Cardiac Resynchronization: Results From the REVERSE Trial.

PubMed

St John Sutton, Martin; Linde, Cecilia; Gold, Michael R; Abraham, William T; Ghio, Stefano; Cerkvenik, Jeffrey; Daubert, Jean-Claude

2017-03-01

This study sought to determine the effects of abnormal left ventricular (LV) architecture on cardiac remodeling and clinical outcomes in mild heart failure (HF). Cardiac resynchronization therapy (CRT) is an established treatment for HF that improves survival in part by favorably remodeling LV architecture. LV shape is a dynamic component of LV architecture on which contractile function depends. Transthoracic 2-dimensional echocardiography was used to quantify changes in LV architecture over 5 years of follow-up of patients with mild HF from the REVERSE study. REVERSE was a prospective study of patients with large hearts (LV end-diastolic dimension ≥55 mm), LV ejection fraction <40%, and QRS duration >120 ms randomly assigned to CRT-ON (n = 419) and CRT-OFF (n = 191). CRT-OFF patients were excluded from this analysis. LV dimensions, volumes, mass index, and LV ejection fraction were calculated. LV architecture was assessed using the sphericity index, as follows: (LV end-diastolic volume)/(4/3 × π × r 3 ) × 100%. LV architecture improved over time and demonstrated significant associations between LV shape, age, sex, and echocardiography metrics. Changes in LV architecture were strongly correlated with changes in LV end-systolic volume index and LV end-diastolic volume index (both p < 0.0001). Sphericity index emerged as a predictor of death and HF hospitalization in spite of the low adverse event rate. A decrease in LV end-systolic volume index >15% occurred in more than two-thirds of patients, which indicates considerable reverse remodeling. We demonstrated that change in LV architecture in patients with mild HF with CRT is associated with structural and functional remodeling. Mean LV filling pressure was elevated, and the inability to lower it was an additional predictor of HF hospitalization or death. (Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction [REVERSE]; NCT00271154). Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Conditioned suppression of sexual behavior in stallions and reversal with diazepam.

PubMed

McDonnell, S M; Kenney, R M; Meckley, P E; Garcia, M C

1985-06-01

Sexual behavior dysfunction unaccompanied by detectable physical or endocrine abnormality is an important cause of reproductive failure among domestic stallions. Several authors have suggested that such dysfunction may be psychogenic, related to negative experience associated with intense handling and training. An experimental model of experience-related dysfunction was developed by exposing pony stallions to erection-contingent aversive conditioning. This resulted in rapid, specific suppression of sexual arousal and response similar to spontaneously occurring dysfunction. Subsequently, treatment with a CNS-active benzodiazepine derivative (diazepam) reversed these effects.

Posterior reversible encephalopathy syndrome in alcoholic hepatitis: Hepatic encephalopathy a common theme

PubMed Central

John, Elizabeth S; Sedhom, Ramy; Dalal, Ishita; Sharma, Ranita

2017-01-01

Posterior reversible encephalopathy syndrome (PRES) is a neuro-radiologic diagnosis that has become more widely recognized and reported over the past few decades. As such, there are a number of known risk factors that contribute to the development of this syndrome, including volatile blood pressures, renal failure, cytotoxic drugs, autoimmune disorders, pre-eclampsia, and eclampsia. This report documents the first reported case of PRES in a patient with severe alcoholic hepatitis with hepatic encephalopathy and delves into a molecular pathophysiology of the syndrome. PMID:28127211

Reversible catecholamine-induced cardiomyopathy due to pheochromocytoma: case report.

PubMed

Satendra, Milan; de Jesus, Cláudia; Bordalo e Sá, Armando L; Rosário, Luís; Rocha, José; Bicha Castelo, Henrique; Correia, Maria José; Nunes Diogo, António

2014-03-01

Pheochromocytoma is a tumor originating from chromaffin tissue. It commonly presents with symptoms and signs of catecholamine excess, such as hypertension, tachycardia, headache and sweating. Cardiovascular manifestations include catecholamine-induced cardiomyopathy, which may present as severe left ventricular dysfunction and congestive heart failure. We report a case of pheochromocytoma which was diagnosed following investigation of dilated cardiomyopathy. We highlight the dramatic symptomatic improvement and reversal of cardiomyopathy, with recovery of left ventricular function after treatment. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

Pupils' Error on the Concept of Reversibility in Solving Arithmetic Problems

ERIC Educational Resources Information Center

Maf'ulah, Syarifatul; Juniati, Dwi; Siswono, Tatag Yuli Eko

2016-01-01

The fact that there is no much study on reversibility is one of reason this study was conducted. Others, the importance of reversibility is also being researcher's motivation for focusing pupils' reversibility. On the other hand, the concern on pupils' reversibility is a major concern. The objective of this research is to identify errors done by…

Improved outcome in neonatal short bowel syndrome using parenteral fish oil in combination with ω-6/9 lipid emulsions.

PubMed

Angsten, Gertrud; Finkel, Yigael; Lucas, Steven; Kassa, Ann-Marie; Paulsson, Mattias; Lilja, Helene Engstrand

2012-09-01

Newborn infants with short bowel syndrome (SBS) represent a high-risk group of developing intestinal failure-associated liver disease (IFALD), which may be fatal. However, infants have a great capacity for intestinal growth and adaptation if IFALD can be prevented or reversed. A major contributing factor to IFALD may be the soybean oil-based intravenous lipid emulsions used since the introduction of parenteral nutrition (PN) 40 years ago. This retrospective study compares the outcome in 20 neonates with SBS treated with parenteral fish oil (Omegaven) in combination with ω-6/9 lipid emulsions (ClinOleic) with the outcome in a historical cohort of 18 patients with SBS who received a soybean oil-based intravenous lipid emulsion (Intralipid). Median gestational age was 26 weeks in the treatment group and 35.5 weeks in the historical group. All patients were started on PN containing Intralipid that was switched to ClinOleic/Omegaven in the treatment group at a median age of 39 gestational weeks. In the treatment group, direct bilirubin levels were reversed in all 14 survivors with cholestasis (direct bilirubin >50 umol/L). Median time to reversal was 2.9 months. Only 2 patients died of liver failure (10%). In the historical cohort, 6 patients (33%) died of liver failure, and only 2 patients showed normalization of bilirubin levels. Parenteral fish oil in combination with ω-6/9 lipid emulsions was associated with improved outcome in premature neonates with SBS. When used instead of traditional soybean-based emulsions, this mixed lipid emulsion may facilitate intestinal adaptation by increasing the IFALD-free period.

Impact of Iron Deficiency on Response to and Remodeling After Cardiac Resynchronization Therapy.

PubMed

Martens, Pieter; Verbrugge, Frederik; Nijst, Petra; Dupont, Matthias; Tang, W H Wilson; Mullens, Wilfried

2017-01-01

Iron deficiency is prevalent in heart failure with reduced ejection fraction and relates to symptomatic status, readmission, and all-cause mortality. The relation between iron status and response to cardiac resynchronization therapy (CRT) remains insufficiently elucidated. This study assesses the impact of iron deficiency on clinical response and reverse cardiac remodeling and outcome after CRT. Baseline characteristics, change in New York Heart Association functional class, reverse cardiac remodeling on echocardiography, and clinical outcome (i.e., all-cause mortality and heart failure readmissions) were retrospectively evaluated in consecutive CRT patients who had full iron status and complete blood count available at implantation, implanted at a single tertiary care center with identical dedicated multidisciplinary CRT follow-up from October 2008 to August 2015. A total of 541 patients were included with mean follow-up of 38 ± 22 months. Prevalence of iron deficiency was 56% at implantation. Patients with iron deficiency exhibited less symptomatic improvement 6 months after implantation (p value <0.001). In addition, both the decrease in left ventricular end-diastolic diameter (-3.1 vs -6.2 mm; p value = 0.011) and improvement in ejection fraction (+11% vs +15%, p value = 0.001) were significantly lower in patients with iron deficiency. Iron deficiency was significantly associated with an increased risk for heart failure admission or all-cause mortality (adjusted hazard ratio 1.718, 95% confidence interval 1.178 to 2.506), irrespectively of the presence of anemia (Hemoglobin <12 g/dl in women and <13 g/dl in men). In conclusion, iron deficiency is prevalent and affects both clinical response and reverse cardiac remodeling after CRT implantation. Moreover, it is a powerful predictor of adverse clinical outcomes in CRT. Copyright © 2016 Elsevier Inc. All rights reserved.

Effect of parathyroid hormone and uremic sera on the autoagglutination and sedimentation of human red blood cells.

PubMed

Earon, Y; Blum, M; Bogin, E

1983-12-30

Parathyroid hormone (PTH) caused a dramatic acceleration of erythrocyte sedimentation rate (ESR). This effect was calcium dependent and was partially reversed by verapamil. It was not mimicked by 5 mumol/l calcium ionophore A-23187. Following the removal of PTH from the cell suspension the ESR returned to normal. PTH also caused haemagglutination, the reaction was Ca2+ dependent, pH dependent and was partially reversed by verapamil. High levels of Ca2+ ionophore A-23187 mimicked this phenomenon. Magnesium ions even at concentrations of 5 mmol/l did not replace Ca2+, while Ca2+ at concentrations of 3 mmol/l and above caused haemagglutination. The glycolytic inhibitor NaF at levels of 1 mmol/l did not inhibit haemagglutination. The polyamines pertusin and spermidin, prostaglandins PGE2 and PGF, and the calcium hormone calcitonin, did not reproduce the PTH effect. Dialysate from serum of patients with chronic renal failure and hyperparathyroidism caused haemagglutination, while dialysate from patients with chronic renal failure following parathyroidectomy and normal individuals did not cause this phenomenon. It seems that abnormal erythrocyte behaviour seen in patients with chronic renal failure is caused by PTH which leads to modified Ca2+ metabolism in these cells.

Static Performance of a Wing-Mounted Thrust Reverser Concept

NASA Technical Reports Server (NTRS)

Asbury, Scott C.; Yetter, Jeffrey A.

1998-01-01

An experimental investigation was conducted in the Jet-Exit Test Facility at NASA Langley Research Center to study the static aerodynamic performance of a wing-mounted thrust reverser concept applicable to subsonic transport aircraft. This innovative engine powered thrust reverser system is designed to utilize wing-mounted flow deflectors to produce aircraft deceleration forces. Testing was conducted using a 7.9%-scale exhaust system model with a fan-to-core bypass ratio of approximately 9.0, a supercritical left-hand wing section attached via a pylon, and wing-mounted flow deflectors attached to the wing section. Geometric variations of key design parameters investigated for the wing-mounted thrust reverser concept included flow deflector angle and chord length, deflector edge fences, and the yaw mount angle of the deflector system (normal to the engine centerline or parallel to the wing trailing edge). All tests were conducted with no external flow and high pressure air was used to simulate core and fan engine exhaust flows. Test results indicate that the wing-mounted thrust reverser concept can achieve overall thrust reverser effectiveness levels competitive with (parallel mount), or better than (normal mount) a conventional cascade thrust reverser system. By removing the thrust reverser system from the nacelle, the wing-mounted concept offers the nacelle designer more options for improving nacelle aero dynamics and propulsion-airframe integration, simplifying nacelle structural designs, reducing nacelle weight, and improving engine maintenance access.

Study of Bulk and Elementary Screw Dislocation Assisted Reverse Breakdown in Low-Voltage (< 250 V) 4H-SiC p(sup +)n Junction Diodes--Part II: Dynamic Breakdown Properties. Part 2; Dynamic Breakdown Properties

NASA Technical Reports Server (NTRS)

Neudeck, Philip G.; Fazi, Christian

1999-01-01

This paper outlines the dynamic reverse-breakdown characteristics of low-voltage (<250 V) small-area <5 x 10(exp -4) sq cm 4H-SiC p(sup +)n diodes subjected to nonadiabatic breakdown-bias pulsewidths ranging from 0.1 to 20 microseconds. 4H-SiC diodes with and without elementary screw dislocations exhibited positive temperature coefficient of breakdown voltage and high junction failure power densities approximately five times larger than the average failure power density of reliable silicon pn rectifiers. This result indicates that highly reliable low-voltage SiC rectifiers may be attainable despite the presence of elementary screw dislocations. However, the impact of elementary screw dislocations on other more useful 4H-SiC power device structures, such as high-voltage (>1 kV) pn junction and Schottky rectifiers, and bipolar gain devices (thyristors, IGBT's, etc.) remains to be investigated.

[Temporary disappearance of EEG activity during reversible respiratory failure in rabbits and cats].

PubMed

Jurco, M; Tomori, Z; Tkácová, R; Calfa, J

1989-02-01

The dynamics of changes of EEG activity was studied on the model of reversible respiratory failure in rabbits and cats in pentobarbital anesthesia. During N2 inhalation, apnea of 60 second duration, and subsequent resuscitation the electrocorticogram in bifrontal and bioccipital connection was recorded. Evaluation of 19 episodes of apnea in 7 rabbits and of 25 episodes in 8 cats yielded the following results: 1. During hyperventilation induced by N2 inhalation a certain activation of the EEG was observed (spindles more pronounced, increased occurrence rate of discharges of the reticular activation system). 2. At the onset of apnea the EEG was still distinct, suggesting that primary apnea is presumably not caused by anoxia and the accompanying electric silence of the structures that control respiration. 3. Disappearance of EEG occurred within 50 seconds from the onset of apnea in rabbits and within 30 seconds in cats. 4. After repeated episodes of apnea lasting for 60 sec., artificial ventilation mostly resulted in normalization of EEG.

Modern methodology of designing target reliability into rotating mechanical components

NASA Technical Reports Server (NTRS)

Kececioglu, D. B.; Chester, L. B.

1973-01-01

Experimentally determined distributional cycles-to-failure versus maximum alternating nominal strength (S-N) diagrams, and distributional mean nominal strength versus maximum alternating nominal strength (Goodman) diagrams are presented. These distributional S-N and Goodman diagrams are for AISI 4340 steel, R sub c 35/40 hardness, round, cylindrical specimens 0.735 in. in diameter and 6 in. long with a circumferential groove 0.145 in. radius for a theoretical stress concentration = 1.42 and 0.034 in. radius for a stress concentration = 2.34. The specimens are subjected to reversed bending and steady torque in specially built, three complex-fatigue research machines. Based on these results, the effects on the distributional S-N and Goodman diagrams and on service life of superimposing steady torque on reversed bending are established, as well as the effect of various stress concentrations. In addition a computer program for determining the three-parameter Weibull distribution representing the cycles-to-failure data, and two methods for calculating the reliability of components subjected to cumulative fatigue loads are given.

Seismic Behaviour of Composite Steel Fibre Reinforced Concrete Shear Walls

NASA Astrophysics Data System (ADS)

Boita, Ioana-Emanuela; Dan, Daniel; Stoian, Valeriu

2017-10-01

In this paper is presented an experimental study conducted at the “Politehnica” University of Timisoara, Romania. This study provides results from a comprehensive experimental investigation on the behaviour of composite steel fibre reinforced concrete shear walls (CSFRCW) with partially or totally encased profiles. Two experimental composite steel fibre reinforced concrete walls (CSFRCW) and, as a reference specimen, a typical reinforced concrete shear wall (RCW), (without structural reinforcement), were fabricated and tested under constant vertical load and quasi-static reversed cyclic lateral loads, in displacement control. The tests were performed until failure. The tested specimens were designed as 1:3 scale steel-concrete composite elements, representing a three storeys and one bay element from the base of a lateral resisting system made by shear walls. Configuration/arrangement of steel profiles in cross section were varied within the specimens. The main objective of this research consisted in identifying innovative solutions for composite steel-concrete shear walls with enhanced performance, as steel fibre reinforced concrete which was used in order to replace traditional reinforced concrete. A first conclusion was that replacing traditional reinforcement with steel fibre changes the failure mode of the elements, as from a flexural mode, in case of element RCW, to a shear failure mode for CSFRCW. The maximum lateral force had almost similar values but test results indicated an improvement in cracking response, and a decrease in ductility. The addition of steel fibres in the concrete mixture can lead to an increase of the initial cracking force, and can change the sudden opening of a crack in a more stable process.

Congenital Portosystemic Shunts: Clinic Heterogeneity Requires an Individual Management of the Patient.

PubMed

Chocarro, Gloria; Amesty, María Virginia; Encinas, Jose Luis; Vilanova Sánchez, Alejandra; Hernandez, Francisco; Andres, Ane M; Gamez, Manolo; Tovar, Juan Antonio; Lopez Santamaria, Manuel

2016-02-01

Congenital portosystemic shunt (CPSS) is a rare entity without insufficiency in treatment issues. The aim of this article is to show our experience in the heterogeneity of this condition. A retrospective study of 25 CPSS in the period 1995 to 2014 was conducted. Description of the morphology, clinical impact, and treatment is given. According to the imaging techniques (IT), the shunt was apparently intrahepatic in 14 patients, extrahepatic in 10 patients, and mixed in 1 patient. In 14 children, IT showed hepatic portal circulation. In total shunts in which radiological examination was performed, invasive radiological techniques were able to demonstrate intrahepatic portal vein. In other patients, it was not investigated as they are asymptomatic. A child presented multiorgan failure with fulminant hepatic failure at birth. The shunt was radiologically closed and clinical impairment reversed rapidly. He is now asymptomatic with no longer images of CPSS in ultrasound scan controls. Also, seven children are asymptomatic at this time and are monitored periodically. Seven children had prenatal diagnosis, in five the shunt closed spontaneously. Nine children were symptomatic in their evolution (hyperammonemia, regenerative nodules, cholestasis, gastrointestinal bleeding). Of these, in five we performed balloon test occlusion, tolerated in all patients, followed by radiological closure. In our experience, the advancement of interventional radiology techniques avoided surgery to close the shunt. Morphologically, the CPSS is extremely heterogeneous, with multiple possible connections established. CPSS has multiple clinical presentations, from asymptomatic patients to acute liver failure. The therapeutic approach should be individualized and therefore held in overspecialized centers. Georg Thieme Verlag KG Stuttgart · New York.

Frequency of pacemaker malfunction associated with monopolar electrosurgery during pulse generator replacement or upgrade surgery.

PubMed

Lin, Yun; Melby, Daniel P; Krishnan, Balaji; Adabag, Selcuk; Tholakanahalli, Venkatakrishna; Li, Jian-Ming

2017-08-01

The aim of this study is to investigate the frequency of electrosurgery-related pacemaker malfunction. A retrospective study was conducted to investigate electrosurgery-related pacemaker malfunction in consecutive patients undergoing pulse generator (PG) replacement or upgrade from two large hospitals in Minneapolis, MN between January 2011 and January 2014. The occurrence of this pacemaker malfunction was then studied by using MAUDE database for all four major device vendors. A total of 1398 consecutive patients from 2 large tertiary referral centers in Minneapolis, MN undergoing PG replacement or upgrade surgery were retrospectively studied. Four patients (0.3% of all patients), all with pacemakers from St Jude Medical (2.8%, 4 of 142) had output failure or inappropriately low pacing rate below 30 bpm during electrosurgery, despite being programmed in an asynchronous mode. During the same period, 1174 cases of pacemaker malfunctions were reported on the same models in MAUDE database, 37 of which (3.2%) were electrosurgery-related. Twenty-four cases (65%) had output failure or inappropriate low pacing rate. The distribution of adverse events was loss of pacing (59.5%), reversion to backup pacing (32.4%), inappropriate low pacing rate (5.4%), and ventricular fibrillation (2.7%). The majority of these (78.5%) occurred during PG replacement at ERI or upgrade surgery. No electrosurgery-related malfunction was found in MAUDE database on 862 pacemaker malfunction cases during the same period from other vendors. Electrosurgery during PG replacement or upgrade surgery can trigger output failure or inappropriate low pacing rate in certain models of modern pacemakers. Cautions should be taken for pacemaker-dependent patients.

Failure Investigation of Radiant Platen Superheater Tube of Thermal Power Plant Boiler

NASA Astrophysics Data System (ADS)

Ghosh, D.; Ray, S.; Mandal, A.; Roy, H.

2015-04-01

This paper highlights a case study of typical premature failure of a radiant platen superheater tube of 210 MW thermal power plant boiler. Visual examination, dimensional measurement and chemical analysis, are conducted as part of the investigations. Apart from these, metallographic analysis and fractography are also conducted to ascertain the probable cause of failure. Finally it has been concluded that the premature failure of the super heater tube can be attributed to localized creep at high temperature. The corrective actions has also been suggested to avoid this type of failure in near future.

Failure and penetration response of borosilicate glass during short-rod impact

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

Anderson, C. E. Jr.; Orphal, D. L.; Behner, Th.

2007-12-12

The failure characterization of brittle materials like glass is of fundamental importance in describing the penetration resistance against projectiles. A critical question is whether this failure front remains 'steady' after the driving stress is removed. A test series with short gold rods (D = 1 mm, L/D{approx_equal}5-11) impacting borosilicate glass at {approx}1 to 2 km/s was carried out to investigate this question. The reverse ballistic method was used for the experiments, and the impact and penetration process was observed simultaneously with five flash X-rays and a 16-frame high-speed optical camera. Very high measurement accuracy was established to ensure reliable results.more » Results show that the failure front induced by rod impact and penetration does arrest (ceases to propagate) after the rod is totally eroded inside the glass. The impact of a second rod after a short time delay reinitiates the failure front at about the same speed.« less

The management of neonatal acute and chronic renal failure: A review.

PubMed

Coulthard, Malcolm G

2016-11-01

Most babies with chronic renal failure are identified antenatally, and over half that are treated with peritoneal dialysis receive kidney transplants before school age. Most infants that develop acute renal failure have hypotension following cardiac surgery, or multiple organ failure. Sometimes the falls in glomerular filtration and urine output are physiological and reversible, and sometimes due to kidney injury, but (illogically) it is now common to define them all as having 'acute kidney injury'. Contrary to widespread opinion, careful interpretation of the plasma creatinine concentrations can provide sensitive evidence of early acute renal failure. Conservative management frequently leads to under-nutrition or fluid overload. Acute peritoneal dialysis is often technically fraught in very small patients, and haemotherapies have been limited by vascular access and anticoagulation requirements, the need to blood-prime circuits, and serious limitations in regulating fluid removal. Newer devices, including the Nidus, have been specifically designed to reduce these difficulties. Crown Copyright © 2016. Published by Elsevier Ireland Ltd. All rights reserved.

Reliability analysis of the F-8 digital fly-by-wire system

NASA Technical Reports Server (NTRS)

Brock, L. D.; Goodman, H. A.

1981-01-01

The F-8 Digital Fly-by-Wire (DFBW) flight test program intended to provide the technology for advanced control systems, giving aircraft enhanced performance and operational capability is addressed. A detailed analysis of the experimental system was performed to estimated the probabilities of two significant safety critical events: (1) loss of primary flight control function, causing reversion to the analog bypass system; and (2) loss of the aircraft due to failure of the electronic flight control system. The analysis covers appraisal of risks due to random equipment failure, generic faults in design of the system or its software, and induced failure due to external events. A unique diagrammatic technique was developed which details the combinatorial reliability equations for the entire system, promotes understanding of system failure characteristics, and identifies the most likely failure modes. The technique provides a systematic method of applying basic probability equations and is augmented by a computer program written in a modular fashion that duplicates the structure of these equations.

Heart Failure with Preserved Ejection Fraction: Molecular Pathways of the Aging Myocardium

PubMed Central

Loffredo, Francesco S.; Nikolova, Andriana P.; Pancoast, James R.; Lee, Richard T.

2014-01-01

Age-related diastolic dysfunction is a major factor in the epidemic of heart failure. In patients hospitalized with heart failure, diastolic heart failure is now as common as systolic heart failure. We now have many successful treatments for HFrEF, while specific treatment options for HFpEF patients remain elusive. The lack of treatments for HFpEF reflects our very incomplete understanding of this constellation of diseases. There are many pathophysiological factors in HFpEF, but aging appears to play an important role. Here we propose that aging of the myocardium is itself a specific pathophysiological process. New insights into the aging heart, including hormonal controls and specific molecular pathways such as microRNAs, are pointing to myocardial aging as a potentially reversible process. While the overall process of aging remains mysterious, understanding the molecular pathways of myocardial aging has never been more important. Unraveling these pathways could lead to new therapies for the enormous and growing problem of HFpEF. PMID:24951760

Acute Right Ventricle Failure in the Intensive Care Unit: Assessment and Management.

PubMed

Hrymak, Carmen; Strumpher, Johann; Jacobsohn, Eric

2017-01-01

Caring for the critically ill patient with acute right ventricle (RV) failure is a diagnostic and management challenge. A thorough understanding of normal RV anatomy and physiology is essential to manage RV failure. Despite the fact that the RV is essentially a volume chamber that ejects into a low-pressure system, the left ventricle contributes significantly to RV function through maintenance of the transseptal gradient (TSG). Preserving systemic mean arterial pressure maintains the TSG and RV perfusion. Various pathological states cause acute RV failure by decreasing the TSG and RV perfusion and/or increasing pulmonary vascular resistance. Early diagnosis prevents rapid progression of RV failure due to the "double hit phenomenon," which is acute intra-abdominal multiple organ system failure as a result of a reduced blood pressure and elevated central venous pressure. Management includes hemodynamic support and reversal of the precipitating cause through optimizing RV rate and rhythm, determining ideal RV filling pressure, reducing RV afterload through nonpharmacologic and pharmacological means, and selecting the appropriate RV inotrope or mechanical support. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Forward- and reverse-bias tunneling effects in n/+/p silicon solar cells

NASA Technical Reports Server (NTRS)

Garlick, G. F. J.; Kachare, A. H.

1980-01-01

Excess currents due to field-assisted tunneling in both forward and reverse bias directions have been observed in n(+)-p silicon solar cells. These currents arise from the effect of conducting paths produced in the depletion layer by n(+) diffusion and cell processing. Forward-bias data indicate a small potential barrier with height of 0.04 eV at the n(+) end of conducting paths. Under reverse bias, excess tunneling currents involve a potential barrier at the p end of the conducting paths, the longer paths being associated with smaller barrier heights and dominating at the lower temperatures. Low-reverse-bias data give energy levels of 0.11 eV for lower temperatures (253-293 K) and 0.35 eV for higher temperatures (293-380 K). A model is suggested to explain the results.

β1-Adrenergic blocker bisoprolol reverses down-regulated ion channels in sinoatrial node of heart failure rats.

PubMed

Du, Yuan; Zhang, Junbo; Xi, Yutao; Wu, Geru; Han, Ke; Huang, Xin; Ma, Aiqun; Wang, Tingzhong

2016-06-01

Bisoprolol, an antagonist of β1-adrenergic receptors, is effective in reducing the morbidity and mortality in patients with heart failure (HF). It has been found that HF is accompanied with dysfunction of the sinoatrial node (SAN). However, whether bisoprolol reverses the decreased SAN function in HF and how the relevant ion channels in SAN change were relatively less studied. SAN function and messenger RNA (mRNA) expression of sodium channels and hyperpolarization-activated cyclic nucleotide-gated (HCN) channel subunits were assessed in sham-operated rats, abdominal arterio-venous shunt (volume overload)-induced HF rats, and bisoprolol- treated HF rats. SAN cells of rats were isolated by laser capture microdissection. Quantitative real-time PCR analysis was used to quantify mRNA expression of sodium channels and HCN channel subunits in SAN. Intrinsic heart rate declined and sinus node recovery time prolonged in HF rats, indicating the suppressed SAN function, which could be improved by bisoprolol treatment. Nav1.1, Nav1.6, and HCN4 mRNA expressions were reduced in SAN in HF rats compared with that in control rats. Treatment with bisoprolol could reverse both the SAN function and the Nav1.1, Nav1.6, and HCN4 mRNA expression partially. These data indicated that bisoprolol is effective in HF treatment partially due to improved SAN function by reversing the down-regulation of sodium channels (Nav1.1 and Nav1.6) and HCN channel (HCN4) subunits in SAN in failing hearts.

Revision shoulder arthroplasty from resurfacing to non-cemented short-stem reverse prosthesis.

PubMed

Natera, L; Bruguera, J; Atoun, E; Levy, O

2016-01-01

To assess the surgical parameters and the clinical and radiological outcomes of revisions of resurfacing shoulder arthroplasty to non-cemented short-stem reverse total shoulder arthroplasty. A total of 23 revisions from resurfacing shoulder arthroplasty to reverse total shoulder arthroplasty were performed. The mean age was 70.3±11.95 years. The patients included 82.6% (19/23) revised for cuff failure; 13.04% (3/23) cuff failure and aseptic loosening, and 4.35% (1/23) peri-prosthetic fracture. The need for humeral osteotomy or structural allograft, operation length, blood loss, blood transfusions and intraoperative fractures were recorded. Minimum follow-up 25 months. No humeral osteotomy or humeral structural allograft was required, and 2/23 (8.69%) required allograft for glenoid reconstruction. The mean operation time was 113.35±21.30minutes. Intra-operative blood loss was 374±245.09 mls. Blood transfusion was required in one case. Intra-operative fracture occurred in 1 case. The Constant score improved from 17.32 to 59.78 (age/sex adjusted, 84). Overall satisfaction improved from 1.37 to 8.04. The range of motion increased 79.57° in forward elevation; 72.88° in abduction; 38.06° in internal rotation; and 13.57° in external rotation. There was no evidence of radiolucency, subsidence, or bone resorption. Revisions of resurfacing implants to non-cemented short-stem reverse prosthesis show good clinical and radiological outcomes, with minimal intra-operative complexities. IV, case series. Copyright © 2016 SECOT. Published by Elsevier Espana. All rights reserved.

Effect of L-Carnitine Supplementation on Reverse Remodeling in Patients with Ischemic Heart Disease Undergoing Coronary Artery Bypass Grafting: A Randomized, Placebo-Controlled Trial.

PubMed

da Silva Guimarães, Sheila; de Souza Cruz, Wanise; da Silva, Licinio; Maciel, Gabrielle; Huguenin, Ana Beatriz; de Carvalho, Monicque; Costa, Bárbara; da Silva, Geisiane; da Costa, Carlos; D'Ippolito, João Alvaro; Colafranceschi, Alexandre; Scalco, Fernanda; Boaventura, Gilson

2017-01-01

During cardiac failure, cardiomyocytes have difficulty in using the substrates to produce energy. L-carnitine is a necessary nutrient for the transport of fatty acids that are required for generating energy. Coronary artery graft surgery reduces the plasma levels of L-carnitine and increases the oxidative stress. This study demonstrates the effect of L-carnitine supplementation on the reverse remodeling of patients undergoing coronary artery bypass graft. Patients with ischemic heart failure who underwent coronary graft surgery were randomized to group A - supplemented with L-carnitine or group B controls. Left ventricular ejection fraction, left ventricular systolic and diastolic diameters were assessed preoperatively, 60 and 180 days after surgery. Our study included 28 patients (26 [93.0%] males) with a mean age ± SD of 58.1 ± 10.5 years. The parameters for the evaluation of reverse remodeling did not improve after 60 and 180 days of coronary artery bypass grafting in comparison between groups (p > 0.05). Evaluation within the L-carnitine group showed a 37.1% increase in left ventricle ejection fraction (p = 0.002) and 14.3% (p = 0.006) and 3.3% (p > 0.05) reduction in systolic and diastolic diameters, respectively. L-carnitine supplementation at a dose of 50 mg/kg combined with artery bypass surgery did not demonstrate any additional benefit in reverse remodeling. However, evaluation within the L-carnitine group may indicate a clinical benefit of L-carnitine supplementation. © 2017 S. Karger AG, Basel.

Fulminant liver failure: clinical and experimental study.

PubMed Central

Slapak, M.

1975-01-01

Clinical experience of some newer methods of hepatic support is described. The results are unpredictable and far from satisfactory. The need for an animal model in which potential therapeutic methods can be studied is emphasized. Such a model based on carefully imposed ischaemic insult to the liver in the absence of portacaval shunting is described. It is suggested that bacterial presence in the bowel together with a depression of the liver reticuloendothelial function plays an important part in the early and rapid mortality of acute liver failure. Temporary auxiliary liver transplantation using an allograft or a closely related primate heterograft seem to be the 2 best available methods of hepatic support for potentially reversible acute liver failure. Images Fig. 8 PMID:812415

Chronic hypertension with subsequent congestive heart failure in a western lowland gorilla (Gorilla gorilla gorilla).

PubMed

Miller, C L; Schwartz, A M; Barnhart, J S; Bell, M D

1999-06-01

Chronic severe subclinical systemic hypertension was diagnosed in a 28-yr-old male western lowland gorilla (Gorilla gorilla gorilla). Thoracic radiography, electrocardiography, and echocardiography revealed an enlarged heart with a hypertrophied left ventricle, mitral regurgitation, and a persistent left bundle branch block. Enalapril, later combined with nifedipine, was of some value in reducing the hypertension, with partial reversal of cardiac enlargement and resolution of the bundle branch block. Two years after initiation of treatment, the gorilla developed lethargy and dyspnea. The diagnosis of heart failure was confirmed under anesthesia; the gorilla did not recover and was euthanized. Postmortem examination confirmed congestive heart failure with chronic, fibrosing cardiomyopathy similar to that in other gorillas.

40 CFR 141.211 - Special notice for repeated failure to conduct monitoring of the source water for Cryptosporidium...

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 23 2014-07-01 2014-07-01 false Special notice for repeated failure to conduct monitoring of the source water for Cryptosporidium and for failure to determine bin classification or mean Cryptosporidium level. 141.211 Section 141.211 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS ...

Heart failure gene therapy: closer to reality. Professor Walter Koch speaks to Christine Forder, commissioning editor.

PubMed

Koch, Walter J

2009-03-01

Professor Walter Koch is currently a Director at the Center for Translational Medicine and Vice Chairman for Research in the Department of Medicine at Jefferson Medical College, Thomas Jefferson University, PA, USA. Professor Koch started his career as a Research Associate at the Howard Hughes Medical Institute, Duke University Medical Center, Durham, NC, USA. His work is based around heart failure and the molecular mechanisms involved in the regulation of signaling through cardiovascular adrenergic receptors, the study of G-proteincoupled receptor function and signaling, and heart failure gene therapy. His current studies are investigating into the use of novel viral-mediated myocardial gene delivery for use in congestive heart failure, with an aim at developing reproducible surgical means of gene therapy. He is also involved in research to understand novel molecular signaling mechanisms responsible for reversible cardiac injury and potential repair.

System and method for floating-substrate passive voltage contrast

DOEpatents

Jenkins, Mark W [Albuquerque, NM; Cole, Jr., Edward I.; Tangyunyong, Paiboon [Albuquerque, NM; Soden, Jerry M [Placitas, NM; Walraven, Jeremy A [Albuquerque, NM; Pimentel, Alejandro A [Albuquerque, NM

2009-04-28

A passive voltage contrast (PVC) system and method are disclosed for analyzing ICs to locate defects and failure mechanisms. During analysis a device side of a semiconductor die containing the IC is maintained in an electrically-floating condition without any ground electrical connection while a charged particle beam is scanned over the device side. Secondary particle emission from the device side of the IC is detected to form an image of device features, including electrical vias connected to transistor gates or to other structures in the IC. A difference in image contrast allows the defects or failure mechanisms be pinpointed. Varying the scan rate can, in some instances, produce an image reversal to facilitate precisely locating the defects or failure mechanisms in the IC. The system and method are useful for failure analysis of ICs formed on substrates (e.g. bulk semiconductor substrates and SOI substrates) and other types of structures.

Neurocognitive Function at the First-Line Failure and on the Second-Line Antiretroviral Therapy in Africa: Analyses From the EARNEST Trial.

PubMed

Kambugu, Andrew; Thompson, Jennifer; Hakim, James; Tumukunde, Dinah; van Oosterhout, Joep J; Mwebaze, Raymond; Hoppe, Anne; Abach, James; Kwobah, Charles; Arenas-Pinto, Alejandro; Walker, Sarah A; Paton, Nicholas I

2016-04-15

To assess neurocognitive function at the first-line antiretroviral therapy failure and change on the second-line therapy. Randomized controlled trial was conducted in 5 sub-Saharan African countries. Patients failing the first-line therapy according to WHO criteria after >12 months on non-nucleoside reverse transcriptase inhibitors-based regimens were randomized to the second-line therapy (open-label) with lopinavir/ritonavir (400 mg/100 mg twice daily) plus either 2-3 clinician-selected nucleoside reverse transcriptase inhibitors, raltegravir, or as monotherapy after 12-week induction with raltegravir. Neurocognitive function was tested at baseline, weeks 48 and 96 using color trails tests 1 and 2, and the Grooved Pegboard test. Test results were converted to an average of the 3 individual test z-scores. A total of 1036 patients (90% of those >18 years enrolled at 13 evaluable sites) had valid baseline tests (58% women, median: 38 years, viral load: 65,000 copies per milliliter, CD4 count: 73 cells per cubic millimeter). Mean (SD) baseline z-score was -2.96 (1.74); lower baseline z-scores were independently associated with older age, lower body weight, higher viral load, lower hemoglobin, less education, fewer weekly working hours, previous central nervous system disease, and taking fluconazole (P < 0.05 in multivariable model). Z-score was increased by mean (SE) of +1.23 (0.04) after 96 weeks on the second-line therapy (P < 0.001; n = 915 evaluable), with no evidence of difference between the treatment arms (P = 0.35). Patients in sub-Saharan Africa failing the first-line therapy had low neurocognitive function test scores, but performance improved on the second-line therapy. Regimens with more central nervous system-penetrating drugs did not enhance neurocognitive recovery indicating this need not be a primary consideration in choosing a second-line regimen.

Feedback Blunting: Total Sleep Deprivation Impairs Decision Making that Requires Updating Based on Feedback.

PubMed

Whitney, Paul; Hinson, John M; Jackson, Melinda L; Van Dongen, Hans P A

2015-05-01

To better understand the sometimes catastrophic effects of sleep loss on naturalistic decision making, we investigated effects of sleep deprivation on decision making in a reversal learning paradigm requiring acquisition and updating of information based on outcome feedback. Subjects were randomized to a sleep deprivation or control condition, with performance testing at baseline, after 2 nights of total sleep deprivation (or rested control), and following 2 nights of recovery sleep. Subjects performed a decision task involving initial learning of go and no go response sets followed by unannounced reversal of contingencies, requiring use of outcome feedback for decisions. A working memory scanning task and psychomotor vigilance test were also administered. Six consecutive days and nights in a controlled laboratory environment with continuous behavioral monitoring. Twenty-six subjects (22-40 y of age; 10 women). Thirteen subjects were randomized to a 62-h total sleep deprivation condition; the others were controls. Unlike controls, sleep deprived subjects had difficulty with initial learning of go and no go stimuli sets and had profound impairment adapting to reversal. Skin conductance responses to outcome feedback were diminished, indicating blunted affective reactions to feedback accompanying sleep deprivation. Working memory scanning performance was not significantly affected by sleep deprivation. And although sleep deprived subjects showed expected attentional lapses, these could not account for impairments in reversal learning decision making. Sleep deprivation is particularly problematic for decision making involving uncertainty and unexpected change. Blunted reactions to feedback while sleep deprived underlie failures to adapt to uncertainty and changing contingencies. Thus, an error may register, but with diminished effect because of reduced affective valence of the feedback or because the feedback is not cognitively bound with the choice. This has important implications for understanding and managing sleep loss-induced cognitive impairment in emergency response, disaster management, military operations, and other dynamic real-world settings with uncertain outcomes and imperfect information. © 2015 Associated Professional Sleep Societies, LLC.

Gastrostomy placement improves height and weight gain in girls with Rett syndrome

USDA-ARS?s Scientific Manuscript database

Growth failure and undernutrition complicate the clinical course of girls with Rett syndrome (RTT). These abnormalities are, in part, the consequence of oral motor dysfunction and inadequate dietary intake. We hypothesized that gastrostomy placement for nutritional therapy reverses the decline in he...

SALMON RECOVERY: LEARNING FROM SUCCESSES AND FAILURES

EPA Science Inventory

Billions of dollars have been spent in a so-far failed attempt to reverse the long-term decline of wild Pacific salmon. Of the Earth's four regions (i.e., Asian Far East, Atlantic Europe, eastern North America, and western North America) where salmon runs occurred originally, it...

The peroxynitrite donor 3-morpholinosydnonimine induces reversible changes in electrophysiological properties of neurons of the guinea-pig spinal cord.

PubMed

Ashki, N; Hayes, K C; Bao, F

2008-09-22

Elevated concentrations of nitric oxide (NO) and peroxynitrite (ONOO(-)) are present within the CNS following neurotrauma and are implicated in the pathogenesis of the accompanying neurologic deficits. We tested the hypothesis that elevated extracellular concentrations of ONOO(-), introduced by the donor 3-morpholinosydnonimine (SIN-1), induce reversible axonal conduction deficits in neurons of the guinea-pig spinal cord. The compound action potential (CAP) and compound membrane potential (CMP) of excised ventral cord white matter were recorded before, during, and after, bathing the tissue (30 min) in varying concentrations (0.125-2.0 mM) of SIN-1 (3.75-60 microM ONOO(-)). The principal results were rapid onset, concentration-dependent, reductions in amplitude of the CAP (P<0.05). At a concentration of 0.25 mM of SIN-1 the reduction in CAP amplitude was fully reversible and was not accompanied by any changes in CMP. At higher concentrations of SIN-1 (> or =0.5 mM) the reversibility was incomplete and there was concurrent depolarization of the CMP. These electrophysiological changes were not evident when the donor had been a priori depleted of ONOO(-) by uric acid or was co-administered with the ONOO(-) scavenger ebselen (3 mM). Immuno-fluorescence staining for nitrotyrosine (Ntyr) revealed extensive nitration of tyrosine residues in neurons exposed to higher concentrations of SIN-1. These results are the first to demonstrate that ONOO(-) induces reversible conduction deficits within axons of the spinal cord. The dissociation of CAP and CMP changes at low concentrations of SIN-1, when the CAP changes were reversible and there was no evidence of nitration of tyrosine residues, is consistent with ONOO(-)-induced alteration in Na+ channel conductance in the axolemma. The results support the view that ONOO(-) contributes to both reversible and non-reversible neurologic deficits following neurotrauma. The reversal of immune-mediated conduction deficits may contribute to spontaneous neurologic deficits following neurotrauma.

Facile Fabrication of Electrically Conductive Low-Density Polyethylene/Carbon Fiber Tubes for Novel Smart Materials via Multiaxial Orientation.

PubMed

Li, Yijun; Nie, Min; Wang, Qi

2018-01-10

Electromechanical sensors are indispensable components in functional devices and robotics application. However, the fabrication of the sensors still maintains a challenging issue that high percolation threshold and easy failure of conductive network are derived from uniaxial orientation of conductive fillers in practical melt processing. Herein, we reported a facile fabrication method to prepare a multiaxial low-density polyethylene (LDPE)/carbon fibers (CFs) tube with bidirectional controllable electrical conductivity and sensitive strain-responsive performance via rotation extrusion technology. The multidimensional helical flow is confirmed in the reverse rotation extrusion, and the CFs readily respond to the flow field leading to a multiaxial orientation in the LDPE matrix. In contrast to uniaxial LDPE/CF composites, which perform a "head to head" conjunction, multiaxial-orientated CF networks exhibit a unique multilayer structure in which the CFs with distinct orientation direction intersect in the interface, endowing the LDPE/CF composites with a low percolation threshold (15 wt %) to those of the uniaxial ones (∼35 wt %). The angles between two axes play a vital role in determining the density of the conductive networks in the interface, which is predominant in tuning the bending-responsive behaviors with a gauge factor range from 12.5 to 56.3 and the corresponding linear respond region from ∼15 to ∼1%. Such a superior performance of conductive LDPE/CF tube confirms that the design of multiaxial orientation paves a novel way to facile fabrication of advanced cost-effective CF-based smart materials, shedding light on promising applications such as smart materials and intelligent engineering monitoring.

Risky Business: condom failures as experienced by female sex workers in Mombasa, Kenya.

PubMed

Bradburn, Caitlyn K; Wanje, George; Pfeiffer, James; Jaoko, Walter; Kurth, Ann E; McClelland, R Scott

2017-03-01

Limited research exists about condom failure as experienced by female sex workers. We conducted a qualitative study to examine how female sex workers in Mombasa, Kenya contextualise and explain the occurrence of condom failure. In-depth, semi-structured interviews were conducted with thirty female sex workers to ascertain their condom failure experiences. We qualitatively analysed interview transcripts to determine how the women mitigate risk and cope with condom failure. Condom failure was not uncommon, but women mitigated the risk by learning about correct use, and by supplying and applying condoms themselves. Many female sex workers felt that men intentionally rupture condoms. Few women were aware of or felt empowered to prevent HIV, STIs, and pregnancy after condom failure. Interventions to equip female sex workers with strategies for minimising the risk of HIV, STIs, and pregnancy in the aftermath of a condom failure should be investigated.

When Project Commitment Leads to Learning from Failure: The Roles of Perceived Shame and Personal Control

PubMed Central

Wang, Wenzhou; Wang, Bin; Yang, Ke; Yang, Chong; Yuan, Wenlong; Song, Shanghao

2018-01-01

Facing a remarkably changing world, researchers have gradually shifted emphasis from successful experiences to failures. In the current study, we build a model to explore the relationship between project commitment and learning from failure, and test how emotion (i.e., perceived shame after failure) and cognition (i.e., attribution for failure) affect this process. After randomly selecting 400 firms from the list of high-tech firms reported by the Beijing Municipal Science and Technology Commission, we use a two-wave investigation of the employees, and the final sample consists of 140 teams from 58 companies in the technology industry in mainland China. The results provide evidence for the positive role of personal control attribution in the relationship between project commitment and learning from failure. However, in contrast to previous studies, perceived shame, as the negative emotion after failed events, could bring desirable outcomes during this process. Based on the results, we further expand a model to explain the behavioral responses after failure, and the implications of our findings for research and practice are discussed. The failures and reverses which await men - and one after another sadden the brow of youth - add a dignity to the prospect of human life, which no Arcadian success would do. —Henry David Thoreau PMID:29467699

When Project Commitment Leads to Learning from Failure: The Roles of Perceived Shame and Personal Control.

PubMed

Wang, Wenzhou; Wang, Bin; Yang, Ke; Yang, Chong; Yuan, Wenlong; Song, Shanghao

2018-01-01

Facing a remarkably changing world, researchers have gradually shifted emphasis from successful experiences to failures. In the current study, we build a model to explore the relationship between project commitment and learning from failure, and test how emotion (i.e., perceived shame after failure) and cognition (i.e., attribution for failure) affect this process. After randomly selecting 400 firms from the list of high-tech firms reported by the Beijing Municipal Science and Technology Commission, we use a two-wave investigation of the employees, and the final sample consists of 140 teams from 58 companies in the technology industry in mainland China. The results provide evidence for the positive role of personal control attribution in the relationship between project commitment and learning from failure. However, in contrast to previous studies, perceived shame, as the negative emotion after failed events, could bring desirable outcomes during this process. Based on the results, we further expand a model to explain the behavioral responses after failure, and the implications of our findings for research and practice are discussed. The failures and reverses which await men - and one after another sadden the brow of youth - add a dignity to the prospect of human life, which no Arcadian success would do. -Henry David Thoreau.

Ephaptic coupling rescues conduction failure in weakly coupled cardiac tissue with voltage-gated gap junctions

NASA Astrophysics Data System (ADS)

Weinberg, S. H.

2017-09-01

Electrical conduction in cardiac tissue is usually considered to be primarily facilitated by gap junctions, providing a pathway between the intracellular spaces of neighboring cells. However, recent studies have highlighted the role of coupling via extracellular electric fields, also known as ephaptic coupling, particularly in the setting of reduced gap junction expression. Further, in the setting of reduced gap junctional coupling, voltage-dependent gating of gap junctions, an oft-neglected biophysical property in computational studies, produces a positive feedback that promotes conduction failure. We hypothesized that ephaptic coupling can break the positive feedback loop and rescue conduction failure in weakly coupled cardiac tissue. In a computational tissue model incorporating voltage-gated gap junctions and ephaptic coupling, we demonstrate that ephaptic coupling can rescue conduction failure in weakly coupled tissue. Further, ephaptic coupling increased conduction velocity in weakly coupled tissue, and importantly, reduced the minimum gap junctional coupling necessary for conduction, most prominently at fast pacing rates. Finally, we find that, although neglecting gap junction voltage-gating results in negligible differences in well coupled tissue, more significant differences occur in weakly coupled tissue, greatly underestimating the minimal gap junctional coupling that can maintain conduction. Our study suggests that ephaptic coupling plays a conduction-preserving role, particularly at rapid heart rates.

Tenofovir-related nephrotoxicity: case report and review of the literature.

PubMed

James, Christopher W; Steinhaus, Mary C; Szabo, Susan; Dressier, Robert M

2004-03-01

Tenofovir is a nucleotide reverse transcriptase inhibitor for treatment of human immunodeficiency virus (HIV) infection. Several cases of renal failure associated with tenofovir therapy recently have been reported. A 54-year-old man with HIV experienced decreasing renal function and Fanconi's syndrome secondary to tenofovir therapy. His condition gradually improved after discontinuation of the drug. The available medical literature for reported cases of tenofovir-related nephrotoxicity indicates that this complication is apparently rare. However, our case report and literature review underscore the importance of monitoring renal function when treating patients with any nucleotide reverse transcriptase inhibitor.

Modular microfluidic valve structures based on reversible thermoresponsive ionogel actuators.

PubMed

Benito-Lopez, Fernando; Antoñana-Díez, Marta; Curto, Vincenzo F; Diamond, Dermot; Castro-López, Vanessa

2014-09-21

This paper reports for the first time the use of a cross-linked poly(N-isopropylacrylamide) ionogel encapsulating the ionic liquid 1-ethyl-3-methylimidazolium ethyl sulphate as a thermoresponsive and modular microfluidic valve. The ionogel presents superior actuation behaviour to its equivalent hydrogel. Ionogel swelling and shrinking mechanisms and kinetics are investigated as well as the performance of the ionogel when integrated as a valve in a microfluidic device. The modular microfluidic valve demonstrates fully a reversible on-off behaviour without failure for up to eight actuation cycles and a pressure resistance of 1100 mbar.

An electrochemical study of a liquid crystal used in information displays

NASA Technical Reports Server (NTRS)

Oglesby, D. M.; Kern, J. B.; Robertson, J. B.

1974-01-01

The operational lifetime of liquid crystal displays were investigated. Electrochemical reaction at the electrodes of the display can cause failure after 2000 to 3000 hours of operation. Studies using cyclic voltametry of electrochemical reactions of N (p-methoxybenzilidene p-butylaniline (MBBA), a nematic liquid crystal were made. These studies indicate the presence of a reversible reduction of MBBA at the cathode, and that the reduction product undergoes a further reaction leading to products which are not reversibly oxidized. It is concluded that the degradation of the liquid crystal in displays can be reduced with a suitable frequency of alternating voltage.

Reversal of progressive necrotizing vasculitis with intravenous pulse cyclophosphamide and methylprednisolone.

PubMed

Fort, J G; Abruzzo, J L

1988-09-01

We describe a patient with polyarteritis nodosa who, despite therapy with daily doses of oral prednisone and cyclophosphamide, developed acute renal failure. Renal histopathologic examination demonstrated crescentic glomerulonephritis. Treatment with intravenous pulse cyclophosphamide and methylprednisolone resulted in clinical improvement and significant recovery of renal function.

Metaphor and the Rhetorical Invention of Cold War "Idealists."

ERIC Educational Resources Information Center

Ivie, Robert L.

1987-01-01

Presents a procedure for identifying metaphorical concepts guiding the rhetorical invention of three Cold War "idealists": Henry Wallace, J. William Fulbright, and Helen Caldicott, whose collective failure to dispel threatening images of the Soviets is located in a recurrent system of metaphors that promotes a reversal of the enemy-image…

How to Teach the Unteachable.

ERIC Educational Resources Information Center

Ciaccio, Joseph

1997-01-01

Describes a strategy of total positive response which aims to reverse the self-defeating cycle of punishment and failure in high-risk and troubled students. Details how to identify those students who are at risk, how to respond before misbehavior occurs, and the importance of finding something positive in all situations. (RJM)

Investigating premature pavement failure due to moisture : final report.

DOT National Transportation Integrated Search

2009-07-01

This report details the forensic investigations conducted to identify the causes of pavement failures shortly after a rehabilitation activity on five interstate highway projects in Oregon, and the research efforts conducted to develop guidelines to m...

Orbiter post-tire failure and skid testing results

NASA Technical Reports Server (NTRS)

Daugherty, Robert H.; Stubbs, Sandy M.

1989-01-01

An investigation was conducted at the NASA Langley Research Center's Aircraft Landing Dynamics Facility (ALDF) to define the post-tire failure drag characteristics of the Space Shuttle Orbiter main tire and wheel assembly. Skid tests on various materials were also conducted to define their friction and wear rate characteristics under higher speed and bearing pressures than any previous tests. The skid tests were conducted to support a feasibility study of adding a skid to the orbiter strut between the main tires to protect an intact tire from failure due to overload should one of the tires fail. Roll-on-rim tests were conducted to define the ability of a standard and a modified orbiter main wheel to roll without a tire. Results of the investigation are combined into a generic model of strut drag versus time under failure conditions for inclusion into rollout simulators used to train the shuttle astronauts.

Monitoring spatial and temporal variations of permeability in constructed wetlands by time-lapse geophysical methods

NASA Astrophysics Data System (ADS)

Tapias, J. C.; Himi, M.; Lovera, R.; Blasco, R.; Folch, M.; Casas, A.

2012-04-01

Constructed wetlands are widely used for removing pollutants from wastewater in small communities because their simplicity and low operation costs. Nevertheless, with time the cleaning process can result in gradual clogging of the porous layer by suspended solids, bacterial film, chemical precipitates and compactation. The clogging development causes decrease of hydraulic conductivity, reduced oxygen supply and further leads to a rapid decrease of the treatment performance. As the investment involved in reversing clogging can represent a substantial fraction of the cost of a new system it is essential to assess in advance the evolution of clogging process and detect potential failures in the system. Since there is a lack of experiences for monitoring the functionality of constructed wedlands a combination of non-destructive geophysical methods have been tested in this study. With this purpose electrical resistivity tomography, induced polarisation, frequency domain EM and ground probing radar have been conducted at different horizontal subsurface flow municipal wastewater treatment wetlands of Catalonia (Spain). The obtained results have shown that the applied geophysical techniques may delineate the clogging expansion and help take the preventive measures for enlarge the lifetime of the treatment system.

A biregional survey and review of first-line treatment failure and second-line paediatric antiretroviral access and use in Asia and southern Africa

PubMed Central

2011-01-01

Background To better understand the need for paediatric second-line antiretroviral therapy (ART), an ART management survey and a cross-sectional analysis of second-line ART use were conducted in the TREAT Asia Paediatric HIV Observational Database and the IeDEA Southern Africa (International Epidemiologic Databases to Evaluate AIDS) regional cohorts. Methods Surveys were conducted in April 2009. Analysis data from the Asia cohort were collected in March 2009 from 12 centres in Cambodia, India, Indonesia, Malaysia, and Thailand. Data from the IeDEA Southern Africa cohort were finalized in February 2008 from 10 centres in Malawi, Mozambique, South Africa and Zimbabwe. Results Survey responses reflected inter-regional variations in drug access and national guidelines. A total of 1301 children in the TREAT Asia and 4561 children in the IeDEA Southern Africa cohorts met inclusion criteria for the cross-sectional analysis. Ten percent of Asian and 3.3% of African children were on second-line ART at the time of data transfer. Median age (interquartile range) in months at second-line initiation was 120 (78-145) months in the Asian cohort and 66 (29-112) months in the southern African cohort. Regimens varied, and the then current World Health Organization-recommended nucleoside reverse transcriptase combination of abacavir and didanosine was used in less than 5% of children in each region. Conclusions In order to provide life-long ART for children, better use of current first-line regimens and broader access to heat-stable, paediatric second-line and salvage formulations are needed. There will be limited benefit to earlier diagnosis of treatment failure unless providers and patients have access to appropriate drugs for children to switch to. PMID:21306608

Unexpected edge conduction in mercury telluride quantum wells under broken time-reversal symmetry

DOE PAGES

Ma, Eric Yue; Calvo, M. Reyes; Wang, Jing; ...

2015-05-26

The realization of quantum spin Hall effect in HgTe quantum wells is considered a milestone in the discovery of topological insulators. Quantum spin Hall states are predicted to allow current flow at the edges of an insulating bulk, as demonstrated in various experiments. A key prediction yet to be experimentally verified is the breakdown of the edge conduction under broken time-reversal symmetry. Here we first establish a systematic framework for the magnetic field dependence of electrostatically gated quantum spin Hall devices. We then study edge conduction of an inverted quantum well device under broken time-reversal symmetry using microwave impedance microscopy,more » and compare our findings to a non-inverted device. At zero magnetic field, only the inverted device shows clear edge conduction in its local conductivity profile, consistent with theory. Surprisingly, the edge conduction persists up to 9 T with little change. Finally, this indicates physics beyond simple quantum spin Hall model, including material-specific properties and possibly many-body effects.« less

Effect of cardiac resynchronization therapy on beat-to-beat T-wave amplitude variability.

PubMed

Žižek, David; Cvijić, Marta; Tasič, Jerneja; Jan, Matevž; Frljak, Sabina; Zupan, Igor

2012-11-01

T-wave amplitude variability (TAV) is a promising non-invasive predictor of arrhythmic events in patients with dilated cardiomyopathy. We aimed to evaluate the effect of cardiac resynchronization therapy (CRT) on native TAV, its relation with left ventricular (LV) reverse remodelling and the occurrence of ventricular tachyarrhythmias (VTs). In this prospective study, we included 40 heart failure patients with left bundle branch block in sinus rhythm (25 male; 16 with ischaemic aetiology; aged 62.7 ± 9.5 years; New York Heart Association class II-IV). Echocardiographic parameters and TAV were evaluated at baseline and 6 months after implantation of CRT device combined with an implantable cardioverter-defibrillator. T-wave amplitude variability was determined by a 20-min high-resolution electrocardiogram Holter recording during native conduction. After TAV assessment, patients were monitored for 15.7 ± 5.2 months for the occurrence of VTs. Decrease in median TAV [from 40.45 μV (24.75-56.00) to 28.15 μV (20.93-37.95), P = 0.004] was observed after 6 months of CRT. However, decrease of median TAV was only noticed in patients with LV reverse remodelling [46.9 μV (27.5-70.0) to 25.8 μV (20.2-32.4), P < 0.001] and in patients without VTs [40.5 μV (27.5-55.9) to 24.4 μV (17.1-31.5), P < 0.001]. Native median TAV > 35.4 µV after 6 months of CRT had an 83% sensitivity and 93% specificity for predicting the occurrence of VTs. Decrease of TAV after CRT is associated with LV reverse remodelling and indicates a reduction of the intrinsic arrhythmogenic substrate. Median TAV after CRT had a good predicting value for VT occurrence in long-term follow-up.

Clinical Pharmacodynamics: Principles of Drug Response and Alterations in Kidney Disease.

PubMed

Keller, Frieder; Hann, Alexander

2018-05-16

Pharmacokinetics and pharmacodynamics follow the logic of cause and consequence. Receptor-mediated and reversible effects can be distinguished from direct and irreversible effects. Reversible effects are capacity-limited and saturable whereas irreversible effects are limited only by the number of viable targets. In the case of receptor-mediated and reversible effects a threshold and a ceiling concentration can be defined. Antimicrobial drugs with concentration-dependent action are distinguished from drugs with time-dependent action. Concentration-dependent effects are associated with a high ceiling concentration and the target is the high peak. Time-dependent effects are associated with a high threshold concentration and the target is the high trough. During kidney dysfunction, alterations of drug response are usually attributed to pharmacokinetic but rarely to pharmacodynamic changes. Dose adjustment calculations, therefore, tacitly presume that pharmacodynamic parameters remain unchanged while only pharmacokinetic parameters are altered in kidney failure. Kidney dysfunction influences the pharmacokinetic parameters of at least 50% of all essential drugs. Clinicians usually consider pharmacokinetics when kidney disease is found, but pharmacodynamics is as important. Alterations of pharmacodynamic parameters are conceivable but only rarely reported in kidney failure. Sometimes surprising dosing adjustments are needed when pharmacodynamic concepts are brought into the decision process of which dose to choose. Pharmacokinetics and pharmacodynamics should both be considered when any dosing regimen is determined. Copyright © 2018 by the American Society of Nephrology.

Regression of Pathological Cardiac Hypertrophy: Signaling Pathways and Therapeutic Targets

PubMed Central

Hou, Jianglong; Kang, Y. James

2012-01-01

Pathological cardiac hypertrophy is a key risk factor for heart failure. It is associated with increased interstitial fibrosis, cell death and cardiac dysfunction. The progression of pathological cardiac hypertrophy has long been considered as irreversible. However, recent clinical observations and experimental studies have produced evidence showing the reversal of pathological cardiac hypertrophy. Left ventricle assist devices used in heart failure patients for bridging to transplantation not only improve peripheral circulation but also often cause reverse remodeling of the geometry and recovery of the function of the heart. Dietary supplementation with physiologically relevant levels of copper can reverse pathological cardiac hypertrophy in mice. Angiogenesis is essential and vascular endothelial growth factor (VEGF) is a constitutive factor for the regression. The action of VEGF is mediated by VEGF receptor-1, whose activation is linked to cyclic GMP-dependent protein kinase-1 (PKG-1) signaling pathways, and inhibition of cyclic GMP degradation leads to regression of pathological cardiac hypertrophy. Most of these pathways are regulated by hypoxia-inducible factor. Potential therapeutic targets for promoting the regression include: promotion of angiogenesis, selective enhancement of VEGF receptor-1 signaling pathways, stimulation of PKG-1 pathways, and sustention of hypoxia-inducible factor transcriptional activity. More exciting insights into the regression of pathological cardiac hypertrophy are emerging. The time of translating the concept of regression of pathological cardiac hypertrophy to clinical practice is coming. PMID:22750195

Characterization of the High-Speed-Stage Bearing Skidding of Wind Turbine Gearboxes Induced by Dynamic Electricity Grid Events

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

Helsen, Jan; Guillaume, Patrick; Guo, Yi

Bearing behavior is an important factor for wind turbine drivetrain reliability. Extreme loads and dynamic excitations pose challenges to the bearing design and therefore its performance. Excessive skidding of the bearing rollers should be avoided because it can cause scuffing failures. Excitations coming from wind and the electricity grid can subject the drivetrain to fluctuating torque and nontorque loads. Wind-induced excitations have been investigated predominantly in literature. However, modern wind turbines are subjected more and more to grid-induced loads because of stricter electricity grid regulations. For example, during fault-ride-through events, turbines are required to stay connected for a longer periodmore » of time during the grid failure. This work investigates the influence of electrically induced excitations on the skidding behaviour of the tapered roller bearings on the high-speed stage of a wind turbine gearbox. This skidding behaviour during dynamic events is described as a potential bearing failure initiator by many researchers; however, only limited full-scale dynamic testing is documented. Therefore, a dedicated gridloss-type event is defined in the paper and conducted in a dynamometer test on a full-scale wind turbine nacelle. During the event, a complete electricity grid failure is simulated while the turbine is at rated speed and predefined torque levels. Particular focus is on the characterization of the high-speed shaft tapered roller bearing slip behavior. Strain-gauge bridges in grooves along the circumference of the outer ring are used to characterize the bearing load zone in detail. It is shown that during the torque reversals of the transient event, roller slip can be induced. This indicates the potential of the applied load case to go beyond the preload of the tapered roller bearing. Furthermore, the relation between the applied torque and skidding level is studied.« less

Characterization of the High-Speed-Stage Bearing Skidding of Wind Turbine Gearboxes Induced by Dynamic Electricity Grid Events: Preprint

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

Helsen, Jan; Guillaume, Patrick; Guo, Yi

Bearing behavior is an important factor for wind turbine drivetrain reliability. Extreme loads and dynamic excitations pose challenges to the bearing design and therefore its performance. Excessive skidding of the bearing rollers should be avoided because it can cause scuffing failures. Excitations coming from wind and the electricity grid can subject the drivetrain to fluctuating torque and nontorque loads. Wind-induced excitations have been investigated predominantly in literature. However, modern wind turbines are subjected more and more to grid-induced loads because of stricter electricity grid regulations. For example, during fault-ride-through events, turbines are required to stay connected for a longer periodmore » of time during the grid failure. This work investigates the influence of electrically induced excitations on the skidding behaviour of the tapered roller bearings on the high-speed stage of a wind turbine gearbox. This skidding behaviour during dynamic events is described as a potential bearing failure initiator by many researchers; however, only limited full-scale dynamic testing is documented. Therefore, a dedicated gridloss-type event is defined in the paper and conducted in a dynamometer test on a full-scale wind turbine nacelle. During the event, a complete electricity grid failure is simulated while the turbine is at rated speed and predefined torque levels. Particular focus is on the characterization of the high-speed shaft tapered roller bearing slip behavior. Strain-gauge bridges in grooves along the circumference of the outer ring are used to characterize the bearing load zone in detail. It is shown that during the torque reversals of the transient event, roller slip can be induced. This indicates the potential of the applied load case to go beyond the preload of the tapered roller bearing. Furthermore, the relation between the applied torque and skidding level is studied.« less

Structural testing for static failure, flutter and other scary things

NASA Technical Reports Server (NTRS)

Ricketts, R. H.

1983-01-01

Ground test and flight test methods are described that may be used to highlight potential structural problems that occur on aircraft. Primary interest is focused on light-weight general aviation airplanes. The structural problems described include static strength failure, aileron reversal, static divergence, and flutter. An example of each of the problems is discussed to illustrate how the data acquired during the tests may be used to predict the occurrence of the structural problem. While some rules of thumb for the prediction of structural problems are given the report is not intended to be used explicitly as a structural analysis handbook.

Delayed recovery of right ventricular systolic function after repair of long-standing tricuspid regurgitation associated with severe right ventricular failure.

PubMed

Kim, Jong Hun; Kim, Kyung Hwa; Choi, Jong Bum; Kuh, Ja Hong

2016-03-01

After tricuspid valve surgery for long-standing tricuspid regurgitation associated with right ventricular failure, reverse remodelling of the enlarged right ventricle, including recovery of right ventricular systolic function, is unpredictable. We present the case of a 31-year old man with early reduction of dilated right ventricular dimensions and delayed recovery of impaired right ventricular systolic function after valve repair for traumatic tricuspid regurgitation lasting 16 years. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Advantages, Disadvantages, and Trend of Integrative Medicine in the Treatment of Heart Failure.

PubMed

Zhang, PeiYing

2015-06-01

Integrative medicine therapy using traditional Chinese medicine (TCM) combined with western medicine has shown some advantages in treating heart failure (HF), such as holistic concept; multi-target treatment; dialectical logic; personalized therapy; formulae compatibility; and reduction of side effects of western medicine. However, problems still exist in TCM treatment of HF, including non-uniformed categorization of TCM, lack of standardized syndrome differentiation and lack of an evidence base. The future of treatment of HF seems to be focused on reversing ventricular remodeling, improving cardiac rehabilitation, and accelerating experimental research and drug discovery in TCM.

High-Temperature Graphitization Failure of Primary Superheater Tube

NASA Astrophysics Data System (ADS)

Ghosh, D.; Ray, S.; Roy, H.; Mandal, N.; Shukla, A. K.

2015-12-01

Failure of boiler tubes is the main cause of unit outages of the plant, which further affects the reliability, availability and safety of the unit. So failure analysis of boiler tubes is absolutely essential to predict the root cause of the failure and the steps are taken for future remedial action to prevent the failure in near future. This paper investigates the probable cause/causes of failure of the primary superheater tube in a thermal power plant boiler. Visual inspection, dimensional measurement, chemical analysis, metallographic examination and hardness measurement are conducted as the part of the investigative studies. Apart from these tests, mechanical testing and fractographic analysis are also conducted as supplements. Finally, it is concluded that the superheater tube is failed due to graphitization for prolonged exposure of the tube at higher temperature.

Frequency-dependent failure mechanisms of nanocrystalline gold interconnect lines under general alternating current

NASA Astrophysics Data System (ADS)

Luo, X. M.; Zhang, B.; Zhang, G. P.

2014-09-01

Thermal fatigue failure of metallization interconnect lines subjected to alternating currents (AC) is becoming a severe threat to the long-term reliability of micro/nanodevices with increasing electrical current density/power. Here, thermal fatigue failure behaviors and damage mechanisms of nanocrystalline Au interconnect lines on the silicon glass substrate have been investigated by applying general alternating currents (the pure alternating current coupled with a direct current (DC) component) with different frequencies ranging from 0.05 Hz to 5 kHz. We observed both thermal fatigue damages caused by Joule heating-induced cyclic strain/stress and electromigration (EM) damages caused by the DC component. Besides, the damage formation showed a strong electrically-thermally-mechanically coupled effect and frequency dependence. At lower frequencies, thermal fatigue damages were dominant and the main damage forms were grain coarsening with grain boundary (GB) cracking/voiding and grain thinning. At higher frequencies, EM damages took over and the main damage forms were GB cracking/voiding of smaller grains and hillocks. Furthermore, the healing effect of the reversing current was considered to elucidate damage mechanisms of the nanocrystalline Au lines generated by the general AC. Lastly, a modified model was proposed to predict the lifetime of the nanocrystalline metal interconnect lines, i.e., that was a competing drift velocity-based approach based on the threshold time required for reverse diffusion/healing to occur.

Rocuronium-induced neuromuscular block and sugammadex in pediatric patient with duchenne muscular dystrophy

PubMed Central

Kim, Ji Eun; Chun, Hea Rim

2017-01-01

Abstract Introduction: Anesthetic management of patients with Duchenne muscular dystrophy (DMD) is complicated because these patients are more sensitive to nondepolarizing neuromuscular blocking agents (NMBAs) and are vulnerable to postoperative complications, such as postoperative residual curarization and respiratory failure. Sugammadex is a new reversal agent for aminosteroidal NMBAs, but its safety in children is controversial. Clinical features: An 11-year-old boy with DMD underwent general anesthesia for a percutaneous nephrolithotomy. We used rocuronium bromide and sugammadex to reverse the deep neuromuscular block. Reversal of neuromuscular block was done 15 minutes after administration of 2 mg/kg of sugammadex. The patient's recovery from anesthesia was uneventful, and he was discharged to the postoperative recovery ward. Conclusion: A delayed recovery was achieved, but no adverse events were observed, such as recurarization or hypersensitivity to sugammadex. We report safe use of 2 mg/kg of sugammadex to reverse a deep neuromuscular block in a child with DMD. PMID:28353578

Rocuronium-induced neuromuscular block and sugammadex in pediatric patient with duchenne muscular dystrophy: A case Report.

PubMed

Kim, Ji Eun; Chun, Hea Rim

2017-03-01

Anesthetic management of patients with Duchenne muscular dystrophy (DMD) is complicated because these patients are more sensitive to nondepolarizing neuromuscular blocking agents (NMBAs) and are vulnerable to postoperative complications, such as postoperative residual curarization and respiratory failure. Sugammadex is a new reversal agent for aminosteroidal NMBAs, but its safety in children is controversial. An 11-year-old boy with DMD underwent general anesthesia for a percutaneous nephrolithotomy. We used rocuronium bromide and sugammadex to reverse the deep neuromuscular block. Reversal of neuromuscular block was done 15 minutes after administration of 2 mg/kg of sugammadex. The patient's recovery from anesthesia was uneventful, and he was discharged to the postoperative recovery ward. A delayed recovery was achieved, but no adverse events were observed, such as recurarization or hypersensitivity to sugammadex. We report safe use of 2 mg/kg of sugammadex to reverse a deep neuromuscular block in a child with DMD.

On the impact of water activity on reversal tolerant fuel cell anode performance and durability

NASA Astrophysics Data System (ADS)

Hong, Bo Ki; Mandal, Pratiti; Oh, Jong-Gil; Litster, Shawn

2016-10-01

Durability of polymer electrolyte fuel cells in automotive applications can be severely affected by hydrogen starvation arising due to transients during the drive-cycle. It causes individual cell voltage reversal, yielding water electrolysis and carbon corrosion reactions at the anode, ultimately leading to catastrophic cell failure. A popular material-based mitigation strategy is to employ a reversal tolerant anode (RTA) that includes oxygen evolution reaction (OER) catalyst (e.g., IrO2) to promote water electrolysis over carbon corrosion. Here we report that RTA performance surprisingly drops under not only water-deficient but also water-excess conditions. This presents a significant technical challenge since the most common triggers for cell reversal involve excess liquid water. Our findings from detailed electrochemical diagnostics and nano-scale X-ray computed tomography provide insight into how automotive fuel cells can overcome critical vulnerabilities using material-based solutions. Our work also highlights the need for improved materials, electrode designs, and operation strategies for robust RTAs.

Ply-level failure analysis of a graphite/epoxy laminate under bearing-bypass loading

NASA Technical Reports Server (NTRS)

Naik, R. A.; Crews, J. H., Jr.

1988-01-01

A combined experimental and analytical study was conducted to investigate and predict the failure modes of a graphite/epoxy laminate subjected to combined bearing and bypass loading. Tests were conducted in a test machine that allowed the bearing-bypass load ratio to be controlled while a single-fastener coupon was loaded to failure in either tension or compression. Onset and ultimate failure modes and strengths were determined for each test case. The damage-onset modes were studied in detail by sectioning and micrographing the damaged specimens. A two-dimensional, finite-element analysis was conducted to determine lamina strains around the bolt hole. Damage onset consisted of matrix cracks, delamination, and fiber failures. Stiffness loss appeared to be caused by fiber failures rather than by matrix cracking and delamination. An unusual offset-compression mode was observed for compressive bearing-bypass laoding in which the specimen failed across its width along a line offset from the hole. The computed lamina strains in the fiber direction were used in a combined analytical and experimental approach to predict bearing-bypass diagrams for damage onset from a few simple tests.

Ply-level failure analysis of a graphite/epoxy laminate under bearing-bypass loading

NASA Technical Reports Server (NTRS)

Naik, R. A.; Crews, J. H., Jr.

1990-01-01

A combined experimental and analytical study was conducted to investigate and predict the failure modes of a graphite/epoxy laminate subjected to combined bearing and bypass loading. Tests were conducted in a test machine that allowed the bearing-bypass load ratio to be controlled while a single-fastener coupon was loaded to failure in either tension or compression. Onset and ultimate failure modes and strengths were determined for each test case. The damage-onset modes were studied in detail by sectioning and micrographing the damaged specimens. A two-dimensional, finite-element analysis was conducted to determine lamina strains around the bolt hole. Damage onset consisted of matrix cracks, delamination, and fiber failures. Stiffness loss appeared to be caused by fiber failures rather than by matrix cracking and delamination. An unusual offset-compression mode was observed for compressive bearing-bypass loading in which the specimen failed across its width along a line offset from the hole. The computed lamina strains in the fiber direction were used in a combined analytical and experimental approach to predict bearing-bypass diagrams for damage onset from a few simple tests.

41 CFR 102-118.410 - Can GSA suspend my agency's prepayment audit program?

Code of Federal Regulations, 2011 CFR

2011-01-01

... conduct a quality assurance review. (b) A systematic or a multitude of individual failures will result in... on his or her determination of a systematic or frequent failure of the program to: (1) Conduct an...

Evaluation of critical nuclear power plant electrical cable response to severe thermal fire conditions

NASA Astrophysics Data System (ADS)

Taylor, Gabriel James

The failure of electrical cables exposed to severe thermal fire conditions are a safety concern for operating commercial nuclear power plants (NPPs). The Nuclear Regulatory Commission (NRC) has promoted the use of risk-informed and performance-based methods for fire protection which resulted in a need to develop realistic methods to quantify the risk of fire to NPP safety. Recent electrical cable testing has been conducted to provide empirical data on the failure modes and likelihood of fire-induced damage. This thesis evaluated numerous aspects of the data. Circuit characteristics affecting fire-induced electrical cable failure modes have been evaluated. In addition, thermal failure temperatures corresponding to cable functional failures have been evaluated to develop realistic single point thermal failure thresholds and probability distributions for specific cable insulation types. Finally, the data was used to evaluate the prediction capabilities of a one-dimension conductive heat transfer model used to predict cable failure.

Post-transcriptional regulation of α-1-antichymotrypsin by microRNA-137 in chronic heart failure and mechanical support.

PubMed

Lok, Sjoukje I; van Mil, Alain; Bovenschen, Niels; van der Weide, Petra; van Kuik, Joyce; van Wichen, Dick; Peeters, Ton; Siera, Erica; Winkens, Bjorn; Sluijter, Joost P G; Doevendans, Pieter A; da Costa Martins, Paula A; de Jonge, Nicolaas; de Weger, Roel A

2013-07-01

Better understanding of the molecular mechanisms of remodeling has become a major objective of heart failure (HF) research to stop or reverse its progression. Left ventricular assist devices (LVADs) are being used in patients with HF, leading to partial reverse remodeling. In the present study, proteomics identified significant changes in α-1-antichymotrypsin (ACT) levels during LVAD support. Moreover, the potential role of ACT in reverse remodeling was studied in detail. Expression of ACT mRNA (quantitative-polymerase chain reaction) decreased significantly in post-LVAD myocardial tissue compared with pre-LVAD tissue (n=15; P<0.01). Immunohistochemistry revealed that ACT expression and localization changed during LVAD support. Circulating ACT levels were elevated in HF patients (n=18) as compared with healthy controls (n=6; P=0.001) and normalized by 6 months of LVAD support. Because increasing evidence implicates that microRNAs (miRs) are involved in myocardial disease processes, we also investigated whether ACT is post-transcriptionally regulated by miRs. Bioinformatics analysis pointed miR-137 as a potential regulator of ACT. The miR-137 expression is inversely correlated with ACT mRNA in myocardial tissue. Luciferase activity assays confirmed ACT as a direct target for miR-137, and in situ hybridization indicated that ACT and miR-137 were mainly localized in cardiomyocytes and stromal cells. High ACT plasma levels in HF normalized during LVAD support, which coincides with decreased ACT mRNA in heart tissue, whereas miR-137 levels increased. MiR-137 directly targeted ACT, thereby indicating that ACT and miR-137 play a role in the pathophysiology of HF and reverse remodeling during mechanical support.

Hippo pathway deficiency reverses systolic heart failure after infarction.

PubMed

Leach, John P; Heallen, Todd; Zhang, Min; Rahmani, Mahdis; Morikawa, Yuka; Hill, Matthew C; Segura, Ana; Willerson, James T; Martin, James F

2017-10-12

Mammalian organs vary widely in regenerative capacity. Poorly regenerative organs, such as the heart are particularly vulnerable to organ failure. Once established, heart failure commonly results in mortality. The Hippo pathway, a kinase cascade that prevents adult cardiomyocyte proliferation and regeneration, is upregulated in human heart failure. Here we show that deletion of the Hippo pathway component Salvador (Salv) in mouse hearts with established ischaemic heart failure after myocardial infarction induces a reparative genetic program with increased scar border vascularity, reduced fibrosis, and recovery of pumping function compared with controls. Using translating ribosomal affinity purification, we isolate cardiomyocyte-specific translating messenger RNA. Hippo-deficient cardiomyocytes have increased expression of proliferative genes and stress response genes, such as the mitochondrial quality control gene, Park2. Genetic studies indicate that Park2 is essential for heart repair, suggesting a requirement for mitochondrial quality control in regenerating myocardium. Gene therapy with a virus encoding Salv short hairpin RNA improves heart function when delivered at the time of infarct or after ischaemic heart failure following myocardial infarction was established. Our findings indicate that the failing heart has a previously unrecognized reparative capacity involving more than cardiomyocyte renewal.

Defining space around conducting polymers: reversible protonic doping of a canopied polypyrrole.

PubMed

Lee, Dongwhan; Swager, Timothy M

2003-06-11

A canopy-shaped pyrrole derivative 2 was prepared, in which a sterically demanding pendant group is juxtaposed to the pyrrole fragment to minimize interstrand pi-pi stacking interactions in the resulting polymer. Anodic polymerization of 2 afforded highly conductive poly(2), the electronic structure of which was probed by various spectroelectrochemical techniques. A limited charge delocalization within poly(2) translates into a well-defined conductivity profile, properties important for resistivity-based sensing. Notably, the bulk conductivity was precisely modulated by a rapid and reversible deprotonation and reprotonation of the polymer backbone.

Cetamolol: a new cardioselective beta-adrenoceptor blocking agent without membrane-stabilizing activity.

PubMed

Beaulieu, G; Jaramillo, J; Cummings, J R

1984-03-01

Cetamolol, a new beta-adrenoceptor blocker with partial agonist activity and cardioselectivity, was studied in vivo to determine its membrane-stabilizing effects. Comparisons were carried out with atenolol, pindolol, practolol, propranolol, timolol, dexpropranolol, lidocaine, and procaine. The following results indicated that cetamolol lacked membrane-stabilizing activity: (i) failure to cause local anesthesia on the rabbit cornea and motor nerve of the rat tail; (ii) ineffectiveness in reversing ventricular arrhythmias induced by coronary artery litigation in dogs; (iii) failure to reduce cardiac automaticity in catecholamine-depleted dogs as determined by the rate of a subatrial rhythm during ventricular (vagal) escape; and (iv) lack of a significant increase in atrioventricular conduction time in vagotomized or atropinized dogs in contrast to the effect in normal dogs indicating a reflex effect of cetamolol. Other results include a restoration of sinus rhythm in dogs with ventricular tachycardia induced by ouabain, and a dose-related decline in the force of cardiac contraction in anesthetized dogs at doses from 3 to 15 mg/kg, which occurred after an initial increase in force owing to intrinsic sympathomimetic activity. Although the mechanisms for the latter two effects are not clear at this time, explanations other than membrane-stabilizing activity have been considered in view of the other findings. It is concluded that cetamolol lacks membrane-stabilizing activity even at inordinately high doses.

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

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

Design of the heart failure endpoint evaluation of AII-antagonist losartan (HEAAL) study in patients intolerant to ACE-inhibitor.

PubMed

Konstam, Marvin A; Poole-Wilson, Philip A; Dickstein, Kenneth; Drexler, Helmut; Justice, Steven J; Komajda, Michel; Malbecq, William; Martinez, Felipe A; Neaton, James D; Riegger, Gunter A J; Guptha, Soneil

2008-09-01

In patients with heart failure and reduced left ventricular ejection fraction, angiotensin receptor blockers have been found to reduce mortality and morbidity and to prevent or reverse left ventricular remodelling, compared to optimized background treatment. In light of these data, The Heart failure Endpoint evaluation of Angiotensin II Antagonist Losartan (HEAAL) study was developed to determine whether losartan 150 mg is superior to losartan 50 mg (antihypertensive dose) in reducing morbidity and mortality among patients with symptomatic heart failure who are intolerant of angiotensin-converting enzyme (ACE)-inhibitors. To compare the effect of high and moderate doses of losartan on the primary endpoint of all-cause mortality and hospitalisation due to heart failure in patients (n = 3834) with symptomatic heart failure and an ejection fraction < or = 40% who are intolerant of ACE-inhibitor treatment. This paper presents the rationale, trial design, and baseline characteristics of the study population. The study, which completed recruitment on 31 March 2005, is event-driven and is estimated to accrue the target of 1710 adjudicated primary events during the latter half of 2008. The results of HEAAL should facilitate selection of an optimal dosing regimen for losartan in patients with symptomatic heart failure who are intolerant of ACE-inhibitors.

High-Field Fast-Risetime Pulse Failures in 4H- and 6H-SiC pn Junction Diodes

NASA Technical Reports Server (NTRS)

Neudeck, Philip G.; Fazi, Christian

1996-01-01

We report the observation of anomalous reverse breakdown behavior in moderately doped (2-3 x 10(exp 17 cm(exp -3)) small-area micropipe-free 4H- and 6H-SiC pn junction diodes. When measured with a curve tracer, the diodes consistently exhibited very low reverse leakage currents and sharp repeatable breakdown knees in the range of 140-150 V. However, when subjected to single-shot reverse bias pulses (200 ns pulsewidth, 1 ns risetime), the diodes failed catastrophically at pulse voltages of less than 100 V. We propose a possible mechanism for this anomalous reduction in pulsed breakdown voltage relative to dc breakdown voltage. This instability must be removed so that SiC high-field devices can operate with the same high reliability as silicon power devices.

The Role of Finance Reform in Comprehensive Service Initiatives.

ERIC Educational Resources Information Center

Cutler, Ira M.

The well-being of a large portion of American children is distressingly low. Integrated service delivery--which provides the broadest range of education, health, housing, and social services--is viewed as one way to remedy the failure of public and private institutions to deliver effective services that can ameliorate or reverse these problems and…

The Effect of Attributional Style Change on Self-Esteem and Depression.

ERIC Educational Resources Information Center

Layden, Mary Anne

Low self-esteem and depressed individuals tend to have an attributional style of externalizing success and internalizing failure. To evaluate a program developed to help reverse this pattern of responses to be more similar to high self-esteem and nondepressed individuals, subjects were first tested for self-esteem, depression, and attributional…

China-U.S. Trade Issues

DTIC Science & Technology

2008-10-07

practices. In response, it filed a number of trade dispute resolution cases against China in the WTO, including China’s failure to protect IPR and...in China. In addition, the Administration reversed a long-standing policy that countervailing cases (dealing with government subsidies) could not be...13 WTO Implementation Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 U.S. WTO Cases Against China

Clinical and radiological outcomes after reverse shoulder arthroplasty in patients with failed deltoid or latissimus dorsi transfers. A review of ten cases.

PubMed

Valenti, Philippe; Maqdes, Ali; Werthel, Jean-David

2017-10-01

The purpose of this study was to report clinical and radiological results of reverse shoulder arthroplasty (RSA) after failure of either a deltoid and/or a latissimus dorsi transfer. Between 2001 and 2011, ten patients (average age, 61 years) underwent primary RSA after a failed tendon transfer for irreparable postero-superior rotator cuff tear (five deltoid muscle transfers, four latissimus dorsi transfers and one both). Average follow-up was 48 months. Outcome measures included pain, range of motion and postoperative Constant-Murley score. Pain score improved significantly from a mean 8.3 to a mean 0.3. Mean shoulder elevation improved from 66 to 134°, and absolute Constant-Murley scores increased from 25.8 to 62.8 The mean improvement in external rotation was limited to 7.5°. Subjectively, six patients rated the result as much better and three rated it as better than before surgery. Failure of the tendon transfer with deterioration of the functional outcomes can be salvaged with a RSA with no impact on the expected outcome.

Conduction block of mammalian myelinated nerve by local cooling to 15–30°C after a brief heating

PubMed Central

Zhang, Zhaocun; Lyon, Timothy D.; Kadow, Brian T.; Shen, Bing; Wang, Jicheng; Lee, Andy; Kang, Audry; Roppolo, James R.; de Groat, William C.

2016-01-01

This study aimed at understanding thermal effects on nerve conduction and developing new methods to produce a reversible thermal block of axonal conduction in mammalian myelinated nerves. In 13 cats under α-chloralose anesthesia, conduction block of pudendal nerves (n = 20) by cooling (5–30°C) or heating (42–54°C) a small segment (9 mm) of the nerve was monitored by the urethral striated muscle contractions and increases in intraurethral pressure induced by intermittent (5 s on and 20 s off) electrical stimulation (50 Hz, 0.2 ms) of the nerve. Cold block was observed at 5–15°C while heat block occurred at 50–54°C. A complete cold block up to 10 min was fully reversible, but a complete heat block was only reversible when the heating duration was less than 1.3 ± 0.1 min. A brief (<1 min) reversible complete heat block at 50–54°C or 15 min of nonblock mild heating at 46–48°C significantly increased the cold block temperature to 15–30°C. The effect of heating on cold block fully reversed within ∼40 min. This study discovered a novel method to block mammalian myelinated nerves at 15–30°C, providing the possibility to develop an implantable device to block axonal conduction and treat many chronic disorders. The effect of heating on cold block is of considerable interest because it raises many basic scientific questions that may help reveal the mechanisms underlying cold or heat block of axonal conduction. PMID:26740534

[A reversible cause of dilated cardiomyopathy: hypocalcemia].

PubMed

Benzarouel, D; Hasni, K; Ashab, H; El Hattaoui, M

2014-04-01

Hypocalcemia is very rare reversible cause of dilated cardiomyopathy (DCMP) witch can concern one or both ventricules. We here presented two cases of DCMP that caused by hypocalcemia and recovered totally after oral calcium and vitamin D supplementation. CASE PRESENTATION 1: A 29-year-old Caucasian female was admitted in our hospital due to congestive heart failure with dyspnea (NYHA class IV) and generalized edema for 2days. She had a history of total thyroidectomy one year a go. She had taken synthyroid as a daily medication associated to calcium supplementation and vitamin D because of hypoparathyroidism. Patient was not compliant to treatment. Trans thoracic echocardiography (TTE) showed a dilated left ventricule (LV) with global hypokinesia with 28% of left ventricule ejection and moderate mitral regurgitation. Laboratory test showed a severe hypocalcemia. After correction of hypocalcemia, there was a clear clinical improvement and four months later a total recovery was found. CASE PRESENTATION 2: A 44-year-old Caucasian male was referred to the hospital for rebel congestive heart failure with dyspnea and edema of lower limbs despite optimal treatment. Patient had no medical past history. TEE showed dilated cardiomyopathy with severe alteration of left ventricule systolic function (25%). Biological tests showed a hypocalcemia and primary hypoparathyroidism. An improvement of symptoms after correction of metabolic disorder was found. LV gradually recovered its performance. Patients outcome in end stage heart failure is different from the classical outcomes in patients with hypocalcemia induced heart disease. DCMP induced by hypocalcemia should be considered in patients with heart failure associated with medical conditions leading to hypocalcemia. It requires a specific treatment. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Test Method for the Fatigue Life of Layered TiB/Ti Functionally Graded Beams Subjected to Fully Reversed Bending

NASA Astrophysics Data System (ADS)

Byrd, Larry; Rickerd, Greg; Wyen, Travis; Cooley, Glenn; Quast, Jeff

2008-02-01

Sonic fatigue of aircraft is characterized by fully reversed bending of components subjected to acoustic excitation. This problem is compounded in high temperature environments because solutions for acoustics which tend to result in stiff structures make thermal problems worse. Conversely solutions to the thermal problem which allow expansion often fail in the presence of high acoustic levels. Errors in fatigue life prediction in the combined environment often range from a factor of 4 to 10. This results in either heavy, overly stiff structure or premature failure. This work will test the hypothesis that the fatigue life of a layered functionally graded material (FGM) will be dominated by the failure of the stiffest outer layer. This is based on the observation that for isotropic materials the life is approximately 90% crack initiation and only 10% crack growth before failure. Four sets of cantilever specimens will be tested using an electro-mechanical shaker for base excitation. The excitation will be narrow band random around the fundamental frequency. Two sets of specimens are of uniform composition consisting of 85%TiB/Ti and two are graded specimens consisting of layers that vary from commercially pure titanium to 85%TiB/Ti. Strain vs number of cycles to failure curves will be generated with both constant amplitude sine and narrow band random around the fundamental frequency excitation. The results will be examined to compare life of the uniform material to the functionally graded material. Also to be studied will be the use of Miner's rule to predict the fatigue life of the randomly excited specimens.

Flexible and reversibly deformable radio-frequency antenna based on stretchable SWCNTs/PANI/Lycra conductive fabric

NASA Astrophysics Data System (ADS)

Guo, Xiaohui; Huang, Ying; Wu, Can; Mao, Leidong; Wang, Yue; Xie, Zhicheng; Liu, Caixia; Zhang, Yugang

2017-10-01

We demonstrated a flexible and reversibly deformable radio-frequency antenna based on SWCNTs/PANI/Lycra conductive fabric and semipermeable film for wireless wearable communications applications. The conductive fabric fabricated by using the ‘dip and dry’ process exhibits good flexibility, electrical stability, stretchability and mechanical properties, and a high electrical conductivity (with low sheet resistance of ˜35 Ω/sq) was obtained based on the SWCNTs/PANI synergistic conductive network. The morphology of the semipermeable film was investigated to further illustrate the waterproof breathable features. Meanwhile, the modeling, fabrication procedure and radiating properties of the radio-frequency textile antenna worked at 2.45 GHz were systematically illustrated. The measured reflection coefficient, VSWR and the -10 dB bandwidth is ˜-18.6 dB, 1.58 and ˜270 MHz respectively, which agreed well with the simulation results. Furthermore, the results indicate that the design methodology for the radio-frequency textile antenna could have promising applications in flexible and reversibly deformable antennas for wearable wireless communications systems.

Uncaria alkaloids reverse ABCB1-mediated cancer multidrug resistance

PubMed Central

Huang, Bao-Yuan; Zeng, Yu; Li, Ying-Jie; Huang, Xiao-Jun; Hu, Nan; Yao, Nan; Chen, Min-Feng; Yang, Zai-Gang; Chen, Zhe-Sheng; Zhang, Dong-Mei; Zeng, Chang-Qing

2017-01-01

The overexpression of ATP-binding cassette (ABC) transporters is the main cause of cancer multidrug resistance (MDR), which leads to chemotherapy failure. Uncaria alkaloids are the major active components isolated from uncaria, which is a common Chinese herbal medicine. In this study, the MDR-reversal activities of uncaria alkaloids, including rhynchophylline, isorhynchophylline, corynoxeine, isocorynoxeine (Icory), hirsutine and hirsuteine, were screened; they all exhibited potent reversal efficacy when combined with doxorubicin. Among them, Icory significantly sensitized ABCB1-overexpressing HepG2/ADM and MCF-7/ADR cells to vincristine, doxorubicin and paclitaxel, but not to the non-ABCB1 substrate cisplatin. Noteworthy, Icory selectively reversed ABCB1-overexpressing MDR cancer cells but not ABCC1- or ABCG2-mediated MDR. Further mechanistic study revealed that Icory increased the intracellular accumulation of doxorubicin in ABCB1-overexpressing cells by blocking the efflux function of ABCB1. Instead of inhibiting ABCB1 expression and localization, Icory acts as a substrate of the ABCB1 transporter by competitively binding to substrate binding sites. Collectively, these results indicated that Icory reversed ABCB1-mediated MDR by suppressing its efflux function, and it would be beneficial to increase the efficacy of these types of uncaria alkaloids and develop them to be selective ABCB1-mediated MDR-reversal agents. PMID:28534954

High Rates of Baseline Drug Resistance and Virologic Failure Among ART-naive HIV-infected Children in Mali.

PubMed

Crowell, Claudia S; Maiga, Almoustapha I; Sylla, Mariam; Taiwo, Babafemi; Kone, Niaboula; Oron, Assaf P; Murphy, Robert L; Marcelin, Anne-Geneviève; Traore, Ban; Fofana, Djeneba B; Peytavin, Gilles; Chadwick, Ellen G

2017-11-01

Limited data exist on drug resistance and antiretroviral treatment (ART) outcomes in HIV-1-infected children in West Africa. We determined the prevalence of baseline resistance and correlates of virologic failure (VF) in a cohort of ART-naive HIV-1-infected children <10 years of age initiating ART in Mali. Reverse transcriptase and protease genes were sequenced at baseline (before ART) and at 6 months. Resistance was defined according to the Stanford HIV Genotypic Resistance database. VF was defined as viral load ≥1000 copies/mL after 6 months of ART. Logistic regression was used to evaluate factors associated with VF or death >1 month after enrollment. Post hoc, antiretroviral concentrations were assayed on baseline samples of participants with baseline resistance. One-hundred twenty children with a median age 2.6 years (interquartile range: 1.6-5.0) were included. Eighty-eight percent reported no prevention of mother-to-child transmission exposure. At baseline, 27 (23%), 4 (3%) and none had non-nucleoside reverse transcriptase inhibitor (NNRTI), nucleoside reverse transcriptase inhibitor or protease inhibitor resistance, respectively. Thirty-nine (33%) developed VF and 4 died >1 month post-ART initiation. In multivariable analyses, poor adherence [odds ratio (OR): 6.1, P = 0.001], baseline NNRTI resistance among children receiving NNRTI-based ART (OR: 22.9, P < 0.001) and protease inhibitor-based ART initiation among children without baseline NNRTI resistance (OR: 5.8, P = 0.018) were significantly associated with VF/death. Ten (38%) with baseline resistance had detectable levels of nevirapine or efavirenz at baseline; 7 were currently breastfeeding, but only 2 reported maternal antiretroviral use. Baseline NNRTI resistance was common in children without reported NNRTI exposure and was associated with increased risk of treatment failure. Detectable NNRTI concentrations were present despite few reports of maternal/infant antiretroviral use.

Multi-criteria analysis of potential recovery facilities in a reverse supply chain

NASA Astrophysics Data System (ADS)

Nukala, Satish; Gupta, Surendra M.

2005-11-01

Analytic Hierarchy Process (AHP) has been employed by researchers for solving multi-criteria analysis problems. However, AHP is often criticized for its unbalanced scale of judgments and failure to precisely handle the inherent uncertainty and vagueness in carrying out the pair-wise comparisons. With an objective to address these drawbacks, in this paper, we employ a fuzzy approach in selecting potential recovery facilities in the strategic planning of a reverse supply chain network that addresses the decision maker's level of confidence in the fuzzy assessments and his/her attitude towards risk. A numerical example is considered to illustrate the methodology.

HIV genotype resistance testing in antiretroviral (ART) exposed Indian children--a need of the hour.

PubMed

Shah, Ira; Parikh, Shefali

2013-04-01

Development of drug resistance in HIV infected children with treatment failure is a major impediment to selection of appropriate therapy. HIV genotype resistance assays predict drug resistance on the basis of mutations in the viral genome. However, their clinical utility, especially in a resource limited setting is still a subject of debate. The authors report two cases in which both the children suffered from treatment failure of various antiretroviral therapy regimes. In both the cases, Genotype Resistance Testing (GRT) prompted a radical change from proposed failure therapy as per existing guidelines. GRT was specifically important for the selection of a new dual Nucleoside reverse transcriptase inhibitors (NRTI) component of failure regimen by identifying TAMS and M184V mutations in the HIV genome. These case reports highlight the importance of GRT in children failing multiple antiretroviral regimes; and emphasizes the need to recognize situations where GRT is absolutely essential to guide appropriate therapy, even in a resource limited setting.

Current state of knowledge on Takotsubo syndrome: a Position Statement from the Taskforce on Takotsubo Syndrome of the Heart Failure Association of the European Society of Cardiology.

PubMed

Lyon, Alexander R; Bossone, Eduardo; Schneider, Birke; Sechtem, Udo; Citro, Rodolfo; Underwood, S Richard; Sheppard, Mary N; Figtree, Gemma A; Parodi, Guido; Akashi, Yoshihiro J; Ruschitzka, Frank; Filippatos, Gerasimos; Mebazaa, Alexandre; Omerovic, Elmir

2016-01-01

Takotsubo syndrome is an acute reversible heart failure syndrome that is increasingly recognized in modern cardiology practice. This Position Statement from the European Society of Cardiology Heart Failure Association provides a comprehensive review of the various clinical and pathophysiological facets of Takotsubo syndrome, including nomenclature, definition, and diagnosis, primary and secondary clinical subtypes, anatomical variants, triggers, epidemiology, pathophysiology, clinical presentation, complications, prognosis, clinical investigations, and treatment approaches. Novel structured approaches to diagnosis, risk stratification, and management are presented, with new algorithms to aid decision-making by practising clinicians. These also cover more complex areas (e.g. uncertain diagnosis and delayed presentation) and the management of complex cases with ongoing symptoms after recovery, recurrent episodes, or spontaneous presentation. The unmet needs and future directions for research in this syndrome are also discussed. © 2015 The Authors European Journal of Heart Failure © 2015 European Society of Cardiology.

Vamistor resistor investigation

NASA Technical Reports Server (NTRS)

1973-01-01

Results are presented of the failure investigation conducted on resistors produced by the Vamistor Divison, Wagner Electric Corporation. This failure investigation included; failure analyses, chemical and metallurgical analyses, failure mechanism studies, seal leak analyses, and nondestructive stress tests. The data, information, conclusions, and recommendation can be helpful in assessing current usage of these resistors.

The effect of current reversal on coated titanium electrodes

NASA Astrophysics Data System (ADS)

Elnathan, Francis

Coated titanium electrodes have applications in the electrochemical industry, including water treatment and swimming pool chlorination. Current/polarity reverse electrolysis is a technique used for "self-cleaning" of the coated titanium anodes employed in water disinfection and treatment. However, the literature holds very little information about the effects of polarity reversal on these anodes. The present work appears to be the first to investigate coated titanium anodes in polarity reversal in a systematic method. Two commercial titanium electrodes (RuTi and IrTa) were studied. Polarity reversal was the main electrochemical technique employing a current density of 1200 A/m 2, except when current density was studied. The effects of NO 3-, SO42-, ClO4 -, HPO42-, CO32-, Mg2+ and Ca2+ on electrode lifetime were examined. Analysis of the electrochemical results showed that plateau time (tau p), for gas evolution, is highly important to the lifetime of the coated titanium anodes. The effects of three electrolysis variables on the coated titanium anode life were examined. Current density was observed to have an inverse relationship with anode life while reversal cycle time had a direct relation with lifetime. NaCl concentration had no discernible effect. In general, the RuTi electrode exhibited longer lifetimes than IrTa except for a few specific conditions. The influence of the concentration of five anions (NO3-, SO42-, ClO 4-, HPO42-, and CO3 2-) was determined. Changing the composition and concentration of anions affected the lifetimes of the two electrodes, especially nitrate, hydrogen phosphate and carbonate. The lifetime of IrTa was highest in nitrate, and increased as a function of nitrate concentration. The service life of RuTi was highest in hydrogen phosphate, and increased with increasing hydrogen phosphate concentration. Lifetime of both anodes decreased with increasing carbonate ions. The effects of Mg2+ and Ca2+ on electrode lifetime were examined with three anions (NO3-, HPO42-, ClO4-) electrolytes. While there were numerous effects and interactions between Mg2+ or Ca2+ and anions on lifetime, these effects were found to mainly affect the amount of time the electrodes spent in the charging and discharging reactions. The times related to gas evolution (which is the plateau time, tau p) were found to be strikingly similar. The charging times (tau C) which are related to adsorption and desorption of species were not also any significantly different. Coating dissolution, substrate and/or coating passivation mechanisms were identified as being responsible for coated titanium anode failure in current reverse and hard water electrolysis. IrTa is believed to have failed predominantly by the dissolution mechanism in nitrate, hydrogen phosphate and perchlorate. RuTi failed predominantly by substrate and/or coating passivation in hydrogen phosphate, nitrate and carbonate. Anode failure is believed to be the result of plateau (taup) and charging (tauC)reactions occurring at the coating/electrolyte and/or substrate/coating interface. The tau p and tauC are useful determinants for the process of anode failure.

Infrared spectroscopic near-field mapping of single nanotransistors.

PubMed

Huber, A J; Wittborn, J; Hillenbrand, R

2010-06-11

We demonstrate the application of scattering-type scanning near-field optical microscopy (s-SNOM) for infrared (IR) spectroscopic material recognition in state-of-the-art semiconductor devices. In particular, we employ s-SNOM for imaging of industrial CMOS transistors with a resolution better than 20 nm, which allows for the first time IR spectroscopic recognition of amorphous SiO(2) and Si(3)N(4) components in a single transistor device. The experimentally recorded near-field spectral signature of amorphous SiO(2) shows excellent agreement with model calculations based on literature dielectric values, verifying that the characteristic near-field contrasts of SiO(2) stem from a phonon-polariton resonant near-field interaction between the probing tip and the SiO(2) nanostructures. Local material recognition by s-SNOM in combination with its capabilities of contact-free and non-invasive conductivity- and strain-mapping makes IR near-field microscopy a versatile metrology technique for nanoscale material characterization and semiconductor device analysis with application potential in research and development, failure analysis and reverse engineering.

Wear of Spur Gears Having a Dithering Motion and Lubricated with a Perfluorinated Polyether Grease

NASA Technical Reports Server (NTRS)

Krantz, Timothy; Oswald, Fred; Handschuh, Robert

2007-01-01

Gear contact surface wear is one of the important failure modes for gear systems. Dedicated experiments are required to enable precise evaluations of gear wear for a particular application. The application of interest for this study required evaluation of wear of gears lubricated with a grade 2 perfluorinated polyether grease and having a dithering (rotation reversal) motion. Experiments were conducted using spur gears made from AISI 9310 steel. Wear was measured using a profilometer at test intervals encompassing 10,000 to 80,000 cycles of dithering motion. The test load level was 1.1 GPa maximum Hertz contact stress at the pitch-line. The trend of total wear as a function of test cycles was linear, and the wear depth rate was approximately 1.2 nm maximum wear depth per gear dithering cycle. The observed wear rate was about 600 times greater than the wear rate for the same gears operated at high speed and lubricated with oil.

Self-Heating Effects In Polysilicon Source Gated Transistors

PubMed Central

Sporea, R. A.; Burridge, T.; Silva, S. R. P.

2015-01-01

Source-gated transistors (SGTs) are thin-film devices which rely on a potential barrier at the source to achieve high gain, tolerance to fabrication variability, and low series voltage drop, relevant to a multitude of energy-efficient, large-area, cost effective applications. The current through the reverse-biased source barrier has a potentially high positive temperature coefficient, which may lead to undesirable thermal runaway effects and even device failure through self-heating. Using numerical simulations we show that, even in highly thermally-confined scenarios and at high current levels, self-heating is insufficient to compromise device integrity. Performance is minimally affected through a modest increase in output conductance, which may limit the maximum attainable gain. Measurements on polysilicon devices confirm the simulated results, with even smaller penalties in performance, largely due to improved heat dissipation through metal contacts. We conclude that SGTs can be reliably used for high gain, power efficient analog and digital circuits without significant performance impact due to self-heating. This further demonstrates the robustness of SGTs. PMID:26351099

GAS DISCHARGE SWITCH EVALUATION FOR RHIC BEAM ABORT KICKER APPLICATION.

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

ZHANG,W.; SANDBERG,J.; SHELDRAKE,R.

2002-06-30

A gas discharge switch EEV HX3002 is being evaluated at Brookhaven National Laboratory as a possible candidate of RHIC Beam Abort Kicker modulator main switch. At higher beam energy and higher beam intensity, the switch stability becomes very crucial. The hollow anode thyratron used in the existing system is not rated for long reverse current conduction. The reverse voltage arcing caused thyratron hold-off voltage de-rating has been the main limitation of the system operation. To improve the system reliability, a new type of gas discharge switch has been suggested by Marconi Applied Technology for its reverse conducting capability.

Agenesis of the ductus venosus-A case with favorable outcome after early signs of cardiac failure.

PubMed

Hofmann, Sigrun R; Heilmann, Antje; Häusler, Hans J; Kamin, Gabriele; Nitzsche, Katharina I

2013-01-01

Absence of the ductus venosus (ADV) is a rare vascular anomaly. Its prognosis depends on the pathway of the umbilical flow to the systemic venous circulation, and the presence or absence of associated structural or chromosomal anomalies, sometimes resulting in hydrops fetalis. In cases with isolated ADV in the absence of associated anomalies, survival rates are as high as 85%, depending on the shunt situation. Here, we report a patient with ADV and extrahepatic umbilical vein drainage with favorable outcome after intrauterine reversal of early signs of cardiac failure. Diagnosis was made after the appearance of moderate cardiomegaly in the 25th gestational week. Thus, in the case of cardiomegaly with or without further signs of cardiac failure, ultrasound imaging of the venous duct should be considered. Copyright © 2012 Wiley Periodicals, Inc.

Novel function of N,N-bis(2-chloroethyl)docos-13-enamide for reversal of multidrug resistance in tongue cancer.

PubMed

Qin, Qing; Ma, Peng-Fei; Kuang, Xiao-Cong; Gao, Ming-Xing; Mo, De-Huan; Xia, Shuang; Jin, Ning; Xia, Jun-Jie; Qi, Zhong-Quan; Lin, Cui-Wu

2013-12-05

Multidrug resistance (MDR) is a key element in the failure of chemotherapies, and development of agents to overcome MDR is crucial to improving cancer treatments. The overexpression of glutathione-S-transferases (GSTs) is one of the major mechanisms of MDR. Because some agents used in traditional Chinese medicine have strong antitumor effects coupled with low toxicity; we investigated the ability of N,N-bis(2-chloroethyl)docos-13-enamide (compound J), the synthesized analog of a highly unsaturated fatty acid from Isatis tinctoria L., to reverse the MDR induced by adriamycin (ADM) in TCA8113/ADM cells. We found that compound J significantly increased the cytotoxicity of ADM in TCA8113/ADM cells, with a reversal fold of 2.461. Analysis of the mechanisms through which compound J reversed MDR indicated that compound J significantly decreased the activity of GSTs and enhanced the depletion of GSH in TCA8113/ADM cells, but did not affect the P-glycoprotein (P-gp) efflux. Taken together, our data suggested that compound J was an excellent candidate for reversing MDR in cancer therapy. © 2013 Published by Elsevier B.V.

The response of dense dry granular material to the shear reversal

NASA Astrophysics Data System (ADS)

Zhang, Jie; Ren, Jie; Farhadi, Somayeh; Behringer, Robert

2008-11-01

We have performed two dimensional granular experiments under pure shear using bidisperse photo-elastic disks. Starting from a stress free state, a square box filled with granular particles is subject to shear. The forward shears involved various number of steps, leading to maximum strains between 0.1 and 0.3. The area is kept constant during the shear. The network of force chains gradually built up as the strain increased, leading to increased pressure and shear stress. Reverse shear was then applied to the system. Depending on the initial packing fraction and the strain at which the shear is reversed, the force chain network built prior to the shear reversal may be destroyed completely or partially destroyed. Following the force chain weakening, when the reserve shear is continuously applied to the system, there is a force chain strengthening. Following each change of the system, contact forces of individual disks were measured by applying an inverse algorithm. We also kept track of the displacement and angle of rotation of every particle from frame to frame. We present the results for the structure failure and reconstruction during shear reversals. We also present data for stresses, contact force distributions and other statistical measures.

Biomechanical outcome of proximal femoral nail antirotation is superior to proximal femoral locking compression plate for reverse oblique intertrochanteric fractures: a biomechanical study of intertrochanteric fractures.

PubMed

Ma, Jian-Xiong; Wang, Jie; Xu, Wei-Guo; Yu, Jing-Tao; Yang, Yang; Ma, Xin-Long

2015-01-01

Reverse obliquity intertrochanteric fractures are a challenge for orthopedic surgeons. The optimal internal fixation for repairing this type of unstable intertrochanteric fractures remains controversial. This study aimed to compare the biomechanical properties in axial load and cyclical axial load of proximal femoral nail antirotation (PFNA) and proximal femoral locking compression plate (PFLCP) for fixation of reverse obliquity intertrochanteric fractures. Sixteen embalmed cadaver femurs were sawed to simulate reverse obliquity intertrochanteric fracture and instrumented with PFNA or PFLCP. Axial loads and axial cyclic loads were applied to the femoral head by an Instron tester. If the implant-femur constructs did not fail, axial failure load was added to the remaining implant-femur constructs. Mean axial stiffness for PFNA was 21.10% greater than that of PFLCP. Cyclic axial loading caused significantly less (p=0.022) mean irreversible deformation in PFNA (3.43 mm) than in PFLCP (4.34 mm). Significantly less (p=0.002) mean total deformation was detected in PFNA (6.16 mm) than in PFLCP (8.67 mm). For fixing reverse obliquity intertrochanteric fractures, PFNA is superior to PFLCP under axial load.

Static internal performance of a single-engine onaxisymmetric-nozzle vaned-thrust-reverser design with thrust modulation capabilities

NASA Technical Reports Server (NTRS)

Leavitt, L. D.; Burley, J. R., II

1985-01-01

An investigation has been conducted at wind-off conditions in the stati-test facility of the Langley 16-Foot Transonic Tunnel. The tests were conducted on a single-engine reverser configuration with partial and full reverse-thrust modulation capabilities. The reverser design had four ports with equal areas. These ports were angled outboard 30 deg from the vertical impart of a splay angle to the reverse exhaust flow. This splaying of reverser flow was intended to prevent impingement of exhaust flow on empennage surfaces and to help avoid inlet reingestion of exhaust gas when the reverser is integrated into an actual airplane configuration. External vane boxes were located directly over each of the four ports to provide variation of reverser efflux angle from 140 deg to 26 deg (measured forward from the horizontal reference axis). The reverser model was tested with both a butterfly-type inner door and an internal slider door to provide area control for each individual port. In addition, main nozzle throat area and vector angle were varied to examine various methods of modulating thrust levels. Other model variables included vane box configuration (four or six vanes per box), orientation of external vane boxes with respect to internal port walls (splay angle shims), and vane box sideplates. Nozzle pressure ratio was varied from 2.0 approximately 7.0.

Diagnosis of renal disease in rabbits.

PubMed

Harcourt-Brown, Frances Margaret

2013-01-01

There are differences in renal anatomy and physiology between rabbits and other domestic species. Neurogenic renal ischemia occurs readily. Reversible prerenal azotemia may be seen in conjunction with gut stasis. Potentially fatal acute renal failure may be due to structural kidney damage or post-renal disease. Chronic renal failure is often associated with encephalitozoonosis. Affected rabbits cannot vomit and often eat well. Weight loss, lethargy, and cachexia are common clinical signs. Polydypsia/polyuria may be present. Derangements in calcium and phosphorus metabolism are features of renal disease. Radiography is always indicated. Urolithiasis, osteosclerosis, aortic and renal calcification are easily seen on radiographs. Copyright © 2013 Elsevier Inc. All rights reserved.

Investigation into Cause of High Temperature Failure of Boiler Superheater Tube

NASA Astrophysics Data System (ADS)

Ghosh, D.; Ray, S.; Roy, H.; Shukla, A. K.

2015-04-01

The failure of the boiler tubes occur due to various reasons like creep, fatigue, corrosion and erosion. This paper highlights a case study of typical premature failure of a final superheater tube of 210 MW thermal power plant boiler. Visual examination, dimensional measurement, chemical analysis, oxide scale thickness measurement, microstructural examination are conducted as part of the investigations. Apart from these investigations, sulfur print, Energy Dispersive spectroscopy (EDS) and X ray diffraction analysis (XRD) are also conducted to ascertain the probable cause of failure of final super heater tube. Finally it has been concluded that the premature failure of the super heater tube can be attributed to the combination of localized high tube metal temperature and loss of metal from the outer surface due to high temperature corrosion. The corrective actions have also been suggested to avoid this type of failure in near future.

The Prognostic Value of Late Gadolinium-Enhanced Cardiac Magnetic Resonance Imaging in Nonischemic Dilated Cardiomyopathy: A Review and Meta-Analysis.

PubMed

Becker, Marthe A J; Cornel, Jan H; van de Ven, Peter M; van Rossum, Albert C; Allaart, Cornelis P; Germans, Tjeerd

2018-04-13

This review and meta-analysis reviews the prognostic value of cardiac magnetic resonance (CMR) in nonischemic dilated cardiomyopathy (DCM). Late gadolinium-enhanced (LGE) CMR is a noninvasive method to determine the underlying cause of DCM and previous studies reported the prognostic value of the presence of LGE to identify patients at risk of major adverse cardiovascular events. PubMed was searched for studies describing the prognostic implication of LGE in patients with DCM for the specified endpoints cardiovascular mortality, major ventricular arrhythmic events including appropriate implantable cardioverter-defibrillator therapy, rehospitalization for heart failure, and left ventricular reverse remodeling. Data from 34 studies were included, with a total of 4,554 patients. Contrast enhancement was present in 44.8% of DCM patients. Patients with LGE had increased cardiovascular mortality (odds ratio [OR]: 3.40; 95% confidence interval [CI]: 2.04 to 5.67), ventricular arrhythmic events (OR: 4.52; 95% CI: 3.41 to 5.99), and rehospitalization for heart failure (OR: 2.66; 95% CI: 1.67 to 4.24) compared with those without LGE. Moreover, the absence of LGE predicted left ventricular reverse remodeling (OR: 0.15; 95% CI: 0.06 to 0.36). The presence of LGE on CMR substantially worsens prognosis for adverse cardiovascular events in DCM patients, and the absence indicates left ventricular reverse remodeling. Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Etravirine and rilpivirine resistance in HIV-1 subtype CRF01_AE-infected adults failing non-nucleoside reverse transcriptase inhibitor-based regimens.

PubMed

Bunupuradah, Torsak; Ananworanich, Jintanat; Chetchotisakd, Ploenchan; Kantipong, Pacharee; Jirajariyavej, Supunnee; Sirivichayakul, Sunee; Munsakul, Warangkana; Prasithsirikul, Wisit; Sungkanuparph, Somnuek; Bowonwattanuwong, Chureeratana; Klinbuayaem, Virat; Petoumenos, Kathy; Hirschel, Bernard; Bhakeecheep, Sorakij; Ruxrungtham, Kiat

2011-01-01

We studied prevalence of etravirine (ETR) and rilpivirine (RPV) resistance in HIV-1 subtype CRF01_AE infection with first-line non-nucleoside reverse transcriptase inhibitor (NNRTI) failure. A total of 225 adults failing two nucleoside reverse transcriptase inhibitors (NRTIs) plus 1 NNRTI in Thailand with HIV RNA>1,000 copies/ml were included. Genotypic resistance results and HIV-1 subtype were interpreted by Stanford DR database. ETR resistance was calculated by the new Monogram weighted score (Monogram WS; ≥ 4 indicating high-level ETR resistance) and by DUET weighted score (DUET WS; 2.5-3.5 and ≥ 4 resulted in intermediate and reduce ETR response, respectively). RPV resistance interpretation was based on previous reports. Median (IQR) age was 38 (34-42) years, 41% were female and CDC A:B:C were 22%:21%:57%. HIV subtypes were 96% CRF01_AE and 4% B. Antiretrovirals at failure were lamivudine (100%), stavudine (93%), nevirapine (90%) and efavirenz (10%) with a median (IQR) duration of 3.4 (1.8-4.5) years. Median (IQR) CD4(+) T-cell count and HIV RNA were 194 (121-280) cells/mm³ and 4.1 (3.6-4.6) log₁₀ copies/ml, respectively. The common NNRTI mutations were Y181C (41%), G190A (22%) and K103N (19%). The proportion of patients with Monogram WS score ≥ 4 was 61.3%. By DUET WS, 49.8% and 7.5% of patients were scored 2.5-3.5 and ≥4, respectively. Only HIV RNA ≥ 4 log₁₀ copies/ml at failure was associated with both Monogram WS ≥ 4 (OR 2.3, 95% CI 1.3-3.9; P=0.003) and DUET WS ≥ 2.5 (OR 1.9, 95% CI 1.1-3.3; P=0.02). The RVP resistance-associated mutations (RAMs) detected were K101P (1.8%), Y181I (2.7%) and Y181V (3.6%). All patients with RPV mutation had ETR resistance. No E138R/E138K mutations were detected. Approximately 60% of patients had high-level ETR resistance. The role of ETR in second-line therapy is limited in late NNRTI failure settings. RVP RAMs were uncommon, but cross-resistance between ETR and RVP was high.

The Behavior Analysis Follow Through Evaluation Strategy: A Multifaceted Approach.

ERIC Educational Resources Information Center

Green, Dan S.; And Others

The Behavior Analysis (BA) approach to Project Follow Through, a federally funded education intervention program, has reversed the trend of academic failure of poor children by improving the educational experience of poor children from 12 communities in the urban East, Midwest, rural South, and on Indian reservations in the West. The BA model is…

Federal Policy toward Youth Employment: An Historical and Political Analysis.

ERIC Educational Resources Information Center

McIntire, James L.

The development of Federal policies affecting youth employment has gone through five critical periods during the 20th century. The period began with the failure of child labor reformers to obtain Federal intervention in youth labor markets. The New Deal greatly enhanced a reversal of the trend. Development of the Great Society programs provided an…

The Addition of Saccharin to Taste Cues Affects Taste Preference Conditioning in Thirsty Rats

ERIC Educational Resources Information Center

Forestell, Catherine A.; LoLordo, Vincent M.

2004-01-01

Previous failures to condition preferences for the unacceptable taste cues sucrose octaacetate (SOA) and citric acid (CA) using a reverse-order, differential conditioning procedure (Forestell & LoLordo, 2000) may have been the result of low consumption of the taste cues in training or of their relatively low acceptability to rats that are thirsty…

Four Radical Panaceas for Reversing Mass Failure in Certificate English Language Examinations in Nigeria

ERIC Educational Resources Information Center

Fasasi, Khabyr Alowonle; Amadi, Gloria U.

2015-01-01

Given the present-day perspectives of Nigerians to the imperatives of qualitative education in the lives of youths, quite a lot of Nigerians have strongly bemoaned and condemned the recurrent woeful performances of students in Certificate examinations. Many research works have therefore concerned themselves with solving the problems of mass…

Failure of ETeMS: The Teaching Courseware Factor?

ERIC Educational Resources Information Center

Azmi, Mohd Nazri Latiff; Maniam, Mahendren

2013-01-01

This study was carried out in response to the announcement of the reversal of the ETeMS policy (English in the Teaching of Mathematics and Science) which had been practiced by teachers in Malaysia since 2003. The Ministry of Education took a drastic approach in gradually halting this controversial policy for several related reasons, namely the…

Decision Makers Calibrate Behavioral Persistence on the Basis of Time-Interval Experience

ERIC Educational Resources Information Center

McGuire, Joseph T.; Kable, Joseph W.

2012-01-01

A central question in intertemporal decision making is why people reverse their own past choices. Someone who initially prefers a long-run outcome might fail to maintain that preference for long enough to see the outcome realized. Such behavior is usually understood as reflecting preference instability or self-control failure. However, if a…

36 CFR 13.1170 - What are the rules for operating vessels?

Code of Federal Regulations, 2014 CFR

2014-07-01

...) Operating a vessel within 1/4 nautical mile of a whale is prohibited, except for a commercial fishing vessel... whale must immediately slow the vessel to ten knots or less, without shifting into reverse unless impact... from the whale until at least 1/4 nautical mile of separation is established. Failure to take such...

36 CFR 13.1170 - What are the rules for operating vessels?

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Operating a vessel within 1/4 nautical mile of a whale is prohibited, except for a commercial fishing vessel... whale must immediately slow the vessel to ten knots or less, without shifting into reverse unless impact... from the whale until at least 1/4 nautical mile of separation is established. Failure to take such...

36 CFR 13.1170 - What are the rules for operating vessels?

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Operating a vessel within 1/4 nautical mile of a whale is prohibited, except for a commercial fishing vessel... whale must immediately slow the vessel to ten knots or less, without shifting into reverse unless impact... from the whale until at least 1/4 nautical mile of separation is established. Failure to take such...

36 CFR 13.1170 - What are the rules for operating vessels?

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Operating a vessel within 1/4 nautical mile of a whale is prohibited, except for a commercial fishing vessel... whale must immediately slow the vessel to ten knots or less, without shifting into reverse unless impact... from the whale until at least 1/4 nautical mile of separation is established. Failure to take such...

FLUID PURIFIER AND SEALING VALVE

DOEpatents

Swanton, W.F.

1962-04-24

An improved cold trap designed to condense vapors and collect foreign particles in a flowing fluid is described. In the arrangement, a valve is provided to prevent flow reversal in case of pump failure and to act as a sealing valve. Provision is made for reducing the temperature of the fluid being processed, including a pre-cooling stage. (AEC)

78 FR 12074 - Office of Biotechnology Activities; Recombinant DNA Research: Actions Under the NIH Guidelines...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-21

... designed to avoid airflow reversal during failure, with periodic verification and at least annual... of HPAI H5N1 viruses, if the experimental procedures are such that it could reasonably be anticipated... (3) the research is designed to increase the ability of that influenza virus to be transmissible...

China-U.S. Trade Issues

DTIC Science & Technology

2007-07-11

economic and trade practices. It has recently filed a number of trade dispute resolution cases against China in the WTO, including over China’s failure to...various industries in China. In addition, the Administration recently reversed a long-standing policy that countervailing cases (dealing with...15 U.S. WTO Cases Against China . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Violations of U.S. Intellectual Property Rights

Graphene-silicone elastomer nanocomposite

NASA Astrophysics Data System (ADS)

Pan, Shuyang

The incorporation of fillers to improve the Young's modulus, tensile strength, and elongation at failure of polymeric matrices is ubiquitous. While Young's modulus and tensile strength of the matrix increase with the filler concentration, a threshold filler concentration must be achieved for the elongation at failure to increase. Furthermore, a decrease in elongation at failure has also been observed beyond a critical filler concentration. While the increases in modulus and tensile strength have been attributed to the transfer of mechanical load to the stronger filler, the onset and reversal in elongation at failure are not understood. In this thesis, we use a functionalized graphene sheet (FGS) -- silicone elastomer (SE) nanocomposite as a model system to demonstrate the mechanisms responsible for this observed filler concentration-dependant elongation at failure as well its subsequent reversal. We will also demonstrate the mechanisms that create the continual increase in tensile strength as filler concentration increases. As the lateral size of FGS strongly influences the tensile strength of the resulting composite, in the first part of this thesis, we show that the oxidation path and the mechanical energy input influence the size of graphene oxide sheets derived from graphite oxide. The cross-planar oxidation of graphite from the (0002) plane results in periodic cracking of the uppermost graphene oxide layer, limiting its lateral dimension to less than 30 microm. We use an energy balance between the elastic strain energy associated with the undulation of graphene oxide sheets at the hydroxyl and epoxy sites, the crack formation energy, and the interaction energy between graphene layers to determine the cell size of the cracks. Under both edge-to-center and cross-planar oxidations, the size of graphene oxide sheets is determined by the aspect ratio of graphite and the mechanical energy input in processing the sheets. In the second part of this thesis, we use atomic force microscopy-based single molecule force spectroscopy and infrared spectroscopy to show that the FGS-SE interface is dominated by the hydrogen bonds between the hydroxyl and epoxy groups on FGS and polydimethylsiloxane (PDMS, uncrosslinked form of SE) monomers. These hydrogen bonds allow the mechanical load to be transferred from the weaker SE to the stronger FGS, leading to an improvement in the tensile strength of SE. The strength of a single PDMS-FGS hydrogen bond is measured to be 30-120 pN and it is on the same order of magnitude as the strengths of other types of hydrogen bonds previously reported. In the final part of the thesis, utilizing experimental analysis and a two dimensional viscoelastic lattice model constructed by our collaborators, we show that while load transfer to FGS is the main cause of the enhancements in modulus and strength, the enhancement in elongation at failure is due to FGS-induced distributed tearing. First critical concentration, which defines the mechanical percolation, corresponds to the isolation of tensile zones generated by the fillers, as well as the initiation of tear arresting and deflection, thus enhancing distributed tearing and deformation. At the second critical concentration, cumulative dilation caused by distributed tearing reaches a maximum, leading to the reversal in elongation in failure.

Reversible posterior leucoencephalopathy syndrome associated with bone marrow transplantation.

PubMed

Teive, H A; Brandi, I V; Camargo, C H; Bittencourt, M A; Bonfim, C M; Friedrich, M L; de Medeiros, C R; Werneck, L C; Pasquini, R

2001-09-01

Reversible posterior leucoencephalopathy syndrome (RPLS) has previously been described in patients who have renal insufficiency, eclampsia, hypertensive encephalopathy and patients receiving immunosuppressive therapy. The mechanism by which immunosuppressive agents can cause this syndrome is not clear, but it is probably related with cytotoxic effects of these agents on the vascular endothelium. We report eight patients who received cyclosporine A (CSA) after allogeneic bone marrow transplantation or as treatment for severe aplastic anemia (SSA) who developed posterior leucoencephalopathy. The most common signs and symptoms were seizures and headache. Neurological dysfunction occurred preceded by or concomitant with high blood pressure and some degree of acute renal failure in six patients. Computerized tomography studies showed low-density white matter lesions involving the posterior areas of cerebral hemispheres. Symptoms and neuroimaging abnormalities were reversible and improvement occurred in all patients when given lower doses of CSA or when the drug was withdrawn. RPLS may be considered an expression of CSA neurotoxicity.

β-Glucan Reverses the Epigenetic State of LPS-Induced Immunological Tolerance

PubMed Central

Novakovic, Boris; Habibi, Ehsan; Wang, Shuang-Yin; Arts, Rob J.W.; Davar, Robab; Megchelenbrink, Wout; Kim, Bowon; Kuznetsova, Tatyana; Kox, Matthijs; Zwaag, Jelle; Matarese, Filomena; van Heeringen, Simon J.; Janssen-Megens, Eva M.; Sharifi, Nilofar; Wang, Cheng; Keramati, Farid; Schoonenberg, Vivien; Flicek, Paul; Clarke, Laura; Pickkers, Peter; Heath, Simon; Gut, Ivo; Netea, Mihai G.; Martens, Joost H.A.; Logie, Colin; Stunnenberg, Hendrik G.

2018-01-01

Summary Innate immune memory is the phenomenon whereby innate immune cells such as monocytes or macrophages undergo functional reprogramming after exposure to microbial components such as lipopolysaccharide (LPS). We apply an integrated epigenomic approach to characterize the molecular events involved in LPS-induced tolerance in a time-dependent manner. Mechanistically, LPS-treated monocytes fail to accumulate active histone marks at promoter and enhancers of genes in the lipid metabolism and phagocytic pathways. Transcriptional inactivity in response to a second LPS exposure in tolerized macrophages is accompanied by failure to deposit active histone marks at promoters of tolerized genes. In contrast, β-glucan partially reverses the LPS-induced tolerance in vitro. Importantly, ex vivo β-glucan treatment of monocytes from volunteers with experimental endotoxemia re-instates their capacity for cytokine production. Tolerance is reversed at the level of distal element histone modification and transcriptional reactivation of otherwise unresponsive genes. PMID:27863248

Posterior reversible encephalopathy syndrome: a case of unusual diffusion-weighted MR images.

PubMed

Benziada-Boudour, A; Schmitt, E; Kremer, S; Foscolo, S; Rivière, A-S; Tisserand, M; Boudour, A; Bracard, S

2009-05-01

Posterior reversible encephalopathy (PRES) represents an uncommon entity related to multiple pathologies, the most common of which is hypertensive crisis. PRES is classically characterized as symmetrical parieto-occipital edema, but may affect other areas of the brain. Diffusion-weighted magnetic resonance imaging (DWI) is important for differentiating between vasogenic and cytotoxic edema. We present here the case of a 43-year-old woman, known to suffer from arterial hypertension and severe renal failure, who developed PRES with restricted apparent diffusion coefficients (ADC) in various cerebral areas, suggesting irreversible tissue damage. Nevertheless, follow-up cranial MRI revealed complete remission, indicating that restricted diffusion does not always lead to cell death in this pathology. The underlying pathophysiological mechanism is not well understood. Such reversibility of diffusion anomalies has already been reported with transient ischemia, vasospasm after subarachnoid hemorrhage and epilepsy but, to our knowledge, never before in PRES.

Energy-efficient membrane separations in the sweetener industry. Final report for Phase I

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

Babcock, W.C.

1984-02-14

The objective of the program is to investigate the use of membrane processes as energy-efficient alternatives to conventional separation processes in current use in the corn sweetener industry. Two applications of membranes were studied during the program: (1) the concentration of corn steep water by reverse osmosis; and (2) the concentration of dilute wastes called sweetwater with a combination of reverse osmosis and a process known as countercurrent reverse osmosis. Laboratory experiments were conducted for both applications, and the results were used to conduct technical and economic analyses of the process. It was determined that the concentration of steep watermore » by reverse osmosis plus triple-effect evaporation offers savings of a factor of 2.5 in capital costs and a factor of 4.5 in operating costs over currently used triple-effect evaporation. In the concentration of sweetwater by reverse osmosis and countercurrent reverse osmosis, capital costs would be about the same as those for triple-effect evaporation, but operating costs would be only about one-half those of triple-effect evaporation.« less

Storm-Induced Slope Failure Susceptibility Mapping

DOT National Transportation Integrated Search

2018-01-01

A pilot study was conducted to characterize and map the areas susceptible to slope failure using state-wide available data. The objective was to determine whether it would be possible to provide slope-failure susceptibility mapping that could be used...

Current and future management of treatment failure in low- and middle-income countries.

PubMed

Boyd, Mark A

2010-01-01

Access to second-line therapy in low- and middle-income countries has been limited to date. The WHO predicts that between 500 000 and 800 000 HIV-infected people on first-line combination antiretroviral therapy will require switch to second-line therapy by 2010. This paper aims to describe and review access to second-line therapy in low- and middle-income countries at present and examine future possibilities. The majority of HIV-infected patients failing first-line combination antiretroviral therapy is identified by way of routine monitoring of clinical and immunological status as a surrogate for virological monitoring. Evidence suggests that immunological and clinical monitoring lack both sensitivity and specificity for virological failure. Consequently, at treatment failure, patients have often selected a degree of resistance within the nucleoside/nucleotide reverse transcriptase inhibitor class that questions the efficacy of using nucleoside/nucleotide reverse transcriptase inhibitors in a second-line regimen. There is a paucity of good-quality evidence on which to base guidelines and policy. Optimally, a second-line regimen would be simple, potent, tolerable and lend itself to provision according to the successful 'public health' approach. Provision of second-line therapy to HIV-infected individuals failing first-line therapy is a major challenge to the ongoing success of access to HIV care programmes in low- and middle-income countries. The optimal second-line combination antiretroviral therapies are unknown. Research trials to help define best practice are in advanced stages of development and implementation.

Global Comparison of Drug Resistance Mutations After First-Line Antiretroviral Therapy Across Human Immunodeficiency Virus-1 Subtypes

PubMed Central

Huang, Austin; Hogan, Joseph W.; Luo, Xi; DeLong, Allison; Saravanan, Shanmugam; Wu, Yasong; Sirivichayakul, Sunee; Kumarasamy, Nagalingeswaran; Zhang, Fujie; Phanuphak, Praphan; Diero, Lameck; Buziba, Nathan; Istrail, Sorin; Katzenstein, David A.; Kantor, Rami

2016-01-01

Background. Human immunodeficiency virus (HIV)-1 drug resistance mutations (DRMs) often accompany treatment failure. Although subtype differences are widely studied, DRM comparisons between subtypes either focus on specific geographic regions or include populations with heterogeneous treatments. Methods. We characterized DRM patterns following first-line failure and their impact on future treatment in a global, multi-subtype reverse-transcriptase sequence dataset. We developed a hierarchical modeling approach to address the high-dimensional challenge of modeling and comparing frequencies of multiple DRMs in varying first-line regimens, durations, and subtypes. Drug resistance mutation co-occurrence was characterized using a novel application of a statistical network model. Results. In 1425 sequences, 202 subtype B, 696 C, 44 G, 351 circulating recombinant forms (CRF)01_AE, 58 CRF02_AG, and 74 from other subtypes mutation frequencies were higher in subtypes C and CRF01_AE compared with B overall. Mutation frequency increased by 9%–20% at reverse transcriptase positions 41, 67, 70, 184, 215, and 219 in subtype C and CRF01_AE vs B. Subtype C and CRF01_AE exhibited higher predicted cross-resistance (+12%–18%) to future therapy options compared with subtype B. Topologies of subtype mutation networks were mostly similar. Conclusions. We find clear differences in DRM outcomes following first-line failure, suggesting subtype-specific ecological or biological factors that determine DRM patterns. PMID:27419147

Cyclic Strain Resistance, Stress Response, Fatigue Life, and Fracture Behavior of High Strength Low Alloy Steel 300 M

NASA Astrophysics Data System (ADS)

Manigandan, K.; Srivatsan, T. S.; Tammana, Deepthi; Poorgangi, Behrang; Vasudevan, Vijay K.

2014-05-01

The focus of this technical manuscript is a record of the specific role of microstructure and test specimen orientation on cyclic stress response, cyclic strain resistance, and cyclic stress versus strain response, deformation and fracture behavior of alloy steel 300 M. The cyclic strain amplitude-controlled fatigue properties of this ultra-high strength alloy steel revealed a linear trend for the variation of log elastic strain amplitude with log reversals-to-failure, and log plastic strain amplitude with log reversals-to-failure for both longitudinal and transverse orientations. Test specimens of the longitudinal orientation showed only a marginal improvement over the transverse orientation at equivalent values of plastic strain amplitude. Cyclic stress response revealed a combination of initial hardening for the first few cycles followed by gradual softening for a large portion of fatigue life before culminating in rapid softening prior to catastrophic failure by fracture. Fracture characteristics of test specimens of this alloy steel were different at both the macroscopic and fine microscopic levels over the entire range of cyclic strain amplitudes examined. Both macroscopic and fine microscopic observations revealed fracture to be a combination of both brittle and ductile mechanisms. The underlying mechanisms governing stress response, deformation characteristics, fatigue life, and final fracture behavior are presented and discussed in light of the competing and mutually interactive influences of test specimen orientation, intrinsic microstructural effects, deformation characteristics of the microstructural constituents, cyclic strain amplitude, and response stress.

Transcatheter closure of patent ductus arteriosus reverses left ventricular dysfunction in a septuagenarian.

PubMed

Rapacciuolo, Antonio; Losi, Maria Angela; Borgia, Francesco; De Angelis, Maria Carmen; Esposito, Francesca; Cavallaro, Massimo; De Rosa, Roberta; Piscione, Federico; Chiariello, Massimo

2009-04-01

A 70-year-old man was admitted because of a 6-month history of progressive dyspnoea on exertion. The medical history showed that he suffered from patent ductus arteriosus (PDA) that was closed at 35 years of age by surgical ligation. Subsequently, up to year 1992, no evidence of residual left-to-right shunt was found. When he first came to our attention, we performed an echocardiographic test evidencing left ventricular dilation and contractile dysfunction and a recurrence of PDA. To exclude other possible causes of congestive heart failure, we performed several tests, including a coronary angiogram that showed coronary atherosclerosis without significant lesions. The haemodynamic study confirmed that the PDA was associated with a mild pulmonary hypertension with a QP: QS of 2: 1. The patient did not report any cardiovascular risk factor. Therefore, we concluded that PDA was responsible for congestive heart failure in this patient. We performed percutaneous closure of PDA, which was able to reverse left ventricular dilation and dysfunction, improving the patient's symptoms, at 1 month as well as 4 months after the interventional procedure. Although this kind of device is frequently used in the paediatric population, adult patients may present different challenges in proper management, such as poor visualization, calcification and pulmonary hypertension. In the description of the case reported here, we show that a PDA can present as congestive heart failure in the elderly. Percutaneous closure can be very effective in ameliorating left ventricular performance as well as symptoms.

Organ dysfunction, injury and failure in acute heart failure: from pathophysiology to diagnosis and management. A review on behalf of the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC).

PubMed

Harjola, Veli-Pekka; Mullens, Wilfried; Banaszewski, Marek; Bauersachs, Johann; Brunner-La Rocca, Hans-Peter; Chioncel, Ovidiu; Collins, Sean P; Doehner, Wolfram; Filippatos, Gerasimos S; Flammer, Andreas J; Fuhrmann, Valentin; Lainscak, Mitja; Lassus, Johan; Legrand, Matthieu; Masip, Josep; Mueller, Christian; Papp, Zoltán; Parissis, John; Platz, Elke; Rudiger, Alain; Ruschitzka, Frank; Schäfer, Andreas; Seferovic, Petar M; Skouri, Hadi; Yilmaz, Mehmet Birhan; Mebazaa, Alexandre

2017-07-01

Organ injury and impairment are commonly observed in patients with acute heart failure (AHF), and congestion is an essential pathophysiological mechanism of impaired organ function. Congestion is the predominant clinical profile in most patients with AHF; a smaller proportion presents with peripheral hypoperfusion or cardiogenic shock. Hypoperfusion further deteriorates organ function. The injury and dysfunction of target organs (i.e. heart, lungs, kidneys, liver, intestine, brain) in the setting of AHF are associated with increased risk for mortality. Improvement in organ function after decongestive therapies has been associated with a lower risk for post-discharge mortality. Thus, the prevention and correction of organ dysfunction represent a therapeutic target of interest in AHF and should be evaluated in clinical trials. Treatment strategies that specifically prevent, reduce or reverse organ dysfunction remain to be identified and evaluated to determine if such interventions impact mortality, morbidity and patient-centred outcomes. This paper reflects current understanding among experts of the presentation and management of organ impairment in AHF and suggests priorities for future research to advance the field. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

Determinants of noninvasive ventilation success or failure in morbidly obese patients in acute respiratory failure.

PubMed

Lemyze, Malcolm; Taufour, Pauline; Duhamel, Alain; Temime, Johanna; Nigeon, Olivier; Vangrunderbeeck, Nicolas; Barrailler, Stéphanie; Gasan, Gaëlle; Pepy, Florent; Thevenin, Didier; Mallat, Jihad

2014-01-01

Acute respiratory failure (ARF) is a common life-threatening complication in morbidly obese patients with obesity hypoventilation syndrome (OHS). We aimed to identify the determinants of noninvasive ventilation (NIV) success or failure for this indication. We prospectively included 76 consecutive patients with BMI>40 kg/m2 diagnosed with OHS and treated by NIV for ARF in a 15-bed ICU of a tertiary hospital. NIV failed to reverse ARF in only 13 patients. Factors associated with NIV failure included pneumonia (n = 12/13, 92% vs n = 9/63, 14%; p<0.0001), high SOFA (10 vs 5; p<0.0001) and SAPS2 score (63 vs 39; p<0.0001) at admission. These patients often experienced poor outcome despite early resort to endotracheal intubation (in-hospital mortality, 92.3% vs 17.5%; p<0.001). The only factor significantly associated with successful response to NIV was idiopathic decompensation of OHS (n = 30, 48% vs n = 0, 0%; p = 0.001). In the NIV success group (n = 63), 33 patients (53%) experienced a delayed response to NIV (with persistent hypercapnic acidosis during the first 6 hours). Multiple organ failure and pneumonia were the main factors associated with NIV failure and death in morbidly obese patients in hypoxemic ARF. On the opposite, NIV was constantly successful and could be safely pushed further in case of severe hypercapnic acute respiratory decompensation of OHS.

Assessing plant hydraulic architecture with ultrasonic acoustic emission techniques

NASA Astrophysics Data System (ADS)

Meinzer, F. C.; Johnson, D.; McCulloh, K.; Woodruff, D.

2012-12-01

Water is transported through the xylem of plants under tension (negative pressure). If the tension within a xylem conduit exceeds a critical value, cavitation can occur, which if followed by embolism leads to blockage of water transport through the conduit. Plant species and different organs within the plant such as roots, stems and leaves vary widely in the xylem tension thresholds at which cavitation events begin to occur. Massive cavitation and embolism can lead to catastrophic hydraulic failure and plant death from dehydration. Ultrasonic acoustic emission (UAE) transducers provide a non-invasive means of detecting cavitation events in plants and recording the accumulation of these events through time. When used in combination with other techniques, recording of UAEs can be a powerful tool for characterizing and understanding plant hydraulic architecture; the collection of properties that determine the efficiency and vulnerability of water transport from roots to leaves. The hydraulic architecture of leaves is particularly complex because water must traverse the dead cells of the xylem plus an extra-xylary pathway consisting of living cells and intercellular spaces before it arrives at the internal evaporating surfaces. We used UAE, imaging and other techniques to determine the extent to which dehydration-induced declines in leaf hydraulic conductance were associated with xylem cavitation and embolism versus changes in the conductance of the extra-xylary pathway. In most of the evergreen and deciduous tree species studied there was a close correspondence between the trajectories of cumulative UAEs and loss of whole-leaf hydraulic conductance during dehydration. The mean amplitude of UAEs was positively correlated with mean conduit diameter indicating that in addition to detecting cavitation events, analysis of UAE features can provide information about relative changes in xylem hydraulic conductivity because conductivity is a function of conduit radius to the fourth power. We were unable to detect UAEs from conduits smaller than about 4 micrometers in diameter. The occurrence of embolism in leaf xylem was confirmed independently with cryo-SEM and light microscopy imaging. As expected, there was considerable variation among species in the leaf water potential thresholds at which xylem cavitation and loss of hydraulic conductance began to occur. Contrary to suggestions from some published studies, we saw no evidence of reversible partial xylem conduit collapse instead of cavitation during dehydration. Results from our field studies indicate that dehydration-induced embolism in leaf xylem is completely reversible over a 24-hour cycle, but the mechanism for refilling xylem conduits is unknown. We discuss constraints on the application of UAE techniques for studying plant hydraulics.

Reversible infantile mitochondrial diseases.

PubMed

Boczonadi, Veronika; Bansagi, Boglarka; Horvath, Rita

2015-05-01

Mitochondrial diseases are usually severe and progressive conditions; however, there are rare forms that show remarkable spontaneous recoveries. Two homoplasmic mitochondrial tRNA mutations (m.14674T>C/G in mt-tRNA(Glu)) have been reported to cause severe infantile mitochondrial myopathy in the first months of life. If these patients survive the first year of life by extensive life-sustaining measures they usually recover and develop normally. Another mitochondrial disease due to deficiency of the 5-methylaminomethyl-2-thiouridylate methyltransferase (TRMU) causes severe liver failure in infancy, but similar to the reversible mitochondrial myopathy, within the first year of life these infants may also recover completely. Partial recovery has been noted in some other rare forms of mitochondrial disease due to deficiency of mitochondrial tRNA synthetases and mitochondrial tRNA modifying enzymes. Here we summarize the clinical presentation of these unique reversible mitochondrial diseases and discuss potential molecular mechanisms behind the reversibility. Understanding these mechanisms may provide the key to treatments of potential broader relevance in mitochondrial disease, where for the majority of the patients no effective treatment is currently available.

Forensic Study of Early Failures with Unbonded Concrete Overlays

DOT National Transportation Integrated Search

2017-11-01

A forensic investigation was conducted to identify failure mechanisms responsible for early failures of unbonded concrete overlays on selected projects in Ohio, including I-70 in Madison County, I-77 in Washington and Noble Counties, and I-90 in Lake...

40 CFR 141.211 - Special notice for repeated failure to conduct monitoring of the source water for Cryptosporidium...

Code of Federal Regulations, 2011 CFR

2011-07-01

... determine whether water treatment at the (treatment plant name) is sufficient to adequately remove... source of your drinking water for Cryptosporidium in order to determine by (date) whether water treatment... conduct monitoring of the source water for Cryptosporidium and for failure to determine bin classification...

Practical Implementation of Failure Mode and Effects Analysis for Safety and Efficiency in Stereotactic Radiosurgery

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

Younge, Kelly Cooper, E-mail: kyounge@med.umich.edu; Wang, Yizhen; Thompson, John

2015-04-01

Purpose: To improve the safety and efficiency of a new stereotactic radiosurgery program with the application of failure mode and effects analysis (FMEA) performed by a multidisciplinary team of health care professionals. Methods and Materials: Representatives included physicists, therapists, dosimetrists, oncologists, and administrators. A detailed process tree was created from an initial high-level process tree to facilitate the identification of possible failure modes. Group members were asked to determine failure modes that they considered to be the highest risk before scoring failure modes. Risk priority numbers (RPNs) were determined by each group member individually and then averaged. Results: A totalmore » of 99 failure modes were identified. The 5 failure modes with an RPN above 150 were further analyzed to attempt to reduce these RPNs. Only 1 of the initial items that the group presumed to be high-risk (magnetic resonance imaging laterality reversed) was ranked in these top 5 items. New process controls were put in place to reduce the severity, occurrence, and detectability scores for all of the top 5 failure modes. Conclusions: FMEA is a valuable team activity that can assist in the creation or restructuring of a quality assurance program with the aim of improved safety, quality, and efficiency. Performing the FMEA helped group members to see how they fit into the bigger picture of the program, and it served to reduce biases and preconceived notions about which elements of the program were the riskiest.« less

CO2 Responsive Imidazolium-Type Poly(Ionic Liquid) Gels.

PubMed

Zhang, Jing; Xu, Dan; Guo, Jiangna; Sun, Zhe; Qian, Wenjing; Zhang, Ye; Yan, Feng

2016-07-01

Poly(ionic liquid) (PIL) gels with CO2 stimulus responsiveness have been synthesized through the copolymerization of an imidazolium-type ionic liquid monomer with 2-(dimethyl amino) ethyl methacrylate. Upon bubbling with CO2 gas, the prepared PIL solution is converted to a transparent and stable gel, which can be turned back to the initial solution state after N2 bubbling. The reversible sol-gel phase transition behavior is proved by the reversible values of viscosity and ionic conductivity. The possible mechanism for such a reversible sol-gel phase transition is demonstrated by NMR, conductivity, and rheological measurements. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

49 CFR Appendix D to Part 230 - Civil Penalty Schedule

Code of Federal Regulations, 2010 CFR

2010-10-01

... the boiler 1,000 2,000 230.36Hydrostatic testing of boilers: (a) Failure to perform hydrostatic test of boiler as required 1,500 3,000 (b) Failure to properly perform hydrostatic test 1,500 3,000 (c) Failure to properly inspect boiler after conducting hydrostatic test above MAWP 1,500 3,000 230.37 Failure...

Case report: Unilateral conduction hearing loss due to central venous occlusion.

PubMed

Ribeiro, Phillip; Patel, Swetal; Qazi, Rizwan A

2016-05-07

Central venous stenosis is a well-known complication in patients with vascular access for hemodialysis. We report two cases involving patients on hemodialysis with arteriovenous fistulas who developed reversible unilateral conductive hearing loss secondary to critical stenosis of central veins draining the arteriovenous dialysis access. A proposed mechanism for the patients' reversible unilateral hearing loss is pterygoid venous plexus congestion leading to decreased Eustachian tube patency. Endovascular therapy was conducted to treat the stenosis and the hearing loss of both patients was returned to near normal after successful central venous angioplasty.

Interhospital transfer of children in respiratory failure: a clinician interview qualitative study.

PubMed

Odetola, Folafoluwa O; Anspach, Renee R; Han, Yong Y; Clark, Sarah J

2017-02-01

To investigate the decision making underlying transfer of children with respiratory failure from level II to level I pediatric intensive care unit care. Interviews with 19 eligible level II pediatric intensive care unit physicians about a hypothetical scenario of a 2-year-old girl in respiratory failure: RESULTS: At baseline, indices critical to management were as follows: OI (53%), partial pressure of oxygen in arterial blood (Pao 2 )/Fio 2 (32%), and inflation pressure (16%). Poor clinical response was signified by high OI, inflation pressure, and Fio 2 , and low Pao 2 /Fio 2 . At EP 1, 18 of 19 respondents would initiate high-frequency oscillatory ventilation, and 1 would transfer. At EP 2, 15 of 18 respondents would maintain high-frequency oscillatory ventilation, 9 of them calling to discuss transfer. All respondents would transfer if escalated therapies failed to reverse the patient's clinical deterioration. Interhospital transfer of children in respiratory failure is triggered by poor response to escalation of locally available care modalities. This finding provides new insight into decision making underlying interhospital transfer of children with respiratory failure. Copyright © 2016 Elsevier Inc. All rights reserved.

Hypophosphatemia-induced Cardiomyopathy.

PubMed

Ariyoshi, Nobuhiro; Nogi, Masayuki; Ando, Akika; Watanabe, Hideaki; Umekawa, Sari

2016-09-01

Relatively few studies have been conducted to evaluate the effect of hypophosphatemia on cardiac function. The goal of this review was to determine whether there is an association between hypophosphatemia and cardiac function and to increase awareness of hypophosphatemia-induced cardiomyopathy as a new clinical entity and a reversible cause of heart failure. We searched MEDLINE and PubMed from 1971 until March 2015 for primary studies, which reported the relationship between hypophosphatemia and cardiac function. A total of 837 articles were initially obtained. Of these articles, 826 publications were excluded according to the inclusion and exclusion criteria. In all, 11 articles were included in this review. These articles included 7 case series or case reports, 1 case-control study, 1 pretest versus posttest in a single group and 2 animal studies. In conclusion, the mechanisms of hypophosphatemia in cardiomyopathy have been reported to be a depletion of adenosine triphosphate in myocardial cells and decreased 2,3-diphosphoglycerate in erythrocytes. After correction of hypophosphatemia, left ventricular performance seems to improve in patients with severe hypophosphatemia, but not in those with mild-to-moderate hypophosphatemia. However, analyses of the relationship between cardiac function and hypophosphatemia using clinical end points have not been conducted. Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

Study of temperature, air dew point temperature and reactant flow effects on proton exchange membrane fuel cell performances using electrochemical spectroscopy and voltammetry techniques

NASA Astrophysics Data System (ADS)

Wasterlain, S.; Candusso, D.; Hissel, D.; Harel, F.; Bergman, P.; Menard, P.; Anwar, M.

A single PEMFC has been operated by varying the assembly temperature, the air dew point temperature and the anode/cathode stoichiometry rates with the aim to identify the parameters and combinations of factors affecting the cell performance. Some of the experiments were conducted with low humidified reactants (relative humidity of 12%). The FC characterizations tests have been conducted using in situ electrochemical methods based on load current and cell voltage signal analysis, namely: polarization curves, EIS measurements, cyclic and linear sweep voltammetries (CV and LSV). The impacts of the parameters on the global FC performances were observed using the polarization curves whereas EIS, CV and LSV test results were used to discriminate the different voltage loss sources. The test results suggest that some parameter sets allow maximal output voltages but can also induce material degradation. For instance, higher FC temperature and air flow values can induce significant electrical efficiency benefits, notably by increasing the reversible potential and the reaction kinetics. However, raising the cell temperature can also gradually dry the FC and increase the risk of membrane failure. LSV has also shown that elevated FC temperature and relative humidity can also accelerate the electrolyte degradation (i.e. slightly higher fuel crossover rate) and reduce the lifetime consequently.

Feedback Blunting: Total Sleep Deprivation Impairs Decision Making that Requires Updating Based on Feedback

PubMed Central

Whitney, Paul; Hinson, John M.; Jackson, Melinda L.; Van Dongen, Hans P.A.

2015-01-01

Study Objectives: To better understand the sometimes catastrophic effects of sleep loss on naturalistic decision making, we investigated effects of sleep deprivation on decision making in a reversal learning paradigm requiring acquisition and updating of information based on outcome feedback. Design: Subjects were randomized to a sleep deprivation or control condition, with performance testing at baseline, after 2 nights of total sleep deprivation (or rested control), and following 2 nights of recovery sleep. Subjects performed a decision task involving initial learning of go and no go response sets followed by unannounced reversal of contingencies, requiring use of outcome feedback for decisions. A working memory scanning task and psychomotor vigilance test were also administered. Setting: Six consecutive days and nights in a controlled laboratory environment with continuous behavioral monitoring. Subjects: Twenty-six subjects (22–40 y of age; 10 women). Interventions: Thirteen subjects were randomized to a 62-h total sleep deprivation condition; the others were controls. Results: Unlike controls, sleep deprived subjects had difficulty with initial learning of go and no go stimuli sets and had profound impairment adapting to reversal. Skin conductance responses to outcome feedback were diminished, indicating blunted affective reactions to feedback accompanying sleep deprivation. Working memory scanning performance was not significantly affected by sleep deprivation. And although sleep deprived subjects showed expected attentional lapses, these could not account for impairments in reversal learning decision making. Conclusions: Sleep deprivation is particularly problematic for decision making involving uncertainty and unexpected change. Blunted reactions to feedback while sleep deprived underlie failures to adapt to uncertainty and changing contingencies. Thus, an error may register, but with diminished effect because of reduced affective valence of the feedback or because the feedback is not cognitively bound with the choice. This has important implications for understanding and managing sleep loss-induced cognitive impairment in emergency response, disaster management, military operations, and other dynamic real-world settings with uncertain outcomes and imperfect information. Citation: Whitney P, Hinson JM, Jackson ML, Van Dongen HPA. Feedback blunting: total sleep deprivation impairs decision making that requires updating based on feedback. SLEEP 2015;38(5):745–754. PMID:25515105

Asiatic Acid (AA) Sensitizes Multidrug-Resistant Human Lung Adenocarcinoma A549/DDP Cells to Cisplatin (DDP) via Downregulation of P-Glycoprotein (MDR1) and Its Targets.

PubMed

Cheng, Qilai; Liao, Meixiang; Hu, Haibo; Li, Hongliang; Wu, Longhuo

2018-01-01

P-glycoprotein (P-gp, i.e., MDR1) is associated with the phenotype of multidrug resistance (MDR) and causes chemotherapy failure in the management of cancers. Searching for effective MDR modulators and combining them with anticancer drugs is a promising strategy against MDR. Asiatic acid (AA), a natural triterpene isolated from the plant Centella asiatica, may have an antitumor activity. The present study assessed the reversing effect of AA on MDR and possible molecular mechanisms of AA action in MDR1-overexpressing cisplatin (DDP)-resistant lung cancer cells, A549/DDP. Human lung adenocarcinoma A549/DDP cells were either exposed to different concentrations of AA or treated with DDP, and their viability was measured by the MTT assay. A Rhodamine 123 efflux assay, immunofluorescent staining, ATPase assay, reverse-transcription PCR (RT-PCR), and western blot analysis were conducted to elucidate the mechanisms of action of AA on MDR. Our results showed that AA significantly enhanced the cytotoxicity of DDP toward A549/DDP cells but not its parental A549 cells. Furthermore, AA strongly inhibited P-gp expression by blocking MDR1 gene transcription and increased the intracellular accumulation of the P-gp substrate Rhodamine 123 in A549/DDP cells. Nuclear factor (NF)-kB (p65) activity, IkB degradation, and NF-kB/p65 nuclear translocation were markedly inhibited by pretreatment with AA. Additionally, AA inhibited the MAPK-ERK pathway, as indicated by decreased phosphorylation of ERK1 and -2, AKT, p38, and JNK, thus resulting in reduced activity of the Y-box binding protein 1 (YB1) via blockage of its nuclear translocation. AA reversed P-gp-mediated MDR by inhibition of P-gp expression. This effect was likely related to downregulation of YB1, and this effect was mediated by the NF-kB and MAPK-ERK pathways. AA may be useful as an MDR reversal agent for combination therapy in clinical trials. © 2018 The Author(s). Published by S. Karger AG, Basel.

Reverse left ventricular remodeling after acute myocardial infarction: the prognostic impact of left ventricular global torsion.

PubMed

Spinelli, Letizia; Morisco, Carmine; Assante di Panzillo, Emiliano; Izzo, Raffaele; Trimarco, Bruno

2013-04-01

Reverse left ventricular (LV) remodeling (>10 % reduction in LV end-systolic volume) may occur in patients recovering for acute ST-elevation myocardial infarction (STEMI), undergoing percutaneous revascularization of infarct-related coronary artery (PCI). To detect whether LV global torsion obtained by two-dimensional speckle-tracking echocardiography was predictive of reverse LV remodeling, 75 patients with first anterior wall STEMI were studied before (T1) and after PCI (T2) and at 6-month follow-up. Two-year clinical follow-up was also accomplished. LV volumes and both LV sphericity index and conic index were obtained by three-dimensional echocardiography. Reverse remodeling was observed in 25 patients (33 %). By multivariate analysis, independent predictors of reverse LV remodeling were: LV conic index, T2 LV torsion and Δ torsion (difference between T2 and T1 LV torsion expressed as percentage of this latter). According to receiver operating characteristic analysis, 1.34°/cm for T2 LV torsion (sensitivity 88 % and specificity 80 %) and 54 % for Δ torsion (sensitivity 92 % and specificity 82 %) were the optimal cutoff values in predicting reverse LV remodeling. In up to 24 month follow-up, 4 non-fatal re-infarction, 7 hospitalization for heart failure and 4 cardiac deaths occurred. By multivariate Cox analysis, the best variable significantly associated with event-free survival rate was reverse LV remodeling with a hazard ratio = 9.9 (95 % confidence interval, 7.9-31.4, p < 0.01). In conclusion, reverse LV remodeling occurring after anterior wall STEMI is associated with favorable long-term outcome. The improvement of global LV torsion following coronary artery revascularization is the major predictor of reverse LV remodeling.

Creep test observation of viscoelastic failure of edible fats

NASA Astrophysics Data System (ADS)

Vithanage, C. R.; Grimson, M. J.; Smith, B. G.; Wills, P. R.

2011-03-01

A rheological creep test was used to investigate the viscoelastic failure of five edible fats. Butter, spreadable blend and spread were selected as edible fats because they belong to three different groups according to the Codex Alimentarius. Creep curves were analysed according to the Burger model. Results were fitted to a Weibull distribution representing the strain-dependent lifetime of putative fibres in the material. The Weibull shape and scale (lifetime) parameters were estimated for each substance. A comparison of the rheometric measurements of edible fats demonstrated a clear difference between the three different groups. Taken together the results indicate that butter has a lower threshold for mechanical failure than spreadable blend and spread. The observed behaviour of edible fats can be interpreted using a model in which there are two types of bonds between fat crystals; primary bonds that are strong and break irreversibly, and secondary bonds, which are weaker but break and reform reversibly.

Reverse Shoulder Arthroplasty for the Treatment of 3 and 4- Part Fractures of the Humeral Head in the Elderly

PubMed Central

Gigis, Ioannis; Nenopoulos, Alexandros; Giannekas, Dimitrios; Heikenfeld, Roderich; Beslikas, Theodoros; Hatzokos, Ippokratis

2017-01-01

Background: Proximal humeral fractures in elderly patients present with severe comminution and osteoporotic bone quality. Reverse shoulder arthroplasty has lately been proven beneficial in treating patients with complex proximal humeral fractures. The above technique is recommended and has better results in elderly than in younger individuals. Methods: We performed a literature search in the databases Pubmed, Medline, EMBASE and Cochrane Library for published articles between 1970 and 2016 using the terms: proximal humerus fractures and reverse shoulder arthroplasty. Results: Significant benefits with the use of reverse prosthesis, especially in patients older than 70 years with a proximal humeral fracture, include reduced rehabilitation time as well as conservation of a fixed fulcrum for deltoid action in case of rotator cuff failure. Compared with hemiarthroplasty and internal fixation, reverse prosthesis may be particularly useful and give superior outcomes in older patients, due to comminuted fractures in osteopenic bones. However, significant disadvantages of this technique are potential complications and a demanding learning curve.Therefore, trained surgeons should follow specific indications when applying the particular treatment of proximal humeral fractures and be familiar with the surgical technique. Conclusion: Although long-term results and randomized studies for reverse prosthesis are lacking, short and mid- term outcomes have given promising results encouraging more shoulder surgeons to use this type of prosthesis in proximal humeral fractures. PMID:28400879

Integral physicochemical properties of reverse micelles of sodium bis(2-ethylhexyl) sulfosuccinate (AOT)

NASA Astrophysics Data System (ADS)

Fedyaeva, O. A.; Shubenkova, E. G.; Poshelyuzhnaya, E. G.; Lutaeva, I. A.

2016-08-01

The effect the degree of hydration has on optical and electrophysical properties of water/AOT/ n-hexane system is studied. It is found that AOT reverse micelles form aggregates whose dimensions grow along with the degree of hydration and temperature. Aggregation enhances their electrical conductivity and shifts the UV spectrum of AOT reverse emulsions to the red region. Four states of water are found in the structure of AOT reverse micelles.

Cyclic behavior, development, and characteristics of a ductile hybrid fiber-reinforced polymer (DHFRP) for reinforced concrete members

NASA Astrophysics Data System (ADS)

Hampton, Francis Patrick

Reinforced concrete (R/C) structures especially pavements and bridge decks that constitute vital elements of the infrastructure of all industrialized societies are deteriorating prematurely. Structural repair and upgrading of these structural elements have become a more economical option for constructed facilities especially in the United States and Canada. One method of retrofitting concrete structures is the use of advanced materials. Fiber reinforced polymer (FRP) composite materials typically are in the form of fabric sheets or reinforcing bars. While the strength and stiffness of the FRP is high, composites are inherently brittle, with limited or no ductility. Conventional FRP systems cannot currently meet ductility demand, and therefore, may fail in a catastrophic failure mode. The primary goal of this research was to develop an optimized prototype 10-mm diameter DHFRP bar. The behavior of the bar under full load reversals to failure was investigated. However, this bar first needed to be designed and manufactured in the Fibrous Materials Research at Drexel University. Material properties were determined through testing to categorize the strength properties of the DHFRP. Similitude was used to demonstrate the scaling of properties from the original model bars. The four most important properties of the DHFRP bars are sufficient strength and stiffness, significant ductility for plasticity to develop in the R/C section, and sufficient bond strength for the R/C section to develop its full strength. Once these properties were determined the behavior of reinforced concrete members was investigated. This included the testing of prototype-size beams under monotonic loading and model and prototype beam-columns under reverse cyclic loading. These tests confirmed the large ductility exhibited by the DHFRP. Also the energy absorption capacity of the bar was demonstrated by the hysteretic behavior of the beam-columns. Displacement ductility factors in the range of 3--6 were achieved for all concrete elements tested. To study the long-term behavior of DHFRP, the creep-rupture strength of 5-mm bars was tested. This was conducted first on individual bar specimens and is important in the life-cycle design and performance of DHFRP reinforced concrete.

TRIPPING CIRCUIT

DOEpatents

Lees, G.W.; McCormick, E.D.

1962-05-22

A tripping circuit employing a magnetic amplifier for tripping a reactor in response to power level, period, or instrument failure is described. A reference winding and signal winding are wound in opposite directions on the core. Current from an ion chamber passes through both windings. If the current increases at too fast a rate, a shunt circuit bypasses one or the windings and the amplifier output reverses polarity. (AEC)

Reversible and irreversible wrinkling in tube hydroforming process

NASA Astrophysics Data System (ADS)

El-Aty, Ali Abd; Ahmed, Tauseef; Farooq, Ahmed

2017-07-01

The aim of this research is to analyzeandoptimize the hydroforming process parameters in order to achieve a sound bulged tube without failure. Theoretical constitutive model is formulated to develop a working diagram including process window, which represents the optimize region to carry out the hydroforming process and predict the type of tube failure during the process accurately. The model is applied into different bulging ratios for low carbon steel (C1010). From this study, it is concluded that the tubes with bulging ratios up to 50% and 70% are successfully formed without defects. The tubes with bulging ratio of 90% are successfully formed by hydroforming with optimized the loading path (axial feed versus internal pressure) within the process window. The working diagram is modified due to different types of formation of wrinkling during the hydroforming process. The formation of wrinkles with increasing axial feed can be useful in terms of the achievement of higher bulging ratio and/or less thinning and this type of wrinkles can be overcome through the internal pressure in the later stage of the hydroforming process. On the other hand, the formation of wrinkles may be harmful, if it cannot be reversed.

Honeycomb Core Permeability Under Mechanical Loads

NASA Technical Reports Server (NTRS)

Glass, David E.; Raman, V. V.; Venkat, Venki S.; Sankaran, Sankara N.

1997-01-01

A method for characterizing the air permeability of sandwich core materials as a function of applied shear stress was developed. The core material for the test specimens was either Hexcel HRP-3/16-8.0 and or DuPont Korex-1/8-4.5 and was nominally one-half inch thick and six inches square. The facesheets where made of Hercules' AS4/8552 graphite/epoxy (Gr/Ep) composites and were nominally 0.059-in. thick. Cytec's Metalbond 1515-3M epoxy film adhesive was used for co-curing the facesheets to the core. The permeability of the specimens during both static (tension) and dynamic (reversed and non-reversed) shear loads were measured. The permeability was measured as the rate of air flow through the core from a circular 1-in2 area of the core exposed to an air pressure of 10.0 psig. In both the static and dynamic testing, the Korex core experienced sudden increases in core permeability corresponding to a core catastrophic failure, while the URP core experienced a gradual increase in the permeability prior to core failure. The Korex core failed at lower loads than the HRP core both in the transverse and ribbon directions.

NASA Structural Analysis Report on the American Airlines Flight 587 Accident - Local Analysis of the Right Rear Lug

NASA Technical Reports Server (NTRS)

Raju, Ivatury S; Glaessgen, Edward H.; Mason, Brian H; Krishnamurthy, Thiagarajan; Davila, Carlos G

2005-01-01

A detailed finite element analysis of the right rear lug of the American Airlines Flight 587 - Airbus A300-600R was performed as part of the National Transportation Safety Board s failure investigation of the accident that occurred on November 12, 2001. The loads experienced by the right rear lug are evaluated using global models of the vertical tail, local models near the right rear lug, and a global-local analysis procedure. The right rear lug was analyzed using two modeling approaches. In the first approach, solid-shell type modeling is used, and in the second approach, layered-shell type modeling is used. The solid-shell and the layered-shell modeling approaches were used in progressive failure analyses (PFA) to determine the load, mode, and location of failure in the right rear lug under loading representative of an Airbus certification test conducted in 1985 (the 1985-certification test). Both analyses were in excellent agreement with each other on the predicted failure loads, failure mode, and location of failure. The solid-shell type modeling was then used to analyze both a subcomponent test conducted by Airbus in 2003 (the 2003-subcomponent test) and the accident condition. Excellent agreement was observed between the analyses and the observed failures in both cases. From the analyses conducted and presented in this paper, the following conclusions were drawn. The moment, Mx (moment about the fuselage longitudinal axis), has significant effect on the failure load of the lugs. Higher absolute values of Mx give lower failure loads. The predicted load, mode, and location of the failure of the 1985-certification test, 2003-subcomponent test, and the accident condition are in very good agreement. This agreement suggests that the 1985-certification and 2003- subcomponent tests represent the accident condition accurately. The failure mode of the right rear lug for the 1985-certification test, 2003-subcomponent test, and the accident load case is identified as a cleavage-type failure. For the accident case, the predicted failure load for the right rear lug from the PFA is greater than 1.98 times the limit load of the lugs. I.

Reversible temperature regulation of electrical and thermal conductivity using liquid–solid phase transitions

PubMed Central

Zheng, Ruiting; Gao, Jinwei; Wang, Jianjian; Chen, Gang

2011-01-01

Reversible temperature tuning of electrical and thermal conductivities of materials is of interest for many applications, including seasonal regulation of building temperature, thermal storage and sensors. Here we introduce a general strategy to achieve large contrasts in electrical and thermal conductivities using first-order phase transitions in percolated composite materials. Internal stress generated during a phase transition modulates the electrical and thermal contact resistances, leading to large contrasts in the electrical and thermal conductivities at the phase transition temperature. With graphite/hexadecane suspensions, the electrical conductivity changes 2 orders of magnitude and the thermal conductivity varies up to 3.2 times near 18 °C. The generality of the approach is also demonstrated in other materials such as graphite/water and carbon nanotube/hexadecane suspensions. PMID:21505445

Reversible temperature regulation of electrical and thermal conductivity using liquid-solid phase transitions.

PubMed

Zheng, Ruiting; Gao, Jinwei; Wang, Jianjian; Chen, Gang

2011-01-01

Reversible temperature tuning of electrical and thermal conductivities of materials is of interest for many applications, including seasonal regulation of building temperature, thermal storage and sensors. Here we introduce a general strategy to achieve large contrasts in electrical and thermal conductivities using first-order phase transitions in percolated composite materials. Internal stress generated during a phase transition modulates the electrical and thermal contact resistances, leading to large contrasts in the electrical and thermal conductivities at the phase transition temperature. With graphite/hexadecane suspensions, the electrical conductivity changes 2 orders of magnitude and the thermal conductivity varies up to 3.2 times near 18 °C. The generality of the approach is also demonstrated in other materials such as graphite/water and carbon nanotube/hexadecane suspensions.

Shunting for hydrocephalus: analysis of techniques and failure patterns.

PubMed

Nigim, Fares; Critchlow, Jonathan F; Schneider, Benjamin E; Chen, Clark; Kasper, Ekkehard M

2014-09-01

Hydrocephalus is characterized by ventricular dilatation because of progressive accumulation of cerebrospinal fluid. Normal pressure hydrocephalus (NPH) affects a subset of patients representing a reversible clinical triad of gait disturbance, urinary incontinence, and dementia with normal cerebrospinal fluid pressure and composition. Various shunting procedures have been used for treatment, but techniques and outcomes remain under debate. The objective of this study was to evaluate the clinical outcomes of 232 patients with and without NPH after the first-time Ventriculoperitoneal shunt placement and assessed patterns of failure between December 2004 and December 2012. Mean age was 54.7 y in non-NPH and 71.9 y in NPH patients. We used open technique in 34.3% and laparoscopic technique in 65.7% of NPH patients and 32.7% and 67.3% of the non-NPH patients, respectively. A total of 36 of 232 patients displayed shunt failure, 16.4% in NPH and 15.2% in non-NPH patients. Twenty-three of 155 patients failed after laparoscopic and 13 of 77 failed after open placement. Proximal shunt failure was more frequent in the non-NPH cohort. Distal failures accounted for 13 of 232 cases, and the difference between laparoscopic (six of 155) and open failures (seven of 77) was profound, but not between NPH- and non-NPH patients. Shunt failures are related to the placement method. Non-NPH patients showed more proximal failures. NPH patients showed fewer proximal failures. Less distal failures were observed after laparoscopic ventriculoperitoneal shunt placement without significant differences between NPH and non-NPH patients. Beyond this, laparoscopic surgery carries distinct advantages such as shorter operating room times and hospital stays, which should translate into less use of pain medications, earlier mobilization, and a lower incidence of ileus. Copyright © 2014 Elsevier Inc. All rights reserved.

A review of wiring system safety in space power systems

NASA Technical Reports Server (NTRS)

Stavnes, Mark W.; Hammoud, Ahmad N.

1993-01-01

Wiring system failures have resulted from arc propagation in the wiring harnesses of current aerospace vehicles. These failures occur when the insulation becomes conductive upon the initiation of an arc. In some cases, the conductive path of the carbon arc track displays a high enough resistance such that the current is limited, and therefore may be difficult to detect using conventional circuit protection. Often, such wiring failures are not simply the result of insulation failure, but are due to a combination of wiring system factors. Inadequate circuit protection, unforgiving system designs, and careless maintenance procedures can contribute to a wiring system failure. This paper approaches the problem with respect to the overall wiring system, in order to determine what steps can be taken to improve the reliability, maintainability, and safety of space power systems. Power system technologies, system designs, and maintenance procedures which have led to past wiring system failures will be discussed. New technologies, design processes, and management techniques which may lead to improved wiring system safety will be introduced.

Normalization of reverse redistribution of thallium-201 with procainamide pretreatment in Wolff-Parkinson-White syndrome

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

Nii, T.; Nakashima, Y.; Nomoto, J.

1991-03-01

Stress thallium-201 myocardial perfusion imaging was performed in a patient with Wolff-Parkinson-White syndrome. Reverse redistribution phenomenon was observed in the absence of coronary artery disease. This seems to be the first report of normalization of this phenomenon in association with reversion of accessory pathway to normal atrioventricular conduction after pretreatment with procainamide.

Effectiveness of Non-nucleoside Reverse-Transcriptase Inhibitor-Based Antiretroviral Therapy in Women Previously Exposed to a Single Intrapartum Dose of Nevirapine: A Multi-country, Prospective Cohort Study

PubMed Central

Stringer, Jeffrey S. A.; McConnell, Michelle S.; Kiarie, James; Bolu, Omotayo; Anekthananon, Thanomsak; Jariyasethpong, Tavatchai; Potter, Dara; Mutsotso, Winnie; Borkowf, Craig B.; Mbori-Ngacha, Dorothy; Muiruri, Peter; Ong'ech, John Odero; Zulu, Isaac; Njobvu, Lungowe; Jetsawang, Bongkoch; Pathak, Sonal; Bulterys, Marc; Shaffer, Nathan; Weidle, Paul J.

2010-01-01

Background Intrapartum and neonatal single-dose nevirapine (NVP) reduces the risk of mother-to-child HIV transmission but also induces viral resistance to non-nucleoside reverse transcriptase inhibitor (NNRTI) drugs. This drug resistance largely fades over time. We hypothesized that women with a prior single-dose NVP exposure would have no more than a 10% higher cumulative prevalence of failure of their NNRTI-containing antiretroviral therapy (ART) over the first 48 wk of therapy than would women without a prior exposure. Methods and Findings We enrolled 355 NVP-exposed and 523 NVP-unexposed women at two sites in Zambia, one site in Kenya, and two sites in Thailand into a prospective, non-inferiority cohort study and followed them for 48 wk on ART. Those who died, discontinued NNRTI-containing ART, or had a plasma viral load ≥400 copies/ml at either the 24 wk or 48 wk study visits and confirmed on repeat testing were characterized as having failed therapy. Overall, 114 of 355 NVP-exposed women (32.1%) and 132 of 523 NVP-unexposed women (25.2%) met criteria for treatment failure. The difference in failure rates between the exposure groups was 6.9% (95% confidence interval [CI] 0.8%–13.0%). The failure rates of women stratified by our predefined exposure interval categories were as follows: 47 of 116 women in whom less than 6 mo elapsed between exposure and starting ART failed therapy (40%; p<0.001 compared to unexposed women); 25 of 67 women in whom 7–12 mo elapsed between exposure and starting ART failed therapy (37%; p = 0.04 compared to unexposed women); and 42 of 172 women in whom more than 12 mo elapsed between exposure and starting ART failed therapy (24%; p = 0.82 compared to unexposed women). Locally weighted regression analysis also indicated a clear inverse relationship between virologic failure and the exposure interval. Conclusions Prior exposure to single-dose NVP was associated with an increased risk of treatment failure; however, this risk seems largely confined to women with a more recent exposure. Women requiring ART within 12 mo of NVP exposure should not be prescribed an NNRTI-containing regimen as first-line therapy. Please see later in the article for the Editors' Summary PMID:20169113

Chronic Heart Failure: Contemporary Diagnosis and Management

PubMed Central

Ramani, Gautam V.; Uber, Patricia A.; Mehra, Mandeep R.

2010-01-01

Chronic heart failure (CHF) remains the only cardiovascular disease with an increasing hospitalization burden and an ongoing drain on health care expenditures. The prevalence of CHF increases with advancing life span, with diastolic heart failure predominating in the elderly population. Primary prevention of coronary artery disease and risk factor management via aggressive blood pressure control are central in preventing new occurrences of left ventricular dysfunction. Optimal therapy for CHF involves identification and correction of potentially reversible precipitants, target-dose titration of medical therapy, and management of hospitalizations for decompensation. The etiological phenotype, absolute decrease in left ventricular ejection fraction and a widening of QRS duration on electrocardiography, is commonly used to identify patients at increased risk of progression of heart failure and sudden death who may benefit from prophylactic implantable cardioverter-defibrillator placement with or without cardiac resynchronization therapy. Patients who transition to advanced stages of disease despite optimal traditional medical and device therapy may be candidates for hemodynamically directed approaches such as a left ventricular assist device; in selected cases, listing for cardiac transplant may be warranted. PMID:20118395

Response of resin transfer molded (RTM) composites under reversed cyclic loading

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

Mahfuz, H.; Haque, A.; Yu, D.

1996-01-01

Compressive behavior and the tension-compression fatigue response of resin transfer molded IM7 PW/PR 500 composite laminate with a circular notch have been studied. Fatigue damage characteristics have been investigated through the changes in the laminate strength and stiffness by gradually incrementing the fatigue cycles at a preselected load level. Progressive damage in the surface of the laminate during fatigue has been investigated using cellulose replicas. Failure mechanisms during static and cyclic tests have been identified and presented in detail. Extensive debonding of filaments and complete fiber bundle fracture accompanied by delamination were found to be responsible for fatigue failures, whilemore » fiber buckling, partial fiber fracture and delamination were characterized as the failure modes during static tests. Weibull analysis of the static, cyclic and residual tests have been performed and described in detail. Fractured as well as untested specimens were C-scanned, and the progressive damage growth during fatigue is presented. Optical Microscopy (OM) and Scanning Electron Microscopy (SEM) for the fractured specimen were also performed and the analysis of the failure behavior is presented.« less

Shuttle Gaseous Hydrogen Venting Risk from Flow Control Valve Failure

NASA Technical Reports Server (NTRS)

Drummond, J. Philip; Baurle, Robert A.; Gafney, Richard L.; Norris, Andrew T.; Pellett, Gerald L.; Rock, Kenneth E.

2009-01-01

This paper describes a series of studies to assess the potential risk associated with the failure of one of three gaseous hydrogen flow control valves in the orbiter's main propulsion system during the launch of Shuttle Endeavour (STS-126) in November 2008. The studies focused on critical issues associated with the possibility of combustion resulting from release of gaseous hydrogen from the external tank into the atmosphere during assent. The Shuttle Program currently assumes hydrogen venting from the external tank will result in a critical failure. The current effort was conducted to increase understanding of the risk associated with venting hydrogen given the flow control valve failure scenarios being considered in the Integrated In-Flight Anomaly Investigation being conducted by NASA.

Solid state switch

DOEpatents

Merritt, Bernard T.; Dreifuerst, Gary R.

1994-01-01

A solid state switch, with reverse conducting thyristors, is designed to operate at 20 kV hold-off voltage, 1500 A peak, 1.0 .mu.s pulsewidth, and 4500 pps, to replace thyratrons. The solid state switch is more reliable, more economical, and more easily repaired. The switch includes a stack of circuit card assemblies, a magnetic assist and a trigger chassis. Each circuit card assembly contains a reverse conducting thyristor, a resistor capacitor network, and triggering circuitry.

Interplay of Coulomb interactions and disorder in three-dimensional quadratic band crossings without time-reversal symmetry and with unequal masses for conduction and valence bands

NASA Astrophysics Data System (ADS)

Mandal, Ipsita; Nandkishore, Rahul M.

2018-03-01

Coulomb interactions famously drive three-dimensional quadratic band crossing semimetals into a non-Fermi liquid phase of matter. In a previous work [Nandkishore and Parameswaran, Phys. Rev. B 95, 205106 (2017), 10.1103/PhysRevB.95.205106], the effect of disorder on this non-Fermi liquid phase was investigated, assuming that the band structure was isotropic, assuming that the conduction and valence bands had the same band mass, and assuming that the disorder preserved exact time-reversal symmetry and statistical isotropy. It was shown that the non-Fermi liquid fixed point is unstable to disorder and that a runaway flow to strong disorder occurs. In this paper, we extend that analysis by relaxing the assumption of time-reversal symmetry and allowing the electron and hole masses to differ (but continuing to assume isotropy of the low energy band structure). We first incorporate time-reversal symmetry breaking disorder and demonstrate that there do not appear any new fixed points. Moreover, while the system continues to flow to strong disorder, time-reversal-symmetry-breaking disorder grows asymptotically more slowly than time-reversal-symmetry-preserving disorder, which we therefore expect should dominate the strong-coupling phase. We then allow for unequal electron and hole masses. We show that whereas asymmetry in the two masses is irrelevant in the clean system, it is relevant in the presence of disorder, such that the `effective masses' of the conduction and valence bands should become sharply distinct in the low-energy limit. We calculate the RG flow equations for the disordered interacting system with unequal band masses and demonstrate that the problem exhibits a runaway flow to strong disorder. Along the runaway flow, time-reversal-symmetry-preserving disorder grows asymptotically more rapidly than both time-reversal-symmetry-breaking disorder and the Coulomb interaction.

Probabilistic Reverse dOsimetry Estimating Exposure Distribution (PROcEED)

EPA Pesticide Factsheets

PROcEED is a web-based application used to conduct probabilistic reverse dosimetry calculations.The tool is used for estimating a distribution of exposure concentrations likely to have produced biomarker concentrations measured in a population.

Role of failure-mechanism identification in accelerated testing

NASA Technical Reports Server (NTRS)

Hu, J. M.; Barker, D.; Dasgupta, A.; Arora, A.

1993-01-01

Accelerated life testing techniques provide a short-cut method to investigate the reliability of electronic devices with respect to certain dominant failure mechanisms that occur under normal operating conditions. However, accelerated tests have often been conducted without knowledge of the failure mechanisms and without ensuring that the test accelerated the same mechanism as that observed under normal operating conditions. This paper summarizes common failure mechanisms in electronic devices and packages and investigates possible failure mechanism shifting during accelerated testing.

Large magneto-conductance and magneto-electroluminescence in exciplex-based organic light-emitting diodes at room temperature

NASA Astrophysics Data System (ADS)

Ling, Yongzhou; Lei, Yanlian; Zhang, Qiaoming; Chen, Lixiang; Song, Qunliang; Xiong, Zuhong

2015-11-01

In this work, we report on large magneto-conductance (MC) over 60% and magneto-electroluminescence (MEL) as high as 112% at room temperature in an exciplex-based organic light-emitting diode (OLED) with efficient reverse intersystem crossing (ISC). The large MC and MEL are individually confirmed by the current density-voltage characteristics and the electroluminescence spectra under various magnetic fields. We proposed that this type of magnetic field effect (MFE) is governed by the field-modulated reverse ISC between the singlet and triplet exciplex. The temperature-dependent MFEs reveal that the small activation energy of reverse ISC accounts for the large MFEs in the present exciplex-based OLEDs.

Reversible and Irreversible Time-Dependent Behavior of GRCop-84

NASA Technical Reports Server (NTRS)

Lerch, Bradley A.; Arnold, Steven M.; Ellis, David L.

2017-01-01

A series of mechanical tests were conducted on a high-conductivity copper alloy, GRCop-84, in order to understand the time dependent response of this material. Tensile, creep, and stress relaxation tests were performed over a wide range of temperatures, strain rates, and stress levels to excite various amounts of time-dependent behavior. At low applied stresses the deformation behavior was found to be fully reversible. Above a certain stress, termed the viscoelastic threshold, irreversible deformation was observed. At these higher stresses the deformation was observed to be viscoplastic. Both reversible and irreversible regions contained time dependent deformation. These experimental data are documented to enable characterization of constitutive models to aid in design of high temperature components.

Three component vibrational time reversal communication

DOE PAGES

Anderson, Brian E.; Ulrich, Timothy J.; Ten Cate, James A.

2015-01-01

Time reversal provides an optimal prefilter matched signal to apply to a communication signal before signal transmission. Time reversal allows compensation for wave speed dispersion and can function well in reverberant environments. Time reversal can be used to focus elastic energy to each of the three components of motion independently. A pipe encased in concrete was used to demonstrate the ability to conduct communications of information using three component time reversal. Furthermore, the ability of time reversal to compensate for multi-path distortion (overcoming reverberation) will be demonstrated and the rate of signal communication will be presented. [The U.S. Department ofmore » Energy, through the LANL/LDRD Program, is gratefully acknowledged for supporting this work.]« less

Model-dependent effects of the gap junction conduction-enhancing antiarrhythmic peptide rotigaptide (ZP123) on experimental atrial fibrillation in dogs.

PubMed

Shiroshita-Takeshita, Akiko; Sakabe, Masao; Haugan, Ketil; Hennan, James K; Nattel, Stanley

2007-01-23

Abnormal intercellular communication caused by connexin dysfunction may be involved in atrial fibrillation (AF). The present study assessed the effect of the gap junctional conduction-enhancing peptide rotigaptide on AF maintenance in substrates that result from congestive heart failure induced by 2-week ventricular tachypacing (240 bpm), atrial tachypacing (ATP; 400 bpm for 3 to 6 weeks), and isolated atrial myocardial ischemia. Electrophysiological study and epicardial mapping were performed before and after rotigaptide administration in dogs with ATP and congestive heart failure, as well as in similarly instrumented sham dogs that were not tachypaced. For atrial myocardial ischemia, dogs administered rotigaptide before myocardial ischemia were compared with no-drug myocardial ischemia controls. ATP significantly shortened the atrial effective refractory period (P=0.003) and increased AF duration (P=0.008), with AF lasting >3 hours in all 6-week ATP animals. Rotigaptide increased conduction velocity in ATP dogs slightly but significantly (P=0.04) and did not affect the effective refractory period, AF duration, or atrial vulnerability. In dogs with congestive heart failure, rotigaptide also slightly increased conduction velocity (P=0.046) but failed to prevent AF promotion. Rotigaptide had no statistically significant effects in sham dogs. Myocardial ischemia alone increased AF duration and impaired conduction (based on conduction velocity across the ischemic border and indices of conduction heterogeneity). Rotigaptide prevented myocardial ischemia-induced conduction slowing and AF duration increases. Rotigaptide improves conduction in various AF models but suppresses AF only for the acute ischemia substrate. These results define the atrial antiarrhythmic profile of a mechanistically novel antiarrhythmic drug and suggest that gap junction dysfunction may be more important in ischemic AF than in ATP remodeling or congestive heart failure substrates.

30 CFR 285.815 - What must I do if I have facility damage or an equipment failure?

Code of Federal Regulations, 2011 CFR

2011-07-01

... Assessments for Activities Conducted Under SAPs, COPs and GAPs Equipment Failure and Adverse Environmental... damage or failure under § 285.831, MMS may require you to revise your SAP, COP, or GAP to describe how you will address the facility damage or failure as required by § 285.634 (COP), § 285.617 (SAP), § 285...

Reverse engineering of aircraft wing data using a partial differential equation surface model

NASA Astrophysics Data System (ADS)

Huband, Jacalyn Mann

Reverse engineering is a multi-step process used in industry to determine a production representation of an existing physical object. This representation is in the form of mathematical equations that are compatible with computer-aided design and computer-aided manufacturing (CAD/CAM) equipment. The four basic steps to the reverse engineering process are data acquisition, data separation, surface or curve fitting, and CAD/CAM production. The surface fitting step determines the design representation of the object, and thus is critical to the success or failure of the reverse engineering process. Although surface fitting methods described in the literature are used to model a variety of surfaces, they are not suitable for reversing aircraft wings. In this dissertation, we develop and demonstrate a new strategy for reversing a mathematical representation of an aircraft wing. The basis of our strategy is to take an aircraft design model and determine if an inverse model can be derived. A candidate design model for this research is the partial differential equation (PDE) surface model, proposed by Bloor and Wilson and used in the Rapid Airplane Parameter Input Design (RAPID) tool at the NASA-LaRC Geolab. There are several basic mathematical problems involved in reversing the PDE surface model: (i) deriving a computational approximation of the surface function; (ii) determining a radial parametrization of the wing; (iii) choosing mathematical models or classes of functions for representation of the boundary functions; (iv) fitting the boundary data points by the chosen boundary functions; and (v) simultaneously solving for the axial parameterization and the derivative boundary functions. The study of the techniques to solve the above mathematical problems has culminated in a reverse PDE surface model and two reverse PDE surface algorithms. One reverse PDE surface algorithm recovers engineering design parameters for the RAPID tool from aircraft wing data and the other generates a PDE surface model with spline boundary functions from an arbitrary set of grid points. Our numerical tests show that the reverse PDE surface model and the reverse PDE surface algorithms can be used for the reverse engineering of aircraft wing data.

Development of Decision Making in School-Aged Children and Adolescents: Evidence from Heart Rate and Skin Conductance Analysis

ERIC Educational Resources Information Center

Crone, Eveline A.; van der Molen, Maurits W.

2007-01-01

Age differences in decision making indicate that children fail to anticipate outcomes of their decisions. Using heart rate and skin conductance analyses, we tested whether developmental changes in decision making are associated with (a) a failure to process outcomes of decisions, or (b) a failure to anticipate future outcomes of decisions.…

Selection of reference genes for gene expression studies in heart failure for left and right ventricles.

PubMed

Li, Mengmeng; Rao, Man; Chen, Kai; Zhou, Jianye; Song, Jiangping

2017-07-15

Real-time quantitative reverse transcriptase-PCR (qRT-PCR) is a feasible tool for determining gene expression profiles, but the accuracy and reliability of the results depends on the stable expression of selected housekeeping genes in different samples. By far, researches on stable housekeeping genes in human heart failure samples are rare. Moreover the effect of heart failure on the expression of housekeeping genes in right and left ventricles is yet to be studied. Therefore we aim to provide stable housekeeping genes for both ventricles in heart failure and normal heart samples. In this study, we selected seven commonly used housekeeping genes as candidates. By using the qRT-PCR, the expression levels of ACTB, RAB7A, GAPDH, REEP5, RPL5, PSMB4 and VCP in eight heart failure and four normal heart samples were assessed. The stability of candidate housekeeping genes was evaluated by geNorm and Normfinder softwares. GAPDH showed the least variation in all heart samples. Results also indicated the difference of gene expression existed in heart failure left and right ventricles. GAPDH had the highest expression stability in both heart failure and normal heart samples. We also propose using different sets of housekeeping genes for left and right ventricles respectively. The combination of RPL5, GAPDH and PSMB4 is suitable for the right ventricle and the combination of GAPDH, REEP5 and RAB7A is suitable for the left ventricle. Copyright © 2017 Elsevier B.V. All rights reserved.

Levosimendan Prevents Pressure-Overload-induced Right Ventricular Failure.

PubMed

Hillgaard, Thomas Krarup; Andersen, Asger; Andersen, Stine; Vildbrad, Mads D; Ringgaard, Steffen; Nielsen, Jan M; Nielsen-Kudsk, Jens E

2016-04-01

We investigated if chronic levosimendan treatment can prevent and revert pressure-overload-induced right ventricular hypertrophy and failure in rats. Right ventricular hypertrophy and failure was induced in Wistar rats by pulmonary trunk banding (PTB). The PTB rats were treated with levosimendan (3 mg·kg·d) 3 days before surgery [n = 10, prevention (PREV)], 3 weeks after surgery [n = 10, reversal (REV)] or vehicle (n = 10, VEH). Sham-operated rats received vehicle (n = 16, SHAM). Right ventricular function was evaluated 7 weeks after surgery by echocardiography, magnetic resonance imaging, pressure-volume relations, gross anatomy, and histology. PTB induced right ventricular hypertrophy and compensated heart failure evident by reduced cardiac index (CI) without extra cardiac signs of heart failure. Levosimendan treatment prevented deterioration of right ventricular function measured by CI and right ventricular ejection fraction (RVEF) (CI: VEH vs. PREV 281 ± 17 vs. 362 ± 34 mL·min·kg, P ≤ 0.05, RVEF: VEH vs. PREV 57 ± 2% vs. 68 ± 3%, P ≤ 0.01) to values similar to SHAM (CI: 345 ± 21 mL·min·kg, RVEF: 71 ± 2%). RV contractility was improved in the REV group measured by preload recruitable stroke work (VEH vs. REV 39 ± 3 vs. 66 ± 10 mmHg P ≤ 0.05). Chronic treatment with levosimendan prevents the development of right ventricular failure and improves contractility in established pressure-overload-induced right ventricular failure.

Targeting focal adhesion kinase with small interfering RNA prevents and reverses load-induced cardiac hypertrophy in mice.

PubMed

Clemente, Carolina F M Z; Tornatore, Thais F; Theizen, Thais H; Deckmann, Ana C; Pereira, Tiago C; Lopes-Cendes, Iscia; Souza, José Roberto M; Franchini, Kleber G

2007-12-07

Hypertrophy is a critical event in the onset of failure in chronically overloaded hearts. Focal adhesion kinase (FAK) has attracted particular attention as a mediator of hypertrophy induced by increased load. Here, we demonstrate increased expression and phosphorylation of FAK in the hypertrophic left ventricles (LVs) of aortic-banded mice. We used an RNA interference strategy to examine whether FAK signaling plays a role in the pathophysiology of load-induced LV hypertrophy and failure. Intrajugular delivery of specific small interfering RNA induced prolonged FAK silencing ( approximately 70%) in both normal and hypertrophic LVs. Myocardial FAK silencing was accompanied by prevention, as well as reversal, of load-induced left ventricular hypertrophy. The function of LVs was preserved and the survival rate was higher in banded mice treated with small interfering RNA targeted to FAK, despite the persistent pressure overload. Studies in cardiac myocytes and fibroblasts harvested from LVs confirmed the ability of the systemically administered specific small interfering RNA to silence FAK in both cell types. Further analysis indicated attenuation of cardiac myocyte hypertrophic growth and of the rise in the expression of beta-myosin heavy chain in overloaded LVs. Moreover, FAK silencing was demonstrated to attenuate the rise in the fibrosis, collagen content, and activity of matrix metalloproteinase-2 in overloaded LVs, as well as the rise of matrix metalloproteinase-2 protein expression in fibroblasts harvested from overloaded LVs. This study provides novel evidence that FAK may be involved in multiple aspects of the pathophysiology of cardiac hypertrophy and failure induced by pressure overload.

Mumps virus reinfection is not a rare event confirmed by reverse transcription loop-mediated isothermal amplification.

PubMed

Yoshida, Naoko; Fujino, Motoko; Miyata, Akiko; Nagai, Takao; Kamada, Makoto; Sakiyama, Hiroshi; Ihara, Toshiaki; Kumagai, Takuji; Okafuji, Teruo; Okafuji, Takao; Nakayama, Tetsuo

2008-03-01

Clinically apparent mumps reinfection is considered extremely rare, but several cases have been suspected of reinfection in an out-patient clinic. In this study, virological examination, virus isolation, the reverse transcription loop-mediated isothermal amplification (RT-LAMP), and IgG and IgM EIA antibodies, were examined in order to identify mumps reinfection. Patients were divided into three categories; the reinfection group comprised 29 patients with a history of natural infection, the vaccine-failure group consisted of 37 patients with an immunization history, and two patients had histories of both immunization and mumps infection. Another 25 patients were enrolled as a primary infection group. Mumps virus was isolated in 5 (17%) and the genome was detected in 12 (41%) of 29 in the reinfection group. Reinfection was confirmed in 21/28, demonstrating high avidity of IgG EIA. Mumps virus was isolated in 15 (41%) and there was a higher positivity of genome amplification in 25 (68%) of 37 patients in the vaccine-failure group. Among these, 23 were confirmed as secondary vaccine failure by high avidity IgG EIA serology. In the primary infection group, the isolation rate and genome detection rate was higher in 16 (64%) and in 18 (72%) of 25 patients, respectively. There was no significant difference in virus load among the three groups but high mumps virus load was suspected in the IgM EIA-positive group based on the shorter amplification time on RT-LAMP. Mumps virus reinfection was confirmed by RT-LAMP and an IgG avidity test and was not a rare event.

[Acute renal failure in a prisoner after hunger strike].

PubMed

Gorsane, Imène; Zouaghi, Karim; Goucha, Rim; El Younsi, Fethi; Hedri, Hafedh; Barbouch, Samia; Ben Abdallah, Taïeb; Ben Moussa, Fatma; Ben Maiz, Hedi; Kheder, Adel

2007-03-01

Acute renal failure may occur in varied circumstances. It is potentially reversible spontaneously or after specific treatment. It is rare after hunger strike and fewer cases were reported in the literature. The physiopathological mechanisms are varied and remain incompletely known. We report the case of a prisoner having presented an acute renal failure after a hunger strike wich was completely reversible. He's a 29 year old man, without a past medical facts, in July 2004 he was incarcereted in prison. In October 2004 he undertake a hunger strike during one month. In November 2004 he was hospitalized for global dehydration and shock. His physical examination showed blood pressure 60/40 mmHg, weight 59 Kg with a loss of weight about 10 Kg, diuresis 800 cc/day. His biological findings showed urea 100 mmol/l, creatinemia 679 (mo/l, natremia 179 mmol/l, kaliemia 5 mmol/l, glycemia 5.2 mmol/l, albuminemia 35 g/l, calcemia 2.35 mmol/l and biological marques of rhabdomyolysis: CPK at 11 times the normal and LDH two times the normal. His treatment consisted on rehydratation, parenteral then enteral refeeding and psychiatric talks. The evolution was favourable, re-establishment of good hydration state with a gain weight of 7 Kg, normalization of renal function, his creatininemia reached 85 (mol/l in three weeks and normalization of muscles enzymes in one month. Hunger strike continue to pose a problem because of it's frequency in penitentiary structures and its organic disorders which can lead to death. A good psychiatric cares may be undertaked in order to prevent a such bad manifestations.

Reversible Deformation of Transfusion Tracheids in Taxus baccata Is Associated with a Reversible Decrease in Leaf Hydraulic Conductance1[OPEN

PubMed Central

Zhang, Yong-Jiang; Rockwell, Fulton E.; Wheeler, James K.; Holbrook, N. Michele

2014-01-01

Declines in leaf hydraulic conductance (Kleaf) with increasing water stress have been attributed to cavitation of the leaf xylem. However, in the leaves of conifers, the reversible collapse of transfusion tracheids may provide an alternative explanation. Using Taxus baccata, a conifer species without resin, we developed a modified rehydration technique that allows the separation of declines in Kleaf into two components: one reversible and one irreversible upon relaxation of water potential to −1 MPa. We surveyed leaves at a range of water potentials for evidence of cavitation using cryo-scanning electron microscopy and quantified dehydration-induced structural changes in transfusion tracheids by cryo-fluorescence microscopy. Irreversible declines in Kleaf did not occur until leaf water potentials were more negative than −3 MPa. Declines in Kleaf between −2 and −3 MPa were reversible and accompanied by the collapse of transfusion tracheids, as evidenced by cryo-fluorescence microscopy. Based on cryo-scanning electron microscopy, cavitation of either transfusion or xylem tracheids did not contribute to declines in Kleaf in the reversible range. Moreover, the deformation of transfusion tracheids was quickly reversible, thus acting as a circuit breaker regulating the flux of water through the leaf vasculature. As transfusion tissue is present in all gymnosperms, the reversible collapse of transfusion tracheids may be a general mechanism in this group for the protection of leaf xylem from excessive loads generated in the living leaf tissue. PMID:24948828

Association of the Endobiont Double-Stranded RNA Virus LRV1 With Treatment Failure for Human Leishmaniasis Caused by Leishmania braziliensis in Peru and Bolivia

PubMed Central

Adaui, Vanessa; Lye, Lon-Fye; Akopyants, Natalia S.; Zimic, Mirko; Llanos-Cuentas, Alejandro; Garcia, Lineth; Maes, Ilse; De Doncker, Simonne; Dobson, Deborah E.; Arevalo, Jorge; Dujardin, Jean-Claude; Beverley, Stephen M.

2016-01-01

Cutaneous and mucosal leishmaniasis, caused in South America by Leishmania braziliensis, is difficult to cure by chemotherapy (primarily pentavalent antimonials [SbV]). Treatment failure does not correlate well with resistance in vitro, and the factors responsible for treatment failure in patients are not well understood. Many isolates of L. braziliensis (>25%) contain a double-stranded RNA virus named Leishmaniavirus 1 (LRV1), which has also been reported in Leishmania guyanensis, for which an association with increased pathology, metastasis, and parasite replication was found in murine models. Here we probed the relationship of LRV1 to drug treatment success and disease in 97 L. braziliensis–infected patients from Peru and Bolivia. In vitro cultures were established, parasites were typed as L. braziliensis, and the presence of LRV1 was determined by reverse transcription–polymerase chain reaction, followed by sequence analysis. LRV1 was associated significantly with an increased risk of treatment failure (odds ratio, 3.99; P = .04). There was no significant association with intrinsic SbV resistance among parasites, suggesting that treatment failure arises from LRV1-mediated effects on host metabolism and/or parasite survival. The association of LRV1 with clinical drug treatment failure could serve to guide more-effective treatment of tegumentary disease caused by L. braziliensis. PMID:26123565

The annual global economic burden of heart failure.

PubMed

Cook, Christopher; Cole, Graham; Asaria, Perviz; Jabbour, Richard; Francis, Darrel P

2014-02-15

Heart failure (HF) imposes both direct costs to healthcare systems and indirect costs to society through morbidity, unpaid care costs, premature mortality and lost productivity. The global economic burden of HF is not known. We estimated the overall cost of heart failure in 2012, in both direct and indirect terms, across the globe. Existing country-specific heart failure costs analyses were expressed as a proportion of gross domestic product and total healthcare spend. Using World Bank data, these proportional values were used to interpolate the economic cost of HF for countries of the world where no published data exists. Countries were categorized according to their level of economic development to investigate global patterns of spending. 197 countries were included in the analysis, covering 98.7% of the world's population. The overall economic cost of HF in 2012 was estimated at $108 billion per annum. Direct costs accounted for ~60% ($65 billion) and indirect costs accounted for ~40% ($43 billion) of the overall spend. Heart failure spending varied widely between high-income and middle and low-income countries. High-income countries spend a greater proportion on direct costs: a pattern reversed for middle and low-income countries. Heart failure imposes a huge economic burden, estimated at $108 billion per annum. With an aging, rapidly expanding and industrializing global population this value will continue to rise. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Strength and Anisotropy in Tournemire Shale: Temperature, Pressure and Time Dependences

NASA Astrophysics Data System (ADS)

Bonnelye, A.; Schubnel, A.; Zhi, G.; David, C.; Dick, P.

2017-12-01

Time and temperature dependent rock deformation has both scientific and socio-economic implications for natural hazards, the oil and gas industry and nuclear waste disposal. During the past decades, most studies on brittle creep have focused on igneous rocks and porous sedimentary rocks. To our knowledge, only few studies have been carried out on the brittle creep behavior of shale. We conducted a series of creep experiments on shale specimens coming from the French Institute for Nuclear Safety (IRSN) underground research laboratory located in Tournemire, France, under two different temperatures (26°C, 75°C) and confining pressures (10 MPa, 80 MPa), for three orientations (σ1along, perpendicular and 45° to bedding). In these long-term experiments (approximately 10 days), stress and strains were recorded continuously, while ultrasonic acoustic velocities were recorded every 1 15 minutes. The brittle creep failure stress of our Tournemire shale samples was systematically observed 50% higher than its short-term peak strength, with larger final axial strain accumulated. During creep, ultrasonic wave velocities first decreased, and then increased gradually. The magnitude of elastic wave velocity variations showed an important orientation and temperature dependence: velocities measured perpendicular to bedding showed increased variation, variation that was enhanced at higher temperature and higher pressure. The case of complete elastic anisotropy reversal was observed for sample deformed perpendicular to bedding, with amount of axial strain needed to reach anisotropy reversal reduced at higher temperature. SEM observations highlight the competition between crack growth, sealing/healing, and possibly mineral rotation, pressure solution or anisotropic compaction during creep defromation. Our study highlights that the short-term peak strength has little meaning in shale material, which can over-consolidate importantly by `plastic' flow. In addition, we show that elastic anisotropy can switch and even reverse over relatively short time periods (<10 days) and for relatively small amount of plastic deformation (<5%).

Effect of micellar collisions and polyvinylpyrrolidone confinement on the electrical conductivity percolation parameters of water/AOT/isooctane reverse micelles

NASA Astrophysics Data System (ADS)

Guettari, Moez; Aferni, Ahmed E. L.; Tajouri, Tahar

2017-12-01

The main aim of this paper is the analysis of micellar collisions and polymer confinement effects on the electrical conductivity percolative behavior of water/sodium bis(2-ethylhexyl) sulfosuccinate (AOT)/isooctane reverse micelles. Firstly, we have performed conductance measurements of the system for three AOT to isooctane volume ratio, φm = 0.1 , 0.15 and 0.2 to examine the influence of micellar collisions on the percolation parameters. All the measurements were carried out over the 298.15 K-333.15 K temperature range at a fixed water to AOT molar ratio, W0 = 45 . We have assessed that the rise of micellar collisions frequency enhances the conductance percolation. Secondly, the confinement effect of a water-soluble polymer, polyvinylpyrrolidone (PVP), on the reverse micelles conductance behavior was investigated. Temperature-induced percolation, Tp , have shown a dependence on the polymer concentration, CPVP . It was also observed that for various PVP concentrations, the activation energy of percolation decreases. Finally, the values of the critical exponents determined in the presence and absence of PVP prove that the polymer affects the dynamic of percolation.

Aromatic Polyimide/Graphene Composite Organic Cathodes for Fast and Sustainable Lithium-Ion Batteries

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

Lyu, Hailong; Li, Peipei; Liu, Jiurong

A composite organic cathode material based on aromatic polyimide (PI) and highly conductive graphene was prepared through a facile in situ polymerization method for application in lithium-ion batteries. The in situ polymerization generated intimate contact between PI and electronically conductive graphene, resulting in conductive composites with highly reversible redox reactions and good structure stability. The synergistic effect between PI and graphene enabled not only a high reversible capacity of 232.6 mAh g -1 at a charge–discharge rate of C/10 but also exceptionally high-rate cycling stability, that is, a high capacity of 108.9 mAh g -1 at a very high charge–dischargemore » rate of 50C with a capacity retention of 80 % after 1000 cycles. This improved electrochemical performance resulted from the combination of stable redox reversibility of PI and high electronic conductivity of the graphene additive. In conclusion, the graphene-based composite also exhibited much better performance than composites based on multi-walled carbon nanotubes and the conductive carbon black C45 in terms of specific capacity and long-term cycling stability under the same charge–discharge rates.« less

Aromatic Polyimide/Graphene Composite Organic Cathodes for Fast and Sustainable Lithium-Ion Batteries

DOE PAGES

Lyu, Hailong; Li, Peipei; Liu, Jiurong; ...

2018-01-24

A composite organic cathode material based on aromatic polyimide (PI) and highly conductive graphene was prepared through a facile in situ polymerization method for application in lithium-ion batteries. The in situ polymerization generated intimate contact between PI and electronically conductive graphene, resulting in conductive composites with highly reversible redox reactions and good structure stability. The synergistic effect between PI and graphene enabled not only a high reversible capacity of 232.6 mAh g -1 at a charge–discharge rate of C/10 but also exceptionally high-rate cycling stability, that is, a high capacity of 108.9 mAh g -1 at a very high charge–dischargemore » rate of 50C with a capacity retention of 80 % after 1000 cycles. This improved electrochemical performance resulted from the combination of stable redox reversibility of PI and high electronic conductivity of the graphene additive. In conclusion, the graphene-based composite also exhibited much better performance than composites based on multi-walled carbon nanotubes and the conductive carbon black C45 in terms of specific capacity and long-term cycling stability under the same charge–discharge rates.« less

"It Makes You Rethink Your Choice of the Pill": Theory-Based Formative Research to Design a Contraceptive Choice Campaign.

PubMed

Sundstrom, Beth; DeMaria, Andrea L; Meier, Stephanie; Jones, Annabel; Moxley, Grace E

2015-01-01

Half of all pregnancies in the United States remain unplanned despite improved access to highly effective long-acting reversible contraception, including the intrauterine device and the implant. This study conducted theory-based formative research to develop a contraceptive choice campaign aimed at increasing long-acting reversible contraception uptake by women ages 18-44 years in Charleston, South Carolina, an urban area in the southeastern United States. Researchers developed and tested message concepts and designs. Six focus groups and 18 interviews were conducted among reproductive-age women (n = 79). Qualitative data analysis revealed messages and designs that resonated with these women. Emphasizing long-acting reversible contraception as the healthy option, highlighting long-acting reversible contraception effectiveness, including relatable and trustworthy characters, and using language of control emerged as themes. Women reported a preference for statistics illustrating effectiveness combined with empowering messages of control over contraceptive decision making. Findings from this study offer practical recommendations for developing contraceptive choice campaigns targeting long-acting reversible contraception use and further the goal of reducing unintended pregnancy among women.

Failure after reverse total shoulder arthroplasty: what is the success of component revision?

PubMed

Black, Eric M; Roberts, Susanne M; Siegel, Elana; Yannopoulos, Paul; Higgins, Laurence D; Warner, Jon J P

2015-12-01

Complication rates remain high after reverse total shoulder arthroplasty (RTSA). Salvage options after implant failure have not been well defined. This study examines the role of reimplantation and revision RTSA after failed RTSA, reporting outcomes and complications of this salvage technique. Sixteen patients underwent component revision and reimplantation after a prior failed RTSA from 2004 to 2011. Indications included baseplate failure (7 patients, 43.8%), instability (6 patients, 37.5%), infection (2 patients, 12.5%), and humeral loosening (1 patient, 6.3%). The average age of the patient during revision surgery was 68.6 years. Outcomes information at follow-up was recorded, including visual analog scale score for pain, subjective shoulder value, American Shoulder and Elbow Surgeons score, and Simple Shoulder Test score, and these were compared with pre-revision values. Repeated surgeries and complications were noted. Average time to follow-up from revision was 58.9 months (minimum, 2 years; range, 24-103 months). The average postoperative visual analog scale score for pain was 1.7/10 (7.5/10 preoperatively; P < .0001), and the subjective shoulder value was 62% (17% preoperatively; P < .0001). The average postoperative American Shoulder and Elbow Surgeons score was 66.7, and the Simple Shoulder Test score was 52.6. Fourteen patients (88%) noted that they felt "better" postoperatively than before their original RTSA and would go through the procedure again if given the option. Nine patients suffered major complications (56%), and 6 of these ultimately underwent further procedures (38% of cohort). Salvage options after failure of RTSA remain limited. Component revision and reimplantation can effectively relieve pain and improve function compared with baseline values, and patient satisfaction levels are moderately high. However, complication rates and reoperation rates are significant. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Limited clinical benefit of minority K103N and Y181C-variant detection in addition to routine genotypic resistance testing in antiretroviral therapy-naive patients.

PubMed

Metzner, Karin J; Scherrer, Alexandra U; von Wyl, Viktor; Böni, Jürg; Yerly, Sabine; Klimkait, Thomas; Aubert, Vincent; Furrer, Hansjakob; Hirsch, Hans H; Vernazza, Pietro L; Cavassini, Matthias; Calmy, Alexandra; Bernasconi, Enos; Weber, Rainer; Günthard, Huldrych F

2014-09-24

The presence of minority nonnucleoside reverse transcriptase inhibitor (NNRTI)-resistant HIV-1 variants prior to antiretroviral therapy (ART) has been linked to virologic failure in treatment-naive patients. We performed a large retrospective study to determine the number of treatment failures that could have been prevented by implementing minority drug-resistant HIV-1 variant analyses in ART-naïve patients in whom no NNRTI resistance mutations were detected by routine resistance testing. Of 1608 patients in the Swiss HIV Cohort Study, who have initiated first-line ART with two nucleoside reverse transcriptase inhibitors (NRTIs) and one NNRTI before July 2008, 519 patients were eligible by means of HIV-1 subtype, viral load and sample availability. Key NNRTI drug resistance mutations K103N and Y181C were measured by allele-specific PCR in 208 of 519 randomly chosen patients. Minority K103N and Y181C drug resistance mutations were detected in five out of 190 (2.6%) and 10 out of 201 (5%) patients, respectively. Focusing on 183 patients for whom virologic success or failure could be examined, virologic failure occurred in seven out of 183 (3.8%) patients; minority K103N and/or Y181C variants were present prior to ART initiation in only two of those patients. The NNRTI-containing, first-line ART was effective in 10 patients with preexisting minority NNRTI-resistant HIV-1 variant. As revealed in settings of case-control studies, minority NNRTI-resistant HIV-1 variants can have an impact on ART. However, the implementation of minority NNRTI-resistant HIV-1 variant analysis in addition to genotypic resistance testing (GRT) cannot be recommended in routine clinical settings. Additional associated risk factors need to be discovered.

Cardiovascular Disease in Acromegaly.

PubMed

Sharma, Morali D; Nguyen, Anh V; Brown, Spandana; Robbins, Richard J

2017-01-01

In patients with acromegaly, chronic excess of growth hormone (GH) and insulin-like growth factor-1 (IGF-1) leads to the development of acromegalic cardiomyopathy. Its main features are biventricular hypertrophy, diastolic dysfunction, and in later stages, systolic dysfunction and congestive heart failure. Surgical and/or pharmacological treatment of acromegaly and control of cardiovascular risk factors help reverse some of these pathophysiologic changes and decrease the high risk of cardiovascular complications.

Fracture prediction using modified mohr coulomb theory for non-linear strain paths using AA3104-H19

NASA Astrophysics Data System (ADS)

Dick, Robert; Yoon, Jeong Whan

2016-08-01

Experiment results from uniaxial tensile tests, bi-axial bulge tests, and disk compression tests for a beverage can AA3104-H19 material are presented. The results from the experimental tests are used to determine material coefficients for both Yld2000 and Yld2004 models. Finite element simulations are developed to study the influence of materials model on the predicted earing profile. It is shown that only the YLD2004 model is capable of accurately predicting the earing profile as the YLD2000 model only predicts 4 ears. Excellent agreement with the experimental data for earing is achieved using the AA3104-H19 material data and the Yld2004 constitutive model. Mechanical tests are also conducted on the AA3104-H19 to generate fracture data under different stress triaxiality conditions. Tensile tests are performed on specimens with a central hole and notched specimens. Torsion of a double bridge specimen is conducted to generate points near pure shear conditions. The Nakajima test is utilized to produce points in bi-axial tension. The data from the experiments is used to develop the fracture locus in the principal strain space. Mapping from principal strain space to stress triaxiality space, principal stress space, and polar effective plastic strain space is accomplished using a generalized mapping technique. Finite element modeling is used to validate the Modified Mohr-Coulomb (MMC) fracture model in the polar space. Models of a hole expansion during cup drawing and a cup draw/reverse redraw/expand forming sequence demonstrate the robustness of the modified PEPS fracture theory for the condition with nonlinear forming paths and accurately predicts the onset of failure. The proposed methods can be widely used for predicting failure for the examples which undergo nonlinear strain path including rigid-packaging and automotive forming.

The effect of hydrogen and microstructure on the deformation and fracture behavior of a single crystal nickel-base superalloy. Final Report Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Walston, William S.

1990-01-01

A study was conducted on the effects of internal hydrogen and microstructure on the deformation and fracture of a single crystal nickel-base superalloy. In particular, room temperature plane strain fracture toughness and tensile tests were performed on hydrogen-free and hydrogen charged samples of PWA 1480. The role of microstructure was incorporated by varying the levels of porosity and eutectic gamma/gamma prime through hot isostatic pressing and heat treatment. The room temperature behavior of PWA 1480 was unusual because precipitate shearing was not the primary deformation mechanism at all strains. At strains over 1 percent, dislocations were trapped in the gamma matrix and an attempt was made to relate this behavior to compositional differences between PWA 1480 and other superalloys. Another unique feature of the tensile behavior was cleavage of the eutectic gamma/gamma prime, which is believed to initiate the failure process. Fracture occurred on (111) planes and is likely a result of shear localization along these planes. Elimination of the eutectic gamma/gamma prime greatly improved the tensile ductility, but pososity had no effect on tensile properties. Large quantities of hydrogen (1.74 at. percent) were gas-phase charged into the material, but surprisingly this was not a function of the amount of porosity or eutectic gamma/gamma prime present. Desorption experiments suggest that the vast majority of hydrogen is at reversible lattice trapping sites. This large, uniform concentration of hydrogen dramatically reduced the tensile strain to failure, but only slightly affected the reduction in area. Available hydrogen embrittlement models were examined in light of these results and it was found that the hydrogen enhanced localized plasticity model can explain much of the tensile behavior. K(IC) fracture toughness tests were conducted, but it was necessary to also perform J(IC) tests to provide valid data.

Solid state switch

DOEpatents

Merritt, B.T.; Dreifuerst, G.R.

1994-07-19

A solid state switch, with reverse conducting thyristors, is designed to operate at 20 kV hold-off voltage, 1,500 A peak, 1.0 [mu]s pulsewidth, and 4,500 pps, to replace thyratrons. The solid state switch is more reliable, more economical, and more easily repaired. The switch includes a stack of circuit card assemblies, a magnetic assist and a trigger chassis. Each circuit card assembly contains a reverse conducting thyristor, a resistor capacitor network, and triggering circuitry. 6 figs.

Reversible pulmonary hypertension in a cat.

PubMed

Baron Toaldo, M; Guglielmini, C; Diana, A; Giunti, M; Dondi, F; Cipone, M

2011-05-01

A 13-year-old, neutered female domestic shorthair cat was presented for sudden respiratory distress following palliative radiotherapy and the combined administration of a single dose of carboplatin for the treatment of recurrent fibrosarcoma. Clinical and radiographic findings were suggestive of pleural effusion. Echocardiography revealed marked right-sided cardiac enlargement associated with tricuspid regurgitation and Doppler evidence of pulmonary hypertension. After 25 days of treatment for congestive heart failure and suspected pulmonary thromboembolism, clinical signs and echocardiographic and Doppler evidence of right-sided cardiac enlargement and pulmonary hypertension had completely resolved. To the best of the authors' knowledge, this is the first report of reversible pulmonary hypertension, likely secondary to pulmonary thromboembolism, in a cat. © 2011 British Small Animal Veterinary Association.

Aggressive TAFRO syndrome with reversible cardiomyopathy successfully treated with combination chemotherapy.

PubMed

Yasuda, Shunichiro; Tanaka, Keisuke; Ichikawa, Ayako; Watanabe, Ken; Uchida, Emi; Yamamoto, Masahide; Yamamoto, Kouhei; Mizuchi, Daisuke; Miura, Osamu; Fukuda, Tetsuya

2016-10-01

TAFRO (thrombocytopenia, anasarca, myelofibrosis, renal dysfunction, and organomegaly) syndrome is an atypical manifestation of Castleman's disease. However, the mechanism underlying this very rare syndrome remains unknown, and there is no established standard treatment. Here we report cases of two young females with TAFRO syndrome who showed similar clinical courses. Both cases showed severe anasarca, ascites, and thrombocytopenia. Although high-dose steroids were ineffective, combination chemotherapy showed remarkable effects. However, both patients developed severe but reversible heart failure after CHOP therapy owing to diffuse cardiomyopathy, which was presumably associated with TAFRO syndrome. Therefore, although combination chemotherapy may be very effective in the treatment of TAFRO syndrome, careful observation for cardiomyopathy development is needed, particularly when using adriamycin-containing regimens.

30 CFR 585.815 - What must I do if I have facility damage or an equipment failure?

Code of Federal Regulations, 2014 CFR

2014-07-01

... Conducted Under SAPs, COPs and GAPs Equipment Failure and Adverse Environmental Effects § 585.815 What must... failure under § 585.831, BOEM may require you to revise your SAP, COP, or GAP to describe how you will address the facility damage or failure as required by § 585.634 (COP), § 585.617 (SAP), § 585.655 (GAP...

30 CFR 585.815 - What must I do if I have facility damage or an equipment failure?

Code of Federal Regulations, 2012 CFR

2012-07-01

... Conducted Under SAPs, COPs and GAPs Equipment Failure and Adverse Environmental Effects § 585.815 What must... failure under § 585.831, BOEM may require you to revise your SAP, COP, or GAP to describe how you will address the facility damage or failure as required by § 585.634 (COP), § 585.617 (SAP), § 585.655 (GAP...

30 CFR 585.815 - What must I do if I have facility damage or an equipment failure?

Code of Federal Regulations, 2013 CFR

2013-07-01

... Conducted Under SAPs, COPs and GAPs Equipment Failure and Adverse Environmental Effects § 585.815 What must... failure under § 585.831, BOEM may require you to revise your SAP, COP, or GAP to describe how you will address the facility damage or failure as required by § 585.634 (COP), § 585.617 (SAP), § 585.655 (GAP...

Failure environment analysis tool applications

NASA Astrophysics Data System (ADS)

Pack, Ginger L.; Wadsworth, David B.

1993-02-01

Understanding risks and avoiding failure are daily concerns for the women and men of NASA. Although NASA's mission propels us to push the limits of technology, and though the risks are considerable, the NASA community has instilled within, the determination to preserve the integrity of the systems upon which our mission and, our employees lives and well-being depend. One of the ways this is being done is by expanding and improving the tools used to perform risk assessment. The Failure Environment Analysis Tool (FEAT) was developed to help engineers and analysts more thoroughly and reliably conduct risk assessment and failure analysis. FEAT accomplishes this by providing answers to questions regarding what might have caused a particular failure; or, conversely, what effect the occurrence of a failure might have on an entire system. Additionally, FEAT can determine what common causes could have resulted in other combinations of failures. FEAT will even help determine the vulnerability of a system to failures, in light of reduced capability. FEAT also is useful in training personnel who must develop an understanding of particular systems. FEAT facilitates training on system behavior, by providing an automated environment in which to conduct 'what-if' evaluation. These types of analyses make FEAT a valuable tool for engineers and operations personnel in the design, analysis, and operation of NASA space systems.

Failure environment analysis tool applications

NASA Technical Reports Server (NTRS)

Pack, Ginger L.; Wadsworth, David B.

1993-01-01

Understanding risks and avoiding failure are daily concerns for the women and men of NASA. Although NASA's mission propels us to push the limits of technology, and though the risks are considerable, the NASA community has instilled within, the determination to preserve the integrity of the systems upon which our mission and, our employees lives and well-being depend. One of the ways this is being done is by expanding and improving the tools used to perform risk assessment. The Failure Environment Analysis Tool (FEAT) was developed to help engineers and analysts more thoroughly and reliably conduct risk assessment and failure analysis. FEAT accomplishes this by providing answers to questions regarding what might have caused a particular failure; or, conversely, what effect the occurrence of a failure might have on an entire system. Additionally, FEAT can determine what common causes could have resulted in other combinations of failures. FEAT will even help determine the vulnerability of a system to failures, in light of reduced capability. FEAT also is useful in training personnel who must develop an understanding of particular systems. FEAT facilitates training on system behavior, by providing an automated environment in which to conduct 'what-if' evaluation. These types of analyses make FEAT a valuable tool for engineers and operations personnel in the design, analysis, and operation of NASA space systems.

Failure environment analysis tool applications

NASA Technical Reports Server (NTRS)

Pack, Ginger L.; Wadsworth, David B.

1994-01-01

Understanding risks and avoiding failure are daily concerns for the women and men of NASA. Although NASA's mission propels us to push the limits of technology, and though the risks are considerable, the NASA community has instilled within it, the determination to preserve the integrity of the systems upon which our mission and, our employees lives and well-being depend. One of the ways this is being done is by expanding and improving the tools used to perform risk assessment. The Failure Environment Analysis Tool (FEAT) was developed to help engineers and analysts more thoroughly and reliably conduct risk assessment and failure analysis. FEAT accomplishes this by providing answers to questions regarding what might have caused a particular failure; or, conversely, what effect the occurrence of a failure might have on an entire system. Additionally, FEAT can determine what common causes could have resulted in other combinations of failures. FEAT will even help determine the vulnerability of a system to failures, in light of reduced capability. FEAT also is useful in training personnel who must develop an understanding of particular systems. FEAT facilitates training on system behavior, by providing an automated environment in which to conduct 'what-if' evaluation. These types of analyses make FEAT a valuable tool for engineers and operations personnel in the design, analysis, and operation of NASA space systems.

Reducing preference reversals: The role of preference imprecision and nontransparent methods.

PubMed

Pinto-Prades, José Luis; Sánchez-Martínez, Fernando Ignacio; Abellán-Perpiñán, José María; Martínez-Pérez, Jorge E

2018-05-16

Preferences elicited with matching and choice usually diverge (as characterised by preference reversals), violating a basic rationality requirement, namely, procedure invariance. We report the results of an experiment that shows that preference reversals between matching (Standard Gamble in our case) and choice are reduced when the matching task is conducted using nontransparent methods. Our results suggest that techniques based on nontransparent methods are less influenced by biases (i.e., compatibility effects) than transparent methods. We also observe that imprecision of preferences influences the degree of preference reversals. The preference reversal phenomenon is less strong in subjects with more precise preferences. Copyright © 2018 John Wiley & Sons, Ltd.

Failure mode and effects analysis drastically reduced potential risks in clinical trial conduct.

PubMed

Lee, Howard; Lee, Heechan; Baik, Jungmi; Kim, Hyunjung; Kim, Rachel

2017-01-01

Failure mode and effects analysis (FMEA) is a risk management tool to proactively identify and assess the causes and effects of potential failures in a system, thereby preventing them from happening. The objective of this study was to evaluate effectiveness of FMEA applied to an academic clinical trial center in a tertiary care setting. A multidisciplinary FMEA focus group at the Seoul National University Hospital Clinical Trials Center selected 6 core clinical trial processes, for which potential failure modes were identified and their risk priority number (RPN) was assessed. Remedial action plans for high-risk failure modes (RPN >160) were devised and a follow-up RPN scoring was conducted a year later. A total of 114 failure modes were identified with an RPN score ranging 3-378, which was mainly driven by the severity score. Fourteen failure modes were of high risk, 11 of which were addressed by remedial actions. Rescoring showed a dramatic improvement attributed to reduction in the occurrence and detection scores by >3 and >2 points, respectively. FMEA is a powerful tool to improve quality in clinical trials. The Seoul National University Hospital Clinical Trials Center is expanding its FMEA capability to other core clinical trial processes.

Lifetime Extension Report: Progress on the SAVY-4000 Lifetime Extension Program

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

Welch, Cynthia F.; Smith, Paul Herrick; Weis, Eric M.

The 3-year accelerated aging study of the SAVY-4000 O-ring shows very little evidence of significant degradation to samples subjected to aggressive elevated temperature and radiation conditions. Whole container thermal aging studies followed by helium leakage testing and compression set measurements were used to establish an estimate for a failure criterion for O-ring compression set of ≥65 %. The whole container aging studies further show that the air flow and efficiency functions of the filter do not degrade significantly after thermal aging. However, the degradation of the water-resistant function leads to water penetration failure after four months at 210°C, but doesmore » not cause failure after 10 months at 120°C (130°C is the maximum operating temperature for the PTFE membrane). The thermal aging data for O-ring compression set do not meet the assumptions of standard time-temperature superposition analysis for accelerated aging studies. Instead, the data suggest that multiple degradation mechanisms are operative, with a reversible mechanism operative at low aging temperatures and an irreversible mechanism dominating at high aging temperatures. To distinguish between these mechanisms, we have measured compression set after allowing the sample to physically relax, thereby minimizing the effect of the reversible mechanism. The resulting data were analyzed using two distinct mathematical methods to obtain a lifetime estimate based on chemical degradation alone. Both methods support a lifetime estimate of greater than 150 years at 80°C. Although the role of the reversible mechanism is not fully understood, it is clear that the contribution to the total compression set is small in comparison to that due to the chemical degradation mechanism. To better understand the chemical degradation mechanism, thermally aged O-ring samples have been characterized by Fourier Transform Infrared (FTIR), Electron Paramagnetic Resonance (EPR), Gel Permeation Chromatography (GPC), and Differential Scanning Calorimetry (DSC). These experiments detect no significant O-ring degradation below 80°C. Furthermore, durometer measurements indicate that there is no significant change in O-ring hardness at all aging conditions examined. Therefore, our current conservative lifetime estimate for the O-ring and the filter is 10 years at 80°C. In FY17, we will continue to probe the chemical degradation mechanism using oxygen consumption measurements under accelerated aging conditions to reveal temperatures at which oxidation occurs, along with any differences in oxidation rate at the low vs. high aging temperatures. We will also refine the failure criteria and finalize the radiation/thermal synergistic studies to determine a final design lifetime.« less

Managing heart failure in the long-term care setting: nurses' experiences in Ontario, Canada.

PubMed

Strachan, Patricia H; Kaasalainen, Sharon; Horton, Amy; Jarman, Hellen; D'Elia, Teresa; Van Der Horst, Mary-Lou; Newhouse, Ian; Kelley, Mary Lou; McAiney, Carrie; McKelvie, Robert; Heckman, George A

2014-01-01

Implementation of heart failure guidelines in long-term care (LTC) settings is challenging. Understanding the conditions of nursing practice can improve management, reduce suffering, and prevent hospital admission of LTC residents living with heart failure. The aim of the study was to understand the experiences of LTC nurses managing care for residents with heart failure. This was a descriptive qualitative study nested in Phase 2 of a three-phase mixed methods project designed to investigate barriers and solutions to implementing the Canadian Cardiovascular Society heart failure guidelines into LTC homes. Five focus groups totaling 33 nurses working in LTC settings in Ontario, Canada, were audiorecorded, then transcribed verbatim, and entered into NVivo9. A complex adaptive systems framework informed this analysis. Thematic content analysis was conducted by the research team. Triangulation, rigorous discussion, and a search for negative cases were conducted. Data were collected between May and July 2010. Nurses characterized their experiences managing heart failure in relation to many influences on their capacity for decision-making in LTC settings: (a) a reactive versus proactive approach to chronic illness; (b) ability to interpret heart failure signs, symptoms, and acuity; (c) compromised information flow; (d) access to resources; and (e) moral distress. Heart failure guideline implementation reflects multiple dynamic influences. Leadership that addresses these factors is required to optimize the conditions of heart failure care and related nursing practice.

Effect of atracylodes rhizome polysaccharide in rats with adenine-induced chronic renal failure.

PubMed

Yang, C; Liu, C; Zhou, Q; Xie, Y C; Qiu, X M; Feng, X

2015-01-01

The aim of the study was to elucidate the therapeutic effects of Atracylodes rhizome polysaccharide on adenine-induced chronic renal failure in rats. Fifty male Sprague Dawley rats were selected and randomly divided in to 5 groups (n=10 rats per group): The normal control group, the chronic renal failure pathological control group, the dexamethasone treatment group and two Atracylodes rhizome polysaccharide treatment groups, treated with two different concentrations of the polysaccharide, the Atracylodes rhizome polysaccharide high group and the Atracylodes rhizome polysaccharide low group. All the rats, except those in the normal control group were fed adenine-enriched diets, containing 10 g adenine per kg food for 3 weeks. After being fed with adenine, the dexamethasone treatment group, Atracylodes rhizome polysaccharide high group and Atracylodes rhizome polysaccharide low group rats were administered the drug orally for 2 weeks. On day 35, the kidney coefficient of the rats and the serum levels of creatinine, blood urea nitrogen, total protein and hemalbumin were determined. Subsequent to experimentation on a model of chronic renal failure in rats, the preparation was proven to be able to reduce serum levels of creatinine, blood urea nitrogen and hemalbumin levels (P<0.05) and improve renal function. Atracylodes rhizome polysaccharide had reversed the majority of the indices of chronic renal failure in rats.

Implementing guideline based heart failure care in the Northern Territory: challenges and solutions.

PubMed

Iyngkaran, Pupalan; Harris, Melanie; Ilton, Marcus; Kangaharan, Nadarajan; Battersby, Malcolm; Stewart, Simon; Brown, Alex

2014-05-01

The Northern Territory of Australia is a vast area serviced by two major tertiary hospitals. It has both a unique demography and geography, which pose challenges for delivering optimal heart failure services. The prevalence of congestive heart failure continues to increase, imposing a significant burden on health infrastructure and health care costs. Specific patient groups suffer disproportionately from increased disease severity or service related issues often represented as a "health care gap". The syndrome itself is characterised by ongoing symptoms interspersed with acute decompensation requiring lifelong therapy and is rarely reversible. For the individual client the overwhelming attention to heart failure care and the impact of health care gaps can be devastating. This gap may also contribute to widening socio-economic differentials for families and communities as they seek to take on some of the care responsibilities. This review explores the challenges of heart failure best practice in the Northern Territory and the opportunities to improve on service delivery. The discussions highlighted could have implications for health service delivery throughout regional centres in Australia and health systems in other countries. Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). All rights reserved.

Reverse waffle cone technique in management of stent dislodgement into intracranial aneurysms.

PubMed

Luo, Chao-Bao; Lai, Yen-Jun; Teng, Michael Mu-Huo; Chang, Feng-Chi; Lin, Chung-Jung; Guo, Wan-Yuo

2013-09-01

Stent-assisted coil embolization (SACE) is a common method to manage intracranial wide-neck aneurysm. Using this technique, a stent must be successfully deployed into the parent artery to cross the aneurysm neck. We describe the reverse waffle cone technique in management of intra-procedural stent dislodgement during SACE of internal carotid artery (ICA) wide-neck aneurysms. Two patients with unruptured wide-neck ICA aneurysms underwent SACE. Intra-procedural forward stent migration occurred during catheterization with proximal stent dislodgement and migration into the aneurysm sac. Navigation of a second stent to bridge the aneurysm neck failed in one patient because the second stent was impeded by the dislodged stent. Using the reverse waffle cone technique, a microcatheter was navigated into the aneurysm sacs. Coils were safely detached into each aneurysm sac without any device assistance. The two wide-neck aneurysms were successfully treated with preservation of flow to the internal carotid arteries. The complication of intra-procedural distal stent migration and dislodgement, with proximal stent prolapse into an aneurysm sac, may not result in a failure to coil the aneurysm. The reverse waffle cone technique provides an effective treatment in the management of this complication. Copyright © 2013 Elsevier Ltd. All rights reserved.

Methodological approaches to conducting pilot and proof tests on reverse-osmosis systems: Results of comparative studies

NASA Astrophysics Data System (ADS)

Panteleev, A. A.; Bobinkin, V. V.; Larionov, S. Yu.; Ryabchikov, B. E.; Smirnov, V. B.; Shapovalov, D. A.

2017-10-01

When designing large-scale water-treatment plants based on reverse-osmosis systems, it is proposed to conduct experimental-industrial or pilot tests for validated simulation of the operation of the equipment. It is shown that such tests allow establishing efficient operating conditions and characteristics of the plant under design. It is proposed to conduct pilot tests of the reverse-osmosis systems on pilot membrane plants (PMPs) and test membrane plants (TMPs). The results of a comparative experimental study of pilot and test membrane plants are exemplified by simulating the operating parameters of the membrane elements of an industrial plant. It is concluded that the reliability of the data obtained on the TMP may not be sufficient to design industrial water-treatment plants, while the PMPs are capable of providing reliable data that can be used for full-scale simulation of the operation of industrial reverse-osmosis systems. The test membrane plants allow simulation of the operating conditions of individual industrial plant systems; therefore, potential areas of their application are shown. A method for numerical calculation and experimental determination of the true selectivity and the salt passage are proposed. An expression has been derived that describes the functional dependence between the observed and true salt passage. The results of the experiments conducted on a test membrane plant to determine the true value of the salt passage of a reverse-osmosis membrane are exemplified by magnesium sulfate solution at different initial operating parameters. It is shown that the initial content of a particular solution component has a significant effect on the change in the true salt passage of the membrane.

Three-dimensional time reversal communications in elastic media

DOE PAGES

Anderson, Brian E.; Ulrich, Timothy J.; Le Bas, Pierre-Yves; ...

2016-02-23

Our letter presents a series of vibrational communication experiments, using time reversal, conducted on a set of cast iron pipes. Time reversal has been used to provide robust, private, and clean communications in many underwater acoustic applications. Also, the use of time reversal to communicate along sections of pipes and through a wall is demonstrated here in order to overcome the complications of dispersion and multiple scattering. These demonstrations utilize a single source transducer and a single sensor, a triaxial accelerometer, enabling multiple channels of simultaneous communication streams to a single location.

Thin SOI lateral IGBT with band-to-band tunneling mechanism

NASA Astrophysics Data System (ADS)

Fu, Qiang; Tang, Zhaohuan; Tan, Kaizhou; Wang, Zhikuan; Mei, Yong

2017-06-01

In this paper, a novel 200V lateral IGBT on thin SOI layer with a band-to-band tunneling junction near the anode is proposed. The structure and the operating mechanism of the proposed IGBT are described and discussed. Its main feature is that the novel IGBT structure has a unique abrupt doped p++/n++ tunneling junction in the side of the anode. By utilizing the reverse bias characteristics of the tunneling junction, the proposed IGBT can achieve excellent reverse conducting performance. Numerical simulations suggest that a low reverse conduction voltage drop VR=-1.6V at a current density of 100A/cm2 and a soft factor S=0.63 of the build-in diode are achieved.

Current-induced alternating reversed dual-echo-steady-state for joint estimation of tissue relaxation and electrical properties.

PubMed

Lee, Hyunyeol; Sohn, Chul-Ho; Park, Jaeseok

2017-07-01

To develop a current-induced, alternating reversed dual-echo-steady-state-based magnetic resonance electrical impedance tomography for joint estimation of tissue relaxation and electrical properties. The proposed method reverses the readout gradient configuration of conventional, in which steady-state-free-precession (SSFP)-ECHO is produced earlier than SSFP-free-induction-decay (FID) while alternating current pulses are applied in between the two SSFPs to secure high sensitivity of SSFP-FID to injection current. Additionally, alternating reversed dual-echo-steady-state signals are modulated by employing variable flip angles over two orthogonal injections of current pulses. Ratiometric signal models are analytically constructed, from which T 1 , T 2 , and current-induced B z are jointly estimated by solving a nonlinear inverse problem for conductivity reconstruction. Numerical simulations and experimental studies are performed to investigate the feasibility of the proposed method in estimating relaxation parameters and conductivity. The proposed method, if compared with conventional magnetic resonance electrical impedance tomography, enables rapid data acquisition and simultaneous estimation of T 1 , T 2 , and current-induced B z , yielding a comparable level of signal-to-noise ratio in the parameter estimates while retaining a relative conductivity contrast. We successfully demonstrated the feasibility of the proposed method in jointly estimating tissue relaxation parameters as well as conductivity distributions. It can be a promising, rapid imaging strategy for quantitative conductivity estimation. Magn Reson Med 78:107-120, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

Synaptic transistor with a reversible and analog conductance modulation using a Pt/HfOx/n-IGZO memcapacitor

NASA Astrophysics Data System (ADS)

Yang, Paul; Kim, Hyung Jun; Zheng, Hong; Beom, Geon Won; Park, Jong-Sung; Kang, Chi Jung; Yoon, Tae-Sik

2017-06-01

A synaptic transistor emulating the biological synaptic motion is demonstrated using the memcapacitance characteristics in a Pt/HfOx/n-indium-gallium-zinc-oxide (IGZO) memcapacitor. First, the metal-oxide-semiconductor (MOS) capacitor with Pt/HfOx/n-IGZO structure exhibits analog, polarity-dependent, and reversible memcapacitance in capacitance-voltage (C-V), capacitance-time (C-t), and voltage-pulse measurements. When a positive voltage is applied repeatedly to the Pt electrode, the accumulation capacitance increases gradually and sequentially. The depletion capacitance also increases consequently. The capacitances are restored by repeatedly applying a negative voltage, confirming the reversible memcapacitance. The analog and reversible memcapacitance emulates the potentiation and depression synaptic motions. The synaptic thin-film transistor (TFT) with this memcapacitor also shows the synaptic motion with gradually increasing drain current by repeatedly applying the positive gate and drain voltages and reversibly decreasing one by applying the negative voltages, representing synaptic weight modulation. The reversible and analog conductance change in the transistor at both the voltage sweep and pulse operations is obtained through the memcapacitance and threshold voltage shift at the same time. These results demonstrate the synaptic transistor operations with a MOS memcapacitor gate stack consisting of Pt/HfOx/n-IGZO.

Synaptic transistor with a reversible and analog conductance modulation using a Pt/HfOx/n-IGZO memcapacitor.

PubMed

Yang, Paul; Jun Kim, Hyung; Zheng, Hong; Won Beom, Geon; Park, Jong-Sung; Jung Kang, Chi; Yoon, Tae-Sik

2017-06-02

A synaptic transistor emulating the biological synaptic motion is demonstrated using the memcapacitance characteristics in a Pt/HfOx/n-indium-gallium-zinc-oxide (IGZO) memcapacitor. First, the metal-oxide-semiconductor (MOS) capacitor with Pt/HfOx/n-IGZO structure exhibits analog, polarity-dependent, and reversible memcapacitance in capacitance-voltage (C-V), capacitance-time (C-t), and voltage-pulse measurements. When a positive voltage is applied repeatedly to the Pt electrode, the accumulation capacitance increases gradually and sequentially. The depletion capacitance also increases consequently. The capacitances are restored by repeatedly applying a negative voltage, confirming the reversible memcapacitance. The analog and reversible memcapacitance emulates the potentiation and depression synaptic motions. The synaptic thin-film transistor (TFT) with this memcapacitor also shows the synaptic motion with gradually increasing drain current by repeatedly applying the positive gate and drain voltages and reversibly decreasing one by applying the negative voltages, representing synaptic weight modulation. The reversible and analog conductance change in the transistor at both the voltage sweep and pulse operations is obtained through the memcapacitance and threshold voltage shift at the same time. These results demonstrate the synaptic transistor operations with a MOS memcapacitor gate stack consisting of Pt/HfOx/n-IGZO.

Experimental and modeling results of creep fatigue life of Inconel 617 and Haynes 230 at 850 C

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

Chen, Xiang; Sokolov, Mikhail A; Sham, Sam

Creep fatigue testing of Ni-based superalloy Inconel 617 and Haynes 230 were conducted in the air at 850 C. Tests were performed with fully reversed axial strain control at a total strain range of 0.5%, 1.0% or 1.5% and hold time at maximum tensile strain for 3, 10 or 30 min. In addition, two creep fatigue life prediction methods, i.e. linear damage summation and frequency-modified tensile hysteresis energy modeling, were evaluated and compared with experimental results. Under all creep fatigue tests, Haynes 230 performed better than Inconel 617. Compared to the low cycle fatigue life, the cycles to failure formore » both materials decreased under creep fatigue test conditions. Longer hold time at maximum tensile strain would cause a further reduction in both material creep fatigue life. The linear damage summation could predict the creep fatigue life of Inconel 617 for limited test conditions, but considerably underestimated the creep fatigue life of Haynes 230. In contrast, frequency-modified tensile hysteresis energy modeling showed promising creep fatigue life prediction results for both materials.« less

Genotypic Characterization of Human Immunodeficiency Virus Type 1 Derived from Antiretroviral Drug-Treated Individuals Residing in Earthquake-Affected Areas in Nepal.

PubMed

Negi, Bharat Singh; Kotaki, Tomohiro; Joshi, Sunil Kumar; Bastola, Anup; Nakazawa, Minato; Kameoka, Masanori

2017-09-01

Molecular epidemiological data on human immunodeficiency virus type 1 (HIV-1) are limited in Nepal and have not been available in areas affected by the April 2015 earthquake. Therefore, we conducted a genotypic study on HIV-1 genes derived from individuals on antiretroviral therapy residing in 14 districts in Nepal highly affected by the earthquake. HIV-1 genomic fragments were amplified from 40 blood samples of HIV treatment-failure individuals, and a sequencing analysis was performed on these genes. In the 40 samples, 29 protease, 32 reverse transcriptase, 25 gag, and 21 env genes were sequenced. HIV-1 subtyping revealed that subtype C (84.2%, 32/38) was the major subtype prevalent in the region, while CRF01_AE (7.9%, 3/38) and other recombinant forms (7.9%, 3/38) were also detected. In addition, major drug resistance mutations were identified in 21.9% (7/32) of samples, indicating the possible emergence of HIV-1 drug resistance in earthquake-affected areas in Nepal.

Massive and Reproducible Production of Liver Buds Entirely from Human Pluripotent Stem Cells.

PubMed

Takebe, Takanori; Sekine, Keisuke; Kimura, Masaki; Yoshizawa, Emi; Ayano, Satoru; Koido, Masaru; Funayama, Shizuka; Nakanishi, Noriko; Hisai, Tomoko; Kobayashi, Tatsuya; Kasai, Toshiharu; Kitada, Rina; Mori, Akira; Ayabe, Hiroaki; Ejiri, Yoko; Amimoto, Naoki; Yamazaki, Yosuke; Ogawa, Shimpei; Ishikawa, Momotaro; Kiyota, Yasujiro; Sato, Yasuhiko; Nozawa, Kohei; Okamoto, Satoshi; Ueno, Yasuharu; Taniguchi, Hideki

2017-12-05

Organoid technology provides a revolutionary paradigm toward therapy but has yet to be applied in humans, mainly because of reproducibility and scalability challenges. Here, we overcome these limitations by evolving a scalable organ bud production platform entirely from human induced pluripotent stem cells (iPSC). By conducting massive "reverse" screen experiments, we identified three progenitor populations that can effectively generate liver buds in a highly reproducible manner: hepatic endoderm, endothelium, and septum mesenchyme. Furthermore, we achieved human scalability by developing an omni-well-array culture platform for mass producing homogeneous and miniaturized liver buds on a clinically relevant large scale (>10 8 ). Vascularized and functional liver tissues generated entirely from iPSCs significantly improved subsequent hepatic functionalization potentiated by stage-matched developmental progenitor interactions, enabling functional rescue against acute liver failure via transplantation. Overall, our study provides a stringent manufacturing platform for multicellular organoid supply, thus facilitating clinical and pharmaceutical applications especially for the treatment of liver diseases through multi-industrial collaborations. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Experimental and modeling results of creep-fatigue life of Inconel 617 and Haynes 230 at 850 °C

NASA Astrophysics Data System (ADS)

Chen, Xiang; Sokolov, Mikhail A.; Sham, Sam; Erdman, Donald L., III; Busby, Jeremy T.; Mo, Kun; Stubbins, James F.

2013-01-01

Creep-fatigue testing of Ni-based superalloy Inconel 617 and Haynes 230 were conducted in the air at 850 °C. Tests were performed with fully reversed axial strain control at a total strain range of 0.5%, 1.0% or 1.5% and hold time at maximum tensile strain for 3, 10 or 30 min. In addition, two creep-fatigue life prediction methods, i.e. linear damage summation and frequency-modified tensile hysteresis energy modeling, were evaluated and compared with experimental results. Under all creep-fatigue tests, Haynes 230 performed better than Inconel 617. Compared to the low cycle fatigue life, the cycles to failure for both materials decreased under creep-fatigue test conditions. Longer hold time at maximum tensile strain would cause a further reduction in both material creep-fatigue life. The linear damage summation could predict the creep-fatigue life of Inconel 617 for limited test conditions, but considerably underestimated the creep-fatigue life of Haynes 230. In contrast, frequency-modified tensile hysteresis energy modeling showed promising creep-fatigue life prediction results for both materials.

Fatigue Behavior and Modeling of Additively Manufactured Ti-6Al-4V Including Interlayer Time Interval Effects

NASA Astrophysics Data System (ADS)

Torries, Brian; Shamsaei, Nima

2017-12-01

The effects of different cooling rates, as achieved by varying the interlayer time interval, on the fatigue behavior of additively manufactured Ti-6Al-4V specimens were investigated and modeled via a microstructure-sensitive fatigue model. Comparisons are made between two sets of specimens fabricated via Laser Engineered Net Shaping (LENS™), with variance in interlayer time interval accomplished by depositing either one or two specimens per print operation. Fully reversed, strain-controlled fatigue tests were conducted, with fractography following specimen failure. A microstructure-sensitive fatigue model was calibrated to model the fatigue behavior of both sets of specimens and was found to be capable of correctly predicting the longer fatigue lives of the single-built specimens and the reduced scatter of the double-built specimens; all data points fell within the predicted upper and lower bounds of fatigue life. The time interval effects and the ability to be modeled are important to consider when producing test specimens that are smaller than the production part (i.e., property-performance relationships).

Experimental observations on uniaxial whole-life transformation ratchetting and low-cycle stress fatigue of super-elastic NiTi shape memory alloy micro-tubes

NASA Astrophysics Data System (ADS)

Song, Di; Kang, Guozheng; Kan, Qianhua; Yu, Chao; Zhang, Chuanzeng

2015-07-01

In this work, the low-cycle fatigue failure of super-elastic NiTi shape memory alloy micro-tubes with a wall thickness of 150 μm is investigated by uniaxial stress-controlled cyclic tests at human body temperature 310 K. The effects of mean stress, peak stress, and stress amplitude on the uniaxial whole-life transformation ratchetting and fatigue failure of the NiTi alloy are observed. It is concluded that the fatigue life depends significantly on the stress levels, and the extent of martensite transformation and its reverse play an important role in determining the fatigue life. High peak stress or complete martensite transformation shortens the fatigue life.

[Cardiogenic shock associated with inappropriate nutritional regimen: refeeding syndrome].

PubMed

Campos-Ferrer, C; Cervera-Montes, M; Romero, A; Borrás, S; Gómez, E; Ricart, C

2004-01-01

Situations of cardiac arrest have been reported in under-nourished patients with protein and calorie deficits when the provision of nutrients was initiated in an uncontrolled manner. The recognition of the association between the provision of food in these circumstances and the serious clinical consequences, generally heartbeat disorders, has led this condition to be described as "re-feeding syndrome". The case presented here is of severe acute respiratory failure and cardiogenic shock in a 44-year-old female patient with severe protein and calorie malnutrition associated with the start of hyperproteic nutritional support. Treatment with inotropic-vasoactive drugs and diuretics together with a progressive nutritional programme brought about the complete reversal of her heart failure and the concomitant endocrine-metabolic syndrome.

A young man presenting with paralysis after vigorous exercise.

PubMed

Gubran, Christopher; Narain, Rajay; Malik, Luqmaan; Saeed, Saad Aldeen

2012-08-27

Thyrotoxic periodic paralysis (TPP) is a rare metabolic disorder characterised by muscular weakness and paralysis in predisposed thyrotoxic patients. Although patients with TPP are almost uniformly men of Asian descent, cases have been reported in Caucasian and other ethnic populations. The rapid increase in ethnic diversity in Western and European nations has led to increase in TPP reports, where it was once considered exceedingly rare. Correcting the hypokalaemic and hyperthyroid state tends to reverse the paralysis. However, failure to recognise the condition may lead to delay in diagnosis and serious consequences including respiratory failure and death. We describe a young man who was diagnosed with hyperthyroidism who presented with acute paralysis. The clinical characteristics, pathophysiology and management of TTP are reviewed.

Deep RNA sequencing reveals dynamic regulation of myocardial noncoding RNAs in failing human heart and remodeling with mechanical circulatory support.

PubMed

Yang, Kai-Chien; Yamada, Kathryn A; Patel, Akshar Y; Topkara, Veli K; George, Isaac; Cheema, Faisal H; Ewald, Gregory A; Mann, Douglas L; Nerbonne, Jeanne M

2014-03-04

Microarrays have been used extensively to profile transcriptome remodeling in failing human heart, although the genomic coverage provided is limited and fails to provide a detailed picture of the myocardial transcriptome landscape. Here, we describe sequencing-based transcriptome profiling, providing comprehensive analysis of myocardial mRNA, microRNA (miRNA), and long noncoding RNA (lncRNA) expression in failing human heart before and after mechanical support with a left ventricular (LV) assist device (LVAD). Deep sequencing of RNA isolated from paired nonischemic (NICM; n=8) and ischemic (ICM; n=8) human failing LV samples collected before and after LVAD and from nonfailing human LV (n=8) was conducted. These analyses revealed high abundance of mRNA (37%) and lncRNA (71%) of mitochondrial origin. miRNASeq revealed 160 and 147 differentially expressed miRNAs in ICM and NICM, respectively, compared with nonfailing LV. Among these, only 2 (ICM) and 5 (NICM) miRNAs are normalized with LVAD. RNASeq detected 18 480, including 113 novel, lncRNAs in human LV. Among the 679 (ICM) and 570 (NICM) lncRNAs differentially expressed with heart failure, ≈10% are improved or normalized with LVAD. In addition, the expression signature of lncRNAs, but not miRNAs or mRNAs, distinguishes ICM from NICM. Further analysis suggests that cis-gene regulation represents a major mechanism of action of human cardiac lncRNAs. The myocardial transcriptome is dynamically regulated in advanced heart failure and after LVAD support. The expression profiles of lncRNAs, but not mRNAs or miRNAs, can discriminate failing hearts of different pathologies and are markedly altered in response to LVAD support. These results suggest an important role for lncRNAs in the pathogenesis of heart failure and in reverse remodeling observed with mechanical support.

The invisible hand: how British American Tobacco precluded competition in Uzbekistan

PubMed Central

Gilmore, Anna B; McKee, Martin; Collin, Jeff

2007-01-01

Background Tobacco industry documents provide a unique opportunity to explore the role transnational corporations (TNCs) played in shaping the poor outcomes of privatisation in the former Soviet Union (FSU). This paper examines British American Tobacco's (BAT's) business conduct in Uzbekistan where large‐scale smuggling of BAT's cigarettes, BAT's reversal of tobacco control legislation and its human rights abuses of tobacco farmers have been documented previously. This paper focuses, instead, on BAT's attitude to competition, compares BAT's conduct with international standards and assesses its influence on the privatisation process. Methods Analysis of BAT documents released through litigation. Results BAT secured sole negotiator status precluding the Uzbekistan government from initiating discussions with other parties. Recognising that a competitive tender would greatly increase the cost of investment, BAT went to great lengths to avoid one, ultimately securing President Karimov's support and negotiating a monopoly position in a closed deal. It simultaneously secured exclusion from the monopolies committee, ensuring freedom to set prices, on the basis of a spurious argument that competition would exist from imports. Other anticompetitive moves comprised including all three plants in the deal despite intending to close down two, exclusive dealing and implementing measures designed to prevent market entry by competitors. BAT also secured a large number of exemptions and privileges that further reduced the government's revenue both on a one‐off and ongoing basis. Conclusions BAT's corporate misbehaviour included a wide number of anticompetitive practices, contravened Organisation of Economic Cooperation and Development's and BAT's own business standards on competition and restricted revenue arising from privatisation. This suggests that TNCs have contributed to the failure of privatisation in the FSU. Conducting open tenders and using enforceable codes to regulate corporate conduct would help deal with some of the problems identified. PMID:17652239

Diurnal and seasonal variation in root xylem embolism in neotropical savanna woody species: impact on stomatal control of plant water status.

PubMed

Domec, J C; Scholz, F G; Bucci, S J; Meinzer, F C; Goldstein, G; Villalobos-Vega, R

2006-01-01

Vulnerability to water-stress-induced embolism and variation in the degree of native embolism were measured in lateral roots of four co-occurring neotropical savanna tree species. Root embolism varied diurnally and seasonally. Late in the dry season, loss of root xylem conductivity reached 80% in the afternoon when root water potential (psi root) was about -2.6 MPa, and recovered to 25-40% loss of conductivity in the morning when psi root was about -1.0 MPa. Daily variation in psi root decreased, and root xylem vulnerability and capacitance increased with rooting depth. However, all species experienced seasonal minimum psi root close to complete hydraulic failure independent of their rooting depth or resistance to embolism. Predawn psi root was lower than psi soil when psi soil was relatively high (> -0.7 MPa) but became less negative than psi soil, later in the dry season, consistent with a transition from a disequilibrium between plant and soil psi induced by nocturnal transpiration to one induced by hydraulic redistribution of water from deeper soil layers. Shallow longitudinal root incisions external to the xylem prevented reversal of embolism overnight, suggesting that root mechanical integrity was necessary for recovery, consistent with the hypothesis that if embolism is a function of tension, refilling may be a function of internal pressure imbalances. All species shared a common relationship in which maximum daily stomatal conductance declined linearly with increasing afternoon loss of root conductivity over the course of the dry season. Daily embolism and refilling in roots is a common occurrence and thus may be an inherent component of a hydraulic signaling mechanism enabling stomata to maintain the integrity of the hydraulic pipeline in long-lived structures such as stems.

Profile of sugammadex for reversal of neuromuscular blockade in the elderly: current perspectives.

PubMed

Carron, Michele; Bertoncello, Francesco; Ieppariello, Giovanna

2018-01-01

The number of elderly patients is increasing worldwide. This will have a significant impact on the practice of anesthesia in future decades. Anesthesiologists must provide care for an increasing number of elderly patients, who have an elevated risk of perioperative morbidity and mortality. Complications related to postoperative residual neuromuscular blockade, such as muscle weakness, airway obstruction, hypoxemia, atelectasis, pneumonia, and acute respiratory failure, are more frequent in older than in younger patients. Therefore, neuromuscular blockade in the elderly should be carefully monitored and completely reversed before awakening patients at the end of anesthesia. Acetylcholinesterase inhibitors are traditionally used for reversal of neuromuscular blockade. Although the risk of residual neuromuscular blockade is reduced by reversal with neostigmine, it continues to complicate the postoperative course. Sugammadex represents an innovative approach to reversal of neuromuscular blockade induced by aminosteroid neuromuscular-blocking agents, particularly rocuronium, with useful applications in clinical practice. However, aging is associated with certain changes in the pharmacokinetics of sugammadex, and to date there has been no thorough evaluation of the use of sugammadex in elderly patients. The aim of this review was to perform an analysis of the use of sugammadex in older adults based on the current literature. Major issues surrounding the physiologic and pharmacologic effects of aging in elderly patients and how these may impact the routine use of sugammadex in elderly patients are discussed.

Profile of sugammadex for reversal of neuromuscular blockade in the elderly: current perspectives

PubMed Central

Carron, Michele; Bertoncello, Francesco; Ieppariello, Giovanna

2018-01-01

The number of elderly patients is increasing worldwide. This will have a significant impact on the practice of anesthesia in future decades. Anesthesiologists must provide care for an increasing number of elderly patients, who have an elevated risk of perioperative morbidity and mortality. Complications related to postoperative residual neuromuscular blockade, such as muscle weakness, airway obstruction, hypoxemia, atelectasis, pneumonia, and acute respiratory failure, are more frequent in older than in younger patients. Therefore, neuromuscular blockade in the elderly should be carefully monitored and completely reversed before awakening patients at the end of anesthesia. Acetylcholinesterase inhibitors are traditionally used for reversal of neuromuscular blockade. Although the risk of residual neuromuscular blockade is reduced by reversal with neostigmine, it continues to complicate the postoperative course. Sugammadex represents an innovative approach to reversal of neuromuscular blockade induced by aminosteroid neuromuscular-blocking agents, particularly rocuronium, with useful applications in clinical practice. However, aging is associated with certain changes in the pharmacokinetics of sugammadex, and to date there has been no thorough evaluation of the use of sugammadex in elderly patients. The aim of this review was to perform an analysis of the use of sugammadex in older adults based on the current literature. Major issues surrounding the physiologic and pharmacologic effects of aging in elderly patients and how these may impact the routine use of sugammadex in elderly patients are discussed. PMID:29317806

Mutations Related to Antiretroviral Resistance Identified by Ultra-Deep Sequencing in HIV-1 Infected Children under Structured Interruptions of HAART

PubMed Central

Vazquez-Guillen, Jose Manuel; Palacios-Saucedo, Gerardo C.; Rivera-Morales, Lydia G.; Garcia-Campos, Jorge; Ortiz-Lopez, Rocio; Noguera-Julian, Marc; Paredes, Roger; Vielma-Ramirez, Herlinda J.; Ramirez, Teresa J.; Chavez-Garcia, Marcelino; Lopez-Guillen, Paulo; Briones-Lara, Evangelina; Sanchez-Sanchez, Luz M.; Vazquez-Martinez, Carlos A.; Rodriguez-Padilla, Cristina

2016-01-01

Although Structured Treatment Interruptions (STI) are currently not considered an alternative strategy for antiretroviral treatment, their true benefits and limitations have not been fully established. Some studies suggest the possibility of improving the quality of life of patients with this strategy; however, the information that has been obtained corresponds mostly to studies conducted in adults, with a lack of knowledge about its impact on children. Furthermore, mutations associated with antiretroviral resistance could be selected due to sub-therapeutic levels of HAART at each interruption period. Genotyping methods to determine the resistance profiles of the infecting viruses have become increasingly important for the management of patients under STI, thus low-abundance antiretroviral drug-resistant mutations (DRM’s) at levels under limit of detection of conventional genotyping (<20% of quasispecies) could increase the risk of virologic failure. In this work, we analyzed the protease and reverse transcriptase regions of the pol gene by ultra-deep sequencing in pediatric patients under STI with the aim of determining the presence of high- and low-abundance DRM’s in the viral rebounds generated by the STI. High-abundance mutations in protease and high- and low-abundance mutations in reverse transcriptase were detected but no one of these are directly associated with resistance to antiretroviral drugs. The results could suggest that the evaluated STI program is virologically safe, but strict and carefully planned studies, with greater numbers of patients and interruption/restart cycles, are still needed to evaluate the selection of DRM’s during STI. PMID:26807922

Model-based Extracted Water Desalination System for Carbon Sequestration

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

Gettings, Rachel; Dees, Elizabeth

The focus of this research effort centered around water recovery from high Total Dissolved Solids (TDS) extracted waters (180,000 mg/L) using a combination of water recovery (partial desalination) technologies. The research goals of this project were as follows: 1. Define the scope and test location for pilot-scale implementation of the desalination system, 2.Define a scalable, multi-stage extracted water desalination system that yields clean water, concentrated brine, and, salt from saline brines, and 3. Validate overall system performance with field-sourced water using GE pre-pilot lab facilities. Conventional falling film-mechanical vapor recompression (FF-MVR) technology was established as a baseline desalination process. Amore » quality function deployment (QFD) method was used to compare alternate high TDS desalination technologies to the base case FF-MVR technology, including but not limited to: membrane distillation (MD), forward osmosis (FO), and high pressure reverse osmosis (HPRO). Technoeconomic analysis of high pressure reverse osmosis (HPRO) was performed comparing the following two cases: 1. a hybrid seawater RO (SWRO) plus HPRO system and 2. 2x standard seawater RO system, to achieve the same total pure water recovery rate. Pre-pilot-scale tests were conducted using field production water to validate key process steps for extracted water pretreatment. Approximately 5,000 gallons of field produced water was processed through, microfiltration, ultrafiltration, and steam regenerable sorbent operations. Improvements in membrane materials of construction were considered as necessary next steps to achieving further improvement in element performance at high pressure. Several modifications showed promising results in their ability to withstand close to 5,000 PSI without gross failure.« less

Drug resistance-related mutations T369V/I in the connection subdomain of HIV-1 reverse transcriptase severely impair viral fitness.

PubMed

Wang, Zheng; Zhang, Junli; Li, Fan; Ji, Xiaolin; Liao, Lingjie; Ma, Liying; Xing, Hui; Feng, Yi; Li, Dan; Shao, Yiming

2017-04-02

Fitness is a key parameter in the measurement of transmission capacity of individual drug-resistant HIV. Drug-resistance related mutations (DRMs) T369V/I and A371V in the connection subdomain (CN) of reverse transcriptase (RT) occur at higher frequencies in the individuals experiencing antiretroviral therapy failure. Here, we evaluated the effects of T369V/I and A371V on viral fitness, in the presence or in the absence of thymidine analogue resistance-associated mutations (TAMs) and assessed the effect of potential RT structure-related mechanism on change in viral fitness. Mutations T369V/I, A371V, alone or in combination with TAMs were introduced into a modified HIV-1 infectious clone AT1 by site-directed mutagenesis. Then, experiments on mutant and wild-type virus AT2 were performed separately using a growth-competition assay, and then the relative fitness was calculated. Structural analysis of RT was conducted using Pymol software. Results showed that T369V/I severely impaired the relative virus fitness, and A371V compensated for the viral fitness reduction caused by TAMs. Structural modeling of RT suggests that T369V/I substitutions disrupt powerful hydrogen bonds formed by T369 and V365 in p51 and p66. This study indicates that the secondary DRMs within CN might efficiently damage viral fitness, and provides valuable information for clinical surveillance and prevention of HIV-1 strains carrying these DRMs. Copyright © 2017 Elsevier B.V. All rights reserved.

Lactate as a marker of energy failure in critically ill patients: hypothesis.

PubMed

Valenza, Franco; Aletti, Gabriele; Fossali, Tommaso; Chevallard, Giorgio; Sacconi, Francesca; Irace, Manuela; Gattinoni, Luciano

2005-01-01

Lactate measurement in the critically ill has been traditionally used to stratify patients with poor outcome. However, plasma lactate levels are the result of a finely tuned interplay of factors that affect the balance between its production and its clearance. When the oxygen supply does not match its consumption, organisms such as man who are forced to produce ATP for their integrity adapt in many different ways up to the point when energy failure occurs. Lactate, being part of the adaptive response, may then be used to assess the severity of the supply/demand imbalance. In such a scenario, the time to intervention becomes relevant: early and effective treatment may allow the cell to revert to a normal state, as long as the oxygen machinery (i.e. mitochondria) is intact. Conversely, once the mitochondria are deranged, energy failure occurs even in the presence of normoxia. The lactate increase in critically ill patients may therefore be viewed as an early marker of a potentially reversible state.

Modeling Geometry and Progressive Failure of Material Interfaces in Plain Weave Composites

NASA Technical Reports Server (NTRS)

Hsu, Su-Yuen; Cheng, Ron-Bin

2010-01-01

A procedure combining a geometrically nonlinear, explicit-dynamics contact analysis, computer aided design techniques, and elasticity-based mesh adjustment is proposed to efficiently generate realistic finite element models for meso-mechanical analysis of progressive failure in textile composites. In the procedure, the geometry of fiber tows is obtained by imposing a fictitious expansion on the tows. Meshes resulting from the procedure are conformal with the computed tow-tow and tow-matrix interfaces but are incongruent at the interfaces. The mesh interfaces are treated as cohesive contact surfaces not only to resolve the incongruence but also to simulate progressive failure. The method is employed to simulate debonding at the material interfaces in a ceramic-matrix plain weave composite with matrix porosity and in a polymeric matrix plain weave composite without matrix porosity, both subject to uniaxial cyclic loading. The numerical results indicate progression of the interfacial damage during every loading and reverse loading event in a constant strain amplitude cyclic process. However, the composites show different patterns of damage advancement.

Bmi1 limits dilated cardiomyopathy and heart failure by inhibiting cardiac senescence

PubMed Central

Gonzalez-Valdes, I.; Hidalgo, I.; Bujarrabal, A.; Lara-Pezzi, E.; Padron-Barthe, L.; Garcia-Pavia, P.; Gómez-del Arco, Pablo; Redondo, J.M.; Ruiz-Cabello, J.M.; Jimenez-Borreguero, L.J.; Enriquez, J.A.; de la Pompa, J.L.; Hidalgo, A.; Gonzalez, S.

2015-01-01

Dilated cardiomyopathy (DCM) is the most frequent cause of heart failure and the leading indication for heart transplantation. Here we show that epigenetic regulator and central transcriptional instructor in adult stem cells, Bmi1, protects against DCM by repressing cardiac senescence. Cardiac-specific Bmi1 deletion induces the development of DCM, which progresses to lung congestion and heart failure. In contrast, Bmi1 overexpression in the heart protects from hypertrophic stimuli. Transcriptome analysis of mouse and human DCM samples indicates that p16INK4a derepression, accompanied by a senescence-associated secretory phenotype (SASP), is linked to severely impaired ventricular dimensions and contractility. Genetic reduction of p16INK4a levels reverses the pathology of Bmi1-deficient hearts. In parabiosis assays, the paracrine senescence response underlying the DCM phenotype does not transmit to healthy mice. As senescence is implicated in tissue repair and the loss of regenerative potential in aging tissues, these findings suggest a source for cardiac rejuvenation. PMID:25751743

Therapeutic potential of microRNAs in heart failure.

PubMed

Dorn, Gerald W

2010-05-01

There is an ongoing explosion of information about microRNAs (miRs) in cardiac disease. These small noncoding RNAs regulate protein expression by destabilization and translational inhibition of target mRNAs. Similar to mRNAs, miRs are regulated in cardiac hypertrophy and heart failure, but miR expression profiles appear to be more sensitive than mRNA signatures to changes in clinical status, suggesting that miR levels in myocardium or plasma could enhance clinical diagnostics. Single miRs can target dozens or hundreds of different mRNAs, complicating attempts to determine their individual physiologic effects. However, manipulating individual miRs by overexpression or gene ablation in experimental models has begun to unravel this conundrum: Single miRs tend to regulate numerous effectors within the same functional pathway, producing a coherent physiologic response via multiple parallel perturbations. miRs are attractive nodal therapeutic targets, and stable miR mimetics (agomiRs) and antagonists (antagomiRs) are being evaluated to prevent or reverse heart failure.

Potential of resveratrol in the treatment of heart failure.

PubMed

Raj, Pema; Louis, Xavier Lieben; Thandapilly, Sijo Joseph; Movahed, Ali; Zieroth, Shelley; Netticadan, Thomas

2014-01-30

The concept of food has expanded beyond its traditional role of survival and hunger satisfaction, to include a role in the prevention and treatment of disease. Polyphenols are classes of compounds that are synthesized by plants to serve a wide variety of functions including growth pollination and defense. These compounds have recently received increased attention in medical research. In this group, one of the most studied has been resveratrol (3,5,4,-trihydroxystilbene), a polyphenol, which is found predominantly in grapes and berries. Over the past two decades, researchers have studied the ability of resveratrol to prevent or reverse the development of abnormalities in heart structure and function in animal models of heart disease and heart failure. The results from animal studies have been promising, and very recently, this knowledge has been translated into examining the efficacy of resveratrol in humans with heart disease/failure. In this review we will discuss the current status of resveratrol research on cardioprotection. Copyright © 2013 Elsevier Inc. All rights reserved.

Middle Eastern Energy Security: Synchronizing Domestic and Foreign Policy

DTIC Science & Technology

2009-05-18

Reversing profligacy is largely an undertaking to change consumer behavior that will reduce demand and therefore dependence on oil. It will have the...transportation technology and associated goods and services. One of the most powerful catalysts for change in America is consumer behavior . As such...and reducing consumption run the risk of failure because changing consumer behavior and long-standing cultural norms will face stiff resistance in the

Stem Cell-Based Therapies for Epidermolysis Bullosa

DTIC Science & Technology

2015-12-01

itself in multiple organ failures, cancer, and age -associated skin phenotypes such as dyskeratotic nails, delayed wound heal- ing, and hair loss (Agarwal...tissue rejuvenation and provide in- sights into mechanisms underlying aging and longevity. Although it is now clear that cells from older patients can be...can be used for reversing skin aging and improving outcomes of stem cell–based therapies for skin disorders. As a particular example, the gen- eration

High Throughput Determination of Critical Human Dosing ...

EPA Pesticide Factsheets

High throughput toxicokinetics (HTTK) is a rapid approach that uses in vitro data to estimate TK for hundreds of environmental chemicals. Reverse dosimetry (i.e., reverse toxicokinetics or RTK) based on HTTK data converts high throughput in vitro toxicity screening (HTS) data into predicted human equivalent doses that can be linked with biologically relevant exposure scenarios. Thus, HTTK provides essential data for risk prioritization for thousands of chemicals that lack TK data. One critical HTTK parameter that can be measured in vitro is the unbound fraction of a chemical in plasma (Fub). However, for chemicals that bind strongly to plasma, Fub is below the limits of detection (LOD) for high throughput analytical chemistry, and therefore cannot be quantified. A novel method for quantifying Fub was implemented for 85 strategically selected chemicals: measurement of Fub was attempted at 10%, 30%, and 100% of physiological plasma concentrations using rapid equilibrium dialysis assays. Varying plasma concentrations instead of chemical concentrations makes high throughput analytical methodology more likely to be successful. Assays at 100% plasma concentration were unsuccessful for 34 chemicals. For 12 of these 34 chemicals, Fub could be quantified at 10% and/or 30% plasma concentrations; these results imply that the assay failure at 100% plasma concentration was caused by plasma protein binding for these chemicals. Assay failure for the remaining 22 chemicals may

An integrated lipidomics and metabolomics reveal nephroprotective effect and biochemical mechanism of Rheum officinale in chronic renal failure

PubMed Central

Zhang, Zhi-Hao; Vaziri, Nosratola D.; Wei, Feng; Cheng, Xian-Long; Bai, Xu; Zhao, Ying-Yong

2016-01-01

Chronic renal failure (CRF) is a major public health problem worldwide. Earlier studies have revealed salutary effects of rhubarb extracts in CRF. In this study, we employed lipidomic and metabolomic approaches to identify the plasma biomarkers and to determine the effect of treatment with petroleum ether, ethyl acetate and n-butanol extracts of rhubarb in a rat model of CRF with adenine-induced chronic tubulointerstitial nephropathy. In addition, clinical biochemistry, histological evaluation and pro-fibrotic protein expression were analyzed. Significant changes were found between the CRF and control groups representing characteristic phenotypes of rats with CRF. Treatment with the three rhubarb extracts improved renal injury and dysfunction, either fully or partially reversed the plasma metabolites abnormalities and attenuated upregulation of pro-fibrotic proteins including TGF-β1, α-SMA, PAI-1, CTGF, FN and collagen-1. The nephroprotective effect of ethyl acetate extract was better than other extracts. The differential metabolites were closely associated with glycerophospholipid, fatty acid and amino acid metabolisms. The results revealed a strong link between renal tubulointerstitial fibrosis and glycerophospholipid metabolism and L-carnitine metabolism in the development of CRF. Amelioration of CRF with the three rhubarb extracts was associated with the delayed development and/or reversal the disorders in key metabolites associated with adenine-induced CRF. PMID:26903149

Childhood Conduct Problems and Young Adult Outcomes Among Women with Childhood ADHD

PubMed Central

Owens, Elizabeth B.; Hinshaw, Stephen P.

2015-01-01

We tested whether conduct problems predicted young adult functioning and psychiatric symptoms among women diagnosed with ADHD during childhood, in the context of three potential adolescent mediators: internalizing problems, peer rejection, and school failure and disciplinary problems. We controlled for childhood ADHD severity, IQ, and demographic factors, and in the mediational tests, for adolescent conduct problems. Data emanated from 140 participants in the Berkeley Girls with ADHD Longitudinal Study. We used bootstrapping methods to assess indirect effects (mediators). Both childhood (F1,118 change = 9.00, p = .003, R2 change = .069) and adolescent (F1,109 change = 10.41, p = .002, R2 change = .083) conduct problems were associated with worse overall functioning during young adulthood, controlling for initial ADHD severity, child IQ, and demographics. Results were similar when predicting psychiatric symptoms. Adolescent school failure and disciplinary problems mediated the relations between childhood conduct problems and both young-adult functioning and externalizing problems; adolescent internalizing problems and peer conflict mediated the relation between childhood conduct problems and young-adult internalizing problems. As is true for boys, childhood and adolescent conduct problems are associated with poor adult outcomes among girls with ADHD, with school failure and disciplinary problems, internalizing problems, and peer conflict functioning as mediators of these relations. PMID:26854507

A Broad Stability Investigation of Nb-Doped SrCoO 2.5+δ as a Reversible Oxygen Electrode for Intermediate-Temperature Solid Oxide Fuel Cells

DOE PAGES

Wang, Jie; Jiang, Long; Xiong, Xiaolei; ...

2016-06-10

The present work reports a systematic study on the structural, thermal, electrical and electrochemical stability of SrCo 1–xNb xO 2.5+δ series as a potential reversible oxygen-electrode for intermediate-temperature solid oxide fuel cells. The identified best composition is x = 0.10, which exhibits a stable pseudo primitive cubic structure at <700°C and a reversible oxygen redox reaction at 350°C. The conductivity of this material is p-type and also exhibits a peak at 350°C, implying that the electron hole conduction is closely associated with the oxygen nonstoichiometry. Electrochemical impedance spectroscopy analysis indicates a low polarization resistance rate-limited by a slower surface Omore » 2 dissociation step. Altogether, the material is thermally stable and oxygen redox reversible below 700°C, above which a catalytically less active brownmillerite SrCoO 2.5 is formed.« less

Leakage current transport mechanism under reverse bias in Au/Ni/GaN Schottky barrier diode

NASA Astrophysics Data System (ADS)

Peta, Koteswara Rao; Kim, Moon Deock

2018-01-01

The leakage current transport mechanism under reverse bias of Au/Ni/GaN Schottky diode is studied using temperature dependent current-voltage (I-V-T) and capacitance-voltage (C-V) characteristics. I-V measurement in this study is in the range of 140 K-420 K in steps of 10 K. A reduction in voltage dependent barrier height and a strong internal electric field in depletion region under reverse bias suggested electric field enhanced thermionic emission in carrier transport via defect states in Au/Ni/GaN SBD. A detailed analysis of reverse leakage current revealed two different predominant transport mechanisms namely variable-range hopping (VRH) and Poole-Frenkel (PF) emission conduction at low (<260 K) and high (>260 K) temperatures respectively. The estimated thermal activation energies (0.20-0.39 eV) from Arrhenius plot indicates a trap assisted tunneling of thermally activated electrons from a deep trap state into a continuum of states associated with each conductive threading dislocation.

The whole number axis integer linear transformation reversible information hiding algorithm on wavelet domain

NASA Astrophysics Data System (ADS)

Jiang, Zhuo; Xie, Chengjun

2013-12-01

This paper improved the algorithm of reversible integer linear transform on finite interval [0,255], which can realize reversible integer linear transform in whole number axis shielding data LSB (least significant bit). Firstly, this method use integer wavelet transformation based on lifting scheme to transform the original image, and select the transformed high frequency areas as information hiding area, meanwhile transform the high frequency coefficients blocks in integer linear way and embed the secret information in LSB of each coefficient, then information hiding by embedding the opposite steps. To extract data bits and recover the host image, a similar reverse procedure can be conducted, and the original host image can be lossless recovered. The simulation experimental results show that this method has good secrecy and concealment, after conducted the CDF (m, n) and DD (m, n) series of wavelet transformed. This method can be applied to information security domain, such as medicine, law and military.

Growing Lemon Trees from Lemons: Lessons Reaped from a SoTL Faculty Learning Community's Research "Failures"

ERIC Educational Resources Information Center

Dich, Linh; Brown, Karen M.; Kuznekoff, Jeff H.; Conover, Theresa; Forren, John P.; Marshall, Janet

2017-01-01

Failure can be central to faculty research; however, failure produces a vehicle for learning. Through an interdisciplinary faculty community, the authors supported each other in facing, learning from, and overcoming "failed" aspects of research projects. This article reports obstacles encountered in conducting Scholarship of Teaching and…

Relationships between Phytophthora ramorum canker (sudden oak death) and failure potential in coast live oak

Treesearch

Tedmund J. Swiecki; Elizabeth Bernhardt; Christiana Drake; Laurence R. Costello

2006-01-01

In autumn 2002, we conducted a retrospective study on coast live oak (Quercus agrifolia) failures in Marin County, California, woodlands affected by Phytophthora ramorum canker (sudden oak death). The objectives of this case-control study were to quantify levels of bole, large branch, and root failure in these woodlands and...

Early prediction of norepinephrine dependency and refractory septic shock with a multimodal approach of vascular failure.

PubMed

Conrad, Marie; Perez, Pierre; Thivilier, Carine; Levy, Bruno

2015-08-01

The purpose of the study is to improve our ability to detect catecholamine dependency and refractory septic shock. Fifty-one patients with septic shock were studied within the first 4 hours of norepinephrine administration. Patients were divided into 2 groups according to their evolution in the intensive care unit, namely, group A, shock reversal, and group B, no shock reversal. Reversal of shock was defined as the maintenance of a systolic blood pressure greater than or equal to 90 mm Hg without vasopressor support for 24 hours or more. Vascular reactivity was tested using incremental doses of phenylephrine. Muscle tissue oxygen saturation and its changes during a vascular occlusion test were measured. Group B patients had a higher Sequential Organ Failure Assessment (SOFA) score and lactate level and more frequently received norepinephrine and renal replacement. Overall mortality was 100% in group B (16/16) and 20% (7/35) in group A. Phenylephrine increased mean arterial pressure in a dose-dependent manner more significantly in group A patients than in group B (P = .0004). Basal tissue oxygen saturation and the recovery slope after vascular occlusion test were lower in group B. In multivariate analysis, 4 parameters remained independently associated with mortality: the increase in mean arterial pressure at phenylephrine 6 μg/kg per minute, the recovery slope, SOFA score, and norepinephrine doses at H0. The intensity of septic shock-induced vascular hyporesponsiveness to vasopressor is tightly linked to septic shock severity and evolution and may potentially be identified early with simple to obtain parameters such as near-infrared spectroscopy value, SOFA score, or norepinephrine dose. Copyright © 2015 Elsevier Inc. All rights reserved.

Experimental Study on Surrogate Nuclear Fuel Rods under Reversed Cyclic Bending

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

Wang, Hong; Wang, Jy-An John

The mechanical behavior of spent nuclear fuel (SNF) rods under reversed cyclic bending or bending fatigue must be understood to evaluate their vibration integrity in a transportation environment. This is especially important for high-burnup fuels (>45 GWd/MTU), which have the potential for increased structural damage. It has been demonstrated that the bending fatigue of SNF rods can be effectively studied using surrogate rods. In this investigation, surrogate rods made of stainless steel (SS) 304 cladding and aluminum oxide pellets were tested under load or moment control at a variety of amplitude levels at 5 Hz using the Cyclic Integrated Reversible-Bendingmore » Fatigue Tester developed at Oak Ridge National Laboratory. The behavior of the rods was further characterized using flexural rigidity and hysteresis data, and fractography was performed on the failed rods. The proposed surrogate rods captured many of the characteristics of deformation and failure mode observed in SNF, including the linear-to-nonlinear deformation transition and large residual curvature in static tests, PPI and PCMI failure mechanisms, and large variation in the initial structural condition. Rod degradation was measured and characterized by measuring the flexural rigidity; the degradation of the rigidity depended on both the moment amplitude applied and the initial structural condition of the rods. It was also shown that a cracking initiation site can be located on the internal surface or the external surface of cladding. Finally, fatigue damage to the bending rods can be described in terms of flexural rigidity, and the fatigue life of rods can be predicted once damage model parameters are properly evaluated. The developed experimental approach, test protocol, and analysis method can be used to study the vibration integrity of SNF rods in the future.« less

Static performance and noise tests on a thrust reverser for an augmentor wing aircraft

NASA Technical Reports Server (NTRS)

Harkonen, D. L.; Marrs, C. C.; Okeefe, J. V.

1974-01-01

A 1/3 scale model static test program was conducted to measure the noise levels and reverse thrust performance characteristics of wing-mounted thrust reverser that could be used on an advanced augmentor wing airplane. The configuration tested represents only the most fundamental designs where installation and packaging restraints are not considered. The thrust reverser performance is presented in terms of horizontal, vertical, and resultant effectiveness ratios and the reverser noise is compared on the basis of peak perceived noise level (PNL) and one-third octave band data (OASPL). From an analysis of the model force and acoustic data, an assessment is made on the stopping distance versus noise for a 90,900 kg (200,000 lb) airplane using this type of thrust reverser.

Economic Value and Cost-Effectiveness of Cardiac Resynchronization Therapy Among Patients With Mild Heart Failure: Projections From the REVERSE Long-Term Follow-Up.

PubMed

Gold, Michael R; Padhiar, Amie; Mealing, Stuart; Sidhu, Manpreet K; Tsintzos, Stelios I; Abraham, William T

2017-03-01

This study investigated the cost effectiveness of early cardiac resynchronization therapy (CRT) implantation among patients with mild heart failure (HF). The differential cost effectiveness between CRT using a defibrillator (CRT-Ds) and CRT using a pacemaker (CRT-P) was also assessed. Cardiac resynchronization has been shown to be cost effective in New York Heart Association (NYHA) functional classes III/IV but is less studied in class II HF. The incremental costs of early CRT implementation in mild HF compared with the costs potentially avoided because of delaying disease progression to advanced HF are also unknown. Finally, combined biventricular pacing and defibrillator (CRT-D) devices are more expensive than biventricular pacemakers (CRT-P), but the relative cost effectiveness is controversial. Data from the 5-year follow-up phase of REVERSE (REsynchronization reVErses Remodeling in Systolic Left vEntricular Dysfunction) were used. The economics were evaluated from the U.S. Medicare perspective based on published clinical projections. Probabilistic estimates yielded $8,840/quality-adjusted life year (QALY) gained (95% confidence interval [CI]: $6,705 to $10,804/QALY gained) for CRT-ON versus CRT-OFF (i.e., programmed "ON" or "OFF" at pre-specified post-implantation timings) and $43,678/QALY gained for CRT-D versus CRT-P (95% CI: $35,164 to $53,589/QALY gained) over the patient's lifetime. Results were robust to choice of patient subgroup and alterations of ±10% to key model parameters. An "early" CRT-D class II strategy totaled $95,292 compared with $91,511 for a "late" implantation. An "early" implant offered on average 1.00 year of additional survival for $3,781, resulting in an ICER of $3,795/LY gained. This study demonstrates CRT cost effectiveness in mild HF. The incremental CRT-D costs are justified by the anticipated benefits, despite increased procurement costs and shorter generator longevities. "Early" CRT-D implants have essential cost parity with "late" implants while increasing the patient's survival. (REsynchronization reVErses Remodeling in Systolic Left vEntricular Dysfunction [REVERSE]; NCT00271154). Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Can Patients Who Develop Cerebral Death in Fulminant Liver Failure Despite Liver Transplantation Be Previously Forseen?

PubMed

Sarici, K B; Karakas, S; Otan, E; Ince, V; Koc, C; Koc, S; Bayraktar, H; Aydin, C; Kayaalp, C; Gungor, S; Kablan, Y; Yilmaz, S

2017-04-01

The outcome of medical treatment is worse in fulminant liver failure (FLF) developing on acute or chronic ground. Recently, liver transplantations with the use of living and cadaveric donors have been performed in these diseases and good results obtained. In this study, we aimed to present the factors affecting the recovery of cerebral functions after liver transplantation in hepatic encephalopathy (HE) developing in FLF, to identify irreversible patient groups and to prevent unnecessary liver transplantation. In Inonu University's Liver Transplant Institute, 69 patients who made an emergency notice to the National Coordination Center for liver transplantation owing to FLF from January 2012 to December 2015 were included in the study. Patients were divided into 2 groups. Group 1 consisted of 52 patients who underwent liver transplantation and recovered normal brain function, and group 2 had 17 patients who underwent liver transplantation and did not recover normal brain function and had cerebral death. All patients were evaluated before surgery for clinical encephalopathy stage, light reflex, and convulsions. Groups were compared and assessed according to age (>40, 10-40 and <10 years), body mass index, etiologic factor, preoperative laboratory values, transplantation type, mortality, and encephalopathy level. Multivariate analysis was done for specific parameters. Prothrombin time (PT), international normalized ratio (INR), and total bilirubin values were significantly different between the groups. There was no significant difference between the groups regarding ammonia and lactate levels. There was a statistically significant difference between the groups regarding sodium and potassium levels from serum electrolytes. However, the averages of both groups were within normal limits. pH and total bilirubin levels were meaningful for multivariate analysis. HE reversibility, mortality, and morbidity are important in patients with HE who undergo liver transplantation. Therefore, West Haven clinical staging and serum INR, PT, and total bilirubin level may be helpful in predicting the reversibility of FLF patients with HE before liver transplantation. It was determined that West Haven encephalopathy grading is important in determining the reversibility of HE after transplantation in FLF; especially the probability of reversibility of stage 4 HE decreases significantly. High PT and INR levels, hyperbilirubinemia, and serum sodium and potassium concentrations were risk factors for the reversibility of HE in this study. Copyright © 2017 Elsevier Inc. All rights reserved.

Reverse innovation: an opportunity for strengthening health systems.

PubMed

Snowdon, Anne W; Bassi, Harpreet; Scarffe, Andrew D; Smith, Alexander D

2015-02-07

Canada, when compared to other OECD countries, ranks poorly with respect to innovation and innovation adoption while struggling with increasing health system costs. As a result of its failure to innovate, the Canadian health system will struggle to meet the needs and demands of both current and future populations. The purpose of this initiative was to explore if a competition-based reverse innovation challenge could mobilize and stimulate current and future leaders to identify and lead potential reverse innovation projects that address health system challenges in Canada. An open call for applications took place over a 4-month period. Applicants were enticed to submit to the competition with a $50,000 prize for the top submission to finance their project. Leaders from a wide cross-section of sectors collectively developed evaluation criteria and graded the submissions. The criteria evaluated: proof of concept, potential value, financial impact, feasibility, and scalability as well as the use of prize money and innovation team. The competition received 12 submissions from across Canada that identified potential reverse innovations from 18 unique geographical locations that were considered developing and/or emerging markets. The various submissions addressed health system challenges relating to education, mobile health, aboriginal health, immigrant health, seniors health and women's health and wellness. Of the original 12 submissions, 5 finalists were chosen and publically profiled, and 1 was chosen to receive the top prize. The results of this initiative demonstrate that a competition that is targeted to reverse innovation does have the potential to mobilize and stimulate leaders to identify reverse innovations that have the potential for system level impact. The competition also provided important insights into the capacity of Canadian students, health care providers, entrepreneurs, and innovators to propose and implement reverse innovation in the context of the Canadian health system.

The attribution of success when using navigation aids.

PubMed

Brown, Michael; Houghton, Robert; Sharples, Sarah; Morley, Jeremy

2015-01-01

Attitudes towards geographic information technology is a seldom explored research area that can be explained with reference to established theories of attribution. This article reports on a study of how the attribution of success and failure in pedestrian navigation varies with level of automation, degree of success and locus of control. A total of 113 participants took part in a survey exploring reflections on personal experiences and vignettes describing fictional navigation experiences. A complex relationship was discovered in which success tends to be attributed to skill and failure to the navigation aid when participants describe their own experiences. A reversed pattern of results was found when discussing the navigation of others. It was also found that navigation success and failure are associated with personal skill to a greater extent when using paper maps, as compared with web-based routing engines or satellite navigation systems. This article explores the influences on the attribution of success and failure when using navigation aids. A survey was performed exploring interpretations of navigation experiences. Level of success, self or other as navigator and type of navigation aid used are all found to influence the attribution of outcomes to internal or external factors.

Dystrophic heart failure blocked by membrane sealant poloxamer

NASA Astrophysics Data System (ADS)

Yasuda, Soichiro; Townsend, Dewayne; Michele, Daniel E.; Favre, Elizabeth G.; Day, Sharlene M.; Metzger, Joseph M.

2005-08-01

Dystrophin deficiency causes Duchenne muscular dystrophy (DMD) in humans, an inherited and progressive disease of striated muscle deterioration that frequently involves pronounced cardiomyopathy. Heart failure is the second leading cause of fatalities in DMD. Progress towards defining the molecular basis of disease in DMD has mostly come from studies on skeletal muscle, with comparatively little attention directed to cardiac muscle. The pathophysiological mechanisms involved in cardiac myocytes may differ significantly from skeletal myofibres; this is underscored by the presence of significant cardiac disease in patients with truncated or reduced levels of dystrophin but without skeletal muscle disease. Here we show that intact, isolated dystrophin-deficient cardiac myocytes have reduced compliance and increased susceptibility to stretch-mediated calcium overload, leading to cell contracture and death, and that application of the membrane sealant poloxamer 188 corrects these defects in vitro. In vivo administration of poloxamer 188 to dystrophic mice instantly improved ventricular geometry and blocked the development of acute cardiac failure during a dobutamine-mediated stress protocol. Once issues relating to optimal dosing and long-term effects of poloxamer 188 in humans have been resolved, chemical-based membrane sealants could represent a new therapeutic approach for preventing or reversing the progression of cardiomyopathy and heart failure in muscular dystrophy.

Manipulation of sarcoplasmic reticulum Ca2+ release in heart failure through mechanical intervention

PubMed Central

Ibrahim, Michael; Nader, Anas; Yacoub, Magdi H; Terracciano, Cesare

2015-01-01

Left ventricular assist devices (LVADs) were developed as a means of temporary circulatory support, but the mechanical unloading they offer also results in significant reverse remodelling. In selected patients, these improvements are sufficient to allow ultimate device explantation without requiring transplantation; this represents a fundamental shift in our understanding of heart failure. Like heart failure itself, LVADs influence multiple biological systems. The transverse tubules are a system of membrane invaginations in ventricular cardiomyocytes which allow rapid propagation of the action potential throughout the cell. Through their dense concentration of L-type Ca2+ channels in close proximity to intracellular ryanodine receptors, the t-tubules enable synchronous Ca2+ release throughout the cell. The t-tubules’ structure appears to be specifically regulated by mechanical load, such that either the overload of heart failure (or the spontaneously hypertensive rat model) or the profound unloading in a chronically unloaded heart result in impaired t-tubule structure, with ineffective Ca2+ release. While there are multiple molecular pathways which underpin t-tubule regulation, Telethonin (Tcap) appears to be important in regulating the effect of altered loading on the t-tubule system. PMID:25922157

The attribution of success when using navigation aids

PubMed Central

Brown, Michael; Houghton, Robert; Sharples, Sarah; Morley, Jeremy

2015-01-01

Attitudes towards geographic information technology is a seldom explored research area that can be explained with reference to established theories of attribution. This article reports on a study of how the attribution of success and failure in pedestrian navigation varies with level of automation, degree of success and locus of control. A total of 113 participants took part in a survey exploring reflections on personal experiences and vignettes describing fictional navigation experiences. A complex relationship was discovered in which success tends to be attributed to skill and failure to the navigation aid when participants describe their own experiences. A reversed pattern of results was found when discussing the navigation of others. It was also found that navigation success and failure are associated with personal skill to a greater extent when using paper maps, as compared with web-based routing engines or satellite navigation systems. Practitioner Summary: This article explores the influences on the attribution of success and failure when using navigation aids. A survey was performed exploring interpretations of navigation experiences. Level of success, self or other as navigator and type of navigation aid used are all found to influence the attribution of outcomes to internal or external factors. PMID:25384842

Parenteral Nutrition and Intestinal Failure

PubMed Central

Bielawska, Barbara; Allard, Johane P.

2017-01-01

Severe short bowel syndrome (SBS) is a major cause of chronic (Type 3) intestinal failure (IF) where structural and functional changes contribute to malabsorption and risk of micronutrient deficiencies. Chronic IF may be reversible, depending on anatomy and intestinal adaptation, but most patients require long-term nutritional support, generally in the form of parenteral nutrition (PN). SBS management begins with dietary changes and pharmacologic therapies taking into account individual anatomy and physiology, but these are rarely sufficient to avoid PN. New hormonal therapies targeting intestinal adaptation hold promise. Surgical options for SBS including intestinal transplant are available, but have significant limitations. Home PN (HPN) is therefore the mainstay of treatment for severe SBS. HPN involves chronic administration of macronutrients, micronutrients, fluid, and electrolytes via central venous access in the patient’s home. HPN requires careful clinical and biochemical monitoring. Main complications of HPN are related to venous access (infection, thrombosis) and metabolic complications including intestinal failure associated liver disease (IFALD). Although HPN significantly impacts quality of life, outcomes are generally good and survival is mostly determined by the underlying disease. As chronic intestinal failure is a rare disease, registries are a promising strategy for studying HPN patients to improve outcomes. PMID:28481229

Parenteral Nutrition and Intestinal Failure.

PubMed

Bielawska, Barbara; Allard, Johane P

2017-05-06

Severe short bowel syndrome (SBS) is a major cause of chronic (Type 3) intestinal failure (IF) where structural and functional changes contribute to malabsorption and risk of micronutrient deficiencies. Chronic IF may be reversible, depending on anatomy and intestinal adaptation, but most patients require long-term nutritional support, generally in the form of parenteral nutrition (PN). SBS management begins with dietary changes and pharmacologic therapies taking into account individual anatomy and physiology, but these are rarely sufficient to avoid PN. New hormonal therapies targeting intestinal adaptation hold promise. Surgical options for SBS including intestinal transplant are available, but have significant limitations. Home PN (HPN) is therefore the mainstay of treatment for severe SBS. HPN involves chronic administration of macronutrients, micronutrients, fluid, and electrolytes via central venous access in the patient's home. HPN requires careful clinical and biochemical monitoring. Main complications of HPN are related to venous access (infection, thrombosis) and metabolic complications including intestinal failure associated liver disease (IFALD). Although HPN significantly impacts quality of life, outcomes are generally good and survival is mostly determined by the underlying disease. As chronic intestinal failure is a rare disease, registries are a promising strategy for studying HPN patients to improve outcomes.

Mechanics and complications of reverse shoulder arthroplasty: morse taper failure analysis and prospective rectification

NASA Astrophysics Data System (ADS)

Hoskin, HLD; Furie, E.; Collins, W.; Ganey, TM; Schlatterer, DR

2017-05-01

Since Sir John Charnley began his monumental hip arthroplasty work in 1958, clinical researchers have been incrementally improving longevity and functionality of total joint systems, although implant failure occurs on occasion. The purpose of this study is to report the fracture of the humeral tray Morse taper of a reverse total shoulder system (RTSS), which to date has not been reported with metallurgic analysis for any RTSS. There was no reported antecedent fall, motor vehicle collision, or other traumatic event prior to implant fracture in this case. Analysis was performed on the retrieved failed implant by Scanning Electron Microscopy (SEM) and Electron Dispersion Spectroscopy (EDS) in an attempt to determine the failure method, as well as to offer improvements for future implants. At the time of revision surgery all explants were retained from the left shoulder of a 61-year old male who underwent a non-complicated RTSS 4 years prior. The explants, particularly the cracked humeral tray, were processed as required for SEM and EDS. Analysis was performed on the failure sites in order to determine the chemical composition of the different parts of the implant, discover the chemical composition of the filler metal used during the electron beam welding process, and to detect any foreign elements that could suggest corrosion or other evidence of failure etiology. Gross visual inspection of all explants revealed that implant failure was a result of dissociation of the taper from the humeral tray at the weld, leaving the Morse taper embedded in the humeral stem while the tray floated freely in the patient’s shoulder. SEM further confirmed the jagged edges noted grossly at the weld fracture site, both suggesting failure due to torsional forces. EDS detected elevated levels of carbon and oxygen at the fracture site on the taper only and not on the humeral tray. In order to determine the origin of the high levels of C and O, it was considered that in titanium alloys, C and O are used as stabilizers that help raise the temperature at which titanium can be cast. Since the presence of stabilizers reduces ductility and fatigue strength, all interstitial elements are removed after casting. Considering this, the presence of C and O suggests that not all of the interstitials were removed during the manufacturing process, resulting in decreased fatigue strength. Further destructive analytical testing would verify weld quality and failure mode. RTSSs are quite successful in select patients not amenable to traditional shoulder arthroplasty options. This case report highlights how an implant may function well for several years and then suddenly fail without warning. SEM and EDS analysis suggest that residual C and O in the taper lowered the metal implant’s integrity, leading to torsional cracking at the weld junction of the humeral tray and the taper. The elevated levels of C and O measured at fracture sites on both the tray and the taper suggest poor quality filler metal or failure to remove all interstitial elements after casting. In both cases, the results would be decreased fatigue strength and overall toughness, leading to mechanical failure. A manufacturer’s recall of all implants soon followed the reporting of this implant failure; subsequently, the metal materials were changed from Ti6Al4V to both titanium alloy and cobalt-chrome alloy (Co-Cr-Mo). Time will tell if the alterations were sufficient.

Failure analysis of stainless steel femur fixation plate.

PubMed

Hussain, P B; Mohammad, M

2004-05-01

Failure analysis was performed to investigate the failure of the femur fixation plate which was previously fixed on the femur of a girl. Radiography, metallography, fractography and mechanical testing were conducted in this study. The results show that the failure was due to the formation of notches on the femur plate. These notches act as stress raisers from where the cracks start to propagate. Finally fracture occurred on the femur plate and subsequently, the plate failed.

Spontaneous breaking of time-reversal symmetry in strongly interacting two-dimensional electron layers in silicon and germanium.

PubMed

Shamim, S; Mahapatra, S; Scappucci, G; Klesse, W M; Simmons, M Y; Ghosh, A

2014-06-13

We report experimental evidence of a remarkable spontaneous time-reversal symmetry breaking in two-dimensional electron systems formed by atomically confined doping of phosphorus (P) atoms inside bulk crystalline silicon (Si) and germanium (Ge). Weak localization corrections to the conductivity and the universal conductance fluctuations were both found to decrease rapidly with decreasing doping in the Si:P and Ge:P delta layers, suggesting an effect driven by Coulomb interactions. In-plane magnetotransport measurements indicate the presence of intrinsic local spin fluctuations at low doping, providing a microscopic mechanism for spontaneous lifting of the time-reversal symmetry. Our experiments suggest the emergence of a new many-body quantum state when two-dimensional electrons are confined to narrow half-filled impurity bands.

Possible effects of depolarizing GABAA conductance on the neuronal input-output relationship: a modeling study.

PubMed

Morita, Kenji; Tsumoto, Kunichika; Aihara, Kazuyuki

2005-06-01

Recent in vitro experiments revealed that the GABAA reversal potential is about 10 mV higher than the resting potential in mature mammalian neocortical pyramidal cells; thus GABAergic inputs could have facilitatory, rather than inhibitory, effects on action potential generation under certain conditions. However, how the relationship between excitatory input conductances and the output firing rate is modulated by such depolarizing GABAergic inputs under in vivo circumstances has not yet been understood. We examine herewith the input-output relationship in a simple conductance-based model of cortical neurons with the depolarized GABAA reversal potential, and show that a tonic depolarizing GABAergic conductance up to a certain amount does not change the relationship between a tonic glutamatergic driving conductance and the output firing rate, whereas a higher GABAergic conductance prevents spike generation. When the tonic glutamatergic and GABAergic conductances are replaced by in vivo-like highly fluctuating inputs, on the other hand, the effect of depolarizing GABAergic inputs on the input-output relationship critically depends on the degree of coincidence between glutamatergic input events and GABAergic ones. Although a wide range of depolarizing GABAergic inputs hardly changes the firing rate of a neuron driven by noncoincident glutamatergic inputs, a certain range of these inputs considerably decreases the firing rate if a large number of driving glutamatergic inputs are coincident with them. These results raise the possibility that the depolarized GABAA reversal potential is not a paradoxical mystery, but is instead a sophisticated device for discriminative firing rate modulation.

Determination of slope failure using 2-D resistivity method

NASA Astrophysics Data System (ADS)

Muztaza, Nordiana Mohd; Saad, Rosli; Ismail, Nur Azwin; Bery, Andy Anderson

2017-07-01

Landslides and slope failure may give negative economic effects including the cost to repair structures, loss of property value and medical costs in the event of injury. To avoid landslide, slope failure and disturbance of the ecosystem, good and detailed planning must be done when developing hilly area. Slope failure classification and various factors contributing to the instability using 2-D resistivity survey conducted in Selangor, Malaysia are described. The study on landslide and slope failure was conducted at Site A and Site B, Selangor using 2-D resistivity method. The implications of the anticipated ground conditions as well as the field observation of the actual conditions are discussed. Nine 2-D resistivity survey lines were conducted in Site A and six 2-D resistivity survey lines with 5 m minimum electrode spacing using Pole-dipole array were performed in Site B. The data were processed using Res2Dinv and Surfer10 software to evaluate the subsurface characteristics. 2-D resistivity results from both locations show that the study areas consist of two main zones. The first zone is alluvium or highly weathered with the resistivity of 100-1000 Ωm at 20-70 m depth. This zone consists of saturated area (1-100 Ωm) and boulders with resistivity value of 1200-3000 Ωm. The second zone with resistivity values of > 3000 Ωm was interpreted as granitic bedrock. The study area was characterized by saturated zones, highly weathered zone, highly contain of sand and boulders that will trigger slope failure in the survey area. Based on the results obtained from the study findings, it can be concluded that 2-D resistivity method is useful method in determination of slope failure.

Use of prazosin in management of hypertension in patients with chronic renal failure and in renal transplant recipients.

PubMed Central

Curtis, J R; Bateman, F J

1975-01-01

Prazosin was used in combination with other antihypertensive drugs in the successful management of hypertension in seven patients with chronic renal failure and six renal transplant recipients, also with chronic renal failure. The addition of small doses of prazosin (mean 3 mg/day) to the antihypertensive regimen produced significant falls in systolic and diastolic blood pressures in both the lying and standing positions. The standing blood pressures were significantly lower than the lying blood pressures during prazosin treatment. Neither the mean blood urea concentrations nor the mean plasma creatinine concentrations changed significantly during prazosin administration. Chromium-51 edetic acid clearances did not change significantly during prazosin treatment in the seven patients in whom it was measured. Severe symptomatic postural hypotension occurred in one patient a week after starting prazosin 3 mg/day. This hypotensive episode was associated with a transient and reversible deterioration in renal function. Another patient developed a rash while on prazosin but it was probably related to propranolol rather than prazosin. Prazosin is thus an effective antihypertensive drug in patients with chronic renal failure, and it may be used with a variety of other drugs. It should be used cautiously, however, since patients with chronic renal failure may respond to small doses, and significant postural falls in blood pressure may result. There was no evidence that the use of prazosin resulted in progressive deterioration in the residual renal function of the patients with chronic renal failure. PMID:811312

Association of the Endobiont Double-Stranded RNA Virus LRV1 With Treatment Failure for Human Leishmaniasis Caused by Leishmania braziliensis in Peru and Bolivia.

PubMed

Adaui, Vanessa; Lye, Lon-Fye; Akopyants, Natalia S; Zimic, Mirko; Llanos-Cuentas, Alejandro; Garcia, Lineth; Maes, Ilse; De Doncker, Simonne; Dobson, Deborah E; Arevalo, Jorge; Dujardin, Jean-Claude; Beverley, Stephen M

2016-01-01

Cutaneous and mucosal leishmaniasis, caused in South America by Leishmania braziliensis, is difficult to cure by chemotherapy (primarily pentavalent antimonials [Sb(V)]). Treatment failure does not correlate well with resistance in vitro, and the factors responsible for treatment failure in patients are not well understood. Many isolates of L. braziliensis (>25%) contain a double-stranded RNA virus named Leishmaniavirus 1 (LRV1), which has also been reported in Leishmania guyanensis, for which an association with increased pathology, metastasis, and parasite replication was found in murine models. Here we probed the relationship of LRV1 to drug treatment success and disease in 97 L. braziliensis-infected patients from Peru and Bolivia. In vitro cultures were established, parasites were typed as L. braziliensis, and the presence of LRV1 was determined by reverse transcription-polymerase chain reaction, followed by sequence analysis. LRV1 was associated significantly with an increased risk of treatment failure (odds ratio, 3.99; P = .04). There was no significant association with intrinsic Sb(V) resistance among parasites, suggesting that treatment failure arises from LRV1-mediated effects on host metabolism and/or parasite survival. The association of LRV1 with clinical drug treatment failure could serve to guide more-effective treatment of tegumentary disease caused by L. braziliensis. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Use of prazosin in management of hypertension in patients with chronic renal failure and in renal transplant recipients.

PubMed

Curtis, J R; Bateman, F J

1975-11-22

Prazosin was used in combination with other antihypertensive drugs in the successful management of hypertension in seven patients with chronic renal failure and six renal transplant recipients, also with chronic renal failure. The addition of small doses of prazosin (mean 3 mg/day) to the antihypertensive regimen produced significant falls in systolic and diastolic blood pressures in both the lying and standing positions. The standing blood pressures were significantly lower than the lying blood pressures during prazosin treatment. Neither the mean blood urea concentrations nor the mean plasma creatinine concentrations changed significantly during prazosin administration. Chromium-51 edetic acid clearances did not change significantly during prazosin treatment in the seven patients in whom it was measured. Severe symptomatic postural hypotension occurred in one patient a week after starting prazosin 3 mg/day. This hypotensive episode was associated with a transient and reversible deterioration in renal function. Another patient developed a rash while on prazosin but it was probably related to propranolol rather than prazosin. Prazosin is thus an effective antihypertensive drug in patients with chronic renal failure, and it may be used with a variety of other drugs. It should be used cautiously, however, since patients with chronic renal failure may respond to small doses, and significant postural falls in blood pressure may result. There was no evidence that the use of prazosin resulted in progressive deterioration in the residual renal function of the patients with chronic renal failure.

Prevalence of HIV drug resistance mutation in the northern Indian population after failure of the first line antiretroviral therapy.

PubMed

Sinha, S; Shekhar, R C; Ahmad, H; Kumar, N; Samantaray, J C; Sreenivas, V; Khan, N H; Mitsuyasu, R T

2012-09-01

There is limited information available about the prevalence and pattern of human immunodeficiency virus (HIV) drug resistance mutations (DRMs) among antiretroviral therapy (ART) experienced patients from northern India. Results of genotypic drug resistance testing were obtained from plasma samples of 128 patients, who had presented with clinical or immunological failure to treatment after at least six months of ART. Major DRMs associated with any of the three classes of antiretroviral (ARV) drugs, nucleoside reverse transcriptase inhibitors (NRTI), non-nucleoside reverse transcriptase inhibitors (NNRTI) and protease inhibitors (PI), were seen in 120 out of 128 patients (93.8% prevalence). NRTI and NNRTI DRMs were each seen in 115/128 (89.8%) patients, with M184V, M41L, D67N and T215Y being the most frequent among NRTI associated mutations, and K103N, G190A, Y181C and A98G among NNRTI associated ones. PI DRMs were observed in 14/128 (10.9%) patients, with L10I, V82A and L89V being the commonest. These results present a high prevalence of DRMs among ART experienced patients from northern India with clinical or immunological failure of therapy. It emphasizes the need for regular testing of plasma samples of such patients for DRMs in order to detect and replace a failing regimen early, and also the use of HIV drug resistance genotyping of ART naive individuals prior to initiating first line ART for possible transmitted resistance. It is very important to enhance the access of patients to ARV drugs so that their compliance could be improved and hence development of DRMs be minimized.

Permanent atrial fibrillation in heart failure patients as another condition with increased reverse triiodothyronine concentration.

PubMed

Jakowczuk, Maciej; Zalas, Dominika; Owecki, Maciej

2016-09-01

To fully investigate the thyroid hormonal function in patients with the most common arrhythmia - atrial fibrillation. 120 patients (aged 55-85 yrs) with symptoms of congestive heart failure exacerbation and no other concomitant disorders (inclusion criteria: normal cardiac troponin T at admission and 12 hours after, normal renal, hepatic and respiratory function; exclusion criteria: inflammatory state, history of myocardial infarction). Depending on the presence of permanent atrial fibrillation (PAF), patients were divided into two groups: PAF (34 females, 26 males) and regular sinus heart rhythm (43 females, 17 males), the groups did not differ in terms of heart rate, blood pressure, presence of overt/subclinical thyroid dysfunction, and medical therapy used. In all subjects thyroid stimulating hormone, free thyroxine, free triiodothyronine, reverse triiodothyronine were measured; echocardiography was performed. PAF group showed higher FT4 and rT3 (1.41 vs. 1.27 ng/dl, p=0.0007; 0.61 vs. 0.32 ng/ml, p<0.0001, respectively). With ROC curve analysis the biochemical thyroid related factor of the highest prognostic value for PAF occurrence (with the highest sensitivity and specificity: 77% and 72%, respectively) was rT3 with the cut-off of above 0.3 ng/ml. Also, a positive correlation between rT3 levels and left ventricular posterior wall diameter was observed (Spearman's correlation coefficient 0.33, p=0.0093). PAF is another condition where an increase in rT3 is observed. rT3 concentration above 0.3 ng/ml may be a novel biochemical sign associated with the presence of PAF in patients with chronic heart failure.

Biomechanical strength of the Peri-Loc proximal tibial plate: a comparison of all-locked versus hybrid locked/nonlocked screw configurations.

PubMed

Estes, Chris; Rhee, Peter; Shrader, M Wade; Csavina, Kristine; Jacofsky, Marc C; Jacofsky, David J

2008-01-01

The purpose of this study was to compare the biomechanical properties of a contoured locking plate instrumented with either an all-locked or hybrid locked/nonlocked screw construct in a proximal metaphyseal fracture of the tibia (AO 41-A3.2). A standardized proximal metaphyseal wedge osteotomy (AO 41-A3.2) was created in five pairs of cadaveric tibia. Each pair was randomly instrumented with either an all-locked or combination locked/nonlocked screw construct using a locked contoured periarticular plate (Peri-Loc periarticular locked plating system, Smith & Nephew, Memphis, TN). Vertical subsidence (irreversible deformation) and deflection (reversible deformation) in each pair were analyzed and compared. Load to failure, defined by complete fracture gap closure, was also determined. There was no statistically significant difference in vertical subsidence (P = 0.19) or deflection (P = 0.19) of the proximal tibia between the all-locked and combination locked/nonlocked screw construct with increasing levels of cyclical axial load from 200 to 1200 N. Failure occurred at a mean value of 2160 N in the locked group and 1760 N in the hybrid group (P = 0.19); the failure mode was plate bending in all specimens. The results indicate that the use of compression screws with locked screws in this particular construct allows a similar amount of irreversible and reversible deformation in response to an axial load when compared to an all-locked screw construct. This suggests that there is no statistically significant difference in the stability in fixation between the two methods, allowing the surgeon the freedom to choose the appropriate screw combination unique to each fracture.

Effect of dolutegravir in combination with Nucleoside Reverse Transcriptase Inhibitors (NRTIs) on people living with HIV who have pre-existing NRTI mutations.

PubMed

Sörstedt, Erik; Carlander, Christina; Flamholc, Leo; Hejdeman, Bo; Svedhem, Veronica; Sönnerborg, Anders; Gisslén, Magnus; Yilmaz, Aylin

2018-05-01

Until the introduction of dolutegravir (DTG), people living with HIV (PLWH) who have developed nucleoside reverse transcriptase inhibitor (NRTI) mutations have had few other treatment options outside of regimens based on ritonavir-boosted protease inhibitors (PI/r). Here we report treatment results among PLWH in Sweden with pre-existing NRTI mutations on antiretroviral treatment (ART) with DTG and one to two NRTIs. All PLWH on ART with DTG and one to two NRTIs with pre-existing NRTI mutations were retrospectively identified from the National InfCare HIV database. As controls, PLWH on PI/r and one to two NRTIs, matched according to Genotypic Susceptibility Score and observation time, were included. Data were collected as long as the study population was on treatment with DTG; controls were monitored for the same interval. Outcome was classified as either treatment success or failure. In total, 244 participants (122 individuals treated with DTG and 122 individuals treated with PI/r) were included. Median observation time was 78 weeks (interquartile range 50-98 weeks) for participants on DTG and 75 weeks (50-101 weeks) for individuals on PI/r. Viral failure was detected in four individuals treated with DTG and three individuals treated with PI/r, resulting in similar success rates of 96.7% and 97.5%, respectively. No new mutations were found among participants with treatment failure. DTG in combination with one to two NRTIs was as efficient as PI/r in individuals with pre-existing NRTI mutations in this setting. It may be considered an alternative to PI/r-based ART even in the presence of NRTI resistance. Copyright © 2018 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

Pulmonary vascular response to exercise in symptomatic heart failure with reduced ejection fraction and pulmonary hypertension.

PubMed

Verbrugge, Frederik H; Dupont, Matthias; Bertrand, Philippe B; Nijst, Petra; Grieten, Lars; Dens, Joseph; Verhaert, David; Janssens, Stefan; Tang, W H Wilson; Mullens, Wilfried

2015-03-01

To study pulmonary vascular response patterns to exercise in heart failure with reduced ejection fraction (HFrEF) and pulmonary hypertension (PH). In this prospective single-centre cohort study, consecutive symptomatic HFrEF patients (n = 40) with mean pulmonary arterial pressure (MPAP) ≥25 mmHg, pulmonary artery wedge pressure (PAWP) >15 mmHg, and cardiac index <2.5 L/min.m(2) , received protocol-driven titrated sodium nitroprusside (SNP) and diuretics to reach mean arterial blood pressure 65-75 mmHg and PAWP ≤15 mmHg. Patients performed symptom-limited supine bicycle testing under continued SNP administration. Afterwards, SNP was gradually withdrawn, renin-angiotensin system blockers uptitrated, and hydralazine added to maintain haemodynamic targets. Subsequently, bicycle testing was repeated. Patients presented with pulmonary vascular resistance (PVR) = 3.8 ± 1.4 Wood Units at rest, decreasing to 2.9 ± 0.9 Wood Units after decongestion, with PH was completely reversed (MPAP <25 mmHg) in 22%. From rest to maximal exercise, the cardiac index did not change significantly (P = 0.334 under SNP; P-value = 0.552 under oral therapy). A dynamic exercise-induced PVR increase >3.5 Wood Units was noted in 19 patients (48%) under oral therapy vs. five (13%) under SNP. Such exercise-induced PVR increase was associated with a 33% relative decrease in right ventricular stroke work index (P = 0.037). Even after thorough decongestion and under continuous afterload reduction, PH secondary to HFrEF is completely reversible in only a minority of patients. Others demonstrate an exercise-induced PVR increase, associated with impaired right ventricular stroke work, which might be ameliorated by nitric oxide donor support. © 2014 The Authors. European Journal of Heart Failure © 2014 European Society of Cardiology.

Hemodynamics and vasopressor support in therapeutic hypothermia after cardiac arrest: prognostic implications.

PubMed

Bro-Jeppesen, John; Kjaergaard, Jesper; Søholm, Helle; Wanscher, Michael; Lippert, Freddy K; Møller, Jacob E; Køber, Lars; Hassager, Christian

2014-05-01

Inducing therapeutic hypothermia (TH) in Out-of-Hospital Cardiac Arrest (OHCA) can be challenging due to its impact on central hemodynamics and vasopressors are frequently used to maintain adequate organ perfusion. The aim of this study was to assess the association between level of vasopressor support and mortality. In a 6-year period, 310 comatose OHCA patients treated with TH were included. Temperature, hemodynamic parameters and level of vasopressors were registered from admission to 24h after rewarming. Level of vasopressor support was assessed by the cardiovascular sub-score of Sequential Organ Failure Assessment (SOFA). The population was stratified by use of dopamine as first line intervention (D-group) or use of dopamine+norepinephrine/epinephrine (DA-group). Primary endpoint was 30-day mortality and secondary endpoint was in-hospital cause of death. Patients in the DA-group carried a 49% all-cause 30-day mortality rate compared to 23% in the D-group, plog-rank<0.0001, corresponding to an adjusted hazard ratio (HR) of 2.0 (95% CI: 1.3-3.0), p=0.001). The DA-group had an increased 30-day mortality due to neurological injury (HR=1.7 (95% CI: 1.1-2.7), p=0.02). Cause of death was anoxic brain injury in 78%, cardiovascular failure in 18% and multi-organ failure in 4%. The hemodynamic changes of TH reversed at normothermia, although the requirement for vasopressor support (cardiovascular SOFA≥3) persisted in 80% of patients. In survivors after OHCA treated with TH the induced hemodynamic changes reversed after normothermia, while the need for vasopressor support persisted. Patients requiring addition of norepinephrine/epinephrine on top of dopamine had an increased 30-day all-cause mortality, as well as death from neurological injury. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Reversal of cardiac myocyte dysfunction as a unique mechanism of rescue by P2X4 receptors in cardiomyopathy.

PubMed

Shen, Jian-Bing; Shutt, Robin; Agosto, Mariela; Pappano, Achilles; Liang, Bruce T

2009-04-01

Binary cardiac transgenic (Tg) overexpression of P2X(4) receptors (P2X(4)R) improved the survival of the cardiomyopathic calsequestrin (CSQ) mice. Here we studied the mechanism of rescue using binary P2X(4)R/CSQ Tg and CSQ Tg mice as models. Cellular and intact heart properties were determined by simultaneous sarcomere shortening (SS) and Ca(2+) transients in vitro and echocardiography in vivo. Similar to a delay in death, binary mice exhibited a slowed heart failure progression with a greater left ventricular (LV) fractional shortening (FS) and thickness and a concomitant lesser degree of LV dilatation in both systole and diastole at 8 or 12 wk. By 16 wk, binary hearts showed similarly depressed FS and thinned out LV and equal enlargement of LV as did 12-wk-old CSQ hearts. Binary cardiac myocytes showed higher peak basal cell shortening (CS) and SS as well as greater basal rates of shortening and relaxation than did the CSQ myocytes at either 8 or 12 wk. Similar data were obtained in comparing the Ca(2+) transient. At 16 wk, binary myocytes were like the 12-wk-old CSQ myocytes with equally depressed CS, SS, and Ca(2+) transient. CSQ myocytes were longer than myocytes from wild-type and binary mice at 12 wk of age. At 16 wk, the binary myocyte length increased to that of the 12-wk-old CSQ myocyte, parallel to LV dilatation. The data suggest a unique mechanism, which involves a reversal of cardiac myocyte dysfunction and a delay in heart failure progression. It represents an example of targeting the abnormal failing myocyte in treating heart failure.

Evolution of a Planar Wake in Adverse Pressure Gradient

NASA Technical Reports Server (NTRS)

Driver, David M.; Mateer, George G.

2016-01-01

In the interest of improving the predictability of high-lift systems at maximum lift conditions, a series of fundamental experiments were conducted to study the effects of adverse pressure gradient on a wake flow. Mean and fluctuating velocities were measured with a two-component laser-Doppler velocimeter. Data were obtained for several cases of adverse pressure gradient, producing flows ranging from no reversed flow to massively reversed flow. While the turbulent Reynolds stresses increase with increasing size of the reversed flow region, the gradient of Reynolds stress does not. Computations using various turbulence models were unable to reproduce the reversed flow.

33 CFR 154.804 - Review, certification, and initial inspection.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., property, and the environment if an accident were to occur; and (4) If a quantitative failure analysis is... quantitative failure analysis. (e) The certifying entity must conduct all initial inspections and witness all...

33 CFR 154.804 - Review, certification, and initial inspection.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., property, and the environment if an accident were to occur; and (4) If a quantitative failure analysis is... quantitative failure analysis. (e) The certifying entity must conduct all initial inspections and witness all...

33 CFR 154.804 - Review, certification, and initial inspection.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., property, and the environment if an accident were to occur; and (4) If a quantitative failure analysis is... quantitative failure analysis. (e) The certifying entity must conduct all initial inspections and witness all...

33 CFR 154.804 - Review, certification, and initial inspection.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., property, and the environment if an accident were to occur; and (4) If a quantitative failure analysis is... quantitative failure analysis. (e) The certifying entity must conduct all initial inspections and witness all...

The Full Spectrum of Clinical Ethical Issues in Kidney Failure. Findings of a Systematic Qualitative Review.

PubMed

Kahrass, Hannes; Strech, Daniel; Mertz, Marcel

2016-01-01

When treating patients with kidney failure, unavoidable ethical issues often arise. Current clinical practice guidelines some of them, but lack comprehensive information about the full range of relevant ethical issues in kidney failure. A systematic literature review of such ethical issues supports medical professionalism in nephrology, and offers a solid evidential base for efforts that aim to improve ethical conduct in health care. To identify the full spectrum of clinical ethical issues that can arise for patients with kidney failure in a systematic and transparent manner. A systematic review in Medline (publications in English or German between 2000 and 2014) and Google Books (with no restrictions) was conducted. Ethical issues were identified by qualitative text analysis and normative analysis. The literature review retrieved 106 references that together mentioned 27 ethical issues in clinical care of kidney failure. This set of ethical issues was structured into a matrix consisting of seven major categories and further first and second-order categories. The systematically-derived matrix helps raise awareness and understanding of the complexity of ethical issues in kidney failure. It can be used to identify ethical issues that should be addressed in specific training programs for clinicians, clinical practice guidelines, or other types of policies dealing with kidney failure.

The Full Spectrum of Clinical Ethical Issues in Kidney Failure. Findings of a Systematic Qualitative Review

PubMed Central

Kahrass, Hannes; Strech, Daniel; Mertz, Marcel

2016-01-01

Background When treating patients with kidney failure, unavoidable ethical issues often arise. Current clinical practice guidelines some of them, but lack comprehensive information about the full range of relevant ethical issues in kidney failure. A systematic literature review of such ethical issues supports medical professionalism in nephrology, and offers a solid evidential base for efforts that aim to improve ethical conduct in health care. Aim To identify the full spectrum of clinical ethical issues that can arise for patients with kidney failure in a systematic and transparent manner. Method A systematic review in Medline (publications in English or German between 2000 and 2014) and Google Books (with no restrictions) was conducted. Ethical issues were identified by qualitative text analysis and normative analysis. Results The literature review retrieved 106 references that together mentioned 27 ethical issues in clinical care of kidney failure. This set of ethical issues was structured into a matrix consisting of seven major categories and further first and second-order categories. Conclusions The systematically-derived matrix helps raise awareness and understanding of the complexity of ethical issues in kidney failure. It can be used to identify ethical issues that should be addressed in specific training programs for clinicians, clinical practice guidelines, or other types of policies dealing with kidney failure. PMID:26938863

Failure mode and effects analysis drastically reduced potential risks in clinical trial conduct

PubMed Central

Baik, Jungmi; Kim, Hyunjung; Kim, Rachel

2017-01-01

Background Failure mode and effects analysis (FMEA) is a risk management tool to proactively identify and assess the causes and effects of potential failures in a system, thereby preventing them from happening. The objective of this study was to evaluate effectiveness of FMEA applied to an academic clinical trial center in a tertiary care setting. Methods A multidisciplinary FMEA focus group at the Seoul National University Hospital Clinical Trials Center selected 6 core clinical trial processes, for which potential failure modes were identified and their risk priority number (RPN) was assessed. Remedial action plans for high-risk failure modes (RPN >160) were devised and a follow-up RPN scoring was conducted a year later. Results A total of 114 failure modes were identified with an RPN score ranging 3–378, which was mainly driven by the severity score. Fourteen failure modes were of high risk, 11 of which were addressed by remedial actions. Rescoring showed a dramatic improvement attributed to reduction in the occurrence and detection scores by >3 and >2 points, respectively. Conclusions FMEA is a powerful tool to improve quality in clinical trials. The Seoul National University Hospital Clinical Trials Center is expanding its FMEA capability to other core clinical trial processes. PMID:29089745

Conducted noise analysis and protection of 45 kJ/s, ±50 kV capacitor charging power supply when interfaced with repetitive Marx based pulse power system.

PubMed

Naresh, P; Patel, Ankur; Sharma, Archana

2015-09-01

Pulse power systems with highly dynamic loads like klystron, backward wave oscillator (BWO), and magnetron generate highly dynamic noise. This noise leads to frequent failure of controlled switches in the inverter stage of charging power supply. Designing a reliable and compatible power supply for pulse power applications is always a tricky job when charging rate is in multiples of 10 kJ/s. A ±50 kV and 45 kJ/s capacitor charging power supply based on 4th order LCLC resonant topology has been developed for a 10 Hz repetitive Marx based system. Conditions for load independent constant current and zero current switching (ZCS) are derived mathematically. Noise generated at load end due to dynamic load is tackled effectively and reduction in magnitude noise voltage is achieved by providing shielding between primary and secondary of high voltage high frequency transformer and with LCLC low pass filter. Shielding scales down the ratio between coupling capacitance (Cc) and the collector-emitter capacitance of insulated gate bi-polar transistor switch, which in turn reduces the common mode noise voltage magnitude. The proposed 4th order LCLC resonant network acts as a low pass filter for differential mode noise in the reverse direction (from load to source). Power supply has been tested repeatedly with 5 Hz repetition rate with repetitive Marx based system connected with BWO load working fine without failure of single switch in the inverter stage.

Conducted noise analysis and protection of 45 kJ/s, ±50 kV capacitor charging power supply when interfaced with repetitive Marx based pulse power system

NASA Astrophysics Data System (ADS)

Naresh, P.; Patel, Ankur; Sharma, Archana

2015-09-01

Pulse power systems with highly dynamic loads like klystron, backward wave oscillator (BWO), and magnetron generate highly dynamic noise. This noise leads to frequent failure of controlled switches in the inverter stage of charging power supply. Designing a reliable and compatible power supply for pulse power applications is always a tricky job when charging rate is in multiples of 10 kJ/s. A ±50 kV and 45 kJ/s capacitor charging power supply based on 4th order LCLC resonant topology has been developed for a 10 Hz repetitive Marx based system. Conditions for load independent constant current and zero current switching (ZCS) are derived mathematically. Noise generated at load end due to dynamic load is tackled effectively and reduction in magnitude noise voltage is achieved by providing shielding between primary and secondary of high voltage high frequency transformer and with LCLC low pass filter. Shielding scales down the ratio between coupling capacitance (Cc) and the collector-emitter capacitance of insulated gate bi-polar transistor switch, which in turn reduces the common mode noise voltage magnitude. The proposed 4th order LCLC resonant network acts as a low pass filter for differential mode noise in the reverse direction (from load to source). Power supply has been tested repeatedly with 5 Hz repetition rate with repetitive Marx based system connected with BWO load working fine without failure of single switch in the inverter stage.

ANALYSIS OF SELECTED PYRETHROID PESTICIDES USING REVERSE PHASE HIGH PRESSURE LIQUID CHROMATOGRAPHY/UV

EPA Science Inventory

This research was conducted in cooperation with EPA Region 4 in Athens, GA to develop a method to analyze selected pyrethroid pesticides using Reverse Phase-High Pressure Liquid Chromatography (HPLC). This HPLC method will aid researchers in separating and identifying these py...

5-Fluorouracil cardiotoxicity: reversible left ventricular systolic dysfunction with early detection.

PubMed

Iskandar, Muhammad Zaid; Quasem, Wahid; El-Omar, Magdi

2015-05-02

A 33-year-old man presented to hospital with acute shortness of breath and evolving ST segment changes on ECG 3 days following a cycle of 5-fluorouracil (5-FU) for colon cancer. Despite no cardiac history, subsequent echocardiogram showed severe left ventricular systolic dysfunction. The patient was initially treated with heart failure medications and his coronary angiogram was normal. Chemotherapy was stopped and he was started on nitrates and calcium channel blockers. A repeat echocardiogram and cardiac MRI a week later showed complete resolution of his left ventricular dysfunction and he was discharged home. This case report summarises 5-FU cardiotoxicity, and emphasises the importance of early recognition and correct treatment, as left ventricular systolic dysfunction in this context is potentially reversible. 2015 BMJ Publishing Group Ltd.

5-Fluorouracil cardiotoxicity: reversible left ventricular systolic dysfunction with early detection

PubMed Central

Iskandar, Muhammad Zaid; Quasem, Wahid; El-Omar, Magdi

2015-01-01

A 33-year-old man presented to hospital with acute shortness of breath and evolving ST segment changes on ECG 3 days following a cycle of 5-fluorouracil (5-FU) for colon cancer. Despite no cardiac history, subsequent echocardiogram showed severe left ventricular systolic dysfunction. The patient was initially treated with heart failure medications and his coronary angiogram was normal. Chemotherapy was stopped and he was started on nitrates and calcium channel blockers. A repeat echocardiogram and cardiac MRI a week later showed complete resolution of his left ventricular dysfunction and he was discharged home. This case report summarises 5-FU cardiotoxicity, and emphasises the importance of early recognition and correct treatment, as left ventricular systolic dysfunction in this context is potentially reversible. PMID:25935919

Effect of thalidomide on the expression of TNF-alpha m-RNA and synthesis of TNF-alpha in cells from leprosy patients with reversal reaction.

PubMed

Tadesse, Azeb; Abebe, Markos; Bizuneh, Elizabeth; Mulugeta, Wondwossen; Aseffa, Abraham; Shannon, E J

2006-01-01

Hypersensitivity reactions called reversal reaction (RR) and erythema nodosum leprosum (ENL) occur in leprosy. They are characterized by an increase in tumor necrosis factor-alpha (TNF-alpha). Thalidomide is an effective treatment for ENL but not RR. Its effectiveness in ENL is attributed to inhibition of TNF-alpha, and this does not explain its failure to treat RR. We assessed thalidomide's effect on TNF-alpha in RR. Mononuclear cells from RR and non-RR patients and healthy individuals were treated with thalidomide and M.leprae (AFB), a cytosol fraction of M. leprae or Dharmendra lepromin. Thalidomide suppressed TNF-alpha, but when some RR patients' cells were stimulated with AFB, it enhanced TNF-alpha.

Electrically reversible cracks in an intermetallic film controlled by an electric field

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

Liu, Z. Q.; Liu, J. H.; Biegalski, M. D.

Cracks in solid-state materials are typically irreversible. We report electrically reversible opening and closing of nanoscale cracks in an intermetallic thin film grown on a ferroelectric substrate driven by a small electric field (~0.83 kV/cm). Accordingly, a nonvolatile colossal electroresistance on-off ratio of more than 10 8 is measured across the cracks in the intermetallic film at room temperature. Cracks are easily formed with low-frequency voltage cycling and remain stable when the device is operated at high frequency, which offers intriguing potential for next-generation high-frequency memory applications. Moreover, endurance testing demonstrates that the opening and closing of such cracks canmore » reach over 10 7 cycles under 10-μs pulses, without catastrophic failure of the film.« less

Electrically reversible cracks in an intermetallic film controlled by an electric field

DOE PAGES

Liu, Z. Q.; Liu, J. H.; Biegalski, M. D.; ...

2018-01-03

Cracks in solid-state materials are typically irreversible. We report electrically reversible opening and closing of nanoscale cracks in an intermetallic thin film grown on a ferroelectric substrate driven by a small electric field (~0.83 kV/cm). Accordingly, a nonvolatile colossal electroresistance on-off ratio of more than 10 8 is measured across the cracks in the intermetallic film at room temperature. Cracks are easily formed with low-frequency voltage cycling and remain stable when the device is operated at high frequency, which offers intriguing potential for next-generation high-frequency memory applications. Moreover, endurance testing demonstrates that the opening and closing of such cracks canmore » reach over 10 7 cycles under 10-μs pulses, without catastrophic failure of the film.« less

Herb Hydraulics: Inter- and Intraspecific Variation in Three Ranunculus Species.

PubMed

Nolf, Markus; Rosani, Andrea; Ganthaler, Andrea; Beikircher, Barbara; Mayr, Stefan

2016-04-01

The requirements of the water transport system of small herbaceous species differ considerably from those of woody species. Despite their ecological importance for many biomes, knowledge regarding herb hydraulics remains very limited. We compared key hydraulic features (vulnerability to drought-induced hydraulic decline, pressure-volume relations, onset of cellular damage, in situ variation of water potential, and stomatal conductance) of three Ranunculus species differing in their soil humidity preferences and ecological amplitude. All species were very vulnerable to water stress (50% reduction in whole-leaf hydraulic conductance [kleaf] at -0.2 to -0.8 MPa). In species with narrow ecological amplitude, the drought-exposed Ranunculus bulbosus was less vulnerable to desiccation (analyzed via loss of kleaf and turgor loss point) than the humid-habitat Ranunculus lanuginosus Accordingly, water stress-exposed plants from the broad-amplitude Ranunculus acris revealed tendencies toward lower vulnerability to water stress (e.g. osmotic potential at full turgor, cell damage, and stomatal closure) than conspecific plants from the humid site. We show that small herbs can adjust to their habitat conditions on interspecific and intraspecific levels in various hydraulic parameters. The coordination of hydraulic thresholds (50% and 88% loss of kleaf, turgor loss point, and minimum in situ water potential) enabled the study species to avoid hydraulic failure and damage to living cells. Reversible recovery of hydraulic conductance, desiccation-tolerant seeds, or rhizomes may allow them to prioritize toward a more efficient but vulnerable water transport system while avoiding the severe effects that water stress poses on woody species. © 2016 American Society of Plant Biologists. All Rights Reserved.

Herb Hydraulics: Inter- and Intraspecific Variation in Three Ranunculus Species1[OPEN

PubMed Central

Ganthaler, Andrea; Beikircher, Barbara

2016-01-01

The requirements of the water transport system of small herbaceous species differ considerably from those of woody species. Despite their ecological importance for many biomes, knowledge regarding herb hydraulics remains very limited. We compared key hydraulic features (vulnerability to drought-induced hydraulic decline, pressure-volume relations, onset of cellular damage, in situ variation of water potential, and stomatal conductance) of three Ranunculus species differing in their soil humidity preferences and ecological amplitude. All species were very vulnerable to water stress (50% reduction in whole-leaf hydraulic conductance [kleaf] at −0.2 to −0.8 MPa). In species with narrow ecological amplitude, the drought-exposed Ranunculus bulbosus was less vulnerable to desiccation (analyzed via loss of kleaf and turgor loss point) than the humid-habitat Ranunculus lanuginosus. Accordingly, water stress-exposed plants from the broad-amplitude Ranunculus acris revealed tendencies toward lower vulnerability to water stress (e.g. osmotic potential at full turgor, cell damage, and stomatal closure) than conspecific plants from the humid site. We show that small herbs can adjust to their habitat conditions on interspecific and intraspecific levels in various hydraulic parameters. The coordination of hydraulic thresholds (50% and 88% loss of kleaf, turgor loss point, and minimum in situ water potential) enabled the study species to avoid hydraulic failure and damage to living cells. Reversible recovery of hydraulic conductance, desiccation-tolerant seeds, or rhizomes may allow them to prioritize toward a more efficient but vulnerable water transport system while avoiding the severe effects that water stress poses on woody species. PMID:26896395

Fourier heat conduction as a phenomenon described within the scope of the second law

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

Jesudason, Christopher G.

The historical development of the Carnot cycle necessitated the construction of isothermal and adiabatic pathways within the cycle that were also mechanically 'reversible' which lead eventually to the Kelvin-Clausius development of the entropy function S where for any reversible closed path C, ∮{sub C} dS = 0 based on an infinite number of concatenated Carnot engines that approximated the said path and where for each engine ΔQ{sub 1}/T{sub 1}+ΔQ{sub 2}/T{sub 2} = 0 where the Q's and T's are the heat absorption increments and temperature respectively with the subscripts indicating the isothermal paths (1;2) where for the Carnot engine, the heat absorptionmore » is for the diathermal (isothermal) paths of the cycle only. Since 'heat' has been defined as that form of energy that is transferred as a result of a temperature difference and a corollary of the Clausius statement of the Second law is that it is impossible for heat to be transferred from a cold to a hot reservoir with no other effect on the environment, these statements suggested that the local mode of transfer of 'heat' in the isothermal segments of the pathway does imply a Fourier heat conduction mechanism (to conform to the definition of 'heat') albeit of a 'reversible' kind, but on the other hand, the Fourier mechanism is apparently irreversible, leading to an increase in entropy of the combined reservoirs at either end of the material involved in the conveyance of the heat energy. These and several other considerations lead Benofy and Quay (BQ) to postulate the Fourier heat conduction phenomenon to be an ancillary principle in thermodynamics, with this principle being strictly local in nature, where the global Second law statements could not be applied to this local process. Here we present equations that model heat conduction as a thermodynamically reversible but mechanically irreversible process where due to the belief in mechanical time reversible symmetry, thermodynamical reversibility has been unfortunately linked to mechanical reversibility, that has discouraged such an association. The modeling is based on an application of a 'recoverable transition', defined and developed earlier on ideas derived from thermal desorption of particles from a surface where the Fourier heat conduction process is approximated as a series of such desorption processes. We recall that the original Carnot engine required both adiabatic and isothermal steps to complete the zero entropy cycle, and this construct lead to the consequent deduction that any Second law statement that refers to heat-work conversion processes are only globally relevant. Here, on the other hand, we examine Fourier heat conduction from MD simulation and model this process as a zero-entropy forward scattering process relative to each of the atoms in the lattice chain being treated as a system where the Carnot cycle can be applied individually. The equations developed predicts the 'work' done to be equal to the energy transfer rate. The MD simulations conducted shows excellent agreement with the theory. Such views and results as these, if developed to a successful conclusion could imply that the Carnot cycle be viewed as describing a local process of energy-work conversion and that irreversible local processes might be brought within the scope of this cycle, implying a unified treatment of thermodynamically (i) irreversible, (ii) reversible, (iii) isothermal and (iv) adiabatic processes.« less

Global epidemiology of drug resistance after failure of WHO recommended first-line regimens for adult HIV-1 infection: a multicentre retrospective cohort study

PubMed Central

2016-01-01

Summary Background Antiretroviral therapy (ART) is crucial for controlling HIV-1 infection through wide-scale treatment as prevention and pre-exposure prophylaxis (PrEP). Potent tenofovir disoproxil fumarate-containing regimens are increasingly used to treat and prevent HIV, although few data exist for frequency and risk factors of acquired drug resistance in regions hardest hit by the HIV pandemic. We aimed to do a global assessment of drug resistance after virological failure with first-line tenofovir-containing ART. Methods The TenoRes collaboration comprises adult HIV treatment cohorts and clinical trials of HIV drug resistance testing in Europe, Latin and North America, sub-Saharan Africa, and Asia. We extracted and harmonised data for patients undergoing genotypic resistance testing after virological failure with a first-line regimen containing tenofovir plus a cytosine analogue (lamivudine or emtricitabine) plus a non-nucleotide reverse-transcriptase inhibitor (NNRTI; efavirenz or nevirapine). We used an individual participant-level meta-analysis and multiple logistic regression to identify covariates associated with drug resistance. Our primary outcome was tenofovir resistance, defined as presence of K65R/N or K70E/G/Q mutations in the reverse transcriptase (RT) gene. Findings We included 1926 patients from 36 countries with treatment failure between 1998 and 2015. Prevalence of tenofovir resistance was highest in sub-Saharan Africa (370/654 [57%]). Pre-ART CD4 cell count was the covariate most strongly associated with the development of tenofovir resistance (odds ratio [OR] 1·50, 95% CI 1·27–1·77 for CD4 cell count <100 cells per μL). Use of lamivudine versus emtricitabine increased the risk of tenofovir resistance across regions (OR 1·48, 95% CI 1·20–1·82). Of 700 individuals with tenofovir resistance, 578 (83%) had cytosine analogue resistance (M184V/I mutation), 543 (78%) had major NNRTI resistance, and 457 (65%) had both. The mean plasma viral load at virological failure was similar in individuals with and without tenofovir resistance (145 700 copies per mL [SE 12 480] versus 133 900 copies per mL [SE 16 650; p=0·626]). Interpretation We recorded drug resistance in a high proportion of patients after virological failure on a tenofovir-containing first-line regimen across low-income and middle-income regions. Effective surveillance for transmission of drug resistance is crucial. Funding The Wellcome Trust. PMID:26831472

Probabilistic structural analysis of aerospace components using NESSUS

NASA Technical Reports Server (NTRS)

Shiao, Michael C.; Nagpal, Vinod K.; Chamis, Christos C.

1988-01-01

Probabilistic structural analysis of a Space Shuttle main engine turbopump blade is conducted using the computer code NESSUS (numerical evaluation of stochastic structures under stress). The goal of the analysis is to derive probabilistic characteristics of blade response given probabilistic descriptions of uncertainties in blade geometry, material properties, and temperature and pressure distributions. Probability densities are derived for critical blade responses. Risk assessment and failure life analysis is conducted assuming different failure models.

Energy-efficient membrane separations in the sweetener industry. Final report

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

Ray, R.J.

1986-02-14

Objective was to investigate the use of membrane processes as energy-efficient alternatives to certain conventional separation processes now in use in the corn-sweetener industry. Three applications of membranes were studied during the program: the concentration of corn steep water by reverse osmosis; the concentration of dilute wastes, called ''sweetwater,'' by a combination of reverse osmosis and countercurrent reverse osmosis; and the enrichment of corn syrup in fructose by a process involving selective complexation of fructose by membrane filtration. Laboratory experiments were conducted for all three applications, and the results were used to conduct technical and economic analyses of the process.more » Calculations indicate that the use of reverse osmosis in combination with conventional mechanical-vapor-recompression evaporation to concentrate steep water, offers savings of a factor of 2.5 in capital costs and a factor of 4.5 in operating costs over currently used evaporation alone. In the concentration of sweetwater by reverse osmosis and countercurrent reverse osmosis, capital costs would be about the same as those for evaporation, but operating costs would only be about one-half those of evaporation. For the fructose-enrichment scheme, preliminary results indicate that the savings in energy alone for the membrane process would be about $0.01/lb of sweetener produced by the process, or about $20 million annually, for the corn-sweetener industry.« less

Effect of Reverse Bias Stress on Leakage Currents and Breakdown Voltages of Solid Tantalum Capacitors

NASA Technical Reports Server (NTRS)

Teverovsky, Alexander A.

2011-01-01

The majority of solid tantalum capacitors are produced by high-temperature sintering of a fine tantalum powder around a tantalum wire followed by electrolytic anodization that forms a thin amorphous Ta2O5 dielectric layer and pyrolysis of manganese nitrite on the oxide to create a conductive manganese dioxide electrode. A contact to tantalum wire is used as anode terminal and to the manganese layer as a cathode terminal of the device. This process results in formation of an asymmetric Ta -- Ta2O5 -- MnO2 capacitor that has different characteristics at forward (positive bias applied to tantalum) and reverse (positive bias applied to manganese cathode) voltages. Reverse bias currents might be several orders of magnitude larger than forward leakage currents so I-V characteristics of tantalum capacitors resemble characteristics of semiconductor rectifiers. Asymmetric I-V characteristics of Ta -- anodic Ta2O5 systems have been observed at different top electrode materials including metals, electrolytes, conductive polymers, and manganese oxide thus indicating that this phenomenon is likely related to the specifics of the Ta -- Ta2O5 interface. There have been multiple attempts to explain rectifying characteristics of capacitors employing anodic tantalum pentoxide dielectrics. A brief review of works related to reverse bias (RB) behavior of tantalum capacitors shows that the mechanism of conduction in Ta -- Ta2O5 systems is still not clear and more testing and analysis is necessary to understand the processes involved. If tantalum capacitors behave just as rectifiers, then the assessment of the safe reverse bias operating conditions would be a relatively simple task. Unfortunately, these parts can degrade with time under reverse bias significantly, and this further complicates analysis of the I-V characteristics and establishing safe operating areas of the parts. On other hand, time dependence of reverse currents might provide additional information for investigation of the processes under reverse bias conditions. In practice, there were instances when, due to unforeseen events, the system operated at conditions when capacitors experience periodically a relatively small reverse bias for some time followed by normal, forward bias conditions. In such a case an assessment should be made on the degree to which these capacitors are degraded by application of low-voltage reverse bias, and whether this degradation can be reversed by normal operating conditions. In this study, reverse currents in different types of tantalum capacitors were monitored at different reverse voltages below 15%VR and temperatures in the range from room to 145 C for up to 150 hours to get better understanding of the degradation process and determine conditions favorable to the unstable mode of operation. The reversibility of RB degradation has been evaluated after operation of the capacitors at forward bias conditions. The effect of reverse bias stress (RBS) on reliability at normal operating conditions was evaluated using highly accelerated life testing at voltages of 1.5VR and 2 VR and by analysis of changes in distributions of breakdown voltages. Possible mechanisms of RB degradation are discussed.

Interfacial control of oxygen vacancy doping and electrical conduction in thin film oxide heterostructures

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

Veal, Boyd W.; Kim, Seong Keun; Zapol, Peter

2016-06-10

Oxygen vacancies in proximity to surfaces and heterointerfaces in oxide thin film heterostructures have major effects on properties, resulting, for example, in emergent conduction behaviour, large changes in metal-insulator transition temperatures or enhanced catalytic activity. Here we report the discovery of a means of reversibly controlling the oxygen vacancy concentration and distribution in oxide heterostructures consisting of electronically conducting In2O3 films grown on ionically conducting Y2O3-stabilized ZrO2 substrates. Oxygen ion redistribution across the heterointerface is induced using an applied electric field oriented in the plane of the interface, resulting in controlled oxygen vacancy (and hence electron) doping of the filmmore » and possible orders-of-magnitude enhancement of the film's electrical conduction. The reversible modified behaviour is dependent on interface properties and is attained without cation doping or changes in the gas environment.« less

Thermally Conductive-Silicone Composites with Thermally Reversible Cross-links.

PubMed

Wertz, J T; Kuczynski, J P; Boday, D J

2016-06-08

Thermally conductive-silicone composites that contain thermally reversible cross-links were prepared by blending diene- and dienophile-functionalized polydimethylsiloxane (PDMS) with an aluminum oxide conductive filler. This class of thermally conductive-silicones are useful as thermal interface materials (TIMs) within Information Technology (IT) hardware applications to allow rework of valuable components. The composites were rendered reworkable via retro Diels-Alder cross-links when temperatures were elevated above 130 °C and required little mechanical force to remove, making them advantageous over other TIM materials. Results show high thermal conductivity (0.4 W/m·K) at low filler loadings (45 wt %) compared to other TIM solutions (>45 wt %). Additionally, the adhesion of the material was found to be ∼7 times greater at lower temperatures (25 °C) and ∼2 times greater at higher temperatures (120 °C) than commercially available TIMs.

Interfacial control of oxygen vacancy doping and electrical conduction in thin film oxide heterostructures

DOE PAGES

Veal, Boyd W.; Kim, Seong Keun; Zapol, Peter; ...

2016-06-10

Oxygen vacancies in proximity to surfaces and heterointerfaces in oxide thin film heterostructures have major effects on properties, resulting, for example, in emergent conduction behavior, large changes in metal-insulator transition temperatures, or enhanced catalytic activity. Here in this paper, we report the discovery of a means of reversibly controlling the oxygen vacancy concentration and distribution in oxide heterostructures consisting of electronically conducting In 2O 3 films grown on ionically conducting Y 2O 3-stabilized ZrO 2 substrates. Oxygen ion redistribution across the heterointerface is induced using an applied electric field oriented in the plane of the interface, resulting in controlled oxygenmore » vacancy (and hence electron) doping of the film and possible orders-of-magnitude enhancement of the film's electrical conduction. The reversible modified behavior is dependent on interface properties and is attained without cation doping or changes in the gas environment.« less

Investigating premature pavement failure due to moisture : final report : appendices.

DOT National Transportation Integrated Search

2009-07-01

The article are appendices. : This report details the forensic investigations conducted to identify the causes of pavement failures shortly after a rehabilitation activity on five interstate highway projects in Oregon, and the research efforts conduc...

33 CFR 154.2020 - Certification and recertification-owner/operator responsibilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Procedures,” and in Military Standard MIL-STD-882B for a quantitative failure analysis. For assistance in... quantitative failure analysis is also conducted, the level of safety attained is at least one order of...

(PRESENT AT NCCU) ANALYSIS OF SELECTED PYRETHROID PESTICIDES USING REVERSE PHASE HIGH LIQUID CHROMATOGRAPHY

EPA Science Inventory

This research was conducted in cooperation with EPA Region 4 in Athens, GA to develop a method to analyze selected pyrethroid pesticides using Reverse Phase-High Pressure Liquid Chromatography (HPLC). This HPLC method will aid researchers in separating and identifying these pyre...

Reversing Spoken Items--Mind Twisting Not Tongue Twisting

ERIC Educational Resources Information Center

Rudner, Mary; Ronnberg, Jerker; Hugdahl, Kenneth

2005-01-01

Using 12 participants we conducted an fMRI study involving two tasks, word reversal and rhyme judgment, based on pairs of natural speech stimuli, to study the neural correlates of manipulating auditory imagery under taxing conditions. Both tasks engaged the left anterior superior temporal gyrus, reflecting previously established perceptual…

Normal and Reversed-Phase Thin Layer Chromatography of Green Leaf Extracts

ERIC Educational Resources Information Center

Sjursnes, Birte Johanne; Kvittingen, Lise; Schmid, Rudolf

2015-01-01

Introductory experiments of chromatography are often conducted by separating colored samples, such as inks, dyes, and plant extracts, using filter paper, chalk, or thin layer chromatography (TLC) plates with various solvent systems. Many simple experiments have been reported. The relationship between normal chromatography and reversed-phase…

Parental Control of Children's Television Viewing Behavior: Support for the Reverse Modeling Principle.

ERIC Educational Resources Information Center

Surlin, Stuart H.; And Others

A study was conducted to document the existence of the "reverse modeling" principle of television viewing behavior whereby children, rather than parents, determine the television viewing choices for family members. Through telephone interviews, 284 adult respondents were questioned regarding their knowledge of the television advisory…

Report of the NASA Ad Hoc Committee on failure of high strength structural materials

NASA Technical Reports Server (NTRS)

Brown, W. F., Jr. (Editor)

1972-01-01

An analysis of structural failures that have occurred in NASA programs was conducted. Reports of 231 examples of structural failure were reviewed. Attempts were made to identify those factors which contributed to the failures, and recommendations were formulated for actions which would minimize their effects on future NASA programs. Two classes of factors were identified: (1) those associated with deficiencies in existing materials and structures technology and (2) those attributable to inadequate documentation or communication of that technology.

In-Flight Validation of a Pilot Rating Scale for Evaluating Failure Transients in Electronic Flight Control Systems

NASA Technical Reports Server (NTRS)

Kalinowski, Kevin F.; Tucker, George E.; Moralez, Ernesto, III

2006-01-01

Engineering development and qualification of a Research Flight Control System (RFCS) for the Rotorcraft Aircrew Systems Concepts Airborne Laboratory (RASCAL) JUH-60A has motivated the development of a pilot rating scale for evaluating failure transients in fly-by-wire flight control systems. The RASCAL RFCS includes a highly-reliable, dual-channel Servo Control Unit (SCU) to command and monitor the performance of the fly-by-wire actuators and protect against the effects of erroneous commands from the flexible, but single-thread Flight Control Computer. During the design phase of the RFCS, two piloted simulations were conducted on the Ames Research Center Vertical Motion Simulator (VMS) to help define the required performance characteristics of the safety monitoring algorithms in the SCU. Simulated failures, including hard-over and slow-over commands, were injected into the command path, and the aircraft response and safety monitor performance were evaluated. A subjective Failure/Recovery Rating (F/RR) scale was developed as a means of quantifying the effects of the injected failures on the aircraft state and the degree of pilot effort required to safely recover the aircraft. A brief evaluation of the rating scale was also conducted on the Army/NASA CH-47B variable stability helicopter to confirm that the rating scale was likely to be equally applicable to in-flight evaluations. Following the initial research flight qualification of the RFCS in 2002, a flight test effort was begun to validate the performance of the safety monitors and to validate their design for the safe conduct of research flight testing. Simulated failures were injected into the SCU, and the F/RR scale was applied to assess the results. The results validate the performance of the monitors, and indicate that the Failure/Recovery Rating scale is a very useful tool for evaluating failure transients in fly-by-wire flight control systems.

The MONET trial: week 144 analysis of the efficacy of darunavir/ritonavir (DRV/r) monotherapy versus DRV/r plus two nucleoside reverse transcriptase inhibitors, for patients with viral load < 50 HIV-1 RNA copies/mL at baseline.

PubMed

Arribas, J R; Clumeck, N; Nelson, M; Hill, A; van Delft, Y; Moecklinghoff, C

2012-08-01

In the MONotherapy in Europe with Tmc114 (MONET) trial, darunavir/ritonavir (DRV/r) monotherapy showed noninferior efficacy vs. two nucleoside reverse transcriptase inhibitors (NRTIs) plus DRV/r at the primary 48-week analysis. The trial was continued to week 144 to assess the durability of the results. A total of 256 patients with viral load < 50 HIV-1 RNA copies/mL on current highly active antiretroviral therapy (HAART) for at least 6 months switched to DRV/r 800/100 mg once daily, either as monotherapy (n=127) or with two NRTIs (n=129). Treatment failure was defined as two consecutive HIV RNA levels above 50 copies/mL [time to loss of virological response (TLOVR)] by week 144, or discontinuation of study drugs. Eighty-one per cent of patients were male and 91% were Caucasian, and they had a median baseline CD4 count of 575 cells/uL. More patients in the DRV/r monotherapy arm had hepatitis C virus coinfection at baseline than in the control arm (18% vs. 12%, respectively). By week 144, the percentage of patients with HIV RNA < 50 copies/mL [intent to treat (ITT), TLOVR, switch=failure method] was 69% vs. 75% in the DRV/r monotherapy and triple therapy arms [difference= -5.9%; 95% confidence interval (CI) -16.9%, +5.1%]; by a strict ITT analysis (switches not considered failures), the percentage of patients with HIV RNA < 50 copies/mL was 84% vs. 83.5%, respectively (difference= +0.5%; 95% CI -8.7%, +9.7%). Twenty-one and 13 patients had two consecutive HIV RNA results above 50 copies/mL in the DRV/r monotherapy arm and triple therapy arm, respectively, of whom 18 of 21 (86%) and 10 of 13 (77%) had HIV RNA < 50 copies/mL at week 144. In this study, for patients with HIV RNA < 50 copies/mL at baseline, switching to DRV/r monotherapy showed noninferior efficacy to DRV/r plus two NRTIs in a strict ITT (switches not considered failures) analysis, but not in a TLOVR switch equals failure analysis. © 2012 British HIV Association.

Failure Waves in Cylindrical Glass Bars

NASA Astrophysics Data System (ADS)

Cazamias, James U.; Bless, Stephan J.; Marder, Michael P.

1997-07-01

Failure waves, a propagating front separating virgin and comminuted material, have been receiving a fair amount of attention the last couple of years. While most scientists have been looking at failure waves in plate impact geometries, we have conducted a series of experiments on Pyrex bars. In this paper, we present two types of photographic data from a series of tests. A streak camera was used to determine velocities of the failure front as a function of impact stress. A polaroid camera and a flash lamp provide detailed pictures of the actual event. Attempts were made to observe failure waves in amorphous quartz and acrylic.

Failure warning of hydrous sandstone based on electroencephalogram technique

NASA Astrophysics Data System (ADS)

Tao, Kai; Zheng, Wei

2018-06-01

Sandstone is a type of rock mass that widely exists in nature. Moisture is an important factor that leads to sandstone structural failure. The major failure assessment methods of hydrous sandstone at present cannot satisfy real-time and portability requirements, especially lacks of warning function. In this study, acoustic emission (AE) and computed tomography (CT) techniques are combined for real-time failure assessment of hydrous sandstone. Eight visual colors for warning are screened according to different failure states, and an electroencephalogram (EEG) experiment is conducted to demonstrate their diverse excitations of the human brain's concentration.

[PATHOPHYSIOLOGY OF THE CARDIORENAL SYNDROME].

PubMed

Balint, I; Vučak, J; Bašić-Marković, N; Klarić, D; Šakić, V Amerl

2016-12-01

Cardiorenal syndrome, a complex pathophysiological disorder of both the heart and kidneys, is a condition in which acute or chronic damage to one organ can lead to acute or chronic dysfunction of the other organ. Depending on primary organ dysfunction and disease duration, there are five different types of cardiorenal syndrome. Type 1 cardiorenal syndrome (acute cardiorenal syndrome) is defined as acute kidney injury caused by sudden decrease in heart function. Type 2 cardiorenal syndrome (chronic cardiorenal syndrome) refers to chronic kidney disease linked to chronic heart failure. Type 3 cardiorenal syndrome (acute renocardial syndrome) is caused by acute kidney injury that leads to heart failure. Type 4 cardiorenal syndrome (chronic renocardial syndrome) includes chronic heart failure due to chronic kidney disease. Type 5 cardiorenal syndrome (secondary cardiorenal syndrome) is reversible or irreversible condition marked by simultaneous heart and kidney insufficiency, as a result of multiorgan disease such as sepsis, diabetes mellitus, sarcoidosis, amyloidosis, etc. The pathophysiological patterns of cardiorenal syndrome are extremely complicated. Despite numerous publications, perplexed physiological, biochemical and hormonal disturbances as parts of the main pathogenic mechanisms of cardiorenal syndrome remain obscure. Even though there are guidelines for the treatment of patients with heart failure and chronic kidney disease, similar guidelines for the treatment of cardiorenal syndrome are lacking. In everyday practice, it is crucial to diagnose cardiorenal syndrome and use all diagnostic and therapeutic procedures available to prevent or alleviate kidney and heart failure.

Renal denervation in male rats with heart failure improves ventricular sympathetic nerve innervation and function

PubMed Central

Pinkham, Maximilian I.; Loftus, Michael T.; Amirapu, Satya; Guild, Sarah-Jane; Quill, Gina; Woodward, William R.; Habecker, Beth A.

2017-01-01

Heart failure is characterized by the loss of sympathetic innervation to the ventricles, contributing to impaired cardiac function and arrhythmogenesis. We hypothesized that renal denervation (RDx) would reverse this loss. Male Wistar rats underwent myocardial infarction (MI) or sham surgery and progressed into heart failure for 4 wk before receiving bilateral RDx or sham RDx. After additional 3 wk, left ventricular (LV) function was assessed, and ventricular sympathetic nerve fiber density was determined via histology. Post-MI heart failure rats displayed significant reductions in ventricular sympathetic innervation and tissue norepinephrine content (nerve fiber density in the LV of MI+sham RDx hearts was 0.31 ± 0.05% vs. 1.00 ± 0.10% in sham MI+sham RDx group, P < 0.05), and RDx significantly increased ventricular sympathetic innervation (0.76 ± 0.14%, P < 0.05) and tissue norepinephrine content. MI was associated with an increase in fibrosis of the noninfarcted ventricular myocardium, which was attenuated by RDx. RDx improved LV ejection fraction and end-systolic and -diastolic areas when compared with pre-RDx levels. This is the first study to show an interaction between renal nerve activity and cardiac sympathetic nerve innervation in heart failure. Our findings show denervating the renal nerves improves cardiac sympathetic innervation and function in the post-MI failing heart. PMID:28052866

Alterations in left ventricular diastolic function in conscious dogs with pacing-induced heart failure

NASA Technical Reports Server (NTRS)

Komamura, K.; Shannon, R. P.; Pasipoularides, A.; Ihara, T.; Lader, A. S.; Patrick, T. A.; Bishop, S. P.; Vatner, S. F.

1992-01-01

We investigated in conscious dogs (a) the effects of heart failure induced by chronic rapid ventricular pacing on the sequence of development of left ventricular (LV) diastolic versus systolic dysfunction and (b) whether the changes were load dependent or secondary to alterations in structure. LV systolic and diastolic dysfunction were evident within 24 h after initiation of pacing and occurred in parallel over 3 wk. LV systolic function was reduced at 3 wk, i.e., peak LV dP/dt fell by -1,327 +/- 105 mmHg/s and ejection fraction by -22 +/- 2%. LV diastolic dysfunction also progressed over 3 wk of pacing, i.e., tau increased by +14.0 +/- 2.8 ms and the myocardial stiffness constant by +6.5 +/- 1.4, whereas LV chamber stiffness did not change. These alterations were associated with increases in LV end-systolic (+28.6 +/- 5.7 g/cm2) and LV end-diastolic stresses (+40.4 +/- 5.3 g/cm2). When stresses and heart rate were matched at the same levels in the control and failure states, the increases in tau and myocardial stiffness were no longer observed, whereas LV systolic function remained depressed. There were no increases in connective tissue content in heart failure. Thus, pacing-induced heart failure in conscious dogs is characterized by major alterations in diastolic function which are reversible with normalization of increased loading condition.

Acute-on-chronic liver failure: Pathogenesis, prognostic factors and management

PubMed Central

Blasco-Algora, Sara; Masegosa-Ataz, José; Gutiérrez-García, María Luisa; Alonso-López, Sonia; Fernández-Rodríguez, Conrado M

2015-01-01

Acute-on-chronic liver failure (ACLF) is increasingly recognized as a complex syndrome that is reversible in many cases. It is characterized by an acute deterioration of liver function in the background of a pre-existing chronic liver disease often associated with a high short-term mortality rate. Organ failure (OF) is always associated, and plays a key role in determining the course, and the outcome of the disease. The definition of ACLF remains controversial due to its overall ambiguity, with several disparate criteria among various associations dedicated to the study of liver diseases. Although the precise pathogenesis needs to be clarified, it appears that an altered host response to injury might be a contributing factor caused by immune dysfunction, ultimately leading to a pro-inflammatory status, and eventually to OF. The PIRO concept (Predisposition, Insult, Response and Organ Failure) has been proposed to better approach the underlying mechanisms. It is accepted that ACLF is a different and specific form of liver failure, where a precipitating event is always involved, even though it cannot always be ascertained. According to several studies, infections and active alcoholism often trigger ACLF. Viral hepatitis, gastrointestinal haemorrhage, or drug induced liver injury, which can also provoke the syndrome. This review mainly focuses on the physiopathology and prognostic aspects. We believe these features are essential to further understanding and providing the rationale for improveddisease management strategies. PMID:26576097

Bidirectional dc-to-dc Power Converter

NASA Technical Reports Server (NTRS)

Griesbach, C. R.

1986-01-01

Solid-state, series-resonant converter uses high-voltage thyristors. Converter used either to convert high-voltage, low-current dc power to lowvoltage, high current power or reverse. Taking advantage of newly-available high-voltage thyristors to provide better reliability and efficiency than traditional converters that use vacuum tubes as power switches. New converter essentially maintenance free and provides greatly increased mean time between failures. Attractive in industrial applications whether or not bidirectional capability is required.

Quiet Clean Short-Haul Experimental Engine (QCSEE) acoustic and aerodynamic tests on a scale model over-the-wing thrust reverser and forward thrust nozzle

NASA Technical Reports Server (NTRS)

Stimpert, D. L.

1978-01-01

An acoustic and aerodynamic test program was conducted on a 1/6.25 scale model of the Quiet, Clean, Short-Haul Experimental Engine (QCSEE) forward thrust over-the-wing (OTW) nozzle and OTW thrust reverser. In reverse thrust, the effect of reverser geometry was studied by parametric variations in blocker spacing, blocker height, lip angle, and lip length. Forward thrust nozzle tests determined the jet noise levels of the cruise and takeoff nozzles, the effect of opening side doors to achieve takeoff thrust, and scrubbing noise of the cruise and takeoff jet on a simulated wing surface. Velocity profiles are presented for both forward and reverse thrust nozzles. An estimate of the reverse thrust was made utilizing the measured centerline turning angle.

How the use of creatine supplements can elevate serum creatinine in the absence of underlying kidney pathology

PubMed Central

Williamson, Lydia; New, David

2014-01-01

Serum creatinine is a widely used marker in the assessment of renal function. Elevated creatinine levels suggest kidney dysfunction, prompting the need for further investigation. This report describes a case in which the consumption of the bodybuilding supplement creatine ethyl ester resulted in raised serum creatinine in the absence of true underlying kidney pathology. The abnormalities reversed after discontinuation of the supplement. A case of pseudo renal failure was recognised and kidney function was concluded to be normal. This report aims to address the mechanisms by which the ingestion of creatine ethyl ester can mimic the blood results expected in advanced renal failure, and confronts the problems faced when relying on serum creatinine as a diagnostic tool. PMID:25239988

How the use of creatine supplements can elevate serum creatinine in the absence of underlying kidney pathology.

PubMed

Williamson, Lydia; New, David

2014-09-19

Serum creatinine is a widely used marker in the assessment of renal function. Elevated creatinine levels suggest kidney dysfunction, prompting the need for further investigation. This report describes a case in which the consumption of the bodybuilding supplement creatine ethyl ester resulted in raised serum creatinine in the absence of true underlying kidney pathology. The abnormalities reversed after discontinuation of the supplement. A case of pseudo renal failure was recognised and kidney function was concluded to be normal. This report aims to address the mechanisms by which the ingestion of creatine ethyl ester can mimic the blood results expected in advanced renal failure, and confronts the problems faced when relying on serum creatinine as a diagnostic tool. 2014 BMJ Publishing Group Ltd.

Model-specific selection of molecular targets for heart failure gene therapy

PubMed Central

Katz, Michael G.; Fargnoli, Anthony S.; Tomasulo, Catherine E.; Pritchette, Louella A.; Bridges, Charles R.

2013-01-01

Heart failure (HF) is a complex multifaceted problem of abnormal ventricular function and structure. In recent years, new information has been accumulated allowing for a more detailed understanding of the cellular and molecular alterations that are the underpinnings of diverse causes of HF, including myocardial ischemia, pressure-overload, volume-overload or intrinsic cardiomyopathy. Modern pharmacological approaches to treat HF have had a significant impact on the course of the disease, although they do not reverse the underlying pathological state of the heart. Therefore gene-based therapy holds a great potential as a targeted treatment for cardiovascular diseases. Here, we survey the relative therapeutic efficacy of genetic modulation of β-adrenergic receptor signaling, Ca2+ handling proteins and angiogenesis in the most common extrinsic models of HF. PMID:21954055

Multimaterial lamination as a means of retarding penetration and spallation failures in plates

NASA Technical Reports Server (NTRS)

Dibattista, J. D.; Humes, D. H.

1972-01-01

Experimental data are presented which show that hypervelocity impact spallation and penetration failures of a single solid aluminum plate and of a solid aluminum plate spaced a distance behind a Whipple meteor bumper may be retarded by replacing the solid aluminum plate with a laminated plate. Four sets of experiments were conducted. The first set of experiments was conducted with projectile mass and velocity held constant and with polycarbonate cylinders impacted into single plates of different construction. The second set of experiments was done with single plates of various construction and aluminum spherical projectiles of similar mass but different velocities. These two experiments showed that a laminated plate of aluminum and polycarbonate or aluminum and methyl methacrylate could prevent spallation and penetration failures with a lower areal density than either an all-aluminum laminated plate or a solid aluminum plate. The aluminum laminated plate was in turn superior to the solid aluminum plate in resisting spallation and penetration failures. In addition, through an example of 6061-T6 aluminum and methyl methacrylate, it is shown that a laminated structure ballistically superior to its parent materials may be built. The last two sets of experiments were conducted using bumper-protected main walls of solid aluminum and of laminated aluminum and polycarbonate. Again, under hypervelocity impact conditions, the laminated main walls were superior to the solid aluminum main walls in retarding spallation and penetration failures.

Plasma wall sheath contributions to flux retention during the formation of field-reversed configurations

NASA Astrophysics Data System (ADS)

Milroy, R. D.; Slough, J. T.; Hoffman, A. L.

1984-06-01

Flux loss during field reversal on the TRX-1 field-reversed θ pinch is found to be much less than predicted by the inertial model of Green and Newton. This can be explained by a pressure bearing, conducting sheath which naturally forms at the wall and limits the flux loss. A one-dimensional (r-t) magnetohydrodynamic (MHD) numerical model has been used to study the formation and effectiveness of the sheath. The calculations are in excellent agreement with experimental measurements over a wide range of operating parameters. The results indicate that good flux trapping can be achieved through the field reversal phase of FRC formation with much slower external field reversal rates than in current experiments.

The 727 airplane target thrust reverser static performance model test for refanned JT8D engines

NASA Technical Reports Server (NTRS)

Chow, C. T. P.; Atkey, E. N.

1974-01-01

The results of a scale model static performance test of target thrust reverser configurations for the Pratt and Whitney Aircraft JT8D-100 series engine are presented. The objective of the test was to select a series of suitable candidate reverser configurations for the subsequent airplane model wind tunnel ingestion and flight controls tests. Test results indicate that adequate reverse thrust performance with compatible engine airflow match is achievable for the selected configurations. Tapering of the lips results in loss of performance and only minimal flow directivity. Door pressure surveys were conducted on a selected number of lip and fence configurations to obtain data to support the design of the thrust reverser system.

Real space mapping of oxygen vacancy diffusion and electrochemical transformations by hysteretic current reversal curve measurements

DOEpatents

Kalinin, Sergei V.; Balke, Nina; Borisevich, Albina Y.; Jesse, Stephen; Maksymovych, Petro; Kim, Yunseok; Strelcov, Evgheni

2014-06-10

An excitation voltage biases an ionic conducting material sample over a nanoscale grid. The bias sweeps a modulated voltage with increasing maximal amplitudes. A current response is measured at grid locations. Current response reversal curves are mapped over maximal amplitudes of the bias cycles. Reversal curves are averaged over the grid for each bias cycle and mapped over maximal bias amplitudes for each bias cycle. Average reversal curve areas are mapped over maximal amplitudes of the bias cycles. Thresholds are determined for onset and ending of electrochemical activity. A predetermined number of bias sweeps may vary in frequency where each sweep has a constant number of cycles and reversal response curves may indicate ionic diffusion kinetics.

Monitoring of urea and potassium by reverse iontophoresis in vitro.

PubMed

Wascotte, Valentine; Delgado-Charro, M Begoña; Rozet, Eric; Wallemacq, Pierre; Hubert, Philippe; Guy, Richard H; Préat, Véronique

2007-06-01

Reverse iontophoresis is an alternative to blood sampling for the monitoring of endogenous molecules. Here, the potential of the technique to measure urea and potassium levels non-invasively, and to track their concentrations during hemodialysis, has been examined. In vitro experiments were performed to test (a) a series of subdermal urea and potassium concentrations typical of the pathophysiologic range, and (b) a decreasing profile of urea and potassium subdermal concentrations to mimic those which are observed during hemodialysis. (a) After 60-120 min of iontophoresis, linear relationships (p < 0.05) were established between both urea and potassium fluxes and their respective subdermal concentrations. The determination coefficients were above 0.9 after 1 h of current passage using sodium as an internal standard. (b) Reverse iontophoretic fluxes of urea and K(+) closely paralleled the decay of the respective concentrations in the subdermal compartment, as would occur during a hemodialysis session. These in vitro experiments demonstrate that urea and potassium can be quantitatively and proportionately extracted by reverse iontophoresis, even when the subdermal concentrations of the analytes are varying with time. These results suggest the non-invasive monitoring of urea and potassium to diagnose renal failure and during hemodialysis is feasible, and that in vivo measurements are warranted.

Associations of emotional arousal, dissociation and symptom severity with operant conditioning in borderline personality disorder.

PubMed

Paret, Christian; Hoesterey, Steffen; Kleindienst, Nikolaus; Schmahl, Christian

2016-10-30

Those with borderline personality disorder (BPD) display altered evaluations regarding reward and punishment compared to others. The processing of rewards is basal for operant conditioning. However, studies addressing operant conditioning in BPD patients are rare. In the current study, an operant conditioning task combining learning acquisition and reversal was used. BPD patients and matched healthy controls (HCs) were exposed to aversive and neutral stimuli to assess the influence of emotion on learning. Picture content, dissociation, aversive tension and symptom severity were rated. Error rates were measured. Results showed no group interactions between aversive versus neutral scenes. The higher emotional arousal, dissociation and tension, the worse the acquisition, but not reversal, scores were for BPD patients. Scores from the Borderline Symptom List were associated with more errors in the reversal, but not the acquisition phase. The results are preliminary evidence for impaired acquisition learning due to increased emotional arousal, dissociation and tension in BPD patients. A failure to process punishment in the reversal phase was associated with symptom severity and may be related to neuropsychological dysfunctioning involving the ventromedial prefrontal cortex. Conclusions are limited due to the correlational study design and the small sample size. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Asclepiasterol, a novel C21 steroidal glycoside derived from Asclepias curassavica, reverses tumor multidrug resistance by down-regulating P-glycoprotein expression

PubMed Central

Wang, Jun; Ma, Yan; Li, Wen-Xue; Jiang, Ren-Wang; Cai, Shao-Hui

2016-01-01

Multidrug resistance (MDR) mediated by P-glycoprotein (P-gp) is a major cause of cancer therapy failure. In this study, we identified a novel C21 steroidal glycoside, asclepiasterol, capable of reversing P-gp-mediated MDR. Asclepiasterol (2.5 and 5.0μM) enhanced the cytotoxity of P-gp substrate anticancer drugs in MCF-7/ADR and HepG-2/ADM cells. MDR cells were more responsive to paclitaxel in the presence of asclepiasterol, and colony formation of MDR cells was only reduced upon treatment with a combination of asclepiasterol and doxorubicin. Consistent with these findings, asclepiasterol treatment increased the intracellular accumulation of doxorubicin and rhodamine 123 (Rh123) in MDR cells. Asclepiasterol decreased expression of P-gp protein without stimulating or suppressing MDR1 mRNA levels. Asclepiasterol-mediated P-gp suppression caused inhibition of ERK1/2 phosphorylation in two MDR cell types, and EGF, an activator of the MAPK/ERK pathway, reversed the P-gp down-regulation, implicating the MAPK/ERK pathway in asclepiasterol-mediated P-gp down-regulation. These results suggest that asclepiasterol could be developed as a modulator for reversing P-gp-mediated MDR in P-gp-overexpressing cancer variants. PMID:27129170

Asclepiasterol, a novel C21 steroidal glycoside derived from Asclepias curassavica, reverses tumor multidrug resistance by down-regulating P-glycoprotein expression.

PubMed

Yuan, Wei-Qi; Zhang, Rong-Rong; Wang, Jun; Ma, Yan; Li, Wen-Xue; Jiang, Ren-Wang; Cai, Shao-Hui

2016-05-24

Multidrug resistance (MDR) mediated by P-glycoprotein (P-gp) is a major cause of cancer therapy failure. In this study, we identified a novel C21 steroidal glycoside, asclepiasterol, capable of reversing P-gp-mediated MDR. Asclepiasterol (2.5 and 5.0μM) enhanced the cytotoxity of P-gp substrate anticancer drugs in MCF-7/ADR and HepG-2/ADM cells. MDR cells were more responsive to paclitaxel in the presence of asclepiasterol, and colony formation of MDR cells was only reduced upon treatment with a combination of asclepiasterol and doxorubicin. Consistent with these findings, asclepiasterol treatment increased the intracellular accumulation of doxorubicin and rhodamine 123 (Rh123) in MDR cells. Asclepiasterol decreased expression of P-gp protein without stimulating or suppressing MDR1 mRNA levels. Asclepiasterol-mediated P-gp suppression caused inhibition of ERK1/2 phosphorylation in two MDR cell types, and EGF, an activator of the MAPK/ERK pathway, reversed the P-gp down-regulation, implicating the MAPK/ERK pathway in asclepiasterol-mediated P-gp down-regulation. These results suggest that asclepiasterol could be developed as a modulator for reversing P-gp-mediated MDR in P-gp-overexpressing cancer variants.

Optimized ventricular restraint therapy: adjustable restraint is superior to standard restraint in an ovine model of ischemic cardiomyopathy.

PubMed

Lee, Lawrence S; Ghanta, Ravi K; Mokashi, Suyog A; Coelho-Filho, Otavio; Kwong, Raymond Y; Kwon, Michael; Guan, Jian; Liao, Ronglih; Chen, Frederick Y

2013-03-01

The effects of ventricular restraint level on left ventricular reverse remodeling are not known. We hypothesized that restraint level affects the degree of reverse remodeling and that restraint applied in an adjustable manner is superior to standard, nonadjustable restraint. This study was performed in 2 parts using a model of chronic heart failure in the sheep. In part I, restraint was applied at control (0 mm Hg, n = 3), low (1.5 mm Hg, n = 3), and high (3.0 mm Hg, n = 3) levels with an adjustable and measurable ventricular restraint (AMVR) device. Restraint level was not altered throughout the 2-month treatment period. Serial restraint level measurements and transthoracic echocardiography were performed. In part II, restraint was applied with the AMVR device set at 3.0 mm Hg (n = 6) and adjusted periodically to maintain that level. This was compared with restraint applied in a standard, nonadjustable manner using a mesh wrap (n = 6). All subjects were followed up for 2 months with serial magnetic resonance imaging. In part I, there was greater and earlier reverse remodeling in the high restraint group. In both groups, the rate of reverse remodeling peaked and then declined as the measured restraint level decreased with progression of reverse remodeling. In part II, adjustable restraint resulted in greater reverse remodeling than standard restraint. Left ventricular end diastolic volume decreased by 12.7% (P = .005) with adjustable restraint and by 5.7% (P = .032) with standard restraint. Left ventricular ejection fraction increased by 18.9% (P = .014) and 14.4% (P < .001) with adjustable and standard restraint, respectively. Restraint level affects the rate and degree of reverse remodeling and is an important determinant of therapy efficacy. Adjustable restraint is more effective than nonadjustable restraint in promoting reverse remodeling. Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Childhood conduct problems and young adult outcomes among women with childhood attention-deficit/hyperactivity disorder (ADHD).

PubMed

Owens, Elizabeth B; Hinshaw, Stephen P

2016-02-01

We tested whether conduct problems predicted young adult functioning and psychiatric symptoms among women diagnosed with attention-deficit/hyperactivity disorder (ADHD) during childhood, in the context of 3 potential adolescent mediators: internalizing problems, peer rejection, and school failure and disciplinary problems. We controlled for childhood ADHD severity, IQ, and demographic factors, and in the mediational tests, for adolescent conduct problems. Data came from 140 participants in the Berkeley Girls With ADHD Longitudinal Study. We used bootstrapping methods to assess indirect effects (mediators). Both childhood, F(1, 118) change = 9.00, p = .003, R2 change = .069, and adolescent, F(1, 109) change = 10.41, p = .002, R2 change = .083, conduct problems were associated with worse overall functioning during young adulthood, controlling for initial ADHD severity, child IQ, and demographics. Results were similar when predicting psychiatric symptoms. Adolescent school failure and disciplinary problems mediated the relations between childhood conduct problems and both young adult functioning and externalizing problems; adolescent internalizing problems and peer conflict mediated the relation between childhood conduct problems and young adult internalizing problems. As is true for boys, childhood and adolescent conduct problems are associated with poor adult outcomes among girls with ADHD, with school failure and disciplinary problems, internalizing problems, and peer conflict functioning as mediators of these relations. (c) 2016 APA, all rights reserved).

Slow quenches in two-dimensional time-reversal symmetric Z2 topological insulators

NASA Astrophysics Data System (ADS)

Ulčakar, Lara; Mravlje, Jernej; Ramšak, Anton; Rejec, Tomaž

2018-05-01

We study the topological properties and transport in the Bernevig-Hughes-Zhang model undergoing a slow quench between different topological regimes. Due to the closing of the band gap during the quench, the system ends up in an excited state. We prove that for quenches that preserve the time-reversal symmetry, the Z2 invariant remains equal to the one evaluated in the initial state. On the other hand, the bulk spin Hall conductivity does change, and its time average approaches that of the ground state of the final Hamiltonian. The deviations from the ground-state spin Hall conductivity as a function of the quench time follow the Kibble-Zurek scaling. We also consider the breaking of the time-reversal symmetry, which restores the correspondence between the bulk invariant and the transport properties after the quench.

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

NASA Technical Reports Server (NTRS)

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

1977-01-01

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

Large Deformation Dynamic Bending of Composite Beams

NASA Technical Reports Server (NTRS)

Derian, E. J.; Hyer, M. W.

1986-01-01

Studies were conducted on the large deformation response of composite beams subjected to a dynamic axial load. The beams were loaded with a moderate eccentricity to promote bending. The study was primarily experimental but some finite element results were obtained. Both the deformation and the failure of the beams were of interest. The static response of the beams was also studied to determine potential differences between the static and dynamic failure. Twelve different laminate types were tested. The beams were loaded dynamically with a gravity driven impactor traveling at 19.6 ft/sec and quasi-static tests were conducted on identical beams in a displacement controlled manner. For laminates of practical interest, the failure modes under static and dynamic loadings were identical. Failure in most of the laminate types occurred in a single event involving 40% to 50% of the plies. However, failure in laminates with 30 deg or 15 deg off-axis plies occured in several events. All laminates exhibited bimodular elastic properties. Using empirically determined flexural properties, a finite element analysis was reasonably accurate in predicting the static and dynamic deformation response.

Marburg Virus Reverse Genetics Systems

PubMed Central

Schmidt, Kristina Maria; Mühlberger, Elke

2016-01-01

The highly pathogenic Marburg virus (MARV) is a member of the Filoviridae family and belongs to the group of nonsegmented negative-strand RNA viruses. Reverse genetics systems established for MARV have been used to study various aspects of the viral replication cycle, analyze host responses, image viral infection, and screen for antivirals. This article provides an overview of the currently established MARV reverse genetic systems based on minigenomes, infectious virus-like particles and full-length clones, and the research that has been conducted using these systems. PMID:27338448

Marburg Virus Reverse Genetics Systems.

PubMed

Schmidt, Kristina Maria; Mühlberger, Elke

2016-06-22

The highly pathogenic Marburg virus (MARV) is a member of the Filoviridae family and belongs to the group of nonsegmented negative-strand RNA viruses. Reverse genetics systems established for MARV have been used to study various aspects of the viral replication cycle, analyze host responses, image viral infection, and screen for antivirals. This article provides an overview of the currently established MARV reverse genetic systems based on minigenomes, infectious virus-like particles and full-length clones, and the research that has been conducted using these systems.

Monitoring and Follow-up of Chronic Heart Failure: a Literature Review of eHealth Applications and Systems.

PubMed

de la Torre Díez, Isabel; Garcia-Zapirain, Begoña; Méndez-Zorrilla, Amaia; López-Coronado, Miguel

2016-07-01

In developed countries heart failure is one of the most important causes of death, followed closely by strokes and other cerebrovascular diseases. It is one of the major healthcare issues in terms of increasing number of patients, rate of hospitalizations and costs. The main aim of this paper is to present telemedicine applications for monitoring and follow-up of heart failure and to show how these systems can help reduce costs of administering heart failure. The search for e-health applications and systems in the field of telemonitoring of heart failure was pursued in IEEE Xplore, Science Direct, PubMed and Scopus systems between 2005 and the present time. This search was conducted between May and June 2015, and the articles deemed to be of most interest about treatment, prevention, self-empowerment and stabilization of patients were selected. Over 100 articles about telemonitoring of heart failure have been found in the literature reviewed since 2005, although the most interesting ones have been selected from the scientific standpoint. Many of them show that telemonitoring of patients with a high risk of heart failure is a measure that might help to reduce the risk of suffering from the disease. Following the review conducted, in can be stated that via the research articles analysed that telemonitoring systems can help to reduce the costs of administering heart failure and result in less re-hospitalization of patients.

The human subject: an integrative animal model for 21st century heart failure research

PubMed Central

Chandrasekera, P Charukeshi; Pippin, John J

2015-01-01

Heart failure remains a leading cause of death and it is a major cause of morbidity and mortality affecting tens of millions of people worldwide. Despite decades of extensive research conducted at enormous expense, only a handful of interventions have significantly impacted survival in heart failure. Even the most widely prescribed treatments act primarily to slow disease progression, do not provide sustained survival advantage, and have adverse side effects. Since mortality remains about 50% within five years of diagnosis, the need to increase our understanding of heart failure disease mechanisms and development of preventive and reparative therapies remains critical. Currently, the vast majority of basic science heart failure research is conducted using animal models ranging from fruit flies to primates; however, insights gleaned from decades of animal-based research efforts have not been proportional to research success in terms of deciphering human heart failure and developing effective therapeutics for human patients. Here we discuss the reasons for this translational discrepancy which can be equally attributed to the use of erroneous animal models and the lack of widespread use of human-based research methodologies and address why and how we must position our own species at center stage as the quintessential animal model for 21st century heart failure research. If the ultimate goal of the scientific community is to tackle the epidemic status of heart failure, the best way to achieve that goal is through prioritizing human-based, human-relevant research. PMID:26550463

Research Progress in Reversal of Tumor Multi-drug Resistance via Natural Products.

PubMed

Guo, Qi; Cao, Hongyan; Qi, Xianghui; Li, Huikai; Ye, Peizhi; Wang, Zhiguo; Wang, Danqiao; Sun, Mingyu

2017-11-24

Multidrug resistance occurs when a tumor develops resistance to multiple chemotherapeutic drugs, which may include antitumor drugs with different chemical structures and mechanisms. Multidrug resistance limits the treatment effects of antitumor drugs, and is the main cause of chemotherapy failure. Multidrug resistance is caused by numerous factors including changes in ATP-binding cassette transporters, target proteins, detoxification, deoxyribonucleic acid repair, drug metabolic enzymes, and signal pathways of apoptosis. Clinical research indicates that natural products have great potential to treat tumors and reverse multidrug resistance. Natural products, which often have multiple targets, could play an important role in tumor treatment, have beneficial effects on tumor inhibition, improve symptoms, reduce radiotherapy and chemotherapy side effects, enhance immunity, and prolong survival. Because natural products often have few adverse reactions and less drug resistance, the antitumor activities of natural products have attracted extensive research. We aimed to review the basic research and clinical application of natural products in the reversal of multidrug resistance. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Recent advances in the development of next generation non-nucleoside reverse transcriptase inhibitors.

PubMed

Tarby, Christine M

2004-01-01

Since their discovery, non-nucleoside reverse transcriptase inhibitors (NNRTIs) have become one of the cornerstones of highly active anti-retroviral therapy (HAART). Currently, three NNRTI agents, efavirenz, nevirapine and delavirdine are commercially available. Efavirenz and nevirapine, used in combination with nucleoside reverse transcriptase inhibitors (NRTIs), provide durable regimens with efficacy comparable to protease inhibitor (PI) containing therapies. When virological failure occurs following treatment with an NNRTI, the resistance mutations can confer reduced sensitivity to the entire agent class. Therefore, the strategy for the development of next generation NNRTIs has been to focus on compounds which have improved potencies against the clinically relevant viral mutants. Agents with improved virological profiles and which maintain the ease of administration and favorable safety profiles of the current agents should find use in anti-retroviral naïve patients as well as in components of salvage regimens in the anti-retroviral experienced patient. This review summarizes the recent developments with compounds in clinical trials as of January 2002 as well as to summarize information on new agents appearing in the primary and patent literature between January 2001 and December 2002.

Impact of lopinavir/ritonavir use on antiretroviral resistance in recent clinical practice.

PubMed

Lambert-Niclot, Sidonie; Masquelier, Bernard; Cohen Codar, Isabelle; Soulie, Cathia; Delaugerre, Constance; Morand-Joubert, Laurence; Charpentier, Charlotte; Ferre, Virginie; Plantier, Jean-Christophe; Montes, Brigitte; Carret, Sophie; Perrot, Valerie; Peytavin, Gilles; Costagliola, Dominique; Calvez, Vincent; Marcelin, Anne-Geneviève

2012-10-01

This observational study was requested by French health authorities to determine the impact of lopinavir/ritonavir (Kaletra(®)) on antiretroviral resistance in clinical practice. Virological failures of lopinavir/ritonavir and their effects on the resistance to protease inhibitors and reverse transcriptase inhibitors were evaluated in protease inhibitor-experienced patients. Virological failure was defined as an HIV-1 plasma viral load >50 copies/mL after at least 3 months of lopinavir/ritonavir-containing antiretroviral therapy. For all patients, a resistance genotypic test was available at failure and before lopinavir/ritonavir treatment. Data from 72 patients with inclusion criteria were studied. The mean viral load at baseline was 4 log(10) copies/mL (1.6-6.5). Mutations in the protease gene significantly selected between baseline and failure were L10V, K20R, L33F, M36I, I47V, I54V, A71V and I85V (P < 0.05). Patients who had more than seven protease inhibitor mutations at baseline showed a significantly increased risk of occurrence of protease inhibitor mutations. The proportion of viruses susceptible to atazanavir, fosamprenavir and darunavir decreased significantly between baseline and failure (P < 0.05). Among patients with a virus susceptible to atazanavir at day 0, 26% (n = 14) exhibited a virus resistant or possibly resistant at the time of failure. This proportion was 32% (n = 16) for fosamprenavir and 16% (n = 7) for darunavir. A darunavir-based regimen appears to be a sequential option in the case of lopinavir/ritonavir failure. To compare and determine the best treatment sequencing, similar studies should be performed for darunavir/ritonavir and atazanavir/ritonavir.

Extracorporeal Respiratory Support With a Miniature Integrated Pediatric Pump-Lung Device in an Acute Ovine Respiratory Failure Model.

PubMed

Wei, Xufeng; Sanchez, Pablo G; Liu, Yang; Claire Watkins, A; Li, Tieluo; Griffith, Bartley P; Wu, Zhongjun J

2016-11-01

Respiratory failure is one of the major causes of mortality and morbidity all over the world. Therapeutic options to treat respiratory failure remain limited. The objective of this study was to evaluate the gas transfer performance of a newly developed miniature portable integrated pediatric pump-lung device (PediPL) with small membrane surface for respiratory support in an acute ovine respiratory failure model. The respiratory failure was created in six adult sheep using intravenous anesthesia and reduced mechanical ventilation at 2 breaths/min. The PediPL device was surgically implanted and evaluated for respiratory support in a venovenous configuration between the right atrium and pulmonary artery. The hemodynamics and respiratory status of the animals during support with the device gas transfer performance of the PediPL were studied for 4 h. The animals exhibited respiratory failure 30 min after mechanical ventilation was reduced to 2 breaths/min, indicated by low oxygen partial pressure, low oxygen saturation, and elevated carbon dioxide in arterial blood. The failure was reversed by establishing respiratory support with the PediPL after 30 min. The rates of O 2 transfer and CO 2 removal of the PediPL were 86.8 and 139.1 mL/min, respectively. The results demonstrated that the PediPL (miniature integrated pump-oxygenator) has the potential to provide respiratory support as a novel treatment for both hypoxia and hypercarbia. The compact size of the PediPL could allow portability and potentially be used in many emergency settings to rescue patients suffering acute lung injury. Copyright © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Downregulation of MicroRNA-126 Contributes to the Failing Right Ventricle in Pulmonary Arterial Hypertension.

PubMed

Potus, François; Ruffenach, Grégoire; Dahou, Abdellaziz; Thebault, Christophe; Breuils-Bonnet, Sandra; Tremblay, Ève; Nadeau, Valérie; Paradis, Renée; Graydon, Colin; Wong, Ryan; Johnson, Ian; Paulin, Roxane; Lajoie, Annie C; Perron, Jean; Charbonneau, Eric; Joubert, Philippe; Pibarot, Philippe; Michelakis, Evangelos D; Provencher, Steeve; Bonnet, Sébastien

2015-09-08

Right ventricular (RV) failure is the most important factor of both morbidity and mortality in pulmonary arterial hypertension (PAH). However, the underlying mechanisms resulting in the failed RV in PAH remain unknown. There is growing evidence that angiogenesis and microRNAs are involved in PAH-associated RV failure. We hypothesized that microRNA-126 (miR-126) downregulation decreases microvessel density and promotes the transition from a compensated to a decompensated RV in PAH. We studied RV free wall tissues from humans with normal RV (n=17), those with compensated RV hypertrophy (n=8), and patients with PAH with decompensated RV failure (n=14). Compared with RV tissues from patients with compensated RV hypertrophy, patients with decompensated RV failure had decreased miR-126 expression (quantitative reverse transcription-polymerase chain reaction; P<0.01) and capillary density (CD31(+) immunofluorescence; P<0.001), whereas left ventricular tissues were not affected. miR-126 downregulation was associated with increased Sprouty-related EVH1 domain-containing protein 1 (SPRED-1), leading to decreased activation of RAF (phosphorylated RAF/RAF) and mitogen-activated protein kinase (MAPK); (phosphorylated MAPK/MAPK), thus inhibiting the vascular endothelial growth factor pathway. In vitro, Matrigel assay showed that miR-126 upregulation increased angiogenesis of primary cultured endothelial cells from patients with decompensated RV failure. Furthermore, in vivo miR-126 upregulation (mimic intravenous injection) improved cardiac vascular density and function of monocrotaline-induced PAH animals. RV failure in PAH is associated with a specific molecular signature within the RV, contributing to a decrease in RV vascular density and promoting the progression to RV failure. More importantly, miR-126 upregulation in the RV improves microvessel density and RV function in experimental PAH. © 2015 American Heart Association, Inc.

Urgent Chemotherapy in Sepsis-Like Shock Related to Hematologic Malignancies.

PubMed

Cherruault, Marlène; Le Goff, Marielle; Tamburini, Jérôme; Pène, Frédéric

2018-05-01

Hematologic malignancies may result in multiple organ involvement including pulmonary and renal dysfunctions, and the less common acute circulatory failure. We herein addressed the outcome of patients with sepsis-like shock related to aggressive hematologic malignancies. A 10-year (2007-2016) monocenter retrospective study. A medical ICU in a tertiary care center. Patients with circulatory shock requiring vasopressors and who subsequently received chemotherapy. Shock was presumably related to the underlying malignancy after ruling out an ongoing or new-onset infectious process. The extent and time course of organ failures was assessed by a modified Sequential Organ Failure Assessment score devoid of the platelet component. None. Seventeen patients were included, including 13 with non-Hodgkin lymphoma, two with hyperleukocytic acute myeloid leukemia, and two with "Human Herpes virus 8"-associated multicentric Castleman's disease. The following associated conditions prompted urgent administration of chemotherapy: tumor lysis syndrome (n = 10), hemophagocytic lymphohistiocytosis (n = 3), compressive bulky tumor (n = 3), pulmonary involvement (n = 3), and disseminated intravascular coagulation (n = 1). Following the initiation of chemotherapy, a number of patients died rapidly from untractable multiple organ failure. In contrast, chemotherapy led to a fast and dramatic improvement in organ failures in early survivors, as shown by the decrease in the modified Sequential Organ Failure Assessment score. However, the overall outcome was poor since only four and three patients could be discharged alive from the ICU and the hospital, and three and two patients remained alive at 6 months and 1 year. Multiple organ dysfunction syndrome related to hematologic malignancies is associated with a dismal outcome. A chemotherapy trial may provide a fast prognostic assessment of the reversibility of organ failure.

Absolute and Functional Iron Deficiency Is a Common Finding in Patients With Heart Failure and After Heart Transplantation.

PubMed

Przybylowski, P; Wasilewski, G; Golabek, K; Bachorzewska-Gajewska, H; Dobrzycki, S; Koc-Zorawska, E; Malyszko, J

2016-01-01

Anemia is relatively common in patients with heart failure and heart transplant recipients. Both absolute and functional iron deficiency may contribute to the anemia in these populations. Functional iron deficiency (defined as ferritin greater than 200 ng/mL with TSAT (Transferrin saturation) less than 20%) is characterized by the presence of adequate iron stores as defined by conventional criteria, but with insufficient iron mobilization to adequately support. The aim of this study was to determine prevalence of absolute and functional iron deficiency in patients with heart failure (n = 269) and after heart transplantation (n = 130) and their relation to parameters of iron status and inflammation. Iron status, complete blood count, and creatinine levels were assessed using standard laboratory methods. C-reactive protein, hepcidin and hemojuvelin were measured using commercially available kits. Absolute iron deficiency was present in 15% of patients with heart failure and 30% in heart transplant recipients, whereas functional iron deficiency was present in 18% of patients with heart failure and 17% in heart transplant recipients. Functional iron deficiency was associated with significantly higher C-reactive protein and hepcidin levels in heart failure patients, and higher hepcidin and lower estimate glomerular filtration rates in heart transplant recipients. Prevalence of anemia (according to the World Health Organization) was significantly higher in heart transplant recipients (40% vs 22%, P < .001), they were also younger, but with worse kidney function than patients with heart failure. Both absolute and functional iron deficiency were present in a considerable group of patients. This population should be carefully screened for possible reversible causes of inflammation. Copyright © 2016 Elsevier Inc. All rights reserved.

Finite Element Creep-Fatigue Analysis of a Welded Furnace Roll for Identifying Failure Root Cause

NASA Astrophysics Data System (ADS)

Yang, Y. P.; Mohr, W. C.

2015-11-01

Creep-fatigue induced failures are often observed in engineering components operating under high temperature and cyclic loading. Understanding the creep-fatigue damage process and identifying failure root cause are very important for preventing such failures and improving the lifetime of engineering components. Finite element analyses including a heat transfer analysis and a creep-fatigue analysis were conducted to model the cyclic thermal and mechanical process of a furnace roll in a continuous hot-dip coating line. Typically, the roll has a short life, <1 year, which has been a problem for a long time. The failure occurred in the weld joining an end bell to a roll shell and resulted in the complete 360° separation of the end bell from the roll shell. The heat transfer analysis was conducted to predict the temperature history of the roll by modeling heat convection from hot air inside the furnace. The creep-fatigue analysis was performed by inputting the predicted temperature history and applying mechanical loads. The analysis results showed that the failure was resulted from a creep-fatigue mechanism rather than a creep mechanism. The difference of material properties between the filler metal and the base metal is the root cause for the roll failure, which induces higher creep strain and stress in the interface between the weld and the HAZ.

Personalizing protocol-driven care: the case of specialist heart failure nurses.

PubMed

Sanders, Tom; Harrison, Stephen; Checkland, Katherine

2010-09-01

This paper is a report of a study conducted to explore how specialist heart failure nurses negotiate treatment advice with patients, in the context of an increasing expectation that clinical staff in the National Health Services will follow guidelines in their daily work. The development of specialist nurse roles has given rise to questions about their compatibility with patient-centred care. However, research has revealed little about how specialist nurses balance clinical guidelines with traditional caring tasks. Semi-structured interviews (n = 10) were conducted with specialist heart failure nurses in northern England recruited from a heart failure specialist nursing contact list. In addition, non-participant observations were carried out on nurse-patient consultations (n = 16) in one regional nurse-led heart failure clinic. Data were collected between 2003 and 2005, and analysed using a variation of grounded theory. Heart failure nurses sought to combine traditional caring work with the wider goal of improving patient outcomes by 'personalizing' their advice to patients and presenting their heart failure as 'typical'. They accommodated protocol-driven care into their daily routines, and perceived no disjuncture between evidence-based practice and patient-centredness. However, their approach allowed little space for the exploration of each patient's own priorities about their illness. There is a need both to re-examine the appropriateness of traditional caring concepts, and to reflect on the need to incorporate patients' own values into the consultation process.

Cycle life test and failure model of nickel-hydrogen cells

NASA Technical Reports Server (NTRS)

Smithrick, J. J.

1983-01-01

Six ampere hour individual pressure vessel nickel hydrogen cells were charge/discharge cycled to failure. Failure as used here is defined to occur when the end of discharge voltage degraded to 0.9 volts. They were cycled under a low earth orbit cycle regime to a deep depth of discharge (80 percent of rated ampere hour capacity). Both cell designs were fabricated by the same manufacturer and represent current state of the art. A failure model was advanced which suggests both cell designs have inadequate volume tolerance characteristics. The limited existing data base at a deep depth of discharge (DOD) was expanded. Two cells of each design were cycled. One COMSAT cell failed at cycle 1712 and the other failed at cycle 1875. For the Air Force/Hughes cells, one cell failed at cycle 2250 and the other failed at cycle 2638. All cells, of both designs, failed due to low end of discharge voltage (0.9 volts). No cell failed due to electrical shorts. After cell failure, three different reconditioning tests (deep discharge, physical reorientation, and open circuit voltage stand) were conducted on all cells of each design. A fourth reconditioning test (electrolyte addition) was conducted on one cell of each design. In addition post cycle cell teardown and failure analysis were performed on the one cell of each design which did not have electrolyte added after failure.